Second Painting in my Life Quilt Series- Courage

I completed the first painting in the series I call Life Quilts last year. The series combines quilt square designs with cancer awareness colors and ribbons. The first painting is called Hope and uses teal, the ovarian cancer awareness color. I wrote about it here . I will be using that painting in a future fundraising campaign for the Cancer Institute of New Jersey . More details about that campaign tomorrow. Please check back.

Yesterday, I finished the second in the painting series. This one is called Courage and incorporates pink the color for breast cancer awareness.

I painted Courage in honor of my sister ,Roberta and also 5 friends recently diagnosed with breast cancer. Roberta faced her cancer diagnosis and treatment with Courage and she showed me the path to follow. Thank you , Bert.

Dee

Every Day is a Blessing!

Glycobiology Research

A friend and fellow ovarian cancer survivor sent me a link to the article "Attacking "bad carbs" to fight ovarian cancer" which appeared in Beaker , the Sandford-Burnham Medical Research Institute's blog. . The article reports on glycobiology research by Michiko Fukuda, Ph.D. and her team.

Glycobiology is the study of glycoproteins. Glycoproteins are molecules made up of carbohydrates and proteins. The surface of epithelial cells are protected by carbohydrates. When a cell becomes cancerous the surface carbohydrates are altered and may contribute to cell growth and metastasis. Dr Fukuda and her postdocs worked with a monoclonal antibody (HMOCC-1) that attaches itself to the surface of malignant Ovarian Cancer cells. They developed a biochemical method to determine which modified carbohydrate the antibody attached itself to. The complete research article was published in the Journal of Biological Chemistry . Click here for a link to the article.

The more we understand the structure of ovarian cancer cells the better we can develop treatments.

Dee

Every Day is a Blessing!

In One Word

Yesterday I read an article in U.S. 1 magazine about a project done by Westminster Choir College called "Giving Voice to Community". "Giving Voice to Community" is based on NPR's "Story Corps" and "Anthropological Wordsmith Picture Show". The project asks those attending Westminster Choir College concerts to be photographed with one word of their choice. Those who participate are not given any guidance as to what the word should represent. See some photos here.

That article got me thinking of what word I would choose.

The first word that popped into my mind was "SURVIVOR". But does that word make cancer the focus of my life? I admit that many times it is. I call myself a cancer advocate so I am reading about cancer, talking to other survivors , trying to raise awareness of ovarian cancer , volunteering with ovarian cancer organizations and raising funds for cancer research. That happens just about every day.

I am also a survivor who worries. This week I worried that my port might not function correctly. It functioned like brand new. I worried as I waited to see my doctor. And when her nurse practitioner came in to do the exam because my doctor had to see a newly diagnosed patient I was a bit hesitant. But then I thought to myself " You are 3 years out of surgery for your recurrence and 2 and a half years out of chemo , your CA-125 is 11 isn't it time to move on?" . The exam went well. So I am good for 3 more months.

So yes, I am a survivor. But I would choose the word

MORE

I am more than just a cancer survivor , I am a wife, mother, grandmother, friend, advocate, engineer, teacher, blogger , crocheter, painter, Disney fan & dog owner. And I hope to add more to life in the years ahead.

Dee

Every Day is a Blessing

Access to Cancer Research Should Remain Free

I often call myself a research "Hound" . I love sniffing out the latest ovarian cancer research. One of my favorite sources is PubMed which is a free archive of research papers that were published by NIH-funded scientists. Articles are posted one year from their original publication date.

When I gave a talk at the Cancer Support Network of Central New Jersey I used the site to find research papers I could present as examples. I also provided the link to my audience so that they themselves could look up the latest cancer research on their particular types of cancer. I did try to use sample research articles from the New England Journal of Medicine but that would have required me to subscribe at $169 per year for the magazine or $139 for the online version. That is a bit of a steep price to pay. Some other journals will allow you to download a pdf version of an individual journal article if you pay $35. To be fair there are usually 1-2 articles per issue that they offer the entire content online for free but they are usually not on a topic I am interested in.

US Representatives Darrel Issa and Carolyn Mahoney have introduced bill H.R. 3699 the "Research Works Act" that will make it illegal for other federal agencies to offer the same free access. And based on my reading of the text , the bill would also roll back the law that allows free access to NIH-funded articles. Now that part makes me very unhappy.

As a cancer survivor interested in understanding the research that is taking place that can affect my life I urge every member of the House committee on Oversight and Reform to prevent this bill from ever reaching a House Vote. If any of the Committee members were from NJ, I would be sending them an e-mail. Check the site and write your representative if he/she is on the committee.

Dee

Every Day is a Blessing!

Are there really that many different types of Ovarian Cancer?

After writing the last post about CA-125 I started to think about what causes the differences between ovarian cancer tumor cells. Why is cancer antigen CA-125 ,a protein , not elevated (or not being produced at the same level by my cancer tumor cells) as compared to other women who have been diagnosed at the same stage.

When I attended the ASCO meeting, I learned that there are many different subtypes of ovarian cancer. Many more than those I was initially aware of. So I put together a list of the different types of ovarian cancer.

What type/ histology is your ovarian cancer tumor?

Epithelial

• serous
• mucinous
• clear cell
• undifferentiated
• mixed epithelial
• endometrioid

Germ Cell

• teratoma
• dysgerminoma
• yolk sac tumor
• embryomal
• choriocarcinoma

Sex Cord Stromal

• granulosa cell
• Sertoli-Leydig

Check out the source of my list at

John Hopkins Pathology ( http://ovariancancer.jhmi.edu/home.cfm). The site offers excellent description of each of these different types and subtypes.

So it seems that even if you have the most common type of ovarian cancer, epithelial, your cells may be different than a friends since you may have a different sub-type. The ovarian cancer cell type along with the stage is important in determining the type of treatment you will be offered, so knowing that information is important.

I know what subtype I am. What subtype are you? Check your pathology report or ask your doctor. It is good knowledge to have.

Dee

Every Day is a Blessing!

HopeNet Social Network to be Discontinued- 1/1/12

As many of you know I volunteer with the Cancer Hope Network and speak to other ovarian cancer survivors throughout the country. For the past year I have also been the moderator of the trial online service of Cancer Hope Network known as HopeNet Social Network's Gynecologic Cancer Survivors and Supporters group. I recently e-mailed this message to members of the group.

Hello Gynecologic Cancer Survivors and Supporters Group,

Thank you so much for being part of this group. As you may have heard Cancer Hope Network’s social network, HopeNet, will be shutting down Feb 1^st 2012.

This service was begun as a trial to increase awareness and knowledge of Cancer Hope Network's core service: one-on-one matching with another cancer survivor. Analysis of the site’s usage and quantity of membership indicate it is not achieving results consistent with what we hope to achieve in our mission and vision. Therefore, the decision has been made to discontinue this aspect of Cancer Hope Network's web services. Please note, the web site is still completely active – only the HopeNet tab will be deactivated.

If you would like to stay in touch with Cancer Hope Network, please join them on Facebook or follow themon Twitter. Also, if at any point you would like to be able to speak one-on-one with a fellow cancer survivor, please contact Cancer Hope Network by email atinfo@cancerhopenetwork.org or phone at 877-HOPNET (877-467-3638) and they can try to match you with one of their support volunteers.

It has been a pleasure getting to know so many of you. You may contact me through my Blog, Women of Teal( womenofteal.blogspot.com).If you are interested in online groups you may want to join Inspire (www.inspire.com) or the ovarian cancer mailing list at ACOR (http://www.acor.org/) . I have been a member of both these groups for five years now and found them very helpful.

May the New Year bring you good health and happiness.

Wishing you all the best,

Dee

Dee

Every Day is a blessing!

So about that CA-125

This past week I wrote about going for my CA-125 blood test. Waiting for the results is always nerve wracking for me even after all these years.

The CA-125 is a biomarker protein that may be elevated in the blood of women who have ovarian cancer. But the CA-125 is not specific to ovarian cancer since it can be elevated for reasons other than ovarian cancer such as diverticulitis and other abdominal inflammations.

When I was first diagnosed with ovarian cancer ( Stage 3B) my CA-125 was 177. Yes, it was above the normal guideline (0-21 and now 0-35 )but so much lower than other women with the same disease load whose numbers were in the thousands. When I recurred my CA-125 was 16 up from 9. And, yes, that would be a normal reading. At that point I had a diseased spleen and tumors on the surface of my liver. So my doctors and I don't necessarily look at the absolute value of the CA-125 result but we are looking at the trend , even if the results are in the normal range. We have also agreed that if I am asymptomatic she will not treat me because of a rising CA-125 unless there is evidence on a scan.

In December of 2010 my CA-125 was 10 and during 2011 my results were between 10 and 13 until December when it shot up to 16.7. Uh Oh it is rising! Of course the fact that I could be recurring entered my brain but there was no way that was going to stop me from having an awesome Christmas and New Years. It would have to wait.

I had my follow-up blood test on Thursday. My nurse e-mailed me on Friday that the result was 11. Right there between 10 and 13. I'm not sure why there was that jump in December. But I am happy with the 11 . And I'll be happy going in to see my gyn-onc later this month knowing that it is 11.

Dee

Every Day is a Blessing!

How Do Those Ovarian Cancer Treatments Work?

I have always been interested in how cancer treatments work to destroy cancer cells. The other day I was talking to another ovarian cancer survivor on the phone. She was deciding between two treatments for a recurrence. When I hung up the phone I realized that I knew the side effects of the treatments but I really didn't know how they worked to kill off the cancer cells. So I decided to do some research on the NCI site to find the answer.

Here is a summary of the popular Chemotherapy treatments, drugs and biologics, used in the treatment of Ovarian Cancer. More complete information can be found at http://www.cancer.gov/drugdictionary

Paclitaxel ( Taxol) & Abraxane

“binds to and stabilizes microtubules,preventing their depolymerization and so inhibiting cellular motility, mitosis and replication”

Remember high school biology and the steps of cell reproduction. This drug affects that process. Abraxane is similar to Paclitaxel but does not use a solvent which causes side effects so it permits the administration of larger doses.

Carboplatin

“binds to GC-rich sites in DNA , thereby inducing intrastrand and interstrand DNA cross-link, as well as DNA-protein cross- links...results in apoptosis and cell growth inhibition.”

This platinum drug binds to the Guanine and Cytosine rungs on the DNA helix and causes cell growth to stop and then cell death occurs.

Gemcitabine ( Gemzar)

“is converted intracellularly to the active metabolites dFdCPD and dFdCTP... thereby decreasing the deoxynucleotide pool available for DNA synthesis and ... is incorporated into DNA , resulting in DNA strand termination and apoptosis.”

Inside the cell the drug is incorporated in its modified form into the DNA strands and leads to cell death.

Topotecan

“topotecan selectively stabilizes topoisomerase I-DNA covalent complexes, inhibiting religation of topoisomerase I-mediated single-strand DNA breaks and producing potentially lethal double-strand DNA breaks when complexes are encountered by the DNA replication machinery.”

Breaks in the strands of DNA caused by the topotecan prevents the DNA from replicating correctly and cell reproduction is inhibited.

Etoposide

“etoposide binds to and inhibits topoisomerase II and its function in ligating cleaved DNA molecules, resulting in the accumulation of single- or double-strand DNA breaks, the inhibition of DNA replication and transcription, and apoptotic cell death.”

Etoposide causes breaks in the DNA thereby affecting cell reproduction and leads to cell death.

Bevacizumab ( Avastin)

“Bevacizumab binds to VEGF and inhibits VEGF receptor binding, thereby preventing the growth and maintenance of tumor blood vessels.”

Cancer cells create blood vessels. Bevacizumab is a monoclonal antibody that binds to the vascular endothelial growth factor which helps create and maintain those cancer cell's blood vessels.

Dee

Every Day is a Blessing!

Thankful Thursdays- Quest Diagnostic Phlebotomists

photo from Wikipedia

I was heading toward the Quest Diagnostic Center this morning in some heavy rain. I turned on the radio and the announcer on the radio station ( 99.1FM) reminded her listeners that it was Thankful Thursday and to call in or post on Facebook what they are thankful for. She said of course we should be thankful that the rain we were having was not snow and thankful because we needed the rain.

I didn't have an appointment for my blood test but it took no more than 10 minutes to update my info and head into the blood draw room. After a quick hello I mentioned to the phlebotomist that I have very bad veins but that I tried to drink more water yesterday to plump them. I mentioned that most times a butterfly needle is used. She smiled and said"Lets see what we have here" . She gently tapped the visible veins on my left arm - where they usually can find a suitable candidate for puncture. Then said "Lets try your right?" No one has been able to find a vein in my right arm for almost 4 years now. But I told her sure give it a shot. She found a vein, picked up the butterfly needle and said "This will pinch a little." BINGO she got right in with blood flow and filled the vial in no time. Out came the needle . On came the gauze and paper tape and I was done. I told her she got an A+ in drawing blood.

So on this Thankful Thursday I am thankful for the excellent phlebotomists at Quest Diagnostics in Jamesburg, NJ!

Dee

Every Day is a Blessing!

Newly Released Ovarian Cancer Data

Cancer Statistics for 2012 were recently released by the American Cancer Society. You may read the full report here.

But I will provide the pertinent data for Ovarian Cancer here.

• Estimated new cases of cancer of the ovary in 2012: 22,280
• Estimated deaths - cancer of the ovary : 15,500
• Estimated deaths - cancer of the ovary in New Jersey: 490
• Cancer of the Ovary is the 5th leading cause of death in women .
• In 2008 deaths caused by cancer of the ovary for all ages of woomen: 14,362
• For women 40-59 years of age cancer of the ovary ranked 4th (2008) behind breast,lung and colorectal
• In women 60-79 years of age cancer of the ovary was the 5th (2008) leading cause of death
• 5 Year relative survival rate ( 2001-2007) for ovarian cancer:

92% localized
73% regional
28% distant

• Data shows that 43% of women diagnosed with ovarian cancer were distant , while 16% were regional and 14% were localized.

PS Cancer of the ovary is considered a rare cancer.

Dee

Every Day is a Blessing!

Valentines Dinner and Elixir Fund Support

Why not take a loved one to dinner and lend your support to the Elixir Fund and their programs for cancer survivors and caregivers.

Valentines Dinner and Wine Paring

Saturday, February 11, 2012 from 7:00 PM to 11:00 PM (ET)

Hamilton, United States

Please join us for a very special 5 Course Dinner and Wine pairing at the

Jersey Girl Cafe

John Kafarski, of the Wine Culture Project, will be providing wines specially paired with our dinner menu. John will provide details about the evening's wine pairings, their background, and why they were selected.

Our St. Valentine's Menu:

• First Course: Pan Roasted Baby Lamb Chops - Parsley, Sage, Rosemary, Thyme
• Salad Course: Baby Arugula - Hearts of Palm, Blood Orange, Goat Cheese Custard, Honey Drizzle
• Third Course: Papardelle Pasta - Roasted Beets, Wilted Radicchio, Riccotta Salata, Toasted Almonds
• Chef's Amuse: TBD
• Entree: Seared Swai fish - Shaved Asparagus and Fennel
• Dessert: 3 Tastes of Chocolate Decadence

Proceeds from our dinner will be donated to the Elixir Fund to benefit cancer patients and their caregivers.

The cost is $100 per person.

Dee

Every Day is a Blessing!

Fun, Italian Food and Finding a Cure

On January 17th Rosa's Ristorante and Pizzeria in Hamilton, NJ will host an event to benefit the Teal Tea Foundation. Stop in any time between 11:00 AM and 10:00 PM and mention the Teal Tea Foundation and a portion of the sales will benefit the Foundation. Support doesn't get much easier than that.

Dee

Every Day is a Blessing!

NJ Bill Creates Ovarian Cancer Public Awareness Campaign

Thank you Assemblyman Benson for using Twitter to bring this to my attention.

danielrbenson Dan Benson

My bill establishing an ovarian cancer public awareness campaign by NJ DHSS passes Assembly unanimously

S-1711 Establishes ovarian cancer public awareness campaign in DHSS.

The bill was first introduced back in 2010. The Senate passed the bill in December of 2010 and sent it to the Assembly. The NJ Assembly passed the bill on December 15,2011 .

The Bill's sponsors were Senators Turner and Allen, and Assemblyman Benson,Vainieri Huttle, Riley,Quijano, Singleton, and Co-sponsored by Senators Beck, Greenstein, Madden, Ruiz, and Asssemblywoman Spencer.

The Bill's states:

"This bill establishes an ovarian cancer public awareness campaign in the Department of Health and Senior Services.

Under the provisions of the bill, the Commissioner of Health and Senior Services is required to establish the public awareness campaign to inform the general public about the clinical significance of ovarian cancer and its public health implications. The campaign would include risk factors, symptoms, the need for early detection and methods of treatment.

To carry out the public awareness campaign, the commissioner would, at a minimum:

-- provide for the development of printed educational materials and public service announcements in English and Spanish; and

-- disseminate information for distribution to the public, through a variety of entities, including, but not limited to, local health agencies and clinics, physicians, health care facilities, county offices on aging, pharmacies, libraries, senior citizen centers, other community-based outreach programs and organizations and the department's official website."

The goal of this bill resembles the Gynecologic Cancer action plan ( GY-8-1,2,3) of the NJ Comprehensive Cancer Control Plan. For the complete S1711 bill please see this page on the NJ Legislature's website and put S1711 in the Search By Bill Number box.

Thank you to each and every member of the Senate and Assembly who made the passage of this bill possible. A special thank you to Senator Greenstein and Assemblywomen Beck who represent my Mercer County district .

I look forward to Gov Christie signing the bill into law.

Dee

Every Day is a Blessing!

Did You Know You Can Prevent Cervical Cancer?

Poster from Women's Cancer Network

This month is Cervical Cancer Screening month in the United States.

Every woman can prevent cervical cancer by:

Getting regular PAP tests

Getting the HPV vaccine

Having the HPV test if recommended by your Physician

Want to learn more about cervical cancer? Please visit Tamika and Friends a national non-profit founded by Tamika Felder. I met Tamika in 2006. She is a cervical cancer survivor and a dynamic advocate who is raising awareness of cervical cancer and the link between the Human Papilloma virus and cervical cancer. Thanks Tamika for all that you do.

Dee

Every Day is a Blessing !

What is that I hear about Avastin?

Busy with holiday travel and gatherings I am just getting around to posting about the latest Bevacizumab/ Avastin ( made by Genentech ) news.

Two studies were reported in the December issue of the New England Journal of Medicine. How helpful is Avastin in treating ovarian cancer?

First, here are direct links to the NEJM previews of the articles and their conclusions ( You have to be a NEJM subscriber to read the full article) :

Study 1 Incorporation of Bevacizumab in The Primary Treatment of Ovarian Cancer

1873 women enrolled in the study.

Conclusion:"The use of bevacizumab during and up to 10 months after carboplatin and paclitaxel chemotherapy prolongs the median progression-free survival by about 4 months in patients with advanced epithelial ovarian cancer. (Funded by the National Cancer Institute and Genentech; ClinicalTrials.gov number, NCT00262847.)

"

Study 2 A Phase 3 Trial of Bevacizumab in Ovarian Cancer

1528 women enrolled in the study.

Conclusion: "Bevacizumab improved progression-free survival in women with ovarian cancer. The benefits with respect to both progression-free and overall survival were greater among those at high risk for disease progression. (Funded by Roche and others; ICON7 Controlled-Trials.com number, ISRCTN91273375.)

"Note: This article was an update of the Icon7 results previously reported. I heard preliminary results at the ASCO meeting in June.

Based on the authors conclusions the use of Bevacizumab improved progression free survival.

The NCI definition of progression free survival:

"The length of time during and after treatment in which a patient is living with a disease that does not get worse. Progression-free survival may be used in a clinical study or trial to help find out how well a new treatment works."

Let's look at the Progression Free Survival (PFS) results a bit closer. PFS for Study 1 was 10.3 months without Bevacizumab and 14.1 with Bevacizumab or an improvement of 4 months. The mean PFS for Study 2 was 22.4 months without Bevacizumab vs 24.1 months with Bevacizumab or an improvement of 1.7 months . Study 2 also looked at those women at high risk for progression and found that the PFS was 14.5 months without Bevacizumab and 18.1 months with Bevacizumab or a 3.6 month improvement. Study 2 did look at overall survival (which is harder to measure when other measures might have been taken to improve survival ).Median Overall Survival reported for Study 2 was 28.8 months without Bevacizumab and 36.6 months for the Bevacizumab group or 7.8 months.

When looking at these survival results one must keep in mind the side effects from the use of Bevacizumab. Study 1 reported more hypertension and gastro-intestinal perforations in the Bevacizumab group than the control. Study 2 reported the Bevacizumab group had "more toxic effects" than the control group.

For me the question is whether or not the 2-4 month progression free survival is worth the increased toxic side effects? I won't even think about cost - which is an entirely different discussion.

Here is how the media reported these studies:

Bevacizumab Delays Progession of Ovarian Cancer

Avastin for Ovarian cancer slows tumors but fails to prolong life

Avastin Passes Test in Delaying Ovarian Cancer

Avastin May Help Some with Ovarian Cancer:Studies

An article published today Avastin Disappoints Against Ovarian Cancer provided this information:

"The Genentech drug won approval in Europe for advanced ovarian cancer.But its maker has no immediate plans to seek the same approval in the United States. After talking with the Food and Drug Administration, "we do not believe the data will support approval" although no final decision has been made, said Charlotte Arnold, a spokeswoman for Genentech, part of the Swiss company Roche. "

To me the results of these ovarian cancer studies resemble the recently reported breast cancer studies and the FDA probably would not approve Avastin for ovarian cancer. I know women who have been taking Avastin for a long period of time and others who were on Avastin trials. When I recurred in 2008 I was offered a trial which included Avastin and I chose to not enter the trial so that I would be guaranteed surgery then chemo. I wonder how I would feel reading these results if I had chosen Avastin and felt that it is what has kept me in remission for 2+ years? If you are a survivor how do you feel about the results?

Avastin will continue to be approved for metastatic colorectal cancer, advanced non-squamous small cell lung cancer , metastatic kidney cancer and glioblastoma.

Dee

Every Day is a Blessing!

Hello 2012

I made it. Yup I'm here and it's 2012. Now that is pretty awesome.

I am looking forward to all 366 days of 2012. I'm sure all those days will not be sunny or easy but they will be and that is what is meaningful.

I don't really make resolutions because they are too hard to keep but I do have aspirations. I aspire to post more on this blog; fundraise for CINJ; help chair an inspiring One Force Symposium for OC survivors; paint more ; visit my daughter, son-in-law and grandson ; travel to a few more states ( I have 17 more to hit all 50) and move more. No not move to another house. I love the one I am in now . But I will move - walking, pilates, yoga, swimming because when I move more I feel better.

So stop back occasionally and see how I'm doing.

Happy New Year to you and yours.

Dee

Every Day is a Blessing!