I truly understand when a patient comes in for their regularly scheduled follow up appointments and the apprehension and fear that encompasses you during that time. I often say for me going through it that I hold my breath until I hear the all clear and of course that is not exactly accurate but it is how I feel. I have been with patients that come to me and celebrate the all clear that they just received from their doctor and turn around and in the next five minutes or hour or day, have a patient that turns to me for support since their cancer is either not receding or is back and they are once again faced with treatment decisions and possible outcomes. This is all in a day and I feel the full gambit of what these people have turned to me for support for. I know that I want to jump and shout when it is good news and words are difficult to find when it is not so good news. You as family and friends hear the rest of the story...the what if's, the possible outcomes, the uncertainty in an otherwise strong person that may be the leader of your family or circle of friends. No matter what the news, we all need support. Listening may be one of the hardest jobs in the world and I for one want to be able to fix it all and have to realize that it is not mine to fix. I believe in a higher power and turn more and more over each day to that higher power. I also ask for support so that I may help others. No one can do this all alone, I am fortunate to have good friends and family and also an amazing husband to help find the steps and words and skills to just listen. No matter what side the coin lands on, we are all put here to help one another and I for one am no better or worse than the next. I hope that I can make your day a little better for both sides of the coin and hopefully you will be able to do the same. Challenging days!
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Cancer study surprises researchers
More women than expected benefit from amenorrhea
Thursday, June 03, 2010
By Sean D. Hamill, Pittsburgh Post-Gazette
It has long been understood that one of the reasons most premenopausal women benefited from chemotherapy drugs after breast cancer surgery was because the drugs stop menstruation for a time, suppressing their ovaries and the estrogen they produce.
That helped them fight the disease because 75 percent of women with breast cancer typically have estrogen receptor-positive (ER-positive) cancer cells in their tumors, which can grow in response to the estrogen. As a result, it also has been thought that the 25 percent of women who have ER-negative cancer cells -- that don't react to the estrogen -- would not benefit from chemotherapy-induced amenorrhea, which is the absence of menstruation. But a new nine-year study of 5,351 women with early-stage, node-positive breast cancer, to be published as the lead article today in the New England Journal of Medicine, with much of the research done by Pittsburgh doctors, has stunned researchers by finding that even women with ER-negative cancer cells benefit from amenorrhea. "That was a surprise," said Charles E. Geyer Jr., one of the lead authors and a breast medical oncologist at Allegheny General Hospital. "We're spending a lot of time now trying to come up with hypotheses as to why." Dr. Geyer is also the director of medical affairs for the National Surgical Adjuvant Breast and Bowel Project, which conducted the study in collaboration with leading U.S. cancer centers and cooperative cancer research groups, including Allegheny General, the University of Pittsburgh Cancer Institute, and the University of Pittsburgh's Graduate School of Public Health. The study's finding that amenorrhea in ER-negative women was associated with higher rates of survival and disease-free life was such a surprise that when they were first presented at a breast cancer symposium in San Antonio in December 2008, "a lot of people were skeptical of our findings," said Dr. Geyer. "They said we had to go back and test our tumor testing." Double-checking those tests that classified all 2,245 premenopausal women in the study into ER-positive and ER-negative categories confirmed the findings. Now experts in the field say the study's results will probably be the beginning of a whole new range of studies that, first, will try to duplicate the results, but also try to find out why this occurs. "It was a very interesting finding that I didn't expect," said Nancy Davidson, director of the University of Pittsburgh's Cancer Institute, who was not involved in the study, but, like most in the field, was aware of it and eager to see its results. "Maybe it's something else going on with the ovaries. Maybe it's doing something else we don't understand." The finding on amenorrhea was so out of the blue that it is getting more attention than the main objective of the study, testing which of three regimens of chemotherapy drugs was best for breast cancer patients. The regimens involved different dosages and lengths of cycles for combinations of three of the most effective chemotherapy drugs in use today: doxorubicin, an anthracycline antibiotic that inhibits DNA replication in rapidly growing cancer cells; cyclophosphamide, a nitrogen mustard alkylating agent, which slows or stops cancer cell growth; and docetaxel, a taxane that prevents cancer cells from undergoing mitosis and growing. One regimen, known as "sequential ACT" gave patients four cycles (or 12 weeks) of doxorubicin and cyclophosphamide at the same time, followed by four more cycles of docetaxel (for 24 weeks total for all three drugs); the second regimen, known as "concurrent ACT" gave patients four cycles of the three drugs at the same time for four cycles (or 12 weeks total); and the third regimen gave four cycles of just doxorubicin and docetaxel. "The hope had been to find out if you could use less chemotherapy, because they're so toxic," said Priya Rastogi, one of the study's co-authors who is an assistant professor of medicine at the University of Pittsburgh Cancer Institute. But the results were clear that the longer, heavier doses of the drugs worked better, with 83 percent of the women receiving the sequential ACT regimen surviving at the eight-year mark in the survey, compared to 79 percent for both concurrent ACT and the doxorubicin-docetaxel regimen. "It seems they proved that. The differences in the regimen are quite conclusive," said Abenaa Brewster, a breast cancer researcher at the M.D. Anderson Cancer Center at the University of Texas, whose prior work on the topic was cited in this new study. While many oncologists already follow that protocol, for some doctors this will verify that belief and could change how they administer drugs. "Now we know that's the way we should be giving drugs," said Joseph P. Costantino, a University of Pittsburgh professor of biostatistics and director of the National Surgical Adjuvant Breast and Bowel Project's Biostatistics Center, which collected and analyzed the study's data. After skin cancer, breast cancer is the No. 1 form of cancer in women, with about 180,000 new cases diagnosed each year in the United States. About 40,000 women die from breast cancer each year, second only to lung cancer. A sobering statistic in the report noted that 803 of the 5,351 women who volunteered to take part died by study's end on Aug. 31, 2008, a fact the researchers said points to the women's courage and the ongoing motivation for more research. "A big part of the credit for this study goes out to these women," said Dr. Rastogi. "You can't get this information without them." Sean D. Hamill: [email protected] or 412-263-2579. Read more: http://www.post-gazette.com/pg/10154/1062767-114.stm#ixzz0pthDa2SG Look Good Feel Better witll be June 15th from 6-8 here at the Yolanda G. Barco Oncology Institute. This is open to all women who are going through treatment and the best part is you will learn new techniques for hats, scarves, make-up. It is a fun evening and if you are interested, please call me so we can sign you up. We must have reservations for this program. Again, call :373-3381 and I will get you in on this great program.
On Wednesday, the 16th, we will have the STAYING CONNECTED support group for all those in treatment or have completed treatment and we just ask you bring your sack lunch and meet in the library from 12-1 and we just get together and kabitz. That way you stay connected to those friends you made during your treatment and possibly make new ones along the way. That evening at 7 is THROUGH YOUR EYES which is a support program for caregivers here at the institute and this helps you to connect to others that have walked the path ahead of you or are currently going through it. Both groups are totally driven by the needs of the group and we would love to have you come and share with us. I am now on a mission for bang snaps before the holidays. Laughter is the best and I would love to hear how many ways you have used bang snaps. The worse story I have heard was as a young man, this person put a cherry bomb in the toilet and as they are waterproof, it blew up the toilet. Guess I will stay with my bang snaps as it really won't cause damage but sure can make enough noise to cause some laughs. Great day yet again! S
New Vaccine "Could Eliminate Breast Cancer"
A first-of-its-kind vaccine to prevent breast cancer has shown overwhelmingly favorable results in animal models, according to a study by researchers at Cleveland Clinic's Lerner Research Institute. The researchers found that a single vaccination with the antigen alpha-lactalbumin prevents breast cancer tumors from forming in mice, while also inhibiting the growth of already existing tumors. Human trials could begin within the next year. If successful, it would be the first vaccine to prevent breast cancer. The research will be published in the journal Nature Medicine. "We believe that this vaccine will someday be used to prevent breast cancer in adult women in the same way that vaccines prevent polio and measles in children," said Vincent Tuohy, Ph.D., the study's principal investigator and an immunologist in Cleveland Clinic's Lerner Research Institute Department of Immunology. "If it works in humans the way it works in mice, this will be monumental. We could eliminate breast cancer." In the study, genetically cancer-prone mice were vaccinated - half with a vaccine containing alpha-lactalbumin and half with a vaccine that did not contain the antigen. None of the mice vaccinated with alpha-lactalbumin developed breast cancer, while all of the other mice did. Continue at PhysiciansNews.com. |
AuthorMy name is Sue Kilburn and I am a clinical nurse breast cancer educator at the Yolanda G. Barco Oncology Institute in Meadville, Pennsylvania. Archives
March 2015
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