Financial help ready for Katrina victims with cancer

More than $500,000 has been donated to the [ASCO Foundation](http://asco.org/ac/1,1003,_12-002144-00_18-0042423,00.asp) to help pay for cancer-related expenses for people affected by Hurricanes Katrina and Rita.

Patients and their families can get assistance by calling **800 813 HOPE.**

Those funds will be managed by [CancerCare](http://www.cancercare.org/), an organization with the staff and resources to get help into the hands of those cancer patients who need it. In addition, the [Lance Armstrong Foundation](http://www.livestrong.org/site/c.jvKZLbMRIsG/b.594849/k.CC7C/Home.htm) and the [Susan G. Komen Foundation](http://www.komen.org/intradoc-cgi/idc_cgi_isapi.dll?IdcService=SS_GET_PAGE&ssDocName=katrina) have contributed additional money to CancerCare for the effort.

Diane Blum of CancerCare writes:

The ASCO Foundation has asked CancerCare to be the primary organization to disburse more than $500,000 that has been raised to help cancer patients who have been displaced by Hurricanes Katrina and Rita. We have also received funds from the Lance Armstrong Foundation and the Komen Foundation for this purpose. These organizations recognize CancerCare’s long experience in providing financial assistance along with psychosocial support

We will be able to distribute up to $2500 per family for cancer treatment and supportive care, durable medical equipment, homecare, childcare, transportation and lodging. We will also provide support services in the form of counseling, support groups, and education.

Professionals and advocates with questions about the program can call Jane Levy, CancerCare’s Director of Patient Assistance at 212 712-8356.

Again, patients affected by Katrina or Rita should call 800 813 HOPE for financial assistance with cancer-related expenses.

Posted by Kate Murphy on October 7th, 2005
Posted in: Research & Treatment News | No Comments »

Local excision of small rectal tumors carries increased risk of local recurrence

Although some surgeons believe that removing small, early rectal tumors through the anus rather than a larger opening in the abdomen is safer surgery for patients and reduces the need for colostomy, two studies show this treatment carries a higher risk of local recurrence.

A study published in the October, 2005 edition of [*Annals of Surgery*](http://www.mdlinx.com/HemeOncLinx/thearts.cfm?artid=1337876&specid=17&ok=yes) reviewed outcomes for 319 consecutive patients treated for T1 rectal cancers over a 17 year period. 151 were treated with ransanal excision (LE). A second group of 160 had surgery that opened the abdomen and removed the tumor and part of the rectum (RAD). This group actually had more poor progrostic factors than the local excision group including larger tumors and an 18% rate of lymph node spread.

Despite poorer expected prognosis the RAD group had fewer local recurrences at the surgical site, fewer distant recurrences, and significantly better recurrence-free survival. However, overall survival and disease-specific survival were similar for both groups.

A [T1 tumor](http://www.cancer.gov/cancertopics/pdq/treatment/rectal/Patient/page2) is limited to the inner lining of the colon and does not extend into the muscular layers. These cancers have not spread to lymph nodes or distant sites. Transanal excision can avoid removing the sphincter requiring colostomy in some situations so patients and surgeons may choose the more limited operation.

David J. Bentrem, M.D. headed the study team, who concluded,

Despite a similar risk profile in the 2 surgical groups, patients with T1 rectal cancer treated by local excision were observed to have a 3- to 5-fold higher risk of tumor recurrence compared with patients treated by radical surgery. Local excision should be reserved for low-risk cancers in patients who will accept an increased risk of tumor recurrence, prolonged surveillance, and possible need for aggressive salvage surgery. Radical resection is the more definitive surgical treatment of T1 rectal cancers

In a different study published in the June 2005 Supplement of the [*Journal of Clinical Oncology*](http://meeting.jco.org/cgi/content/abstract/23/16_suppl/3526), researchers analyzed information in the National Cancer Database. In the database, there were 1114 patients who had T1 rectal cancers that were treated with surgery only. Slightly more than half (616 or 55.3%) were treated with local excision through the anus (LE). The other group (498 or 44.7%) had surgical resections that opened the abdomen (SR).

Local excision was more likely to be chosen by patients and surgeons if:

+ tumor was close to the anus: for tumors within 5 cm of the anal verge 58% were removed by local excision (LE) versus 42% treated with standard resection (SR)

+ tumor was small: for tumors less than 1 cm, 77% were treated by LE versus 23% by SR.

+ patients had no other serious medical problems: 58% for LE versus 42%. SR

Mortality and morbidity due to surgery were significantly worse for standard open resection than local excision: Thirty-day mortality was 2.4% for SR compared to 0.5% for LE; morbidity rates for SR was 12.7% versus 4.4% for local excision.

However, local recurrence rates significantly favored standard resection at both 5 years and 8 years. At 5 years 12.7% of patients treated with local excision had experienced local recurrence compared to 6.1% of those who had standard resections. This difference was 14.4% versus 9.5% eight years after surgery. At five years there was no difference in overall survival between the groups.

Y. N. You MD and colleagues reported their results at the 2005 ASCO meeting, and they were published in the June 1, 2005 supplement to the *Journal of Clinical Oncology.* She wrote.

Patients considering LE for T1 rectal cancer may expect lower rates of perioperative morbidity and mortality, but are likely to face greater risks of local/regional tumor recurrence. For those treated with LE, long-term and vigilant oncological follow-up is essential.

[Read the abstract of the Bentrem research in the *Annals of Surgery.*](http://www.mdlinx.com/HemeOncLinx/thearts.cfm?artid=1337876&specid=17&ok=yes)

[Read the abstract of the You study in the *Journal of Clinical Oncology.*](http://meeting.jco.org/cgi/content/abstract/23/16_suppl/3526)

[See the slides of Dr. Nancy You's presentation at the 2005 meeting of the American Society of Clinical Oncology](http://asco.org/ac/1,1003,_12-002511-00_18-0034-00_19-003345,00.asp)

Posted by Kate Murphy on October 7th, 2005
Posted in: Research & Treatment News | 3 Comments »

Radiation treatment increases cancer fatigue

While a majority of cancer patients are already fatigued before they ever begin radiation therapy, almost all will have experienced it by the end of treatment.

Researchers at the University of Rochester had 370 radiotherapy patients fill out of a symptom inventory at the beginning of their radiation treatment and each week during therapy. Before therapy began 57% were fatigued. By the end of the third week, 76% were expressing fatigue. By the end of treatment 78% said that they were fatigued. Only 13% never experienced any fatigue at any point.

Of those 160 patients who were not fatigued at the beginning of treatment, 70% developed it during radiotherapy.

Prostate cancer patients reported the least severe fatigue while the most severe was experienced by patients with lung, gastrointestinal, and head and neck cancers. Age, sex, or radiation dose was not signficantly related to how severe fatigue was.

Jane Hickock M.D. and her team, in reporting their results in the October 15, 2005 issue of *Cancer* (Volume 104, Issue 8 , Pages 1772 - 1778), concluded:

Fatigue was a common adverse effect of RT for cancer, reported by more than three-fourths of patients by the third to fifth weeks of treatment. Cancer diagnosis was the only factor found to be significantly related to variation in fatigue severity. Additional studies should be devised to identify other underlying causes of RT-related fatigue

[Read the study abstract in *Cancer*.](http://www3.interscience.wiley.com/cgi-bin/abstract/111081990/ABSTRACT)

Posted by Kate Murphy on October 6th, 2005
Posted in: Research & Treatment News | No Comments »

FDA issues E.coli warning on Dole pre-packaged salads

The FDA has warned consumers of the potential of E.coli illness from the use of certain brands and “use-by” dates of Dole pre-packaged salads. The nationwide health alert is based on an outbreak of E. coli O157:H7 in Minnesota.

Since people undergoing chemotherapy are at increased risk for any infection and those who have been treated for rectal or colon cancer may also experience increased diarrhea, colorectal cancer patients and their families should be particularly careful to check the brands and “use-by” dates for any pre-packaged salads. Although these salads should no longer be on store shelves, consumers may still have them in their refrigerators.

The alert covers the following products:

+ Classic Romaine - with a “best-if-used-by (BIUB)” date of September 23, 2005 and a production code beginning with “B250.”
+ American Blend - with a “best-if-used-by (BIUB)” date of September 23, 2005 and a production code beginning with “B250.”
+ Greener Selection - with a “best-if-used-by (BIUB)” date of September 22, 2005, and a production code beginning with “B250.”

The FDA warns consumers not to eat or serve salads from these batches. The “best used if” code date is located in the upper right-hand corner of the front of the bag. At this time the FDA does not believe that other DOLE products are affected, and they say that the DOLE company is working cooperatively with them and has recalled alll potentially dangerous salads.

The FDA believes that this warning is an urgent one because:

E. coli O157:H7 infection often causes severe bloody diarrhea and abdominal cramps; sometimes the infection causes non-bloody diarrhea or no symptoms. Usually little or no fever is present, and the illness resolves in five to ten days. Although most healthy adults can recover completely within a week, in some persons, particularly children under five years of age and the elderly, the infection can also cause a complication called hemolytic uremic syndrome (HUS). This condition can lead to serious kidney damage and even death.

The FDA recommends anyone who experienced any of these symptoms after eating pre-packaged salad contact their physician or their local health department.

Although these lettuces are washed prior to packaging, high risk individuals, especially those who might become dehydrated from diarrhea, should wash them again at home and keep them refrigerated.

“Lettuce is washed before it’s sold, but our research has shown the risks of food-borne illness can be greatly reduced by washing it again at home,” said Joe Frank, a food microbiologist with the University of Georgia Center for Food Safety in Griffin, Ga.

Frank found that E.coli clings to the “stomata” or tiny breathing holes in lettuce leaves. He also found increased levels of E. coli on the cut edges of lettuce and in bruised areas.

Although washing with a chlorine solution destroys E. coli on cut surfaces of lettuces, the scientists at the University of Georgia do not recommend this at home. Washing will reduce, but not eliminate risk of disease.

Not all strains of E. coli cause disease. In fact, the organism is part of the helpful bacteria in the healthy human intestinal tract. However, dangerous strains such as the E. coli O157:H7 found in the Minnesota outbreak can cause severe illness in people who are already battling other disease.

[FDA Nationalwide Health Alert](http://www.fda.gov/bbs/topics/news/2005/new01239.html)

[Recommendations from the Center for Food Safety at the University of Georgia](http://www.griffin.peachnet.edu/cfs/hottopics/lettuce.html)

Posted by Kate Murphy on October 6th, 2005
Posted in: Research & Treatment News | No Comments »

Move research out of the labs and into people!

The process of developing cancer treatments, diagnostics and interventions can easily take 15 years or more:

* Ideas turn into lab experiments
* Lab experiments are moved to animals
* … and then to early research with people
* Good results mean large late-phase trials with large numbers of participants

The jump from lab experiments to large clinical trials is called TRANSLATIONAL RESEARCH –and without translational research, promising ideas may be stuck in labs and test tubes instead of moving to patients.

NCI’s SPORE program [Specialized Programs of Research Excellence](http://spores.nci.nih.gov/index.html) funds translational research. SPORE research has resulted in 210 clinical interventions for patients in the last 13 years, a remarkable record.

The SPORE program is being reviewed by NCI, and significant changes are proposed. There is concern about the changes in many quarters, [including Congress](http://www.c-three.org/pdf/lettertohhs.pdf) and [SPORE advocates](http://www.sporeadvocates.net/content/index.php?option=content&task=view&id=78&Itemid=2).

C3 urges NCI to be sure that changes are made thoughtfully in the context of scientific merit. [You can send the same message by asking your Congressional member to sign onto the Shaw-Harman letter before October 9. Click here to take action!](http://www.kintera.org/siteapps/advocacy/index.aspx?c=cgKJLROyEpH&b=437949)

Posted by Nancy Roach on October 6th, 2005
Posted in: Research & Treatment News | No Comments »