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Surgery for advanced colorectal cancer? Each patient’s needs are unique

January 21, 2015 | by   

Surgery is vital in the treatment of cancer – it’s used to help diagnose, treat and even prevent the disease – so a new colorectal cancer study linking a decrease in surgeries for advanced cancer to increased survival rates may raise more questions than it answers for some patients.

advance colorectal cancer surgery

Treatment options for advanced colorectal cancer depend on the unique needs of each patient. The decision needs to individualized, said Stephen Sentovich, a board-certified colon and rectal cancer surgical expert at City of Hope.

The surgery-and-survival study, conducted by researchers at MD Anderson Cancer Center and published recently in JAMA Surgery, found that although surgery is still the most-used treatment for Stage 4 colorectal cancer, it has become less common. Surgical rates decreased from 74.5 percent in 1988 to 57.4 percent in 2010, with survival rates doubling from 8.6 percent in 1988 to 17.8 percent in 2009.

The trend reflects a greater use of new chemotherapy drugs and targeted treatment options and highlights the overall improvements made in the treatment of colorectal cancer. But Stephen Sentovich, M.D., M.B.A., a board-certified colon and rectal cancer surgical expert at City of Hope, cautions against making broad assumptions about the best treatment options.

Treatment choices aren’t always black and white, he says. Decisions needs to be individualized, based on the unique needs of each patient. » Continue Reading

Geriatric oncology nurse Peggy Burhenn: Older adults need special care

January 20, 2015 | by   

Age is the single greatest risk factor overall for cancer; our chances of developing the disease rise steeply after age 50. For geriatric oncology nurse Peggy Burhenn, the meaning is clear: Cancer is primarily a geriatric condition. That’s why she is forging inroads in the care of older adults with cancer.

Nurse Peggy Burhenn

Geriatric oncology nurse Peggy Burhenn at City of Hope, has received the 2014 Advanced Oncology Certified Nurse of the Year Award.

Burhenn, M.S., C.N.S., A.O.C.N.S., is a professional practice leader in geriatric oncology in the Department of Clinical Practice and Professional Education at City of Hope. She focuses on the needs of older adults with cancer, researching better treatments for them and teaching other clinicians the best approach to caring for this important population.

Her innovative work and excellence in clinical care recently earned her the Advanced Oncology Certified Nurse of the Year Award from the Greater Los Angeles Oncology Nursing Society. The honor adds to a list of accolades and achievements that includes the Margo McCaffery Excellence in Pain Management Award and leadership roles on the National Comprehensive Cancer Center’s Older Adult Oncology Expert Panel and the International Society for Geriatric Oncology.

Burhenn earned both bachelor’s and master’s degrees in nursing from the University of Illinois in Chicago. She joined City of Hope in 2011 after nearly a decade as a nurse educator in the biotechnology industry and as a nurse oncologist at a private hematology-oncology practice. She said her work with older patients began early in her career, sparked to some degree by her own parents’ experience with aging. » Continue Reading

Sportscaster Stuart Scott’s young age is reminder: Check family history

January 19, 2015 | by   
Stuart Scott

ESPN sportscaster Stuart Scott’s cancer diagnosis is a reminder to check family history. (Photo by Alan Rose)

One of American’s great sportscasters, Stuart Scott, passed away from recurrent cancer of the appendix at the young age of 49. His cancer was diagnosed when he was only 40 years old. It was found during an operation for appendicitis. His courageous fight against this disease began in 2007, resumed again with an operation for recurrent cancer in 2011, and yet again in 2013 when the cancer returned. Despite surgery, a long period of surgical healing, and then prolonged courses of different kinds of chemotherapy, he died on Jan. 4, 2015.

Scott went public with his struggle against the disease, and urged people to follow his example to fight cancer with both chemotherapy and an aggressive exercise program to keep his body strong. Because so many of my patients suffer from fatigue associated with treatments, I am sure his fitness program improved his quality of life.

But more important for all of us, we should realize that the occurrence of cancer at a young age (40 in Scott’s case) should raise a red flag to patients, families and physicians. Hereditary cancer syndromes due to mutations in our genes are the cause of 5 to 10 percent of cancers. And when we are reminded of this by the death of one of our celebrities at a young age, we should each examine our own family history and get tested for gene abnormalities.

When should we be asking for a discussion about gene testing? Family cancer syndromes are likely to be present when there are multiple family members with cancer, or when an individual patient has more than one cancer, or when a cancer occurs at a young age (less than 50). While we do not know if Scott was tested (that’s private health information), having cancer at age 40 warrants discussing gene testing with a physician.

» Continue Reading

Clinical trial for triple-negative breast cancer shows promise

January 16, 2015 | by   

When Homa Sadat found a lump in her breast at age 27, her gynecologist told her what many doctors say to young women: You’re too young to have breast cancer.

triple negative breast cancer

Triple-negative breast cancer is diagnosed at a higher rate in patients with BRCA-related breast cancer and in African-American women. A City of Hope clinical trial for triple-negative breast cancer is proving especially promising.

With the lump dismissed as a harmless cyst, she didn’t think about it again until she was at a restaurant six months later and felt shooting pain. She went back to her doctor and asked for a biopsy. The biopsy confirmed her fear: She had breast cancer. A biopsy of a suspicious lymph node in the underarm area confirmed that the cancer had spread.

Sadat was diagnosed with what’s known as triple-negative breast cancer.

When pathologists test breast cancer cells, they look for the presence of estrogen and progesterone hormone receptors and the overexpression of receptors for a type of protein called HER2. Breast cancer that is positive for one of the hormone receptors can be targeted with hormonal therapy such as tamoxifen or aromatase inhibitors. Other therapies, like trastuzumab (Herceptin) or its newer versions, have been developed to target HER2 overexpressive – that is, positive – breast cancers.

Cancers that are negative for all three receptors are often referred to as triple-negative cancers. They’re the toughest to treat.

» Continue Reading

Sometimes, ‘bone marrow transplants’ come from umbilical cord blood

January 15, 2015 | by   

What most people call a “bone marrow transplant” is not actually a transplant of bone marrow; it is instead the transplantation of what’s known as hematopoietic stem cells. Such cells are often taken from bone marrow, but not always.

blood cells can come from cord blood

Umbilical cord blood can provide the stem cells necessary for transplant when a blood cancer patient doesn’t have a related or unrelated donor who is a match.

Hematopoietic stem cells are simply immature cells that can develop into any type of blood cells, including white blood cells, red blood cells and platelets. They’re used to treat blood cancers and other hematologic disorders, and they can come from bone marrow, peripheral blood (blood that circulates through the arteries and veins) or even umbilical cord blood banked at the time of a baby’s birth.

Transplantation follows a fairly similar process: First, a donor (or in some cases, the patient himself) provides stem cells that match the patient’s blood cells in key ways. Then the patient is treated with chemotherapy and radiation to prepare him for the transplant, and the new cells are infused.

Having access to all options for stem cell transplantation is important for patients with a blood cancer or other hematologic malignancy, said Chatchada Karanes, M.D., director of the Cord Blood Transplant Program in City of Hope’s Hematologic Malignancies and Stem Cell Transplantation Institute, because many factors must be weighed when choosing the best transplantation option for a patient.

» Continue Reading

Atypical hyperplasia’s link to breast cancer ‘more serious’ than thought

January 14, 2015 | by   

Doctors have long known that women with a precancerous condition called atypical hyperplasia have an elevated risk of breast cancer. Now a new study has found that the risk is more serious than previously thought.

atypical hyperplasia

New research has found that women with atypical hyperplasia have up to a 30 percent risk of developing breast cancer in their lifetime.  This is a higher risk than physicians had thought was linked to atypical hyperplasia. Researchers hope the findings will lead to more thorough screening options, such as MRI (shown), for women facing this increased risk.

Hyperplasia itself is an overgrowth of cells; atypical hyperplasia is an overgrowth in a distorted pattern. The condition is common, amounting to about 10 percent of the more than 1 million breast biopsies with benign findings in the U.S. The commonness of the condition is one reason the new study is so concerning.

The breast cancer risk study, conducted by researchers from the Mayo Clinic and published this month in the New England Journal of Medicine, found that about 30 percent of women with atypical hyperplasia developed breast cancer within 25 years of the diagnosis.

“The news is atypical hyperplasia is much more serious than we have been taking it,” said Laura Kruper, a breast surgeon and head of breast surgery service at City of Hope, in a HealthDay article on the study.  “When you say a cumulative risk of 30 percent at 25 years, that is pretty serious. … We as a medical community need to pay more attention to this.” » Continue Reading

Make these 5 healthy resolutions for 2015. (No, it isn’t too late)

January 13, 2015 | by   

Don’t kid yourself. Just because it’s mid-January doesn’t mean it’s too late to make resolutions for a happier, and healthier, 2015. Just consider them resolutions that are more mature than those giddy, sometimes self-deluded, Jan. 1 resolutions.

healthy resolutions list

Don’t wait until next Jan. 1 to make some healthy resolutions.

To that end, we share some advice from Cary A. Presant, M.D., an assistant clinical professor and hematologist at City of Hope.

  • Get health insurance.
  • Check if your doctor is the right doctor for you.
  • Start your own home medical record.
  • Decide now about making your advance medical directives.
  • Recognize your unhealthy habits and take a first step today to correct them.

This is sage guidance. To get the details and the rationale for each recommendation, check out the full column at Huffington Post. » Continue Reading

Esophageal cancer patient Jim Murphy: What I learned from cancer

January 12, 2015 | by   
patinet riding mountain bike

Esophageal cancer patient Jim Murphy never let cancer take over his life during his treatment at City of Hope. He continued to bike ride and ski during chemotherapy and radiation.

Sales and marketing executive Jim Murphy first came to City of Hope in 2002 to donate blood for a friend who was being treated for esophageal cancer.

The disease is serious. Although esophageal cancer accounts for only about 1 percent of cancer diagnoses in the U.S., only about 20 percent of patients survive at least five years after diagnosis. Murphy wanted to do whatever he could to help.

His friend successfully beat the cancer and is still doing well today ­— 12 years after diagnosis. Then, in 2012, Murphy began to have trouble swallowing. An avid mountain biker and skier who knew how “healthy” was supposed to feel, Murphy knew something wasn’t right. He made an appointment with his physician for an endoscopy.

 

» Continue Reading

#LastChemo: Lymphoma patient begins 2015 cancer-free

January 9, 2015 | by   

Aaron Bomar and his family were celebrating his daughter’s 33rd birthday in September 2014 when he received alarming news: According to an X-ray taken earlier that day at an urgent care facility, he had a node on his aorta and was in danger of an aneurysm.

lymphoma

Lymphoma patient Aaron Bomar will celebrate his last round of chemotherapy — and being lymphoma-free — on Jan. 5. He is pictured here with wife Julie Bomar and daughter Jessica Bomar Karylyle.

Bomar held hands with his wife and daughter and said a prayer. His daughter, Jessica Bomar Karylyle,  blew out her candles, wishing for her 58-year-old father’s good health, and the family headed to the emergency room.

Earlier in 2014, Bomar, of Antelope Valley, had been treated for skin cancer. Lumps had developed on his face, ears and neck, making his doctors suspect another illness was also in play, but Bomar had been reluctant to have the lumps checked out. He couldn’t afford health insurance and, as the sole provider for his family, he feared he simply couldn’t pay the medical bills.

But Bomar had grown sicker by the day, quickly losing weight, and the lumps grew to golf-ball and soft-ball size. A concrete masonry inspector, Bomar is described by his daughter as strong, unflappable – and not terribly eager to go to the doctor. Finally, his wife, Julie, had convinced him to go to urgent care on that September day; there he had received the X-ray that prompted the family to go to an emergency room in Sylmar. » Continue Reading

The profit: $17.35 from handmade bracelets. The donation: Priceless

January 8, 2015 | by   
Aurora

Patient Gerald Rustad’s granddaughter Aurora helped raise funds for prostate cancer research by selling homemade bracelets.

Explaining a prostate cancer diagnosis to a young child can be difficult — especially when the cancer is incurable. But conveying the need for prostate cancer research, as it turns out, is easily done. And that leads to action.

Earlier this year, Gerald Rustad, 71, who is living with a very aggressive form of metastatic prostate cancer, found himself trying to explain his heath condition to 10-year-old granddaughter Aurora.

He told her that his cancer couldn’t be cured, but that scientists at City of Hope were busily conducting research so they could help patients like himself. His doctor, for example, Sumanta Pal, M.D., co-director of City of Hope’s Kidney Cancer Program, was working with other City of Hope researchers to develop a drug that could treat metastatic prostate cancer without targeting testosterone.

The targeting of testosterone is too arcane for most 10-year-olds, but the need for scientific answers isn’t. Aurora asked if there were any way she could help. » Continue Reading