What do they have in common? All are forms of creative expression that cancer patients have used to “add life to their days,” wrote oncologist Evan Lipson, MD, of Johns Hopkins University in the Journal of Clinical Oncology (online edition Feb. 7, 2011).

One of his patients, Mike, was building a stone patio in his backyard because it was “therapeutic, physical, and something I could control and have a sense of accomplishment.”

Among the “unique and remarkable ways that people living with cancer make the most of their time,” Lipson has observed several themes: exercising, leaving a legacy, activism, building relationships, giving. And the most powerful, he thinks, is “creating something.”

It can be painting, pottery, gardening, writing—any outlet to express unspeakable feelings, to get a brief vacation from the roller-coaster of cancer, and/or to leave something behind.

Several studies have shown tangible physical results—improved lung function in patients having asthma; decreased pain in rheumatoid arthritis; and in a 2010 review of 12 studies in cancer patients, improved psychological states and perceived quality of life.

In his own patients, Lipson wrote, he has seen them find “relaxation, solace, calm, catharsis, and healing.” He added, “What you end up creating is not important. What matters is that the process feels good.” If it doesn’t feel good, it’s fine to move on to something else. Instead of judging the outcome according to some external standard, Lipson said, “A project is worthwhile because it comes from inside you.”

Source: Journal of Clinical Oncology (online edition Feb. 7, 2011)

Briefly

Swedish researchers have found a drug that inhibits a dangerous cell pathway while leaving a protective one intact pointing the way to preventing colon polyps from becoming cancerous.  In a large study, 8 out of 10 chemotherapy patients experienced symptoms of insomnia or outright insomnia after their first cycle of chemo.

A work team from the United Kingdom will help restore an elementary school in South Africa while simultaneously raising money for colon cancer research.

Connect to a poem by Elspeth Murray asking doctors to communicate clearly but with empathy and to an article about coping with cancer during the holidays.

Research Updates

• Researchers at the Karolinska Institute in Sweden have discovered a group of signalling proteins that both promote the growth of cells in the colon into polyps (adenomas) and, paradoxically, also inhibit the development of polyps into cancer.  EphB controls two pathways in the cell — one leading to cell division and another that curbs the cell’s progress toward cancer.  They have also found that imatinib (Gleevec®) can inhibit the first dangerous pathway while leaving the protective one in place.  So far the drug has kept cells from dividing in test tubes and in mice, but no human trials have been done.   Their studies were published in the November 13, 2009 issue of Cell.
• Nearly 8 out of ten patients receiving their first cycle of chemotherapy reported either symptoms of insomnia (36.6 percent) or insomnia syndrome (43 percent), where symptoms occurred at least 3 days a week for more than three weeks.  The combined rate  is three times what is seen in the general population. Insomnia symptoms included difficulty falling asleep, waking during the night for long periods, or waking up early.  There was no difference between men and women, but younger patients had more sleep problems. Lung cancer patients had the highest rates of insomnia while patients with colon cancer had the lowest.   Insomnia was connected to both fatigue and depression.   Oxana G. Palesh, PhD from the University of Rochester published the team’s results in the Journal of Clinical Oncology early release November 23, 2009.

Other Headlines

• Our friends in the UK will help raise funds for bowel cancer research and also aid children in South Africa. Forty people will work together to restore the Sandeberg primary school near Leipoldtsville.  During their  ten-day stay professional soccer players Luther Blissett and George Parris will coach local children. Money raised by trip participants will benefit the Bobby Moore Fund which raises money specifically for colorectal cancer research.  Moore led England to its only World Cup.  He died of colon cancer in 1993 at the age of 51.
• Poet Elspeth Murray recites her poem This is Bad Enough on YouTube, asking that doctors not give her gobblydegook but the information she needs to know because she says, “This is bad enough and hard and tough enough.” She also asks that they, “Show us the facts, some figures, and don’t forget our feelings.”
• Cancer.Net, ASCO’s website for people living with cancer, has a good article about coping with cancer during the holidays. They answer common questions like dealing with fatigue, honoring the memory of someone who died, coping with anxiety about cancer recurrence, and finding a gift for someone with cancer.  Some people worry about weight loss or thinning hair and how to explain it to visitors.  Others are looking for places to volunteer.  Cancer.Net says, “Make this holiday season about rediscovering peace and happiness in old and new ways.

Briefly: Health care providers are less likely to recommend colorectal cancer screening to their patients with a high school education or less.  IV ibuprofen enhances morphine to control post-operative pain, reducing pain and letting patients use less morphine.

Superspreaders with dirty hands infect large numbers of patients with hospital-borne infections.

The United Ostomy Associations of America has a new video for new and potential ostomates that provides encouragement and support, and CR Magazine’s monthly podcast provides help coping with medical testing stress.

Research Reports

• According to an analysis of the Health Information National Trend Survey (HINTS) there was a strong association between a health provider recommending colorectal cancer screening and a patient actually being screened.  However, the study also showed that providers were less likely to recommend screening to patients with only a high school education or less.  Income or insurance status didn’t make a difference in whether screening was recommended.  Writing in the October 2009 issue of Cancer Epidemiology,  Jaili Le and colleagues recommended, ” To increase awareness of colorectal cancer risks and the benefit of screening, health care providers need to make a concerted effort to recommend colorectal cancer screening to all relevant patients, regardless of socioeconomic status and other personal characteristics.”
• A randomized, double-blinded clinical trial comparing two doses of IV ibuprofen to a placebo in addition to morphine to control post-operative pain found that 800 mg of IV ibuprofen every 6 hours after surgery decreased the amount of morphine patients used and significantly decreased pain at rest and during movement.  Patients in the study used patient-controlled analgesia (PCA) pumps to administer morphine.  400 mg of ibuprofen reduced pain, but didn’t decrease morphine use.  Patients who got ibuprofen also had less nausea and fever, although they had more dizziness.  Stephen Southworth, MD, and his team report the full study in the September, 2009 issue of Clinical Therapeutics.

Other Headlines

• One physical therapist, radiology technician, or other health care professional  who sees many patients just once a day without washing his or her hands can spread hospital infections far more rapidly than a nurse or doctor who sees a limited number or patients several times each day and also neglects handwashing.    In fact, this one “superspreader” can infect more patients alone than if all staff neglected hand hygiene 25 percent of the time.  Laura Temime and her team from France published their analysis in the Proceedings of the National Academy of Science, online October 19, 2009.
• A new video from the United Ostomy Associations of America Living with an Ostomy can help patients faced with ostomy surgery cope with their diagnosis and move ahead.  Ostomates talk about their initial fears and all they can do now — working, jogging, swimming, biking, surfing, playing golf, farming, and even doing stand-up comedy, as C3 advocate Brenda Elsagher does.   For many ostomy surgery improved their quality of life, for others it saved their lives.
• CR Magazine’s monthly podcast has tips for coping with the stress of medical tests.  Oncology social worker and cancer survivor Hester Hill Schnipper suggests being specific with your doctor about how and when you’ll hear results.  Be sure if your doctor will be phoning, that you get a call with either good or worrisome results so you’re not left with more anxiety if you don’t hear from the doctor.  Schnipper also talks about ways of managing MRI claustrophobia.  When you’re worried and waiting for tests, she suggests staying busy, exercising, spending time with friends and family, and indulging in at least one special treat.