mCancer Talk: Coping and living with cancer

Edward Rosario preps fruit for a smoothie fortified with protein powder which he can tolerate to combat nausea.

Nausea is a common side effect of cancer – especially for people going through chemotherapy. When non-Hodgkin’s lymphoma patient Edward Rosario came to the University of Michigan Comprehensive Cancer Center, his nausea was overwhelming.

Although it can be difficult to find relief, there are several ways to combat an unsettled stomach. Rosario’s relief came when the Cancer Center’s Symptom Management and Supportive Care Clinic prescribed him medicine to help treat the symptom.

Emily Mackler, Pharm.D., a pharmacist in the clinic, says there are different medications to treat nausea. A queasy stomach may be caused by neurotransmitters within the brain, and medications can be prescribed to target these. Other medications target receptors lining the gastrointestinal tract that can contribute to nausea. In some cases, more than one medication may be used to provide the best control. “We also look at the medicines a person is already taking to see if those are contributing to the nausea,” Mackler says. “If so, we’ll look at modifying the patient’s medical regimen by changing how they take their medicine or perhaps by switching to a different drug so they can feel some relief.”

Medicine is one way to combat nausea, but staying away from certain foods and rethinking portion size and meal timing can also make a difference in relieving nausea or keeping it under control. Read the rest of this entry →

Volunteers at the U-M Comprehensive Cancer Center's 2011 Survivors Day pose with keynote speaker Charlie Lustman.

Thanks to advances in cancer treatments, the American Cancer Society estimates there are nearly 12 million cancer survivors in the United States today.   Cancer survivors may face i complex health needs, living with after- effects of cancer treatments, – and financial issues.

According to the National Coalition For Cancer Survivorship (NCCS), “Cancer survivorship is a day-to-day, ongoing process that begins with your diagnosis and continues through the rest of your life.”  The NCCS provides the Cancer Survival Toolbox which helps cancer survivors adapt to life after cancer.

Tips for Moving on After Treatment

• Seeing a new doctor – At some point, you may be seeing a new doctor. Keep copies of all your medical records to give to your new doctor.
• Eat healthy – During and after cancer treatment eating right may be hard.  Creating healthy eating habits is one of the best things you can do for your well -being.
• Exercise – Being active can help reduce your fatigue and make your muscles strong.  Talk with your doctor before starting a program.
• Emotional health – A lot of cancer survivors are filled with emotions. Support can come from family, friends, cancer support groups, church groups, online support groups, or counselors.

Surviving cancer is a complex, continual process.  It is not unusual for a cancer survivor to wonder,” When will the cancer return?”  Survivors, family and friends should also recognize that it is difficult to maintain a positive outlook after facing a cancer diagnosis.  Living with hope is imperative for healthy coping.

Yesterday is history, tomorrow is a mystery, today is a gift of God, which is why we call it the present.”
― Bil Keane

The U-M Comprehensive Cancer Center will host its Cancer Survivor’s Day event on Sunday, June 3.  The theme is Fostering Hope through Cancer and Beyond.

Resources

National Coalition For Cancer Survivorship

National Cancer Institute, Survivorship

U-M Cancer Survivorship

Many factors can increase the risk of developing melanoma and other skin cancers.  Some of these factors are due to behaviors, like exposure to the sun.  However, some risk factors for skin cancer are inherited in families.

Melanoma is a type of skin cancer that affects about 59,000 people every year in the United States.  People who have a parent or sibling who has had melanoma are at about double the risk of the general population.  This is because family members may have similar histories of sun exposure and may share inherited physical features like fair skin or light hair.  In some families, there is an inherited risk for melanoma related to genes that are passed from parents to their children.

If you or a family member has had melanoma, it may be worth talking with your doctor about the rest of your family history.  Some clues to inherited risk include:

• Individuals with more than one melanoma
• Other cancers in family members including:
  • Pancreatic cancer
  • Head and neck cancer
  • Breast cancer
  • Ovarian cancer
  • Cancers diagnosed at earlier ages than typically expected

People who have a family history of multiple relatives with cancers could benefit from meeting with a genetic counselor to talk about possible genetic testing, personal cancer risk, and cancer screening options.

For people who have an increased risk of melanoma, there are important steps that can help to reduce the chance of developing melanoma.

Limit sun exposure

• Find shade when possible
• Avoid exposure between 10 a.m. and 4 p.m. when UV light is strongest
• Wear protective clothing
• Use sunscreen with SPF 15 or higher daily

Check your skin

• Learn how to do a skin self-exam and check your skin once a month
• Have regular skin exams by a doctor
• Talk to your doctor if a mole or spot on the skin is changing in size, shape or color, or if it is persistently itching, bleeding, or growing

You can find out more about skin cancer and genetics by participating in an online chat with me and U-M dermatologist Kelly Cha, M.D. Ph.D., this Thursday at noon. Registration is not required to participate in the chat.

Patient Michelle Johnson

Heading to the hospital or clinic for your cancer treatment takes time, costs money in gas and pulls you away from your regular life, sometimes for days at a time. What if you could receive inpatient-like hospital services in the comfort of your own home?

Home-based treatment options are a reality for many patients, including Michelle Johnson, who used U-M Home Care Services for post-surgery care, chemotherapy and radiation to treat esophageal cancer.

“If I had to sit for two or three days in the hospital’s infusion center every week, it would take an emotional toll on me. With my home chemo, it enables me to do things I want to do,” Johnson says.

Home Care nurses visit her several times a week to help with her PICC line, change dressings after surgery, and oversee and disconnect an infusion pack she wears for 46 hours straight every other week.

Worried you won’t be able to manage home-based treatments?

“One of the reasons home care runs so smoothly is that so many procedures have been standardized and coordinated between HomeMed and the U-M Cancer Center,” explains Nurse Manager Debra Kovacevich, R.N., from U-M HomeMed. “With such high standards of hospital care, it is easy to transfer standard processes to home care.”

Many resources are available to help patients, including:

• Patient education materials
• Home Care nurse visits
• 24/7 number to call about infusing drugs in the home, as well as concerning signs and symptoms
• A guide to home care services

Get a complete list of Home Care services and read more of Michelle’s story in Thrive.

It’s not easy to avoid the sun – and there are reasons why we shouldn’t.  Sunlight interacts with a hormone in skin cells to trigger the production of vitamin D, which builds strong bones and may help protect against heart disease. Sunshine also eases the symptoms of depression and other mood disorders. But dermatologists say just 10-15 minutes of exposure per day is enough to get the benefits of sunlight, without increasing the risk of skin cancer.

May is National Melanoma/Skin Cancer Detection and Prevention Month. This month is dedicated to increasing public awareness of the importance of prevention, early detection and treatment of skin cancer, including basal cell, squamous cell and melanoma. More than 3.5 million skin cancers are diagnosed annually.

Here are some resources to help you be skin cancer savvy:

• Thursday, May 10, from noon to 1 p.m., join us for Genetics, Skin Cancer and You – a FREE online chat with dermatologist Kelly Cha, M.D., Ph.D., and genetic counselor Jessica Everett, M.S., CGC.  To learn more and to register, please visit our community outreach registration page.
• Our skin cancer awareness web page – is filled with information and links to resources about all forms of skin cancer.

Kate Muir opted not to wear a wig.

As if confronting a life-threatening illness isn’t challenging enough for cancer patients, treating that illness often means coming face-to-face with changes in physical appearance, too. Baldness. Scarring. The loss of a breast. The loss of a limb.

When one’s health — or life — is at stake, do appearances really matter? According to Claire Weiner, L.M.S.W., a social worker in the University of Michigan Comprehensive Cancer Center’s PsychOncology Program, that’s one of the first questions many patients — male and female — wrestle with. Weiner and the other members of the PsychOncology team are quick to remind patients that it’s normal — not vain — to be concerned about how we look.

When it comes to coping with that new face in the mirror, a strong sense of self-worth and a solid support system are invaluable.

Kate Muir (pictured above), who is currently in treatment for breast cancer, remembers looking in the mirror at one point and seeing “an alien, not someone I knew.” Eventually, she says, she was able to deal with the changes.

“In my family today, who you are is based on what you do, what you speak, what you feel — not on how you look,” she says. From the very start, Muir’s family encouraged her to go out just as she was. Her son, who lives in Ann Arbor, told her, “Who cares? No one cares how they look in Ann Arbor!”  Continue reading “Keeping Up Appearances: When cancer changes your looks, the makeover starts inside”.

We’ve also got a list of resources to help support you and provide products to help:  “Keeping Up Appearances:  Resources”.

If you have questions or would just like to talk to someone, contact Cancer AnswerLine™ at 800-865-1125 or go to the Ask the Nurse tab and one of our cancer nurses will help.

Do you have any advice you’d like to share?  Please let us know by posting in our comments section.

Choosing your cancer treatment course can be a difficult decision, as you quickly begin to learn a whole new language and a world of options. A recent study found that breast cancer patients were deciding on their surgery without consulting a radiation oncologist. In some cases, women were choosing a more aggressive operation in the hopes of avoiding radiation – but not understanding that radiation might still be required. Learn your options first, starting with choosing the right doctor and the right cancer program for your diagnosis. It’s also important to understand the information your health care team presents. U-M researchers who specialize in decision-making offer 10 tips to help patients understand their risk and how treatment options will affect that risk.

If you have questions about your treatment options, contact Cancer AnswerLine™ at 800-865-1125 or go to the Ask the Nurse tab and one of our cancer nurses will help.

April is National Minority Health Month and April 17-23 is National Minority Cancer Awareness Week, so we thought that this would be a great time to discuss the impact of cancer on minorities in the United States and what the University of Michigan is doing to address cancer disparities. According to the National Cancer Institute, “cancer health disparities” are defined as “differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States.”

Complex and interrelated factors contribute to the observed disparities in cancer incidence and death among racial, ethnic and underserved groups. The most obvious factors are associated with a lack of health care coverage and low socioeconomic status. Although cancer deaths have declined for both whites and African-Americans living in the United States, African-Americans continue to suffer the greatest burden for each of the most common types of cancer.

Other examples of cancer disparities include:

• African-American males have the highest incidence and mortality rates for colon, prostate and lung cancers.
• Cervical cancer incidence is the highest among Hispanic/Latina women when compared to all other ethnic groups.
• Liver cancer, usually caused by exposure to the hepatitis B virus, disproportionately affects Asian-Americans.
• American Indians and Alaska Natives continue to have the poorest survival from “all cancers combined” than any other racial group.
• Poor people are at greater risk of being diagnosed and treated for cancer at late stages of disease.

Research

Research studies, including many performed by University of Michigan investigators such as Lisa Newman, Arden Morris, Christopher Sonnenday and Ken Resnicow, continue to document persistent and significant disparities in access to health care and disease outcomes. Often times, researchers are looking into the impact of factors such as race, ethnicity, gender, geography and socioeconomic status on cancer risk, screening or outcomes. The Cancer Center has a health disparities work group that meets quarterly to collaborate, present their work and share research findings.

Resources

Paths of Healing and Color of Cancer are two examples of how the U-M Comprehensive Cancer Center is addressing disparities. The Community Outreach program is the driving force behind many these efforts including the Minority Outreach Initiative.

Other areas of interest include:

National Cancer Institute Center to Reduce Health Disparities
National Center on Minority Health and Health Disparities
U.S. Department of Health and Human Services Office of Minority Health
Intercultural Cancer Council

Michael Douglas, Sigmund Freud, Ulysses S. Grant, George Harrison and Babe Ruth –what could these people possibly have in common?  Throat Cancer.

Even though it’s not talked about as much as some other types of cancer, throat cancer isn’t rare. In fact it’s the sixth most common cancer in the United States.

Throat cancer can start in the soft tissues of the upper, middle or bottom portion of the throat and can include the voice box (larnyx).

Researchers have found that 85% percent of throat cancers occur after exposure to cancer-causing chemicals like tobacco and alcohol and tend to develop in areas where these chemicals have the most contact. Those at risk for developing throat cancer are people who drink 3 or more alcoholic beverages per day, or smoke or chew tobacco (or have in the past).  People that use both tobacco and alcohol are at an even greater risk for developing throat cancer than people who use alcohol or tobacco alone.

Symptoms like difficulty swallowing, a sore or painful area in the mouth or throat, a persistent hoarse voice, or a lump in the throat or neck that doesn’t go away should be checked by a doctor.

The good news is that throat cancer may be prevented by changing habits and can be treated if caught early. You can reduce your risk for developing throat cancer by receiving regular medical check- ups, eating a healthy diet with lots of fruits and vegetables, and seeing the doctor when symptoms persist for more than a couple of weeks.

Screening is also important in the detection of throat cancer. In today’s economic climate we understand the importance of making sure everyone has access to routine preventive measures. On Saturday, April 28, we are offering a free throat cancer screening on the U-M Health System campus. Registration is required and can be made by calling 800-865-1125.

Learn more about throat cancer:

University of Michigan Head and Neck Cancer program

Head & Neck Cancer Alliance

National Cancer Institute

For many years the PSA (prostate specific antigen) blood test, together with a digital rectal exam, has been used as a screening tool to identify men that may have prostate cancer. If the PSA level is elevated, then men typically need to undergo additional testing — including a prostate biopsy. While a useful tool, the PSA test shows only the level of the PSA and can’t tell if prostate cancer or another medical condition is the reason for the elevation.

Enter the PCA3 test — a new urine test that University of Michigan Comprehensive Cancer Center researchers have been working on to detect prostate cancer.  The PCA3 urine test can provide additional information to help a man and his physician decide if a prostate biopsy is needed. Simply put: prostate cells have PCA3 genes that stimulate the production of a small amount of a certain protein.  Because prostate cancer cells make more of this protein than normal prostate cells, men with prostate cancer can be identified with this test when PCA3 proteins leak into the urine.

Men interested in PCA3 testing should ask their physician if PCA3 testing is appropriate for their individual situation. The University of Michigan does offer the PROGENSA® PCA3 test as a supplement to the PSA test, upon physician request. To learn more about next steps for PROGENSA® PCA3 urine test at U-M, contact Cancer AnswerLine™ at 800-865-1125 or go over to the Ask the Nurse tab and one of our cancer nurses will answer your question.