As the population ages, and thus becomes more prone to cancer, the nation’s health care providers will have to make significant changes to prepare for the influx of new patients and to ensure that current patients are getting the best treatments possible, says a new Institute of Medicine report.
Cancer is the No. 2 cause of death in the United States, after heart disease, causing more than half a million deaths each year. An estimated 1.6 million new diagnoses are expected in 2013, and that number is expected to balloon to 2.6 million cases by 2030.
Currently, many treatment decisions are not based on sound scientific evidence, the report says, and patients may not understand their choices or what to expect. For example, the report says, two-thirds of cancer patients with poor prognoses incorrectly believe that their treatments could cure them.
One of the report’s top recommendations was that health care providers and institutions must find ways to help patients make more informed decisions, providing them with clear information on the pros, cons and costs of treatments.
Betty Ferrell, Ph.D., R.N., professor in the Division of Nursing Research and Education at City of Hope, served on the high-profile panel behind the report. She distilled the report’s message this way: Consumers need to take charge of their care.
Great gains and health can be reaped through small, incremental changes. Starting to eat better doesn’t necessarily mean abandoning every indulgence at once.
Emmy-nominated celebrity chef and cookbook author Nathan Lyon is helping drive home the message that healthy food can be every bit as rich in flavor as in nutrients. As part of the Foothill Fitness Challenge kickoff at City of Hope on Oct. 5, he’ll be offering challenge participants an array of ideas and recipes on how to do just that.
In addition to co-hosting “Growing a Greener World” on PBS and hosting “A Lyon in the Kitchen” on Discovery Health and Fit TV, Lyon has a bachelor’s degree in health science from James Madison University and a culinary arts degree from Le Cordon Bleu. He channeled his expertise into his cookbook “Great Food Starts Fresh,” which is a seasonally organized guide to cooking healthy, delicious food with the freshest ingredients available throughout the year.
Here’s a sample of the tips he has to share with Foothill Fitness Challenge participants:
Continue reading “Foothill Fitness: Chef Nathan Lyon serves up healthy eating tips” »
Breast cancer treatment can be not only daunting but depressing, with 15 to 25 percent of cancer patients suffering from depression, according to the National Cancer Institute. Going online may help, with a new study finding that online intervention tools can help boost breast cancer patients’ moods, making them feel less depressed.
The study, co-authored by James Waisman, M.D., a clinical professor in City of Hope’s Department of Medical Oncology & Therapeutics Research, found that these tools give patients a way to express their feelings about their health, enabling them to communicate with loved ones and resulting in a more positive outlook.
Waisman and his colleagues studied 88 women who were either currently undergoing treatment for breast cancer or who had already finished treatment. The women were recruited using BreastLink — a network of cancer treatment centers in Southern California.
The women, ages 28 to 76, were randomly assigned either to a group tasked with creating a personal website using a program called Project Connect Online or to a wait-list group. Participants in the second group were told they’d have to wait six months before having a chance to create a personal website. Continue reading “Breast cancer: Online tools can improve patient outlook” »
Thanks to highly effective treatments, thyroid cancer is among the most treatable of cancers. But Thyroid Cancer Awareness Month — which is this month — brings attention to its challenges, including its growing occurrence and lack of routine screening.
Although thyroid cancers are relatively rare — with approximately 60,000 new cases expected this year — incidence rates have doubled since 1990, in a time when many other cancers’ incidences have stayed stable or dropped.
However, Robert S. Kang, M.D., assistant clinical professor in City of Hope’s Division of Otolaryngology/Head and Neck Surgery, said the trend isn’t particularly worrisome.
“The [growth] statistics may be somewhat misleading … due to increased utilization of and access to imaging and health care,” Kang said. The American Cancer Society concurred, noting that better screening tools have led to improved detection of thyroid cancer, particularly smaller nodules that may have been missed by older tests.
Unlike ovarian cancer, dubbed the “silent killer” because it can stealthily grow for months, endometrial cancer loudly announces its presence through hard-to-miss clues: vaginal bleeding or discharges in between periods and, particularly after menopause, difficult or painful urination as well as pain during intercourse.
Women experiencing these symptoms should immediately consult a gynecologist, said Robert Morgan, M.D., co-director of the Gynecological Oncology/Peritoneal Malignancy Program at City of Hope.
And if the doctor suggests “watchful waiting” instead of immediate treatment?
“Get a second opinion,” advised Morgan.
“Endometrial [or uterine] cancer is the most common gynecologic cancer, but it’s very treatable if it’s diagnosed in time,” said Ernest Han, M.D., Ph.D., an assistant professor and surgeon in the Division of Gynecologic Oncology at City of Hope. Continue reading “Endometrial cancer: ‘Very treatable’ if diagnosed in time” »
An increased demand for cancer care, the rising costs of treatment and the complex nature of cancer itself – combined with a shrinking oncology work force – add up to one thing: a crisis in cancer care. That’s the conclusion of a new report from the Institute of Medicine. But the report, written by a committee that included two City of Hope experts, also recommended specific strategies to improve care for cancer patients.
Those strategies are ones that City of Hope knows well. As such, it’s natural that Betty Ferrell, Ph.D, and Arti Hurria, M.D., were asked to take part in a high-profile endeavor charting the nation’s course for better cancer care. They were also featured in a video (above) released with the report.
Ferrell, a professor in the Division of Nursing Research and Education, is an internationally known expert in pain management, quality of life and palliative care. She is a fellow of the American Academy of Nursing and has published more than 300 papers in peer-reviewed journals and texts. She is principal investigator of a program project funded by the National Cancer Institute, “Palliative Care for Quality of Life and Symptom Concerns in Lung Cancer.” She’s also principal investigator of the “End-of-Life Nursing Education Consortium” project. She has written eight books, including “Cancer Pain Management,” a text on “Suffering,” “Pain in the Elderly” and “Oxford Textbook of Palliative Nursing,” published by Oxford University Press (third edition published in 2010).
Ferrell’s work on the report – “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis” – centered around the recommendations on patient care issues and palliative care, such as the importance of having advance directives, the need for palliative care and referral to hospice and, in general, the need for patient and family support in decision-making.
“Quality cancer care means the best treatment for the cancer but also the best attention for the patient with the cancer and the family,” Ferrell said of the new report and its recommended strategies.
Hurria, director of the Cancer and Aging Research Program, is an expert on the requirements necessary for quality cancer care given the aging population and the special needs of geriatric oncology. She was honored this year at the annual meeting of the American Society of Clinical Oncology for her contributions to the research, diagnosis and treatment of cancer in the elderly.
Her work on the report focused on the growing percentage of elderly patients, the segment of the population most likely to be diagnosed with cancer.
“Although the majority of patients with cancer and cancer survivors are older adults, historically there have been and continue to be less research studies which include this population,” Hurria said. “Critically appraising our health care system and redefining our challenges as opportunities will help us to start charting a new and better course, one that will escalate the quality of cancer care for older adults with cancer in the decades to come.”
Ferrell’s and Hurria’s efforts on the committee behind the report – the Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population – could ultimately improve cancer care for everyone. The report itself, released Tuesday, is already garnering media attention. Continue reading “Cancer care: City of Hope experts shape new IOM report (w/VIDEO)” »
Young women may want to think twice before having a glass of wine with their dinner or a beer at the end of the day. A new study has found an increased risk of breast cancer among women who regularly consumed alcoholic beverages in the years between the start of menstruation and first pregnancy.
In an analysis of data from more than 91,000 women, researchers at Washington University School of Medicine in St. Louis found that females who consumed just one alcoholic drink a day — one bottle of beer, a 4-ounce glass of wine or a shot of liquor — before their first pregnancy increased their risk of being diagnosed with breast cancer by 11 percent. They increased their risk of proliferative benign breast disease by 16 percent. Many previous studies have linked alcohol consumption to breast cancer, but researchers noted that this study is one of the first to focus primarily on the effect of alcohol intake before a first pregnancy.
But, noting the nature of statistics, Laura Kruper, M.D., director of the Rita Cooper Finkel and J. William Finkel Women’s Health Center at City of Hope, said that women and their doctors must keep the 11 percent increased risk in perspective. A women’s overall lifetime risk of breast cancer is about 12 percent.
Even as a new Cancer study reignites the debate over the ideal age at which to begin mammogram screenings for breast cancer, City of Hope experts are urging women not to settle for a one-size-fits-all approach.
The Harvard University study, published Monday, started with data on 7,301 women diagnosed with breast cancer at one Boston hospital. Of the 609 women who died, 65 percent either had never had a mammogram or had not had a mammogram within two years of their diagnosis, researchers found. Half of the deaths occurred in women under age 50.
The American Cancer Society maintains a recommendation that yearly mammograms should begin at age 40, but the U.S. Preventive Services Task Force has recommended that women receive mammograms from ages 50 to 74, and then only every two years. That recommendation was based on data showing that earlier tests do more harm than good, leading to many false-positives that often cause additional expense, unnecessary anxiety and needless follow-up procedures.
The authors of the new study said their findings suggest that screening guidelines should encourage earlier, regular mammograms for all women. Other experts, including those at City of Hope, aren’t so sure.
Joanne Mortimer, M.D., director of the Women’s Cancers Program at City of Hope, points out that the study was not a randomized clinical trial – a gold standard for research. Data from those trials does not support across-the-board screening for every woman beginning at age 40, she said.
Further, the key to preventing breast cancer deaths and catching the disease as early as possible, Mortimer said, is assessing women for their individual risk, then screening appropriately.
Prostate cancer facts, both good and bad, have already been summed up quite succinctly: “Cancer of the prostate gland is a serious health risk for men. In fact, this year nearly 240,000 American men will be diagnosed with it. The good news is that prostate cancer is survivable, especially if it is detected early, before it can spread.”
Those facts will lead many men to undergo a prostatectomy, specifically a robotic-assisted prostatectomy. And, of course, they – and their loved ones – will have questions along the way. A new video series can answer many of those questions.
The series, “Your Guide to Robotic-assisted Laparoscopic Radical Prostatectomy,” introduced by Timothy G. Wilson, M.D., the Pauline & Martin Collins Family Chair in Urology at City of Hope, eliminates much of the confusion men and their partners may have about the operation, expected side effects, potential complications and long-term outcomes.
Of course, the proof is in the outcomes. And City of Hope has that proof. As the data on prostate cancer shows: “Our survivorship exceeds the survival rate of patients treated at other cancer programs that report their data to the Commission on Cancer [a national database maintained jointly by the American Cancer Society and the American College of Surgeons].” Continue reading “Prostate cancer leads many to prostatectomy. Learn more (w/VIDEOS)” »
Although surgeons can remove most of a breast cancer tumor through surgery, microscopic amounts of cancer can remain. To ensure those cancer remnants don’t grow or spread, breast cancer patients often undergo follow-up radiation treatment for as long as seven weeks after their surgery.
A relatively new technique could make their post-surgery lives much easier. Called intraoperative radiation therapy, or IORT, this new form of radiation therapy replaces weeks of traditional radiation therapy. It’s administered in a single dose directly at the tumor site – and given at the same time as the surgery. “For most patients, they will not require the normal daily radiation treatments that normally require six to seven weeks,” said Laura Kruper, M.D., director of the Rita Cooper Finkel and J. William Finkel Women’s Health Center. “It allows a woman to get her radiation and her surgery in one day.” Continue reading “Breast cancer: Therapy cuts radiation treatment to 1 day, 1 dose” »