University of Pennsylvania Health System

Focus on Cancer

We are happy to announce the launch of our new Abramson Cancer Center website.

Please stay connected to our Focus On Cancer blog by visiting us there.

Friday, June 29, 2012

Cover Up and Protect with SPF Clothing

Colleen Bronstein is a melanoma and breast cancer survivor, mother, artist, entrepreneur and a contributor to the Focus On Cancer blog. After her melanoma diagnosis in 1999, Colleen started her own business, Sun Threadz, which promotes skin cancer awareness and protection with clothing designed to protect skin from the sun’s harmful rays.

As a melanoma survivor I understand the need to protect myself when I am exposed to the sun.

I love the beach and everything associated with the beach - swimming, sailing, beachcombing.

But when I was diagnosed with melanoma in 1999, my world was shaken to say the least. I was afraid I could no longer do the things I loved so much, and I was worried I would be homebound during my favorite sunny seasons.

To keep doing all these things that I loved, I had to be well protected from the sun. That meant I needed to do more than just apply sunscreen.

I researched sun protection clothing in 1999 and the clothing was very generic and unisex. Since I would have to wear this clothing out in public for the rest of my life, I wanted something stylish and feminine. I was disappointed in what I saw, so I decided to design some key pieces for myself.

Shirt and skirt from Sun Threadz
The design part was easy, but finding fabric that had sufficient SPF was not. After years of searching I did find a supplier and my clothing line, Sun Threadz, was launched Memorial Day weekend, 2008.

My clothing can be found at Faith & Hope Boutique at the Perelman Center for Advanced Medicine and on my website, 

On my website, you will find SPF clothing for babies, women and men. I have hats, gloves, scarves, bathing suits and jewelry from my sea, sun and sand collection.

Recently, Sun Threadz was invited to be part of the Go Sun Smart Program sponsored by San Diego State University and Klein Buendel. This project is to educate vacationing Americans about comprehensive sun safety techniques and skin cancer prevention. The study is funded by the National Cancer Institute, and has the potential to reach a significant portion of the US population when they are most vulnerable to skin damage from the sun. Employees of the project will be outfitted in sun safe attire and will visit the resorts and interface with vacationers from a nationwide market.

You will always find me and my clothing at the Abramson Cancer Center’s Focus on Melanoma Conference which is held annually in May. I’ll be there to answer your questions, show pieces from my sun-safe collection, and share my own story.

Thursday, June 28, 2012

10 Farmers Markets in Philadelphia and New Jersey

A diet rich in a variety of fresh fruits and vegetables is important for cancer prevention, not to mention it’s trendy too.

An increasing number of farmers have been making their way to Philadelphia and its surrounding areas as a part of a nation-wide movement to buy local.

Did you know most of the fresh fruits and vegetables you purchase in your supermarket have already spent as many as seven to 14 days in transit? Once produce is picked, it stops receiving nutrients from the source plant, but it is still alive. Produce loses heat and moisture over time through a process called respiration, which is one way nutrients and flavor are lost.

Asparagus, broccoli, mushrooms, and spinach have very high respiration rates and will lose moisture, flavor and nutrients quicker than an apple or onion, which have low respiration rates.

Spinach, for example loses up to 50 to 90 percent of its vitamin C content within 24 hours of being picked.

This is why local food is fresher and tastes better than food shipped long distances from other states or countries.

Should You Shop Local?

Although, farmer’s markets appear to be more expensive than supermarkets, food at local farmer’s markets may be more nutritious.

Most of the farmers’ markets accept Farmers' Market Nutrition Program paper vouchers, issued to seniors or WIC recipients. Farm to City, with its partner the Reading Terminal Market Corporation, has terminals that enable farmers to accept SNAP, debit, and credit cards, promoting fresh and local produce to everyone.

Buying local food keeps your dollars circulating in your community.

Shopping Local is a Fun Family Experience

Buy local because it’s fun for the whole family!

Shopping at farmer’s markets is a great way for kids to learn more about the fruits and vegetables on their plates. The farmers are knowledgeable and eager to share information with their customers.

Plus, many farmers sell homemade sausage, eggs, yogurt, cheese, jams, spreads, and baked goods in addition to fruits and vegetables.

To learn more visit and

Farmers Markets in the Philadelphia Area

Clark Park Farmers Market
The Food Trust Farmers' Markets
43rd and Baltimore Avenue, Philadelphia, PA 19104
Tel: 215-568-0830
Contact: The Food Trust
Saturdays, 10 am- to 2pm

Cliveden Park Farmers Market
The Food Trust Farmers' Markets
Chew Avenue & Johnson Street, Philadelphia, PA 19107
Tel: 215-568-0830
Contact: The Food Trust
Wednesdays, 2 pm to 6 pm

Fairmount Farmers' Market
22nd Street and Fairmount Avenue, Philadelphia, PA 19107
Tel: 215-568-0830
Contact: The Food Trust
Thursdays, 3 pm to 7 pm

Headhouse Farmers' Market
The Food Trust Farmers' Markets
2nd and Lombard Streets, Philadelphia, PA 19147
Tel: 215-575-0444
Fax: 215-575-0466
Sundays, 10 am to 2 pm

Overbrook Farms Farmers' Market
The Food Trust
Lancaster Avenue at City Avenue, (Overbrook Presbyterian Church), Philadelphia, PA 19103
Tel: 215-575-0444
Fax: 215-575-0466
Saturdays, 9 am to 1 pm

Farmers Markets in Southern New Jersey

Collingswood Farmers’ Market
Between Collings and Irvin Avenues, Collingswood
Saturdays, 8 am to Noon

Camden Community Farmers Market

Our Lady of Lourdes Community Farmers Market
1600 Haddon Avenue
July 1 to October 28
Wednesdays, 2 pm to 5 pm

Camden Farmers Market
Walter Rand Transportation Center, Broadway
June 23 to October 27
Tuesdays, 10 am to 3 pm

Virtua Health Farmers Market
Atlantic & Mt. Ephriam Aves.
Thursdays 11 am to 3 pm
June 18 to October 29

Wednesday, June 27, 2012

Diagnosing and Staging Lymphedema

Cancer-related lymphedema is characterized as secondary lymphedema since it is ‘secondary to’ known damage to the lymphatic system due to surgery and/or radiation associated with the treatment of cancer.

There are very few medical tests that are valuable in the diagnosis of lymphedema. The diagnosis is made primarily based on an extensive and accurate medical history and physical examination.

Lymphoscinitgraphy is one diagnostic test that may be performed. In this test, radioactive labeled protein is injected beneath the surface of the skin, and the uptake and transport of the labeled protein is observed over several hours. This test can characterize the impairment of the lymphatic system’s ability to transport proteins and fluid, but is rarely necessary to plan and provide appropriate treatment.

Stages of Lymphedema

The stage of lymphedema is determined as part of the diagnosis. Lymphedema can be successfully treated in all stages, but the best and most rapid results occur when the lymphedema is identified and treated early.
  • Stage 0: Achiness, heaviness, increased warmth, sensation of fullness
  • Stage 1: Visible swelling that is soft and ‘pits’ if pressed and may disappear with elevation or overnight in bed
  • Stage 2: Swelling that doesn’t go away with elevation. Often the tissue is becoming more firm and less likely to be indented or ‘pit’ with pressure
  • Stage 3: Hard swelling associated with other changes in the skin- callus formations or small mushroom-like growths called papillomas.

Tuesday, June 26, 2012

Treating Lymphedema in Lower Extremities

Lymphedema is a possible complication of cancer treatment. While it is a well known complication after breast cancer treatment with swelling in the arm or chest wall, lymphedema can also occur in the lower half of the body after treatment for cancers in abdomen and pelvis.



What is lymphedema?

The body’s lymphatic system performs several important functions.
  • Drains protein and excessive fluid from the tissues
  • Helps to digest fat
  • Works as part of the immune system to protect against infection and cancer
Lymphedema is the accumulation of protein-rich fluid causing swelling, or edema, in the soft tissues. This edema irritates the tissues causing inflammation that can lead to thickening and hardening of the tissue. Lymph node sampling (removal) or radiation therapy, as part of treatment for cancer, are two known risk factors for the developing lymphedema after cancer.

Early signs and symptoms of lymphedema include:
  • Achiness
  • Heaviness
  • Increased warmth
  • Swelling
  • Unusual sensation in the limb
Swelling in the region of surgery is normal after a surgical procedure, but swelling that persists for extended periods of time may be cause for concern.

Lymphedema in Lower Extremities

Cardiac disease, nutritional abnormalities or blood clots (deep vein thrombosis or DVT) are all conditions that can cause swelling in the legs. It’s important to have any swelling evaluated by a physician to determine the cause.

If it is determined that the swelling is caused by lymphedema it’s important to be evaluated by a health professional with expertise in lymphedema management. Only a few physicians in the United States have expertise in lymphedema diagnosis and management, but many specialists in oncology or physical medicine and rehabilitation recognize this condition and make referrals to specialists in lymphedema management.

Friday, June 22, 2012

A Sister’s Journey: Cancer Treatment

Caroline (left) with her sister.
Cassandra Hogue is a guest contributor to the Focus On Cancer blog. Cassandra’s sister was treated at Penn’s Abramson Cancer Center. Through her sister’s surgery, several rounds of chemotherapy, radiation therapy and most recently, proton therapy, Cassandra has been a solid source of support and comfort for her sister.

My sister Caroline began cancer treatment at Penn’s Abramson Cancer Center, two months after she was diagnosed with cancer. Those were two of the longest, strangest and scariest months I can remember.

Her doctors explained thoroughly and patiently that mapping studies were needed before radiation therapy could begin, surgery was needed to place the chemotherapy port, and even more diagnostic tests had to be done before anything else could be scheduled.

When her treatment finally began, I was simultaneously relieved and worried. This was totally foreign territory shadowed by my own fear and every horror story I’ve heard about cancer treatment.

How sick would she be? Would she need blood transfusions? What constituted an “emergency?” All of the staff, especially her physicians, gave so much of their time to answer every “what if” question that we could ask.

And so began six weeks of daily trips to Penn, and weekly visits by nurses to change the chemo infusion pack that Caroline had to wear 24 hours a day. My constant anxiety slowly diminished, and my resilience slowly grew. I focused on my Buddhist meditation practice with new fervor, now suddenly realizing the truth of impermanence.

When Caroline began radiation treatment, the Perelman Center for Advanced Medicine at Penn had just opened. We became friendly with the receptionists, the parking lot attendants, and of course her oncology and radiation technicians and nurses. In a very real way, having a normal conversation with kind and considerate people made it so much easier.

Caroline tolerated the chemotherapy and radiation treatments incredibly well. She was even allowed a single weekly glass of wine, that we often enjoyed together Friday nights outside on the deck.

Major life-changing surgery was ahead for Caroline. But for now, she was feeling well. She even accompanied me to Barcelona on a business trip. As I worked, she visited art museums, strolled the Ramblas, and sipped espresso in outdoor cafes in the September sunshine. She seemed to enjoy every moment with a quiet strength.

A week before her surgery was scheduled, she and I planted dozens of tulip bulbs, in shades of wine red and golden yellow. We didn’t talk much that day; we had had many amazing talks over the weeks of her treatment. We had spoken of so many things that only sisters can share: childhood memories, adult disappointments, accomplishments and happiness.

We planted those 50 bulbs on a chilly day in October, trusting that spring would come.

Thursday, June 21, 2012

Cancer-fighting Foods: Rosemary-Lemon White Bean Dip

This cancer-fighting recipe for Rosemary-Lemon White Bean Dip is perfect to take to a summer picnic or party. And, it's healthy.

Limonene, a compound shown to have anti-cancer properties in laboratory animals, is found in the rind of the lemon.

Rosemary and garlic have a number of phytochemicals with bacteria killing and cancer-fighting properties.

Cannellini beans are a high in fiber and protein. They also contain B6, which may contribute to maintenance of healthy immune function.



Rosemary-Lemon White Bean Dip

Yields 2 cups

  • 2 cups cooked white beans (i.e. cannellini), drained but moist
  • 1 to 3 cloves garlic
  • ¼ cup + 1 tbsp extra virgin olive oil
  • 2 tsp minced fresh rosemary
  • The zest of 2 lemons

  1. Put the beans in the container of a food processor with 1 clove of garlic, along with a pinch of salt, blend and add the ¼ cup olive oil in a steady stream to the mixture, until smooth. Add more garlic, to taste.
  2. Beat in the rosemary, lemon zest and remaining tbsp of olive oil, add more salt and pepper as needed.
  3. Use immediately, can be refrigerated for up to 3 days.

Nutrition Facts/serving: 65 kcals; 4 grams of fat; 2 grams of protein; 1.5grams of fiber; 5 grams of carbohydrates

Recipe credit: Mark Bittman, author of Food Matters Cook Book (2010)

Wednesday, June 20, 2012

Who is at Risk for Pancreatic Cancer?

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s Focus On Pancreatic Cancer Conference. In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

Approximately five to 10 percent of pancreatic cancer is considered to be familial, or hereditary.  For those who have a family history of pancreatic cancer or one of several genetically linked syndromes that predispose them to pancreatic cancer, it is very important to identify that risk and get appropriate screening and intervention. 

Anyone who has had at least one parent or sibling (first-degree relative) with pancreatic cancer should meet with a certified genetic counselor to develop a comprehensive family history, and discuss their own risk for developing pancreatic cancer.  A genetic counselor can also help identify conditions such as hereditary pancreatitis that can significantly increase the risk of developing pancreatic cancer, as well as specific genetic mutations that increase the risk of developing other cancers.

The gene mutation BRCA1, for example, is associated with a high incidence of breast cancer, and has also been linked to increases in pancreatic cancer. 

It is important to realize not all risks are equal. By learning family history, every person can understand their own personal risk level. That information can be used to make decisions about screenings and tests as well as medical interventions that may reduce the chance of someone developing pancreatic cancer. 

The Abramson Cancer Center’s Gastrointestinal Cancer Risk Evaluation Program offers complete genetic testing and can provide clinical, genetic and research services for people with concerns about their risk for developing pancreatic as well as other GI cancers.

View the Focus on Pancreatic Cancer Conference to learn more about your risk for pancreatic cancer.

Tuesday, June 19, 2012

Learn About New Treatment Options for Prostate Cancer

Join Penn Medicine and 6 ABC News for a webchat about advances in prostate cancer treatment, and treatment options for prostate cancer available at Penn Medicine.

Chief of the Division of Urology Alan Wein, MD, PhD (Hon), and Chief of Genitourinary Service, Department of Radiation Oncology Neha Vapiwala, MD, will discuss proton therapy for prostate cancer, as well as the many options for prostate cancer treatment at Penn Medicine.

Date: Thursday, June 21
Time: 5 to 6 pm EST
Register here

Register for this webchat about prostate cancer treatment options at Penn Medicine, and submit your questions to Drs. Wein and Vapiwala.

If you or a loved one would like a consultation for prostate cancer treatment, you can schedule an appointment with a Penn clinician to learn about your specific treatment options.

About Prostate Cancer Treatment at Penn

Penn Medicine has one of the few programs in the nation to offer all the available options for cancer treatment.

During this one-hour live event, participants will be able to get answers to questions like:
  • What are all the treatment options for prostate cancer?
  • How do you choose the right treatment plan?
  • What is proton therapy, and how is it effective?
  • Is proton therapy right for everyone?
  • What are the latest research discoveries in prostate cancer treatment?
Register here for the live webchat about prostate cancer treatment options.

Monday, June 18, 2012

"Good Morning America" Host Reveals She Has Blood Disorder

Last week, "Good Morning America" host Robin Roberts revealed Monday she has myelodysplastic syndrome (MDS) a blood and bone marrow disorder characterized by the production of blood cells.

The 51-year-old co-host says she developed MDS after treatment for breast cancer in 2007.

Selina Luger, MD, is director of the leukemia program at Penn Medicine. She says previous cancer treatment with chemotherapy or radiation can be a risk factor for developing MDS. Dr. Luger is not treating Robin Roberts but has experience treating patients with this disease.

“Most people who develop MDS have not had prior chemotherapy or radiation treatment for cancer,” says Dr. Luger. “However, there is a small percentage of people who may develop MDS 18 to 24 months or 5 to 7 years after their treatment for cancer, depending on the type of treatment they received.”

What is MDS?

To understand MDS, it’s helpful to understand how it affects the body. In the body, there are three main types of cells that circulate in the blood:
  1. Red blood cells carry inhaled oxygen from the lungs to the rest of the body, and carry carbon dioxide from the body to the lungs to be exhaled.
  2. Platelets help blood clot.
  3. White blood cells help the body fight off infection.

Blood cells originate in the spongy material inside the bones called bone marrow. In people with MDS, bone marrow stem cells do not mature properly. They create immature blood cells called blasts, which are not capable of becoming fully functional white blood cells, red blood cells or platelets. If left untreated, the number of normal blood cells continue to decrease, resulting in significant impairment of quality of life or an increase in the number of blasts resulting in progression to acute leukemia.

In either case patients are at risk of life threatening complications most often because of infections or bleeding that cannot be controlled.

“When bone marrow is not functioning properly, blood counts become low and people have symptoms or complications related to those low blood counts,” says Dr. Luger. “Most people learn they have MDS after going to their doctor because they are tired. They may be anemic, and tests might reveal abnormalities.”

Treatment of MDS can either manage symptoms of the disease if the disease is not aggressive, or can be very aggressive if the disease warrants it.

“Most patients are treated for low blood counts with transfusions and other medications that provide supportive care, but those provide only temporary benefits,” says Dr. Luger. “In patients with an aggressive MDS, a bone marrow transplant offers the only chance for a cure.”

Bone Marrow Transplant for MDS

In the past the only treatment option, other than supportive care, available for patients with MDS was a traditional myeloablative bone marrow transplant from a donor (allogeneic). The patient receives massive doses of chemotherapy with or without radiation to destroy existing abnormal cells. The patient then receives bone marrow from a donor – if possible someone related. Those cells populate the body, replacing the unhealthy bone marrow cells with healthy donor bone marrow cells. Also, the bone marrow and blood cells bring with them a new immune system, which continues long term to fight off abnormal cells in a way that the patient’s immune system hadn’t previously done. Unfortunately, however, sometimes the new immune system also sees the patient’s body as foreign and tries to attack it, causing something called ‘graft versus host disease” which can be life threatening.

Although the only potentially curative option, a traditional bone marrow transplant is risky, and limited to patients under age 55 because the risks increase with age. Until recently, many patients with MDS did not have any treatment options other than supportive care, since the majority of patients are over age 60.

“Over the last five to 10 years, we have developed significant advances in the treatment of MDS. We now know that transplants don’t have to be myeoablative (irreversibly destroy the bone marrow) in order to be successful. We now do ‘mini’ or ‘reduced intensity’ transplants that are suitable for patients up to 75 years of age,” says Dr. Luger.

In a reduced intensity-transplant, less aggressive chemotherapies which don’t kill off the patient’s bone marrow cells, are used to prepare the patient’s body to accept the donor cells. Once the transplant takes place, the new marrow engrafts and over time the donor’s immune system destroys the cancer cells that are there. This is also referred to as a “graft versus tumor” effect.

Also, thanks to research and clinical trials that have been done, there are new drugs available for patients with MDS. Some of them have been shown to improve the blood counts and as a result improve quality of life of these patients, while others, while not curative have been shown to improve survival in patients with aggressive MDS.

Treatment for MDS at Penn

Penn hematologists/oncologists are national leaders in the treatment of MDS and other blood and bone marrow cancers as well as in bone marrow and stem cell transplant.

The Abramson Cancer Center also has one of the few hematologic malignancy research programs in the country approved and funded by the National Cancer Institute.

“Patients at Penn have access to the best treatment available for MDS as well as the latest clinical trials for MDS and leukemia,” says Dr. Luger..”

Learn more about bone marrow transplant for MDS at the Abramson Cancer Center.

Learn more about MDS at Oncolink.

Friday, June 15, 2012

This Father's Day: Forever Filled With Gratitude

Frank Jr., and his dad.
In 2010, Frank McKee was diagnosed with prostate cancer. He chose to have proton therapy at Penn Medicine for prostate cancer, and today, lives a full life with his family and friends. In this blog post, his son, Frank McKee, Jr., talks about what it was like to watch his father overcome prostate cancer with proton therapy treatment at Penn.

I’ll never forget the moment my dad told me he had prostate cancer. I was leaving work, getting ready to get in my car when he called. There was something ominous about his voice that told me I shouldn’t start the car – that I was about to hear some news that would affect me deeply.

He told me he had prostate cancer, and that it was found very early. He sounded calm and collected as he told me he was researching treatments for prostate cancer and had a good chance of overcoming cancer.

Despite his optimism, my heart began to sink. His diagnosis would forever change my world.

Choosing Proton Therapy for Prostate Cancer

My dad was very confident, and after meeting with Stephen Hahn, MD, he chose Penn Medicine for proton therapy. I was confident in Penn Medicine, and was ready to be there for him to support him every step of the way.

Except, he really didn’t need it! He’d drive himself to receive proton therapy treatments nearly every day – rarely accepting an offer for a ride from me or my family. He went to work everyday too. His treatment made him a little tired, but it was nothing that stopped him from his daily routine.

His life didn’t have to stop just because he had prostate cancer.

As a son watching his father go through cancer treatment, it was challenging to be strong for him. He made it easier though, because he had a great spirit about him and was always very optimistic.

At his last treatment, our entire family came with him to celebrate with noisemakers and signs. It was a great feeling to see him at the finish line.

He finished proton therapy for prostate cancer, and today, I’d say his experience changed him for the better. He is living his life to the fullest, and has adopted a healthy lifestyle.

This Father’s Day – and every Father’s Day since his diagnosis, will be filled with gratitude.

Happy Father’s Day, Dad.

Diagnosed with prostate cancer?

Have you or a loved one been diagnosed with prostate cancer?

Penn Medicine is one of only 10 centers in the United States to offer proton therapy. Proton therapy treats prostate cancer with external beam radiotherapy in which protons are directed at a tumor. The radiation dose that is given through proton therapy is very precise, and limits the exposure of radiation to normal tissues. This reduced exposure leads to the possibility of decreased toxicity, side effects and complications for patients.

Learn more about proton therapy for prostate cancer, and how proton therapy offers potentially less side effects for men with prostate cancer.

Thursday, June 14, 2012

This Father's Day: The Hardest Thing I’ve Had to Do

Robert Lustig, MD, is professor of radiation oncology at Penn Medicine, prostate cancer survivor and proton beam therapy patient. At Penn, Dr. Lustig was able to have proton therapy for prostate cancer at the Abramson Cancer Center. In this blog, he discusses his diagnosis, and how difficult it was to tell his kids he had cancer.

A few years ago I went to the urologist for a problem unrelated to my prostate. I was not at all concerned about prostate cancer as my prostate-specific antigen (PSA) was less than 1.

While my presenting problem was minor, the urologist felt a scar on my prostate and recommended a biopsy. Two days after the biopsy, I read the diagnosis, prostatic intraepithelial neoplasia (PIN).

PIN can be a precursor of prostate cancer or may actually regress spontaneously. Six months later, a repeat biopsy confirmed my prostate was normal, and I let out a great sigh of relief.

I continued to monitor my PSA, which increased slightly but remained below 1. Two years later at a follow-up appointment, my urologist recommend a repeat biopsy, as some of the newest data recommended a repeat biopsy to confirm there was no malignancy.

I expected the third biopsy to be normal, but instead, I learned I had prostate cancer.

I checked to see that it was my report, and I read it again.

Now, how to tell my family?

My wife is a social worker in the medical field and has spent many years working with cancer patients, so telling her my diagnosis and discussing my feelings was easy. But how do I tell my children? How would they feel? How scared would they be? Their father’s mortality would suddenly jump out at them. My wife and I spent some time talking about how to tell the children.

I have two daughters, and at the time they were 27 and 33.

My youngest came home for a family discussion, and I explained to her that I had a low grade prostate cancer diagnosed at a very early stage with a very high rate of cure. I told her I would be receiving proton beam therapy at Penn, and I did not expect to miss a day of work. I assured her I would be around for a long time.

While I do not believe in keeping health secrets, the three of us agreed not to tell my eldest daughter as she was due with her first child in less than a month. This health secret was only temporary and absolutely necessary.

About a month after her delivery we again sat down as a family and told her that I would be treated for early stage prostate cancer. She obviously had similar concerns as my youngest but at least they could talk to each other.

Today, I am one year post proton beam radiation therapy for my prostate cancer.

My PSA is 0.28. I never missed a day of work.I still have the “what if the cancer comes back” thoughts, but less frequently.

Telling my children I had cancer was one of the most difficult things I ever had to do. Difficult situations occur in life. But they pass and life goes on.

Read more about Dr. Lustig’s story, and watch a video in which he discusses his experience with proton therapy at Penn Medicine. Get 10 tips for talking to kids about cancer.

Diagnosed with prostate cancer?

Have you or a loved one been diagnosed with prostate cancer?

Penn Medicine is one of only 10 centers in the United States to offer proton therapy. Proton therapy treats prostate cancer with external beam radiotherapy in which protons are directed at a tumor. The radiation dose that is given through proton therapy is very precise, and limits the exposure of radiation to normal tissues. This reduced exposure leads to the possibility of decreased toxicity, side effects and complications for patients.

Learn more about proton therapy for prostate cancer, and how proton therapy offers potentially less side effects for men with prostate cancer.

Wednesday, June 13, 2012

Should You Tell Your Child About Your Cancer Diagnosis?

Ruth Steinman, MD, is a clinical associate professor of psychiatry at the Abramson Cancer Center. Here, Dr. Steinman discusses ways to tell children of all ages about a cancer diagnosis.

Many parents feel overwhelmed about their cancer diagnosis and how it affects their families, especially their children. They may wonder what they should tell their children, or how their children will react to their cancer diagnosis.

Each child copes with a parent’s cancer according to his or her phase of development and his or her coping style. Children can cope far better than parents imagine if there is an understanding of their developmental needs and how to maximize an important support system for their children.

Children old enough to speak should be told about a parent’s cancer diagnosis. Below are recommendations for how to tell children of any age group about a cancer diagnosis and what a parent can expect at certain ages and stages of development.

Infants (age 0 to 2)
Babies and very young children are sensitive to changes in their routine and may respond with increased fussiness to the change in emotional tone in the household. Increased difficulty with separation in not uncommon and sleep may become an issue.
Maintaining consistency in caregiving is very important.

Pre-school children (age 3 to 6)
Preschoolers do not need a lot of detailed information. Magical thinking is common: “My sister was born and then mommy got cancer so my sister caused mommy’s cancer” or “I made my mommy angry and that is what made her sick.” It’s important for parents to tell their children that they did not cause cancer.

Under stress, preschoolers can regress and problems can manifest around separation, toileting and bedtime. Maintaining routine is essential with familiar toys, sippy-cups, and a consistent bedtime routine. These routines may help lower anxiety and worry.

School-aged children (age 7 to 12)
School-aged kids can cope with more information, but they too need to be reminded that they are in no way are responsible for their parent’s cancer. These children often cope by fact-finding so they tend to ask a lot of questions. They worry about how the illness affects them socially. Support consistent engagement in school activities and friendships. Anger often shows before sadness.

Adolescents (age 13 to 20)
Adolescents can understand more abstract concepts about prognosis and uncertainty. Some may stay close and other’s may withdraw, show little emotion and become occupied with peer relationships and activities. Try to limit how much extra responsibility is given to teenagers and continue to maintain as much routine as possible. Support and foster relationships teenagers have with trustworthy adults.

What if they ask if I’m going to die?
If children ask about dying, tell them you are doing everything you can to get better. Reassure them you will be honest with them along the way and that when they have concerns, they should talk to you: “From what I’ve been told, I don’t expect to die from this cancer, but if there are any changes, I’ll talk to you about it.”

Help them learn the difference between when the treatment is making you sick and when symptoms are caused by cancer: “Many people are made better by these treatments but the cancer cells are pretty nasty and I need really strong medicine to make me better,” or “The treatment is making my hair fall out and making me so tired all the time—not the cancer.”

Learn more about talking to your child about your cancer diagnosis.

Tuesday, June 12, 2012

Young Friends Fund Young Faculty

Dr. Julia Tchou with son at a Young Friends event.
Chef Daniel Stern has helped lead the revolution in Philadelphia’s restaurant scene as chef at some of the city’s premier restaurants — Le Bec Fin, Gayle, Rae, R2L and Mid-Atlantic.

Together with wife, Jennifer, co-chairs Robert Blumenthal, Jonathan Feinberg, David Goldstein, Maria Papadakis, and honorary co-chairs, Judy Abramson Felgoise, Marcy A. Shoemaker, and Nancy A. Wolfson, Stern is now leading the charge to support young faculty members at Penn’s Abramson Cancer Center.

The Young Friends of the Abramson Cancer Center supports young faculty members and researchers with funds and resources to help them develop the next generation of cancer therapies, treatments and preventive measures.

Through philanthropy and fundraising events, the group supports clinicians and scientists whose research is often underfunded.

“The Young Friends bring a different perspective to cancer philanthropy,” says Stern. “Cancer affects so many families, and it’s a cause that is very meaningful to me and my family.”

Group members encompass a wide range of ages and interests – from recent college graduates, to men and women with careers in business, real estate and design. Every member of the group has a personal desire to eradicate cancer and improve the lives of those afflicted with the disease.

Support the Young Friends of the Abramson Cancer Center, learn more about the organization here or get involved here,  or email

Monday, June 11, 2012

Understanding How Pancreatic Cancer Spreads

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s Focus On Pancreatic Cancer Conference. In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

The ability of cancer cells to invade neighboring tissue and spread to distant organs, called metastasis, is what makes pancreatic cancer such a dangerous and potentially deadly disease. How does metastasis occur? When do cancer cells start to spread?

Metastasis is a very complex, multistep process that requires a gradual accumulation of changes in the cells, or mutations. At the cellular level, metastasis is actually very rare. Only a very few cells in a tumor ever develop the ability to spread, which makes it difficult to study.

At the Focus On Pancreatic Cancer conference, Ben Stanger, MD, PhD, likened the challenge to that of "finding Waldo." Stanger's research aims to understand which cells metastasize and how and when they do.

Early results of his research indicate in pancreatic cancer, the process may begin much earlier than previously thought. Even some pre-malignant cells appear to begin moving away from their site of origin and taking on the characteristics of the cells that surround them, which are critical steps in metastasis. Dr. Stanger’s work provides important clues as to why pancreatic cancer is so difficult to treat effectively, and it could potentially lead to the development of new therapies.

Using the Immune System to Fight Pancreatic Cancer

Greg Beatty, MD, PhD, is taking another approach to understanding how pancreatic cancers interact with normal cells in the body. His research centers on the ways in which pancreatic cancer "teaches our immune systems to help them grow and spread, cloaking themselves to avoid detection."

The body’s immune system has the ability to identify cancer cells as enemies and destroy them. But in many cases this doesn't occur and the cancer cells actually are able to interact with surrounding tissue and the immune system to help promote their growth.

Dr. Beatty calls this "bad education," and is working on approaches to send the immune system "back to school," re-educating it to attack and destroy cancer cells. Pre-clinical research has yielded positive results, and a clinical trial that utilizes an antibody known as CD40 to treat metastatic pancreatic cancer is under way at Penn.

View the Focus on Pancreatic Cancer Conference to learn more about pancreatic cancer research being done at the Abramson Cancer Center

Thursday, June 7, 2012

The Benefits of Protein

In this video, Debra DeMille, MS, RD, CSO, registered dietitian and nutritional counselor at the Joan Karnell Cancer Center, discusses the benefits of eating protein and offers tips for choosing and cooking meat, fish and other sources of protein.

Wednesday, June 6, 2012

Maintain Oral Health During Cancer Treatment

Elizabeta Evtimovska, DDS, MS, is a maxillofacial prosthodontist at Penn. In this article, she discusses complications from treatments for head and neck cancer, and how patients can prevent long-term side effects of head and neck cancer treatment.

Head and neck radiation and chemotherapy can cause a range of short and long-term oral complications.

The acute complications such as mucositis (sores) and infections, as well as others are managed by the oncology team during the treatment. Some of the long-term complication, such as xerostomia (dry mouth) and osteoradionecrosis (ORN), is a serious complication of radiation therapy for head and neck cancer that occurs in a small percentage of patients as result of head and neck radiation treatment.

Osteoradionecrosis is bone that has died. Because radiation works to destroy cancerous cells through the deprivation of oxygen and vital nutrients, it inevitably destroys normal cells as well, damaging small arteries and reducing circulation to the area of the mandible (jaw bone).

As there is no treatment for ORN, the focus is on prevention. This means, avoiding extractions of teeth from the radiated parts of the jaws and making sure that dentures fit properly and don’t cause any sores. It most often occurs in the setting of tooth extraction from the radiated parts of the jaws, but can also occur spontaneously. In both cases, there is exposed bone in the mouth which can be asymptomatic or it can be further complicated by infections, pain, and/or malodor.

Preparing for head and neck cancer therapy

Patients who are planning to undergo chemotherapy or radiation should be evaluated by a dentist prior to the start of treatment.

During this appointment, the patient’s oral condition is evaluated and it is determined if any teeth need to be extracted prior to the start of radiation treatment. This visit is also a perfect time to go over good oral health care.

In our practice, I advise patients to do the following during and after radiation:
  • Maintain excellent oral hygiene by flossing and brushing every morning and evening and after every meal. If dry mouth develops, it is especially crucial to brush teeth after every meal and only drink water between meals, as opposed to sugary drinks or snacks.
  • Use fluoride to prevent caries (when xerostomia, dry mouth, is present, the patient has increased risk of caries). Fluoride is especially important to prevent extracting teeth from the radiated parts of the jaws and therefore prevent osteoradionecrosis.
  • Visit a local dentist regularly for regularly scheduled maintenance visits (cleanings), as well as any other routine dental treatment.
The severity of oral complications from chemoradiation differs depending on the diagnosis, the type of treatment administered, the amount and location of the delivered radiation, etc. Therefore, it is best to consult with a dentist prior to and after radiation in terms of the above discussed needs and recommended treatment.

Learn about managing cancer treatment side effects.

Learn about the Abramson Cancer Center Center’s Center for Head and Neck Cancer.

Tuesday, June 5, 2012

Learn More About Thyroid Cancer and Thyroid Cancer Treatments

Penn’s Abramson Cancer Center invites patients, family members and anyone interested in learning about thyroid cancer risk, diagnosis and treatment to attend Focus on Thyroid Cancer.

Focus on Thyroid Cancer is a free educational conference featuring Penn’s leading thyroid cancer experts with specialties in surgery, endocrinology, pathology, cytology and nuclear medicine.

Penn’s Focus on Thyroid Cancer Conference addresses the personal and medical issues facing people with thyroid cancer including those in treatment, survivors, their loved ones, relatives and caregivers.

The conference provides patient-focused information on the latest advances in thyroid cancer risk, prevention, diagnosis, treatment, symptom management and psychosocial issues. It is also an opportunity to network and gain support from other thyroid cancer patients and survivors.

Who Should Attend

  • Those at risk for thyroid cancer
  • People who are newly diagnosed, currently in treatment or a long-term survivor
  • Family members, caregivers or healthcare professionals

Join Us

Time: 7:30 am to 3:45 pm
Date: Friday, June 8, 2012
Location: Hilton Hotel located at 4200 City Avenue, Philadelphia, PA
Registration: Register online or call 800-789-PENN (7366)
Cost: FREE

Unable to Attend?

If you are unable to attend in person, join the conference via free livestream. View the free conference livestream from 7:30 am to 3:45 pm ET on June 8.

Join a live web chat from the conference with a panel of expert clinicians who will answer questions about risk, diagnosis and treatment. To participate in the live web chat or submit a question before the conference, visit

The web chat will take place at 12:15 pm EDT, June 8.

Follow Penn Medicine on Twitter for event information before the conference date, and live tweeting throughout the conference with the hashtag #ThyroidACC.

Monday, June 4, 2012

Improving Results for Pancreatic Cancer Treatment

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s Focus On Pancreatic Cancer Conference. In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

Anyone who has been affected by pancreatic cancer, either as a patient, caregiver or member of the treatment team, knows pancreatic cancer is difficult to detect in its early stages and to treat effectively. Pancreatic cancer often grows silently, and the symptoms pancreatic tumors cause are similar to those resulting from other gastrointestinal conditions. In fact, many patients experience months of symptoms and are treated for a variety of other problems before pancreatic cancer is diagnosed.

There are no screening tests or biomarkers available for pancreatic cancer, and even standard CT scans often do not detect these tumors. The result is that many patients are diagnosed with pancreatic cancer at such a late stage that it cannot be surgically removed and therefore is not potentially curable. Patients who do undergo surgery often experience recurrences.

The future of pancreatic cancer treatment depends on new understanding of the biology and genetics of this disease, and there is real hope on the horizon, but what can be done for today's patients?

Greater awareness of pancreatic cancer among primary physicians and patients
It's very important that both doctors and their patients be attuned to the possibility of pancreatic cancer and take appropriate steps to detect these tumors early. Patients at risk include those who experience unexplained weight loss or persistent GI symptoms, a sudden onset of type 2 diabetes or a sudden worsening of existing diabetes, or repeated episodes of pancreatitis.

Patients with a family history of pancreatic cancer should be seen by a certified genetic counselor.

Appropriate diagnostic interventions for suspected pancreatic tumors.
A standard abdominal CT scan does not detect many pancreatic tumors, so a special pancreatic scan is required. Using the wrong imaging technique can lead to extensive delays in diagnosis. It is also important that pancreatic cysts, which can range from harmless to premalignant, be evaluated and managed appropriately.

Penn offers a comprehensive pancreatic cyst program headed by Nuzhat Ahmad, MD.

Careful evaluation of patients to select those who are candidates for surgery
Evaluating newly diagnosed pancreatic cancer patients for surgery is one of the most difficult and critical steps in the treatment process. Surgery offers the only possible cure, but the surgery itself is a major procedure that can lead to significant complications.

Michael Kochman, MD, co-director at the GI Cancer Evaluation Center explained at the Focus on Pancreatic Cancer conference the importance of using the appropriate imaging to determine who is and isn't a candidate for surgery. Endoscopic ultrasound has become the most widely used and an effective means of making this determination, but it needs to be done in a facility that has experience and expertise in pancreatic cancer.

Surgery done by an experienced, expert team
Jeffrey Drebin, MD, PhD, chair of Penn's department of surgery, stressed the critical importance of having a highly experienced surgical team , skilled in performing a complicated surgery called the Whipple procedure, for pancreatic cancer. He noted that proper selection of patients for the surgery and the combination of high surgical volume and expertise markedly affects outcomes.

Penn's long-term survival results for surgically resected pancreatic cancer patients are close to double the national average with significantly reduced complication rates.

Availability of radiation therapy options for all stages of pancreatic cancer
James Metz, MD, clinical director of radiation oncology at Penn, stressed the new options and innovative approaches that are being developed at Penn for pancreatic cancer patients. These include the use of proton therapy to minimize the dose of radiation to normal tissues. Proton therapy, available at only eight centers in the United States, also has the potential to be used for "retreatment" of areas that have already received doses of radiation therapy for metastatic disease. Metz also pointed to the integration of radiation therapy with other modes of treatment, including new drugs that make tissue more sensitive to the effects of the radiation.

Aggressive chemotherapy approaches
Chemotherapy is used for almost all stages of pancreatic cancer.

For patients whose tumors can be surgically removed, or resected, chemotherapy is given either before or after surgery. Patients with borderline resectable tumors receive chemotherapy to help shrink their tumors and those with advanced or metastatic disease get chemotherapy to help control their tumors.

Weijing Sun, MD, director of GI medical oncology, discussed the efforts that are under way to improve the results of chemotherapy by developing new targeted agents and combining existing drugs in new ways or with other approaches such as immunotherapy. The results are slow, but are showing steady improvements in survival.

For most patients with pancreatic cancer, clinical trials are an important option and should be a part of the treatment planning discussion from the day of diagnosis.

Comprehensive management of the whole patient and the problems pancreatic cancer can cause
Patients with pancreatic cancer frequently face multiple physical and psychosocial challenges. Understanding these issues and managing them requires a full team of well-trained, experienced professionals.

At the Abramson Cancer Center’s Integrative Oncology Program, led by Jun Mao, MD, MSCE, patients learn the value of mindfulness, yoga, reiki and physical therapy in conjunction with standard medical treatment. For patients with pancreatic cancer, proactive management of physical and psychosocial issues is an essential part of treatment.

View the Focus On Pancreatic Cancer Conference to learn more about treatment options at the Abramson Cancer Center for patients with pancreatic cancer.

Friday, June 1, 2012

How Do You Fit in Exercise?

Whether we work full time or manage a house full family, everyone is busy. Finding time to work out and fit in fitness isn’t always easy to do, but it is important for your health, and to set a good example for your family, children and friends.

Kathryn Schmitz, PhD, MPH, FACSM, is an associate professor at the Perelman School of Medicine at the University of Pennsylvania. She is also the mom of two teens who works 60 to 70 hours a week, and still manages to find time to work out. In this blog, she discusses her own fitness goals, and how she finds time to exercise.

I work 60 to 70 hours a week, I’m the mother of two teens, and I work out three to five times a week.

In the past, I kept up with my workout schedule by setting a goal to train for a particular running event. I’ve done many 10-mile and half-marathon races in the Philadelphia area. I’m not fast, but by setting a goal for myself, I was able to focus and train for a specific event, even if I wasn’t the fastest person there.

The last race I trained for was the Broad Street Run in 2011. I trained to do this 10 mile event with a breast cancer survivor who was participating in one of my studies and who wanted to do the race but didn’t know whether she could.

We crossed the finish line together with our arms raised high.

I decided it was a terrific note on which to end my long races. You see, I have never enjoyed running long races. I just set the goal of completing a particularly long running event so that I would be motivated to stay on my training schedule.

But since I haven’t been training for an event, I needed a new way to set goals. Late last year I found a terrific one on the blog of a cancer survivor fitness professional by the name of Alwyn Cosgrove. Mr. Cosgrove set a goal of completing 200 workouts a year. I liked this idea so much that I’ve adopted it for 2012. I’m three months in and have 48 workouts to show for it!

Finding time to work out

I fit in my workouts in the evening. I have a rule that I cannot sit and watch television in the evening, I have to be lifting weights, stretching or on the treadmill if the television is on. This limits my television viewing and motivates me to exercise if there is a particular show I like to watch.

I also use exercise time to spend time with my family. My partner and my children and I work out together sometimes. Those are my favorite workouts because we get to spend time together, and I know I am setting a good example for my children.

We also make it fun. My 14-year-old son and I make faces when we are lifting weights and that makes us both laugh. Then we find ourselves remembering those faces later and we laugh again!
The bottom line is that for me, setting fitness goals helps me stay on track and focus on personal fitness achievements. You don’t have to run a race, or climb a mountain to focus on getting exercise. Do what works for you, find time when you can, and remember to have fun.

Do you struggle to find time to work out? How do you do it?

Stay fit and join the Penn Medicine/CHOP LIVESTRONG Challenge Team.

Learn more about Dr. Schmitz’s fitness based research

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