University of Pennsylvania Health System

Focus on Cancer

Wednesday, November 30, 2011

Promising New Radiation and Medical Oncology Treatments for Lung Cancer

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Focus On Lung Cancer Conference. You can view all the presentations from the conference here. In this blog, she discusses new lung cancer treatments available at Penn’s Abramson Cancer Center.

Corey Langer, MD, has been a contributor to the advances that have occurred in treating lung cancer for the last 20 years. He notes that in 1990, a patient diagnosed with advanced lung cancer had few treatment options. And the drugs that were available were highly toxic and generally ineffective.

Today, that picture has improved significantly.

Patients with lung cancer today have the potential for living longer, often years, and enjoying a good quality of life. These improvements are the result of research that has led to a new understanding of the biology of lung cancer, as well as treatment programs that are multidisciplinary and personalized in their approaches.

New Radiation Oncology Treatments for Lung Cancer
For patients with bronchial tumors that can be removed surgically, photodynamic therapy (PDT) has contributed to improved outcomes.

Photodynamic therapy for lung cancer, (PDT) is a radiation oncology treatment that allows physicians to deliver highly targeted doses of anti-cancer drugs while patients are undergoing surgery. PDT is currently used to treat pleural mesothelioma in addition to some lung cancers.

Penn physicians and researchers are working on ways to improve the delivery of photodynamic therapy as well as how to combine it with gene therapy or other radiation oncology therapies for optimal outcomes.

Proton therapy for lung cancer, the most targeted form of radiation therapy, is also showing promise in treating locally advanced lung cancers. Penn has the largest, most comprehensive proton therapy facility in the United States and is actively engaged in developing protocols for the optimal use of this treatment for lung cancer.

New Chemotherapy Treatments for Lung Cancer
For patients who are not surgical candidates or whose cancers recur, the major improvements in treatment are in the form of more effective, less toxic drugs. The most recent therapies target specific gene mutations found in some lung cancer patients.

In 2001, there were no known genetic mutations associated with lung cancer, but today, more than half of the patients with lung cancer have an identifiable gene mutation. This has opened exciting new pathways for treating these cancers.

The most common genetic mutations in lung cancer are the EGRF and KRAS mutations. Recently the EML4/ALK mutation has been found in 5 to 7 percent of patients. Patients who have these mutations often respond very well to targeted therapies. Avastin, which stops the growth of blood vessels that feed the tumor, has also been shown to be effective in treating adenocarcinomas of the lung.

In the last 20 years the options for patients with lung cancer have expanded from few or none to an array of first, second, third and even fourth line therapies, many of which are based on an increasing understanding of the biology of the disease. Lung cancer remains a difficult disease to treat, but the prospects are improving.

Watch all the presentations from the 2011 Focus on Lung Cancer Conference here.

Tuesday, November 29, 2011

National Lung Screening Trial Aims to Detect Lung Cancer Earlier

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference. You can view all the presentations from the conference here. In this blog, she discusses a presentation from Drew Torigian, MD, MA, about the National Lung Screening Trial, which compared cancer screens to detect lung cancer early.

Experts agree that if cancer is detected early, a patient has a better chance of recovery. The goal of detecting lung cancer early, however, has been elusive. 

Study after study has shown that standard chest X-rays do not detect early lung cancers. This is true even when X-rays are given on a regular basis to those at high risk for developing lung cancer. 

So how can lung cancer be caught earlier? And how can lung cancer deaths be prevented?

Lung cancer remains the second most common cancer in this country and the most common cause of cancer deaths. Additionally, lung cancer rates continue to rise in many countries around the world.

CT Scans for Lung Cancer
Computed tomography (CT) scans for cancer are more sensitive in finding lung abnormalities, and better able to detect more and smaller lesions. CT scans are, however, a more expensive technology than chest X-rays. They can also be non-specific in determining if abnormalities are lung cancers are benign nodules. 

The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer in high-risk smokers: low-dose helical computed tomography (CT) and standard chest X-ray.

The study aimed to find it is possible to detect lung cancers at an earlier, more treatable stage, and whether such screening would decrease cancer deaths.  

Drew Torigian, MD, MA, associate professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, served as principle investigator at Penn for this national study, which involved more than 53,000 patients in 33 different sites. He described the results of this trial, the largest, most expensive randomized screening trial ever conducted, at the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference.

All clinical trials have a specific primary endpoint or goal by which success is measured. For the NLST, that goal was to determine if low dose CT screening could reduce the death rate from lung cancer among heavy smokers. Patients enrolled in the trial were current or past heavy smokers between the ages of 55 and 74. Half received regular chest X-rays while the other half received helical CT scans over a period of three years.

The results were encouraging.

CT scanning detected significantly more cancerous and pre-cancerous lesions than chest X-rays. However, finding lesions isn't enough. The study had to demonstrate early detection actually saved lives.Preliminary results of the study showed 87 more lives were spared by helical CT as compared to chest X-rays, which translates into a 20 percent reduction in the death rate.

While the NLST results are positive, Dr. Torigian points out there are many questions that still need to be addressed and answered before low-dose, helical CT scanning can be considered a standard screening procedure. Many of these questions relate to the overall costs and cost-effectiveness of implementing CT scanning programs, such as:
  • Who should be get a cancer screen?
  • How often should they be scanned?
  • At what age should screening begin?
  • Will insurance cover helical CT scanning?
  • How many screenings are needed?
  • What is the impact, both in cost and on the health of the participants of the high rate of false positives (non-cancerous, and generally non-clinically important lesions) found in CT screening?
  • Are there biomarkers that will allow better targeting of populations that will benefit from this type of screening?
There are social policy questions as well, including the impact of undergoing CT screening on smoking behavior. Does the screening encourage people to quit, or give them a false sense of security?

Dr. Torigian stressed the unanswered questions do not detract from the importance of finding better ways to detect early lung cancers. Lung cancer is a global epidemic, and finding more early stage cancers will lead to better outcomes in treating lung cancer.

Watch all the presentations from the 2011 CANPrevent Lung Cancer Conference here.

Learn more about lung cancer treatment at the Abramson Cancer Center.

Monday, November 28, 2011

Young Friends of the Abramson Cancer Center Fundraiser @ Please Touch Museum in Philadelphia

The Young Friends of the Abramson Cancer Center are having a unique play date on Sunday, December 4, 2011 at Please Touch Museum.

The Young Friends of the Abramson Cancer Center is a dedicated group of men and women under the age of 50 who serve as the next generation of leadership volunteers and donors to Penn’s Abramson Cancer Center.

Young Friends supports the work of young cancer researchers and clinicians, whose brilliant ideas often go unrealized because of a lack in funding. Young Friends provides a forum for becoming more engaged with the mission of the cancer center and staying informed about the latest advances in prevention, detection and treatment of cancer.

The Please Touch Museum in Philadelphia was the first museum in the nation whose target audience is families with children under the age of seven. Its mission is to enrich the lives of children by creating learning opportunities through play, and lays the foundation for a lifetime of learning and cultural awareness.

This event takes place prior to the museum’s opening to the general public at 11 am, and promises to be a less crowded Please Touch experience.

Entertain your children and support a great cause at the same time:

Date: Sunday December 4, 2011
Time: 9 to 11 am
Location: Please Touch Museum, Memorial Hall in Fairmount Park, 4231 Avenue of the Republic, Philadelphia, PA 19131
Cost: $25 per person ($10 tax deductible), which includes admission, parking, carousel rides, and a discount coupon to the café. Children under 1 are free.

Click here to register for this event.

For more information about this event, please contact Michal Greenberg at or 215-573-2480.

Learn more information about the Young Friends of Abramson Cancer Center.

Make a gift to the Young Friends of the Abramson Cancer Center here.

Friday, November 25, 2011

Store Your Thanksgiving Leftovers Safely

Thanksgiving is over, and perhaps the best thing about the Thanksgiving dinner is the leftovers. But, it's important to make sure leftovers and any perishable food follows safe food storage guidelines.

Food safety following basic food safety guidelines minimizes individual's risk of contracting food borne illnesses (commonly referred to as "food poisoning). This concept is particularly important for cancer patients whose immune systems are suppressed when undergoing active treatment.

Here are some helpful tips to remember when storing food in the refrigerator.

Refrigerator safety:
  • Always refrigerate perishable food within two hours (one hour when the temperature is above 90°F).
  • Place food into shallow containers and immediately put in the refrigerator or freezer for rapid cooling.
  • Check the temperature of your refrigerator and freezer with an appliance thermometer. The refrigerator should be at 40°F or below and the freezer at 0°F or below.
  • Cook or freeze fresh poultry, fish, ground meats, and variety meats within two days; other beef, veal, lamb, or pork, within three to five days.
  • Perishable food such as meat and poultry should be wrapped securely to maintain quality and to prevent meat juices from getting onto other food. Always store these on the lowest shelf possible, to further eliminate any change of juices dripping onto other food items.
Information adapted from the USDA Food Safety and Inspection Service “Safe Food Handling Fact Sheet."

Content provided by the Joan Karnell Cancer Center

Wednesday, November 23, 2011

Five Ways to Avoid Caregiver Burnout

National Family Caregivers Month recognizes those people who care for others with cancer or chronic illness.

Caring for someone with a chronic illness is one of the greatest expressions of love. It can also be an overwhelming experience for a caregiver. Caregivers need to know it is okay to take some time for themselves, and that the feelings they experience during their caregiver roles are normal.

Here are some steps caregivers can (and should) take for themselves while caring for a loved one with cancer or a chronic illness. There is also a list of support groups at Penn Medicine at the bottom of this article.

Reach out to available resources
Both the Abramson and Joan Karnell Cancer Centers offer family members and caregivers support through counseling, support groups and other professional support services. Caregivers do not have to navigate the system completely alone, and are encouraged to reach out for support to make this stressful time easier.

Recognize when you need time off
All caregivers should be open and honest when they need some time to take care of themselves. Primary caregivers are encouraged to identify a backup caregiver, or to develop a caregiver team approach. The additional support from multiple caregivers can help to alleviate the stress of caring for a loved one and allow caregivers to regroup and re-energize when needed.

Take care of yourself
It’s important for caregivers to get enough rest, sleep, proper nutrition and exercise. Don’t feel guilty about doing something healthy for yourself.

Learn all you can
The more you know about a treatment and what to expect, the less anxiety you may feel when faced with a situation. Be involved in your loved one’s care plan. Meet with the clinicians, and have a sense of what’s coming.

Sometimes, just having a friend or family member who can listen to you can make a world of difference. Don’t let your worries and stress eat away inside at you. Talk to someone about what’s stressing you, your feelings and your situation.

Being a caregiver to a loved is a great gift. But think about what that person would want for you in your situation, and remember it’s okay to take a break.

Support groups at Penn Medicine
Learn more about the support groups at Penn Medicine and the Abramson Cancer Center for patients and their caregivers.

Learn more about the support groups at Penn Medicine ant the Joan Karnell Cancer Center for patients and their caregivers.

Tuesday, November 22, 2011

Palliative Care Provides Extra Support for Cancer Patients

Barbara Reville, DNP, CRNP is a palliative care nurse practitioner and co-directs the Palliative Care Program at the Hospital of the University of Pennsylvania (HUP) with Michael Ashburn, MD, MPH, a pain medicine specialist and palliative care physician.

Penn Medicine offers consultation with palliative care professionals for hospitalized patients and an outpatient clinic at both the Perelman Center for Advanced Medicine and the Penn Pain Medicine Center. Partners at Penn’s Home Care & Hospice Services provide home-based palliative and hospice care.

Life takes on new meaning when you receive a cancer diagnosis. Doctor appointments, therapy dates and uncomfortable or painful symptoms derail your daily routines of family, work and leisure. Now you have worries about medical decisions and concerns about an uncertain future. Even with top medical care, outstanding nursing support and your family at your side, these are trying times.

Palliative care is a medical specialty focused on relieving pain and other symptoms, and helping patients and families navigate difficult medical decisions. When life gets distressing, palliative care can provide an extra layer of support. Effective symptom management is necessary for many patients coping with serious illness, regardless of the diagnosis or stage of disease. Most hospitals in the United States have a palliative care program, either as a consultation service in the hospital or access to professionals in the outpatient area.

Many people confuse palliative care with hospice care. While they both focus on symptom management, they are not the same. Palliative care supports patients with unacceptable pain, symptoms, or emotional distress at any stage of their illness. While hospice also offers palliative care, it is reserved for individuals with a limited life expectancy who may require advanced symptom management and comprehensive home care.

A Palliative Care Story

Bill, a 67-year-old retired Air Force pilot was vacationing with his wife, Ruth, when his life took a tailspin.

He began to experience difficulty swallowing and gnawing abdominal pain. Back at home, Bill’s doctors found cancer in his pancreas. Bill did not waver when cancer specialists at Penn's comprehensive cancer center, the Abramson Cancer Center recommended an aggressive treatment program of chemotherapy and radiation.

His oncologist prescribed pain medicines, but the pain broke through sapping his appetite and disrupting his sleep. His wife, Ruth, was concerned that at this rate Bill would not be able to tolerate his full treatment.

For extra help, Bill’s doctor referred him to Michael Ashburn, MD and Barbara Reville, DNP, CRNP clinic, at Penn’s Perelman Center for Advanced Medicine. In addition to his pain, the team asked Bill and Ruth about other symptoms and practical needs. As a result of a change in his pain medicine and a referral for home nursing visits, Bill is back on course toward recovery.

Bill and Ruth continue to hope for the best. During discussions with the palliative care professionals, they expressed a desire for complete and honest information from their doctors about Bill’s progress and his options. There may come a time when less treatment and more palliative care are best for Bill. If his symptoms worsen, palliative care professionals can partner with Bill’s oncologist to optimize his medicines and discuss options.

But for now, Bill maintains his recovery plan and is living well.

Learn more about palliative care at Penn Medicine.

Learn more about Penn Home Care & Hospice Services.

Monday, November 21, 2011

How Spiritual Care Can Help Cancer Patients

Kava Schafer, MDiv, MA, is a palliative care chaplain and member of the symptom management and palliative care program pain team at the Hospital of the University of Pennsylvania (HUP). As part of caregiver awareness month, Kava blogs about her role as a spiritual care provider to patients with cancer and their families.

I am the spiritual care provider for the nurse practitioner solid tumor oncology palliative care team at Hospital of the University of Pennsylvania (HUP). By writing this blog, I hope to give you an understanding of what it can mean to someone living with cancer to have a chaplain at the bedside when a team of clinicians makes its rounds.

Our multidisciplinary team of cancer specialists responds to the physical, emotional, and spiritual needs of the patient. Its primary intention is to address the symptoms of disease, alleviate suffering, and increase the quality of each person’s life while living with illness. My role, within this team, as a bedside spiritual provider is to help patients understand if and how emotional and spiritual experiences contribute to their pain. I am there to remind patients of their innate wholeness as human beings during crisis.

Earlier this year, Deborah had been under our inpatient care for more than three weeks.  Only 50 years old, she lived in rural Kentucky with her husband and two children. After living for more than four years with papillary thyroid cancer, she traveled to HUP to participate in a phase II clinical trial.

During Deborah’s stay, her care team focused on many goals; one of which was addressing the pain in her right shoulder.I rounded with the team on the day that the suggestion was made that she needed to postpone her return to KY.
Imaging studies could determine whether or not there was an infection in the shoulder needing antibiotics.

Deborah had been hoping for permission to leave. Throughout her hospitalization, in spite of excruciating pain and great uncertainty, she always expressed her emotions directly. On the morning she learned she would not be discharged right away, she broke down in tears. She didn’t know what to do – stay, or leave against the team’s wishes.

At the time, I didn’t know Deborah well, but when she mentioned through her tears she had a strong faith that grounded her, I waited until the team left the room and asked Deborah if a prayer would help her to make a decision. She immediately said yes, and we prayed for clarity. The tension in the room melted away.

I left her to her own thoughts and feelings, and five minutes later, she announced she would stay and follow the medical advice.

Ultimately, after her biopsy, Deborah found out her tumor had transformed into fast moving anaplastic thyroid cancer. We stabilized her and managed her pain so that she could return home to KY.Everyone who crossed her path as a caregiver was moved by her resiliency and strength. I remember Deborah telling us frequently she felt safe at Penn, even though she was far away from home.

Her family never left her completely alone and I was moved by such devotion and love crossing great distances.

As a chaplain on a team focused on symptom management throughout the continuum of care, my presence may serve to remind each patient what is essentially and spiritually important to them during treatment. Remembering what sustains and nourishes us during crisis is often a source of healing strength and consolation.

If you interested in palliative care services for yourself or a loved one, please speak with someone your cancer care team.

Friday, November 18, 2011

What Happens After You Survive Childhood Cancer?

Melanie Gaffney is a proud childhood cancer survivor, and a contributor to the Focus On Cancer blog.

Today she is cancer-free, but lives with the after effects of her cancer treatments.
In addition to being a mom and a wife, she operates a small marketing and graphic design boutique called Melanie Gaffney and also founded Mason’s Mission to raise awareness and funds for Chiari malformation research, a neurological disorder that affects her son. Read more about Melanie here.

Watch for Melanie’s blogs here, and connect with
Melanie on Twitter.

For survivors of childhood cancer, the great news is that you survived cancer. But is that the end? Is it really over? Can you stop focusing on your health all the time?

Depending on the type of cancer and the treatments you received, probably not.
There are about 350,000 childhood cancer survivors in the United States. As survivors age, they can experience late effects and long-term medical complications as a result of the treatments that saved their lives.

Today, because of advances in treatment, about 80 percent of children treated for cancer survive five years or more. But the treatments that saved your lives can also cause health problems that may not show up until years later.

In fact, 30 years out, survivors are at more risk of dying from treatment-related illness than from cancer recurrence . Because childhood cancer survivors are living longer, their long-term health and these late effects are issues for most of their lives. Childhood cancer survivors’ aftercare and watchfulness for late effects must be as specialized as the cancer treatments they received as children. Late effects may involve more than one part of the body and range from mild to severe.

The main factors that contribute to possible late side effects include the types of treatment you received, the drugs used in chemotherapy, and the amount and location of radiation and surgeries.

This is why it’s important to find a great primary care physician and a multidisciplinary survivorship program.

Below are some of the effects childhood cancer survivors may experience:
  • Bone density issues
  • Thyroid problems
  • Hearing loss
  • Vision problems
  • Dental problems
  • Lung, liver or kidney problems
  • Heart problems
  • Fertility issues
  • Second cancers
  • Emotional issues
  • Neurological issues
My Own Survivorship Journey
I didn’t realize I needed a survivorship program until my mid-twenties. I knew I had some physical limitations as a result of my childhood cancer, but I considered them to be minor. I was invincible! I truly believed that since I had beaten cancer, nothing else would ever happen to me. In some sense I felt I had paid my dues and could live like everyone else. This made sense to me as a teenager and sadly even into young adulthood. I ignored any and all signs that my body was telling me that I was, in fact, not invincible.

I was told that fertility and carrying a child may be an issue. Although I am sure other late side effects were probably mentioned when I was younger, these were the only two that I noted. So when I did get pregnant, to say I was totally shocked is an understatement. After the bliss and excitement of finding out I would have a baby came the rush of fear. My cancer came back to haunt me. The moment I remembered I wasn’t like everyone else was when I called my oncologist when most women are calling their obstetrician.

I was referred to the Living Well After Childhood Cancer Survivorship Program at the Abramson Cancer Center. After many tests, pokes and exams I received my first diagnosis of my late-term cancer treatment effects; heart disease (cardiomyopathy) due to chemotherapy, restrictive lung disease due to radiation therapy and an increased risk of breast cancer because of the amount and location of the radiation.

Like many survivors, I also faced some emotional issues like anxiety and dealing with the uncertainty that many cancer survivors deal with - the thought that my cancer may come back.
My life changed when I received my test results. Today, I try to spread knowledge and reach out to childhood cancer survivors about these late side effects. While fundraising for a cure and treatment is important, (without it there wouldn’t be survivors), there also has to be awareness and research to help support those survivors.

I am so excited to be attending the Stupid Cancer Boot Camp in Philadelphia on November. I can’t wait to listen to the speakers, learn more about survivorship and hopefully meet and share stories with other childhood cancer survivors.

The Abramson Cancer Center is part of the LIVESTRONG™ Survivorship Center of Excellence Network, a group of eight Comprehensive Cancer Centers that have been chosen to lead the effort across the country in clinical care and research with cancer survivors of all ages.

Learn more about the Living Well After Childhood Cancer Survivorship Program.

Learn about managing cancer treatment side effects.

Learn more about long-term follow-up guidelines for childhood cancer survivors.

Thursday, November 17, 2011

What Non-Smokers Will Never Understand - Overcoming Nicotine Addiction

Frank T. Leone, MD, MS, associate professor of medicine, is director of the Comprehensive Smoking Treatment Program at Penn Medicine. You can listen to Dr. Leone talk more about smoking-related health complications and how those who smoke find it hard to quit – even with the growing trend against smoking in public locations.

Join Dr. Leone in an online chat about quitting smoking on at 2 pm today, November 17.

Nicotine addiction is complex. People who are addicted to nicotine know it’s bad for them, yet they can’t stop. And those who aren’t addicted to nicotine can’t understand why they just can’t quit. Even family members and friends have a hard time understanding nicotine addiction.

My patients are people who smoke, but know they should stop. They often try to tell me how it feels. They describe feeling sad, angry, and hopeless. They tell me it’s frustrating and confusing; embarrassing and shameful. They feel trapped between desperately wanting to stop and desperately wanting NOT to stop.

Their lives are literally on the line, and they have no idea how to get “un-stuck” from this trap. They are facing cancer and are afraid.

Nicotine addiction is simultaneously one of the most common, powerful, and deadly addictions in our society. It is also one of the least understood. Nicotine works in that place in the brain where survival instincts are born. Nicotine addiction takes those normal instincts and “hijacks” them so that they get turned inside out: The more a person wants to change, the more their instincts tell them that change is bad. The net effect is that people spend a lifetime telling themselves “I want to quit… soon.” But sometimes soon doesn’t come soon enough.

Penn Medicine’s Comprehensive Smoking Treatment Program works hard to help smokers and their families understand why they feel trapped and powerless to change. The team tries to understand the specific needs of every smoker, whether it relates to health, family, work, or other aspects of their lives.

The program is based on the belief that smokers deserve to quit comfortably, so the treatment tends to be aggressive with medications in a way that helps keep that “devil inside” quiet. Most of all, the team respects the problem for what it is. And they respect the people struggling to find a way out from under it.

Specialists in Penn’s Comprehensive Smoking Treatment Program have been fortunate to help thousands of patients overcome nicotine addiction over the years, and it’s amazingly rewarding. Patients keep in touch with the program throughout the years. Our staff answers their questions, provides them with support during difficult times, and helps them to get right back on track if they relapse.

It’s not about success or failure. It’s not about blame or disappointment. It’s about long-term control over the compulsion to smoke.

Here are a few helpful tips that may make it easier for a person to overcome nicotine addiction. Whether you smoke, or care about someone who smokes, try having an honest discussion about the following:

  • How smoking affects your life. Of course you like smoking. Why wouldn’t you? But of course you don’t like what smoking does to you. Try to understand how your nicotine addiction has been keeping you from taking control and making progress.
  • Start working on solution-based thinking. For now, ignore all the reasons you want to quit smoking and focus instead on all the reasons you’d like to keep smoking. Don’t be surprised if these reasons are hard to put into words. Now, start figuring out what you need to do to start overcoming some of these obstacles. Review all the things that have helped in the past. Was it a medication? Someone in your family? Make a list of things you want to learn more about from your doctor. Find a source of support, like a friend or a colleague who won’t judge you, but who will focus instead on finding solutions.
  • Ask for help from a professional. There are lots of resources, like Penn’s Comprehensive Smoking Treatment Program, to help people who smoke overcome nicotine addiction. Community quit classes, research-based quit programs that look into novel approaches, telephone quit lines, even Internet resources. Find a program that fits your style and use it to its fullest potential.
Call the Penn Comprehensive Smoking Treatment Program for help with your nicotine addiction, even if you don’t feel ready to quit. The staff is happy to answer your questions and discuss your options. No hassle. No pressure. Just help. 800-789-PENN (7366).

Post a comment below. Tell your personal story around tobacco. How did it affect your life? How did it affect those you love? How can the community do a better job dealing with this problem?

Wednesday, November 16, 2011

What You Need to Know About Medicare Open Enrollment

It’s time for Medicare open enrollment and it is important patients familiarize themselves with Medicare open enrollment before making health coverage decisions.

Open enrollment for Medicare continues now through December 7. People who are 65 years old, or who have received Social Security disability for 24 months since the beginning of their disability are eligible for Medicare coverage.

Penn’s Abramson Cancer Center offers some tips to help patients make their decisions for Medicare coverage.

Social Worker Christina Bach, MSW, LCSW, has written three helpful articles about Medicare open enrollment, Advantage plans and prescription drug coverage through Medicare. These articles focus specifically on what cancer patients need to know about making coverage decisions.

Click on the titles of the articles below to read Christina’s articles.

The Ins and Outs of Medicare Open Enrollment Part 1
The Ins and Outs of Medicare Open Enrollment Part 2: Medicare Advantage Plans
The Ins and Outs of Medicare Open Enrollment Part 3: Medicare Part D Prescription Drug Coverage

Friday, November 11, 2011

Meet Patient Blogger Melanie Gaffney

Melanie Gaffney is a proud childhood cancer survivor, and a new contributor to the Focus On Cancer blog.

In 1982 at the age of 5, she was diagnosed at with stage IV Wilm’s tumor, a childhood kidney cancer that had metastasized to her lungs and heart. Melanie’s treatments included the removal of her left kidney, extensive radiation from collarbone to hip and two years of chemotherapy treatments.

Due to chemotherapy and the locations of radiation therapy, she was told she might not be able to have children. Never one to take no for an answer, she tried anyway, and when she became pregnant with her first child, she found herself thrilled - and scared.

Melanie quickly learned she was living with the after effects of her cancer treatments. Today, she lives with cardiomyopathy and restrictive lung disease from her childhood cancer treatments. Because of her health and only having one kidney, both of her pregnancies were considered high risk.

But every day that she looks into her children’s eyes she knows it was all worth it.

Melanie doesn’t let cancer define her. In addition to being a mom and a wife, she is a work at home mom. In Melanie’s spare time she enjoys photography and taking photos of her family and friends.

Watch for Melanie’s blogs here, and connect with Melanie on Twitter.

Thursday, November 10, 2011

Cancer Fighting Cupboard: Pumpkin Soy Sausage Soup

Pumpkin is a super cancer food that has been said to prevent cancer. Packed with antioxidants alpha-carotene and beta-carotene, pumpkins help boost the immune system and block potential cancerous cells.

Antioxidants are found in pumpkins, and are typically higher in vegetables and fruits that are brighter colors. In fact, beta-carotene is what gives pumpkins their orange-red color.

Here is a delicious soup to enjoy in the midst of "Pumpkin Season."

  • 3 tbs. transfat free margarine or olive oil
  • 1 diced onion (~ 2 cups)
  • 1 lb. sausage flavored soy crumbles
  • 1 quart chicken or vegetable broth
  • 1 can (29 oz.) pumpkin (NOT pumpkin pie filling)
  • 1/4 tsp. black pepper
  • 1/2 tsp. dried marjoram
  • 1/2 tsp. salt
  • 1/2 tsp. dried thyme

In a stockpot, sauté onions in olive oil/margarine until tender (about 5 minutes). Add soy ground crumbles (sausage flavored is preferred) and stir in for 5 more minutes. If the soy product is similar to raw beef (as with Gimme Lean) be sure to brown this for 5 to 10 minutes. Add all of the additional ingredients (pumpkin, broth and seasonings). Simmer over low heat for 20 minutes. Serves 6 people.
Nutrition ingredients per serving (10 oz.): 150 calories, 3g fat, 12g protein, 9g fiber

Content provided by the Joan Karnell Cancer Center

Wednesday, November 9, 2011

Joe Frazier Loses Battle with Liver Cancer

On Monday, boxing great Smokin’ Joe Frazier died of liver cancer in his Philadelphia home. The two-time heavyweight champ was 67 years old.

Each year, there are approximately 24,120 new cases of primary liver cancer and bile duct cancer. Of those, about 18,910 people die from these cancers.*

The liver is the largest solid organ in the body and is located on the right side of the abdomen. The liver is responsible for such functions as filtering the blood for excess toxins, helping regulate blood sugar, creating bile for digestion, and creating enzymes responsible for blood clotting.

At Penn Medicine’s Abramson Cancer Center, patients with liver cancer receive care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

There are two main types of liver cancer.
  1. Primary liver cancer: Cancer that forms in the tissues of the liver.
  2. Secondary liver cancer: Cancer that spreads, or metastasizes, to the liver from another part of the body like the breast, lung, thyroid or other gastrointestinal cancers.

Symptoms of Liver Cancer

In its earliest stages, liver cancer is typically not associated with any symptoms. As the disease progresses, symptoms may include:
  • Jaundice or yellowing of the skin and eyes
  • Fatigue
  • Weight loss without dieting
  • Loss of appetite
  • Feeling of abdominal fullness or bloating
  • Pain and/or discomfort on the right side of the abdomen
  • Pain or discomfort that occurs in the right shoulder blade

Treating Liver Cancer
Liver cancer treatment may include:
  • Surgery including a partial or hepatic lobectomy, radiofrequency ablation or total hepatectomy and liver transplant. The Abramson Cancer Center’s close collaboration with Penn Medicine’s transplant program provides access to comprehensive medical and surgical care for patients who require a liver transplant. Penn Transplant Institute has performed more than 1,500 liver transplants.
  • Radiation therapy including intensity-modulated therapy, proton therapy, stereotactic body radiotherapy, 3-D conformal radiation therapy and volume-modulated arc therapy. Radiation therapy uses high-energy radiation to kill cancer cells. A radiation therapy schedule usually consists of a specific number of treatments given over an extended period of time. In many cases, radiation therapy is capable of killing all of the cancer cells. Proton therapy at Penn Medicine will soon be used to treat liver cancer, and is currently used to treat recurrent tumors in the digestive tract. Penn Medicine is the only facility in the country treating gastrointestinal cancers in this way.
  • Chemotherapy and other biologic therapies including liver-directed therapies such as ethanol injections and chemoembolization of the hepatic artery. Penn Medicine specializes in a team approach to treatment with interdisciplinary care and innovative approaches that use chemotherapy to target tumors prior to surgery. Chemotherapy uses drugs to kill cancer cells. It is delivered through the bloodstream, targeting cancer cells throughout the body.

The Abramson Cancer Center’s multidisciplinary approach to liver cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Learn more about the gastrointestinal cancer treatment at the Abramson Cancer Center here.

Watch presentations from the Focus On Gastrointestinal Cancers conference here.

Tuesday, November 8, 2011

Save a Life With a Swab of Your Cheek

Perelman students are spearheading a marrow donation drive at the University of Pennsylvania. Watch the video of their story here. 

Did you know that with one swab of your mouth, you can save another person's life?

This is National Marrow Awareness Month. Each year, 10,000 of cancer patients need a bone marrow transplant.* Unfortunately, only half of those patients get one due to a variety of issues, including donor availability.

A bone marrow transplant is a life-saving treatment for people with leukemia, lymphoma and many other blood cancers. First these patients undergo chemotherapy and sometimes radiation to destroy their diseased marrow. Then a donor's healthy blood-forming cells are delivered directly into the patient's bloodstream where they can begin to function and multiply.

The need for marrow donors is great. Patients need donors who are a genetic match and even with a registry of millions, many patients cannot find a match. Donors with diverse racial or ethnic backgrounds are especially needed.

The good news is that registering to become a bone marrow donor is easy.

To become a marrow donor, visit Be the Match Registry ®, of the National Donor Marrow Program. Complete the questionnaire, and register to receive your donation kit.

The donation kit includes instructions and materials to collect a swab of your cheek cells.
The commitment to donate is very important, but if you match a patient you have the right to change your mind before the donation. However, a late decision to not donate can be life threatening to a patient. Please think seriously about your commitment before joining the registry.

Bone Marrow and Stem Cell Transplantation at the Abramson Cancer Center
Abramson Cancer Center’s bone marrow and stem cell transplant clinicians and researchers have led the way nationally for years; both in the care of patients undergoing transplant and in the research of bone marrow transplant as a cancer treatment. Penn has one of the oldest and largest programs in the country and the team is putting that experience to work to offer the best possible treatment outcomes.

Today, there's more hope than ever for those who face a cancer diagnosis in which bone marrow or stem cell transplant is a treatment option.

Learn more about the Bone Marrow and Stem Cell Transplant Program at the Abramson Cancer Center.

*Statistic from National Marrow Donation Program

Perelman students are making a difference for marrow donation. Watch the video of their story here.

Friday, November 4, 2011

Cancer in Pets

November is National Pet Cancer Awareness month.
Cancer is remarkably similar in its incidence and treatment between humans and companion animals.
Christina Bach, MSW, discusses cancer in pets, signs and symptoms of cancer in pets, and treatment options to discuss with your pet’s veterinarian should your pet have cancer.

Learn more about cancer in pets.

Thursday, November 3, 2011

Cancer Fighting Cupboard: Greens with Lemon and Summer Herbs

This dish is not only tasty, but is high in folic acid along with cancer fighting herbs.

The lemon zest also is rich in limonene. Belonging to a vital class of phytochemicals called terpenes, limonines may stimulate enzymes to block carcinogens and enhance the immune system.
The lemon juice helps to take away the toughness of greens and provides the lemon tang.

Greens with Lemon and Summer Herbs
Limonene, found in lemons, has
been found to boost the immune system
Yields: 4 servings
  • 1 Tbsp. extra-virgin olive oil
  • 2 – 3 cloves garlic minced
  • 1 bunch leafy greens (kale, collards) rinsed well,
  • stem removed and sliced into ¼” ribbons
  • 1 cup vegetable stock
  • Grated zest of lemon
  • Juice of 1/2 lemon
  • 1 tsp. red wine vinegar
  • 6 leaves fresh basil, minced
  • 1 sprig of fresh rosemary, minced

Heat oil and garlic in a skillet for about one minute over medium heat. Add greens and vegetable stock. Steam until the greens are tender (about 5 minutes). Toss in the remaining ingredients during the last 1 to 2 minutes of cooking. Remove from heat. Serve immediately.

Adapted from Greens: A Country Garden Cookbook by Sibella Krause. Collins Publishers, San Francisco ISBN 0-00-255166-7

Content provided by the Joan Karnell Cancer Center
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