BY KATHY LATOUR | MAY 15, 2013
Results from one of the first studies looking at fitness has concluded that a high level of cardiovascular fitness in middle-age men reduces their risk of developing and dying from lung and colorectal cancer. In addition, while it doesn't reduce their risk of developing prostate cancer, it does reduce their risk of dying from the disease.
Lead author Susan Lakoski, MD, assistant professor of medicine at the University of Vermont, partnered with the Cooper Institute in Dallas where she followed more than 17,000 men who underwent a single cardiovascular fitness assessment at the institute as part of a specialized preventive health checkup at a mean age of 50 years. The test entailed walking on a treadmill while the speed and elevation were increased.
Each man's performance was recorded in one of five groups (quintiles) of established units of fitness called metabolic equivalents (METs) depending on their level of fitness.
"When you ask someone about their physical activity, you get information that may or may not be correct," Lakoski points out. "Fitness is a formal measurement that is known to prevent cardiovascular disease. Now it is also known that it helps in terms of survival risk. What hasn't been known is if it prevents cancer and affects mortality after cancer diagnosis and that is what is elucidated in the current study."
Over a median follow up of 20 to 25 years, researchers analyzed the Medicare claims data of the men who took part to identify who had developed lung, colorectal or prostate cancer. They found 2,332 were diagnosed with prostate cancer, 276 with colorectal cancer and 277 were diagnosed with lung cancer. There were 347 deaths attributable to cancer and 159 deaths due to cardiovascular disease.
Analysis of the numbers indicated that the risk of being diagnosed with lung or colorectal cancer was reduced by 68 and 38 percent, respectively, in men who were the most fit, relative to those who were the least fit. Prostate risk was not significantly impacted. Factors such as body mass index, age and smoking were taken into consideration. Indeed, an interesting finding was that men with low fitness score had an increased risk of cardiovascular disease and cancer even if they were not obese. For the men who developed cancer, those who were more fit at middle age, their chances of dying were lower.
Lakoski calls the research into fitness and its connection to cancer "early and promising."
"There are several benefits in measuring fitness," she says. "It's an accurate and stable marker to exercise exposure and it can be measured over time. It also provides a benchmark for patients to determine how they stack up against other individuals of similar age and sex and it allows clinicians to personalize prescriptions for their patients."
These findings, she says, make clear that patients should be advised that they need to achieve a certain fitness level and not just be told they need to exercise.RELATED POSTS
BY KATHY LATOUR | MAY 14, 2013
Women who are diagnosed with breast cancer usually do one of two things, they go through treatment and get back to their lives, or they go through treatment, get back to their lives and also get involved in some aspect of breast cancer. Either path is just fine, and I know women who have gone both directions.
I needed to get involved. The primary reason I chose to do so was that when I was diagnosed in 1986, there were very few young women out there who were advocating for support once treatment ended. We know now that survivorship services are more than nice, they are essential to our emotional and physical health and well being. I just knew that for me when it was supposedly over – it wasn't over. I had a 1-year-old and I spent the majority of my time reading the obituaries and wondering when I would wake up with a lump somewhere that it wasn't supposed to be.
I learned fear was much scarier than surgery.
And I also found that when I was doing something for someone else, I wasn't as consumed with fear of recurrence. I also spent a lot of time angry, and being busy tended to keep that under control. At first I was angry at the healthcare system that wasn't providing what I saw as essential, equal services for all women. Then I was angry at cancer when I found out that my daughter might be at risk for breast cancer. When I learned I didn't carry the breast cancer genes, I was just angry that cancer took the lives of so many young women and that we weren't making much headway in learning why. Then I was angry that there weren't any survivorship services. By then the anger had dissolved into passion about educating women and helping women get treatment.
Then in 1992 my mother was diagnosed with metastatic breast cancer. She died six months later and I got angry all over again.
In 2008 I learned I had been named a Pink Power Mom by The Bright Starts division of Kids II®, national baby and children toys and gear creator that has lines such as Baby Disney and Baby Einstein as well as Bright Starts and Ingenuity. This organization decided to name eight women a year from communities across the nation Pink Power Moms and help support their 501c3 nonprofits with a $5,000 check. I was in the class of 2008 and since then they have named a class each year.
Now with six classes, the Pink Power Moms are coming together to support each other in their endeavors with advice and support in their various causes. We also help get the word out when nominations are open for the next class of Pink Power Moms, which is what today's blog is doing.
So, this is your chance to get some recognition for that breast cancer survivor mom who has turned her energy toward making a difference. If you are wondering if she is a worthy candidate just go to the Kids II web page and read what the other Pink Power Moms have been up to and decide for yourself. If you think she would make a good Pink Power Mom, nominate her. The eight selected will each get $5,000 for the nonprofit of their choice plus $1,000 a year for five years. They will also get a weekend of pampering in Atlanta in February 2014 where they will meet and discuss their directions for the year.
They will also meet the recently formed steering committee to talk about plans for the future. So, get those nominations in.RELATED POSTS
BY KATHY LATOUR | MAY 10, 2013
I am beginning to feel like I used to when my dad would say, "Shop around" before I got my car fixed. I am being facetious, but the new reports on the varying costs for procedures coming from hospitals reminds me of the day I asked my plastic surgeon how much a procedure cost, and his reply was, "You have insurance don't you."
That's not the point, but let me back up.
For those of you who have been on a desert island, the government has for the first time released data on what hospitals are charging Medicare for specific medical procedures.
While some of the differences are bound to be clerical and the distinction between what one hospital includes in a defined service compared to another, it's fairly clear we have some significant discrepancies here, and we are all being hurt by them. You can see where they biggest costs accumulate with an excellent map created by National Public Radio that has the South looking rather greedy.
Medicare is under the gun. My last blog had to do with cuts to cancer clinics that are sending cancer patients on Medicare to hospitals for treatment. These hospitals may be hundreds of miles from the patients' homes and require that they acclimate to all kinds of new procedures and people that require difficult, confusing and stressful transitions. For those clinics that try to hang on to their patients, the cuts will be made in support staff and other overhead.
What galls me the most about this whole cost structure issue remains the bottom line for the poor. These procedure costs are not just for Medicare, they are the costs for the procedure, and they are also billed to insurance companies who can negotiate a lower rate based on the fact that they are insurance companies and that is how they operate. So insurance companies speak for the insured and Medicare speaks for the elderly and in some instances Medicaid speaks for the destitute.
The people who get hit with the whole bill are the hard working lower middle class who don't have insurance and aren't poor enough to get Medicaid.
We already know that anyone who gets cancer, insured or not, will probably declare bankruptcy. Yes, your read right, with insurance. If your insurance pays 80 percent that still leaves 20 percent for those without really good insurance. Add up 20 percent of $300,000 for two years and you have massive debt, and that does not account for loss of income and all the personal expense that goes into a cancer diagnosis.
I really don't know where to go from here – except England. Oh, except I don't believe in socialized medicine either.RELATED POSTS
BY KATHY LATOUR | MAY 7, 2013
For most of us the "sequester" has just been a weird word that meant small airports were going to have to shut down because of less federal money to keep them open.
But for those of us in the cancer community, the sequester is now emerging as something that will impact us in a number of ways -- some immediate and some long term.
Last week I heard a story on NPR about less money being granted for research by NCI and other funding agencies in Washington because of the sequester. They interviewed a young cancer researcher who spent most of her time trying to find funds to set up her lab. She had been unsuccessful, and by the end of the interview said she was considering looking into other areas for a career.
Folks this is the brain trust that will find the cure for us – and they can't get the money to do their work. Score one for Sequester – 0 for cancer.
Now it's cancer treatment for our Medicare patients who are being cut off due to the sequester. To follow the impact of the sequester and Obamacare in general, read the Washington Post blog by Sarah Kliff. One of her latest blogs, which you can see her discuss here in a video blog, pointed out that the small clinics around the country that take Medicare patients are having to turn them away because of the Medicare cuts required by the sequester.
Right now the oncologists who administer expensive chemotherapy drugs, and many are very expensive, are reimbursed by Medicare plus 6 percent for storage and all the costs associated with giving the drug. The cost of the drug isn't going down, so it's the associated costs that are being cut.
These are costs associated with running the clinic and hiring staff called nurses. The critical part of cancer care we have been fighting in the cancer community for more of not fewer. The answer found by the clinics is to turn the patients away and tell them to go to hospitals for treatment, which ultimately will be more expensive, and, by my way of thinking, less personal than their clinic setting.
Indeed, a study done by Millman found Medicare patients ended up with an average of $650 more in out-of-pocket costs when they were seen only in a hospital. And for rural cancer patients, traveling to a larger cancer center may mean significant travel they can neither afford nor endure.
One report even had Rush Limbaugh eating his words. When he announced that the so called cuts to Medicare were, in fact, inaccurate and that Medicare was protected, one of his own followers, a conservative oncologist called in and explained that, actually, Medicare cuts were causing Medicare patients to be sent to other locations or to be turned away.
What does all this mean. Medicare is supposedly one of our protected rights. We worked for it, but it's looking more and more like it will be gone by the time many of us get a chance to use it -- and if we can there won't be any doctors left who take it. And as for those who have the misfortune to be diagnosed with cancer while on Medicare, well, . . .RELATED POSTS
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 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 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 11, 2013
On Tuesday in Dallas we saw the second screening of Decoding Annie Parker, the movie by first-time director Steven Bernstein about the search for the BRCA 1 and 2 genetic mutations that increase the risk of breast cancer for those who carry them.
It's an important movie, and those of us who know women who carry the BRCA gene want it to be in every theater in the country. I don't know that this will be a reality, but I wish it were. Right now the film is making the rounds of film festivals and then it will be shown in conjunction with nonprofits such as FORCE (Facing our Risk of Cancer Empowered).
The movie follows the lives of two women, researcher Mary-Claire King,PhD, and Toronto resident Annie Parker, who has watched breast cancer take her mother, sister and various other women in the family. We see way more of Annie's life than we need to so we'll understand she is a wacky, fun young woman who wants to live before the inevitable happens and she is diagnosed with breast cancer. She survives to continue her work on trying to understand the DNA that we never quite understand. At the same time we get glimpses of Mary-Claire King over a period of years as she gathers her team and discusses the next question that they must answer to ultimately bring it all together. We see time pass with the kind of computers they use and the length of everyone's hair until finally the gene is found.
In the meantime Annie has been diagnosed with breast cancer and then ovarian cancers, and we see a scene of chemotherapy that is more than realistic for anyone who has been there.
In quizzing some folks in the theater who didn't know about BRCA, I asked if they understood the whole issue about the gene and how to find it, and, while they got the general idea, they really didn't understand what King was looking for and what she found.
Overall, it's an important movie, but it needs to spend less time on Annie and more explaining what King is doing and why. The highlight of the night was the presence of Annie Parker, who is touring with the movie to talk about the gene. To see her and hear her energy around women getting information really sent me out with new energy.
Bernstein was also present and I give him a big thank you for his commitment to the project.RELATED POSTS
BY KATHY LATOUR | APRIL 5, 2013
For those of you near Dallas, come on into town next Tuesday evening for the second national showing of Decoding Annie Parker at the Angelika theater at Mockingbird Station. The movie starts at 7:30 and director Steven Bernstein will be on site. The national premiere took place in New York City on April 1.
This is the true story of geneticist Mary Claire King and Canadian breast cancer survivor Anne Parker, who both spent years fighing their own communities to convince them that breast cancer had a genetic component. As we all know, King's work resulted in identification of the BRCA1 and 2 genes. Parker was the first woman in Canada to get the test after losing her mother and sister to breast cancer and going through her own battle with the disease.
You can get tickets for the movie at the website for the film festival and I'll see you there.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