Saturday November 30, 2013
Most of us are familiar with clinical trials as a method to study new drugs and procedures, and many of us have heard references to these studies using words such as "human guinea pig."
While these myths linger on, it's important to keep in mind that the only way that a new drug or procedure becomes available for people with cancer - the only way advances in treatment are made - is through the use of clinical trials. That said, only 5% of people with cancer are involved in a clinical trial as part of their cancer treatment.
There are many reasons. But one of these is that there are many myths that circulate the airwaves about these studies. For example:
- People may be afraid that if the investigational drug or treatment is causing side effects that are intolerable, that they won't be able to leave the study. Fact: It is your right to stop your involvement in a clinical trial at any time.
- Another concern is that you will receive a placebo. Fact: In medical studies for cancer a placebo is rarely used - and then only if a treatment that could help more than a placebo is not available.
- Yet another general thought is that if a clinical trial that may give you an opportunity to use a treatment that appears initially to be superior to standard treatment, your oncologist will tell you. Fact: Physicians are human. With the vast amount of information regarding cancer treatments, and the explosion in new information as a result of our ability to evaluate specific genetic abnormalities in cancer cells, it's impossible for any one person to be aware of every clinical trial available for every form of cancer worldwide. While your oncologist may very well suggest a clinical trial, it's now possible to learn about clinical trials online, and matching services are even available in which a nurse navigator can help you determine if there are any clinical trials that may be a match for your particular situation.
There are several other myths about clinical trials. What is fact, and what is fiction? Check out this article:
Photo: National Cancer Institute, Daniel Sone (photographer)
Friday November 29, 2013
In years past it was usually doctors alone that looked at pathology reports after a biopsy or surgery. But increasingly people are requesting copies of their medical records or are able to read these through a patient portal provided by their cancer center.
If you look at these reports it can be very confusing and the language foreign. Not a good situation when your doctor may recommend treatment based on the results of this report. Being an empowered patient by understanding a few terms may help you play a larger role in your health care.
When you see these documents, they first provide your identifying information as well as symptoms and possibly a tentative diagnosis. This is followed by what your tumor looks like visually. Under your report this may be written as "gross evaluation." This doesn't mean that your tumor looks bad, it is simply medical lingo for the naked eye view of a tissue sample.
Then it can get even more confusing. Don't be alarmed if it sounds like the pathologist isn't sure of what your sample or tumor looks like under a microscope. It's common to see notations such as "the appearance is that of a non-small cell lung cancer with characteristics of small cell lung cancer" or other such "uncertainties." Cancers all are different, and the appearance as seen under the microscope isn't always "black and white."
Further terms such as tumor grade, tumor margins, well-differentiated and poorly differentiated, are also confusing. Check out this article for help in making your pathology report a little more readable.
Tuesday November 26, 2013
Once considered "alternative" treatments, many cancer centers are now using complementary therapies as a regular part of cancer treatment. This integrative approach - combining conventional treatments such as chemotherapy and surgery with complementary treatments such as acupuncture - is designed to treat the whole person; body, mind and spirit.
But since this is a fairly new approach, researchers were wondering how older patients with lung cancer and colon cancer felt about the use of complementary therapies.
Through interviewing patients at a hospital in Ireland, they learned several things:
- Older patients believe these services should be promoted more effectively
- Older patients felt these treatments should be more accessible
While desiring more information these patients had a few concerns:
- That there is a lack of good written information about complementary treatments (and as such there is uncertainty about possible benefits leading to fewer people receiving them)
- Some patients were concerned that if they use complementary therapies and let their physician know, that it will harm their relationship
This leads to some good instructions for doctors who treat cancer patients: provide better information to patients about complementary therapies and become educated themselves about these treatments.
If you are a cancer patient, here are some articles that talk about complementary therapies and possible benefits they may have for people with cancer:
Roulston, A., Wilkinson, P., Haynes, T., and J. Campbell. Complementary therapy: perceptions of older people with lung or colorectal cancer. International Journal of Palliative Nursing. 2013. 19(7):333-9.
Tuesday November 12, 2013
Unlike some cancers - for example mammograms for breast cancer - we don't have a screening tool for everyone to look for lung cancer (see criteria below.) For most people who develop lung cancer we have to rely on an awareness of symptoms.
But is that working? No. 40% of people already have stage 4 lung cancer when they are diagnosed, meaning it has spread to other regions of the body, and hence, isn't curable.
So what are people missing? The Global Lung Cancer Coalition recently supported research to answer that question. What symptoms are people aware of and what are they not?
Breathlessness and short-term cough were fairly well known as possible symptoms.
What are people missing? Here are 2 biggies :
- A Persistent Cough - meaning one that lasts for at least 2 weeks
- Coughing Up Blood - even a tiny amount of blood on the tissue after a cough warrants a doctor's visit
Strikingly they noted that almost a 4th of people were unaware of any of the symptoms of lung cancer. Admittedly, ages interviewed were as low as 14. My kids have certainly been aware since they were toddlers as I preach on my soapbox about support for lung cancer. But I know kids in "normal homes" don't likely have a mom on a soapbox.
As I promised to mention above, CT screening for lung cancer can lower deaths by 20% when done on certain people. This includes:
- People between the ages of 55 and 74
- Those who have smoked at least 30 pack-years
- Those who continue to smoke, or quit smoking in the last 15 years.
It's important to note that everyone is different. Your doctor may recommend CT screening for other reasons as well.
What can you do? Familiarize yourself with possible symptoms. Here are a few great articles to get you started: