Audrey Rabalais

 continues to fight his adenocarcinoma with Tarceva (erlotinib). Although Bailey has a particular genetic profile that made him unable to participate in the clinical trial mentioned in the article, he says his current scans are good and there are no recent brain metastases.

and her family and documented her journey through the final stages of non-small cell lung cancer. The resulting article, “

 in Spring of 2009. Two years after her passing, Judy's daughter, Christy Green, says the family is doing well and moving forward, always with their beloved mother, grandmother and and wife on their minds.

“We can all at least laugh now and remember the good times without just busting out in tears. It's not like she's off my mind,” Green says. Richard, Judy's former husband, suffered a heart attack and underwent bypass surgery in March 2009, five months after her death. Green says that just before he entered the operating room for the surgery, a nurse with gray hair entered the room. When the family read her name tag that said “Judy,” Green says they all suddenly felt OK.

“I told him 'You're going to be just fine. Mom is here with you.'” Richard now has an implanted defibrillator and is doing well, tackling projects around the house to keep busy.

Green's daughter, Heather, 22, recently graduated from college with honors and is planning on attending law school. Green says that Heather remembers her grandmother by writing down her thoughts and memories. Brandon, 15, Green's oldest son, recently got his learner's permit to drive and wishes he could take his late grandmother driving. However, he keeps her memory alive in the kitchen. Green says his specialty is spaghetti with homemade sauce, the first thing Judy taught him to cook. Nine-year-old Ethan was the closest to Judy and cherishes the pictures he made with his grandmother. Like Heather, Ethan also continues to write down his thoughts about Judy.

 featured her battle with metastatic cancer in the Summer issue's “

” article. Since then, Lindley, 43, has had a birthday and a 24th wedding anniversary with her husband Ronnie, and they have added a member to the family. On July 19, they adopted 2-year-old Chloe, who was formerly their foster child.

Lindley has organized several liver cancer symposiums across the country, offering treatment advice and support to physicians and survivors of liver cancer. So far, the attendance has far exceeded Lindley's expectations.

“It makes you realized there are so many people out there who have liver cancer and liver metastases,” Lindley says. Through her organization, 

, Lindley has also organized the “Speedways deLIVER Hope” campaign. Race fans can bid on luxury suite tickets to NASCAR races, and all proceeds go to support for those affected by liver tumors. YES has received advertising and promotion in many major sports programs and will be featured in the World Series programs. “We're just a shoestring organization, and to have the support and backing has just been really incredible,” Lindley says.

Despite maintaining a schedule that would exhaust even the healthiest of people, Lindley's health is good. “My tumors are stable for the first time in a long time,” Lindley says. She is currently on a chemo break, and she and her doctors have been mixing and matching treatments.

” about revealing medical history to significant others as the Spring 2009 issue's Readers Forum. Though the relationship mentioned at the end of the essay did not work out, Zimmerman has not lost hope. He says he tends to reveal his medical history earlier in a relationship than he previously did.

“I'll tend to tell the story a lot sooner rather than later just to kind of get it out there and have everything on the table,” Zimmerman says. He now refers his dates to the published essay, saying that it is easier for them to read his medical history and his thoughts on the issue rather than putting it into words every time.

Since the publication, Zimmerman has added only a sinus surgery to his impressive list of medical procedures. His advice to others on revealing medical history is to reveal it as soon as possible, but to be nonchalant about it.

“Spin it in a positive way,” Zimmerman says. “Come to terms with being sick and make it positive, not 'I'm really messed up.' ”

” article in the Summer 2009 issue, died from the disease Dec. 4, 2010. After his diagnosis of stage 4 renal cell carcinoma, a type of kidney cancer, in late 2007, Benner had “hitchhiked” on a number of recently approved drugs. Unfortunately, in August, imaging scans showed an inoperable tumor above his hip, which led his oncologist to recommend a clinic trial. In September, scans found small lesions on his brain, which were treated with radiation. Afterward, he began another newly approved treatment, Votrient (pazopanib), to battle the metastatic cancer.

“The side effects of the radiation were just too much for his already declining health,” says his girlfriend, Teresa Morris. Marc entered hospice on Dec. 2 and died the morning of Dec. 4 surrounded by family and friends.  Morris says Marc had wanted to update 

 on his progress. “I am doing it to honor him and to hopefully educate others,” she says. 

Since January, Bailey has become a globetrotter. He has sailed around Fiji, climbed mountains in New Zealand, skydived into Aruba, zip-lined through Costa Rica and dined with his parents in France and Germany. When he is in the United States, Bailey continues to substitute teach in Columbus, Ohio and keeps up with his children, ages 10, 6 and 4.

“I have to stay positive. One day they're gonna find a cure and I hope to be around when they find it,” Bailey says.

Articles

CURE hears from survivors and caregivers featured in past issues and shares how their lives have changed.

An Update from Friends

Pain and depression are two of the most common symptoms experienced by cancer patients, but they are not always recognized and treated properly. However, a recent study suggests that oncology practices can detect and alleviate these often-undetected symptoms and improve patient quality of life by using simple technology.

A large percentage of cancer patients suffer from pain or depression, and up to 40 percent experience both, according to Kurt Kroenke, MD, lead investigator of the study and professor of medicine at the Indiana University School of Medicine. Such knowledge led to the year-long Indiana Cancer Pain and Depression (INCPAD) trial.

“While they are among the most common and disabling cancer-related symptoms, pain and depression are also among the most undertreated symptoms,” says Kroenke, “so we decided to do a study to improve their care.”

The INCPAD trial used telephone care management, which combined automated survey calls and follow-up calls by a nurse care manager, to diagnose and mitigate the symptoms of pain and depression. Patients continued to visit their oncologist for their primary cancer care. The trial included 405 patients from 16 different oncology practices in Indiana. Researchers did not select for a specific tumor type, cancer stage, or whether they were in active treatment or a survivor.

“What they had in common was they all had cancer,” says Kroenke. “What we were treating was not their cancer, but their pain and depression.”

While they are among the most common and disabling cancer-related symptoms, pain and depression are also among the most undertreated symptoms.

Participants in the study had to have had at least moderately severe depression (131 patients), moderately severe pain (96 patients), or both (178 patients). Patients were randomly assigned to either a usual care group or a telecare management group, with an even distribution of pain and depression in both groups.

Those in the usual care group received standard treatment from their oncologists with no special attention to pain or depression other than what would normally occur. The intervention group received automated symptom-monitoring surveys twice a week at the beginning of the trial, then in decreasing frequency for those showing symptom improvement as the trial progressed. Patients chose to receive the surveys either by an automated telephone call scheduled at their convenience or via Internet. Survey items included brief scales for pain and depression and questions about medication use, side effects, overall improvement, and desire for additional medical attention—usually resulting in a follow-up call from a nurse.

The survey results were sent to a nurse care manager who tracked each patient’s responses as the study progressed. If a patient showed signs of increased or unchanging pain or depression, the nurse would then contact the patient by phone to discuss the results and treatment. The nurse care manager met weekly with a pain and depression specialist who offered treatment recommendations for patients with persistent symptoms. These recommendations, often for prescription medications, were then sent to the patient’s primary oncologist to be considered.

With these positive results, the INCPAD trial shows that both physical and psychological symptoms can be alleviated with telephone-based care, potentially reducing unnecessary visits to their oncologists’ office.

After one year, pain and depression were assessed in both groups. Pain was evaluated using a system called the Brief Pain Inventory (BPI) while depression was evaluated by the Hopkins Symptom Checklist. The researchers found that of the patients with pain, patients in the intervention group had greater improvements, with more having at least a 30 percent decrease in BPI score. Depression improved in the intervention group as well, with more having at least a 50 percent decrease in depression severity.

With these positive results, the INCPAD trial shows that both physical and psychological symptoms can be alleviated with telephone-based care, potentially reducing unnecessary visits to their oncologists’ office, notes Kroenke.

Becky Sanders, RN, BSN, the nurse care manger for the study, mentioned that telecare extends beyond the relief of pain and depression. She not only compiled survey results and called patients about symptoms but also helped with details such as questions about medications and transportation issues.

“It was often that I could so easily fix something for a patient by just a simple answer to a question that would keep them from needling to call back into the clinic,” she says. “I think that the practices do a really good job of educating patients, but I equally think patients are just overwhelmed.”

According to Kroenke, many patients said they could feel more comfortable bringing up details about their symptoms than if they were in a doctor’s office with the pressures of a limited appointment time because they were in a comfortable place and had time to think about the survey questions. The next step in telecare management, he says, is to cover a broader range of symptoms, including fatigue, nausea, anxiety, and insomnia.

“If you could figure out what parts of clinical care we deliver that could be best done by phone and what things really need the patient to come in physically, then I think we can come up with a more patient-centered approach,” says Kroenke.

You can read the full results of the study in the July 14, 2010 issue of the 

http://jama.ama-assn.org/cgi/content/full/304/2/163

Journal of the American Medical Association. 

A recent study suggests that oncology practices can detect and alleviate pain and depression and improve patient quality of life by using telecare. 

Dialing It In

Skin cancer advocates hope a new 10 percent tax on indoor tanning will pull tanners out from under the bulbs. The tax, which went into effect  July 1, is part of the new health care law and could generate up to $2.7 million over 10 years. 

Skin cancer advocates hope the tax will lower melanoma and other skin cancer rates in the United States. More than 2 million people are diagnosed annually with non-melanoma skin cancer;  2,000 will die from it each year. Melanoma, which is the more deadly type, was diagnosed in more than 68,000 people and claimed 8,700 lives in 2009. 

The WHO’s International Agency for Research on Cancer classified ultraviolet-emitting tanning devices as Group I agents, meaning they are confirmed to be carcinogenic. A recent study shows participants who used tanning beds for more than 50 hours were 2.5 to 3 times more likely to develop melanoma than those who had never used them. Experts such as William D. James, MD, president of the American Academy of Dermatology, hope that research and federal laws will be enough to convince the public that tanning beds are bad. 

“It really adds a lot when the federal government steps in and says ‘we’re going to tax this,’” says James. “It gives a much stronger public health message.” The AAD is also working to ban indoor tanning to minors, following in the footsteps of several European countries that completely ban access to those younger than 18. In the U.S., Howard County, Maryland, became the first to ban tanning access to minors last year. Currently, eight states ban individuals under 14 from tanning beds. Most require parental permission for those under 18. 

For more on tanning and cancer, and to comment on this topic, read 

Skin cancer advocates hope a new 10 percent tax on indoor tanning will pull  tanners out from under the bulbs. 

Tan Tax Begins

, 65, will undergo eight weeks of radiation and chemotherapy for a tumor found in his throat. His doctors say they expect him to make a full recovery, and Douglas is said to be optimistic. The actor’s latest film, 

 for which Douglas won an Academy Award portraying the cut-throat Gordon Gekko, will hit theaters beginning Sept. 24. Douglas has also been active in supporting roles for various charities over the years. 

 announced on June 30 that he had been diagnosed with esophageal cancer. The British-born author, best known for his atheist book 

 began challenging fans to register as bone marrow donors after learning that 11-year-old 

 was diagnosed with acute myeloid leukemia in April. Tavarez was diagnosed about six months after she landed the role of young Nala in the Broadway production 

. Her best chance of survival is through a bone marrow transplant. However, Tavarez’ father is Dominican (Hispanic) and her mom is black. Both ethnic groups are highly underrepresented in donor registries (Latinos make up 10 percent, blacks 8 percent, in the National Be The Match Registry). To learn more about becoming a bone marrow donor, visit 

To mark the first anniversary of her death, friends and family of 

 dedicated a cancer research foundation in her honor. The Farrah Fawcett Foundation was created by close friend Alana Stewart, beau Ryan O’Neal, his daughter Tatum O’Neal, and their son Redmond O’Neal. The 

 star died June 25, 2009 from anal cancer, and through the foundation her friends hope to raise awareness about this rare form of cancer. The foundation will also focus on funding alternative research and treatment methods and pediatric cancer.

 created “Monsters against Myeloma,” a fundraising contest and awareness campaign for multiple myeloma after his mom was diagnosed with the disease earlier this year. To raise money for the Multiple Myeloma Research Foundation, he auctioned off his floor seats to Lady Gaga’s concert in Edmonton, Canada. With the help of other “little monsters,” which is Gaga’s name for her fans, the 21-year-old student from Alberta, Canada, raised more than $2000, which included the winning bid for the tickets and additional donations. You can view Chung’s MMRF fundraising page 

Audrey Rabalais

An Update from Friends

Dialing It In

Tan Tax Begins

Douglas "Optimistic"

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