Few decisions are more important than those involving health care, and few decisions can have such lasting impact, not only on oneself but on relatives and loved ones.
Those choices, especially, should be made in advance – carefully, deliberately, free of pain and stress, and with much weighing of values and priorities. That’s the purpose of National Healthcare Decisions Day, to help people make those decisions while they’re still able to do so and then to make their wishes, or directives, known.
The alternative is, ultimately, to force distraught loved ones and well-meaning health care workers to guess at what the incapacitated you would have wanted. They don’t always get it right.
So on Wednesday, April 16, observe National Healthcare Decisions Day by assessing your values, deciding on the kind of care that you want and choosing your own way. That means creating your own advance care directives. » Continue Reading
Using a card game to make decisions about health care, especially as those decisions relate to the end of life, would seem to be a poor idea. It isn’t.
The GoWish Game makes those overwhelming, but all-important decisions not just easy, but natural. On each card of the 36-card deck is listed what seriously ill, even dying, people often say are most important to them.
- To have my family prepared for my death
- To remember personal accomplishments
- To say goodbye to important people in my life
- To maintain my dignity
- To have my family with me
- To know how my body will change
- To prevent arguments by making sure my family knows what I want
- To pray
- To die at home
- To not be connected to machines
- To be mentally aware
Dawn Gross, M.D., Ph.D., the Arthur M. Coppola Family Chair in Supportive Care Medicine at City of Hope, is a fan of the game and, more specifically, the conversations it creates among family members. » Continue Reading
Young adults and adolescents with cancer face unique challenges both during their treatment and afterward. Not only are therapies for children and older adults not always appropriate for them, they also must come to terms with the disease and treatment’s impact on their relationships, finances, school or career, and fertility.
All of these challenges point to the need for more research to improve care and follow-up for this age group. Here, one of those patients – 20-year-old Monica Curiel – shares her experience with lymphoma and also her advice for others in her position.
By Monica Curiel
My story began April 10, 2013. I was diagnosed with lymphoma (stage 2) cancer on that day. The cancer was found after I blacked out in a car accident while driving on the highway.
At first, the doctors could not figure out if I had an infection or if it was cancer. I spent weeks in and out of hospital visits, trying to figure out a diagnosis. After many pokes from needles, biopsies and consultations from teams of oncologists, physicians and various types of specialists, it was concluded I had cancer.
At first, I really did not believe it. I was a 19-year-old freshman at the Fashion Institute of Design and Merchandising (FIDM) in Los Angeles. Having grown up in a rural town on the outskirts of Dallas, I was far from home. I was trying to pursue a career and establish friendships, essentially beginning a new chapter in my life, like millions of other 19-year-olds do at this point in their lives.
As the doctors began to explain my type of cancer and the stages, the next steps and treatments, my first thought was: “This is a mistake, other people get cancer, not me…. I am not strong enough for this; strong people can take on the disease. I am too young, I have so much to learn before I can fight cancer, so much to do.” » Continue Reading
Breast cancer is the most common cancer, other than skin cancer, among women in the United States. It’s also the second-leading cause of cancer death, behind lung cancer. In the past several years, various task force recommendations and studies have questioned the benefits of broad screening guidelines for mammograms, disagreeing over how often to screen, when women should start screening and when they should stop.
The waters become especially muddy when experts discuss the potential harm caused by “overdiagnosing” cancer – that is, the number of false-positive results or abnormalities that are treated unnecessarily.
A new review of 50 years worth of studies published recently in the Journal of the American Medical Association is unlikely to clear up those waters: The study concluded that the benefits of mammograms are often overstated and the harms minimized. But the study also confirmed, again, what many experts, including those at City of Hope – have been saying: Screening decisions must be tailored to the specific risks and medical histories of each woman.
“Risk assessment is really very critical,” Joanne Mortimer, M.D., director of the Women’s Cancers Program at City of Hope, has said. “We harp on individualized health care, and that means understanding each woman’s risk. At low risk, don’t expose them to radiation unnecessarily. Women at very high risk, by all means, they may need mammograms and they may also need an MRI.” » Continue Reading
Hormone therapy, which is prescribed to women for relief of menopausal symptoms such hot flashes, night sweats and vaginal dryness, has recently seen a decline in popularity (and use) due to its link to an increased risk of breast and endometrial cancer. But City of Hope researchers have found that menopausal hormone therapy may actually lower the risk of B-cell non-Hodgkin lymphoma.
Sophia Wang, Ph.D., associate professor at City of Hope’s Division of Cancer Etiology and first author of this study, will present the findings at the American Association for Cancer Research (AACR) annual meeting on Monday, April 7.
“The connection between lymphomas and menopausal hormone therapy use hinges on understanding the disease’s biology and the window of susceptibility,” Wang said. “Hormone therapy is of interest because the loss of estrogen coupled with aging in women result in decreased immune function, which can elevate risk of non-Hodgkin lymphoma.”
For this study, Wang and her colleagues examined data from the Los Angeles Cancer Surveillance Program, comparing 685 postmenopausal women diagnosed with B-cell non-Hodgkin lymphoma to 685 postmenopausal women who did not have the disease and assessing their use of menopausal hormone therapy (either estrogen alone or estrogen with progestin, in either pill, patch, topical cream or injected forms). » Continue Reading
Myeloproliferative neoplasms can’t be narrowed down to a single cancer, but they can be described by a defining characteristic: too many blood cells. The diseases bring with them a host of frustrating, potentially life-altering symptoms, and management of the diseases and their symptoms is crucial.
An upcoming City of Hope event – offered by a group founded by, and for, cancer patients – could help. But first, more about myeloproliferative neoplasms, or MPNs.
The diseases, which include polycythemia vera, essential thrombocythemia and myelofibrosis, begin in the bone marrow and lead to an unhealthy abundance of white cells, red cells, platelets or even a combination of cell types. » Continue Reading
More than 18,000 researchers, clinicians, advocates and other professionals will convene at the 105th American Association for Cancer Research (AACR) annual meeting taking place in San Diego from April 5 to 9. With more than 6,000 findings being presented over this five-day period, the amount of information can seem overwhelming.
But all those posters, presentations and seminars serve a purpose, which is best summed up by the theme of this year’s meeting: “Harnessing Breakthroughs –Targeting Cures.”
“We are in the generation of personalized, precision medicine where we can learn a great deal about cancers,” said Steven T. Rosen, M.D., City of Hope’s Irell & Manella Cancer Center Director’s Distinguished Chair. “Conferences such as AACR’s annual meeting lead to true dialogue, exchange of information and collaboration. This not only benefits the scientists’ own research projects, but also leads to meaningful advances for treating, detecting and preventing cancers.”
Added Rosen, who is also City of Hope’s provost and chief scientific officer: “City of Hope investigators are well-represented at this year’s annual meeting. They have made significant contributions to our understanding of cancers. This includes furthering our knowledge of individual cancers’ epidemiology and etiology, developing novel therapies and enhancing survivorship.”
The findings and knowledge that City of Hope researchers are sharing at this year’s conference include: » Continue Reading
Cancer of the prostate is the No. 2 cancer killer of men, behind lung cancer, accounting for more than 29,000 deaths annually in this country. But because prostate cancer advances slowly, good prostate health and early detection can make all the difference.
Many prostate cancer tumors don’t require immediate treatment because they’re small, confined and slow-growing. For patients with these type of tumors, so-called “watchful waiting,” increasingly known as “active surveillance” may be the best course of action. In “active surveillance,” physicians closely monitor patients so they can identify early signs of disease progression and treat the cancer before it spreads outside the prostate.
Here, Philip G. Pearson, M.D., and David W. Rhodes, M.D., of City of Hope | Pasadena, provide simple strategies that can help men better understand this important gland. They also explain why active surveillance is becoming a more common prostate cancer management option. » Continue Reading
Despite advances made in detecting and treating nonsmall cell lung cancer, its prognosis remains grim. Even patients whose cancers are caught at their earliest stage have only a 50 percent chance of five-year survival. This poor prognosis is due in part to the cancer’s ability to resist treatment, rendering the chemotherapy ineffective.
However, a group of City of Hope researchers have identified and synthesized a novel compound — called COH-SR4 — that is effective against drug-resistant lung cancer. If its safety and efficacy pan out in future studies, COH-SR4 could play a vital role in treating lung cancers that no longer respond to first-line chemotherapy.