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News from CaSfA's Director
News from CaSfA's Director
Blog
Meditation
Posted on June 5, 2019 at 12:36 PM |
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The continuing rise in cancer rates and longer survivorship underscores the need for effective symptom management. Based on current evidence, meditation is a promising modality for the relief of both psychological and physical symptoms associated with cancer and its treatments. Meditation can reduce stress, control anxiety, improve sleep, and improve emotional health and self-awareness. It has also been reported to lengthen attention span and reduce age-related memory loss. CaSfA recently hosted a Meditation Workshop utilizing the free app, Insight Timer. Recommended by CaSfA members and psychosocial counselors, it contains over 19,000 meditations and offers the “largest free library of meditations and music tracks on earth.” I’ve recently started using it, and now also recommend it! The app allows you to select from many categories of guided meditations such as: · Recovery and Healing · Stress and Anxiety · Performance (clarity, creativity, leadership, etc.) · Health and Happiness · Relationships · Spiritual · Kids The app allows you to pick a meditation based on time too, varying from less than 5 minutes to over 30 minutes. You can choose between verbally guided meditations or those with music. We experimented with a few short meditations at our workshop. It became clear that what works for one individual may not work for another, so you have to try different options to find the best meditations for you. The app also contains courses in meditation. At our workshop we started the beginner course, “Learn to Meditate in Seven Days”. The course consists of seven, easy-to-do, 12-minute lessons: · All You Do is Breathe · Here and Now · Witness Your Thoughts · Mind-Body Connection · Exploring Emotions · Power of Intention · Finding Inner Stillness There are also courses for those who are more advanced in meditation (although there are fees associated some of these.) New content is added every day, so you really cannot run out of free offerings! Give it a try! |
The American Cancer Society's 2019 Annual Report
Posted on January 16, 2019 at 4:44 PM |
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Much has been written in the past weeks about the American Cancer Society’s Annual Report. (To read the 70+page report visit https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf) Here are some facts from the report: The Good News · The U.S. cancer death rate has hit a milestone, falling for the past 25 years. The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27% between 1991 and 2016 · This decline translates into more than 2.6 million fewer cancer deaths from 1991 to 2016. This progress has been driven by steady declines in death rates for the four most common cancer types – lung, colorectal, breast, and prostate. · More than 15.5 million Americans with a history of cancer were alive on January 1, 2016, most of who were diagnosed many years ago and have no current evidence of cancer. · Lower smoking rates are translating into fewer deaths. · Advances in early detection and treatment also are having a positive impact. · The 5-year relative survival rate for all cancers combined has increased substantially since the early 1960s, from 39% to 70% among whites and from 27% to 63% among blacks. Improvements in survival reflect advances in treatment, as well as earlier diagnosis for some cancers. The Bad News: · Cancer remains the nation’s No. 2 killer · The ACS predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year. · Obesity-related cancer deaths are rising. Of the most common types of cancer in the US, all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus. Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis. The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, so we may just be starting to see the effect of the obesity epidemic on cancer. · Prostate cancer deaths are no longer dropping. The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to overdiagnosis and overtreatment. The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths. · There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking. In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties. |
Colon Cancer Screening
Posted on August 15, 2018 at 11:22 AM |
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Tonight I will be attending a wake for a woman who was taken much too soon due to Stage IV Colon Cancer. Please heed the advice of the American Cancer Society for screening: Research has shown that the risk of colorectal cancer has been increasing in younger adults. This finding spurred the American Cancer Society to update their screening guidelines for colorectal cancer: The ACS recommends that people at average risk of colorectal cancer start regular screening at age 45. For screening, people are considered to be at average risk if they do not have: · A personal history of colorectal cancer or certain types of polyps · A family history of colorectal cancer · A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) · A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC) · A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history. People over 85 should no longer get colorectal cancer screening. Several test options are available for colorectal cancer screening: · Stool-based tests · Highly sensitive fecal immunochemical test (FIT) every year · Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year · Multi-targeted stool DNA test (MT-sDNA) every 3 years · Visual (structural) exams of the colon and rectum · Colonoscopy every 10 years · CT colonography (virtual colonoscopy) every 5 years · Flexible sigmoidoscopy (FSIG) every 5 years There are some differences between these tests to consider (see Colorectal Cancer Screening Tests), but the most important thing is to get screened, no matter which test you choose. Talk to your health care provider about which tests might be good options for you, and to your insurance provider about your coverage. If a person chooses to be screened with a test other than colonoscopy, any abnormal test result should be followed up with colonoscopy. For people at increased or high risk People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people with: · A strong family history of colorectal cancer or certain types of polyps · A personal history of colorectal cancer or certain types of polyps · A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) · A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC) · A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer The American Cancer Society does not have screening guidelines specifically for people at increased or high risk of colorectal cancer. However, some other professional medical organizations, such as the US Multi-Society Task Force on Colorectal Cancer (USMSTF), do put out such guidelines. These guidelines are complex and are best looked at along with your health care provider. In general, these guidelines divide people into several groups (although the details depend on each person’s specific risk factors). 1. People with one or more family members who have had colon or rectal cancer Screening recommendations for these people depend on who in the family had cancer and how old they were when it was diagnosed. Some people with a family history will be able to follow the recommendations for average risk adults, but others might need to get a colonoscopy (and not any other type of test) more often, and possibly starting before age 45. 2. People who have had certain types of polyps removed during a colonoscopy Most of these people will need to get a colonoscopy again after 3 years, but some people might need to get one earlier (or later) than 3 years, depending on the type, size, and number of polyps. 3. People who have had colon or rectal cancer Most of these people will need to start having colonoscopies regularly within a year of surgery to remove the cancer. Other procedures like ultrasound might also be recommended for some people with rectal cancer, depending on the type of surgery they had. 4. People who have had radiation to the abdomen (belly) or pelvic area to treat a prior cancer Most of these people will need to start having colonoscopies at an earlier age (depending on how old they were when they got the radiation), and might need to be screened more often than normal (such as at least every 5 years). 5. People with inflammatory bowel disease (Crohn’s disease or ulcerative colitis) These people generally need to get colonoscopies (not any other type of test) every 1 to 2 years, starting at an earlier age. 6. People known or suspected to have certain genetic syndromes These people generally need to have colonoscopy (not any of the other tests). Screening is often recommended to begin at a young age, possibly as early as the teenage years for some syndromes – and needs to be done much more frequently. Specifics depend on which genetic syndrome you have, and other factors. |
End of Life Care
Posted on February 7, 2018 at 4:53 PM |
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End-of-life care is the term used to describe the
support and medical care given during the time surrounding death. This care
does not happen only in the moments before breathing stops and the heart stops
beating. People living with one or more
chronic illnesses may need a lot of care for days, weeks, and even months
before death. In addition, we don’t
always know when death is near, so it is important that we figure out a plan in
advance. According to the National Cancer Institute, “End-of-life
care includes physical, emotional, social, and spiritual support for patients
and their families. The goal of end-of-life care is to control pain and other
symptoms so the patient can be as comfortable as possible. End-of-life care may
include palliative care, supportive care, and hospice care.” Some
interesting statistics: ·
90% of people say it’s important to discuss end
of life care with their families, but only 27% have done so. ·
80% of people say it’s important to discuss end
of life treatment with their physicians, but only 7% have done so. ·
82% of people say it’s important to put their
wishes in writing, but only 23% have done so. Visit these sites for help in documenting your end-of-life care wishes: https://theconversationproject.org |
Yoga for Survivors
Posted on November 8, 2017 at 3:31 PM |
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CaSfA had such
a wonderful evening of Yoga with Eileen Nikopoulos!
Gentle, simple poses and breath work started the class. We were then guided into a few restorative
poses and experienced a sample of Thai Yoga bodywork. We all left the evening feeling much more
relaxed and rejuvenated!! Eileen
Nikopoulos, RYT 500 is an experienced yoga teacher and Certified Thai Yoga
Bodywork Practitioner who practices at several studios in the Central Massachusetts area. Her private studio is at 14 South Street,
Westborough, but she will also travel to your home or office. Eileen
specializes in private instruction in yoga, meditation and Mindfulness Based
Stress Reduction, as well as Traditional Thai Yoga Bodywork. Eileen applies these ancient arts to the
problems of modern life – stress, sitting and the erosion of attention. Eileen
will help you live life more fully, whether your goals are to cope with stress
more effectively, reduce pain or regain strength and flexibility. You can contact Eileen to work with you privately.
What’s the benefit of working privately with Eileen? Group
classes are helpful, but you can make more significant and faster progress in a
private setting because Eileen customizes the each session to fit your goals. Eileen is generously offering a special
for CaSfA members: Schedule any 90-minute session for the
price of a 60-minute session. This offer
includes yoga bodywork, meditation and MBSR (mindfulness based stress reduction
introductory session). Please
contact Eileen directly at 508 591-FLOW or email [email protected]
. You can also go to mountainbrookyoga.com to learn more and sign up for
her newsletter to receive announcements about upcoming workshops, classes and
special offers! |
Cancer and Exercise
Posted on September 8, 2017 at 4:11 PM |
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There is a
physical (and mental) decline in our bodies as we age—and studies have shown
that biologic aging begins in our 20’s!
Add cancer and the effects of its treatments to this decline and we can
end up with significant weaknesses. It can be
extremely challenging to do any exercise or fitness program during treatment
and even after treatment is completed. I
remember some days, just getting out of bed was a major accomplishment. There is pain and limited abilities that may
be secondary to surgeries and radiation.
Cancer and its treatments may also leave one with disorders of the
nervous system, such as peripheral neuropathy, making even walking painful, and
disrupting balance. Many of these issues
can take a very long time to improve, but research has shown that a program of
fitness and exercise can not only aid in recovery, but also reduce the risk
certain cancers forming and/or returning. Here’s great
info from National Cancer Institute: (From: https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet; Go to link for references) Physical
activity: · Any movement that uses
skeletal muscles and requires more energy than does resting · Can include working,
exercising, performing household chores, and leisure-time activities such as
walking, tennis, hiking, bicycling, and swimming. · Is essential for people to
maintain a balance between the number of calories consumed
and the number of calories used. Consistently
expending fewer calories than are consumed leads to obesity, which is linked
to increased risks of 13 different cancers: Adenocarcinoma of the esophagus Colon and Rectal cancer Gastric cancer Liver cancer Gallbladder cancer Pancreatic cancer Breast cancer (postmenopausal) Uterine cancer (endometrial) Ovarian cancer Renal Cell (Kidney) cancer Meningioma (Brain) Thyroid cancer Multiple Myeloma (Blood cancer) Evidence
also indicates that physical activity may reduce the risk of getting several
cancers through other mechanisms, independent of its effect on obesity. (From:
https://www.health.harvard.edu/exercise-and-fitness/does-regular-exercise-reduce-cancer-risk)
A recent study from the National Cancer
Institute, published in JAMA Internal Medicine, strongly supports
the theory that regular exercise reduces the risk of many types of cancer. The
research team pooled the results of 12 large studies conducted both in the
United States and Europe, including over 1.4 million people. Study participants
provided information on their lifestyle, including physical activity. All of
the illnesses they developed were recorded, including nearly 190,000 cases of
cancer. The research team compared the rates of
cancer in those people with the highest levels of physical activity and those
with the lowest levels. They found that those with the highest levels of
physical activity had lower rates of cancer of the esophagus, lung, kidney,
colon, head and neck, rectum, bladder, and breast, as well as of two cancers of
the blood (myeloma and myeloid leukemia). The rates of these cancers in the
most active people were 7% to 38% lower than in the least active people.
Interestingly, the most active men had a 4% higher rate of prostate cancer and
a 28% higher rate of melanoma. The researchers doubted the significance of the
very slightly higher rate of prostate cancer, and they presented evidence that
the higher rate of melanoma was likely because the more active people spent a
lot more time in the sun. Exercise
has a number of biological effects on the body, some of which have been
proposed to explain associations with specific cancers, including: · Lowering the levels of hormones, such as insulin and estrogen, and of certain growth factors that have been associated with cancer
development and progression [especially important for reducing risk of breast and colon cancer] · Helping to prevent obesity and decreasing the harmful
effects of obesity, particularly the development of insulin resistance (failure
of the body's cells to respond to insulin) · Reducing inflammation · Improving immune system function · Altering the metabolism of bile acids, resulting in decreased exposure
of the gastrointestinal tract to these suspected carcinogens [especially important for reducing risk of colon cancer] ·
Reducing the amount of time it
takes for food to travel through the digestive system, which decreases
gastrointestinal tract exposure to possible carcinogens [especially important for
reducing risk of colon cancer] The
benefits of physical activity/fitness for cancer survivors (and remember, by
current definition, you are considered a survivor from the day you are
diagnosed): · Not only reduces chance of
getting certain cancers, but also reduces incidence of recurrence · Improves prognosis and
likelihood of survival · Improves quality of
life—including self-esteem, emotional well-being, sexuality,
sleep disturbance, social functioning, anxiety, fatigue, depression and pain · Reduces incidence and
severity of other chronic conditions which may complicate care, such as
cardiovascular disease and Type 2 diabetes · Reduces body weight and
body mass index (which may have increased as a result of cancer therapy) · Improves cognitive
function · Reduces side effects of
some cancer therapies (Dr. Ligibel of Dana Farber has done studies that showed
exercise reduced the side effects of aromatase inhibitors used to treat some
breast cancers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372849/
and http://www.breastcancer.org/research-news/exercise-helps-ease-ai-side-effects) How
much exercise should we be getting? Adults need at least: 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e.,
brisk walking) every week and
muscle-strengthening activities on 2 or more
days a week that work all major muscle groups (legs, hips, back, abdomen,
chest, shoulders, and arms). OR 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e.,
jogging or running) every week and
muscle-strengthening activities on 2 or more
days a week that work all major muscle groups (legs, hips, back, abdomen,
chest, shoulders, and arms). OR An equivalent mix of moderate- and
vigorous-intensity aerobic activity and
muscle-strengthening activities on 2 or more
days a week that work all major muscle groups (legs, hips, back, abdomen,
chest, shoulders, and arms). NOTE: 10
minutes at a time is fine We know 150 minutes each week sounds like a lot
of time, but it's not. That's 2 hours and 30 minutes, about the same amount of
time you might spend watching a movie. The good news is that you can spread
your activity out during the week, so you don't have to do it all at once. You
can even break it up into smaller chunks of time during the day. It's about
what works best for you, as long as you're doing physical activity at a
moderate or vigorous effort for at least 10 minutes at a time. |
Cancer Survivorship: Sexual Health and the Pelvic Floor
Posted on June 8, 2017 at 3:20 PM |
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CaSfA members learned a lot of useful information at "Cancer Survivorship:
Sexual Health and the Pelvic Floor", a presentation by Stacey Berger, PT. Stacey specializes in
women’s health, men’s health, pelvic pain, pelvic floor rehabilitation,
continence control, and musculoskeletal conditions. She is STAR (Survivorship
Training and Rehabilitation) Certified
in Oncology Rehab. Here are some take home pelvic health tips:
To read all the notes from the presentation, join CaSfA to receive our newsletters. |
USPSTF's Recommendations for PSA Testing
Posted on April 18, 2017 at 1:17 PM |
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The
US Preventive Services Task Force recently released a draft statement with updated
advice for the use of Prostate Specific Antigen (PSA) in screening for prostate
cancer. They will be accepting public
feedback regarding their recommendations until May 8, 2017, after which time a
final recommendation will be released. Back
in 2012, the USPSTF unequivocally told doctors to discourage patients from
getting PSA testing. They stated that
the risks of false positives and overtreatment outweighed the benefits. But after much debate, the USPSTF has backed
off that advice. Here
is the upshot of their updated recommendations from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/prostate-cancer-screening1 ▪ PSA tests for men age 70 and
older and men under age 55 are still discouraged ▪ For men between 55 and 69, the
panel is punting the decision to doctors. “The decision about whether to be screened for
prostate cancer should be an individual one.
Screening offers a small potential benefit of reducing the chance of dying of
prostate cancer. However, many men
will experience potential harms of screening, including false-positive results that require
additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment
complications, such as incontinence and impotence. The USPSTF recommends individualized decision making about
screening for prostate cancer after
discussion with a clinician, so that each man has an opportunity to understand the potential benefits and
harms of screening and to incorporate his values and preferences into his decision.” ▪ The task force backed down on
its earlier advice in light of new evidence. Back in 2012, the best evidence suggested that for
every 1,000 men screened, 0.8 prostate cancer deaths would be prevented in the
next 10 to 15 years. But a longer look at the participants in prostate cancer
studies has raised that to 1.3 deaths prevented in the same time frame. Additionally, studies have since reported
that screening 1,000 men ages 55 to 69 years may prevent approximately 3 men
from developing metastatic prostate cancer. ▪ The panel also took into
consideration that how men seek treatment has shifted. More men now who receive cancer
diagnoses are opting for active surveillance — watching their cancer closely —
rather than treatment. That lessens the potential harms, such as impotence and
incontinence after surgery; compared to the last time the task force evaluated
the screenings. More detailed information is in CaSfA's April 18, 2017 newsletter. Join CaSfA to receive our newsletters!! |
Skin Care After Cancer
Posted on April 6, 2017 at 4:33 PM |
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CaSfA members were fortunate to have Holly Brown of Looking and
Feeling FAB, Inc.(http://lookfeelfab.org) for a presentation, “Skin Care After the Diagnosis of Cancer”. This non-profit organization offers those
with cancer and other serious illnesses FREE
skin care products, treatments and education at multiple locations in
Massachusetts (including Westborough!!). We learned how our skin changes with cancer
and what we can do to preserve and protect our skin. We even received gift bags with sample
products! My notes from the presentation, as well as how to access Looking and Feeling FAB’s services, were distributed in the April 4, 2017 newsletter. Join CaSfA to receive this and all future CaSfA newsletters! |
What's New In Cervical Cancer
Posted on March 22, 2017 at 1:38 PM |
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In a recent Facebook webchat,
Dr. Ursula Matulonis, medical director of Gynecologic Oncology in
Dana-Farber’s Susan F. Smith Center for Women’s Cancers,
and Dr. Colleen Feltmate , director of minimally invasive surgery in
Gynecologic Oncology at Brigham and Women’s Hospital, discussed what is new in
Cervical Cancer. You
can access the webchat at: http://blog.dana-farber.org/insight/2017/01/what-you-should-know-about-cervical-cancer-webchat/?utm_source=newsletter&utm_medium=email&utm_content=What%20you%20should%20know%20about%20cervical%20cancer&utm_campaign=spotlight Here are my notes: About 13,000 women are diagnosed with cervical cancer each
year in the US Screening for cervical cancer: ·
Is a bit of controversial ·
Can be confusing even for doctors. ·
Should include screening for Human Papilloma
Virus (HPV), especially for age 30 and over ·
All agree women should see gynecologist by the
time become sexually active ·
Now using HPV and pap test in combination for
screening women over 30 yo. Where do you find out about screening? ASCCP (American Society for Colposcopy and Cervical
Pathology web site (http://www.asccp.org/asccp-guidelines) guides doctors and patients with
practical algorithms Risk factors for cervical cancer: ·
HPV-sexually transmitted through direct contact. ·
Increased sexual partners—increases risk of HPV ·
Smoking ·
Immunosuppression—don’t clear the virus well ·
Skipping pap smears/no access to medical care
for pap smears—one of biggest factors is not having pap smear for five or more years Vaccination for HPV: ·
As young as 9-11 up to age 26 ·
Important to get before exposure (sex activity) ·
Boys and girls should be vaccinated ·
Anal, throat, and oral cancer—risk for women and
also risk for men ·
Three shot series—some immunity to HPV if do
partial series, but need to complete all for it to work best [when I was looking for more information, I
found the CDC is now recommending two doses, 6-12 months apart. If a child received the second dose within 6
months of the first, then a third dose should be given. Here’s the link with info: https://www.cdc.gov/hpv/parents/vaccine.html ] Many women will have precancerous changes on their pap
smear—it is a screening test, meant to
pick up any abnormalities ·
If abnormal pap, next step is colposcopy
(procedure that uses a binocular-like tool to get a closer look at the
cervix). ·
Depending on result of colposcopy, may biopsy to
test if pre or cancer ·
Often if cervical cancer is picked up early can
do limited excision ·
If your pap smear shows precancerous changes,
you can get medical care with general gynecologist ·
Sometimes gyn will refer to oncologic gynecologist Cervical cancer Almost 100% cervical cancer is driven by HPV Two types of cervical cancer: squamous cell carcinomas—begin
in the flat cells of the cervix; and Adenocarcinomas – begin in the glandular
cells of the cervix. Some argue
adenocarcinoma can be more virulent and come back more often. Others argue they are the same. Another type is combination of both, but this type is very rare HPV types 16 & 18 cause the vast majority of cervical
cancers. Initial HPV vaccine covered
these types only. Now the vaccine protects against 7 types-covers about 99%
cervical cancer causing HPV. [Again, this
is a bit off from the CDC info: “All three licensed HPV vaccines
protect against types 16 and 18, which cause the majority of cervical cancers
across racial/ethnic groups (67% of the cervical cancers among whites, 68%
among blacks, and 64% among Hispanics). The 9-valent HPV vaccine protects
against seven HPV types that cause about 80% of cervical cancer among all
racial/ethnic groups in the United States.”
From https://www.cdc.gov/hpv/parents/questions-answers.html
] When cervical cancer is first diagnosed: Staging of Cancer- Imaging techniques may be
ordered—CT/MRI/PET scans Is having children a concern?—may change approach of
treatment Is the cancer a visible or a microscopic lesion? Minimally invasive surgery—has come along way Stage 1—in past did a radical abdominal hysterectomy—removed
uterus, cervix, much of vagina. Had a
lot of surgical complications, long recovery and no longer able to have
children. Now if don’t want children
will do a laparoscopic hysterectomy—less bleeding, less pain and less late side
effects. Patients can even go home the next
day. And in younger women, doctors are doing
less surgery so that many can still have children. [Radical trachelectomy—removes
cervix, top 1-2cm of vagina and surrounding tissue, but leaves uterus]. Research continues to look at ways to map the
cancer so only take out the cancer, and leave behind healthy tissue. In later stages, cancer may be in the lymph nodes and pelvis.
If surgery isn’t curative—chemo and radiation may be needed Quality of life: Side effects of treatment—trouble with intercourse due to
changes in tissue—Multidisciplinary approach is most beneficial (used at Dana
Farber): Includes biofeedback techniques, sometimes local estrogen
creams, dilators, and counseling. Racial disparity a big concern with cervical cancer. Rate of
cervical cancer in African Americans is almost double that of Caucasians--probably
due to limited access to medical care among African Americans. Audience Questions: Is there any age when a woman can stop cervical cancer
screening? If a woman has had normal pap smears, has no evidence of HPV
infection, and has had the same sex partner, probably can stop screening after
age 65. However, women and men are
living longer and longer, and often having new partners later in life. In this case, screening is still necessary
after age 65 [According to the American
Cancer Society, more than 15% of cervical cancers are diagnosed in women over
65.https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html ]. When should someone seek a second opinion? Consider it before any major intervention or surgery If anything a doctor does or says doesn’t feel right to you It is always reasonable to decide between medical practitioners—no
reasonable doctor should feel slighted when patient gets a second opinion Where is the field going? Looking into molecular mechanisms driving cervical disease Immunotherapy may play a larger role in the future A trial is now being conducted at Dana Farber looking at using
a vaccine to treat HPV-16 in patients with HPV 16 anal and oral cancer [https://clinicaltrials.gov/ct2/show/NCT02865135?term=HPV+and+anal+cancer&rank=2
] Another trial is looking at using a HPV vaccine in patients
who are at high risk for cancer recurrence. |
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