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How to Regain Self-Esteem and Body Confidence After Cancer Treatment

Getting through cancer treatment is a huge accomplishment. The moment you’re finished with your final session, it can feel like you’re on cloud nine. You’ve done something incredible.

Unfortunately, it may not take long for those positive feelings to waver.

Cancer treatments are often intense and can cause noticeable changes to your body. While those changes are necessary to fight back against the disease, many can linger once treatment is done. That can leave you with low self-esteem. You might even start to struggle with mental health conditions like depression or anxiety1.

Whether it’s healing from major surgery, dealing with hair loss, weight fluctuations, or a change in your sex drive, it’s not uncommon for the after-effects of cancer treatment to make you see yourself differently.

So, how can you regain confidence in your body after your treatment journey is over?

Common Body Image Issues

Going through cancer treatment can make you feel strong on the inside, but lose confidence in your external appearance. Because both the disease and treatment can cause your body to change, it’s not uncommon for your physical appearance to affect your self-esteem.

If you’re feeling “off” after your treatment or you’re struggling with your self-confidence, it could be the result of how you see yourself when you look in the mirror. Some of the most common signs of body image issues are:

  • Your feelings about your body are affecting other areas of your life
  • You speak negatively/harshly about your image
  • You avoid seeing your own image as much as possible
  • You obsessively try to change your image with makeup/grooming

Unfortunately, we’re currently living in a period that makes it harder than ever to avoid your own image. If you’re working remotely, for example, you might be one of the 300 million people logging into Zoom meetings every day2.

The current remote culture has created some self-esteem issues of its own. Working from home can be beneficial for patients going through treatment or those in recovery. But, it’s not without its potential drawbacks.

Problems like Zoom fatigue and Zoom dysmorphia have come to the forefront for many people. Zoom dysmorphia, for example, is a condition that causes someone to develop self-image issues from looking at themselves on a screen. When you’re on Zoom meetings all day, it’s easy to start nitpicking your flaws or seeing things that others wouldn’t even notice. If you’ve recently gone through cancer treatment and are already dealing with body image issues, seeing a pixelated version of yourself on a screen can make matters worse.

So, what can you do if you’re struggling with any of these problems?

Explore Your Emotions

You might feel negative about having a negative image of yourself. After all, you just went through something life-changing and came out on the other side. But, one of the biggest mistakes you can make is ignoring how you really feel. By shoving your feelings aside, you’re putting yourself at risk for them to “bubble up” and explode later.

Instead, accept how you’re feeling. Accept the loss you’ve experienced when it comes to the way you used to look. It’s okay to feel sad or frustrated. It’s okay to grieve.

Once you’ve worked through those feelings, you can attempt to shift your mindset. Focus on the things you’ve been through and how they have made you stronger. What have you gained from this experience, and how have you changed positively?

If you’re having a difficult time focusing on the brighter side, lean on your support system. That can include:

  • Family members
  • Friends
  • Doctors
  • Support groups
  • Online forums

You can even talk to other cancer patients for advice about self-image3. The important thing is to remember you’re not alone. You undoubtedly had support with you throughout your treatment. That doesn’t just disappear because you’re cancer-free. Keep leaning on that support for help with your mental health and advice on how to keep moving forward.

Focus On What You Can Change

When it comes to your physical appearance, there are things you can and can’t control.  For example, if you lost your hair during treatment, you can’t make it grow back any faster. But, you can opt for a wig, or choose to wear hats when out in public. If your skin became dull and dry, you can’t change it overnight. But, you can use creams and lotions to bring back hydration and elasticity. If you experienced weight loss, you can purchase clothes that fit better for now, and work on slowly regaining the weight over time.

By focusing on the things you can control, you’re less likely to get frustrated. Most image issues you’ll face after cancer treatment are temporary. It may take a long time to get back to normal. But, you can take comfort in knowing most of them aren’t permanent.

When it comes to physical issues like surgery scars, they will typically fade over time, too. You can help that process with different creams and body butter. But, it’s okay to accept the fact that you may always have a scar or two. Instead of looking at those scars as something “ugly” or embarrassing, consider the fact that you get to stand there and see them. You made it through something that not everyone else gets to. A surgery scar is a sign of strength and victory.

In addition to changing what you can and accepting what you can’t, regaining confidence can come from leading a healthy life. Practice self-care every day. Develop healthy habits that make you feel good about yourself, inside and out. Get enough sleep, work out if you feel strong enough, and take time to relax each day.

Your body has been through a lot. While it’s understandable to feel self-conscious at first, realizing what it’s done for you can make you more accepting and willing to love yourself again.


Sources:

  1. Cancer patients left to cope with mental health problems alone
  2. Zoom User Stats: How Many People Use Zoom in 2021?
  3. Self-Image, Sexuality, and Cancer

Cancer-Related Depression: What You Should Know

An overwhelming 40 percent of people are projected to experience cancer at some point in their lifetime and of those patients, over 10 percent will suffer from depression related to their illness. There are a variety of reasons a person’s mental health can be impacted by cancer. Common factors are if the cancer is terminal or invasive, feeling a lack of autonomy or control over one’s life, feelings of guilt or shame for behaviors associated with cancer like smoking, loss of identity resulting from weakness, appearance changes, or loss of friends or a job.

The mental health of cancer patients is often less considered, but its impact on the progression of cancer is strongly considered by doctors, with over 70 percent of oncologists believing that mood affects the progression of cancer.

Wherever you are in your journey with cancer –– if you were recently diagnosed, if you’re a caregiver, relative, or friend of a patient, or if it is a long part of your past –– it’s important to consider mental, not just physical, health. Even cancer survivors can develop depression after they are declared cancer-free. Fear of recurrence, permanent changes to the body and overall health, and lack of community or understanding take a huge mental toll on patients.

For a variety of reasons, it’s important to recognize symptoms of depression in yourself or loved ones who live with cancer. Keep reading to explore methods of acknowledging and alleviating depression related to cancer.

Common symptoms to look out for:

  • Loss of interest in things you used to enjoy
  • Irritability
  • Frequent crying
  • Lack of motivation
  • Feelings of worthlessness
  • Sleep changes
  • Fatigue
  • Appetite loss
  • Decreased libido

Methods of coping

Get professional help

As with any serious mental health issue, it is best to see a mental health professional. A mental health professional such as a therapist or a psychiatrist can help you view your mental health holistically, not just in the context of cancer, and help determine triggers and various treatment plans individualized for each patient.

Although cancer patients may feel overwhelmed with doctor’s appointments, there are increasingly more flexible options like online psychiatry services that incorporate treatments like talk therapy with the option to prescribe an antidepressant if needed.

Surround yourself with community

Feeling supported by friends and family in difficult times is extremely important for one’s well being. In fact, it has been found that a lack of friendship is a major diagnostic criterion for a variety of mental health issues.

If you have lacked friendships or support in the past, cancer may be an opportunity to bond with those with similar experiences. There are often a variety of cancer support groups associated with charities and hospitals that help cancer patients establish community and social assistance. Some even organize retreats and wellness clinics so it is worth looking into the resources available to you. Your oncologist, for example, may be able to point you in the right direction.

If you find it difficult to keep up with your friendships, or if you lack the energy to socialize in a way that feels comfortable, pets are also found to be extremely therapeutic in the way that they provide a sort of social support. For example, dogs can provide a sense of companionship and help lower stress levels by increasing “feel-good” hormones like oxytocin in their owners. Pets like dogs even help promote a healthy lifestyle by walking them and helping their owners socialize with other dog owners at places like a dog park. This is an especially beneficial option for introverted individuals.

Make an effort to laugh

Laughter is also therapeutic, and luckily also extremely accessible. Whether it be with family and friends or by watching a comedy on Netflix, laughter can counterbalance the somberness of cancer treatment and recovery. Laughter is even considered a serious treatment for stress and depression in the medical community. However, it’s not something that can be prescribed, it has to be actively sought.

Be aware of the content you’re consuming and ask yourself whether it lightens or dampens your mood. When you pick a movie to watch or a book to read, if not a comedy try and choose something lighthearted. Ask your family and friends to send you pictures of their pets or funny videos. Go after whatever makes you happy and promotes laughter in your life!

It is completely natural to experience overwhelming emotions and even develop depression while experiencing, and even long after, cancer. Cancer is not only a diagnosis but an experience that changes nearly all aspects of a person’s life. Whether it be you yourself or a close friend or family member, it is important to recognize not just the physical, but the mental health implications of cancer. There are many ways to support someone who is experiencing cancer-related depression. Try experimenting with different options to see what works for you.

April 2021 Notable News

Eating mushrooms, lowering your BMI, personalized vaccines, a rare plant compound, and targeted treatments are all ways to treat or prevent cancer, which is a good thing, because it looks like cancer alters your cardiovascular health, and the entire cancer landscape is going to change in the next 20 years, so the more mushrooms you can eat, the better.

People seem to either love or hate mushrooms. A 2019 survey puts mushrooms on the top ten list of the most hated vegetables, but now their popularity is on the rise, and with good reason. Those little fungi could reduce your cancer risk, reports psu.edu. A study from Penn State University showed that people who eat a lot of mushrooms, about 1/8th to 1/4th cup daily, had a 45 percent lower cancer risk than those who did not eat mushrooms. All mushrooms are rich in vitamins, nutrients, and antioxidants, so any variety provides the cancer preventing benefits. Mushrooms are also the highest dietary source of a unique cell-protecting antioxidant called ergothioneine. Learn more about the study here, and for an interesting and deep dive all about mushrooms, check out this article at civileats.com.

Mushrooms are low in calories and high in protein so they are a great dietary addition if you are trying to lower your BMI, which you may want to consider if you’ve had breast cancer. A new study shows that women who have been diagnosed with breast cancer have a higher risk of being diagnosed with a second cancer if their weight increases, reports breastcancer.org. The study found that women who had an increased body mass index (BMI) after breast cancer treatment also had a seven percent greater risk of a second primary cancer, a 13 percent greater risk of an obesity related cancer, an 11 percent greater risk of a second breast cancer, and a 15 percent greater risk of a second estrogen-receptor-positive breast cancer. The 13 types of cancer linked to being overweight and obese include multiple myeloma, thyroid cancer, pancreatic cancer, and uterine cancer. Find more about the study and the other cancers linked to obesity here.

Researchers are finding better and better ways to treat cancers and early trials are proving that a personalized cancer vaccine is possible, says webmd.com. A personalized vaccine called PGV-001 was developed with custom peptides, which are types of amino acids. The vaccine was given to 13 patients who had a high risk of cancer recurrence after initial treatments. The types of cancers the patients had were head and neck cancer, multiple myeloma, lung cancer, breast cancer, and bladder cancer. Eleven of the 13 patients received all ten doses of the vaccine. Half of the patients experienced mild adverse effects, including reactions at the injection site and low-grade fever, and after about two years, four of the patients had no evidence of cancer and had received no further treatment. Four other patients were receiving other types of treatments, and three of the patients have died. Two of the patients could no longer be contacted for the study. Researchers are hopeful that personalized vaccines to treat a variety of tumor types is a viable option. Read more here.

Being able to keep cancer from spreading could make treatments more effective, and researchers at Massachusetts Institute of Technology (MIT) may have figured out a way to do it, reports mit.edu. Researchers set out to understand the physical changes that occur in a cancer cell when they metastasize, and were able to measure the properties of aggressive, metastatic tumor cells as they passed through the lining of the blood cells. The study shows that tumor cells actually become softer, which allows them to squeeze through the wall of blood vessels and spread. Researchers still don’t know what causes the cells to soften but believe that the development and use of drugs to prevent the cancer cells from softening could stop or slow down metastasis. See how they made their discovery here.

Not to be outdone by MIT, researchers at Purdue University have turned to the plant world in search of cancer treatment and have discovered that a rare compound in a plant could help treat many cancers, reports purdue.edu. A chemist from Purdue University studied a compound called curcusone D, which proved very effective at stopping cancer cells, and found a way to recreate it in the lab. The compound fights a cancer protein called BRAT1 which was believed to be “undruggable”. BRAT1 is found in many cancers including breast, brain, colorectal, prostate, lung, and liver cancers, and curcusone D is the first BRAT1 inhibitor. The plant, Jatropha curcas, or the purging nut, is native to North America, and is known for its medicinal properties, but only produces a small amount of the compound. The lab-created version of the compound can be produced in large amounts and is also effective at killing cancer cells and stopping their migration. Learn more about the curcusone D research here.

Researchers are also getting closer to finding better treatment for hard-to-treat cancers. Early studies in Japan show that there may be a way to make pancreatic cancer more responsive to chemotherapy, says eurekalert.org. The researchers discovered that targeting a gene regulator called TUG1 could interrupt its activity which helps make pancreatic cells resistant to chemotherapy. The team plans to further test their strategy. Learn more here.

Having cancer is already linked to a greater risk of heart issues, but new research shows that some types of cancer may actually alter the heart, says medicalxpress.com. The study found that people with cancer had reduced volume of the left ventricle and their hearts pumped less blood per heartbeat. Their hearts also showed signs of elevated strain and inflammation. Until now, the research has looked at how treatments like chemotherapy are detrimental to the heart, but this study shows that cancer itself can affect heart health. Questions like how cancer causes the changes to the heart and how long the changes might last after treatment still need to be answered. Learn more here.

The cancer landscape is changing and will look very different by 2040, reports ajmc.com. A new study shows that there will be more cases of melanoma and there will be more deaths from pancreatic and liver cancers. By 2040 breast cancer, melanoma, lung cancer, and colorectal cancer will have the highest number of cases in that order.

While breast cancer will lead in number of cases, it will cause fewer deaths. Prostate cancer, which is currently one of the most common cancers, will move to 14th place. Lung cancer will continue to be the leading cause of cancer deaths, followed by pancreatic, liver and intrahepatic bile duct cancer, colorectal cancer, and breast cancer, which will move down from the number three spot to the fifth spot. The future cancer landscape study was done so that plans could be made to fund research, provide healthcare, and inform policy making. Learn more about what cancer will look like in 2040 and how it was determined here.

Dealing With A Cancer Diagnosis During Your Pregnancy

Every year, nearly 3.7 million babies are born in the USA. While pregnancy and the subsequent birth of a baby is nothing short of a joyous occasion for countless women, there are many others who face various obstacles throughout their pregnancies. Apart from potentially contracting urinary tract infections, hypertension, and gestational diabetes, approximately one in every 1000 women will receive a cancer diagnosis during their pregnancy. Although the risk of being diagnosed with cancer during pregnancy is quite low, the thought of having to fight a potentially fatal disease while awaiting the birth of your baby can be devastating. Apart from placing your trust in your medical team, it is also vital to educate yourself as much about your condition as you can, and do everything in your power to keep you and your baby as healthy and comfortable as possible.

Ask Questions About Your Treatment

Although your medical team will undoubtedly discuss your treatment options with you, it is important that you ask as many questions as you need to fully understand how the treatment will be administered, as well as the benefits and risks associated with it. Some courses of treatment are safer to administer during pregnancy. Surgery is generally the safest treatment, as there is typically limited risk to the fetus. Chemotherapy can also be safely administered during the second and third trimesters. Various bodies of research have found that children who were exposed to chemotherapy while in the womb do not present more health challenges than children who weren’t. It is important to note that you will not be able to breastfeed if you are undergoing chemo, as it may be harmful to your baby.

Be Mindful of the Effects of Your Cancer on the Fetus

Despite in-depth research by some of the world’s top scientists and doctors, it is very hard to predict to what exact extent a cancer diagnosis will affect an unborn fetus. In most cases, cancer itself has no effect on the fetus. There is, however, a possibility that specific cancers such as leukemia and melanoma can spread from the mom to her unborn baby. Your oncologist will be able to provide greater insight into the possibility of this transmission occurring, and also what steps will be taken if it does occur. Once your baby is born they will immediately be checked for early signs of cancer to provide them with the best possible chance of full remission in case of a positive diagnosis.

Focus on Personal Comfort

Personal comfort becomes somewhat of a rare commodity during pregnancy, and especially in the final trimester. As your baby’s movements become stronger during the last few months of your pregnancy, you may also start feeling increasingly uncomfortable. In addition to any pain and discomfort associated with your cancer diagnosis, you may also experience backache, increased heat burn, and overall restlessness while lying down in bed. A warm bath and gentle massage may help to ease back pain, while avoiding certain foods and eating smaller portions can relieve heartburn considerably. Investing in a maternity pillow may be a saving grace if you are unable to comfortably lie down. As these pillows provide support in all the right places for pregnancy, it becomes increasingly easier to relax and drift off to sleep.

Reduce Your Stress Levels

A certain degree of stress is normal during any pregnancy. The excessive stress brought on by a cancer diagnosis can, however, be detrimental to your own health and that of your baby. According to Dr. Ann Borders from the Division of Maternal-Fetal Medicine at Evanston Hospital, severe, chronic stress during pregnancy may result in developmental concerns in babies. There are a number of things a pregnant cancer patient can do to reduce stress. This includes doing regular light exercise, engaging in meditation and other mindfulness practices, and spending time doing things you enjoy, such as reading a book or listening to music. If your stress and anxiety are getting the better of you, your medical team may recommend additional strategies to employ.

Manage Your Fatigue

The majority of pregnant women experience varying degrees of tiredness throughout their pregnancies. A cancer diagnosis can contribute to your tiredness in various ways. Apart from the increased fatigue you are undoubtedly experiencing wreaking havoc with your sleep, your cancer treatment can also leave you feeling increasingly lethargic. Rest as much as you can, and don’t be afraid to ask for help if you need it. Having someone assist you with shopping and preparing meals or offering to look after your children for a night can help you get the rest you need to replenish your energy levels. You may also benefit from a quality prenatal vitamin supplement, especially considering that up to 52% of women experience an iron deficiency during pregnancy.

Eat and Sleep Well

Following a nutrient-rich diet and getting enough sleep is pivotal to a healthy, enjoyable pregnancy. It becomes even more important when fighting cancer. According to the Sleep Foundation, sleep has the ability to help your body heal. It can also help ward off depression and decrease your risk for further medical concerns. Just as your body needs sleep to be healthy, it also requires nourishment. You can benefit both as a pregnant woman and a cancer patient from following a diet that is rich in nutrient-dense foods. Opt for fresh fruit and vegetables, lean protein, dairy, nuts, grains and legumes, and a variety of healthy fats. Steer clear of any processed foods, and limit your sugar intake as much as possible. Also, remember to stay well-hydrated at all times.

Being diagnosed with cancer during your pregnancy is something no one can ever adequately prepare for. Despite how devastating such a diagnosis may be, however, it is important to not only work closely with your medical team, but also make the necessary lifestyle changes that will help give you and your unborn baby the best chance at health and happiness.

3 Things To Know About Your Cardiac Health During Cancer Treatment

According to recent data from the American Cancer Society, 19 million new cancer cases were diagnosed in 2020 alone. However, times are changing, and cancer patients now have access to better treatment and thus an increased chance of survival. But sometimes the cancer treatment itself has detrimental effects on the body, especially the heart. This can predispose patients to heart diseases or worsen already existing symptoms. Furthermore, chemotherapy, radiation and immunotherapy can cause abnormally high blood pressure, arrhythmia, and in extreme cases, even heart failure. It is important, therefore, not to overlook the health of the heart, as it is vital to the chances of survival when undergoing treatment for cancer. The good news, however, is that the heart can be cared for through healthy life choices, and there’s a lot patients can do to protect themselves throughout their treatment.

How The Heart Is Involved

Chemotherapeutic agents in use during cancer treatment have been extensively studied for years and have some known side effects during the course of therapy. Drugs, such as Adriamycin, which is widely used as the first line of treatment for breast cancer, lymphoma, and leukemia, are known to have the highest risk of developing heart-related symptoms, with a 2% risk for developing heart failure. Two percent might not seem significant, but if combined with another chemo agent, Herceptin, which is used for HER2+ breast cancer patients, the lifelong risk for heart failure is now increased to 8-30%. In fact, adding stress to an already weakened cardiac system can lead to sudden cardiac arrest, which occurs when the heart stops beating suddenly, and is the leading cause of death in the US.

Becoming More At Risk Without Treatment

Although the side effects of some therapies are frightening, it is necessary to weigh up the pros and cons of undergoing chemotherapy. The cardiac problems are rarely present in those undergoing cancer treatment, but often enough that cardiac care and prevention should be focused on before the beginning of therapy. Over time, inflammation can lead to sudden irritation in the cardiac system, which can cause the formation of plaques and blood clots. This will also lead to triggers of a sudden heart attack.

Protecting the Heart During Cancer Therapy

Even with the advancements in medical innovations, treating cancer is not yet a precise science. Before chemotherapy can be authorized to begin by your oncologist, your medical history and results from various tests will be discussed by the medical team to pursue the most efficient treatment. Chemotherapeutic plans are specially tailored to each patient to ensure the best possible outcome and to not interfere with other conditions. During the course of treatment, regular check-ups to monitor the heart for potential conditions are vital so that problems can be found and addressed early on. Healthy lifestyles such as nutritious eating habits, daily exercise, and keeping blood pressure under control are additional, yet vital, ways to keep your heart healthy.

Detecting cardiac symptoms early is key in the treatment of heart problems. To protect your heart during and after treatment, pay attention to your entire body and maintain regular check-ups with your doctor. Not only will doing so give you peace of mind, but it will also pave the way for living a longer and healthier life.

An Expert’s Take on Promising Myeloma Treatment and Research

An Expert’s Take on Promising Myeloma Treatment and Research from Patient Empowerment Network on Vimeo.

 Myeloma research is advancing quickly. Dr. Joshua Richter, a myeloma expert, shares his excitement about emerging treatments in development.

Dr. Joshua Richter is director of Multiple Myeloma at the Blavatnik Family – Chelsea Medical Center at Mount Sinai. He also serves as Assistant Professor of Medicine in The Tisch Cancer Institute, Division of Hematology and Medical Oncology. Learn more about Dr. Richter, here.

See More From Engage Myeloma


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Myeloma Treatment: When Should a Clinical Trial Be Considered?

What Standard Testing Follows a Myeloma Diagnosis?


Transcript:

Katherine:

When it comes to myeloma research and emerging treatment options, what are you most excited about, specifically?

Dr. Richter:

So, I think the big thing that I’m excited about from myeloma that we’re on the cusp of is T-cell engagers and T-cell based therapies. And, essentially, we all have T cells in our body, and T cells are a part of our immune system. They attack bacteria, viruses, and cancer.

And one of the best cancer fighters that exists is our own immune system. And the old way of treating cancer and blood cancers like myeloma was just to give medicines that suppressed all of the immune system, the good and the bad. Now, we’re trying to be more precise, and there’s certain parts of the immune system that we don’t want down, we want up. So, they help attack the cancer.

And the two biggest technologies are something called CAR T and something called bispecific antibodies. CAR T stands for chimeric antigen receptor T cells.

And, basically, what that is is we collect your T cells, we engineer them in the lab to rev them up and target the cancer. And we can put them back into you and they attack the cancer, very exciting. And then we have something called a bispecific antibody that has two arms. And as we infuse this medicine into you, one arm grabs onto the cancer cell, the other arm grabs onto your T cell and makes that T cell activate and attack the cancer cell.

And a lot of these drugs are in clinical trials as well. So, we’re very excited about moving from, you know, just lowering everything, the good and the bad, to being more precise and saying, no, no, no. There are some cells that we want way, way up.

Katherine:

Right. Right. So, you’re – you’re being much more specific now.

Dr. Richter:

Mm-hmm.

What You Need to Know Before Choosing a Cancer Treatment

What You Need to Know Before Choosing a Cancer Treatment from Patient Empowerment Network on Vimeo.

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What steps could help you and your doctor decide on the best treatment path for your specific cancer? This animated video explains how identification of unique features of a specific cancer through biomarker testing could impact prognosis, treatment decisions and enable patients to get the best, most personalized cancer care.


If you are viewing this from outside of the US, please be aware that availability of personalized care and therapy may differ in each country. Please consult with your local healthcare provider for more information.


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TRANSCRIPT:

Dr. Jones:

Hi! I’m Dr. Jones and I’m an oncologist and researcher. I specialize in the care and treatment of patients with cancer. 

Today we’re going to talk about the steps to accessing personalized care and the best therapy for YOUR specific cancer. And that begins with something called biomarker testing.

Before we start, I want to remind you that this video is intended to help educate cancer patients and their loved ones and shouldn’t be a replacement for advice from your doctor.

Let’s start with the basics–just like no two fingerprints are exactly alike, no two patients’ cancers are exactly the same. For instance, let’s meet Louis and another patient of mine, Ben. They both have the same type of cancer and were diagnosed around the same time–but when looked at up close, their cancers look very different.  And, therefore, should be treated differently.

We can look more closely at the cancer type using biomarker testing, which checks for specific gene mutations, proteins, chromosomal abnormalities and/or other molecular changes that are unique to an individual’s disease.

Sometimes called molecular testing or genomic testing, biomarker testing can be administered in a number of ways, such as via a blood test or biopsy. The way testing is administered will depend on YOUR specific situation.

The results could help your healthcare team understand how your cancer may behave and to help plan treatment. And, it may indicate whether targeted therapy might be right for you. When deciding whether biomarker testing is necessary, your doctor will also take into consideration the stage of your cancer at diagnosis.

Louis:

Right! My biomarker testing results showed that I had a specific gene mutation and that my cancer may respond well to targeted therapy.

Dr. Jones, Can you explain how targeted therapy is different than chemo?

Dr. Jones:

Great question! Over the past several years, research has advanced quickly in developing targeted therapies, which has led to more effective options and better outcomes for patients.

Chemotherapy is still an important tool for cancer treatment, and it works by affecting a cancer cell’s ability to divide and grow. And, since cancer cells typically grow faster than normal cells, chemotherapy is more likely to kill cancer cells.

Targeted therapy, on the other hand, works by blocking specific mutations and preventing cancer cells from growing and dividing.

These newer therapies are currently being used to treat many blood cancers as well as solid tumor cancers.  As you consider treatments, it’s important to have all of the information about your diagnosis, including biomarker testing results, so that you can discuss your treatment options and goals WITH your healthcare team.

Louis:

Exactly–Dr. Jones made me feel that I had a voice in my treatment decision. We discussed things like potential side effects, what the course of treatment looks like and how it may affect my lifestyle.

When meeting with your healthcare team, insist that all of your questions are answered. Remember, this is YOUR life and it’s important that you feel comfortable and included when making care decisions. 

Dr. Jones:

And, if you don’t feel your voice is being heard, it may be time to consider a second—or third—opinion from a doctor who specializes in the type of cancer you have. 

So how can you use this information to access personalized treatment?

First, remember, no two cancers are the same. What might be right for someone else’s cancer may not work for you.

Next! Be sure to ask if biomarker testing is appropriate for your diagnosis. Then, discuss all test results with your provider before making a treatment decision. And ask whether testing will need to be repeated over time to identify additional biomarkers.

Your treatment choice should be a shared decision with your healthcare team. Discuss what your options and treatment goals are with your doctor.

And, last, but not least, it’s important to inquire about whether a targeted therapy, or a clinical trial, might be appropriate for you. Clinical trials may provide access to promising new treatments.

Louis:

All great points, Dr. Jones! We hope you can put this information to work for you. Visit powerfulpatients.org to learn more tips for advocating for yourself.

Dr. Jones:

Thanks for joining us today. 


This program is supported by Blueprint Medicines, and through generous donations from people like you.

January 2021 Notable News

What do cancer cells and bears have in common? How is artificial intelligence changing cancer? How do ovarian cancer cells survive in hostile environments? Can CML patients stop taking their medication? Why are cancer death rates continuing to decline? What should cancer patients know about the Covid-19 vaccines? There are a lot of questions to answer this month. Fortunately, we have the answers.

COVID-19 Vaccine

Some of the most pressing questions cancer patients have are about the Covid-19 vaccines. Some of the answers can be found at curetoday.com, which has put together a list of some things you should know. There are currently two Covid-19 vaccines available in the United States. They were authorized by the Food and Drug Administration (FDA) in late 2020. The two vaccines made by Pfizer-BioNTech and Moderna both require two doses, and both have an over 90 percent efficacy rate after both doses are administered. Both vaccines trigger the immune system to react defensively to the SARS-CoV-2 virus without causing the virus. There are common side effects seen as a result of the vaccines that include tiredness, pain at the injection site, headache, muscle ache, and fever. The side effects can last for several days or a week. While cancer patients should discuss the vaccine options with their doctors, it’s important to note that getting the vaccine should not affect most cancer treatments. Find the complete comparison of the two vaccines, which includes an explanation of how each vaccine works and the common side effects specific to each vaccine, here. There is also a helpful and easy-to-read infographic.

Declining Cancer Death Rates

There’s no question that declining death rates are good news. As of 2018, cancer death rates are continuing to decline in the United States, reports abcnews.go.com. The rate has been falling since 1991, and from 2017 to 2018, it fell 2.4 percent. In the past five years, almost half of the decline in cancer deaths was attributed to lung cancer. With fewer people smoking, the rates of lung cancer illness and death have declined, and due to better treatments and diagnostics, people with lung cancer are living longer. While cancer remains the second leading cause of death, it’s encouraging that the death rates are continuing to decline. Learn more here.

CML News

A question CML patients could be asking their doctors is whether or not they can stop taking their medication. Some chronic myelogenous leukemia (CML) patients may not have to, reports cancer.gov. The tyrosine kinase inhibitors (TKIs) CML patients take to make the disease manageable are taken every day and they come with some disruptive side effects, which affect the quality of life for patients. However, a new clinical study shows that patients who were in remission for at least two years, and stopped using nilotinib, imatinib, and two other TKIs, had an improved quality of life, and about two thirds of the patients remained in remission three years after stopping treatment. Find more information about the study results and which patients could be eligible to stop taking their CML medications here.

Ovarian Cancer

Researchers have long been questioning how ovarian cancer cells survive in hostile environments, but now have an understanding of how ovarian cancer cells survive and grow in the fluid of the abdomen, which should be a hostile environment of low nutrients and oxygen, reports eurekalert.org. The study looked at the structures inside the cells during different stages of ovarian cancer and found that one of the structures, the mitochondria, changed shape and function in the peritoneal cavity, the space in the abdomen that contains the intestines, liver, and stomach, which made it possible for aggressive cancer cells to flourish. Knowing how the cells are able to survive and thrive in the abdomen could help develop better treatments for the disease that may prevent the spread of cells from the original tumor to the peritoneal cavity. When ovarian cancer cells spread through the peritoneal cavity, a patient’s survival rate is just 30 percent. Learn more about the findings here.

AI Being Used in Cancer Care

Some researchers are answering the question of how artificial intelligence will play a role in the future of treating cancer. A new telescope developed at Rice University could be a game changer for cancer surgeries, says texasmonthly.com. Using artificial intelligence, it can take a lot of the guess work out of analyzing tissue and could save valuable time during surgeries. Find out how here.

Artificial intelligence is also being used to develop a technique to diagnose prostate cancer, reports phys.org. The technique is almost 100 percent accurate and can diagnose prostate cancer from urine within 20 minutes. This new technique is less invasive and much more accurate than current prostate cancer testing. Learn more about the development of the new technique here.

Cell Hibernation

Finally, who isn’t asking what bears and cancer cells have in common? It’s hibernation, of course! Cancer cells can go into a type of hibernation as a means of surviving chemotherapy, reports scitechdaily.com. Research shows that cancer cells have the ability to become sluggish and enter a slow-dividing state of rest to protect themselves when threatened by chemotherapy or other targeted therapies. They hibernate, just like bears, until the threat is gone, and they can resume their normal state of growth. The information helps look at chemotherapy-resistant cancers and how to better treat them. The study also showed that cancer regrowth can be prevented when therapies target cancer cells in their slow-dividing state of rest. Learn more about hibernating cancer cells here.

Cancer Awareness Calendar 2021

January

Cervical Cancer Awareness Month

Blood Donor Month


February

National Cancer Prevention Month

Gallbladder and Bile Duct Cancer Awareness Month

World Cancer Day (February 4, 2021)

National Donor Day (February 14, 2021)

Rare Disease Day (February 28, 2021)


March

Colorectal Cancer Awareness Month

International Women’s Day (March 8, 2021)

Triple-Negative Breast Cancer Day (March 3, 2021)

Kidney Cancer Awareness Month

Multiple Myeloma Awareness Month

Anal Cancer Awareness Day (March 21, 2021)


April

National Cancer Control Month

Esophageal Cancer Awareness Month

Minority Cancer Awareness Month

Minority Health Month

National Oral, Head, and Neck Cancer Awareness Week (April 11-17, 2021)

Testicular Cancer Awareness Month

World Health Day (April 7, 2021)


May

Bladder Cancer Awareness Month

Brain Tumor Awareness Month

Cancer Research Month

Clinical Trial Awareness Week

Melanoma and Skin Cancer Awareness Month

Melanoma Monday (May 3, 2021)

Women’s Check-up Day (May 10, 2021)

Women’s Health Week (May 9−15, 2021)

Skin Cancer Detection and Prevention Month


June

Cancer Survivors Month

Cancer Survivors Day (June 6, 2021)

Men’s Health Week (June 14−20, 2021)


July

UV Safety Awareness Month

Sarcoma and Bone Cancer Awareness Month


 August

Summer Sun Safety Month

World Lung Cancer Day (August 1, 2021)


September

Childhood Cancer Awareness Month

Uterine Cancer Awareness Month

Gynecologic Cancer Awareness Month

Blood Cancer Awareness Month

MPN Awareness Day (September 9, 2021)

Ovarian Cancer Awareness Month

Prostate Cancer Awareness Month

Take a Loved One to the Doctor Day (September 21, 2021)

Thyroid Cancer Awareness Month


October

Breast Cancer Awareness Month

National Mammography Day (October 15, 2021)

Liver Cancer Awareness Month


November

Lung Cancer Awareness Month

National Family Caregiver Month

Carcinoid Cancer Awareness Month

Neuroendocrine Tumor (NET) Awareness Day (November 10, 2021)

Pancreatic Cancer Awareness Month

Stomach Cancer Awareness Month

The Best of 2020

As 2021 begins, we would like to take a moment to highlight a few of our most popular posts from 2020 and to thank the people who contributed to the popularity of these posts. We cannot thank the authors and organizations enough that have contributed to make 2020 one for the books, even during a trying year. Your efforts to Patient Empowerment Network are greatly appreciated!

January

Patient Profile: Perseverance and Positive Thinking Helped This Young Mother

Stage IIB Hodgkin Lymphoma patient, Lindsay, shares her cancer journey from searching for a diagnosis to adjusting to her new mantle of ‘cancer survivor’.

10 Body Signals Warning Health Problems

We should always be aware of what our body is trying to tell us. Here are ten ways our body is signaling that we should be more concerned with our health.


February

How Can You Best Support A Friend With Cancer?

What happens when someone close to you has been diagnosed with cancer? Here are some tips and advice to be the most helpful to cancer patients.

Confused About Immunotherapy and Its Side Effects? You Aren’t Alone

Patients need to be aware of the side effects of immunotherapy and vigilant in addressing them with their doctor as they can signal complications.


March

Practicing Self Care In The Time of Coronavirus – How To Mind Your Mental Health And Well-Being During Covid-19

While this is naturally a worrying time, there are many things we can do to mind our mental health and boost our immunity and well-being at this time. In this blog, you will find tips to help you navigate your way through this time of global crisis.

Health Fraud Scam – Be Aware and Careful

This blog explains what healthcare fraud is and provides tips to help you avoid falling victim to these scams.


April

Cutting Through the Panic in a Pandemic

A list of trusted sources to help you cut through all the information that is being share online about the coronavirus pandemic.

Fact or Fiction: Finding Scientific Publications Infographic

This infographic from our PEN Powered Activity Guide shares her tips for finding and understanding scientific publications.


May

Cancer, COVID, and Change

Cissy White gets used to her new normal dealing with having ovarian cancer during a pandemic, and the challenges and benefits that presents.

Diversity in Clinical Trials Benefits Everyone

It is critical that minority groups are included in clinical trials because, as the broader population, their data will affect the outcome of precision medicine for everyone.


June

Social Determinants of Hope

Casey Quinlan explains that everyone’s social determinants of health have been impacted by COVID19, but she is seeing strong signals of hope.

Music as Medicine: The Healing Power of Music

For cancer patients, music can be a powerful therapeutic tool in coping with a cancer diagnosis and treatment. Here is a list of some crowd favorites.


July

Dealing with a Cancer Diagnosis During COVID-19

There’s never a good time for a cancer diagnosis, especially during a global pandemic. Here are some recommendations from cancer treatment experts.

Quotation Inspiration: 10 Quotes to Inspire, Motivate and Uplift Cancer Patients

A list of 10 quotes and messages of hope and inspiration from patients that can bring you that much needed boost in your day.


August

Turning Your Home Into a Sanctuary

These days we are spending more time at home, so you need to feel like your happy place. Turn your home in a sanctuary in 5 simple steps.

Oncology Social Worker Checklist

Oncology Social Worker, Sara Goldberger, MSSW, LCSW-R, shares her checklist for resiliency during the time of a global pandemic.


September

The Nitty Gritty on Care Partnering

Casey Quinlan provides a short checklist that can be used in any patient-with-a-bedside-care-partner situation.

Are Cancer Survivors More Susceptible To Respiratory Illnesses When Air Quality Is Poor?

A recent study published examines the connection between air pollution and respiratory health among cancer survivors.


October

Patient Empowerment Revisited

In this Part 2, we’ll look at the role of peer to empowerment and explore whether the term “empowerment” is even the right term to use.

The Power of Journaling During Cancer Treatment

This article is meant to help cancer patients understand just how much journaling can help them emotionally and physically during their treatments.


November

The Caregiver Impact: A Vital Part of Healthcare

Network Managers, Carly Flumer and Sherea Cary, team up to discuss the importance caregivers and some quick tips for caregivers.

5 Ways a Patient Portal Can Improve Your Health Care Experience

This blog shares 5 helpful tips for utilizing your patient portal to the fullest.


December

“Wait, There’s a Good Cancer?”

Carly Flumer shares her thyroid cancer diagnosis story and what it’s like being told you have the “good” cancer.

Chronic Myeloid Leukemia (CML) Patient Profile

A patient story from a chronic myeloid or myelogenous leukemia (CML), an uncommon cancer of the bone marrow, patient.

December 2020 Notable News

This month there is a lot of promising news giving hope to the possibility of a brighter, better new year. A better understanding of why humans are prone to advanced cancers and more knowledge about obesity as a risk factor, coupled with advances in targeted therapies and combinations of medications to better treat myeloid leukemias, breast cancer, and get the immune cells involved are all helping to bring about better treatments and outcomes for cancer patients. However, the technology used to create the vaccine for the novel coronavirus Covid-19, that dominated the year and changed the world for us all, just may be the biggest game changer of all. It could revolutionize the way we treat cancers and many other diseases.

The Covid-19 vaccines use a technology that could lead to managing other diseases, like cancer and heart disease, reports bloomberg.com. The technology, called mRNA therapeutics, uses messenger RNA in the vaccines to turn the body’s immune system into a factory with the healthy cells producing viral proteins that create a strong immune response. The approach has never-before been used outside of clinical experiments, and many researchers are stunned by how well it works. Cancer researchers have been studying the technology for 20 years, and the vaccine was able to be created so quickly due to what they knew from working on developing cancer vaccines. These vaccines could lead to a whole new field of medicine, with mRNA drugs for treating cancer expected to be approved in two or three years. It’s possible all infectious disease vaccines will use the technology in the next ten to 20 years, as the method is faster and cheaper than current options. The hope is to use mRNA to create flu vaccines, heart failure treatments, an HIV vaccine, and much more. Learn more about the exciting mRNA possibilities here.

When compared to our closest cousin, the chimpanzee, humans have a high risk of developing advanced cancers, and researchers now think they know why, says sciencedaily.com. New research shows that there is an evolutionary genetic mutation that is unique to humans. The SIGLEC12 gene was eliminated by the body because it lost its ability to distinguish between self and invading microbes. However, it’s not completely gone from the population, and it can be a problem for the 30 percent of people who still produce SIGLEC12 proteins. Those people, when compared to people who don’t produce the proteins, are at more than twice the risk of developing an advanced cancer during their lifetimes. Researchers are hoping to use the information to help determine who is most likely to get advanced cancers, and have developed a simple urine test to detect the proteins. Learn more about this evolutionary snafu here.

In another story about cancer risk from sciencedaily.com, researchers better understand the relationship between obesity and cancer. Obesity is linked to increased risk for more than a dozen types of cancer, as well as a worse prognosis and chance of survival. Researchers at Harvard Medical School have discovered that obesity provides the right environment for cancer cells to take fuel away from cancer-fighting T cells. Cancer cells respond to increased fat availability by reprograming themselves to eat fat molecules and thus deprive T cells of fuel. Get more information here.

When it comes to treating cancer, better therapies are discovered all the time, and now researchers have found a new class of targeted cancer drugs that may effectively treat some common types of leukemia, reports medicalxpress.com. The drugs target and eliminate leukemia cells with TET2 mutations, which are one of the most common mutations found in myeloid leukemias. The findings show that a synthetic molecule called TETi76 can target and kill cancer cells in both early and fully developed phases of leukemia and may be more effective than current targeted therapies. Find out more here.

Speaking of more effective treatments, it turns out that some women with breast cancer might not have to undergo chemotherapy for treatment, reports nih.gov. Initial results from a clinical trial show that postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER 2)-negative breast cancer that has spread to one to three lymph nodes and has a low risk of recurrence won’t benefit from adding chemotherapy to hormone therapy. The trial also showed that premenopausal women with the same HR-positive, HER2-negative breast cancer characteristics did benefit from chemotherapy. The trial was made up of more than 9,000 women who were monitored for an average of five years and will continue to be followed, so more insights about breast cancer are expected to come out of the trial. Get more information about the trial here.

Another advancement in breast cancer treatment was reported by cancernetwork.com. The U.S. Food and Drug Administration (FDA) approved margetuximab-cmkb (Margenza) in combination with chemotherapy to treat patients with metastatic HER2-positive breast cancer who have received 2 or more prior anti-HER2 regimens. A study showed a 24 percent reduction in the risk of disease progression or death. More information is available here.

Immunotherapies have helped change the way many cancers are treated, and the process is still evolving. Researchers at Purdue University have created a new immunotherapy treatment, reports purdue.edu. The new treatment focuses on the immune system and has been shown to work in six different tumor types by reprograming the immune cells within the tumor to kill the tumor rather than giving it the chance to grow. The technique could be used to treat many types of cancers because the nonmalignant immune cells that are in the different types of tumors tend to be similar. Folate, a type of vitamin B, is used to deliver the anti-cancer drugs to the cells. The new therapy could be available within ten years. Learn more about the new therapy here.

Immunotherapies used to treat advanced cancers don’t always work for everyone, but now researchers have found that two cholesterol lowering drugs might improve the effectiveness of these therapies, reports cancer.gov. Studies show that when evolocumb (Repatha) and alirocumab (Praluent) are used on their own and in combination with immune checkpoint inhibitors, they slowed the growth of tumors. The drugs, approved by the FDA since 2015 are considered safe, can be taken at home, and are less expensive than many cancer therapies. Learn more here.

Metastatic BC Research: How Can You Advocate for the Latest Treatment?

Metastatic BC Research: How Can You Advocate for the Latest Treatment? from Patient Empowerment Network on Vimeo.

What do metastatic breast cancer patients need to know about the latest research news? Dr. Megan Kruse shares highlights from the 2020 San Antonio Breast Cancer Symposium (SABCS), along with her advice for advocating for the right testing to help guide treatment options.

Dr. Megan Kruse is a Breast Medical Oncologist at the Cleveland Clinic. More about this expert here.

See More From INSIST! Metastatic Breast Cancer

Related Resources:

 

What Could Advances in Breast Cancer Research Mean for You?

How Can You Advocate for the Best Breast Cancer Care?

Factors That Guide a Metastatic Breast Cancer Treatment Decision

 


Transcript:

Dr. Kruse:                   

At this year’s San Antonio Breast Cancer Symposium, there were a few interesting presentations about the treatment of first-line metastatic triple-negative breast cancer that I think patients should be aware of.

Two of the presentations centered around trials that were presented in the past. Those reporting, patients reported outcomes from the IMpassion 130 study, which looked at chemotherapy for metastatic triple-negative disease plus the immunotherapy atezolizumab. And then, there was also an update on the results from the KEYNOTE-355 study, which was a study again of chemotherapy for metastatic triple-negative patients in combination with pembrolizumab, a different immunotherapy. And both of these studies showed that there was benefit for women in certain sub-groups of triple-negative breast cancer when looking at addition of immunotherapy.

And so, what I’d like to draw patients’ attention to with these presentations is that you have to be aware of if you fall into one of these categories so you know if you’re a candidate for the particular type of immunotherapy that can be added to chemotherapy. There are two different ways to test for if a patient is a candidate for immunotherapy and they are both tests that can be done on biopsies of metastatic or cancer recurrent sites in the body.

They can also be sent off of original breast cancer tumors. And what we now know is that for patients who do not have markers that suggest immune activation or where the immune system would be responsive to immunotherapy the addition of that extra therapy really does not help to improve cancer control over chemotherapy alone. And I think that’s a really important topic because everyone is very interested in immunotherapy, but it does have side effects of its own and it can actually be lasting side effects in terms of inflammation in organs like the liver, the colon, and the lungs.

And then, the third presentation that I’d like to bring up is the IPATunity study, which looked at the addition of a targeted therapy called ipatasertib to, again, chemotherapy for the first treatment of metastatic triple-negative disease.

And so, this is getting into an area of targeted therapy for metastatic triple-negative disease. And again, only looks at patients that have a particular marker that suggests sensitivity to this drug. And those are certain genetic markers, predominately changes in a DNA marker called PIK3CA. In this study, we actually found that there was no benefit for the targeted therapy added to chemotherapy for patients that had that genetic mutation, which was different than what was seen in earlier studies of the same combination. So, I think there’s more work to be done and it’s probably too early to say that this targeted therapy will not be used in treatment of metastatic breast cancer.

But what all of these research studies show together is that metastatic triple-negative cancer is not really just one disease. It’s very clear that within that one name, there are multiple different patient types and tumor types that need to be cared for differently.

And so, again, I think the theme from these abstracts and these research presentations is that we have to look into the right therapy for the right patient at the right time, which largely involved DNA-based testing.

So, when patients are thinking about their treatment options and how to best help with their providers about what treatment options exist for them, I think it’s important to recognize the type of testing that may be advantageous in your cancer type.

And so, for all metastatic breast cancer patients, we really recommend that they’ve had genetic testing to look for DNA changes like BRCA mutations that will lead to treatment options. For metastatic triple-negative disease, it’s important to make sure that you’re providers are testing for PDL1, which would make you a candidate for immunotherapy. And then, the more we learn about clinical trials, the more we have options for patients that have had drug-based DNA or genome-based testing. So, that’s an important term for patients to become familiar with is genomic testing.

And I think when you bring that up with your providers, they’ll know what you’re talking about and they’ll know that what you’re potentially interested in is new targeted therapy for the cancer that may either come in combination with chemotherapy or as a standalone treatment option. If you don’t have those options that are available, and FDA approved basis for regular routine patient care, there is always the option of clinical trials.

And so, if that is something that you’re interested in, genomic testing will often open the way. So, I think as you’re writing notes when you’re talking to your providers, you might wanna jot down whether or not you’ve had genetic testing and whether or not you’ve had genomic testing in the past, as both of those things will help potentially address all of your treatment options.

I’ve very hopeful about the research that is going to lead to new developments for breast cancer treatment in the next few years.

I think what we’ve seen both at this San Antonio Breast Cancer Symposium as well as other conferences in the recent past has been a lot of focus on finding the right treatment for the right patient at the right time. And so, patients seem to be very interested in finding out this information. They often come to clinic armed with the most recent data, which allows their providers to have really informed discussions about what the best treatment might be. And to talk about if the new treatments are not great right now, what treatments might look like in the future.

I think the other thing that’s encouraging about the research that we’ve seen presented at this conference is that some of these trials are very, very large. For example, the RxPONDER trial was a trial of over 9,000 patients. And I really think that’s amazing to get that many patients interested in research that may not directly impact their patient care but will impact the care of others moving forward.

It’s just a sign that our breast cancer patients are empowered, and they want to make a difference in the scientific community as a whole.

 

Breast Cancer Research News: SABCS Conference Highlights

Breast Cancer Research News: SABCS Conference Highlights from Patient Empowerment Network on Vimeo

Expert Dr. Megan Kruse shares highlights from the 2020 San Antonio Breast Cancer Symposium (SABCS). Dr. Kruse provides an overview of what this news means for early stage breast cancer patients, along with her optimism about the future of breast cancer research and treatment.

Dr. Megan Kruse is a Breast Medical Oncologist at the Cleveland Clinic. More about this expert here.

See More From The Pro-Active Breast Cancer Patient Toolkit

Related Resources:

 

Transcript:

Dr. Kruse:                   

The San Antonio Breast Cancer Symposium is a national meeting with international presence that combines all of the latest data from research on breast cancer topics. It involves clinical research, basic science research, a lot of patient, and patient advocate support.

And the idea here is to bring together all the different disciplines that are involved in breast cancer patient care and do the best information and knowledge sharing that we can each year.

This year’s San Antonio Breast Cancer Symposium brought us a lot of interesting research focusing on early-stage breast cancer patients. I think the most important presentations that were given had to do with the treatment of high-risk lymph node-positive hormone receptor-positive breast cancer patients. And these were really across three abstracts. The first abstract of interest was the Monarch E study, which looked at high-risk women with hormone receptor-positive HER2-negative breast cancer and optimizing their medical therapy.

So, these patients are typically treated with anti-estrogen therapy and the idea of the research that was presented was if the addition of a targeted medication called abemaciclib or Verzenio could help to improve outcomes for women in this population. And what the trial found was that for women who took their anti-estrogen therapy for the usual length of time but added the abemaciclib for the first two years of that anti-estrogen therapy that there is actually an improvement in cancer-free survival time or an improvement in cure rates. And this was important because these women may not benefit from chemotherapy, as we’ll talk about in another abstract.

An addition research presentation that was given that goes alongside of the monarch E study was that of the Penelope B study. And the Penelope B took a similar population to what was studied in Monarch E. So, again high-risk women with lymph node-positive, hormone receptor-positive, HER2-negative breast cancer; however, in Penelope B, all of these patients had received pre-surgery chemotherapy.

And in order to qualify for the trial, the patients had to have some cancer that remained in the breast or the lymph nodes that was taken out at the time of their surgery. So, these are patients clearly in which chemotherapy did not do the whole job in terms of getting rid of the cancer. And again, the idea here was to add a second targeted therapy to the endocrine therapy to see if that would improve cancer-free time for patients in this population. The difference in this study was that the partner targeted therapy that was used was a drug called palbociclib or Ibrance.

And the drug was actually only used for one year in combination with endocrine therapy rather than two years as was used in the Monarch E study with abemaciclib. Interestingly enough, the Penelope B study was a negative study, meaning that it did not improve the cancer-free survival time for women who took the endocrine therapy plus targeted therapy compared to women who took the endocrine therapy alone.

So, I think that these are two interesting studies that one should look at together. And clearly, may impact what we do for the treatment of high-risk hormone receptor-positive women moving forward. The third abstract that I’d like to touch on that I think was important for women with early-stage breast cancer is the RxPONDER study, also known as SWOG 1007. And this study again was looking at lymph node-positive, hormone receptor-positive HER2-negative breast cancer patients and seeing if the addition of chemotherapy helped to improve their cancer-free survival compared to anti-estrogen therapy alone.

And so, in this study, while the study population was all women with early-stage breast cancer, meeting the one to three lymph node-positive criteria, you really have to break the results down into the results for pre-menopausal women and the results for post-menopausal women.

Because overall the study really showed no significant benefit to chemotherapy on top of endocrine therapy for women in this population; however, we did see that there was a clear benefit for women who were pre-menopausal. So, the women who had no benefit from chemotherapy were largely those who were post-menopausal, while those who were pre-menopausal derived extra benefit from chemo on top of anti-estrogen therapy. And that benefit depended on what the Oncotype recurrent score was.

With women that had the lowest of the recurrent scores having a chemo benefit of about three percent going up to over five percent for women who had Oncotype recurrent scores in the mid-teens to 25 range. In both of these groups, women who had Oncotype scores of 26 or above would have chemotherapy as per our standard of care.

So, I think that this abstract is important because in the past women who had lymph node-positive breast cancer generally received chemotherapy no matter what. More recently we’ve understood that not all of these cancers are created equal and that some cancers may not actually have benefit from chemotherapy in terms of improving cure rate. So, this study is a big step forward to help individualize and specify the treatment for women with lymph node-positive, hormone receptor-positive, HER2-negative early breast cancer.

I’ve very hopeful about the research that is going to lead to new developments for breast cancer treatment in the next few years.

I think what we’ve seen both at this San Antonio Breast Cancer Symposium as well as other conferences in the recent past has been a lot of focus on finding the right treatment for the right patient at the right time. And so, patients seem to be very interested in finding out this information. They often come to clinic armed with the most recent data, which allows their providers to have really informed discussions about what the best treatment might be. And to talk about if the new treatments are not great right now, what treatments might look like in the future.

I think the other thing that’s encouraging about the research that we’ve seen presented at this conference is that some of these trials are very, very large. For example, the RxPONDER trial was a trial of over 9,000 patients. And I really think that’s amazing to get that many patients interested in research that may not directly impact their patient care but will impact the care of others moving forward.                                   

It’s just a sign that our breast cancer patients are empowered, and they want to make a difference in the scientific community as a whole.

 

November 2020 Notable News

If you or someone in your life has been affected by cancer, you probably know that cancer isn’t fair, but the evidence is mounting that, when it comes to cancer diagnosis and treatment, cancer may be particularly unfair to those who are of lower income or who are minorities. This month there is also evidence that vitamin D could help lower cancer risk if you have the right BMI, a popular gameshow host made us all very aware of pancreatic cancer during Pancreatic Cancer Awareness month, and WHO has launched big plans to eliminate cervical cancer.

Poverty and Cancer

Poverty is known to put people at a higher risk of dying from cancer, and in a new study, the National Cancer Institute took a closer look at the relationship between poverty and cancer deaths, reports cancer.gov. The study revealed that people in the United States, who live in counties with persistent poverty, have a higher risk of dying from cancer. Counties with persistent poverty are identified by the US census as having had 20 percent or more of the population living below the federal poverty level from 1980 to the present day. Twelve percent of the counties in the US are considered persistent poverty counties, and many of them are in the southeastern part of the country. The counties are mainly rural and have a high percentage of Black and Hispanic residents. Between 2007 and 2011, cancer deaths were higher in counties with persistent poverty. The study specifically showed an increased risk of dying from lung, colorectal, stomach, and liver cancers. The findings reveal the widespread need to address the disparities among those living in poverty who are diagnosed with, and are at risk of, developing cancer. More information can be found here.

Inequities in Lung Cancer

Another report reveals further inequities when it comes to lung cancer treatment and survival rates. Black Americans, and in particular Black males, are more likely to get lung cancer and less likely to survive it, reports healthline.com. When Black Americans are diagnosed, the cancer is more likely to be in a later stage and to have spread to other parts of the body, making it harder to treat. No matter when they are diagnosed, Black Americans tend to have worse outcomes. Past studies have shown that Black patients are 66 percent less likely than white patients to get quality treatment for lung cancer. Many factors are involved, but there is research that shows that bias and racism in the healthcare system affects the quality of care given to racial and ethnic minorities. Learn more about the healthcare disparity affecting Black Americans and what can be done about it here.

Vitamin D

Vitamin D may reduce your risk of cancer, but only if you are at a healthy weight, reports medicalxpress.com. People who live near the equator, where they have a high exposure to vitamin D-producing sunlight, have lower incidence of and lower death rates from some cancers. However, clinical trial results have not shown vitamin D to have much effect on cancer, despite the fact that vitamin D deficiency is present in 72 percent of cancer patients. A study known as the Vitamin D and Omega-3 Trial (VITAL), which ended in 2018, found that vitamin D did not reduce cancer. However, researchers are analyzing the VITAL data again and think they have found the link between vitamin D and a reduction in cancer risk. The connection seems to be body mass. Researchers found, that when vitamin D supplements were used, the overall risk reduction for advanced cancer was 17 percent. However, the risk reduction increased to 38 percent in study participants with a normal body mass index. Find out more about vitamin D and cancer here.

Pancreatic Cancer Awareness

November is the month dedicated to pancreatic cancer awareness, and despite losing popular “Jeopardy!” host, Alex Trebek, to the disease early in the month, the outlook on pancreatic cancer is improving, reports medicalxpress.com. The improved outlook is a result of advances in screening, early detection for high-risk people, and treatment. Advances in MRI technology are used for screening and detection, and improvements in chemotherapy have increased the chance of removing tumors. A diabetes diagnosis can also help find the cancer early, while it is still curable. In this small number of cases, the diabetes diagnosis is unexpected and is actually being caused by the cancer. Researchers continue to focus on early diagnosis, and there have been promising advances in that as well, including a potential stool test like the Cologuard test that is used to screen for colon cancer. Trebek, who succumbed to pancreatic cancer on November 8, was able to posthumously address his audience on World Pancreatic Cancer Day, November 19. He described the disease as terrible and urged people to see their doctors if they experienced symptoms. Per mayoclinic.org, pancreatic cancer symptoms include abdominal pain that radiates to your back, loss of appetite or unintended weight loss, yellowing of skin and whites of your eyes (jaundice), light-colored stools, dark-colored urine, itchy skin, new diagnosis of diabetes or existing diabetes that’s becoming more difficult to control, blood clots, and fatigue. Learn more about the positive developments for pancreatic cancer here. See Alex Trebek’s posthumous message on World Pancreatic Cancer Day here. See the Mayo Clinic’s list of pancreatic cancer symptoms here.

Cervical Cancer

The World Health Organization (WHO) launched its strategy to eliminate cervical cancer, reports who.int. WHO hopes with vaccination, screening, and treatment, more than 40 percent of new cases and 5 million deaths will be reduced by 2050. This is the first time that 194 countries will come together with a commitment to eliminate cancer. Cervical cancer is preventable, and it is curable if detected early and treated properly. However, for women, it is the fourth most common cancer in the world. If no changes are made to address cervical cancer, the number of new cases is expected to increase from 570,000 to 700,000 each year, and the number of deaths may increase from 311,000 to 400,000 each year. Find more information about the WHO strategy to eliminate cervical cancer here.

How Can You Advocate for the Best Breast Cancer Care?

How Can You Advocate for the Best Breast Cancer Care? from Patient Empowerment Network on Vimeo.

Breast cancer expert Dr. Julie Gralow explains how you can advocate for the best metastatic breast cancer care, through speaking up, utilizing care team members and taking key steps to achieving better care.

Dr. Julie Gralow is the Jill Bennett Endowed Professor of Breast Medical Oncology at the University of Washington, Fred Hutchinson Cancer Research Center, and the Seattle Cancer Care Alliance. More about this expert here.

See More From INSIST! Metastatic Breast Cancer


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Transcript:

Katherine:                  

For patients who may be hesitant to speak out for themselves and advocate for their own care and treatment, what advice do you have?

Dr. Gralow:                

You have a whole team who’s behind you, and I’m the MD on the team, but I’ve got a nurse practitioner, and a nurse, and a scheduler, and a social worker, and a nutritionist, and a physical therapy team, and financial counselors. I’ve got a whole team who works with me. And so, a patient might be hesitant to speak up during the actual appointment with their physician. It’s a short amount of time. I would recommend come into it with written-down questions because things go fast. You don’t get a lot of time with your doctor.

Things go fast, but don’t come in with 25 questions, either. Pick your top few that you want to get taken care of this visit because if you come in with 25 or 30, you’re going to lose the answers to most of them. Maybe bring somebody with you who’s an advocate and a listener for you who could be taking notes, so you can process and you don’t have to write it down, or ask if you can record it. It’s really important if you’re newly diagnosed or maybe there’s a progression and you’re going on a new treatment. That’s okay too.

But, I would also say you have a whole team behind you, so sometimes, if you don’t have time or if you’re hesitant to speak up in your doctor’s visit, you can ask the nurse, or maybe you can ask the social worker for help, even. See if there’s support groups around.

Interestingly, we’ve got a peer-to-peer network where patients can request to talk to somebody else who’s matched to them by some tumor features, and their stage, and things like that. Maybe finding somebody else who’s gone through something similar, and somebody independent to talk to instead of relying on your family.

It can also be really helpful to talk to a therapist or a psychologist about your fears, and sometimes, you want to be strong for your family, strong for your children and all, but you need a safe space with somebody that you can just express your fears and your anger if that’s what’s going on, or your depression or anxiety to while you’re trying to hold a strong face for others in your family. So, I would encourage patients to look at who is the whole team and talk to the other members of the team as well, and sometimes, they can help advocate.

Also, find somebody who might be able to come to your appointments with you, somebody who will help you advocate or remind you – “Didn’t you want to ask this question?” – or be another set of ears that you can process it with afterwards.

Katherine:                  

Dr. Gralow, we’ve covered a lot of useful information today for patients. Thank you so much for joining us.

Dr. Gralow:                 

Thank you, Katherine.

Katherine:                  

And, thank you to all of our partners. To learn more about breast cancer and to access tools to help you become a proactive patient, visit powerfulpatients.org. I’m Katherine Banwell.