BY KATHY LATOUR | APRIL 26, 2013
Washington DC has become the City of Angels this week as more than 3,500 oncology nurses have gathered to attend the Oncology Nursing Society's 38th Annual Congress. CURE is present to confer our Extraordinary Healer award on one oncology nurse nominated by you, our readers.
This is the 7th year we have had the event and last night there was standing room only when some 750 nurses gathered in the ballroom of the Washington Convention Center to hear the three finalists read their essays before we awarded the top prize and an all expenses paid spa weekend in the Austin Hill Country.
Our mistress of ceremonies, actress Marlee Maitlin, was the youngest actress to win an Academy Aaward for Children of a Lesser God. It was mesmerizing to watch her sign her presentation while her interpreter, Jack Jason, spoke about her family's struggles with cancer and her feelings that, like deafness, cancer does not define a person.
This was the first year we didn't have all three essayists there to read their essay. In fact we had two who were seen on video.
Julie Hinson, RN, BSN, OCN, a nurse from the Gynecologic Oncology department at the Salem Cancer Institute at Salem Hospital in Salem, Oregon, was nominated by her patient Joyce Lowry. Lowry teaches in Okinawa, Japan, and couldn't travel to be with us.
Another essayist, Anne Ott of Metairie, Louisiana, stayed with her husband in the transplant unit of M.D. Anderson Cancer Center in Houston. She also delivered her essay about nurse Angela Krach on video and was represented by her parents John and Margaret Falgoust at the event.
The third finalist was Steven Cuzzilla, RN, ADN, from the Myelosuppression Bone Marrow Transplant Unit at Vanderbilt University Medical Center in Nashville, Tennessee. He was nominated by Cassie Jones of Ingleside, Texas.
Each of these nurses went above and beyond in their nursing careers for their patients -- from the mounds of forms needed by Lowry to travel back and forth when she learned she had had a recurrence of her cancer to Cuzzilla, who changed his career to oncology nursing after losing his wife to melanoma so touched was he by the loving care they received while she battled her cancer.
Angela Krach, RN, BSN was instrumental in helping Ann and her fiancé James get married in the chapel at M.D. Anderson. The couple was putting the finishing touches on their wedding for last summer when James was diagnosed and they picked up their lives and moved them to Houston from Metarie.
The event was made possible by sponsorship from Amgen Oncology and Millennium: The Takeda Oncology Company.
When Angela Krach was announced the winner, it was time to celebrate oncology nursing and the strength of these amazing women and men who have come this week to learn how to be there for us in our hour of need.
So if you haven't thanked your oncology nurse today, you might want to give him or her a call.RELATED POSTS
BY KATHY LATOUR | APRIL 17, 2013
We are all looking forward to the Affordable Care Act. At the same time, we are hoping that someone will be around to tell us how it relates to us. Let's face it. The administration didn't do a very good job of selling it or explaining it. Each of us is figuring out how it will apply to us as small issues surface.
We know that our kids can stay insured until 26, and we know as cancer survivors that our history can't be used against us.
Today there was a good piece in the Kaiser Health News feed that is available through email sign up. There are a number of these health care feeds available, and to be a knowledgeable consumer, I recommend you find them and sign up. Today they focused on screening tests for colon and rectal cancers.
Most health plans cover preventive health services if it's one of those recommended by the U.S. Preventive Services Task Force, and since colorectal cancer is the second leading cause of cancer death in the United States, it is one of those covered. Finding colon cancer early is the key to survival and that means removing polyps discovered during a colonoscopy before they turn into cancer.
The colonoscopy is one of those tests that should not cost the patient anything – unless, of course, polyps are found and removed, and that's when it gets complicated.
Because if polyps are removed to see if they are cancerous, the test can then be judged to be therapeutic or diagnostic rather than screening, and the patient can be billed for the cost – around $2,000 or more. Right now, half the people who get screening colonoscopies have polops removed.
And what about patients who have a positive fecal occult blood test before their colonoscopy? Is that colonoscopy part of the screening process or diagnostic? And what if they have a family history?
In February, according to Kaiser, the government clarified that high-risk patients who qualify for more frequent screening should not have to cost share.
Take the time to educate yourself on the specifics so you will know what you do and do not have to pay for.RELATED POSTS
BY KATHY LATOUR | APRIL 5, 2013
From Livestrong AUSTIN, Texas – April 4, 2013 – Today, The Washington Post reported that cancer centers across the United States are turning away thousands of Medicare patients due to recent spending cuts known as "sequestration." According to The Washington Post, the two percent cuts are unexpectedly harming cancer patients because cancer drugs, which must be administered by a physician, are among the pharmaceuticals covered by Medicare Part B and therefore subject to the sequester.
The LIVESTRONG Foundation has mobilized its free cancer support services to help anyone confronting challenges getting access to drugs understand their options and advocate on their behalf to ensure that a needed treatment is not withheld. The LIVESTRONG Foundation helps people affected by cancer navigate the health care system and overcome barriers to their care. These free cancer support services offer confidential, on-one guidance dealing with the financial, emotional and practical challenges that accompany a cancer diagnosis. These highly personalized and resourceful services are available in English and Spanish online, by phone and in-person. The Foundation's trained, bilingual navigators assist patients nationwide with a wide-range of issues including insurance coverage, financial assistance and employment concerns, as well as clinical trial matching, transportation and treatment options. Since its founding 16 years ago, the Foundation has served more than 2.5 million people affected by cancer.
"No one in this great country should be turned away from life-saving cancer treatment," said Doug Ulman, LIVESTRONG Foundation President and CEO. "We stand ready to serve any person in the U.S. affected by cancer, through our comprehensive, free services that help cancer survivors and their families cope with the financial, emotional and practical challenges that accompany a diagnosis."
• Emotional Support: Assistance coping with a cancer diagnosis, help accessing support groups, as well as peer-to-peer connections;
• Fertility Risks and Preservation Options: Information on fertility risks and help accessing discounted rates for fertility preservation options;
• Insurance, Employment and Financial Concerns: Information on employment rights and benefits, financial assistance and debt management, including insurance and billing issues as well as medication co-pay assistance; and
• Treatment Concerns: General cancer and treatment information, and matching to clinical trials.
• Access to Care: residents of Central Texas can receive free rides to and from cancer-related medical appointments through the Foundation's transportation program
People affected by cancer can access the Foundation's free cancer support services the following ways:
• By phone: (855) 220-7777 (English & Spanish)
• In person: LIVESTRONG Cancer Navigation Center, Address: 2201 East Sixth Street, Austin, Texas 78702
• To schedule an appointment, email email@example.com or call (512) 220-7777.
• For more information, visit LIVESTRONG.org/GetHelp/AustinRELATED POSTS
BY SUZANNE LINDLEY | MARCH 26, 2013
I have a thirst for wanting to accelerate medical research; a personal plea for more advances and greater funding that is instead threatened with huge cuts. When the drip of my chemo began 14 years ago I didn't think about the hard work, dedication and science that was behind my treatment or how many drips it would take to bring about a cure. I knew only that this scary concoction might prolong my life.
As new treatments were developed, I benefited but still didn't realize what was needed to get even one new treatment to my infusion room. I assumed that there would always be a treatment. I thought that there would be an easy fix. I know better now. For without research, I wouldn't be here today enjoying and harnessing the power of everyday life; creating extraordinary milestones out of ordinary moments.
I woke up this morning to what would have once been a normal day; a day pre-cancer that most likely would have been taken for granted. It is the everyday experiences provided to me through research that now bring me great joy. I listened to Chloe's steady breath, snuggled next to me after having made an appearance in the middle of the night. I let her sleep late while I, too, took in a few more minutes of rest. Today will be filled with everyday stuff and precious moments that interlace colorful life threads ... a lazy morning with my pre-schooler, lunch with Katie, texts with Karlie and dinner on the table when Ronnie gets home. ...finger painting, "Fancy Nancy," a quiet walk to the lake, a picnic and the grand feeding of the two resident ducks.
Spring is here and new life is budding on the trees. The season is awakening and I feel that I am, too.
Fourteen years feels like a breath, and like forever all at once. These years have been abundant with colorectal cancer research. Research that saved my life.
Tomorrow is chemo day. From the I.V. bag, slowly into the tubing and steadily into my veins I will watch the drip, drip, drip of research that will bring me even more time. I will be grateful that there are still treatments to receive. These treatments, procedures and clinical trials made possible because of cancer research have given me hope.
Twenty-eight million other Americans are counting on further cancer research to give them hope, too, but budget cuts at the National Institutes of Health (NIH) threaten those hopes and our lives. These cuts won't just affect those of us with cancer but will impede the research for every disease from Alzheimer's to Zellweger Syndrome (A to Z).
Your voice makes a difference. Join Rally for Medical Research and "unite with millions of Americans across the country to call on our nation's policymakers to make life-saving medical research funding a national priority. This unified call to action will raise awareness about the critical need for a sustained investment in the NIH to improve health, spur more progress, inspire more hope and save more lives. Visit Rally for Medical Research to get involved!
We need cures, not cuts!RELATED POSTS
BY KATHY LATOUR | MARCH 1, 2013
On Thursday Doug Ullman, the president and CEO of the LIVESTRONG Foundation, was to have delivered the state of the foundation report to the gathering of more than 500 leaders, partners, grantees and advocates from around the United States and the world who had gathered in Chicago.
Instead, operations executive VP Andy Miller took to the stage and said that, as cancer survivors we are used to adjusting when things don't go as planned, and as Ullman was stuck in the weather somewhere, he would be presenting the state of the Foundation. No matter who delivered the message, it was clear: The foundation is strong and it's not going anywhere.
Miller didn't ignore the elephant in the room, conceding that the admission by Lance Armstrong that he doped was a shock and disappointment to everyone. But he said that Lance did the right thing distancing himself from the Foundation so it can continue with its mission to help every cancer patient and survivor live every moment of every day of his or her life.
OK, enough about Lance and, no matter how you feel about Lance, get over it. The LIVESTRONG Foundation is moving on without him to keep offering myriad services and support to cancer patients and survivors around the country.
Miller also unveiled the new Logo for LIVESTRONG – a double bar, the top one the ubiquitous yellow with black lettering that says LIVESTRONG and then the second, a black bar below that extends past the top bar that says Foundation.
Reading from Ullman's prepared remarks, Miller said that the Foundation will celebrate LIVESTONG day on May 17th, moving it to the day the yellow wristbands were introduced nine years ago and away from the former day that Armstrong won his first Tour de France.
He also said the foundation's 2013 call to action would involve working on the medical community to include all phases of the cancer journey into their care.
The Foundation has been a primary source of support for research into survivorship issues by creating the LIVESTRONG Survivorship Centers of Excellence around the country. The reality is that nothing will ever change in how cancer survivors are treated until there is research behind it.
In talking to Ruth Rechis, the director of research and evaluation, she reiterated that the foundation focuses on determining what people going through cancer need and finding ways to provide it. They have been surveying the patient community through their navigation hotline as well as holding meetings to bring together thought leaders in survivorship about what essential elements should be included in survivorship programs.
From their home base in Austin, Texas, LIVESTRONG's navigation program offers phone support from 9 a.m. to 5 p.m. daily. Reichs says they are now exploring ways to expand the navigation model with needs assessments in other communities.RELATED POSTS
BY LINDSAY RAY | FEBRUARY 22, 2013
Today, Kadcyla (ado-trastuzumab emtansine, or T-DM1) received a long-awaited approval from the Food and Drug Administration (FDA) to treat patients with metastatic, HER2-positive breast cancer who have previously been treated with Herceptin (trastuzumab) or taxanes, a class of drugs that includes paclitaxel and docetaxel.
Kadcyla belongs to a new class of drugs called antibody-drug conjugates and works by fusing the powerful chemotherapy drug emtansine to the antibody Herceptin, which targets HER2 receptors on cancer cells.
The approval was based on results from the phase 3 EMILIA trial, which enrolled 991 patients who had previously been treated with Herceptin and a taxane-based chemotherapy. Patients were randomly assigned to either receive Kadcyla, or the current standard--a combination of Xeloda (capecitabine) and lapatinib. Those in the Kadcyla arm had a median overall survival of 30.9 months compared with 25.1 months for those in the combination arm. Patients receiving Kadcyla also had improved median progression-free survival: 9.6 months compared with 6.4. Furthermore, patients on Kadcyla experienced fewer severe side effects (grade 3 or higher) than those on Xeloda and lapatinib (43.1 percent compared with 59.2 percent).
Common side effects included low platelet count, nausea, fatigue and joint or muscle pain. This drug also carries a boxed warning (the highest warning the FDA can give) advising doctors and patients that in some instances, this drug can cause liver toxicity, heart toxicity and death. It can also lead to severe birth defects.
The drug is expected to be available within two weeks, and the estimated cost will be $9,800 a month, or $94,000 for a course of treatment. Genentech, the drug's manufacturer, is planning to begin patient assistance programs to help patients that might not be able to afford Kadcyla.RELATED POSTS
BY LINDSAY RAY | FEBRUARY 11, 2013
The Food and Drug Administration approved Pomalyst (pomalidomide) on Feb. 8 to treat patients with multiple myeloma who have progressed during or within 60 days after receiving at least two therapies, such as Revlimid (lenalidomide) or Velcade (bortezomib).
Pomalyst is a derivative of Thalomid (thalidomide), another drug used to treat multiple myeloma and in the same family of drugs as Revlimid. Called immunomodulating agents, these drugs incite the immune system to attack the myeloma cells.
The approval is based on a phase 2 clinical trial in which patients received either Pomalyst and low-dose dexemethasone, a type of steroid, or Pomalyst alone. In those on Pomalyst alone, 7.4 percent had their cancer completely or partially disappear compared with 29.2 percent for those receiving the combination. This response lasted for more than 7 months in the combination arm.
Pomalyst also performed well in a phase 3 clinical trial in which patients received either Pomalyst and low-dose dexemethasone, a type of steroid, or high-dose dexemethasone alone. Those in the Pomalyst combination arm lived 7.7 weeks longer without their disease progressing than those on the steroid alone. The median for overall survival had not yet been reached for those receiving Pomalyst when the data were presented at the American Society of Hematology annual meeting in December.
Common side effects included low white and red blood cell counts, fever and infections. The drug also includes a boxed warning (the highest warning the FDA can give) that pregnant women should not take the drug as it causes serious side effects, such as blood clots and birth defects. Therefore, prescribing physicians must be certified with the Pomalyst Risk Evaluation and Management Strategy (REMS) program.
For more information, visit pomalyst.com or call 800-931-8691.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 KATHY LATOUR | JANUARY 25, 2013
My email box had its usual number of press releases relating to health and well being this morning. I get them from all kinds of sources and generally scan to see if they relate to cancer before sending them off to the trash bin. This morning the CDC put out a media advisory about the latest state related smoking statistics. And then a few emails later it put out another one with a correction. That got me interested. They don't usually make mistakes, so I opened it.
The first one said: Each year, approximately 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million suffer from a serious smoking-related illness. Moreover, costs associated with smoking-related illness amount to nearly $96 million in medical expenses, $97 million in lost productivity, and 5.1 million years of potential life lost in the United States annually.
The corrected one said: Each year, approximately 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million suffer from a serious smoking-related illness. Moreover, costs associated with smoking-related illness amount to nearly $96 BILLION in medical expenses, $97 BILLION in lost productivity, and 5.1 million years of potential life lost in the United States annually.
That's right, BILLIONS.
What is the matter with us. Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 1 of every 5 deaths in the United States each year.
And you can be darned sure that lots of those billions are from uninsured Americans, meaning the cost is coming back to you and me in our insurance costs.
When do we stop this. When do we just put our foot down and demand that this end. We don't allow people to shoot us, but they can stand next to us and blow second hand smoke in our face -- or in the faces of children in their care.
Some states have made it really uncomfortable -- and costly to smoke. Check out how your state is doing at the CDC website.RELATED POSTS
BY ELIZABETH WHITTINGTON | JANUARY 7, 2013
Today, the Annual Report to the Nation on the Status of Cancer was released, again showing cancer deaths continue to decrease overall. That's the good news.
The not-so-good news is some hard-to-treat cancers aren't. Melanoma (men only), liver, pancreatic and uterine cancers have increased in the past decade.
The number of oral cancers associated with human papillomavirus (HPV) is also rising. HPV is most notably known to cause cervical cancer, but lately it has been the cause of the high rate of oral cancers, specifically oropharyngeal cancers. ["Facing the Facts: HPV-Associated Head and Neck Cancers Get a Second Look" June 14, 2012]
In 2011, an analysis from the National Cancer Institute predicted HPV-related oral cancers could significantly increase over the next decade, overtaking HPV-related cervical cancer. ["Men May Be at Greater Risk Than Women for Developing HPV-Related Cancers" June 8, 2011].
The Annual Report to the Nation on the Status of Cancer is co-authored by researchers from the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute and the North American Association of Central Cancer Registries. The full report will be available online and published in the Journal of the National Cancer Institute.
The report also features a special section on HPV, including HPV-associated cancers vaccination factoids. The NCI reports:
...in 2010, fewer than half (48.7 percent) of girls ages 13 through 17 had received at least one dose of the HPV vaccine, and only 32 percent had received all three recommended doses. Vaccination series completion rates were generally lower among certain sub-populations, including girls living in the South, those living below the poverty level, and among Hispanics. The national three-dose coverage estimate among girls ages 13 through 17 in 2010 falls well short of the U.S. Government's Healthy People 2020 target of 80 percent for three-dose coverage among girls ages 13 through 15...
The HPV vaccine is also approved for young boys. The CDC predicts that about 7,000 HPV-associated cancers in the U.S. may be prevented by vaccine each year in men, including oropharyngeal cancers.
Cancer prevention methods that appear so easy on paper (reduce tobacco, decrease obesity, vaccinate against cancer-associated viruses), unfortunately doesn't play out as quickly in real life. Here's hoping that we figure it out pretty soon.RELATED POSTS