University of Pennsylvania Health System

Focus on Cancer

Thursday, November 29, 2012

Cancer Fighting Recipe: Spicy Kale with Fried Grapes and Frizzled Onions


Kale’s strong and sometimes bitter flavor comes from its sulfur-containing compounds, which are converted into isothiocyanates (ITCs) when its leaves are broken by blending or chopping. ITCs have proven immune boosting and anticancer effects, making this the perfect dish for combating those fall sniffles!

Lacinato kale has long and slender leaves and is usually more tender than its cousin curly kale. Other braising greens such as Swiss chard, beet greens or mustard greens are great substitutes.

 

 

 

Spicy Kale with Fried Grapes and Frizzled Red Onions

Serves 6
Ingredients
  • 2 tablespoons extra-virgin olive oil, divided
  • 2 teaspoons balsamic vinegar
  • ⅛ to ¼ teaspoon red pepper flakes
  • 1 medium red onion, halved and thinly sliced lengthwise
  • 1¼ teaspoons salt, divided, plus extra for serving if needed
  • 1¼ cups halved seedless red grapes
  • 1½ bunches Lacinato kale (about 6 ounces)--stems removed, leaves stacked, rolled and sliced crosswise into wide ribbons
Directions
  1. In a small bowl, whisk together 1 tablespoon of the olive oil with the balsamic vinegar and the red pepper flakes. Set aside.
  2. In a large skillet set over medium-high heat, add the remaining 1 tablespoon of olive oil. Add the onion and ½ teaspoon salt and cook, stirring often, until the onion is brown and frizzled around the edges, about 4 minutes. Add the grapes and cook until browned, about 2 minutes.
  3. Pour the oil-balsamic mixture into the pan and immediately add the kale. Use tongs to stir and turn the kale into the onion-grape mixture. Once the kale starts to wilt, after about 1 minute, turn off the heat and transfer the kale mixture to a serving bowl. Taste and season with the remaining ¾ teaspoon of salt. Serve warm or at room temperature.
Nutrition per serving: 80 calories; 4.5 grams of fat; 5 grams of sugar; 1gram of protein
Recipe from the Tasting Table Test Kitchen www.tastingtable.com

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.

Wednesday, November 28, 2012

5 Easy Yoga Poses to Do Anywhere


The practice of yoga calms the mind by providing a deep feeling of relaxation and balance. Did you know that the very basics of a yoga practice can be done during your “everyday” life at any place or any time?

When you find yourself caught up in the hustle and bustle this holiday season, give yourself the gift of “instant yoga” by practicing these quick and simple techniques…anywhere…anytime:

Staying Grounded During the Holidays: 5 Easy Ways to Take Yoga off of the Mat

Standing Pose

The next time you are in the middle of a busy mall and feel overwhelmed by the crowds, take a few second to ground yourself by standing with your feet hip’s distance apart, relaxing your shoulders and fixing your gaze straight ahead. Take a few release breaths in through your nose and out through your mouth. This will reset your body and mind to allow you to continue with the remainder of your shopping!

Alternate Nostril Breathing

If holiday shopping gives you a headache, try inhaling and exhaling through each nostril by closing off one nostril and breathing in to a count of 8 and exhaling out of the other nostril to a count of 16. Do a few rounds of this ancient yogic breathing practice slowly for relief of stress and anxiety.

Shoulder Rolls

When lines at the cashier drive you crazy and cause stress, draw your attention to your shoulders and take a nice, long inhale bringing your shoulders up to your ears, circle them back and down. While you are at it, circle your neck around a few times while inhaling and exhaling slowly. You will feel a renewed sense of calm.

Lion’s Pose

Are those office parties making you tired of talking, smiling and socializing? Go to a quiet place and try this pose by opening up your mouth wide and sticking out your tongue. Making the sound of a roaring lion helps, too. Sounds funny, but this ancient pose is a great release for the facial muscles and really helps if you have been doing a lot of talking.

Meditate

The best way to get through the holiday season feeling happy, healthy and whole is starting each day with a few minutes of meditation. Just sitting silently with your eyes closed at any point during your day is very helpful to keep yourself in balance. Remember, it doesn’t have to be for a long period of time…even just one minute of silent meditation in the midst of a busy holiday season will go a long way!

Join Us for FREE Yoga Sessions

The Abramson Cancer Center offers FREE yoga classes to patients, caregivers and survivors every Tuesday and Thursday from 2 to 3 pm. Contact Fern Nibauer-Cohen by email at Fern.Nibauer-Cohen@uphs.upenn.edu or phone at  215-662-3919 for more information.

Fern Nibauer-Cohen is the associate director of program development in the department of radiation oncology at Penn Medicine. She received her certification to teach yoga from Yoga On Main in Manayunk, PA and has completed the level one certification of the “Teaching Yoga to Cancer Patients Program” from Integral Yoga. 

Tuesday, November 27, 2012

Surgery, Radiation and Proton Therapy for Lung Cancer Treatment at Penn


Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new treatments in radiation and proton therapies for lung cancer patients. 


"At Penn, we care about the total patient experience,” says John Kucharczuk, MD. “ We know that for most people, the diagnosis of lung cancer is their first experience with this disease. As doctors, we need to recognize what that means to people, understand their anxiety level.”

Surgery for Lung Cancer

At Penn, the highest quality of surgical care for lung cancer encompasses understanding what it means to have this disease and undergo treatment. Penn has one of the largest divisions of thoracic surgery in the country, one that includes a dedicated surgical unit staffed with nurses who care only for patients who have undergone this kind of surgery.

Surgeons work as a team with experts from other disciplines to assure optimal care for every patient, and are leaders in developing new technologies and approaches that minimize the invasiveness of surgery, while maximizing the therapeutic effect. These include innovative approaches to lung sparing surgery, robotic platforms and the use of photosensitizers to improve local control of tumors.

Skill and technology are critical, but underlying the Penn program is an active commitment to preserving quality of life for patients. To Dr. Kucharczuk and his team, that involves engaging with each patient to understand what quality of life means to that person, and working to tailor the treatment to the individual.

Radiation and Proton Therapy for Lung Cancer


"Lung cancer treatment is a 'team sport.' We see ourselves as a group of physicians who have the privilege of caring for you. Effective treatment is truly a partnership with our patients." Ramesh Rengan, MD.

For many lung cancer patients, radiation therapy is an important part of their treatment. Penn offers a number of options to patients with most kinds and stages of lung cancer. These include:
  • Conventional radiation therapy utilizing 3-D imaging and IMRT
  • Protons
  • Stereotactic body radiation

Charles Simone, MD, emphasized that there are two major components in delivering effective radiation therapy to lung cancer patients.
  • Where is the cancer? This means locating the tumor as precisely as possible. Penn is one of the few centers that has integrated PET scanning and metabolic evaluation of tumors into this process.
  • How do we target the cancer? This means getting as much of the radiation dose to the tumor while sparing normal tissue.

The exact type of radiation used depends on the patient--the kind and extent of the cancer, and the overall health or other conditions that might exist. Newer options, such as stereotactic body radiation are making it possible to treat older, sicker or more advanced patients.

Proton therapy is another option for patients with locally advanced lung cancers, the most common diagnosis. Penn is one of only eight centers in the United States that offers proton therapy--a technique that allows more precise, targeted delivery of radiation to the tumor. Protons have the potential to reduce side effects from therapy while being equally effective in treating the cancer.

See all the presentations from the Focus On Lung Cancer Conference here. 

Monday, November 26, 2012

Advances in Diagnosing Lung Cancer


Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new imaging and diagnostic advances for lung cancer.

Defining Risk, Reducing Deaths from Lung Cancer

The National Lung Screening Trial (NLST) demonstrated that regular, low dose CT screening for people at high risk of developing lung cancer reduces the death rate by 20 to 25%.

That trial, the largest screening trial in history, also raised a number of questions.
  • Who is at high risk? The NLST included people over the age of 55 with a 30 pack year history of smoking. Should that definition be broadened to include younger people, or those with less of a smoking history?
  • What are the appropriate protocols for evaluating various types of lung lesions discovered on these CT scans? In some instances, the lesion is clearly a lung cancer--or clearly not one, but if you do CT scans of people's lungs, you discover a lot of lesions that are not as clear cut. Following those lesions can mean additional studies, or even invasive procedures such as biopsies. It is important to have low dose CT scans done in a center that has the expertise to evaluate and follow any findings.
  • What is the appropriate amount of time after treatment to switch to low dose CT for follow up? Lung cancer survivors are also at higher risk of developing a recurrence of their tumors, or even a second cancer. Penn currently recommends making that change at the five-year mark.
Learn more about CT scans to detect lung cancer.

Imaging for Lung Cancer is Critical

"It takes a village to care for a lung cancer patient." Andrew Haas, MD, PhD

Until they are diagnosed with a potentially serious disease such as lung cancer, few people realize what a critical role diagnostic radiology plays in the treatment process. The ability to "see" the tumor is essential to accurate diagnosis and staging, which is, in turn, essential to optimal treatment planning.

For lung cancer patients, the ability to both see and reach the tumor--and biopsy it in the least invasive way possible is also important. In order to do molecular profiling, now standard for lung cancer patients, it is necessary to have tissue for the pathologist to analyze. New imaging techniques and technologies are improving that process, allowing interventional radiologists to reach deep into previously inaccessible airways to visualize smaller and smaller tumors, and extract the needed tissue. The instruments they use are increasingly smaller and more flexible, often employing robotic technology and navigational aids much like the ones we use in our GPS systems.

The line between diagnostic radiology and treatment has all but disappeared. Today, Penn interventional radiologists treat common side effects of lung cancer and its treatment such as pleural effusion and airway blockages.

On the horizon....new imaging technologies that will make it possible to deliver therapies directly to the tumor.

View all the presentations from the 2012 Focus On Lung Cancer Conference here. 

Friday, November 23, 2012

Cancer in Pets


November is National Pet Cancer Awareness month.

Cancer is remarkably similar in its incidence and treatment between humans and companion animals.

Symptoms of cancer in pets may include lumps and bumps, abnormal odors, wounds that won't heal, weight loss and difficulty breathing.

Christina Bach, MSW, discusses cancer in pets, signs and symptoms of cancer in pets, and treatment options to discuss with your pet’s veterinarian should your pet have cancer.

Learn more about cancer in pets.

Wednesday, November 21, 2012

Proton Therapy Patient Says Thank You

Today is the one-year anniversary of my initial proton therapy consultation visit at Penn Medicine. This time last year I was nearing the Thanksgiving holiday with a guarded hopefulness. After being diagnosed with prostate cancer earlier in May, it was time to get moving on a treatment and I wanted to learn more about proton therapy at Penn Medicine.

I was guarded because there were some hurdles to clear. Wanting to have proton therapy and being a good candidate for the treatment are two different things. After my consultation I needed to undergo testing and evaluation to find out if I was a good fit for treatment. I would also need insurance approval.

To complicate everything, I did not live in Philadelphia. Being in New York, I was still 180 miles away, which made a daily commute out of the question. I would need to commute weekly but where was I to stay? Could I afford it? Would I be able to continue working to support my family back home?

The answers to those questions gradually and wonderfully unfolded between Thanksgiving and December holidays last year. I remember thinking that it would be understandable for me to be depressed during the holidays. However, it turned out to be my best holiday season ever as I anticipated starting my proton therapy in the New Year.

On this anniversary I find myself in Philadelphia again for volunteer work, and it has provided me with the time and perspective to consider all that I am thankful for.

I am thankful that I live in America, and that I am fortunate enough to have a job when so many aren’t working. But there is much more for me to be thankful for this time.

Last year I was thankful for the hope to have a chance to survive. This year I am thankful for my post-treatment outcome.

Today, I am disease-free, and my PSA is continuing its downward trend.

I have experienced very minimal effects of proton therapy– almost not worth mentioning. I am forever thankful to many people, without which, my survival could have not happened.

I dedicate this writing to those that helped me get to this anniversary and I owe each of them an un-repayable debt of gratitude. I hope to honor each one as I attempt to pay my debt forward through helping others that may find themselves in a similar position to mine a year ago.

I wish everyone their best Thanksgiving ever.

My special thanks to:
  • My wife and 4 terrific children for allowing me to travel to Philadelphia for 2 months
  • My personal physician for lighting the fire to move my tail (pun intended) and get treatment
  • My employer for allowing me the flexibility to travel to Philadelphia for my treatment
  • Bob Marckini for blazing a well-marked trail for other prostate cancer patients to follow
  • My radiation oncologist for his professional, personal care and medical know-how
  • My Host for Hospitals family – my second family - including their puppy
  • My proton therapists (Proton 2 and 4!) – you guys are the best of the best! Gold medal!
  • The nursing staff – you run an efficient operation, but always take time to deliver personal care
  • The reception staff – nothing happens without you – you are the first smiles of the day
  • My fellow Penn Medicine patients – we had a good time didn’t we? Well didn’t we?
  • The Penn Medicine volunteers – you guys do so much and mean so much to us

Tuesday, November 20, 2012

10 Facts About Pancreatic Cancer

November is National Pancreatic Cancer Awareness Month. Pancreatic cancer remains the fourth leading cause of cancer death in the United States.

  1. Pancreatic cancer is cancer that develops within the pancreas, the gland about six inches long that is responsible for making hormones, including the enzymes responsible for the digestion of food and control of blood sugar.
  2. Pancreatic cancer survival rates are poor as more than 90 percent of pancreatic cancer patients die within the first year of diagnosis. Recent advancements in pancreatic cancer research have had little impact patients' pancreatic cancer prognosis, and new pancreatic cancer treatments are desperately needed.
  3. It's estimated that more than 37,000 people died from pancreatic cancer last year, and another 44,000 will be diagnosed with pancreatic cancer this year.
  4. Risk factors for pancreatic cancer include smoking, having diabetes, being obese, being over the age of 65, having chronic inflammation of the pancreas, or a family history of pancreatic cancer.
  5. Penn's pancreatic cancer team is nationally recognized for its specialized techniques in treating pancreatic cancer, and is part of the multidisciplinary team of cancer specialists at the Abramson Cancer Center.
  6. Pancreas surgery is technically difficult, and surgeons at Penn Medicine perform the highest volume of pancreatic procedures, including the Whipple surgery (procedure), in the Philadelphia region, and are among the top 10 in the United States.
  7. There are currently multiple active clinical trials for pancreatic cancer at Penn, two of which are related to the Stand Up 2 Cancer effort. Penn and its fellow pancreatic cancer dream team sites have recruited more than 1,000 patients for these studies thus far, while only a few thousand patients enroll in pancreatic cancer clinical trials in the Unites States every year.
  8. The Stand Up To Cancer (SU2C or Stand Up 2 Cancer) Dream Team at Penn Medicine supports and contributes to pancreatic cancer research.
  9. Members of the Stand Up 2 Cancer Dream Team for pancreatic cancer research at Penn are developing tests using advanced imaging technology to understand pancreatic cancer cells and develop new, personalized pancreatic cancer treatments based on their pancreatic cancer research.
  10.  Penn Medicine's Abramson Cancer Center is one of seven sites coordinating "Dream Teams" and the only site coordinating projects focusing on pancreatic cancer.
Learn more about pancreatic cancer and pancreatic cancer research at Penn Medicine through Stand Up 2 Cancer. 

    Monday, November 19, 2012

    How to Become a Bone Marrow Donor


    This is National Marrow Awareness Month. Each year, 10,000 of cancer patients need a bone marrow transplant.* Unfortunately, only half of those patients get one due to a variety of issues, including donor availability.
    A bone marrow transplant is a life-saving treatment for people with leukemia, lymphoma and many other blood cancers. First these patients undergo chemotherapy and sometimes radiation to destroy their diseased marrow. Then a donor's healthy blood-forming cells are delivered directly into the patient's bloodstream where they can begin to function and multiply.

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

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

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

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

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

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

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

    *Statistic from National Marrow Donation Program

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

    Friday, November 16, 2012

    Research Shows Yoga is More Than Just Physical Postures

    Sat Bir S. Khalsa, Ph.D
    Sat Bir S. Khalsa, Ph.D
    Sat Bir S. Khalsa, Ph.D. recently presented “Yoga Research: Past, Present and Future” to the Integrative Oncology Working Group of Penn’s Abramson Cancer Center. Dr. Khalsa is an assistant professor of medicine at Brigham and Women’s Hospital, Harvard Medical School. Khalsa provided an overview of the evolving field of yoga research, especially in the areas of stress management and the use of yoga as a therapeutic intervention. As Dr. Khalsa explained, yoga research has been going on since the 1920s, and has been looking at everything from the physiology of meditation to the positive impact of a yoga practice on mood and anxiety.

    The bottom line is that there is significant evidence on many levels that mind-body practices such as yoga elicit the “relaxation response,” which is opposite of what you experience during a “stress response.”

    Five percent of yoga students enrolled in beginner’s yoga programs that were willing to complete a survey reported that their doctor had recommended that they take yoga. Yoga has become so popular in the United States that it has become part of our culture,” said Khalsa as he addressed a crowd of scientists, clinicians, nurses and others in the healthcare field. However, that popularity reaches a restricted segment of the population, and it would be ideal if everyone could benefit from the preventive and therapeutic aspects of these practices.

    How can this be done? Dr. Khalsa reported on the following:
    • Conduct high quality research on the psychophysiological and therapeutic benefits of yoga practice that will provide the evidence base to justify inclusion of yoga into our education and healthcare systems.
    • Since the majority of serious and persistent conditions have child-adolescent onsets,there is a growing need and interest to bring the practice of yoga into the schools to teach school age children how to cope with stress and anxiety. This could have positive and lasting changes in behavior, mental health, attention, academics and physical health of our children.
    • Provide yoga programs with trained and certified instructors within the clinical setting, such as the Yoga Program offered at the Abramson Cancer Center, to help balance the stress and anxiety associated with a cancer diagnosis and treatment.
    • Educate clinical staff about the importance of yoga and provide referral sources and resources to help clinicians educate their own patient base.
    While the popularity of yoga has really exploded over the past several years it is important to know that yoga is not just a form of physical exercise, but an ancient practice with multiple practices that affect the individual holistically including the body, breath, mind, emotions and spirit.

    What’s most exciting is that the benefits of yoga are understood by many who practice and that this is being offered as an integrative and therapeutic program many healthcare settings. It is Dr. Khalsa’s prediction that programs such as the one recently started at the Abramson Cancer Center will grow and there will be increasing opportunity to prove the benefits that yoga has on areas such as fatigue reduction, symptom management and sleep disturbances of the cancer patient.

    The beauty of the yoga practice is that it provides a skill set that lasts a lifetime.

    Join the Abramson Cancer Center for Free Yoga

    Yoga is offered at the Abramson Cancer Center on Tuesdays and Thursdays from 2 to 3 pm, free of charge, to patients. Please contact Fern Nibauer-Cohen (Fern.Nibauer-Cohen@uphs.upenn.edu) 215-662-3919 for more information.

    Thursday, November 15, 2012

    Squash the Cigarettes – National Smokeout Day

    Today is the Great American Smokeout. It’s a day many people who smoke use as their quit date. It’s also a day to remind everyone about the dangers of smoking, and how by even quitting for one day, people who smoke can take an important step in a healthier lifestyle.

    How to Quit Smoking

    If you are looking for ways to quit smoking or tobacco use, the Comprehensive Smoking Cessation Treatment at Penn Medicine can help you quit for good.

    If you want to try to quit smoking on your own, here are some things you can do to take the first steps.*
    1. Set a Quit Date: Whether it is today, on National Smokeout Day, or another day, setting a quit date can help you focus your efforts and plan accordingly.
    2. Tell People: Tell your friends and family members you are quitting smoking on that date. Let them help you and support you along the way and on that day.
    3. Anticipate the challenges. Identify what they are and plan on how you will cope with them.
    4. Remove cigarettes and all tobacco products from your home, work and car.
    5. Talk to your doctor about getting help to quit smoking.

    Penn's Comprehensive Smoking Treatment Program provides state-of-the-art and individualized treatment to help smokers quit safely and comfortably. Specialists at the center offer treatment that is respectful and supportive, without guilt or pressure.

    Learn how you can get help to quit smoking at Penn. 

    Watch Frank Leone, MD, MS, director of the Comprehensive Smoking Cessation Treatment Program at Penn talk about how Penn can help you quit smoking.

    *These steps were taken from the website, Smokefree.gov.

    Wednesday, November 14, 2012

    Lower Lung Cancer Risk With These Foods

    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.

    The American Institute of Cancer Research found compelling evidence that a diet high in fruit can lower lung cancer risk as much as 36% of those U.S. lung cancer cases not caused by tobacco. The AICR recommends eating at least 5 servings of a variety of fruits and vegetables every day!

    This may seem hard to do, but the AICR makes it easy by suggesting you rethink your plate.

    As a dietitian, my mantra is food first; there is convincing evidence that high-dose supplements of beta-carotene can actually increase lung cancer risk. Therefore, it is better to get your beta-carotene from vegetables such as carrots, pumpkin, and sweet potato.

    In the food form, the phytochemical beta-carotene neutralizes free radicals, which may damage cells. The anti-cancer compounds found in cabbage and kale such as indole-3-carbinoles and isothiocyanates have also been linked to a lower incidence of lung cancer.

    Sauerkraut anyone?

    Tuesday, November 13, 2012

    Brooke Burke Announces Thyroid Cancer Diagnosis

    Actress and Dancing with the Stars co-host Brooke Burke-Charvet announced this week she has thyroid cancer. The 41-year-old mother of four says she will have a thyroidectomy, or surgery to remove her thyroid.

    Thyroid cancer is cancer that occurs in the thyroid, a butterfly-shaped gland located in the throat just under the “Adam’s apple.” The thyroid gland is responsible for producing, storing and secreting hormones that regulate functions within the body.

    Cancer occurs when a mass of abnormal cells grow within or on the thyroid gland.

    There are few known risk factors for thyroid cancer, but previous radiation to the chest/neck area has been shown to increase a person’s chance of developing thyroid cancer.

    Penn’s Abramson Cancer Center has one of the largest thyroid cancer program on the East Coast.

    Thyroid Nodules and The Penn Thyroid Cancer

    More than 12 million Americans have thyroid nodules that require medical evaluation. In addition, the annual incidence of thyroid cancer is rapidly rising and its rate of increase outpaces that of all other malignancies. This year, it is estimated that over 45000 Americans will be diagnosed with thyroid cancer, which afflicts women three times more than men.

    Susan Mandel, MD, director of clinical endocrinology and diabetes at Penn, developed the first thyroid nodule clinic in the country, and developed the thyroid nodule clinic – the nation’s second – at Penn. The thyroid nodule clinic at Penn is the only clinic of its kind in the tri-state area and has an on-site pathologist, providing patients with rapid diagnoses – sometimes the same day.

    Brooke Burke Thyroid CancerThe Penn Thyroid Center specializes in evaluating, diagnosing and treating patients with both thyroid nodules and thyroid cancer

    Patients at Penn also have access to clinical trials for thyroid cancer and thyroid disorders.

    Penn is the only center using dosimetry for thyroid cancer patients. Dosimetry is an instrument that measures the dose of x-rays or other radiation absorbed by matter or the intensity of a source of radiation

    Treatment for Thyroid Cancer

    Surgery to remove cancer may be the central component of treatment, depending on the stage of the cancer. The entire thyroid or part of the thyroid may be removed.

    After surgery, patients may require radiation therapy, radioactive iodine therapy or thyroid hormone therapy.

    For more information about thyroid cancer, visit the 2012 Focus On Thyroid Conference media hub. There you can view presentations from internationally recognized thyroid cancer about thyroid nodule evaluation, thyroid cancer diagnosis and thyroid cancer treatment.

    Free Yoga at the Abramson Cancer Center


    Relax and renew the body, mind and spirit with free yoga sessions at the Abramson Cancer Center.

    We are pleased to announce that free yoga sessions will be held at the Abramson Cancer Center every Tuesday and Thursday from 2 to 3 pm in the Patient and Family Services Conference Room at the Perelman Center.

    All levels are welcome from beginners with no experience to those who have practiced yoga for years.

    This is a very gentle and supportive class designed to support patients currently in treatment as well as post treatment.

    Caregivers are also welcome.

    Please contact Fern Nibauer-Cohen at 215-662-3919 for more information.

    Learning More About Lung Cancer in the Lab


    Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses how basic science research can bring about new treatments for lung cancer.

    "The answer lies in our DNA--the blueprint for life." Steven Abeida, MD

    Basic science research is complex, but very important because it teaches researchers about how cancer cells grow and respond to treatment.

    One way findings from basic science is translating into treatments for lung cancer is through personalized medicine. By studying the way cells act and interact within the body, researchers can explore more personalized approaches to lung cancer treatment.

    Cancer occurs when cells grow and divide in an uncontrolled way. That sounds like a relatively simple statement, but the processes that control normal, and abnormal cell growth, turn out to be very complex. In fact, the more researchers learn about how cells behave, the more complex it becomes.

    For lung cancer patients, there are several core concepts that can help you understand how unraveling the mysteries of DNA is leading to the new era of personalized medicine.
    • Normal cell growth is carefully controlled. Cells only grow and divide when they get a specific signal to do so. Think about wound healing as an example.
    • Normal cells are programmed to live for a period of time and then die. Cancer cells are often "immortal," meaning they don't "listen to or receive " the signal to die.
    • Cell growth is controlled by genes that turn on and off as needed. Cancer occurs when these genes are damaged and the signaling is disrupted. It is as if you are driving a car and either the accelerator gets stuck in the go position, or the brakes fail.
    • These genes don't work by themselves or in isolation. They are all part of pathways--sequences of inter-related reactions that regulate cell growth.
    • Researchers have identified a number of "driver mutations” - specific genetic changes that are essential to the growth and survival of the cancer cells. These are the targets of new therapeutic approaches.
    • Cancer cells are "smart." They continue to change and evolve, developing new ways of growing and resisting attacks from either standard treatments or newer targeted ones.

    What does this mean for lung cancer patients?

    Right now, doctors are able to identify several driver mutations in lung cancer and target those with therapies that block the pathways.
    • EGFR is a mutation found in about 10% of patients with adenocarcinoma of the lung. It can be targeted with the drug erlotinib.
    • ALK-1 is found in about 5% of lung cancer patients. The drug crizotonib is showing real promise in treating people with this mutation.
    That' s only 15% of people who have lung cancer though. The goal now is to find more driver mutations, and to develop drugs that target known mutations. KRAS, for example, is found in a higher percentage of lung cancer patients, but there is currently no drug available that targets this mutation.

    The real goal for the future is to be able to identify driver mutations in every tumor, and treat that tumor on an individual basis. That means full gene sequencing for every patient.

    One obstacle to achieving that goal is the need for tissue, which come only from biopsies. Circulating tumor cells could prove to be another significant advance. This technology allows doctors to find tiny numbers of cancer cells in the blood; cells that can be used to profile tumors, monitor response to treatment and determine the best therapeutic approaches for every patient.

    Monday, November 12, 2012

    What You Need To Know About Nicotine Addiction


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

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

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

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

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

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

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

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

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

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

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


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

    Friday, November 9, 2012

    Translating Research to Treatment for Lung Cancer

    Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses how the new treatments for lung cancer come about from research in the lab.

    "We have a phenomenal interdisciplinary research program in lung cancer. It's really unique to Penn Medicine. We bring together the experts from every field, and our patients are always the center of everything we do." - Chi Van Dang, MD, PhD, director, Abramson Cancer Center

    From the Lab to the Patient

    Dr. Van Dang set the tone for the day in his introductory remarks when he stated the current goal of lung cancer research is to "move from remission to cure." The pathway to that progress is through what is known as translational research.

    Translational research takes new knowledge from the laboratory and uses it to develop new approaches to cancer treatment.

    For lung cancer, and many other cancers, that increasingly means being able to profile individual tumors, identifying specific genetic mutations and changes that provide targets for therapy. Penn Medicine is leading the way with a new Center for Personalized Diagnostics that will not only provide these critical services to patients but expand the research base by identifying new genes and ways to control their behavior.

    The other "new tools" in the fight against lung cancer are coming from the field of immunotherapy--using the body's own immune system to recognize and fight cancers. Penn is a national leader in this emerging area of cancer therapy.

    Learn more about the Center for Personalized Diagnostics.

    Thursday, November 8, 2012

    Focus On: Leukemia, Lymphoma, Myeloma and Bone Marrow/Stem Cell Transplantation Conference

    Join the Abramson Cancer Center and the Leukemia and Lymphoma Society Friday, November 16 for a free conference about leukemia, lymphoma, myeloma and bone marrow and stem cell transplantation.

    Leukemia, lymphoma and myeloma are cancers that start in blood-forming tissues such as bone marrow.

    Who Should Attend?

    This conference is for people who are newly diagnosed, in treatment, long-term survivors, or a parent, caregiver or loved one of someone with:
    • Leukemia, lymphoma, mutiple myeloma, myelodysplasia, myeloproliferative disorders
    • Bone marrow/stem cell transplantation: autologous or allogeneic
    • Nurses and social workers

    Register for the Leukemia, Lymphoma, Myeloma and Bone Marrow/Stem Cell Transplantation Conference

    The conference is free, and open to the public.

    Date: Friday, November 16, 2012
    Time: 7:30 am to 3 pm
    Location: Hilton Hotel, 4200 City Line Avenue, Philadelphia, PA
    Registration: Register here for the conference

    Can’t Attend In Person?

    If you can’t attend in person, view the Livestream of the event, at PennMedicine.org/Abramson/BloodLive , follow @PennMedicine on Twitter with the hashtag #BloodCancers, or join Oncolink from Noon to 1 pm for a Webchat about blood cancers.

    Wednesday, November 7, 2012

    Coping with Breast Cancer- Fear, Uncertainty and Insensitive Comments


    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. 

    Breast cancer – these are two words that can strike fear in the heart of every woman out there. Fear so great that your mind, body and soul are at the brink of total shut down.

    I know this because this is exactly what I experienced the day I was called to come back for an ultrasound after the results of my mammogram. During the ultrasound your senses become so heightened and you are super vigilant to every movement the technician makes. You watch the technician’s face for that telltale sign that yes, there is a tumor in your breast. Then the doctor is invited in to review the ultrasound in motion and makes some suggestions and you know again this is not going to end well.

    With the word cancer now attached to you, be prepared for the inevitable insensitive comments from family, friends and co-workers. Probably the most painful comment for me was “you know everyone is thinking this but not saying it – better you than me.” We cancer patients and survivors do not want pity but we do want and need respect for our own personal feelings. Simple gestures of kindness go a long way during difficult times, and I am thankful to family and friends who provided an extra measure of support.

    My daughter is my rock, my inspiration, my heart and soul. She was with me every step of the way throughout my diagnosis and treatment. I would move heaven and earth for my daughter and that was my approach to surviving this terrible diagnosis. If you have someone whom you trust implicitly, let them into your life during this time, as they will provide love and comfort that you will need to help you through. They are silent heroes who when called upon are exceptional in giving their love and support.

    Life goes on after your cancer diagnosis and you get back what you put into it. For me it is as full as ever, I was recently juried into a highly regarded art show; American Craft Council (ACC) Baltimore and Atlanta. The last time I did an ACC show was July 1999, the month of my melanoma diagnosis. I have a sun protection clothing company, a full time job, a newly married beautiful daughter, new son-in-law, husband and recently rescued Old English Sheepdog; Lewie who came to us by way of Houston,TX, he is a delight and a handful.

    I am due for a checkup very soon and I am experiencing the anxiety that accompanies such visits. I do know this will lessen over time but for the time being it is something I must face every six months. I know this will lessen over time because this is my second cancer diagnosis, the first one in 1999; Melanoma. I feel more courageous now than I did for the first number of years after that diagnosis. For now I will be put through the paces and continue to grow stronger and braver.

    Tuesday, November 6, 2012

    What is Pancreatic Cancer?

    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.

    For many, the first time they heard about pancreatic cancer may have been when celebrity, Patrick Swayze or Apple CEO, Steve Jobs, was diagnosed with pancreatic cancer. Pancreatic cancer is the fourth leading cause of cancer death in the United States.

    What is the Pancreas?

    The pancreas is an organ that is located behind the stomach, it plays an essential role in converting the food we eat into energy for the body’s cells. The pancreas actually has two main functions; the first function is to secrete enzymes to aid in the digestion of protein, fat and carbohydrates and the second function is to create and release insulin, a hormone responsible for lowering blood sugar and glucagon, a hormone that raises blood sugar.

    This year, an estimated 43,920 people will be diagnosed with pancreatic cancer in the United States and approximately 37,390 will die from the disease.

    Risk Factors for Pancreatic Cancer

    Risk factors for developing pancreatic cancer include:
    • Family history pancreatic cancer
    • Age
    • Chronic or hereditary pancreatitis
    • Recent-onset of diabetes
    • Smoking
    • Being overweight, especially in the abdomen.
    The American Institute for Cancer Research estimates that being lean can prevent 19% of the pancreatic cases that occur in the United States each year. Pancreatic cancer is easily concealed; it may cause only vague symptoms that could be mistaken for many different conditions within the gastrointestinal tract. Unfortunately, there are no detection tools to diagnose the disease in its early stages when it the tumor can be surgically removed, this is one of the main reasons pancreatic cancer is a leading cause of cancer death.

    Pancreatic Cancer Treatment at Penn

    At Penn, patients with pancreatic cancer are treated by a multidisciplinary team of cancer specialists who see more patients with gastrointestinal (GI) cancers in one year than many doctors see in their careers.

    The Penn Medicine SU2C Dream Team

    As the fourth leading cause of cancer death in the United States, pancreatic cancer remains one of the most deadly forms of cancer. More than 90 percent of patients die within the first year of diagnosis. Recent advancements have had little impact, and a new approach is desperately needed.

    The SU2C Dream Team at Penn is actively researching better ways to prevent, diagnose and treat pancreatic cancer. Together, members of the Pancreatic Cancer Dream Team working to translate scientific breakthroughs into new treatment options faster than ever before. Their research focuses on developing tests using advanced imaging technology to understand pancreatic cancer cells and developing new, personalized pancreatic cancer treatments based on their research.

    Learn more about pancreatic cancer treatment at Penn.

    Friday, November 2, 2012

    A Survivor's Perspective: A Grain of Salt

    Donna-Lee Lista
    Donna-Lee Lista is a lung cancer survivor and an advocate for lung cancer research. In this blog, she talks about nutrition and prevention advice… and why sometimes, you just have to take all the advice with a grain of salt. 

    Who does all the research about what foods you should and shouldn’t eat to avoid cancer? I’ve often questioned how accurate all this nonsense is. Then again can nonsense be accurate? I really get a kick out of these reports that say you can lesson your chance of cancer by eating this or doing that. Blueberries, for instance, are supposed to lower your risk of cancer. Eat a diet of fruits and vegetables and limit red meat. Make sure to exercise and only drink in moderation (a little helps your heart!).

    The list goes on and on and on.

    I followed it all! Most of it I did when I wasn’t even aware it was supposed to help prevent cancer. As a kid, I loved blueberries, and detested cigarettes and red meat. I was the one always stuck sitting at the dinner table poking at my steak, because I just couldn’t swallow it. I ate healthy - one of the few kids that loved vegetables when I was young. I played outside all day long, and got plenty of exercise.

    As an adult I got all the recommended screenings, EARLY! Had a few wild drinking nights in college, but honestly only a few and as an adult never really drank much, and lately, not at all. There were many years as a teenager that I fried my skin at the beach. I actually wouldn’t have been surprised if I got melanoma, but no, I dodged that bullet. I actually got hit with the bullet that I didn’t even knew could be aimed my way!

    So, it means one of three things: God only knows what would have happened to me if I didn’t do those things, my case is a head-scratcher for the scientific community, OR (and this is the one I’m going with) no one knows for sure – it’s pure luck. A combination of factors so diverse that it’s as complicated, and with as many variables, as picking the correct lottery numbers… while blindfolded and sleeping!

    So, until we know with absolute certainty what the cure is, what absolutely works, or what is an official recommendation, everybody do everything in moderation, give a lot of money to cancer research, and take all the cancer prevention advice you read with a grain of salt.

    Hey, a grain of salt…hmm- I wonder if anyone has looked into …?

    Thursday, November 1, 2012

    Know Your Options for Prostate Cancer Treatment at Penn

    In his "Open Letter to the Newly Diagnosed" prostate cancer survivor, Bill Barbour did a lot of research about his treatment options for prostate cancer. He had proton therapy for prostate cancer at Penn, and today, he advises other prostate cancer survivors to know their treatment options for prostate cancer.

    Men can get a first, second, and third opinions all in one place at Penn Medicine's Abramson Cancer Center. After a complete evaluation, we'll work with you to develop a personalized treatment plan, with all your options under one roof.

    Penn offers the following treatment options:

    Surgery for Prostate Cancer

    Penn Urologists are world renowned for developing leading-edge surgical techniques such as nerve-sparring and minimally invasive prostatectomy, both designed to preserve urinary and sexual function for prostate cancer patients.

    Traditional Radiation Therapy for Prostate Cancer

    Penn Radiation Oncology is one the few programs in the nation that can offer prostate cancer patients all of the different conventional radiation therapies.

    Proton Therapy for Prostate Cancer

    Penn is only cancer center in the region that offers, proton therapy, an incredibly precise form of radiation with the potential for less side effects. The Roberts Proton Therapy Center at Penn is the largest and most advanced center in the world.

    Medical Oncology for Prostate Cancer

    Depending on how advanced the prostate cancer is, some patients may need to see a medical oncologist. Penn Medicine's oncology program offers patients the latest clinical trials and novel therapies for prostate cancer.

    Learn More About Prostate Cancer Treatment at Penn

    If you or a loved one has been diagnosed with prostate cancer or an abnormal PSA, you're probably wondering what to do next. Look to Penn's Abramson Cancer Center for the most advanced cancer program in the region - for full insight on all your options.

    Our team will:
    • Help you understand your PSA levels and guide you towards the next steps you should take
    • Ensure you have the most accurate diagnosis using advanced diagnostics
    • Offer you the most advanced surgical and radiation treatment options – all in one place
    • Answer your questions about the potential side effects of all your options
    • Provide an unbiased opinion on your best treatment option

    Call 800-789-PENN (7366) to schedule a consultation with a Penn prostate cancer specialist.

    Or, learn more about prostate cancer treatment, side effects of prostate cancer, and other prostate cancer information by watching a five-part video series about prostate cancer.
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