Network Newsletter - Summer 2009

network

Summer

’09

The Anderson Network is a program of Volunteer Services at M. D. Anderson Cancer Center

Giving the mouth its due Patients may be unaware that treatment for cancer can affect the hard and soft tissues of the mouth. In some cases, patients even delay or stop their treatment because they experience painful complications in their oral cavity or oropharynx.

Complications vary by patient, depending on the individual’s oral and dental status, the type of malignancy and the therapeutic approach. To help manage these oral side effects, the dentist and oncologist can work together — before and during cancer treatment — to make recovery as comfortable as possible.

At least two weeks before treatment begins, cancer patients should schedule a thorough dental checkup. At this visit, the medical history can be updated, dental cleaning performed and existing oral problems, such as decayed or broken teeth, addressed.

Patients also should provide the dentist with contact information for the medical oncologist and treating physicians for use in future communications regarding any oral complications.

During cancer treatment, patients should gently brush teeth at least twice daily unless the dentist recommends otherwise. A fluoridated toothpaste should be used to optimize oral health. If patients discover they cannot tolerate the flavor of their regular

by Mark Chambers, D.M.D., with Bayan Raji

toothpaste, they should try unflavored toothpaste or toothpaste with reduced levels of flavoring agents. Patients also should gently floss teeth once a day, avoiding any sore or bleeding areas of the gums.

Tips for ongoing dental care Once all complications of chemotherapy have been resolved and blood counts have recovered, most patients may resume their normal dental care schedule.

However, radiation therapy to the head and neck can cause oral complications that continue or emerge long after treatment has ended. Such treatment results in a lifelong risk of bone death, dry mouth and cavities.

Patients may decrease the risk or severity of oral complications by reducing the acidity in the mouth with a baking soda rinse. Use onefourth teaspoon of baking soda and one-eighth teaspoon of salt in one cup of warm water. This is particularly helpful if vomiting after cancer treatment occurs.

If dry mouth develops, an artificial saliva replacement may be recommended. Taking frequent sips of water, sucking on ice chips or sugar-free candy, or chewing sugar-free gum may provide relief.

Patients should eat a soft, balanced diet and avoid using tobacco and alcohol. Mucosal ulcerations, infection and oral pain need to be assessed by a

Sharing hope, support and understanding with anyone diagnosed with cancer regardless of where treatment is or was received.

clinician and treated accordingly with topical coating agents or other medicine as deemed appropriate.

Preventing and treating oral complications of cancer therapy involve identifying the patient at risk, starting prevention before cancer therapy begins and treating complications as soon as they appear.

Chemotherapy and radiation treatment can cause multiple oral side effects and functional disabilities: • caries (rampant tooth decay) • xerostomia (dry mouth) • mucositis (inflammation and ulceration of the mucous membranes) • oral pain • infection (hard and soft oral tissues) • macroglossia (swollen tongue) or odynophagia (burning mouth/tongue) • trismus (stiffness in the jaws) • dysgeusia (altered taste acuity) • dysphagia (trouble swallowing)

People Profiles Marisa Ramirez: In her own words, ‘Yup, buddy’ Calling him five years ago to tell him I had cancer was the worst call I ever had to make. Happy to hear from me, he asked about my husband John and my young son Alex. We may have talked about the Dallas Cowboys or the lack of rain.

Then I told him.

He was quiet for a long time, and I realized he was crying. It was an awful sound that I tried to drown by conveying in great detail my treatment plan, how I wouldn’t lose much time at work or too much weight. I even tried to tell a joke, anything to fill the distance with words and not sobs, especially not my own. But then he stopped, took a deep breath and said, “It will be OK. Yup.”

An identity crisis

I spent several days last month debating whether or not to go to San Antonio. My 72-year-old father, a newly published writer, had called to invite me to a reading at the local bohemian bookstore and coffee shop. A “Short Story Revival,” he called it. He said he hoped to spark a discussion on the merits of the short story — and, if audience members were so moved, allow them to buy a few of his books.

They would come, he was sure He’s always been sure. As a kid, I never worried when he was around. We’d get where we needed to go, bills would be paid, everything would be OK. “Yup, buddy,” he’d say to assure us.

When my mother’s disease progressed to where we didn’t recognize her, and I’d look at him with unsure eyes, he’d say, “It’s OK. Yup, buddy.” And I’d believe him. His assurance comes from a weathered life — migrant worker, Marine, widower, patient.

Dad’s endured the slings and arrows — and is here to write about them.

2

Before Nov. 3, 2003, I was sure who I was. I’d spent years becoming Houston’s KTRH Newsradio’s Marisa Ramirez. I’d been John Cannon’s wife for five years and was getting used to being called Alex’s mom. Adding “cancer patient” to that list was surreal, alien and uncomfortable. Who would I be now? I wasn’t sure.

When you lose your footing, it’s natural to fall.

When each shower leaves the drain clogged with hair, when walking across the room drains you, when you rush to take the pill before the nausea comes, who wouldn’t feel each layer of identity peeling away until all that’s left is what the radiation leaves behind.

It takes focus and faith to find your balance: to shampoo gently, sit and sleep and let the nausea have its moment. When I turned unsure eyes to the girl in the mirror, she looked tired and weathered.

But deep in that reflection were my father’s eyes, telling me it was going to be OK. And it was.

So, I went to San Antonio. I was the proud daughter in the back of the room when my dad read from his new book and detailed his philosophy of the novel versus the short story. He’s OK, my dad.

And so am I. I’m John’s wife, Alex’s mom and Fernando’s daughter. I’m a cancer fighter and here to write about it. Yup, buddy.

Marisa Ramirez is a veteran newsradio journalist, currently a media representative at the University of Houston and a cancer survivor.

Cancer survivors gather to honor ‘the strength within’

by Mary Brolley Hoda Kotb’s experience with breast cancer in 2007 changed her. “It gave me clarity,” she says. “A sense that life is not to be wasted.”

Even so, after her mastectomy and reconstructive surgery, the award-winning broadcast journalist wasn’t sure how much of her journey she wanted to share.

But when a stranger on an airplane urged her to reach out to others with cancer, Kotb was moved.

“He said, ‘Don’t hog your journey — use what you’ve learned to help others,’” she recalls. “So I decided to do what I could.”

A “Dateline NBC” correspondent and host of the weekly syndicated series “Your Total Health,” Kotb is the keynote speaker for Anderson Network’s 21st annual Living With, Through and Beyond Cancer Conference, Sept. 10-12.

The conference theme, “The Strength Within,” acknowledges the inner resources and grace cancer patients and survivors like Kotb find essential for their journey and recovery.

You’re invited to join us at the Houston Marriott Westchase to learn more about the issues cancer survivors face, to meet and share with other survivors, to take wellness classes and have fun.

Speakers, breakout sessions, medical panel Other speakers include M. D. Anderson clinical professor and cancer survivor Martin Raber, M.D., and humorist Charles Petty, Ph.D. M. D. Anderson President John Mendelsohn, M.D., will lead the popular medical panel on Saturday morning.

Open to all cancer patients, their families and caregivers, the conference includes a breakout session spotlighting the Beth Sanders Moore Young Breast Cancer Survivors’ Program, which will offer a lively panel including oncologists, a nutrition expert, a plastic surgeon and an internist who specializes in cancer patients and fatigue.

A sampling of the nearly two dozen conference breakout sessions includes: • Navigating the world of health insurance • Dermatology issues

the strength within

• Fear of recurrence • Young adult survivors • Proton therapy • Caregiver issues As always, a number of complementary and integrative modalities are offered by Place ... of wellness. Tai chi, qigong, music therapy, aromatherapy, journaling and safe massage techniques will be offered to participants.

Thanks to M. D. Anderson, conference sponsors and individual donors, the cost of the conference is just $75, which includes all meals, activities and self-parking. Registration is available online until Sept. 4.

For more information or to register, log on to the Internet site at www.mdanderson.org/ patientconference or call 713-792-2553 in Houston, 800-345-6324 toll-free.

The Anderson Network, an organization with support and educational services for patients/survivors, their families and caregivers, is a program of the Department of Volunteer Services.

3

The University of Texas M. D. Anderson Cancer Center Public Affairs Office 156300/18050663 – Unit 700 6900 Fannin St. FHB 5th Floor, Room 5.1082 Houston, TX 77030-3800

Non-Profit Org. U.S. Postage PAID Houston, Texas Permit No. 7052

network The Anderson Network is a program of Volunteer Services at M. D. Anderson Cancer Center.

Address changes should be sent to: Sandi Stromberg University of Texas M. D. Anderson Cancer Center Communications Office – Unit 700 6900 Fannin St. Houston, TX 77030-3800 Phone: 713-792-3457 Fax: 713-563-9735 E-mail: sfstromb@mdanderson.org Articles and photos may be reprinted with permission.

Susan French, Executive Director, Volunteer Services Debbie Schultz, Assistant Director, Volunteer Services/ Anderson Network Sandi Stromberg, Writer/Editor, Network Kelley Moore, Graphic Design Kenneth Woo, Chair, Anderson Network © 2009 The University of Texas M. D. Anderson Cancer Center

Page 4 Briefs Young Cancer Connection is a group of M. D. Anderson programs that connect and provide resources for

young cancer patients and survivors.

• Anderson Network’s Cancer180 offers social outings and activities in the greater Houston area for young adult patients, survivors and friends in their 20s and 30s. The cancer survivor message board — www.mdanderson.org/andersonnetwork — provides virtual support.

• The Adolescent and Young Adult (AYA) program — www.mdanderson.org/aya — of the Children’s Cancer Hospital at M. D. Anderson helps young cancer patients and survivors cope with their disease and its effects. AYA is a comprehensive program with medical, psychological, social, educational and vocational services specifically for teens and young adults.

• The Beth Sanders Moore Young Breast Cancer Survivors’ Program — www.mdanderson.org/ departments/yngbreastsrv — provides clinical support, research and educational resources for the nearly 28,000 American women under the age of 45 diagnosed with breast cancer every year.

Find Young Cancer Connection on www.facebook.com and follow the Anderson Network on www.twitter.com/.

Call the Anderson Network at 713-792-2553 and 800-345-6324 or visit the Anderson Network Internet site at www.mdanderson.org/andersonnetwork