Super ASK Patient: Community Kindness Helps a Family Face Lung Cancer


Update:  We are deeply saddened to report that Michael passed away on July 20, 2016. It is a privilege to continue to share his story and keep his memory alive.

In October of 2014, Michael Hrabal’s wife Hazel urged him to go to the doctor for a small but persistent cough. The doctor prescribed cough medicine, but it didn’t help, and by the end of the month Michael had been diagnosed with stage IV non-small cell lung cancer.

“It was kind of shocking that this little cough turned out to be cancer,” says Michael, who was 57 years old at the time and living north of New York City with Hazel and their son Andrew. This was actually his second time facing cancer; he’d been treated for kidney cancer 15 years earlier, but had remained cancer-free until the new diagnosis. Continue reading…


Active Surveillance for Prostate Cancer Can Give Men Good Quality of Life

“Choosing ongoing monitoring instead of immediate curative treatment (surgery or radiotherapy) leads to a better overall quality of life for men with low-risk prostate cancer. In fact, the Quality of life (QoL) is about the same as for men who do not have cancer. These are the findings of a new long-term study comparing Active Surveillance, immediate curative treatment, and a reference group of men without cancer, presented at the European Association of Urology Congress in Munich.

“Prostate cancer is the most common male cancer, with around 400,000 new cases every year in Europe. Most  are treated quickly by  -radical prostatectomy (RP) – or radiotherapy (RT), but both treatments can show significant and distressing side effects, most commonly incontinence, or erectile dysfunction. One alternative which is increasingly considered for patients with less-aggressive cancers is to delay or avoid initial treatment, but instead keeping the patient under Active Surveillance (AS), meaning that the cancer is regularly monitored, with the option of switching to curative treatment if the condition of the tumour changes. Now a new study has examined whether AS actually helps prostate cancer patients to live a better quality of life in the long term.”


More Women With Cancer in One Breast Are Having Double Mastectomies. That Might Not Be a Good Idea.

“For years, doctors and researchers have been concerned about a surprising trend: More and more women with early-stage cancer in one breast were choosing to have double mastectomies to reduce the risk of cancer in the other.

“Many of the patients said they thought an aggressive approach would help their quality of life by lessening their worries about future cancer and making them more comfortable with their bodies.

“But new evidence released Monday shows that the surgery doesn’t improve peace of mind or quality of life very much.”


Radium-223 Improves QoL Over Placebo in CRPC

“Analyses from the phase III ALSYMPCA trial showed that treatment with the alpha-emitting radiopharmaceutical radium-223 resulted in quality-of-life (QoL) improvements over placebo in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases.

“ ‘Patients with CRPC and bone metastases often present with symptoms such as pain fatigue, anorexia, and, rarely, spinal cord compression, contributing to rapid and significant deterioration in health-related QoL and mortality,’ wrote study authors led by Sten Nilsson, MD, PhD, of Karolinska University Hospital in Stockholm.

“The ALSYMPCA trial found that radium-223 prolonged overall survival (OS) as well as time to first symptomatic skeletal event by significant periods. The trial included prospective QoL measurements using the EuroQoL EQ-5D and the Functional Assessment of Cancer Therapy–Prostate (FACT-P). The results from these tests were published online ahead of print in Annals of Oncology.”


Intermittent Hormonal Therapy Proves to be Viable in Prostate Cancer

“With no significant difference between intermittent and continuous androgen-deprivation therapy, patients with prostate cancer may experience an improvement in their quality of life with the former.

“Androgen-deprivation therapy may be an effective treatment in prostate cancer, though its side effects may result in a loss of quality of life for patients. Allowing low-risk patients to take breaks between treatments—a practice known as intermittent hormonal therapy, or a ‘hormone holiday’—may combat these challenges without impacting survival.

” ‘Intermittent hormonal therapy has been growing in popularity over the years. Patients who receive hormone therapy often have side effects, and giving them so-called “hormone holidays” may improve quality of life. Over the years, there has really been a lot of trials and experimental work that laid the groundwork for this going back 20 years,’ said Leonard G. Gomella, MD, in an interview with Targeted Oncology.”


“Hormone Holiday” Can Improve QoL for Select Patients With Prostate Cancer

“Androgen-deprivation therapy, while an effective treatment for prostate cancer, can result in side effects and a reduced quality of life. Allowing low-risk patients to take breaks between treatments—a practice known as intermittent hormonal therapy, or a ‘hormone holiday’—may combat these challenges without impacting survival.

“A recent systematic review and meta-analysis conducted by JAMA Oncology found no significant difference between intermittent and continuous therapy for overall survival (HR, 1.02; 95% CI, 0.93-1.11; 8 trials, 5352 patients), cancer-specific survival (HR, 1.02; 95% CI, 0.87-1.19; 5 trials, 3613 patients), and progression-free survival (HR, 0.94; 95% CI, 0.84-1.05; 4 trials, 1774 patients).”


Long-term Toxicity Surprise With ADT for Prostate Cancer

“In a surprising study result, the use of intermittent androgen-deprivation therapy (ADT) for prostate cancer is not associated with fewer long-term adverse events than continuous ADT.

“The outcome was unexpected because it was hypothesized that the intermittent schedule, which gives patients a break from the treatment, would be less harmful.

“ADT is a cornerstone of locally advanced and metastatic prostate cancer treatment, but is associated with an array of adverse events, including sexual dysfunction, bone demineralization, cardiovascular disease, metabolic complications, cognitive changes, and diminished quality of life.”


Checkpoint Inhibitors Improve QoL in Melanoma Survivors

“The checkpoint inhibitors pembrolizumab and nivolumab not only prolong survival in advanced melanoma patients but also maintain health-related quality of life (QoL), according to two presentations at the Society for Melanoma Research 2015 International Congress, held November 18–21 in San Francisco.

“In the international, randomized, open-label phase III KEYNOTE-006 study, the anti–programmed death-1 (PD-1) humanized monoclonal antibody pembrolizumab provided superior overall survival (OS), progression-free survival (PFS), and response, and with less high-grade toxicity compared with the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor ipilimumab in 834 patients with ipilimumab-naive advanced melanoma who received up to one prior therapy.”


Super Advocate: Surviving Lung Cancer Revitalizes Dave Bjork’s Life


In 1998, Dave Bjork went to the doctor for a high fever accompanied by chills so intense that he shivered even though he wore three jackets. A chest X-ray revealed pneumonia and Dave went back to his life. “I didn’t think anything of it,” he says.

But then Dave had another bout of pneumonia only a few months later, and his new X-ray and his old one had a terrible similarity. “My radiologist held up the two X-rays and showed me that the infection was in the same spot,” he says. Next came a CAT scan and a call from his doctor saying they’d found a tumor in his lung. Continue reading…