CURE readers respond to the latest issue with comments and questions.
Scope of Magazine Praised
I want to thank you so much for my CURE
subscription. Even though I am six years out from my diagnosis, the battle continues. The fall issue of the magazine seemed to be written personally for me, because it covered so many topics I’ve had to deal with (some of which I didn’t quite understand at the time), and topics I still deal with day in and day out. Bless you for the work you do!
Sherry Chartrand, Chippewa Falls, Wisc.
Finding Joy and Peace
Thank you for the wonderful article “Tough Talk
” in your fall issue. I was diagnosed with primary peritoneal (ovarian) cancer in April 2010. After four years of continuous chemotherapy, my oncologist told us that nothing else could be done. We not only appreciated the honesty and dignity with which he delivered the news, but his encouragement to embrace a quality of life. I am now under the care of hospice, at home, for the remainder of my journey with my family and friends. We are grateful every day for our decision that allows us to find joy and peace at the end of life.
Elaine Waples, Atlantic Beach, Fla.
Portal Vein, Clarified
In the summer 2014 issue of CURE
magazine, Anne Covey is quoted as saying: “Normal liver tissue gets most of its blood supply from the portal vein, which not only carries oxygen and nutrients to the liver but also carries away the waste products that the liver normally removes from the blood.” Is that true? I thought the portal vein was a one-way avenue for nutrients from the stomach and intestines into the liver. The only exit from the liver would be the hepatic vein.
C. Walt Hammonds, San Andreas, Calif.
Former Managing Editor Jon Garinn responds: As a result of our editing process, the sentence was constructed to imply that the portal vein carries partially oxygenated, nutrient-rich blood into the liver and carries away waste products that the liver normally removes from the blood. The blood’s waste products are primarily removed through the bile ducts. The blood that is returned to the circulation does contain some metabolic waste products, but it is returned via the hepatic veins (there are three of them) that connect to the inferior vena cava.
Late Effects of Radiation
Peter Skurkiss’ comment about the late effects of radiation [in a June letter to the editor about the article “Burn Concern,” which appeared in the spring 2014 issue] brought up an important point: Late effects are rarely seen by radiologists, and academic studies of adverse effects don’t follow patients long enough for these effects to show up. I think that radiologists fail to warn patients because these devastating effects are vastly under-reported in the medical literature.
I have late-effect, radiation-induced lumbosacral plexopathy, which is slowly but progressively compromising my ability to walk. It began five years after my radiation treatment for endometrial adenocarcinoma, and it was another three years before I got a diagnosis. Most academic studies followed patients for only five years; I would not have been counted. Now, 14 years past radiation treatment, my walking continues to get worse, there is no accepted treatment, and its rarity and slow progression make it unlikely that research will be done to develop new treatments.
The only really long-term study I found followed breast cancer patients after radiation treatment for 34 years (Johansson. Timescale of evolution of late radiation injury after postoperative radiotherapy of breast cancer patients. Int J Radiat Oncol Biol Phys.
2000;48(3):745- 750). They found that late adverse effects “increased progressively over the whole 34-year follow-up period.” Ninety-two percent of study patients had arm paralysis by the end of the study.
Most patients are followed long term by tumor registries. Perhaps registries could also record long-term effects of treatment and help to fill the gap in our knowledge.
Trish Miller, Winter Springs, Fla.