University of Pennsylvania Health System

Focus on Cancer

Tuesday, July 31, 2012

Melanoma Treatment Moves Forward in 2011

Lynn Schuchter, MD, program leader for Penn's Melanoma Research Program says 2011 was the “year of melanoma,” one in which two important new agents were approved by the FDA (the first in over 40 years). It was in 2011, cancer research for melanoma began to make a significant difference for patients with advanced forms of melanoma.

2012 is emerging as a year in which researchers and clinicians are taking these new clinical approaches to the next level.

The two key areas are therapies targeted to specific genetic mutations and immunotherapy.

Dr. Schuchter and other melanoma experts at Penn believe we are only beginning to understand enough about how melanoma cells grow and spread to develop effective new treatments based.

Dr. Schuchter opened this year’s Focus On Melanoma Conference with an update on melanoma treatments and advances in melanoma research. Last year, the introduction of the drug vemuranefenib was the first big piece of news. Vemuranefenib works by inhibiting BRAF gene activity in the approximately 50% of melanoma patients who in whom this gene is "broken." The drug is powerful, producing often dramatic responses in patients with advanced melanoma, but it almost always stops working after a period of six to 18 months. This phenomenon --in which patients respond well to a drug for a period of time only to see the cancer come back or start growing again--is called resistance, and is one of the most perplexing barriers to developing effective, lasting cancer treatments.

Cancer researchers are beginning to understand the amazingly complex mechanisms by which cancer cells become resistant.

In the case of BRAF inhibitors, this occurs when the melanoma cells in essence take a detour--an alternate pathway that allows them to avoid the STOP growing and dividing sign they encounter when BRAF activity is inhibited. The goal now is to combine the original drug, vemuranefenib, with other targeted agents that block these alternative pathways. A major clinical trial in which vemuranefenib is used with a drug known as a MEK inhibitor is showing very promising results, and will be featured at the 2012 meeting of the American Society of Clinical Oncology (ASCO). This is one of what will be many clinical trials aimed at overcoming the problem of resistance with targeted therapies in malignant melanoma. A surprising, but welcome finding in this trial, is that the combined therapy is not only superior to vemuranefenib alone but the incidence of side effects, especially those related to skin problems, is significantly reduced.

Immunotherapy is the other very promising area in treating melanoma. Researchers have known for a long time that the immune system is active in trying to seek out and destroy melanoma cells—while on the other hand the melanoma cells are effective in hiding from the immune system. New therapies are focused on making melanoma cells more visible and increasing the level of immune activity. Last year's new agent in the immunotherapy arena is known as ipilumubab (ipi). The drug works very well for some patients, often resulting in delayed responses, meaning that in the first several weeks of therapy, the melanoma will actually grow--but then begin to regress and sometimes disappear completely. Ipi also stimulates an auto-immune response that can cause a wide range of side effects, ranging from colitis to endocrine problems to inflammations of the skin and liver.

The current goal for ipi is to understand in advance which patients should receive this drug and when. Right now, ipi is only approved for late stage melanoma patients and for a limited course of therapy. For melanoma patients at high risk of recurrence, researchers are very interested in finding out whether this drug can be effective as additional therapy once primary cancer treatment is completed (know as adjuvant therapy) -- or whether it can be used as maintenance therapy. A big question is whether ipi can be successfully combined with BRAF inhibitors— Currently they are given sequentially.

New insight in the ways in which the immune system interacts with melanoma cells is also opening the door to developing new agents and approaches to immunotherapy. PD-1 is an antibody similar to ipi which has been shown to be very active in early trials--without the autoimmune response. Another technique that is being successfully used to treat leukemias is now on the cusp of being used for melanomas as well. This involves extracting t-cells from the patient, "supercharging" them in the lab and then injecting them back into the patient--another example of an emerging new therapy that is both highly tailored and personalized.

As Dr. Schuchter said in concluding her remarks, "These are not conversations we were having nine years ago when we first started this conference. We have a lot more to do, but these are exciting times."

Watch all of the presentations from the 2012 Focus On Melanoma Conference here

Learn more about treatment for melanoma at Penn in Philadelphia.

Monday, July 30, 2012

Age and Melanoma

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012 Focus On Melanoma Conference In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

We all know that our skin undergoes changes as we age, but does the aging process affect the environment in which melanomas live and grow?

According to research underway at The Wistar Institute, the answer is yes.

Ashani Weeraratna, MD, work focuses on the role of a specific enzyme known as Klotho which functions as a kind of anti-aging molecule. When we are young, we have lots of Klotho, but by the time we reach our 40s, it has almost disappeared from our systems.

Researchers have also found that Klotho is expressed in primary melanomas, but rarely, or in very small amounts in metastatic melanomas.

The presence of Klotho appears to inhibit metastases, while its absence, promotes them in malignant melanomas.

The goal of Dr. Weeraratna's research is to determine if putting Klotho back into a patient's body will help inhibit metastases--with the ultimate hope that this could be developed as a preventive measure.

Watch all of the presentations from the 2012 Focus On Melanoma Conference here

Learn more about treatment for melanoma at Penn in Philadelphia.

Friday, July 27, 2012

Avid Cyclist Rides Bike to Proton Therapy Treatment in Philadelphia



Bill Barbour, 63, of New York, is an avid cyclist who was diagnosed with prostate cancer in May, 2011. Always active, he wasn’t ready to let treatment for prostate cancer slow down his life, or his participation in his favorite activity, cycling. Bill chose to have proton therapy for prostate cancer at Penn in February, 2012, and today he is cancer-free, and looking forward to riding with the Abramson Cancer Center cycling team in the Philadelphia LIVESTRONG challenge this August.

Watch Bill tell his story about before and after cancer treatment.

I was diagnosed with prostate cancer in May, 2011. Last fall when my doctor recommended I start to consider treatment options for my prostate cancer, I immediately thought about the effects that the popular treatments for prostate cancer may have on my cycling. Cycling plays a significant role in my life, so I sought the advice from a fellow avid cyclist who had undergone treatment for prostate cancer. He related that he wasn’t able to ride for an extended period after his treatment.

My thoughts turned to the negative impact that such a layoff from cycling would have on my physical conditioning. It takes top physical conditioning to ride the distances needed for my frequent group rides and for my daily commute to work. I wanted a treatment option for prostate cancer that would minimize any reduction of my cycling activity, and I began researching various treatments for prostate cancer.

I quickly learned about proton therapy for prostate cancer from the excellent book called You Can Beat Prostate Cancer by Robert Marckini. After reading it, and doing some more research on my own, I felt that proton therapy, was not only as an effective treatment for my prostate cancer, but it was also a treatment that would allow me to maintain my active lifestyle.

Proton treatment at the Roberts Proton Therapy Center within the Perelman Center for Advanced Medicine in Philadelphia could not have worked out any better for me.

Through Hosts for Hospitals, I found a gracious family that opened their home in Philadelphia for me during my 8 weeks of proton therapy treatments. I acquired a bike and I was able to ride from my host’s home to my proton therapy sessions at the Roberts Proton Therapy Center in Philadelphia. Thanks to laptop computers and the internet, I was even able to bring my work with me, and never missed a beat.

Not only did proton therapy allow me to avoid a lengthy post-surgery layoff from cycling, I was able to regularly include cycling, something so important to me and my lifestyle, in my routine while undergoing my treatment.

During each ride I realized how fortunate I was to have gone from the prospect of not being able to sit on a bike seat to having the best seat in the house. I rode the scenic Schuykill River Trail, and I never tired of the great views of center city from the South Street Bridge.

Every pedal stroke reminded me that we are truly living in the age of advanced medicine and how important it is for those facing a potentially lifestyle altering treatment decision to consider proton therapy for prostate 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 in Philadelphia, and how proton therapy offers potentially less side effects for men with prostate cancer.

Thursday, July 26, 2012

How to Understand Grocery Store Lingo


The grocery store can be a tricky place to navigate. It can be especially frustrating if you are trying to strike a balance between health and affordability. If you frequently find yourself questioning whether you should choose the organic croutons or the croutons on sale, you are not alone. Below, I have defined some of this new grocery store vocabulary.

 

Certified Organic

Organic agriculture is grown without the use of genetically engineered seeds or crops, sewage sludge, long-lasting pesticides, herbicides or fungicides.

Certified organic goes beyond agriculture, there is certified organic livestock as well. These animals are provided organically grown feed, fresh air and outdoor access while using no antibiotics or added growth hormones.

The United States Department of Agriculture (USDA) requires that anyone who produces, processes or handles organic agricultural products must be certified by a USDA-accredited certifier in order to sell, label or represent their products as "organic."

To become certified, an organic producer, processor or handler must develop, implement and maintain an organic system plan.

Certified Naturally Grown

Certified naturally grown is an alternative to the USDA's National Organic Program meant primarily for small farmers distributing through local channels such as farmer's markets, roadside stands, local restaurants, community supported agriculture (CSA) programs and small local grocery stores.

The standards and growing requirements are no less strict than the USDA National Organic Program rules. The primary difference between Certified Naturally Grown and the USDA Organic program is cost to farmers and paperwork requirements.

Visit the Certified Naturally Grown Website.

Basic Conventional Farming

This has been an acceptable form of farming since the 1950s. Synthetic pesticides, fertilizers, genetically engineered organisms and growth enhancers are used to stimulate the soil and crops.

Synthetic fertilizers add various nutrients to the soil and pesticides or fungicides help control insects. Their focus is on short-term yield increases rather than long term soil health.

When it comes to choosing conventional versus organic, I defer to the Environmental Working Group’s list of the Dirty Dozen or Clean 15.

The Environmental Working Group tested produce to provide shoppers’ with a guide to help them decrease their exposure to pesticides. The Dirty Dozen were found to have the highest amount of pesticides after washing and the Clean 15 contained the least.

If you commonly eat foods on the Clean 15, it is not necessary to choose organic.

Grass-fed or Pasture-raised

These terms refer to livestock that are fed their natural diet which could include grass, bugs, and other organisms in a field.

Typically, farmers who raise pastured livestock do not feed their livestock antibiotics or inject them with hormones.

Research shows that meat, eggs, and dairy products from grass-fed animals have higher omega-3 fatty acids, more favorable omega-3 to omega-6 ratios, and lower cholesterol than non-pastured animals.

Grass Finished

Animals considered “grass finished” are fed only grass during the period preceding processing. This is distinguished from the industry standard of feeding grain, usually corn, during the same period.

Chemical Free

Part of sustainable agriculture prohibits the use of harmful chemical pesticides.
As a practice, chemical-free farming tries to restore soil stability and fertility in target locations. Chemical-free agriculture is difficult, especially where land has already been degraded.

Heirloom

Similar to your great grandmother’s tea pot, heirloom is a variety of horticulture that is maintained by small groups of private individuals to preserve genetic diversity and/or certain characteristics, over thousands of years.

Genetically Modified Organisms (GM or GMOs)

The term GM foods or GMOs (genetically-modified organisms) is most commonly used to refer to crop plants created for human or animal consumption using the latest molecular biology techniques.

Gluten-free

The term gluten free means a product does not contain gluten.

Gluten is defined as a combination of protein fragments found in wheat, rye, barley and sometimes oats. A gluten-free diet is currently the only known treatment for Celiacs’ disease, a chronic digestive disorder. These individuals experience a toxic immune response when they ingest gluten.

Wheat-free

Some individuals are allergic to the protein in wheat itself, including wheat albumin and wheat globulins. People allergic to wheat will want to avoid wheat and its by-products.

If you are interested in learning more visit: www.buylocalpa.org/glossary.

Learn more about cancer nutrition services at the Joan Karnell Cancer Center and Abramson Cancer Center. 

Carly Roop RD, CSO, is a registered dietitian at the Joan Karnell Cancer Center (JKCC). She provides nutrition education and support to patients while addressing nutrition-related side effects from chemotherapy and radiation. Dietitians at JKCC provide educational nutrition programs that are open to patients as well as the community.

Tuesday, July 24, 2012

Treatment for Lymphedema

The current standard for managing lymphedema is complete decongestive therapy (CDT). CDT is a multifactorial approach combining manual lymphatic drainage, multilayer compression bandaging, exercise to increase the muscle pump to help move fluid from the limb and meticulous skin care.

This “intensive phase” provided three to five times per week can lead to a reduction in the volume of swelling and a softening and improvement in the skin quality. When the swelling has reduced sufficiently, patients are fitted with elastic compression garments (a stocking), which are worn during the day, and replaced by compression bandaging for sleep during what is called the “maintenance phase.” This conservative approach is highly effective in reducing the swelling and daily self-care with garment use, exercise and meticulous skin care maintain the reduction achieved during treatment.

Unfortunately, the underlying damage to the lymphatic system is not able to be repaired and patients must develop good habits to maintain the limb reduction.

Other treatments for lymphedema are currently being investigated, but it is important to consider the long-term implications of any treatment chosen. Treatments such as pneumatic compression pumps, microsurgical procedures and lymph node transfers have yet to show long-term, lasting benefit to their use, and most of these treatments still require the use of compression garments for adequate maintenance of the reduction in the size of the arm/leg after daily use or surgery.

Monday, July 23, 2012

When is Less More for Melanoma Surgery

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012 Focus On Melanoma Conference In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

Surgery for melanoma has two goals:
1. To remove all of the cancer with a margin of healthy tissue around it, known as wide excision
2. To determine if the melanoma has spread beyond the primary site to the adjacent lymph nodes

For years, the second goal was achieved by a lymph node dissection or total removal of the nodes nearest the melanoma. This procedure often led to short- and long-term problems for patients.

More recently, however, surgeons have begun to use a procedure in which they remove only the one or two lymph nodes closest to the tumor, the ones to which cancer cells are most likely to spread.
They identify these "sentinel" nodes as they are called by using special dyes as tracers. The dyes follow the same drainage paths as the cancer cells. If the cancer has not spread to the sentinel node, the chances are extremely high that it has not spread to any other nodes.

As Penn surgeon, Giorgos Karakousis, MD, noted, it is important to optimize the results for each patient while minimizing any negative consequences of the treatment.

For melanoma patients, this means tailoring the surgery to the individual patient's disease, using a wide range of factors that predict the risk that the cancer will spread. New technology, which is more accurate and sensitive, is also helping doctors to make individual decisions as to what surgery to do for various subsets of patients.

In general, patients with stage I and II disease will have wide excision of the melanoma. The decision as to whether to use the wide excision alone, add SNL or do the complete lymph node dissection depends on the thickness of the melanoma and those other factors such as whether there is evidence of active cell division, mitosis, in the tumor and whether the melanoma is ulcerated or not.

"In the past, we did a lot of complete lymphadenectomy, and many of our patients had problems either from the surgery itself or as a result of lymphedema,” says Dr. Karakousis. “We can avoid those negative outcomes for many of our patients today without compromising their overall treatment."

Dr. Karakousis also pointed to the increasing ability to surgically remove isolated metastases for patients with Stage IV melanomas, an approach that has had positive results for some patients. The decision as to whether or not to attempt to do this kind of surgery should be made by a multidisciplinary team.

Watch all of the presentations from the 2012 Focus On Melanoma Conference here

Learn more about treatment for melanoma at Penn in Philadelphia.

Thursday, July 19, 2012

Mediterranean Quinoa Salad

Quinoa (pronounced "keen-wah") is a "superfood" with great nutritional value. It is packed with protein, and is a great source of iron and calcium.

This quinoa salad is perfect for a summer day because it is light, and rich with seasonal vegetables and herbs.

 

 

Mediterranean Quinoa Salad

  • 1 cup uncooked quinoa
  • 2 cups water or vegetable stock
  • 1/4 tsp. salt
  • 1 small cucumber, seeded and diced
  • 6 calamata olives, diced
  • 3 sun dried tomatoes, diced
  • 1 tbsp. olive oil
  • 1/4 cup feta cheese rinsed and crumbled
  • 1/2 lemon or 2 tbsp. lemon juice
  • 2 tbsp. chopped basil (1 tsp. if dried)
  • 1 clove crushed garlic 
Directions
  1. Place quinoa in a colander and rinse under cold water for at least one minute. 
  2. Combine quinoa, water and salt in a quart saucepan. 
  3. Bring to a boil. 
  4. Reduce heat to a simmer and cover for 15 to 20 minutes. 
  5. Spread quinoa out on a sheet pan to cool. 
  6. Toss cooled quinoa with the remaining ingredients in a large bowl.
  7. Chill for one hour. 
  8. Serve. 

Yields 8 half-cup servings.
Nutrition information: 120 calories, 4g protein, 16g carbohydrates, 5g fat, 1g saturated fat, 5mg cholesterol, 2g dietary fiber, 180mg sodium, iron 10% of daily vitamins, calcium 4% iron 10% of daily vitamins, vitamin C 6% of daily vitamins, vitamin A 2% of daily vitamins.

Wednesday, July 18, 2012

Wigs for Hair Loss From Chemotherapy

A common side effect of chemotherapy is hair loss. Many chemotherapy drugs have no affect on hair. Others cause mild hair thinning or complete hair loss.

A doctor or nurse will tell patients if hair loss can be expected with cancer treatment.

For those women who experience hair loss as a result of cancer treatment, there is a solution at Pennsylvania Hospital.

A new American Cancer Society Free Wig Salon is open at Solutions for Women at Pennsylvania Hospital.

Wigs can be expensive but through the American Cancer Society Free Wig Salon program, women who experience hair loss as a result of cancer treatment are given brand new, high-quality wigs free of charge.

There are a variety of colors and styles to choose from and they are made to be adjusted to fit comfortably.

The Free Wig Salon at Solutions for Women is open Monday, Tuesday, Thursday, and Friday from 10 am to 3 pm.

Please call 215-829-5046 for more information.

To find out about other American Cancer Society Free Wig Salons in the area, please call 1-800-227-2345.

Learn more about managing side effects from cancer treatment.

Tuesday, July 17, 2012

Preventing Lymphedema

The best strategy for treating lymphedema after cancer treatment is prevention education.

In particular, patients should learn how to care for and protect the skin to reduce the risk of infection. The lymphatic system is compromised by treatment, making patients more susceptible to infection in the region of the body close to the damaged lymph nodes. For most patients with gynecologic or colorectal cancer, this includes both legs and the lower abdomen and genital region. For patients treated for melanoma on one leg, that leg and the lower abdomen on that side are at risk for swelling.

Keeping the skin meticulously clean, free of injury and healthy with moisturizing and protection can reduce the risk of cellulitis which, for some patients, may be trigger swelling or increase swelling.

The signs and symptoms of cellulitis include a hot, red, painful, swollen area of skin in the “at risk” region. Many patients developing cellulitis also have a fever or feeling that they are becoming ill. These symptoms require emergency treatment as cellulitis can spread rapidly, causing significant illness and swelling of the limb.

The best advice is to seek medical attention immediately.

While lymphedema cannot be prevented as doctors are unable to predict with certainty who will develop lymphedema after cancer treatment, the best approach is for patients to be well educated about its signs and symptoms, practice risk reduction and find effective treatment early if symptoms of lymphedema appear.

Research at Penn Medicine in breast cancer-related lymphedema has shown that a healthy lifestyle emphasizing weight management and progressive exercise can be beneficial for patients at risk for lymphedema and those who have been diagnosed with lymphedema.

More research is required to determine if these same guidelines can be proven for patients with leg lymphedema.

Monday, July 16, 2012

5 Tips to Avoid Caregiver Burnout

Caring for someone with a chronic illness is one of the greatest expressions of love. It can also be an overwhelming experience for a caregiver. Caregivers need to know it is okay to take some time for themselves, and that the feelings they experience during their caregiver roles are normal.
Here are some steps caregivers can (and should) take for themselves while caring for a loved one with cancer or a chronic illness. There is also a list of support groups at Penn Medicine at the bottom of this article.

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

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

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

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

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

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

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

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

Thursday, July 12, 2012

New Treatment at Penn Destroys Mesothelioma


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

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

Mesothelioma Treatment with Photodynamic Therapy

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

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

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

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

Associate Professor of Surgery, Joseph Friedberg, MD, is researchering ways PDT is uses to treat cancer, such as combining PDT with gene therapy or with tumor vaccines to stimulate the immune system to fight cancer.

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

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

Would you like to learn more about treatments for mesothelioma and pleural diseases?

The Penn Mesothelioma and Pleural Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered worldwide and a number of treatments offered only at Penn such as PDT.

For more information about the Penn Mesothelioma and Pleural Program, call 215-662-9697.

A dedicated patient navigator will assist you with specific questions about mesothelioma and pleural diseases, and can help you schedule an appointment with a Penn specialist.

Helpful links:

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, July 11, 2012

Learn About Mesothelioma Treatment in Philadelphia at Penn Medicine

The Penn Mesothelioma and Pleural Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered worldwide and a number of treatments offered only at Penn such as photodynamic therapy, as recently featured in the Philadelphia Inquirer.

In this video, Penn cancer specialists discuss mesothelioma, diagnosis for mesothelioma and treatment for mesothelioma.



Helpful links:
















Tuesday, July 10, 2012

Penn Leads the Way in Treatment for Mesothelioma


Penn thoracic surgeon Joseph Friedberg, MD, recently led research published in the Annals of Thoracic Surgery that found photodynamic light therapy, or PDT, improved median survival rates of patients with mesothelioma to more than 31 months, compared to a median survival rate of 8 months with lung-sparing surgery.

This Sunday, the Philadelphia Inquirer featured a story about Dr. Friedberg and the team of clinicians and researchers at Penn Medicine who are using PDT to treat patients with pleural mesothelioma.

Photodynamic therapy, also known as photoradiation therapy, phototherapy, or photochemotherapy is used to treat certain types of cancer.

It is based on the discovery that certain chemicals known as photosensitizing agents can kill organisms when they are exposed to a particular type of light. PDT destroys cancer cells through the use of a fixed-frequency laser light (an intense narrow beam of light) in combination with a photosensitizing agent

From the Inquirer:

"...for more than two decades, Penn scientists have been doggedly pursuing innovations. They are combining conventional treatments with gene therapy, T-cell therapy, and the laser technology, called photodynamic therapy. Patients come thousands of miles to Penn after exploring their options - or lack thereof."

Read the full article about how Penn is changing the way lung disease is treated.

Would you like to learn more about treatments for mesothelioma and pleural diseases?

The Penn Mesothelioma and Pleural Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered worldwide and a number of treatments offered only at Penn such as PDT.

For more information about the Penn Mesothelioma and Pleural Program, call 215-662-9697.

A dedicated patient navigator will assist you with specific questions about mesothelioma and pleural diseases, and can help you schedule an appointment with a Penn specialist.

Helpful links:

Monday, July 9, 2012

What is Photodynamic Light Therapy?


Mesothelioma is one of the most aggressive and deadliest forms of cancer and is usually caused by exposure to asbestos. Exposure to asbestos typically precedes development of the cancer by anywhere from 10 to 50 years, but once diagnosed, only about 40 percent of U.S. mesothelioma patients survive one year.

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

In a study published in the Annals of Thoracic Surgery, lead author Joseph Friedberg, MD, co-director of the Penn Mesothelioma and Pleural Program, and Penn thoracic surgeon, found that among patients with malignant pleural mesothelioma, treatment with lung-sparing surgery in combination with photodynamic therapy (PDT) yielded unusually long survival rates, with median survival rates up to two or more years longer than is reported with traditional treatments

Stephen Hahn, MD, is chair of the department of radiation oncology and the Henry K. Pancoast Professor of Radiation Oncology at the Perelman School of Medicine at the University of Pennsylvania. He is board certified in radiation oncology, medical oncology, and internal medicine and is internationally renowned for his work in photodynamic therapy (PDT).

Dr. Hahn recently answered a series of questions related to lung cancer and radiation therapy for TalkAboutHealth.com.

 

 

What is photodynamic therapy for lung cancer?

Photodynamic therapy is a cancer treatment in which a patient receives (typically by vein) a special light sensitive drug followed by the delivery of a specific type of laser light to a tumor. The drug in the tumor is activated by laser light, which kills cancer cells. We can focus the laser light on a tumor and minimize the amount of laser light on the normal tissues thereby limiting side effects. Currently photodynamic therapy is approved by the FDA in lung cancer for the treatment of tumors within the trachea or bronchus (breathing tubes) that are causing obstruction. It is also approved for esophageal cancers that are causing obstruction of the esophagus (swallowing tube) and some precancerous conditions of the esophagus and skin.

When can photodynamic therapy be used to treat cancer?

Photodynamic therapy cannot be used for all cancers because it is not possible to delivery an adequate dose of laser light to some tumors. In other words, they may be inaccessible. At Penn Medicine, we have one of the largest photodynamic therapy research programs in the world and are currently studying its use in patients with a tumor the chest called mesothelioma.

Learn about Treatment for Lung Cancer and Mesothelioma in Philadelphia

At Penn's Abramson Cancer Center, patients with lung cancer have access to every lung cancer and mesothelioma treatment option available, provided by nationally recognized cancer experts.

Penn's expert care and leading-edge treatments give patients with lung cancer the best chance of an excellent outcome.

Have questions about lung cancer treatments offered at Penn's Abramson Cancer Center in Philadelphia?


Helpful links:

Thursday, July 5, 2012

How to Get Vitamin D Without the Sun

Vitamin D is frequently referred to as the “sunshine vitamin.” That’s because a common source of vitamin D is sun exposure. While sun exposure is great for vitamin D, frequent sun exposure is not recommended because too much sun exposure is associated with an increase in skin cancer risk.

Vitamin D is synthesized in the skin. Vitamin D deficiency increases as we age and has become more prevalent partly due to the avoidance of the sun. A vitamin D deficiency may undermine bone health and is further potentially associated with an increase in cancer risk.

How to Get Vitamin D Without the Sun

Natural sources of vitamin D include cod liver oil and fatty fishes such as tuna, herring, catfish, sardines and salmon.

Wild salmon may have as much as 4 times more vitamin D than farm raised salmon. Because these foods are not eaten on a daily basis, more common sources of vitamin D are in fortified foods such as dairy through milk and yogurt consumption. Oil spreads and cereals may also be fortified. It is best to check the nutrition facts section of the food label.

Supplements also are available in the form of ergocalciferol (made by plants) or cholecalciferol (made in the skin).

Check your calcium supplement for vitamin D as well. The Institutes of Medicine recommends 600 IU per day as the recommended dietary allowance for vitamin D, 800 IU for individuals over 70 years of age and an upper level of 4,000 IU per day.

Risk for Vitamin D Deficiency

Approximately 32% of Americans are vitamin D deficient. If you are homebound, have a poor nutritional intake or digestive disorders you may be at higher risk for deficiency.

If you are concerned that you are vitamin D deficient, ask your health care practitioner if your levels can be checked at your next blood test. This test is called 25-hydroxyvitamin D.

Much controversy currently exists as to the best range to meet, however, this blood test will give you an idea if you need a vitamin D supplement. There are risks to taking too much Vitamin D, such has causing elevated calcium levels, therefore, it is important to not start taking a high dose Vitamin D supplement without reviewing your blood levels.

Researchers are currently studying vitamin D, how it works in the body, and if there is a relationship between a deficiency and diseases.

For more information about nutrition during cancer treatment, schedule an appointment with a dietitian at the Joan Karnell Cancer Center, or Abramson Cancer Center.


Tuesday, July 3, 2012

How to Find a Lymphedema Specialist

The Cancer Rehabilitation Program at the Abramson Cancer Center and at the Joan Karnell Cancer Center along with the lymphedema program at Good Shepherd Penn Partners help patients prevent or treat lymphedema.

Therapists at Good Shepherd Penn Partners are certified lymphedema therapists (CLT) who have attended programs recognized as the most advanced training available. Many of Penn’s therapists have further certification through the Lymphology Association of North America (LANA).

Penn is also home to groundbreaking research on lymphedema caused by treatment for breast cancer, specifically the Physical Activity and Lymphedema (PAL) Trial. This study found that lifting weights may prevent, or relieve, lymphedema.

The National Lymphedema Network is a well-known patient advocacy group for individuals with lymphedema. Its website is a valuable source of accurate information and for locating treatment professionals

The American Physical Therapy Association lists specialists in many areas, including lymphedema, through its ‘Find a PT’ service.
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