Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts

Sunday, March 8, 2020

Online #coronavirus Information for Cancer Survivors

There is a lot of information available on the internet about the COVID -19 virus ( #coronavirus ) and what we know changes daily. Those with underlying conditions such as heart, lung  or kidney disease and compromised immune systems are at greatest risks. .

The best place to get your information is directly from the CDC. The page is updated regularly.
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
The CDC has a special page for People at Risk for Serious Illness from COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html

The WHO  ( World Health Organization) provides information at https://www.who.int/emergencies/diseases/novel-coronavirus-2019 .

Cancer.net has a page with advice for cancer patients ( https://www.cancer.net/blog/2020-03/coronavirus-2019-what-people-with-cancer-need-know) as do a number of cancer centers. Here are a few website,

Fred Hutch  - Corona Virus : What Patients Need to Know
https://www.fredhutch.org/en/news/center-news/2020/03/coronavirus-what-cancer-patients-need-to-know.html

Memorial Sloan Kettering Cancer Center - Novel Coronavirus(COVID-19) What You Should Know
https://www.mskcc.org/experience/become-patient/novel-coronavirus-covid-19

MD Anderson Cancer Center  - 2019 Novel Coronavirus Precautions
https://www.mdanderson.org/patients-family/becoming-our-patient/planning-for-care/coronavirus-protections.html?intcmp=HPFaces1_coronavirus_03052020

If you are like me and are interested in a visual way to see data regarding COVID-19 cases you may view Coronavirus Global Cases by Johns Hopkins CSSE at https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

You may also want to check to see if your county has specific information about COVIS-19 for their residents like my county in NJ.(http://www.mercercounty.org/departments/division-of-public-health/coronavirus-disease-2019-covid-19-outbreak ) 

Remember to follow this advice:



 If you have symptoms ( Fever, Cough, Shortness of Breath) or questions regarding your specific situation, please contact your Health Care Provider .

Dee
Every Day is a Blessing!

Saturday, December 14, 2019

A Virtual Gift of Resources

It is hard to believe that it has been a month since I last posted. Life can certainly keep one busy.

As I prepare for the holidays, I thought about doing something for my readers.

Here is my virtual gift to you - my choices of the best, most useful, reliable and sound sources of information and support for women diagnosed with cancer.

 Dee's Best Resources List

Best General Cancer Information Sites:
NCI Cancer Types https://www.cancer.gov/types
American Cancer Society https://www.cancer.org/cancer.html

Best Ovarian Cancer Information Sites:
Foundation for Women's Cancer   https://www.foundationforwomenscancer.org/
NCI Ovarian cancer site https://www.cancer.gov/types/ovarian
American Cancer Society https://www.cancer.org/cancer/ovarian-cancer.html
OCRA https://ocrahope.org/


Best Support Platforms:
Online Membership required
Inspire (OCRA) https://www.inspire.com/groups/ovarian-cancer/
Smart Patients https://www.smartpatients.com

SHARE  https://www.sharecancersupport.org/
LiveSTRONG https://www.livestrong.org/we-can-help
Cancer Support Community https://www.cancersupportcommunity.org/online-cancer-support
Survivorship Toolkit https://www.sgo.org/clinical-practice/management/survivorship-toolkit/ 
Support Connection https://supportconnection.org/

Best Hereditary Cancer Information
FORCE https://www.facingourrisk.org (Includes Peer support)
Sharsheret https://sharsheret.org/
National Society of Genetic Counselors http://aboutgeneticcounselors.com/

Treatment Guidelines and Information
NCCN : https://www.nccn.org/patients/guidelines/ovarian/index.html
CA-125 Information https://www.foundationforwomenscancer.org/wp-content/uploads/FWC-CA-125-Levels-Your-Guide.pdf

Sunday, December 2, 2018

Volunteers Needed for a Study on Self-reporting Symptoms During Cancer Treatment

Today I am sharing information about a study being done to determine the experience cancer patients have when reporting symptoms.  Sharyn Carrasco, RN, MSN, APRN is a student in the PhD program in Nursing Science at Texas Woman’s University and is conducting this study. The study has IRB approval. Please take a few minutes to read through the details about the study and reach out to Sharyn if you qualify and are interested in participating. 
 
 “Experiences of Self-Reporting Symptoms by Adults receiving Cancer Treatment”
 
Your voice is needed. Do you have cancer that is inoperable or metastatic and receiving cancer
treatment? Looking for volunteers to participate in a research study to talk about how you self-report
your symptoms.

This qualitative study is patient-focused, and the purpose is to understand your experience and
perspective of self-reporting your symptoms. There were many studies conducted over the past 10
years regarding patients self-reporting their symptoms, yet there were no studies that asked the
patients their perspective and experiences of self-reporting their symptoms. This is the reason for my
study; to talk you, the patient with cancer, about your perspective of self-reporting your symptoms. 
 
So, I am looking for volunteers to participate in this study to learn about how you report your symptoms. As a participant in this study, you would be asked to discuss your experience reporting your symptoms. This conversation will be with Sharyn Carrasco, the oncology nurse researcher, and can take place in person or via FaceTime/Skype. Your participation would involve 1 session, which will be approximately 60 minutes, including follow-up questions. If clarification is needed, one follow-up may occur to validate content, that may last up to 20 minutes.

If you are 18 years or older, have inoperable or metastatic cancer AND receiving cancer treatment,
please contact me for more information or to sign up to participate in this study at 713-503-4261 (text
or call) or email: scarrasco@twu.edu.

Dee
Every Day is a Blessing!
 
 
 
 

Friday, October 5, 2018

Answering the Questions We All Have About Sugar

Today when I checked out the latest postings to Beyond the Pink Moon, a closed international support group for those with breast and ovarian cancer, I ran across a post by Cathy Leman, a dietitian and breast cancer survivor. She shared with the group a recent post she wrote on her blog,  dammadaboutbreastcancer.com about sugar and cancer. I found it so informative that  I asked Cathy if I could share it in its entirely on this blog. Thank you Cathy for allowing me to share such valuable information with my followers.


The True Does Sugar Fuel Breast Cancer Story

Sugar, in all its stark white, sparkling glory is an enormously popular, widely misunderstood, and hotly-debated topic in the breast cancer world.

Rarely a week passes when I don’t hear or read “Sugar feeds breast cancer.” proclaimed with absolute certainty.
People accept this declaration as truth, yet I ask; does it really?
The annual October convergence of breast cancer awareness with the sugar-overload of Halloween is the perfect time for sharing sweet words of wisdom with my readers about the ubiquitous ingredient we love to hate and debate.
First, let’s make one thing clear. When I write about breast cancer nutrition, foods or diets, the first thing I do is hit the research. I’m a dietitian. I have a bachelor of science degree in nutrition. I will say this until the day I leave this earth – nutrition is a science, not an opinion.
While everyone rightly deserves to have their own opinion about nutrition (and foods and diets), I’m not “everyone.” I’m a nutrition professional AND a breast cancer survivor.
I have a professional, ethical obligation to write from the science, and a personal mission and purpose to develop and share trusted nutrition information that serves my breast cancer community. (1)
I take both very seriously.

What You Need to Know About Sugar NOW

So I asked myself what non-sugar-coated information would be most helpful for someone newly diagnosed, feeling frustrated and confused because they couldn’t find consistent answers to their questions about sugar and diet.
Here’s what I came up with:
  • will sugar really kill me?
  • is sugar really horrible?
  • does sugar cause cancer?
  • does sugar make cancer grow?
  • should I cut out sugar completely?
  • does sugar affect the chances of recurrence?
  • what amount of sugar can I eat and still be as healthy as possible going into treatment?
I then thought about the person who perhaps doesn’t give a rat’s ass about the science, feels overwhelmed and impatient by the idea of sifting through pages of conflicting online information and believes doing so would be about as effective as herding cats, and just wants to be told what to do.
If that’s YOU. . .

Start Here.

There are literally hundreds of studies and reams of information on sugar and breast cancer; there’s no way I could possibly cover it all in this single blog. Watch for more on this topic, but for the purpose of this article, here are my goals:
  • Provide a quick “Carbohydrates 101.”
  • Give you a tiny taste of the current research/science.
  • Provide a sweet guide to help you put this information into practice.

A Little Carbohydrate Background

Carbohydrates are one of three macronutrients (protein and fat are the other two) necessary in the diet to support energy, growth, and life, and include a wide range of starches, sugars and fiber.
Some sugars are NATURALLY OCCURRING, like the sugar found in fruits, vegetables, whole grains, and some dairy products. Other sugars, such as high fructose corn syrup, are produced commercially and then ADDED to foods.
“Carbohydrate” is a category that includes a wide range of starches, sugars (both naturally occurring and commercially produced), and fiber.
There are many TYPES of sugar, which are classified by chemists according to their chemical structure i.e. monosaccharides (single, simple sugars) and disaccharides (two simple sugars joined together), and several FORMS of sugar, i.e. glucose, fructose and galactose, which come together to create even more forms of sugar, like the lactose in milk (glucose + galactose), and the maltose found in molasses (glucose + glucose.)
The concern for newly diagnosed and metastatic patients is that sugar “feeds” cancer, making it grow faster and uncontrollably, hastening its potential and/or further spread throughout the body.

For patients undergoing treatment, there may be concern that sugar interferes with chemo and/or radiation. For women without a breast cancer diagnosis or are “NED” (no evidence of disease) post-treatment, the concern is that sugar will “cause” an initial cancer diagnosis or a recurrence.

A (very small) Taste of The Current Research

  1. Including “naturally occurring” sugars in your diet from fruits, vegetables, whole grains and dairy (i.e. PLAIN cow’s milk versus chocolate or other “flavored” milks which have ADDED sugar) is an eating pattern you can feel comfortable about. These naturally sweet (or “savory” whole grain) foods not only provide energy-rich carbohydrates, they’re loaded with vitamins, minerals, fiber, antioxidants, and phytochemicals versus only the empty calories of most added sugars. (2)
  2. Sugar does indeed feed cancer cells, as well as ALL of your other cells. Every cell in your body uses glucose (the “broken down” form of carbohydrate) for energy. Even on a no/low carbohydrate diet, your body transforms protein and fat into usable glucose (blood sugar) to support the function of your brain (which can use ONLY carbohydrate for energy) and all your other tissues.
  3. Because cancer cells are especially “hungry and hyperactive,” they consume glucose more quickly than non-cancerous cells. With the help of a radioactive compound very SIMILAR to glucose that allows detection of the metabolic activity (hungriness and hyperness) of cancer cells, medical professionals are able to see this phenomenon during a PET (Positron Emission Tomography) scan.
  4. Cells use sugar like cars use gasoline. Normal cells use a reasonable amount of gas, but because cancer cells divide at faster rates than normal cells, they’re gas (sugar) guzzlers. (3)
  5. Compelling epidemiologic studies have shown that dietary sugar intake has a significant impact on the development of breast cancer, but the data is inconsistent and the mechanism is unclear. One proposed mechanism for how sugar impacts breast cancer is through inflammation (obesity is a strong driver of systemic inflammation.) In one study, sugar did accelerate and promote the development of breast cancer in mice fed the equivalent of the average sugar consumption by the American population – 70 pounds/person/year according to this particular study – through changes in metabolic signaling pathways and the expression and production of certain proteins linked to the inflammatory response. Takeaway: sugar DID NOT DIRECTLY cause breast cancer, rather, it exerted influence on a particular signal and pathway involved in promoting its development. (4)
  6. Another very small study, again, done on mice and only certain types of breast cancer cells in culture and for select chemo medications, indicated that sugar may interfere with the body’s response to and effectiveness of chemotherapy, calling for further investigation to achieve definite outcomes and practices for real-life applications. (5)
  7. When carbohydrates are eaten, the body increases its output of insulin to help return post-meal blood sugar levels to normal. Failure of insulin levels to return to normal after the blood sugar is cleared indicates insulin resistance and high levels of insulin remaining in the blood. Insulin resistance can result from obesity and inactivity; insulin resistance is associated with higher breast cancer recurrence risk. (6)

A SWEET Guide To Help You Navigate Sugar Challenges

  • Aim to keep your ADDED sugar intake to 10% or less of the TOTAL calories you eat daily:
    • For example, if you eat 2,000 calories per day, all the calories you eat from ADDED sugar for the entire day would equal 200 calories. Remember, that’s CALORIES not grams, there’s a difference (see below.)
  • Added sugars are found in:
    • candy, cookies, cake, pie, brownies, muffins, sweet rolls and pastry, ice cream, sorbet, gelato, sweetened beverages like juice-drinks, fruit punch, sports drinks, sweetened iced tea, bottled smoothies, soda and coffee drinks, cereals, some breads, ketchup, barbeque sauce, spaghetti and tomato sauces, flavored milks (plant-based and cow), flavored yogurt, protein and cereal bars, salad dressing, canned baked beans (this is NOT a definitive list – check ingredient labels!)
  • 1 gram of sugar has 4 calories:
    • If a food label shows 5 grams of sugar in one serving, that food gives you 20 calories of sugar (5 grams x 4 calories.)
  • When choosing packaged foods, look at the “ingredients” label.
    • If you see any of the following terms, you’ll know there is ADDED sugar: brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, invert sugar, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, turbinado sugar.

What 200 calories/day of Added Sugar Looks Like

Breakfast

  • 1 packet instant maple and brown sugar oatmeal; 12 grams sugar (48 calories from sugar)
  • 1 cup vanilla almond milk; 13 grams sugar (52 calories from sugar)

Lunch

  • 2 tablespoons honey Dijon dressing; 5 grams sugar (20 calories from sugar)
  • Mixed greens salad with 1 ounce candied walnuts and 2 tablespoons dried cranberries; 9 grams sugar + 13 grams sugar (88 calories from sugar)
Surprise! You’re already at 208 calories from sugar and your day’s not even over.
This example isn’t meant to prevent you from eating ANY added sugar, rather, to give you an idea of how added sugars can creep in without you being aware. This is an easy fix!

Fix It Like This. . .

Choose plain instant oatmeal and add 1 teaspoon honey, use plain (no-sugar-added) vanilla almond milk. Add olive oil and balsamic vinegar to your salad, raisins vs dried cranberries (raisins have natural vs. added sugar) and non-sugared, toasted walnuts.

Sources

  1. Code of Ethics for the Nutrition and Dietetics Profession
  2. “Does Sugar Feed Cancer?”
  3. “Does Sugar Feed Cancer? It’s Not That Simple.”
  4. “Dietary sugar induces tumorigenesis in mammary gland partially through 12 lipoxygenase pathway”
  5. “Modification of dietary sugar on the chemotherapeutic potential in breast cancer”
  6. “Obesity, Insulin Resistance and Insulin”

If you would like to see the photos that accompany the post please visit http://dammadaboutbreastcancer.com/sweet-guide-help-navigate-breast-cancer-sugar/ .

I hope you learned some important new facts from this post. 

Dee
Every Day is a Blessing!
 

 

Thursday, June 30, 2016

NJ's Regional Moonshot Summit

Yesterday hundreds of researchers, oncologists, advocates,  insurance and pharmaceutical industry representatives met at Howard University in DC for the Cancer Moonshot Summit.

Here in NJ running concurrently with the DC meeting we held a regional Cancer Moonshot Summit.  As in DC advocates, insurance and pharmaceutical industry representatives, oncologists and others met at the Cancer Support Community Central New Jersey (CSCCNJ) to discuss the initiative. Cancer Support Community is a partner in the Moonshot Initiative lead by VP Joe Biden. The Regional Summit was co-sponsored by Rutgers Cancer Institute of NJ. This regional Summit was an excellent way for individuals to share their ideas and provide input to the  White House Cancer Moonshot Initiative.

The NJ Summit included watching VP Biden's speech from DC and a panel discussion. The panel included D. Toppmeyer, MD Rutgers Cancer Institute of NJ, U. Dugan, MD, PhD Bristol Myers Squibb, E. Levine LCSW, W. Wengel III Aetna, D. Gonzalez, US Dept of Health and Human Services and myself.

Panel participants .
Photo courtesy of @RutgersCancer
We discussed putting patients at the center - how to improve the experience of patients when initially diagnosed, after treatment as well as those treating cancer as a chronic illness as well as how to insure the information patients read online is accurate.  We also discussed the best way for oncologists in a community setting to be on top of the latest treatments and clinical trials. We ended with a short discussion of how to recruit patients to clinical trials and dispel the myths associated with clinical trials.

I was honored to be a part of this initiative. I am usually the one Tweeting from conferences but multitasking at this event was a bit of a challenge. So I share this Tweet with you. 

I have also submitted ideas to the Cancer Moonshot through the website. Do you have an idea? The site is live until July 1,2016 

As VP Biden said "This is Urgent" and I agree . This initiative gives me hope that we will develop a screening test.

Dee
Every Day is a Blessing!





Thursday, October 1, 2015

It Is More Than Pink and Teal

It is about research.

In October, I see posts online from women diagnosed with ovarian cancer and other gynecologic cancers complaining and peeved about being surrounded by pink ribbons - on TV , in stores, on shirts, etc. Even women who have breast cancer write about how they see pink ribbons on items that appear to just be a way to sell products. They note that the  percentage of money earned from these products actually going to an organization is small.There are other complaints about a large breast cancer non-profit and how so much of the money raised doesn't go to research. Women with metastatic breast cancer are asking to be "seen and heard".  They want a greater amount of funds used for metastatic breast cancer research. I can understand why each person complaining or asking for recognition of ovarian cancer feels the way they do.  And believe me I have my share of teal shirts , earrings, etc and a few pink things too.  In October 2011, I even wrote a post about the "pinking" of the NFL.

My friend Christina and co-moderator of the #gyncsm chat said this on twitter.


 

So true. But what should that action be?

My life has been impacted by cancer in many ways in addition to my ovarian cancer diagnosis. My sister at the age of 42 was diagnosed with breast cancer and had a mastectomy and chemotherapy. She had a bone marrow transplant when her cancer metastasized. She passed away five years later. It has been twenty years since her passing.  And metastatic breast cancer continues to kill women - as does ovarian cancer in the ten years since my diagnosis.

Why is that? Cancer is a very complex disease. After attending medical conferences and listening to researchers I know that.  But how does spending money on items that are pink or teal for that matter make a difference?So the next time you make a donation to an organization or buy a product check out how much of the dollars raised actually goes to research.

Let's spend money on research. Because  the only way we will be able to understand cancer - breast, ovarian, kidney, lung, pancreatic   is through research.

What will you do to support cancer research?


Dee
Every Day is a Blessing!





Monday, August 10, 2015

Paying it Forward- 7 years

This arrived in the mail from Cancer Hope Network .


I love the sentiment on the front. Then I opened it and saw that it was a thank-you for the seven years I have been a support volunteer. Wow! I remarked to my husband that it sure hasn't seemed like seven years.

Back in 2005 I was upset. I knew the statistics about women diagnosed with late stage ovarian cancer. Jeez I knew that Gilda Radner died from that disease. I just wanted to talk to someone who had the disease and lived. Heck I didn't even meet any women in my cancer center with the disease. So when I saw a brochure for Cancer Hope Network in the waiting room I picked it up and brought it home. I hesitated at first to call. I'm not too keen on cold calling someone. But one afternoon as I sat in bed I went ahead and called. I told the person who answered that I just needed to talk to someone who had been in my situation and lived. She took all my information and said she would call back when she had a match. The very next day she called and said she could connect me right then and there with a volunteer. I spent the next half hour talking to a women diagnosed with 3b, lived in my state,  had the same chemotherapy and surgery and was a 5 year survivor. It was wonderful. I was not alone. I could survive too!

When I was out of treatment one year I called Cancer Hope Network and said I wanted to be one of their support volunteers. I did training and within a week or two I was talking to other women with ovarian cancer. I have been volunteering ever since. Although I did take a break when I recurred and was back in treatment but once treatment was done I was back on the phone.

I have spoken to women from NYC, Florida, California, Indiana and Kentucky just to name a few. I have spoken to women treated in the top cancer centers in the country and those going to community cancer centers and oncologists. I have talked to women who are a short ride from their doctor and center and those that drive eight hours or take a plane and stay at hotels when then go for treatment.But each and every time I remark "I felt that way too" the reply is the same " thank goodness I thought it was just me."

Thank you Cancer Hope Network and all their volunteers for supporting those diagnosed with cancer. If you are newly diagnosed with any cancer or a caregiver for someone diagnosed with cancer you may call( 1-800-552-4366 )  or visit the Cancer Hope Network website online  to be matched with a survivor.

Dee
 Every Day is a Blessing !

Friday, June 26, 2015

Science , Communities and Life with Cancer- The 3rd Annual AstraZeneca Bloggers Summit

On June 24th,  I attended the 3rd Annual AstraZeneca Bloggers Summit.  The day gave me an opportunity to meet other bloggers and to learn about social media and topics of interest to cancer patients and survivors.

What I learned at the Summit can be separated into three areas-science, communities and life with cancer.

The Science:
Photo provided by AstraZeneca
Deborah Torgersen-Paul, PhD (Executive Medical Science Liaison, AstraZeneca) presented the Evolution of Science and Understanding Cancer. Dr Torgersen-Paul began her presentation with a discussion of how the Human Genome Project changed our understanding of cancer.  She then went on to explained the role of oncogenes, tumor suppressor genes, cell death from chemotherapy and apoptosis( a cells normal death). She described driver mutations and how small molecules (such as Parp inhibitors) are used. She also discussed immunotherapy (which I heard a lot about while at the ASCO meeting this year). Some cancers don't stimulate the immune system as well as others so if we can find ways to boost our body's immune system the better we can destroy the cancer cells.  She also described work going on in immuno-oncology in which chemotherapy and immunotherapy are given together.  Lastly, she spoke of the research into circulating tumor DNA (ctDNA) , also  called a liquid biopsy,  and its role in screening for different cancers.

 After the presentation we took a tour of the Phase 1 laboratories at MedImmune where the Summit was held.
Oncology Bloggers at the Summit had the opportunity to see the MedImmune Phase1 labs.

Our Communities:

Photo provided by AstraZeneca
Ciaran Blumenthal (@momfluential) , a social media and marketing expert provided insight into "The Story of Us: Best Practices for Growing Communities Online". We ( the oncology bloggers)  were all at the summit because we share our story with a community of followers. Ciaran began by defining a community and the differences between online and "in real life" communities. She then talked about how characters can develop the community - content creators, experts, influencers and supersharers. She stressed the importance of the Hashtag in social media. From my own experience, the #gyncsm hashtag has been important in growing and sharing information among members of the gynecologic cancer community especially between our monthly chats. She then went on to discuss online platforms - blogs, Instagram, Twitter, YouTube, Pinterest and the strategies that can be used to grow a community. She stressed how content is key!

Life with Cancer:

Photo provided by AstraZeneca
Sage Bolte PhD, director of Life With Cancer,  presented the afternoon sessions geared toward different aspects of living with cancer.

Did you know that patients should be asked their distress level at each doctor visit? Studies have shown that 50% of all cancer patients experience a high level of distress ( emotional , mental, social, spiritual) during treatment. Lung, pancreatic and brain cancer patients report the highest levels. One in four cancer patients will experience depression. It has also been found that patients with lower quality of life experience more depression. When a person has situational depression it has been found that as the stressors patients experience subside so does the depression . When clinical depression occurs medication and therapy( cognitive or behavioral) may be prescribed.

Then Dr. Bolte talked about anxiety and fear.  I could definitely relate. To this day when I have to have a CA-125 test or CT scan my anxiety level shoots through the roof.  And it was good to see some of the things I use to calm down were listed in Dr Bolte's list of things to do to deal with anxiety.
  • Stillness- prayer, mediation, allow to grieve, acknowledge ( I have a favorite mantra.)
  • Motion- exercise, journaling, etc ( I love to paint when I am  anxious.)
  • Ignore- this is ok for short periods of time ( When I learned my friend had passed last month I did choose to ignore it for a few hours. )
For the last session of the day, Dr. Bolte talked about Sexuality and Intimacy. Health care providers are as reluctant as patients to discuss the impact surgery and treatment have on the sexual life of their patients. A number of sexual challenges occur when a person has cancer:
  • Cancer itself
  • Psychological Distress
  • Cancer Therapy
  • Side Effects
  • Alterations in relationships
One of the physical problems associated with the instant menopause many women enter into after gynecologic cancer surgery or due to cancer treatment is vaginal stenosis- a narrowing of the vaginal canal. There are a number of techniques ( dialators, lubricants ) that can be used when the condition develops.

As I was listening to Dr Bolte I noticed that the key word she kept using was communication. Cancer patients / survivors should communicate with their partner, spouse, family, friends and physician so everyone is aware of what you need and don't need. I can agree with that 100%.

One of the best parts of the Summit was being able to spend time with the other bloggers. Since I follow most of the bloggers online it was wonderful meeting them in person. Below is a list of my fellow blogger's names as well as links to their blogs and twitter handles. 

Katie Brown - Lung cancer
Website/blog: www.lungevity.org & www.iamkatiebrown.com 
Twitter @LUNGevity & @brownbeansprout
 

Dian “CJ” Corneliussen-James - metastatic breast cancer
Blog http://www.metavivor.org/blog/
Twitter @METAvivor

Katherine O'Brien - metastatic breast cancer
Website https://ihatebreastcancer.wordpress.com/
Twitter @ihatebreastcanc

Jennifer Campisano- metastatic breast cancer
Blog http://www.boobyandthebeast.com/
Twitter @Jcampisano

Alana Ray Osborne  - general cancer
Blog: http://www.powerfulpatients.org/blog/
Twitter @alanaray40

Thank you AstraZeneca and MedImmune for such an informative day!

Dee
Every Day is a Blessing!




Friday, November 7, 2014

The Words I Use

Over the past few weeks I have taken part in a number of tweet chats and Facebook discussions that revolve around the words we use when we are diagnosed with cancer.

People diagnosed with cancer and those who treat them often use the term "survivor". The NCI definition of survivor is:

 "One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.".

When I was in treatment I called myself a cancer patient. When I finished treatment I called myself a survivor and that word choice was solidified when I attended the LiveSTRONG Survivors Summit in 2006. Then I recurred, I wasn't sure what to label myself- I was a cancer patient and a survivor.  At the time I was on my cancer center's Survivorship Day planning committee.  I even questioned whether or not it was OK that I be a committee member since I had recurred and was back in treatment. The chair told me she considers everyone from the day of diagnosis as a survivor. Since that day whether I am in treatment or not I have called myself a survivor.

I know there are women with recurrent ovarian cancer or metastatic breast cancer who don't like the term survivor. Susan Gubar shares her thoughts on words like survivor in this article from 2012.
( http://well.blogs.nytimes.com/2012/09/06/not-a-cancer-survivor/?_php=true&_type=blogs&_r=0 ) Women are looking for a different word to describe their situation. What to you say when you are living with cancer? What about women who are living for long periods of time with stable disease and are not in treatment? I have read that some use the word "thriver" . That is an interesting word - thriving while in treatment and thriving between treatments.

In other online discussions, I have found people do not like using words that relate cancer to terms of war such as battle or fighter. When I was in treatment I felt I was in a battle. I was in a battle for my life. And my weapons were the chemotherapy drugs I took and the support I had and the prayers I said. I visualized the chemo traveling via my blood into the cancer cells and killing them. Yes, I fought cancer. And I would not have been able to do that without the expertise of my doctors and their surgical skills and their ability to offer me clinical trials and chemotherapy options. Will I recur? I'm not sure but if I do I will fight again.

Do I think any less of women like Pam, Sharon, Rita Kay, or any of the other women from my support group who died because of their disease. No. Do I think they didn't fight hard enough? Heck NO! If their families want to say they "lost their battle" I am OK with that.  And if you are in cancer treatment and you disagree with me that's OK you may have your opinion and I have mine. Two pieces, one by Aria  Jones (http://www.mcsweeneys.net/articles/an-open-letter-to-people-who-use-the-battle-metaphor-for-other-people-who-have-the-distinct-displeasure-of-cancer  ) and one by Kate Granger (http://www.theguardian.com/society/2014/apr/25/having-cancer-not-fight-or-battle ) offer the opposing view. This article "Fighting Battles and the Language of Cancer"in  Journeying Beyond Breast Cancer  discusses metaphors and feelings of guilt in those with terminal disease (http://journeyingbeyondbreastcancer.com/2014/11/06/fighting-battles-and-the-language-of-cancer/) but suggests the metaphors are important as a tool to handle our experiences . You may make up your own mind as to which terms work best for you.

I know by putting my thoughts and opinions on this page I open myself to people who will disagree with me. That is fine as long as you do so while respecting my opinion of the words I choose to describe my journey with cancer.

Dee
Every Day is a Blessing!

Wednesday, May 21, 2014

2014 Annual Retreat on Cancer Research In NJ: Public Forum Personalized Cancer Therapy

For the past few years, I have attended Public Forums that are part of the Annual Retreat on Cancer Research in NJ. Today's forum on Personalized Cancer Therapy held a special interest for me.

I have always wondered how my cancer was different from other women who were diagnosed with Stage 3 serous papillary epithelial ovarian cancer (high grade). Why did my tumors respond so well to chemotherapy treatments? Why was I able to go into remission for a second time for a longer period of time than my first remission?  Well, there are researchers in NJ who are asking the same questions. They are looking beyond the organ and histology but looking at the genetics of tumors. 

You may recall that last year I was asked to participate in a clincial trial in which tumor tissue from my initial diagnosis and my recurrence well as my blood would undergo genetic sequencing.  I learned a bit more about that process today at the public forum. 

Dr. Shrindar Ganesan, Rutgers Cancer Institute of NJ ( RCINJ),  and the lead investigator of the trial I participated, in welcomed everyone to the forum. He explained that genome sequencing is generating a large amount of information and what must now be done is to transfer that into useful knowledge for patients. He also said that each patient has a unique response to treatment be it chemotherapy, immunotherapy or targeted therapy. He then went on to introduce each of the other speakers. 

Dr. Kim Hirshfield ( RCINJ ) began "Next-Generation Sequencing for Every Generation:Everything you Need to Know but Didn't Know to Ask"  by telling us that "one size fits all" in cancer treatment does not work due to differences in individuals and tumors. She went on to explain about chromosomes, genes and how proteins are involved in the growth, proliferation , death and movement of cells. She described oncogenes and tumor suppressor genes and how they can cause cancer. There are also different type of mutations: germline mutations which are mutations you are born with and  somatic mutations those which are acquired later in life. 

Dr Hirshfield then went on to describe the Precision Medicine Initiative in which researchers are trying to understand the biology and mutations of tumor cells in order to offer patients the best treatment. Tumor samples are evaluated for 236 genes. The data from the evaluation is presented to a Molecular Tumor Board which helps determine the treatment. So far 100 patients have taken part in the Initiative. Twenty percent have been prescribed treatment based on their evaluation, another 20 percent have treatment plants but have not yet been prescribed the treatment due to the fact that they are stable or are in remission at this time. For the remainder of the patients some are no longer participating in the study for various reasons and for some there are no current drugs or trial drugs available for their specific mutations. In the 100 patient tumor samples tested there was an average of 3.6 mutations. 

Hetal Vig, a genetic counselor at RCINJ, presented "Capturing the Spectrum of Hereditary Cancers:A Moving Target in the Setting of Targeted Therapy.  She spoke about family pedigrees and germline mutations. Women with BRCA1 mutation have a 60% risk of developing ovarian cancer while those with the BRCA2 mutation have a 25% risk of developing ovarian cancer. She then went on to mention Li-Fraumeni Syndrome ( I had not heard about this syndrome before and will have to look into it further.) This syndrome is linked to the p53 mutation. Hetal also said that all cancers are genetic but not all cancer is hereditary.  

Although the last speaker, Dr Janice Mehnert (RCINJ), spoke mainly about melanoma I found her presentation very exciting because of the progress that has made in less than 10 years in Melanoma treatments. In 2006 there was no good treatment for melanoma. Then they found that they could target the BRAF and MEK genes with some success (Vemurafenib). There has also been success with immunotherapy by targeting the PD1 and PDL1 genes. It may be possible to use targeted therapy and immunotherapy together but clinical trials are needed since more targets may translate into the treatment being more toxic to the patient.  Dr Mehnert then said that "Your tumor is your life" and the focus should be on the understanding each patients tumor. 

During the question and answer period I learned that:
The more suppressed the immune system the more cancer.
When using immunotherapy there may be an increase in tumor size due to inflammation but if the therapy is effective subsequent shrinkage will  occur. 
The researchers agreed that more advocates are needed to raise awareness of the importance of participation in clinical trials.  

I am so pleased to see such important research being done right here in NJ. I also urge my readers to consider participation in a clinical trial. It is through clinical trials that the knowledge we need to better understand how to target our individual cancers can be found. 

Dee
Ever Day is a Blessing!


Sunday, December 1, 2013

George Johnson's "Cancer Chronicles..."

I often describe myself  as a cancer information "hound". I am always sniffing out new information about cancer in general and gynecologic cancers in particular.

I first heard about George Johnson's new book Cancer Chronicles Unlocking Medicine's Deepest Mystery in September. George Johnson is an accomplished science writer. He has been published in the New York Times, National Geographic and  Scientific American and wrote nine books. When I learned that he was prompted to learn more about cancer and write this book when his wife Nancy was  diagnosed with uterine papillary serous carcinoma I knew I had read the book. So I put my name on the  reserve list at my local library.


Last week my name moved to the top of the list and I picked up the book. I began reading it as soon as I got home.. The first chapter with its' discussion of cancer in dinosaurs (spinal bones from Hadrosaurus skeletons exhibit cancer.) drew me right in to the book.

Johnson covers topics from epidemiology and the structure of DNA to clinical trials, risk factors and mutations. He discusses how chemicals and environmental issues originally thought to cause cancer have been found to play a less prominent role. The book is an interesting mix of history ( he speaks of  Madame Curie in a section on radiation) and recent studies of herceptin, hedgehog genes and translational research. His wife's journey through surgery and treatment are woven into the factual information he provides.

Johnson never forgets who his audience is. He explains difficult concepts in a way that any cancer patient, survivor or caregiver can understand. He provides 60+ pages of notes and sources at the end of the book.

I highly recommend this book and regret having to return this copy to the library. I guess I will just have to buy my own copy.

More information about the book and author can be found at http://talaya.net/chronicles/.

Dee
Every Day is a Blessing!

Thursday, August 29, 2013

Cancer: My Unwelcome Traveling Companion (or: Who is @btrfly12?)


I am pleased to share this post written by Christina Lizaso my fellow moderator of the #gyncsm chat. 

Thanks so much to Dee for providing me a space here to tell my story. She is such a wonderful, influential patient advocate. I am working with her to build #gyncsm, an online community for those impacted by gynecologic cancers (cervical, ovarian, uterine, primary peritoneal, endometrial, tubal, GTD, vaginal, vulvar). Here's why I'm passionate:

Cancer has been a theme in my life, but one that I chose to ignore and let lie in the background. So here’s my story of how cancer has shaped my life to this point.

When I was in the first grade (circa 1983), I lost my maternal grandfather to pancreatic cancer. My “Papa” was one of the great men and heroes in my life up to that point. A coach and trainer of young men, he was also a journey-man philosopher. Pancreatic cancer being a “silent cancer” typically found in its advanced stages, there wasn’t much time to adjust to him being sick, weak, and gone. My dad would sneak me into his hospital room though a construction entrance because Papa considered me “his best medicine”, despite the age restrictions for visitors. After the funeral, I remember feeling a certain peace and coloring a picture of him as an angel going up from the graveyard to heaven. My grandmother lost a big piece of herself that day and remained tight in her shell in a house on a hill in the country. A good reminder to me to fight my own tendencies to remain closed off and hideout when the storms of life come.

Early pre-teen years brought the loss of my paternal grandmother. We aren’t actually sure if this one was cancer. She lived with us for a while during her illness and those were great bonding days. Both the good times (watching All My Children together that summer) and the inevitable bickering of pre-teen vs. another female in the house brought us closer. I’m told by my mom that the description we were given was that there was a growth wrapped around the artery to the lung cutting off circulation and limiting the oxygen in her blood. I remember being called to the hospital late in the night and receiving the news of her death. My mom, dad and I just stood in a big circle hug and cried for a long, lingering moment. Since she died within 18 hours of the above description, we did not seek further details. Her actual cause of death was a heart attack. The doctor actually told mom and dad: "The operation was a success but the patient died." That was quite an emotional night for all of us.

Later on, my great-grandfather passed away from leukemia. Now, he was in his 90s and his rickety old house was falling down around him. He always said not to worry because the house would outlast him, and he was right. He was a man of quiet confidence, as many farmers are, and I admired him greatly.

My mom was diagnosed with breast cancer in 1998 during my senior year of college. It seems ludicrous to me now that I don’t know the stage and type other than it wasn’t a lump, it was in the ducts. Looking back I know that I wasn’t there for her and my dad with the support they needed when faced with cancer. My mom was his everything. An only child, he had no siblings to lean on. My college was just across town, so I was close-by but I was dealing with my own process of facing this as a daughter. I did get her a beautiful ceramic angel with painted light pink skirt because that seemed more lasting than flowers or food.  My mom tackled cancer the same way she approaches everything, with research, an organized notebook and a plan. Having lost her dad to cancer, her attitude was GET THIS CANCER OUT OF ME. Mastectomy and no reconstruction. She was fortunate that it had not spread to the lymph nodes (so stage 1 or 2?) and she did not have to go through chemo. A few months after the surgery, it was Komen Race for the Cure time and we were there. It was powerful and moving being in a sea of thousands who had been through something similar. When in graduate school, I did the Race for the Cure in that city with a classmate who had been diagnosed and also flew back home to be on my mom’s team. It felt important to support her in that way.

Next came my maternal aunt. A different and more aggressive type of breast cancer than my mom’s. My aunt is a music teacher and organist with a passion for those may be overlooked in life. I had just started working at a hospital and I put my aunt in touch with the fabulous woman who ran the cancer store and I got her some lovely, soft turbans. Chemo was grueling but she pushed through it. Could I have done anything for her son, my cousin, to support him during that time? I don’t think I knew how. Later she had genetic testing and it didn’t indicate that others of us in the family should be tested. Said her cancer was most likely from some of the medications her mom had been taking while pregnant with her. She and my mom do Relay for Life together each year and gain strengthen from that community.  She’s had had two recurrences. The first was in the non-affected breast from the first round and was the same type as my mom’s. The most recent was a mix of cell types found and with the chemo she got an infection in her fingernails so bad there was at one point a chance she’d loose her fingertips. Cancer threatening the fingertips of an organist - how foul. Months later she got an infection behind her expander placed for reconstruction and had emergency surgery. She remains strong.

Dad…
I was living on the third floor of an old house during grad school and that is where I was when I got the call that stopped my world. In what must have been one of the hardest conversations of his life, my dad told his “daddy’s girl” that he had leukemia, the same strain as his grandfather, CLL. The early on-set was later attributed to his chemical exposure in Viet Nam. I asked him if I should come home and he said no, to stay focused on school (a high priority of his for me his whole life) and wait for the holiday break. Grad school is stressful enough but this was just overwhelming. Again, it seems ludicrous now that I don’t know the details of his treatment regimen but my denial of cancer was that powerful. I wondered if he would make it long enough to walk me down the aisle and have a daddy/daughter dance at my wedding. And a couple years later in 2001, he did and it was the sweetest thing.

Dad joined all the on-line discussion boards he could and kept in touch with many others in the CLL community. Patients have to band together, be their own advocates, and have others pick up for them when they can’t advocate for themselves. I had been working in a hospital about 8 months when he was due for a major surgery. [Looking back – why was he fighting cancer at a rural hospital?] Armed with “knowledge from the inside”, I’m sure the nurses hated me. When things weren’t going right, like the roll-away bed my mom had been promised for the night before his surgery that we were being told wasn’t available now, I knew the magic words: “Ok, then I will just reach out to the Admin On Call”. A rollaway bed magically appeared. Victory - a proud daughter who could use some of her knowledge to do something, ANYthing to help. Again, looking back I don’t think I was there for my mom like she needed. After a long surgery, in which well meaning people were trying to distract me with small talk despite my need for reflective time, we got the devastating news, the cancer was too far along and it was time to talk hospice and the dreaded “quality of life”. There in the hallway I told my mom I was sorry that I wasn’t the kind of daughter that had children early in life so dad could be a grandfather. He would have been an amazing one. She told me to never feel bad about the kind of daughter and woman I am, but this still pains me.

I made the long drive to see him every weekend. I made him a CD of music I thought he would like, but it was about a month too late. He wasn’t aware enough of things by then. Did he wait to be alone with my mom for the final moment? I was in a work meeting about some issue that was being blown out of proportion due to politics. When I got back my boss said my husband had been trying to reach me. And I knew. I guess my mom couldn’t bear it and so called him for him to tell me. It is still hard talking to her sometimes because then I have to think about dad too.

The next year is a blur and the only way to describe the loss of a parent that I have found is that you feel exactly how it feels when you are physically lost. My daily commute was a daily chance to cry. I have a strong interest in end of life, palliative care and hospice topics.  I have a piece brewing in my head about the details of my dad’s last days.

In 2011, my maternal uncle was diagnosed with prostate cancer. That is a slow growing cancer and immediate surgery is not always the recommended course of action. My mom and her sister agonized over the news. The last thing in the world they wanted was for their brother to join them in the “I had cancer club” and they also wanted the cancer out of him. When surgery was scheduled, they put their lives on hold to be there at every step for their big brother.

Throughout my life, whenever the topic of cancer would come up, I would pretty much figure that cancer would be coming for me eventually. So I guess you could stay cancer has been an unwelcome “along for the ride” companion in my life. I pretty much ignored this unwanted passenger it until I started working for a cancer nonprofit. In the interview, they asked about my cancer connection and I talked about my mom and aunt being breast cancer survivors. It didn’t even enter my mind to talk about losing my dad. I had been on the job about a month before I realized that. That is how walled off I keep that part of my life. Getting into the job, I dove into reading all the educational materials provided by the organization. As I was reading, I realized that I was reading everything from the perspective of someone who very likely would be needing all of this information as a patient one day. A moment of clarity. A look into my future.

I’ve known that I wanted to work in nonprofit management since seventh grade when it became clear that a calling to serve for me meant outreach and behind the scenes mission-focused work. Having such clarity at such a young age, what didn’t become clear was where within the nonprofit world I should serve - hence heading right off to grad school after undergrad. I always figured something in social services and ignored healthcare (skipping those sections in my graduate school reading – ha!). Yet, here I am. I worked in a hospital setting for six and a half years and now work for an education and awareness cancer organization. I have found a passion for healthcare and the people in it. I just didn’t want to face up to it and my intimate connection to it early on. So now, I have a daily relationship with cancer instead of pretending it isn’t right there along beside me, in waiting.

Christina Lizaso, could be described by the labels associated with those touched by cancer: co-vivor, previvor, fighter, etc. but by her own description, she is a mom to two sweeties, a wife, and a community engagement professional whose life has been touched - and given purpose - by cancer. Follow her on twitter: @btrfly12



Don't forget to join us on September 11,2013 at 9pm EST for the #gyncsm chat. 

Dee
Every Day is a Blessing!

Monday, December 3, 2012

Metformin and Ovarian Cancer

A article titled " Metformin intake is associated with better survival in ovarian cancer" was published today in the journal Cancer . Metformin is a drug used to treat type 2 diabetes. The research was done at the Mayo Clinic College of Medicine.

This retrospective study showed that women with epithelial ovarian cancer who were taking Metformin had significantly better survival compared to women with epithelial ovarian cancer who were not taking Metformin.  The 5 year disease specific survival for cases vs control was 67% vs 47%.

The conclusion was"The results of this study indicated an association of metformin intake with survival in patients with ovarian cancer. The receipt of metformin was associated with better survival, and the authors concluded that metformin is worthy of clinical trials in ovarian cancer. Cancer 2012. © 2012 American Cancer Society."

This is an interesting line of research and I look forward to seeing the results of future prospective clinical trials.  Source : http://onlinelibrary.wiley.com/doi/10.1002/cncr.27706/abstract
Metformin information: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a696005.html

Dee
Every day is a Blessing!


Monday, October 17, 2011

A Worthwhile Read


In July,at my support group meeting I mentioned that I had just finished reading The Immortal Life of Henrietta Lacks and had written about it on this blog. Another survivor asked me if I had read The Emperor of All Maladies - A Biography of Cancer by Siddhartha Mukherjee. She told me that it should be the very next book I read.

I put my name on the reserve list for the book at my local library and I waited. But early last month I decided to not wait any longer and I purchased my own copy. I am so glad that I did.

Don't let its large size, 470 pages, stop you. The Emperor of All Maladies is a brilliantly written history of cancer. From the first description of cancer in Egypt in 2500BC to describing the discovery of the drug Gleevec and the Human Genome project, Mukherjee kept me engaged. The glimpse we had at the care he provided his patients was wonderfully linked to the history. Mukherjee presents complex microbiological and genetic processes in a way that is easy to grasp. As I read about the ras pathway I found myself wishing I had read the book prior to going to the ASCO conference in June.

I finished the book feeling that each research development described, some with more positive results than others, has given us a better understanding of cancer that ultimately will lead to - dare I day it - a cure.

I highly recommend this book.

Dee
Every Day is a Blessing!

Wednesday, October 5, 2011

I Often Ask Myself

As a six year ovarian cancer survivor I often ask myself these questions.
" What makes my cancer different from other women with the same type ovarian cancer?"
" Why have I responded so well to the chemotherapy treatments?"
"Why have so many other women I have come to know during these past six years with the same type and grade of ovarian cancer been unable to go into remission and pass away from the disease"

I know that ovarian cancer is not one disease but that it has many types and subtypes. Some ovarian cancer is cause by a broken pathway , some by genetic mutation and some by ways we are just learning about. I know a lot about my disease , stage , tumor grade,tumor type , whether or not I am estrogen positive or negative, whether or not I am progesterone positive or negative, whether or not I am Her-2 positive or negative. I also have had genetic testing and know whether or not I am BRCA1 or BRCA2 positive or if I carry the gene for Lynch syndrome or colon cancer. How many of my readers (survivors or caregivers) know that information about their tumors or genetic background?I know a few ways my care has been different because of this information.

As the state of medicine changes and we learn more about the causes and treatments of different cancers and pathways to cancer development maybe we should all be asking these questions. There are some who are taking the lead on a more personalized approach to medicine. Here are two I recently learned about . ( If you know of others please leave a comment and let me know about them.)

The first, a GE Healthcare-sponsored website, www.IsMyCancerDifferent, was launched on Sept 19. Through videos and downloads they are educating others about the benefits of asking for more personalized cancer treatment.



The second is called Cancer Commons. Their goal is an "open science initiative for physicians, scientists, and patients engaged in personalized oncology. Its goals are to: 1) give each patient the best possible outcome by individualizing their treatment based on their tumor’s genomic subtype; 2) learn as much as possible from each patient’s response, and 3) rapidly disseminate what is learned in time to help the next patient." .

I suggest that you visit these sites to learn more.


Dee
Every Day is a Blessing!

Thursday, March 13, 2008

Bill of Rights for Adolescent and Young Adult Cancer survivors

SeventyK is a relatively new Adolescent and Young Adult
Cancer Advocacy campaign created by Dr. Leonard Sender,
oncologistfrom Children's Hospital of Orange County .
On his website he has this Bill of Rights :

We are neither pediatrics nor geriatrics,
we have unique needs- medically, socially, and economically.
However, the rights and dignity of adolescent and young adults are
equal and vital to all individuals.
We deserve to have our beliefs, privacy,
and personal values respected.
Access to care is a right not a privilege.....

Click here for the complete Bill and more info.

As a younger older adult ;o) I feel that the young
survivors do have special needs the cancer community
have to consider.
I support their Bill of Rights.

Website - www.seventyK.org

LiveStrong
Dee