This week we review research on the impacts of colonoscopy screening in Germany, folic acid flour supplementation in Chile, and untreated anxiety and pain during the last months of life on surviving spouses of cancer patients.

In the news are reports of colon cancer surgery using a tiny incision in the belly button, requirements for KRAS testing before insurance will pay for Erbitux or Vectibix treatment, and information about how stem cells in the intestinal tract become cancer stem cells, driving the development and progression of colorectal cancer. Read the rest of this entry »

It is important to stage somebody correctly that you examine a reasonable number of lymph nodes.

Many studies now show that the ideal number is 12 or higher. We know that if you have no lymph nodes involved with cancer out of 12 lymph nodes that you really have stage II disease.  You might wonder when only two nodes are removed and none are involved in cancer if additional lymph nodes could show cancer. Therefore, even when the pathological stage is II, we would classify this tumor as not well-staged and treat it like a stage III cancer. Read the rest of this entry »

Patients who wore an acupressure wristband during radiation treatment had less nausea. However, it made no difference if they received a leaflet telling them that previous research showed that the bands reduced nausea or not.

The patients in the study were receiving radiation to the intestinal tract and had already experienced some nausea during treatment.  Wearing the bands reduced nausea scores by about 24 percent.

To test the theory that the reduction was caused by patient expectations or a placebo effect, half of the group who wore wristbands received a positive handout saying that research showed wristbands reduced nausea.  The other half had a neutral handout.  There was no difference between the two groups.  Both had less nausea.

Another group who didn’t have wristbands, had a very small reduction in nausea of about 5 percent.

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Working every day with cancer patients, many of whom will not get better, can leave health care staff exhausted and demoralized.

The term compassion fatigue began to be used in the 1990′s to describe physical and emotional affects sometimes experienced by health care professionals caring for patients facing  limited possibilities of recovery.   It goes beyond empathy or feeling bad  for their patients and leads to setting up walls of distance from patients as a means of self-protection.

Researchers at Indiana University School of Medicine and Regenstrief Institute reviewed almost sixty studies of compassion fatigue, finding that it often takes a toll not only on the health care workers who experience it but in the places where they work.

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Since the last ASCO meeting in June 2008 not only has KRAS made headlines but also microsatellite instability (MSI).

Microsatellite instability has developed into the most important prognostic and predictive marker for patients with stage II colon cancer. Recent studies presented by Dr. Daniel Sargent at ASCO showed that patients with stage II colon cancer who have microsatellite instability did not benefit from 5-FU chemotherapy. Therefore these patients with no risk factors such as clinical obstruction, lymphovascular invasion, poorly differentiated adenocarcinoma, or insufficient lymph node collection should not receive 5-FU. Read the rest of this entry »