October, 2005

NCI Teleconference: Why Statistics Matter for Advocates

NCI is offering a teleconference *Why Statistics Matter for Advocates*. This follows up a conference held in April of 2005. The teleconference is free and available on a toll-free line. Playbacks are also possible for a month after the teleconference.

+ *Why Statistics Matter for Advocates: Follow Up from the April, 2005 SEER Advocacy Conference*
featuring Dr. Brenda Edwards, Associate Director, NCI Surveillance Research Program

+ Wednesday, October 19, 2005 at 2:30 p.m. (EST)

+ USA Toll-Free: 1-800-857-6584 Passcode: 4683#

+ Toll-Free Playback: 1-800-229-6227 until Nov. 19, 2005 at 10:30 p.m. (EST)

Toll-free playbacks of the first in this series of teleconferences *Eliminating Suffering and Death Due to Cancer by 2015: The Future of Cancer Research* featuring Dr. Andrew C. von Eschenbach, Director, National Cancer Institute is available until October 20, 2005.

Toll-Free Playback: 1-866-443-2931 until Oct. 20, 2005 at 5:30 p.m. (EST)

Posted by Kate Murphy on October 13th, 2005
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Cancer Funding in the Wake of Natural Disasters

Katrina and Rita — names now linked to two hurricanes which left massive destruction on the Gulf Coast. One cannot help but to express concern and to do something for the several million people affected by this natural disaster.

Our nation faces a fiscal challenge to find a way to pay for the tremendous amount of resources this region needs to recover.

In a letter the Colorectal Cancer Coalition sent to members of the Senate and House Appropriations Committees, Nancy Roach, C3 President, stated,

>”…we must find a way to pay for the relief effort without compromising our nation’s commitment to programs that are critical to the fight against cancer.”

The Administration through its National Cancer Institute set a challenge goal of eliminating suffering and death due to cancer by the year 2015. Congress expressed its commitment in early October, 2005 when 92 Senators and 280 House Members sent a letter to the President in support of the goal.

We will make real progress toward the 2015 goal by building on past investments with continued funding of research as well as programs to prevent, detect and treat cancer.

Congress, through a continuing resolution which extends through November 18, imposed a six-week freeze on biomedical research and cancer prevention and control programs and would cut funding to address the national nursing shortage. In its letter C3 urges Congress “to maintain our nation’s commitment to the war against cancer as it continues to address unexpected emergencies now and in the years to come.”

You can make a difference right now by sending a letter to your Senators and Representative. Click on the “One Minute Advocate” logo located on the right side of of the opening page. Scroll down the page to the heading “Move Forward Against Cancer: Cancer funding in the wake of natural disasters”, click the “Take Action” button and follow the directions.

Read the letter C3 sent to members of the Senate and House Appropriations Committees.

Posted by Dusty Weaver on October 12th, 2005
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Age and gender do not make a difference in how soon to repeat colonoscopy after removing a suspicious polyp

Neoplastic polyps either are already malignant or have the potential to become cancerous over time. When a non-malignant neoplastic polyp is discovered and removed during colonoscopy, a follow-up colonoscopy is scheduled to watch for additional polyps. Current [guidelines](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=3686&nbr=2912&string=)
call for follow-up colonoscopy after 3 - 5 years unless there is unusual risk.

Researchers were concerned that age or gender might make a difference in how often such follow-up should be scheduled. They reviewed the information in a database of 1800 patients who had two colonoscopies where a neoplastic polyp was removed during the first one.

They found that 19% of patients had at least one new polyp bigger than 5 millimeters on the second colonoscopy. Six percent had a polyp larger than 10 millimeters. However, there was no difference in the overall risk of polyps recurring in any age group or gender.

They wrote in the November/December 2005 issue of the *Journal of Clinical Gastroenterology* — 39(10):894-899:

Conclusions: Similar rates of neoplasia recurrence were observed among patients of different gender and age groups on surveillance colonoscopy. From a health resource utilization perspective, these findings support current recommendations for similar surveillance intervals for patients regardless of age and gender.

It is important to note that last year a survey published in the [Annals of Internal Medicine](http://www.annals.org/cgi/content/summary/141/4/264) found that half of gastroenterologists and from 50 to 80 percent of general surgeons would perform colonoscopy more frequently than the guidelines call for. The authors of the study asked, *”Are physicians doing too much colonoscopy?”*

[Read the abstract of the article in the *Journal Clinical Oncology*.](http://www.jcge.com/pt/re/jclngastro/abstract.00004836-200511000-00009.htm;jsessionid=DLd1Nrh6yh1i2eU2xQ51sqtxG5Fr0DTluBn0U5Q37sStEni3zbXX!-1774793403!-949856145!9001!-1)

Posted by Kate Murphy on October 10th, 2005
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Radiotherapy before surgery for rectal cancer increases sexual problems in men

Radiation therapy given before surgery to remove rectal cancer can reduce the risk that the cancer will return at the site of the original tumor. In some cases it can shrink tumors significantly allowing for surgery that spares the sphincter muscle closing the anus and avoiding a permanent colostomy.

However, research in the [October 2005 *Annals of Surgery*](http://www.annalsofsurgery.com/pt/re/annos/toc.00000658-200510000-00000.htm;jsessionid=DLXGyCyb1Tc8BDtrfGDR254EBG0zJn5b48F6zJPWzjOts8wwT9il!586698740!-949856144!9001!-1) found that radiotherapy results in more sexual problems in men than surgery alone.

Surgeons studied the difference between surgery alone and surgery with pre-operative radiotherapy in 201 men being treated for rectal cancer. They assessed the ability to achieve and maintain an erection, have an orgasm, and be sexually active at 7 time points, beginning before surgery and ending 4 years later.

The most severe dysfunction was found 8 months after surgery when there was a 7.4% difference in achieving an erection, 12.6% difference in maintaining one, and a 16.2% difference in having orgasm between the radiotherapy and surgery only groups. In addition, men who had radiotherapy were 13.7% less likely to be sexually active. Recovery of sexual functioning after the 8 month point was slow, but never returned completely.

The effect increased with age.

The researchers were able to build and validate a model to help patients and doctors predict how much radiotherapy might effect the sexuality of an individual man.

The research and the predictive model were reported in the *Annals of Surgery* (240-4:502-511, October 2005). The lead author was Alexander G. Heriot. The team concluded:

Conclusions: Radiotherapy has an adverse effect on sexual function, the effect being maximal at 8 months after surgery. The risk of sexual dysfunction can be quantified preoperatively using the proposed index and can assist patients in making better informed choices on the type of treatment they receive.

In [a Dutch study in the March 20, 2005 edition of the *Journal of Clinical Oncology*](http://www.jco.org/cgi/content/abstract/23/25/6199), 900 men and women, who were part of a randomized trial surgery alone or surgery and radiotherapy, also showed poorer sexual functioning in males. Females also had sexual problems after pre-surgical radiotherapy.

In addition, radiation-treated patients recovered normal bowel movements more slowly and were less active 3 months after surgery than those who had surgery alone.

However, the patients reported no significant differences in health-related quality of life on questionnaires answered before treatment and at 3, 6, 12, 18, and 23 months after treatment.

Since there is a way of predicting the risk of sexual problems after radiation treatment for rectal cancer developed by Dr. Heriot’s team, patients should be encouraged to discuss risks and benefits of radiation prior to surgery.

[Read the abstract of the Heriot study in the *Annals of Surgery*.](http://www.annalsofsurgery.com/pt/re/annos/abstract.00000658-200510000-00005.htm;jsessionid=DLXGyCyb1Tc8BDtrfGDR254EBG0zJn5b48F6zJPWzjOts8wwT9il!586698740!-949856144!9001!-1)

[Read the Marijnen study abstract in the *Journal of Clinical Oncology.*](http://www.jco.org/cgi/content/abstract/23/9/1847)

Posted by Kate Murphy on October 10th, 2005
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Closing of 2015 Goal Letter Brings Time to Thank and Time to Ask Why

Since visiting Congress March 15, 2005 during the One Voice Against Cancer (OVAC) Lobby Day, Colorectal Cancer Coalition (C3) advocates worked hard to get their Senators and Representatives to sign a letter from Congress to the President in support of the Administration’s goal of eliminating cancer death and suffering by the year 2015. The closing and sending of the letter brings the time to thank those who did sign and the time to ask why to those who did not sign.

Below are suggested letters you can send to your Senators and Representative. Feel free to make it your own by making changes as you see fit. Be sure to add the name and address of you Senator or Representative at the beginning, to add your name and contact informaition at the end and to make the appropriate change in the third paragraph.

Go here to find out if your Senators and Representative signed the 2015 goal letter.

Example letter to Senators who signed:

>Thank you for joining 92 of your Senate colleagues in signing a letter to the President in support of the Administration’s goal of eliminating suffering and death due to cancer by the year 2015. A similar letter was also sent to the President from 275 Members of the House of Representatives.

>Thanks to prior investments in cancer research and programs, we can now actually envision a time when the outcomes of cancer — suffering and death — can be eliminated. While the 2015 goal is clearly ambitious, we will make real progress towards it if we make cancer a higher national priority and make the right policy choices.

>As a (cancer survivor)(caregiver for someone with cancer) I thank you again for your support. I look forward to working with you to make the 2015 goal a reality.

Example letter to Senators who did not sign:

>The National Cancer Institute (NCI) set a goal of eliminating cancer death and suffering by the year 2015. Thanks to prior investments in cancer research and programs, we are making remarkable progress in the fight against cancer. Achieving the 2015 goal is now within our reach if we make cancer a higher national priority and make the right policy choices.

>This September 92 of your colleagues in the Senate signed and sent a letter to the President to express their commitment to and support of the NCI’s goal. I am disappointed to know that you were one of the eight Senators who did not sign the letter.

>As a (cancer survivor)(caregiver for someone with cancer) I ask you to tell me why you did not demonstrate your commitment to and support of our country’s efforts to eradicate cancer by signing the letter to the President.

Example letter to Representatives who signed:

>Thank you for joining 275 of your colleagues in the House of Representatives in signing a letter to the President in support of the Administration’s goal of eliminating suffering and death due to cancer by the year 2015. A similar letter was also sent to the President from 92 Senators.

>As a (cancer survivor)(caregiver for someone with cancer) I thank you again for your support. I look forward to working with you to make the 2015 goal a reality.

Example letter to Representatives who did not sign:

>This September 280 of your colleagues in the House of Representatives signed and sent a letter to the President to express their commitment to and support of the NCI’s goal. I am disappointed to know that you were one of the 160 Members who did not sign the letter.

Posted by Dusty Weaver on October 9th, 2005
Posted in: Policy & Advocacy News | No Comments »