By Lana Maciel, MD Anderson Staff Writer

Every summer, the Mireles family has enjoyed vacations at the beach, whether it was in Galveston, Texas, Destin, Fla., or somewhere else along the Gulf shores. And whenever they spent time soaking up the sun, they always kept a bottle of sunscreen handy. They knew about the dangers of sun exposure, and mom Lupe Mireles made sure to keep her family protected.

But one summer, when Lauren Mireles was 4 years old, her parents noticed a mysterious spot on her leg. It wasn't round, and it grew and darkened over time.

Lauren's pediatrician suggested that she see a dermatologist. They saw several. But every doctor assured them there was no cause for alarm. All they had to do was keep an eye on it.

As the years went by, the family continued to go on summer vacations, always wearing plenty of sunscreen. But two years ago, when Lauren was 11, the family grew alarmingly concerned over how unusual the mole looked. They again visited the dermatologist and requested a biopsy. The results left them speechless and shocked.

"When we returned for the follow-up, the doctor asked us to step outside so we could discuss the test results," Lupe says. "At that point, I knew it was serious. He said that Lauren had stage II melanoma. And I panicked. All I heard was 'stage II,' and I wanted to get a second opinion."

'It can happen to anyone'

Knowing that a melanoma diagnosis might entail long-term treatment, Lupe and her husband, Daniel, then brought Lauren to MD Anderson, where they met with Dennis Hughes, M.D., Ph.D., assistant professor in the Division of Pediatrics.

Hughes later confirmed that Lauren actually had stage I melanoma. Fortunately, the disease was gone along with the mole, and no post-surgery treatment was needed due to its early stage.

Regardless, Lupe says, the diagnosis sent the family into survival mode. They began educating themselves on everything related to childhood melanoma.

What they learned was that about 500 children a year are diagnosed with pediatric melanoma, and the numbers are growing. Researchers have found that in addition to excessive sun exposure, the disease can also develop from a combination of genetic predisposition and other unknown factors. What was unusual, Daniel says, is that Lauren doesn't have the fair skin and blond or red hair typically associated with a high risk of melanoma. (For more information, see link to related story below.)

"We're still in such disbelief that something like this could happen to her, not only because of her young age, but because of her darker skin tone," Daniel says. "Because of that, we didn't really see the dangers of it. But it's important for people to be aware of it, and to know that it can happen to anyone."

An overwhelming summer

Though Hughes was able to help Lauren understand what was happening, she admits she still couldn't comprehend what cancer was. The only thing she knew about cancer was that her grandfather passed away from multiple myeloma when she was 4 years old. Naturally, for an 11-year-old, this association made her afraid of what her own cancer might bring.

"I didn't really know what was going on because I was so young," Lauren says. "But I wasn't really that worried about it until we decided to get the mole removed. Then I was a little scared."

Lupe remembers her daughter being overly cautious after the diagnosis. She always wore protective clothing, and she didn't want to go out into the sun.

"That time was very tough for her, and even more so because after that summer, she was starting middle school, which was a big change," Lupe says. "Everything was just happening all at once."

Between the extensive doctor's exams and the experience of entering the sixth grade, it was obvious to Lupe that her daughter was having a hard time coping with the situation.

"At first, we noticed that her grades suffered a little, and she wasn't as outgoing as she was before," Lupe recalls. "But now with her second year, there's been a big change. She's more outgoing again, and she's doing much better."

Living a watchful post-cancer life

To this day, Lauren, who plays violin for her school orchestra, visits Hughes every six months for regular skin checks. Though the hard part is over, the family is aware of the fact that children who have melanoma are at greater risk of recurrence later in life.

"As Dr. Hughes explained to us, now that her body has learned to create this cancer, the harsh reality is that it can create it again," Daniel says. "So every time we see something new appear on her skin, we immediately think, 'What is this? Could it be another cancer?'"

But for now, the Mireles family is staying positive and moving forward. The key, Lupe says, is to stay aware and always be cautious.

"As long as we keep learning and staying informed, we'll be OK and we'll try to live a normal life."


Related story:

Q&A: Childhood Melanoma
Although melanoma is primarily a disease that occurs among adults, it is also seen occasionally in children, and the number of diagnoses increases each year. Read more about Childhood Melanoma.


MD Anderson resources:
Childhood melanoma
Dennis Hughes, M.D., Ph.D.
Children's Cancer Hospital

Although melanoma is primarily a disease that occurs among adults, it is also seen occasionally in children, and the number of diagnoses is increasing each year. Children can develop melanoma from excessive sun exposure without proper protection, or it can develop in time after a severe sunburn. Fair-skinned children typically have a higher risk of melanoma, but it is important to know that people of all skin tones can develop the disease. Lauren Mireles in the related story is a case in point.

Dennis Hughes, M.D., Ph.D., assistant professor in MD Anderson's Division of Pediatrics, discusses the differences between adult and pediatric melanoma, as well as some of the risk factors parents should be aware of regarding this disease.

The number of pediatric melanoma cases is on the rise. Why do you think this disease is becoming so prevalent among children?

There are really two reasons. The first is an increasing awareness, on the part of doctors in all specialties, that children can get melanoma. As a result, more skin lesions in children are being evaluated as possible melanomas. In the past, I suspect that there were skin lesions on children that were true melanomas that were removed at doctors' offices and discarded without proper evaluation. Hopefully, that dangerous practice is a thing of the past.

The second reason, I suspect, is that there has probably been a true rise in the incidence of this disease. This may be due to increased sun exposure in children and adolescents compared to some years ago. I hope this is a trend that we will be able to turn around.

Does the disease affect children differently than it does adults?

Pediatric melanoma is so rare that it is very difficult to say how much the behavioral characteristics of this disease differ from the adult disease. As far as we are able to tell, the disease behaves the same way in children as it does in adults. However, there is a clear trend that children fare better than adults at any given stage of disease. One reason could be that children withstand difficult therapies and intensive treatments much better than adults and, therefore, receive more complete therapy when it is needed.

I believe another reason has to do with the nature of the disease itself. Of all of the cancers, melanoma is most susceptible to immunologic approaches to therapy. Indeed, after surgery, immune treatments are the next most likely approach used for this disease. Older children and teenagers have much more robust immune systems than do older adults, and they may combat melanoma on their own better than older patients.

How do treatments for pediatric melanoma patients differ from those for adult melanoma patients?

For the most part, the treatments for pediatric melanoma are similar, stage for stage, to the treatments used in adults. The only real difference is that we have a tendency to use more aggressive treatments in children than we might in adults with the same stage of disease. The reason for this is that pediatric patients are expected to have a much longer life than an adult melanoma patient. Since the average pediatric melanoma patient might be expected to survive another 70 or 80 years, we have an obligation to be very thorough in ensuring that the best possibilities of maintaining a complete remission have been undertaken.



What are some risk factors for pediatric melanoma?

Similar to the situation in adults, children with very light skin, lighter hair and light-colored eyes are at the greatest risk for melanoma. Also, children who have a lot of moles on their skin and children with a family member who has developed melanoma are at increased risk. Severe sunburns in early childhood or during teenage years will predispose children to an increased risk of melanoma later in young adult life.

However, while pale, blond, blue-eyed children are at the highest risk of melanoma, all ethnicities and skin types are potentially at risk. Here at the Children's Cancer Hospital, we have diagnosed melanoma in dark-skinned Hispanic children and in African-Americans. In African-Americans, in particular, there is a tendency toward melanomas presenting at a more advanced stage, perhaps because patients and caregivers erroneously assume that this population cannot develop this disease. The truth is, people of all colors need to be aware of the risk of melanoma and, if there is a spot on the skin that is suspicious, it should be taken seriously and evaluated.

Related story:

Young Patient, Family Experience Shock of Childhood Melanoma
Two years ago, when Lauren Mireles was 11 years old, her parents grew alarmingly concerned over an unusual mole. When they requested a biopsy, the results left them speechless and shocked. Read more about Lauren Mireles.



MD Anderson resources:
Childhood melanoma
MD Anderson Children's Cancer Hospital

Additional resources:
Rare childhood cancers (National Cancer Institute)

By Lana Maciel, MD Anderson Staff Writer

For cancer patients undergoing treatment for their disease, doctors are offering a new kind of prescription -- exercise.

Despite beliefs that patients should rest as much as possible during therapy, a new set of guidelines from the American College of Sports Medicine (ACSM) indicates that exercise is actually beneficial for patients and survivors.

The ACSM's message to avoid inactivity stems from a recent review of published studies on the safety and effectiveness of exercise during and after cancer treatment.

Influence on health is beneficial

The new guidelines seem to contradict what many doctors have previously advised. But for the majority of cancer patients, exercise is an important part of the long-term healing process.

"Before, it was generally thought that patients needed to rest because they were sick, and that they shouldn't exert themselves too much," says Karen Basen-Engquist, Ph.D., professor in MD Anderson's Department of Behavioral Science. "There were always questions like, 'Is it safe?' or 'Is exercising right for me?' But it's important for patients to stay active. It helps improve their general quality of life."

Benefits of exercising while undergoing treatment include less fatigue, increased physical functioning and improved body image. For those who do not exercise during therapy, daily activities such as climbing stairs or walking distances can become difficult, even after the cancer treatment is complete.

Regimens should be tailored

A panel of 13 ACSM members created the guidelines, which recommend that cancer patients do about 30 minutes of moderate aerobic activity each day, five days a week.

The guidelines generally apply to patients of all cancer types, but the ACSM panel found exercise benefits to be strongest in those with breast, colon, gynecologic, prostate and hematologic (leukemia, lymphoma and myeloma) cancers.

In some cases, however, physical activity can affect safety, and patients should seek professional supervision.

"With some conditions, such as known heart problems or cancer that has metastasized to the bone, patients and survivors should consult with a physician before beginning an exercise," Basen-Engquist says. "Such conditions will often require a modification of the exercise recommendation. But for the majority of cancer survivors, the quick summary of the guidelines is important to remember -- avoid inactivity."


MD Anderson resources:
Department of Behavioral Science at MD Anderson

Cancer Newsline - What Diet and Exercise mean the Cancer Patient (audio)


Additional resources:
Physical activity and cancer (National Cancer Institute)

American College of Sports Medicine

For the second year, MD Anderson has hosted graduate students from the University of Tokyo for two months of research. A lively, video-linked symposium marking the end of this year's visit was held Aug. 20. Participants included the students and MD Anderson faculty who hosted them, as well as faculty from the Schools of Engineering, Medicine and Pharmaceutical Sciences at Todai, short for Tokyo Daigaku as the University of Tokyo is also known. 

The program is run by the Center for Medical Systems Innovation (CMSI) at Todai. CMSI embodies a novel, cross-disciplinary approach to training and research on the boundary of medicine and engineering, with elements of social sciences and business rolled in.

I attended the CMSI Annual Meeting earlier this year and was impressed to see not only a wide range of innovative science and engineering projects, but also business plan presentations by the CMSI students. Equally creative, but thinking in a different way, the students identified needs and were proposing commercially viable solutions to them.

This year the students who visited us, and the research projects they worked on, were:

• Yusuke Egashira, Mentor: Dr. Ritsuko Komaki, Radiation Oncology Treatment
  Experimental Evaluation of Dose Calculation Algorithms for Proton Therapy
  
  
• Hitomi Hosoya, Mentor: Drs. Renata Pasqualini and Wadih Arap, Genitourinary Med Oncology-Research 
  Multi-platform, Ligand-Directed Delivery of Doxorubicin for Cancer Therapy
                                    
  
• Mariko Ikuo, Mentor: Dr. George Calin, Experimental Therapeutics
  Plasma microRNA of Chronic lymphocytic leukemia patients
  
  
• Hiroki Akiba, Mentor: Dr. Juri Gelovani, Experimental Diagnostic Imaging
  Construction of Reporter System for Monitoring HIF-1 Dimerization
  
  
• Minghui Bai, Mentor: Dr. Oliver Bogler, Neurosurgery and Neuro-Oncology
  Importin beta1 and CRM1 are involved in nuclear cytoplasmic shuttling of EGFRvIII
                         
  
• Shinya Hirota, Mentor: Dr. Joseph McCarty, Cancer Biology
  alphaVbeta8 integrin-mediated TGFbeta activation and signaling is essential for angiogenesis in the neonatal retina
  
  

For the first time this year, two MD Anderson students, from the Pasqualini/Arap lab, traveled to Tokyo for the summer: 

• Julianna Edwards, Mentor: Dr. Tatsuro Irimura, University of Tokyo
  Characterizing the mechanism of action of a mitogenic, lectin-like, synthetic polymer
  
  
• Lawrence Bronk, Mentor: Dr. Kazunori Kataoka, University of Tokyo 
  ICG Encapsulating Micelle for Photodynamic Therapy and Photodynamic Diagnosis

MD Anderson graduate students interested in participating next summer, by applying to visit Tokyo, are encouraged to contact Gloria Da Roza in Global Academic Programs. 

The students who join this competitive CMSI program represent some of the best of the upcoming generation of scientists and innovators, and it is an honor for MD Anderson to be part of the CMSI exchange program. We hope that many of the CMSI-graduates will join us in our mission to fight cancer.

 

By Laura Nathan-Garner and Lora Shea, MD Anderson Staff

Is a prostate-specific antigen (PSA) test the best way to screen for prostate cancer? And if my doctor finds prostate cancer, how aggressively should it be treated, if at all?

If you've read recent headlines, you may be asking these questions. It's understandable. After all, about 217,730 men will be diagnosed with prostate cancer in 2010, according to the American Cancer Society. So it's smart to arm yourself with knowledge about prostate cancer detection, prevention and treatment.

We recently chatted with John W. Davis, M.D., assistant professor, Department of Urology at MD Anderson and organizer of Prostate Health Conference 2010. Check out the slide-show and podcast below.




Still have questions? Post them below or on our Facebook page. We'll try to get them answered by Dr. Davis and other MD Anderson experts at Prostate Health Conference 2010 on Saturday, Sept. 11. 

We also invite you to join us at this free event. Among the topics we'll be discussing are what men at high risk for prostate cancer need to know, when to seek treatment, PIN and prostate cancer risk, and Finasteride. To learn more about Prostate Health Conference 2010, visit www.mdanderson.org/prostate-health.

After a long and successful career in broadcast journalism in Houston, North Texas and Oklahoma, Judy Overton joined MD Anderson in 2008 as a senior communications specialist. Her husband Tom was treated at MD Anderson for renal cancer. He died in April 2007. Judy's occasional posts will cover aspects of the cancer experience from the caregiver's perspective.
Read more posts in this series


By Judy Overton

My sister Jackie reminded me last weekend that Sunday, Aug. 22, would've been Tom's and my 29th wedding anniversary. We always favored the day we met, May 5, 1977, so it's not a surprise that I needed a reminder. However, as I reflect on our wedding day, I'm reminded of one line in the vows:

        ... in sickness and in health ...

We had just finished dinner on Labor Day six years ago. It had been a quiet weekend. Tom had studied for a class he was taking toward his master's degree and had made some marvelous ribs. I was on the phone with a friend around seven that evening when he entered the kitchen, doubled over in pain. "I need to go to the emergency room," he said, with a lot of effort. I got off the phone and we drove to the hospital about a mile from the house.

We should have called an ambulance.

We reported Tom's symptoms to the receptionist, and were directed to chairs in the busy waiting area. Our wait dragged on for 2-3 hours, during which I made several trips to speak with the receptionist to see when Tom would get into the inner sanctum. She said, "We see the people brought in by ambulance first, and then the most serious cases after that." Isn't urinating blood and having excruciating pain pretty serious, I thought to myself.

After one of these frustrating exchanges, another woman approached the desk and was given a similar line. She walked up to me and said, "Do you know they haven't even offered my husband any ice for his ankle?" The man had been sitting in a wheelchair when we first sat down in the lobby. His ankle was extremely swollen. "What's wrong with your husband?" she asked.

"He's urinating blood," I replied.

"And that's not serious?" she responded.

Tom eventually made it to an emergency room with the temperature of a meat locker. He was not only in great pain, but extremely cold. No one seemed to be tending to him. I know he produced a urine sample after they requested one, but other than a nurse getting his vitals, that was the extent of the check-up.

My timing may be off a bit since six years have passed, but I recall a nurse asking Tom to again give her a urine sample. "I did," he responded curtly. When she saw that it was filled with blood, she looked startled and got into action. "I need to order an MRI," she said. It was around 4 a.m., and Tom would be taken to the MRI room. Since I couldn't settle down in the straight-backed chair, I told him I was going to go home and get some sleep. "Please call me as soon as you know something," I pleaded.

About two hours later, the ringing of the phone awakened me. It was Tom. "They found a large mass, and are transporting me to Hermann Hospital," he said calmly.

 "I'll be right there," I replied. After collecting myself and quickly getting cleaned up, I drove back to the hospital for a short wait. I followed the ambulance to Hermann Hospital, where I'd been many times before as a news photographer awaiting the arrival of a shooting victim or a patient being brought in by the LifeFlight helicopter.

This flight would be for the life of my love -- my very best friend.

Contact Judy Overton at jboverton@mdanderson.org.

By: François Pouliot, Ph.D., M.D., assistant professor and clinical ethicist, Department of Critical Care

Five interns had the chance to discover clinical, research and/or organizational ethics during the summer and to contribute to activities and projects of the Section of Integrated Ethics at MD Anderson Cancer Center. One of them, Thomas Hoang, tells us more about his experience in Clinical Ethics.

Tell us more about yourself

I attend The University of Texas at Austin. I am pursuing a degree in biology and a minor in Spanish. After receiving my undergraduate degree, I plan to embark on a career in medicine, and plan on applying to medical schools shortly after I graduate. Health care has always been an interest of mine since I was young, and it continues to be because I admire the profession of a physician. Helping others and living a life of selflessness are two virtues that I've come to believe will satisfy me in this lifetime, and both are intertwined within the career of a doctor.

 

Why did you apply to a clinical internship?

Before I was appointed to this intern position, I had a background in the hard sciences more than I did the philosophical and ethical. We all know that health care is heavily science-based, but there is that other dimension of ethics that is also very important to patient care. My previous experiences in a clinical setting were administrative and more focused on hospitality toward the families of the patient. I applied to this internship to gain more exposure  to patients, to see other aspects of the clinical setting and to understand that health care is not just science, but that there are many other spectrums of patient care that are just as important as the surgeries, lab techniques, DNA assessments and epi tubes.

 

What is an average day like in this internship?

I have done a wide array of things in the duration of this summer internship. My daily schedule for this past summer consisted of researching and reading in an effort to gain a better understanding of ethics, I attended rounds in the ICU, attended various lectures that address many different aspects of health care, took a survey course in clinical ethics, and researched for the design of a protocol to create an efficient screening tool. The experience I've gained from doing these things has been extremely beneficial to me.

One event I remember very clearly was the bus rounds hosted by Dr. Eduardo Bruera and his colleagues. This was quite intriguing to me because it gave me exposure to terminal patients, which was quite difficult to deal with at first. Overall, the kind of exposures to patients I had this summer further developed my interests in seeking a profession in health care.

 

What are the most important things you learned during this experience?

Aside from the clinical experiences and research experiences, this internship let me dive into the daily work life of the health profession. It allowed me to work with a diverse group of professionals and colleagues that I have learned so much from. Learning about the organizational structure of a large medical institution like the well-renowned MD Anderson Cancer Center was a great experience.  It defined for me all of the types of people involved in health care. I also had great exposure to research creation and protocol review. The most interesting was being able to attend an Institutional Review Board (IRB) session and to see how they review protocols, as well as being involved in creating one to potentially be submitted through the IRB.

 

What comes next?

I will continue to pursue acceptance into a medical school. This experience has been a privilege and will be very beneficial to me as I continue with my education. I have a year left of undergraduate study and, hopefully, this experience will make me a more competent medical school canidate. I have learned during my tenure here at MD Anderson that many health professionals are not aware of clinical ethics and its importance especially to the patient. If my goals are achieved, I will practice medicine with the utmost respect for patient autonomy, beneficence, non-maleficence and justice.

 

To learn more about the Ethics Internship Program visit

http://inside.mdanderson.org/departments/integrated-ethics/internship.html

 

After a long and successful career in broadcast journalism in Houston, North Texas and Oklahoma, Judy Overton joined MD Anderson in 2008 as a senior communications specialist. Her husband Tom was treated at MD Anderson for renal cancer. He died in April 2007. Judy's occasional posts will cover aspects of the cancer experience from the caregiver's perspective. Write to her at jboverton@mdanderson.org.

The Caregiver Chronicles, Part 1
By Judy Overton

Each time I visit my husband's grave, I can't help but zero in on the date of his birth - November 2, 1953. Tom died a little more than three years ago at the age of 53. My eyes then pan to my name and date of birth: February 23, 1955.

I'm 55 years old. My next thought is, "What would I do if I knew this would be my last year on earth?"

For one, I've always wanted to share Tom's and my cancer experience with others by writing a book. In fact, the title I've given this blog is the one I planned to use for it.

I often talk to my closest colleagues about my husband and our experiences during our more than 30 years together. Of course, sometime when I share moments of his diagnosis and treatment, my pent-up emotions can't help but surface. Recently, after such a conversation, a colleague suggested that I contribute to the Cancerwise blog in order to share my experiences with other caregivers.

Caregivers, my heart goes out to you. 

A family member once corrected my use of the term, insisting it should be "caretakers." My immediate thought was, "Doesn't she know! Caretakers don't take anything, but we give everything we've got."

It just seems appropriate that I'm writing this just a few days before the beginning of Caregivers Week here at MD Anderson.

In truth, my husband was an ideal patient who so appreciated my efforts. Toward the end of his life, Tom would often say, "You're an angel." But I never could accept it, and would flinch at the thought, because I knew how imperfect I was. My curt answer would be, "No, I'm not!"

I felt I was falling short in so many ways.


The "Birth" Date

Tom's diagnosis occurred six years ago, in 2004, during the Labor Day weekend. He casually told me on that Sunday morning that his urine was mainly blood. I was a little stunned, but since he wasn't experiencing pain, we agreed he would make an appointment with a physician on Tuesday after the holiday passed.

Still in shock, I consulted a medical diagnosis book. Under "urinating blood," I was led to information about prostate and renal cancer.

Cancer? Could it really be that? We were enjoying our first full year of having an empty nest. Our younger son, Matt, was now a sophomore at the university where Tom worked, and his older brother Nathan had been in college for about three years.

Things were running so smoothly, and we were now connecting at a much deeper level than ever before.

After my consultation with the medical books and sharing the unsettling news with Tom, I went for a walk at the high school track.

(We both would walk at the track on weekends, but we always went in separate cars. Tom liked to cruise the small town where we lived before he began his walk. I preferred to get right to the heart of the matter. In fact, people didn't know we were married, because we wouldn't walk together.)

During the walk, I remember thinking, "I could be a widow before I'm 50."

I shed a few tears, then decided I really ought to wait for a professional diagnosis before burying him!

And as I looked across the field to where Tom was strolling, I wondered what was going on in his head, too.

Two studies led by scientists at MD Anderson open new areas of research that could potentially improve ovarian cancer treatment.

The discoveries published today in the journal Cancer Cell are preclinical - they employ laboratory experiments to better understand the molecular processes that drive formation and growth of cancer.  Both studies found previously unknown roles for two proteins, singling them out for further research and possible drug development.  

In the August edition's featured article, Robert C. Bast Jr., M.D., vice president for translational research and professor of experimental therapeutics, and colleagues show that the protein SIK2 plays a vital role in mitosis, or cell division.  The team  demonstrated in a mouse model that inhibiting SIK2 makes ovarian cancer more susceptible to the chemotherapy drug paclitaxel, one of a group of drugs that attack cancer cells by blocking their division.   

Overabundance of the protein occurs in 30 percent of human ovarian cancer cases and is associated with advanced disease.  

Another article by Anil Sood, M.D., professor in the departments of Cancer Biology and Gynecologic Oncology, and colleagues reports that the protein EZH2 fuels the formation of blood vessels that feed ovarian cancer by shutting down genes that block the birth of new blood vessels -- angioigenesis. Depleting EZH2 in the tumor and in blood vessel cells with an engineered nanoparticle steeply reduced the size of tumors in a mouse model of the disease.

An analysis of 180 ovarian cancer tumors showed that patients with the protein overexpressed in either their tumor or its associated blood vessels survived about one third as long as those without abundant EZH2.

Both teams are following up on their initial findings.

Novel Role: EZH2 Boosts Creation of Ovarian Cancer Blood Vessels

Researchers Identify Potential New Target for Ovarian Cancer

By: DJ Fomby, Andrea Skoglund, and Stephen Collazo, MD Anderson Social Work Counselors

"There was a narrowing of my vision; nothing mattered except helping him survive."
Caregiver 4 Caregiver Group Participant

The acute nature of a patient's illness and the need for swift treatment often means that the patient's needs supersede all other considerations as the family focuses on the patient's survival. Caregivers experience tunnel vision, or as one caregiver explained, "There was a narrowing of my vision; nothing mattered except helping him survive." This contracted outlook often means that caregivers, especially spouses, neglect their own needs.

Another common feeling caregivers experience is a sense of loneliness. Typically, the caregiver has primary, if not sole, responsibility for the patient's care. This can mean a support role as extensive as around-the-clock oversight of the patient's condition by that caregiver. Hobbies, friendships and even the caregiver's career may be put on hold so that the obligation to care for the patient can be fulfilled.

By Laura Nathan-Garner, MD Anderson Staff Writer

Work. The economy. Your health. Relationships. There's a lot to be stressed about, isn't there?

But as I learned from chatting with friends from around the Web, and Focused on Health's Facebook and Twitter followers, there are plenty of ways to unwind.
Here are just a few ways people told me they unwind:

• I can't believe I'm saying this, but clean house. -- Lynda H.
  
  
• I watch short segments of Mama Mia. It's impossible to stay stressed out listening to "Dancing Queen" or "If You Change Your Mind." The music is infectious.  -- Christy M.
  
  
• I have a small office with no windows. To reduce stress at work, I have taken pictures of the great outdoors and the ocean, and put them all over my tiny office space walls. -- Michael C.
  
  
• Take a bubble bath and watch a funny show -- there's no better medicine than a nice bath and some laughter after a stressful day. -- Connie R.
  

Why all this talk about reducing stress? Because making time to relax, recharge and connect with others helps your body fight off diseases like cancer.

Find out more in this month's issue of Focused on Health.

You'll get stress-reduction advice from an MD Anderson expert and find out other ways real people unwind. You'll also learn how healthy relationships boost your health and find out whether you should take supplements to prevent cancer.

How do you de-stress? Share your strategies below, or join the conversation on our Focused on Health Facebook page.

By: Shubhra Ghosh MD, CCRP, Project Manager, Global Academic Programs

A research retreat was held in Houston July 29-30 in which participants from Banner Health and MD Anderson discussed developing a research program at the Banner MD Anderson Cancer Center, due to open in Phoenix next year.

The visitors from Banner had the opportunity to meet experts from MD Anderson who introduced them to different aspects of cancer research. Raymond DuBois, M.D., Ph.D., provost and executive vice president, talked about MD Anderson's mission to eliminate cancer within Texas and beyond by a seamless integration of research with clinical care and prevention. He mentioned that MD Anderson is using advanced educational and training programs and developing new technologies to enhance the level of cancer care.

 

Eric Reiman, M.D., chief scientific officer, Banner Research Institute, expressed great interest in developing a clinical research program at Banner MD Anderson Cancer Center that would offer the best treatment options to patients coming to the new center. He wanted to know how MD Anderson works with its partners in this regard. Oliver Bogler, Ph.D., vice president for Global Academic Programs, presented an overview of the global network of MD Anderson partners that collaborate on research projects to make breakthroughs in the understanding of cancer and explore novel ways to treat it.

 

The significance of research-driven cancer care was highlighted in the presentations on various types of cancers. All speakers stated that the vast majority of clinicians in their departments were actively involved in research. Hagop Kantarjian, M.D., associate vice president for Global Academic Programs, Clinical Research, summed up the group's sentiment by stating that "in cancer, research-based care is the best care."

 

Bill Camp, chief executive officer for the Banner Research Institute, presented Banner's current research infrastructure and stated the importance of developing a fiscally viable research program at the new cancer center. The group discussed the challenges and investment required to set up the infrastructure in terms of personnel, policies and procedures, information technology, quality assurance and quality control, and oversight.

The plan made by the integrated team foresees starting with a focused deployment of clinical trials and research in selected specialties, to achieve early success, and then move aggressively to bring the new center up to speed with research closely tracking clinical development.

The retreat ended with an agreement to continue the dialogue. The next step is for MD Anderson to visit Banner.