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June 2011 Archives

survivors.jpgThe survivorship stage in a cancer journey does not always signify the end of a cancer experience.

For testicular cancer survivors, it is important to receive long-term, follow-up care after treatment ends.

Long-term, follow-up care helps survivors:

  • Monitor for late effects and recurrence
  • Cope with physical changes
  • Be informed about sexual and reproductive health
  • Address psychosocial concerns
  • Learn health behaviors that reduce cancer risk
  • Develop a comprehensive follow-up care plan
  • Be connected to support services
At MD Anderson, testicular cancer survivors receive long-term, follow-up care through the Genitourinary Cancer Survivorship Clinic. In addition, the clinic helps those treated at MD Anderson for bladder, prostate, kidney and penile cancer.

William Osai, an advanced practice nurse who oversees the Genitourinary Cancer Survivorship Clinic, answers questions concerning testicular cancer survivorship issues.

By Katrina Burton, MD Anderson Staff Writer

Munden_Jun2011_022.jpgLung cancer is the leading cause of death for men and women in the United States, with more than 157,000 deaths reported last year, according to the National Cancer Institute. Most lung cancers are caused by tobacco smoke. The longer a person is exposed to the smoke the greater the risk for developing the disease.

For many years there have been no accepted screening tests for lung cancer. Today there's a new sense of hope on the horizon. It comes in the form of the spiral computed tomography (CT) screening.

According to the National Lung Screening Trial (NLST), this spiral CT screening can reduce lung cancer mortality by 20%. The New England Journal of Medicine published the results of this national randomized clinical trial today

"On average, lung cancer is typically diagnosed in the later stages of the disease when it is extremely difficult to treat," says Reginald Munden, M.D., a professor in the Department of Diagnostic Radiology and MD Anderson's principal investigator on the clinical trial. In the NLST, the low-dose spiral CT scan identified more tumors at early stages, when they are more easily treated.

By Lindsey Garner, MD Anderson Staff Writer

cinnamin.jpgCinnamon, a spice found in kitchens across the country, has shown promise in preventing and treating cancer.

Stopping cancer in its tracks

Bharat Aggarwal, Ph.D., professor in MD Anderson's Department of Experimental Therapeutics, led a 2009 review of 41 common dietary spices and how they impact the various phases of tumorigenesis, the formation of tumors.

Aggarwal's study showed that many spices, including cinnamon, are promising preventive and treatment agents for cancer. Cinnamon nutraceuticals, part of a food that provides medical or health benefits, were given to mice. Results showed that they inhibited multiple pro-inflammatory pathways in cancer cells.

Inhibiting inflammation is key. It is linked to the formation and spread of cancer.

Recent study gives hope

In a 2010 study, researchers at the School of Life Sciences and Immune Synapse Research Center at the Gwangju Institute of Science and Technology in the Republic of Korea tested cinnamon's anti-tumor effects.

By Charles Cleeland, Ph.D., chair, Symptom Research, MD Anderson

The research goals of MD Anderson's Department of Symptom Research are focused on finding ways to lessen and even eradicate the symptoms produced by cancer and its treatment.

The immediate and late effects of symptoms and toxicities of cancer treatment include:

  • Fatigue
  • Neuropathy
  • Pain
  • Mood changes
  • Cognitive deficits
  • Damage to several organ systems
These symptoms and toxicities cause great distress to patients, limiting their functioning during and after treatment, and sometimes causing premature termination of treatment or reductions in dose. Therapy-related toxicities also can limit the development of new treatment options.

At least one-third of cancer survivors have significant residual post-treatment symptoms. Unfortunately, there is little recognition at all levels of the large numbers of patients and survivors affected by severe symptoms. Also, there is insufficient pharmaceutical industry interest in developing and testing agents that can address these problems.



integrated.jpgBy Alex De Alvarado and Lorenzo Cohen, Ph.D.

If you're a patient with cancer, most likely you've experienced fatigue -- and you're not alone. Fatigue is one of the most common cancer-related symptoms described by cancer survivors.

The National Comprehensive Cancer Network defines cancer-related fatigue as "an unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning." For people with cancer, chronic fatigue can be distressing and can dramatically interfere with quality of life.

Understanding the causes of fatigue and finding the right approach for managing it could help to improve your quality of life and daily functioning.

By Rhea Li, nutritionist at the Children's Cancer Hospital

recipe.jpgChicken nuggets, fries and pizza top the list of favorite foods for most kids, whether these items are healthy or not. As adults, we know that a regular diet high in fat and sugar can cause long-term damage to our bodies.

Obesity doesn't discriminate
Childhood cancer survivors and healthy children are at risk


Studies have linked obesity to an increased risk of cancer, heart disease and diabetes, and it has become a growing concern in the United States. Like the healthy public, more than one-third of childhood cancer survivors are overweight or obese. Many attribute this to issues related to therapy received as a patient, bad eating habits adopted during treatment and a general lack of exercise.

Last year, I was part of a team that launched the Optimizing Nutrition (ON) to Life Program at MD Anderson Children's Cancer Hospital. It's a multidisciplinary program that promotes healthy eating habits in pediatric cancer patients and survivors by combining education, behavioral sciences and innovative laboratory research.

Nutritionists, educators and health care teams work together with patients and their families to help them implement better nutrition within their daily lives. The program also hopes to educate the community about what healthy families can do to reduce their risks of cancer through nutrition.

In MD Anderson's quest to eliminate cancer in Texas, the nation and the world, creating relationships beyond 1515 Holcombe that extend the reach of its research-driven patient care becomes crucial.  Next stop: Arizona.

Banner MD Anderson Cancer Center opens its doors in Gilbert, Ariz., a suburb of Phoenix, on Sept. 26, and will deliver an unprecedented level of cancer care to residents in Arizona and the southwest.  The center is a collaboration between MD Anderson and Banner Health, Arizona's leading nonprofit health care system.

This will be MD Anderson's first full clinical extension outside of Greater Houston. The center will support the multi-disciplinary care approach pioneered at the institution, which includes individual areas for specific cancer.

mendelsohnnnnn.jpgLast year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

This is the last in a series of posts on key actions outlined by Mendelsohn:

10. Enhance the value of cancer care and reduce costs.

New therapies and medical instruments and devices are major contributors to the rising cost of medical care in the United States. The current payment system incentivizes their use and rewards procedures, tests and treatments rather than rewarding outcomes and efficiency.

rainbow1.jpgAfter 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

"I believe in angels. Something good in everything I see.
I believe in angels, when I know the time is right for me."
                Abba


The lyrics from the rock group Abba's song resonate deeply within me. I truly believe in angels, especially those beloved souls who leave us, too soon.

The days march on
Four days had passed since I'd buried Tom. The sun streamed in through the blinds of our bedroom. The radio, which had been silent since Tom had died, beckoned.

When I turned it on, I was blown away.

By Laura Nathan-Garner, MD Anderson Staff Writer

focusedonhealth.jpgMaybe you've heard: eating red and processed meats may increase your risk of colorectal cancer. That's the word according to a new report from the American Institute for Cancer Research.

News like that sure can put a damper on your summer grilling plans. After all, who wants to host a barbecue when the food could send your guests' health up in flames?

Well, here's some good news. By making a few small changes to what -- and how -- you grill, you can keep cancer off the menu at your next barbecue.

Learn about healthier ways to grill meat in this month's issue of Focused on Health. For a sweet treat, you might even want to whip up our cancer-fighting recipe for strawberry-rhubarb parfaits.

By Will Fitzgerald, MD Anderson Staff Writer

Several young patients, along with their siblings, had the opportunity to take a behind-the-scenes tour of Metro's Rail Operations Center this week. The children took turns driving in vehicle simulators, while doing their best to avoid cars and pedestrians, and also spent time in the cockpit of an actual train during a ride on Metro's closed course.

The trip was part of a collaboration between the Children's Art Project (CAP) and Metro, which began after Metro featured a CAP design on its 2010 holiday card. In exchange for the artwork, Metro placed CAP awareness banners in 700 of their vehicles.

Of course, this experience was about providing the young patients with a fun and unique learning opportunity. They especially enjoyed playing conductor and shouting over the train's speaker system to "take your seats" and "behave yourselves."The trip concluded with a heap of wide smiles and with one patient asking me, "When can we come back?"

mendelsohn99.jpgLast year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

This is the ninth in a series of posts on key actions outlined by Mendelsohn:

9. Provide access to cancer care for everyone who lives in the United States.

Insurance coverage: Today, more than 47 million Americans are uninsured, and many others are underinsured for major illnesses like cancer.

WeAreFamily4.jpgGail Goodwin, program manager in External Communications at MD Anderson, is a survivor of a stage III oligodendroglioma, a rare malignant brain tumor. She is grateful for her "dream team" in the MD Anderson Brain and Spine Center -- specifically, her surgeon Jeffrey Weinberg, M.D., who was one of the conference chairs, and her oncologist Charles Conrad, M.D., who spoke at the conference.

Two years ago, when I was only a few weeks out of brain surgery, I was waiting in the Brain and Spine Center, and someone came by with information about a brain tumor conference. Since my entire situation was still a little much for me to comprehend, I said maybe next time.

Next time did come. Together in Hope, a conference for brain tumor patients and their families, was held this May 20-22. Once again, the Brain and Spine Center at MD Anderson and the National Brain Tumor Society teamed up to provide patients and their caregivers information on:

  • pathology
  • surgery
  • the newest treatment strategies
  • what current research advances can mean for future therapies

By April Greene, L.C.S.W. and Alicia Rubel, L.C.S.W., Department of Social Work

A cancer diagnosis forces unexpected change in every patient. Especially in the case of head and neck cancers, because the treatments often result in somewhat permanent changes to patients' physical appearance. This can have an effect on their emotional well-being and overall self-perception.  

There's a period of adjustment to these changes for head and neck cancer patients, as well as for their caregivers, friends and families. But, there are strategies to help them cope.

Be patient

Patients: If your treatment resulted in noticeable scarring or disfigurement, remember that it's normal to have concerns and fears about changes in your appearance. You may feel as though others are staring, but in time people will get used to your new appearance.

Caregivers: If loved ones have undergone treatment that resulted in noticeable scarring or disfigurement, allow them some time to adjust to their new appearance. You may find they're hesitant to go out in public or be as social as they once were. In time, they'll regain confidence and resume a lot of their activities. Be patient with yourself, too. You might find that it takes you some time to adjust to their new appearance, and that's OK.

Develop a support network
Patients: Friends and family can be a wonderful resource during the cancer experience. Although it can be hard at times, try to be open to accepting help. If there's something you know they can do to help, don't be afraid to ask. It can also be helpful to connect with other patients who have undergone the same type of treatment.

Caregivers: There's a great deal of attention on the patient right now, but it's important to have friends and family to help you as well. Talk with other caregivers who share similar experiences. Ask friends and family to help with some of your new-found responsibilities. It's a great way to get small breaks.

By Leslie Schover, Ph.D., and Andrea Bradford, Ph.D.

Women frequently ask physicians or sex therapists for a pill to increase sexual desire. Low sexual desire is the most common sexual problem in women and one of the top sexual complaints among cancer survivors.

So far, the promise of a quick fix for low desire remains unfulfilled. In this post we discuss some medications touted as "performance enhancers."

Viagra for women: why not?

Drugs to treat men's erection problems work by increasing blood flow to the penis. Sexual arousal in women also involves increased genital blood flow.

However, in clinical trials, erectile dysfunction drugs (e.g., Viagra and Cialis) offered no more relief than a placebo to women who lacked physical excitement during sex. Since most women in these studies also had little interest in sex, better blood flow would be unlikely to help.

Recently, drug developers have turned their attention to sexual desire problems.

By Lucy Richardson, MD Anderson staff writer

Saturday, June 4, through Friday, June 10, cancer survivors and caregivers were celebrated through a variety of activities and educational events in and around MD Anderson. The institution organizes annual Survivorship Week activities to commemorate National Cancer Survivor's Day, which is recognized nationally on the first Sunday in June.

The week kicked off with a motorcycle ride on Saturday morning sponsored by Riders for the Cure and continued with a series of events and classes focused on relaxation, arts and survivor support. The week concludes tonight with a celebration and Houston Astros game at Minute Maid Park.

Throughout the week, we had the privilege of talking with many of the survivors and caregivers who participated in the events. We heard so many stories of resilience. We asked a few to share their perspective on what it really means to be a cancer survivor.

DePinho_Town_Hall1_edit.jpgRonald A. DePinho, M.D., was formally named the next president of MD Anderson today by The University of Texas System Board of Regents. He will begin his duties on Sept. 1.

"Dr. DePinho's talents and experience make him an ideal choice to lead UT MD Anderson," says UT System Chancellor Francisco G. Cigarroa, M.D. "It is because he has such deep understanding of the impact of cancer research at the patient's bedside -- and of the complexities of cancer care -- that he is so well suited to the responsibilities of leading the nation's, and in my opinion the world's, most revered cancer center."

A genetics researcher, DePinho is director of the Belfer Institute for Applied Cancer Science at the Dana-Farber Cancer Institute in Boston. He was chosen as the sole finalist on May 11, but Texas law required a waiting period before the final vote could be taken.

Setting No Limits

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By Alma Faz, cancer survivor

Faz.jpgAlma Faz survived both osteosarcoma and ovarian cancer at the young age of 18. Today, she is living her dream. She works at MD Anderson in Computed Tomography and spends her spare time training for a marathon, white water rafting, snow skiing and more. She is also active in the Cancer180 program and serves on the Adolescent and Young Adult Advisory Council.

To know you are a cancer survivor is a pretty awesome feeling. However, an even more awesome feeling is to know that you beat cancer and can now help others do the same. At age 18, I was diagnosed with two different cancers, bone and ovarian. Originally, I came to MD Anderson to be treated for one cancer, but ended up being treated for two at the same time.

I cannot say I enjoyed a single moment of chemotherapy, any of the numerous hospital stays, any of the numerous visits to the emergency room or any of the various surgeries. But I can honestly say the life that emerged post-cancer is one I enjoy very much. It is one I absolutely love because it is a life full of life.

Both cancers left their wounds and scars. Both cancers left me with great losses -- one, the children I had yet to have; the other, my leg and my "normal" appearance.

By Claudia Hopper, cancer survivor

hopeinfertal.jpgEvery time I feel the kicks or look down and see my growing belly, I have to remind myself that it's not a dream. The life growing inside me is real.

After hearing for 18 years that the chances of having a baby are slim, one might begin to believe it. Well, I'm here to disprove all the statistics and the studies and provide hope to cancer survivors who dream of one day being able to have a baby.

My cancer journey began at age 12 when I was diagnosed with thyroid cancer. I was treated with surgery and two radioactive iodine treatments. Unfortunately, there was still a spot behind my sternum that could only be treated through radiation. After a year of treatment, I was cancer-free.

Nine years later, at age 21, I began having pain in my sternum. Scans found a tumor the size of an orange wrapped around my sternum and collar bones. I was immediately sent to MD Anderson for further testing. Radiation-induced osteosarcoma was the diagnosis, and I would start treatment immediately.

Photo by © ASCO/Todd Buchanan 2011

ASCOFloor_edit.jpgEvery year around this time, there's a scheduled pilgrimage for clinical oncologists. From all over the world they flock, young and old, to attend the Annual Meeting of the American Society of Clinical Oncology (ASCO). 

Although the attendance numbers vary from year to year, there is on the order of 25,000 professional attendees and about 4,500 scientific abstracts available for review and discussion. As I prepare to return home to Houston after this 2011 meeting, I have the familiar mixed feeling of inspiration and physical exhaustion.

The exhaustion is easy to understand. Each day, there are innumerable scientific and educational sessions integral to the ASCO meeting itself. Then there are side meetings with other agencies, institutions or colleagues planning and monitoring various projects. In addition, more meetings with friends and mentors who are treasured yet seldom seen in the ordinary flow of a frenetic work life. 

What about this experience was so inspiring? 
 

Taking the Next Steps

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By Val Marshall

Val Marshall's cancer journey began in May 2009 when her son Addison was diagnosed with acute lymphocytic leukemia. A visit to the family doctor for what they thought was a simple high school football injury turned out to be so much more.

Inspired by her son's strength and hope, Val strives to be a voice to help connect other parents on this journey. Her series shares insight into her life as a mom of a typical teenager who just happens to be fighting leukemia.

Addison Marshall Crush Cancer

Addie finished hospital chemotherapy last week but refused to ring the bell to signify completion of this treatment, as he doesn't want to jinx the process. However, he reluctantly relented to have a picture taken with his nurses and teachers.

I wrapped them all up in 21 feet of his Beads of Courage strand. It symbolizes the journey that begins with a single bead with the child's first name and grows as the months of treatment saunter by. Yes, saunter is the politically correct term for walking with cancer.

By Jonathan Cobb, cancer survivor

Cobb 1.jpgJonathan is a pastor in Colorado Springs, Colo. He was diagnosed with duodenal cancer in March 2006 and had a pancreaticoduodenectomy (also known as the Whipple procedure) in April. He also received chemotherapy (Xeloda) and had 28 radiation treatments.

There is a reason why the Whipple procedure is often referred to as the "mother of all surgeries." The surgery, treatment and recovery are described as physically grueling and intense. Having experienced it firsthand, I concur wholeheartedly.

To further compound my situation, I encountered an even great juggernaut -- the emotional and mental impact of a cancer diagnosis. And, if this wasn't enough, my mother-in-law was diagnosed with the same cancer two months prior to my diagnosis. The doctor who treated me also treated her at MD Anderson.

Although my mother-in-law did not survive her cancer, she paved the wave for my treatment and success. If I had not been doing research on her cancer, I don't think I would have ever discovered mine.

younesJune11.jpgUp until now, the role of intensified therapy for newly diagnosed lymphoma in the rituximab era remained unknown. 

This week at ASCO, four independent randomized trials, looking at different strategies, reported that more intensive front-line therapy offers no added advantage over standard chemotherapy regimens in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). 

If you don't have the time to read this full report, all you need to know is that RCHOP-21 remains the standard of care.

By Kenneth Woo, cancer survivor and Anderson Network volunteer

Woo's on rock.jpgIt was almost 19 years ago when I first got the news. At a local hospital, I was diagnosed with Hodgkin's disease, a type of lymphatic cancer. I was told this was the best kind of cancer to have if you have to have cancer! I immediately asked to be transferred to MD Anderson Cancer Center for treatment.

After rounds of chemo and radiation, I was in full remission.

Luck of the draw
It turns out that this cancer was so good that I ended up having it twice within three years -- lucky me! 

Because of the heavy dosage of chemo and radiation from my original two treatments, I was diagnosed with another more aggressive cancer, acute myeloid leukemia (AML) eight years ago.

This one hit me like a death sentence. At the time, I had started on my career path as a young architect and the proud parent of two young daughters.

I can still remember my doctor telling my wife that AML probably wouldn't kill me, but the treatment might.

By Jennifer Litton, M.D., assistant professor, Department of Breast Medical Oncology, MD Anderson Cancer Center

Litton1a.jpgAt ASCO, Canada's NCIC Clinical Trials Group released three-year results from a large randomized double-blind Phase III trial comparing Exemestane (Aromasin), an aromatase inhibitor, to placebo for postmenopausal women at high risk of developing breast cancer.

The study showed a 65% decrease in developing breast cancer when compared to placebo in high-risk, postmenopausal women.

Given how this drug works, it is only effective in women who are postmenopausal without ovarian estrogen production. Exemestane is a drug that has been used for years when treating women with early breast cancer and metastatic disease. Now, it may have another indication in preventing breast cancer.

This is not surprising, as we saw a decrease in second breast cancers that developed in the opposite breast in the early breast cancer trials from this class of drugs. Tamoxifen, which has been used in prevention for years, is a well-tolerated and very effective drug. However, only a small percentage of women choose to take the drug.

By Scott Merville and Laura Sussman, MD Anderson Staff Writers

Customized treatment that matches specialized cancer drugs to their targets on each patient's tumor has been found to increase survival of people with late-stage disease in a Phase I clinical trial at MD Anderson.

Researchers presented results today at the annual meeting of the American Society for Clinical Oncology in Chicago. ASCO also chose to highlight this project to the news media from among thousands submitted to the meeting.

Patients who enroll in Phase I clinical trials have no regular treatment options left and have advanced disease that has spread to other organs or can't be surgically removed. 


 

How this research was done
In this trial, patients' tumors were analyzed for genetic flaws and when there were drugs available to attack that defect, patients received those drugs rather than those thought to target their type of cancer, such as breast or lung. Patients with just about every type of solid tumor -- lung, breast, colorectal, prostate, brain, pancreas, liver, kidney, melanoma, thyroid and many others -- participated.

mendelsohn8.jpgLast year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

This is the eighth in a series of posts on key actions outlined by Mendelsohn:

8. Encourage new partnerships for drug and device development.

One way to shorten the time for drug and device development is to encourage and reward collaboration among research institutions, and collaboration between academia and industry.

Increasingly, partnerships are required to bring together sufficient expertise and resources needed to confront the complex challenges of treating cancer. There is enormous opportunity here, but many challenges, as well.

Although academic institutions already collaborate, we need to explore new ways to stimulate increased participation in cooperative enterprises.

I'm a survivor.

Collage.jpgThat's a bold statement to make when I'm just a little more than two years out from brain surgery. But according to the American Cancer Society, you and your caregivers are survivors from the day of your diagnosis. So, I'll take that definition and celebrate.

I hope that all survivors will join me as MD Anderson observes National Survivorship Day with an entire week of events and activities, June 4-10. This is held in conjunction with National Cancer Survivors Day, which occurs annually on the first Sunday in June in hundreds of communities worldwide to celebrate survivors and their caregivers.  

A week's worth of activities
The celebration kicks off with a police-escorted Ride for Life on Saturday, June 4. Sponsored by Riders for the Cure, this event supports Anderson Network's annual September Survivorship Conference for patients and caregivers.

When you visit MD Anderson June 6-10, you'll be aware that something special is going on. Large, brightly-colored balloon sculptures will be scattered around the hospital and clinic buildings, and pins to commemorate the week will be given to all survivors and caregivers.

From activities such as origami, collage and balloon twisting to special seminars on using makeup to make a difference, weight changes after cancer treatment, and learning that caregivers are survivors, too, the week is chock full of fun and entertainment.

You can try pilates, NIA dance play, two kinds of yoga and Kundalini meditation -- and then schedule a massage to just relax.

Stop by for a scarf-tying demonstration, learn relaxation techniques using music, and attend an expressive writing session led by one of the authors of "Chicken Soup for the Soul."

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