Posts tagged Doctor Discussions
Did you know that the CCAC has a full-time Research & Education Specialist? Along with our Medical Advisory Board, this individual is a vital link between medical research and the many patients who come to our site seeking information about colorectal cancer http://premier-pharmacy.com/ screening, treatment and prevention. Below, you’ll find a selection of this month’s selected journal article summaries. A gift to you from our Research & Education Specialist! Click here to catch up on previous months’ selected articles.
- FDA Approves Fusilev
- Reintroduction of Oxaliplatin in the Treatment of Metastatic Colorectal
- Pain Relievers May Lower Colorectal Cancer Risk
- Erbitux in First Line Therapy for the Treatment of Metastatic Colorectal Cancer
- Zaltrap Extends Survival in Metastatic Colorectal Cancer
- Drug May Have Utility in Treating Colorectal Cancer
- Prophylactic Drugs Help Prevent Oxaliplatin-Related Nausea and Vomiting
- Unresectable Peritoneal Carcinomatosis from Colorectal Cancer
- Laparoscopic Liver Resection Becoming More Popular
- Liver Resection in Presence of Extrahepatic Disease
- Sentinel Lymph Node Procedure in Colorectal Cancer
- New Test for Colon Cancer Detection
- CT Colonography More Sensitive At Detecting Colorectal Cancer
- Simple Urine Test for Colorectal Cancer
- Interval Colorectal Cancers Increased After Flexible Sigmoidoscopy
- Estrogen Use For a Few Years After Menopause is Safe
- Decision Aid for Patients with Advanced Colorectal Cancer Considering Chemo
- How Inflammation Can Lead to Cancer
- Vitamin D [25(OH)D] and Colorectal Cancer
- Alcohol and Cancer
- Study Shows No Link Between Folates & Colorectal Cancer
- Office Desk Job Doubles Colon Cancer Risk
- Smokers Diagnosed With Colon Cancer Have Greater Likelihood of Dying
- Eating Anything At Anytime & Risk of Colorectal Cancer
- Thin People Face Colon Cancer Risk As Well
A story on Medical News Today suggests that many nurses and other healthcare professionals express difficulty in initiating discussions about sexuality with their patients. This finding was outlined in an abstract presented at the 36th Annual Congress of the Oncology Nursing Society by nurses from the University of Texas MD Anderson Cancer Centre.
We hear about this issue often- it seems the cancer care industry has known for some time that physical intimacy can be a real concern for patients striving to maintain the best possible quality of life.
While no online guide should replace guidance from your healthcare team, these documents may be a good place to start, buy kamagra online, if you or your partner is having difficulties during treatment:
- The Canadian Cancer Society has a comforting resource entitled Sexuality in Cancer.
- The National Cancer Institute (USA) has fact sheets regarding sexual chemo side effects for both men and women.
- The American Cancer Society has comprehensive resources for men, touching on topics like hormone therapy, orgasm intensity, erectile dysfunction and how to feel good about yourself during treatment.
- The American Cancer Society has comprehensive resources for women, touching on topics like reaching orgasm, preventing discomfort, fertility and how to feel good about yourself during treatment.
Do you have any resources to add to the list? We’re especially interested in resources for the LGBT (Lesbian, Gay, Bisexual and Transgender) community.
- The National LGBT Cancer’s Project’s own site, where they focus on LGBT cancer survivor support and advocacy with the help of oncologists, social workers, psychologists and patients
- Malecare.org, a multilingual site that focuses on the quality-of-life of men during treatment and palliation
- OutWithCancer.com, a social network for gay, lesbian, bi and trans men and women who have been diagnosed with cancer
Worry not- nobody is suggesting that you give up meat and dairy products outright! The decision to adopt a vegan or vegetarian diet is a personal choice, and one that you should certainly discuss with your physician or registered dietitian.
There are, however, serious cases to be made for reducing your meat (especially red meat) intake. In honour of World Vegan Month, we would like you to take some time to think about your diet- your colon may thank you!
On meat consumption: According to one American study, scientists may have discovered which biological mechanisms are behind the already established link between colorectal cancer and diets high in red or processed meat. The suggested culprits? Three compounds: heme iron (iron found in red blood cells), nitrate/nitrite (preservatives), and heterocyclic amines (compounds created when food is cooked at high temperatures). [SOURCE: Fung, Teresa, et al., Low Carbohydrate diets and all-cause and cause-specific mortality two cohort studies. Annals of Internal Medicine. September 7, 2010, 153 (5)]
When it comes to dairy consumption, some research suggests that it may have a protective benefit due to its calcium content. In one study, researchers found that the risk of colorectal cancer was approximately 20% lower in men who consumed the most calcium than in men who consumed the least. The risk was about 30% lower in women who consumed the most calcium than in women who consumed the least. Colorectal cancer risk was also lower in men or women who ate the most dairy foods. [SOURCE: Park, Y, et al., Dairy food, calcium, and risk of cancer in the NIH-AARP Diet and Health Study. Archives of Internal Medicine. 2009, Volume 169, Issue 4, Pages 391-401]
If you’re toying with the idea of occasionally working vegan or vegetarian principles into your lifestyle, we suggest reading up on the various nutrients that may be of concern. Canadian Living Magazine has a good, unbiased article that you may wish to start from. In addition to your conversation with your doctor, you may also wish to consult a registered dietitian.
The group’s report, published in last Friday’s version of The Lancet, summarized the 20-year results of trials involving the use of ASA (acetylsalicylic acid), more commonly known to consumers as Aspirin. The studies involved more than 14,000 people, with the primary intention of studying the drug’s use in preventing strokes and heart attacks.
The study found, however, that the benefits of regular ASA also include protective effects against colon cancer, and that regular use even seemed to prevent tumours in certain areas (most notably in the higher reaches of the colon, where discovery through traditional colonoscopy is often difficult). As for dose, the study found no real advantage to taking more than 75 milligrams daily, or about the dose of a “baby Aspirin.”
The study’s findings are an exciting step for colorectal cancer prevention practices, but the CCAC urges you to speak with your doctor before commencing any kind of drug regimen. Though commonly available over-the-counter, even ASA has potentially serious side effects, including irritation of the stomach, intestines and colon.
Click here to read the Lancet article and learn more.
It’s estimated that, on average, North Americans consume less than 50% of the daily recommended levels of fibre- which could be a problem, since fibre consumption has been shown to significantly reduce blood cholesterol levels, lower variance in blood sugar levels and facilitate regularity.
But not everyone should be eating a diet rich in fibre. We recently received an inquiry from a patient looking for low-fibre recipes that would be suitable for a post-ileostomy diet. This individual was also instructed by a physician to put on weight. Tricky!
PUTTING ON WEIGHT
Let’s discuss each problem independently of the other. Putting on weight safely and healthfully can be just as difficult as losing weight can be. The key is to keep your diet healthy, while introducing more calorie-dense foods. Katherine Zeratsky, Registered Dietitian with the Mayo Clinic, suggests the following, upon clearance from your physician:
- Eat more frequently- five to six small meals through the day
- Eat nutrient-dense foods, like nuts, seeds, lean protein, low-fat dairy products etc
- Drink fluids at least 30 minutes before meals, but not with. This will let you keep your appetite for the nutritious foods you’ll be eating
- Limit diet soda, coffee and tea. These items have little nutritional value and few calories. Instead, consider homemade smoothies with a variety of fresh fruits and lean dairy products
- Add calorie-dense snacks, such as nuts, peanut butter, cheese, dried fruits, or avocado. You may with to have a small bedtime snack as well.
- Add cheese to casseroles, soups and scrambled eggs; nonfat dried milk to stews, and lean chicken to soups
- When selecting sweets, be sure to select items that also provide nutrients. Yogurt, fruit and granola bars are good choices.
- Exercise! It may seem counter-intuitive, but regular exercise will stimulate your appetite. If your doctor condones it, consider starting a moderate weight training routine as well.
Click here to read more.
The British Columbia Cancer Agency has created an excellent resource on low-fibre options that you may wish to share with your doctor or Registered Dietitian when creating an ileostomy-friendly diet plan. Among their recommendations:
- Have very small servings of food
- Eat more often throughout the day. Aim for six to seven small snacks per day
- Drink as much as you can. Aim for six to eight cups of fluids per day
- A multivitamin and mineral supplement may be necessary if your diet is very restricted
- Avoid any foods that make your symptoms worse. These might include: vegetables like booked spinach, swiss chard, and peas; Figs/dates, prunes and some berries; High-fibre cereals like All Bran, Shredded Wheat or Raisin Bran; whole-wheat pastas and breads; Snacks such as popcorn; Legumes such as beans, chickpeas and lentils
- You may be more comfortable with low-fibre foods, including: vegetables such as asparagus, cucumber, peppers, skinless potatoes, tomato, lettuce and mushrooms; fruits such as cantaloupe, banana, watermelon and grapes; hot cereals such as Cream of Wheat; Cold cereals such as Rice Krispies or Cornflakes; White, cracked wheat or 60% whole wheat bread, plain bagels or flatbreads; regular noodles and pastas; white ric; any lean meat; any lean dairy
- If your symptoms become more frequent and intense, your doctor may recommend temporarily cutting out fruits and vegetables alltogether, or temporarily avoiding all solid foods
Click here to read more
The American Cancer Society’s new cookbook, What to Eat During Cancer Treatment, helps cancer patients and their caregivers by providing great recipes and useful, comforting advice about cancer nutrition.
Click here to purchase
The Cancer Lifeline Cookbook is designed to help patients through difficult nutritional situation. Kimberly Mathai, a registered dietitian, and Ginny Smith, a freelance health journalist worked together to create this resource.
Click here to purchase
Over 138,000 French-language copies sold, now available in English! A highly accessible and practical text, with beautiful full-colour illustrations.
Click here to purchase
There are numerous studies that point to sedentary work environments (the average 9-to-5 office gig) as colorectal cancer risk factors, when not balanced out by excerise and healthful eating. However, some professionals, including printing machine operators, workers in food manufacturing and workers employed in the petroleum product trade are at an increased risk due to the materials they encounter on the job. Click here to read more about the occupational risk of colorectal cancer. One of the most-documented of these risk-factor professions is firefighting.
The CCAC urges everyone to go cigarette-free to decrease their colorectal cancer risk. What about the men and women who are exposed to smoke throughout their entire careers?
An ABC News article pointed us to the case of retired Boston firefighter Tom Alden, a 30-year veteran of the profession who had been diagnosed with Stage III colorectal cancer. “I’ve sucked in a lot of smoke over the years. There’s a lot of stuff that’s burning in a house that’s harmful to you, so I wouldn’t be surprised if I got cancer. I just wouldn’t.” Click here to read the original article.
Findings of University of Cincinnati environmental health researchers indeed suggest that the protective equipment used by firefighters may not be able to protect against the cancer-causing agents they are repeatedly exposed to. Common chemicals, including benzene, styrene, chloroform and formaldehyde can be inhaled or absorbed through the skin. In addition to the risk inherent to exposure burning chemicals found in the average home, the practice of idling firetrucks exposes firefighters to harmful diesel exhaust fumes.
So in addition to the obvious dangers of the profession, firefighters may face cumulative dangers at the cellular level. Among the achievements of the Fire Fighter Cancer Foundation (FFCF) is the formation of a database tracking the occupational diseases for all firefighters in Canada and the United States, with the hopes of producing the data needed to encourage legislative action and encouraging further research.
The bottom line: Even with following the CCAC’s nutrition and lifestyle guidelines, your career may be putting you at a higher risk. Talk to your physician about early screening measures and encourage your doctor to consider your profession a heightened risk factor.
You may be eligible for this trial if you are a colorectal cancer patient with metastases to the liver, and you have previously undergone chemotherapy treatment that included irinotecan or oxaliplatin. The trial is taking place at the National Institutes of Health Clinical Center in Bethesda, Maryland, and Canadians are welcome to apply to the study. The trial will test the effectiveness of infusing the drug melphalan through the artery that feeds the liver. Click here for in-depth information regarding the “Hepatic Arterial Infusion of Melphalan With Hepatic Perfusion in Treating Patients With Unresectable Liver Cancer” trial.
How much do you know about clinical trials? The CCAC has developed a comprehensive website section to help you navigate the potentially intimidating world of clinical trials. Since the CCAC always advocates becoming an informed patient, here are some questions to ask when considering a trial:
- What is the purpose of the study?
- Who is going to be in the study?
- Why do researchers believe the experimental treatment being tested may be effective? Has it been tested before?
- What kinds of tests and experimental treatments are involved?
- How do the possible risks, side effects, and benefits in the study compare with my current treatment?
- How might this trial affect my daily life?
- How long will the trial last?
- Will hospitalization be required?
- Who will pay for the experimental treatment?
- What type of long-term follow up care is part of this study?
- How will I know that the experimental treatment is working? Will results of the trials be provided to me?
- Who will be in charge of my care?
If you are interested in the trial and require more information, please contact the Principal Investigator, Dr. Itzhak Avital: firstname.lastname@example.org, or by telephone at 301-402-0083.
Cancer treatment is extremely complex, and can be comprised of components like medicine, surgery, radiation and more. Each oncologist you encounter has unique experiences that will affect the treatments s/he prescribes for your individual cancer management. But what if you are uncomfortable or apprehensive about a proposed treatment? What if your diagnosis is unclear?
Many patients are nervous to ask their oncologists for access to a second opinion, but consider this: isn’t the minor (but very uncommon) awkwardness a price worth paying for becoming an even more thoroughly informed patient?
The truth is, a second opinion is a very common request, and one that most doctors will be happy to cater to. Securing a second opinion can be done through a referral from your physician, or you may wish to seek out a second opinion on your own and then have your current treating physician forward the referral.
When should I ask for a second opinion? (Click here to view the source)
- You don’t trust the opinion of your treating physician
- Your diagnosis is unclear
- Your case is borderline (such as a tumor that is “nearly inoperable”)
- You have a rare form of cancer
- Your treatment is controversial or experimental
- You have been given no hope for a cure
How can I tactfully request a second opinion? (Click here to view the CCAC’s Physician Questions site)
- “Before we start treatment, I would like to get a second opinion. Will you assist me with that?”
- “If you had my type of cancer, who would you see for a second opinion?”
- “I think I would like to speak to another doctor to be sure I have all my bases covered.”
- “I’m thinking of seeking out a second opinion. Can you recommend someone? If so, who would you recommend and why?”
Asking for a second opinion is a sure sign that you aspire to be a well-informed patient. Educating yourself on your various treatment options and the various points of view within the medical community make you a member of your cancer care team. Be the player, not the puck.
“When it comes to the treatment of your case, be a player, not the puck.”
In other words, become an active member of your cancer care team. When fighting a disease as aggressive as colorectal cancer, the additional distress of navigating the healthcare system and being passed from doctor to doctor can take its toll on your emotional wellbeing. Become a player. Educate yourself so that you can interact with the many brilliant physicians and nurses you’ll meet in the ‘rink’.
The CCAC takes the stance that a well-informed patient is a well-coping patient, and we take pride in directing you to the vital psychosocial assistance and technical background information you may need when facing a diagnosis or when embarking on a new treatment journey.
Just a few ideas:
- Know the language. The CCAC operates a Glossary of Terms that you may find useful, especially when reading medical journal articles or news posted on our site.
- Consult the Physician Questions section of the CCAC site- you’ll find that it’s a valuable resource from diagnosis to treatment to recovery. Arrive at your oncology appointment armed with a list of queries and topics to discuss- questions like how your sexual relations may be affected by a certain treatment, or even whether the doctor would be willing to assist you in seeking a second opinion. No question is to small.
- Reach out to a Cancer Coach. In addition to providing emotional support and being knowledgeable about methods for coping with distress, a CCAC Cancer Coach can direct you to the information you need if you’re overwhelmed by technical terms or the abundance of research on the subject. Many of our Cancer Coaches are themselves survivors of colorectal cancer.
Deep in the heart of NHL playoff season, we were thrilled to hear these words of wisdom from one of our Cancer Coaches! Not only because hockey is our national pastime (and great source of exercise!), but because the analogy captures the concept of teamwork vital to cancer patient care. In your journey with colorectal cancer, your expertise (and faith) in yourself is every bit as important as the input from your surgical oncologist, medical oncologist, interventional radiologist or nurse navigator.
Join the team!
In a study published in the Journal of Cancer Survivorship, researchers found that cognitive impairment (and memory loss randing from minor to acute) was one of the most frequently reported post-treatment side effects in breast cancer survivors. This collection of symptoms, referred to colloquially as ‘chemobrain’, is not unique to breast cancer patients- and only recently has it been taken seriously by the medical community as a whole.
Click here to read the original article.