Amazing Life

One treatment option for people with colon cancer is surgery, followed by chemotherapy. This combination can be effective at managing, and in many cases completely curing, colon cancer. How soon after surgery is the optimal time to start chemotherapy?
A study presented at the recent Gastrointestinal Cancers Symposium in San Francisco aimed to answer this question. The study authors hope the information will help people make more informed treatment decisions that will give them the highest likelihood of a colon cancer cure.
Colon Cancer Meta-Analysis for Better Understanding
The researchers weren't able to conduct a randomized controlled trial, but they did the next best thing. They collected information (data) from nine studies that included 14,357 colon cancer patients.
They analyzed all of this information together in a type of study called a meta-analysis. The larger number of patients being studied in a meta-analysis allows for statistical testing that wouldn't be possible in smaller studies.
Within Four Weeks Optimal
After considering all of this information, the researchers found:

• Patients treated within four weeks of surgery had a better chance of survival compared with people who started chemotherapy more than four weeks post-surgery.
• There was a 15% increased risk of disease recurrence at five years after diagnosis, for every additional four weeks of treatment delay, beyond the initial four weeks after surgery.
• There was 12% increased risk of death at five years after diagnosis, for every additional four weeks of treatment delay, beyond the initial four weeks after surgery.
• Even though risk of recurrence went up with every additional four weeks after surgery that a patient didn't start chemotherapy, there was still some benefit to receiving chemotherapy even after three months post-surgery.

The bottom line is that starting chemotherapy within one month of your colon cancer surgery is optimal. Waiting longer may increase the chances of cancer recurrence.
If you have been diagnosed with colon cancer, ask your doctor what steps you can take to help yourself heal and get your strength back after surgery. This will help ensure you're ready to tackle chemotherapy as soon as possible.
If you have to wait longer than four weeks after surgery to start chemotherapy, you still can get benefit from your treatment. However, you'll want to work with your medical team to come up with a good plan for monitoring your health after treatment ends.
The best way to treat any type of cancer recurrence is to catch it as soon as possible after it occurs.

Advanced, or metastatic colon cancer, is cancer that has spread beyond the colon to other areas of the body. Colon cancer experts are constantly testing new treatment options to determine the best way to manage the disease. A recent study compared two induction chemotherapy treatments to determine which provided the best results for patients.
What is Induction Chemotherapy?
Often, chemotherapy is given after surgery to remove the tumor from the colon. Induction chemotherapy, however, is given before surgery. The goal is to shrink tumors with the hope of making surgery more successful.
In most cases, smaller tumors are easier to remove than larger ones. Induction chemotherapy also may be able to eliminate or slow down cancer cells that have spread to other parts of the body.
FOLFIRI vs. FOLFOXIRI
A recently published trial compared risks and benefits of two induction chemotherapy methods in 244 people with advanced (metastatic) colon cancer:

1. FOLFIRI - a combination of the chemotherapy medications 5-fluorouracil, leucovorin, and irinotecan
2. FOLFOXIRI - a combination of the chemotherapy medications 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin

The researchers looked at progression-free survival, which is the amount of time a person lives during which their colon cancer does not advance, grow larger, or spread any further in the body. They also considered average survival time and 5-year survival in the two groups.
After following the group for a median (similar to average) of five years, the researchers found that:

• The FOLFOXIRI group had median progression-free survival of 9.8 months vs. 6.8 months for the FOLFIRI group.
• The FOLFOXIRI group had median overall survival of 23.4 months vs. 16.7 months for the FOLFIRI group.
• The FOLFOXIRI group had a 5-year survival rate of 15% vs. 8% for the FOLFIRI group.

Survival differences of months may not seem like much, but to someone who's dealing with advanced colon cancer, this can mean the difference between seeing a loved one get married, graduate from high school or college, or reach some other important milestone, and missing this opportunity
The 5-year survival rate was nearly doubled in the FOLFOXIRI group compared with the FOLFIRI group.
Making Your Best Treatment Choices
You probably noticed that the main difference between these two treatments was the addition of one chemotherapy drug, called oxaliplatin. With every new drug that is added to cancer treatment, the chances of side effects go up.
Sometimes these side effects are more of a nuisance. Other side effects can be debilitating and painful, so it's important to fully understand the risks and benefits of any treatment you are considering. The chances to double your odds of survival may be worth serious side effects to some people, but not to others.
Only you know what is right for you. Consult with your family and friends. Discuss the options with your medical team. Get second opinions if you need them. Once you know all the facts, you can move forward with your treatment plan for advanced colon cancer.

Bevacizumab (Avastin) is one of the newer, targeted therapies that have been added to the list of colon cancer treatment options in recent years. Bevacizumab works by inhibiting the growth of blood vessels around a tumor.
Blood vessel growth is referred to as angiogenesis, so bevacizumab is an angiogenesis inhibitor. The objective is to "starve" the tumor by preventing it from getting a good blood supply.
Bevacizumab is often used to treat advanced colon cancers, those that have spread beyond the colon to other parts of the body. In addition to colon cancer, bevacizumab is used to treat advanced cancers of the breast, lung, kidney, pancreas, and prostate.
The Big Picture on Bevacizumab
Now researchers have conducted the largest study to date on bevacizumab, to determine potential risks and benefits of this treatment. The researchers performed a type of study known as a meta-analysis. A meta-analysis allows information (data) from many studies to be considered (analyzed) together.
The larger number of patients being studied in a meta-analysis allows for statistical testing that wouldn't be possible in smaller studies. In this way, meta-analysis helps researchers get a better picture of the overall risks and benefits of a given treatment.
Bevacizumab by the Numbers

The most important thing to come out of this new study is that the risk of fatal side effects, which is any side effect that results in a patient's death, is higher than originally suspected. Compared with people receiving standard chemotherapy alone, those who received standard chemotherapy plus bevacizumab had a 46% increased risk of dying (having a fatal adverse event).
Another way to look at this is that 1.7% of people receiving standard chemotherapy alone had a fatal adverse event (death) vs. 2.5% of people receiving chemotherapy plus bevacizumab. This may not sound like a big deal, but it is. Unless a treatment has a very significant benefit, even a tiny increase in the risk of death must be considered as a potential reason not to use that treatment.
Problematic Combinations
The biggest problems with bevacizumab seemed to occur when it was used in combination with certain other medications. The risk death in patients receiving bevacizumab plus taxanes or platinum drugs was about three and a half times higher than the risk in people taking bevacizumab and other medications.
The Bevacizumab Bottom Line
Bevacizumab can be a useful treatment for advanced colon cancer, but it needs to be considered with care and respect. If your doctor would like to use this medication as part of your treatment, find out all the facts. Ask specifically about the risk of very serious side effects, such as excessive bleeding or blood clots.
Be sure to ask how these risks will be managed and what you can do to keep the risk as low as possible. And always ask for the full list of potential risks and benefits of any treatment you're receiving.
An informed patient is much more likely to make the right treatment decisions for his or her particular situation. It's OK to question your doctor and it's OK to get a second opinion.

"Modern medicine has focused so intently on fighting disease that it has overlooked a natural ally in the battle--the patient's personal mental management of the stresses associated with cancer." Thus begins a very important commentary in a recent issue of the Journal of the American Medical Association.
In this commentary, Dr. David Spiegel, MD, highlights the importance of attending to the mental, emotional, and psychological needs of people living with advanced cancer. He points to studies suggesting that supportive information sessions on resuscitation preferences, pain control, and quality of life, as well as cancer support groups, can significantly extend life in those with advanced cancer. Not only that, people have a much better quality of life too.
Taking Care of Your Needs
One of the most important messages to take away from this commentary is that when cancer cannot be cured, providing supportive care and mental/emotional resources for people may extend life more effectively than treating the disease aggressively.
However, this does not mean that people should give up hope or give up on treatment. That is not the key message. The commentary simply points to the potential downsides of providing treatment at the expense of providing supportive care. You can seek to get the best of both worlds.
If you have advanced cancer and are pursuing aggressive treatment, don't forget to take care of your mind too. Aggressive treatment often causes people to focus on the medical issues, leaving little focus on coping with the stresses of cancer and its treatment.
Talk to your medical care team about supportive and informational services that are available to you. If the thought of walking into a room full of people with cancer who are talking about their emotional concerns is overwhelming, consider online support resources.
_{Sources
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine 2010;363:733-42.
Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989;2:888-91.}

Spring's arrival and summer just around the corner mean flowers blooming, longer days, lunches in the park -- and potential migraine triggers in the warmer forecast.
As many sufferers know, changes in temperature and weather can spell trouble in the form of more migraine attacks, with certain seasons being especially bad for people over other times of the year.
There are proactive ways to try and ward migraines off before they strike, however, and these tips for avoiding weather-related triggers are a great starting point.

The video of reporter Serene Branson (KCBS-TV) slurring her speech and speaking gibberish while covering the Grammys has gone viral, making headlines all over the country. Many people wondered, did she have a stroke on air? Did she drink a little too much at the show?
But during a follow up interview, Branson revealed that she suffered from a complex migraine. The symptoms of a complex migraine, slurred speech and slight numbness on the side of the face, mimic that of a stroke.
According to Branson, she came down with a severe headache around 10PM. As she reviewed her notes, "the words on the page are blurry" and she noticed that her "thoughts were not forming the way they normally do." While on air, there was an numbness on the right side of her face that prevented of her from saying what she wanted.
While the symptoms of a complex migraine and a stroke may appear similar, the two conditions are different. A complex migraine is caused by an electrical malfunction in the brain, while stroke is caused by a restriction of blood to the brain. Also, the effects of a complex migraine are reversible. The symptoms only last up to an hour at the most.
If you are feeling any of the symptoms of a severe migraine, especially for an extended period of time, don't hesitate to see a doctor.

After a decade of study and debate, the Food and Drug Administration has finally approved Botox to treat chronic migraines. Patients who experience debilitating migraines 14 days a month or more may experience a reduction in their symptoms with injections in the face and neck of the drug, Allergan's onabotulinumtoxinA, which was originally created to reduce wrinkles by inducing muscle contractions. The FDA's new recommendation says that treatment every 12 weeks should be sufficient for chronic migraine sufferers.

As one in six women and one in 12 men well know, a cure for migraines would mean relief from debilitating pain. In fact, the World Health Organization ranks migraines 19th among all causes of "years lived with disability."
That's why it's a big deal that an international team of researchers, having studied data from 50,000 people, identified a genetic risk factor associated with common migraines. The DNA variant in question affects the regulation of the neurotransmitter glutamate. It seems that this variant's effect is to thwart the clearance of glutamate from the synapses, potentially resulting in a migraine-inducing neurotransmitter buildup.
Needless to say, these findings have the potential to affect migraine treatments down the line.

What are the most common symptoms of prostate cancer?
The most common symptoms of prostate cancer relate to problems with urinating.  The prostate gland is located just under the bladder and wraps around the beginning of the urethra (the tube that carries urine from the bladder to outside the body).   When cancer or BPH (benign prostatic hyperplasia) cause the prostate to enlarge there are numerous urinary symptoms that can develop.  These are often the first symptoms of prostate cancer.
There are a number of less common symptoms as well.
There is much more to learn about both common and uncommon symptoms of prostate cancer.

A new study in the Journal of the American Medical Association has highlighted the need for patients to update their family histories on a regular basis, especially when it comes to cancer.
The study showed the importance of an up-to-date family history for obtaining the appropriate cancer screening tests. For example, updating your doctor as to a sibling who has recently been diagnosed with prostate cancer may significantly alter your doctor's recommendations for you as to when you should begin screening tests for prostate cancer.
Nearly all types of cancer have a set of screening recommendations for those individuals who are thought to be of normal risk of developing the disease and a second set of recommendations for those who are thought to be of high risk of developing the disease.  One of the most common reasons for being considered "high risk" is to have a close family member (or multiple family members) who have been diagnosed with the disease.
Prostate cancer is well known to have a strong familial risk factor and it is important to let your doctor know when/if someone in your family is diagnosed with prostate cancer.

A new study has shown that men with early-stage prostate cancer may have improved survival when treated with radiation therapy plus hormone therapy when compared with men treated with radiation therapy alone.
The study, published in the New England Journal of Medicine, followed men for over 10 years who had undergone either radiation therapy alone or radiation therapy plus hormone therapy for their prostate cancer.  The results showed that there was an overall significantly increased survival in the men treated with both therapies.
At the time of treatment, the men were categorized into low, medium, and high risk groups.  The results showed that men in the low and risk groups showed no definite increased survival benefit from the hormone therapy, while the intermediate group did.
Of concern, the men who were treated with both radiation therapy and hormone therapy reported increased rates of erectile dysfunction than those treated with radiation alone.

In the past year and a half, there have been three drugs approved by the FDA for use in men with advanced prostate cancer who have stopped responding to hormone therapy.  They are the first new drugs to be approved since 2004 that have been shown to increase the length of survival in men with advanced prostate cancer.
That is, of course, great news for men with prostate cancer.
The drugs have been receiving a great deal of attention both inside and outside the healthcare world not only because they represent significant steps forward in the fight against prostate cancer, but also because they carry very large price tags.
The three drugs (Provenge, Zytiga, and Jevtana) each costs tens of thousands of dollars over the course of just a few months.  Additionally, many men may receive more than one of these medications in succession in hopes of further increasing their survival - thus greatly increasing the price tag per patient.
In recent weeks, several prominent media outlets, politicians, and government agencies have cast their attention on these new, expensive prostate cancer treatments.  Expect much more scrutiny of pricey treatments in the coming months as increasing health care costs become even more center stage for the U.S.