Radiation time down from 2 months to 2 weeks

Newest prostate cancer therapy cuts length of treatments but adds intensity, NY Times says

A comparatively new — and popular — prostate cancer therapy can be shorter (and more intense) than standard treatments.

But it's efficacy is unproven.

And there's insufficient data so far to compare side effects.

According to an article by Gina Kolata in The New York Times today, the new treatment — called SBRT, or stereotactic body radiation therapy — usually involves five sessions within two weeks instead of 40 seasons spread over two months or 28 sessions over five or six weeks.

The National Cancer Institute (NCI) has just agreed to fund a clinic trial that will compare the SBRT and 28-session treatments, although it may be eight years before the results are finalized.

"Ideally," the Times quotes Dr. Rodney J. Ellis, a radiation oncologist at Case Comprehensive Cancer Center in Cleveland and the principal investigator for the trial, as saying, "we want to show five treatments is better."

The Times pieces says the number of men getting SBRT more than doubled between 2007 and 2013, according to the most recent Medicare data.

Prostate cancer strikes about 180,000 men annually, second only to lung cancer.

Some clinical trials, Kolata's story indicates, have provided "important information. For example, a recent one shows that hormone-blocking drugs can prolong life for men whose prostate cancer recurs after surgery to remove the prostate."

The article also indicates that a change in attitude seems to be occurring.

In favor of the shorter, more intense treatments.

Dr. Michael J. Zelefsky

Kolata's article quotes Dr. Michael J. Zelefsky, a Memorial Sloan Kettering Cancer Center radiation oncologist, to the effect that "several years ago, 90 percent of his patients had the standard course of treatment. Now 90 percent choose the shorter course."

The newer treatment, he added, "is emerging as a very exciting form of therapy."

Why? Probably because more patients are considering "quality of life" issues and the shorter length of therapy may add to that.

Want an additional look at clinical trials and new treatments? "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten (a guy who's undergone regular radiation, brachytherapy and hormonal therapy for prostate cancer), aimed at male caregivers, provides it.

24% dip in the disease's recurrence is possible

Exercise can help breast cancer patients diminish risks and bolster their quality of life

Exercise is hardly a cure-all for breast cancer.

But it can help.

Stacy Simon

According to an American Cancer Society story by senior editor Stacy Simon that I just found on the cancer.org website, exercise "is not only safe and possible during and after breast cancer treatment, but it also can reduce symptoms and improve quality of life."

The ACS article states that studies have shown "certain kinds of exercise appear to help breast cancer survivors at high risk for arm, breast and chest swelling (lymphedema) avoid the condition."

The studies have also shown that "some types of exercise can improve symptoms" for those who already have breast cancer.

And, as might be expected, that regular exercise "significantly improves physical functioning and reduces fatigue."

Perhaps most important is that Simon's piece notes, too, that physical activity "has also been linked to a 24% decrease in breast cancer coming back, and a 34% decrease in breast cancer deaths."

Her story cautions, however, that women should first check with their doctors to determine the exercise best suited for them (and to ensure their safety) — and then, after surgery, to wait to heal properly before starting a physical regimen.

The ACS story also lists possible exercise benefits as strengthening of muscles (or, at least, lessening muscle deterioration), heightening self-esteem and lowering anxiety and depression risk, and, finally, helping to control weight — "itself a risk factor for breast cancer recurrence."

Details about the healing process can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Lead author calls research results 'shocking'

New study says risk of Gen Xers and millennials getting colon and rectal cancer is rising

Americans under 55 — those known as Gen Xers and millennials — are at a greater risk today of colon and rectal cancer than any generation before.

According to American Cancer Society (ACS) and National Cancer Institute (NSI) researchers, those born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer than those born in 1950 had at the same age.

And most of those cancers would be in more advanced stages when discovered, a study published today in the Journal of the NSI indicates — probably because routine screening normally isn't recommended for those under 50.

Rebecca Siegel

The lead author of the study, Rebecca Siegel, an ACS epidemiologist, called the size of the increase "very shocking,'" most likely because the surge of younger diagnoses contrasts with the decades-long descent of colorectal cancer cases.

According to a Washington Post story by Laurie McKinley reprinted in the San Francisco Chronicle last week, Siegel noted that the drop has been driven by older adults who've gotten regular screenings, including colonoscopies, that detect growths before they become cancerous.

She also suggested that younger people are more apt to be uninsured, which might keep them from seeing a doctor until they can no longer ignore their symptoms.

"We had such great strides just in the past years in insurance coverage because of the Affordable Care Act," she said — hinting that the situation might change for the worse under the Trump administration and Congressional Republicans' desire to "repeal and replace" Obamacare.

The study looked at nearly half a million cases of colorectal cancer from 1974 to 2013. 

It found that colon cancer rates increased about 1 to 2 percent per year for people in their 20s and 30s, and that rates for middle-aged adults also rose, albeit at a slower pace.

"Rectal rates climbed even faster in recent decades," the story added, "at about 3 percent per year for people in their 20s and 30s and 2 percent annually for those 40 to 54."

Specific reasons for the increases, not incidentally, remain unclear.

The ACS, which predicts more than 95,000 new cases of colon cancer and almost 40,000 of colorectal cancer will be diagnosed this year, is reviewing colorectal cancer screening guidelines.

Research into the risks of diseases is an integral part of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Will FDA obey Trump, take step backward?

Researcher warns of using under-tested drugs, cites futile treatment on his father 

Dr. Cary Gross

Can some cancer treatments do more harm than good?

Absolutely, indicates Cary Gross, professor of medicine and cancer researcher at the Yale University School of Medicine, in a recent article in The Washington Post.

Gross cites the case of his own 80-year-old father, who'd been treated for Hodgkin's disease and couldn't walk because of weakness when his oncologist suggested a new, expensive, risky drug that was covered by insurance.

The oncologist was afraid chemo might do more harm than good but believed the "targeted therapy" treatment that used antibodies to kill only cancer cells would work.

Although the tumors shrunk at first, and Gross' father regained some strength, he experienced mild pain in his feet after a few months, followed by more severe shooting pains through his legs. Those side effects, Gross wrote in his article, again prevented him from walking and kept him bed-bound.

He subsequently died.

"The Food and Drug Administration had approved the treatment based only on a small study of about 100 patients, one-third of whom demonstrated complete remission," Gross reported.

"Although side effects were rare, the average age of patients in the study was 31. This is typical of cancer-treatment studies, which most often test new drugs in younger and healthier people — not older people with lots of medical conditions."

Gross expresses fear that "unfortunately, our government's commitment to evaluating new drugs is about to take a step backward. At a recent meeting with pharmaceutical company executives, President Trump announced he would be cutting regulations 'at a level nobody's ever seen before.'"

The FDA, he contends, "shouldn't shy away from requiring thorough evaluation of new drugs. The same level of enthusiasm and funding that goes into developing new treatments should be invested in testing whether they are safe and effective in patients outside of the initial small trials. Under-tested drugs with unclear safety profiles and efficacy should not be given to broad swaths of the population."

Other illustrations of clinic trials and their aftermath 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.

64 percent more likely to succumb to disease

Being socially isolated may markedly raise risk of women with early breast cancer dying

Is being isolated socially a killer?

Very possibly.

An article by Liz Szabo of Kaiser Health News cites a recent study that "patients with early breast cancer who are socially isolated have a higher risk of dying from their disease."

According to the story, women with fewer social ties "were 43 percent more likely to see their breast cancer return, 64 percent more likely to die from breast cancer."

The study, funded by the National Cancer Institute and published in the journal Cancer, considered ties of friends, family and community and religious groups.

As well as spouses or romantic partners.

Dr. Wendy Chen

The study's co-author, Wendy Chen, a breast cancer medical oncologist at Boston's Dana-Farber Cancer Institute, clearly stated, however, that the findings do not prove "strong social support actually prolongs life."

Still, she said, they should be a reminder to physicians to evaluate more than their patients' physical health.

Szabo's story postulates that patients with stronger social ties not only receive moral support but encouragement to check out symptoms, to exercise, to eat healthier and to take meds.

Those patients also receive practical assistance, it adds, like picking up prescriptions, cooking meals and providing transportation to doctors' appointments.

The study looked at 9,267 women in the After Breast Cancer Pooling Project, which combined four studies of women from five U.S. states and China. Doctors, the Kaiser Health News story indicated, "followed women for a median of 10 years."

Isolated women, researchers found, also "were heavier, more likely to smoke, less likely to exercise and less likely to undergo chemotherapy, even if this treatment would have been appropriate for them."

Just under 250,000 American women are predicted to be diagnosed with breast cancer annually, with more than 40,000 expected to die from it.

A closer look at the ups and downs of the disease 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.

Similar to females in poor developing nations

Racial gap widening in cervical cancer deaths — to the detriment of black women

A widening racial gap has been found in regard to cervical cancer deaths.

With black women being on the short end of the stick.

Over all, according to an article in The New York Times by Jan Hoffman late last month, a study published in the journal Cancer has determined that "the death rate…is considerably higher than previously estimated."

Hoffman's story says researchers have reported that "the rate which black American women are dying from the disease is comparable to that of women in many poor developing nations" in Latin America, Asia and Africa.

The article notes that "what makes the findings especially disturbing…is that when screening guidelines and follow-up monitoring are pursued, cervical cancer is largely preventable."

Some experts say the expected repeal of the Affordable Care Act, which covers screening, is likely to make matters worse.

The new study, which looked at data from 2000 to 2012, showed the mortality rate for blacks was 10.1 per 100,000, compared to 4.7 for white women.

Anne F. Rositch, Ph.D.

Anne F. Rositch, Ph.D., lead author and an assistant epidemiology prof at Johns Hopkins Bloomberg School of Public Health, explained that women who'd had hysterectomies — which almost always remove cervixes — were excluded from the study.

The racial disparity, it was speculated, reflected "unequal access to screening, ability to pursue early-warning test results, and insurance coverage."

"Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers touches on studies that show other racial disparities.

Women warned of post-mastectomy risks

Reconstructive surgery can numb breasts, cause pain and become potentially perilous

Reconstruction, according to The New York Times, can lead to complete numbness in the breasts.

An article by Roni Caryn Rabin yesterday contends that doctors often fail to warn patients that although reconstructive surgery following breast cancer might save their nipples and keep their breasts natural-looking, they afterwards may be unable to "sense the slightest touch of [their] breasts, perceive warmth or cold, feel an itch if [they have a rash or pain if they bang into a door]."

And nipples may "lack any feeling."

In addition, sexual arousal may not be restored.

Rabin's story indicates that "plastic surgeons performed more than 106,000 breast reconstructions in 2015, up 35 percent from 2000."

Most often, they use a woman's belly fat to create a new breast.

The lack of sensation "is potentially dangerous," the story charges. "Women who have had mastectomies and reconstructive surgery have sustained severe burns on the breasts from heating pads, hair dryers, curling irons, sunbathing and overly hot showers."

Dr. Andrea L. Pusic

And although the surface of the skin may become numb, pain underneath still may radiate everywhere: 

The Times piece notes that some women have tingling sensations after the surgery, others have "debilitating pain."

The "post-mastectomy pain syndrome," the story maintains, "is fairly common, affecting anywhere from 25 percent to 60 percent of mastectomy patients, according to published studies."

The Times article quotes Dr. Andrea L. Pusic, a plastic surgeon at Memorial Sloan Kettering Cancer Center who specializes in reconstruction and studies patients' post-surgery quality of life, as admitting that "our focus has been on what women look like. What it felt like to the woman has been a kind of blind spot in breast surgery. That's the next frontier."

Reconstruction and other post-surgery treatments are dealt with in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Need for caregivers growing while supply shrinks

Volunteer U.S. caregiving force of 40 million is in grave danger, doctor asserts in N.Y. Times

The American reliance on a volunteer caregiving force may be unsustainable.

Why?

Because the demand for caregivers is growing — due to longer life expectancies and more complex medical care, according to a story in The New York Times by Dr. Dhruv Khullar, resident physician at Massachusetts General Hospital in Boston — while the supply is shrinking, "a result of declining marriage rates, smaller family sizes and greater geographic separation."

That, Khullar indicates, is what members of the National Academies of Sciences, Engineering and Medicine think.

His piece notes that "some 40 million Americans…help a parent, grandparent, relative or neighbor [every day] with basic needs: dressing, bathing, cooking, medications or transportation."

Dr. Dhruv Khullar

And it suggests the AARP and National Alliance for Caregiving believe "the typical family caregiver is a 49-year-old woman caring for an older relative — but nearly a quarter of caregivers are now millennials and are equally likely to be male or female."

A third of them apparently provide more than 21 hours of care weekly.

Mostly, they're unpaid, "but the economic value of their care is estimated at $470 billion a year — roughly the annual American spending on Medicaid."

About a third of the total also have full-time job, and a quarter work part-time.

The strain on caregivers is evident, however.

Especially when it comes to finances.

Sixty percent of those caring for older family members, the Times story says, end up cutting their work hours, taking a leave of absence or making other career changes.

In addition, "family caregivers are more likely to experience negative health effects like anxiety, depression and chronic disease."

One study Khullar cited found that those caring for a disabled spouse and experiencing mental or emotional distress "were 63 percent more likely to die within four years than noncaregivers."

His article says one way of helping caregivers is to bolster counseling and support services available to them. Another way would be to develop "respite programs to temporarily relieve them of their responsibilities."  

Details about overcoming such stresses and distresses can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregiving.