loaded civil war cannon
with gunpowder mixed with purple anger
schredded medical bills printed in cold red blood
lab reports cold facts on rye
cat scans with dark shadows of the past
crushed confetti compressed into a cannon mixed with chocolate buckshot
i aimed the cannon
out the window and fired into times square below
a hot branding iron stamped "CURED"
hiding the cancer tatoo branded into my hide
I fired the cannon with the sound of sulfure mixed with whispers
explosion of rage into the street
white snow falling on a parade of cancer patients
returning home
after another chemo treatment
Wednesday, August 3, 2011
Tuesday, July 12, 2011
My Friend in the Muumuu
My chemo treatments had become routine. Xeloda twice a day at home, Oxyplain once a week in the doctor’s office. Today was Wednesday. Time for Oxyplatin.
Nurse Betty smiled and called my name. We walked to treatment room B. The door was left open. Nurse Betty took my vitals. Tried to get comfortable. Patients passed my open door. A bald woman dressed in a brilliantly colored Hawaiian muumuu dropped a large canvas bag to rest and peeked into my room.
“Good morning. How are you ?”
“Ok I guess…”
“What type of cancer do you have?”
“Stage three colon cancer. And you?”
“Ovarian.”
“What do you have in your bag there?”
She recited a list of items from memory. Magazines, a thick mystery novel, water bottles, snacks, walkman cassette player and new age relaxation tapes in a ziplock bag.
“How long is your chemo treatment?”
“Eight hours. And yours?”
“One hour.”
“I don’t know what your treatment is like. Did you bring a book?”
“Angels and Demons by Dan Brown.”
“Do you have a bookmark?”
“No. I use scrap paper”
“Here is a stainless steel bookmark. I got a bunch from my sister. I think you will like it.”
I smiled and thanked her for the gift. She picked up her bag and disappeared.
I was shocked. The lady in the muumuu had to endure eight hours of chemo!
Oh. My God.
I was lucky!
I will be out of here in one hour.
Nurse Betty entered my room with two clear bags, closed the door, hung a bag of saline solution and a bag of Oxyplatin over my head, put a needle in my left hand, adjusted the drip, checked her watch, made a note on my chart and asked how am I doing.
“Fine thanks.”
She disappeared. I read my book. The cold chemo creped up my arm. I tried to read with bookmark in place. Oxyplain knocked me out cold. I opened my eyes Rick was standing in the doorway to drive me home. In four hours I recovered. My friend in the muumuu was still sitting in a chemo chair for three more hours as I sat in a lounge chair watching Seabisket on a large screen TV and nibbled on mac and cheese.
I never saw my friend in the muumuu again. I don’t know her name. Don’t know if she is still alive. Still have the ACCO Stainless steel bookmark (made in Taiwan). Now holding my place in a Kurt Wallender mystery The Pyramid by Henning Mankell.
Nurse Betty smiled and called my name. We walked to treatment room B. The door was left open. Nurse Betty took my vitals. Tried to get comfortable. Patients passed my open door. A bald woman dressed in a brilliantly colored Hawaiian muumuu dropped a large canvas bag to rest and peeked into my room.
“Good morning. How are you ?”
“Ok I guess…”
“What type of cancer do you have?”
“Stage three colon cancer. And you?”
“Ovarian.”
“What do you have in your bag there?”
She recited a list of items from memory. Magazines, a thick mystery novel, water bottles, snacks, walkman cassette player and new age relaxation tapes in a ziplock bag.
“How long is your chemo treatment?”
“Eight hours. And yours?”
“One hour.”
“I don’t know what your treatment is like. Did you bring a book?”
“Angels and Demons by Dan Brown.”
“Do you have a bookmark?”
“No. I use scrap paper”
“Here is a stainless steel bookmark. I got a bunch from my sister. I think you will like it.”
I smiled and thanked her for the gift. She picked up her bag and disappeared.
I was shocked. The lady in the muumuu had to endure eight hours of chemo!
Oh. My God.
I was lucky!
I will be out of here in one hour.
Nurse Betty entered my room with two clear bags, closed the door, hung a bag of saline solution and a bag of Oxyplatin over my head, put a needle in my left hand, adjusted the drip, checked her watch, made a note on my chart and asked how am I doing.
“Fine thanks.”
She disappeared. I read my book. The cold chemo creped up my arm. I tried to read with bookmark in place. Oxyplain knocked me out cold. I opened my eyes Rick was standing in the doorway to drive me home. In four hours I recovered. My friend in the muumuu was still sitting in a chemo chair for three more hours as I sat in a lounge chair watching Seabisket on a large screen TV and nibbled on mac and cheese.
I never saw my friend in the muumuu again. I don’t know her name. Don’t know if she is still alive. Still have the ACCO Stainless steel bookmark (made in Taiwan). Now holding my place in a Kurt Wallender mystery The Pyramid by Henning Mankell.
Wednesday, May 18, 2011
Colon Cancer: Prevention, Early Detection and Treatment
Steps you can take NOW to prevent or defeat this highly treatable cancer
Colon (or colorectal) cancer is the second leading cause of cancer-related deaths among both men and women in the United States...
...Yet when diagnosed and treated in the early stages, it is among the most curable of all cancers.
Consider this: The five-year survival rate for people whose colon or rectal cancer is discovered and treated in its earliest stage is 93 percent.
In many cases, regular screening reveals precancerous growths that can be removed, thereby preventing cancer from developing in the first place. In fact, it is estimated that 80 to 90 percent of all colorectal cancers could be prevented if everyone were screened and polyps identified and removed!
The challenge: What can you do right now to protect yourself against colorectal cancer, or, if you've already been diagnosed, to ensure a positive outcome?
To answer this question, we turned to Ross. C. Donehower, M.D., Director of the Division of Medical Oncology at the Johns Hopkins University School of Medicine. Dr. Donehower is at the forefront of research in gastrointestinal malignancies and new anticancer therapies. Dr. Donehower shares his expertise and extensive hands-on experience treating patients with colorectal cancer and those at high risk for it in our new guide: Colon Cancer: Prevention, Early Detection and Treatment .
If you have been diagnosed with colon or rectal cancer - or you think you may be at risk - it's critically important to learn everything you can now, so you can partner with your doctor effectively, ask the right questions and understand the answers. That's why we have made Colon Cancer: Prevention, Early Detection and Treatment available to you instantly as a digital PDF download.
Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple.
Knowledge is Key
When It Comes To Preventing and Defeating Colon Cancer
What will you learn in this comprehensive resource? Colon Cancer: Prevention, Early Detection and Treatment explains the way colorectal cancer develops, how it can be detected early and how you can reduce your risk. It describes new developments in colon cancer screening, diagnosis, treatment and research. And it explains the ways in which people who have already been treated for colon cancer can lower their risk of having a recurrence.
In the early chapters, we explain the risk factors for colorectal cancer and look in-depth at the importance of family history. If you have a familial history of colon cancer, you may want to consider genetic testing to determine your risk. Is it a good idea? What about privacy concerns? What about the cost?
In Colon Cancer, we discuss the risks and benefits of genetic testing and counseling as well as the roles of diet, lifestyle and ethnicity on colon cancer risk.
You'll read about hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) and familial adenomatous polyposis (FAP), the most common genetic causes of colon or rectal cancer. Other genetic conditions that increase your risk are also explained, including MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS).
The "Ick" Factor: Colon Cancer Screening
Fewer than HALF of Americans over the age of 50 have ever had any kind of colon-cancer screening test. If you've been putting off screening because of the "ick" factor, you'll want to read our chapter on Screening and Prevention, which explains your many screening choices:
Take-home fecal occult blood test (FOBT)
FIT - an alternative to the standard FOBT
Stool DNA test - the latest option
Flexible sigmoidoscopy - the five-year test
Colonoscopy - the gold standard
Double-contrast barium enema
Virtual colonoscopy - the new noninvasive option
Computed tomography - spiral CT scans, PET, MRI and ultrasound
What else can you do to prevent colon cancer? While the only known way to prevent it is to have regular colonoscopies to detect and remove precancerous polyps, researchers are looking at various medications, minerals and nutrients that may be protective.
We discuss the progress - and pitfalls - of many of the more promising options and offer bottom-line advice:
Asprin
HRT
Omega 3s
Statins
Vitamin B6
Vitamin D
For Patients Diagnosed with Colorectal Cancer:
Your Options for Treatment
If your polyp biopsy results come back positive for colon cancer, it's time to make treatment decisions, and these decisions often involve surgery. Dr. Donehower addresses many of the questions that may be on your mind as you weigh your treatment options:
What type of cancer do I have - colon or rectal?
Where is it located? Is it in more than one place?
Are the lymph glands involved? Has the cancer spread outside the colon?
What stage is the cancer?
Am I a candidate for minimally invasive therapy or do I need abdominal surgery for my colon cancer?
What's transanal edoscopic microsurgery (TEM)? What's fulguration?
What will happen during abdominal surgery for colorectal cancer?
What about recovery - how long will I be in the hospital and what complications can I expect?
Will I need adjuvant therapy after surgery - radiation, chemotherapy or both?
What drugs are used for chemotherapy?
How serious are the side effects from chemotherapy drugs?
New treatments for advanced colon cancer are emerging all the time, and can often offer hope of a longer life and better quality of life. In Colon Cancer you'll learn about:
State-of-the-art chemotherapy for treating advanced, recurrent, and metastatic colorectal cancer: "targeted" antibody therapies like Avastin, Erbitux and vertibix... transarterial chemoembolization (TACE)... hepatic artery infusion (HAI).
Radiation therapy is used most often for inoperable tumors or for tumors that have not responded to chemotherapy. Choices include: brachytherapy, intensity-modulated radiationt therapy (IMRT), intraoperative radiation therapy (IORT), TheraSphere and cyberknife.
Weighing the benefits of participating in a clinical trial. A clinical trial may give you access to promising new or experimental therapies that are not available otherwise.
Palliative and hospice care
Emotional issues surrounding colon cancer and its treatments
Direct to You From Johns Hopkins - America's #1 Hospital
Colon Cancer: Prevention, Early Detection and Treatment is designed to give you unprecedented access to the expertise of the hospital consistently ranked #1 of America's Best Hospitals by U.S. News & World Report -in annual rankings for more than 4,800 American hospitals.
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Colon (or colorectal) cancer is the second leading cause of cancer-related deaths among both men and women in the United States...
...Yet when diagnosed and treated in the early stages, it is among the most curable of all cancers.
Consider this: The five-year survival rate for people whose colon or rectal cancer is discovered and treated in its earliest stage is 93 percent.
In many cases, regular screening reveals precancerous growths that can be removed, thereby preventing cancer from developing in the first place. In fact, it is estimated that 80 to 90 percent of all colorectal cancers could be prevented if everyone were screened and polyps identified and removed!
The challenge: What can you do right now to protect yourself against colorectal cancer, or, if you've already been diagnosed, to ensure a positive outcome?
To answer this question, we turned to Ross. C. Donehower, M.D., Director of the Division of Medical Oncology at the Johns Hopkins University School of Medicine. Dr. Donehower is at the forefront of research in gastrointestinal malignancies and new anticancer therapies. Dr. Donehower shares his expertise and extensive hands-on experience treating patients with colorectal cancer and those at high risk for it in our new guide: Colon Cancer: Prevention, Early Detection and Treatment .
If you have been diagnosed with colon or rectal cancer - or you think you may be at risk - it's critically important to learn everything you can now, so you can partner with your doctor effectively, ask the right questions and understand the answers. That's why we have made Colon Cancer: Prevention, Early Detection and Treatment available to you instantly as a digital PDF download.
Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple.
Knowledge is Key
When It Comes To Preventing and Defeating Colon Cancer
What will you learn in this comprehensive resource? Colon Cancer: Prevention, Early Detection and Treatment explains the way colorectal cancer develops, how it can be detected early and how you can reduce your risk. It describes new developments in colon cancer screening, diagnosis, treatment and research. And it explains the ways in which people who have already been treated for colon cancer can lower their risk of having a recurrence.
In the early chapters, we explain the risk factors for colorectal cancer and look in-depth at the importance of family history. If you have a familial history of colon cancer, you may want to consider genetic testing to determine your risk. Is it a good idea? What about privacy concerns? What about the cost?
In Colon Cancer, we discuss the risks and benefits of genetic testing and counseling as well as the roles of diet, lifestyle and ethnicity on colon cancer risk.
You'll read about hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) and familial adenomatous polyposis (FAP), the most common genetic causes of colon or rectal cancer. Other genetic conditions that increase your risk are also explained, including MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS).
The "Ick" Factor: Colon Cancer Screening
Fewer than HALF of Americans over the age of 50 have ever had any kind of colon-cancer screening test. If you've been putting off screening because of the "ick" factor, you'll want to read our chapter on Screening and Prevention, which explains your many screening choices:
Take-home fecal occult blood test (FOBT)
FIT - an alternative to the standard FOBT
Stool DNA test - the latest option
Flexible sigmoidoscopy - the five-year test
Colonoscopy - the gold standard
Double-contrast barium enema
Virtual colonoscopy - the new noninvasive option
Computed tomography - spiral CT scans, PET, MRI and ultrasound
What else can you do to prevent colon cancer? While the only known way to prevent it is to have regular colonoscopies to detect and remove precancerous polyps, researchers are looking at various medications, minerals and nutrients that may be protective.
We discuss the progress - and pitfalls - of many of the more promising options and offer bottom-line advice:
Asprin
HRT
Omega 3s
Statins
Vitamin B6
Vitamin D
For Patients Diagnosed with Colorectal Cancer:
Your Options for Treatment
If your polyp biopsy results come back positive for colon cancer, it's time to make treatment decisions, and these decisions often involve surgery. Dr. Donehower addresses many of the questions that may be on your mind as you weigh your treatment options:
What type of cancer do I have - colon or rectal?
Where is it located? Is it in more than one place?
Are the lymph glands involved? Has the cancer spread outside the colon?
What stage is the cancer?
Am I a candidate for minimally invasive therapy or do I need abdominal surgery for my colon cancer?
What's transanal edoscopic microsurgery (TEM)? What's fulguration?
What will happen during abdominal surgery for colorectal cancer?
What about recovery - how long will I be in the hospital and what complications can I expect?
Will I need adjuvant therapy after surgery - radiation, chemotherapy or both?
What drugs are used for chemotherapy?
How serious are the side effects from chemotherapy drugs?
New treatments for advanced colon cancer are emerging all the time, and can often offer hope of a longer life and better quality of life. In Colon Cancer you'll learn about:
State-of-the-art chemotherapy for treating advanced, recurrent, and metastatic colorectal cancer: "targeted" antibody therapies like Avastin, Erbitux and vertibix... transarterial chemoembolization (TACE)... hepatic artery infusion (HAI).
Radiation therapy is used most often for inoperable tumors or for tumors that have not responded to chemotherapy. Choices include: brachytherapy, intensity-modulated radiationt therapy (IMRT), intraoperative radiation therapy (IORT), TheraSphere and cyberknife.
Weighing the benefits of participating in a clinical trial. A clinical trial may give you access to promising new or experimental therapies that are not available otherwise.
Palliative and hospice care
Emotional issues surrounding colon cancer and its treatments
Direct to You From Johns Hopkins - America's #1 Hospital
Colon Cancer: Prevention, Early Detection and Treatment is designed to give you unprecedented access to the expertise of the hospital consistently ranked #1 of America's Best Hospitals by U.S. News & World Report -in annual rankings for more than 4,800 American hospitals.
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Wednesday, March 30, 2011
Signs and Symptoms of Colon Cancer
When something goes wrong with the digestive system, it usually makes itself known pretty quickly, through pain or discomfort. Common problems are upset stomach, constipation, and diarrhea, which are usually not serious and don’t last long.
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Wednesday, March 9, 2011
Can dietary fiber help prevent colorectal cancer ?
The issue of whether dietary fiber can help prevent colorectal cancer has always been unclear, as studies have reached inconsistent results. Now a study from the Journal of the National Cancer Institute (Volume 102, page 614) suggests that the type of dietary assessment tools used in these studies might be to blame.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Friday, January 28, 2011
FICE -- A New Imaging Tool
FICE -- A New Imaging Tool
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Wednesday, January 5, 2011
Narrow Band Colonoscopy
Mixed Results on Narrow-Band Imaging
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
Wednesday, December 15, 2010
Preventive Immunotherapy for Colorectal Cancer
In the Pipeline: Preventive Immunotherapy
for Colorectal Cancer
Your immune system serves as the front line in your body's defense against illness. Its job is to detect foreign intruders, like bacteria or viruses, and to then manufacture the antibodies necessary to destroy them. And it does this quite well -- except when the intruder is cancer.
The problem is that cancer cells are like double agents. They start off as normal, healthy cells, but when they become cancer cells, they act like foreign invaders. And even though they are doing things cells are not supposed to do, your immune system continues to perceive them as the normal cells they used to be.
But what if it were possible to teach your immune system that cancer cells are just like any other foreign invader that needs to be sought out and destroyed? That's the question cancer researchers have been pursuing. And they are now getting closer to finding the answer.
Preventive Immunotherapy
Most likely, you've received a number of preventive vaccines over your lifetime. And they've been incredibly effective at controlling diseases like measles and chickenpox and at virtually eradicating others such as smallpox and polio. All of these vaccines were designed to do the same thing: introduce your immune system to a virus so that it would know how to fight off the virus if it ever encountered it again.
The same strategy has been effective in fighting off some virus-related cancers: The hepatitis B vaccine, which helps prevent infection with the hepatitis B virus, reduces the risk of liver cancer, and Gardasil, the vaccine against human papillomavirus, reduces the risk of cervical cancer. But will a vaccine for colorectal cancer prevention be next in line?
That is the hope of a group of researchers at the University of Pittsburgh. They are currently conducting a phase II trial of a vaccine, called MUC1 poly-ICLC, in people at high risk for developing colorectal cancer.
MUC1 is a cell protein that is produced in large amounts by precancerous polyps and colorectal cancer tumors. The vaccine teaches the immune system that the MUC1 protein is a foreign invader and that it needs to destroy any cells that are harboring it. Poly-ICLC is a drug used to boost the body's response to vaccination.
The researchers hope that by getting the immune system to go after these cells, the vaccine will be able to prevent polyps from turning into colorectal cancers and to keep the polyps from recurring. Interest in MUC1 for colorectal cancer stems, in part, from research showing that people with pancreatic cancer or breast cancer who naturally produce antibodies against the MUC1 vaccine live longer than those who don't produce them.
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
December 15, 2010
Copyright © 2010 MediZine LLC. 500 Fifth Avenue, 19th Floor, New York, NY 10110. All rights reserved.
Wednesday, August 11, 2010
Personalized Colon Cancer Therapy
What if there was a test that could determine the best treatment regimens for your specific tumor? How about a test that could tell you how likely you are to have a cancer recurrence? A decade ago, doctors could only dream of such tests. But in the not-too-distant future, they will probably be the mainstay of cancer care.
These developments reflect changes in the way scientists think about cancer. Initially, researchers believed that cancer was just one disease and that all cancers could be treated in virtually the same way. Now we know that's not the case. Not only does colorectal cancer differ from, say, breast or pancreatic cancer, but the latest research demonstrates that all colorectal cancers are not the same disease biologically, either.
This, in turn, is changing the way we think about colorectal cancer care. The more we learn about the different types of tumors, the clearer it becomes that not all tumors will respond in the same way to treatment regimens. Instead, the treatment must be tailored to the tumor's specific characteristics. Your doctor might refer to this new era of cancer care as personalized medicine; others call it individualized therapy, tailored treatment, or genome-based medicine. Each term refers to the same process: using genetic information obtained from your tumor to assess which treatment plan is best for you.
Biological Markers --
To move fully into this era of personalized medicine, scientists must first identify the biological markers -- measurable characteristics, like a protein level or the presence or absence of a certain gene or gene mutation -- that can tell us about your tumor's personality. These markers fall into two broad categories: predictive and prognostic.
Predictive biomarkers provide information about which chemotherapy regimens or biological agents might be effective against your tumor and which might not be effective at all.
Prognostic biomarkers assess how likely it is that your tumor is aggressive and, in turn, how likely it is to spread or recur. If you have an aggressive tumor, you may need more or different types of treatment than if your tumor is one that can be cured successfully by surgery alone. Prognostic markers could also be used in conjunction with predictive markers to determine the type of chemotherapy you need.
KRAS: The First Predictive Biomarker -- The National Comprehensive Cancer Network's treatment guidelines now recommend that if you are diagnosed with metastatic colorectal cancer and are a candidate for anti-epidermal growth factor receptor (EGFR) therapy, your tumor tissue should be tested for a predictive biomarker called KRAS, or K-ras. KRAS is a gene that helps tumors grow by sending signals to the cell nucleus through the EGFR on the cell's surface.
MACC1:
A Possible Prognostic Biomarker? A German research group recently reported that it had identified a gene, called metastasis-associated in colon cancer 1 (MACC1), that promotes rapid tumor growth and encourages cancer to spread to additional organs throughout the body. Early studies suggest that if your tumor has high levels of MACC1 you are at a much greater risk for developing metastatic cancer and should consider more aggressive treatment and closer monitoring than someone whose tumor has low levels of MACC1. Larger studies will need to be done to confirm these findings. However, if the results are reproduced, we might see a day when treatment decisions are influenced by a tumor's MACC1 level.
Posted in Colon Cancer on August 11, 2010
These developments reflect changes in the way scientists think about cancer. Initially, researchers believed that cancer was just one disease and that all cancers could be treated in virtually the same way. Now we know that's not the case. Not only does colorectal cancer differ from, say, breast or pancreatic cancer, but the latest research demonstrates that all colorectal cancers are not the same disease biologically, either.
This, in turn, is changing the way we think about colorectal cancer care. The more we learn about the different types of tumors, the clearer it becomes that not all tumors will respond in the same way to treatment regimens. Instead, the treatment must be tailored to the tumor's specific characteristics. Your doctor might refer to this new era of cancer care as personalized medicine; others call it individualized therapy, tailored treatment, or genome-based medicine. Each term refers to the same process: using genetic information obtained from your tumor to assess which treatment plan is best for you.
Biological Markers --
To move fully into this era of personalized medicine, scientists must first identify the biological markers -- measurable characteristics, like a protein level or the presence or absence of a certain gene or gene mutation -- that can tell us about your tumor's personality. These markers fall into two broad categories: predictive and prognostic.
Predictive biomarkers provide information about which chemotherapy regimens or biological agents might be effective against your tumor and which might not be effective at all.
Prognostic biomarkers assess how likely it is that your tumor is aggressive and, in turn, how likely it is to spread or recur. If you have an aggressive tumor, you may need more or different types of treatment than if your tumor is one that can be cured successfully by surgery alone. Prognostic markers could also be used in conjunction with predictive markers to determine the type of chemotherapy you need.
KRAS: The First Predictive Biomarker -- The National Comprehensive Cancer Network's treatment guidelines now recommend that if you are diagnosed with metastatic colorectal cancer and are a candidate for anti-epidermal growth factor receptor (EGFR) therapy, your tumor tissue should be tested for a predictive biomarker called KRAS, or K-ras. KRAS is a gene that helps tumors grow by sending signals to the cell nucleus through the EGFR on the cell's surface.
MACC1:
A Possible Prognostic Biomarker? A German research group recently reported that it had identified a gene, called metastasis-associated in colon cancer 1 (MACC1), that promotes rapid tumor growth and encourages cancer to spread to additional organs throughout the body. Early studies suggest that if your tumor has high levels of MACC1 you are at a much greater risk for developing metastatic cancer and should consider more aggressive treatment and closer monitoring than someone whose tumor has low levels of MACC1. Larger studies will need to be done to confirm these findings. However, if the results are reproduced, we might see a day when treatment decisions are influenced by a tumor's MACC1 level.
Posted in Colon Cancer on August 11, 2010
Thursday, May 20, 2010
10 Questions to ask doctor about colon cancer
10 Questions to Ask Your Doctor
About Your Colon Cancer Diagnosis
The stress of a colon cancer diagnosis can feel overwhelming, so it's very important to have a support system of family and friends to help you with the questions and decisions you face. In this Health Alert, Johns Hopkins provides practical advice to help you cope.
Q. My doctor just told me that I have colon cancer and will need to undergo colon cancer surgery. Should I get a second opinion?
A. It is common for people to request a second opinion, especially before surgery or other involved treatment. Indeed, many insurance companies require a second opinion.
Ask your insurance company what your policy covers and if it requires you to see a doctor within that plan. Also tell your doctor you would like to have a second opinion. Most doctors are accustomed to this and will be supportive.
Ask for a referral and for copies of your medical records, including all test results, x-rays, and other imaging tests to take with you to the next doctor. You may have to sign a release and pay a copying fee, but there should be no problem in getting your records. If a second opinion (or the doctor you wish to consult) is not covered by insurance, it may be worthwhile to pay for this examination out of pocket.
When you meet with your doctor, be prepared in advance with questions you want to ask. For example:
Where is the colon cancer located?
Is the cancer in more than one place?
Are the lymph glands involved?
Has the cancer spread outside the colon? Are other organs involved?
What stage is the cancer, and exactly what does that mean?
Is this type of cancer life threatening?
Are there other tests I should have?
How soon do I need to begin cancer treatment?
What are the side effects of cancer treatment?
Is colon cancer genetic? Could my children be at risk?
About Your Colon Cancer Diagnosis
The stress of a colon cancer diagnosis can feel overwhelming, so it's very important to have a support system of family and friends to help you with the questions and decisions you face. In this Health Alert, Johns Hopkins provides practical advice to help you cope.
Q. My doctor just told me that I have colon cancer and will need to undergo colon cancer surgery. Should I get a second opinion?
A. It is common for people to request a second opinion, especially before surgery or other involved treatment. Indeed, many insurance companies require a second opinion.
Ask your insurance company what your policy covers and if it requires you to see a doctor within that plan. Also tell your doctor you would like to have a second opinion. Most doctors are accustomed to this and will be supportive.
Ask for a referral and for copies of your medical records, including all test results, x-rays, and other imaging tests to take with you to the next doctor. You may have to sign a release and pay a copying fee, but there should be no problem in getting your records. If a second opinion (or the doctor you wish to consult) is not covered by insurance, it may be worthwhile to pay for this examination out of pocket.
When you meet with your doctor, be prepared in advance with questions you want to ask. For example:
Where is the colon cancer located?
Is the cancer in more than one place?
Are the lymph glands involved?
Has the cancer spread outside the colon? Are other organs involved?
What stage is the cancer, and exactly what does that mean?
Is this type of cancer life threatening?
Are there other tests I should have?
How soon do I need to begin cancer treatment?
What are the side effects of cancer treatment?
Is colon cancer genetic? Could my children be at risk?
Tuesday, April 6, 2010
How Old Is Too Old for Colorectal Cancer Surgery?
How Old Is Too Old for Colorectal Cancer Surgery?
When a reasonably healthy octogenarian gets a diagnosis of colon cancer, the issue of age is bound to come up. How old is too old for colon cancer surgery? What are the risks? What kind of recovery and quality of life can the very elderly expect afterward? Is it worth it? Johns Hopkins explores these questions and others in this Special Report.
The first line of treatment for colorectal cancer is to remove the primary tumor or tumors. If your cancer is confined to polyps or a small area, surgery is probably the only treatment that you need. For stage I or II cancers that have not spread to the lymph nodes, the expected five-year survival rate after surgery without chemotherapy is 80 to 90%.
Surgery usually involves removing the segment of the colon or rectum that has the primary cancer and a margin of healthy colon on either side of the cancer. The surgeon will also remove the tissue that holds the colon in place (mesentery) and the adjacent lymph nodes. The number of lymph nodes removed can be important in providing an accurate stage and prognosis.
It is true that the risks of colorectal cancer surgery are higher for some older people. An analysis of 28 studies found lower survival rates among the elderly who have coexisting health conditions, are diagnosed at an advanced cancer stage, and have to undergo emergency procedures. Another study found that octogenarians with early stage cancer survived 10 or more years after colorectal cancer surgery if they had no chronic illnesses.
It appears that quality of life after colorectal cancer treatment can be as good for octogenarians as it is for younger seniors -- even in the face of coexisting illness, according to a Canadian study that compared the outcomes of people over age 80 with those in their 60s. The average age of the older group was 83 years at the time of colorectal cancer surgery, while the "youngsters" ranged in age from 65-69. People in both groups underwent comparable surgical procedures and had similar coexisting health problems (such as hypertension and diabetes), although the older group had somewhat less advanced (lower-stage) cancers.
The responses to a survey on quality of life and functioning before and after colorectal cancer surgery were remarkably similar in both groups. Before surgery, both worried about pain, becoming a burden, and death. After colorectal cancer surgery, there were no major changes or differences between the groups in terms of their ability to perform daily functions or their overall health, sexual function, or quality of life.
Too Early To Draw Firm Conclusions?
The Canadian researchers emphasize that their study findings are preliminary, and some results may be biased. While the results are preliminary, the study provides further ammunition for the argument that determining which patients are candidates for colorectal cancer surgery shouldn’t be made solely on the basis of chronological age. High-functioning elderly people who undergo colorectal cancer surgery appear able to retain their ability to function and maintain a good quality of life.
Experts note that regardless of age the outcome of colorectal cancer surgery is likely to be better under these conditions:
The cancer is at an early stage. Most people in the study had stage 0, I, or II cancer; none had stage III or IV.
The person about to have treatment is functioning at a high level before surgery and in good general health, without multiple serious chronic diseases. People who have three or more chronic diseases -- such as diabetes, rheumatoid arthritis, or heart disease -- tend to have poorer outcomes.
The surgery is seen as a positive action, and the person with cancer is aware of the procedures to be performed and the potential outcomes.
Other issues that could affect outcomes at any age include a family history of longevity and a good support system of family and friends.
Posted in Colon Cancer on March 6, 2010
When a reasonably healthy octogenarian gets a diagnosis of colon cancer, the issue of age is bound to come up. How old is too old for colon cancer surgery? What are the risks? What kind of recovery and quality of life can the very elderly expect afterward? Is it worth it? Johns Hopkins explores these questions and others in this Special Report.
The first line of treatment for colorectal cancer is to remove the primary tumor or tumors. If your cancer is confined to polyps or a small area, surgery is probably the only treatment that you need. For stage I or II cancers that have not spread to the lymph nodes, the expected five-year survival rate after surgery without chemotherapy is 80 to 90%.
Surgery usually involves removing the segment of the colon or rectum that has the primary cancer and a margin of healthy colon on either side of the cancer. The surgeon will also remove the tissue that holds the colon in place (mesentery) and the adjacent lymph nodes. The number of lymph nodes removed can be important in providing an accurate stage and prognosis.
It is true that the risks of colorectal cancer surgery are higher for some older people. An analysis of 28 studies found lower survival rates among the elderly who have coexisting health conditions, are diagnosed at an advanced cancer stage, and have to undergo emergency procedures. Another study found that octogenarians with early stage cancer survived 10 or more years after colorectal cancer surgery if they had no chronic illnesses.
It appears that quality of life after colorectal cancer treatment can be as good for octogenarians as it is for younger seniors -- even in the face of coexisting illness, according to a Canadian study that compared the outcomes of people over age 80 with those in their 60s. The average age of the older group was 83 years at the time of colorectal cancer surgery, while the "youngsters" ranged in age from 65-69. People in both groups underwent comparable surgical procedures and had similar coexisting health problems (such as hypertension and diabetes), although the older group had somewhat less advanced (lower-stage) cancers.
The responses to a survey on quality of life and functioning before and after colorectal cancer surgery were remarkably similar in both groups. Before surgery, both worried about pain, becoming a burden, and death. After colorectal cancer surgery, there were no major changes or differences between the groups in terms of their ability to perform daily functions or their overall health, sexual function, or quality of life.
Too Early To Draw Firm Conclusions?
The Canadian researchers emphasize that their study findings are preliminary, and some results may be biased. While the results are preliminary, the study provides further ammunition for the argument that determining which patients are candidates for colorectal cancer surgery shouldn’t be made solely on the basis of chronological age. High-functioning elderly people who undergo colorectal cancer surgery appear able to retain their ability to function and maintain a good quality of life.
Experts note that regardless of age the outcome of colorectal cancer surgery is likely to be better under these conditions:
The cancer is at an early stage. Most people in the study had stage 0, I, or II cancer; none had stage III or IV.
The person about to have treatment is functioning at a high level before surgery and in good general health, without multiple serious chronic diseases. People who have three or more chronic diseases -- such as diabetes, rheumatoid arthritis, or heart disease -- tend to have poorer outcomes.
The surgery is seen as a positive action, and the person with cancer is aware of the procedures to be performed and the potential outcomes.
Other issues that could affect outcomes at any age include a family history of longevity and a good support system of family and friends.
Posted in Colon Cancer on March 6, 2010
Wednesday, February 24, 2010
My sigmo exam
I learned two very interesting facts during my sigmo exam today...
Fact #1: The outside of my behind is way uglier than I ever imagined it to be. (All hairy and bumpy.)
Fact #2: The inside of my behind is way more beautiful than I ever imagined it to be. (All pink and smooth.)
You know, I can't tell you how happy I have been since watching that "scope". If they could run a camera through my whole body -- and if everything looked that pink and clean -- I would be happier yet!
Cancer-Free-Since-1991. email from a female breast cancer survivor.
Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. A sigmoidoscopy is an effective screening tool. Doctors use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum.
A sigmoidoscopy is similar but not the same as a colonoscopy. A Sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.
Fact #1: The outside of my behind is way uglier than I ever imagined it to be. (All hairy and bumpy.)
Fact #2: The inside of my behind is way more beautiful than I ever imagined it to be. (All pink and smooth.)
You know, I can't tell you how happy I have been since watching that "scope". If they could run a camera through my whole body -- and if everything looked that pink and clean -- I would be happier yet!
Cancer-Free-Since-1991. email from a female breast cancer survivor.
Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. A sigmoidoscopy is an effective screening tool. Doctors use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum.
A sigmoidoscopy is similar but not the same as a colonoscopy. A Sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.
Friday, May 29, 2009
2009 Johns Hopkins Colon Cancer White Paper
The 2009 Johns Hopkins Colon Cancer White Paper
Colon cancer patients and their families have a new resource.
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
Need to contact us?
Click here: http://www.johnshopkinshealthalerts.com/contact_us/
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Copyright © MediZine LLC. 500 Fifth Avenue, 19th Floor, New York, NY 10110. All rights reserved.
Colon cancer patients and their families have a new resource.
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
Need to contact us?
Click here: http://www.johnshopkinshealthalerts.com/contact_us/
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Copyright © MediZine LLC. 500 Fifth Avenue, 19th Floor, New York, NY 10110. All rights reserved.
Tuesday, April 14, 2009
Doc Says Doug’s Done
Doc Says Doug’s Done
March 3, 2008
Mr. Beckstein, let me take a moment to look at your chart.
Here are the results from my last Colonscopy.
OK.
Here are my CEA lab tests from 2007.
OK.
I had a CAT scan in March 2007, and there was no evidence of cancer.
I see that. No evidence of disease.
It has been five years since my colon cancer diagnosis.
Mr. Beckstein, you are done.
What.
You are done with cancer.
No more CEA tests?
Yes every six months but you will need a reading of 10 before I would be concerned.
What about CAT scans?
You really don’t have to go through that test anymore.
So I am done with cancer?
Yes. Doug you are done.
I left the doctor’s office a free man.
March 3, 2008
Mr. Beckstein, let me take a moment to look at your chart.
Here are the results from my last Colonscopy.
OK.
Here are my CEA lab tests from 2007.
OK.
I had a CAT scan in March 2007, and there was no evidence of cancer.
I see that. No evidence of disease.
It has been five years since my colon cancer diagnosis.
Mr. Beckstein, you are done.
What.
You are done with cancer.
No more CEA tests?
Yes every six months but you will need a reading of 10 before I would be concerned.
What about CAT scans?
You really don’t have to go through that test anymore.
So I am done with cancer?
Yes. Doug you are done.
I left the doctor’s office a free man.
I've Nothin' To Do
I've Nothin' To Do
by Douglas Beckstein
I opened my eyes and saw my brother, David, napping in the chair in the corner of my hospital room. This was day two after my abdominal resection.
My hair was soaked with sweat. Pain meds worked great, but I had had wild dreams last night. I had no idea what kind of day it was outside the hospital. Food did not appeal. A young doctor making his rounds entered my room. “Good morning, Mr. Beckstein," he said. "What are you reading?”
I had to look at the book open on my bed to answer his question. “Gods and Demons,” I replied, with a very dry mouth. I took a sip of water through a straw.
“Is it any good?"
"I don't know,” I said. “I can't really read on this pain killer.”
Ignoring my brother sprawled in the chair, the doctor walked over to the window and stood with his back to me. “How’s the view from here?” I asked.
"I can see the highway and the roof of this hospital,” he responded. Then he turned to face me again. “Is that an iPOD you have there?"
"Sixty gigs!" I said proudly.
"Cool. I want one," he said, inspecting the device closely.
The doctor sat on my bed, lifted the sheet covering my incision, and inspected the tubes connected to my body. I was very relaxed due to his engaging conversation. There was a nine inch incision in my body; staples held me together.
He stared at my drainage tube. “You don’t need this thing anymore,” he said. He placed one hand on my belly, grabbed the tube with his other hand, and yanked. Then he stood up, wrapped the tubing and collection pouch into a ball, tossed the mess into the hazardous medical waste garbage can, and returned to my bedside.
“You are doing very well. Healing right on schedule," he said, applying a band aid to my belly. Then he was gone.
My brother woke up. “Who was that guy?" he asked.
“I think he was a doctor.” Song lyrics entered my brain. "David, do you remember the artist who sang this song?"
Countin' flowers on the wall, that don't bother me at all
Playin' solitaire 'til dawn, with a deck of fifty-one
Smokin' cigarettes and watchin' Captain Kangaroo
Now don't tell me
I've nothin' to do.
"Statler Brothers," he replied, opening yesterday's newspaper.
by Douglas Beckstein
I opened my eyes and saw my brother, David, napping in the chair in the corner of my hospital room. This was day two after my abdominal resection.
My hair was soaked with sweat. Pain meds worked great, but I had had wild dreams last night. I had no idea what kind of day it was outside the hospital. Food did not appeal. A young doctor making his rounds entered my room. “Good morning, Mr. Beckstein," he said. "What are you reading?”
I had to look at the book open on my bed to answer his question. “Gods and Demons,” I replied, with a very dry mouth. I took a sip of water through a straw.
“Is it any good?"
"I don't know,” I said. “I can't really read on this pain killer.”
Ignoring my brother sprawled in the chair, the doctor walked over to the window and stood with his back to me. “How’s the view from here?” I asked.
"I can see the highway and the roof of this hospital,” he responded. Then he turned to face me again. “Is that an iPOD you have there?"
"Sixty gigs!" I said proudly.
"Cool. I want one," he said, inspecting the device closely.
The doctor sat on my bed, lifted the sheet covering my incision, and inspected the tubes connected to my body. I was very relaxed due to his engaging conversation. There was a nine inch incision in my body; staples held me together.
He stared at my drainage tube. “You don’t need this thing anymore,” he said. He placed one hand on my belly, grabbed the tube with his other hand, and yanked. Then he stood up, wrapped the tubing and collection pouch into a ball, tossed the mess into the hazardous medical waste garbage can, and returned to my bedside.
“You are doing very well. Healing right on schedule," he said, applying a band aid to my belly. Then he was gone.
My brother woke up. “Who was that guy?" he asked.
“I think he was a doctor.” Song lyrics entered my brain. "David, do you remember the artist who sang this song?"
Countin' flowers on the wall, that don't bother me at all
Playin' solitaire 'til dawn, with a deck of fifty-one
Smokin' cigarettes and watchin' Captain Kangaroo
Now don't tell me
I've nothin' to do.
"Statler Brothers," he replied, opening yesterday's newspaper.
Thursday, February 26, 2009
Waiting
Waiting
Waiting for an appointment
Waiting for a parking space
Waiting for an elevator
Sitting in a waiting room
Signing yet another medical form
Looking for my health insurance card
Glancing at magazines that have nothing to do with my life
Waiting to see the doctor
Waiting for the diagnosis
Wondering, is this test accurate?
Looking at numbers on a page
Wanting to understand
Lying on my back for a CAT Scan
Trying to be brave
Asking for a second opinion
Crying quietly
Wanting you to make it better
Worrying about dying
Waiting for a cure
Wanting something sweet
Waiting for a blood test
Wanting to run away
Waiting for a prescription
Cursing side effects
Looking for solutions
Wasting time
Wishing my life was different
Wondering how long will I live?
Praying to God
Talking with friends
Telling my story
Recovering
Living more
Loving deeply
Waiting for an appointment
Waiting for a parking space
Waiting for an elevator
Sitting in a waiting room
Signing yet another medical form
Looking for my health insurance card
Glancing at magazines that have nothing to do with my life
Waiting to see the doctor
Waiting for the diagnosis
Wondering, is this test accurate?
Looking at numbers on a page
Wanting to understand
Lying on my back for a CAT Scan
Trying to be brave
Asking for a second opinion
Crying quietly
Wanting you to make it better
Worrying about dying
Waiting for a cure
Wanting something sweet
Waiting for a blood test
Wanting to run away
Waiting for a prescription
Cursing side effects
Looking for solutions
Wasting time
Wishing my life was different
Wondering how long will I live?
Praying to God
Talking with friends
Telling my story
Recovering
Living more
Loving deeply
Friday, January 2, 2009
Colon Cancer
Colon cancer is the #2 cause of cancer-related death among BOTH men and women in the United States. Yet this cancer is highly treatable if detected early. I would like to introduce you to an invaluable resource in our ongoing war against colon cancer:
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
The key to preventing and treating colon cancer is current, accurate, reliable knowledge.
John's Hopkins University 2008
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
The key to preventing and treating colon cancer is current, accurate, reliable knowledge.
John's Hopkins University 2008
Wednesday, December 10, 2008
Cancer will Overtake Heart Disease as World's Top Killer iby 2010
ATLANTA – Cancer will overtake heart disease as the world's top killer by 2010, part of a trend that should more than double global cancer cases and deaths by 2030, international health experts said in a report released Tuesday. Rising tobacco use in developing countries is believed to be a huge reason for the shift, particularly in China and India, where 40 percent of the world's smokers now live.
So is better diagnosing of cancer, along with the downward trend in infectious diseases that used to be the world's leading killers.
Cancer diagnoses around the world have steadily been rising and are expected to hit 12 million this year. Global cancer deaths are expected to reach 7 million, according to the new report by the World Health Organization.
An annual rise of 1 percent in cases and deaths is expected — with even larger increases in China, Russia and India. That means new cancer cases will likely mushroom to 27 million annually by 2030, with deaths hitting 17 million.
Underlying all this is an expected expansion of the world's population — there will be more people around to get cancer.
By 2030, there could be 75 million people living with cancer around the world, a number that many health care systems are not equipped to handle.
"This is going to present an amazing problem at every level in every society worldwide," said Peter Boyle, director of the WHO's International Agency for Research on Cancer.
Boyle spoke at a news conference with officials from the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for the Cure and the National Cancer Institute of Mexico.
The "unprecedented" gathering of organizations is an attempt to draw attention to the global threat of cancer, which isn't recognized as a major, growing health problem in some developing countries.
"Where you live shouldn't determine whether you live," said Hala Moddelmog, Komen's chief executive.
The organizations are calling on governments to act, asking the U.S. to help fund cervical cancer vaccinations and to ratify an international tobacco control treaty.
Concerned about smoking's impact on cancer rates in developing countries in the decades to come, the American Cancer Society also announced it will provide a smoking cessation counseling service in India.
"If we take action, we can keep the numbers from going where they would otherwise go," said John Seffrin, the cancer society's chief executive officer.
Other groups are also voicing support for more action.
"Cancer is one of the greatest untold health crises of the developing world," said Dr. Douglas Blayney, president-elect of the American Society of Clinical Oncology.
"Few are aware that cancer already kills more people in poor countries than HIV, malaria and tuberculosis combined. And if current smoking trends continue, the problem will get significantly worse," he said in a written statement.
By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer – Tue Dec 9, 5:43 pm ET
So is better diagnosing of cancer, along with the downward trend in infectious diseases that used to be the world's leading killers.
Cancer diagnoses around the world have steadily been rising and are expected to hit 12 million this year. Global cancer deaths are expected to reach 7 million, according to the new report by the World Health Organization.
An annual rise of 1 percent in cases and deaths is expected — with even larger increases in China, Russia and India. That means new cancer cases will likely mushroom to 27 million annually by 2030, with deaths hitting 17 million.
Underlying all this is an expected expansion of the world's population — there will be more people around to get cancer.
By 2030, there could be 75 million people living with cancer around the world, a number that many health care systems are not equipped to handle.
"This is going to present an amazing problem at every level in every society worldwide," said Peter Boyle, director of the WHO's International Agency for Research on Cancer.
Boyle spoke at a news conference with officials from the American Cancer Society, the Lance Armstrong Foundation, Susan G. Komen for the Cure and the National Cancer Institute of Mexico.
The "unprecedented" gathering of organizations is an attempt to draw attention to the global threat of cancer, which isn't recognized as a major, growing health problem in some developing countries.
"Where you live shouldn't determine whether you live," said Hala Moddelmog, Komen's chief executive.
The organizations are calling on governments to act, asking the U.S. to help fund cervical cancer vaccinations and to ratify an international tobacco control treaty.
Concerned about smoking's impact on cancer rates in developing countries in the decades to come, the American Cancer Society also announced it will provide a smoking cessation counseling service in India.
"If we take action, we can keep the numbers from going where they would otherwise go," said John Seffrin, the cancer society's chief executive officer.
Other groups are also voicing support for more action.
"Cancer is one of the greatest untold health crises of the developing world," said Dr. Douglas Blayney, president-elect of the American Society of Clinical Oncology.
"Few are aware that cancer already kills more people in poor countries than HIV, malaria and tuberculosis combined. And if current smoking trends continue, the problem will get significantly worse," he said in a written statement.
By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer – Tue Dec 9, 5:43 pm ET
Monday, November 10, 2008
CEA test used for tracking Colon Cancer
The carcinoembryonic antigen (CEA) test is a laboratory blood study. CEA is a substance which is normally found only during fetal development, but may reappear in adults who develop certain types of cancer.
Purpose
The CEA test is ordered for patients with known cancers. The CEA test is most commonly ordered when a patient has a cancer of the gastrointestinal system. These include cancer of the colon, rectum, stomach (gastric cancer), esophagus, liver, or pancreas. It is also used with cancers of the breast, lung, or prostate.
The CEA level in the blood is one of the factors that doctors consider when determining the prognosis, or most likely outcome of a cancer. In general, a higher CEA level predicts a more severe disease, one that is less likely to be curable. But it does not give clear-cut information. The results of a CEA test are usually considered along with other laboratory and/or imaging studies to follow the course of the disease.
Once treatment for the cancer has begun, CEA tests have a valuable role in monitoring the patient's progress. A decreasing CEA level means therapy is effective in fighting the cancer. A stable or increasing CEA level may mean the treatment is not working, and/or that the tumor is growing. It is important to understand that serial CEA measurements, which means several done over a period of time, are the most useful. A single test result is difficult to evaluate, but a number of tests, done weeks apart, shows trends in disease progression or regression.
Certain types of cancer treatments, such as hormone therapy for breast cancer, may actually cause the CEA level to go up. This elevation does not accurately reflect the state of the disease. It is sometimes referred to as a "flare response." Recognition that a rise in CEA may be temporary and due to therapy is significant. If this possibility is not taken into account, the patient may be unnecessarily discouraged. Further, treatment that is actually effective may be stopped or changed prematurely.
CEA tests are also used to help detect recurrence of a cancer after surgery and/or other treatment has been completed. A rising CEA level may be the first sign of cancer return, and may show up months before other studies or patient symptoms would raise concern. Unfortunately, this does not always mean the recurrent cancer can be cured. For example, only a small percentage of patients with colorectal cancers and rising CEA levels will benefit from another surgical exploration. Those with recurrence in the same area as the original cancer, or with a single metastatic tumor in the liver or lung, have a chance that surgery will eliminate the disease. Patients with more widespread return of the cancer are generally not treatable with surgery. The CEA test will not separate the two groups.
Patients who are most likely to benefit from non-standard treatments, such as bone marrow transplants, may be determined on the basis of CEA values, combined with other test results. CEA levels may be one of the criteria for determining whether the patient will benefit from more expensive studies, such as CT scan or MRI.
Precautions
The CEA test is not a screening test for cancer. It is not useful for detecting the presence of cancer. Many cancers do not produce an increased CEA level. Some noncancerous diseases, such as hepatitis, inflammatory bowel disease, pancreatitis, and obstructive pulmonary disease, may cause an elevated CEA level.
Description
Determination of the CEA level is a laboratory blood test. Obtaining a specimen of blood for the study takes only a few minutes. CEA testing should be covered by most insurance plans.
Preparation
No preparation is required.
Aftercare
None.
Risks
There are no complications or side effects of this test. However, the results of a CEA study should be interpreted with caution. A single test result may not yield clinically useful information. Several studies over a period of months may be needed.
Another concern is the potential for false positive as well as false negative results. A false positive result means the test shows an abnormal value when cancer is not present. A false negative means the test reveals a normal value when cancer actually is present.
Normal results
The absolute numbers which are considered normal vary from one laboratory to another. Any results reported should come with information regarding the testing facility's normal range.
Abnormal results
A single abnormal CEA value may be significant, but must be regarded cautiously. In general, very high CEA levels indicate more serious cancer, with a poorer chance for cure. But some benign diseases and certain cancer treatments may produce an elevated CEA test. Cigarette smoking will also cause the CEA level to be abnormally high.
Purpose
The CEA test is ordered for patients with known cancers. The CEA test is most commonly ordered when a patient has a cancer of the gastrointestinal system. These include cancer of the colon, rectum, stomach (gastric cancer), esophagus, liver, or pancreas. It is also used with cancers of the breast, lung, or prostate.
The CEA level in the blood is one of the factors that doctors consider when determining the prognosis, or most likely outcome of a cancer. In general, a higher CEA level predicts a more severe disease, one that is less likely to be curable. But it does not give clear-cut information. The results of a CEA test are usually considered along with other laboratory and/or imaging studies to follow the course of the disease.
Once treatment for the cancer has begun, CEA tests have a valuable role in monitoring the patient's progress. A decreasing CEA level means therapy is effective in fighting the cancer. A stable or increasing CEA level may mean the treatment is not working, and/or that the tumor is growing. It is important to understand that serial CEA measurements, which means several done over a period of time, are the most useful. A single test result is difficult to evaluate, but a number of tests, done weeks apart, shows trends in disease progression or regression.
Certain types of cancer treatments, such as hormone therapy for breast cancer, may actually cause the CEA level to go up. This elevation does not accurately reflect the state of the disease. It is sometimes referred to as a "flare response." Recognition that a rise in CEA may be temporary and due to therapy is significant. If this possibility is not taken into account, the patient may be unnecessarily discouraged. Further, treatment that is actually effective may be stopped or changed prematurely.
CEA tests are also used to help detect recurrence of a cancer after surgery and/or other treatment has been completed. A rising CEA level may be the first sign of cancer return, and may show up months before other studies or patient symptoms would raise concern. Unfortunately, this does not always mean the recurrent cancer can be cured. For example, only a small percentage of patients with colorectal cancers and rising CEA levels will benefit from another surgical exploration. Those with recurrence in the same area as the original cancer, or with a single metastatic tumor in the liver or lung, have a chance that surgery will eliminate the disease. Patients with more widespread return of the cancer are generally not treatable with surgery. The CEA test will not separate the two groups.
Patients who are most likely to benefit from non-standard treatments, such as bone marrow transplants, may be determined on the basis of CEA values, combined with other test results. CEA levels may be one of the criteria for determining whether the patient will benefit from more expensive studies, such as CT scan or MRI.
Precautions
The CEA test is not a screening test for cancer. It is not useful for detecting the presence of cancer. Many cancers do not produce an increased CEA level. Some noncancerous diseases, such as hepatitis, inflammatory bowel disease, pancreatitis, and obstructive pulmonary disease, may cause an elevated CEA level.
Description
Determination of the CEA level is a laboratory blood test. Obtaining a specimen of blood for the study takes only a few minutes. CEA testing should be covered by most insurance plans.
Preparation
No preparation is required.
Aftercare
None.
Risks
There are no complications or side effects of this test. However, the results of a CEA study should be interpreted with caution. A single test result may not yield clinically useful information. Several studies over a period of months may be needed.
Another concern is the potential for false positive as well as false negative results. A false positive result means the test shows an abnormal value when cancer is not present. A false negative means the test reveals a normal value when cancer actually is present.
Normal results
The absolute numbers which are considered normal vary from one laboratory to another. Any results reported should come with information regarding the testing facility's normal range.
Abnormal results
A single abnormal CEA value may be significant, but must be regarded cautiously. In general, very high CEA levels indicate more serious cancer, with a poorer chance for cure. But some benign diseases and certain cancer treatments may produce an elevated CEA test. Cigarette smoking will also cause the CEA level to be abnormally high.
Wednesday, November 5, 2008
steps to avoid cancer
Some do’s and don’ts for helping to avoid and fight cancer.
Your mental state
* Be positive.
* Resolve stress and past traumas.
* Accept yourself and your emotions, including the negative ones.
* Practice meditation, yoga, tai chi or some other form of relaxation.
Your diet
* These vegetables have great cancer-fighting characteristics: beets, Brussels sprouts, cabbage, garlic, kale, leeks and scallions.
* Also good are onions, blueberries, raspberries, cherries, red wine, soy.
* Increase your intake of omega-3s, typically found in fish (herring, trout, sardines, mackerel, halibut) and flax seeds and oils.
* Avoid sugar, white flour, vegetable oils, white rice and non-organic animal fat (meat, eggs, milk, cheese).
* Filter your tap water.
Your activity
* Spend 20 to 30 minutes a day on a physical activity like tennis, swimming or walking.
* Be out in the sun for 20 minutes every day.
And...
* Avoid being surrounded by people who smoke.
* Use cosmetic products that don’t contain parabens or phthalates.
* Use skin-care products without estrogens or placental by-products.
* Use cleaning products without synthetic chemicals.
* Don’t prepare food in a scratched Teflon pan.
* Reduce the influence of cell phones by using a headset consistently.
Source: David Servan-Schreiber, Anticancer 11-05-08
David Servan-Schreiber | November 2008 issue of ODE Magazine
Your mental state
* Be positive.
* Resolve stress and past traumas.
* Accept yourself and your emotions, including the negative ones.
* Practice meditation, yoga, tai chi or some other form of relaxation.
Your diet
* These vegetables have great cancer-fighting characteristics: beets, Brussels sprouts, cabbage, garlic, kale, leeks and scallions.
* Also good are onions, blueberries, raspberries, cherries, red wine, soy.
* Increase your intake of omega-3s, typically found in fish (herring, trout, sardines, mackerel, halibut) and flax seeds and oils.
* Avoid sugar, white flour, vegetable oils, white rice and non-organic animal fat (meat, eggs, milk, cheese).
* Filter your tap water.
Your activity
* Spend 20 to 30 minutes a day on a physical activity like tennis, swimming or walking.
* Be out in the sun for 20 minutes every day.
And...
* Avoid being surrounded by people who smoke.
* Use cosmetic products that don’t contain parabens or phthalates.
* Use skin-care products without estrogens or placental by-products.
* Use cleaning products without synthetic chemicals.
* Don’t prepare food in a scratched Teflon pan.
* Reduce the influence of cell phones by using a headset consistently.
Source: David Servan-Schreiber, Anticancer 11-05-08
David Servan-Schreiber | November 2008 issue of ODE Magazine
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