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Breast Cancer Survival Guide: Physical & Clinical Updates

A diagnosis of breast cancer sets into motion a whirlwind of appointments, tests, surgeries and possibly chemotherapy and radiation treatment. A new study reviewed the timeline between surgery and initiating chemotherapy for different subtypes of breast cancer and found a survival advantage when chemotherapy was initiated within 30 days of surgery. Although treating within the 30-60 post-surgical window did not show a statistically significant survival advantage, there is a trend towards better outcomes. Exceeding 60 days post treatment had a negative impact on survival. The clinical impact of timing is most relevant for patients with stage II and III breast cancer, triple negative breast cancer and HER2-positive tumors.
 
Treatment for breast cancer can be exhausting and take a toll on the physical health of patients as treatment ends and they begin post-treatment life. Cancer survivors are at an increased risk of poor health, depression and physical disability. Approximately one third  ...

Nicotine addiction and quitting smoking

The presence of tobacco dates back at least 8,000 years in the world’s history.  Throughout time, this plant was central to religious ceremonies, thought to have healing powers, delivered as gifts, traded for goods, and smoked by many.  As early as the mid 1700s tobacco was formally manufactured and distributed in the form of cigarettes.  Interestingly doctors were featured in promotional cigarette ads in the 1930s.  However, the ill effects of tobacco were identified long before this and Massachusetts state law banned smoking in public in 1632.

Nicotine is a stimulant and a very addictive substance contained in tobacco.  It is extremely easy to become addicted to nicotine.  With repeated exposure to the chemical, the brain’s nicotinic receptors crave more and drive the need to smoke at higher levels.  Nicotine is well known for its pleasurable physiological and psychological side effects.  These pleasurable side effects result in addiction to the substance and make it difficult to quit smoking, even when an individual is highly motivated to stop.  Tobacco companies have complicated this addiction by adding numerous other addictive chemicals that strengthen the difficulty in quitting, making cigarettes the most common form of chemical dependency in this country.

Use of cigarettes in the United States (U.S.) has dropped considerably since an all-time consumption high of 640 billion cigarettes in 1981.  Currently the U.S. consumption is about half that volume but smoking remains the leading cause of preventable illnesses and death in this country; attributing....

Resources and social support for dealing with cancer

Here at the Swedish Cancer Institute (SCI), we understand that individuals cope in their own unique ways, and that receiving personalized education and support is important in the healing process. For this reason, the SCI is devoted to providing complementary supportive services for newly diagnosed patients, those undergoing treatment, and those who have completed treatment, as well as their caregivers.

The SCI offers programs that promote education, hope, and healing. Many of these programs are offered free of charge, while others are offered on a sliding scale. These integrated care programs include:

  • American Cancer Society Patient Navigation: The American Cancer Society Patient Navigator helps patients find resources related to financial assistance, transportation, access to wigs and prosthetics, and much more.
  • Art Therapy: Art therapy is a confidential, supportive, and individualized experience for examining health issues through visual and verbal self-exploration.
  • Cancer Rehabilitation: Cancer rehabilitation integrates medical management of cancer treatment-related side effects with a variety of exercise therapies.
  • Health Education: The Swedish Cancer Education Centers offer complementary educational materials, innovative learning opportunities, and patient education classes.
  • Genetic Counseling and Testing: Genetic testing is available for individuals to determine their risk for developing certain cancers.
  • Massage Therapy: Massage therapy may help with cancer-related pain, fatigue and nausea.
  • Naturopathic Medicine: Combining modern science with natural remedies, naturopathic doctors are available for consultation and treat¬ment through coordination with the patient’s oncologist.
  • Nutrition Care Services: Nutritionists are available to help patients and caregivers make healthy dietary choices during cancer treatment.
  • Psychiatry: Psychiatrists help patients and caregivers maintain the emotional and mental well-being needed to cope with stresses of cancer.
  • Oncology Social Work: Licensed oncology social workers provide patients and caregivers ongoing counseling and assistance.
  • Support Groups: Support groups for patients and caregivers are offered weekly, creating an environment for people to share their feelings with others going through similar experiences. 

Patients often hear that it’s important to find a strong support system during and after treatment; this may include a partner, sibling, parent, child or close friend. These are ...

How to manage tinnitus (when your ears are ringing)

Almost all individuals experience ”transient ear noises” which is the intermittent sensation of ringing (lasting less than 5 minutes), typically in one ear. At times this sensation is accompanied by a sensation of fullness or a momentary change in hearing. When this change is brief, it is a normal phenomenon.  If it lasts longer than 5 minutes twice week, you should be evaluated for tinnitus.

What should I do when my ear(s) start ringing? 

The first step is a comprehensive hearing evaluation by an audiologist.  Tinnitus can be caused by a variety of auditory disorders and a complete audiology evaluation will confirm and/or rule out many of these conditions.  Pending the hearing test results, you may be referred to an otolaryngologist (sometimes referred to as an ENT or an Ear, Nose and Throat physician) or other health care providers.  The otolaryngologist will further investigate your tinnitus for possible medical causes. 

It is normal for tinnitus to occasionally change in the pitch and intensity; however, significant and prolonged changes in tinnitus (increased loudness or tinnitus that is one-sided) should be (re)evaluated.   Tinnitus that is present in one ear (unilateral) or pulsatile will always require an otolaryngology evaluation after the hearing evaluation.  Tinnitus that is accompanied by a sudden hearing loss is considered an emergent condition and individuals should be evaluated by an audiologist and otolaryngologist as soon as possible.

How can I manage my tinnitus?

Tinnitus can evoke ...

Service animals help support people with MS

On October 21, 2013 the Multiple Sclerosis Center at Swedish Neuroscience Institute hosted a meet and greet with Buddy Hayes, national speaker for Canine Companions for Independence.  Buddy, as she prefers to be called, is a military veteran and the owner of Stanford, a handsome Labrador Retriever service dog given to her by Canine Companions for Independence.

Canine Companions for Independence is the largest national nonprofit organization provider of assistance dogs in the United States.  Canine Companions proudly provides assistance dogs to people in need completely free of charge.  They use hundreds of volunteers around the country and an expert team of professionals to deliver a service that allows people to continue living active and independent lives with the help of a professionally trained dog.

Stanford has been taught to make Buddy’s life easier and safer.  For example, Stanford can help open doors, turn lights on/off, pick up dropped items, and pull her lightweight wheelchair if needed.  One of the very practical lessons a dog is taught is to go to the bathroom on verbal command.  To obtain a service dog, one must ...

Therapy and rehab for stroke survivors

Stroke survivors often encounter physical, cognitive or emotional challenges after their stroke. Rehab helps stroke survivors relearn skills that are lost when part of the brain is damaged.  Participating in physical or occupational therapy can be extremely beneficial in assisting patients and their families in the recovery process.

Physical therapists commonly examine, evaluate, and treat stroke patients, facilitating progress towards restoring function, reducing pain, and preventing further injuries or complications.  This therapy is a form of exercise treatment to help with mobility, strength and general function based upon the individual’s needs.

Occupational therapists focus on occupations or activities are meaningful to the individual. They develop individualized care plans that may include adaptations for how to perform tasks, changes to the survivor’s surroundings, or helping individuals to alter their own behaviors.  These plans are designed to ...

Cancer control and survivorship

I recently attended the Southwest Oncology Group (SWOG) meeting, a consortium of research institutions doing clinical trials on cancer. The conference highlighted how new research will remarkably affect cancer survivorship, quality of life (QOL), integrative care and our ability to predict and provide needed services more accurately and with greater cost effectiveness for cancer survivors. The tools for implementing cancer control are evolving quickly.

Here are some highlights from the meeting:

  • Biomarkers, which are any human characteristics that are measurable including everything from gene expression (or over-expression) to pain surveys, can potentially predict long term survival as well as the specific services that will most benefit patients.
  • Symptoms that are increasingly predictable by biomarker assays include fatigue, insomnia, pain, anorexia, nausea, depression and others. This means that we will soon be able to better predict the patients who will be affected by these problems and deliver interventions much earlier and more effectively.
  • Patient satisfaction is frequently not related to treatment outcome. Factors such as QOL and survivorship are important.
  • Lung cancer patients suffer inordinately high, long-term QOL deficits. Many of these respond well to interventions but interventions are frequently not provided to patients with lung cancer.
  • Symptom clusters ...
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