MARCH 2019 | FUTUREOFPERSONALHEALTH.COM
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Future of Cancer Care Joan Lunden opens up about her battle with triple negative breast cancer
DISCOVER how one father is honoring the legacy of his daughter who lost her life to cancer
LEARN why lifesaving cancer research depends on increased federal funding
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WWW.CANCERSUPPORTCOMMUNITY.ORG CANCER SUPPORT HELPLINE: 1-888-793-9355 We provide support, financial counseling, nutrition information, housing assistance while traveling for treatment, and more. Because Community is Stronger Than Cancer
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The Domino Effect of Developing Cancer Treatments
Why Oncology Nursing Certification Matters Oncology-certified nurses are experts in their field, promoting the highest level of cancer care and excellence for their patients and their profession. Navigating a complex health care system is a terrifying, often-lonesome journey for patients with cancer. But nurses can provide clinical expertise, detailed explanations and guidance in a sea of uncertainty. To steward patients through their diagnoses, many nurses seek oncology certification to demonstrate clinical expertise and a commitment to the art of oncology nursing — for themselves and for their patients. Only 1 percent of all U.S. registered nurses are oncology certified. They must meet strict criteria to qualify: at least 2,000 hours in oncology practice and more than two years of registered nursing experience. Currently, more than 39,000 practicing nurses have certification through the Oncology Nursing Certification Corporation. Taking cancer care to the next level Obtaining oncology certification means that nurses have doubled down on their commitment to providing the highest quality patient-centered care. Oncology-certified nurses have sought continuing education opportunities and voluntarily entered the process of applying for, achieving and maintaining certification. It’s no easy task— but it’s one that demonstrates a commitment to patients and the profession. Oncology-certified nurses are leaders among their peers. They’re mentors, patient advocates and motivators, pushing for excellence in practice. Oncology nursing certification is key to creating powerful, confident nurses who offer the best patient-centered cancer care possible. Chris Pirschel, Staff Writer, Oncology Nursing Society
Data from clinical trials to treat cancer patients has propelled the field into an era with new treatment options becoming available all the time.
Monica M. Bertagnolli, MD, FACS, FASCO, President, American Society of Clinical Oncology
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s a surgical oncologist and cancer researcher, I have the opportunity to see firsthand the significant improvements that science has made in improving outcomes and quality of life for people with cancer. Consider the story of a young boy who was diagnosed with advanced cancer at the age of three. After years of treatment, he was placed on a clinical trial that cured his cancer. His mother said it was an easy decision to place him in a clinical trial. Other mothers had once
given permission for their own children to participate in trials, which led to the treatments now available to her son. “It’s a domino effect,” his mother said. This domino effect is responsible for much of the progress we’ve made against cancer. Without patients volunteering to share their clinical trial data, many of the treatments available today would not have been discovered. Ongoing learning Despite this progress, there’s much more we need to learn. This year alone, more than 600,000 people are estimated to die from cancer in the United States and more than 1.7 million new people will receive a cancer diagnosis. Clinical trials have long been the primary way we learn about how patients respond to new treatments. They provide the insights we need to refine treatment options so that new therapies are more effective, and cause fewer side effects than the current standard of care.
However, participants in clinical trials generally are younger, healthier and less racially diverse than the majority of patients with cancer. That might mean the results are less relevant to the general population. By adjusting the way trials are designed so that older and sicker patients can join, and making sure that trials are available to all patients, we can improve our understanding about what works — and what doesn’t — for all patients with cancer. The future of care Imagine what we could uncover if we understood how every single patient responded to their cancer treatment. We could identify trends and patterns, learn more about long-term side effects and rapidly accelerate our progress against cancer. The work to build such a system has now begun. It’s time to give every person with cancer the opportunity to participate in research, share their experience and continue the domino effect to help inform the next generation of cancer treatments and cures. n
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Inside the New Florida Treatment Center That Is Helping Cancer Patients With Bone Marrow or Stem Cell Transplants A new adult inpatient blood and marrow transplant center on the East Coast is poised to be a convenient treatment location for patients with leukemias, lymphomas, multiple myelomas and other blood cancers and diseases, who need bone marrow or stem cell transplants. involves the patient’s own stem cells being collected and then reintroduced. Allogeneic transplants, which use stem cells from a donor, are indicated for patients with leukemia, myelodysplastic and myeloproliferative disorders and are more complex procedures which always require hospitalization. For these procedures, The Institute built a state-of-the-art stem cell processing and immunotherapy laboratory.
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iami Cancer Institute, part of Baptist Health South Florida, recently earned approval from the State of Florida’s Agency for Health Care Administration to open the Inpatient Blood and Marrow Transplant program. The agency found that the Institute’s program would expand access to transplantation services for transplant patients and could save them time and costs. Bone marrow — the tissue inside bones that makes white blood cells to fight infections; red blood cells to carry oxygen throughout the body; and plate-
lets to help stop bleeding — can be impaired by blood cancers including leukemias, lymphomas and multiple myelomas. A bone marrow transplant (BMT) can repair or replace unhealthy marrow with healthy marrow to restore normal cell-making functions. BMT is safe and more effective than ever. The transplantation technology can also be used to treat sickle cell disease, multiple sclerosis and other autoimmune diseases. Lifesaving procedures The need for BMTs has been increasing in South Florida. Nationally in 2014, there were 17,303 BMT procedures involving patients over the age of 21. In 2016, there were 1,026 BMT cases in Florida involving patients over the age of 15. Demand is expected to increase. “These are lifesaving proce-
dures and the intent is to cure patients,” says Guenther Koehne, M.D., Ph.D., chief of blood and marrow transplantation and hematologic oncology at Miami Cancer Institute. Dr. Dennis Confer, chief medical officer at National Marrow Donor Program/Be the Match agrees. “There’s a lot of need in the Florida area,” he says, noting patients in the Caribbean could benefit too. “There are a lot of people out there who could benefit from blood and marrow transplantation that are probably not getting their transplants.” Outpatient services Also new, Miami Cancer Institute offers outpatient and inpatient autologous stem cell transplants for patients with multiple myeloma, non-Hodgkin’s lymphoma and Hodgkin’s disease. That procedure, which saves patients weeks of hospitalization,
Closer to home A significant number of bone marrow and stem cell transplant patients leave South Florida to seek treatment for many reasons, including the complexity and duration of transplantation pre-testing and conditioning phases, as well as treatment and post-transplantation care. “It’s an interruption of the patient’s daily activity to be away for three months, plus a financial burden,” says Dr. Koehne. “It affects the whole family.” But that could change with The Institute’s new facilities. Getting treatments in facilities close to home is ideal for patients and their families. Miami Cancer Institute’s new center is also expected to be a convenient location for international patients from Latin America and the Caribbean, who otherwise have limited bone marrow and stem cell transplant treatment options. “Now we can provide this to everybody here within the area and the Caribbean that wouldn’t
require you to go out of state or far away from the Caribbean,” he says. A recently opened Hilton Hotel on The Institute’s campus puts patients and their families within steps of the cancer facility. Best outcomes Miami Cancer Institute is Florida’s only member of the Memorial Sloan Kettering Cancer Alliance, a facility that has the country’s largest BMT programs and among the best outcomes for transplantation anywhere. This progressive collaboration ensures patients have access to innovative cancer treatments and the highest standards of care. Miami Cancer Institute and Memorial Sloan Kettering doctors and multidisciplinary disease management teams regularly meet to develop those standards of care. “When you have such a strong brand attached to the Miami Cancer Institute, it will be very important and very helpful,” says Dr. Confer. “It also gives the opportunity to exchange, meet with Sloan Kettering physicians and to exchange plans and ideas and ensure that patient care plan is well thoughtout and thorough.” Miami Cancer Institute is committed to discovering better cancer preventions and treatments, and delivering some of the best outcomes for cancer patients. For more information on Miami Cancer Institute and their BMT and stem cell transplants, visit MiamiCancerInstitute.com.n Kristen Castillo
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Pediatric Oncology Nurses Make a Difference Your child’s oncology nurse provides a pillar of support during uncertain times. Pediatric oncology nursing has been my passion for over 35 years. I have been privileged to form long-lasting relationships with amazing families affected by childhood cancer. A parent’s perspective Through conversations with parents, I gained perspective on the meaning of the relationship pediatric oncology nurses have with the families of children with cancer. I have compiled the following thoughts based on my interactions with parents over the course of time. These quotes are anonymous for the sake of privacy. “Our pediatric oncology nurse is always there for us. She is the smiling face we look forward to seeing when we have appointments. She treats us as if we are the only family she cares for, giving us her undivided attention. She takes time to listen to our fears, providing reassurance along the way.” “Our nurse shares a special bond with our child. She treats our child as an individual, learning about what makes them unique. She normalized the cancer experience by encouraging socialization through school and camp, reducing stress through play and distraction. She set aside time to have fun, balancing silliness with more serious moments. She helped our child cope by communicating information at their level of understanding. She included siblings, reaffirming their importance.” Susan Burke, MA, RN, CPNP, CPHON, President, Association of Pediatric Hematology/Oncology Nurses
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The Side Effects of Treating Cancer With Radiation Therapy A radiation oncologist talks about potential side effects associated with cancer treatment and shares ways to manage them. The side effects of cancer treatments can vary from person to person. They can also differ depending on the type of treatment your doctor recommends, such as radiation therapy, chemotherapy or surgery. Radiation therapy is a safe and effective cancer treatment that has been used for more than 120 years. This lifesaving therapy can lead to some side effects, although most are generally well-tolerated by patients. Much has changed in radiation oncology in recent years, including new technology that helps doctors target tumors very precisely. This has led to a sharp decrease in side effects, especially skin irritation. Various side effects Some physical and emotional side effects are common no matter what type of cancer is being treated. For
example, patients who receive radiation therapy may have noticeably less energy or experience fatigue that can interrupt daily activities, although most patients return to their normal energy levels within a few weeks after treatment. Other side effects, especially those of the skin, tend to differ depending on the type of cancer being treated. For example, patients with breast cancer commonly experience skin irritation like a mild-to-moderate sunburn, although most say this irritation is not as bad as expected. Skin effects are cumulative and may be more painful near the end of treatment. We advise patients to treat their skin gently and recommend over-the-counter skin products to help relieve irritation. Men treated with radiation therapy for prostate cancer can experience side effects such as more frequent urination or bowel movements. These side effects can usually be managed with medication and diet changes, and typically improve within a few weeks after treatment is completed.
Managing your treatment Managing side effects is a collaborative effort that involves your radiation oncologist, the radiation therapists who deliver treatments, specially trained nurses, registered dieticians and others. Patients and caregivers also play an active role in this process, and we encourage you to speak up. The radiation oncologist will examine patients as often as needed to assess the effectiveness of their treatment, manage side effects, answer questions and offer reassurance. Every person’s experience with cancer treatment is different. Your radiation oncologist should explain in detail all potential side effects associated with treatment. Be sure to ask questions. Cancer care teams are most successful when we work closely with our patients to ensure your concerns are understood and addressed. ■ Thomas Eichler, MD, FASTRO, President-Elect, American Society for Radiation Oncology (ASTRO
The preeminent leaders in pediatric hematology/oncology nursing. APHON is the professional organization for pediatric hematology/oncology nurses and allied healthcare professionals. Our members are dedicated to promoting optimal nursing care for children, adolescents, and young adults with cancer and blood disorders, and their families.
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Lifesaving Cancer Research Depends on Increased Federal Funding The field of cancer research needs lawmakers to prioritize treatment for cancer patients.
Funding sources Each of these research breakthroughs were in some way funded by the National Institutes of Health (NIH) and the National Cancer Institute (NCI). As the largest funder of cancer research, the federal government plays a role in virtually every major medical development in the fight against cancer. That’s why sustained, significant increases to federal research funding are essential to spurring additional progress in our fight against cancer. Without a predictable source of funding, our momentum against this life-threatening disease will be greatly impacted. Congressional action Lawmakers have already illustrated widespread, bipartisan support of federal funding for cancer research in recent years, including the 2016 passage of the National Cancer Moonshot Initiative as part of the 21st Century Cures Act. Congress again has the opportunity to make funding for cancer research a priority. This is a necessary next step in conquering a disease that will claim the lives of more than 600,000 Americans this year. As Congress prepares fiscal year 2020 appropriations bills, legislators can continue to fuel the momentum of discovery in cancer treatment by including a $2.5 billion funding increase for the NIH and a $378 million increase for the NCI. Lisa Lacasse, President, American Cancer Society Cancer Action Network
What Joan Lunden Wants Every Woman to Know about Breast Cancer
PHOTO: ANDREW ECCLES
For the 1.7 million Americans who will be diagnosed with cancer this year, recent breakthroughs in research offer lifesaving potential. Extraordinary medical advancements have introduced innovative treatments for cancer patients, taught us how to better prevent cancer and how to detect it at its earliest stages.
American journalist Joan Lunden talks about life after cancer and shares life-saving advice.
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ournalist Joan Lunden was shocked when she was diagnosed with stage 2 triple negative breast cancer in 2014. The rare breast cancer wasn’t detected on a mammogram. An ultrasound identified the two tumors in her right breast. Although the former co-host of ABC’s “Good Morning America” had reported on breast cancer, she admittedly had never worried about the disease affecting her. She’d had a baseline mammogram at age 35, followed by fairly regular screenings yearly after she turned 40. A few years before her diagnosis, when Lunden interviewed well-known cancer physician Dr. Susan Love, she mentioned that after routine mammograms, she was often asked to come back to take more images because she has dense breasts. Dr. Love explained dense breasts are difficult for mammographers to read, comparing it to looking for a snowball
in a snowstorm. Dr. Love recommended that with Lunden’s breast density, she should have an ultrasound in addition to a mammogram. That advice saved Lunden’s life. After her diagnosis, she received aggressive chemotherapy, radiation and surgery. Because the tumors shrunk from chemo, her surgery was less extensive and she didn’t need breast reconstruction surgery. Now 68, she’s approaching five years of being cancer-free. What to know The TV personality urges women to know the density of their breasts and to get yearly screenings after age 40. “If it is caught at an early stage, there is a 98 percent chance that you will survive it,” Lunden says, concluding, “This doesn’t have to be a death sentence.” She advises getting a second opinion, and tells fellow cancer patients to take a loved one with
them to appointments for support, to ask questions and to take notes. A rewarding experience Lunden’s father, who died in a plane crash when she was 12, was a cancer surgeon. She always looked up to him for the work he did to save lives. Now she’s helping carry on her father’s legacy by using her platform for good. Lunden took her phone to every doctor’s appointment so she could document her treatments for her website and social media followers, and shared her experience and findings as a special correspondent on NBC’s “Today Show.” She also wrote about her cancer journey in her book, “Had I Known: A Memoir of Survival.” “What you would think would have been the worst year of my life ironically turned into an incredibly rewarding year of my life.” ■ Kristen Castillo
Millions like Jackie fight cancer while lifesaving treatments sit in here. CONGRESS SHOULD CONTINUE TO INCREASE RESEARCH FUNDING AT THE NATIONAL INSTITUTES OF HEALTH, or new treatments, prevention and detection tests may not reach patients like Jackie, a 17-year cancer survivor. With roughly 1 in 3 Americans diagnosed with cancer in their lifetime, we can’t afford to let promising research go to waste. To learn more about our efforts to increase funding for cancer research, visit fifififififififififififififififififififififififi.
Congress, increase research funding at the National Institutes of Health and save more lives.
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