Are Lung Cancer Survivors Getting Too Many Costly Scans for No Reason? Study Suggests So

“Once you’ve made it through lung cancer treatment, you want to make sure you catch it early if it comes back again.

“But a new study suggests that one approach to watching for a cancer’s return is being inappropriately used at many hospitals. And it isn’t helping patients survive longer, the research shows. The findings are published in the Journal of the National Cancer Institute.

“The study looked at how often survivors of lung and esophageal cancer went through a kind of imaging called PET scanning as the primary way of monitoring their condition, instead of as a backstop to other kinds of scans.

“PET scans are expensive, but potentially powerful. They let doctors see increased activity by cells inside the body — including fast-growing cancer cells — and can do so early. Many cancer patients receive PET scans as part of diagnosis, to see how advanced their cancer is, and to see how it’s responding to treatment.”

ACOG: Vaginal Estrogen Safe for Breast Ca Survivors

“Vaginal estrogen is safe for breast cancer survivors suffering from such urogenital symptoms as vaginal atrophy, vasomotor symptoms, and lower urinary tract infections, and there is no evidence of increased risk of cancer recurrence with the treatment, according to a statement from the American College of Obstetricians and Gynecologists (ACOG).

“However, the decision to use vaginal estrogen should be made in consultation with a woman’s oncologist, and only if ‘first-line choices’ for managing urogenital symptoms — which should be nonhormonal products such as lubricants — are ineffective for breast cancer patients, reported ACOG’s Committee on Gynecologic Practice, writing in Obstetrics and Gynecology.

“Sexual medicine specialist Lauren Streicher, MD, of Northwestern University, who was not involved with the statement, said that although the treatment clearly eases vaginal dryness, many physicians are reluctant to prescribe it for breast cancer patients. But she said the response is quite different when gynecologists are asked about it.”

For Breast Cancer Patients, Never Too Late to Quit Smoking

“Documenting that it’s never too late to quit smoking, a large study of breast cancer survivors has found that those who quit smoking after their diagnosis had a 33 percent lower risk of death as a result of breast cancer than those who continued to smoke.

“The study involved more than 20,600  with breast cancer, and is one of the largest studies of survival outcomes according to  habits in women with a history of breast cancer, and the first study to assess smoking habits both before and after diagnosis.

“The paper was published in the Journal of Clinical Oncology on January 25, 2016.”

Oncologist Recs Plus Motivation Package Increases Exercise

“For breast and colorectal cancer survivors, the level of exercise participation is significantly increased for those receiving an oncologist’s exercise recommendations with an exercise motivation package, according to a study published online May 12 in Cancer.

“Ji-Hye Park, Ph.D., from Yonsei University in Seoul, South Korea, and colleagues recruited 162 survivors of early-stage breast and colorectal cancer who completed primary and adjuvant treatments. Participants were randomized into three groups: control (59 patients); oncologist’s exercise recommendations (53 patients); and oncologist’s exercise recommendations with an exercise motivation package (50 patients). The level of exercise participation and quality of life were assessed at baseline and at four weeks.

“The researchers found that 80.2 percent of the participants completed the trial. Participants who received an oncologist’s exercise recommendation with an exercise motivation package significantly increased their level of exercise participation compared with controls in intention-to-treat analysis (47.57 added minutes per week [P = 0.022] and 4.14 additional Metabolic Equivalent of Task-hours per week [P = 0.004]). No increase in exercise participation level was seen for participants who received only their oncologist’s exercise recommendations. Participants who received an oncologist’s exercise recommendation with an exercise motivation package had significantly improved role functioning.”

After Prostate Cancer, Start Walking: Walking Routine Improves Health-Related Quality of Life

“Walking at an easy pace for about three hours every week may be just enough physical activity to help prostate cancer survivors reduce damaging side effects of their treatment, according to a new Northwestern Medicine study.

” ‘Non-vigorous walking for three hours per week seems to improve the fatigue, depression and body weight issues that affect many men post-treatment,’ said Siobhan Phillips, lead author of the study. ‘If you walk even more briskly, for only 90 minutes a week, you could also see similar benefits in these areas.’

“Phillips is a kinesiologist and an assistant professor in the department of preventive medicine at Northwestern University Feinberg School of Medicine. The paper will be published April 16, 2015 in the Journal of Cancer Survivorship: Research and Practice.

“This is one of the first papers to investigate how different intensities and types of physical activity affect the health-related quality of life of men after prostate cancer treatment.

” ‘This study shows that you don’t have to engage in high-impact, vigorous activities to improve your quality of life after a prostate cancer diagnosis,’ Phillips said. ‘Since many prostate cancer survivors might find vigorous activities hard to stick with, the good news is that simply focusing on walking more may be enough to make them feel better.’ “

Stress Management Techniques Improve Long-Term Mood and Quality of Life

“A new study shows that providing women with skills to manage stress early in their breast cancer treatment can improve their mood and quality of life many years later. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings suggest that women given the opportunity to learn stress management techniques during treatment may benefit well into survivorship.

“At the turn of the century, 240 women with a recent breast cancer diagnosis participated in a randomized trial that tested the effects of a stress management intervention developed by Michael Antoni, Ph.D., professor of psychology in the University of Miami (UM) College of Arts & Sciences. Dr. Antoni and his team in the Department of Psychology found that, compared with patients who received a one-day seminar of education about breast cancer, patients who learned relaxation techniques and new coping skills in a supportive group over 10 weeks experienced improved quality of life and less depressive symptoms during the first year of treatment.

“In their latest report, the researchers found that the women who received the stress management intervention had persistently less depressive symptoms and better quality of life up to 15 years later.

ASCO: Oncologists Struggling to Meet Demand in Volatile Landscape

“More and more cancer patients are surviving their diseases as better treatments become available, and while that’s good news, it poses challenges for clinicians, says a new report from the American Society of Clinical Oncology (ASCO). Many oncology practices are struggling to meet demand for post-treatment services while grappling with rising drug costs and pressure to adapt to new delivery and payment models.

“The US Food and Drug Administration (FDA) added 10 new treatments to its list of more than 170 approved anticancer agents in 2014 while more than 770 therapies are in the research and development pipeline, ASCO reports in The State of Cancer Care in America: 2015.” New treatments have led to better outcomes, with more than 68% of patients living beyond 5 years past their diagnosis compared to 49% in 1975.

“However, with new diagnoses of cancer expected to increase by 45% by 2030—and rising levels of obesity contributing to an additional 500,000 cases—oncologists will face significant challenges in meeting the demand for post-care services, the report says. For example, as a group, oncologists are aging, with those 64 years or older greatly outnumbering new physicians entering the field.”

Mental Training Exercises Shown to Help Mitigate the Effects of 'Chemo Brain'

“UCLA researchers have developed a program that could improve the day-to-day lives of women with breast cancer by addressing post-treatment cognitive difficulties, sometimes known as ‘chemo brain,’ which can affect up to 35 percent of women after their treatments.

“An estimated one in eight women will develop invasive breast cancer in their lifetimes, and following treatment, a mental fogginess can prevent them from being able to concentrate, staying organized and completing everyday activities, such as sticking to a schedule or planning a family gathering.

“The new study, led by breast cancer research pioneer and UCLA Jonsson Comprehensive Cancer Center member Dr. Patricia Ganz, builds upon her earlier research that found a statistically significant association between neuropsychological test performance and memory complaints among women with early stage breast cancer following treatment.

” ‘We invited the women to participate in a research study that assigned them to early or delayed treatment with a five-week, two-hour group training session, where a psychologist taught them strategies to help them with their memory and maintaining their ability to pay attention to things,’ said Ganz, director of prevention and control research at the cancer center. ‘These are activities we call executive function and planning, or the things all of us do in order to organize our day.’ “

Lost in Transition After Cancer

“ ‘You are being deported,’ a surgeon announced to me last fall. That’s a scary thing for a child of two immigrants to hear. But he was referring to the removal of my port, a medical device implanted just beneath my right collarbone — a gateway for the dozens of rounds of chemotherapy, antibiotics and blood transfusions that have entered my body since I received a leukemia diagnosis at age 22.

“I love a good pun, but I wasn’t in the mood for laughter or lightness that day. After three and a half years of cancer treatment, I no longer needed the port. My doctors had finally pronounced me in remission. I had thought I’d want to celebrate or dance a jig in my hospital gown or throw a rager when I got there. But it didn’t feel anything like the endgame I had imagined.

“It took me a long time to be able to say I was a cancer patient. Then, for a long time, I was only that: A cancer patient. Now that I’m done with my treatment, I’m struggling to figure out who I am. On paper, I am better: I no longer have cancer, and with every passing day I’m getting stronger. The constant flood of doctor’s appointments, blood tests and phone calls from concerned family and friends have trickled to a slow drip. But off paper, I feel far from being a healthy 26-year-old woman.”