Stage IV colon cancer survivor Anita Mitchell featured on Health Talk

Anita Mitchell is alive and without any evidence of cancer, despite a diagnosis of metastatic (stage 4) colon cancer a year ago.  Her story will be featured on a live Health Talk broadcast on Monday evening, July 31st at 8:30 p.m. (Eastern).

Joining Anita are Dr. Lowell Anthony,  Director of Gastrointestinal and Neuroendocrine Oncology at Louisiana State University Health Sciences Center in New Orleans, and Dr. Thomas H. Cartwright, president of the medical staff at Ocala Regional Medical Center in Florida.  Rick Turner will host the panel.

• Colorectal Cancer: Understanding Your Options
• Monday, July 31, 2006
• 8:30 p.m. Eastern
• Via Webcast or Teleconference
• To Register

Registration is required.

Posted by Kate Murphy on July 30th, 2006
Posted in: Research & Treatment News | 14 Comments »

You can make a difference. Make sure that your Representative and Senators hear from you in August when they are at home. C3 will help!

Congress hasn’t yet made final decisions on funding for cancer research and prevention programs. Money is very tight this year, and without stronger support from Congress, these programs are at risk.

Last week the Senate Appropriations Committee completed its consideration of the Labor-HHS-Education Appropriation bill, which contains funding for nearly all federal cancer programs. The House Appropriations Committee completed its work last month on its own version of the bill. Now, each chamber’s version will be scheduled respectively for consideration by the full Senate or House, though many congressional observers believe that won’t happen until well into the fall and perhaps, after the elections.

Both House and Senate versions of the bill are severely lacking in what they propose to do for cancer patients and for cancer research, with the House version being worse.

The following chart gives an idea of how far we need to go to meet the budget levels needed for cancer research, screening, and treatment. A brief explanation of the columns:

1. “Current 2006” describes the levels currently allocated for fiscal year 2006, i.e., the budget that Congress passed last year.
2. “2007 Do-No-Harm” is the amount necessary to avoid cuts in cancer programs, as identified by One Voice Against Cancer, a coalition of cancer and health organizations in which C3 plays a key role.
3. “House 2007” is the amount allocated thus far by the House Appropriations Committee in its Labor-HHS-Education Appropriation bill.
4. “Senate 2007” is the amount allocated last week by the Senate Appropriations Committee in its Appropriation bill.

Amounts included in this chart are from initial sources of information and may change slightly as more congressional data is made available.

Obviously, Congress has not yet done what it must if it is to show its support to colorectal cancer patients and families.In fact, it hasn’t even come close to increasing cancer programs enough to account for inflation, and the House bill actually makes small (but real) cuts!  Therefore, C3 and its advocates must work diligently during the rest of the summer and in the fall to ensure that Congress hears about our priorities.

Just what can you do? The most immediate, important (and even fun) thing is to set up visits with your Representative and two Senators when they are home in the district or state in August. These meetings can be amazingly effective in elevating the issue of colorectal cancer for Members of Congress. And it is in August that Congress takes its longest recess – or “work period” – during which Members of Congress are often very visible and available in their home communities and regions. This provides an extraordinarily good time for constituents to meet with them and impress upon them: 1) what it means to be someone living with colorectal cancer or to be a family member of a person who has had colorectal cancer, and 2) what it is that you need them to do to support cancer research, screening, and treatment.

And…it is not as difficult as you might think! We at C3 stand ready to help you every step of the way. If you are interested in doing more to convince your Members of Congress of the importance of cancer funding, please email us at advocacy@fightcolorectalcancer.org, and Dusty Weaver and/or I will be in touch with you. Thanks for all your summer efforts.

Posted by Jim Wetekam on July 24th, 2006
Posted in: Policy & Advocacy News | No Comments »

Can patients have earlier food and water after colon surgery?

After colon or rectal surgery, there is a period when the bowel’s rhythmic forward motion or peristalsis stops. Traditionally, patients are not allowed water or food until the bowel begins moving again, usually when gas is passed or there is a bowel movement.  This can be a difficult two or three days for patients, sometimes longer.

Nursing researchers at Flinders University in Australia reviewed studies of early feeding in the medical literature and found that reintroducing food and water before peristalsis resumed was safe, well-tolerated by patients, and beneficial.  They found 15 studies in the medical literature between 1995 and 2004 that looked at the benefits and risks of allowing food and water after colon surgery before peristalsis had resumed.

All of the studies concluded that early feeding was safe based on low complication rates.  Complications for nearly 1,000 patients averaged 12.5% with no increased risk of leaking at the surgical connection (anastomosis), bowel obstruction, or aspiration pneumonia. Complications in the 15 studies ranged from 0 to 25%.

Studies found that earlier resumption of bowel activity and shorter hospital times can result from a program that combines early feeding with:

• early mobilization — getting out of bed and walking after surgery
• epidural anesthesia
• good patient education

The literature review by nursing student Wai Quin Ng appears in June 2006 issue of The Journal of Clinical Nursing.

A poster of Wai Quin Ng’s study Start Early, Go Home Early is available as a PDF file online.

WHAT THIS MEANS FOR PATIENTS

If you are planning colon surgery, talk to your surgeon about trying water and food earlier in your hospital recovery even before your bowels begin working again.  Point out that studies have not found increased risks for leaking at the surgical connection, pneumonia from inhaling food, or bowel obstruction. 

Work with the nursing staff to get out of bed and walk as soon as possible.

Discuss the risks and benefits of epidural anesthesia to control pain during the first recovery days.

Posted by Kate Murphy on July 22nd, 2006
Posted in: Research & Treatment News | No Comments »

If you live in New York, tell Governor Pataki to guarantee access to colon cancer treatment

Good news! Governor Pataki signed the Colon-Prostate Treatment Act into law, making New York the first state in the country to have such coverage for colon cancer treatment. Thank you to all the advocates who took action and made a difference!

Attention New Yorkers! On July 14th a bill to provide Medicaid treatment coverage for people diagnosed with colon cancer through the Healthy Women and Healthy Living Partnerships (NY State Dept. of Health Cancer Services screening programs) was sent to the Governor Pataki for his approval – or veto. A6763a/S4691a is a bill which will guarantee treatment costs are covered for uninsured people diagnosed with colon cancer by local state-funded screening programs. Colon cancer is the second-leading cause of cancer death in New York, and uninsured people are much more likely to die of this disease than people with health insurance.

Because this legislation adds a new group of people eligible for Medicaid, the American Cancer Society  anticipates the Governor may be reluctant to approve the bill. (read ACS’s memo in support)

C3 has just sent the following email to our New York constituency:

Imagine that you have no medical insurance.

You find out that there is a no-cost screening program for colorectal cancer. But – if you are diagnosed with cancer, you know that you cannot pay for treatment without bankrupting yourself and your family.

Would you be screened? Would you be screened even if you knew that screening can find colorectal polyps before they become cancer and actually prevent colorectal cancer? Or would lack of insurance to pay for treatment be too high a barrier?

The NY State Legislature, both Assembly and Senate, has passed a bill that would qualify uninsured people for Medicaid coverage for colorectal cancer if it is diagnosed as a result of New York State Health Department screening programs. Breast and cervical cancer found during screening are already covered ? this bill will be fair in adding the same benefit for colorectal cancer.

The bill has just gone to Governor Pataki for his signature. He has 2 weeks (10 business days) to sign it. There is some pressure for him not to sign the bill since it may increase Medicaid costs. He needs to hear from people who know how critical colorectal screening and medical treatment are. Your action today is urgent.

Please contact Governor Pataki and urge him to sign the bill — S4691/A6763. You can do this easily through this action alert. Just sign in and send. We urge you to personalize our sample letter and follow up with a phone call. Tell Governor Pataki how colon cancer has personally affected you or someone you care about.

If you vote in New York, please visit our action alert page (or forward that URL to someone who does live/vote in New York) to send a message to Governor Pataki urging him not to veto this life-saving legislation.

Posted by Judi Sohn on July 17th, 2006
Posted in: Policy & Advocacy News | No Comments »

See leading oncologists explain the science behind their clinical research

The Eastern Cooperative Oncology Group (ECOG) has informational videos available online about their colorectal cancer clinical trials. These videos are intended to help patients and caregivers learn about the trials and where patients can get more information.

If you have any feedback about the videos, please email mike@nyckatz.com.

The trials are:

• E5202: Trial For Patients With Stage II Colon Cancer
• E4203: Trial for Patients With Untreated Metastatic Colorectal Cancer
• E5204 Trial For Patients With Stage II or III Rectal Cancer

E5202: Trial For Patients With Stage II Colon Cancer

You can learn more about this trial by viewing a short informational video featuring Dr. Al Benson, the study chair for this trial:

• Real Media
• Windows Media

Click here for a list of institutions participating in this trial

This randomized phase III study is for patients who have had surgery to remove colon cancer and may benefit from additional treatment. When cancer is found in the colon that extends through the wall of the colon, but not in the lymph nodes or other organs, it is considered Stage II colon cancer.

This study is designed to:

• Determine whether specific biological features (often called tumor markers) seen in tests done on a tumor can be used to predict recurrence of tumors in patients with Stage II colon cancer.

• Compare the effects of a combination of chemotherapy drugs, given with and without a new drug, bevacizumab, on patients with Stage II colon cancer at high-risk for recurrence. The US Food and Drug Administration (FDA) considers the use of bevacizumab to be investigational for treating Stage II colon cancer.

There must be a biopsy of the tumor to evaluate two specific tumor markers. Samples of tumor tissue will be forwarded to a designated laboratory and examined to determine whether the participant will be assigned to the high-risk or low-risk group.

If the marker evaluation of the tumor shows that the patient is at low risk for tumor recurrence, the patient will have no further treatment for the cancer, including chemotherapy.

If the marker evaluation shows that the patient is at high-risk for tumor recurrence, then the participant will be randomized into one of two study groups. There will be an equal chance of being in either one of the two groups and neither the patient nor the doctor can choose the group.

• One group will receive a standard two-day regimen of chemotherapy, often referred to as FOLFOX (fluorouracil/leucovorin/oxaliplatin), given on days 1 and 2, every two weeks for a total of twelve (12) two-week cycles.

• Those randomized to the second group will also receive a standard two-day chemotherapy, referred to as FOLFOX (fluorouracil/leucovorin/oxaliplatin), given on days 1 and 2, every two weeks for a total of twelve (12) two-week cycles. In addition, they will recieve bevacizumab during one (1) day of each cycle. After completing the twelve cycles of chemotherapy, patients will continue to receive bevacizumab alone for twelve (12) subsequent treatments, given once every two weeks.

Participants will be required to have a temporary tube place into a vein in the chest or arm during the course of treatment to receive the 5-FU (fluorouracil) for a 46-hour period during each cycle.

Participants will be followed for up to 10 years to determine the long-term effects of the study treatments and the effectiveness of the tumor marker tests.

E4203: Trial for Patients With Untreated Metastatic Colorectal Cancer

You can learn more about this trial by viewing a short informational video featuring Dr. Neal J. Meropol, one of the study chairs for this trial:

• E4203 Real Media Video
• E4203 Windows Media Video

Click here for a list of institutions participating in this trial

NEW! Click here for a FAQ about this trial

This is a Phase II study for people who have colon or rectal cancer that has spread to other organs or has come back. The participants must be at least 18 years old, have measurable disease, and have had surgery or a biopsy more than 4 weeks earlier.

The purpose of the study is to test whether measuring the amount of a specific protein in the tumor (thymidylate syntahse) can help select better therapy for patients with colon and rectal cancer. Standard therapies for colorectal cancer use the drug fluorouracil (5-FU), which kills cancer cells by blocking the action of the TS protein, along with other drugs. Research studies suggest that if the level of TS protein in the tumor is high, then 5-FU is less likely to kill the cancer cells and/or shrink the tumor. So far, no study has tested whether choosing a therapy that does not contain 5-FU will be more effective in patients whose tumors have high levels of the TS protein.

In this study one group of patients who have a high level of TS protein in the tumor will receive treatment that does not include 5-FU; instead these patients will receive bevacizumab with oxaliplatin and irinotecan. The combination of bevacizumab/oxaliplatin/irinotecan is considered experimental in this study.

In order to be part of this study, a biopsy of the tumor that has spread to other organs or has come back locally must be done. If the patient has already had such a biopsy, and there is tissue left over, this can be used to allow measurement of TS protein. If not, the patient will be asked to have a biopsy done so that the TS protein can be measured in the tumor. The tissue will be sent to a central laboratory and the amount of TS protein in the tumor tissue will then be measured. If the amount of TS protein is low, then the patient will be assigned to receive what is considered an acceptable therapy for advanced colorectal cancer (a combination of oxaliplatin, 5-FU, leucovorin and bevacizumab). If the amount of TS protein is high, then the patient will be randomized into one of two study groups. One study group will have the same treatment mentioned above and the other arm will use oxaliplatin, bevacizumab with irinotecan (another drug that has shown benefit in patients with colorectal cancer). The patients whose tumors have high TS levels will have an equal chance of being placed in either study group.

• Patients in group one will receive a 30-90 minute infusion of bevacizumab, a 2-hour infusion of oxaliplatin, and a 90-minute infusion of irinotecan in weeks 1 and 3

• Patients in groups two and three will receive bevacizumab and oxaliplatin as in group one, a 2-hour infusion of leucovorin, and a 2-day continuous infusion of fluorouracil in weeks 1 and 3

Treatment may be repeated every 4 weeks for as long as benefit is shown and patients will be evaluated periodically for 4 years.

E5204 Trial For Patients With Stage II or III Rectal Cancer

• E5204 Real Media Video
• E5204 Windows Media Video

Click here for a list of institutions participating in this trial

This is a Phase II study for individuals who have Stage II or III rectal cancer and have had chemotherapy and radiation prior to having the rectal cancer surgically removed. There have been very few studies of combination chemotherapies for this patient group.

This study will compare the overall survival in patients, and will compare the treatment combination of oxaliplatin, fluorouracil (5-FU) and leucovorin to the same combination of drugs with the addition of bevacizumab. The combination of oxaliplatin, fluorouracil and leucovorin is the standard of care for stage III colon cancer, but this treatment plan has not been evaluated for patients with rectal cancer. We want to see if adding bevacizumab to the other cancer-fighting agents is better for treating rectal cancer patients. We also want to see if adding bevacizumab will help prevent the cancer from coming back. Bevacizumab is the common name for the commercial drug, Avastin.

This is a randomized study, which means that the two chemotherapy treatment combinations are compared with each other to find out if one is better. We expect 2,100 people to take part in this study. You have an equal chance of an assignment to either one. Neither you nor your doctor will have a say as to which group you are assigned, but both you and your doctor will be informed as to which treatment you will receive. You will be assigned to one of the following groups:

• Group A – FOLFOX (acronym commonly used to refer to the following regimen) – this is a two day treatment given every 2 weeks for a total of twelve 2-week cycles. Medications are given before chemotherapy to prevent nausea and vomiting. All of the chemotherapy drugs will be given through a vein. Oxaliplatin is given over 2 hours; leucovorin is given over 2 hours, followed by 5-FU (fluorouracil) given as a quick infusion, followed by 5-FU given as a constant infusion through a portable pump over the next 46 hours.
• Group B – FOLFOX + Bevacizumab

All of the chemotherapy drugs will be given through a vein. Bevacizumab is given over 30-90 minutes, before the oxaliplatin, leucovorin and 5-FU. Oxaliplatin is given over 2 hours; leucovorin is given over 2 hours, followed by 5-FU (5-fluorouracil) given as a quick infusion, followed by 5-FU given as a constant infusion through a portable pump over the next 46 hours.

The treatments are expected to take 6 months. Participants are expected to be followed for 10 years to determine long term effects of the treatment.

Posted by Judi Sohn on July 14th, 2006
Posted in: Research & Treatment News | No Comments »