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  • Stopping Work after Cancer

    Posted 12/18/2014 by hhill
      I have written several times before about returning to work after cancer. Many people take a temporary medical leave during treatment and then return to the job when they feel able to do so. This is a challenge in many ways, both physical and psychological, but a decision not to return to work brings equally difficult issues. Read more... Comments (0)
  • Cancer and Friendships

    Posted 12/17/2014 by hhill
      Especially during this busy holiday season, we all think a lot about our closest relationships with family and friends. It is, I think, safe to also say that those of us who have had cancer truly cherish these ties and acknowledge their importance. Read more... Comments (0)
  • Suggested Changes in Phase One Clinical Trials

    Posted 12/16/2014 by hhill

      First, let's have a quick review of the structure of clinical trials in the United States. There are three phases (there are actually four defined phases, but the 4th is rarely done in the US) of all clinical trials that are described this way in a fact sheet from the NIH:

    Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.


    Phase I: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

    Phase II: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.

    Phase III: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

    Phase IV: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

    Additional Resource Information on clinical trials can be found at http://clinicaltrials.gov/info/resources

     

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  • Immunotherapy

    Posted 12/15/2014 by hhill

      "Immunotherapy" is a term that you likely have heard and wondered about. The simple definition is that immunotherapy is therapy that uses the body's own immune system/defenses to fight cancer. Some types are also called biologic therapy or biotherapy. Some of these treatments try to generally boost the immune system and some are more cancer-fighting-specific. None are in widespread use, but there is a great deal of excitement and hope in the scientific community about their value in the future.

      One reason that scientists are excited about these possibilities is that immunotherapies generally have far fewer side effects than standard chemotherapies. We are in favor of that! The main types of immunotherapies currently in use to treat cancer are:

    Monoclonal antibodies: These are man-made versions of immune system proteins. Antibodies can be very useful in treating cancer because they can be designed to attack a very specific part of a cancer cell.
    Cancer vaccines: Vaccines are substances put into the body to start an immune response against certain diseases. We usually think of them as being given to healthy people to help prevent infections. But some vaccines can help prevent or treat cancer.
    Non-specific immunotherapies: These treatments boost the immune system in a general way, but this can still help the immune system attack cancer cells.

      Note that none of these treatments are fully ready for prime time. Meaning that, yes, they are available; yes, there has been real promise shown; yes, most are parts of clinical trials rather than widely available treatments. The American Cancer Society has a good information section about all of this: http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-immune-system

      For more exciting reading, here is a story from The Wall Street Journal:

    Cancer’s Super-Survivors
    BY RON WINSLOW

    How the Promise of Immunotherapy Is Transforming Oncology
    Tom Telford ’s stomach ached. The New York City teacher had been
    drinking cup after cup of coffee as he labored to finish year-end grading
    and coach his high-school baseball team through the playoffs. He worried he
    might have an ulcer.
    When school let out, though, Mr. Telford looked forward to relaxing on a 25th
    anniversary cruise with his wife. But once in the Caribbean, he struggled to
    swim and climbing from one deck to another exhausted him. Back at home, he
    collapsed while running a TV cable in his bedroom.
    His family doctor told him he had lost two pints of blood. Further tests revealed
    a tumor the size of a quarter on his small intestine. He had surgery at Memorial
    Sloan Kettering Cancer Center, followed by months of chemotherapy. But the
    disease spread to his liver and kidneys. The diagnosis: Stage 4 melanoma, a skin
    cancer typically fatal within a year.
    “Death is not an option,” he told his doctor.
    Nine years later, against all odds, Mr. Telford is still alive. What saved him was
    an experimental immunotherapy drug—a medication that unleashes the body’s
    own immune system to attack cancer.

    Read more: http://online.wsj.com/articles/cancers-super-survivors-how-immunotherapy-is-transforming-oncology-1417714379

     

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  • What if You are Not so Happy

    Posted 12/12/2014 by hhill
      This is a rather difficult, but important, post to write. Yesterday, I met with a woman whom I have been seeing very regularly for several years. Over the course of those years, she has had three separate cancers (breast, ovarian, and thyroid). Each was diagnosed at an early stage, treated, and she likely will stay well from those cancers. But she carries an unusual gene mutation that increases the odds of another cancer developing, and she is painfully aware that any previous life as a happy-go-lucky-sure-of-her-good-health woman is gone. Read more... Comments (2)
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