Patient Care


Cancer side effects: 4 tips for coping with appearance changes

March 26, 2015 | by
beauty bus event

Cancer side effects can take a toll on self-confidence. Here, patient Veronica Bedjakian receives a makeover during a recent Beauty Bus event at City of Hope’s Positive Image Center.

The physical side effects of cancer can damage anyone’s self-confidence, but especially that of women who, rightly or wrongly, are more likely to find their appearance (or their own perception of their appearance) directly connected to their ability to face the world with something resembling aplomb.

Further, although many people may think they’re prepared for such side effects, the reality is often different.

City of Hope understands this.

  • The Positive Image CenterSM routinely sponsors complimentary events and beauty classes for patients going through treatment.
  • It hosts monthly Look Good . . . Feel Better sessions, part of a free, national program sponsored by the American Cancer Society for women currently undergoing radiation or chemotherapy. The classes are taught by specially trained, licensed cosmetologists on skin care techniques, alternatives for hair loss and much more.
  • And twice a year, City of Hope welcomes the Beauty Bus, a mobile self-confidence boost that “delivers dignity, hope and respite to chronically ill men, women and children and their caregivers through beauty and grooming services and pampering products.”

This healing-on-wheels program brings complimentary salon services to patients directly, many of whom have compromised immune systems that prevent them from going to salons.

Amy Donner, L.C.S.W., in the Department of Supportive Care Medicine at City of Hope, offers the following tips for anyone, especially women, struggling with the physical changes of cancer. » Continue Reading


As stem cell therapy research advances, so does nursing

March 25, 2015 | by

The promise of stem cell therapy has long been studied in laboratories. Now, as medicine enters an era in which this therapy will be increasingly available to patients, the nurses who help deliver it will be in the spotlight.

stem cell

Nurses in the Alpha Clinic for Cell Therapy and Innovation at City of Hope will develop new nursing standards for stem cell therapies.

City of Hope, which has launched its Alpha Clinic for Cell Therapy and Innovation (ACT-I), is among the first to have a dedicated clinic for leading-edge stem cell therapy. The clinic’s nurses will bridge two disciplines that have long been separate: compassionate care, for which City of Hope is known worldwide, and protocol-heavy stem cell clinical trial research.

“In the Alpha Clinic, we will have staff who are seasoned in working with inpatient units for stem cell transplants, and we will combine that with excellent clinical research nursing support in a much more coordinated fashion than we’ve seen in any place else to date,” said Shirley Johnson, R.N., senior vice president, chief nursing and patient services officer at City of Hope. » Continue Reading


Not all conditions should be treated at end of life, study suggests

March 24, 2015 | by

Just because you can treat a condition, such as high cholesterol, at the end of life — well, that doesn’t mean you should. That’s the basic lesson of a study to be published March 30 in JAMA Internal Medicine. The ramifications go far beyond that.

drugs and end-of-life care

Some conditions, such as high cholesterol, might not need to be treated at the end of life. A new study found that stopping statin treatment for high cholesterol actually improved quality of life.

The research, in which City of Hope’s Betty Ferrell, Ph.D., R.N., participated, found that stopping the use of statins in patients with late-stage cancer and other terminal illnesses can actually improve quality of life, without doing harm to the patient. That’s no small finding. Statins are one of the most commonly prescribed medications in the United States, as the press release about the study points out, and many patients for whom cure is no longer an option will be affected if doctors take the lesson to heart.

To summarize: The study on end-of-life care involved 381 patients — with a mean age of 74.1 years — about half of whom continued their cholesterol medication and about half of whom stopped. More than a fifth were cognitively impaired, and almost half had cancer. The researchers found that the number of study participants who died within 60 days was about the same for both the statin-taking and statin-forgoing groups but, of special significance, the quality of life was better for those who stopped taking statins. » Continue Reading


Discovering tools for genetic testing – and teaching others to use them

March 23, 2015 | by

The understanding of the relationship between genetics and cancer risk continues to grow, with more genetic testing than ever before available to patients.

genetic testing

City of Hope leaders have created a program to teach clinicians nationwide and worldwide how to use available genetic testing tools.

However, the adage that a little knowledge is a dangerous thing is applicable: Without context for what a test result means, and without meaningful guidance from genetic counselors, genetic tests don’t do patients much good.

Case in point: In addition to those better-known mutations contributing to breast cancer, such as BRCA1 and BRCA2, researchers have identified about 20 other genes that may be implicated in causing cancer, many of them rare or having more discreet effects. People who carry those other mutations – and who test negative for the BRCA mutations – may face a higher risk than they realize.

The doctors and counselors who deal with patients every day need training in order to help as many people as possible benefit from such knowledge and from today’s scientific advances. Scientists, clinicians and genetic experts at City of Hope are committed to bridging the gap between the technology that’s available and the number of professionals who know how to use and interpret the results of that technology.

Led by Jeffrey Weitzel, M.D.,  director of the Division of Clinical Cancer Genetics, City of Hope recently hosted a cancer genetics and genomics conference, “From Evidence to Action: Next-Generation Approaches to Cancer Risk Assessment and Research.” Nearly 200 physicians and clinicians from across the nation and abroad attended the conference.  » Continue Reading


Prostate cancer: Jonathan Yamzon on MRI/ultrasound fusion biopsy

March 21, 2015 | by

Standard prostate biopsies haven’t changed significantly in the past 30 years – nor have the problems inherent with them. Regular biopsies have an expected error rate: Tumors may potentially be undersampled and, 30 percent of the time, men who undergo a radical prostatectomy are found to have more aggressive tumors than expected based on the initial biopsy.

Here, Jonathan Yamzon, M.D., assistant clinical professor in the Division of Urology and Urologic Oncology, explains some of the pitfalls of prostate biopsies, as well as the potential benefits of a magnetic resonance imaging (MRI)/ultrasound fusion biopsy.

What happens during a prostate biopsy?

In a standard prostate biopsy, an ultrasound probe is placed into the rectum to visualize the prostate. Local anesthesia is applied, and biopsy samples are taken systematically across the prostate, with the minimum standard being 12 cores.

Prostate cancer expert Jonathan Yamzon

Jonathan Yamzon explains the basics of prostate biopsies and how an MRI/ultrasound fusion biopsy can improve accuracy.

A pathologist evaluates the tissue samples, assesses the aggressiveness of the cancer and gives the individual samples a Gleason score ranging from 3 to 5.

The sum of the Gleason scores is achieved by combining the two most prevalent scores seen in the tissue, ranging from 6 (least abnormal and aggressive) to 10 (most abnormal and aggressive). For example, if the reported Gleason is 3+4=7, a pathologist assigned a 3 to the most prevalent grade, followed by a 4, the second most-prevalent grade. The sum totals up to a Gleason score of 7.

Physicians use the Gleason score, among other clinical variables, to assess the aggressiveness of the cancer and recommend follow-up treatment. » Continue Reading


Cancer Insights: The dawn of precision medicine for cancer

March 17, 2015 | by

“Tonight, I’m launching a new precision medicine initiative to bring us closer to curing diseases like cancer.” These were the words of President Barack Obama on Jan. 20, 2015, during his State of the Union address. So what is precision medicine, and how close are we to making it a reality for patients?

Potential of precision medicine

Precision medicine is rapidly becoming a reality. With it comes an unprecedented potential to treat patients as the individuals they are.

Let’s begin with some definitions. Precision medicine entails two general tenets: (1) understanding the biology of an individual patient’s cancer, and (2) treating the patient according to this biology. When I was in medical school, both elements would have been perceived as a pipe dream. Now, they are slowly becoming a reality.

Comprehensive genetic tests that used to take days to weeks to run can now be done in minutes; these tests can point an oncologist toward specific medications that target proteins at the cancer cell surface, while sparing normal cells. In contrast to chemotherapy (which attacks cells indiscriminately), targeted therapies may potentially have fewer side effects. » Continue Reading


Cancer Insights: A message from ‘Simpsons’ co-creator Sam Simon

March 16, 2015 | by
Sam Simon

Sam Simon, co-creator of “The Simpsons, died of colon cancer during Colon Cancer Awareness Month. In his death, there is a lesson for us all. Credit: Getty Images

March is Colon Cancer Awareness Month. How sad, yet how serendipitous, that the co-creator of “The Simpsons” Sam Simon passed away in March after a four-year battle against colon cancer. What message can we all learn from his illness that can help us prevent and overcome colon cancer in our own lives?

Colon cancer is one of the most common cancers in men and women. One out of every 20 people will get colon cancer. And it is the third-leading cause of cancer death in the country, with nearly 50,000 deaths every year from this disease.

Simon was not alone in fighting this battle. Other famous people who have had this cancer are Audrey Hepburn, President Ronald Reagan, Eartha Kitt, Vince Lombardy and Charles Schulz.

From each of these people comes the same message: This illness can be prevented and the cure rate can be high.

Here are five tips to help prevent and screen for this illness, tips that could save your life: » Continue Reading


Meet our doctors: Oncologist Misagh Karimi on obesity and cancer

March 14, 2015 | by

Misagh Karimi, M.D., assistant clinical professor, is a medical oncologist at one of City of Hope’s newest community practice locations, located in Corona in Riverside County. A recent community health report from Corona’s public health department stated that obesity rates for teens and adults in Riverside County are the highest in California.

Here, Karimi discusses the connection between obesity and cancer.

What is known about the relationship between obesity and cancer?

Dr. Karimi on obesity and cancer

Misagh Karimi practices at City of Hope | Corona. Here, he explains the connections between obesity and cancer.

Multiple studies have shown correlations between obesity and a risk of cancer recurrence. There is significant evidence that obesity increases the chance of recurrence of cancer in multiple diseases, such as breast, colon, esophageal and other cancers. According to the American Society of Clinical Oncology, more than 50,000 new cases of cancer in women and 34,000 in men were due to obesity in 2007. Obesity may soon eclipse smoking as the No. 1 preventable cause of cancer.

Among obese individuals, specific biological characteristics can increase cancer risk:

· Obese people typically have increased levels of insulin (and insulin-like growth factor IGF-1), which can promote tumor growth.
· Sub-acute inflammation, which has been associated with cancer risk, is also common among obese people.

Are specific cancers more prevalent due to obesity?

Certainly, breast, colon, esophageal and stomach cancers appear to have a significant relationship with obesity. » Continue Reading


Ovarian cancer treatment: New guidelines reflect better outcomes

March 13, 2015 | by

In 1975, the median survival for patients with ovarian cancer was about 12 months. Today, the median survival is more than 5 years.

ovaries and ovarian cancer

Cancer of the ovaries, illustrated here on the left and right, is, in fact, a treatable illness. Newly released ovarian cancer treatment guidelines highlight just how much progress has been made. City of Hope’s Robert Morgan has been instrumental in establishing guidelines for best possible treatment.

Although researchers and clinicians are far from satisfied, the progress in ovarian cancer treatment is encouraging, said Robert Morgan, M.D., F.A.C.P., professor of medical oncology in the Department of Medical Oncology and Therapeutics Research at City of Hope. Morgan is also chair of the National Comprehensive Cancer Network’s Guidelines Panel for Ovarian Cancer, which recently released its 20th annual edition of the guidelines.

“This is a very treatable illness,” Morgan said. “I’m frustrated that I still hear from women who are diagnosed and told to get their affairs in order. That’s exactly the wrong advice. Much of the time, these patients are curable.”

In fact, ovarian cancer responds to drug treatment as often as 90 percent of the time. While fewer than 40 percent of women are cured, overall survival is improving – and so are treatments. » Continue Reading


Colorectal cancer: What our experts have to say

March 12, 2015 | by

Colorectal cancer may be one of the most common cancers in both men and women, but it’s also one of the most curable cancers. Today, because of effective screening tests and more advanced treatment options, there are more than 1 million survivors of colorectal cancer in the United States.

Here, colorectal cancer experts Donald David, M.D., clinical professor and chief of City of Hope’s Division of Gastroenterology, and Stephen Sentovich, M.D., a clinical professor of surgery at City of Hope, explain the importance of colorectal screening and the growing list of treatments for the disease.

On who is most at risk:

Sentovich: “In the U.S., we are all at risk of colon and rectal cancer. It can occur at any age, but the incidence increases as we age, particularly as we get over 50 years of age. For both men and women here in the U.S., the lifetime chance of getting colon and rectal cancer is about 5 percent. In some families, the risk is much higher due to genetic risk factors.” » Continue Reading