January 6th, 2009
Among the many studies researchers are doing to understand ovarian cancer risks, some are looking at the relationship between obesity and ovarian cancer.
In a study, published in the most recent issue of the journal CANCER, researchers write that obesity may be a contributing factor to developing the cancer, with hormones playing the deciding factor.
According to a recently issued press release:
To investigate this issue, Dr. Michael F. Leitzmann of the National Cancer Institute and colleagues studied 94,525 U.S. women aged 50 to 71 years over a period of seven years. The researchers documented 303 ovarian cancer cases during this time and noted that among women who had never taken hormones after menopause, obesity was associated with an almost 80 percent higher risk of ovarian cancer. In contrast, no link between body weight and ovarian cancer was evident for women who had ever used menopausal hormone therapy.
Among women with no family history of ovarian cancer, obesity and increased ovarian cancer risk were also linked in this study. However, women that did have a positive family history of ovarian cancer showed no association between body mass and ovarian cancer risk.
These latest findings provide important additional information related to women’s risks of developing ovarian cancer. "The observed relations between obesity and ovarian cancer risk have relevance for public health programs aimed at reducing obesity in the population," the authors wrote.
This is interesting work. Hopefully they will be able to narrow things down in the not so distant future.
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Tags: cancer blog, ovarian cancer, obesity and ovarian cancer
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By Marijke -- 0 comments
January 6th, 2009
Ok, pop quiz: What do these men have in common?
- Former Secretary of State Colin Powell
- Singer Harry Belafonte
- Golfer Arnold Palmer
- Former South African President Nelson Mandela
- Musician Frank Zappa
Answer…
They all had prostate cancer.
Breast cancer is talked about all the time among the rich and famous, so it seems, but prostate cancer - not so much. Luckily, there are famous men who are speaking out about their diagnosis and battles with the disease. The more who talk, hopefully the more men will get the message about prostate cancer screening.
Colin Powell had localized prostate cancer for which he had surgery in 2003. He was 66 at the time of diagnosis and all seems well up to now.
In 1997, Harry Belafonte was the subject of this very interesting article on his battle with prostate cancer and the subsequent incontinence and impotence. He said that these things needed to be discussed for men to realize that they’re not alone.
Arnold Palmer, a golfer that was popular wherever he went, is another man who was shocked by a diagnosis of prostate cancer. His story The Legend Continues…. is a good run down on how he coped.
Nelson Mandela is one man who has experienced more than his share of pain - both physical and emotional. In 2001 he, too, was diagnosed with prostate cancer. He was 83 at the time and this miraculous and inspiring man underwent 7 weeks of radiotherapy and continues to live his life, a symbol of freedom that couldn’t be denied.
Frank Zappa was one of the unlucky ones. He was diagnosed with advanced, inoperable prostate cancer in 1990 - it had been present for 10 years, reports say. He died in 1993. Other famous men who died of prostate cancer include actors Telly Savalas (most known for his portrayal of detective Kojak), Bill Bixby (from The Courtship of Eddy’s Father and the Incredibly Hulk TV series, among others), and Linus Pauling, PhD, a 2-time Nobel Prize winner.
Get checked. Be screened. A little bit of discomfort with a digital rectal exam and a blood test can and does save lives.
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Tags: cancer blog, bill bixby, frank zappa, harry belafonte, nelson mandela, former secretary of state colin powell, digital rectal exam, died of prostate cancer, diagnosed with prostate cancer
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By Marijke -- 0 comments
January 5th, 2009
This question is a bit tricky to answer. The news reports say yes, African Americans are more likely to get colon cancer and to die from colon cancer than their white peers. However, we need to look more closely at the details before coming to a certain finding.
Studies that look at African Americans and whites who have equal access to health care do not have a higher rate of colon cancer. In fact, if both groups have equal health insurance, equal medical care access and treatment, then their detection, treatment and recovery rates are similar.
However, if you look at the differences in access to health care and treatments, that’s when things change. It’s a known fact that people without health insurance or who are underinsured have a lower rate of disease prevention screening. They also have a lower rate of seeing a doctor when they experience signs or symptoms of an illness. Therefore, when they finally do see a doctor, their disease is usually farther along and more difficult to treat.
Statistics from the US government show that African Americans often fall into the uninsured group. Almost 20% of African Americans who are under 65 years old don’t have any health insurance.
Is there a genetic component? It’s definitely a possibility because of the type of cancer many African Americans are diagnosed with. Right-sided polyps and cancer is more common among African Americans than in whites.
More studies are being done and more efforts are being made to encourage lower income and uninsured people to be screened for colon cancer. It’s so much less expensive and life changing to have colon cancer detected early, when it has an over 90% cure rate.
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Tags: cancer blog, colon cancer, african americans colon cancer
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By Marijke -- 0 comments
January 3rd, 2009
I remember working with a writer once, editing her work, as she writing about neck pain caused by disc problems. The uppermost part of the back and the neck are part of the cervical spine. Near the end of the article, she had written something about how the problem could ultimately cause cervical cancer.
When I contacted her to tell her that the cervix and the cervical spine were totally unrelated, she became quite huffy and told me that she was well aware of the difference. The story still gives me a chuckle years later.
Anyway, it’s Cervical Health Awareness Month and it has nothing to do with your spine! The United States Congress designated January as Cervical Health Awareness Month and the National Cervical Cancer Coalition wants to make teen girls and women more aware of the health of their cervix and cervical cancer prevention.
The cervix is found at the top of the vagina and is the lower part of the uterus. There is an opening in the middle of the cervix and this is through where menstrual blood flows, semen enters, and babies are born.
The most important issue in cervical health is the Pap smear or Pap test. A Pap test is a screening test that checks for abnormal cells on the cervix. A Pap test can usually detect changes in a cell before it becomes cancerous. Because of this, cervical cancer is extremely treatable. However, you must HAVE the test for it to find the cells.
It’s recommended that women have their first Pap test when they become sexually active, if they’re under 18, or at 18 if they’ve not yet had sex. The nurse practitioner or doctor will then instruct each woman as to how often they should return for screening.
A Pap test is not a preventative thing - it can’t prevent you from getting infections or diseases, it can only detect if some things have already changed in the cervical cells.
Stay tuned to learn more about cervical health and cervical cancer.
~~~~~
Tags: cancer blog, cervical health, cervix, cancer of the cervix, cervical cancer, pap tests, pap smears
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By Marijke -- 2 comments
January 3rd, 2009
Many kids say they want to be a doctor when they grow up - especially if they or someone they love has been seriously ill. But, as life takes us through its twists and turns, not as many who say they’ll be doctors actually become them. And then there are the special ones.
There’s a great story over at ctv.ca, about a doctor who treated a 12-year-old for cancer, replacing cancerous bone in the knee with a prosthetic knee. Now, several years later, this patient, 28-year-old Trevor Banka, MD, is a second year resident (training period after you get your medical degree), specializing in oncology, just like his mentor, Michael Mott, MD.
You can read about this story in the article, Doctor, former patient now colleagues in Detroit.
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Tags: cancer blog, oncology
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By Marijke -- 0 comments
January 1st, 2009
I know, you’re probably shaking your head thinking, "what???" So did I when I first saw this after fellow b5media blogger Angela, over at Breastfeeding 123 told the channel about it. Starting on Sunday, January 4th, it’s National Delurking Week, so it would be great if you would speak up and let me know you’re there!
If you think about it, it does kind of make sense.
After all, millions of people are reading websites and blogs, right? You’re one of them, and there are millions more like you out there maybe even reading this post. But you (maybe), again like millions of others, won’t leave a comment on the blogs you read. I know, I can be the same way. Heck, I *am* the same way, forget the "can be" part.
But I’ll tell you something from a writer and blogger’s point of view. Comments keep us going. Comments encourage us to write more stuff for you. Comments help us from slowly going crazy because we think that no-one cares about what we’re writing. We do know, deep down, that you do care, because many of you keep coming back, but we’d so love to hear from you too.
If you need a little hand-holding, I can do that:
How do you comment? At the bottom of each post is a link that says how many comments are there. If it says "0 comments," then you can be the first! Just click on the link, the one that says "0 comments" or however many there are, and you will be led to the comments section.
You’ll be asked your name (put in whatever name you like, this isn’t to ID you, it’s to give you a handle of sorts), your email address and website if you have one. If you don’t like giving your email address, you can get a "throw away" one from gmail, yahoo, or hotmail, just to name a few. The emails don’t go anywhere but the dashboard for the blog and the only person that sees it is the blogger. In this case - that would be me. Emails are good because sometimes people leave messages that would make a great starting point for a post, but I like to ask permission from the poster. Or, if there’s more information I can provide, this way I can contact you. But if you’re really spooked about it, just get a throwaway email address - I have that for a few places on insisting knowing my email.
The website section is just so you can let other readers know about your site if you have one and you want. If you don’t, just leave it blank. And then write your comment.
Unfortunately, I have to leave my comments on moderated status. This means you won’t see your comment right away. You wouldn’t believe the *hundreds* (yes, hundreds) of sickening spam emails I get every day. I’m no prude by any stretch of the imagination, but I really don’t want to be reading most of what the spammers send me. Also, some people try to use blogs as a forum for their advertising. That’s not a good idea. So, the comments go into moderation - I get emails saying they’re there and I go and allow them or spam them, whichever the case may be.
I try to do this right away, but it’s not always possible. Although it does seem as if I’m chained to my computer, I do step away from it every so often. Shocking, huh? ;-)
You’re there… I know you’re peaking….let me know you’re there!
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Computer screen image used with permission from Angela and "Weirdvis"
Eye image: iStock.com
Tags: national delurking week
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By Marijke -- 1 comment
December 31st, 2008
Or, in English, Happy New Year!
Gelukkig Nieuwjaar is Dutch and Bonne Année is French -
both for Happy New Year!
I wish all my Cancer Commentary visitors, new and regular, and their loved ones a safe and peaceful new year. For those of you who are living or dealing with cancer right now, my best wishes and hopes for you as you go through the process. For those who have recovered, may you stay healthy and cancer free.
See you on the other side of the calendar!
~~~
Image: MorgueFile.com
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By Marijke -- 0 comments
December 31st, 2008
If you are the one with cancer, you’ve likely been thinking about what you would decide if treatment doesn’t work. If you’re the one who loves someone who has cancer, you’ll likely have thought of the same things, although hoping that it never comes to that.
One thing that cancer does for almost everyone is it makes us confront our mortality, be it from an illness like cancer or a car accident. While living wills, or advance directives, are often thought of as something for the elderly or ill, they really are for everyone. As we have time to think about what we want, do research and talk to others, we can decide what we think we want should the unthinkable happen and we become incapacitated - unable to decide for ourselves what type of medical treatment we want. Or don’t want.
What is a living will?
A living will tells your family and doctor what it is you wish to be done if you’re not able to tell them yourself. For example, if you’ve been in a car accident and you are in a coma - how aggressive do you want the doctors to be? If you have cancer are in the last stages, how far do you want care to go? If you have a stroke and are considered to be in a vegetative state, do you want to be fed by a tube? Those are just a few of the questions that are answered with living wills.
Why have one if you’ve told people what you want?
Many of us have discussed with our families and maybe our friends, what we would like done for us if we ever become incapacitated. I know I have - but I also know that my wishes have changed over the years, depending on what stage we were at and how old my children were at the time.
If you’ve told your family what you want, this is a great start, but it’s not enough. When you’re ill or have been injured, they may not be in any shape to fulfill your wishes. They may not remember, they may think there’s hope - or maybe they aren’t around or have been injured as well. There are many, many factors that could result in your wishes not being followed.
Can you do it yourself?
While you can do a living will yourself, whether it will be recognized as a legal document to be followed by the healthcare workers may be very iffy. To be absolutely sure that your wishes are noted and will be followed for legal purposes, you should go through a lawyer or the legal designate for your province or state.
Are they revocable?
Absolutely! Just like a regular will, you don’t *have* to stick with what you’ve written for a living will. You can change your mind and change the contents whenever you want. The only thing that you must ensure is that every change is done legally and is noted for all to follow.
Do doctors have to follow the living will?
To learn the ins and outs of legal wills in your state or province, it’s best to get legal advice. A professional can help you understand what you can and can’t do.
So, do you have one? Are you thinking about getting one? I’m running a survey about living wills and am looking for answers from everyone - those who have living wills and those who do not. The goal of the survey is to get at least 1000 answers so we can try to determine what the biggest concerns are and where the educational needs are.
Please consider taking my survey, which you can find here: Living Wills and Advance Directives.
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Tags: cancer blog, living wills, chronic illnesses, advance directives
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By Marijke -- 0 comments
December 31st, 2008
This article is the third and final installment of a 3-part series on breast reconstruction surgery introducing the reconstructive options available to women facing mastectomy for breast cancer. The first two in the series are: Every woman has a right to breast reconstruction and Muscle flaps in breast reconstruction surgery after breast cancer.
Dr Minas Chrysopoulo has offered to write some information on various breast reconstruction issues. What he writes is from his point of view and knowledge. I hope that the series is of interest and help to those who live through breast cancer and helps those who love them understand the issues more clearly.
Breast Reconstruction Surgery: What Every Woman Needs To Know – Part III – Perforator Flaps
By Minas Chrysopoulo, MD
The ideal breast reconstruction technique is one which allows reconstruction of a “natural," warm, soft breast with the least impact on the woman’s body. While breast reconstruction with stem cells may not be too far off, until it becomes a reality we are limited to using the woman’s own tissue to achieve these goals. As discussed in the previous posts in this breast reconstruction series, until fairly recently the only tissue reconstruction options involved sacrificing muscle. This made recovery from the surgery difficult and painful, not to mention the risk of long-term muscle function loss and weakness.
Perforator flap techniques use skin and fat from various parts of the body. All muscles are preserved. Since no muscle is sacrificed recovery is much easier and muscle strength and function are preserved long-term.
The downside to these procedures is that they are technically much more demanding than other breast reconstruction techniques and require microsurgical expertise. For this reason they are not offered by many plastic surgeons and patients must be prepared to travel when choosing these procedures. DIEP (Deep Inferior Epigastric Perforator) Flap
The DIEP flap is the latest evolution of the TRAM flap (discussed in Part II) and represents today’s gold standard in breast reconstruction.
Images credit: Dr. Minas Chrysopoulo
The DIEP flap procedure is similar to the TRAM flap but only requires the removal of skin and fat. NO MUSCLE is sacrificed. The blood vessels required to keep the tissue alive lay just beneath the abdominal muscle. Therefore, a small incision is made in the abdominal muscle in order to dissect the vessels and microsurgery is required to reattach the blood vessels to the chest area.
Even though an incision is made in the abdominal muscle no abdominal muscle is removed or transferred to the breast in the DIEP flap procedure. As a result, women do not have to sacrifice their abdominal strength and they experience less pain and a much quicker recovery. The risk of abdominal bulging and hernia is also very small.
The DIEP flap was first described in the early 1990s but has remained much less popular than the TRAM flap among plastic surgeons, presumably because of the increased complexity and difficulty of the procedure compared to the TRAM.
So the advantages of the DIEP flap are multiple: it uses living tissue to recreate a breast that often looks and feels like a normal breast; abdominal strength is not affected; the risk of bulging or hernias is significantly reduced; and, like the TRAM flap, the patient benefits from a simultaneous “tummy-tuck.”
The DIEP flap is a very technically demanding operation but the benefits are tremendous for the patient, especially when performed at the same time as a skin-sparing mastectomy.
SIEA (Superficial Inferior Epigastric Artery) Flap: The SIEA flap procedure is very similar to the DIEP flap procedure. The main difference between the SIEA and DIEP is the artery used for blood flow supply to the reconstructed breast. The SIEA arteries are generally found in the fatty tissue just below skin. As in the DIEP the SIEA flap reconstruction does not sacrifice the abdominal muscle and only uses the woman’s skin and fat to reconstruct the breast. While the SIEA flap procedure is similar to the DIEP it is used less frequently since less than 20% of women have the anatomy required to allow this procedure.
GAP (Gluteal Artery Perforator) Flap
Women who do not have an adequate amount of abdominal tissue for reconstruction may be eligible for the GAP flap. This procedure uses excess skin and fat from the gluteal or buttock region. Fat and skin from either the upper or lower buttock region can be used and microsurgically transplanted to the chest. Once again, no muscle is sacrificed. Incisions can generally be hidden by most underwear.
Images credit: Dr. Minas Chrysopoulo
If a woman requires a bilateral reconstruction with GAP flaps most surgeons prefer to only perform one side at a time. It is important to discuss this possibility with your surgeon. Advantages of the GAP flap include: a scar that is generally hidden with underwear or swimsuits, and no loss of muscle function or strength.
Other Breast Reconstruction Options:
TUG (Transverse Upper Gracilis) Flap
Like the GAP flap, the TUG flap is an option in cases where there is not enough lower abdominal tissue to reconstruct the breast(s). The TUG procedure uses the upper part of the inner thigh; skin, fat and a small amount of muscle are disconnected and transferred to the chest to create the new breast. The woman benefits from a simultaneous inner thigh lift. Once again, this procedure is not widely available due to its complexity and need for microsurgical expertise.
It is important to realize that whichever method of reconstruction is used, the vast majority of women will require 2 or even 3 procedures for the optimal cosmetic result. Each procedure is typically separated by several weeks. The entire reconstructive process, regardless of the method of reconstruction, can therefore take several months to complete. However, breast reconstruction does NOT typically complicate or delay cancer treatment such as chemotherapy.
With all this in mind and also remembering the superior cosmetic results associated with immediate breast reconstruction (reconstruction performed at the same time as mastectomy), it is recommended that women discuss their reconstructive options with a plastic surgeon specializing in breast reconstruction before undergoing mastectomy whenever possible.
For more information about breast reconstruction options please visit www.prma-Enhance.com. For the latest news and developments in breast reconstruction please also visit The Breast Cancer Reconstruction Blog.
Dr Chrysopoulo, board certified plastic surgeon, PRMA Plastic Surgery, San Antonio, TX. Specializing in breast reconstruction surgery after mastectomy for breast cancer. Over 350 DIEP flaps performed yearly. In-network for most US insurance plans. Toll Free (800) 692-5565. www.prma-Enhance.com. Latest breast reconstruction news available at The Breast Cancer Reconstruction Blog.
Note from Marijke: I don’t have any personal experience with breast cancer and reconstruction issues. The information, particularly of the DIEP flap procedures, is provided by the doctor’s knowledge and experience.
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Tags: breast cancer, breast reconstruction, mastectomy, perforator flaps breast reconstruction, DIEP flap, deep inferior epigastric perforator flap, TRAM flap, SIEA flap, superficial inferior epigastric artery flap, GAP flap, gluteal artery perforator flap, TUG flap, transverse upper gracilis flap
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By Marijke -- 0 comments
December 30th, 2008
Press Release
FDA Approves Drug for Patients with Advanced Prostate Cancer
The U.S. Food and Drug Administration recently approved the injectable drug degarelix, the first new drug in several years for prostate cancer.
Degarelix is intended to treat patients with advanced prostate cancer. It belongs to a class of agents called gonadotropin releasing hormone (GnRH) receptor inhibitors. These agents slow the growth and progression of prostate cancer by suppressing testosterone, which plays an important role in the continued growth of prostate cancer.
Hormonal treatments for prostate cancer may cause an initial surge in testosterone production before lowering testosterone levels. This initial stimulation of the hormone receptors may temporarily prompt tumor growth rather than inhibiting it. Degarelix doesn’t do this.
“Prostate cancer is the second leading cause of cancer death among men in the United States and there is an ongoing need for additional treatment options for these patients,” said Richard Pazdur, M.D., director of the Office of Oncology Drug Products, Center for Drug Evaluation and Research, FDA.
Prostate cancer is one of the most commonly diagnosed cancers in the United States. In 2004, the most recent year for which statistics are currently available, nearly 190,000 men were diagnosed with prostate cancer and 29,000 men died from the cancer.
Several treatment options exist for different stages of prostate cancer including observation, prostatectomy (surgical removal of the prostate gland), radiation therapy, chemotherapy, and hormone therapy with agents that affect GnRH receptors.
The efficacy of degarelix was established in a clinical trial in which patients with prostate cancer received either degarelix or leuprolide, a drug currently used for hormone therapy in treating advanced prostate cancer. Degarelix treatment did not cause the temporary increase in testosterone that is seen with some other drugs that affect GnRH receptors.
In fact, nearly all of the patients on either drug had suppression of testosterone to levels seen with surgical removal of the testes.
The most frequently reported adverse reactions in the clinical study included injection site reactions (pain, redness, and swelling), hot flashes, increased weight, fatigue, and increases in some liver enzymes.
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Image: Newscom
Tags: cancer blog, degarelix, leuprolide, FDA approves prostate cancer drug, prostate cancer, advanced prostate cancer
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