BY KATHY LATOUR | APRIL 19, 2013
It's hard to imagine that someone who has been through cancer would have to worry about dying of cardiac disease, but according to a new study, long-term cancer survivors have more risk factors for cardiovascular disease than those who have not had cancer.
The 1,582 survivors of breast, prostate, colorectal and gynecologic cancers who were studied came from two California cancer registries who were recruited from four to 14 years past treatment.
Once accepted into the study, the survivors were sent a survey that asked them to self report about a number of cardiovascular disease (CVD) risk factors, including smoking, body mass index, physical inactivity, cholesterol, hypertension and diabetes. It also asked whether the survivor had discussed these factors and living a healthier lifestyle with their health care providers.
The results are rather astounding. Except for smoking, risk factors for cardiovascular disease were more common among survivors than the general public: 62 percent were overweight or obese, 55 percent had hypertension, 20 percent were diabetic, and 18 percent described themselves as inactive. Five percent said they smoked. Hispanic and African-American survivors had a greater number of CVD risk factors, particularly obesity and diabetes.
One third said they had not discussed their cardiovascular factors with their physicians.
This study points again to the importance of primary care physicians understanding the cancer history of their patients, and cancer patients understanding their susceptibility to cardiovascular disease.
We continue to focus on the need for patients to leave treatment with the understanding that their lives will be different because of their cancer therapy, particularly if they have had radiation and chemotherapy, both of which can impact their heart.
Take charge of your future. Get a survivorship care plan for your future. Stop smoking, start moving and begin eating for your health. You have a number of years ahead of you if you do.
You can read more from my CURE article on the subject: "Planning for Cancer Survivorship."RELATED POSTS
BY SUZANNE LINDLEY | MARCH 19, 2013
Colon cancer takes me to Washington, D.C. each year to spread awareness with Fight Colorectal Cancer about a disease that is "preventable, treatable and beatable." I've stepped outside of my comfort zone and shared a very private story so that future generations are able to talk about colorectal cancer in past tense. I make this trip so that my children and their children will one day live in a world without colorectal cancer.
For seven years, I've climbed the steps of the Capitol armed with the knowledge that cancer research has allowed me to open these legislative doors. I have not taken for granted the opportunity to march down these grand hallways in quest of more funding for cancer research. I've shared my story time and again; thankful for the research that has brought me to these halls and given me the ability to spend precious and tender moments with my family and friends.
Staying a step ahead of metastatic colon cancer isn't an easy task. The novelty of living with dying has long worn off. It's something now that is as much a part of my life as is taking another breath and in order for that to continue for me, and 1 million other Americans, more research is needed. Prevention is key. I should be on Capitol Hill this week, but the very disease that takes me there is now keeping me at home. Still, colon cancer won't weaken my voice.
Join me and Fight Colorectal Cancer tomorrow (Wednesday, March 20) and CALL on Congress! Your call will coincide with visits by colorectal cancer survivors meeting face-to-face with members of Congress. Make the call! Advocacy is at your fingertips.
Call on Congress: 866-615-3375
Tell your member of Congress you support:
A bill in Congress that will cut out copays for screening colonoscopies when polyps are removed. Your call could make screening colonoscopy affordable for millions.
Get behind a cure!RELATED POSTS
BY SUZANNE LINDLEY | MARCH 8, 2013
In February, I helped to host a survivor fashion show to create awareness about living with liver tumors. Among those who modeled were a number of stage 4 colon cancer survivors. Shocking to many were the young ages of our survivors. Out of the nine colon cancer survivors that participated, EIGHT were diagnosed before age 50! Even more notable is the fact that four of us have lived with metastatic disease for more than eight years! The ages are sobering; the longevity exciting!
It has been 14 years since my diagnosis with colon cancer, and I'm thankful to see the progress. Way back when we talked about survival of stage 4 colon cancer in months, not years! How things have changed! In the early days of my diagnosis it took a great deal of courage to say "colon" in anything other than a hushed voice.
In the years since, we've made great progress thanks to ACOR (ACOR.org), Chris 4 Life (chris4life.org), Colon Cancer Alliance (ccalliance.org), COLONTOWN (facebook.com/colontown), and Fight Colorectal Cancer (fightcolorectalcancer.org) ... among others. Advocates have shared their stories and offered support, taken their voices to Capitol Hill (Call on Congress with Fight Colorectal Cancer is just around the corner!), and created awareness programs that are truly making colon cancer preventable, treatable and beatable!Research has paved the way for numerous novel treatments and procedures.
What was dealt to me as a death sentence can often be managed as a chronic disease. For some that have seen their disease spread it is even possible to downstage to NED, or no evidence of disease. We are able to live longer and better in spite of advanced cancer.
I have benefited from the research and advocacy these past 14 years. The much needed momentum has provided time, options and hope for cancer patients everywhere. For others, awareness has prevented colon cancer. Be a part of the momentum for colorectal cancer. You can make a difference in the fight by joining Fight Colorectal Cancer's "One Million Strong." Visit the ONE MILLION STRONG TOOLBOX as a guide for how you can be involved in the fight against colorectal cancer.
We are stronger together! One million strong!RELATED POSTS
BY LINDSAY RAY | JANUARY 31, 2013
On Jan. 23, the FDA approved another version of second-line therapy for treating patients with metastatic colorectal cancer. Avastin was first approved for use as a first-line therapy in colorectal cancer in 2004, and Avastin with 5-FU based-chemotherapy was approved as a second-line option in 2006. This most recent indication allows Avastin (bevacizumab) to be used as a second-line therapy in conjunction with fluoropyrimidine-combination chemotherapy and either irinotecan or oxaliplatin. Fluoropyrimidines include Xeloda (capecitabine) and floxuridine, as well as 5-FU (fluorouracil). Avastin cannot be used as adjuvant therapy (additional treatment after the primary therapy).
Approval is based on a phase 3 trial with 820 patients with metastatic colorectal cancer who had progressed during or following treatment with Avastin-based chemotherapy. Patients were randomly assigned to "cross-over" chemotherapy plus Avastin or cross-over chemo alone. (Cross-over chemotherapy means that patients who had previously been treated with oxaliplatin-based chemo received irinotecan-based chemo in the study, and vice versa.)
Patients in the Avastin arm had a median overall survival of 11.2 months compared with 9.8 months for those in the chemotherapy-only arm. Progression-free survival was also improved by a median of 1.7 months for those in the Avastin arm.
The side effects in this study were similar to those seen in previous studies, which include fatigue, diarrhea and mouth sores.
Avastin can cost $88,000 per year and is also approved for treating advanced renal cell carcinoma, glioblastoma and non-squamous, non-small cell lung cancer.
For more information, visit avastin.com or call 877-428-2784.RELATED POSTS
BY ELIZABETH WHITTINGTON | JANUARY 8, 2013
Colonoscopies 58% : Congress 31%
That's the favorability rating people gave when given a choice between the two, along with other non-desirables at the moment, which also included cockroaches and root canals.
Public Policy Polling does favorability surveys to see how the public views Congress. This year the institution decided to compare it with other things to give people a better understanding of the poll.
"Colonoscopies are not a terribly pleasant experience but at least they have some redeeming value that most voters aren't seeing in Congress: Colonoscopies 58 Congress 31"
Or as one of my tweeps noted: "Sure. Colonoscopies are useful. RT @hillhealthwatch: Congress less popular than colonoscopies, root canals, poll finds"
You can read the full results here if you're interested.
While this may look bad for Congress, maybe colonoscopies are being seen in a better light. Incidence and mortality related to colorectal cancer have decreased in the past decade, and much of that can be credited to colon cancer screening, including colonoscopies.
Percentage of Adults Aged 50–75 Years Who Reported Being Up-to-Date with Colorectal Test Screening, by State; Behavioral Risk Factor Surveillance System, United States, 2010
We've gone from the Katie Couric Effect to it being a milestone of turning 50, a "colonoscopy getaway" that was featured on "Men of a Certain Age."RELATED POSTS
BY DEBU TRIPATHY | OCTOBER 29, 2012
The New England Journal of Medicine tends to publish larger and higher impact studies that will affect standards of care, but they also will print eye-opening studies that tell us something unexpected and give us pause for thought.
A very important survey appeared in the Journal recently – it was part of a larger study that explored the attitudes and knowledge of patients with colorectal and lung cancer. This analysis of patients with advanced metastatic cancer who opted for chemotherapy showed that most patients had unrealistic expectations of cure – something that is rare in metastatic cancer. This is in contrast to earlier studies, many of which were done at larger and specialized cancer centers, which showed that most patients understood that cure was not likely.
What does this study say about patients being seen in clinical practice that reflects the average across the United States? At initial glance, it appears that patients are not adequately informed or do not fully understand their accurate prognosis. However, it is difficult to interpret results of questions asked or over the phone and to surrogates who answer in the patient's stead as was the case in this study. This study was not designed to delve into the complexities of patients' levels of hopes and understanding about their disease. Still, there are important lessons for us all in these results.
A higher expectation of cure was seen in patients who were non-white, or had colorectal cancer, and interestingly, who reported better communication with their physician. It means that physicians need to use better educational methods, but still retain their patients' trust and confidence. We live in a time where technology keeps pushing the envelope on outcomes in cancer, but where cure of many common cancers in the metastatic setting is still fleeting. The public needs to make fully informed decisions about their health care – whether it is for metastatic cancer or open heart surgery for coronary artery disease.
In this age of information at one's fingertip, this should be much more achievable, but on the other hand, the savviest of readers needs a guide in the informational jungle. CURE's special edition on metastatic cancer, which will be available in December, aims to educate with compassion, realism and hope – we believe that all of these are mutually compatible.RELATED POSTS
BY SUZANNE LINDLEY | SEPTEMBER 27, 2012
What a day!
I woke up in the wee hours of the morning and couldn't go back to sleep. It's a very special day that I never expected to see. Today is Katie's birthday. She is 25!
With scans on the agenda, it was nice to begin the day with happiness. Much has happened in her young quarter of a century. She has experienced more time with cancer in her vocabulary than without. In some ways, it may have helped to provide her life with compassion, understanding, and determination beyond her years. Definitely, it has given us cause to celebrate! We had a birthday lunch and then left in different directions.
I sat in the waiting room before my scan, thinking of years past and years to come. I was paying little attention to my surroundings when the words colorectal cancer buzzed from the overhead television. My senses came to life as the wonderful words that regorafenib had gained FDA approval for metastatic colorectal cancer sang through air. I could barely contain my enthusiasm and couldn't wait to get home and share the news! It is an oral, targeted treatment. The approval came almost a month earlier than many expected.
Not just one, but two more weapons have now been added to our arsenal of artillery for metastatic colorectal cancer - Zaltrap and regorafenib! How thrilling to have more treatments to use while living with stage 4 cancer, more options from which to hitch-hike, and more hope on the horizon.
Excitement and celebration fill the air today; from beginning to end.RELATED POSTS
BY LINDSAY RAY | SEPTEMBER 27, 2012
After the approval of Zaltrap (ziv-aflibercept) for colorectal cancer in August, there's more good news for metastatic colorectal cancer patients. This morning, the Food and Drug Administration announced that it had approved Stivarga (regorafenib) for patients with metastatic colorectal cancer (mCRC) who have progressed after trying other therapies. The FDA had granted the drug a priority review in late June, which guarantees a drug will be reviewed within six months.
Stivarga works as a multi-kinase inhibitor, which means it targets several different pathways that can promote tumor growth, including the vascular endothelial growth factor receptor (VEGF), which signals tumor blood vessel growth, and c-KIT, an oncogene that also helps cancer growth. Patients take the drug orally, once-a-day in four week cycles (three weeks on, one week off before starting the therapy again).
The approval is based on the phase 3 CORRECT trial, which randomly assigned 760 mCRC patients who had prior treatment to either receive Stivarga or placebo. All patients in the trial received best supportive care. Stivarga was shown to extend median overall survival to 6.4 months compared with the 5 months for those in the placebo arm. The drug also delayed tumor growth by two months compared with the 1.7 months for those on placebo.
Common side effects include fatigue, hand-foot syndrome and diarrhea. The drug also carries a warning that severe and fatal liver toxicity can sometimes occur.
Stivarga has already been made available to some patients through an extended access program. Regorafenib is also being considered for FDA approval for patients with gastrointestinal stromal tumors (GIST).
Be sure to check out CURE's feature on colorectal cancer in our Winter issue.RELATED POSTS
BY SUZANNE LINDLEY | SEPTEMBER 19, 2012
Most of you have heard about the seven-year itch. Some of you knew me when I wrote about it seven years ago. I'm using the same words today as I did then with the addition of seven years of living! The only thing I wish I could change is the ending. How I would love to say that there is now a cure for cancer.
Instead, I'll say that I'm grateful for the research that continues to allow me to, as Kathy LaTour so eloquently states, hitchhike treatments and buy more time. Today is my turn to experience a seven-year itch for the second time around, but again not for the reason many of you are thinking. Fourteen years have passed since my diagnosis with stage 4 colon cancer. To quote an age old song.... "what a long, strange trip it's been."
The journey has been more than extraordinary. It has been a great learning experience, filled with twists and turns, miracles and wonderment, heartache and triumph. It has been interesting and fun while at the same time scary and challenging. From that one day has sprung an entire life vision and a flourishing new perception. In these 14 years I have learned to embrace the ALL of life, to savor each precious moment, and to accept with awe the transformation of every day in spite of the words terminal, incurable, and hopeless.
The changes I've experienced with this disease have been abundant. Prognosis is better, yet there is much more work to be done in awareness, support and research. Only one approved treatment existed at my diagnosis. Since then Levamisole, Leucovorin, CPT-11, Oxaliplatin, Avastin, Erbitux, Vectibix, PTK-787, Iressa, Tarceva, Alimta, Regaforanib, RFA, cyberknife, gamma knife radiation, tomotherapy and SIR-Spheres have all been discovered - just to name a few. More are on the horizon. Vaccines are closer to reality. Medications for side effects, pain and fatigue have vastly improved. Hope lies around every corner.
For me and for so many others waging war against colon cancer, it has been an incredible encounter with the development of medical technology and treatment options. The selfless dedication of so many tireless advocates has paved the path for awareness of an underpromoted disease. Survivors are changing physician's perspectives. Their leadership and championing effort have opened doors for support and compassion for all those affected. When you start something new you hope for the extreme, you pray for the best, you prepare for the worst, but you never really know if you will be successful...you can only hope. These individuals, along with the many caregivers and survivors touched by this disease, have spent every hour of every day fostering that hope.
I have benefited from their diligent endeavor. I have discovered moving forward means sometimes moving in a direction that wasn't quite expected. Living involves finding miracles in circumstances that are less than miraculous, uncovering meaning in the meaningless, looking for sense in the senseless, and most importantly believing there is hope in the hopeless.
Fourteen years of living fully in spite of cancer is a major milestone! May you each experience a seven year itch (more than once) with as much depth and significance as mine. Celebrate with me!RELATED POSTS
BY LINDSAY RAY | AUGUST 6, 2012
On Aug. 3, the FDA approved Zaltrap (ziv-aflibercept) for treating patients with metastatic colorectal cancer and tumors that have progressed or are resistant to oxaliplatin-containing therapies. The drug is used in combination with FOLFIRI, a standard treatment regimen for colorectal cancer containing 5-FU (fluorouracil), leucovorin and irinotecan.
Zaltrap is an angiogenesis inhibitor, meaning it cuts off the tumor's blood supply, thereby inhibiting growth. While Avastin (bevacizumab), which is also approved for treating colorectal cancer, works by attaching to and disabling the vascular endothelial growth factor (VEGF) receptor, a necessary component for growing new blood vessels. Zaltrap also targets VEGF but does so through trickery and acting like the VEGF receptor, essentially setting a trap (thus the name) and preventing two proteins from starting new blood vessel growth.
The approval is based on results from the phase 3 VELOUR trial, which were reported at this year's American Society of Clinical Oncology (ASCO) meeting. In the study, 1,226 patients who had previously received some combination of treatment featuring oxaliplatin were randomized to receive Zaltrap and FOLFIRI or placebo plus FOLFIRI. The patients in the Zaltrap arm had a median overall survival of 13.5 months compared with 12 months in the placebo arm. Furthermore, Zaltrap extended progression-free survival to 6.9 months compared to the 4.7 months with FOLFIRI alone.
Some severe side effects were seen with Zaltrap, so the drug includes a boxed warning that it can lead to severe bleeding, particularly gastrointestinal bleeding, and holes in the gastrointestinal tract. It also might be harder for wounds to heal. Other side effects include diarrhea, fatigue, neutropenia, mouth ulcers and decreased appetite.
Many see this as an excellent step forward for this hard-to-treat patient population. In an email to CURE, Fight Colorectal Cancer's President Carlea Bauman stated, "Fight Colorectal Cancer is pleased that Zaltrap has been approved for patients with metastatic colorectal cancer. There are few treatment options for late stage disease, so adding Zaltrap to the list of drugs that physicians have to treat patients is hopeful news."RELATED POSTS