University of Pennsylvania Health System

Focus on Cancer

Tuesday, January 31, 2012

Learn the Symptoms of Cervical Cancer

January is cervical cancer awareness month. This article is the third in a series that discusses cervical cancer, its prevention, symptoms and treatment.

In its early stages, cervical cancer usually has no symptoms. It develops slowly, beginning as a pre-cancerous condition called dysplasia. Symptoms of cervical cancer often do not begin until the cancer spreads into nearby tissue.

Cervical cancer starts in the lower part of the uterus that opens at the top of the vagina. If cervical cancer spreads into nearby tissue, symptoms may include:

  • Increased vaginal discharge including discharge that is pale, watery, pink, brown, bloody or foul-smelling
  • Abnormal vaginal bleeding between periods, after intercourse, or after menopause
  • Periods become heavier and last longer than usual
  • Any bleeding after menopause
  • Pain during intercourse
These symptoms can also be caused by other conditions, so it is best to contact a physician for a diagnosis. If interested in making an appointment with a Penn Medicine physician, call 1-800-789-PENN (7366) or make an online appointment here.

Monday, January 30, 2012

The Future of Breast Cancer Treatment

Kevin Fox MD, is the Mariann T. and Robert J. MacDonald Professor of Medicine and medical director of the Rena Rowan Breast Center at Penn’s Abramson Cancer Center. He treats all aspects of early stage and advanced stage breast cancer researches adjuvant therapy of breast cancer.

The future of breast cancer treatment


The next 20 years will bring more targeted therapy for the treatment of advanced breast cancer, and will most likely see a decline in the use of chemotherapy.

Special drugs will continue to be developed that attack special “targets” that exist only in breast cancer cells. These drugs, we hope, will spare the patient’s normal cells, thus avoiding many of the side effects we have come to expect from chemotherapy.

Drugs with names like PARP inhibitors and MTOR inhibitors will become part of our everyday language, and more drugs that target HER-2 like trastuzumab will be released in the very near future.

Twenty years from now, many things about breast cancer treatment will have changed again. Tomograms may replace mammograms as the standard method of breast cancer detection,surgeons may not need to remove lymph nodes at all, and radiation therapy may become shorter in duration. Perhaps chemotherapy will have become a thing of the past.

Whatever the case, treatments will be better, more patients will be cured, and in every respect, there will be less suffering for patients at every stage of treatment.

Learn more about breast cancer treatment at the Abramson Cancer Center in Philadelphia.

Watch conference presentations from the 2011 Life After Breast Cancer 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.

Friday, January 27, 2012

Cervical Cancer Risk and Prevention

January is cervical cancer awareness month. This article is part two in a series that discusses cervical cancer, its prevention, symptoms and treatment.

Cervical Cancer Risk and Prevention

Most risk factors for cervical cancer, like age and family history, cannot be prevented. Patients who feel they are at higher risk for cervical cancer may benefit from consulting with a risk assessment specialist through one of Penn Medicine’s programs at the Abramson Cancer Center or the Joan Karnell Cancer Center at Pennsylvania Hospital.

Cervical Cancer Risk Factors

Risk factors affect the chance of developing cervical cancer. Having a risk factor, or even several, does not mean that someone will get cancer.
All women need to be aware of the risk factors for cervical cancer, and what they can do to prevent it.

Penn Medicine gynecologists work with patients to identify their risk of developing cervical cancer and the steps they can take to lower their risk.
The human papilloma virus, or HPV, causes the majority of cervical cancers. HPV is a group of more than 100 related viruses that can infect cells on the surface of the skin, genitals, anus, mouth and throat.

Genital HPV is the most common sexually transmitted virus in the United States. An estimated 75 to 80 percent of males and females will be infected with HPV during their lifetime. For most people, the virus clears on its own. When it doesn’t, HPV can cause genital warts, precancerous dysplasia and cervical, vulvar or vaginal

Other risk factors for cervical cancer include:
  • Having sex early
  • Multiple sexual partners, or having sex with someone who has had multiple partners
  • Sexual partners who have multiple partners or who participate in high-risk sexual activities
  • A weakened immune system
  • Lack of regular pap tests
  • Weakened immune system
  • Smoking
  • Long term birth control use
  • Having more than 5 children
  • DES exposure
  • Poor economic status or inadequate health coverage
  • HPV infection or genital warts
Cervical cancer is easily treated if it is caught early, so it is important for women to get regular screening exams including a Pap test and HPV test.

Cervical Cancer Prevention


Penn Medicine gynecologists recommend several methods to prevent cervical cancer. Regular screenings, vaccines for preventing the human papilloma virus (HPV) and lifestyle choices can prevent cervical cancer or help find cervical cancer at an early stage when it is most treatable.

Pelvic Exam, Pap Test and HPV Test

Pelvic exams, Pap test screening and HPV testing can detect cervical cancer in its early stages. Pap tests are one of the most effective screening tools used to determine if women have infections, abnormal (unhealthy) cervical cells, cervical cancer or other reproductive problems. A Pap test is the screening of cells scraped from the cervix during a pelvic exam that are examined under a microscope. Pap tests screen for pre-cancers and cancer, but do not provide a final diagnosis.

The American College of Obstetrics and Gynecologists (ACOG) recommends that cervical cancer screening begin at age 21. Most women under the age 30 should undergo cervical screening once every two years and women 30 and older with no other risk factors can be screened every three years. These are not the guidelines. See below.

  • Under 21 and never sexually active: No pap
  • Adolescent: Within 3 yrs of onset of sexual activity
  • 21 to 29 years old: Annual pelvic exam with Pap Smear
  • 30 to 64 years old: ACOG recommends annual Pap. After 3 consecutive normal paps, screening = every 2-3 years. (This is only if the patient has never had CIN 2 or 3, is not immune-compromised or HIV-positive, and has not been exposed to diethylstilbestrol (DES) in utero.
  • 65 and older:  Pap Smears may be disontinued if the woman has had 3 or more consecutive negative paps; no abnormal tests in the previous 10 years; no history of cervical cancer; no DES-exposure; is HIV negative and has a normal immune system; and has no other risk factors for STDs. 
The above was taken from http://www.kltv.com/story/10543955/acog-changes-pap-smear-guidelines. i had trouble accessing the ACOG site.

Preventing HPV: The HPV vaccine

Vaccines are now available that protect against four major types of HPV, including the two types that cause about 70 percent of cervical cancer cases and two types that cause about 90 percent of genital warts.

The HPV vaccine is expected to be long-lasting, but because the vaccine does not protect against all HPV types that cause cervical cancer vaccinated women still need cervical cancer screening (Pap tests and HPV tests). The vaccine does prevent HPV, but does not protect against HPV exposure before vaccination. Also add that it is not a cure.

Condoms do not protect completely against HPV because they don't cover all of the potential HPV-infected areas of the body. However, condoms do provide some protection against HPV, and they protect against HIV and other sexually transmitted diseases.

Although penetrative intercourse is not necessary to get and spread HPV women can do the following to decrease their risk of cervical cancer:
  • Stay up-to-date with recommended paps and exams.
  • Avoid smoking
  • Avoid early onset of sexual activity and sexual activity with people who have had several sexual partners.
  • Use condoms
  • Try to maintain a healthy immune system
  • Limit the amount of sexual partners

Women may avoid HPV, and therefore reduce their risk of cervical cancer, by waiting to have sex until they are older and limiting the number of sexual partners. They should also avoid having sex with anyone who has had multiple sexual partners.

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

Learn more about the Jordan Center for Gynecologic Cancer.

Learn more about the MacDonald Women’s Cancer Risk Evaluation Center.

Thursday, January 26, 2012

Include These Vegetables in Your Diet to Prevent Gynecologic Cancer



Nutrition plays a role in the prevention of various gynecological cancers.

The World Cancer Research Fund along with the American Institute for Cancer Research analyzed research on nutrition and its role in cancer and published the “Food, Nutrition and the Prevention of Cancer: A Global Perspective."



The recommendations for the general public are as follows:
  • Be as lean as possible within the normal range of body weight.
  • Be physically active as part of everyday life.
  • Limit consumption of energy-dense foods.  Avoid sugary drinks.
  • Eat mostly foods of plant origin.
  • Limit intake of red meat and avoid processed meat.
  • Limit alcoholic drinks.
  • Limit consumption of salt.
  • Aim to meet nutritional needs through diet alone.
This report analyzes the evidence by cancer type including three gynecological cancers.

Nutrition to prevent cervical cancer

Specific to cervical cancer, there is some evidence that an intake of carrots may protect again cervical cancer.  According to the American Institute for Cancer Research “The evidence, from case-control studies only, is sparse but consistent.  There is limited evidence suggesting that carrots protect against cervical cancer.”

Additional sources of produce high in carotenoids include:
  • Sweet potatoes
  • Spinach
  • Kale and other greens
  • Papaya
  • Oranges
  • Sweet peppers
  • Tomatoes

Nutrition to prevent ovarian cancer

For ovarian cancer, evidence suggests that consuming these non-starchy vegetables may decrease the risk of ovarian cancer:
  • Asparagus
  • Carrots
  • Tomatoes
  • Cauliflower
  • Broccoli

Nutrition to prevent endometrial (uterine) cancer

For endometrial cancer, a high percentage of body fat as well as weight gain in the adult years may increase the risk of endometrial cancer.

So clearly at the top on your priority is weight management and just as your mother said “eat your vegetables."

The two work hand in hand as well as vegetables are a very high fiber, low calorie food which can provide cancer fighting compounds and assist with the feeling of fullness.  Easy ways to incorporate vegetables in your diet are:
  • Breakfast: Top your cereal off with berries or make a spinach omelet.
  • Lunch: Layer sandwiches with greens, tomatoes and cucumber.  Have raw vegetables on the side instead of chips.
  • Dinner: always include a colorful salad and aim to fill half your dinner plate with non-starchy vegetables like steamed asparagus, broccoli and carrots.
  • Snacks: Try baby carrots, sugar snaps peas and sliced red peppers dipped into hummus.
Continue following this blog for more recipes with cancer fighting properties.

Debra DeMille, MS, RD, CSO is a nutritional counselor at the Joan Karnell Cancer Center.  Debra has worked at Pennsylvania Hospital since 1988 with the last 12 years specializing in oncology.  Debra guides individuals receiving chemotherapy and radiation as well as addressing survivorship issues including the use of Integrative therapies.  She conducts cooking programs and group counseling sessions for cancer survivors. 

Wednesday, January 25, 2012

What is Cervical Cancer?

January is cervical cancer awareness month. This article is part one in a series that discusses cervical cancer and its prevention symptoms and treatment.

According to National Cancer Institue, there were approximately 12,000 women diagnosed with cervical cancer last year. Cervical cancer develops in the cervix, the narrow outer end of the uterus that extends into the vagina. When diagnosed early, cervical cancer is generally curable and patients have an excellent chance of recovery. Penn Medicine physicians and scientists are working together to develop new ways to diagnose and treat cervical cancer.

There are two types of cervical cancer:
  • Squamous cell carcinoma. The most common type of cervical cancer consisting of flat, thin cells called squamous cells that cover the surface of the cervix.
  • Adenocarcinoma. Develops in the mucus-producing glands of the endocervix or opening to the uterus.
About half of the women diagnosed with cervical cancer are between the ages of 35 and 55 (check stats). The majority of cases are caused by exposure to the human papillomavirus (HPV), a common sexually transmitted disease. HPV affects up to 80 percent of females and males in their lifetime. Many cases of HPV clear on their own, but certain types of HPV can cause cervical, vulvar and vaginal cancer in females.

Cervical cancer treatment at Penn Medicine is provided by the Jordan Center for Gynecologic Cancers. As part of Penn’s Abramson Cancer Center, the Jordan Center takes a multidisciplinary approach to care, combining the expertise of Abramson Cancer physicians and scientists from the Penn’s division of gynecologic oncology, the Joan Karnell Cancer Center and the Penn Ovarian Cancer Research Center.

Tuesday, January 24, 2012

The BRCA Gene Mutation: Should You Tell Your Children?

Parents of who children learn they have the BRCA gene mutation have a difficult question to answer: Should they tell their children?

Jill Stopfer,MS, genetic counselor at Penn Medicine's Abramson Cancer Center, was recently interviewed by the Huffington Post about this topic.

"One of the questions we all have and we all worry about in this area is 'how much information is too much?'" said Stopfer. "Are we hopefully helping our children and not hurting them?"

Read the full article about telling children about a BRCA gene mutation here.  

Learn more about the MacDonald Women’s Cancer Risk Evaluation Center.

Monday, January 23, 2012

More Advances in Breast Cancer Treatment

Kevin Fox MD, is the Mariann T. and Robert J. MacDonald Professor of Medicine and medical director of the Rena Rowan Breast Center at Penn’s Abramson Cancer Center. He treats all aspects of early stage and advanced stage breast cancer researches adjuvant therapy of breast cancer.

Advances in surgery for breast cancer

Surgeons began using a technique in the mid-1990s called the sentinel node procedure to evaluate whether a breast cancer has spread to the lymph nodes under the arm.

For almost a century, the standard of care included removing a large number of lymph nodes from the underarm of most breast cancer patients in an operation called an axillary dissection. This procedure left many patients in pain, disabled, or with a swollen arm.

The sentinel node procedure allows the surgeon to detect the first lymph node in the underarm. If that lymph node contains no cancer, then the surgeon doesn’t need to perform the axillary dissection: if the first lymph node is cancer-free, the other lymph nodes will almost always be free of cancer as well.

Using this technique, hundreds of thousands of patients have avoided unnecessary axillary dissections.

Advances in radiation therapy for breast cancer

Radiation treatments for breast cancer, particularly in those women who do not choose a mastectomy, have also advanced during the last 20 years.

Partial breast radiation describes several techniques in which the radiation is applied only to the portion of the breast where the cancer was found, rather than the whole breast. Until recently, whole-breast radiation had been the standard of care. Partial breast techniques are not appropriate for all women, but are being offered to patients with increasing frequency.

At the present time, radiation oncologists are exploring more targeted, shorter treatment periods in the hope that many patients can finish treatment in as little as three or four weeks, rather than the current six or seven.

Adjuvant therapy for breast cancer

Most women who have early stage breast cancer have adjuvant therapy after surgery.

Adjuvant therapy describes drug treatments that are given for a period of time after surgery in order to reduce the risk of recurrence or spread of the breast cancer.

Patients may receive several months or years of adjuvant therapy in the form of chemotherapy, hormonal therapy or both.

The most significant advance in the adjuvant therapy of early stage breast cancer came in 2005 in the form of a substance called trastuzumab, or Herceptin®. Trastuzumab is an antibody that attacks HER-2, a protein that is present in large amounts on certain breast cancer cells.

Only 20 percent of breast cancer patients are HER-2 positive (have too much of the protein), but these cancers can be very aggressive and spread quickly and often. Patients treated with this antibody for a year, along with several months of chemotherapy, reduce the risk of their cancer spreading by 50 percent.

Nearly every patient with HER-2 positive invasive breast cancer now receives trastuzumab in addition to chemotherapy..

In 2006, we began using a special test called the Oncotype DX® assay in patients who had cancers that were considered hormone-sensitive, particularly women whose hormone-sensitive cancers has not spread to the lymph nodes.

Oncotype is a diagnostic test that can provide information about the biological activity of the specific tumor. Along with other information, the test results can help in making decisions about whether or not to include chemotherapy in the treatment plan and indicate how likely it is that a woman’s cancer may return in the future.

For many years, patients with hormone-sensitive cancers that have not affected the lymph nodes received both chemotherapy and hormonal therapy. The Oncotype assay enables us to determine which of these women really need the chemotherapy and determine those who can do just as well without it.

Up to 50 percent of women with this type of breast cancer don’t need chemotherapy at all.

Hormone therapy for breast cancer

Even the way in which we use hormonal therapy for early stage breast cancer has changed.

Hormone therapy works by blocking the actions of certain hormones that may trigger cancer growth, preventing the body from producing hormones that may trigger cancer growth, or eliminate hormone receptor in the body.

For many years, the drug tamoxifen was prescribed for most women who had hormone-sensitive breast cancers and it was very effective in reducing the risk of recurrence or spread of the cancer.

In late 2001, we began to prescribe a new type of pill called an aromatase inhibitor. Aromatase inhibitors work better in women who have entered menopause at the time they are first diagnosed with breast cancer.

Tamoxifen remains the best choice for premenopausal women with early stage breast cancer.

Chemotherapy for breast cancer

Over the years, the use of chemotherapy for treating patients with early stage breast cancer has changed considerably.

In general, courses of chemotherapy are now shorter, lasting from 12 to 18 weeks instead of 24 weeks or even longer. Different drugs, particularly paclitaxel and docetaxel, are used in almost every patient who receives chemotherapy. Many of the most dreaded side effects of chemotherapy, particularly nausea and the risk of infection, have decreased considerably as a result of the changes we have made in the last 20 years.

Advances in treating advanced breast cancer

The treatment of advanced (metastatic or stage IV) breast cancer has seen drastic changes in the last 20 years.

Six new chemotherapy drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of advanced breast cancer since 1992, and several other chemotherapy drugs used for other types of cancer are given routinely to breast cancer patients as well, with some success.

For patients with hormone-sensitive breast cancer, the aromatase inhibitors mentioned above have proven very useful, as has the drug fulvestrant.

Special compounds such as pamidronate, zoledronate, and denosumab are used routinely in women whose breast cancer has spread to the bones. These compounds are not cancer treatments, but protect the bones against the injuries that the cancer can cause.


Learn more about breast cancer treatment at the Abramson Cancer Center in Philadelphia.


Watch conference presentations from the 2011 Life After Breast Cancer 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.

Friday, January 20, 2012

I Survived Cancer, Now I Want a Family!

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.

Before I ever pictured myself in the “what-do-you-want-to-be-when-you-grow-up” role, being a mom always foreshadowed any career or profession. I had a vivid concept/vision in my head about motherhood: the mother I would try to be, the hugs and kisses I would smother a child with, life lessons I would teach, even the sex --  I always envisioned boy and girl twins.

This was even after I was told that a baby, especially “babies,” might not be possible. I had come to terms with knowing that I might not be able to conceive, carry or deliver because of my cancer treatments and health limitations. I knew if I couldn’t conceive, I would adopt. I realized this about the age of 13. I know it sounds young, but I think when forced to battle for your life at a young age, your outlook and decisions about life tend to mature quickly.

During my treatments I received radiation directly to my pelvic area and my left ovary was in the direct line of radiation. It could not be protected, but someone, even back in 1982 during the early stages of this research, had the foresight to shield my right ovary.

Now I have my dream: a 5-year-old boy and 1-year-old little girl. Pregnancy was hard on my body and I was under constant supervision from my multidisciplinary, high-risk pregnancy team at Penn. But I have bounced back. I wouldn’t change a thing. I thank the incredible medical team I have and I thank myself, the sheer will to achieve and fight for what you want can be surprisingly strong.

I am a Cancer Survivor and I got more than I ever thought I would, my family!

Advances in childhood cancer treatment have significantly improved a patient’s chance of survival, which results in a large number of adult childhood cancer survivors who are hoping for the same life they would have if they had never had cancer. 

One big concern is about the effects of treatment on reproductive possibilities. For myself and many other women, there are indications that both radiation and chemotherapy may affect how well the ovaries function (if you are left with just one) and the health of the uterus. All of these can lead to infertility, negative pregnancy outcomes and entering menopause at an earlier age.

We are very thankful for surviving and the chance to live our lives, but we also want to experience life, not just survive it. Having children plays an incredibly important role in the lives of many people.  Along with advances in cancer treatments over the years, the advancement of preserving fertility has grown as well.

The Cancer Survivorship Program at CHOP’s Cancer Center is working with Fertile Hope, an organization dedicated to addressing fertility concerns for cancer survivors, and they have developed ways to help preserve a woman’s fertility.

Penn Fertility Care at Penn Medicine is a leader in helping adult survivors of childhood cancer realize their dreams of parenthood. The physicians are working with patients who were not able to take advantage of the fertility services during that small window, before their cancer treatment begins. These physicians are doing what they can to help these women realize their dreams of a family.

Learn more about Penn Fertility Care at Penn Medicine.

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

In addition to being a mom and a wife, Melanie operates a small marketing and graphic design boutique called Melanie Gaffney. Read more about Melanie here.

Thursday, January 19, 2012

Cancer-fighting Recipe: Winter Miso Soup

This recipe for miso soup has great cancer-fighting ingredients. Garlic, carrots, cabbage, mushrooms, ginger and 2 forms of soy are all cancer-fighting foods.

Ginger and garlic are anti-inflammatory foods; carrots are full of carotenoids, an antioxidants; cabbage has indole 3 carbinol and sulforaphan – natural detoxification compounds; mushrooms may help the immune system with beta glucans and tofu and miso come from soybeans.

 

Miso Soup

Ingredients:
3 tablespoons dark miso paste
1 tablespoon canola oil
1 celery rib (about 2 ounces), sliced thin
1 medium red onion (about 5 ounces), sliced thin
1 garlic clove, peeled and crushed
1 medium carrot (about 3 ounces), peeled and sliced thin
2 cups shredded white, savoy, or Chinese cabbage
1 cup sliced mushrooms
½ teaspoon grated fresh ginger
2 teaspoons rice wine vinegar or sherry vinegar
1 tablespoon tamari (a Japanese soy sauce)
Salt and freshly ground black pepper
2 teaspoon brown sugar
½ pound extra-firm low-fat (lite) tofu, cut into small cubes
2 scallions, sliced thin, for garnish
Serves 4 to 6


Directions:
1. In a large bowl, dissolve the miso paste into 6 cups boiling water or whatever the package instructions call for – usually 1 tablespoon miso for 2 cups water. Stir to combine well. Set aside.
2. Heat the canola oil in a large nonstick saucepan over medium-high heat. Add the celery, onion, and garlic and cook, stirring often, for 5 minutes.
3. Add the carrot, cabbage, and mushrooms.  Continue cooking for 15 more minutes; lower the heat if necessary and stir often to prevent browning.
4. Add the ginger and miso-water mixture, bring to a boil, then reduce the heat so the mixture simmers.
5. Cook for 15 to 20 minutes, then season with the rice wine vinegar, tamari, salt and pepper to taste, and brown sugar.
6. Add tofu 1 to 2 minutes before serving. Garnish with scallions.


One serving (based on 4 servings): 135 calories, 8g protein, 15g carbohydrates, 5g fat, 4g fiber, 0g saturated fat.

Source: Laura Pensiero, RD, co-owner, Gigi Trattoria, Rhinebeck, New York; Nutritionist, Strang Cancer Prevention Center.

Wednesday, January 18, 2012

Power of Philanthropy in Penn’s Cancer Research at Penn

Tricia Bruning is Senior Executive Director and Principal Gifts Officer of Development at Penn Medicine for the Abramson Cancer Center, Department of Radiation Oncology and Pennsylvania Hospital.  In her nearly ten years at Penn Medicine, Tricia has overseen the programmatic and fundraising efforts for our premier clinical and research efforts in the area of cancer.

2011 was an amazing year for cancer research and clinical care at Penn’s Abramson Cancer Center

As we celebrate the advances made in the fight against cancer at Penn’s Abramson Cancer Center, we are grateful for the vital role that philanthropy has played, and the hope it has brought to patients and families in the community and around the world.

Renewing philanthropic support is essential to moving research and patient care advances forward.

Penn’s Abramson Cancer Center provides this hope throughout the year. 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.

This year, make a gift to the Abramson Cancer Center and help patients and families fight and cope with a cancer diagnosis.

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.

Learn more about giving to Penn’s Abramson Cancer Center.

Tuesday, January 17, 2012

How to Build Strength After Cervical Cancer Treatment

A common, but manageable side effect of cervical cancer treatment is the loss of strength and flexibility of the pelvic floor.

The pelvic floor refers to the muscles and connective tissue that span the area under the pelvis. In women, the pelvic floor muscles support the bladder, intestines and uterus. Like other muscles in the body, these muscles need to be strong and flexible in order to work correctly.

Strong muscles and tissues in the pelvic floor are important to for sexual activity, maintaining urinary and anal continence and providing support for the abdomen and lower back.

Women who have undergone radiation therapy in the pelvic region may have difficulty with strength and flexibility of their pelvic floor muscles and surrounding tissues. Your vaginal wall, hips and upper thighs may lose normal motion due to radiation fibrosis. Gentle exercises including Kegel exercises and dilators can help them regain mobility and strength in these tissues. 

Kegel exercises build strength in the pelvic floor muscles. Strong pelvic floor muscles help maintain urinary continence. Some women describe this exercise as if they were stopping a stream of urine.

In order to perform a correct pelvic floor exercise, you should:
  • Place one hand on top of your pubic bone.
  • Tighten, and draw in the muscles around the anal and the vaginal openings so that you feel the muscles lift towards your pubic bone and squeeze the openings shut.
  • Start lying down with your knees bent and supported with pillows.

There are two types of exercise contractions: 
  1. Quick contractions that tighten, lift and release.
  2. Endurance contractions that tighten, lift and hold the muscles for up to 10 seconds.

Kegel exercises can be performed sitting or standing.

Treatment for cervical cancer can also cause the vagina and vaginal opening to shrink. This can make it difficult for a doctor to perform internal exams, and can also make sexual intercourse difficult and uncomfortable.

A vaginal dilator stretches the scar tissue that has formed in the vagina. It can take up to eight to 12 weeks to feel an increase in the size of the vaginal opening and a softening of the tissues. 

Because the process takes several weeks, patience is important. For most women, there is a period of adjustment, and then using the dilator will become more routine.

Building strength of your pelvic floor will make you feel better all over.  Strength and flexibility of these muscles can help you feel more in control and more like yourself.

Some women find it difficult to do Kegel exercises or use their dilator, especially when they first start. If you are having difficulty a physical therapist who specializes in treating the pelvic region can help. Good Shepherd Penn Partners has pelvic floor specialists. If interested in making an appointment call 1-877-9-MY-REHAB.

Monday, January 16, 2012

20 Years of Learning Breast Cancer Causes and Prevention

Kevin Fox MD, is the Mariann T. and Robert J. MacDonald Professor of Medicine and medical director of the Rena Rowan Breast Center at Penn’s Abramson Cancer Center. He treats all aspects of early stage and advanced stage breast cancer researches adjuvant therapy of breast cancer.

Every aspect of breast cancer prevention, diagnosis and treatment has seen meaningful changes in the last 20 years. In some areas of breast cancer research and treatment, the advances have been subtle; in other cases, they have been profound.

Learning what causes breast cancer

In just 20 years, we’ve come to understand there are many factors that can contribute to a woman’s risk of getting breast cancer.

In 1994, we learned that certain women have mutations in one of two genes — either BRCA1 or BRCA2 — and that these women were at a higher risk of developing breast and ovarian cancer during their lifetimes.

In 2002, we learned that women who take hormone replacement therapy (HRT) in the form of premarin and progesterone have an increased risk of breast cancer versus those who do not take HRT. The risk is not great, and women who took premarin without progesterone didn’t have such a risk, but as a result, millions of women stopped taking HRT.

Advances in breast cancer prevention

Mammograms

The mammogram remains the most important screening device in the detection of breast cancer and it probably saves thousands of lives every year.

Several years ago, the digital mammogram became the standard in most hospitals and breast centers. The digital mammogram experience isn’t much different for the patient, but these digital images are more accurate than older, film screen mammograms, particularly for younger women or women with very dense breasts.

Today, the breast imaging technology at the Ruth and Raymond Perelman Center for Advanced Medicine includes digital breast tomosynthesis, or DBT, to perform three-dimensional mammography for breast cancer screening and diagnosis.

The DBT system employs a digital X-ray that records a series of low-dose, high-resolution images of the breast while traversing a small (15 degree) arc around the compressed breast. The advantages of DBT include fewer false-positives and false-negatives associated with traditional mammography.

Preventative drug therapy

By 1998 we learned that a woman’s risk of developing breast cancer can be cut by 50 percent by taking the drug tamoxifen for five years. Several years later, researchers found that the drug raloxifene could accomplish the same thing, but only in postmenopausal women. More recently, the drug exemestane has been shown to reduce breast cancer risk as well, but again, only in postmenopausal women.

These drugs, however, have not gained widespread use in most women because of unpleasant side effects.

Learn more about breast cancer treatment at the Abramson Cancer Center in Philadelphia.

Watch conference presentations from the 2011 Life After Breast Cancer 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, January 12, 2012

Reiki for Cancer Patients

Kimberly Fleisher, MEd and Reiki master, is the founder and director of The Reiki School + Clinic in Philadelphia. She has been practicing Reiki since 1995.  Kim specializes in Reiki education, particularly in the healthcare field and is the team leader for Penn Medicine's Volunteer Reiki Program, providing Reiki sessions to patients receiving cancer treatments.

For patients undergoing treatment for cancer, the stress can be overwhelming. Finding tools that help you stay calm are invaluable. 

Reiki is a gentle therapeutic practice that originates in Japan. Reiki is facilitated through light touch and is an easy addition to most medical treatments to help many cancer patients handle the stress of cancer treatment.

If you or someone you love is receiving cancer treatment at Penn, you may be eligible to receive free Reiki sessions through the volunteer Reiki program. 

Here are five ways Reiki practice can help reduce stress during cancer treatment:

Reiki sessions are balancing.

After receiving a Reiki session, it’s not uncommon for the recipient to say, “I feel like myself again.” 

Reiki creates an opportunity for patients to restore inner harmony and a sense of connection with their inner selves that might seem lost during the whirlwind of cancer treatment. 

One cancer patient recently remarked after a session “…it connected me to a place inside myself that I forgot all about.”

Reiki sessions create a space for you to slow down and relax.

During a Reiki session, patients sit comfortably or lie down while the practitioner places their hands gently on or right above different areas on the body for several minutes at a time. During a Reiki a session, there is nothing that a patient has to do. It’s a space for the patient to rest, and to focus on their well being.

Zen Master Thich Nhat Hanh often refers to the importance of stopping as a way to cultivate inner healing:
“At first, ’stopping’ may look like a kind of resistance to modern life, but it is not... Humankind's survival depends on our ability to stop rushing. Stopping is not only to stop the negative, but to allow positive healing to take place.”

Reiki sessions are nurturing.

How often do you allow yourself the space to be cared for? During a session, patients are totally immersed in the experience of care through the light touch of the practitioner’s hands.

Most people report that sessions are very soothing and supportive. Whether someone learns Reiki practice to treat him or herself, or receives a session from a trained practitioner, the time spent practicing Reiki creates a nourishing space for healing. 

A patient noted: “It had a very calming effect on me. I could actually feel my body relaxing. I was able to let go of a lot of my anxiety.”

Reiki sessions are non-invasive.

Reiki is a completely non-manipulative and non-diagnostic adjunct to conventional care. A practitioner doesn’t press, poke or ask a patient to ingest something. They don’t talk about cancer, or how to fix cancer.  They don’t need to know specific information about your cancer treatment, or any other thing that’s going on with you, and they won’t touch you anywhere where you don’t like to be touched.

A Reiki practitioner simply places their hands on or slightly above your body in spots where you are comfortable being touched and they allow the session to unfold naturally. 

Reiki sessions promote well being while giving patients the opportunity to be completely in control of the session, empowered to receive only what feels good to them.

Reiki sessions can help with sleep and restoration.

Most people know that rest and sleep are critical components for allowing the body to heal. One of the most commonly reported benefits heard from clients is that Reiki sessions help them sleep better. 

People often find Reiki sessions restorative and rejuvenating. When you sleep better and feel rested, you feel better in general and are then more capable of dealing with life’s stressers. 

If you are interested in receiving a Reiki session while receiving chemotherapy or radiation therapy treatment at the Abramson Cancer Center, please notify your nurse.

View the 2011 Focus On Integrative Medicine and Wellness Conference.

Learn about other integrative medicine and wellness services offered at the Abramson Cancer Center.

To learn more about Reiki practice please visit Oncolink’s Reiki Basics.

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.

Wednesday, January 11, 2012

The HPV Vaccine: Recommended for Both Boys and Girls

The Centers for Disease Control and Prevention (CDC) recently announced it is recommending boys also get the HPV vaccine. Previously, the CDC recommended only girls get the vaccine.

What is HPV?

Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. There are over 100 types of HPV, with more than 40 able to affect the genital area (CDC.gov). Nearly 20 million people in the United States are infected, and about 6.2 million more become infected each year with more than 50 percent of sexually active men and women infected with HPV at some time in their lives.

Most HPV infections do not cause any symptoms, and go away on their own. However, HPV can cause cervical cancer in women. The National Cancer Institute estimates that in 2011 alone, 12,710 new cases of cervical cancer will be diagnosed with 4,290 deaths from the disease.  It is the second leading cause of cancer deaths among women around the world.

HPV can cause genital warts and warts in the oral and upper respiratory tract in both men and women. HPV is also associated with several less common types of cancer in both men and women. There is no treatment for an HPV infection, but many of the conditions it causes can be treated.

Why get the HPV vaccine?

There are 2 FDA approved HPV vaccines on the market; Gardasil and Cervarix. The HPV vaccine Gardasil, protects against four major types of HPV; HPV 16 and 18, the two types that cause about 70 percent of cervical cancer and HPV 6 and 11 which cause 90 percent of genital warts. Cervarix is protective against HPV 16 and 18.

Protection from the HPV vaccine is expected to be long lasting, but vaccinated women still need cervical cancer screening (such as Pap tests and HPV tests) because the vaccine does not protect against all HPV types that can cause cervical cancer.

Who should get the HPV vaccine?

The HPV vaccine is approved for girls and boys ages 9-26.  Only Gardasil has been approved for use in males.

The CDC recommends that all girls aged 11 to 12 years old receive vaccination with either brand of HPV vaccine to protect against cervical cancer. (CDC) They also recommend that girls and young women ages 13 through 26 get the HPV vaccine if they have not received any or all doses when they were younger.

The CDC recommends Gardasil vaccine for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not receive any or all of the recommended doses when they were younger. It is recommended that all men receive the vaccine through age 26. (CDC)

The vaccine is given in a three-dose series with the second dose given two months after the first dose and the third given six months after the first dose.

Why is the HPV vaccine given at this age?

It is important for girls and boys to receive the HPV vaccine before their first sexual contact — when they have not been exposed to HPV. For these girls and boys, the vaccine can prevent almost 100 percent of diseases caused by the four types of HPV targeted by the vaccine. However, if a girl or boy is already infected with a type of HPV, the vaccine does not prevent disease from that type of the virus and will not cure a current HPV infection.

Catch–up HPV vaccinations

The vaccine is also recommended for those between the ages of 13 and 26 who did not receive it when they were younger. No booster doses are recommended at this time. The HPV vaccine may be given at the same time as other vaccines.

Who should not get the HPV vaccine?

Anyone who has ever had a life-threatening allergic reaction to yeast, latex, to any other component of the HPV vaccine, or to a previous dose of the HPV vaccine should not get the vaccine. People with severe allergies should tell their doctor before receiving the vaccine.

Pregnant women should not get the vaccine. The vaccine appears to be safe for both the mother and the unborn baby, but it is still being studied. Receiving the HPV vaccine when pregnant is not a reason to consider terminating the pregnancy. Women who are breastfeeding may safely get the vaccine.

People who are mildly ill when the shot is scheduled can still get the HPV vaccine. People with moderate or severe illnesses should wait until they recover

What are the risks of the HPV vaccine?

The HPV vaccine does not appear to cause any serious side effects. However, vaccines, like any medication, may cause problems such as severe allergic reactions. The risk of any vaccine causing serious harm, or death, is extremely small. If side effects do occur, they happen within a few minutes to a few hours after the vaccination.

Mild problems that may occur with the HPV vaccine:
  • Pain at the injection site (eight of 10 people)
  • Redness or swelling at the injection site (one in four people)
  • Mild fever (100 degrees F) (one person in 10)
  • Itching at the injection site (one person in 30)
  • Moderate fever (102 degrees F) (one person in 65)
  • These symptoms do not last long and go away on their own.
These are just some of the side effects that may occur. It's best to speak with your physician about side effects from the HPV vaccine.

What to do for severe reaction to the HPV vaccine

Any unusual condition, such as a high fever or behavior changes could indicate a severe reaction. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat or dizziness.

If you believe you or your child is having a severe reaction to the HPV vaccine, call a doctor or get the person to a doctor right away. Tell your doctor what happened, the date and time it happened and when the vaccination was given.

Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form or you can file this report through the VAERS website or by calling 1-800-822-7967.

Learn more about the HPV vaccine

Ask your doctor or nurse. They can show you the vaccine package insert or suggest other sources of information.

Call your local or state health department.

Contact the Centers for Disease Control and Prevention (CDC).

Call 800-232-4636 (1-800-CDC-INFO).

Visit the CDC’s website http://www.cdc.gov/std/hpv.

Learn more about cervical cancer and other gynecologic cancers at the Abramson Cancer Center’s Focus On Gynecologic Cancers Conference.

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

Tuesday, January 10, 2012

Sitting for Long Periods of Time May Increase Cancer Risk

Researchers from Australia recently presented evidence from a study* that suggests sitting for long periods of time is associated with health risks – even for people who are regularly physically active.

Neville Owen, PhD, head of behavioral epidemiology at Australia's Baker IDI Heart and Diabetes Institute, says: "Sitting time is emerging as a strong candidate for being a cancer risk factor in its own right. It seems highly likely that the longer you sit, the higher your risk. This phenomenon isn't dependent on body weight or how much exercise people do.”

In the study, Dr. Owen measured waist circumference, insulin resistance and inflammation, which are indicators of cancer risk common to many physical activity-cancer studies.

His team found that when prolonged sitting is broken up with breaks as short as one minute, these biomarkers can be lowered. 

“Sedentary time is also likely an important factor for cancer survivors,” said Dr. Owen. For survivors, diabetes and cardiovascular disease are particular concerns and overweight and obesity increase the risk for both conditions. "Television viewing time, a sign of sedentary behavior, appears to increase subsequent risk of weight gain in cancer survivors."

What do you think? Based on this study’s findings, will you take more breaks away from your desk?

The Penn Transdisciplinary Research on Energetics and Cancer seeks to understand more about exercise, weight loss and quality of life of cancer patients through research. Some projects at the center include studies on exercise and weight loss as they relate to cancer recurrence, and how exercise can help manage effects of cancer treatment.

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.

*Dr. Owen’s study called “Adults’ Sedentary Behavior: Determinants and Inteventions” appeared in the August 2011 American Journal of Preventive Medicine.

Monday, January 9, 2012

Frequently Asked Questions About the CAR T-19 Study

The results from a Penn clinical trial using genetically modified T cells to target a molecule on chronic lymphocytic leukemia (CLL) cells, prompted many patients and physicians to ask for information about enrolling in the study. This trial has been referred to as the “CART-19 cell" (chimeric antigen receptor T Cells against CD19) trial.

Only a few participants were included in the first phase of the trial, and Penn researchers are currently enrolling a small number of additional participants for the next phase of this trial.

Below are frequently asked questions about the trial.

Is the trial currently enrolling participants?

The trial is currently treating another small group of patients but has limited availability.

Follow this blog or check our website from time to time, where you will find updates about our research on genetically modified T cells (CAR T-19).

How does this trial work?

The CAR T Cells Trial uses genetically modified T cells to treat patients with B cell Chronic Lymphocytic Leukemia (CLL) and other B cell malignancies.  A patients own immune cells (T cells) are removed from the blood and genetically modified in the laboratory by infecting them with a virus.  This modification allows them to potentially target and kill their own CLL cells.The modified cells (CART-19 cells) are then grown in the laboratory and re-infused into patients.

Who are suitable candidates for this trial?

This phase I clinical trial is designed for patients with documented CD19 positive leukemia or lymphoma. For example, patients who have one of the following:
  • Acute lymphoblastic leukemia (ALL)
  • Chronic lymphocytic leukemia (CLL)
  • Follicular lymphoma
  • Mantle cell lymphoma
  • B cell prolymphocytic leukemia (PLL)
  • Diffuse large cell lymphoma 
However, all potential study candidates must meet all study specified eligibility criteria in order to be enrolled in the study.

What are requirements to participate in the trial?

The CAR T Cells Trial requires patients have had at least two prior regimens and have some progression after the second regimen. All potential study candidates must provide written consent prior to undergoing any study related tests or procedures. They must also undergo screening tests/procedures to determine eligibility to participate in the study. In order to qualify patients must meet all protocol specified eligibility criteria.

Am I too old/ young to participate in the trial?

Patients must be at least 18 years old in order to participate.

Do I need to live in Philadelphia to participate in the CAR T Cells Trial?

Although it is not a requirement  to live in Philadelphia to participate, frequent multiple study visits are required weekly for the first 2 months and may necessitate patients to take temporary residence near University of Pennsylvania. Additionally, numerous study procedures and follow-up visits must be take place at the Hospital of University of Pennsylvania or Perelman Center for Advanced Medicine

Do I need insurance to participate in the clinical trial?

Investigational procedures for the study such as collection, manufacturing and administration of cells are paid for by the study. Other aspects of care throughout the course of the study that are part of the patient routine care monitoring will be billed to the patient’s insurance.

How can I learn more about the CAR T Cells Trial at Penn?

You may follow this blog for updates on our CART-19 trial. Learn more about the CAR T Cells Trial’s findings or other clinical trials currently enrolling patients at the Abramson Cancer Center or, Oncolink or www.clinicaltrials.gov. Or call 800-474-9892 to find a clinical trial right for you.


Learn more about the hematological malignancies (blood cancers) program at the Abramson Cancer Center.

How can I help make cancer research possible at Penn Medicine?

Philanthropy plays a key role in supporting novel advances in research, which are often deemed too risky to be funded through traditional sources. We are at the forefront of discovering ways to adapt recent immunotherapy breakthroughs to even more types of cancer, providing hope for many in our community and beyond. Philanthropy continues to be the catalyst for moving these discoveries forward quickly.

Learn how you can support the CAR T Cells Trial at Penn Medicine with a gift.

Thursday, January 5, 2012

About the CAR T Cells Trial at Penn Medicine

In a cancer treatment breakthrough 20 years in the making, researchers from Penn’s Abramson Cancer Center and Perelman School of Medicine demonstrated sustained remissions of over a year among a small group of patients with advanced chronic lymphocytic leukemia (CLL) treated with genetically engineered versions of their own T cells.

The CAR T Cells clinical trial involves removing the patients’ cells and modifying them in Penn's Cell and Vaccine Production Facility in Philadelphia. Those cells are then infused the back into the patients following chemotherapy, providing a tumor-attack roadmap for the treatment of other cancers including those of the lung and ovaries and myeloma and melanoma.

The CART19 trial is designed for patients with documented CD19 positive leukemia or lymphoma. These include patients with:
  • Acute lymphoblastic leukemia (ALL)
  • Chronic lymphocytic leukemia (CLL)
  • Follicular lymphoma
  • Mantle cell lymphoma
  • B cell prolymphocytic leukemia (PLL)
  • Diffuse large cell lymphoma

It is important to note that this therapy is very early in testing, and is open to only a small number of participants. Researchers testing any new approaches to cancer treatment must be methodical and meticulous to protect patients and validate findings.

Learn more about the CAR T Cells Trial’s findings or other clinical trials currently enrolling patients at the Abramson Cancer Center or, Oncolink or  www.clinicaltrials.gov. Or call 800-474-9892 to find a clinical trial right for you.

Make an appointment with a Penn Medicine blood cancer specialist.

Learn more about the hematological malignancies (blood cancers) program at the Abramson Cancer Center.

Wednesday, January 4, 2012

Ovarian Cancer Research at Penn Medicine

Penn Medicine is leading the way with groundbreaking research in ovarian cancer. Launched in 2007 under the leadership of George Coukos, MD, PhD, Penn’s Ovarian Cancer Research Center is making prevention, early detection, treatment and understanding the biology of ovarian cancer a priority.

Leaders in Ovarian Cancer Research

The Abramson Cancer Center, in collaboration with Penn’s Ovarian Cancer Research Center and the Jordan Center for Gynecologic Cancer is one of the nation’s leading programs in ovarian cancer research and patient care.

The ovarian cancer research center has three major research programs:
  • Prevention and early detection of ovarian cancer including the development of new blood tests, imaging, and other tools to detect cancer as well as studying environmental causes of ovarian cancer and potential vaccines.
  • Advanced therapeutics program, which focuses on developing innovative treatments for ovarian cancer including immune and biologic therapies.
  • Ovarian cancer biology and pathogenesis program aimed to understand the genomics, genetics, immunology and biology of ovarian cancer

Promising Discoveries in Ovarian Cancer Research

Dr. Coukos is currently working on developing novel treatments for ovarian cancer using immunotherapy.

At the time of surgery, the patient’s tumor is saved for future use. Within the tumor are tumor-specific killer T-cells, white blood cells that help the body fight disease. Immunotherapy uses these T-cells from the tumor to develop vaccines and therapeutic lymphocytes for personalized treatment therapy.

“The vaccine that Penn is supporting takes the natural attack function of the immune system and amplifies it, thereby focusing a much higher percentage of the patient's immune system on her ovarian cancer,” says Dr. Coukos. “The ultimate objective of these cancer vaccines is to direct a larger percentage of the patient's killer T-cell army against the patient's specific cancer.”

The Future of Ovarian Cancer Treatment

Currently, immunotherapy is only available to women with ovarian cancer who are enrolled in clinical trials at the Jordan Center for Gynecologic Cancer at Penn’s Abramson Cancer Center. Penn is currently building a new facility, the Penn Regional Ovarian Cancer Network and Ovarian Tumor Processing Facility.

This new facility will connect Penn with community-based gynecologic practices and physicians throughout the Mid-Atlantic Region to collect, transport, process and store tumor tissue. After completing standard chemotherapy, patients will have access to individualized treatments using their own tumor tissue.

Connecting women to Penn’s experts in research and treatment provides new options to women with ovarian cancer and may lead to improved survival rates and quality of life.

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

View the 2011 Focus On Gynecologic Cancers 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, January 3, 2012

Why Survivorship Plans Are Important for Women with Gynecologic Cancer

Lori Smith, MSN, CRNP, is a certified registered nurse practitioner in gynecologic oncology at Penn Medicine. She works with women with cancer and immune therapy clinical trials for ovarian cancer. She is also a co-investigator on many other clinical trials focusing on women’s cancer. Additionally, she leads the Living Well After Cancer™ Program within the Jordan Center for Gynecologic Cancer.

It is important for women who have been treated for a gynecologic cancer to undergo a survivorship visit because the time is completely devoted to addressing your concerns and needs. It is also vital that any other medical providers who participate in your care are aware of your past treatments and current plan of care so that they too can manage your health in a comprehensive manner.

Many women who have been treated for a gynecologic cancer often report significant side effects that they feel affect their quality of life. Those reported side effects include vaginal dryness, painful intercourse, fatigue, lymphedema, urinary and fecal incontinence and pain.

Many women also report psychosocial concerns such as depression, fear/anxiety of their cancer recurring, and concern for family members in cancers with a possible or confirmed genetic mutation.


The Living Well After Cancer™ Program at Penn is a member of the LIVESTRONG TM Survivorship Center of Excellence Network. As part of this network, Penn joins several other LIVESTRONG TM centers nationwide in providing patients and their healthcare providers with the tools necessary to develop a comprehensive cancer survivorship plan.

Penn’s cancer survivorship program offers thorough medical and psychosocial evaluations, follow-up visits, and referrals to other specialists as needed. During this visit, team members discuss any concerns you may have related to your cancer diagnosis and treatment history. A cancer survivorship care plan is developed for you, which includes information about:

  • Potential late effects and symptoms
  • Recommendations for cancer screening (recurrence or new primary)
  • Psychosocial effects (relationships and sexuality)
  • Financial issues (work, insurance and employment)
  • Recommendations for a healthy lifestyle
  • Genetic counseling
  • Effective prevention options
  • Referrals for follow-up care and a list of supportive resources
  • Fertility or reproductive options.

Also during this visit, a complete, personalized care plan and treatment history is created using the LIVESTRONG Care Plan tool. This tool can be found on OncoLink.org and can be completed in the office or anyplace you have computer access. The LIVESTRONG Care Plan provides you with a detailed account of your past diagnosis, treatment history and information about your follow-up care, symptoms to watch for and a report to your healthcare provider. It also provides you with helpful tips to stay healthy.

If you were treated for gynecologic cancer at Penn Medicine and would like to make an appointment for a survivorship visit, please call 215-662-3318 or 800-789-PENN (7366).

Watch the 10th Focus on Gynecologic Cancers Conference.

Learn more about the Jordan Center for Gynecologic Cancers at the Abramson Cancer Center.

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.
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