May, 2006
ArchivesSupport and counseling helps families at the very end of life
Hospice programs are adding a new dimension to their services, providing companionship for families and patients during the last days and hours of life.
Continuum Hospice Care in New York City provides vigil services for patients in their program that prepares families for what to expect during the dying process and provides round the clock companions during final days.
Continuum has specially trained 29 volunteers to help at the bedside of dying patients. The volunteers call themselves doulas, a Greek term for women who assist midwives and mothers during home births.
The program uses music, massage, meditation, and aromatherapy to calm both patient and family members and create a positive environment. Doulas remind those at the bedside that hearing is usually the last sense to go and encourage them to reassure patients with a steady, soothing murmur.
More information about the vigil program along with stories of families that have used it is available in the May 20, 2006 issue of The New York Times.
Posted by Kate Murphy on May 22nd, 2006
Posted in: Research & Treatment News | 1 Comment »
House: Non-Binding Resolution Supports Funding for Health and Education
The House approved its FY 2007 budget resolution (H.Con.Res. 376) on May 18th. Moderate Republicans, led by Mike Castle, agreed to support the budget resolution when House leadership agreed in a non-binding resolution to support additional funding for health and education.
The American Association of Medical Colleges says:
The moderates, led by Rep. Mike Castle (Del.), Nancy Johnson (Conn.), and Dave Reichert (Wash.), had offered a substitute budget to increase funding for the Labor-HHS-Education appropriation by $7.158 billion to bring the bill to its FY 2006 level plus a 2 percent inflationary increase. As a result of negotiations on that amendment, the moderates secured a partial victory earlier this month when the House Appropriations Committee agreed to transfer over $6 billion from the defense and foreign operations accounts to domestic programs, including increasing the allocation for the Labor-HHS-Education Subcommittee by $4.1 billion above the President’s budget.
The budget resolution was amended to create a $3.1 billion reserve fund for health, education, and other domestic priorities, but only if these funds are offset by savings from other discretionary or mandatory programs. Under an amendment by Rep. Curt Weldon (R-Pa.), at least $1 billion of the offset for any increases for the Labor-HHS-Education bill would come from unobligated funds for Iraq reconstruction. The moderates also received assurances from the leadership that the additional $3.1 billion would not come from Medicaid, Medicare or other programs to help special populations.
What does this mean for cancer research and prevention?
It’s too soon to tell how the final negotiations between the House, the Senate and the President will end. However, in theory, this brings the funding available to health and education up to a level which will preclude the cuts envisioned in the President’s Budget.
Again, these are just the initial decisions on cancer research and prevention funding this year. The fight to increase funding will continue throughout the spring and summer in both the House and Senate. C3 will alert you when your actions will make the most difference, so be sure you have registered as a One Minute Advocate to get our action alerts!
Posted by Nancy Roach on May 21st, 2006
Posted in: Research & Treatment News | No Comments »
C3 Supports Funding for Nuclear Medicine Research
Research in nuclear medicine has give cancer patients procedures such as PET scans and radiation therapy. A source of funding for nuclear medicine research is the Department of Energy’s Medical Applications and Measurement Science Program.
This program provided resources to molecular/nuclear medicine professionals so that they could develop PET scanners to diagnose and monitor treatment in cancer. PET scans can offer significant advantages over CT and MRI scans in diagnosing disease and are sometimes more effective in identifying whether cancer is present or not, if it has spread, if it is responding to treatment, and if a person is cancer free after treatment.
The fiscal year (FY) 2006 Energy and Water Appropriations bill eliminated funding for nuclear medicine research at the Department of Energy (DOE). Consequently, the Federal government is providing no funding for nuclear medicine research in FY 2006, abandoning a fifty-year commitment to funding this vital research.
C3 has signed onto the Society of Nuclear Medicine letter (PDF) requesting that these critical research funds be restored. To learn more, see this fact sheet. (PDF)
Posted by Nancy Roach on May 21st, 2006
Posted in: Policy & Advocacy News | No Comments »
Genetics predict neuropathy from oxaliplatin
Colorectal cancer patients treated with oxaliplatin (Eloxatin™) are at risk for peripheral neuropathy — tingling, numbness, and pain in their hands and feet. Neuropathy accumulates and gets worse as treatment sessions and cumulative dose progress. For some patients, the neuropathy can be severe enough to limit their ability to accomplish daily activities.
Although peripheral neuropathy from oxaliplatin usually gets better after treatment ends, it recedes slowly and a few people will still have effects 12 to 18 months later.
French scientists studied variations in genes that affect the enzymes involved in metabolizing platinum-based drugs such as oxaliplatin. They measured clinical neuropathy in 64 patients before they began oxaliplatin therapy and after each treatment. They also examined genetic patterns (polymorphisms) in the patients to see if there was any correlation with the severity of neuropathy.
They found one polymorphism that was nearly 6 times more likely to involve severe (grade 3) neuropathy. People with a different variation of that gene were at low risk for serious peripheral neuropathy.
Thierry Lecomte and his team working in Paris reported their findings in the May 15, 2006 issue of Clinical Cancer Research. They concluded:
The results of the current study suggest that the105Val allele variant of the GSTP1 gene at exon 5 confers a significantly decreased risk of developing severe oxaliplatin-related cumulative neuropathy.
Clinical Cancer Research Vol. 12, 3050-3056
Oxaliplatin, in combination with 5FU and leucovorin, is standard treatment for metastatic colorectal cancer and stage III colon cancer. It is also used to reduce the risk of recurrence in stage II colon cancer. Regimens containing oxaliplatin included FOLFOX and FLOX.
oxaliplatin neuropathy genetic polymorphism
Posted by Kate Murphy on May 19th, 2006
Posted in: Research & Treatment News | 2 Comments »
Surgical resection outperforms radiofrequency ablation in single liver-only spread from colorectal cancer
When colorectal cancer has spread to the liver only and nowhere else, removal or destruction of the liver tumors offers the best chance for a long term survival or cure. Tumors can be removed surgically (hepatic resection) or destroyed with heat produced by radio waves (radiofrequency ablation or RFA).
Researchers at M.D. Anderson Cancer Center at the University of Texas prospectively studied patients with a first solitary liver metastasis who were treated either with hepatic resection or radiofrequency ablation. They wanted to test the idea that outcomes after either procedure would be similar.
180 patients were studied — 150 who had surgical treatment and 30 who received radiofrequency ablation. Twenty (20) of the RFA patients had a very large tumor that would have left too little healthy liver after surgery. The other 10 had other medical conditions that made surgery too dangerous.
The treatment method (hepatic resection vs. radiofrequency ablation) and the size of the tumor (less than 3 centimeters vs 3 cm or larger) made a difference in outcome, with smaller tumors and those treated with surgery having fewer recurrences in the liver and better survival at five years.
Treatment method outcomes:
- Tumors recurred in the liver more often after RFA (37%) than hepatic resection (5%).
- After 5 years, more patients who had surgery were free of liver mets (92% vs. 60%).
- After 5 years, 50% of the surgical group were cancer-free compared to none in the RFA group.
- After 5 years, 71% who had surgery were alive compared to 27% who had RFA.
Tumor size outcomes (79 patients had tumors 3 cm or larger)
- In the group with larger tumors, 31% of the RFA patients had recurrence in their livers compared to 3% of patients treated with surgery.
- At five years, 66% of the RFA patients with large tumors were alive with no liver recurrence compared to 97% of the surgical patients.
- Among patients with smaller tumors less than 3 cm. 18% of the RFA group.were alive, compared to 72% of those who had surgery.
Thomas A. Aloia, MD and his team at M.D. Anderson reported their results in the May 2006 Archives of Surgery. They concluded:
The survival rate following HR (hepatic resection) of solitary colorectal liver metastasis exceeds 70% at 5 years. Radiofrequency ablation for solitary metastasis is associated with a markedly higher LR (local recurrence) rate and shorter recurrence-free and overall survival rates compared with HR, even when small lesions (3 cm) are considered. Every method should be considered to achieve resection of solitary colorectal liver metastasis, including referral to a specialty center, extended hepatectomy, and chemotherapy
hepatic resection radiofrequency ablation liver metastasis
Posted by Kate Murphy on May 18th, 2006
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