Finding Happiness Despite Stage IV Lung Cancer

Posted by Brigham and Women's Hospital November 29, 2016

joann-and-girls

Joann (center) with her daughters, Mei and Lia.

Today’s post is written by Joann Totten, a patient at Dana-Farber/Brigham and Women’s Cancer Center.

As a non-smoker, I never imagined I would be diagnosed with stage IV lung cancer, let alone at age 50. But that’s what happened on Aug. 5, 2015, just six weeks after I started experiencing a non-productive cough. The doctors felt certain it was bronchitis, but as a radiation therapist for more than 20 years, I advocated for myself and insisted on a chest x-ray, which came back a bit abnormal. After additional testing for tuberculosis and pneumonia, I began experiencing shortness of breath and had another chest x-ray and CT scan. When I saw the scan, which was hard to believe was mine; I knew immediately I had cancer. A few days later, a biopsy confirmed my diagnosis: non-small cell lung cancer, stage IV.

Although it’s been more than a year, it’s still so hard to believe I have lung cancer. I never smoked, I exercise, and I eat very healthy; I thought I took pretty good care of myself. But cancer doesn’t discriminate; all you need are lungs to be diagnosed with this disease. Read More »

New Approaches to Breast Reconstruction Surgery

Posted by Brigham and Women's Hospital November 11, 2016

Innovative flap procedures offer breast reconstruction options to patients who are not candidates for implant-based breast reconstruction.

Many women who have lost a breast to cancer cannot undergo common breast reconstruction procedures, because they have had abdominal surgery, or lack sufficient donor tissue in their abdomen.

However, with advances in surgical reconstruction, many have new options. “We can now use the patient’s own tissue to rebuild the breast,” says Dr. Matthew Carty, Co-Director of the Microsurgical Breast Reconstruction Program at Brigham and Women’s Hospital (BWH).

The innovative reconstructive options involve transferring tissue, known as flaps, from one part of the body to the chest without compromising muscle functioning.

“After the surgical procedure, patients can still run, ride bikes, swim, do ballet, yoga, all the general activities that people like to do,” says Dr. Carty. Read More »

Managing Oral Side Effects of Cancer Treatment

Posted by Brigham and Women's Hospital November 8, 2016

oral-side-effects-blog-post

Cancer treatments such as radiation and chemotherapy may cause mouth sores and dry mouth, while some newer targeted therapies may lead to taste changes and oral sensitivity.

Oral problems such as mouth sores, dry mouth, jaw pain, and sensitive gums are a common complaint for cancer patients, because the very treatments that target fast-growing cancer cells can also affect healthy cells in the mouth. Treatments such as radiation and chemotherapy may cause mouth sores and dry mouth, while some newer targeted therapies may lead to taste changes and oral sensitivity. Patients with head and neck cancers are particularly likely to experience oral problems, because treatments often focus on areas near the mouth and jaw.

Here are some tips for dealing with common oral side effects of cancer treatment: Read More »

Why is Breast Density Important?

Posted by Brigham and Women's Hospital October 31, 2016

screening-mammo-negative

This image shows a negative screening mammogram of 45-year-old woman with dense breast tissue.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the final in our series, discusses breast density.

Breasts contain fibrous, glandular, and fatty tissue. Generally, breasts are considered dense if they contain a lot of fibrous and glandular tissue and less fat. Breast density is classified on a mammogram report in one of four ways:

  • Almost entirely fatty
  • Scattered areas of fibroglandular density
  • Heterogenously dense
  • Extremely dense

According to the American College of Radiology, 80 percent of women in the United States fall into one of the middle two categories, 10 percent have almost entirely fatty breasts, and the remaining 10 percent have extremely dense breast tissue.

Breast density is important for several reasons. Dense breast tissue may increase a woman’s chance of developing breast cancer. Also, detection of breast cancer using mammography is more difficult in women with dense breast tissue. Read More »

Who is Reading Your Mammogram?

Posted by Brigham and Women's Hospital October 21, 2016

Radiology technician examens mammography test on location

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms and has radiologists who are dedicated to breast imaging.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the second in our series, discusses the importance of specialized training in reading mammograms.

When choosing a location for your mammogram, it is important to look for a center that performs a high volume of mammograms. Preferably, the radiologists in the center should be dedicated to breast imaging. Breast imaging specialists devote their time exclusively to breast imaging, including mammography, breast MRI, and breast ultrasound.

The detection of very subtle changes in early breast cancer can be very challenging. Studies have shown that radiologists specializing in breast imaging outperform non-specialist radiologists in detecting breast cancer.  Furthermore, the more mammograms and other breast images that radiologists read, the better they become at identifying these subtle changes, with higher accuracy. Read More »

Stem Cell Transplants Rise Among Older Patients

Posted by Brigham and Women's Hospital October 18, 2016

Dana-Farber/New Hampshire Oncology-Hematology (DF/NHOH). Patient Shirley Clark (consent # 6228) with Garrick Johnson, PA.

Stem cell transplantation has grown among older patients largely due to the development of reduced-intensity transplants.

Stem cell transplantation following chemotherapy can extend survival and potentially cure certain advanced cancers. Although these demanding procedures were once considered too risky for older patients, advances in transplant methods are challenging that assumption.

“In transplants involving donor cells, there was concern that older patients wouldn’t be able to tolerate the high doses of chemotherapy traditionally used,” explains Joseph Antin, MD, chief of the Adult Stem Cell Transplantation Program at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC)

“Older patients were also thought to be more at risk from graft-versus-host disease,” a sometimes severe condition in which immune system cells in the transplanted tissue attack the patient’s own tissue, Antin adds.

Now, due largely to the development of reduced-intensity transplants, which use lower doses of chemotherapy than standard transplants, greater numbers of older people nationwide are getting transplants. At Dana-Farber/Brigham and Women’s Cancer Center, for example, 1,627 patients 55 and older underwent transplants between 2011 and 2015, compared to 964 between 2006 and 2010.

Read More »

Breast Cancer Screening: Understanding the Guidelines

Posted by Brigham and Women's Hospital October 4, 2016

Digital 3D mammography (digital breast tomosynthesis), the latest technology used in mammography, takes multiple images of each breast from different angles. It has been shown to improve earlier detection of breast cancers and reduce the number of call backs for repeat imaging.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we will be publishing a three-part Breast Imaging Series throughout October. Today’s post, the first in our series, is designed to outline breast cancer screening guidelines.

“Mammography is a very important screening tool for early breast cancer detection, but there are several different guidelines for when to start and how often to undergo mammography,” says Dr. Catherine Giess, Chief of the Division of Breast Imaging at Brigham and Women’s Hospital (BWH).  “This can be confusing for many women.”

The American College of Radiology recommends annual screening mammography beginning at age 40.  The ACS guidelines (outlined below) emphasize screening based on a woman’s individual risk of developing breast cancer and her personal preferences.

 

When should I start?

A woman’s first mammogram serves as a baseline to compare results of subsequent mammograms.

  • Women should begin discussing breast cancer screening with their health care providers at age 40. From 40-44 years of age, women have the option to begin annual screening if they choose to do so.  All women should begin yearly mammograms by age 45.
  • Women who are at higher risk for developing breast cancer, such as women with a family history of breast or ovarian cancer, should discuss their own personal risk factors with their health care providers, and may need to start screening earlier.

Read More »

COSMOS Trial: Can Cocoa Extract and a Multivitamin Help to Keep You Healthy?

Posted by Brigham and Women's Hospital October 3, 2016

The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health.

Researchers at Brigham and Women’s Hospital (BWH) and the Fred Hutchinson Cancer Research Center are collaborating in a new research study, known as the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), for the most extensive study to date testing the roles of cocoa extract and a multivitamin in improving health, including preventing heart disease and cancer.

Previous studies of cocoa flavanols conducted by researchers at BWH and other institutions have found that cocoa may reduce the risk of heart disease (including a short-term decrease in blood pressure), as well as slow age-related cognitive decline. BWH researchers have also previously found that multivitamin use modestly reduced cancer risk in a trial of more than 14,000 male physicians.

“COSMOS will allow us to further explore these promising nutritional supplements in both men and women as part of a very large-scale national clinical trial,” said Dr. JoAnn Manson, Chief of the Division of Preventive Medicine at BWH and Co-Director of COSMOS with BWH epidemiologist Dr. Howard Sesso.

Read More »

Daughter Donates Stem Cells to Honor Dad’s Successful Transplant

Posted by Brigham and Women's Hospital September 29, 2016

Lauren Marsden (daughter), Don Marsden (dad), Kelly Marsden (mom), Rachel Beaver (nurse). When Lauren Marsden signed up to be a stem cell donor during freshman orientation at college in 2010, she never thought her own father -- Don Marsden – would be diagnosed with multiple myeloma in 2014 and need a stem cell transplant himself at Dana-Farber/Brigham and Women’s Cancer Center that November. Two years later, on her dad’s 63rd birthday – May 6, 2016 -- Lauren got the call that a match had been found for her stem cells. She donated on July 5 at the Kraft Family Blood Donor Center. Here Lauren and Don pose in the Kraft Center with their mother/wife Kelly Marsden, and Kraft Center nurse Rachel Beaver, RN, BSN. Lauren and Kelly are both nurses as well. Photo by Sam Ogden.

In 2014, Don underwent a successful stem cell transplant at Dana-Farber/Brigham and Women’s Cancer Center for the treatment of multiple myeloma. Earlier this year, his daughter Lauren (pictured second from left) honored him by becoming a stem cell donor.

Lauren Marsden joined DKMS/Delete Blood Cancer Registry during freshman orientation at St. Anselm’s College for the same reason she majored in nursing: She wanted to help others. What she couldn’t foresee then was how this decision would intersect with her own family’s experience.

Two months after Lauren’s graduation in May 2014, her father was diagnosed with multiple myeloma. Don Marsden required a stem cell transplant as part of his treatment at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC), and Lauren’s clinical acumen and knowledge of the procedure made her an invaluable confidant during the radiation and chemotherapy that preceded his transplant, as well as the long recovery after it.

This spring, six years after Lauren first signed up to be on the registry, she received a call. “They told me I was a match for someone who needed a stem cell transplant and asked if I still was willing to donate,” says Lauren, 24. “Of course I said yes right away.”

Read More »

How Does Exercise Reduce Cancer Risk?

Posted by Brigham and Women's Hospital September 13, 2016

Group Yoga Class in Studio

Researchers at Dana-Farber/Brigham and Women’s Cancer Center are investigating the link between exercise and lower risk of cancer, including risk of cancer recurrence.

This much is known: A sedentary lifestyle raises the risk of cancer, while physical activity – even moderate exercise – can reduce the risk not only of developing cancer but having a recurrence following treatment. What’s not so clear is exactly why.

“It’s still a little unknown,” says Dr. Jeffrey Meyerhardt, co-director of the Colon and Rectal Cancer Center at Dana-Farber/Brigham and Women’s Cancer Center, who has studied the relationship of exercise and colorectal cancer risk. In a previous study, he and Charles Fuchs, MD, MPH, director of the Gastrointestinal Cancer Center, reported that in patients with stage III colorectal cancer, more physical activity was associated with a lower risk of cancer recurrence and mortality.

According to Dr. Meyerhardt and other researchers, one way exercise can influence cancer risk is by lowering the amounts of insulin and insulin-like growth factors in the bloodstream. These hormones stimulate tumor cells to spread and survive despite the body’s attempts to kill abnormal cells. Studies show physical activity can directly reduce insulin levels, and research on this link is continuing. Jennifer Ligibel, MD, a Dana-Farber/Brigham and Women’s Cancer Center oncologist and director of the Leonard P. Zakim Center for Integrative Therapies, led a study in breast cancer patients that showed that participation in an exercise program led to a reduction in insulin levels in previously inactive breast cancer survivors.

Read More »