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A Cancer Diagnosis Does Not Mean Life is Over

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In life it has been said that there are truly no absolutes. With time, all things change, nothing is forever the same. It is an outlook filled both with prospects of hope and dread but singular in its certainty. “Just when I think I have learned the way to live, life changes”, said Hugh Prather, author, lay minister, and counselor.

No one ever wants to be told they have cancer. The emotions of that moment cannot be fully understood until you have experienced it. For those born decades ago when such news brought little more than a prognosis of certain death, the diagnosis can elicit strong emotions of remorse, anger and depression. The lifetime probability of being diagnosed with cancer is 39.7% for men and 37.6% for women. “There is no denying that cancer is devastating news, but it does not mean your life is over. Millions of people cope with cancer every day. You are not alone.”

For Catherine, in 1999 and at age 31, life was good. Married with a good career, her life appeared to be tracking in a mostly positive direction. An examination to ferret out an explanation for a few minor health problems brought news that her life was about to change forever. Triple negative breast cancer wasn’t even known in 1999. The only certainty after the news was she needed chemotherapy as well as surgery and radiation to stem the progress of the disease. “My memories of that period in my life are that of anxiety underpinning and coloring everything I said and did,” says Catherine. “I was at a very low ebb at this stage and my family weren’t sure how we could overcome this, as all of us were flailing around trying to make sense of this terrible period in our lives.”

Planning a normal future beyond the cancer diagnosis is pre-empted by the promise of months or even years of invasive treatments, drug protocols, clinical trials and the accompanying continuing life-maintenance issues. Taking out the trash, mowing the lawn and getting the kids to soccer practice suddenly takes on a different perspective and position in life’s scale of importance. However, planning for and visualizing a future can be the very act that can assure and expedite recovery. After fourteen years, Catherine received news that her cancer was out of remission.

“I figured that this must be the beginning of the end as I was lucky to get nearly fourteen years remission. This time around, I was told my tumor was triple negative breast cancer. I was horrified and terrified on reading the statistics. I could not think past a month at a time, and holidays and family events were all abstract events. Again my mind went into a tailspin as I tried to deal with my worst fear. I then realized I probably had triple negative breast cancer before but didn’t realize how aggressive it was back in 1999 and I survived. What is not to say that this can happen again?” She is approaching her 50th birthday and no longer thinks of the future. “I have opened myself to all possibilities and am letting life happen. One of my goals was to start blogging once I felt well again and hopefully bring hope to some of my fellow triple negative breast cancer survivors.”

As a teenager in 2015, Chandler Bankos was diagnosed with advanced, stage 2 Hodgkin’s Lymphoma. An athletic and seemingly healthy seventeen year old, Chandler’s news that he had cancer wasn’t made any easier by knowing that the most common age of diagnosis of this cancer is between 20 and 40 years of age. A positive and outgoing personality, Chandler found help and treatment at the Gettysburg Cancer Center in Gettysburg, Pennsylvania. There he found experienced professionals who are dedicated to treating not only the science of his disease but the personal emotional conditions that often accompany a cancer diagnosis and regiment of treatment.

Chandler speaks of his year-long experience with cancer treatment. “If I had one thing to take away from this past year, it’s to never turn back and keep looking forward. To everyone who walked with me, fought with me, prayed for me and supported me, thank you. Today, I am officially done with everything pertaining to my fight. I completed my final surgery and I am proud to say: I am clear, I am healthy and I am moving on. I can now focus on living my life and enjoying everything it gives me. Life can be short, life can throw you around,but it all depends on how you take those negatives, and build yourself up.”

For Catherine and Chandler, cancer diagnosis didn’t mean their lives were over. Through all the pain of treatment and the turmoil it brought, they moved forward in their belief that a new life of joy and accomplishment was just beyond the struggle against their disease.

Understanding the Nexus of Aging and the Increase in Cancer Risk

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As Americas’ Greatest Generation continue to age studies are revealing that with the increase in the age of the population comes an increase in cancer risk. The nexus of age and cancer is supported by National Cancer Institute (NCI) research. The convergence of an overall aging population and a peak cancer incidence among those aged 65 to 74 will result in a significant rise in the number of people diagnosed with cancer. In addition, as people age the types of treatments and the eligibility and ability for older patients to participate in clinical trials diminishes.

According to the most recent statistical data from NCI’s Surveillance, Epidemiology, and End Results program, the median age of a cancer diagnosis is 66 years. The median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer, and 66 years for prostate cancer.

Healthcare professionals treating older cancer patients often discover other health conditions that may limit the use of specific therapies. Unless there is sufficient evidence that older patients can benefit from standard dosage of some therapies, clinicians can be reluctant to give older patients potentially beneficial treatments. This practice of less intensive therapy in aging patients is historically understandable; however, a growing field of geriatric oncologists now consider chronological age insufficient evidence for denying aggressive cancer therapy.

The solution to this aging dilemma, like the disease, is complex and we need to better understand how the biological underpinnings of aging affect the onset and trajectory of cancer. Reasons for this increase of cancer with aging can be contributed to the fact that living longer increases our exposure to things that have been shown to be contributing factors in determining cancer risk, such as exposure to sunlight, radiation, environmental toxins and noxious by-products of metabolism that increase with age. “Most aging cells develop genomic changes that make them more susceptible to the carcinogens in the environment,” says oncologist Lodovico Balducci, who studies and treats cancer in the elderly at the Moffitt Cancer Center in Tampa, Fla. In addition, the various immune defenses that keep our tissues healthy begin to break down with age.

Some of the more serious health conditions that are more common in adults over 65 that may impact the response to a cancer diagnosis include; high blood pressure, heart disease, lung disease, diabetes, kidney disease and arthritis. These co-existing conditions must be taken into account when designing cancer treatment protocols for older patients. For those older patients with cancer, knowing how treatments will be affected by these contributing factors is important to understanding how to respond to the process of therapy.

But progress towards better understanding is underway. A joint collaborative effort with the National Institute on Aging (NIA) and the Samuel Waxman Cancer Research Foundation is underway which will promote and support interdisciplinary research projects, sharing of resources, and development of new technologies and approaches to better understand how the physiological changes associated with aging affect cancer development, progression, and response to therapy. NCI is also committing more resources aimed to increase enrollment for older patients in clinical trials.

Proper Screening and Lifestyle Changes Can Impact Cancer Risk

GCC February Blog Image 2 (640x427)When Cheryl and her husband of thirty-five years sold their business and headed off to retirement, they looked forward to having more time to dedicate to their three children and four grandchildren. Discovering a lump in her left breast while on vacation dramatically altered their retirement plans and her outlook on the future. With no family history of breast cancer, the results of her mammogram were stunning. Cheryl was diagnosed with Stage 2 triple negative ductal carcinoma breast cancer.

Cheryl is not unlike many thousands of women who receive an unexpected breast cancer diagnosis. While aware of the disease and its impact on the lives of those suffering from it, the thought of receiving the bad news is one stuck in the back of the mind, hopefully never to be realized.

In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 63,960 new cases of non-invasive breast cancer. Death rates have been decreasing since 1989, but approximately 40,920 women in the U.S. are expected to die in 2018 from breast cancer. About 85% of breast cancers occur in women who have no family history of breast cancer. The two most common risk factors are gender and growing older. While you can’t change some breast cancer risk factors there are some risk factors that you can control.

Personal behaviors, such as diet and exercise, and taking medicines that contain hormones can impact the chances of getting breast cancer. Drinking alcohol is clearly linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Being overweight or obese increases the risk in women after menopause. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity. Moderate and vigorous physical activity lowers risk for postmenopausal breast cancer. Vigorous physical activity lowers risk for pre-menopausal breast cancer, according to the recently released American Institute for Cancer Research “Breast Cancer Report.”

Early detection of breast cancer is the leading factor in the historic decline in cancer deaths. With screening mammography, treatment can be started earlier in the course of the disease, possibly before it has spread. Results from randomized clinical trials and other studies show that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74.

“The importance of love and life hits you square in the face and it takes a strong toll on your body and spirit,” says Cheryl of her diagnosis and treatment regimen.  Today she is more than one year cancer free.

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting close to home. The all-encompassing oncology and hematology programs provide a complete range of diagnosis, treatment, and follow-up care for all types of cancer.

Finding New Solutions in the Fight Against Cancer Through Research

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While the most overt cancer research news usually comes from efforts to derail the progression of the deadly disease, research into the development of alternative pathways to finding an ultimate solution to cancer often go unnoticed or fail to receive the same level of notice among the public. Advances are being made in new techniques to improve the effectiveness of traditional treatment protocols, the utilization of non-traditional or culturally specific treatment methods or identifying dietary or physical behaviors that may lead to increasing or decreasing the risk factors associated with cancer.

An innovative new treatment for an aggressive form of blood cancer has been approved by the U.S. Food and Drug Administration. According to Mounzer Agha, Director of the Mario Lemiuex Center for Blood Cancers at Hillman Cancer Center, the cell based therapy produced a 51 percent remission rate among patients with a strain of lymphoma that didn’t respond well to traditional chemotherapy or radiation. “There was no treatment that could possibly put them into remission, so to get a 50 percent remission rate with this kind of treatment is a major accomplishment,” Agha said. This is a breakthrough for patients and physicians, according to Agha. The treatment is customized to each individual’s immune system. “This type of therapy represents a paradigm shift in the treatment of blood cancer and it will completely change the landscape of how we approach and treat blood cancers in the future,” he said.

In oriental medicine, treatment using acupuncture needles has been commonly practiced for thousands of years in the fields of treating musculoskeletal disorders, pain relief, and addiction relief. Recently, it has emerged as a promising treatment for brain diseases, gastrointestinal disorders, nausea, and vomiting, and studies are under way to use acupuncture to treat severe diseases. A research team lead by Professor Su-Il In, through joint research with Dr. Eunjoo Kim of Companion Diagnostics & Medical Technology Research Group at DGIST and Professor Bong-Hyo Lee’s research team from the College of Oriental Medicine at Daegu Haany University, has published a study showing that the molecular biologic indicators related to anticancer effects are changed only by the treatment of acupuncture. The research was published in the online edition of Scientific Reports, the sister journal of the globally renowned academic journal Nature. Professor Su-Il In said, “This research, which combines nanotechnology and oriental medicine technology, is a scientific study that shows the possibility of using acupuncture as a method to treat severe diseases such as cancer.”

For decades researchers have known that dietary issues can often be a factor in the incidence of cancer. In a paper published in the journal Nature Communications, researchers from VIB, a life sciences research institute, and Vrije University in Brussels found that a compound in sugar stimulates aggressive cancer cells and helps them to grow faster. Led by Johan Thevelein, a microbiologist with VIB, this research builds on what scientists already knew about the Warburg effect, where cancer cells rapidly break down sugar for energy and to fuel for further growth. While the research identifies a link between sugar and the aggressiveness of cancer cells, it doesn’t mean that eliminating sugar from one’s diet will eliminate the likelihood of getting cancer. “We have no evidence of this effect happens in healthy people,” Thevelein says, but “Reducing sugar intake during cancer treatment might help the system to overcome the cancer and it might facilitate the action of chemotherapy because it’s difficult to kill the cancer cells if they’re always activated [by sugar],” he says. “Providing sugar to cancer cells carries a greater risk of stimulating their aggressiveness.”

In Queensland, Australia scientist Georgia Chenevix-Trench has uncovered an additional 72 genetic markers that can indicate an increased likelihood that a patient may be more susceptible to getting cancer in their lifetime.  The discovery may lead to the development of a more definitive predictive test for breast cancer in women.

While most of us hope for quick and all-encompassing cure for cancer, the complexity and the infinite variety of cancer types indicate that a single solution is more than unlikely. The ultimate solutions will come from a combination a multitude of treatments and advances in early prediction and detection.

Gettysburg Cancer Center is actively involved with a consortium of doctors offering clinical trials for patients seeking alternative solutions and therapies.  For more information on the current clinical trials available, visit http://gettysburgcancercenter.com/patients/clinical-trials/.

Gene Therapy. A New Frontier in Medical Innovation

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Cancer is a disease that is experienced by young and old and by every economic and social segment of the world populace. At some point in everyone’s life, cancer will affect us individually, a member of our family or one or many of our friends and acquaintances. The American Cancer Society projects there will be 1,688,780 new cancer patients and 600,920 deaths due to cancer in 2017, for a disease that does not discriminate by race or national origin.

Cancer is where abnormal cell growths form in the body and interfere with normal, healthy body functions. Not new to the world stage, cancer dates back to ancient times. Today, after millennials of research and discovery, new treatments for a vast array of cancer types are being studied, many with promising results.  One such new treatment called chimeric antigen receptor T-cell therapy (CAR-T) involves taking samples of T-immune cells called T-cells from a patient, genetically engineering them, and putting them back in to fight the cancer. Co-developed with the drug giant Novartis, the therapy, CAR-T, genetically alters a patient’s own immune cells to target and destroy cancer cells.

“We’re entering a new frontier in medical innovation with the ability to reprogram a patient’s own cells to attack a deadly cancer,” said FDA Commissioner Dr. Scott Gottlieb. The process takes about 22 days and begins with the extraction of a patients T cells, exposing them to the vector which genetically transforms them. They’re then expanded and frozen for shipment back to the patient. During the out-of-body processing of the cells, the patient receives chemotherapy to wipe out any remaining T cells to avoid interference with the, soon to be, newly implanted cells.

“This is a major advance, and is ushering in a new era,” said Malcolm Smith, a pediatric oncologist at the National Institutes of Health. The treatment appears to strengthen a patient’s immune system allowing their own body to fight the cancer. The treatment is recommended for cancer patients who have run out of options for traditional therapy. The new therapy is only currently available for patients 25 years or younger. Thus far, 83 percent of patients are experiencing positive survival results.

While overtly touting the success of gene therapy, researchers are tempering their enthusiasm after experiencing some significant life threatening side effects in 47 percent of the studies participants. These side effects have resulted in brain swelling and deaths, casting a shadow over the field. Seizures and hallucinations were also relatively common, but temporary. Though concerning, the side effects have been successfully managed with drugs. Quality control and how to standardize the potency and purity of living cells extracted from each patient are also a concern. Because of the risks, the treatment is only currently available at 20 US hospitals. The individualized nature and relatively small patient population both drive up the cost of the treatment for now.

“This is a big paradigm shift, using this living drug,” says Dr. Kevin Curran, a pediatric oncologist at Memorial Sloan Kettering Cancer Center that will soon be offering the treatment. “It will provide a lot of hope. This is the beginning.”

“The approval of CAR T-cell therapy for pediatric leukemia marks an important shift in the blood cancer treatment paradigm,” says the American Society of Hematology. “We now have proof that it is possible to eradicate cancer by harnessing the power of a patient’s own immune system. This is a potentially curative therapy in patients whose leukemia is unresponsive to other treatments and represents the latest milestone in the shift away from chemotherapy toward precision medicine. Today’s approval is the result of over a decade of hematology research, including research funded by the National Institutions of Health (NIH).”

October is Breast Cancer Awareness Month Around the World

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Billed as the most common cancer in women, breast cancer is impacting the lives of one in eight women in the United States. The second leading cause of cancer death in women after lung cancer, breast cancer most commonly occurs in women 50 years of age and older. Breast cancer is caused by a genetic mutation in the DNA of breast cancer cells but how or why this damage occurs isn’t fully understood. Some mutations may develop randomly over time, while others are inherited or may be the result of environmental exposures or lifestyle factors. More than 3.5 million women are living in the U.S. with a history of breast cancer.

Early detection remains the most important factor in the successful treatment and survivability of breast cancer. Caught early when known treatments have the best chance of success, breast cancer is survivable. Successful treatments include surgery, chemotherapy, radiation and immunotherapy. “Risk factors include being female, obesity, a lack of physical exercise, drinking alcohol, hormone replacement therapy during menopause, ionizing radiation, early age at first menstruation, having children late or not at all, older age, and family history.” With the clear lack of knowledge for its causes, early detection of the disease remains the cornerstone of breast cancer control.

National Breast Cancer Awareness Month (NBCAM) was founded in 1985 by the American cancer Society and what is now known as AstraZeneca Pharmaceuticals. Held each October, the event is an attempt to increase the awareness of breast cancer and to aid the solicitation of funds for research and treatment of the disease. NBCAM unites cancer organizations around the world in providing information and support for those suffering from the cancer. Breast Cancer Awareness is represented by the display of pink ribbons, first introduced by the Susan G. Komen Foundation at its New York City race for breast cancer survivors in 1991.

The effort by so many to bring worldwide attention to the disease appears to be having a positive impact. A new report from the American Cancer Society finds that death rates from breast cancer in the United States have dropped 39% between 1989 and 2015. The overall declines in breast cancer death rates have been attributed to both improvements in treatment and early detection by mammograms. The American Cancer Society recommends women find breast cancer earlier when treatments are more likely to be effective. While there is a lack or definite agreement on when and how often screening is most effective, The National Comprehensive Cancer Network recommends annual screening beginning at age 40.

The professional team of oncologists and staff at Gettysburg Cancer Center supports the efforts of Breast Cancer Awareness Month in its world-wide goal to provide the latest information, research, treatment options and support for those who suffer from breast cancer.

Targeted Radiation Therapy Effective For Breast Cancer Patients

A new cancer research project funded by the United Kingdom is revealing some very positive results for breast cancer patients. The study (IMPORT LOW trial), led by The Institute of Cancer Research, London and the Cancer Research UK Cambridge Centre indicates that breast “cancer patients who received radiotherapy targeted at the original tumor site experience fewer side effects five years after treatment than those who have whole breast radiotherapy, and their cancer is just as unlikely to return.” The results which were recently published in The Lancet, an independent, international weekly general medical journal. “This approach could spare many women significant physical discomfort and emotional distress,” says Professor Arnie Purushotham, Cancer Research UK. “One of the challenges when treating early stage breast cancer is trying to minimize the side effects that can have a real impact on a woman’s life, without affecting the chances of curing her.”

The study included more than 2,000 women aged 50 or over who had early stage breast cancer that was at a low risk of coming back. Radiation therapy or radiotherapy uses ionizing radiation as part of cancer treatment to control or kill malignant cells. A common and effective treatment for breast cancer for many decades, large field radiotherapy is relatively painless in its application, but often the treatments produce side effects that range from low, short term to more severe, long term in nature. Depending on the intensity of the radiation, higher doses can cause varying, acute side effects for months or years following treatment. The nature, severity, and longevity of side effects depend on a number of treatment factors and the individual patient.

Precisely targeted radiation therapy can eradicate all evidence of disease in patients with cancer that has spread to only a few sites. Because radiation destroys cells, targeting the treatment to specific cancer cells limits the collateral damage to areas not affected by the cancer, reducing the side effects suffered by the patient.

The IMPROT LOW trial found that women who received partial radiotherapy reported fewer long term changes to the appearance and feel of their breast, than those who had radiotherapy to the whole breast. Dr. Charlotte Coles, Reader in Breast Radiation Oncology at Cambridge University, chief investigator for the trial and first author of the publication, said, “We started this trial because there was evidence that if someone’s cancer returns, it tends to do so close to the site of the original tumor, suggesting that some women receive unnecessary radiation to the whole breast. Now we have evidence to support the use of less, but equally effective, radiotherapy for selected patients.”

The technique, delivered by standard radiotherapy equipment, may lead to increased use of this treatment at cancer centers across the country and around the world. Professor Judith Bliss, scientific lead for the study within the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, said: “We’re delighted that the results of this trial have the potential to lead to a real change in the way selected breast cancer patients are treated.”

Gettysburg Cancer Center is actively working with researchers on clinical trials, providing alternative treatments for its patients. For more information on clinical trials at Gettysburg Cancer Center, click here.