Integrative Oncology
posted by admin on June 14th, 2011 | Comments (0)
Integrative Oncology is an important part of patient care at Radiotherapy Centers of Georgia.
Integrative Oncology is an important part of patient care at Radiotherapy Centers of Georgia.
Katie and Kim Messer are mother and daughter, facing cancer together. Katie is a Non-Hodgkin’s lymphoma and breast cancer survivor. And, her daughter Kim is now facing stage IV breast cancer. Watch their moving story.
With the identification of more than 25 types of prostate cancer by PCF-funded scientists in the past 24 months, and the fact that it remains one of the least talked about cancers, it’s no wonder there remains a great deal of confusion surrounding this disease.
Ask any group of men about prostate cancer. If they don’t abruptly change the subject or take the opportunity to crack a few wise remarks, chances are you will get a wide variety of answers when it comes to what it is, how it should be treated and whether or not (and when) one should be screened for this disease. Against this reality, it is always a good idea to review some of the more popular myths and misconceptions about this disease that claims the lives of more than 32,000 men in the U.S. each year.
While it may be true that the older you are, the more likely you are to be diagnosed with prostate cancer (65% of cases are diagnosed in men who are 65 or older), the fact remains that 35% of those diagnosed, or more than 76,000 each year, are diagnosed at an earlier age. I was diagnosed at age 51 and I have met many men who were diagnosed in their early 40s. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate skyrockets up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69.
There are many risk factors to consider. Your race, family history, physical health and lifestyle—even geographic location—are all factors that can increase your likelihood of developing prostate cancer.
Wrong. Prostate cancer is one of the most asymptomatic cancers in oncology, meaning not all men experience symptoms. Many times symptoms can be mistaken or attributed to something else. Signs of prostate cancer are often first detected by a doctor during a routine check-up. Common symptoms include a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.
The answer to this one is sometimes, yes. Sometimes, no. With the 25 types of prostate cancer discovered by PCF-supported researchers, we can confirm that there are those prostate cancers a man may die with and not of, while others are very aggressive. Once a biopsy confirms the presence of cancer in the prostate, a physician uses the data contained in the pathologist’s report to characterize the potential aggressiveness of the cancer and make recommendations for treatment based on many factors, including a patient’s age and health status. There are many treatments available for patients and one approach does not fit all cases. Patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted medical professional.
The good news is that we believe, with the accelerated pace of scientific discovery, we will soon be able to identify the specific cancer a patient has at time of their diagnosis and match the most effective treatments for their prostate cancer and their biological makeup. This will enable us to cure more and overtreat less.
Wrong. While a family history of prostate cancer doubles a man’s odds of being diagnosed to 1 in 3, the fact remains that 1 out of 6 American men will be diagnosed with prostate cancer in their lifetime. This compares to 1 in 8 women who will be diagnosed with breast cancer. African-American men are 60% more likely to be diagnosed with prostate cancer and 2.4 times more likely to die as a result.
Family history and genetics do, however, play a role in a man’s chances for developing prostate cancer. A man whose father or bother had prostate cancer is twice as likely to develop the disease. The risk is further increased if the cancer was diagnosed in a family member at a younger age (less than 55 years old), or if it affected three or more family members.
In 2010, approximately 218,000 new cases were diagnosed in the U.S. and more than 32,000 men died as a result of this cancer. The number of new U.S. cases could exceed 300,000 per year by 2015.
Incorrect. The PSA tests measures levels of prostate-specific antigen in the prostate, not cancer. PSA is produced by the prostate in response to a number of problems that could be present in the prostate including an inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer. Think of it as a first alert smoke alarm, instead of a fire alarm. The PSA test is the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested. Personally, I believe the PSA test saved my life and will continue to save it as we track my response to treatment.
Although prostate cancer is a common cause of elevated PSA levels, some men with prostate cancer may even have low levels of PSA. PSA can also be diluted in men who are overweight or obese, due to a larger blood volume, and a biopsy should be considered at a relatively lower number (i.e. 3.5 instead of 4). Again, elevated levels can be an indication of other medical conditions.
Having a vasectomy was once thought to increase a man’s risk. This issue has since been carefully researched by epidemiologists. Vasectomy has not been linked to increasing a man’s chance of getting prostate cancer but has led to the prostate being checked by the urologist more often and prostate cancer consequently being detected in the clinic.
While erectile dysfunction (ED) and urinary incontinence are possibilities following surgery or radiation therapy for prostate cancer, it is not true that all men experience complications. These side effects can also be highly dependent on age and physical condition. Numerous therapies and aids can improve erectile function and limit incontinence following treatment and nerve sparing surgical procedures have improved outcomes for patients as well. When selecting a surgeon, patients should inquire about the surgeon’s outcomes for ED and incontinence as well as the number of surgical procedures (open or robotic) performed.
High levels of sexual activity or frequent ejaculation were once rumored to increase prostate cancer risk. In fact, some studies show that men who reported more frequent ejaculations had a lower risk of developing prostate cancer. Ejaculation itself has not been linked to prostate cancer.
Prostate cancer is not infectious or communicable. This means that there is no way for you to “pass it on” to someone else.
The first step in dealing effectively with prostate cancer is knowing the facts and eliminating confusion. Recent studies have shown that lifestyle decisions such as maintaining a healthy diet and regular exercise, such as walking 30 minutes a day, may also play a pivotal role in reducing the risk of getting prostate cancer and surviving it if you get the disease. Talk to your family and friends about prostate cancer and, if you are over 40, talk to your physician to develop a prostate health and screening plan that is right for you.
By Dan Zenka
Faced with her’s father’s diagnosis and treatment, one teen spun into action despite her fears.
Kylee Lahners is a wonderful young woman who is supporting cancer research and helping other teens believe that they can get through having cancer in their family.
Last month, I had the honor of meeting a wonderful family and a remarkable young woman named Kylee Lahners. Her father, Ken was diagnosed with prostate cancer and was then told that his cancer was metastatic. He has endured surgery and chemotherapy and, like all of us in his situation, he is faithfully going for his blood draws and visits with his oncologist.
From diagnosis, through treatment and years of follow up, I don’t need to underscore how stressful the situation can be for a family, especially on the children. Not only is their father’s’ well-being threatened, but they can also see, and have to live with, the burden and fear that is placed on their other parent. Like other things in life, stress and fear roll down hill and our children are often the final emotional catch basins in life. Their entire sense of security can be rocked. I’ve seen my own sons react to our reality in a variety of ways, both overt and subtle.
When I met Kylee and her family, it was to accept $1,200 in donations that Kylee had collected to support research for a cure. Among her responses to her father’s struggle was a strong urge to spring into action and do something meaningful for all families. The results of her effort were visible in the handful of checks she delivered.
During Kylee’s visit, I was able to talk to her and her sister and understand how they were dealing with their father’s cancer. They are a tight-knit family and it is evident that their bond is helping them deal with Ken’s journey. I realized it might be helpful to other families and teens if I invited Kylee to hare some of her feelings and insights. Here is her essay.
My dad was recently diagnosed with prostate cancer and as an 18-year-old girl, this was something that I have never had to deal with before. When my dad was constantly going into the doctor’s office to get a bunch of tests done is when I started to get worried. I thought they would find something else on top of the cancer which would lead to something else and it would have been just a big scary mess of my dad’s health.
Once my family found out that my father needed to go in for surgery we were somewhat relieved but worried at the same time. I visited my dad in the hospital and he was doing well, which softened things up with me. I made sure I stayed positive throughout the process, believing that everything would all work out. My dad’s next step to getting cured is going through chemo; he is now half way done with his treatments. Chemo is a very strong chemical that makes my dad act differently– he isn’t his normal self. It would be 2 days after he would go in to get the injection that my father would start to feel the symptoms of chemo. It normally last for 5 days. Those five days were my dad’s toughest and also my toughest . The chemical would make him tired, feel sick and lethargic but the social aspect is what really hit me. He gets agitated really easily. He has no patience for anything, is extremely grumpy and tends to lose train of thought and hearing.
To help my dad get through these days I don’t ask him a lot of questions, do what he says right away, and am really supportive. In times like this, you just have to help out and do what you can do to make things go smoothly. There must be bad stuff before the good stuff can come. When it is so tough at times, just remember good will reward you soon, just stay tough!
If you haven’t already guessed, Kylee is also a champion in other fields. She is a 2010-11 USA Softball Junior Women’s National Team member and a 2010 Pan American Championship (18-Under) Gold Medalist.
Thank you, Kylee, for supporting cancer research. Moreover, thank you for sharing your story and letting other teens know that they are not alone. As families, we are all in this together.
I wish you, your sister and parents, many years of health and happiness going forward.
Abiraterone, 4th New Drug for Prostate Cancer is Approved in 12 Months
In the past few months I have often said there is no better time to be a prostate cancer patient than now. In my position here at the Prostate Cancer Foundation, I have uttered this statement with enthusiasm and a bit of pride. As a patient, I have said it with a healthy portion of relief and a prayer of thanksgiving for progress. Not that I want to ever need any of these new drugs, but, as I grapple with my disease and the ever present possibility of recurrence, I am reassured that these new treatments will be ready and waiting for me and my medical team if and when I need them.
To recap, the four new drugs are: Provenge (the first ever immunotherapy for the disease); Cabazitaxel, an advanced chemotherapy agent also known as Jevtana; Denusomab, marketed as Xgeva for bone health during androgen dperivatrion tehrapy; and now, Abiraterone (Zytiga). Approved just yesterday by the FDA, Abiraterone has been in development since the 1990s and will be utilized for the treatment of castration-resistant, metastatic prostate cancer following docetaxel chemotherapy. It’s a clinical break-through for patients who previously had few good clinical therapies available to them.
During Phase III clinical studies, patient response was so encouraging that those patients who were taking the placebo were given the option of switching to the drug. Good news indeed for so many.
You can read more about Abiraterone here.
Here’s to progress. Here’s to better outcomes.
A new study shows nearly half of men feel worse after having their prostate gland removed due to cancer, although three-quarters would do it again given the same circumstances.
Tens of thousands of men each year undergo the surgery, called prostatectomy, and may suffer long-term consequences to their quality of life, in particular sexual function.
In the current study, published in the Journal of Urology, researchers asked 236 men how they were doing up to 1 year after surgery.
Three out of four had regained their physical and mental well-being and had no more problems with incontinence than before the operation. But just one out of four had recovered his ability to have intercourse.
The research team, led by Dr. Adrian Treiyer at St. Antonius Hospital in Eschweiler, Germany, also teased out the circumstances that were tied to better recovery.
Men were more likely to get their quality of life back if they had a type of surgery that leaves the nerves controlling erection intact, for instance, and if they participated in a rehabilitation program.
While the study doesn’t prove that rehab is helpful — men who did better might be likely to join such a program, for example — the possibility is worth noting, said Dr. Mark Litwin, a urologist at the University of California, Los Angeles, who was not involved in the study.
Rehab programs, which are relatively new in prostate cancer care, can include talk therapy or a drug regimen to treat erectile dysfunction.
“It’s not just about recovery of the penis and its ability to become erect, but helping men come to terms with being a cancer survivor,” Litwin told Reuters Health.
Both physical well-being, such as experiencing less pain, and mental health, including feeling good and functioning well socially, were tied to remaining continent and not encountering any complications after surgery.
“Some of these things, no one can control, such as baseline PSA,” Litwin said. “But some they can. Patients can doctor-shop and find the best care.”
In the type of surgery the patients had, surgeons make a cut between the belly button and the pubic bone to get to the prostate, which is then removed entirely — so-called radical prostatectomy.
About one in six American men get prostate cancer at some point in their life, according to the American Cancer Society. But they don’t necessarily have to have their prostate removed because of it.
Some may get radiation treatment instead, or they may have their tumor destroyed by a kind of surgery that uses freezing liquids. Others may choose just to be monitored — so-called watchful waiting — to see if the cancer grows slowly enough to be safely ignored.
All of these strategies have problems of their own, and the right option depends on both the cancer and the patient’s values.
Litwin said most studies have focused on the drawbacks to prostate cancer surgery, and indeed, the new findings confirm that most men have worse sexual function after the procedure.
“Quality of life definitely takes a hit, both physically and emotionally,” Litwin added, “but ultimately, it tends to go back to normal.”
FROM: http://www.msnbc.msn.com/id/42707779/ns/health-cancer/
By: Kate Santich, Orlando Sentinel
At 68, John Casterline has beaten advanced-stage lung cancer, prostate cancer and throat cancer. Last month, he finished radiation treatments. Just one week ago, his doctors pronounced him cancer-free.
So what is he doing to celebrate?
Forget Disney World. Starting April 28, this Orlando retiree will be hiking 2,650 miles, from Canada to Mexico, along the Pacific Crest Trail — a route that will climb above 13,000 feet elevation and require him to average 20 miles a day.
“I expect that I will experience weather that is too cold, too hot, too wet, too dry and too perfect,” he wrote in his journal a year ago, when he began training seriously for the hike. “I will encounter rattle snakes, bears, and maybe even mountain lions. … The mosquitoes will be horrendous at times, the hills steep, the rocks sharp, the trail blocked, the wind very strong. [Sleep will be] occasionally fitful and I’ll be carrying a backpack with 30-plus pounds.”
But if you have to ask why he’s doing it, he wrote, you wouldn’t understand.
It is not simply that he hopes to raise $26,500 for the dramatically underfunded battle against lung cancer, a disease expected to claim the lives of 160,000 Americans this year — more than colon, breast and prostate cancers combined.
Nor is it about creating some kind of legacy. Though followers can read his ongoing exploits on lungcancerhike.org, the website is intended to give fellow cancer survivors hope — and to collect donations for the American Lung Association — not to brag.
“John is the guy you want with you in a foxhole,” said Eric Gray, an executive director at the American Lung Association of Florida. “He’s the guy who makes you believe anything is possible.”
Casterline is a favorite at Orlando lung-cancer support-group meetings, and Gray often uses him as a beacon of hope when counseling the newly diagnosed.
“In years past, there hasn’t been a lot to say to people other than, ‘I’m so sorry,’ ” Gray said. But now I can say, ‘Let me tell you about this guy who had Stage 4 lung cancer and this remarkable thing he’s doing …”
Casterline was diagnosed in August 2006, a week after he retired from 21 years working for 7-Eleven preceded by 21 years in the Navy. He had quit smoking seven years earlier — 1999, the same year he took up backpacking at the urging of his eldest son. By the time the disease was detected, it was so far advanced he was given a 3.5 percent chance of surviving the next five years.
“You go through these stages of grief,” he said. “For two or three days, I figured I wouldn’t make it a year.”
It may have been the only time his relentless spirit waned, and even then it didn’t last long. He researched exhaustively, interviewed doctors at five hospitals — including Memorial Sloan-Kettering in his birth state of New York — and ultimately selected M.D. Anderson Cancer Center Orlando. He went through surgery, chemotherapy and more than one round of radiation, and by February 2007 he was officially cancer-free.
That lasted a blissful 3 1/2 years, until he developed prostate cancer. He had just finished surgery for that in November last year when, one month later, doctors discovered the earliest stage of throat cancer.
“He exercised all through chemotherapy and radiation,” said Dr. Jennifer Tseng, his medical oncologist, who counts herself a fan. “Probably the only time he didn’t exercise is when he was in the hospital after surgery. And even then, he was back on his feet in no time. He’s got an amazing spirit and willpower.”
The average person undergoing radiation would still be trying to eat solid food at this point, she said. Casterline, who began competing in marathons 10 years ago, has been out hiking 14 miles a day wearing a 35-pound backpack. Within the past week, all three of his doctors have given their blessing to the upcoming hike.
In fact, in some ways, Casterline’s wife of 41 years, Sue, has been the toughest sell.
“When he first told me about this trip, I thought, ‘You’re out of your mind,’ ” she admits. “It was just surreal. But he’s a force of nature, and he’s going to do what he’s going to do. I mean, I can’t stop him.”
She did, however, make him update his will.
As she says this, the family room has turned into a staging area with 13 cardboard boxes of food due to be shipped to various post offices near the Pacific Crest Trail. Those are for the times when the nearest store is 20 miles away. Casterline has the spots numbered on spreadsheets that detail his mileage, route-elevation changes, meet-ups with his wife and two grown sons, and notations on the hazards du jour.
“Water supply contaminated — dead rodents,” he notes for Day 5, a 20-mile stretch through the scrub oak and chaparral of Southern California. “Poison oak about mile 105.”
His gear has been weighed to the nearest tenth of an ounce. All his clothing comes in at 2.56 pounds. His tent, sleeping bag, backpack, ground cover and pad: 7.66 pounds. Total, with cooking and hygiene supplies, medications, emergency whistle, duct tape, bug repellent, iodine tablets, reading glasses and playing cards: 15.97. It’s the food and water that will add an additional 20 or so pounds. Plus there’s the 1-pound ice axe he can ditch after the halfway point.
He has coaxed sponsorships from Nestlé, which owns PowerBar energy products, and Mango International, which sells a small solar panel to recharge his iPhone. He’ll also carry a pocketknife and perhaps a 6-ounce Kindle reader. But he’s still on the fence over a distress signal that alerts rescue workers you need to be airlifted to a hospital.
“It’s 8 to 10 ounces,” he said, frowning.
Though Casterline feigns fearlessness most of the time, he admits one enormous worry: failure.
“I’m very determined, mentally and physically, and I know I’ve already been tested pretty hard,” he said. “But that’s one of my greatest fears: that I won’t make it.”
On bad days — and there will be bad days — he will remember to look at the names his granddaughter has printed on his backpack in ink. “Alysan F.,” “Judy C.” and “William R.,” they read. There are 100 names in all: lung-cancer patients or their loved ones. Some he has only met online. If not for himself, then at least for them, he must try to persevere.
No one is betting against him.
“Short of getting eaten by a bear,” his wife said, “he’s going to do it.”
From: http://www.orlandosentinel.com/news/os-cancer-survivor-hike-20110416,0,6628367.story?page=1
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