Recently by Cancerwise Blogger

If you're a woman or a spouse or loved one of a woman -- and that likely covers most people we know -- you may be struggling with how to interpret some new guidelines on breast cancer screenings that were issued today by the U.S. Preventive Services Task Force. You're probably very surprised to read their recommendations to push back initial mammograms to age 50 and conduct follow-ups every two years.

Thanks to the efforts of the American Cancer Society, Komen for the Cure, Avon, many other advocacy groups and even M. D. Anderson's own Public Education Office, it's likely that most women and their physicians would answer "40 years old" to the question: At what age should you get your first mammogram? Furthermore, we'd expect to hear "every year" in response to the question of how often to have this test.

Based on practices in our Cancer Prevention Center and the risk-based guidelines for breast cancer screenings, M. D. Anderson is standing by those recommendations.  

If you're of average risk, M. D. Anderson recommends you get your first mammogram at age 40 and return every year after that for regular screenings. If you aren't sure how to assess your risk, we recommend setting up time with your physician.

"We believe the benefits of an annual mammogram outweigh the risks for women, starting at age 40," says Therese Bevers, M.D., professor and director of M. D. Anderson's Cancer Prevention Center.

M. D. Anderson has studied the effectiveness of breast cancer screening and M. D. Anderson faculty contributed to the modeling analyses used by the Preventive Services Task Force to make its recommendation.   

Ongoing dialog and research on this topic are very important in the lives of many women. We'll assess these findings and others in the annual evaluation of our guidelines in March 2010.

The task force, and M. D. Anderson, are united in our emphasis on developing risk-based,  specific breast cancer screening guidelines. We'll continue to seek evidence that benefits women by catching this disease in its earliest stages.

"Doctors need to have more discussion about the risks and limitations of breast cancer screening with patients so they can participate in decision-making," Bevers says. "There have been huge successes in teaching American women about the benefits of screening mammography, but women have not been educated about the limitations of screening -- which is why many women believe that there is no harm in screening and if one test is good, two tests are better and more frequent testing with both is the best."

Read more about this discussion on twitter hashtag - #mammogram40

http://tweetchat.com/room/mammogram40

Transcript from Houston Chronicle MedBlog Live Chat Event
 

By Deborah Thomas, Staff Writer

The M. D. Anderson Circle of Sisters program and the Center for Research on Minority Health helped sponsor a visit to M. D. Anderson for Native American women from the Alabama-Coushatta Reservation. During the visit the women received instruction on breast cancer prevention and free mammography screening. They also spent time learning about the role nutrition plays in cancer prevention, the importance of breast cancer screening, and easy ways to relieve stress and stay healthy.




Deborah Scott, of the Native American Health Care Coalition, says, "In the native community breast cancer is a big problem, because many women are diagnosed late." According to The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved, American Indian/Alaska Native women have the lowest incidence of breast cancer yet have the poorest five-year survival rates.

Event Sponsors:
National Center for Minority Health and Health Disparities (NCMHD)
Native American Health Coalition
M. D Anderson Health Disparities Research, Center for Research on Minority Health
M. D Anderson Mobile Mammography Program
M. D. Anderson Place of... Wellness

By Tomise Martin, Staff Writer

When Patrick Williams was diagnosed with an aggressive form of brain cancer called glioblastoma multiforme, the three constants he'd always cherished -- family, laughter and colleagues -- helped him cope.

A 27-year veteran of the fire department in Ocean Spring, Miss., he recalls feeling lightheaded and unable to find his balance one day after a staff meeting.

"I couldn't focus, and I needed to brace against a wall for support," Williams recalls. "All I wanted was to go home and take a nap."

Luckily a friend and colleague, trained as a registered nurse, noticed Williams' difficulty and quickly reacted.

"Initially, he and I joked about me slowing everyone down," Williams says. "The banter turned to concern once he heard my symptoms."

As the colleague was taking him to a local hospital, Williams had a seizure. Tests showed he had a brain tumor and would need surgery. It was unknown whether the tumor was cancerous or non-cancerous.

"When anyone mentions cancer, my family thinks of M. D. Anderson," Williams says. "There was no question about my next step."

His first appointment
Days later, surrounded by a group of friends and family, Williams arrived for his first M. D. Anderson appointment.

His surgeon, Sujit Prabhu, M.D., associate professor in the Department of Neurosurgery, told him the tumor was stage IV glioblastoma multiforme, the most common form of brain cancer, and was located in his right parietal lobe. Prabhu explained that the side effects from surgery could include blurry vision, impaired spatial orientation and headaches.

Three days later, Williams emerged from surgery unable to see images to the far left.

"If a board read 'nurse manager,' I would only see 'n rs  m nager,'" Williams says.

Although Prabhu described the possible side effects very clearly, Williams felt unprepared for the outcome. He still considers the experience unreal.  

Multidisciplinary care
With a team of brain cancer experts, including a neurosurgeon, neuro-oncologist and a radiation oncologist, Williams benefited from M. D. Anderson's multidisciplinary approach to cancer care.

After surgery, he met with Monica Loghin, M.D., assistant professor in the Department of Neuro-Oncology. She checked his neurological functions and discussed the remaining treatment options -- chemotherapy, radiation and clinical trials.

"With chemotherapy and radiation still available, I had no desire to try the third option," Williams says.

Loghin prescribed Temodar® (temozolomide), an oral therapy found to be effective for some patients with glioblastoma multiforme, and referred Williams to Anita Mahajan, M.D., associate professor in the Department of Radiation Oncoloy, for radiation therapy.

To complete his radiation treatments, Williams moved to Houston. While the side effects of treatment were hair loss and nausea, his spirits stayed high with frequent family outings and dining at his favorite restaurants.

Try, try again
During a follow-up appointment with Loghin about six weeks later, Williams learned that the brain cancer had not responded to chemotherapy. As a result, he chose to join a Phase II clinical trial studying the effectiveness of XL184, an investigational drug, on glioblastoma multiforme.

In January 2009, he received the good news that some tumors had disappeared or stopped growing.

Life as a brain cancer survivor
Life has changed. Williams has retired as fire chief of the Ocean Springs fire department and his energy level has dropped. But his vision has cleared enough so he's able to drive again on a limited basis.

"I plan activities with their needed recovery time," Williams says. "One day of fishing is followed by two days of rest."

But he doesn't let these new details hamper life. He's usually cracking jokes or surrounded by his friends and family. A brother-in-law always accompanies him to follow-up appointments, which are every four weeks.

"I'm fortunate to have the love and support of my family," Williams says. "Life is what you make of it. I choose to live mine filled with laughter and surrounded by my loved ones."

Related article:
Q&A: Coping With a Brain Cancer Diagnosis and Treatment

M. D. Anderson resource:

Brain and Spine Center

Additional resources:
Brain Tumors (American Cancer Society)

Brain Tumor (NCI)

A cancer diagnosis can be a shock. But a brain cancer diagnosis is even more challenging. A malignant brain tumor can impact patients' thoughts, speech and communication, and motor skills, and perhaps their ability to financially support themselves or their families.

Brain cancer is a rare disease that originates in the brain, spinal cord or nerves. According to the American Cancer Society, more than 22,000 people will be diagnosed and nearly 13,000 will die from brain cancer in 2009.

Monica Loghin, M.D., assistant professor in the Department of Neuro-Oncology at M. D. Anderson, answers questions on how to deal with a diagnosis and cope with the side effects of both the cancer and its treatment.

What can I expect during my first appointment?
During the first appointment, I always discuss the patient's diagnosis and treatment options. Many patients, however, feel overwhelmed during this appointment and may choose not to discuss details about treatment. In this case, I advise them to take it one step at a time and only gather information that they're able to cope with during their first visit. I suggest having a loved one present during appointments. They can provide emotional support through this process and be an extra pair of ears.

Here are some key questions to ask at a first appointment:
•    Is this a definitive diagnosis?
•    What type of tumor do I have?
•    What are my treatment options?
•    What support services are available to assist during my treatment?

What are the treatment options?
Depending on your diagnosis and type of cancer, a combination of the following treatments could be available:
•    Surgery
•    Radiation
•    Chemotherapy

Each treatment and the associated side effects are discussed with the specialist managing a patient's care.

As a neuro-oncologist, I manage the patient's chemotherapy. We discuss the side effects and concerns the patient or caregivers may have regarding therapy.

The selection of chemotherapy is based on the type of tumor and functional status of the individual diagnosed with the disease. If a patient is physically or mentally impaired, I choose a therapy with low toxicity. In addition, monitoring the individual's health during treatment is very important. When discussing treatment options with the patient, I share my reasons for choosing the chemotherapy, the side effects and any support M. D. Anderson offers.

What are the side effects of chemotherapy?
The usual side effects of therapy are:
•    Nausea
•    Constipation
•    Vomiting

How will treatment impact daily life?
Because chemotherapy impacts each patient differently, it's challenging to anticipate how each one will respond to treatment.

For some patients, chemotherapy may not impact their lives. They can continue working full time and maintain their full neurological functions. This isn't always the case, however. Those receiving treatment may be unable to continue working, which could impact their ability to financially support their families.

My goal is to help patients and family members cope with potential changes in their lives. I explain that treatment can leave patients unable to complete tasks that were once easy for them. They may not be able to think as quickly as before. When psychological effects like these arise, I involve our psychiatry team. The psychiatry team can help those diagnosed and their family members cope with these changes.

At M. D. Anderson, we have an education clinical pharmacologist on staff help monitor  each person's care. Every eight weeks, I evaluate patients' responses to treatment and the impact on their health. These evaluations allow me to make any necessary changes to the treatment schedule. If patients are responding to treatment, we discuss whether or not they can return to work -- or do so on a part-time basis.

What services can patients and caregivers seek to help them adjust and cope?
•    Look for social workers in your community. They can assist with transportation, parking or support at home. If patients exhibit neurological deficits, social workers can evaluate patients' at-home needs through home health support.
•    Sometimes a therapist can help patients and caregivers cope with a cancer diagnosis and the emotional side effects from treatment.
•    Many communities have support groups available to patients and their caregivers. These groups offer support and guidance from others who are facing or have overcome similar challenges.

Related article:
Love and Support Help Gulf Coast Resident Cope With Brain Cancer (November Cancerwise FA1)

M. D. Anderson resources:

Monica Loghin, M.D.

Brain and Spine Center at M. D. Anderson

Additional resources:

Brain Tumors (American Cancer Society)

Brain Tumor

By Bayan Raji, Staff Writer

For some cancer patients, reactions to certain medications and treatments create tingling sensations -- similar to when you sit on your foot too long -- that don't go away.

This tingling, known as neuropathy, typically begins on the palms of the hands or the soles of the feet. Eventually, it may become painful and debilitating.

About half of cancer patients who receive chemotherapy drugs experience neuropathy. In about one-eighth of patients, the pain may become chronic.

Drugs may play a role

Neuropathy can be caused by radiation, surgery or chemotherapy drugs, including taxanes, platinum, Oncovin® (vincristine) and Thalomid® (thalidomide). It often is irreversible and even may worsen over time.



Common symptoms of neuropathy include:
•    Numbness
•    Tingling
•    Prickling
•    Burning, shooting or pinching pain
•    Cramping

Patrick Dougherty, Ph.D., professor in the Department of Anesthesia and Pain Medicine at M. D. Anderson, says patients should bring these symptoms to the attention of their doctors.  

Cause may be elusive

Some doctors believe neuropathy is caused when the interaction between nerve endings and the surrounding tissue is affected during chemotherapy. However, no concrete evidence exists to explain the origins of the neuropathy some cancer patients experience.

"The cause may be difficult to determine because these drugs are very different from one another, and they work differently to kill the cancer cells," Dougherty says.

Trial and error may be necessary

Allen Burton, M.D., chair of the Department of Pain Medicine, says doctors may try several methods to reduce neuropathy symptoms.

"When the symptoms are acute, and the patient is receiving, or has recently finished, chemotherapy, the oncologist may lower the dose or extend the time between doses of the drug that are suspected of causing neuropathy," Burton says. "Often, the problem drug is a component of a combination chemotherapy regimen."

Drugs used to treat severe or chronic neuropathy cases include:
•    Opioids (pain medications)
•    Anticonvulsants such as Neurontin® (gabapentin) and Lyrica® (pregabalin)
•    Antidepressants such as Cymbalta® (duloxetine) or Elavil (amitriptyline)

These medications, in conjunction with physical therapy, often help reduce pain and restore the patient's ability to function, Burton says. Occupational therapy may be useful if the patient's hands are affected by neuropathy.

Alternative therapies may help

In addition to medication, doctors may advise patients to try integrative medicine approaches. These may include:

•    Physical therapy
•    Acupuncture
•    Aromatherapy
•    Heat therapy

Dougherty recommends patients work down the list to find therapies that work for them. The most helpful place to access information to these and other alternative therapies is a multidisciplinary pain center, he says.

"It's important to note that certain methods may work really well for some patients but make the pain worse for others," Dougherty says.

Risk isn't clear

Doctors aren't able to determine fully who is at risk for neuropathy. Dougherty says his general impression is that younger patients are more likely to experience it than older patients, but no real explanation exists.

Clinicians at M. D. Anderson are working to develop a pain level chart to better categorize the sensations of neuropathy.

In addition, researchers are conducting several clinical trials for patients with or at risk for neuropathy. Contact askMDAnderson at 1-877-MDA-6789 for information.

Related articles:

Bridging the Divide (Conquest)

Cancer and Neuropathy (Patient Power webcast)


M. D. Anderson resources:
Peripheral Neuropathy

Department of Pain Medicine


Additional resource:
Peripheral Neuropathy Caused by Chemotherapy (American Cancer Society)

Toad Venom May Help Treat Cancer

Huachansu, a Chinese medicine that comes from venom secreted by the skin glands of toads, may slow the growth of cancer in some patients and do so without significant side effects.

Researchers at M. D. Anderson and Fudan University Cancer Hospital in Shanghai, China, reported their Phase I clinical trial findings Aug. 21 in the online Early View feature of the journal Cancer.

Stereotactic Radiosurgery Preferred for Brain Metastases

Cancer patients who receive stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) to treat 1-3 metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone.

Findings from a Phase III randomized study led by M. D. Anderson researchers were published in the Oct. 5 online edition of The Lancet Oncology.

Cancer Newsline Podcast Series

New Breast Cancer Screening Guidelines
Therese B. Bevers, M.D., Professor in the Department of Clinical Cancer Prevention explains the newly released breast cancer screening guidelines.  Dr. Bevers discusses how the new guidelines address women at higher risk of being diagnosed with breast cancer and when and how often they should be tested by mammogram or breast MRI.

By Dawn Dorsey, Staff Writer

Getting a good night's sleep when you have cancer can be a challenge. In addition to treatment side effects and anxiety, a condition known as restless leg syndrome (RLS) gives some sleepers fits.

As many as one-tenth of adults are affected by RLS, according to the American Academy of Sleep Medicine. It's likely that figure is even higher among cancer patients.

What is RLS?

RLS, which happens most frequently at night when a person is at rest, causes a strong, undeniable urge to move the legs. Many people with RLS also have paresthesia,  uncomfortable feelings deep in the legs that often are described as burning, tingling or prickling.

Many people with RLS also have periodic limb movements, in which muscles tighten, twitch or flex when they are resting. These movements may wake them or another person sleeping nearby.

RLS and its accompanying conditions are roadblocks to sleep quality and quantity, which is so important to the health of cancer patients. Among other dangers, sleep disruption may affect the immune system and endocrine (hormonal) function, since hormones are produced during certain levels of sleep.

Triggers are varied

RLS causes may include:

•    Iron deficiency
•    Medications including:
•    Nonprescription allergy and cold medicine like Benadryl®
•    Antidepressants like Elavil® and Prozac®
•    Major tranquilizers like Haldol®, Mellaril®, Thorazine®
•    Family history of RLS

Solutions depend on severity

For mild cases of RLS, try:

•    Establishing a regular daytime exercise program
•    Taking hot baths
•    Getting leg massages
•    Using a heating pad
•    Avoiding alcohol
•    Doing stretching exercises like yoga or Pilates late in the day

If your iron levels are low, talk to your doctor about oral or intravenous iron treatments.
More severe RLS may be treated with drugs including:

•    Requip® (ropinirole) or other dopaminergic agents
•    Benzodiazepines, such as Valium® or Xanax®
•    Opiates, such as Vicodin®

If you experience RLS symptoms, tell your doctor or health care provider.

Related article:

Cancer Patients Need to Treat Sleep Disorders

By Laura Sussman, Staff Writer

While older women with early invasive breast cancer are increasingly undergoing breast conserving surgery (BCS), commonly known as lumpectomy, significant socioeconomic and geographic disparities still preclude some from receiving the therapy, according to a study published in the Journal of the American College of Surgeons.

Led by Grace Li Smith, M.D., Ph.D., a postdoctoral fellow in M. D. Anderson's Department of Radiation Oncology, the study compares the use of lumpectomy to that of the other surgical option available to women with early invasive disease, mastectomy.

Combined with radiation, lumpectomy has proven to be as effective as a mastectomy for the treatment of early invasive breast cancer, yet previous studies have reported that less than half of all patients eligible receive this option, said Smith.

"Treatment of nonmetastatic invasive breast cancer has improved significantly over the past several decades, but we continue to fall short of the goal to treat every woman with the highest quality of care," said Smith.  "Our study suggests that barriers exist that may prevent may women with breast cancer - especially those in poorer areas, areas with low education levels, rural communities and counties with few radiation oncologists - from being offered every treatment that should be available to them."

For the retrospective study, Smith and her M. D. Anderson colleagues used Medicare claims to examine the treatment history of women 65 and older who were surgically treated for invasive breast cancer in 2003.

Of the 56,725 women identified, 59 percent underwent a lumpectomy, compared to 41 percent who received mastectomy. BCS was used most frequently in women younger than 70 and had no lymph node involvement. In contrast to mastectomy, the study also found BCS more prevalent in areas with low poverty, high education, a high population of treating radiation oncologists and/or in larger metropolitan areas. Looking at geographic regions, the researchers found that women in the Northeast and Pacific West were most likely to receive the procedure, while the South and parts of the Midwest were the least likely.

Smith hopes that results from the study may prompt physicians and patients to work together to overcome some of the barriers to treatment.

"Physicians may be able to help women identify specific barriers to their care and be influential in helping patients overcome such obstacles," suggested Smith. "Or, if there are concerns or misconceptions about surgical options, patients themselves may play a role by becoming educated about the value of lumpectomy as an appropriate therapy, and helping to disseminate this information into their communities."

M. D. Anderson Cancer Center is taking action to safeguard its patients, their families and the health care teams from added exposure to H1N1 and seasonal flu. 

Effective Monday, Oct. 19, M. D. Anderson will not allow visitors 12 years and under in any of its campus buildings or common areas.  For teens or adults who are experiencing flu-like symptoms of runny nose, fever or sore throat, M. D. Anderson will be actively screening patients and visitors at the front desks of all clinics, centers or upon arrival to inpatient areas. Patients showing flu-like illness will be given masks, while visitors experiencing similar symptoms will be asked to leave the institution. 

The change to the visitor policy takes effect Monday, Oct. 19, and will remain in effect until M. D. Anderson determines that the H1N1 and seasonal flu is no longer a threat to the safety of patients, their families and the staff.

In keeping with this policy change, M. D. Anderson's Child Visitation Rooms will not be available for child care.

The only exceptions to this policy will be children who are patients in active treatment or who have appointments at M. D. Anderson Children's Cancer Hospital.

M. D. Anderson urges visitors, family members and staff to remain at home for at least seven days after the onset of influenza-like symptoms or fever or 24 hours without fever (without medication), whichever is longer. Throughout this emerging flu season, M. D. Anderson encourages visitors and staff to wash their hands thoroughly and frequently, cover coughs and sneezes, get a flu shot and stay at home when ill.

M. D. Anderson apologizes for any inconveniences this interim policy causes, but for the safety of the thousands of patients who seek the best cancer care in a safe environment, we appreciate your understanding. 

For more information on H1N1 flu, prevention tips and its impact on patients with weakened immune systems, please see http://www.flu.gov/index.html

Because a cancer diagnosis spurs a raft of questions for patients and caregivers, Anderson Network has arranged week-long online sessions with many of our experts in specific types of cancer.   

The current forum addresses bladder cancer, its new treatment options and results. The fourth most common type of cancer in men and the eighth most common in women, it is diagnosed in 38,000 men and 15,000 women in the United States every year.

Find out more about bladder cancer Oct. 12-16 from three of M. D. Anderson's experts: Colin Dinney, M.D., professor; Barton Grossman, M.D., professor; and Ashish Kamat, M.D., associate professor, Department of Urology.

Visit www.mdanderson.org/andersonnetwork to submit questions or e-mail andersonnetwork@mdanderson.org for more information.

By Susan Kelly M. D., Assistant Professor, Department of Pediatrics

What is cord blood?
When a baby is born, there are a high number of stem cells circulating in the blood that are generally discarded with the placenta. The primary responsibility of these stem cells (what we refer to as umbilical cord blood or cord blood) is to make components of blood -- red blood cells, white blood cells and platelets.

Cord blood can be collected and stored in liquid nitrogen for years and later used for transplants. There are public banks, where mothers can donate the cord blood for use by anyone who needs a transplant (at no charge). There also are private cord blood banks that allow a family to store their baby's cord blood for use by someone in the family (the family pays for its collection and storage). The cord blood units stored in public banks are searchable through a computer registry that's accessible throughout the world.

Cord blood transplants
The first transplant using umbilical cord blood was done in 1988. Since then, thousands of transplants have been performed using cord blood as the source of stem cells.

Why is this important? The first choice for a stem cell donor is usually a perfectly matched sibling (or other matched family member). We look at markers on the cells called HLA types (different than blood type) to see how closely a patient and potential donor match. Matched cells from a family member have a higher chance of taking (engrafting) and cause fewer side effects, such as graft-versus-host disease (GVHD), where the transplanted cells attack their new "host." 

However, as families are changing and getting much smaller, the chance of having a fully matched sibling is quite low. Only one in four full siblings will be a match, and half- and step-siblings are almost never a match. The other options for stem cell transplants include finding an unrelated stem cell donor or receiving stem cells from cord blood.

While the bone marrow registry is expanding, the chance of finding a match is less than 50% and much lower for minority patients or patients with mixed ethnicity. Cord blood doesn't need to be matched as closely as other stem cells because they're more naïve immunologically, causing less GVHD. Therefore, a match can be found for a much higher percentage of people.

By Dawn Dorsey, Staff Writer

Cancer has been playing hide-and-seek with Patsy Lofton for 17 years, traveling from her breast to her lung, spine and brain.

Over the years she's tried many treatments, some more successful than others. Now, she's hoping a recent Gamma Knife radiosurgery procedure at M. D. Anderson will help slow the growth of the cancer in her brain.

Breast cancer began the saga
In 1992, Lofton, who lives in central Mississippi, was diagnosed with stage 1 breast cancer. She had a lumpectomy (surgical removal of the tumor and some of the surrounding tissue), radiation and chemotherapy and felt lucky she had caught the cancer before it spread.

But three years later, she began to have a pain in her back, just under her shoulder blade.

"I had a feeling the cancer was back," Lofton says. "But after you've had cancer, you think every little pain is cancer."

Cancer reappears in lung, spine
Unfortunately she was right; the cancer had reappeared in her lung. The tumor was surgically removed, and Lofton had two bone marrow transplants.

For nine years, she was free of cancer. Then it reared its head again, this time in her spine. Her radiologist referred her to M. D. Anderson.

"Since I was 50, still young the doctor said, he thought we might be able to just remove the two vertebrae where the cancer was," she says. "But to do that, we first had to treat the spine with radiation."

Surgeries take their toll
After the radiation, surgeons removed T3 and T4, two vertebrae in the middle of her back.

"It's been a pretty tough adjustment, and it still affects me," says Lofton, who's now 55. "I can't do very much, and my shoulders hurt a lot. Everything below and above the vertebrae that were removed has to work extra hard to compensate."

Before she was completely healed from the surgery, Lofton slipped and fell as she was leaving a restaurant. She broke her ankle and heel and was in a wheelchair for four months, requiring two surgeries.

Procedure hones in on tumor
Last year, a PET (positron emission tomography) scan revealed several small spots on Lofton's brain and lung. Doctors treated the spots on her brain with radiation, but 10 months later another PET scan revealed two new spots. That's when they decided to try Gamma Knife.

A Gamma Knife procedure is neither a knife nor surgery. It's a type of radiation treatment that delivers highly focused, high-intensity rays to a tumor with little damage to healthy tissue.

Gamma Knife causes little pain
Although the procedure might sound scary, Lofton explains it calmly. She says she felt only minor discomfort.

"They drilled two little holes in my skull: two in front and two in back," she explains. "Then they fitted a metal, locking mechanism called a halo on my head to keep it straight and still during the procedure. First they did an MRI, then the procedure, which lasted about 40 minutes."

Lofton was awake during the procedure, but she was lightly sedated.

"After they removed the halo, I had to sit for about an hour, and then I was dismissed," she says. "They asked me to stay in town overnight, and I went home the next day."

"The only side effect has been a little discomfort and two small knots where they drilled the holes to fit the halo."

Treatment continues for lung cancer
Lofton returns to M. D. Anderson every three months for MRIs of her brain, and the tumors seem to have stopped growing. She still receives chemotherapy for lung cancer, but she's able to do that at a facility about two hours from her home.

Recently, a small spot appeared on her liver.

"The doctor says that's the least of my worries," Lofton says. "But we're keeping an eye on it."

Battle influences her attitude
How does Lofton keep going? She attributes it in large part to family, including her husband of 30 years and a grandchild who lives a little over an hour away.

After fighting a formidable enemy for so many years, Lofton has developed a fairly easygoing attitude.

"I ask a lot of questions and learn what I can," she says. "But, in the end, the cancer's either going to come back or it's not."

Related articles:
Q&A: Gamma Knife® Radiosurgery for Brain Tumors

M. D. Anderson resources:

Breast cancer

Lung cancer

Brain cancer

Division of Radiation Oncology


Additional resources:

Detailed Guide: Brain/CNS Tumors in Adults (American Cancer Society)

Brain Tumor (National Cancer Institute)

Patient Information - North America (Elekta)