'Ask Amy' writer promotes 'ring therapy'

Syndicated columnist offers advice for cancer patients on dealing with anxious supporters

Amy Dickinson

"Grief circles" can be a useful tool for cancer patients to cope with their disease.

According to a recent syndicated "Ask Amy" column by Amy Dickinson, the circles — otherwise known as "ring therapy" — conceptualize "the important idea that, when dealing with tough to tragic times, it is important for the person at the center of the circle [the patient]…to preserve her strength by only dealing with the person most intimately involved in her care — this might be a spouse, family member, or friend."

Other relationships, she wrote, "arrange outward in concentric rings. This is called the 'kvetching order.'"

Dickinson's column, which was in response to an elongated cry for help by a breast cancer patient who signed her plea "Not Dead in California," said that "ring therapy is mainly…to give you permission to react the way you want to during a time when you need to preserve your strength."

The patient is "not supposed to be worrying about how to be gentle and polite," she adds.

Dickinson also notes that the patient "can say anything (complain, cry, howl at the room) to those in outer rings, but those in outer rings should limit their own needs, fears, and statements and focus only on being helpful. No unsolicited advice, no raging at the injustice of it all, no demands for comfort or constant updates."

The letter-writer had explained that a close friend was "having trouble coming to terms with my diagnosis, as well as my not taking her up on her offers of help (yet)," and noted that the friend had "called a few nights ago sobbing and looking to me to help her feel better [about my long-term prospects and diagnosis], "which isn't as good as it could be, but…also not as bad as it could be."

She went on to say that she'd "rather not be calming down my friends when inside I'm losing my mind with the slow paced of health care and juggling my appointments and treatments" and, in this particular case, "cannot be the person making [the friend] feel better about my illness."

The columnist advised the letter-writer to tell members of her support group that she understands "that this is hard for you, but I can't help you through this. I've got too much on my plate" — and to encourage such friends, when they are upset, "to contact someone else in an outer ring."

Details of how I, Woody Weingarten, dealt with my wife, Nancy Fox, when she was being treated for the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I aimed at male caregivers.

It — and the Marin Man to Man website about a weekly support group I've been running since that time — includes anecdotal material about how she hadn't wanted to worry about my reactions to what was going on with her.

Acrylamide chemical in java may be perilous

Judge rules Starbucks, 90 other companies may have to display coffee warning in California

Because of a judge's decision, Starbucks and about 90 other roasters, grocery stores and retail shops may soon have to display a cancer warning on coffee sold in California.

According to yesterday's Associated Press story by Brian Melley, the Los Angeles judge ruled in favor of a nonprofit, the Council for Education and Research on Toxics, that had sued the companies in 2010 for failing to comply with state law by not providing a "clear and reasonable warning" of a known carcinogen.

Superior Court Judge Elihu Berle's decision — to the effect that the companies hadn't shown the threat from the chemical was insignificant — was issued as a proposed ruling, which means he could change his mind (although, reportedly, that's unlikely).

Berle, the AP piece said, gave the defense several weeks "to file objections to the proposed ruling before he makes it final."

After that ruling, a decision on monetary damages could be forthcoming.

The suit has centered on a chemical, acrylamide, that was produced in the roasting process.

Berle wrote that, while the "defendants failed to satisfy their burden of proving…that consumption of coffee confers a benefit to human health," the plaintiff had "offered evidence that consumption of coffee increases the risk of harm to the fetus, to infants, to children and to adults."

He also said that the "defendants' medical and epidemiology experts testified that they had no opinion on causation."

The AP story noted that the coffee industry has maintained that "the chemical was present at harmless levels and should be exempt from the law because it results naturally from the cooking process necessary to make the beans flavorful."

The article also indicated that attorney Raphael Metzger, who brought the lawsuit, said "he wants the industry to remove the chemical from its process [but] coffee companies have said that's not feasible and would make their product taste bad."

Metzger's group had earlier brought a similar case that resulted in potato-chip makers agreeing in 2008 "to pay $3 million and remove acrylamide from their products rather than post startling warnings that can be found throughout California and are largely ignored," the story added.

Many coffee companies, according to the AP, "have already posted warnings that specifically say acrylamide is found in coffee and is among chemicals that cause cancer. However, many of those warnings are posted in places not easily visible, such as below the counter where cream and sugar are available."

William Murray

William Murray, president and CEO of the National Coffee Association, has claimed in an emailed statement that "coffee has been shown, over and over again, to be a healthy beverage. This lawsuit…has confused consumers, and does nothing to improve public health."

Nearly half the defendants in the coffee case have already settled — and agreed to post warnings. Among the latest was 7-Eleven.

Details on everyday products that may cause cancer can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

New drugs can lead to 'varied, bizarre' problems

Cancer-killing immunotherapies can cause major side effects in otherwise healthy organs

New immunotherapies can eliminate cancers but may also cause big problems with healthy body organs. 

According to a recent story by Laurie McKinley in The Washington Post, the perplexing side effects can range from inconsequential to severely dangerous, even life-threatening.

The article cites the case of a 55-year-old patient whose therapy "knocked back her cancer [but] also gave her 'almost every 'itis' you can get'… arthritis-like joint pain, lung inflammation called pneumonitis and liver inflammation that bordered on hepatitis."

The woman, McKinley's piece continues, warns "that highly touted immunotherapy treatments have downsides as well as benefits and to watch for complications, because 'not all doctors know all the side effects.'"

The upside is clear, however.

Checkpoint inhibitors, the new therapies, "offer a tantalizing chance for survival for patients with advanced melanoma and hard-to-treat cancers of the bladder, kidney and lung," the story says.

The downside? 

"The treatments, designed to unleash the immune system to attack malignancies, also can spur an assault on healthy organs, causing varied and bizarre side effects ranging from minor rashes and fevers to diabetes and deadly heart problems."

Dr. Drew Pardoll

Some of the symptoms, unfortunately, can fool doctors because they "can mimic those of the flu, infections or even food poisoning. That lack of awareness [by physicians] can be dangerous, given that quick intervention is the key to preventing serious damage."

The Post article quotes Dr. Drew Pardoll, director of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, as noting that immunotherapy "has a completely different side-effect profile than chemotherapy, and that has caught some physicians off guard."

Doctors, including emergency-room physicians, dermatologists and gastroenterologists, Pardoll insists, "need to go back to school" to earn about immunotherapy.

The side effects, McKinley writes, "occur in 15 to 70 percent of immunotherapy patients, depending on which drug is used and whether the medications are used individually or combined with one another or conventional cancer treatments."'

Are the cancer treatments worth using despite the side effects?

According to Kevan Herald, an immunologist and endocrinologist at Yale University, they absolutely are. "If it's a choice between staying alive and developing diabetes versus not, I'd always pick taking the drug and managing the diabetes."

Jeffrey Bluestone, an immunologist at the University of California, San Francisco, is also quoted in the Post piece. "The last thing you want to do is scare people away from lifesaving treatments," he maintains.

Questions about new treatments, drugs and research on life-threatening diseases are addressed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Problems can pop up years after treatments

Warning: Breast cancer therapy such as chemo, radiation can hike risk of heart disease

Can lifesaving breast-cancer treatments raise your chances of dying from a heart disease?

Possibly.

A recent story in The Washington Post by Laurie McKinley cites an American Heart Association warning to women with breast cancer that "lifesaving therapies like chemotherapy and radiation can cause heart failure and other serious cardiac problems, sometimes years after treatment."

The AHA suggests, however, that rather than avoid the treatments patients should "take steps to prevent or minimize the cardiac risks" by exercising regularly and sticking to a healthy diet.

According to McKinley's dispatch, the caution, published in the journal Circulation, includes the conclusion that "breast cancer survivors who are 65 and older and were treated for their cancer are more likely to die of cardiovascular problems than breast cancer."

Nearly "48 million women in the United States have some kind of heart disease, compared to 3.3 million women with breast cancer," the Post piece asserts, adding that the AHA "said an unprecedented number of women are surviving the disease yet face a risk of developing heart problems, in part because of their cancer treatments."

Dr. Laxmi Mehta

Dr. Laxmi Mehta, who led the writing of the report and is a cardiologist at Ohio State University, is quoted as saying that "it's important for people to know that the heart needs to be taken care of before, during and after treatment."

And Dr. Otis Brawley, chief medical officer of the American Cancer Society, is paraphrased as noting "it isn't unusual for a breast-cancer patient who underwent chemo years earlier to wake up one day with swollen ankles and shortness of breath, symptoms of congestive heart failure," but when such a patient ends up hospitalized, "doctors tend to look for signs of a heart attack or pulmonary embolism while overlooking breast cancer treatment as a possible culprit."

That's a problem, he indicates, "because heart failure caused by a chemo drug like doxorubicin [which once was called adriamycin] is treated differently than heart failure from a heart attack."

The report says some studies have shown that "dexrazoxane can reduce the risk of heart damage in patients getting high doses of doxorubicin for advanced breast cancer" and that some heart damage, including the kind cased by Herceptin, can sometimes be reversed.

The Post article also reveals that some doctors worry that the AHA report might discourage women with high-risk cancer — especially those with HER2-positve and triple negative breast cancer — from getting aggressive treatment.   

More details about the risks of radiation and chemotherapy can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Earpieces, texting can quash disease fears

Anxieties about cellphones causing brain cancer are still unfounded, new studies show

Worried about getting cancer from cellphones?

New studies indicate there's no need to hang up — still.

According to a recent Associated Press story by Seth Borenstein and Lauren Neergaard, although "two government studies that bombarded rats and mice with cellphone radiation found a weak link to some heart tumors," federal regulars and some scientists continue to say it's safe to use your device.

Previous studies had shown little reason for anxiety.

"In particular, scientists could not find hard evidence for concern about brain tumors," the story says.

Dr. John Bucher

It goes on to assert that Dr. John Bucher of the National Institute of Environmental Health Sciences, the lead author of the research, isn't changing his cellphone use "or advising his family to," and that Dr. Otis Brawley, the American Cancer Society's chief medical officer, noted in an interview after reading the studies, "I am actually holding my cellphone up to my ear."

Even though the new studies that involved super-high doses of radiation showed a rare connection to some nerve-tissue tumors in male rats, Brawley's quoted as saying, "the evidence for an association between cellphones and cancer is weak. And so far we have not seen a higher chance risk in people."

If, however, you're still concerned, "wear an earpiece," he urges.

Bucher suggests, moreover, that the rat tumors "do not translate directly into  concern for humans."

According to the AP piece, Bucher's agency "conducted the $25 million study at the behest of the Food and Drug Administration, which quickly said cellphones are safe."

Dr. Jeffrey Shuren

The article also quoted a statement by FDA radiation health chief Dr. Jeffrey Shuren to the effect that the "current safety limits for cellphones are acceptable for protecting the public health."

Bucher, in a news conference, had insisted that the experiment with rats and mice, in which they were bombarded for one hours a day for up to two years, incorporated "a radiation level so high that humans would only experience it briefly, such as when a phone with a weak signal expends more energy searching for as stronger one."

A 2010 analysis in 13 countries had "found little or no risk of brain tumors," and an earlier Danish study that linked phone bills to a cancer registry had found no risk even from more than 13 years of cellphone use.

In December 2017, the state of California issued guidelines saying that if people were still worried, they should reduce exposure by using earphones or texting.

More information about potential links of technological devices to the disease can be extracted from "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Rare, aggressive, often-fatal cancers cured

Immunotherapy puts ovarian cancers in 4 countries into remission despite docs' qualms

Although physicians declared that immunotherapy couldn't cure their ovarian cancer, the docs were mistaken.

According to a recent story by Gina Kolata in The New York Times, four young women — living in different countries — "had an extremely rare, aggressive and fatal form of ovarian cancer" and weren't expected to live much longer.

All four managed to get immunotherapy and their cancers, in total contrast to conventional wisdom, went into remission.

Dr. Jedd Wolchok

Kolata quotes Dr. Jedd Wolchok, chief of the melanoma and immunotherapeutics service at Memorial Sloan Kettering Cancer Center in New York, as saying, "What we are seeing here is that we have not yet learned the whole story of what it takes for tumors to be recognized by the immune system."

He contends that researchers and medical personnel "need to study the people who have a biology that goes against the conventional generalizations."

Dr. Drew Pardoll

Dr. Drew Pardoll, who directs the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins Medicine in Baltimore, notes that although four women hardly constitutes a clinical trial, "it is the exceptions that give you the best insights."

The cancer that had struck all four was hypercalcemic small cell ovarian cancer, which, Kolata writes, "occurs in a woman's teens or 20s [and] is so rare that most oncologist never see a single patient with it."

Immunotherapy drugs have been successful in treating lung cancer, a genetic type of colorectal cancer and melanoma but cancers of the prostate, pancreas, breast and ovaries have rarely responded.

More details about cancer research and trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Carcinogenic chemical in java? Lawsuit may tell

Longstanding suit against possible cancer perils in coffee may be resolved by year's end

Will coffee labels in California soon warn about cancer risks?

Perhaps — at least if Long Beach attorney Raphael Metzger has his way.

Raphael Metzger

Metzger, according to a recent story by Hoa Quách on the Patch website, has "sued restaurants, stating that the warning is needed as coffee contains acrylamide, a carcinogen."

A judge finally is expected to rule before the end of the year on the lawsuit he filed way back in 2010 — against companies such as Starbucks and 7-Eleven, based on Proposition 65, a 1986 law that requires items containing the chemical to have warning labels.

That suit, not incidentally, followed another by the attorney and his Metzger Law Group, one that he filed against fast-food companies in 2002 "contending that french fries also contained the hazardous ingredient," the story notes.

The current suit, on behalf of the Council for Education and Research on Toxics, offers an alternative request to the java labels — have the manufacturers "reduce the acrylamide content of their coffee products to safe levels."

But the National Coffee Association offers this defense: "There is no evidence that coffee causes cancer."

On its website, it says coffee "is a complex beverage (both compositionally and culturally) — and it's much, much more than just one of its elements. Pretending otherwise does not serve public interest in any way."

Meanwhile, CNN writer Jen Christenen has reported that at least 13 of the defendants have settled and agreed to give a warning, most recently 7-Eleven.

Private mediation with some of the remaining retailers, she contends, has been slated.

At a bench trial last fall, Christenen writes, "the coffee companies argued that the level of acrylamide in coffee should be considered safe under the law and that the health benefits of coffee essentially outweigh the risk."

Her story quotes Metzger on a personal level: "I'm addicted to coffee, I confess, and I would like to be able to have mine without acrylamide."

Christenen also points out that "in addition to coffee, acrylamide can be found in potatoes and baked good like crackers, bread and cookies, breakfast cereal, canned black olives and prune juice, although its presence is not always labeled."

A Bloomberg article indicates that the lawyer's initial complaint "grew to include about 90 coffee producers, distributors and retailers, from mom-and-pop roasters to multinationals such as Nestle."

That piece also stated his complaint had "alleged that a 12-ounce cup of coffee contains about 10 times more acrylamide than the state's 'no significant risk level.'"

Metzger's nine-attorney law group, according to its website, was founded in 1987 and "is a boutique firm whose practice is concentrated on the litigation of toxic tort and environmental exposure cases in the state of California."

A multitude of products has previously been linked to the disease. To check out many of these, pick up a copy of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Half of cancer deaths may be preventable

Even small lifestyle changes can sharply cut your cancer risk, NY Times columnist claims

Dr. Aaron E. Carroll

Evidence, writes a medical columnist in The New York Times, "has increasingly accumulated that cancer may be preventable."

Especially if potential patients stop drinking alcohol and smoking tobacco, alter their diets, exercise and lose weight.

In a recent Aaron E. Carroll-bylined column under the rubric of The New Health Care received recently from The New York Times' online service, it's stated that "simple changes to people's behaviors have the potential to make sure many cancers never occur."

And they have "a side benefit of preventing health problems in many other areas, too," Dr. Carroll maintains.

The website headline indicates that "quite a bit is in your control" regarding the prevention of cancer, and the column, originally printed in 2016, cites a study published in Nature to the effect that "there is a lot we can do" to reduce our risk of cancer by changing our behavior.

That study contradicts research published in Science magazine in 2015 that many apparently took to mean that "cancer is much more because of 'bad luck' than because of other factors that people could control."

Carroll's piece contends that "many studies have shown that environmental risk factors and exposures contribute greatly to many cancers. Diet is related to colorectal cancer. Alcohol and tobacco are related to esophageal cancer. HPV is related to cervical cancer, and hepatitis C is related to liver cancer. And you'd have to be living under a rock not to know that smoking causes lung cancer and that too much sun can lead to skin cancer."

But, the professor of pediatrics at the Indiana University School of Medicine notes, "using sophisticated modeling techniques, the researchers argued that less than 30 percent of the lifetime risk of getting many common cancers was because of intrinsic risk factors, or the 'bad luck.' The rest were things you can change."

According to the study, "about 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors. About 29 percent of women and 20 percent of meant might have prevented colon and rectal cancer. About 30 percent of both might have prevented pancreatic cancer."

Over all, it said, "about 25 percent of cancer in women and 33 percent in men was potentially preventable. Close to half of all cancer deaths might be prevented as well."

More information about how to cut down the risk of diseases can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.