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.
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.
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.
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.
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.
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.
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
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.
- 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.
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.
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.
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
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
Cancer and its treatment can create unexpected daily challenges for patients. Side effects from chemotherapy, surgery and radiation therapy as well as the disease itself can cause difficulty in everything from speech to movement to eating. When this happens, rehabilitation is vital; it helps patients restore their lost skills or function and become as self-sufficient as possible.
Too many hospitals and cancer centers underestimate the importance of rehabilitation; that can’t be said of City of Hope.
Through the efforts of a team of clinicians led by the Department of Rehabilitation Services, City of Hope recently gained institutional Survivorship Training and Rehabilitation (STAR) certification, a nationally recognized cancer survivorship designation. The institution is one of only two National Cancer Institute-designated comprehensive cancer centers to do so.
Although several faculty and staff members received STAR certification as individuals last year, the current certification applies to the institution as a whole.
“It’s quite rare for a cancer center to attempt STAR certification,” said Jennifer Hayter, M.A., O.T.R./L., director of rehabilitation services at City of Hope. “We’re proud to be one of the few to successfully attain it.” » Continue Reading
Betsy Sauer and her four daughters share plenty in common. They’re smart and successful. They’re funny, ranging from wryly witty to wickedly hilarious. Their hobbies tend toward the active and adventurous: hiking, rock climbing, skiing, swimming, fishing, kayaking, yoga and horseback riding. Also, they take health seriously.
They’ve had to.
Betsy Sauer is a two-time breast cancer survivor who learned that she was positive for a mutation in the BRCA genes, tumor-suppressing genes that, when mutated, are linked to an increased risk for breast and ovarian cancers. Women with these mutations can have up to an 80 percent risk of developing breast cancer. Knowing their mother’s history, all four of her daughters underwent breast cancer genetic testing. Three of the four tested positive for the BRCA mutation.
Knowing their increased cancer risk gave them options for taking control of their health.
“As hard as it was as a mom to know that I passed this on to my daughters, it was at least tempered by them having this information so they can be aggressive about their own health,” Sauer said in an interview with CBS News. » Continue Reading