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August 2013 Archives

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By Matthew Ballo, M.D.

Most cancer patients are elated to complete their treatment and ready to get back to their normal routines. But along with the excitement, there is often some fear and apprehension about the future.

The fact is, completing cancer treatment doesn't necessarily mean a patient is "done." Going forward, it's imperative that patients adapt to a new normal and commit to a healthier lifestyle to build strength and energy, and to reduce their risk of recurrence. In our Road to Wellness program, which is designed to support patients as they transition from cancer treatment to cancer survivorship, we put a heavy emphasis on the importance of proper nutrition.

Emerging evidence shows that avoiding weight gain after a cancer diagnosis can reduce the risk of recurrence, as well as prevent a number of other chronic diseases. Your goal should be to achieve and/or maintain a Body Mass Index (BMI) of between 19 and 25. With moderate exercise and a healthy diet, that's not difficult for most people to achieve.  It's a commitment cancer survivors need to make in the best interest of their long-term health.

Healthy diet guidelines for cancer survivors
Follow these guidelines to ensure you're eating the best diet for a cancer survivor.

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By Liz Hill

 

Living in southern Louisiana, my family learned to endure the heat, humidity and sun. But we struggled when it came to protection from its effects, especially sunburns.

 

My mom was a redheaded, blue-eyed, extremely fair-skinned woman. She had her fair share of sun exposure as a child. As an adult, after several basal and squamous skin cancer scares, she realized the value of sunscreen and, really, just avoidance of the sun. She passed those values on to me since I have reddish hair, blue/green eyes and extremely fair skin.

 

My mother's malignant melanoma diagnosis

Mom had a growth on her face that had been examined by a local dermatologist many times, but my mom had been advised not to worry about it. 

With a steady decline in traditional cigarettes, tobacco companies are looking for new ways to get people addicted to smoking. 


Now, with the third largest U.S. tobacco company launching a massive campaign to promote electronic cigarettes, or e-cigarettes, smoking may be on rise again. In fact, about 6% of adults have tried e-cigarettes, a number that has nearly doubled since 2010, says the Centers for Disease Control and Prevention.


The e-cigarette is a smokeless electronic device that allows the user to inhale a vapor of liquid nicotine in order to imitate traditional smoking methods. The new gadget is touted as safe and harmless by tobacco companies, but our tobacco prevention and cessation experts tell a different story.

Claims that e-cigarettes are 'safe' are misleading
"We've been telling society for the past 30 years that they shouldn't smoke, and that tobacco is bad," says Paul Cinciripini, Ph.D., director of MD Anderson's Tobacco Treatment Program. "But tobacco companies are smart and have a good marketing strategy when it comes to promoting new products."

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By Hank Lech

When I was diagnosed with chordoma in my C2 vertebrae, my first reaction was "This is a mistake, I can't have cancer. The x-rays, biopsies and doctors are wrong."

I was the one who was at the gym six days a week doing cardio and lifting weights. I was taking my daughter to Rome and on a cruise in three weeks. I cried, worried, prayed and was mad as hell. I vowed that cancer would not win.  

After my consultation at MD Anderson, I learned that life would be turned upside down and I began to hear about a "new normal." I heard about tracheas, peg and NG feeding tubes, drains, and rods and screws that would hold on my head. To top it off, I'd need two surgeries -- one to get part of the vertebrae out of my back, and another in which my jaw would be split and mouth opened wide enough to retrieve the rest of the chordoma. 

I learned I might not be able to eat, talk or swallow for a quite a while, if ever. I worried that I would come out of the hospital looking like Hankenstein. 

I joked with the doctors, my daughter, family and friends to put my mind at ease. I threw a pre-op dinner with a cancer surgery theme. I tried to have a positive attitude. But I was becoming angrier each day.

After chordoma treatment: Anger over my "new normal"
I made it through two 10-plus-hour surgeries. After the second surgery, the anger really hit. There were things that I was unable to do. I looked like hell, couldn't speak, eat or shower, and I was hooked up to so many tubes. My sister, who was there to help and support me, took the brunt of my anger. Even though I couldn't talk, people knew I was angry.  

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By Mary Powell

I labeled the daily emails from our March trip to MD Anderson for my brother's stem cell transplant "our adventure," and that's exactly what it turned out to be.

I was excited to be a stem cell donor for my brother, Dan, who has leukemia. But when the doctors performed a chest x-ray, they discovered a questionable spot on my lung. We hoped it was nothing, but scheduled a CT scan to make sure.  

The scan revealed a tumor on my lung. I cried to my sister as I told her something was wrong.

"We've been here for a week, and you are the first person we have seen cry," she said to me, telling me to remain calm, be positive and toughen up.

"All these people knew they had cancer, and now I might have cancer," I responded.

Neuroendocrine tumor diagnosed by chance
Eleven days after I arrived in Houston, I was told I had a neuroendocrine tumor in my lung. 

This is so not happening to me, I thought. I had to tell Dan I couldn't be his donor. My husband arrived the next day, and the next two weeks we did follow up scans and tests to make sure the tumor hadn't metastasized.

This trip did not turn out the way it was supposed to. Or did it?

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By Brittany Cordeiro 

When caring for a loved one, your health and wellness may often take a backseat. All your time and energy is devoted to nurturing your friend or family member. You grab fast food at the hospital or skip meals entirely to stay by his or her side.

But as a caregiver, it's essential you stay healthy so you can better care for your loved one. In addition, you'll be in better shape to fight off diseases like cancer.

"Research shows that making small changes can lead to bigger diet changes over time and better health," says Mary Ellen Herndon, a wellness dietician at MD Anderson.

Try these tips to maintain good health with a balanced diet.

Tom Barber lung cancer caregiver

by Tom Barber

I have watched several friends and, now, a mother and two sisters at or near death from lung cancer. When my sister passed away this summer, I became a lung cancer patient caring for another lung cancer patient. 

New questions surface when a cancer patient takes care of another cancer patient. During my sister's final phase, the big question for me was, "Am I looking in the mirror?" Would I go through what she was going through?

Approaching my sister, a fellow lung cancer patient

I never avoided my sister because of this fear of looking into the mirror, but I did have to redirect this distraction to make it through the really tough days without affecting my own recovery.

I simply trusted in an approach my father suggested before I went in to say goodbye to my dying mother several years ago.

I asked myself: How would I want to be treated? How would I want her to look at me? How can I make it a little better? How can I be sympathetic but encouraging?

It helps if you believe in miracles. You should. I do. They happen. I am proof. 

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By Linda Ryan

 

Recently, I had the honor of participating in a tour of MD Anderson's campus and research facilities. I learned about the many services available to patients.

 

I now know that I did not fully utilize the services that were available to me when I was a cervical cancer patient. The likely reason for that is simply geography. I flew to MD Anderson for my chemo treatments and then home.

 

If I lived closer, I would have participated in more of the programs that I learned about, such as services offered by the Integrative Medicine Center, which range from nutrition lectures to Pilates and yoga. The patient services are endless. They also offer quiet rooms where you or your caregiver can sleep, as well as a library where patients can research their specific diagnoses. The goal seems to genuinely be to help the patient navigate cancer with many tools in their arsenal.   

 

Learning about cancer prevention at MD Anderson

I recently read about the Division of Cancer Prevention and Population Science in the most recent issue of MD Anderson's Conquest magazine.

 

So, I was happy that our tour took us to the Cancer Prevention Center, which includes the Behavioral Research and Treatment Center. They are studying how certain behaviors have an impact on cancer prevention and recurrence. I am most interested in the research they are doing regarding exercise and its impact on cancer.

Throat Cancer.jpgThe number of throat cancer cases is on the rise, with about 12,000-15,000 people expected to be diagnosed with throat cancer in 2013.

The biggest reason for this increase is the human papillomavirus (HPV) -- the same sexually transmitted infection that causes cervical cancer. In fact, by 2020, HPV may cause more throat cancers than cervical cancers.

We recently spoke with Erich Sturgis, M.D., professor of Head and Neck Surgery, about HPV and throat cancer. Here's what he had to say.

What's the connection between HPV and cancer?
There are over 100 types of HPV, and they're all spread through contact. Some of the most dangerous types are especially spread through sexual contact, including oral sex. Many people will contract HPV at some point, but the body often clears the infection.

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By Jamie Jessee


At age 25, my husband, Bradly, discovered the frequent headaches he was experiencing were something much worse: a
brain tumor.

It was 2005, and Bradly, just nine months out of college, was working as a speech pathologist. We weren't married yet, but after dating for five years, I had no doubt this was the man I was going to spend the rest of my life with. 

I just hadn't expected the rest of his life to potentially be a matter of months or years.

Bradly's astrocytoma diagnosis
Bradly had been having headaches on and off, so his primary care doctor prescribed several different headache and sinus medications. When these didn't work, the doctor finally ordered a CT scan of his head. 

 "Have you seen your scan? It's not good. You have a big brain tumor in your head," the emergency room doctor said.

A needle biopsy of the tumor revealed a grade II astrocytoma, a slow growing, but malignant tumor that needed to be removed immediately. 

The team of local neurosurgeons we saw couldn't agree on the best way to treat Bradly's tumor. A few thought it would be impossible to remove the entire tumor. Because of its location and the possibility of major deficits after surgery, it would be best to wait until Bradly had more severe headaches and other symptoms before attempting to remove part of the tumor.

"You probably won't walk or talk again after this surgery, so you should enjoy the quality of life while you have it," our neurosurgeon told Bradly. "This tumor is going to take your life." 

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Remember playing arcade and video games as a kid? Now, researchers are playing on kids' love for video games by creating interactive games and apps for mobile devices. And, they're doing this to collect research data from patients and to deliver educational information to keep people better informed about their health. 

Here at MD Anderson, Alexander Prokhorov, M.D., Ph.D., professor of Behavioral Science, has been using the gaming concept to help people quit smoking. Prohorov's mission is to develop tobacco prevention programs targeted towards children and teens. 

His latest invention is not only timely, but industry appropriate. Prokhorov has developed a quit smoking app - available for download at no cost on the Apple iTunes Store -- called Tobacco-Free Teens. The app, designed to help prevent tobacco use and help teens stop smoking, is an animated educational experience created with the teen in mind. 

"Our app combines education and entertainment with comics and interactive games," Prokhorov says. "It motivates teens to stay away from tobacco and teaches behavioral skills to help them resist pro-tobacco pressures. Such an approach is much more appealing to youth than text-based instructional tools."

Michael Snyder clinical trials cancer

by Mike Snyder

By nature, clinical drug trials are something of a gamble. Since the drug itself is either brand new or being used in a brand new way, there's no guarantee of the drug's effectiveness or favorable results. 

This is something that we cancer patients understand from the start. In my case, the decision to participate in a clinical trial for cancer treatment wasn't tough. It was my only remaining option. My chondrosarcoma, a rare bone cancer, was inoperable, so a clinical trial was my only cancer treatment option. 

Here's what some people don't realize about clinical trials: they can be stopped at any time for many reasons. Maybe the drug just isn't working, or maybe the side effects are too much of a burden. Or perhaps the drug company isn't seeing enough positive results. That's why my first clinical trial ended. The drug company found that the results from the actual drug wasn't yielding better results than the placebo. 

Reasons to be hopeful after changing clinical trials
I was actually relieved when that clinical trial ended. I'd actually been thinking about withdrawing because the side effects were brutal and my tumors weren't shrinking or stabilizing.  

CarePages cancer patients

By Daphne Bottos

I come from a huge extended family. My mother is the second youngest of 10 and beyond that, I have 30 first cousins, 20 second cousins and 30 third cousins -- all family members just on my mother's side.
 
When one of the top 10 gets sick, it's like playing the telephone game with a bunch of children. Interesting twists to stories, odd facts and the 'he said/she said' make it hard to nail down pertinent information.

Back in 1993, my mom was diagnosed with stage 3 melanoma. I can't imagine the stress it put on my dad when he had to call each of my mother's siblings.

Having to tell multiple people the same news over and over again is tiring and stressful. Having to tell multiple family members that you have cancer is just depressing.
 
CarePages: an easier way to share cancer updates
Recently, my mom was diagnosed with skin cancer again, but this time, my family is having a much easier time sharing updates. That's because my parents are able to share information with friends and family through a site called CarePages.

Tom Barber lung cancer caregiverBy Tom Barber

I am one of four members of my family that have had lung cancer.

I was a primary caregiver to my oldest sister, who died many years before I received my lung cancer diagnosis.

Unfortunately, my second of two sisters to die of lung cancer said goodbye on June 13, 2013. Goodbye, sis. Love you. I am tired of this stuff.

Secrets of a cancer patient caring for a cancer patient
I have two really vivid and distinct cancer memories. Together, they helped me confront my second sister's lung cancer.

On how to be a cancer caregiver, I recall my father asking me how I wanted my mother to remember me just before I stepped into her ICU room to say goodbye. It was gently instructive and made me gather my courage and put a loving and peaceful look on my face as I approached my dear mother for the last time.

It has given me peace many times that she saw me filled with love for her and positive in my countenance to the end.

Gerard Neumann acute myeloid leukemia AML

by Gerard Neumann

When I was diagnosed with acute myeloid leukemia (AML), everyone wanted to help. All of my children rallied to my aid. Seeing their dad beat this thing was important to them.

My son Chris, recently married with a newborn and doing his medical school residency in Houston, opened his small apartment to me so that I would have a place to stay.

When my wife could not go with me to doctor's appointments, Chris or one of my other children went with me to make sure I did not miss something important the doctor said about my AML. 

My siblings: Potential stem cell transplant donors
My siblings also wanted to help. Our parents taught us that charity begins at home, and my siblings proved that a home is not limited by four walls. All six went to be tested to be the donor for my stem cell transplant.

My sister, Terry, started a diet because she heard there were weight requirements.

My brother Robert, wheelchair-bound with a form of dystrophy, wanted to be my donor if he matched. He was ready to get in his van and drive the nearly 900 miles from Albuquerque to Houston.

It was my brother Ed who matched, though. As children we had never gotten along. But he put his life on hold and flew to Houston at his expense to give me his stem cells. 

Lung cancer screening - low-dose spiral CT scan

When a massive clinical trial about lung cancer screening shows a benefit to current and former smokers, why can it take so long to become accessible for most people?

A draft recommendation by a federal task force in favor of using low-dose CT scans to screen past and current heavy smokers for lung cancer provides insight about the time lag.

The recommendation says that low-dose spiral CT lung cancer screening is only appropriate for those who:

• Are 55 to 80 years old

• Have a 30-pack-year history of smoking (which translates to 1 pack of cigarettes a day for 30 years, 2 packs a day for 15 years, etc.)

• Smoke or have quit smoking within the past 15 years

"The U.S. Preventive Services Task Force's recommendation is a great step forward for this life-saving screening," says Reginald Munden, M.D., professor of Diagnostic Radiology.

Health insurance companies expected to cover CT lung cancer screening for smokers
The task force carefully sorts the pros and cons of a preventive procedure before recommending for or against. Its rulings are highly influential, so both governmental and private health insurers tend to wait for its recommendations before deciding whether to pay for a procedure, Munden says.

The task force's recommended B rating for the procedure, subject to a comment period that ends Aug. 26, is significant. Right now, 95% of the people who want screening have to pay for it out-of-pocket, because only two health insurance companies cover it. Medicare and Medicaid don't reimburse for it, but the task force's recommendation is expected to change that.

"The implications are huge," says Therese Bevers, M.D., medical director of MD Anderson's Cancer Prevention Center. "Health plans, under the Affordable Care Act, are required to cover any screening or service given an A or B rating by the U.S. Preventive Services Task Force. They're not only required to cover it, but to cover it without any co-payment or deductible so the patient is able to get this at no out-of-pocket cost."

Anxiety and cancer: My fear of upcoming scansThis week I went to MD Anderson for a follow-up appointment. I am 17 months past the day that I learned that there is no evidence of disease in my body. 

I felt different being at MD Anderson this time. I was not anxious for my appointment. I felt much like when I was first diagnosed with cervical cancer: I didn't feel that I looked like someone with cancer.   

When people who I met on the plane or the hotel asked why I was in Houston, I wasn't sure how to answer. I am here to go to MD Anderson. Am I a cancer patient? Not really. I'm here for follow-up, so does that make me a cancer patient? I don't feel like a patient. 

Looking at other cancer patients as a cancer survivor
There are so many cancer patients at MD Anderson. Some are noticeably very sick. Others look okay, but you can tell they are cancer patients. It's that group of people that that I have noticed a subset. Some look and act miserable. They are miserable, rightfully so.

There is another group of people who are patients in the middle of their battle.They have a bounce in their step. They make eye contact and say hello. They seem noticeably aware of their attitudes and refuse to give cancer an inch.

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