Posts tagged ‘survivorship’


Breast cancer among minorities: Access to care is critical to saving lives

October 13, 2014 | by

All women are at some risk of developing the disease in their lifetimes, but breast cancer, like other cancers, has a disproportionate effect on minorities.

multi-ethnic women talk breast cancer

While breast cancer is most common among white women, minority women, especially African-American women, are more likely to die from the disease. Access to screening, quality care and follow-up care are crucial to bridging the gap.

Although white women have the highest incidence of breast cancer, African-American women have the highest breast cancer death rates of all racial and ethnic groups. They are 40 percent more likely to die of breast cancer than white women. The five-year survival rate for African-American breast cancer patients is 78 percent, compared to 90 percent for white women, according to the American Cancer Society. Many factors contribute to this disparity, including that black women tend to have cancers that are more aggressive and harder to treat.

But access to screening, prompt follow-up when a mammogram indicates something is not normal, and access to high quality medical care also play a significant role. In fact, City of Hope experts on breast cancer among minorities found that 15 percent of black women who have had breast cancer do not receive yearly follow-up mammograms – despite their increased risk of developing the disease. » Continue Reading


Each day is special for cancer survivors (w/VIDEO)

July 16, 2014 | by

The best measure of success in the fight against cancer is in lives saved and families intact, in extra days made special simply because they exist.

Yuman Fong, M.D., chair of the Department of Surgery at City of Hope, understands what precedes that special awareness. When cancer strikes, one minute a person may feel healthy and young, he says, and in the next, they’re wondering how many years they have left.

In those situations, expertise matters. Commitment to research, knowledge of new therapies, unrelenting dedication to quality and improvement all play a role in the best possible cancer care. City of Hope has those factors. But the best measure of cancer care is cancer outcomes – and City of Hope has those, too.

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Her breast cancer diagnosis was grim; a second opinion saved her life

July 15, 2014 | by

At 29, Kommah McDowell was a successful young professional engaged to be married to her best friend. She worked in the financial services sector and kick-boxed to keep in shape and to relax. Then came the diagnosis of triple-negative inflammatory breast cancer, a rare and very aggressive form of breast cancer. She was told she had a 5 percent chance of living two years. Here’s her story …

breast cancer

Kommah McDowell, a breast cancer survivor, serves as a mentor for black women who recently completed breast cancer treatment and are transitioning into the follow-up stage of their care.

For seven months, McDowell had been visiting her primary care doctor every other week complaining of pain, tenderness, swelling and a lump in her right breast. She was assured it was only a benign cyst that would go away – she was too young to have cancer. Finally, at McDowell’s insistence, the “cyst” was removed. During that surgery, the doctor found cancer.

“Unbelievably, the medical staff was not familiar with the type of cancer,” McDowell said. “They just knew it was cancer and the best course of action was to remove it immediately. Fortunately, I was able to go to City of Hope for a second opinion and treatment.” » Continue Reading


Children with cancer, Part 3: Transitioning from patient to survivor

July 7, 2014 | by

John Cloer was three months shy of his third birthday in 2004 when he was diagnosed with acute lymphoblastic leukemia. For the next three and a half years, he received chemotherapy at City of Hope, finally obtaining long-term remission.

childhood cancer survivor John Cloer

The challenges of a cancer diagnosis don’t stop with treatment. Survivorship brings its own challenges, as John Cloer, a former leukemia patient at City of Hope, knows well.

His parents Bill and Gina, along with John and his younger brother Steve, recently sat down to reflect on that experience, sharing tips for family members and friends of children with cancer, as well as advice for parents of children with cancer. Here, they and City of Hope pediatric nurse Karla Wilson, R.N., M.S.N., discuss the sometimes difficult transition from treatment to survivorship.

In this third of a three-part series, they describe the transition from patient to survivor.

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Some of the cancer treatments that save children’s lives also may produce life-altering side effects that don’t materialize for years.

During the Cloers’ annual visit to City of Hope’s Childhood Cancer Survivorship Program, Wilson reviews John’s medical progress, and reminds his parents about conditions they’ll need to monitor.

When alerting patients that they may be prone to future therapy-related conditions, Wilson said she always tries to drive home one message above all: Just because survivors are at risk for a condition doesn’t mean they’ll necessarily develop it. » Continue Reading


Children with cancer, Part 2: How parents can help their kids

June 30, 2014 | by

John Cloer was three months shy of his third birthday in 2004 when he was diagnosed with acute lymphoblastic leukemia. For the next three and a half years, he received chemotherapy at City of Hope, finally obtaining long-term remission.

John Cloer

Now 13, John Cloer, right with younger brother Steve, was only 3 when he was diagnosed with acute lymphoblastic leukemia. His parents learned the hard way how to cope with a new array of parenting challenges. Shown here: John (right) with his brother, Steve.

His parents Bill and Gina, along with John and his younger brother Steve, recently sat down to reflect on that experience, sharing tips for family members and friends of children with cancer and now, their advice for parents facing a similar challenge.

In this second of a three-part series, they answer the question:

How can parents help their children with cancer? 

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1. Numb the pain. Perhaps because he still remembers caregivers frantically trying to start an IV in him the day he was diagnosed, John still dreads IVs and injections. The Cloers now ask nurses to use lidocaine to numb a site before the needle goes in. (They pay for this off-protocol request, but find it worth the costs.)

In the early days of John’s illness, the tense toddler used to “rub the rubber right off his pacifier,” said Bill. “I wish we had had a better tool set to manage his anxiety,” he added. Gina regrets they didn’t get John into the habit of meditating before procedures, “a coping skill I wish he’d have now.” » Continue Reading


Children with cancer, Part 1: How family members and friends can help

June 23, 2014 | by

John Cloer became a teenager in May, an ordinary rite of passage made extraordinary because he is a cancer survivor – one of an estimated 370,000 pediatric cancer survivors in the U.S.

Childhood cancer patient John Cloer

The parents of John Cloer, now a childhood cancer survivor, learned many lessons during his treatment for leukemia. Photo courtesy of the Cloer family.

He was three months shy of his third birthday in 2004 when what his parents Bill and Gina Cloer assumed was the flu was diagnosed as acute lymphoblastic leukemia. For the next three and a half years, John received chemotherapy – eventually leading to his long-term remission.

John finally became well enough to attend kindergarten and enjoy normal pursuits like T-ball. In fact, his perseverance (from staying late to practice, to reveling in teammates’ progress) earned the 6-year-old an invitation to play T-ball on the White House lawn and meet President George Bush. He has long raised awareness for City of Hope, from presenting an award to singer Miley Cyrus to riding on the hospital’s 2014 Tournament of Roses float as his sister Heather, a City of Hope nurse, walked alongside.

When John was embarking on cancer treatment, Bill and Gina were given well-tested roadmaps from oncologists adept at keeping children alive. On the comparatively uncharted path of cancer survivorship, they have longed for a similar roadmap. Along with regular follow-up visits with doctors such as Clarke Anderson, M.D., the Cloers are being helped in their survivorship journey by City of Hope’s Childhood Cancer Survivorship Program, led by Smita Bhatia, M.D., M.P.H., the Ruth Ziegler Chair in Populations Sciences, and nurse practitioner Karla Wilson, M.S.N., R.N.

In this program, John and his family receive a comprehensive medical summary of his diagnosis and treatment, as well as an individualized review of his potential late-effects from treatment.

Bill, Gina, John and his younger brother, Steve, recently sat down around their dining room table and offered some advice to parents of children with cancer, along with well-meaning family and friends.

In this first of a three-part series, they answer the question:

What can family/friends do to help parents whose children have cancer?

» Continue Reading


Kids with leukemia at relapse risk due to forgetfulness about their pills

June 5, 2014 | by

A quarter of children in remission from acute lymphoblastic leukemia, or ALL, are tripling their risk of a relapse because they are missing too many doses of an essential maintenance medication, according to findings from a recent City of Hope study .

bottle with tablets

A City of Hope study found that a quarter of kids with acute lymphoblastic leukemia are at a tripled risk of relapse because they are missing doses of an oral chemotherapy. The No. 1 reason why: they forget.

The research, published in the journal Blood, also reports maintenance medication adherence was lower in minority groups. About 46 percent of African-American children and 28 percent of Asian children are not taking enough doses to prevent relapse, compared with 14 percent of white children.

Acute lymphoblastic leukemia, a cancer of the white blood cells, is the most common form of childhood cancer. While more than 95 percent of children with ALL enter remission within a month of receiving initial cancer therapy, one in five will relapse. Additionally, relapsed disease is often harder to treat and may involve costlier, most toxic therapies.

In order to remain cancer-free, children in ALL remission must take a form of oral chemotherapy, called 6-mercaptopurine(6MP), every day for two years to protect against the disease coming back.

Despite 6MP’s proven benefit, previous studies have suggested pediatric ALL patients have difficulty taking it consistently. Other studies reported survival rates vary greatly among racial groups – prompting investigators to begin studying race-specific patterns of adherence in children with ALL.

“While we don’t yet know why children of different races have significantly different survival rates for ALL, we know that their adherence to their maintenance medication is a critical factor in their survival,” said first author Smita Bhatia, M.D., M.P.H. “With this in mind, we sought to explore the potential linkages that may exist between several key race-specific sociodemographics of these children and their adherence to 6MP.”

Bhatia, who is also the Ruth Ziegler Chair in Population Sciences, and her team began their research studying differences in medication adherence among different racial groups of children in remission from ALL in 2012, reporting that Hispanic children did not follow their prescribed maintenance regimen as consistently as non-Hispanic whites. » Continue Reading


Childhood cancer treatment takes toll; research on it gets a new boost

June 3, 2014 | by

Anyone who’s been around children knows how resilient they can be. Most of them bounce far more than they break. Perhaps that’s one reason why most children who are diagnosed with cancer face strong odds of surviving the disease.

Armenian_Saro

Saro Armenian is determined to reduce the long-term physical toll of treatment for childhood cancer. A grant from the Rally Foundation for Childhood Cancer Research and The Truth 365 will help.

But their survival is not without cost; treatments can be aggressive and result in lingering health issues. Saro Armenian, D.O., M.P.H., medical director of City of Hope’s Pediatric Survivorship Clinic, studies the long-term adverse effects of cancer treatment in survivors of childhood cancers. In particular, he focuses on damage to heart tissue.

He recently received a prestigious grant co-funded by the Rally Foundation for Childhood Cancer Research and The Truth 365 to further his research.

Rally and The Truth 365 are nonprofit organizations that raise awareness and funds for childhood cancer research. Rally in particular funds studies that address long-term side effects of treatment, a topic that has interested Armenian for years. » Continue Reading


National Cancer Survivors Day: Celebrate survival – and research

May 30, 2014 | by


Nearly 14 million Americans are cancer survivors, an impressive community that will celebrate their survival, their lives, on National Cancer Survivors Day, also known as June 1.

On this day each year, survivors, their families, their caregivers and the medical professionals who treated them pause to celebrate milestones, to give thanks for support – and to appreciate all those things in life that cannot be taken for granted.

Survivors remind everyone at City of Hope why they do what they do  – and not just those people who directly care for patients. City of Hope is devoted to scientific discovery, in hopes of developing better treatments, finding ways to prevent and cure cancer and perhaps – as it did when tuberculosis ceased to be a leading health scourge – eventually devoting itself to curing a new disease.

Steven T. Rosen, M.D., City of Hope’s provost and chief scientific officer, explains why research is so crucial in the fight to increase cancer survival. » Continue Reading


Childhood cancer survivors might not need as-frequent heart screenings

May 19, 2014 | by

Childhood cancer survivors who have been treated with a class of drugs called anthracyclines will face an increased risk of heart problems later in life. Thus, oncologists recommend that they undergo regular monitoring with echocardiograms so that this late effect can be detected and treated before it becomes life-threatening.

For childhood cancer survivors, regular echocardiograms can cut risk of treatment-related heart failures later in life. But the frequency needed may be much less than originally thought, according to a City of Hope study.

For childhood cancer survivors, regular echocardiograms can cut risk of treatment-related heart failures later in life. But the frequency needed may be less than originally thought, City of Hope researchers have found.

Currently, for childhood cancer survivors who were treated with anthracyclines or chest radiation, the Children’s Oncology Group (COG) recommends an echocardiogram every one to five years throughout the survivors’ lives, depending on their risk profile. However, a less-frequent screening schedule may be just as effective while significantly saving costs, according to a City of Hope-led study that was published in the May 20 issue of Annals of Internal Medicine.

“Screening too frequently is an unnecessary waste of valuable resources, while screening too infrequently results in a delay of providing needed treatment,” said F. Lennie Wong, Ph.D., associate professor in the Division of Outcomes Research/Intervention and first author of the paper. “So we incorporated the available evidence to set up a computer model to determine the efficacy and cost-effectiveness of the COG recommended screening schedules and to find the ideal monitoring schedule that can detect treatment-related asymptomatic heart failure in a timely yet more cost-effective manner.”

Wong noted that the current COG follow-up recommendations are based on consensus of its expert panel of clinicians and researchers. The panel takes into account published research on heart disease risk factors for childhood cancer survivors, but no data are available about the efficacy of its recommended screening schedule or its cost-effectiveness.
» Continue Reading