Finally, chemo ends and it appears that I have won a few rounds of this battle with breast cancer. This is one ordeal I am glad to be over and done with. Chemotherapy has consumed the better part of my life since February 2012. I can look forward to finishing my reconstruction and getting on with my life. Good riddance, chemo.

Chemo’s side effects

Everyone has a different experience with chemo. There are so many different combinations of drugs and so many side effects that no two people have the same reaction. For me, my white blood counts crashed and they put me on a drug to correct that.

My chemotherapy lasts five hours. Yes, sitting in a recliner for five hours hooked up to an IV through my port is not the way I would want to spend an afternoon. I receive two chemotherapy drugs, a biological therapy and six drugs to prevent side effects. One of the drugs used to pretreat is a steroid. The chemo drugs given to me are Cytoxin and Taxotere.

I have an adverse reaction to the steroid they use. It puts me in a drug induced fog where I am unable to focus. Driving is not an option for three days after chemo. I also turn sunburn red and my chest and face feel like they are on fire. Doctors are aware of this, but not concerned enough to do anything about it.

I also had a bad reaction to the drug used to increase my white blood count. An injection of Neulasta is given 24 hours after chemo. This particular drug causes me unbearable bone pain. The pain is so bad that walking across a room is difficult for me.

Goodbye chemo

I gladly say goodbye to chemotherapy. Although it is very effective at killing cancer cells, it is also very good at trashing healthy cells that your body needs. Now, I can start getting back to living my life again. I still have another surgery to go through but it looks like the hardest part is behind me now.

Going forward

I am still undergoing treatment. Chemo ends, but I have almost a year of a biological therapy ahead of me. My oncologist and I are still discussing hormone therapy–which would involve taking a pill on a daily basis for five years.

Hindsight

Hindsight is 20/20. Would I have changed anything now that I have gone through this? My answer is yes. I would not have undergone chemotherapy, knowing what I know now. I had other options available to me which I would have explored completely before deciding on chemo. Hopefully, I can put this part of cancer behind me and move forward. If cancer returns, God forbid, I will not go through chemo again.

MONDAY, June 4 (HealthDay News) — Girls who receive radiation to the
chest to treat childhood cancer, even those getting lower doses, have a
high risk of developing breast cancer at a young age, according to a new
study.

Researchers from Memorial Sloan-Kettering Cancer Center in New York
City said the risk posed by radiation may be as great as that of the
BRCA1/2 mutation. Previously, it was thought that only moderate to high
doses of radiation raised breast cancer risk, but the new research showed
that even those who got low doses face an increased risk and may warrant
early screening for the disease.

“While radiation doses have decreased and techniques have improved,
radiation is still an essential part of therapy for many childhood
cancers,” said the study’s lead author, Chaya Moskowitz, an associate
member and associate attending biostatistician at the cancer center, in a
news release from the American Society of Clinical Oncology. “The goal is
to maximize the cure rates for childhood cancer while minimizing future
health problems,” Moskowitz said.

The researchers examined information on 1,200 women in the Childhood
Cancer Survivor Study and 4,570 women who are first-degree relatives of
participants in the Women’s Environmental Cancer and Radiation
Epidemiology Study, which involved women diagnosed with breast cancer who
survived at least one year after diagnosis.

Among the childhood cancer survivors, 24 percent were diagnosed with
breast cancer by the time they were 50 years old. Moreover, 30 percent who
survived Hodgkin’s lymphoma developed breast cancer. In comparison, the
incidence of breast cancer by age 50 was 31 percent among the carriers of
a BRCA1 mutation.

The researchers said the roughly 50,000 women in the United States who
were treated with higher doses of radiation when they were younger should
get an annual mammogram and breast MRI either by the time they are 25
years old or eight years after their radiation therapy.

Another 7,000 to 9,000 women received lower-dose radiation to treat
childhood cancer, the researchers said. “Our results suggest that young
women treated with lower doses of radiation who are not currently being
screened also have an elevated risk of breast cancer and might benefit
from a similar screening strategy,” Moskowitz added.

Treatment with a lower dose of chest radiation reduced the incidence of
breast cancer to 7 percent by the age of 40 compared to 12 percent for the
women treated with higher doses of chest radiation, the researchers
found.

The study was scheduled for presentation Monday at the annual meeting
of the American Society of Clinical Oncology in Chicago.

Data and conclusions presented at medical meetings should be considered
preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute provides more information on breast cancer
risk
.

A drug that is already approved for prostate cancer has been shown to slow the spread of advanced forms of the disease for the first time, according to research released Saturday.

Zytiga, made by Johnson and Johnson, is being tested in a randomized phase III trial involving 1,088 men with prostate cancer at 151 cancer facilities in North America, Europe and Australia.

On average, participants in the study were diagnosed five years prior to entering the research but none had begun chemotherapy.

Their cancer had metastasized and had become resistant to initial hormone therapy, but they were not showing major symptoms.

According to interim results, the drug, abiraterone acetate, given in combination with prednisone, delayed the onset of pain and helped improve quality of life in patients whose cancer had metastasized.

The full data set is expected in 2014.

“This drug extended lives and gave patients more time when they weren’t experiencing significant pain from the disease,” said Charles Ryan, an associate professor of clinical medicine at the UCSF Helen Diller Family Comprehensive Cancer Center.

“It appears that this medication may lay a foundation for the use of this drug at an earlier stage of prostate cancer, and its benefits may be able to be delivered to a much wider population of patients as a result.”

The research was to be released at the 48th annual meeting of the American Society of Clinical Oncology in Chicago.

US regulators last year approved abiraterone acetate for men whose disease had spread and who also were resistant to standard hormonal therapy, known as castration-resistant prostate cancer.

The drug was first conceived in a British lab in the 1990s, and works by blocking the production of hormones produced by the cancer that can help it grow.

The drug however carries risk for patients with a history of heart disease, high blood pressure, low blood potassium and fluid retention.

Prostate cancer is the second most common form of cancer in men. Some 241,000 new cases are diagnosed in the US each year and 28,000 men die of the disease annually, according to the American Cancer Society.

About one third of patients require no treatment because their disease does not spread.



CDC Recommends Hepatitis C Tests For Baby Boomers (via redOrbit)

The Centers for Disease Control and Prevention (CDC) is urging baby boomers to have themselves tested for hepatitis C, a disease which results in more fatalities each year than the AIDS virus and has infected an estimated three-plus million people nationwide, according to various media reports. On…

… 

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CHICAGO (Reuters) – German drug company Boehringer Ingelheim said on Monday it would test its experimental lung cancer drug directly against AstraZeneca‘s Iressa and Roche’s Tarceva pill, after it showed promise in a late-stage drug trial.

A study showed Boehringer’s afatinib drug prolonged the time lung cancer patients survived without a worsening of their condition by 4.2 months on average when compared with a control group on standard chemotherapy.

Results of the study were presented at the annual congress of the American Society for Clinical Oncology in Chicago on Sunday.

“This definitely meets our expectations. It’s very encouraging,” said Dr. Lecia Sequist, an oncologist at Massachusetts General Hospital Cancer Center and one of the lead researchers of the study.

The trial involved only patients with non-small cell lung tumors that had undergone the so-called EGFR gene mutation.

“In the U.S., this is important because this study may lead FDA approval of the first drug specifically for the EGFR mutation,” she said in an interview.

Lung cancer is the most common and one of the most difficult to treat types of cancer, and targeted therapies are currently only available for patients with this type of mutation.

Cancer drugs are referred to as targeted when they interfere with cancer cell growth, unlike the shotgun approach of chemotherapy, which slows or stops any cell growth.

Boehringer, the world’s largest private drugmaker, is now recruiting patients to directly compare afatinib with AstraZeneca’s Iressa and Roche’s Tarceva.

Iressa, a once-daily pill, was approved for certain lung cancer patients in Europe in 2009, and its sales rose 32 percent last year to $554 million.

It falls into the category of so-called personalized medicine, in which patients undergo genetic tests before treatment to determine whether they are likely to benefit from the drug in question.

Boehringer plans to take the concept further and narrow down the targeted group even within the EGFR-mutated patients.

The drug trial showed that a sub-group that accounts for 90 percent of EGFR patients had a particular benefit from afatinib. For them, survival without tumor progression was 6.7 months longer on average than in the control group on chemotherapy.

One problem with the drug is that many people develop resistance to it after about a year, Sequist said.

“Delaying resistance will be a focus of future research,” she said.

Boehringer said it was planning to market a test kit to identify the genetic mutation.

(Reporting By Debra Sherman in Chicago and Ludwig Burger in Frankfurt; Editing by David Brunnstrom and Maureen Bavdek)

SUNDAY, June 3 (HealthDay News) — Men with metastatic prostate
cancer who undergo hormone-deprivation therapy sometimes take breaks from
the treatment to minimize its often difficult side effects.

However, a major new study that tracked more than 1,500 men for almost
a decade finds that opting for intermittent treatment may take a toll on
certain patients, in terms of shortened survival.

The study found that for men with cancer involving “minimal spread,”
adopting a stop-and-start treatment schedule was associated with a
two-year decline in survival compared to men who’d been treated on a
continuous basis.

This gap in survival did not appear for men whose prostate tumors
showed more extensive spread, but the researchers stopped short of
recommending intermittent treatment for this subset of patients, pending
better data.

The study, funded by the U.S. National Cancer Institute, was reported
Sunday at the annual meeting of the American Society of Clinical Oncology
(ASCO) in Chicago.

According to the American Cancer Society, prostate cancer is the second
most common cancer in men after skin cancer, with almost 242,000 new cases
diagnosed in the United States each year.

Doctors have long known that prostate tumors “feed” on circulating male
hormones such as testosterone. So hormonal deprivation therapy — designed
to turn off testosterone production and thereby stop cancer growth —
remains a common first-line approach in keeping the cancer at bay.

But, there’s a big downside to the treatment, since it “is associated
with significant side effects, including loss of libido, erectile
dysfunction, osteoporosis, muscle wasting, hot flashes, depression and
cardiovascular issues,” said Dr. Herbert Lepor, chairman of the department
of urology at New York University School of Medicine in New York City.

He said that in prior studies, “intermittent therapy was equally
effective as continuous therapy with fewer side effects,” and so patients
have sometimes opted for this approach.

But, would the intermittent approach remain equally effective over the
long term?

The new phase 3 trial sought to answer that question. In the study,
researchers tracked outcomes for more than 1,500 men with
hormone-sensitive cancers that had spread beyond the prostate. All of the
men first got seven months of continuous hormone deprivation therapy.
Then, half were randomly chosen for intermittent treatments while the
other half stayed on the continuous regimen.

Overall, the men who got the stop-and-start treatment were exposed to
about half the total amount of hormonal therapy as the men in the
continuous group, the researchers said.

Unfortunately, “survival with intermittent hormone therapy was inferior
to survival with continuous hormone therapy,” reported study author Dr.
Maha Hussain, a professor of medicine and urology at the University of
Michigan Comprehensive Cancer Center.

Speaking at an ASCO press briefing, she concluded that “because of
these findings, continuous therapy continues to be the standard of
care.”

After a median follow-up of more than nine years, overall survival in
men with minimal disease spread (no cancer beyond the spine, pelvis and
lymph nodes) was 7.1 years for those on continuous therapy vs. 5.2 years
for those treated intermittently — a two-year difference.

That gap in survival closed for men with more extensive disease (4.4
years for those on continuous therapy vs. 5 years for those in the
intermittent group). However, Hussain was careful not to recommend
treatments breaks, even for this sicker group of patients, saying that the
finding was “surprising” and more data is needed.

For patients with extensive cancer spread, it’s best to discuss
treatment options with a doctor before embarking on either one of the
regimens, she said.

Dr. Bruce Roth, a professor of medicine in the division of oncology at
Washington University School of Medicine in St. Louis, said experts had
waited a long time for the findings of this “important” trial.

“Prior, underpowered studies suggested that there was no downside to
intermittent therapy, which clearly provides less toxicity,” he said at
the press briefing. “This study for the first time indicates that there is
a price to pay.”

Lepor agreed that, “on the basis of this study, intermittent androgen
[hormonal] deprivation therapy should no longer be recommended for those
men with minimal disease spread.”

Findings presented at medical meetings are typically considered
preliminary until published in a peer-reviewed journal.

More information

There’s more on treatments for prostate cancer at the American Cancer Society.

SUNDAY, June 3 (HealthDay News) —
An experimental drug designed to treat patients with a specific kind of
breast cancer known as HER2-positive appeared to boost survival compared
to the standard treatment, a new study shows.

The drug, known as trastuzumab emtansine (T-DM1), is in the final stage
of research necessary before the U.S. Food and Drug Administration can
approve its sale. For now, it is only available in clinical trials.

“The drug worked. It was significantly better than a very effective
approved therapy for HER2-overexpressing metastatic breast cancer,” study
author Dr. Kimberly Blackwell, a professor of medicine and an assistant
professor of radiation oncology at Duke Cancer Institute in Durham, N.C.,
said in a news release from the American Society of Clinical Oncology.

“Also, as a clinician who takes care of a lot of breast cancer
patients, I’m pleased that this drug has very little dose-limiting
toxicity,” she added. “Patients don’t lose their hair from this drug. For
patients facing metastatic breast cancer, this is a breakthrough.”

Patients with HER2-positive breast cancer have a protein called human
epidermal growth factor receptor 2 that promotes cancer cell growth.

The drug T-DM1 is a dual drug made up of the antibody trastuzumab
(Herceptin) and the cytotoxic drug emtansine (DM1).

In the study, nearly 1,000 patients received either T-DM1 or a regimen
of capecitabine (Xeloda) and lapatinib (Tykerb), a combination referred to
as XL. They took the assigned treatment until the disease got worse or
side effects became unmanageable.

After two years, 65.4 percent of those who took T-DM1 were alive,
compared to 47.5 percent of those who took the other treatment.

The median progression-free survival time was 9.6 months for those who
got T-DM1, compared to 6.4 months for the others.

Several side effects were more common in the T-DM1 patients, including
a low platelet count, but the regimen was generally well-tolerated, the
researchers said. Those who got the standard treatment were more likely to
experience diarrhea, stomach upset and redness, swelling and pain in their
palms and the soles of their feet.

Dr. Daniel Hayes, clinical director of the breast oncology program at
the University of Michigan Comprehensive Cancer Center in Ann Arbor, said
the study “suggests that T-DM1 will provide us with yet another effective
and meaningful agent to use in women with HER2-positive breast
cancer.”

The study was scheduled to bepresented Sunday at the American Society
of Clinical Oncology annual meeting in Chicago.

Data and conclusions presented at medical meetings should be considered
preliminary until published in a peer-reviewed medical journal.

More information

For more about breast cancer, see the U.S. National Library of
Medicine.


CLEVELAND, June 1, 2012 /PRNewswire/ — University Hospitals (UH) Case Medical Center’s Harrington Discovery Institute has launched a new program aimed at supporting physician-scientists seeking to move their research into therapies that will improve patients’ lives. Goutham Narla, MD, PhD, formerly at The Mount Sinai School of Medicine in New York, has been named the first Harrington Distinguished Scholar (Early Career Award). Dr. Narla’s research includes the identification and characterization of key genes and pathways involved in human cancer development and progression, and the development of novel drugs to target these genes in various cancers.

The UH Harrington Discovery Institute, launched in February, is the not-for-profit academic medical engine of the Harrington Discovery and Development Project – a first-of-its kind, $250 million initiative that also includes a mission-aligned for-profit commercialization and development company. Aligning these entities, for the first time at an academic medical center, provides a comprehensive model to advance discoveries into development and create novel drugs and therapies for patient care.

Through the Harrington Distinguished Scholars Program, a physician-scientist is chosen to practice medicine at UH Case Medical Center and to hold a faculty position at Case Western Reserve University School of Medicine. Physician-scientists with potential breakthroughs are able to tap into grant funding and a peer network of innovators and mentors within the UH Harrington Discovery Institute’s infrastructure to support their discovery efforts. Over the next decade, the UH Harrington Discovery Institute will recruit 10-20 physician-scientists of outstanding promise and with a determined interest in advancing the treatment of patients.

“We will be bringing physician-scientists with a wide range of experience to UH Case Medical Center—those who have already made exceptional contributions to their research field and others at the beginnings of their research and patient care careers who show extraordinary promise,” said Jonathan S. Stamler, MD, the Institute’s Director and Director of the Institute for Transformative Molecular Medicine at UH Case Medical Center and Case Western Reserve University School of Medicine.

Dr. Narla’s research involves a previously unrecognized signaling network of genes that is disrupted in lung cancer. This network can be turned on by a novel combination of two drugs previously approved by the FDA and that may also help to regulate lung cancer progression.  The research has just been published online in The Journal of Clinical Investigation, a prestigious journal for physician-scientists. The work highlights how understanding the basic mechanisms regulating cancer development and progression can lead to new uses for existing FDA approved drugs in the treatment of cancer.

“My training as a physician-scientist did not prepare me to move clinical discoveries from my laboratory toward commercialization,” said Dr. Narla, a medical geneticist at UH Case Medical Center who specializes in the care of high risk cancer patients.

“The added guidance and resources that come with being a Harrington Distinguished Scholar will enable me to bring my discoveries to patients more quickly,” added Dr. Narla, who is also an assistant professor in the Department of Medicine, Institute of Transformative Molecular Medicine, Case Western Reserve University School of Medicine.  

Scholar-Innovator Grants… 

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