Saturday, November 22, 2014

OC News : Bevacizumab, Rucaparib, Trebananib

During the past few weeks there have been a number of developments in Ovarian Cancer  treatment and research in the news. Below are my top three picks.

Bevacizumab (Avastin) for Recurrent Ovarian Cancer

The FDA approved Avastin, a VEGF inhibitor made by Genentech, for treatment of persistent, recurrent or late stage Ovarian Cancer. Avastin can be used with paclitaxel, pegylated liposomal doxorubicin or topotecan chemotherapy.
FDA announce may be found here
Genentech Press Release and results of the Phase III AURELIA study can be found here.

6th EORTC-NCI-AACR  Symposium on Molecular Targets and Cancer Therapeutics in Barcelona, Spain News

Researchers identified a biomarker that can predict which women will respond to rucaparib, a PARP inhibitor. Rucaparib is an oral drug. Dr Elizabeth Swisher said "good responses to rucaparib in women with ovarian cancers exhibiting a form of cell damage called genomic loss of heterozygosity (LOH), in which an entire chromosomal region on one copy of the genome is lost" as well as in those who have BRCA1/2 mutations. (http://www.medicalnewstoday.com/releases/285788.php)

Trebananib Fails to Improve Overall Surviva

The trial, TRINOVA-1, tested  Amgen 's drug, trebananib along with Placitaxel. Results show that there was not a significant improvement in overall survival trebananib was used.
Reuter's article - http://www.reuters.com/article/2014/11/04/us-amgen-study-idUSKBN0IO1EW20141104?feedType=RSSfeedName=healthNews


Dee
Every Day is a Blessing !


Monday, November 17, 2014

Biases and Cancer

A few days ago Dr Rick Boulay sent me a tweet with a link to his TEDx Lehigh River talk "Cancerism:  Confronting The Biases We Share". ( Dr Boulay is one of #gyncsm's healthcare advisors.) I watched the video and found myself saying "oh, that's me" and " I get it." and agreed that yes, we(patients) need hope. Please take a few minutes to watch this moving talk.



I knew the pain and suffering cancer caused as I watched family and friends go through treatment and die from the disease. I carried biases about the disease. So it isn't surprising that those biases were apparent when I was diagnosis.

My sister would vomit after chemotherapy. So when I heard I had ovarian cancer and would also need chemotherapy, what was I worried about?  Vomiting. That was it. I told my doctor I would do chemotherapy as long as I didn't have to throw up. She told me not to worry there were many new drugs to alleviate the vomiting that came with chemotherapy. And she was right except for one time which occurred right before my severe allergic reaction to carboplatin.

When I was in treatment I would not plan more than a month in advance.  I was living in 3 week segments. On week one I had chemotherapy then I had 2 weeks off and started all over again. I wasn't even sure I would get the chemotherapy treatment on time. My platelets or my white count could be low and then everything was pushed back. I had no control of my time. There were days I never got out of bed so those days just disappeared. When the weather started getting cold and my husband suggested I buy a new coat I said "no!". Why?  I was afraid to buy one. I had heard about Gilda Radner and she didn't make it. Chances were I wouldn't make it either. Why would I buy a coat I will never get a chance to use. It took me almost a year after finishing treatment to be able to plan more than 6 months in advance.


All of us - patients and healthcare providers alike - have preconceived notions about the disease. Patients are afraid and feel vulnerable. I know I was. What can we do to offer hope?

Dee
Every Day is a Blessing! 

Dee

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!