Archive for March 29, 2012

Advocating for student cancer survivors

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At age 7, Sophie was treated for a brain tumor at Dana-Farber/Children’s Hospital Cancer Center. As a result of her treatment, she struggled with ongoing fatigue, weakness on her right side, and chronic headaches.

Sophie began her freshman year as one of 2,000 students at a large public high school. Despite support from special education teachers, she struggled with the academic demands of her classes and the overwhelming size of the school. An extremely dedicated student, she spent hours each evening on homework, but she tired easily, which made the headaches worse, and she struggled to get through each school day.

More children than ever are surviving cancer. But some will pay a price in long-term effects. Radiation and chemotherapy for cancers involving the central nervous system (including brain tumors and leukemia) can impair problem-solving, multi-tasking, attention, and memory, putting students at risk for learning difficulties. Read more

Counting cells at lightning speed

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At many supermarkets, you can dump a pocketful of change into a machine that rapidly counts your coins, sorting them into pennies, nickels, dimes, and quarters and computing the total amount.

Imagine something similar in a research lab. In the past, cells had to be manually studied and counted under a microscope. But the development of flow cytometry technology, beginning in the 1960s and continually improving, has brought automation to counting and sorting human cells that’s reminiscent of the coin machine.

Flow cytometry today is routinely used in medical diagnosis of certain cancers, like lymphomas and leukemias, and as a powerful research tool for studying a host of different cell types and their interactions with drugs or the immune system.

“Investigators may be trying to look at a certain kind of cancer cell or immune system cell,” said Wayne Green, PhD, director of Dana-Farber’s Flow Cytometry Core Facility. “The analyzers can count the members of a certain subpopulation of cells, and then cull them so they can be grown in laboratory culture or used in gene expression studies.” Read more

‘Designed by patients like me’: A patient’s perspective on the Yawkey Center

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As a Dana-Farber employee planning events for the opening of Dana-Farber’s Yawkey Center for Cancer Care, I knew the building was designed with guidance from patients and families.

But I had no idea how important this was until shortly after the building opened – and, newly diagnosed with acute t-cell lymphoblastic leukemia/lymphoma, I walked through the doors as a patient myself.

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Men unite to cure women’s cancers

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For most people, getting involved with a cause means thinking about what type of organization they’d like to support. But this is a story about what happens when a cause selects you – taps you on the shoulder and asks you to engage in battle.

It began in 1998 when my wife Amy, then 40, was diagnosed with late-stage ovarian cancer. Our two daughters were 5 years and 15 months old. Amy battled for 15 months, and died in 1999. Like many spouses of women who die of cancer too young, my next few years were all about balancing the family boat.

Fast forward to three years later, when I met my current wife, Ruth. We married in 2005 and Ruth adopted my daughters.

Just one year later, Ruth’s mother, Mildred Moorman, was diagnosed with late-stage ovarian cancer and was treated at Dana-Farber by Dr. Ursula Matulonis. (She died earlier this year.) I had the opportunity to share our family’s story at a meeting of the Susan F. Smith Center for Women’s Cancers Executive Council at Dana-Farber.

Always a strong supporter of cancer research, I wanted to do more; to find people like me. Read more

Alcohol and breast cancer: What’s the risk?

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For many women who enjoy a glass of wine, research showing that relatively small amounts of alcohol can raise their risk of breast cancer are disconcerting, to say the least. And confusing, too.

How much drinking is OK? Isn’t a glass of red wine a day good for your heart — and couldn’t that be more important?

In the past five or 10 years, knowledge about alcohol and breast cancer has been changing as studies produce new results and are publicized, sometimes over-dramatically, in the media. At the same time, there’s growing evidence that moderate drinking can be healthy for the heart.
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AT/RT: How my son faced a rare cancer and beat the odds

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By Timothy Rourke

Most parents treasure the big moments in a child’s life: first steps, first word, first day of school. I, on the other hand, treasure every moment with my son, Declan – the simple act of eating breakfast together, watching him do his homework, or taking him to ice-skating lessons. This is because Declan is a cancer survivor.

It’s hard enough to learn your child has cancer. One minute your world seems fine, and the next, you’re falling into chaos and fear. But when my wife and I got the news, after Declan had a seizure on Father’s Day 2006, we had the added distinction of a cancer diagnosis so rare that only 30 or so families receive it every year.

Declan, then 15 months old, had an atypical teratoid rhabdoid tumor (AT/RT), a rare cancer that affects the brain and central nervous system. At the time of his diagnosis, researchers could count on one hand the number of long-term survivors. Like a lottery nobody wants to win, we suddenly found ourselves in a category of cancer so small, so remote, that it was easy to think there would be no place for us to turn.

The New Hampshire oncologist who diagnosed our son saw a different picture.

“I have no ego when it comes to kids,” he said. “If the best treatment for their cancer is in France, I send them to France. If it’s in Germany, I send them to Germany. It just so happens that, for your son, the best treatment is just 45 minutes away at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.”

With those words came hope for beating a disease that had inflicted so few, and yet taken so many.

Declan immediately began a year-and-a-half of treatment under the care of Dr. Mark Kieran, Dr. Susan Chi, and Dr. Anupama Narla at Dana-Farber/Boston Children’s. The regimen was brutal: 52-plus weeks of high-dose chemotherapy, six weeks of radiation, and half a dozen surgeries at Boston Children’s Hospital, where surgeons work in partnership with Dana-Farber oncologists. There were feeding tubes, ports in his chest and head, and more blood and platelet transfusions than I can count.

And yet, our family was emboldened by the courage of a group of specialists that dedicated time – and resources – to such a rare disease. And we found comfort in the knowledge that although there were so few cases of atypical teratoid rhabdoid tumor a year, this team had the expertise to give Declan the best possible care.

As I type these words, my son – now seven – sleeps peacefully in his bed.  He has been out of treatment since October 2007, and currently shows no evidence of disease, according to his doctors. As of today, he is one of the only long-term AT/RT cancer survivors in the world.

A world turned upside down is once again right side up. Of course, we dread every check-up and MRI scan that brings a threat of relapse. That’s one downside of being the rarest of the rare; survivorship cannot be taken for granted. We meet other AT/RT families who shared our hope for a cure that, for them, proved elusive.

Tomorrow the sun will rise. My son will open his eyes and greet the day. I’ll find him near his 6-month-old sister’s crib, where she will glance his way, hear his voice, and squeal with glee.

To most parents, the sight would be sweet. But I am not most parents. I am the parent of a cancer survivor. The moment will blind me with its beauty, and bring tears to a man who knows how lucky he is.

Timothy Rourke is a member of the Pediatric Patient and Family Advisory Council at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

 

A focus on patient safety during radiation

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March 4-10 is Patient Safety Awareness Week; at Dana-Farber, patient safety is at the top of our list 365 days a year. Here, we focus on one aspect of cancer treatment in which it’s especially important: radiation therapy.

Radiation therapy is common – about two-thirds of all cancer patients can expect it to be included in their care. And while radiation therapy has been used for 100 years, it’s understandable that the prospect might make you anxious, particularly with regard to safety concerns.

As with all aspects of cancer treatment at Dana-Farber, patient safety is at the core of radiation oncology. It needs to be: We’re highly aware of the fact that once given, radiation cannot be taken back.

Radiation is delivered by linear accelerators, or LINACs. Teams of physicists and therapists put each machine through a regular schedule of performance tests – daily, monthly, and annually. Each also has built-in redundancies: If a LINAC machine is not performing to specifications, it will not deliver radiation.

But obviously we don’t leave everything to machines to ensure patient safety. Our team of physicians, physicists, and radiation therapists works closely together to plan and review each patient’s treatment, and each treatment calculation is checked and double-checked before being delivered to a patient.

Other checks can range from the seemingly mundane — we use photo IDs and barcodes so we know we’re delivering the right treatment to the right person — to the highly technical — we take X-rays or CT scans before treatment to make sure the beams are targeting accurately — but they’re all means to the same end: to ensure the safest and most effective treatment for our patients.

As radiation treatment becomes more complex, so do our safety checks. Intensity modulated radiation therapy (IMRT) allows doctors to customize the dose by varying the amount of radiation given to different parts of the treatment area. Before any IMRT plan is delivered physicists perform “dry-runs,” that deliver and confirm the accuracy of the radiation dose, to ensure patient safety.

This focus on safety is a core value in the treatment of each patient and is a part of the very culture of the department.

Learn more about radiation safety measures at Dana-Farber.

 

 

Specialists recommend regular colonoscopies

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If you’re over 50, have you been screened for colorectal cancer?  If not, the month of March would be a great time to talk about screening with your doctor.

Colorectal cancer is the third leading cause of cancer in men and women in theUnited States. In 2012, an estimated 141,210 people will be diagnosed with colorectal cancer and 49,380 will die of the disease.

But it’s also a very curable cancer when it’s caught early. A new study published in the New England Journal of Medicine in February that tracked patients as long as 20 years shows that colonoscopy screening slashed the colorectal cancer death rate by more than 50 percent.

During National Colorectal Cancer Awareness Month, organizations across the country are holding events and sharing information about the disease, and are encouraging all men and women age 50 to 75 to have a screening test – usually a colonoscopy.

A colonoscopy involves examination of the colon and rectum using a camera-tipped instrument. This method can diagnose cancers early; the test also can prevent cancer from developing, by detecting and removing pre-cancerous polyps.

Though many people dread colonoscopies, with appropriate sedation they are relatively painless. And for people who aren’t at high risk, a colonoscopy every 10 years is sufficient, says Dr. Charles Fuchs, director of Dana-Farber’s Gastrointestinal Cancer Treatment Center. “Beyond our continuing efforts to define better treatments for patients diagnosed with colorectal cancer, we continue to focus on the importance of primary prevention through diet and exercise and early detection through regular screening colonoscopies.”

Here are just two leads researchers at the center are looking at:

  • It appears that patients who have high levels of vitamin D in their body are less likely to have recurrences of colorectal cancer. Dr. Kimmie Ng, a medical oncologist in the gastrointestinal cancer center, is leading what she says is the first randomized clinical trial to determine if boosting vitamin D levels with high doses of supplements can delay progression and lengthen survival in patients with metastatic colorectal cancer. “There are several scientific and observational studies showing that vitamin D may have anti-tumor effects,” Ng says.
  • Physical exercise has also been shown to have benefits for colorectal cancer patients. There’s also evidence that metformin, a widely used diabetes drug, may have an anticancer effect. A new clinical trial led by gastrointestinal oncologist Dr. Jeffrey Meyerhardt, is testing a combination of metformin and exercise in patients at risk for recurrence of colorectal cancer following treatment with surgery, radiation or chemotherapy.

 

From old drugs, new cancer treatments

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When it comes to finding better drugs for cancer, Dana-Farber oncologist Dr. David Frank is not a patient man. While new cancer science promises to bring novel, improved therapies to the bedside, it can take many years — and Frank isn’t willing to wait.

“We need to get new treatments to patients as soon as possible,” he says. Read more