University of Pennsylvania Health System

Focus on Cancer

Monday, June 27, 2011

Cancer Fighting Cupboard: Chicken Pot Pie

Content for this post provided by Joan Karnell Cancer Center.

This chicken pot pie has been “enhanced” with cancer fighting ingredients by Diana Dyer.  Diana is a three-time cancer survivor and an inspiration for cancer survivors everywhere.  Her website, cancerrd.com is a wonderful resource if you are seeking to take charge of the way you eat and live.  In addition, her entertaining blog http://www.365daysofkale.com/ includes more great recipes.

Ingredients:
  • 2 tbsp. olive oil + 1 tsp. olive oil
  • 3 tbsp. whole wheat pastry flour
  • 1 can (14 oz) veggie broth (if using homemade veggie stock, may need to add salt to taste)
  • 1/2 teaspoon turmeric
  • 2-3 teaspoon fresh rosemary
  • 12 oz. soy milk (unflavored)
  • 1 medium yellow onion, sliced
  • 16 ounce bag mixed frozen veggies, thawed and drained
  • 1/2 -16 ounce can of beans (ex: Adzuki beans - save the other half to add on top of a homemade pizza later in the week or add to a can of ready-to-eat soup)
  • Tabasco sauce - just a few drops is enough for a slight kick
  • 1 whole chicken breast (3/4 pound), roasted and cut into cubes (can use leftovers)
  • 2-3 sheets of phyllo dough (thawed)
  • 1 egg white, slightly beaten
Use leftover chicken or sprinkle chicken breasts with dried Italian herbs and bake for approximately 30 minutes at 350 degrees.  Cool and cut into cubes. Increase oven to 400 degrees after the chicken is done cooking. In a large saucepan, heat olive oil over medium high heat. Add flour, stirring with a whisk to make a paste. Stir for a minute or two to toast the flour. Mix in the broth, a quarter cup at a time, until smooth. Whisk in the rosemary, turmeric, and salt (if using salt, start with only 1/4 teaspoon, add more to taste after sauce is done cooking). Continue whisking after broth is added for an additional 5-7 minutes until sauce is starting to thicken. Add soymilk and continue cooking with occasional stirring for 5-7 more minutes. Reduce heat slightly if boiling too rapidly. The sauce will be a beautiful golden yellow. Heat the additional teaspoon of olive oil in a non-stick skillet. Add the onions and heat over medium heat until caramelized (10-15 minutes). Add drained veggies and beans along with the hot sauce. Stir together. Spray a 9 x 9 baking dish with non-stick spray. Place chicken and veggie mixture into dish and then add the sauce over all. The dish will be nearly full. Place 2-3 sheets of the phyllo dough (see directions on box for how to handle so the sheets do not dry out) over the dish, tucking in the edges. Brush the top of the dough with the egg whites. Cut a few slits into the top of the dough. Bake at 400 degrees for 35 minutes or until crust is golden and the dish is piping hot. Serve over whole wheat couscous with fresh fruit and a green salad. Nothing else was needed.

Reprinted with permission from Diana Dyer, MS, RD, founder of the web site http://www.cancerrd.com/ and author of the book A Dietitian's Cancer Story.

Thursday, June 23, 2011

Patients Show Resilience in the Face of Cancer

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the last of a series of four blog posts.  

Bernie Parent addressed the Abramson Cancer Center's Focus On Melanoma Conference on the topic of resilience — overcoming fear with purpose. Judging by the warm reception given to former Flyer goalie, Parent's contributions to two Stanley Cup winning seasons in the mid 1970s have not been forgotten. 

But for me, the real meaning of resilience became clear listening to the patients who participated in the panel discussion that followed his talk.

As I listened to the four panelists, so varied in age and background, yet sharing a common diagnosis, I thought of the program that aired last year on SHOWTIME®, called "The Big C." It purported to be a brave, gutsy, straight-on look at what it means to face a diagnosis of stage IV melanoma.  The main character, a 40-ish school teacher in Minnesota, learns she has the disease and decides to change her life, But she accepts her fate based on a single chest X-ray from a single physician (who looks like he barely finished high school). She doesn't tell a soul, not her husband, her son or a best friend, nor does she seek treatment.  I watched it twice and it made me too angry to watch again.

The voices heard at the conference could not be more different than this TV creation.  These were people who were fighting their cancers. They had formed a tight partnership of trust and hope with their treatment teams and endured multiple painful and debilitating treatments.  Every one in their own way had found meaning in the struggle.  No one suggested that there was a simple formula for becoming and remaining resilient.  They spoke of grief, anger and denial, but also of love, determination and the strength they draw from what may seem like life's smaller joys: a card from a friend, playing catch with their son.  Regardless of the state of their disease, each was deeply grateful for a continued existence, and every one of them expressed profound appreciation for the support and love provided by their friends and family.
 
Alice, the youngest of the group, was only 29 when she was diagnosed five years ago, long after Parent's heroics on the ice. She attributed some of her resilience to a form of denial, to "refusing to believe in her own end" as she put it.  She summed up the feelings of the group, and of so many people who have traveled down the cancer pathway with these words.

"I learned that despite having cancer, life marches on.  Things are still happening around you, work, vacations, babies, weddings," Alice said.  "I learned to accept the reality of the disease as a part of my life, but not as something that defines me. I will give what is due, but I won't let it become who I am."

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Tuesday, June 21, 2011

Cancer Fighting Cupboard: Chopped Kale Salad

Content provided by the Joan Karnell Cancer Center
 
Many foods have cancer fighting properties, like this chopped kale salad that can be paired with almost any food or can be a meal itself.

Kale, a form of cabbage, is ripe with two cancer-fighting compounds: indoles and isothiocyanates. Indoles are nitrogen compounds that researchers believe may prevent certain lesions from turning into cancerous cells. Likewise, isothiocyanates, a phytochemical found in kale, is believed to suppress tumor growth.

The salad dressing also has cancer-fighting properties. Lemon is high in vitamin C and limonene, the chemical that gives lemons their citrus smell and has been shown to have tumor-shrinking properties. As an added bonus, the strong flavors of red wine vinegar and mustard help spark the salad's flavors for those with impaired taste.

Ingredients
  • 1 head of kale, chopped or thinly sliced
  • 1 red pepper, diced
  • 1 green or yellow pepper, diced
  • 1 red onion, chopped
  • 1 can of chickpeas, rinsed
  • 1 can of black olives, pitted and sliced
Dressing
  • 1/4 cup lemon juice
  • 1/4 cup olive oil
  • 1/4 cup red wine vinegar
  • 1/4 teaspoon dried mustard
  • Salt and pepper to taste
Wash and prepare vegetables and combine in a large salad bowl. Mix salad dressing ingredients and whisk prior to pouring over salad mixture. This salad tastes better the longer it sits, and can be used for up to three days, so let it rest in the refrigerator at least overnight.
Serves 6-8 people as a side dish

Thursday, June 16, 2011

Delivering Personalized Medicine for Cancer

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the third in a series of four blog posts.  

One of the key concepts in medicine today is "personalized medicine."  What few people may realize is that the emerging ability to talk about individual profiles for specific cancers results entirely from the type of research being done by people like Jessie Villaneuva, PhD, and Robert Vonderheide, MD. Drs. Villaneuva and Vonderheide presented highlights of their research at the Abramson Cancer Center's Focus On Melanoma Conference.

In the last few years, it has become possible to begin identifying subsets of patients based on the molecular characteristics of their cancers, and tailor new treatments to match those specific profiles.

Identifying these molecular characteristics is critical in treating many cancers, and increasingly so in melanoma.  Mutations in the BRAF gene occur in approximately 50 percent of patients with advanced melanoma and provide a valuable target for new therapies.  These therapies, however, are only effective for those who have the BRAF mutation.  The same principle holds true for other less frequent mutations. 

Finding this target has major implications for both developing new drugs and for delivering treatment to patients with melanoma.  It means more drugs are needed to hit multiple targets and that new drugs are likely to be more potent and more specific.  They will work better and be less toxic but in smaller populations of patients.  It also makes it critical that patients be aware of the need to collect sufficient tumor tissue to allow for molecular profiling of their tumor so they can receive the therapies designed to work best for their type of cancer.  Tissue collection is vital both at the time of diagnosis and if and when metastatic disease occurs as cancers often change their genetic profiles as they grow and spread.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Thursday, June 9, 2011

Advancing Cancer Research

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the second in a series of four blog posts.

Cancer research has become increasingly complex.  It is almost impossible for even the most educated non-scientist to understand the incredibly intricate mechanisms that drive normal and abnormal cell growth, and the language used to describe these phenomena is essentially foreign to all but those trained in biology, chemistry and genetics.  But, as science becomes more difficult to understand, it is also becoming more important.  It wasn't all that long ago that basic and clinical research were considered two separate worlds. Today, the gap between the lab and the clinic is narrowing, and the path between them is a two-way street. 

The presentations of Jessie Villaneuva, PhD, and Robert Vonderheide, MD, at the Abramson Cancer Center's Focus On Melanoma Conference, made it clear just how important research is in advancing the treatment of melanoma, and cancer in general.

Dr. Villaneuva researches cancer at the Wistar Institute, an independent basic research institute located on the Penn campus.  For many years, Wistar has had a top melanoma research program and maintained a highly productive collaboration with the clinical researchers and oncology team at Penn Medicine. Wistar researchers have been among the leaders in identifying specific genetic mutations that regulate cell growth along complex pathways.  For melanoma, these "broken" genes include BRAF, PTEN and several other less frequent mutations.  As Dr. Villaneuva pointed out, understanding the precise mechanisms that turn cell growth on and off is leading to new therapies. 

Basic research at the Wistar Institute and other leading centers is also critical in tackling the problem of drug resistance.  The pattern is all too clear, and too predictable.  A new cancer-fighting agent is identified.  A substantial percentage of patients respond to the drug, sometimes dramatically. But at some point, the drug becomes ineffective.  The cancer starts to grow again as the malignant cells develop ways of eluding or circumventing the action of the anti-cancer agent. 

Dr. Villaneuva described the efforts under way to understand the molecular mechanisms that lead to drug resistance and develop the next level of combination therapies to anticipate and overcome this huge challenge to successful cancer therapy.

For decades, researchers have known that melanoma is in many ways influenced by the body's immune system.  Dr. Vonderheide characterized this as an ongoing struggle between "the immune system versus melanoma."  

Immunotherapeutic approaches to treating melanoma have been consistently intriguing, promising — and disappointing. Melanoma appears to be capable of "waiting out" the body's natural immune response.  But researchers keep returning to this area, and now with their remarkably increased understanding of the complexities of the immune system, their work is bearing rich new fruit.   Immunotherapeutic approaches are the heart and soul of the new agents that are emerging for melanoma treatment. 

According to Dr. Vonderheide, these new approaches can either accelerate or activate the body's natural immune responses against the abnormal cell growth of melanoma, or "hit the brakes," actually slowing down the immune response to allow more effective interventions with vaccines and other cellular therapies.  While the immunotherapy work is proceeding on multiple fronts, the most exciting results are in the area of monoclonal antibodies, including ipilimumab, and several other targeted therapies in early stages of clinical trials.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

Learn more about melanoma treatment at Penn Medicine.

Wednesday, June 8, 2011

Join the Discussion About Cancer-related Topics

The Cancer Fighting Cupboard, the Joan Karnell Cancer Center's blog providing nutrition information and tips, is now part of Penn Medicine's Focus on Cancer blog.

Focus on Cancer provides news and discussions on a variety of cancer-related topics, including treatment advances, research efforts and clinical trials, nutrition, support groups, survivorship and patient stories. We hope you will continue to follow us in our new location.

Thursday, June 2, 2011

The Relentless Fight Against Melanoma

Christine Wilson, cancer survivor, shares her experiences from the Focus On Melanoma conference in the first in a series of four blog posts.

Dr. Lynn Schuchter

Relentless. That word was used a lot at the Eighth Annual Focus on Melanoma Conference sponsored by Penn's Abramson Cancer Center (ACC). It was the word Lynn Schuchter, MD, used to describe Lorraine Gordon's quest to educate patients and physicians about melanoma and its treatment. Lorraine received the ACC Advocacy Award at the conference. *

Relentless. It has also been used to describe melanoma, a disease that for many years has resisted all attempts to improve its treatment and outcomes: until now. The clear message that Dr. Schuchter and her colleagues delivered to the more than 300 conference attendees is that the explosion of new knowledge and new treatments for melanoma are "changing the landscape" for patients at every stage of the disease: especially for those patients with advanced or metastatic melanoma.

Oncologists are rightfully wary about expressing too much enthusiasm for emerging new therapies. They have seen too many promising clinical trials end in disappointment. Physicians know that progress, when it does occur, is frequently measured in added weeks or months of life, not cures.  They are keenly aware that even the most positive results are tempered by the reality that behind every curve lurks the problem of acquired drug resistance, the seemingly inevitable ability of cancer cells to outsmart the approaches used to stop their growth.  But this time, the excitement is real. The optimism is grounded in the growing body of evidence from clinical trials that employ new knowledge and new agents.

As Dr. Schuchter's timeline indicated, progress has been frustratingly slow and elusive, dating all the way back to the identification of the first melanoma patient in the United States in the late 1800s.  In fact, not a single new drug had been approved by the FDA for treating melanoma in more than 20 years.  If surgery failed to eliminate the melanoma, interferon and interleukin, the mainstays of therapy for metastatic disease, were both highly toxic and limited in their effectiveness.

That scenario has changed dramatically in the last five years with the introduction and approval of three new agents with demonstrated effectiveness in treating advanced and high-risk melanoma.  The future is even brighter with the prospect of several new drugs currently in the research pipeline, two of which have reported remarkably promising results from clinical trials in 2011 alone.

The Value of Cancer Education

Just 20, or even 10 years ago, it was very difficult to find information about melanoma or its treatment. Today, the problem is no longer getting information; it is getting good information, and even more so being able to interpret it.  The value of an event such as the Focus On Melanoma conference is having an enormous amount of cancer information and education all in one place. The Focus On conferences, sponsored by the Abramson Cancer Center at the University of Pennsylvania, allows patients and families to get informed and interact with nationally recognized leaders in the clinical oncology and research fields.

A conference like this illustrates the ongoing, irreducible need for patients and their health care teams to interact, to communicate, and to merge information with perspective.

For more information, view the Focus On Melanoma conference video and Melanoma Treatment: A Patient Video Guide, on the ACC website.

* Lorraine Gordon is the wife of Roger A. Gordon, who lost his battle with melanoma. An educational fund was created in his name at the Abramson Cancer Center. Money from the fund was used to create a melanoma awareness brochure and treatment video.

Learn more about melanoma treatment at Penn Medicine.
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