Adolescents and young adults (AYAs) with cancer have different needs and treatment challenges than children or older adults. They’re a unique population because they don’t fit into a distinct group, often falling into a gap between cancer treatment programs designed for children and those designed for adults.
Here, pediatric oncologist Julie Wolfson, M.D., M.S.H.S., discusses how the cancer experience differs for AYAs and how City of Hope’s multidisciplinary AYA team offers assistance and a network of professionals to support teens and young adults from the beginning of treatment through survivorship.
Who are AYAs and what are some of the cancers most often seen in this group?
The National Cancer Institute considers an AYA to be any patient who has been newly diagnosed with a malignancy between the ages of 15 and 39. Some of the more common cancers in AYAs are lymphomas, thyroid cancer, melanoma, testicular cancer, leukemia, brain and spinal cord tumors, cervical cancer and breast cancer. These patients have diagnoses similar to both young children and older adults, depending on what age group they fall into. For example, acute lymphoblastic leukemia is more common with younger AYAs, while older AYAs may see thyroid, breast and skin cancer more often.
What are some of the unique short-term and long-term health and psychosocial issues facing AYAs during and after cancer treatment?
Beyond feeling they’re invincible, AYAs are clearly at a unique developmental time in their life to be diagnosed with a devastating illness. Staying on schedule with their peers in school, work and keeping up with their family life are so important, and losing a (sometimes newfound) control over their lives while instead gaining a sense of social isolation can feel overwhelming. Issues such as sexuality and body image are important in a unique way in AYAs, as is fertility. Many cancer treatments can alter the ability to conceive a child – whether you’re a young man or woman. Communicating with your health-care team about whether or not there is a way to preserve fertility is a very important conversation for an AYA. Continue reading “Meet our doctors: Julie Wolfson on cancer in teens, young adults” »
Year after year, lung cancer continues to be the No. 1 cause of cancer death in the U.S. and worldwide. This year, more than 228,190 people in the U.S. are expected to be diagnosed with lung cancer and approximately 160,000 people are expected to die from the disease — enough people to fill Dodger Stadium, Yankee Stadium and Chicago’s Soldier Field to overflowing.
City of Hope is trying to change that.
The national cancer research hospital has established a program that combines lung cancer screening with tobacco cessation — to help smokers detect problems early and to help them live a smoke-free life.
Smoking is linked to most lung cancer deaths in the U.S. and remains the leading risk factor for lung cancer. (Lung cancer is rising among nonsmokers, however, especially women.)
The first and best step to help avoid smoking-related health problems, including lung cancer, is to give up cigarettes. That is, kick the habit — for good.
“We believe very strongly that one of our missions is to help eliminate the use of tobacco, which is probably the most important thing people can do to decrease their cancer risk,” Dan Raz, M.D., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program, said in a recent interview with City of Hope’s City News.
World Diabetes Day is today, Nov. 14. This year’s theme is “Protect the future,” and in the video above, Raynald Samoa, M.D., assistant professor at City of Hope’s Department of Clinical Diabetes, Endocrinology & Metabolism, discusses current City of Hope research that could benefit future generations.
“We are working tirelessly to try to find new ways to treat diabetes as it reaches epidemic proportions,” Samoa said. According to the World Health Organization, more than 347 million people worldwide have diabetes, and that number — along with diabetes-related complications and deaths — is expected to grow.
Among the promising areas of research that could lead to prevention or better management of the diabetes: Continue reading “World Diabetes Day: New research, new treatments for the future” »
Imbruvica. Unless you or a loved one have mantle cell lymphoma, the word is likely unfamiliar. If you do have the disease, the news that the Food and Drug Administration (FDA) on Wednesday approved the drug for mantle cell lymphoma is significant.
Mantle cell lymphoma is a rare type of non-Hodgkin lymphoma – and it’s difficult to treat. Imbruvica, which inhibits the enzyme that the cancer needs to multiply and spread, is only the third drug approved specifically to treat mantle cell lymphoma.
The new drug, with the generic name ibrutinib, was approved for patients who have already received at least one form of therapy.
Leslie L. Popplewell, M.D., an associate clinical professor at City of Hope and an expert in hematologic malignancies, believes that the drug could have a real impact.
“Mantle cell lymphoma is an uncommon lymphoma and well-known for poor prognosis,” she said. “Unlike other entities like diffuse large B-cell lymphoma, it is not curable with conventional chemotherapy approaches. Young patients who are newly diagnosed are treated with aggressive chemotherapy, and often with autologous transplant in first remission.”
The drug, which has the FDA’s breakthrough therapy designation, was approved under an accelerated approval program based on a study of 111 people. That study showed that cancer shrunk or disappeared in 66 percent of participants.
“It is hard to know where ibrutinib will eventually fall in the treatment schema for MCL – it is not an option for newly diagnosed patients, for example, but it is an important new drug in our arsenal,” Popplewell said. “Being available in pill form makes it especially attractive as a treatment option for patients because it allows them to have fewer disruptions in their daily activities.”
Good Friday 2012 was the day Melissa Pierce decided to change her life.
The 36-year-old Duarte resident made a plan, hopped on a bike that was in her garage, signed up for Weight Watchers and began a weight-loss journey that left her, eight months later, 80 pounds lighter and feeling 100 percent better.
“To me, it’s a matter of life and death, and I want to live,” said the now-slender Pierce. “For me, the battle’s not over. It’s still a day-to-day process. I have to make a plan every day.”
That’s one reason Pierce signed up for the Foothill Fitness Challenge, City of Hope’s friendly competition between local cities to motivate our neighbors to be as healthy as they can be. The goal is for participants to make lifestyle changes – such as getting to a healthy weight and starting an exercise program – that can reduce the risk of cancer, diabetes and other diseases. For Pierce, the goal is maintenance.
After Pierce joined Weight Watchers, she began educating herself about the right foods to fuel her body. That first Sunday of her plan, she spent a portion of the day cooking and planning out her meals for the week.
The start of her excercise program didn’t require as much planning. “I picked up a bike in my garage that was in there, just sitting there,” she said. Continue reading “Foothill Fitness: Participant shares tips for 80-lb. weight loss” »
World Diabetes Day 2013 is Thursday, Nov. 14, and in tune with this year’s theme, “Protect our future,” Americans and everyone else are being encouraged to engage in regular physical activity to lower their risk of developing diabetes later in life.
The amount of exercise needed to help ward off the disease might be less than you think. In the video above, Raynald Samoa, M.D., assistant professor at City of Hope’s Department of Diabetes, Endocrinology & Metabolism, discusses recent research suggesting that even a few minutes of vigorous exercise a week can reduce the risk of diabetes. Continue reading “Even 30 minutes of exercise a week can lower your diabetes risk” »
Weight-loss surgery means sacrificing sweets and making major lifestyle changes. It doesn’t mean having to skip colorectal cancer screenings.
Bariatric surgery is effective for weight loss because it restricts the amount of food or liquid a person can consume, often through banding or surgical alteration of the stomach. But preparation for a colonoscopy usually requires drinking a large amount of liquid twice a day. Even though these preparations have become easier over time, and the amount of liquid is smaller, the quantities can be a lot for a weight-loss surgery patient to swallow.
In response to the news that one in three people recommended for potentially lifesaving colorectal cancer screening skip it, one City of Hope Facebook follower raised an excellent question, asking: “What about people who have had bariatric surgery and drinking or consuming anything in large quantities is not doable?”
Donald David, M.D., chief of the Division of Gastroenterology at City of Hope, responded:
“Alternate preparations are available for bariatric surgery patients so that they may also receive colorectal cancer screenings, including colonoscopy. For example, it’s possible to drink the prep over a longer period of time. There are also ‘pill preps’ available, in which the patient takes 32 pills over a course of a day, usually taking four pills with a glass of water. Consult your doctor to address your specific needs related to your surgery, but colonoscopies are definitely possible – and encouraged – for bariatric surgery patients.”
So, even if you’ve had weight loss surgery, make an appointment for colorectal cancer screening if you’re age 50 or so.
Watch the recent news story above about the recent Centers for Disease Control and Prevention report.
One in three Americans ages 50 to 75 are skipping the recommended screenings for colorectal cancer, says the Centers for Disease Control and Prevention, even though the disease is the nation’s second-biggest cancer killer behind lung cancer.
In total, the CDC reports, about 23 million adults who should undergo the potentially lifesaving screenings have not done so. Those least likely to be screened include Hispanics, people age 50 to 64 and men in general.
One City of Hope expert blames a lack of accurate information. “People have a lot of misconceptions about this kind of exam or think they have to wait for symptoms, but then it’s not a screening test,” Donald David, M.D., chief of the Division of Gastroenterology at City of Hope, said in a USA Today story.
David said one reason people hesitate to be tested for colorectal cancer – often done by a colonoscopy, first around age 50 and again 10 years later – is because they worry about the cost. However, for many, the preventive screening is fully covered by insurance. In fact, the CDC found that about two of every three adults who have never been tested actually have a regular doctor and health insurance that could pay for the test. Continue reading “CDC: Colorectal cancer screening saves lives, but 1 in 3 skip it” »
Radiation therapy for breast cancer has undergone dramatic improvements over the years, increasing survival and reducing the risk of recurrence. But new research suggests that this form of treatment can increase cardiac risk in early-stage breast cancer patients.
The findings, published by researchers from Columbia University Medical Center as a research letter in the journal JAMA Internal Medicine, seem alarming. They’re based on radiation treatment plans in 48 women who had early-stage breast cancer at New York’s University’s department of radiation oncology.
One City of Hope surgeon, however, cautions against overreacting. When used for the treatment of breast cancer, radiation therapy is a highly effective way to destroy cancer cells in the breast that may linger after surgery, said Laura Kruper, M.D., head of breast surgery service at City of Hope and director of the Rita Cooper Finkel and J. William Finkel Women’s Health Center.
“There are newer radiation therapy methods that reduce the risk,” Kruper said in a recent interview with HealthDay. “We are really tailoring patients’ treatments. We have a lot of tools now where we can offer women breast conservation and minimize their [heart] risk.”
Further, the risk found by Columbia researchers was small, with the lifetime risk of a major coronary event ranging from 0.05 percent to 3.5 percent, depending on how the radiation was administered and the patient’s overall risk for heart disease.
Most cancer centers in the United States prefer to communicate only in English. That preference is natural – communication just seems easier when it’s based on a language used by the majority. But the reality is that true communication is a two-way street; it’s not about talking to, but rather conversing with.
City of Hope understands this – and has recently introduced a Chinese language website, cn.cityofhope.org, that offers content focused specifically on the needs of Chinese-speaking patients, caregivers and their families. The institution is now the only National Cancer Institute-designated cancer center on the West Coast to provide a Chinese language site. The move follows the 2012 launch of a Spanish-language site, espanol.cityofhope.org.
“City of Hope was founded 100 years ago on the principle of service to humanity. Our new Chinese language website helps us to further achieve our mission in a meaningful way,” said City of Hope President Robert Stone in a news release about the site. Continue reading “Chinese language website: ‘Important milestone’ in fighting cancer” »