University of Pennsylvania Health System

Focus on Cancer

Thursday, December 22, 2011

Food Safety Tips for Holiday Meals

The holidays are a time for family and friends to come together and celebrate. In most instances, that means that families share meals with one another. Whether it is practicing food safety when preparing the meal or reminding hosts about their guests' safety, here are some safe food handling reminders to ensure guests enjoy their holiday meal. These concepts are especially important if one of the guests has recently been diagnosed or is in active treatment for cancer. Cancer patients are immunodeficient and therefore are more likely to be susceptible to foodborne illness.

Separate: 
  • Washing raw poultry, beef, pork, lamb, or veal before cooking it is not recommended. Bacteria in raw meat and poultry juices can be spread to other foods, utensils, and surfaces.
  • Hand washing after handling raw meat or poultry or its packaging is a necessity because anything you touch afterwards could become contaminated.
  • It is important to prevent cross-contamination from raw meat or poultry juices by washing counter tops and sinks with hot, soapy water. You may sanitize with a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of water.
  • Packaging materials from raw meat or poultry also can cause cross-contamination. Never reuse them. These and other disposable packaging materials, such as foam meat trays, egg cartons, or plastic wraps, should be discarded.
  • Don't use the same platter and utensils that held the raw product to serve the cooked product. Any bacteria present in the raw meat or juices can contaminate the safely cooked product. Serve cooked products on clean plates, using clean utensils and clean hands.
Thawing:               

  • Refrigerator: The refrigerator allows slow, safe thawing. Make sure thawing meat and poultry juices do not drip onto other food. Place item on a plate, and keep on the lowest shelf of the refrigerator.
  • Cold water: For faster thawing, place food in a leak-proof plastic bag. Submerge in cold tap water. Change the water every 30 minutes. Cook immediately after thawing.
  • Microwave: Cook meat and poultry immediately after microwave thawing. 
For those who choose to go out to a local restaurant to enjoy a holiday meal, here are some helpful tips to use when assessing a place to eat.

Eating Out and Food Safety:

When choosing where to eat out, evaluate if the restaurant is likely to follow all of the above food safety practices. 

While at an increased risk for foodbourne illness, avoid eating at:
  • Salad bars,
  • Buffets,
  • Or trying samples, as these foods may have been left out for more time than recommended. 
  • Similarly, food carts and street vendors may not be subject to the same regulation as restaurants, and therefore may not follow appropriate food safety practices.  
Information adapted from the USDA Food Safety and Inspection Service "Safe Food Handling Fact Sheet"

Content provided by the Joan Karnell Cancer Center

Wednesday, December 21, 2011

Spread the Holiday Annual Giving Cheer

This season is a time to celebrate the holidays with family and friends while reflecting on the wonderful things and people surrounding you. It’s also a time to share holiday hope with cancer patients and their families.

Penn’s Abramson Cancer Center provides this hope throughout the year. During a time of ever-decreasing charitable giving, a gift to the Abramson Cancer Center Annual Fund provides essential funding for current and new programs for cancer patients and their families.

Just like every patient is different, every gift the Abramson Cancer Center receives is special and very important. Each gift provides the Abramson Cancer Center with the necessary resources to provide cutting-edge research and the best in cancer care to patients and their families in the Philadelphia region.

Charitable giving to the cancer center’s annual fund is essential in the fight against cancer. Individually, each person can make a difference; collectively, the many friends of the Abramson Cancer Center can shape the future of cancer research and patient care.

Make a gift to the Abramson Cancer Center this holiday season and spread the holiday annual giving cheer.

Ways to give to the Abramson Cancer Center Annual Fund

Online
Make an online gift on the cancer center’s secure giving site.


By mail
Print and fill out a gift form and mail your gift to the Office of Development and Alumni Relations, where your gift will be processed quickly and securely:

Development and Alumni Relations
Abramson Cancer Center
3535 Market Street, Suite 750
Philadelphia, PA 19104-3309
Phone: 215-898-0578

Thanks to you, the Abramson Cancer Center continues to achieve victories in the ongoing effort to conquer cancer.

Everyone at the Abramson Cancer Center thanks you for your generosity during the holiday season, and throughout the entire year.

To learn more about giving to Penn’s Abramson Cancer Center visit the website at www.PennMedicine.org/Abramson/Donatehttp://www.penncancer.org/patients/giving/


Please make a tax deductable gift before December 31 and spread the holiday annual giving cheer.

Tuesday, December 20, 2011

Penn Program Helps Breast Cancer Survivors Exercise During and After Cancer Treatment

Kathryn Schmitz, PhD, MPH, FACSM, is an associate professor at the Perelman School of Medicine at the University of Pennsylvania. She is an exercise interventionist who has led multiple trials, including the Physical Activity and Lymphedema (PAL) Trial. Dr. Schmitz's goal is to make sure oncologists, fitness trainers, and cancer patients understand the important role exercise has in cancer prevention, and cancer treatment.

Are you a breast cancer survivor who wants her strength back? Have you been looking to get back into an exercise routine but are unsure about what is safe for you to do? You’ve come to the right place.

Many breast cancer survivors want to know: Is exercise is safe during cancer treatment or after treatment is complete? The Strength After Breast Cancer (SABC) program is a new clinical partnership between the Penn Medicine and Good Shepherd Penn Partners: Penn Therapy and Fitness.

Strength After Breast Cancer program is a new program for breast cancer survivors that educates survivors about lymphedema and helps them to build strength. After just a few months, the program is quickly gaining popularity among patients and medical professionals in the breast cancer community.

The feedback from participants has been extremely helpful in shaping the program, with the goal being to deliver the best education possible to patients and empowering women to be strong-- beyond breast cancer, beyond therapy - for life.

Those of us involved in the program plan to continue to integrate the great feedback we are receiving in order to improve the program. Our hope is to develop a positive buzz due to the “word of mouth” of those who have completed the program. 

What Women are Saying about Strength After Breast Cancer

Even after cancer treatment, women are finding their bodies are strong and are learning valuable information from their activity leaders and peers, while gaining support along the way.

“I’m learning to use my body in a way that I never thought I could before cancer….and surely not after cancer.”

“The human body has a second circulation, the lymphatic system. I never knew how important this was, especially for women with breast cancer.”

“I learned a lot from my peers, and exercising in a group setting enabled me to learn more quickly than I would have on my own.”

Women in the program are providing great feedback about what they like about their classes and exercise sessions.

“The class instructors were great; they really explained the exercises well. They supplied me with everything I need to be able to continue to do this on my own.” 

“It was great to be in a class where everyone is just like you. We all could relate to each other and it was a great learning experience.”

“The small class size made it easy to get individual attention when I needed it.”
“I have been doing my exercises every day, but have some general questions.  I wish there was someone I could follow up with without making another appointment.”

“The materials that I received for doing the program at home are great, but an online resource you can visit to get the same information and updates would be even better; or maybe instructional exercise videos so that you can get a refresher if you need it.”

For more information about the Strength After Breast Cancer program, visit PennMedicine.org or email fitpal@upenn.edu.

To speak directly with a therapist about the program, please call 215-662-4793.


More articles about exercise and breast cancer:

From Breast Cancer to Figure Competitor: How I Out-Muscled Breast Cancer

Strength Training Helps Breast Cancer Patients



Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Monday, December 19, 2011

Christmas with Cancer

For people with cancer and their loved ones, Christmas and the holiday season may not be the “most wonderful time of the year.”

While no one can “skip” the holiday season, it’s important to keep expectations realistic. Let others help out if you need it, save your energy, and most importantly, share your feelings with others.

Oncolink blogger and cancer survivor, Rodney Warner, JD, writes about Christmas with Cancer in this Oncolink blog.

If you are someone with cancer, how will you cope with the holiday season?

Read this transcript of a live webchat from Oncolink called Surviving and Thriving During the Holiday Season for tips on coping with the holidays.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Friday, December 16, 2011

I Wish You Knew I Had Cancer Too


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.

I’ve been cancer free for many years. Although the cancer has physically been removed from my body, it really never leaves my life. I think about it every single day, usually more than once, and have done so for as long as I can remember.

If you read about me on the Focus On Cancer blog, you know I am a stage IV childhood cancer survivor who is now living with the long-term effects of my cancer and treatments. 

Because of this, I have many appointments at Penn’s Abramson Cancer Center throughout the year. As soon as I pull into the parking garage at the Perelman Center for Advanced Medicine, when most people feel anxious or scared, I have an eerie sense of calm come over me. Once on the elevator, without fail, I see a fellow cancer survivor – someone fighting his or her battle now. The people in the midst of their fight are easier to recognize, but I have a pretty good eye for survivors too. Maybe we are part of a gang now and are in tune to each other.

Before getting to my floor I have to go by two other cancer floors. The first is radiation oncology. Someone inevitably gets on the elevator looking tired and weak; maybe baring a bald head or perhaps covering it. It’s the first time in my visit that day that I want to reach out, touch their shoulder and say: “I know it’s hard and it hurts, but it’s worth it, it will get better. I had cancer, too”.

Then I go by the first oncology floor. There, I usually see someone that has just been diagnosed. He or she has that, “deer in headlights” look, sitting with a loved one trying to comfort them, but looking just as scared. I want to reach out to them, tell them: “Please ask me anything, I had cancer, too.”

I get to my floor, I check in, sit down and try to read or work. But I am easily distracted. Looking around I see fear, pain, boredom, laughter and love. As I meet the eyes of these other cancer warriors, we give each other a small nod and smile with our eyes. An indication of comfort and understanding, but I feel all the emotion in the room as if it were all mine. It’s incredibly overwhelming. I run through the overload of emotions in my head, and there is always one that is at the forefront: 

I feel guilt. I don’t look sick. I don’t look unhealthy. I have long curly hair. I look like the person who is waiting for someone that has an oncology appointment, not the patient. I have this huge sense of guilt for winning my battle with cancer and its aftermath so far, while most of the people I sit with are still fighting.

I wish I could say aloud, “I had cancer, too.” Then they could know that I do understand. They don’t have to feel uncomfortable in front of me, or think I am staring at them because they are bald. I wish they knew I’m admiring their strength and silently hoping that by seeing me, they can know there is a light at the end of the tunnel. I want to tell them it won’t always be like this, you’ll never really get to run away from your diagnosis all together, but it’s possible to have a full, happy life as well.

I truly feel an emotional bond to everyone I meet that is going through cancer treatment or is a survivor. I wish I could help everyone I meet, talk and share our experiences, and grow as a person from sharing my story and learning about others.

It’s a very scary disease that affects us all in different ways, but there is always a positive way to look at something. We aren’t defined by our illness, but it does become a part of who we are.

In addition to being a mom and a wife, Melanie 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.

Thursday, December 15, 2011

Cancer Fighting Cupboard: Kale and Carrot Soup

As we enter the winter solstice, this delicious soup packed with cancer fighting ingredients promises to keep you warm.

Kale is a leafy green vegetable
with many cancer-fighting qualities.
Research has shown that kale reduces the risk of certain cancers, including colon cancer. A leafy green vegetable, kale is rich source of organosulfur compounds and other cancer-preventive compounds that block the growth of cancer cells and contribute to the death of cancerous cells.

Ingredients
  • 2-3 cloves of fresh garlic* (more if you like)
  • 1 small onion, peeled and chopped
  • 1-2 tbsp. olive oil
  • 1 inch of peeled fresh ginger, chopped or grated.
  • 2-1 inch cinnamon sticks, left whole
  • 2 bay leaves, left whole
  • 1/2 lb. carrots, chopped
  • 4 cups, cleaned (washed) or torn kale
  • 1 large partially cooked sweet potato, peeled and cubed
  • *Can cook in microwave for 8-10 minutes
*Chop garlic 10 minutes before you sauté to increase its anti-cancer benefits.

Sauté first six ingredients until tender, but not brown (approximately 5 minutes). Add carrots and 2 cups water. Cook until carrots are tender (approximately 20 minutes). Season with salt and pepper. Add kale, sweet potato and 2 cups water. Cook until kale is wilted, but still bright in color. Sweet potatoes will break up slightly (or you can smash about half the sweet potato) and thicken the broth. Remove the whole cinnamon sticks and bay leaves before eating. Season with salt and pepper to you liking.

Serve with a tossed salad made with lots of different greens and fresh whole grain bread, using more olive oil or hummus for a spread.

Want another recipe using kale? Click here for a recipe for a delicious chopped kale salad.

Source: Suzanne Dixon, MPH, MS, RD, Cancer Nutrition Information, LLC, http://www.cancernutritioninfo.com/

Content for this post provided by Joan Karnell Cancer Center.

Tuesday, December 13, 2011

Breast Cancer Research and The Role of Complementary Medicine

Cancer research is one of the cornerstones of Penn’s Abramson Cancer Center’s mission to eradicate cancer and it has helped distinguish the cancer center from other facilities across the country.

Because Abramson Cancer Center researchers work side-by-side with clinicians, these multidisciplinary cancer treatment teams are able to bring new discoveries from the lab to the clinical setting faster than ever.

Breast cancer research seeks to find new ways to prevent, detect and treat cancer.
Clinical trials at Penn may test new drugs and treatments, new screening methods, seek to determine genetic influence in a cancer diagnosis, or seek to improve the quality of life in cancer patients with nutrition, exercise or group therapy.

In the last four years, more than 800 breast cancer survivors have participated in breast cancer research at the Abramson Cancer Center. These studies have allowed Penn researchers to generate important knowledge that is used to improve the care for breast cancer survivors.

Here are some of the research highlights from research in complementary medicine and therapy for breast cancer.

Improving Communication Between Primary Care Physicians and the Cancer Team

Oncology and primary care communication can be difficult to manage. Recognizing the need to address these issues, researchers designed a study asking breast cancer survivors to identify areas where their primary care physicians could improve the quality of care for survivors. Because of this research, clinicians and researchers at Penn and in United States are working hard to enact change based on the patients’ input and concerns.
Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K. “Primary Care Physicians’ Delivery of Survivorship Care: Perspectives of Breast Cancer Patients.” J Clin Oncol. Feb 20 2009; 27(6):933-8.

Integrating Complementary Therapies into Cancer Care

In this study, Penn researchers discovered the majority of the breast cancer survivors endorse the provision of therapies such as acupuncture, massage, and yoga for survivorship care. Because of this research, the Abramson Cancer Center continues to grow its patient-centered Integrative Medicines and Wellness Program.
Bonner-Millar L, Casarett D, Vapiwala N, DeMichele A, Stricker C, Velder L, Mao JJ, “Integrating complementary therapies into an academic cancer center: The perspective of breast cancer patients.” Journal of Society for Integrative Oncology. Summer 2010, 8(3), pp.106-113.

Genetic Links to Treatment Side Effects

The most recent research has led to the identification of a novel genetic variation that can be used to predict who may develop side effects to aromatase inhibitors. With this knowledge, researchers at Penn hope to create ways to determine which patients are most likely to benefit from aromatase inhibitors as well as those who may develop side effects. This effort will allow for the administration of individualized cancer care to improve quality of life and the survival of breast cancer survivors.
Mao JJ, Su HI, Feng R, Horn M, Aplenc R, Rebbeck TR, Stanczyk FZ, DeMichele A. “Association o f functional polymorphisms in CYP19A1 with aromatase inhibitor associated arthralgia in breastcancer survivors” Breast Cancer Res. 2011 Jan 20;13(1):R8.

The Abramson Cancer Center appreciates those patients who participate in this important research. Together, researchers and breast cancer survivors can make a difference in the lives of millions of women and their families whose lives have been touched by breast cancer.

Learn more about breast cancer research at Penn Medicine.
Search for a clinical trial on OncoLink’s Clinical Trials Matching Service.
Learn more about breast cancer treatment at Penn in Philadelphia.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Monday, December 12, 2011

Life After A Bone Marrow Transplant

Bone marrow transplantation (BMT) treats multiple myeloma, leukemia and lymphoma.

High-dose chemotherapy (and sometimes radiation oncology therapies) can affect the bone marrow. Stem cells in the bone marrow make the cells that carry oxygen through the body, fight infection and help blood clot, A bone marrow transplant replaces the patient’s bone marrow with disease-free bone marrow from a healthy marrow donor. Bone marrow donors are often family members, but may also be unrelated to the patient.

Treatment outcomes for bone marrow transplant have improved over the years. However, there are risks associated with bone marrow transplant. Patients who receive a bone marrow transplant may suffer from a graft-versus-host disease, in which the their immune system attacks the donor marrow cells.   Patient’s immune systems are compromised after such intense chemotherapy and graft-versus-host disease can cause serious complications or even death.

Emotions after a bone marrow transplant

Bone marrow transplants also come with a lot of stress. Full recovery of the immune system may take up to two years, placing a great deal of worry and anxiety on both patients and their families.

While many people might assume the most stressful part of treatment involves the decisions made beforehand and the time spent in hospital, life after a bone marrow transplant presents many challenges.

During the early weeks after leaving the hospital patients still have weakened immune systems and their social contact often needs to be restricted.

Other common complaints include poor sleep, memory problems, poor concentration, lack of appetite, nausea, and less sexual desire. Even after one year, bone marrow transplant recipients often report decreased energy and strength, as well as excessive fatigue.

For many, the hope of a quick return to feeling normal is often transformed into frustration. Bone marrow transplant recipients may also struggle with fears and uncertainly about relapse and their long-term health. As a result, even when physical symptoms improve, anxiety and worry may remain a problem for some time.

This frustration can result in depression as recipients come to terms with new issues in their lives such as increased isolation, loss of control, disruption in their work-life and changes in their role within the family and in relationships.

They may also struggle with guilt over feeling like a burden to others in their post-transplant lives. Prolonged and deepening depression is often a sign that further help is needed and the medical team can often help with the decision to seek help from a therapist and/or start anti-depressant medications.

A good outlook after bone marrow transplantation

The good news is that most bone marrow transplant recipients adjust well to life post-transplant. A key factor in coping is having strong emotional support from loved ones.

Support can include:
  • Listening to feelings and anxiety.
  • Acknowledging together new limitations of strength and energy.
  • Accepting help from others including support groups and professionals.
  • Checking in to see how everyone is doing emotionally.
  • Encouraging each other to talk about feelings.

Bone marrow transplant recipients also tend to fare better if they have realistic expectations about their recovery. It is important to spend time before the transplant with the medical team discussing the recovery process. Knowing that recovery can be slow is often a protection against disappointment and unnecessary fear.

Finally, it is also crucial to have positive goals to work towards and a reason to want to feel better. While life can often be put on hold by a BMT, hope and determination can give shape and direction to a fuller life post transplant.

When to get help

If anxiety and depression is not addressed, it can affect the physical recovery on a bone marrow transplant recipient. It’s important for people experiencing these feelings to reach out to a professional for help. If interested in speaking with a counselor, please notify a member of you medical team.

Learn more about the bone marrow transplant and stem cell transplant program at the Abramson Cancer Center.

Learn more about the stem cell transplant program at the Joan Karnell Cancer Center.

Learn more about managing cancer treatment side effects.

Friday, December 9, 2011

Destroying Mesothelioma with Photodynamic Therapy

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Focus On Mesothelioma Conference.  In this blog, she recaps highlights from the conference. You can view all the presentations from the conference here.

When treating patients with mesothelioma or pleural disease, Penn Medicine lung specialists offer more treatment options than most other health systems across the country and around the world.

One of those treatment options is photodynamic therapy (PDT).

Mesothelioma Treatment with Photodynamic Therapy

Penn was the first health system in the Philadelphia area to begin researching the use of PDT to treat cancer. Also known as photoradiation therapy, phototherapy or photochemotherapy, PDT brings together light-sensitive medication with low-level beams of light to destroy cancer cells.

Mesothelioma is by definition a disease that is multifocal, meaning it occurs in several places in the lining of the lung simultaneously. This has traditionally made surgery as a treatment for mesothelioma difficult and ineffective.

PDT is used during surgery to increase the effectiveness of the treatment. It works by bringing together a light-sensitive medication with low-level beams of light to destroy cancer cells.  The medication is injected into the bloodstream and absorbed by the cancer cells. A light source is then applied to the area being treated. The light causes the drug to react with oxygen to form a chemical that kills the cancer cells. Photodynamic therapy can also work by destroying the blood vessels that feed the tumor.

PDT can only work in areas that the light can actually reach. It is effective in treating mesothelioma because it is a cancer that affects the lining of the lung. During the surgery, the light is applied to the pleural space, or area surrounding the lungs. Penn researchers continue working on ways to improve PDT’s effectiveness.

Associate Professor of Surgery, Joseph Friedberg, MD, talks about the possibilities researchers are exploring today, such as combining photodynamic therapy with gene therapy or with tumor vaccines to stimulate the immune system to fight cancer. He also speaks of using substances called rare earth phosphors to create tiny nano crystals that can absorb radioactivity and make it possible to deliver targeted radiation therapy and photodynamic therapy at the same time. 

These are the areas of PDT research today at Penn, and in all likelihood, the innovations of tomorrow that will make mesothelioma easier to treat.

The outlook for mesothelioma patients is improving both in terms of quality and quantity of life, but those improvements depend on being treated at a center that has the expertise and experience to develop the individual treatment plans that are essential to obtaining the best outcomes.
 
Learn more about mesothelioma treatment at the Abramson Cancer Center.

Watch all the presentations from the 2011 Focus On Mesothelioma Conference.


Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Thursday, December 8, 2011

Cancer Fighting Cupboard: Sunrise Smoothie

After enjoying all of the tasty treats of the holidays, now is a good time to get back to eating healthy.

Start the morning right with this savory smoothie recipe. Packed with delectable fruits, Sunrise Smoothies are a great way to get a daily dose of fruit and cancer-fighting nutrients. 

Raspberries, one of the central ingredients of the Sunrise Smoothie, has been found to be a source of ellagic acid which scientists say slow the growth of cancerous cells.

Smoothies are also a great choice for patients who have been treated for head-and-neck cancers.

Since these patients may have trouble chewing or swallowing, a smoothie offers a delicious meal and a great way to get essential vitamins. Please note, however, highly acidic citrus fruits such as oranges and lemons should be avoided in smoothies for these patients because they may cause mouth pain.

Ingredients:
  • One 15oz. can of 100% juice-packed peaches, drained
  • One 15oz. can of 100% juice-packed apricots, drained
  • 1/3 cup frozen raspberries
  • 1 cup plain non-fat yogurt
  • 1 tbsp. ground flaxseed
  • 3 oz. tofu*
  • 3 ice cubes
Blend and enjoy.
Makes 4 servings

Per serving: 166 calories; 29g carbohydrates, 8g protein; 2g fat; 3.5g fiber

*For tofu, try a brand such as Mori-Nu® This type of tofu does not need to be refrigerated until it is opened.

Source: Suzanne Dixon, MPH, MS, RD, Cancer Nutrition Information, LLC, http://www.cancernutritioninfo.com/


Tips for Smoothie Success

  • Some smoothie recipes may need ice cubes; but you can try frozen fruit instead.
  • Try your smoothie before adding any sweeteners or flavors… it may already be perfect!
  • Take a second to rinse out the blender right after you use it, even if you're planning to wash it later; dried-on fruit makes for slow clean-up.

Content provided by the Joan Karnell Cancer Center

Wednesday, December 7, 2011

New Treatments in Chemotherapy for Mesothelioma

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Focus On Mesothelioma Conference. In this blog, she recaps the conference. You can view all the presentations from the conference here.

At the 2011 Focus on Mesothelioma Conference, Thoracic Surgeon and Conference Chair, Joseph Friedberg, MD, illustrated how the Penn Abramson Cancer Center’s multidisciplinary approach to cancer treatment extends to mesothelioma patients.

"Mesothelioma is not a disease for which there is one treatment,” he said, “It requires a team of experts using different modalities to develop the optimal treatment plan for each patient."

Advances in Chemotherapy for Mesothelioma

There are two major treatment approaches that are creating better outcomes for mesothelioma patients.
  1. The use of more aggressive, innovative surgical techniques to treat primary pleural mesothelioma.
  2. Greatly improved options for chemotherapy.

Oncologist James Stevenson, MD, associate professor of medicine, discussed ways in which patients of different ages, gender, backgrounds and stages of their disease have all benefitted from the personalized, multidisciplinary approach to treating their mesothelioma. Every patient receives multiple treatments and all have survived for a number of years. These patients are not exceptions or unusual anecdotes. They represent the kinds of patients and the results that clinical programs such as the one at the Abramson Cancer Center expect to obtain.

The introduction of the drug Alimta® (pemestrexed) has in Stevenson's words, "changed the landscape" for treating pleural mesothelioma.

Alitma is more effective and less toxic than drugs that were previously used, and can be combined with other drugs.

Alimta also has another unusual advantage: Many drugs used to treat cancer work well for a period of time and then become ineffective as the cancer develops resistance to the drug. Once a cancer becomes resistant, the drug no longer works. Alimta, however, can be used to induce a remission. A patient can discontinue treatment and have the option of going back on Alimta if the cancer recurs with a good chance that the drug will be effective again. Clinical trials are also under way to determine whether Alimta can be used for long periods of time as maintenance therapy, or as a means of controlling the cancer as a chronic condition.

Learn more about mesothelioma treatment at the Abramson Cancer Center.

Watch all the presentations from the 2011 Focus On Mesothelioma Conference.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Tuesday, December 6, 2011

New Treatments for Mesothelioma Help it Evolve to Chronic Disease

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Focus On Mesothelioma Conference. In this blog, she recaps highlights from the conference. You can view all the presentations from the conference here.

Traditionally, mesothelioma has been considered a complex disease that is difficult to treat. But the experts at Penn’s Abramson Cancer Center emphasized the real potential for new treatments for mesothelioma at the 2011 Focus On Mesothelioma Conference.

While there is no cure for mesothelioma, new treatments for mesothelioma have advanced to the point that it can be managed as a chronic disease, one that patients live with for a number of years.

The importance of taking a healing approach, addressing the needs of the whole person through integrative medicine, and developing an individualized treatment plan were the dominant themes of the conference

Mesothelioma as a Chronic Disease

"I know what patients hear when they are diagnosed with this disease," said Joseph Friedberg, MD, thoracic surgeon. "They hear this is incurable and that there are no effective treatments, but we are changing that. We have many patients who are living longer, quality lives."

A key to this progress is the Abramson Cancer Center’s multidisciplinary approach to treatment. Experienced experts from a wide variety of fields including surgery, medical oncology, radiation oncology, pulmonology, pathology, radiology and a variety of supportive care fields care for patients with mesothelioma and pleural disease.

In his opening address to the conference, Abramson Cancer Center Director, Chi Van Dang, MD, PhD, recognized the Penn mesothelioma and pleural program as one of the most comprehensive in the nation and that it has the complete team of experts working together.

Each speaker echoed that same sentiment, urging patients to be seen in a center that has specialized expertise in the diagnosis and treatment of mesothelioma. When treating patients with mesothelioma or pleural disease, Penn Medicine pleural specialists offer more treatment options than most other health systems across the country and around the world.

Penn Medicine's Mesothelioma and Pleural Program and Penn's Abramson Cancer Center bring together internationally renowned experts in medical, surgical and radiation oncology and pulmonology who collaborate in the diagnosis, treatment and research of mesothelioma and pleural disease.

Learn more about mesothelioma treatment at the Abramson Cancer Center.

Watch all the presentations from the 2011 Focus On Mesothelioma Conference.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Monday, December 5, 2011

What You Need to Know About Pancreatic Cancer


Andrew Rhim, MD, is an instructor of medicine at the Perelman School of Medicine at the University of Pennsylvania. Dr. Rhim specializes in cancer risk evaluation, surveillance, and the medical management of gastrointestinal malignancies. His research focuses on defining the biology of early pancreatic tumor formation and progression and developing new technologies to detect pancreatic and other gastrointestinal cancers at their earliest stages, before they metastasize.

Pancreatic cancer is one of the deadliest cancers. It’s estimated 45,000 people will be diagnosed with pancreatic cancer this year, making it the ninth most common cancer in the United States.

Of those people diagnosed with pancreatic cancer, about 38,000 will die of the disease. Unfortunately, these statistics have remained the same for decades.

Why is pancreatic cancer so lethal?
Pancreatic cancer is so deadly because of metastasis.

Metastasis refers to when a cancer leaves its “home” organ, or where it was first found and diagnosed, and spreads to other parts of the body. As it spreads, it damages the other organs, either through the bloodstream or invading them directly.

Pancreatic cancer metastasizes more frequently than almost any other cancer. Currently, the only known way to cure pancreatic cancer, is to catch it early before the cancer has had the chance to spread beyond the pancreas. When caught at this early stage, surgery can lead to cure.

Cancer specialists at the Abramson Cancer Center are able to detect many pancreatic tumors before they grow to a large size, and potentially, before they spread. But, it is impractical and costly to screen everybody for pancreatic cancer. Penn’s cancer team focuses its efforts on those who are at increased risk for this disease.

Who is at risk for pancreatic cancer?
Risk factors for pancreatic cancer can be organized into high, medium, and low risk factors.

High risk factors for pancreatic cancer increase your risk by more than 10-fold over the general population. These factors are due to genetics that are passed on or inherited within a family. These include some rare genetic diseases such as Peutz-Jeghers syndrome, hereditary pancreatitis, and familial atypical multiple mole melanoma syndrome. There are many instances where pancreatic cancer runs in the family, but there isn’t any associated disease that raises a red flag for physicians. These “pancreatic cancer families” can be defined as having three or more members with pancreatic cancer or two first-degree relatives with pancreatic cancer.

Moderate risk factors for pancreatic cancer increase your chances for pancreatic cancer from 5- and 10-fold over the general population. These risk factors include having cystic fibrosis, chronic pancreatitis (an inflammatory disease of the pancreas), and carrying a mutation in the BRCA2 gene (a cause of hereditary breast and ovarian cancer). Patients with some types of pancreatic cyst lesions, which may be discovered on CT scans and MRIs, are also at elevated risk for pancreatic cancer.

Low risk factors for pancreatic cancer increase the risk 1- to 5-fold over the general population. These risk factors include being Ashkenazi Jewish descent or African American, having at least one first-degree relative with pancreatic cancer, and carrying a mutation in the BRCA1 gene.

What should you do if you’re at risk?
All people, regardless of their risk level, should make good lifestyle choices.

Those who smoke, are overweight and lead a sedentary lifestyle, and those who drink a lot of alcohol (four or more drinks per day) may be at increased risk for pancreatic cancer.

These lifestyle factors can combine with any of the genetic factors listed above to increase someone’s chances of pancreatic cancer to even higher levels.

Patients who are at high-risk, and perhaps those at moderate risk, should consider consultation at a specialized high-risk pancreatic cancer clinic, such the program at the Abramson Cancer Center. This clinic has a number of specialized physicians and genetic counselors who can estimate your risk for pancreatic cancer and guide your next steps.

As part of this team, specialized gastroenterologists and radiologists may use a combination of proven and high-tech non-invasive tests that can detect pancreatic tumors before they have spread. These tests include:

Patients at lower risk can discuss their risk with their physician. Some patients may have multiple risk factors, so it can be difficult to determine their actual risk for pancreatic cancer. If you have questions, ask your doctor, or make an appointment with a gastroenterologist at Penn

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

Learn more about the Gastrointestinal Cancer Risk Evaluation Program at the Abramson Cancer Center.

Learn more about the Gastrointestinal Cancer Evaluation Center at the Abramson Cancer Center.

Friday, December 2, 2011

Cancer Experts and Patients Redefine Cancer’s “New Normal”

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 Focus On Lung Cancer Conference. Here, she recounts a panel discussion featuring Jun Mao, MD, MSCE, acupuncturist and leader of the Penn Integrative Medicine Program, Andrea Branas, MSE, MPT, a physical therapist, Joe Carver, MD, a cardiologist, Kimberly Fleisher, RMT, a Reiki specialist and Michael Baime, MD, who heads the Penn Mindfulness Program. You can view all the presentations from the conference here.

Many lung cancer patients are interested in complementary and alternative therapies for cancer symptoms. They often report anxiety and fatigue related to their cancer diagnosis.

Jun Mao, MD, MSCE, shared this patient story at the Abramson Cancer Center’s 2011 Focus On Lung Cancer Conference:

A woman had been healthy and active until her lung cancer diagnosis. She was treated with surgery and chemotherapy, and cancer-wise, was doing well. But she was suffering from anxiety and fatigue. She couldn't sleep and hadn't been able to resume her normal activities.

Dr. Mao asked each expert what he or she recommended to help this patient?

Dr. Mao heads the Penn Integrative Medicine Program, a remarkable multidisciplinary effort dedicated to addressing the many issues that affect the mind and body when people face a serious disease. The program combines real, hands-on interventions with research that seeks to advance this emerging field of medicine.

The panel members responded with both expertise and sensitivity.

Kimberly Fleisher, RMT, described the overall sense of balance that can come from the light touch of Reiki, its ability to move people away from anxious or negative thoughts. 

Andrea Branas, MSE, MPT discussed the value of exercise in combating fatigue and insomnia, and how tailored exercise programs can meet the specific needs of this patient. She also discussed the importance of learning how to breathe deeply. 

Dr. Mao thought that acupuncture could be useful because acupuncture for cancer symptoms may involve helping the brain release endorphins and regulate the autonomic nervous system. Michael Baime, MD, addressed the connection between mind and body, pointing out that by understanding that connection people could help themselves psychologically and physically.

The audience listened to the panel, and one woman who has been battling lung cancer for four years spoke:
"Things don't look the same to me since I got cancer," she said. “I'm different. People treat me differently. I don't even tell people anymore because they can't understand cancer if they haven't been through it."
Several other patients spoke up and affirmed what she had said. In the most respectful of ways, they challenged the panel to dig a little deeper, to hear and respond to another level of pain that they shared.

The panel members conceded that there were no easy answers. The key, Dr. Mao said, is "redefining normal," in discovering a new level of life in which patients find positive meaning. It is a process, but one that many patients achieve.

"We are always moving toward balance in our lives," Fleischer added, “but the definition of balance changes all the time. We have to look deeply at what is happening to understand what balance means."

Joseph Carver, MD, said the discussion was a positive force. "No one knows what you are going through, but by talking to each other, learning, and listening, you can help each other and yourself."

Dr. Baime added: "Your body is smarter than any expert. Take some time to listen to it and be attuned to what is actually happening."

In the panel that followed, several patients offered their suggestions for coping with the ongoing physical and emotional challenges that are part of a lung cancer diagnosis. Their suggestions included tips like: talking to people, accepting help when it is needed or offered, participating in a support group, and staying as active as possible.

Some patients have also discovered that they help themselves by helping others. For many lung cancer patients, their journey begins with what they thought was bronchitis or pneumonia. It becomes a life-changing experience when a chest X-ray or scan reveals a lesion on the lung. By sharing their experiences they can help others cope with the challenges.

One participant summed up her commitment to working with newly diagnosed patients by saying: "No doctor can tell you what it feels like to hear the words 'you have lung cancer.' I can make a difference to someone by talking to them, and in the process, I feel better because I am giving something back."

The message from both patients and clinicians was clear: Cancer is a disease that affects not just the body, but the mind and soul as well. To be successful, treatment needs to address the whole patient, to heal the person as well as to destroy the cancer.

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

Learn more about the Integrative Medicine and Wellness Program at the Abramson Cancer Center.

View presentations and more from this year’s Focus On Lung Cancer Conference.

Thursday, December 1, 2011

Advances in HIV Treatment Pose New Risks for Patients

David Henry, MD
David H. Henry, MD, is a medical oncologist, medical director of the Penn HIV oncology program  and vice chair of the department of medicine at Pennsylvania Hospital. Today, December 1 on World AIDS Day, Dr. Henry discusses how treatment for HIV has evolved since its discovery in 1981, and how patients with HIV may be at an increased risk for cancer.

Since its discovery in 1981, treatment for the human immunodeficiency virus or HIV has quickly evolved. In humans, HIV leads to progressive failure of the immune system (immunosuppression), allowing life-threatening opportunistic infections and cancers to thrive.

While for many of us it seems like yesterday this epidemic appeared, most young doctors and nurses in training today have never known a time without HIV.

When it first became apparent HIV was an epidemic, there was no therapy to stop the consequences of profound immunosuppression. Patients rapidly developed full-blown AIDS (acquired immune deficiency syndrome) and died of unusual, opportunistic infections. Back then, I recall losing as many as three patients a month to AIDS. 

When AZT (azidothymidine), the first therapy for AIDS was developed, it began to change the natural course of HIV. But it wasn’t until the more powerful protease inhibitor drugs that were developed in late 1995 that patients were restored to much greater immunity and could avoid opportunistic infections.

Now with at least five classes of antiretroviral therapies, many patients with HIV enjoy a life without opportunistic infections. They have undetectable viral loads and experience significant elevations in their CD4 immune defenses.

However, this major advance in antiretroviral therapy and improvement in longevity has led to a new issue for people with HIV — cancer. 

From the beginning, physicians and researchers knew that profound immunosuppression led to early/frequent development of so-called AIDS-defining cancers:
With highly active antiretroviral therapy, these AIDS-defining cancers are much less frequent, but several non-AIDS-defining cancers have become much more prevalent:
  • Anal cancer: One hundred times more likely in the HIV-infected patient
  • Liver cancer: Usually associated with co-infection with hepatitis B and/or C
  • Lung cancer: By sheer numbers of new cases, may be the greatest problem of all

All of these cancers tend to occur at a younger age than they would in non-HIV-positive people. Anal, hepatic and lung cancer, occur five to 10 years earlier in the HIV-infected population than in those who are not.

Currently, there are no known strategies, drugs or therapies for stable HIV-infected patients that would restore their immunity completely and lower these cancer rates back down to that of the general population.

However, we are developing screening strategies to detect cancer and treat it earlier. 

Smoking cessation and possibly low-dose CT scanning may decrease or catch lung cancer in a more curable stage. Every six to 12 months, imaging of the liver in patients co-infected with hepatitis C and/or B can help identify liver cancer earlier. Routine anal examination and possibly even Pap testing can help discover anal cancer at an earlier, more curable stage.

HIV treatment has certainly come a long way, but vigilance, surveillance, treatment, and better understanding of cancer has become the next major challenge in this ever-present epidemic.

Learn more about the HIV oncology program at Penn Medicine.

Learn more about AIDS research at Penn Medicine.
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