Discuss Prostate Screening With Your Doctor, Experts Now Say

Excerpt:

“Older men should talk to their doctors about the pros and cons of prostate cancer screening and make an individual decision that is right for them, an influential national panel of experts has proposed.

“The new recommendation, based on new data from a European trial as well as changes in the way men with prostate cancer are treated, modifies an earlier panel guideline from 2012 that advised men to skip prostate cancer screenings altogether. Screening is typically done using a blood test that measures levels of a protein released by the prostate gland called prostate-specific antigen, or PSA, which may indicate the presence of prostate cancer when elevated. But increased levels can also be caused by less serious medical conditions, like inflammation.”

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After Mastectomies, an Unexpected Blow: Numb New Breasts

Excerpt:

“After learning she had a high genetic risk for breast cancer, Dane’e McCree, like a growing number of women, decided to have her breasts removed. Her doctor assured her that reconstructive surgery would spare her nipples and leave her with natural-looking breasts.

“It did. But while Ms. McCree’s rebuilt chest may resemble natural breasts, it is now completely numb. Her nipples lack any feeling. She cannot sense the slightest touch of her breasts, perceive warmth or cold, feel an itch if she has a rash or pain if she bangs into a door.”

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How Do We Solve the Crisis in Cancer Communication?

Excerpt:

“Five rounds of the usual chemotherapy/radiation protocol kept Alan Gross alive through decades of living with lymphoma. The treatments were grueling, but he was living proof that science was giving us ways to live with cancer. Then the disease came roaring back, and doctors told him that their medicine no longer worked. They told him to get his affairs in order.

“Every day, thousands of Americans get the end-of-life warning that Alan and his wife, Jane Townsend, heard two years ago. The words are so powerful that they can have a concussive effect, making it hard to hear, to speak, to process information. ‘Your ability to think clearly and concentrate isn’t there,’ Jane told me.”

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Melanoma Risk Genetic Testing May Help With Prevention

The gist: Genetic testing can help predict a person’s risk of getting melanoma. A recent study found that people who receive genetic testing for melanoma risk might be prompted to discuss melanoma risk and prevention with more family members.

“Positive genetic risk information about melanoma may help to prompt people to discuss melanoma risk with a wider variety of family members, according to a study published in JAMA that examined the effects of hypothetical genetic testing. Interestingly, even people who received negative genetic testing results were still affected by the results.

“ ‘This study shows us that individuals are sensitive to receiving genetic risk information, regardless of the results, and will likely increase their willingness to discuss melanoma risk and prevention strategies with their families after receiving this type of feedback,’ said study author Mallorie Gordon, MA, of the department of psychology, New School for Social Research, New York, New York.

“ ‘This study indicates that providing genetic risk information to patients and their families may not only improve their understanding of their particular skin health needs—specifically telling patients whether their melanoma risk is related to heredity or sun exposure, as defined by the feedback type of the genetic test—but also improve the risk communication that exists around melanoma and its prevention overall,’ she told Cancer Network.”


Experts Suggest Ways to Increase Cancer Patient Participation in Clinical Trials

Clinical trials are the cornerstone of developing better cancer care. However, less than 5% of cancer patients participate in clinical trials. A recent meeting of cancer experts developed a list of recommendations for increasing clinical trial enrollment. Strategies at the patient and community level include involving patient advocates and community leaders in clinical trial recruitment, simplifying patient consent forms, and providing interpreters. At the physician level, electronic registries may help keep doctors informed about the availability of clinical trials for their patients. Doctors must also work on speaking to their patients about clinical trials in culturally sensitive ways. Finally, at the level of organizations that initiate clinical trials, institutions need to become more efficient about opening and conducting trials.


Experts Suggest Ways to Increase Cancer Patient Participation in Clinical Trials

Clinical trials are the cornerstone of developing better cancer care. However, less than 5% of cancer patients participate in clinical trials. A recent meeting of cancer experts developed a list of recommendations for increasing clinical trial enrollment. Strategies at the patient and community level include involving patient advocates and community leaders in clinical trial recruitment, simplifying patient consent forms, and providing interpreters. At the physician level, electronic registries may help keep doctors informed about the availability of clinical trials for their patients. Doctors must also work on speaking to their patients about clinical trials in culturally sensitive ways. Finally, at the level of organizations that initiate clinical trials, institutions need to become more efficient about opening and conducting trials.


Experts Suggest Ways to Increase Cancer Patient Participation in Clinical Trials

Clinical trials are the cornerstone of developing better cancer care. However, less than 5% of cancer patients participate in clinical trials. A recent meeting of cancer experts developed a list of recommendations for increasing clinical trial enrollment. Strategies at the patient and community level include involving patient advocates and community leaders in clinical trial recruitment, simplifying patient consent forms, and providing interpreters. At the physician level, electronic registries may help keep doctors informed about the availability of clinical trials for their patients. Doctors must also work on speaking to their patients about clinical trials in culturally sensitive ways. Finally, at the level of organizations that initiate clinical trials, institutions need to become more efficient about opening and conducting trials.


Doctors Should Discuss Treatment Expenses with Patients

A recent editorial argues that doctors should talk about the issue of cost when discussing treatment options with patients. High out-of-pocket treatment expenses can cause severe financial hardship that may affect patients’ well-being. A study showed that over 60% of patients want to discuss treatment cost with their doctors, yet only 15% do so. Even though patients frequently want to choose the best treatment regardless of expense, sometimes there are viable lower-cost alternatives. Moreover, some patients may indeed be willing to trade potential medical benefits for less financial distress. Finally, even if patients do not change their treatment choices, discussing treatment costs can help them prepare financially for expensive procedures and learn about options for dealing with medical debt.


Patient Feedback Can Provide Valuable Evidence About Cancer Treatments

Findings from a recent clinical trial validate patients as a crucial source of evidence in cancer research. The trial investigated patients with non-small cell lung cancer (NSCLC) receiving chemotherapy plus standard- or high-dose radiotherapy. The high-dose arm of the trial was eventually closed, because its patients had shorter survival than those treated with standard-dose radiation. Notably, health care providers had not reported higher toxicity in high-dose patients. However, patients in this group had reported lower quality of life than those in the standard-dose group, suggesting that patient feedback can pinpoint treatment effects not captured by provider reports. Patients also reported a higher quality of life with intensity modulated radiation therapy (IMRT) than with three-dimensional conformal radiation therapy (3-D CRT).