The Centers for Disease Control is urging doctors to prescribe antiviral medications to high-risk patients suspected of having the flu, even without a positive test. When given within 48 hours of symptoms appearing, antivirals like Tamiflu or Relenza can ease symptoms, shorten illness, and prevent serious complications.

Clinicians are not prescribing antiviral medications as often as in previous years, even though the 2013 flu season is causing more hospitalizations and deaths according to government figures. Complications from this year’s predominant flu strain are especially high among the elderly, causing half of hospitalizations and 90% of deaths so far.

With a sharp increase in both hospitalizations and deaths in the 2^nd week of January, the Centers for Disease Control (CDC) issued a physician advisory urging use of antivirals for more people–especially those at high risk–as soon as flu symptoms appear.

“When given promptly, they work,” CDC Director Thomas Frieden, MD, told a Jan. 18^th press briefing. “They can reduce symptoms, shorten the duration of illness, and prevent serious complications including hospitalization and death.”

Frieden also advised clinicians not to wait for test results or a positive ‘rapid flu test’ when probably flu appears in people at high risk for complications: anyone over age 65 or under age 2, or having any ongoing serious illness (including cancer survivors no longer in treatment).

Only halfway through the flu season

The number of influenza-related hospitalizations and deaths will rise in the coming weeks even as the  national average of new cases begins to slow, Frieden warned, partly because there is a lag time between when flu hits and when complications like pneumonia appear.

And even though flu rates are leveling out in much of the east and south, the outbreak is just beginning in California, Arizona, Hawaii, and Nevada. “Folks out West, you still have most of the flu season yet to come,” Frieden said.

What this means for you:

• Experts are still strongly recommending that anyone over 2 years old should get a flu shot for protection—of you and others—over the next several months.
• Even if you got vaccinated, you can still get a strain of influenza.
• If you begin to have flu symptoms and are “high-risk” or have contact with high-risk people, you should get antiviral medication with 48 hours. (High risk includes cancer survivors, even if you’re no longer in treatment. Even if it’s later than 2 days, you might still benefit, so call your doctor.)
• Flu symptoms include fever, cough, sore throat, body aches.
• You are contagious to anyone within 6 feet until you have been without a fever for 24 hours.  Stay home.

Sources:

• “CDC Urges Tamiflu RX to Curb Flu Death Rate,” Jan. 18 2013 Medscape
• Jan. 15 2013 CDC Health Advisory: Summary of CDC Recommendations for Influenza Antiviral Medications

Disaster preparedness

Knowing that thousands of our neighbors are still struggling (and will be, for days or weeks) with power loss, flood cleanup, lost wages, inability to get from one place to another, there is one pro-active response we can take: Check our own crisis plans—especially if you live with or care for people who have cancer.

 The National Cancer Institute (NCI) and the American Society of Clinical Oncology have a free wallet card for patients, in English or Spanish. It has space for critical information in case the patient must be seen by a doctor unfamiliar with their care, as well as a 1-800-4-CANCER number to get disaster advice.

 There are other key steps you can take to be prepared for any emergency. Read the rest of this entry »

Glad to see that many of our friends are ‘reporting in’ on our Facebook “Good News Tuesday” page that they weathered Storm Sandy.

For those without power or affected by flooding, snow or wind damage—or for those worried about people in possibly affected areas, read on for some quick tips about contacting friends or family, dealing with power outages, and food safety.  Read the rest of this entry »

This week brings some excellent reading about why and how to educate patients so they can help make better decisions about their own care.

What happens when patients get to read their own medical records? The Oct. 2^nd  Annals of Internal Medicine published two editorials and results of a quasi-experimental trial of 100 primary care doctors who voluntarily provided 13,500 patient volunteers with access to their doctors’ notes for a year. To read details, read further, but some results in brief :

• patients loved being able to read their visit report, and 75% said they were more likely to take medicines as directed;
• doctors didn’t see increased patient anxiety, visits, or time demands.

Meanwhile, an expert panel of “thought leaders” gathered by the Institute of Medicine released an in-depth report about helping patients make better care decisions by giving them the best available medical evidence. The results, summarized in an online JAMA article  and discussed by Dr. Robert Miller for ASCO Connections, included:

• 8 in 10 patients want their provider to listen, but only 6 in 10 say it happens;
• 8 in 10 want to hear the full truth about their diagnosis;
• fewer than half of patients say their provider asks about their goals and concerns. Read the rest of this entry »

Diagnosis and Treatment | CRC Symptoms | Diagnostic Tests | Staging | Stay in Touch with us

“Symptoms and Risks” fact sheet (PDF)
Available for free download right here!

People come to an initial medical work-up for colon or rectal cancer from different places. They may have had a suspicious polyp or cancer found during a routine screening. They may be experienced symptoms that might be caused by colorectal cancer. Getting an accurate diagnosis is critical because treatment for colorectal cancer depends on the diagnosis. For example, treatment for colon cancer is different than treatment for rectal cancer, and treatment for cancer which has spread outside of the colon is different than treatment for cancer which is limited to the colon. Getting an accurate diagnosis can take time and many different tests. It may require surgery, and examination of surgically-removed tissue to determine whether the cancer has spread. This process can involve several health professionals including:

• The gastroenterologist who will perform a colonoscopy if it has not been already done and remove tissue for biopsy. The gastroenterologist may remove suspicious polyps for pathology or, if they are large, leave them in place for later surgical removal.
• Pathologists who will examine biopsies under the microscope to identify precancerous cells or cancer (malignancy.)
• Radiologists who will perform CT-scans or other x-ray tests to see if the cancer has spread to other parts of your body.
• A general surgeon or colorectal surgeon who will give you a physical examination and ask about your medical history, order blood tests, review reports from gastroenterologist, radiologist, and pathology, and help decide on an initial treatment plan.
• If necessary, a medical oncologist who deals with chemotherapy treatment or a radiation oncologist may be involved at this point or they may join the treatment team after surgery. Specialized surgeons may also be called in to examine you if there is a possibility that the cancer has spread beyond your colon.

Choosing a medical team is an important initial step in getting an accurate diagnosis, especially if rectal surgery is involved. Work with your medical team to make sure that your evaluation, diagnosis, and staging are done carefully and thoroughly.. Get a second opinion if there is uncertainty about issues such as what tests are necessary, if surgery is the right first step, and whether staging is accurate. A second opinion at a large cancer center, particularly a National Cancer Institute designated cancer cancer or a member of the National Comprehensive Cancer Network can be valuable even early in the diagnostic process.

• Locate an NCI Cancer Center in your state.
• Locate an NCCN Comprehensive Cancer Center

Where Can You Go for More Information?

American Cancer Society How is Colorectal Cancer Diagnosed? Cancer.Net When the Doctor Says Cancer along with a podcast can help you learn questions to ask about your cancer and its diagnosis and how to understand and manage the information you get from your doctor.

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