April 2013 Archives

Sujit Prabhu.JPGBy Sujit Prabhu, M.D.

Brain surgery requires precision and excellent judgment on part of the neurosurgeon for good patient outcomes. We neurosurgeons try to remove as much of the brain tumor as possible and return patients to their full functional capacity.

The most common type of brain surgery for a tumor is a craniotomy. On average, this operation, takes four to six hours. Below, I've answered some common questions about brain surgery. 

How do you decide if a brain tumor patient needs surgery?

The decision depends on the patient's brain tumor symptoms, the tumor location and the type of tumor, if known. In a small number of patients with certain benign tumors no surgery is required. In most instances, however, we make the decision to operate at the initial visit and schedule the operation within seven to ten days.   

What are the pre-operative procedures and medications for a craniotomy?

salad bar CW.JPGBy Joey Tran, MD Anderson Staff Writer

Maintaining a healthy diet is one of the most important things you can do to reduce your risk of cancer and other diseases, according to the American Cancer Society. Making healthy food choices may also help you maintain a healthy weight and keep your body in fighting shape if you do have cancer.

However, making healthy choices can be challenging when you're dining out. That's especially true if you're eating here at MD Anderson, when you already have many other things on your mind.

To make the best out of your healthy dining experience at MD Anderson, Ashley Smith, health and wellness manager of the department of Dining Services, has provided the following smart-eating strategies.

Hamza Iskandar CW.JPGBy Lucy Richardson

Hamza Iskandar has only been fighting gastroesophageal cancer for the past six months, but he was born a fighter. 

As a result of his congenital heart disease, the 21-year-old from Jeddah, Saudi Arabia, learned to have incredible strength in times of adversity long before his cancer diagnosis.

He had open heart surgery at age six, a second at age seven and a third at twelve. He now has a mechanical valve in his heart. "God was preparing me," Hamza says. "My fighting spirit was there."

Hamza thought he was done with hospitals. He was wrong.

Gastroesophageal cancer diagnosis: Testing his strength
In January 2012, while finishing up a finance degree at the university, Hamza started vomiting blood. "I couldn't feel my legs," he recalls. "My body started to go numb."

After a visit to the emergency room, Hamza was diagnosed with an ulcer. He was admitted to the hospital for 14 days, unable to eat or drink.

After multiple endoscopies and a misdiagnosis, Hamza was told he had a tumor and nothing could be done to help him. "My family and I wouldn't accept giving up, so we started searching for the best possible place for treatment."

shah cw.JPGBy Shalin Shah, M.D.

Regardless of where radiation fits into your cancer treatment plan, you may have questions about what you'll experience during radiation therapy.

Here are a few things you should know about radiation.

How radiation works
Receiving radiation is similar to receiving a very strong x-rays.

Advances in radiation therapy allow us to pinpoint cancerous cells with amazing accuracy.

The goal of radiation is to kill the cancerous cells to both shrink a tumor and to prevent it from growing and spreading. We try to avoid normal tissue at the same time.

Common radiation myths
Patients often ask if radiation will make them glow in the dark afterwards. The answer is no.

older man and woman arms around each other-CW.JPGIn early April, the first guidelines on care for sexual problems were published by the National Comprehensive Cancer Network (NCCN).

These guidelines are included in their new Survivorship Guidelines.

Since cancer survivorship begins as soon as someone receives a cancer diagnosis, the guidelines can improve care for both patients who are still planning their cancer treatment and those who are undergoing cancer treatment or have finished active therapy.

Sexual problems are common among cancer patients

Sexual problems are, unfortunately, a very common side effect of cancer treatment. Sexual problems affect at least half of patients who've had prostate, breast or a gynecologic cancer; they also can occur after chemotherapy or radiation to the pelvic area or brain.

The problems are usually caused by physical damage to the nerves, blood vessels and hormones involved in a normal sexual response, although emotional issues also play a role.

parent with cancer CW.JPGBy Laura Nathan-Garner

A parent's cancer diagnosis can turn a child's world upside down, no matter how young or old the child is.

But coping with a parent's cancer diagnosis can be especially difficult for teens, tweens and even younger children.

Below our social work counselors April Greene and Wendy Griffith answer questions about parenting through cancer and helping kids and teens cope with a parent's cancer diagnosis.

What's the best way to talk to kids about cancer?

No matter what your prognosis is, it's essential to talk openly and honestly with kids. If you're telling your kids for the first time, try to have this conversation in a private space where you can focus on the discussion and be close enough to physically console your kids if needed.

Children tend to think in very concrete terms and like to know what's going on and what to expect. If they ask something that you don't know the answer to, it's okay to tell them that you don't know and that you will work on finding the answer. The most important thing is to communicate openly, honestly and frequently.

hands CW how to helop.JPGBy LeAnne Gibbs

My husband, Francis, has stage IV colon cancer. Since his diagnosis, many people have asked how they can help.

Last week I shared advice on what to say and how to support a cancer patient and his or her family.

Here are a few more things we've found beneficial. 

I'm still me even though the cancer will take me/my spouse. Please don't let it take you from me/us.

We've needed time and space to deal with the bad news about Francis's cancer together as a couple and a family.

Eddy Davis CW.JPGBy Joey Tran, MD Anderson Staff Writer

Eddy Davis would have enjoyed teaching golf no matter what. But he has an appreciation for life, and health, that few pros can understand.

Since becoming a golf professional in 1994, Eddy Davis has excelled as a published golf illustrator and tournament calligrapher, an avid golfer who considers himself the "resident artist" at the Jimmy Clay-Roy Kizer Golf Complex in Austin, Texas.

Fear and questions
When he faced a diagnosis of non-Hodgkin B-cell lymphoma in 2003, he feared the unknown and had thousands of questions for his doctors. His golfing buddies. His wife. And himself.

But no one ever questioned the courage and determination that continues to prove the experts wrong.

advanced care planning CW final.JPGBy Stephen Collazo, Department of Social Work

Today is National Healthcare Decisions Day.

Whether you're a patient or caregiver, having conversations about future care should be an essential part of your cancer treatment planning process at every stage. It should start at the time of diagnosis.

By preparing for your future, you can ensure your choices are given the utmost respect.

Here are some steps for implementing the advance care planning process in your specific medical situation. This is by no means an exhaustive list, but it serves as a good starting point for patients and families.

Mark Lewis MD.JPGBy Mark Lewis, M.D.

Individuals with a history of cancer in their family often seek out testing to learn if they, too, carry a gene that might indicate a future cancer diagnosis.

That's certainly true for me. My father, a non-smoker, was diagnosed with a very rare lung cancer when I was 8 years old.

When I got older and began researching facts about my father's cancer, I learned that in my family there exists a cancer syndrome called multiple endocrine neoplasia type 1 (MEN-1) syndrome that makes us more likely to develop tumors on our endocrine glands.

I've had non-malignant tumors in my pituitary and parathyroid glands, as well as my pancreas.

I get screened every year to make sure my tumors are behaving. Because I'm an oncologist, I can keep a vigilant eye on my own health. I can also share this information with my children when they get older because it's possible that our family history could play an important role in their health, and they'll want to share that information with their own doctors.

Megan what to expect photo.JPGBy Megan Silianoff

As a blogger and cancer survivor, I'm knowledgeable about various topics. My favorite television shows, for example, are an area of my expertise. I'm also very good at shopping and can navigate my favorite mall with poise and purpose.

And, when I got my latest mammogram earlier this month, I was reminded that I'm also an expert at getting this important screening exam.

So, first, I'll tell you this: While mammograms can be life-saving, they aren't fun. But learning about them "David Letterman" style could be. (Which is telling of my expertise in watching talk shows.)

10. Plan to wait in a separate waiting room.

I've had mammograms in a number of different hospitals, and they all have separate waiting rooms for people getting mammograms.

Immediately upon checking in for your appointment, they'll call you back, and you'll think, "I'm going to be in and out of here," but that's not necessarily the case. You're actually just getting called to sit in a different waiting room. This is important to know if someone plans to go with you because you won't see them throughout the entire process.

Gibbs family CW.JPGBy LeAnne Gibbs

It seems that something about cancer affects our filters/manners/politeness, and in an effort to say the right thing, we say exactly the most awkward, wrong thing. I, myself, have been guilty of not knowing what to say or saying the wrong things.

I've perused the web for intelligent advice on what to say or not to say to someone with a terminal cancer diagnosis.

My husband, Francis, has terminal stage IV colon cancer, so I have some experience under my belt as well.

Here's what we've found most distressing or helpful. 

LR running.JPGBy Linda Ryan

Yesterday, I visited with my 100-year-old grandmother, Nana. 

By all accounts, she is a healthy woman. When she was 94, she told me in her mind she is 49, but her body says she is 94. 

She lives a few miles away with my aunt and uncle. She can't be left alone as she isn't very agile or steady on her feet. 

My uncle thinks her mind can move much faster than her body, which causes her to fall. That makes sense based on her self-evaluation at 94. 

Nana has a home health aide who comes weekly for a few hours. The aid helps her with any jobs that she wants done.

Nana invited the aid to join her for lunch yesterday. I asked Nana what she wanted the aide to do for her while she was there. Nana said, "Well, I want to go for a walk." I told her that I thought it was impressive that, at 100 years old, she wanted to walk.

journaling through cancer.JPGBy Crystal McCown, social work counselor fellow

Navigating your way through a cancer journey can be tough. It can be hard to find time to care for your body, spirit and mind.

Journaling is one way patients can care for themselves. Writing down your thoughts gives you an opportunity to work out your feelings and emotions, which may help you relax and find reasons to be happier and more hopeful about the future.

Methods of journaling
There are many different types of journaling. Here are a few you might want to explore:

  • Gratitude journaling: Write down everything you're grateful for. This focuses your attention on positive aspects of your life.
  • Blog: A blog is a website that you can easily update by writing short posts.  Blog posts can be as simple as commentary on your day-to-day life and treatment, or reflection pieces exploring your life's purpose or connecting with a higher power.
  • Stream-of-consciousness writing: Write down everything that comes to your mind. This unstructured, unedited writing will reflect your raw thoughts and observations.
  • Art journaling: Draw, doodle or scrapbook what you're feeling and thinking.
  • Line-a-day journaling: Limit yourself to a single line or sentence for the day.

TB CW Pic 1.JPGBy Tom Barber

I'm a 58-year-old lung cancer survivor.

A great thoracic surgeon at MD Anderson, Ara Vaporciyan, M.D., removed my large tumor by doing a lobectomy of my upper left lobe in August 2009. 

I participated in a clinical trial for two-and-a-half years after surgery. It involved some painful injections and side effects, but nothing as bad as what many patients go through.

Now, I'm training for my first triathlon.

Lung cancer in my family

Three of my immediate family members have had lung cancer.

I was my oldest sister's primary caregiver until she died peacefully in my arms in 1995. So, I know what caregivers go through. How it changes the direction of their lives.

My next sister helped me a great deal with our oldest sister. Like me, she's now a lung cancer patient at MD Anderson. 

breast cancer patients with body image concerns.JPGBy Erin Buck, Ph.D.

Most women with breast cancer experience concerns about their body image during and following cancer treatment.

It's not uncommon for patients to struggle with what they see in the mirror after a breast surgery such as a lumpectomy or mastectomy. They may feel disconnected from their breast area or find that how they feel about their breasts is different than it was before cancer.

These types of body image concerns are so common that the Body Image Therapy Program at MD Anderson has developed a support group to help patients with breast cancer address their body image concerns. This group is called the BODY group (Breast Cancer Open Group to Discuss Your Body Image) and is designed to help members achieve greater acceptance of their bodies.

Connecting with others
Group members find support from the group leaders as well fellow members who are working to overcome body image concerns as a result of breast cancer. This group is open to all MD Anderson breast cancer patients.

degroot213.jpgBy John de Groot, M.D. 

Ever heard of gliomas? These primary brain tumors arise within the brain, but we don't know the cell of origin.

There are multiple grades of gliomas -- grade II, III and IV, with grade IV being the most malignant. 

Grade IV tumors are called glioblastoma. They are the most aggressive and are very infiltrative - they spread into other parts of the brain quickly. Glioblastomas don't metastasize outside of the brain.  

Glioblastomas can occur in any lobe of the brain and even the brain stem and cerebellum, but more commonly occur in the frontal and temporal lobes. Below, I've answered some common questions I get about glioblastoma.

flavio cord blood post.JPGBy Judy Overton

The psalmist wrote, "From the mouth of infants and nursing babes, Thou hast established strength." For more than 20 years, from the cord blood of babes, cancer patients have gotten a second chance at life.

Flavio Lopes Ferraz is one of them.

Bone marrow provides the standard of care transplant, but the Brazilian attorney found himself without a viable family marrow donor when he was diagnosed with leukemia seven years ago. His only option: cord blood.

"Our first choice is always to find a donor in the family," says Elizabeth Shpall, M.D., professor in the Department of Stem Cell Transplantation and medical director of MD Anderson's Cord Blood Bank.

"However, usually only one in four patients has a member in the family who can donate marrow, because of the gene pool and how the genes combine," Shpall says.

Lifeline to a cure
With the first cord blood transplant performed in France in 1988, physicians found cord blood -- rich in blood-forming cells -- provided another option toward a cure for patients with leukemia, lymphoma and other life-threatening cancers and blood diseases.

shaun sweet til cell blog post.JPGBy Shaun Sweet

In January 2007, I had a mole removed from my right shoulder that led to my diagnosis of melanoma.

Within six months, I had become a stage IIIC melanoma patient who had had two surgeries, one month of high-dose interferon and one month of interferon as self-injected shots.

In January 2008, tests showed the melanoma had spread to my liver and the lymph node in my neck. I was now diagnosed with stage IV melanoma. 

My oncologist in Michigan was willing to fight as long as I wanted. However, I wasn't given any hope of surviving.

I was advised to go on disability and get my affairs in order. I was 43 years old, with a wife and two young daughters. As far as I was concerned, death wasn't an option.


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