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Patients Split on Discussing Out-of-Pocket Treatment Costs
November 24, 2015
Despite growing interest in the financial burden of out-of-pocket cancer treatment costs, little is known about whether patients actually want to talk about costs with their oncology team. A survey of 300 insured patients is shedding some light on the subject, finding that although 48 percent indicated that they never wanted to discuss the topic, the remainder expressed some level of interest in such conversations.

The survey also found that when these patient–provider discussions took place, it had a positive impact on treatment costs.

Patients with cancer face higher out-of-pocket expenses than individuals with other chronic illnesses, and studies have shown that worry over treatment costs negatively impacts patient quality of life, even for patients with health insurance. For this study, a research team ...

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Recent Approvals Represent Major Steps Forward, But Work Remains in Treatment of Melanoma
November 23, 2015
Since October 1, the FDA has approved two drugs and two drug combinations in melanoma: Opdivo (nivolumab) and Yervoy (ipilimumab) for BRAF V600 wild-type unresectable or metastatic disease; Imlygic (talimogene laherparepvec; T-VEC) for advanced melanoma; adjuvant Yervoy for stage 3 disease at high risk of recurrence following complete resection; and Zelboraf (vemurafenib) and Cotellic (cobimetinib) for metastatic or unresectable BRAF V600E/K mutation-positive melanoma.

To gain insight into this flurry of FDA activity, CURE spoke with Tim Turnham the executive director of the Melanoma Research Foundation.

CURE spoke with Turnham before the approval of Zelboraf and Cotellic on November 10. Read our story about that approval and a statement from Turnham.

What are your overall thoughts on these three drug approvals? Which do you think will affect more patients immediately or in ...

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Making the Case for Neoadjuvant Chemotherapy in Ovarian Cancer
November 16, 2015
Neoadjuvant chemotherapy is increasingly used in advanced ovarian cancer, even though it has not been shown to improve survival versus primary cytoreduction, according to Thomas J. Herzog, clinical director of the University of Cincinnati Cancer Institute.

“There’s growing use of neoadjuvant chemotherapy. It’s gone from less than 10 percent in the 1990s all the way up to well over 35 percent now, if you look at registries,” Herzog said in a presentation at the 33rd Annual Chemotherapy Foundation Symposium, a meeting of over 1,000 physicians and other oncology professionals in New York City.

At the meeting, Herzog reviewed key studies examining whether this increased use of neoadjuvant chemotherapy versus primary surgery is justified.

The phase 3 EORTC 55971 trial (N Engl J Med. ...

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FDA Approves Tagrisso for Resistant NSCLC
November 13, 2015
The FDA has approved Tagrisso (osimertinib, AZD9291) for patients with advanced EGFR T790M mutation positive non–small cell lung cancer (NSCLC) following prior therapy on a prior EGFR TKI, based on data from 411 patients from two single-arm studies.

In the first study, labeled AURA, the objective response rate with Tagrisso was 61 percent for those with previously treated EGFR T790M-mutant NSCLC (201 patients). In the second study, known as AURA2, the objective response rate was 57 percent among 210 patients, according to the FDA. Along with Tagrisso, the FDA also approved the cobas EGFR Mutation Test v2 as a companion diagnostic.

“Our understanding of the molecular basis of lung cancer and reasons these cancers become resistant to prior treatments is rapidly evolving,” Richard Pazdur, ...

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Expert Cautious About Immunotherapy for Ovarian Cancer
November 09, 2015
Early promising responses seen with immune checkpoint inhibitors for patients with ovarian cancer still need to be validated in larger randomized trials before a conclusion is made regarding their true efficacy, according to a presentation by Maurie Markman at the 33rd Annual Chemotherapy Foundation Symposium, a meeting of over 1,000 physicians and other oncology professionals in New York City.

“The checkpoint inhibitors are not ready for prime time yet in ovarian cancer. It's not because there's evidence that they don't work — it's just that there's no evidence at all,” said Markman, president of Medicine and Science at the Cancer Treatment Centers of America. “You could not think of a more appropriate tumor type to explore the concept of immunotherapy than ovarian cancer. Unfortunately, ...

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FDA Approves Adjuvant Yervoy in Melanoma
October 28, 2015
The FDA expanded the approval of Yervoy (ipilimumab) in melanoma to include adjuvant treatment of patients with stage 3 melanoma at high risk of recurrence following complete resection.

The approval is based on results from the phase 3 EORTC 18071 trial, in which adjuvant Yervoy reduced the risk of recurrence by 25 percent versus placebo. In the trial, Yervoy was administered at 10 mg/kg, which is higher than the FDA-recommended dose of 3 mg/kg.

To help provide access to all patients at this dose and in this setting, Bristol-Myers Squibb, the manufacturer of the drug, is offering an assistance program. Through the program, all patients, whether insured or uninsured, will be able to receive Yervoy at 10 mg/kg free of charge for the duration of ...

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The Many People on Your Breast Cancer Treatment Team
October 27, 2015
Josette Snyder

Josette Snyder

Learning that you have breast cancer can make you feel terribly isolated. Suddenly you find yourself in a new, unfamiliar world. But you are not alone.

The best cancer treatment today embraces interdisciplinary patient care, and uses a broad approach with a team of health care and medical providers – all of whom are watching out for you.

Take a few minutes to think about the many people who surround you and want to help you through treatment into survivorship. Who is on your team?

Your Physicians

Your physicians are the medical experts who are in charge of your treatment plan. They will discuss the risks and benefits of the plan, answer ...

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New ACS Breast Screening Guidelines Reinforce Need for Education
October 22, 2015
On Tuesday, the American Cancer Society (ACS) released its updated breast cancer screening guidelines to recommend that women at an average risk of breast cancer should wait to undergo annual screening mammography until they reach the age of 45. After age 55, the guideline recommends transitioning mammography to every other year.

Prior ACS guidelines recommended that annual screening should begin at age 40. In this update, screening for women age 40 to 44 is listed as a personal choice rather than a strong recommendation. For women over the age of 55, annual screening is listed as a choice, rather than a recommendation, in favor of biennial (every other year) exams. The new guideline did not place a maximum age on screening, as long as ...

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Survivors, Patients Face Challenges in the Workplace
October 19, 2015
The majority of survivors and patients with cancer want to work but are faced with common challenges such as fatigue, managing side effects, and taking longer to complete work tasks, a recent survey has found.

The online Harris poll, administered on behalf of Cancer and Careers, surveyed 913 employed and unemployed patients and survivors of cancer between May 6 and June 3, 2015.

Survey results revealed that 73 percent of patients and survivors of cancer want to work, but 59 percent of those who worked through treatment reported feeling that they had no choice. In addition, 68 percent of employed survivors reported financial concerns as their primary reason for continuing to work during treatment.

While nearly 70 percent of patients and survivors agreed that working ...

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Beyond Relief: More Than Symptom Palliation in MPNs
October 15, 2015
When it comes to controlling myeloproliferative neoplasms (MPNs), keeping symptoms at bay has long been the go-to treatment strategy. But drugs that can attack the disease itself are hovering on the horizon for the treatment of MPNs, rare blood cancers that are caused by mutations in the stem cells and characterized by the excess production of white blood cells in the bone marrow. The three main types are polycythemia vera, myelofibrosis and essential thrombocythemia; chronic myeloid leukemia is also considered an MPN, although biologically distinct and treated differently. MPNs that are chronic can, in some cases, turn into acute leukemia.

While patients with asymptomatic or lower-risk disease can opt for observation, treatment is called for in those with higher-risk cases.

In myelofibrosis, one ...

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Medical Illustration: Treatments for NHL
October 12, 2015

Two types of effective treatments for non-Hodgkin lymphoma are cell signaling inhibitors and monoclonal antibodies.

Illustration by Erin Moore

Click to enlarge/download [Illustration by Erin Moore]

  • Cell signaling inhibitors block overactive communication pathways, which send messages from the surface of a cancer cell to its nucleus. Blocking this communication stops the cell’s growth and survival. The leading molecules, or message transmitters, in this pathway are phosphatidylinositol-3-kinase (PI3K), Bruton’s tyrosine kinase (BTK) and mammalian target of rapamycin (mTOR). Blocking these kinases with drugs like idelalisib (Zydelig), ibrutinib (Imbruvica), everolimus (Afinitor) or temsirolimus (Torisel) stops the cancer cells from growing.
  • Monoclonal antibodies recruit the immune system’s natural killer cells to attack the tumor. They do this by targeting specific receptors ...

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FDA Expands Opdivo Approval in Lung Cancer
October 09, 2015
Acting three months ahead of schedule, the FDA approved Opdivo (nivolumab) for patients with nonsquamous non–small cell lung cancer (NSCLC) who progressed on or following platinum-based chemotherapy.

The approval is based on data from the phase 3 CheckMate-057 trial, in which second-line Opdivo reduced the risk of death by 27 percent versus docetaxel in patients with nonsquamous NSCLC, including a 60 percent risk reduction among patients with the highest levels of PD-L1 expression.

Opdivo was previously approved in March 2015 for patients with squamous cell NSCLC who have progressed on or after platinum-based chemotherapy. A diagnostic ...

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Buying Hope: Life After a Fertility-Threatening Diagnosis
October 01, 2015
Photo courtesy of Jennifer Manning

"Boys are at a friend's house so we came to our 'happy place!'" - Jennifer Manning (left)
[Photo courtesy of Jennifer Manning]

In 2004, while living and working in New York City at age 31, just two months before my wedding, I was diagnosed with Stage 4 thymoma, a rare form of thymus gland cancer. As you can imagine, after all of the tests and doctors appointments with oncologists, surgeons, etc. the most important topic was creating a plan. I was given time to be scared, to cry and worry and cry some more and then my doctor said, “No more tears, time for a plan. Here’s what we’re going to ...

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Marathon Men: Living Longer With Prostate Cancer
September 24, 2015
The course of Jim Kiefert’s life took an unexpected turn 26 years ago during a routine physical examination. Along with the usual blood work, his doctor offered to perform a test that was new back then, the prostate-specific antigen (PSA) test, which measures the PSA level in the blood and can, if the level is high, indicate the presence of prostate cancer.

His test revealed a serum PSA concentration of 39 nanograms per milliliter (ng/mL); most healthy men have a PSA level below 4.

“Not only did they find out that I had prostate cancer, but it had also spread to the seminal vesicles,” Kiefert says. “So I began to do research on what to do from that point.”

FDA Approves Lonsurf for Advanced Colorectal Cancer
September 22, 2015
The FDA has approved the oral nucleoside Lonsurf (TAS-102) for the treatment of patients with advanced colorectal cancer (CRC) who have not responded to other treatments, based on results from the phase 3 RECOURSE trial.
In the RECOURSE study, the median overall survival (OS) for patients with refractory metasatic colorectal cancer (mCRC) who received Lonsurf was 7.1 months compared with 5.3 months with placebo. The median progression-free survival (PFS) in the Lonsurf arm was 2 months versus 1.7 months with placebo.
“The past decade has brought a new understanding around colorectal cancer, in how we can both detect and treat this often devastating disease,” said Richard Pazdur, director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation ...

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On Guard: Gauging Aggressiveness of Prostate Cancer Aids Decision Making
September 21, 2015
The story unfolds in a way familiar to many men: A routine blood test brings news of an elevated prostate-specific antigen (PSA) level. It’s nothing alarming, until infection and benign prostatic hyperplasia are ruled out. Then a biopsy reveals a small tumor that probably won’t endanger health in the long run, but it brings a long consultation with a urologist and a list of treatment options that carry a payload of worrisome long-term side effects.

That’s how Jim Cassell of Silver Spring, Md., learned of his prostate cancer. In 2011, his primary care physician noticed a rise in the level of PSA in Cassell’s blood compared with the previous year and suggested he have a follow-up PSA test. Subsequent levels measured over the next ...

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Cardiotoxicity After Cancer Treatment
September 01, 2015
It all began as a typical afternoon when I was in my office, working as a medical transcriptionist at a local neurology practice. I was organizing a few patient charts that had just been brought in by the last few neurologists as they headed out for the day. What I was doing was not physically taxing in any way, and I was not feeling particularly stressed. But in that moment, I became unaccountably aware of my heart — it suddenly seemed to be racing uncontrollably, pounding and galloping in my chest. I immediately sat down, breathed deeply, and waited for the sensation to stop. Fortunately, it quickly did, and I pushed the experience out of my mind.

But only a day or so later, ...

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Inspiring Resilience
September 01, 2015
One thing cancer survivors seem to have in common is a capacity for resilience and an ability to take the challenges a cancer diagnosis brings and channel them into something positive. This issue of Heal magazine brings those qualities into sharp relief with truly inspiring stories of individuals who used their experience of having cancer to forge a new beginning.

This affirmation is beautifully captured in the photographs of Bill Aron, who has shared with Heal a few of the many photos and vignettes from his new book, “New Beginnings: The Triumphs of 120 Cancer Survivors.” Aron, himself a survivor, understands how “cancer makes us realize that each day is meant to be appreciated,” and showcases through his moving photographs and testimonials the lessons ...

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Stitch by Stitch: The Healing Power of Knitting
August 31, 2015
"Ooh! What are you making?"

My name is Dee and I’m a knitter. A cancer survivor, yes, but also one of those people who is absolutely, and completely, obsessed with making things with sticks and pretty string.

I knitted my way through chemo, while waiting for my turn on the radiation table and for CT scans. I purled in exam rooms, before blood work, after speech therapy and while I spent five days in ICU. My surgeon came in to see me and there I was, knitting a sock. My bed and table were covered with patterns and sock yarn and stitch markers and I had a knitting needle jammed behind my left ear. I looked like I’d just wrestled a Muppet and ...

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Caffeinated Coffee May Reduce Risk of Colon Cancer Recurrence
August 28, 2015
Does drinking a lot of coffee reduce colon cancer recurrence risk? Possibly, according to a study published online in the Journal of Clinical Oncology which found that for patients with stage 3 colon cancer, drinking four or more cups of coffee per day may reduce risk of recurrence by 42 percent and death by 34 percent.

The results are based on data from 953 patients with stage 3 colon cancer who during, and six months following, adjuvant chemotherapy prospectively reported their intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. Patients who consumed four cups or more of total coffee per day experienced a decreased risk for colon cancer recurrence or mortality compared with those who did not ...

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Pneumonitis: A Delayed Reaction
August 25, 2015
Pneumonitis, a noninfectious inflammation of the lungs, is a side effect associated with several cancer treatments, including radiation and chemotherapy as well as newer targeted drugs and immunotherapies. The symptoms range from mild to severe respiratory symptoms but may not appear until weeks to months into treatment — and sometimes long after treatments end — leading to frequent misdiagnoses, particularly because the symptoms resemble those of pneumonia.


When sparked by cancer therapies, the underlying causes and frequency of pneumonitis are specific to the type of treatment.

Several chemotherapy medications, including bleomycin, Busulfex (busulfan), cyclophosphamide, BiCNU (carmustine), the taxanes and methotrexate, can cause inflammation in the alveoli, the small air sacs in the lungs, filling them with white blood cells and fluid.

Radiation that targets ...

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Medical Marijuana: Smoking Out the Evidence
August 24, 2015
Medical marijuana has, in recent years, received more attention from voters, regulators, legislators and media than perhaps any pharmaceutical, and it has been approved for use in much of the nation.

Patients with cancer might therefore assume that doctors would thoroughly understand its benefits and drawbacks, and that the health care system would distribute it as efficiently as any other controlled treatment.

They would, however, be gravely mistaken.

Research within the United States on marijuana’s ability to control pain, combat nausea or stimulate appetite in patients with cancer ranges from thin to nonexistent.

“It’s hard to believe that we have so few good studies of a substance that has been used as a medication for thousands of years, but cannabis has ...

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Patients Unable to Work May Qualify for Disability Benefits
August 21, 2015
Photo courtesy of Deanna Power

Deanna Power is the community outreach manager for Social Security Disability Help.
[Photo courtesy of Deanna Power]

Chemotherapy, radiation and other cancer treatments can easily take anyone out of work. If you’ve been diagnosed with cancer, cannot work due to your symptoms and expect to remain in that situation for more than 12 months, the Social Security Administration (SSA) may be able to offer you disability benefits.

Two Types of Benefits Available

The SSA offers two forms of disability benefits: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each program uses its own criteria to determine who is qualified.

SSDI is for people age 18 years or older with disabilities ...

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New Treatments May Be Worth the Wait in CLL
August 21, 2015
Statistically speaking, Raye Murphy figures she’s lucky to be alive.

The 64-year-old kindergarten teacher from San Pedro, Calif., was first diagnosed with chronic lymphocytic leukemia (CLL) in 2003. The most common adult leukemia, CLL is a typically slow-developing cancer diagnosed in about 16,000 Americans a year. In CLL, the bone marrow’s production of white blood cells — specifically, the lymphocytes that help the body fight infection — spirals out of control, crowding out other healthy blood cells.

Abdominal discomfort first sent Murphy to the doctor. Labs showed her white counts were elevated. A few months later, during an annual physical, they had spiked further.

She was officially diagnosed the day before Thanksgiving. The disease was considered to be early-stage, and her doctor’s ...

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For Survivors of Cancer, Finding Love Involves an Extra Hurdle
August 21, 2015
Tia Jones was 28 and stuck in a relationship headed nowhere when she learned that she had stage 2 colon cancer.

“That pretty much did us in as a couple,” says the Wichita, Kan., resident. “At first, I was OK being single. I had enough to manage with staying alive.” But eventually, Jones felt ready to dip her toe back into the dating pool. “I was very nervous. I went from being a carefree, fun-loving person to being a woman with a serious diagnosis of cancer — and an unsexy cancer at that! Of course, I wondered who would want to date me.”

Dating is complicated. Cancer is complicated. The two together don’t exactly make for easy-breezy, get-to-know- one-another-over-dinner-and-drinks conversation. “Cancer makes you ...

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Jimmy Carter Provides Update on His Health, Says He Has Melanoma
August 20, 2015
Former U.S. president Jimmy Carter provided an update on his health today in a press conference, announcing that he has melanoma.

Former U.S. president Jimmy Carter announced today that he has melanoma.
[AP Photo/Elise Amendola]

Former U.S. president Jimmy Carter provided an update on his health today in a press conference, announcing that he has melanoma.

Four small spots of the disease — about 2 mm in size — were found on his brain, Carter, 90, said. He said his first radiation treatment would take place this afternoon.

Additionally, Carter said he would undergo treatment with the immunotherapy ...

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Long-Term Ovarian Cancer Survival Higher Than Thought
August 17, 2015
An analysis of data collected on thousands of ovarian cancer patients in California turned up some promising news for women with this diagnosis. While the study, conducted by researchers at UC Davis, confirmed earlier findings on characteristics associated with ovarian cancer survival — younger age, earlier stage and lower grade tumors at diagnosis — it also identified a surprising number of long-term survivors who didn’t meet those criteria.

“The perception that almost all women will die of this disease is not correct,” says Rosemary Cress, lead author of the study, published online August 5, 2015 in the Journal of Obstetrics and Gynecology. “This information will be helpful to physicians who first diagnose these patients and the obstetricians/gynecologists who take care of them after they ...

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IP/IV Chemo Improves Overall Survival in Ovarian Cancer
August 10, 2015
Though intraperitoneal (IP) chemotherapy along with intravenous (IV) therapy may add 16 months or more to the lives of women with ovarian cancer, less than half of these patients at U.S. hospitals receive this type of treatment, according to a New York Times report.1

In a study2 published August 3, 2015, in the Journal of Clinical Oncology, medical oncologists looked at IP and IV chemotherapy in 823 women with stage 3 ovarian cancer at six National Comprehensive Cancer Network (NCCN) institutions, between 2003 and 2012.

Study findings showed that the use of IP/IV chemotherapy increased from 0 to 33 percent between 2003 and 2006, and then to 50 percent between 2007 and 2008. In the years following, the results seemed to plateau. From ...

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Fear Less
June 29, 2015
The heart may freeze or it can burn
The pain will ease if I can learn

There is no future
There is no past
Thank God this moment's not the last

There's only us
There's only this
Forget regret — or life is yours to miss.
No other road
No other way
No day but today

- Lyrics from"No Day But Today" (from the musical "Rent")
Scan time is looming large on the horizon, so in addition to trying to take my own advice (see "10 Tips for Coping with Scanxiety"), I have been ruminating on the meaning of fear.
Why is scan time so scary? First, there are lots of little fears that flit around my mind, such as...
Cancer Emotional Survival 101: Tips for Newly Diagnosed Cancer Patients and Their Loved Ones
June 26, 2015
Back in the day, there were summaries of classical books and plays that provide a summarized version of the complete story (these summaries acutally still exist today). Here is the short summary of suggestions for someone newly diagnosed with cancer as written by me, someone who has been through breast cancer and melanoma.

Every cancer and every cancer patient are unique, and there are no true shortcuts through cancer. I wish there were. Still, I am hoping these ideas will help you. These are the thoughts I wish I could have heard and used to cope with the feelings of a cancer diagnosis right after hearing the words “You have cancer.” Maybe they will help you or someone you love. Here is the short ...

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Accentuate the Positive
June 25, 2015
Sam Donaldson likes to look on the bright side of things.

At age 81, the veteran television newscaster, a survivor of melanoma, quips that he feels great, with all the energy of a 79-year-old.

All joking aside, that positivity has not only helped Donaldson through his experience with melanoma, but has also driven his involvement in efforts to help others affected by cancer. Over the years, he’s used his celebrity to help raise research funds, donated his own money and spent time encouraging doctors to temper honesty with the rosiest possible view when speaking with patients.

“We want optimistic doctors, but we want honest doctors,” says Donaldson, who addressed the topic with melanoma specialists in Miami, Fla., on March 7 as the ...

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Supreme Court Rules 6-3 to Uphold ACA, Protecting Healthcare Coverage for Millions of Patients
June 25, 2015
In a win for President Obama’s Affordable Care Act (ACA) and millions of Americans, the Supreme Court of the United States ruled against the plaintiffs in the case King v. Burwell and upheld the availability of subsidies for individuals on the federally facilitated marketplace.

The justices voted 6-3 in favor of upholding the subsidies with the decision written by Chief Justice John Roberts. The six justices who affirmed the ruling of the Fourth Circuit were the Chief Justice and Justices Anthony Kennedy, Ruth Bader Ginsburg, Steven Breyer, Sonia Sotomayor, and Elena Kagan. Read the full opinion. The dissent was written by Justice Antonin Scalia, who was joined by Justices Clarence Thomas and Samuel Alito.

The case hinged upon the interpretation of ...

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Fear Takes What Cancer Cannot
June 24, 2015
A cancer diagnosis doesn’t just stall one’s life ... it completely resets it. I reflect on Robert L. Lynn's "Cancer Is So Limited" about what cancer cannot take away. As a fan of the written word, this poem resonates with me on days when I hear my inner cheerleader. As a terminally ill cancer patient wading through the unknown, these words have also made me question my inner strength.

Cancer Is So Limited
By Robert L. Lynn
They’ve sentenced you with invisible cells that
embed themselves deep in body recesses and multiply:
lymphatic assault on vital functions.
Can cancer conquer you?
I doubt it, for the strengths I see in you have
nothing to do with cells and blood and muscle.
For cancer is so limited---
It cannot cripple love.
Leading Us Through CancerLand
June 24, 2015
What do you wish your doctor knew? CURE has partnered with Inspire in their #IWishMyDoctorKnew campaign. The campaign asked patients and caregivers to finish the sentence, “I wish my doctor knew…” in hopes of creating a more understanding relationship. Please share your story in the discussion group.
You feel a lump.
A bump.
A something-isn't-right.
You walk into the doctor's office.
Your heart is racing.
You can't breathe.
You see your future disappearing before your eyes.
Blood pressure
I wish my doctor knew
I wish my doctor knew
I wish my doctor knew
What it feels like
to be a patient
to have to be a patient
check ...

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Different Cancers, Different Journeys: One Problem With Lack of Public's Education
June 22, 2015
After I had cancer (breast cancer and melanoma), I wrote a book to help other cancer survivors. As a motivational speaker and a published writer, it was my way to turn bad events into something good to help fellow cancer patients. My book was based on my personal journaling and my research. I was not a doctor or a psychotherapist. I was and I currently am a cancer survivor who wants to help fellow cancer survivors and their loved ones.

It seemed that the doctors were there to treat the physical issues of cancer but that there was a shortage of resources to address the mental and emotional aspects of cancer — the uncertainty, worry and lingering side effects from treatment. I wrote the ...

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A Singular Sensation
June 20, 2015

Lesli Moore Dahlke

You are alone. In a waiting room. During a medical procedure. Riding up or down an elevator. Waiting for test results. Quietly sitting reading that terrific No. 1 summer read. In a room filled with people. You are alone. Alone in your head. Thinking, worrying and wondering. Why me? How come now? What’s going to happen? Am I going to die? All the questions you’ll never stop asking and never have answers to.

Everywhere around you there are people involved in your care, treatment and healing. No matter how many people you surround yourself with, cancer is a solitary event. There is the deep reality ...

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Meeting Your Match
June 19, 2015
When it comes to cancer treatment, Patricia Kilroe is a minimalist. In targeting her invasive breast cancer, she’s determined to undergo enough treatment, but no more.

Kilroe relied on that philosophy in December, when she was diagnosed with non-invasive ductal carcinoma in situ (DCIS) and chose lumpectomy over mastectomy. Now that an invasive lesion has been found, she’s planning the same method of attack.

This time, though, Kilroe won’t be able to avoid a sentinel node biopsy – or radiation therapy. And that’s why she’s been scanning the Internet for clinical trials offering the gentlest course of treatment she can find that still seems to promise results.

“The current standard (for radiation) is at least three weeks, if not four or five, ...

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Focus on Yoga: Yoga and Cancer
June 18, 2015
My new shoe caught an uneven sidewalk, and in slow motion, the ground was within reach. My yoga bags scattered their contents alongside the front yard I’d just been admiring. My ego was wounded more than my hand and knee, which got bumped and scraped. I gathered strewn contents of my yoga for healing class: “Healing Mudras," organic lavender, eye pillows, chimes and my pride. Just for a moment, I had been distracted by a newly coiffed front yard. My eyes gazed to the left, as I walked forward. Walking requires my full attention these days.

Falling is the biggest danger for the fifty-plus population. And there are roughly 10,000 people turning 65 each day, for the next 15 years.

Balance ...

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What I Learned in Therapy
June 17, 2015
"Think of your head as an unsafe neighborhood; don't go there alone." – Augusten Burroughs

The room was barely big enough for two chairs, a desk and a box of tissues.

Every Tuesday at 10 a.m., I found myself there. Usually, I showed up with a specific issue I needed to talk about. Sometimes, I was just there to be there. Every time, except one, I left feeling better than when I walked in the door.

I’ve been very open about spending an entire year in therapy after my mastectomy. Without a doubt, it was the single best thing I’ve ever done for myself. I don’t know how I could have navigated cancer without it and cannot overstate this:

Therapy saved me. ...

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Sometimes the Answer is No
June 09, 2015
There seems to be some kind of assumption in society that once you are diagnosed with something scary, chronic, or debilitating that your desire and will to fight goes up. It is as though people assume that the scarier the name of the disease the more exponentially the will to beat it becomes. It's just that, isn't it? We're a culture that beats things. Attack us and we'll attack back with a seemingly endless gusto. Be strong and all else will follow behind you. It's a culture that tells us the answers we seek are within ourselves, when often times they simply aren't. No amount of me finding peace with my condition, being prepared to fight and having a good attitude will fix the ailments ...

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It's OK to Cry
June 09, 2015
Most days I'm OK. I've gotten used to living with stage 4 metastatic breast cancer — the ups and downs, the roller coaster ride. I've become accustomed to living while also thinking ahead to my eventual death. Will I outlive my pit bull, Butch, who is 12 years old and failing, a dog I've worked to protect from the kind of people who do bad things to pit bulls? Will my house and belongings be easily sold, easing my nephews' burden while they are also grieving my death? These are the thoughts that sit in the back of my mind. And while holding these thoughts at bay, I continue to book business ...

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Your Heart's Desire
June 08, 2015
"Can you think what the Mirror of Erised shows us all?" Harry shook his head.

"Let me explain. The happiest man on earth would be able to use the Mirror of Erised like a normal mirror, that is, he would look into it and see himself exactly as he is.... It shows us nothing more or less than the deepest, most desperate desire of our hearts. You, who have never known your family, see them standing around you."
- Dumbledore, from Harry Potter and the Sorcerer's Stone

I am one of the lucky ones who, despite a diagnosis of stage 4 lung cancer and the terrible prognosis that goes along with it, is doing remarkably very well on a targeted medication. Yes, I ...

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What's the Best Part of National Cancer Survivors Day?
June 07, 2015
To celebrate National Cancer Survivors Day (June 7), I'm sharing a recent picture of me with Linnea Olson, a sister metastatic lung cancer patient and one of the bloggers (Outliving Lung Cancer) who inspired me to become a lung cancer blogger and advocate. She and I are both alive thanks to research and clinical trials. As Linnea phrased it on Twitter, "Medical research has our backs! Here's to fourteen more (and beyond) years!"

Janet and Linnea at HOPE Summit 2015

The community of lung cancer patients and caregivers, combined with family and friends, keeps me going despite the roller coaster of scans, progressions, side effects, and emotions that are ...

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Five-Year Breast Cancer Anniversary
June 02, 2015
Anniversaries, birthdays and major life events now matter more. Today was an interesting day. I had appointments with my medical oncologist and my surgical oncologist. This was my five-year check-up. I was pretty sure from my five-year mammogram and from my five-year breast MRI that everything was currently OK but, as a cancer survivor, I never really know anymore. Both doctors agreed that things looked good. I am happy, blessed and grateful. I am a little over a year out on my melanoma, but that is a different story for another day.

As a survivor though, one never knows from day to day or year to year. The reality is that cancer can come back at anytime. It can come back before five years, ...

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In Relapsed NHL, Time to Progression Doubles when Gazyva is Added to Rituxan
May 31, 2015
Patients with relapsed indolent non-Hodgkin lymphoma (iNHL) who took the anti-CD20 agent Gazyva (obinutuzumab) with Treanda (bendamustine), rather than Treanda alone, doubled their time until further disease progression during the phase 3 GADOLIN study.
Treanda is a chemotherapy, and Gazyva is a drug that recognizes the protein CD20 expressed on the outsides of abnormal B cells that are associated with NHL, helping the immune system to kill them.
The interim Gazyva results in the GADOLIN study were so positive that the trial closed early, noted lead study author Laurie Helen Sehn, a medical oncologist at the BC Cancer Agency in Vancouver, Canada, who reported the late-breaking data at the 2015 annual meeting of the American Society of Clinical Oncology, a gathering of nearly ...

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Opdivo Sparks Greater Survival Benefit than Docetaxel in Lung Cancers
May 31, 2015
The immunotherapy Opdivo (nivolumab) has been shown to convey an overall survival (OS) benefit superior to that offered by the chemotherapy docetaxel in both nonsquamous and squamous non–small cell lung cancer (NSCLC), according to results from two phase 3 trials. Opdivo, which inhibits the protein PD-1 — thus freeing up the immune system to fight cancer — was also shown to be less toxic than docetaxel.
The results were announced May 29 during the 2015 annual meeting of the American Society of Clinical Oncology (ASCO), a gathering that brought nearly 30,000 health care experts to Chicago to learn about the latest advances in oncology.
In the phase 3 CheckMate-017 trial,1 patients experienced a 41 percent improvement in OS with Opdivo versus docetaxel in ...

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Keytruda Doubles Efficacy of Only Targeted Therapy for Head and Neck Cancer
May 31, 2015
The immunotherapy Keytruda (pembrolizumab), in a recent study, proved twice as effective for the treatment of head and neck cancer as Erbitux (cetuximab), the only targeted therapy indicated as a therapy for the disease.

The multisite study offers the largest experience to date of how immunotherapy can be deployed in patients with head and neck cancer, and could change the way the disease is treated. The findings were announced May 29 during the annual meeting of the American Society of Clinical Oncology, a gathering of nearly 30,000 oncology professionals taking place in Chicago.

Keytruda is an antibody designed to disable the protein PD-1 so it cannot do its job of keeping the immune system in check; this allows T cells to become more ...

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Cancer as Rebirth
May 31, 2015
Two. This month marks my second anniversary of living with stage 4 lung cancer. Two years ago at this time, lung cancer burst into my life, kicking and screaming, demanding all of our attention and making our family completely alter our lives to accommodate it.
Those first few weeks were a fog. Just make it through this day, this hour, this minute. As the months went on, we gradually grew accustomed to its presence and learned how to live with this new creature in our midst. I learned to take those tentative first steps — to get my legs under me again. A stumble, a trip, then finding the courage to pull myself back up and try again. Trying to find a voice, to speak ...

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Fear of Recurrence: Yes, I am Afraid My Cancer Will Come Back
May 27, 2015
Cancer survivors live with uncertainty. It just makes sense — not certainty, just sense. As a breast cancer and melanoma survivor, I live with uncertainty. I just had my five-year mammogram, and I am afraid my cancer will come back. Five isn't a magic number — being five years out is good, but it doesn't mean the cancer won't come back later. Still, I won’t live my life bound up by my fear, and I can’t make that fear go entirely away either.

It isn’t even prudent to completely let go of fear of recurrence when I need to remain vigilant about my health and my self-observation. After active treatment ended and as the weeks and months moved forward, I wished there was more ...

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Are You Rushing Your Body to Heal?
May 27, 2015
We were a small support group of women sitting around a table when she came into the room.

She didn’t even make it to a chair before she shared her distress with her doctor, who had "finally" cleared her for physical activity after her mastectomy.

As an exercise instructor, she had been crazed by weeks of inactivity and weight gain. As soon as she was able to exercise, she threw herself back into it with a vengeance. Now she was in a lot of pain, angry with her doctor and afraid she would never be able to return to exercising.

We’d never met before, but it seemed obvious she had the drive to return to her passion.

What she wasn’t able ...

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Treated With Herceptin? Read This
May 27, 2015
The breast cancer drug Herceptin, also called trastuzumab, has been one of the more remarkable breakthroughs in treating the disease. The drug is a targeted therapy, which means that, unlike regular chemotherapy, which goes after every rapidly dividing cell in the body, Herceptin interferes with the HER2/neu protein that stimulates cell proliferation. When HER2 is overexpressed, cancer cells reproduce faster. Herceptin stops the cells from growing, making it a remarkable drug for the one in four breast cancer patients who have overexpression of HER2.

The bad news is that Herceptin can cause heart problems, which is why oncologists are told to do cardiac monitoring prior to treatment, during treatment and after a patient has received the drug.

And this is the problem. A ...

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How Gastrointestinal Stromal Tumor (GIST) and I Became Acquainted
May 26, 2015
It was a typical Monday morning meeting in my boss' office — a real neck-snapper. Therefore, when I got up to return to my desk, it was not surprising that my left leg and foot had no feeling. What limbs would be able to remain awake under such circumstances?

It took longer than normal to revive my foot, as I marched around my desk, waiting for the ginger ale-like feeling that comes when sensation returns. Though there wasn't any of that, normal feeling came back and I returned to work.

On Tuesday, all was normal, so I didn't give the incident any more thought until Wednesday. While working from home and typing away at my desk, I noticed that my left foot and ...

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Fine-Tuning the Treatment of Melanoma
May 22, 2015
Significant strides have been made in the treatment of patients with immunotherapies and targeted therapies. However, determining which therapies are best for which patients and how to treat patients who don’t respond or stop responding to these new therapies is still a challenge. For further insight on optimizing the recent treatment breakthroughs in melanoma, CURE spoke with Alan Bryce, MD, medical director of the Genomic Oncology Clinic at Mayo Clinic.
CURE: How has the emergence of novel targeted and immunologic agents revolutionized the treatment of patients with melanoma?
Dr. Bryce:  Melanoma care has been transformed in the last 5 years. This started with the approval of Yervoy (ipilimumab), which was the first immunotherapy approved for melanoma. That was followed by the approval of ...

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Job's Friends
May 22, 2015
I've always disliked the Book of Job in the Bible. The idea of God laying a bet with Satan to test the strength of Job's faith by hurting him and taking away everything that he loves and cares about is a disturbing idea, to say the least. 
But there is one important message I heard in reading the story, and that is the reaction of Job's friends. Job's life is being whittled away bit by bit — he has lost his crops, his livestock and his family. He is truly aggrieved. Job's friends live a distance from him, but they come together and decide to visit Job in order to help him mourn. For ...

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What is the Role of Physical Therapy in Cancer Recovery?
May 20, 2015
When someone is undergoing cancer treatment, physical therapy may not be the first healthcare field that comes to mind. Early cancer treatment is met with oncologists, radiologists, nurses and surgeons. Rightly so, as these healthcare practicioners are essential to the treatment and management of cancer. However, you should also consider the role of physical therapy in your cancer recovery.

Cancer rehabilitation is a growing area in medicine due to the increase in cancer survivorship. More and more individuals are beating cancer because of advances in medical technology, treatment and early detection. According to recent research from the American Cancer Society, the five-year survival rate of all cancers that were diagnosed between 2003 and 2009 is 68 percent. This is a 20 percent increase from 1975 ...

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Yoga Hits the Wall Street Journal: Yoga and Cancer
May 20, 2015
Even if I wasn’t looking, I couldn’t miss all the articles on yoga for cancer survivors. Even the Wall Street Journal reported on yoga’s benefits for cancer survivors. The International Journal of Yoga Therapists devoted a whole magazine on the topic and the challenges of coordinating this growing field in yoga.

The NCCS (National Coalition for Cancer Survivorship) defines a cancer survivor as a person who has been diagnosed with cancer from the day of diagnosis to the end of their life. There are 12 million of us in the U.S. alone. What got my attention were the follow-up questionnaires of survivors showing that long-term cancer patients felt they needed information about how to improve the quality of their lives.

If ...

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Cancer Radiation Treatment 101: Challenges and Advice
May 20, 2015
After my chemotherapy for breast cancer, I had radiation treatment on the affected side. It was considered another active treatment. I had gotten through Chemotherapy 101 and my next experience was to be Radiation 101. Many people find radiation to be less difficult than chemotherapy and that was the case for me too, but everyone is different and so is every cancer. Going into radiation, there were a few things I wish I had known. I hope they are helpful to you.

Another marathon to run: Though easier than chemotherapy, my radiation was more frequent — it was daily, in fact, and I was already worn down from the chemotherapy. The daily treatment made radiation a time-consuming, tedious and numbing process. The daily ...

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Catching Cancer
May 16, 2015
When I came out with my diagnosis of breast cancer, I received an incredible number of supportive comments and some interesting ones.

The most interesting question: How did I get cancer?

My answer: "I don't know. My boobs never smoked." I then added, "Maybe they hung out with bad company."

I did wonder though, if there was something I did. Was it my heavy drinking (thank you Alcoholics Anonymous for helping with that)? Was it the fact that I'm overweight (I prefer to say pleasantly plump)? Was it the fact that I've never had children?

Bingo. That's part of it. I found great answers from a book called Breast Cancer: Real Questions, Real Answers by David Chan, MD, from ...

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The Changing Face of Cancer Care
May 15, 2015
I've had a ringside seat to the evolution of cancer care.

The first time I heard the heart-dropping, stomach-churning, breath-stealing words, "you have cancer," I was 14 years old. The second time I heard them, I was 37.

The first time, a chronic ache in my shoulder turned out to be bone cancer. The second time, a chronic cough turned out to be metastatic lung cancer.

When I was a teenager undergoing chemotherapy for osteosarcoma, I never really thought I was going to die. Me and my teen cancer comrades in the hospital went through hell together. But I naïvely thought we would all get better and go home again one day.

I have seen cancer through an adolescent's eyes, and I ...

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After Active Cancer Treatment 101 — The Next Steps
May 14, 2015
What happens after active cancer treatment? Did you celebrate when surgery(s), chemotherapy and/or radiation were done? For me, completing each type of active treatment was a moment to celebrate. It was a milestone. It was worthy of celebrating with my loved ones. I think my family and I went out to dinner after my last chemotherapy and after my last radiation treatment.

Were you scared to be done with active cancer treatment? I was. It was scary to be plopped out on the other side of all the treatments and attention. Who was watching me now to make sure cancer wouldn’t come back? Who was there now to promptly answer questions and address my fears and worries?

Did you feel alone? The time ...

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Understanding Breast Cancer Subtypes
May 12, 2015
Understanding and classifying tumors based on their genomic makeup is an essential component of precision medicine. Genomic characterization can be used to understand why some cancers respond to standard therapies or not, and allows oncologists to begin tailoring treatment to each patient’s disease, said Charles M. Perou, PhD, May Goldman Shaw Distinguished Professor of Molecular Oncology, professor of Genetics, and Pathology and Laboratory Medicine at Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine.

Perou has dedicated his career to the field of genomic characterization and was instrumental in the discovery of the five intrinsic subtypes of breast cancer: luminal A, luminal B, HER2-enriched, basal-like and claudin-low. He was the first to identify the basal-like/triple-negative breast cancer (TNBC) subtype. Today, he focuses ...

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It’s My Cancer and I’ll Cry If I Want To
May 12, 2015
"[W]e need never be ashamed of our tears ..." - Charles Dickens

One of the things I've come to accept about myself is that I cry easily.

What hasn’t come easily is crying in front of other people.

During the diagnostic and treatment phases of cancer, I usually clamped down my tears. As a mother, I felt I had to be strong for my children. As a wife, I saw my husband's pain and, feeling guilty for causing it, didn't want to cause more. As a daughter, sister and friend, I didn't want to worry anyone and tried to keep things positive.

Although I felt no such obligations to my doctors, I hid tears from them too. When my breast surgeon ...

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Make a Bucket List —Time Flies When You're Having What?
May 06, 2015
As a breast cancer and melanoma survivor, time has become a strange entity to me. I am five years out from my breast cancer diagnosis with a negative (no cancer) breast MRI, and I am very, very happy and grateful. I remember when I was going through chemotherapy, I was so frightened and scared that I just wanted to magically transport myself ahead five years to a successful breast MRI. At the same time, a part of me mourned and argued that I didn’t just want to give cancer five years of my life.

I didn’t want to waste the next five years worrying and stressing about making it to the five-year mark. First, what kind of life was that? Second, I knew that ...

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Telephone Intervention Reduces Unplanned Hospital Visits for Patients With Blood Cancers
May 06, 2015
A navigator-designed, proactive, weekly, telephone support call to help patients with blood cancers manage their symptoms between appointments was able to significantly reduce unplanned hospitalizations at a Colorado cancer center.

“Since the implementation of the telephone intervention, we have maintained an average 8 percent rate of unplanned admissions,” said hematology nurse navigator Lori Dagostino, BSN, RN, OCN, during a podium session at the 2015 ONS Annual Congress.

The hematology navigator role was established in 2011 at the Penrose Cancer Center in Colorado Springs where Dagostino primarily focuses on patients who are newly diagnosed with lymphoma, leukemia, and myeloma; 534 patients have been navigated since the program’s inception through 2014.

Approximately one-fourth of the patients in the program are diagnosed with diffuse large B-cell ...

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Making Progress in the Treatment of Ovarian Cancer
May 01, 2015
While surgical advances and new treatment approvals, including Lynparza (olaparib) and Avastin (bevacizumab), have improved the outlook in ovarian cancer, late diagnosis and tumor resistance remain as significant barriers to major progress in treating the disease, according to Robert C. Bast, Jr, MD, vice president of Translational Research at the University of Texas MD Anderson Cancer Center.

In an interview with CURE, Bast discussed the detection of ovarian cancer and where he envisions the treatment paradigm for the disease moving next.

CURE: What is the biggest challenge in the treatment of ovarian cancer?

Dr Bast: Over the last two decades, the five-year survival rate for patients with ovarian cancer has improved significantly. However, we currently are curing no more than 30 percent ...

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The Cancer Survivor’s Waiting Game: Wait and Watch
April 29, 2015
It was a little after the one-year anniversary of my stage 1 melanoma (March 14, 2014) that now looks like a 'dog bite' indentation on the top of my left shoulder. I was at the dermatologist for yet another three-month full-body skin check yesterday and she biopsied three moles this time. I have had too many biopsies to count. Out of all those, three times since the melanoma, there needed to be larger excisions (surgeries) to have wide margins on suspicious moles that they didn’t quite call melanoma. Instead of one 'dog bite' on my left shoulder, I now have three more over the past year — one on my calf, one on my thigh, and one on my back.

I am too old ...

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