Hats off to no hair - and to being chemo sensitive

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I got one of those calls a few weeks ago. As the assistant to a friend who runs a private school, Suzan and I had met briefly in the past, but this time we were brought together by her news: breast cancer. At 48 and a mother to a 7-year-old, Suzan was keeping the information quiet until she and her husband Joost could determine exactly what they were dealing with and how to tell their daughter, Carey. The news wasn't good – what she thought was mastitis was instead advanced local breast cancer with skin involvement, stage 3B. Suzan and Joost began that whirlwind that is rushing to preoperative chemotherapy that such a diagnosis demands while at the same time Suzan tried to be present for her father who was entering hospice. Whew. As soon as her friends were given the all clear, they hit high gear to help Suzan cope in what they knew would be her style – with humor and lots of color. Yesterday it was hat day. With hair loss looming now that she is at day 12 after her first chemo, a friend sent out the word that hats and other fun hair coverings were needed. As Suzan headed for home, she tried to find the place of light where she chooses to stay. But it had been a hard day when the little "what ifs" were arriving at warp speed. Then she arrived home and was met by Joost and Carey with squeals and excitement at the mounds of boxes and tissue that awaited her. New hats, old hats, practical hats, vintage hats, and one from a fellow survivor that she had worn on her 20th anniversary of survivorship – covered with pink feathers and tulle and outlandish in the best sense. The card told Suzan that this was for when she would celebrate her 20th year of survivorship. As Suzan and Carey, who had her own assortment of gift hats, played and modeled the hats, Joost took pictures. Suzan wrote a note to friends later about how remarkable it was to feel the kind of love and friendship that such a time brings. While I was sharing dinner with Suzan, Joost, and Carey last night, the conversation was light. My offering for head covering was a scarf that could be wrapped and wound and looked great on Suzan – the gypsy look, I call it, with big earrings to match. In this case the earrings I chose were rhinestone angels wings, knowing that this time is one when a few angels are welcomed. We chatted as Carey practiced tying her mother's scarves in multiple ways that had us laughing and enjoying the wonderful spontaneous moments that a 7-year-old can bring to any experience. Then Suzan mentioned that she could already feel a distinct reduction in the size of the nodes under her arm. This was great news. Only 12 days into her first chemo and reduction in tumor mass was palpable. It could mean she has a chemo-sensitive tumor that will respond really well to chemo – which greatly improves her possible outcome. It was great news.Suzan, being a creative type, has agreed to let me follow her and Joost and Carey for the next year as they go through breast cancer treatment and recovery. Suzan has already had a photographer friend begin documenting her story. She hopes that in telling her story she will be able to pass on the love and support she has already begun to receive.

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Yuliya P.L Linhares, MD, an expert on CLL
Yuliya P.L Linhares, MD, and Josie Montegaard, MSN, AGPCNP-BC, experts on CLL
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