The question caught me off guard for a moment, then its meaning sunk in. She was really saying, “Cancer is serious stuff, my breast has been cut on and radiated, and you’ve given me cancer fighting poisons in my veins. My hair has fallen out, food tastes funny, and I’m on a first name basis with the muzak at my insurance company. I’ve done my crying, but is it appropriate to laugh at it all?”
I remembered back to an intimidating nurse critiquing a tape of my very first patient interview during my second month of medical school. Her eyes were sharp and piercing and her brow furrowed as she watched the tape. Half way through she stopped it, turned it off, and said, “You are flippant…. I don’t much care for it.” My heart sank, and then she continued without a smile, but with a twinkle in her eyes, “but it works for you, so don’t mind me and keep on doing it.”
I believe that humor is therapeutic. Of course, that is not a new idea. The saying, “laughter is the best medicine” did not originate with Readers Digest. The biblical record states, “A merry heart does good like medicine, but a broken spirit drieth bones” (Proverbs 17:22). I don’t know that a merry heart will add time to a cancer patient’s life, but I know that it will add life to the time that they have.
We don’t know a lot about the physiological effects of humor. It does ....
Recent news about the health of the distinguished journalist, Tom Brokaw, has focused attention on multiple myeloma, a malignant disease of the bone marrow. Myeloma is characterized by an uncontrolled growth of marrow plasma cells, which normally produce antibodies for our immune system. In its advanced stages, the overgrowth of these cells and their associated proteins can cause anemia, painful bone destruction, and kidney failure.
Until about 10 years ago, advanced myeloma was uniformly fatal with a typical survival of about 3 years. Recent years, however, have seen a remarkable improvement in treatment possibilities for myeloma. This began with the discovery that autologous stem cell transplantation could produce complete remissions and longer survival. In addition, a variety of chemotherapy drugs administered in combination with corticosteroid drugs, now produce responses in up to 80% of patients. This means about 80% of patients are surviving longer than 3 years after chemotherapy and autologous stem cell transplant.
Not all patients with myeloma require chemotherapy. Myeloma can exist in an early stage for years. This is called smoldering myeloma. Chromosome analysis is routinely done on myeloma cells and allows us to identify patients with more aggressive forms of the disease, and those requiring treatment due to signs of organ damage or bone pain.
The Swedish Cancer Institute has been a participant in clinical trials leading to the development of some of the effective new treatments for myeloma. We are currently participating in a study of pomalidomide, a newly approved agent, for patients with relapsed myeloma. Another study offers an investigational drug, MLN9708, for newly diagnosed patients.
While the new drugs are more effective and better tolerated than previous chemotherapy, all ...
In these eight-week groups you will have the opportunity to:
- Make peace with the impact of cancer treatment
- Reduce the stress cancer places on relationships
- Overcome the fear of recurrence
- Renew hope and increase resilience
All skin cancers are not alike, and melanoma, a malignant cancer of pigmented skin cells (melanocytes), is by far the most dangerous of the group, accounting for over 75% of skin cancer deaths in the United States. This amounts to about 48,000 melanoma related deaths world wide per year.
Found early, when the lesion is superficial and small, cure rates are high, but as the cancer progresses, it invades deeper into the skin, and becomes far more likely to spread far from where it started. It is for this reason that ...
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 ...
How do we find early cancers?
Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are ...
I was traveling last week. After the stewardess pointed out the exits, the broad shouldered gentleman stuffed into the seat next to the seat I was stuffed into, decided to make some small talk. “What kind of work do you do?”
“I am an oncologist,” I said, and prepared myself for what I knew was coming next. There are only two responses to “I am an oncologist.” The first is, “what’s that?” (The word oncology is code. In the 60s it was politically incorrect to say “cancer”. Even today, patients and clinicians stumble around the word, preferring terms like malignancy, neoplasm, tumor, or just lump. Cancer care was entering the dawn of an era where not everyone was going to die and was soon to become a new specialty, so the word “oncology” was coined to avoid saying the “C word.” But when someone doesn’t know the code word you have to be direct. “I am a cancer doctor.”)
If the second question isn’t asked first, it is asked next. It isn’t really said like a question, it’s more like a statement with a question mark. Sometimes the statement is one of wonderment, but as often as not it is pity. “Why did you decide to be a cancer doctor?”
Cancer is a fascinating disease. It is the closest thing, in this life, that we will get to immortality. Take cancer cells, put them in a test tube and take care of them right and those cells can be grown forever. Take our normal cells and care for them the same way and they will be dead in two weeks. We do research on cells harvested from cancer patients 20 years ago. Besides being mortal our normal cells respect the space of other cells ...