Cancer Care by Mediaplanet_USA

A Mediaplanet Guide to Researching and Treating Cancer

Cancer Care

Kevin Jonas Sr. “Papa Jonas” talks about surviving colon cancer and the importance of early detection The three key advancements improving how colorectal cancer is treated How improvements in clinical trials have paved the way for precision medicine MARCH 2021 | FUTUREOFPERSONALHEALTH.COM

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Giving Every Patient HighQuality Cancer Care Every Day, Everywhere We have witnessed remarkable progress in our understanding and treatment of cancer. Only a few decades ago, a cancer diagnosis was almost certain to be terminal. Now, cancer is often manageable — and for many patients, even curable.

hanks to continuous advancements in the prevention, screening, and treatment of cancer, overall cancer mortality in the United States has reduced significantly, yet not all patients have benefited equally from this progress. Individuals with lower income and education levels, patients living in rural areas, and minorities — Black patients in particular — continue to experience worse cancer survival rates. For me, it’s very personal. When I was a young girl, I saw firsthand that family members @MEDIAPLANETUSA

and other people in my community didn’t enjoy full access to high-quality medical care. Later on, as I devoted my professional life to medicine as a radiation oncologist specializing in breast cancer research and treatment, I witnessed how where you lived and what you looked like could impact how well you did after a cancer diagnosis. For example, while Black women and white women have similar rates of breast cancer incidence, Black women experience a 40 percent higher death rate. That’s the very definition of health inequity for patients with cancer. @FUTUREOFPERSONALHEALTH

Lori Pierce, M.D. President, American Society of Clinical Oncology

Addressing the issues Many factors contribute to health inequities in cancer care, including socioeconomic barriers, lack of adequate health insurance, limited availability of cancer screenings, and lack of access to high-quality oncology care. The solutions are also multifaceted, such as increasing the

participation of underrepresented populations in clinical trials, increasing the diversity of the oncology workforce, and addressing social factors that directly impact health outcomes — to name just a few. Addressing healthcare inequities has long been my passion. When I became president of the American Society of Clinical Oncology, an international organization representing nearly 45,000 professionals who care for individuals with cancer, I chose as my theme “Equity: Every Patient. Every Day. Everywhere.” But, the events of this past year further gal-

vanized me and the American Society of Clinical Oncology (ASCO) to work even harder to ensure all people with cancer have access to high-quality, equitable cancer care. Much work is yet to be done, but I remain hopeful and deeply committed to this cause. ASCO’s work on health equity has been in sharp focus from the start, ever since Dr. Jane Cooke Wright — an incredibly gifted Black cancer researcher and physician — helped found ASCO more than 50 years ago. Her legacy lives on, and her vision and life of accomplishments inspire me every day. n

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Publisher Nellie Dubin Business DeveloperGretchen Pancak Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Celia Hazard Lead Editor Mina Fanous Copy Editor Dustin Brennan Partnership and Distribution Manager Jordan Hernandez Director of Sales Stephanie King Director of Product Faye Godfrey Cover Photo Travis Howard/Fight Colorectal Cancer All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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My hope is that that person out there right now can handle it and get it taken care of.

Jonas, who treated his cancer with surgery, followed by six months of chemotherapy. He experienced fatigue and neuropathy, as well as complications, including infections. He’s been in remission for four years and gets screenings every six months. Jonas and his wife live in North Carolina where they run their family restaurant Nellie’s Southern Kitchen. He’s grateful for the support of his wife, four sons, and three granddaughters. Early detection Colonoscopies are recommended for people over age 50,

but Jonas says if you’re dealing with any stomach issues, ask your doctor for an early colonoscopy. “Don’t ignore the signs, don’t try to be a hero,” said Jonas, who’s a spokesperson for Fight CRC, a non-profit advocacy group that raises awareness about colon cancer and early detection. “It’s a humbling thing to walk through,” he said. “My hope is that that person out there right now can handle it and get it taken care of, without it impacting their life, their livelihood, their mobility. It’s so easy if it’s handled early.” n Kristen Castillo

PHOTO: COURTESY OF TRAVIS HOWARD/FIGHT COLORECTAL CANCER

Kevin Jonas Sr. on His Colon Cancer Journey and the Importance of Early Detection

Three Innovations Advancing Colorectal Cancer Care

Why It’s Important to Get Your Cancer Screenings Back on the Books Early detection is key for treating many cancers, so it is vital to stay current with your routine screening appointments. Many people have delayed medical care during the pandemic. A recent Prevent Cancer Foundation survey found that more than half of Americans delayed routine screenings, including mammograms, Pap/ HPV tests, skin checks, and colonoscopies, due to COVID-19. Delayed or missed diagnoses could result in more advanced cancers that may be harder to treat. Cancer does not stop for a pandemic, so we must remain vigilant to protect our health. Although it is understandable to be cautious about potential exposure to COVID-19, the Prevent Cancer Foundation urges adults of screening age to get their routine cancer screenings back on the books. Healthcare facilities have implemented safety procedures, including temperature checks, social distancing, enhanced cleaning, and mask-wearing, to keep patients safe and protected from COVID-19.

Colorectal cancer care already benefits from advances in genetic testing that guide therapies, but genetics can do even more. When we talk about the future of colorectal cancer (CRC) care, it’s critical to understand what sets this disease apart from most other cancers. CRC can be deadly but is highly preventable with screening, and with early detection, it has a 90 percent survival rate. That’s why the future of treatment for CRC begins before diagnosis. Innovation in screening Screening is often thought of as a way to detect a disease. That’s true, but screening can also identify patients who are at higher risk. One solution is genetic testing, which can provide early warnings for inherited conditions that can cause CRC.

Genetic testing is more popular and affordable than ever. As recently as 2012, one test to analyze two genes cost $3,340. By 2017, a test that analyzed 30 genes was priced at $250. One day soon, an inexpensive genetic test completed at home will give insight about a person’s CRC risk, letting them take preventive measures. Precision treatment Personalized medicine in CRC — tailoring treatment to a specific tumor — relies on continued research on actionable biomarkers. Biomarkers are DNA, proteins, and gene mutations found in blood, tissue, and other body fluids. Biomarkers can provide doctors with a better understanding of an individual patient’s tumor, guiding them toward the most precise and effective treatment. Treatment for CRC has progressed beyond a one-size-fits-all approach.

Already, 12 biomarkers can inform a patient’s CRC prognosis and treatment plan. For example, all CRC patients should be tested for the MSI-H biomarker. Research shows that patients with this biomarker tend to respond well to immunotherapy. Innovative surgical techniques Treatment for CRC usually requires surgery to remove the primary tumor. Laparoscopic surgery for gastrointestinal procedures has been expanding over the past decade. Because a laparoscopic procedure uses small incisions, patients tend to recover faster and easier, with less pain and shorter hospital stays. Novel methods in surgery are aiding in the movement toward patient choice and, ultimately, wellness and survival. n Andrea Goodman, M.P.H., Colorectal Cancer Alliance

At-home screenings For those who need to be screened for colorectal cancer, at-home screening tests offer an alternative to the colonoscopy. With a colonoscopy, your doctor can detect polyps, or growths, that can be monitored and removed before cancer develops. If you are of screening age (between 45 and 75) and are apprehensive or unable to visit a healthcare facility, the guaiac-based fecal occult blood test (gFOBT) fecal immunochemical test (FIT) or FIT-DNA test are effective options. At-home tests must be done every 1-3 years (the colonoscopy is once every 10 years) and abnormal test results require a timely follow-up colonoscopy. Ultimately, the best test is the one you get done. Schedule a time, whether it is in person or via telehealth, to talk to your healthcare provider about the screenings recommended for you based on your age, gender, race, family health history, and other risk factors. Then make — and keep — your appointments. Cassie Smith, Prevent Cancer Foundation

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How COVID-19 Has Changed the Future of Cancer Care Cancer researchers are studying the impact of the COVID-19 pandemic on cancer screening, diagnosis, treatment, and outcomes — and will continue to do so for years to come. We commend the concerted research effort that has led to rapid development of vaccines for COVID-19, and we also recognize how much remains to be done. The COVID-19 pandemic has disrupted everyday life for everyone. Some of that disruption includes changes to cancer care that will continue into the future: Telemedicine While video or phone appointments will never completely replace face-to-face clinic visits, both providers and patients have adapted positively to the use of telemedicine for care when appropriate. More patient participation Patients are now empowered to take an important role in their monitoring and reporting of symptoms, side effects, and adherence to treatment using patientcentered technology and applications. Increasingly, patients are engaging in shared decision-making with their healthcare providers. There are three questions you should ask to improve communication with your cancer care team: What is my main problem? What do I need to do? And why is it important for me to do this? Personal responsibility Research has found links between obesity and inactivity, and increased risk for several types of cancer. Avoiding tobacco use and getting recommended screenings have been shown to lead to better outcomes. Following a “prescription” for exercise and nutrition from your cancer care team is a personal commitment to health. Clinical trials The COVID-19 pandemic put U.S. healthcare disparities front and center. The same populations bearing a greater COVID burden are those also bearing disproportionate burden from cancer. Disparities in access to clinical trials persist. To advance cancer care in the future, cancer clinical trials must better serve populations most affected by the disease, and be available in the communities where people live and work. What will not change The dedication of multidisciplinary cancer care teams across the country who are providing quality care to patients with cancer. Together, all of us are the future of cancer care. Randall A. Oyer, M.D., President, Association of Community Cancer Centers

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Radiation Therapy Clinics Enhance Safety Measures to Continue Cancer Care Surveys find radiation therapy clinics responded with new safety measures and procedures to ensure patient access to cancer treatments. The COVID-19 pandemic did not diminish the need for high-quality cancer treatments, but it profoundly changed how doctors deliver care. To understand how the pandemic has affected cancer care, the American Society for Radiation Oncology (ASTRO) surveyed hundreds of doctors who oversee U.S. radiation therapy clinics. We found that radiation therapy — a treatment prescribed to more than half of people diagnosed with cancer — remained accessible throughout the pandemic. Despite facing challenges, radiation therapy clinics adapted in order to stay open and keep patient access to cancer treatment intact. Here’s how: New safety procedures The first essential step to staying open was quick, widespread adoption of procedures to protect patients and staff from infection. Our survey found the most common new safety procedures were social distancing, masking, and additional cleaning protocols. For example, nearly all practices required masks for staff and patients.

Many of the clinics also staggered patient appointments and used additional protective equipment, such as face shields and gown. New ways to connect People with cancer are at higher risk for contracting COVID-19 because the disease and treatment suppress the immune system. Recognizing this risk, more than 90 percent of radiation therapy clinics launched a new telemedicine program. One year into the pandemic, nearly all still use virtual visits for many patients, helping to prevent new infections without compromising cancer care. New boundaries Radiation therapy teams adopted new safety and treatment guidelines to keep clinics and staff safe, including policies to limit visitation and reduce unnecessary exposures. These enhanced safety protocols help patients feel more secure when they come in to receive care. As more vaccines are given, people can also feel more comfortable resuming their regular, essential cancer screenings. We will continue to see challenges emerge from this pandemic, and we will continue to adapt in order to ensure a safe environment for both patients and providers. n Daniel Wakefield, M.D., M.P.H., American Society for Radiation Oncology (ASTRO)

A Look at The Future of Targeted Therapy Innovations in clinical trials have enabled “precision medicine” to be used in an increasing number of cancer patients. During my medical training 15 years ago, the oncology paradigm was a onesize-fits-all approach for cancer. Chemotherapy drugs were given based on where the cancer originated, without any consideration of the vast molecular diversity of each patient’s cancer. Over the past decade, I have seen the development and application of broad molecular testing of cancers, through analysis of DNA, RNA, and proteins

to decode individual patient tumors. These tremendous improvements in categorizing and determining the driving forces in an individual’s cancer have coincided with the advancement of new categories of treatment for the millions of cancer patients that cannot be cured with surgery alone. “Precision medicine” targets molecular features in cancer cells that are not in normal cells and it is now a focus of drug development. Modernizing clinical trials To test precision medicines, the clinical trial system needed to be modern-

ized; the one-trial-for-one-drug-inone-disease model was inadequate. “Basket” and “umbrella” trial designs allow for multiple drugs to be tested simultaneously in multiple cancer types with unique molecular characteristics, such as DNA mutations, under one master protocol. The American Society of Clinical Oncology and the National Cancer Institute (NCI) have taken the lead with large trials (TAPUR and NCI-Match) that have enrolled thousands of cancer patients within the past five years. I have seen the effects firsthand. This year, I witnessed a man with

three prior surgeries and multiple types of chemotherapy respond for the last 14 months to a pill for a rare RET gene fusion in his colon cancer cells. Another man, whose life expectancy was six months in 2015, has been on three different drugs in the TAPUR trial and is thriving five years later. These experiences have heightened my gratitude for a new era in cancer care, one in which individualized treatment approaches are on the rise. n Timothy Cannon, M.D., Director, Molecular Tumor Board Program, Co-Director, Gastrointestinal Cancer Program, Inova Schar Cancer Institute

Compassionate, Collaborative Care Our commitment to your well-being, treatment and overall care is supported by leading-edge research and the newest advancements in cancer treatment and technologies. Inova Schar Cancer Institute has a network of locations across Northern Virginia and is nationally recognized for its cancer care, including safety, outcomes and an excellent patient experience. Our team of cancer experts will carefully plan and coordinate your care, and guide you to ensure you have the best possible experience – and the best outcome.

For more information, visit inova.org/cancer

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The spark.

The power. Your passion in ﬁghting cancer transforms precious sample into a spark of hope. Conﬁdence in your research gives you the power to impact the future of precision cancer care. Spark your power at explore.agilent.com/cancer-genomics For Research Use Only. Not for use in diagnostic procedures. © Agilent Technologies, Inc. 2021