As summer takes hold, it’s often hard to resist the delicious aroma of a backyard barbeque or soaking in some rays at the beach. However, it’s important to know the health risks associated with these common activities, especially when cancer’s involved.

Grill Clean
The blackened areas on charred and grilled foods like meat, poultry, and fish contain carcinogenic chemicals. Carcinogens damage DNA, consequently catalyzing mutations that can lead to cancer. If these chemicals appear frequently in your diet, your risk of getting cancer can increase. To reduce carcinogenic intake:

• Cook with less intense heat and lower temperatures.
• Keep your grill clean.
•  Use lean meats.
• When grilling meat, poultry or fish, flip often.
• Choose acid based marinades like lemon or vinaigrettes over thicker, sugary marinades.

• Substitute grilled meats with colorful vegetables and other plant based foods like tofu or tempeh, as they don’t produce cancer-causing chemicals when cooked at high heats.
• Remember that maintaining a healthy weight, consuming plenty of fruits and vegetables, and engaging in regular exercise can all help reduce your risk of cancer.

For healthy additions to any summer meal, try our recipes for Strawberry Watermelon Gazpacho, Grilled Fruit Kabobs, Marinated Vegetable Kabobs,  or Cowboy Caviar. You can find more healthy recipes on Dana-Farber’s nutrition pages or in our free Nutrition app.

Protect Your Skin
Spending a day in the sun sounds fun, but it’s no picnic for your skin. Unprotected exposure is a huge contributor to the development of skin cancer, and can often be easily prevented if the right steps are taken.

• Avoid unprotected sun exposure and seek shade when possible.
• Wear sun protective clothing, such as a wide-brimmed hat, sunglasses, and shirts with long sleeves.
• Apply the recommended amount of broad-spectrum (blocking UVA and UVB rays) sunscreen with a SPF of 30 or above when going outside. Find out how to look for the expiration dates on sunscreen with our sun safety video.
• Reapply sunscreen every two hours, or as needed.
• Finally, check your entire body for changes in your skin on a monthly basis.

Learn more about identifying /preventing melanoma (the most deadly form of skin cancer) and five myths about the disease in this  informational video and blog post from Jennifer Y. Lin, MD, of Dana-Farber’s Melanoma Treatment Program.

If you recently learned you have cancer, donating a sample of your cancer tissue to science is probably the last thing on your mind. But it’s a topic that you might discuss with someone on your health care team, because cancer researchers often rely on donated tissue samples to help them better understand what causes cancer and which treatments are most effective.

Whether to donate your tissue is a personal decision, but it can also be an altruistic one. Your donated tissue can help drive research that helps others in the future. For example, tumor samples have allowed researchers learn what drives certain cancer cells, understand how ethnicity and economic status may impact cancer treatment, and discover new cancer biomarkers.

Amy Atwood donated cancer tissue for research.

When asked to donate tissue from her breast tumor, Dana-Farber patient Amy Atwood did not hesitate. “With something as noninvasive as tissue donation, why not do it?” she asks. “They’re taking it out during surgery anyway, so it’s not a big deal to donate.”

If you’re asked to donate tumor tissue for research, here are a few facts to consider.

• Donating tissue won’t change your treatment plan. During a medical procedure such as an operation, biopsy, or blood test, your doctor will remove the tissue needed for a complete pathology report. Then, with your consent, any leftover tissue can be sent to a tissue bank and saved for future research.
• Your donation may help drive innovation. Dana-Farber and its partners in care recently launched Profile, one of the nation’s most comprehensive personalized cancer medicine initiatives. The program gives patients the option of having their tumor tissue scanned for genetic mutations that are known or suspected of being linked to cancer. Researchers will use the resulting database in studies that seek to improve the effectiveness, safety, and precision of future cancer treatments.
• You are in control. Federal laws and regulations protect the privacy and confidentiality of your medical information, and tissue banks must follow those rules. When you donate tissue, you choose what information you want to share. For example, some patients prefer to donate tissue only, while others agree to share a limited amount of personal information, such as gender, age, racial or ethnic group, and history of smoking. Knowing details such as age and lifestyle can help researchers understand how these factors affect the risk of getting cancer.

To learn more about tissue banking, talk with your doctor or nurse. Or take a look at the introductory video and tissue-banking booklet developed by Dana-Farber/Harvard Cancer Center.

Having cancer can be isolating. Even if you’re surrounded by friends and loved ones, you may feel that no one understands what you’re going through. That’s why it can be helpful to join a support group attended by people who face a similar diagnosis, or are in your peer group.

Here are some of the benefits support groups can offer.

1. Empower yourself with practical knowledge and advice. A support group shouldn’t replace the guidance of your doctor and medical team, but it can be a source of practical advice about getting through treatment or common side effects. You can learn from fellow patients and family members as well as expert guest speakers, such as exercise specialists, nutritionists, and social workers.
2. Find a safe place to express yourself. Cancer treatment is challenging and there are times when you may have negative feelings, fears, or frustrations. Joining a support group gives you a safe place to vent these feelings without worrying about burdening friends or family members. It’s a place where you and others can find encouragement, guidance, and listening without judgment.
3. Learn how your peers are coping. Connecting with people who are in your age group can also be a valuable way to ease the emotional burden of coping with cancer. Dana-Farber offers a variety of peer-based support programs, including services for young adults, cancer survivors, and young women with breast cancer.
4.  Offer strength to those who help you. Support groups aren’t just for cancer patients. They can also help caregivers – the friends and loved ones who help another person with the day-to-day challenges of cancer treatment. Dana-Farber offers support groups for caregivers, as well as helpful tips and strategies for taking care of yourself.

Before you get started, take time to decide whether a support group is right for you. It may be helpful to discuss your needs with your doctor, nurse, social worker, or other member of your health care team. You can view Dana-Farber’s  list of support groups, check our online calendar, or call a support group coordinator at 617-632-3301 to learn what’s available in our network and in your community.

If a support group isn’t for you, you may want to consider:

• Dana-Farber’s One-to-One program, a phone support program that links trained volunteer cancer survivors with those who are facing it for the first time.
• CancerConnect, an online forum where you can exchange messages with cancer patients, doctors, survivors, family members, and friends.
• Email lists, blogs, and social media sites such as Facebook.

People experiencing an unusual or particularly bad headache sometimes worry they might have a brain tumor. Headaches are very common and usually don’t signal a serious illness – but when should you be checked out by a doctor?

We asked neuro-oncologists Lakshmi Nayak, MD, and Eudocia Quant Lee, MD, MPH from the Dana-Farber Center for Neuro-Oncology to review the red flags that warrant a medical follow up:

• Headaches that are new or worsening, especially in a person who doesn’t normally have headaches. Often they are worse when lying down and in the morning, or wake someone from sleep. They may include nausea or vomiting.
• Persistent room spinning, dizziness or loss of balance.
• A seizure or loss of ability to speak; double or blurred vision or vision loss; hearing problems. Gradually worsening weakness or loss of sensation in an arm or leg. –Personality changes such as emotional withdrawal or anger, or becoming easily confused.

Lakshmi Nayak, MD, of Dana-Farber’s Center for Neuro-Oncology

The takeaway message, Nayak says, is that “new-onset headaches requiring medical assistance in an adult without prior history of headaches, change in quality or severity of headaches, in conjunction with new visual problems – these would worry me. If someone says it’s the worst headache of their life, I would be suspicious. Also, if the headaches occur in someone who has an active cancer, those should be investigated further.”

Some brain tumor symptoms may mimic symptoms of migraine headaches, Nayak notes, “so that can be a tricky situation.” However, most migraine patients have had the problem since childhood and are familiar with the headaches.

A stroke can also cause similar symptoms, but usually a stroke happens suddenly and without warning, while signs of a brain tumor appear more gradually.

To rule out or diagnose a brain tumor, a person will undergo a neurological exam to test vision, hearing, balance, reflexes, arm and leg strength, and coordination. A CT or MRI scan is commonly used to image the brain for evidence of a tumor.

This information should be reassuring for people who fear the worst when they have a bad headache, because brain tumors are very uncommon. But if your symptoms resemble those listed above, see your doctor.

How do you know if genetic testing is right for you? Judy Garber, MD, MPH, is director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, and one of the leaders of the Institute’s Susan F. Smith Center for Women’s Cancers. She talks about the BRCA test, family history and cancer risk, and preventive options for breast and ovarian cancer.

The Dana-Farber Cancer Genetics and Prevention Program offers advanced genetic tests to determine risk, as well as counseling and education, once the results are determined.

If you have a question about genetic factors that increase cancer risk, you can ask the Dana-Farber cancer genetics team.

By Christine Triantos

In one whirlwind year, Allison Bellevue moved to Boston, started a new job, met her future husband, and discovered she was pregnant. Compared to what followed, that year was a breeze.

When Bellevue, now 31, went for her first fetal ultrasound, doctors noticed a small mass on her right ovary. They told her it was likely a cyst, and they would keep an eye on it over time.

A month later, the mass had grown enough to warrant removal. Three days after surgery, when Bellevue was 17 weeks pregnant, her obstetrician delivered some jolting news: Bellevue had ovarian cancer.

Allison, with her husband Ruyter, and her son Lucas.

“I heard those words and I stopped listening,” says Bellevue. “I thought, this can’t be happening.”

Though she knew her health was in jeopardy, Bellevue was more concerned about her pregnancy and the baby. She and her partner, Ruyter, braced themselves for treatment.

Bellevue turned to Ursula Matulonis, MD, a medical oncologist in the gynecologic oncology program in the Susan F. Smith Center for Women’s Cancers at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC). Though Bellevue’s situation was rare, it wasn’t the first Matulonis had seen. She developed a specific treatment plan to address her patient’s early-stage, clear-cell ovarian cancer — an aggressive type for which chemotherapy would be required, but would be delayed until her second trimester.

“You hear the words ‘chemotherapy’ and ‘pregnancy,’ and wonder, ‘How in the world am I going to have a healthy baby?’” says Bellevue. But she was reassured by Matulonis’ approach and expertise. “She looked me right in the eye, started from the beginning, and explained it all. She answered my questions without my having to ask them.”

Bellevue began chemotherapy in her 23^rd week of pregnancy. Throughout treatment, Matulonis stayed in contact with Bellevue’s high-risk obstetrician and her surgical team.

“We have an obligation to make sure the patient and the baby are as healthy and safe as possible, and it’s very important to work as a team,” Matulonis explains, adding that nurses, social workers, and an OB/GYN surgeon were among those coordinating Bellevue’s care.

She had her final treatment in September 2011, and nearly a month later, she gave birth to Lucas, a healthy, seven-pound-plus baby boy.

Seven weeks after Lucas was born, Bellevue’s right ovary was removed at DF/BWCC. Today, she celebrates her second Mother’s Day with Lucas, and her two young stepsons.

By Naomi Funkhouser

On a cold October evening, Michelle Maloney braced herself against the night chill. As she hugged herself in bed, she felt a lump in her right breast. The next morning, Maloney scheduled an appointment with her primary care physician, who asked if she could be pregnant.

“Anything is possible,” said Maloney.Follow-up blood work revealed that the 39-year-old was, in fact, five weeks pregnant with her first child. Unconvinced that the lump was caused by blocked milked ducts – common in pregnant women – her doctor scheduled her for breast imaging. The tests – performed on October 19, Maloney’s wedding anniversary – revealed breast cancer.

Michelle Maloney with her son, Matthew

Maloney quickly “assembled a team of doctors,” she says. At the helm of her care team was Erica Mayer, MD, MPH, of the Breast Oncology Center  at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), who worked closely with maternal-fetal medicine specialist Katherine Economy, MD, of the Department of Obstetrics and Gynecology at Brigham and Women’s Hospital (BWH), over the course of Maloney’s treatment.

“It never occurred to me to go anywhere else,” says Maloney.

Once past the first trimester of pregnancy, Maloney underwent a mastectomy and reconstructive surgery and then began chemotherapy.

“Chemotherapy was scary for me,” she recalls. “To know that these chemicals can kill cancer but won’t hurt your baby – you have to have faith and belief that it’s going to be OK. I had to be calm more than anything else. That is what propelled me through the process.”

“Pregnancy-associated breast cancer is a rare diagnosis, but it is increasing in frequency,” says Mayer. “Over past years of experience and study, treatment plans have been developed that are effective against the cancer and safe for a developing baby. We bring together a multidisciplinary team to care for a woman with pregnancy-associated breast cancer; that team may include medical oncologists, surgical oncologists, radiation oncologists, maternal-fetal medicine specialists, reconstructive surgeons, nurses, and social workers. Our entire team meets with every patient to create a personalized treatment plan, and works together to guide that patient through her treatment and delivery.”

Managing the joy of pregnancy and the challenges of a cancer diagnosis was a “rollercoaster,” says Maloney. While undergoing her first round of chemotherapy, Maloney visited the high-risk pregnancy center at BWH, where she received weekly nonstress tests and ultrasounds to monitor her baby’s health.

After 12 weeks of initial chemotherapy treatment, her team chose to delay the second portion of her chemo until after she had her baby. “This was their gut feeling,” says Maloney. “This made me feel like I was a person, not just a patient in a tumor board review. They considered everything. It wasn’t the same treatment for every person. I felt valued as a patient and as a person. I can’t say enough about the partnership between Dana-Farber and Brigham and Women’s Hospital. They made a plan for me and truly worked together. They were all in sync with the decisions made both for my cancer treatment and my pregnancy. It was fantastic.”

On May 26, 2011, Matthew Maloney was born at 6 pounds 6 ounces. Less than two weeks later, and two days after her first post-pregnancy chemotherapy, Maloney, her husband, and her healthy new baby boy attended Relay for Life. “I was in pain, but I was so excited to be participating, not only as a team member and committee member, but as a survivor for the first time,” she says. “I had a lot to celebrate.”

However, experts have disagreed on who should be tested, when and how frequently. Some are concerned about whether the benefits outweigh the risks of overdiagnosis and overtreatment. In fact, a federal advisory task force in 2012 recommended against routine PSA testing for healthy men – though many physicians disagreed.

Philip Kantoff, MD, Director of the Lank Center for Genitourinary Oncology

Now, the American Urological Association (AUA) has released new guidelines, based on the findings of clinical studies, that specify groups of men who may benefit from testing.

• Screening isn’t recommended for men under 40 or for those 40 to 54 years old who are at average risk of prostate cancer.
• Men from 55 to 69 years old should discuss with their physician about the benefits and harms of testing. Benefits: Prostate cancer might be detected and treated at an early stage and increase your likelihood of cure and not dying of prostate cancer – though doctors can’t predict whether the cancer will ever become dangerous. The downside: A suspicious PSA reading usually leads to an invasive biopsy, which in turn could lead to unnecessary treatment and the risk of side effects such as impotence and incontinence.
• For men beyond age 70, there is no evidence of benefit of screening.
• Men younger than 55 who are at higher risk – because they are African- American or have a family history of prostate cancer should talk with their physician to make a decision.
• For men who do decide to have PSA testing, it need not be done more often than every two years.

“These guidelines are in effect saying there is benefit to PSA screening but it should be done selectively,” says Philip Kantoff, MD, director of the Lank Center for Genitourinary Oncology at Dana-Farber, as well as the Chair of the Executive Committee for Clinical Research. He served on an independent panel of experts that weighed the evidence and formulated the guidelines.

Kantoff says that the potential benefits of screening are greatest in the 55-to-69 age group because the prevalence of prostate cancer is highest then.

The American Cancer Society estimates that 238,590 cases of prostate cancer will be diagnosed in 2013, with 29,720 deaths. Mortality from the disease has been declining significantly for more than two decades. Kantoff believes the drop is partly due to PSA screening and early detection, and to better treatment of early but curable disease.

by Eric Schuller

For many cancer patients, the Internet serves as a vital tool used to stay in touch with loved ones during treatment, find comfort and advice from other patients and caregivers, or even research clinical trials. But using the Web to learn more about a cancer diagnosis or potential treatments requires a healthy dose of caution. For all of its many benefits, the Internet used unwisely can lead to scams and misinformation, as well.

So what’s the best way to separate fact from fiction on the Web? We asked Sarah Singer, MSW, LICSW, director of Dana-Farber’s Eleanor and Maxwell Blum Patient and Family Resource Center, for some tips to consider when researching cancer information online.

• Rely on reputable websites, such as those run by U.S. government agencies or leading nonprofit health care organizations. The resource experts in Dana-Farber’s Blum Center regularly compile and review a comprehensive list of recommended cancer resources on the Web. The National Cancer Institute also offers helpful tips for vetting online cancer information.

• Check the dates. Cancer research and recommendations can evolve rapidly, so make sure the page you’re viewing is up to date. As a general rule of thumb, aim for information that has been published or reviewed in the past two years. If it’s older, try to compare it to a source published more recently.
• Use your common sense. Be wary of claims that sound too good to be true. When in doubt about a particular product or information source, talk with your health care team. The American Cancer Society regularly updates a list of common cancer myths and rumors and the Federal Trade Commission offers helpful advice for avoiding cancer treatment scams.

• Always rely on your health care team first. Information that you find on the Internet should never take the place of the advice and guidance you get from your doctors and nurses. Even trusted websites can offer information that may not apply to your particular health situation, so it’s vital to talk with your health care team whenever you have a health concern or are considering a new treatment approach.

As you begin your search for cancer information online, Dana-Farber’s online Health Library and Nutrition pages can be good places to start. But you can also call or stop at the Blum Center, which is staffed by experienced health care professionals and volunteers.

Melanoma, the most deadly form of skin cancer, is on the rise, particularly in women aged 25-32. The frequency of tanning and age at which you start tanning both affect your risk of melanoma. Too much sun exposure of any kind can be harmful, but tanning booths are even worse. 75 percent of melanomas diagnosed between the ages of 18 to 29 years of age are associated with tanning bed use. Tanning beds emit three to six times the amount of radiation given off by the sun, meaning that using a bed or a booth for 20 minutes translates into one to three hours of lying out at the beach without any sun screen protection.

Perhaps that is why the Food and Drug Administration (FDA) has proposed putting warning labels on tanning beds.

Indoor tanning systems expose users to ultraviolet A (UVA) radiation, which deeply penetrates the surface of the skin, damages underlying cells, and prematurely ages skin. Contrary to common thought, tanning beds don’t provide users with any vitamin D, an essential part of health. (Most people only need five to ten minutes of sun exposure 2 to 3 times a week to help your skin make this crucial vitamin.)

To better your skin health, incorporate orange juice, milk, fish, and supplements into your diet as alternative sources of Vitamin D, avoid prolonged periods of time in the sun without sun screen protection, see your dermatologist yearly, and stay away from tanning beds.

In an earlier Insight blog post, Lin points out the myths about skin cancer. Her related video discusses how to prevent and identify melanoma.