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Basics
Whether you’re newly diagnosed
RUDORQJWHUP survivor, check out our Basics section on cancer treatment, how to manage side effects and more. cancerhealth.com/basics
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Trends in Treatment
A CANCER DIAGNOSIS INVARIABLY
sets off a stream of daunting questions and decisions. Foremost among them are those surrounding treatment options. Our spring 2025 issue unpacks treatment trends and spotlights a range of patient experiences.
Arizona middle school teacher
Teri Wight, featured on our cover, was diagnosed with a rare type of kidney cancer in 2014. Because much about her illness is unknown, she and her doctors couldn’t rely on well-established treatment protocols. Turn to page 18 for Wight’s story and the lessons she shares—they’re relevant for every type of cancer.
Medical oncologists, like Ibrahim Azar, MD, are well-versed in treatment. As the specialists coordinating your care, they’re what he calls the “quarterbacks” of the team. Get to know more LQRXU<RXU7HDPSURƓOHRQSDJH
A welcome shift in treatment has been the trend toward less aggressive surgery, radiation and medication regimens. This can result in fewer side effects and improved quality of life. Our science editor, Liz Highleyman, analyzes this paradigm shift in our feature on page 22.
What if it’s best not to treat your cancer at all? When Howard Wolinsky was diagnosed with prostate cancer in 2010, doctors said they could cure him by removing the gland, albeit with potentially harsh side effects. Wolinsky did his research and decided on a then-emerging modality called active surveillance, in which the cancer is monitored. Read his Voices essay on
page 10 to see how that turned out. A similar approach, called “watch and wait,” often applies to people with chronic lymphocytic leukemia, like Edward Ratner, MD. Eventually, Ratner did begin treatment, which he details in our Diary on page 12, including his “Rules for Success.” Turn to page 6 for our Care & Treatment column, which highlights new research on blood and breast cancers (presented at the ASH and SABCS conferences) and also includes a roundup of newly approved drugs.
)LQDOO\ƓOORXWRXU6XUYH\RQSDJH to share your treatment experiences.
We have made incredible strides in cancer research, thanks to the dedication of researchers, the courage of survivors, and the support of people like you. But the fight isn’t over. Today, more than ever, your commitment can fuel innovations that will save lives tomorrow. Together, we can pass on a future free from cancer.
Please visit StandUpToCancer.org/legacy to learn more about how you can leave a legacy of hope by supporting cancer research.
RISING CANCER CASES AMONG WOMEN
The American Cancer Society’s latest report also finds some “great news.”
Between 1991 and 2022, cancer deaths in the United States dropped 34% overall, according to the American Cancer Society’s Cancer Statistics, 2025. Researchers estimate that this year will see slightly more than 2 million new cancer diagnoses and 618,120 cancer deaths. Parsing the data, the report notes that cases are increasing among women and young adults. Additional highlights from the report include:
• Incidence rates among women ages 50 to 64 have surpassed those in men, and rates in women under 50 are now 82% higher than among their male counterparts, up from 51% in 2002.
• Lung cancer is now more common in women than in men among people younger than 65.
• Alarming inequalities in cancer mortality persist, notably for Native Americans and Black people.
• Mortality rates are increasing for oral, pancreatic and endometrial cancers as well as for liver
Sobering Facts
cancer among women.
• New diagnoses of colorectal cancer among men and women younger than 65 and cervical cancer among women ages 30 to 44 have also increased.
• Mortality rates have dropped by 70% for children and by 63% for adolescents since 1970, thanks to better treatment for leukemia.
• Cancer incidence among children 14 and younger declined in recent years after decades of increasing rates but continued to rise among adolescents ages 15 to 19.
“Continued reductions in cancer mortality because of drops in smoking, better treatment and earlier detection is certainly great news,” says Rebecca Siegel, MPH, a researcher at the American Cancer Society and lead author of the report. “However, this progress is tempered by rising incidence in young and middle-aged women, who are often the family caregivers, and a shifting cancer burden from men to women, hearkening back to the early 1900s.”
Alcohol consumption is the third leading preventable cause of cancer.
“Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States—greater than the DOFRKRODVVRFLDWHGWUDIƓF crash fatalities per year in the U.S.—yet the majority of Americans are unaware of this risk,” says Surgeon General Vivek Murthy, MD, who released an advisory in January to highlight the link between alcohol and cancer and recommend steps to lower these rates. The advisory
urges, for example, that health warning labels on alcohol containers be updated to include cancer risk.
Alcohol consumption—including wine and beer—is the third leading preventable cause of cancer in the United States, after tobacco use and obesity. It’s connected to at least seven types of cancer: breast, colorectal, esophagus, liver, mouth, throat and voice box (larynx). Slightly over 16% of breast cancer cases are linked to alcohol consumption. What’s more,
the risk for developing cancer can increase with as little as one drink per day. But this risk, the advisory notes, “is determined by a complex interaction of biological, environmental, social and economic factors.”
TEST FOR GENETIC RISK
Have your family members been diagnosed with cancer? Genetic testing can help assess your risk for inherited mutations. Guidelines by the National Comprehensive Cancer Network (NCCN) explain how patients can access these tests and why they should do so. Go to NCCN. org/patients to read and download Genetic Testing for Hereditary Breast, Ovarian, Pancreatic, and Prostate Cancers.
breast cancer, my sister and I sought genetic testing that revealed that all of us except my sister carried the BRCA2 mutation,” says Denise Portner, a breast cancer survivor and member of the NCCN Foundation board of directors, in a press statement.
What’s Your HPV IQ?
“After our mother and aunt were both diagnosed with
“Had I not known my genetic status, I would not have had the MRI screening that caught my breast cancer as early as it did. Genetic testing is a vital tool in enabling individuals to be proactive in their health care to achieve the best possible outcomes.”
WHITE HOUSE UPDATE
Since his inauguration, President Trump has issued numerous executive orders that address the funding and operations of federal health agencies, including the National Cancer Institute, the Food and Drug Administration and the Centers for Disease Control and Prevention. Many of Trump’s actions could impair clinical trials, federal grants and cancer research, but some were immediately rescinded. Health advocates and political leaders are trying to navigate this confusing landscape and preserve science-based national health programs and public data. For breaking news and treatment updates, visit CancerHealth.com.
If you’re aware of human papillomavirus (HPV), a common sexually transmitted infection that nearly 13 million Americans contract each year, then you likely associate it with risk for cervical cancer (see our Basics on page 17). But did you know the virus accounts for 70% of mouth and throat cancers, making it the most common type of HPV-related cancer? According to federal health data, each year about 35,000 people are diagnosed with a cancer caused by HPV. Cancer researchers at the University of Southern California’s Keck Medicine and Department of Otolaryngology found that most Americans are unaware of these facts.
“Knowledge is the ƓUVWVWHSWRZDUGGLVHDVH prevention,” notes USC head and neck surgeon Daniel Kwon, MD, who led the research. “The public is missing crucial information about the link between throat cancer and HPV as well as the fact that vaccines may prevent HPV-related throat cancer.”
WHAT’S NEW IN BLOOD CANCER TREATMENT?
The American Society of Hematology (ASH) annual meeting in December focused on advances in blood cancer care. For chronic lymphocytic leukemia (CLL), the most common type in adults, the 3KDVH,,,$03/,)<WULDOIRXQGWKDWDƓ[HGGXUDWLRQ combination of two pills—the BTK inhibitor Calquence (acalabrutinib) and the BCL-2 inhibitor 9HQFOH[WD YHQHWRFOD[ ŋOHGWRGXUDEOHUHPLVVLRQ and improved survival for patients without highrisk gene mutations. Further back in the pipeline, a ODERUDWRU\VWXG\VKRZHGWKDW9HQFOH[WDPD\ERRVW response to CAR-T immunotherapy by improving WKHƓWQHVVRI7FHOOVŏ7KLVFRXOGEHDQH[FLWLQJZD\ to repair the immune system in patients with CLL,” says Matthew Cortese, MD, MPH, of Roswell Park Comprehensive Cancer Center.
Another study found that among people with acute myeloid leukemia, those who live in ZIP codes with lower education and higher poverty levels were less likely to receive donor stem cell transplants, but patients who did get the proceGXUHZHUHHTXDOO\OLNHO\WREHQHƓWŏ:HQHHGWR IRFXVRQDGGUHVVLQJƓQDQFLDOEDUULHUVLPSURYLQJ health literacy and enhancing support systems to ensure equitable access to treatments,” says
Mohamed Sorror, MD, of Fred Hutch Cancer Center.
Treatment for people with precursor conditions known as monoclonal gammopathy of undeterPLQHGVLJQLƓFDQFHDQGVPROGHULQJPXOWLSOHP\HORma is controversial. Researchers at Dana-Farber Cancer Institute reported that a new scoring system based on genomic markers can help predict which RIWKHVHSDWLHQWVDUHPRUHOLNHO\WRH[SHULHQFH GLVHDVHSURJUHVVLRQDQGFRXOGEHQHƓWIURPHDUO\ treatment. Another small study showed that a SODQWEDVHGKLJKƓEHUGLHWPD\GHOD\SURJUHVVLRQ in people with these conditions.
In the Phase III AQUILA trial, people with smoldering multiple myeloma who received monthly 'DU]DOH[)DVSUR GDUDWXPXPDE LQMHFWLRQVIRUXS WRWKUHH\HDUVZHUHKDOIDVOLNHO\WRH[SHULHQFH progression as those randomized to active monitoring. Finally, the DREAMM-7 trial showed that Blenrep (belantamab mafodotin) demonstrated DVLJQLƓFDQWRYHUDOOVXUYLYDOEHQHƓWIRUUHODSVHG or refractory multiple myeloma compared with 'DU]DOH[DWWKUHH\HDUV7KLVDQWLERG\GUXJFRQMXgate previously lost its accelerated approval status DIWHUDIDLOHGFRQƓUPDWRU\WULDOEXWWKHVHQHZ results could pave the way for its reintroduction.
Piano Lessons May Relieve Chemo Brain
Learning to play the piano may help alleviate cognitive side effects associated with cancer chemotherapy, according to a small study. Many people undergoing treatment experience slow thinking, impaired concentration and memory lapses—commonly known as brain fog or chemo brain—due to the drugs themselves or side effects, such as fatigue, stress and poor sleep.
Researchers evaluated a piano
training protocol dubbed Keys to Staying Sharp in a pilot study of 15 people receiving treatment for breast cancer. The women attended once-weekly classes for nine weeks and were asked to practice at least a half hour daily. While both one-on-one and group lessons offered some EHQHƓWWKHJURXSOHVVRQV\LHOGHGVLJQLƓFDQWLPSURYHPHQWVLQ attention and cognition. What’s more, participants said learning
the piano was enjoyable and relaxing.
“Learning a challenging new activity, such as learning a musical instrument, can increase sensorimotor activity leading to strengthened neural pathways and enhanced cognition,” says Jennifer Bugos, PhD, of the University of South Florida.
ADVANCES IN BREAST CANCER
Studies presented at the San Antonio Breast Cancer Symposium (SABCS) in December highlight the importance of individualized treatment.
The Phase III PATINA trial showed that the CDK 4/6 inhibitor Ibrance (palbociclib) delayed progression of double-positive breast cancer when added WRVWDQGDUGƓUVWOLQHPDLQWHQDQFHWKHUDS\,EUDQFH ZDVƓUVWDSSURYHGLQIRUZRPHQZLWKORFDOO\ advanced or metastatic hormone receptor-positive/ +(5QHJDWLYHEUHDVWFDQFHUWKHPRVWFRPPRQ type. The new data show that it also works well for those with hormone receptor-positive/ +(5SRVLWLYHWXPRUVZKLFKDFFRXQWIRU DURXQGRIFDVHV,EUDQFHLPSURYHG SURJUHVVLRQIUHHVXUYLYDOE\DERXW months compared with a placebo.
Looking at people with inherited %5&$PXWDWLRQVORQJWHUPGDWDIURP the OlympiA study showed that Lynparza (olaparib) continues to offer a survival EHQHƓWDWVL[\HDUV3DWLHQWVZLWKHLWKHU HVWURJHQUHFHSWRUSRVLWLYH+(5 negative or triple-negative high-risk breast cancer who received the
3$53LQKLELWRUIRUD\HDUDIWHUVXUJHU\UDGLDWLRQ and chemotherapy had longer disease-free survival and overall survival compared with placebo recipiHQWV$IWHUDPHGLDQ\HDUVRIIROORZXS of Lynparza patients remained free of invasive UHFXUUHQFHFRPSDUHGZLWKRISODFHERUHFLSLHQWVDQGWKHULVNRIGHDWKZDVUHGXFHGE\ Gentler treatment was once again a theme at the FRQIHUHQFH VHHŏ:KHQ/HVV,V0RUHŐSDJH Improved screening has led to increased detection RIGXFWDOFDUFLQRPDLQVLWX '&,6 RUDEQRUPDOFHOOV in milk ducts with no evidence of invasive disease.
,QWKH3KDVH,,,&20(7WULDOZRPHQZLWK KRUPRQHUHFHSWRUSRVLWLYH+(5QHJDWLYH low-risk DCIS who were randomized to active monitoring had about the same likelihood of progression to invasive breast cancer as those who underwent immediate surgery. Another study adds to the HYLGHQFHWKDWVNLSSLQJD[LOODU\ DUPSLW surgery for sentinel lymph node biopsies did not increase the risk of breast cancer progression or compromise VXUYLYDORYHUƓYH\HDUVRIIROORZXS
CAN A THERAPEUTIC VACCINE HALT PROGRESSION TO CERVICAL CANCER?
While the Gardasil 9 vaccine prevents infection with nine types of human papillomavirus (HPV) that cause cancer or genital warts, an experimental treatment vaccine could halt disease progression in women who have already developed precancerous cervical lesions. Researchers in the Netherlands tested Vvax001, a therapeutic vaccine containing a weakened Semliki Forest virus that encodes the oncogenic E6 and E7 proteins from HPV type 16. In a Phase II trial, 18 patients with high-grade cervical intraepithelial neoplasia (CIN3) received three doses of the
vaccine given three weeks apart. Cervical biopsies taken up to 19 weeks after immunization showed that all but one had smaller lesions, six regressed to low-grade dysplasia and three had FRPSOHWHUHJUHVVLRQŏ,IFRQƓUPHGLQDODUJHU trial, our results could mean that at least half of the patients with CIN3 might be able to omit surgery and avoid all its possible side effects and FRPSOLFDWLRQVŐVD\V5HƓND Yigit, MD, of University Medical Centre Groningen.
DOES ASPIRIN IMPROVE COLON CANCER OUTCOMES?
Two recent studies add to the mixed evidence about the link between daily aspirin use and colorectal cancer (CRC), suggesting it may reduce the risk of recurrence and improve survival.
The ALASCCA trial, presented at the ASCO Gastrointestinal Cancers Symposium, assessed whether low-dose aspirin affects recurrence of CRC with PI3K genetic mutations. The Scandinavian study included 419 people with Stage II or III colon cancer and 207 with Stage I, II or III rectal cancer. They were randomly assigned to receive 160 milligrams of aspirin once daily or a placebo starting within three months after surgery and continuing for three years. Patients who took daily aspirin had a 55% lower risk of cancer recurrence and about a 45% improvement in disease-free survival.
“Aspirin checks all of the boxes: It’s effective, it’s low risk, it’s inexpensive and it’s easy to administer,” Pamela Kunz, MD, of Yale School of Medicine,
Now Approved
VDLGDWDFRQIHUHQFHPHGLDEULHƓQJ
In the second study, researchers evaluated aspirin for secondary prevention of CRC recurrence after treatment. The ASCOLT trial included 1,550 patients in 11 countries, mostly in Asia, with Stage II or III colon or rectal cancer. After undergoing surgery and at least three months of chemotherapy, they were randomized to receive 200 mg of aspirin daily or a placebo for three years.
$IWHUƓYH\HDUVRIIROORZXSGLVHDVHIUHHVXUYLYDO rates were 77% in the aspirin group and 75% in the placebo group. Five-year overall survival rates were 91% and 89%, respectively. Neither difference UHDFKHGWKHWKUHVKROGIRUVWDWLVWLFDOVLJQLƓFDQFH 'DLO\DVSLULQŏZDVZHOOWROHUDWHGEXWGLGQRWVLJQLƓcantly improve disease-free survival,” John Chia, MBBS, of National Cancer Centre Singapore, and colleagues concluded. They added, however, that DPRUHPRGHVWEHQHƓWŏFRXOGQRWEHH[FOXGHGŐ
Here are the latest new cancer drugs approved by the Food and Drug Administration:
• Aucatzyl (obecabtagene autoleucel), a new CAR-T therapy for acute lymphoblastic leukemia
• Bizengri (zenocutuzumab)DELVSHFLƓFDQWLbody for lung cancer and pancreatic cancer
• Datroway (datopotamab deruxtecan), an antibody-drug conjugate for HER2-negative metastatic breast cancer
• Enhertu (fam-trastuzumab deruxtecan), an antibody-drug conjugate for HER2-ultralow metastatic breast cancer
• Ensacove (ensartinib), a targeted therapy for ALK-positive non-small-cell lung cancer
• Itovebi (inavolisib), a PI3K-pathway inhibitor for metastatic breast cancer
• Opdivo Qvantig, an injectable formulation of the PD-1 checkpoint inhibitor nivolumab
• Revuforj (revumenib)WKHƓUVWPHQLQLQKLELWRU for relapsed or refractory acute leukemia
• Unloxcyt (cosibelimab), a PD-L1 checkpoint inhibitor for cutaneous squamous cell carcinoma
• Vyloy (zolbetuximab), a claudin 18.2 monoclonal antibody, for HER2-negative stomach cancer
• Ziihera (zanidatamab), a ELVSHFLƓFDQWLERG\IRU+(5 positive biliary tract cancer
Still Dancing
Before his brain cancer diagnosis, Adam Hayden used to dance all the time. He hasn’t stopped.
I USED TO DANCE.
I still do. I dance over the dishes, with the dishes, in front of the dishes. I dance with the scrub brush, and I dance with the Dawn Powerwash. I dance by the dog. I dance by the raggedy shoes kicked off in a rush. I dance to the music that I love. I dance to new music I don’t like as much. I dance to the concerts in my memories, and I dance with my friends, sweaty, drinks in hand, dim lights interrupted by bright strobes, getting bumped by strangers and paying cover fees. All in my memory, all at the sink. Dinner prep and dishes are my daily dance times.
I dance to the youngest, home from soccer practice, and I dance to the second dinner I made because Noah only eats chicken nuggets. I dance to Whitney asking me what’s on. “This isn’t even music. Is he singing? Is that singing?” I dance to decibels that compete with Fortnite
or Minecraft or FIFA23.
“Is a game on?!” “No, Dad, it’s just FIFA.”
I danced in the hospital, when one whole leg didn’t work and an arm wasn’t much better, earbuds in, turned too loud, long after visitor hours, waiting for the 4 a.m. vitals check. Trying to get that leg to move and that left foot to tap, trying WRJHWP\OHIWƓQJHUV to fret the imaginary guitar.
I play my music loud, and I embarrass the house. I’m sure the neighbors see me.
“I danced when a leg didn’t work.”
I dance with the kids, and I dance without them. I dance in front of them. Because I may not get to sit them down and show them albums when they get old enough to appreciate them, but they’ll ƓQGP\$SSOH0XVLF playlists, and they’ll remember them from the kitchen. One day, an old friend will come around long after I’m gone and tell my boys,
“Your dad and I used to go to shows,” and they’ll see me, in their mind’s eye, dancing at the sink.
I’ll dance at my funeral, well, probably not, but you will (celebration of
life, amirite?). Either way, I’ll dance till I’m dead. Some of y’all may dance on my grave, but I’ll be dancing beneath it.
I used to dance. I still do. Do you? Q
Adam Hayden is a philosopher of science, a champion of the humanities in medical education, an advocate for palliative care and a person living with brain cancer (glioblastoma). He lives in Indianapolis with his wife and three sons.
Deciding Not to Treat My Cancer
Active surveillance spares men with low-risk prostate cancer, like me, from aggressive treatment and its side effects.
IN SPRING 2010, I WAS 63 AND UNDERGOING A PHYSICAL EXAM. 0\LQWHUQLVWRUGHUHGDSURVWDWHVSHFLƓFDQWLJHQ 36$ EORRGWHVWD PHDVXUHRIDSURWHLQSURGXFHGE\WKHSURVWDWH7KHPDOHVH[JODQG LVDERXWWKHVL]HRIDZDOQXWRUVPDOOOHPRQDQGLVORFDWHGEHORZWKH EODGGHU$PRQJRWKHUIXQFWLRQVLWSURGXFHVOLTXLGLQVHPHQIRUVSHUP +LJKHUOHYHOVRI36$ŋWKHWKUHVKROGLVQDQRJUDPVSHUPLOOLOLWHU QJP/ ŋFDQLQGLFDWHDQHQODUJHGSURVWDWHRUSRVVLEO\SURVWDWH FDQFHUWKHVHFRQGPRVWFRPPRQFDQFHULQPHQ DIWHUVNLQFDQFHU DQGWKHVHFRQGPRVWGHDGO\FDQFHU DIWHUOXQJFDQFHU LQ$PHULFDQ PHQ%LRSVLHVFDQGLDJQRVHRUUXOHRXWFDQFHU
$36$WHVWFDQWULJJHUDFDVFDGHRIHYHQWVOHDGLQJWRDSURVWDWH FDQFHUGLDJQRVLVDQGDJJUHVVLYHWUHDWPHQWZLWKVLGHHIIHFWVWKDW can land you in adult diapers and render you impotent.
FHOOVWRGHWHUPLQHZKHWKHUFDQFHU ZDVSUHVHQW LIVRLWVDJJUHVVLYHQHVVZRXOGEHUDQNHGXVLQJWKH *OHDVRQVFRUHZKLFKUDQJHV from 2 to 10. Gleason scores of DQGDERYHLQGLFDWHFDQFHU
,ZDVQōWZDUQHGWKDWWKLVW\SH RIELRSV\ZKLFKSDVVHVDQHHGOH WKURXJKWKHJHUP\UHFWXP could cause sepsis that could EHGLVDEOLQJDQGGHDGO\ 1RUZHJLDQUHVHDUFKHUV HVWLPDWHWKDWHDFK\HDU $PHULFDQPHQGLHRIELRSV\ caused sepsis. European uroloJLVWVSUHIHUWKHVDIHUWUDQVSHULQHDO ELRSV\WKDWSDVVHVWKURXJKWKH JHUPIUHHSHULQHXPVLWXDWHG EHWZHHQWKHDQXVDQGWKHWHVWLFOHV 7KHHYHQLQJRI'HFHPEHU WKHXURORJLVWFDOOHGPH DWKRPHDQGDQQRXQFHGŏ0U :ROLQVN\\RXKDYHFDQFHUŐ+H VDLGZHQHHGHGWRPHHWWR JRRYHUUHVXOWVDQGSODQWKH QH[WVWHSV
7KHXURORJLVWEURXJKWP\ZLIH -XGLDQGPHLQWRDURRPDQG SOD\HGD'9'RQZKLFKKHGLG WKHYRLFHRYHUGHVFULELQJYDULRXV RSWLRQV FU\RWKHUDS\ZKLFK XVHVFROGWRGHVWUR\FDQFHUFHOOV UDGLFDOSURVWDWHFWRP\WRUHPRYH WKHSURVWDWH DQGUDGLDWLRQWKHUDS\7UHDWPHQWKDGULVNVLQFOXGLQJ temporary or permanent incontinence and erectile dysfunction. /DWHUWKHGRFWRUVDLGKHKDG
“good news”—he could “cure” my cancer by removing the gland. He didn’t tell me, as I discovered later, that I had low-risk Gleason 6 prostate cancer, which really was the good news. (Gleason 6 is now called the less scary Grade Group 1; the most aggressive cancer is GG 5.)
I did my research before deciding whether to have surgery. I had heard about a young urologist at the University of Chicago, Scott Eggener, MD, who had started a new program for men like me to follow an emerging approach known as active surveillance (AS) in which patients are monitored closely via PSA tests, biopsies, digital rectal exams and the newly introduced multiparametric MRI prostate scans. I asked urologist no. 1 about AS. He told me: “I don’t support that modality,” which was typical for 2010. (He supports it now.)
Eggener said the other urologist could indeed cure me but warned of the side effects. In my mid-60s, I found them unacceptable. Eggener called me “the poster boy for AS.”
Eggener shared with me a study by Laurence Klotz, MD, of the University of Toronto, one of the developers of AS, which found that the death rate for men with Gleason 6 prostate cancer was the same whether they went on active surveillance, had surgery or did radiation therapy. I thought, Why have surgery or radiation, if I can get the same results with active surveillance and potentially live the rest of my life untreated? The decision was one of the fastest I ever made,
though I understand that many men cannot stand the thought of living with even a “wimpy” cancer.
Eggener predicted that my low-risk prostate cancer wouldn’t grow in 10 years. In fact, the cancer hasn’t been seen in four subsequent biopsies.
Klotz proposes that my immune system vanquished the cancer. And yet, I still am tagged as a prostate cancer patient because most experts think the cancer is lurking in my prostate.
I have not had an MRI, now FRQVLGHUHGDƓUVWVWHSEHIRUH sticking men with needles for a
WHY HAVE SURGERY IF I CAN LIVE UNTREATED?
biopsy, since 2016. Rather, I’ve EHHQRQDGHLQWHQVLƓHGYHUVLRQ of AS known as watchful waiting— I call it AS lite. If my PSA level increases, I will have an MRI or, after that, a transperineal biopsy, if needed.
When I went on AS in 2010, only 6% to 10% of American men with Gleason 6 chose this approach. Today, 60% go on AS, according to the American Urological Association. That’s a big jump, but it means that 40% of men are still undergoing aggressive treatment, compared with fewer than 5% of comparable men in the United Kingdom and Sweden. Here’s a tip for men diagnosed
with prostate cancer: Get a second or third expert opinion of the biopsy results—which are wrong 20% of the time.
During my 14 years on AS, care has changed dramatically. MRIs play a growing role in helping about half of men like me avoid biopsies, unnecessary cancer diagnoses and surveillance.
Newer biomarker tests, such as Stockholm 3, MyProstateScore 2.0 and IsoPSA, can produce similar results. The ArteraAI Prostate Cancer Test, approved in 2024, XVHVDUWLƓFLDOLQWHOOLJHQFHDQDO\VLV of biopsy images to reduce the need for biopsies by 60%.
Genetic testing is becoming more common to help set the course for treatment. And digital rectal exams, which many men ƓQGXQFRPIRUWDEOHDUHEHLQJ phased out because of the MRI.
Looking at the future of low-risk prostate cancer, I see fewer men being diagnosed, which can lead WRHPRWLRQDOGLVWUHVVDQGƓQDQFLDO toxicity—such as denial of life insurance—and fewer men going on active surveillance, which itself is stressful for many. Q
Edward Ratner, 68, a geriatrician, husband, father and grandfather in Minneapolis, has had chronic lymphocytic leukemia for a decade.
2015
I am a physician with expertise in internal medicine, geriatrics and palliative care. My wife and I live in Minneapolis, and we have two daughters, now grown, and two grandchildren. I have generally been healthy, but one morning in January, I woke up with a fast heartbeat, so I saw my primary doctor, who found there was no cardiac problem. But my blood smear showed smudge cells, a hallmark of chronic lymphocytic leukemia—CLL. Like most people diagnosed with CLL, I had no symptoms to suggest cancer. Despite quickly catching up on the medical facts about CLL, I was very upset.
I found an oncologist at the Mayo Clinic [in Rochester, Minnesota] who specializes in CLL. Initial blood tests suggested a less than 20% chance that I would need treatment in the next ƓYH\HDUVDQGPD\EHQHYHU'HVSLWHWKDW,KDGD
lot of anxiety. I knew I wouldn’t die of this immediately, but I thought now I knew what I would die of. I told only two people—my wife and a friend. I didn’t tell my nearly adult children, my siblings or my mother. I knew my siblings would want to tell my mother, and I didn’t want to trouble her. Sharing a CLL diagnosis can lead to uncomfortable advice and questions, especially about delaying treatment. I did seek support from a psychotherapist who, over a few sessions, helped me process my feelings.
At the time, the only nonexperimental initial treatment for CLL was a challenging chemotherapybased regimen, but new drugs were on the horizon. To physically prepare for eventual treatment, I took up jogging, although I never enjoyed it.
2016
I got on the mailing list of the CLL Society, a patient
advocacy and education organization founded by a doctor with CLL, Brian Koffman. In February, I had some enlarged lymph nodes and in August, a mildly low platelet count.
Ed Ratner advocates for the CLL Society and veterans.
1HLWKHUZDVVLJQLƓFDQWEXWLIDQ\WKLQJJRHV awry, you worry whether it’s related to the CLL.
2017–2018
The CLL Society solicited facilitators, so I volunteered to start a support group in Minneapolis in November 2017. Just meeting people who’d had CLL longer than me and were doing well was the most reassuring thing. You can look at statistics, but putting a face on it is much more helpful.
2019–2020
I’ve had heartburn, and I was diagnosed with Barrett’s esophagus, which is precancerous. So I take a heartburn medicine to keep stomach acid from irritating the lining of the esophagus, which reduces my risk. In the big picture of health, this is background noise. Due to COVID-19, our local monthly support group moved online, opening it up to people from around the state and beyond.
2021
Dr. Koffman told me that physicians with CLL were contacting him from around the world. I volunteered to facilitate a new international monthly Zoom support group just for physicians. We talk more about the latest science than our problems
it would help with the cough. Research has shown little risk in holding off treatment for a few weeks or in taking less than the full dose, if necessary.
March 2023
I developed a norovirus infection, which caused diarrhea. If I wasn’t being treated for cancer, I might not have even called my doctor, but I went to urgent care and followed up with specialists, out of fear that the diarrhea would become long-lasting and disabling. Fortunately, I recovered within a few weeks.
December 2023
I completed treatment. My cough wasn’t as bad but persisted. Rather than a big celebration, I chose to enjoy every day in better health.
March 2024
ED RATNER’S RULES FOR SUCCESS
• As soon as you’re diagnosed, get information and emotional support from disease organizations.
• Consider whom to share your diagnosis with and how.
• Practice self-care, including exercise and a healthy diet.
• Get recommended vaccines and cancer screenings.
• Report all symptoms to your oncology team.
• See other specialists as necessary.
•3ODQIRUWUHDWPHQWLQFOXGLQJƓQDQFLDOO\ months before it is needed.
• Advocate to make your medical care as convenient as possible.
• Work with your insurer to identify a covered specialty pharmacy.
• Give back—volunteer, donate.
• Celebrate success.
Given my employment with the Veterans Administration and a higher rate of CLL among veterans, I advocated for a CLL Society support group for veterans. I co-facilitate it with a veteran who has CLL. Now I’m facilitating three groups a month.
April 2024
,ƓQDOO\ZHQWWRDSXOPRQRORJLVWIRUP\FRXJK
He diagnosed me with asthma and prescribed an inhaler. It works pretty well. It’s a good lesson— VLJQLƓFDQWQHZV\PSWRPVZKLOHEHLQJWUHDWHGIRU cancer deserve a workup and possible treatment.
Go see the right specialist! My message to anyone diagnosed with CLL? This is very unlikely to kill you. We have enough treatments now that it’s manageable, like many chronic diseases. But it’s a complex disease, and there’s isn’t a quick, simple or inexpensive Ɠ[7KHLPPXQHV\VWHP affects so much in your body that there are a lot of potential complications. So CLL becomes integrated into many aspects of your life. You should seek the support of professionals, family, friends, support groups.
June—November 2024
Life goes on. But then in June, my wife got sick, and we spent the last six months dealing with her illness. She was my caregiver, going with me to nearly all my appointments, providing empathy and emotional support. Now I was her caregiver. I’ve been through illness on three sides—as a doctor, as a patient and as a caregiver. 1RZVKHōVƓQLVKHG with treatment.
December 2024— January 2025
I’m great; my wife is great—it’s like a reset button. We had a big trip to the Alps planned for last September that we had to cancel, but we’ve rebooked it for April. It’s something to look forward to. We’re both healthy again. It’s like starting over.
IF YOU HAVE CLL, LET CALQUENCE
fighting.
AND YOU CAN FOCUS ON THE THINGS YOU’RE LOVING.
To learn more, visit CALQUENCE.com or scan the QR code with your phone’s
Important Product Information
CALQUENCE is a prescription oral treatment for adults with chronic lymphocytic leukemia or small lymphocytic lymphoma. Can cause serious side effects including: serious infections, bleeding problems, decrease in blood cell count, new cancers, heart rhythm problems, and liver problems. Some may lead to GHDWK7HOO\RXUGRFWRULI\RXH[SHULHQFHLQIHFWLRQVVXFKDVŴXOLNHV\PSWRPV XQH[SHFWHGEOHHGLQJVXFK DVEORRGLQ\RXUVWRRORUXULQH KHDUWUK\WKPSUREOHPVVXFKDVIDVWRULUUHJXODUKHDUWEHDW RUOLYHUSUREOHPV such as stomach pain, dark urine or yellowing of your skin. Use sun protection when outside.
Please read Brief Summary of Prescribing Information on adjacent page. You are encouraged to report the negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088
• CALQUENCE is a prescription medicine used to treat adults with: chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). It is not known if CALQUENCE is safe and effective in children.
Before taking CALQUENCE, tell your healthcare provider about all of your medical conditions, including if you:
• have had recent surgery or plan to have surgery. Your healthcare provider may stop CALQUENCE for any planned medical, surgical, or dental procedure.
• have bleeding problems.
• have or had heart rhythm problems.
• have an infection.
• have or had liver problems, including hepatitis B virus (HBV) infection.
• are pregnant or plan to become pregnant. CALQUENCE may harm your unborn baby and cause problems during childbirth (dystocia).
° If you are able to become pregnant, your healthcare provider may do a pregnancy test before you start treatment with CALQUENCE.
° Females who are able to become pregnant should use effective birth control (contraception) during treatment with CALQUENCE and for 1 week after the last dose of CALQUENCE.
• are breastfeeding or plan to breastfeed. It is not known if CALQUENCE passes into your breast milk. Do not breastfeed during treatment with CALQUENCE and for 2 weeks after your last dose of CALQUENCE.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking CALQUENCE with certain other medications may affect how CALQUENCE works and can cause side effects. Especially tell your healthcare provider if you take a blood thinner medicine.
How should I take CALQUENCE?
• Take CALQUENCE exactly as your healthcare provider tells you to take it.
• Do not change your dose or stop taking CALQUENCE unless your healthcare provider tells you to.
• Your healthcare provider may tell you to decrease your dose, temporarily stop, or completely stop taking CALQUENCE if you develop certain side effects.
• Do not switch (interchange) your CALQUENCE tablets with CALQUENCE capsules.
• Take CALQUENCE 2 times a day (about 12 hours apart).
• Take CALQUENCE with or without food.
• Swallow CALQUENCE tablets whole with a glass of water. Do not chew, crush, dissolve, or cut tablets.
• If you miss a dose of CALQUENCE, take it as soon as you remember. If it is more than 3 hours past your usual dosing time, skip the missed dose and take your next dose of CALQUENCE at your regularly scheduled time. Do not take an extra dose to make up for a missed dose.
What are the possible side effects of CALQUENCE?
CALQUENCE can cause serious side effects, including:
• Serious infections have happened in people treated with CALQUENCE and may lead to death. Your healthcare provider may prescribe certain medicines if you have an increased risk of getting infections. Tell your healthcare provider right away if you have any signs or symptoms of an infection, including fever, chills, or flu-like symptoms.
• Bleeding problems (hemorrhage) have happened in people treated with CALQUENCE and can be serious and may lead to death. Your risk of bleeding may increase if you are also taking a blood thinner medicine. Tell your healthcare provider if you have any signs or symptoms of bleeding, including: blood in your stools or black stools (looks like tar), pink or brown urine, unexpected bleeding, or bleeding that is severe or you cannot control, vomit blood or vomit that looks like coffee grounds, cough up blood or blood clots, dizziness, weakness, confusion, changes in your speech, headache that lasts a long time, or bruising or red or purple skin marks.
• Decrease in blood cell counts. Decreased blood counts (white blood cells, platelets, and red blood cells) are common with CALQUENCE, but can also be severe. Your healthcare provider should do blood tests to check your blood counts regularly during treatment with CALQUENCE.
• Second primary cancers. New cancers have happened in people during treatment with CALQUENCE, including cancers of the skin or other organs. Your healthcare provider will check you for skin cancers during treatment with CALQUENCE. Use sun protection when you are outside in sunlight.
• Heart rhythm problems (cardiac arrhythmias) have happened in people treated with CALQUENCE, and can be serious or lead to death. Tell your healthcare provider if you have any of the following signs or symptoms: fast or irregular heartbeat, dizziness,
feeling faint, chest discomfort, or shortness of breath.
• Liver problems. Liver problems have happened in people treated with CALQUENCE, and can be severe or life-threatening, or lead to death. Contact your healthcare provider if you experience stomach pain or discomfort, urine of dark color or yellowing of your skin. Your healthcare provider will request tests to monitor your liver function during treatment with CALQUENCE.
The most common side effects of CALQUENCE include: diarrhea, upper respiratory infection, headache, muscle and joint pain, lower respiratory infection, and tiredness.
These are not all of the possible side effects of CALQUENCE. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store CALQUENCE?
• Store CALQUENCE at room temperature between 68°F to 77°F (20°C to 25°C).
Keep CALQUENCE and all medicines out of the reach of children.
General information about the safe and effective use of CALQUENCE.
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use CALQUENCE for a condition for which it was not prescribed. Do not give CALQUENCE to other people, even if they have the same symptoms you have. It may harm them. You can ask your healthcare provider or pharmacist for more information about CALQUENCE that is written for health professionals.
Please see full Prescribing Information, including Patient Information.
more information, go to www.CALQUENCE.com or call 1-800-236-9933.
Gynecologic Cancers
Endometrial cancer, uterine sarcoma and cervical cancer have different causes and treatments.
GYNECOLOGIC CANCERS
are malignancies that affect the female reproductive system. Three main types of cancer originate in the uterus, or womb. The most common, endometrial cancer, starts in the endometrium, the inner lining of the uterus that thickens, breaks down and sheds as part of the menstrual cycle. Uterine sarcoma, which begins in the muscular wall of the organ or supporting tissues, is rare. Cervical cancer starts in the cervix, the lower part of the uterus leading to the vagina. Ovarian cancer arises in the ovaries, which produce eggs; cancer may also start in the Fallopian tubes, which carry eggs to the uterus.
Endometrial and ovarian cancer usually occur after menopause. Greater exposure to estrogen— for example, due to early menstruation, late menopause, having few or no pregnancies, obesity or use of estrogen-only hormone replacement therapy— is associated with higher risk for both malignancies. The causes of uterine sarcoma are not well understood, but genetic factors and radiation for other cancers raise the risk. Women with inherited BRCA gene mutations are more prone to ovarian cancer as well as breast cancer.
Endometrial cancer typically causes symptoms, such as unusual vaginal bleeding, so it is often found at an early stage,
when it can more easily be treated or even cured. Uterine sarcoma is harder to detect, more aggressive and harder to treat.
Ovarian cancer can cause symptoms, such as abdominal pain and bloating, but it is usually asymptomatic at early stages, meaning it is often diagnosed
ODWHDQGGLIƓFXOWWRWUHDW7KHUH are no routine screening tests for endometrial cancer, uterine sarcoma or ovarian cancer.
Although it also originates in part of the uterus, cervical cancer is a different type of malignancy altogether. It is usually caused by human papillomavirus (HPV), a sexually transmitted infection that can also cause vaginal, vulvar and anal cancers. The virus triggers abnormal precancerous cell growth (known as dysplasia, cervical intraepithelial neoplasia or squamous intraepithelial lesions), which can progress to invasive cancer. Most people with HPV infection don’t develop
cancer, but progression is more likely in those with compromised immunity (for example, due to untreated HIV).
Regular cervical cancer screening with HPV tests and Pap smears is recommended for women ages 21 to 65. Precancerous cell changes can be managed to prevent disease progression, but once invasive cancer develops, it’s more GLIƓFXOWWRWUHDW)RUWXQDWHO\DQ effective vaccine (Gardasil 9) can prevent HPV infection and its complications.
Treatment for gynecologic cancers may involve surgery, radiation, endocrine therapy (hormone-blocking medications), traditional chemotherapy and newer targeted therapies, antibody-drug conjugates and immunotherapies. In many cases, combination therapy produces the best response, but this can also lead to more side effects. In younger women, surgery, radiation and certain medications can cause temporary or permanent infertility, but fertility preservation (for example, egg freezing) may be possible.
A gynecologic oncologist can explain available approaches EDVHGRQ\RXUVSHFLƓFW\SHRI cancer, how advanced it is and your overall health. Treatment has improved over the years, and new medications are always being tested. Ask your doctor if a clinical trial might be an option. Q
UTERUS
OVARY
CERVIX
FALLOPIAN TUBES
ENDOMETRIUM
VAGINA
OVARY
An uncommon type of kidney cancer has given Scottsdale, Arizona, teacher Teri Wight new insights on life and hope.
BY JENNIFER COOK PHOTOGRAPHY BY STEVE CRAFT
WHEN TERI WIGHT, 51, OF SCOTTSDALE, ARIZONA, MADE AN APPOINTMENT
to see her doctor in October 2014, she had no idea she was about to journey into uncharted medical territory. e middle school Spanish teacher and mom of two wanted to nd out why her menstrual cycle was irregular—maybe perimenopause? e doctor recommended a follow-up ultrasound, which Wight had shortly before anksgiving. “I thought it was going to be something in my uterus,” she says. Instead, it was a 10-centimeter (3.9-inch) mass growing on one of her kidneys.
e doctor who broke the news to Wight was reassuring, telling her the growth appeared to be encapsulated within the kidney. “So he was very positive that, if it were to be cancerous, that it hadn’t spread,” she says. “And he said, ‘You know, I tell you it’s suspicious for cancer. Even if it is, on the ‘holy s--t’ factor, it’s probably about a six or a seven out of 10 just because of the procedure you’re going to have to go through.’”
Wight and her husband met with a urological surgeon in mid-December, and on Christmas Eve, she was wheeled into surgery to have her right kidney removed. Internal bleeding led to an emergency surgery almost immediately
afterward followed by a two-day ICU stay, but she was able to make it home by December 31 to toast the new year with her family.
e pathology report pointed to chromophobe renal cell cancer (chRCC), an extremely rare malignancy. At the time, she was told, only 60 other people in the United States had the same type of cancer, which a ects about 5% of people diagnosed with kidney cancer. Not much was known about it, except that “it doesn’t grow very quickly—most of the time. And it doesn’t metastasize—most of the time,”
Teri Wight had to accept that much about her type of cancer was unknown.
Wight says. Indeed, only 5% of cases become metastatic. e post-surgery protocol called for having blood tests for kidney and liver function, an MRI of the abdomen with contrast and a chest X-ray every three months for two years, then every six months for another two years and then yearly. Wight was told there were no drugs to take because so little was known about the cancer. “I found that to be disappointing, but also, like, phew, thank goodness,” she says.
In seven short weeks, she had gone from being healthy to having a cancerous mass removed along with her kidney to being a cancer survivor. Now, she had to try to settle back into her regular routines of teaching and caring for her son and daughter, given that her doctors assured her that her cancer was unlikely to return.
KIDNEY CANCER ON THE MOVE
For nearly ve years, Wight’s scans were clear and she remained cancer-free. But in December 2019, at the ve-year mark, she had another MRI, and on her health portal she read the report that every cancer patient dreads. It noted suspicious lesions in her liver. “I was crushed,” she recalls. “ e ve-year mark in cancer is pretty huge. Well, every year is pretty huge, but ve especially. You’re like, I’m probably going to be one of those where it’s not ever going to metastasize; I can put this away. But it showed up.”
A follow-up PET scan in January 2020 was negative. Wight went to see an oncologist who declined to put her on drugs, given their severe side e ects, her age and that they likely wouldn’t be e ective against chRCC. e tiny spot was still there, unchanged, on an MRI in March. But in June, another MRI revealed that the spot had grown, which required another surgery to remove it. is was at the height of the coronavirus pandemic, when the only people in the hospital were COVID-19, cancer and heart patients. “My husband literally dropped me o at the entrance and said, ‘I’ll see you in ve days,’” she says.
ACCEPTING HELP FROM OTHERS IS NOT A SIGN OF WEAKNESS.
A biopsy con rmed that Wight had metastatic chRCC. In September 2023, a second recurrence, next to the rst spot, was cryoablated, or frozen away, in a procedure done by an interventional radiologist. Two months later, a third lesion was discovered and was removed laparoscopically in March 2024. In between the second and third recurrences, Wight started systemic therapy, with infusions of immunotherapy combined with an oral medication. She consulted a second oncologist who has treated chromophobe patients at MD Anderson Cancer Center in Houston. is one recommended a di erent drug combination—one he thought would be more e ective—and Wight subsequently switched to two di erent oral medications. Her scans have been clear while she’s been on these new drugs.
HARD-WON LESSONS
Having cancer is always challenging; having a rare cancer can be next-level challenging because so much about the disease is mysterious and unknown. For Wight, that meant living on a roller coaster while being told repeatedly, at di erent stages of her illness, to enjoy her survivorship because her cancer was unlikely to return. And yet it did.
One of the hardest truths she has had to accept is that there’s no guarantee that chRCC will be slow-growing or that it won’t metastasize. A second is that “there’s no treatment protocol, really, for what I have,” Wight says. “It’s just, throw stu at it and guess.” Because of its rarity, there’s a lack of tumor tissue for research. And drug trials for clear-cell renal cell cancer, the most common type of kidney cancer, tend to exclude those with rarer cancers because their genetic pro les are di erent. “We know that a lot of the clear-cell drugs aren’t as e ective for chromophobe,” she says.
Despite the many frustrations and disappointments, Wight has learned lessons that have helped her cope successfully with her illness and that she hopes might help others deal with their cancer.
You must advocate for yourself. “Early on, what really helped me was facing [my disease],” Wight says. “I’m a question-and-answer person. I like to know the facts.” It’s important “to research on your own and also just talk openly and honestly with your medical team.” If they don’t have the answers to your questions, ask them to look into it. “Or maybe you need to ask a di erent person until you nd the right team that works well with you, your personality and also your disease,” she says.
Connect with the cancer community. Privacy is important—you may not want to talk about your cancer with other people if you have nished treatment and you’re returning to your life’s usual rhythms. But Wight is thankful that she is now connected with others who have kidney cancer and wishes she had reached out earlier, when she was rst having recurrences and going through metastatic disease— or even further back, when she was diagnosed. “Within the last 18 months, I’ve found these organizations, like the Kidney Cancer Association (KCA). It is doing great work to connect, provide information, lobby and get funds for kidney cancer research,” she says. Something she appreciates now is learning how other people who have Stage IV kidney cancer manage their symptoms.
Address your stress. “I’m a type A, 100% perfectionist type of person,” Wight says. “But is that really what we need to be doing in life?
TALKING TO YOUR KIDS ABOUT CANCER
When parents with cancer have to tell their kids about the situation, “I think you have to be honest and as positive as you can be,” Wight says. Her kids were young when she was diagnosed, and therefore they didn’t understand that much about serious illness. So she simply told them, “Yep, I have cancer. A lot of people do. They took it all out of me. So I am recovering now, cancer-free, and it’s going to be hard for a while as I recover. But I’ll keep following up. And if something comes up, we’ll just take care of it.” With older kids (including her own as they’ve grown up), though “you can’t hide what you’re going through from them. They have to know—and why you’re doing all these [treatments].”
The best way to frame it, she believes, is: “I’m doing all these things, and I’m going through all this so that I can be with you.”
Maybe I don’t need that stress.” Try looking at the areas in your life that you can control to see what you might change. What can you cut out? What do you not have to do? In your circle of friends, are there people who aren’t working as hard as you to maintain those friendships? If so, consider letting them go so you can keep close the people you know you can depend on. “When you go through this disease, you really get to see what’s important in life and what you should focus on.”
Let your family and friends support you. Having cancer is more than a physical burden; it’s an emotional one too. e people who love you can help carry that burden with you. As Wight wrote in a blog post on the KCA website, “I am a ercely independent woman. Having cancer, however, has taught me that accepting help from others is not a sign of weakness or dependence; it’s necessary to my survival.”
Negative results on health portals can have a silver lining. While Wight acknowledges that it can feel awful to read your scary test results before getting a doctor’s interpretation of them, she also thinks it can be helpful motivation to prepare for a follow-up appointment. “When I see that kind of stu , I’ll research and write down all the things that I want to ask my doctor,” she says. Just be sure to stick to the “dot-orgs” when searching online in order to access the most trusted, research-
based medical information.
Cancer is hard, even when you have a “good” cancer. Some cancers have been labeled “good” because they’re supposed to be more treatable and have better survival rates, especially when found early. “I don’t like to hear that I have the ‘good’ kind of cancer,” Wight says. “Because no cancer is good.” No one who hasn’t had cancer or walked through it with someone close to them can really understand what it’s like, she says, “because even on the days when I feel better and good, I still think of it all day long.” Nonetheless, she is very grateful for the eight years that she didn’t have to take a single drug.
ere are always reasons to be hopeful. When Wight was rst diagnosed, she feared that she might never get to see her kids, ages 8 and 10 at the time, graduate from high school. Now, her daughter is in college, studying Spanish like her mom did, and her son will graduate from high school in the spring. As for the outlook regarding chRCC, things change every day in the medical eld. More research is underway, and there’s hope that clinical trials for chRCC drugs may be in the works in the next few years. “I feel really positive, even now. I’ve gotten 10 more years out of all of this, so that’s good,” Wight says. “I don’t really think that if I get a recurrence again, I’m going to die tomorrow. I know there’ll be something to do about it.” Q
Less aggressive surgery,
gentler
radiation and new medications can reduce treatment side effects and improve quality of life.
BY LIZ HIGHLEYMAN
THE “SLASH, BURN AND POISON” approach to cancer treatment—invasive surgery, powerful radiation and toxic chemotherapy—is getting a rethink. When a person is diagnosed with cancer, the rst impulse may be to do everything possible. If cancer is a war, why not use all available weapons? But a growing body of evidence shows that more is not necessarily better.
e de-escalation trend is perhaps best illustrated by breast cancer. In the late 1800s, doctors started doing radical mastectomies that involved removal of the entire breast, underarm lymph nodes and chest wall muscles. A century later, breast-conserving surgery (such as lumpectomy) became the standard of care. Clinicians learned that rather than removing dozens of armpit lymph nodes—which can lead to swelling, pain and reduced mobility—sentinel lymph node biopsy can often su ce; indeed, new research suggests that even this may not always be necessary. In the 1990s, many women with advanced breast cancer received very high doses of chemotherapy,
followed by a transplant of their own stem cells, but it turned out that this arduous procedure did not improve survival.
Today, thanks to a better understanding of cancer biology, new types of treatment and an emphasis on quality of life, oncology is moving away from “one size ts all” approaches and toward more tailored care and collaborative decision-making.
IS IT REALLY CANCER?
Increased screening has led to diagnosis of more cancers at early stages but also detection of abnormal lesions or growths that never would have progressed. As a result, patients may receive unneeded treatment that does not reduce mortality. As part of the paradigm shift, experts are reconsidering what should count as cancer.
For example, ductal carcinoma in situ (DCIS)—sometimes called Stage 0 breast cancer—refers to abnormal cells in milk ducts with no evidence of invasive disease. Standard treatment traditionally involves breast-conserving
surgery, sometimes followed by radiation and hormone therapy, but this may not be necessary.
e COMET trial randomly assigned nearly 1,000 women with low-risk DCIS to immediate surgery or active monitoring with regular follow-up scans. e study showed that the likelihood of progression to invasive cancer was statistically similar in both groups. What’s more, women in both groups reported comparable anxiety and quality of life.
“Current practice may result in the overtreatment of women whose tumors are at low risk of progression, leading to chronic pain, altered body image, reduced quality of life and other side e ects that may be avoidable,” says lead investigator Shelley Hwang, MD, of Duke Cancer Institute. “ ese early results from our study give us reassurance that active monitoring is safe in the short term and that the cancers that are diagnosed during active monitoring are detected at an early stage.” If these results hold up, most patients with low-risk DCIS could avoid invasive treatment, she added. “ at would be a complete change in how we care for these patients and think about this disease.”
screening and low-grade thyroid tumors as precancer. Laura Esserman, MD, of the University of California San Francisco Breast Care Center, and others have proposed the term “indolent lesion of epithelial origin,” or IDLE.
Yet for some people, prompt treatment can bring peace of mind, even if it might not be necessary. To reduce the uncertainty, researchers are working to nd better biomarkers to identify which abnormalities are likely to progress and which will probably remain harmless.
EVOLVING APPROACHES
In many cases, cancer does progress and requires treatment, but here, too, the landscape has changed. Novel surgery and radiation techniques o er a gentler approach, while new types of medications and dosing regimens provide more options.
ACTIVE MONITORING IS SAFE IN THE SHORT TERM.
Turning to prostate cancer, experts have gone back and forth on the bene ts of prostate-speci c antigen (PSA) screening because test results don’t give a clear answer about how to proceed. Until about a decade ago, most men diagnosed with early prostate cancer in the United States opted for surgery or radiation, which can cause long-term side e ects, such as urinary incontinence and sexual dysfunction. Today, the treatment landscape has changed: Around 60% of U.S. men with Grade Group 1 malignancy opt for active surveillance, which involves frequent monitoring with blood tests, scans and sometimes biopsies. One of them, veteran journalist Howard Wolinsky, did his research and learned that for men with low-risk prostate cancer, the survival rate is about the same for those who undergo immediate surgery or radiation and those who go on active surveillance (see “Deciding Not to Treat My Cancer,” page 10).
Some experts prefer to think of DCIS, Grade Group 1 prostate tumors, early nodules detected during lung cancer
During laparoscopic surgery, the surgeon inserts a tiny camera and instruments through small incisions in the chest or abdomen rather than making a large open incision. Robotic assistance can provide greater precision and control. is minimally invasive approach results in less pain and scarring and shorter recovery times.
It was once common practice to remove entire organs to eliminate residual malignancy, but this can lead to loss of function, resulting, for example, in the need for a urostomy bag after bladder removal. Alternative approaches—such as removing only the tumor or avoiding surgery and instead treating with medications or starting active monitoring—can improve quality of life with similar survival outcomes.
Radiation therapy has also evolved. Proton therapy enables more precise targeting than traditional X-rays, meaning less collateral damage to surrounding tissues. Brachytherapy uses small radioactive seeds to deliver radiation directly to a tumor. Delivering higher doses of radiation all at once or over a few sessions (known as hypofractionated radiation therapy), rather than divided doses over multiple sessions, can work equally well and allows patients to spend less time in the clinic.
Shelley Hwang
Traditional cytotoxic chemotherapy does a good job killing rapidly dividing cancer cells, but it also damages healthy ones, leading to side e ects, such as nausea, hair loss, neuropathy and blood cell de ciencies.
Now, new types of medication have been added to the armamentarium, including targeted therapies that disable cells with speci c characteristics, antibody-drug conjugates that carry toxic drugs directly to tumors and checkpoint inhibitor immunotherapy that helps the immune system ght cancer. While these drugs can also cause side e ects, they a ect a narrower range of healthy cells.
Historically, chemotherapy clinical trials have tested maximum tolerated doses—the most a patient could take without unacceptable toxicity. But new medications and a greater emphasis on quality of life have changed this way of thinking. e Food and Drug Administration (FDA) launched Project Optimus to reform the dose selection paradigm, and in 2023, the agency issued draft guidance for drug companies on how to determine the best doses for new therapies.
“Patients may use targeted drugs for months or years, which increases the importance of evaluating long-term tolerability,” Richard Pazdur, MD, of the FDA’s Oncology Center of Excellence, and colleagues wrote in e New England Journal of Medicine.
“ e answer to the doseselection conundrum may sometimes be that less is more.”
used all three types of treatment. In some cases, starting immunotherapy up front can shrink tumors enough that patients can forgo surgery and radiation altogether.
But “less is more” doesn’t always apply. Some aggressive cancers need the full gamut of treatment as soon as possible. And even as some treatments get easier, there’s a parallel trend toward more complex options, such as CAR-T therapies and personalized cancer vaccines that must be custom-made for each patient.
PATIENTS MAY USE TARGETED DRUGS FOR MONTHS OR YEARS.
Rather than employing the entire arsenal of surgery, radiation and medication as a matter of course, better knowledge about cancer biology and appreciation of patients’ individual risk factors and preferences allows for more tailored treatment.
In the TAILORx trial, for example, a tumor genomic pro le test was used to predict the risk of breast cancer recurrence. e study found that a majority of women with medium-risk hormone receptor-positive/HER2negative breast cancer could safely skip chemotherapy after surgery. Other studies of esophageal and rectal cancers found that patients who underwent surgery and chemotherapy without radiation survived as long as those who
People who require less intensive cancer treatment may experience fewer side e ects and have a lower likelihood of lost organ function, infertility and disability. What’s more, gentler treatment may be more convenient and less time-consuming—for example, if patients spend less time hooked up to an IV at an infusion center. In some cases, less intensive treatment can also be cost-saving. But the latest precision surgery and radiation techniques may be more expensive, and new targeted therapy and immunotherapy medications are typically much pricier than old chemotherapy drugs that have gone o patent.
Cancer was once viewed as a near-certain death sentence, but in many cases, it can now be treated as a chronic manageable illness. Cancer may stabilize indefinitely, or it may progress unexpectedly. Some people would prefer to do everything possible to vanquish the disease, while others would rather do less now and monitor more over time. Everyone’s situation is di erent, so individualized treatment is key.
Some gentler cancer treatment approaches are not yet incorporated into standard-of-care guidelines and may be unfamiliar to some clinicians. Doctors and patients alike may feel anxious about choosing less intensive treatment, and de-escalation can sound like “giving up.” With so many options now on the table, it’s important to develop a collaborative relationship with health care providers who will help you make the best decisions given your personal needs and preferences. Q
Richard Pazdur
The Write Cancer Treatment
Author and breast cancer survivor Emily Rubin teaches writing workshops for folks dealing with the illness. She believes cancer can make you a good storyteller.
EMILY RUBIN HAD JUST FINISHED WORKING ON
her debut novel, Stalina, when she was diagnosed with breast cancer in 2008. She completed treatment in 2010, and the book—about a Russian immigrant who comes to the United States after the fall of the Soviet Union—was published to acclaim in 2011.
Also in 2011, she launched the Write Treatment Workshops for cancer patients, survivors and caregivers. Today, she runs six Zoom workshops a month for Mount Sinai New York City’s cancer centers and several four-week workshops and single workshops for the New York Oncology Hematology Community Cancer Foundation, which supports people in upstate New York. Many of the resulting works have been compiled and published in The Write Treatment Anthology Volume 1: 2011–2016 and Volume 2: The Pandemic Years (book VDOHVEHQHƓWWKHZRUNVKRSVZKLFKDUHIUHHWRSDUWLFLSDQWV
“I started the Write Treatment Workshops because I realized that cancer would always be a part of who I am,” Rubin says, “and through writing, I was able to address some of the anxiety and fear that comes from always wondering if I have to face having cancer again.”
We wanted to learn more about the curative effects of writing, so we reached out to Rubin, 68, who lives in Copake, in New York state’s Hudson Valley, for the latest installment of our Can Heal column—the empowering phrase “Can Heal” is right there in our title. Our interview has been edited for clarity and length.
First off, can you summarize your cancer journey and give us an update?
I had noticed a lump in my left breast that protruded enough to cast a shadow. One day, it was there! I went for a mammogram and ultrasound and a needle biopsy. Very quickly, I was diagnosed with Stage II breast cancer—not hormonal.
7KHƓUVWFRXUVHRIWUHDWPHQWZDVVXUJHU\ZKLFKLQYROYHG a lumpectomy and the removal of eight lymph nodes. This
Emily Rubin; anthologies by cancer patients in her workshops
was followed by chemotherapy and then radiation. I am currently cancer-free. I am very vigilant about self-exams, mammograms and ultrasounds, so I recently had to have something suspicious tested by needle biopsy. Fortunately, it was negative.
You completed a novel before your diagnosis. Did your writing habit change during treatment?
During treatment, I did not write very much. I kept a journal and made entries that were short, sometimes just a word, a sentence or a sketch. I wrote in a notebook, rather than on the computer. I used the computer for the business of dealing with doctors and insurance. Writing by hand—the direct connection
between my thoughts and the page—was very personal and intimate.
The range of thoughts was a roller coaster, but there were often moments of lightness and humor— always a help. I was often thinking about the seasons changing as I went through treatment. One entry was about being so happy when the red-winged blackbirds returned, signaling that winter was coming to an end. Having these thoughts recorded, as spotty as they were, along with photos, my wig DQGOHWWHUVIURPZHOOZLVKHUV,WKLQNKDYHLQŴXenced my writing, storytelling and teaching to this day. It was useful to see what I noticed each day and what I was curious to explore. Making those observations and collecting them has always been a part of my daily writing life.
Aside from your journal and \RXUFDUHWHDPZKDWVSHFLƓF habit or item helped you heal along your journey?
One of the more frustrating WLPHVIRUPHZDVJRLQJƓYH days a week for radiation treatment. The hospital was down to only one radiation table, so the wait time for treatment was long. I would often get there at DPZKHQWKH\ƓUVWWXUQHG on the machines, so I could then get to work. I got some meditation CDs—sounds of the rainforest mixed with jingling bells, soothing deep and airy vocals, all edited into hourlong compositions. It was a bit woo-woo otherworldly, but I needed a break from the stress of all the waiting and getting through treatment. When I was done, I celebrated with friends!
participants writing prompts to be worked on before we meet. We spend some time catching up and offering support for anyone going through a GLIƓFXOWWLPHZLWKWUHDWPHQWRURWKHUOLIHFKDOOHQJHV We all read our work and offer observational and supportive feedback. The prompts are rarely cancer-focused. Although people write about their cancer journeys, they more often write about childhood experiences, travel, relationships, etc. ,HQFRXUDJHSHRSOHWRZULWHƓFWLRQSRHWU\SOD\V and memoirs. All literary forms are welcome.
CANCER GIVES US MANY OF THE THINGS IT TAKES TO
BE A GOOD WRITER.
The goal of the workshops is to take the leap of faith to write a story with no worry about whether it is good or perfect. In fact, I embrace the messiQHVVRIDƓUVWGUDIW$IWHUWKDW,WU\WREULQJWKH writers through the process of rewriting. I make it clear that they have complete control. They are the author and, therefore, have complete authority. This is important for people going through treatment or in recovery. There were times when I felt that I had lost control of what was happening to my body. Writing was the time and place where I could take complete control. It’s about turning what’s inside outside and vice versa.
Do you think cancer can enhance one’s storytelling abilities?
Tell us more about your writing workshops. :KHQ,ƓUVWVWDUWHG,EURXJKWSURPSWVWRLQVSLUH our writing time. Grunts, sighs, tears and laughter were heard in the room as we wrote. After the timed writing, everyone shared what they had written. Now, we’re meeting on Zoom. I hold two surprise prompt workshops every month. For the [separate] workshop I hold weekly, I send the
I always tell new participants that going through cancer gives us many of the things it takes to be a good writer. You are vulnerable, faced with difƓFXOWFKRLFHVUHTXLUHGWRƓQGHPSDWK\IRU\RXUVHOI DQGRWKHUVDQGPXVWEHVWURQJLQWKHIDFHRIGLIƓFXOW challenges, including thoughts about mortality. Listening to others’ stories is an act of empathy, and learning that is very important to the process. All these elements make for good writing. Q
Emily Rubin just completed her second novel, Solo Girl, based on her experiences as an urban homesteader renovating a building in New York City’s East Village during the 1980s. Learn more about her work at EmilyRubin.net.
Meet a Medical Oncologist
Ibrahim Azar, MD, is a medical oncologist and hematologist oncologist at Trinity Health IHA Medical Group in Pontiac, Michigan.
How do medical oncologists contribute to a patient’s cancer journey?
In general, there are three types of oncologists. There are surgical oncologists, who take out cancer by doing surgery. There are radiation oncologists, who usually use beams to get rid of cancer. And then there are medical oncologists. We usually use pills and intravenous treatPHQWVWRKHOSƓJKWFDQFHU
Traditionally, we’ve used chemotherapy, but we also use hormonal therapy, immunotherapy and targeted therapy. As we’ve made a lot of recent progress in cancer, we now have a lot more tools and a lot more options for our patients.
Traditionally, we’ve also been
sort of the quarterback of the team, so we coordinate the care. We’re usually the ones ordering the scans and blood draws, and we also monitor for all the potential side effects of the drugs that we give our patients. We also are usually the ones who have goals of care discussions with our patients, letting them know about prognosis and so on.
At what point in a patient’s cancer journey will they start to interact with the medical oncologist?
that whatever we’re giving them is being given safely and is effective.
A lot of people dread the word chemotherapy. Have the medications evolved? We’re making constant progress. The number of new drugs DSSURYHGLQWKHODVWƓYHWR years is really tremendous. Every month that I look, there is a new drug approved that has improved people’s lives or has helped them live longer. The other good news is that we now have a lot more experience with using the same chemotherapy drugs from 30 or 40 years ago so that our patients don’t experience bad side effects. We know much better how to control nausea and diarrhea, and we’re always looking for ways to make our drugs safer. We’ve had very good improvements in almost all of the cancer types.
What inspires you in your work?
We’re the quarterback of the care team, says Ibrahim Azar.
Sometimes, I will be sent patients before they know that they have cancer. They may have a spot on a CT scan that hasn’t been biopsied yet, and we guide them to what the next step is. And sometimes, patients see me after the biopsy or after the surgery has already been done and the surgeon told them that they have cancer. Other times— for example, in cases like prostate cancer—they may have a urologist who has been treating their prostate cancer. And when it comes time to give chemotherapy or medications that the urologist is not familiar with administering, then they will see me. Typically, we see our patients most frequently when they’re receiving treatment [so we can] make sure
I am inspired every day by the strength and courage of my patients as they go through their cancer journey. I got into this because when I started med school, my mother was diagnosed with breast cancer. I was on the other side of this, and I know what she went through to be in remission. That’s what led me to choose oncology. Q
Who’s on your team?
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7(67,&8/$5&$1&(5'(9(/236:+(1&(//6,17+( testes—the male gonads that produce hormones and sperm— grow out of control. Although rare, this type of cancer is most common in men between ages 15 and 35. What’s more, the incidence has been increasing for several decades. Thankfully, testicular cancer is highly treatable, especially when caught early. Visit these sites for information on self-exams, symptoms such as a lump or swelling, treatments, support groups and more.
$%ƚƥƥƬƲ6ƞƧƬƞƨƟ7ƮƦƨƫ aballsysenseoftumor.com
When Justin Birckbichler was diagnosed with testicular cancer in 2016, he began blogging about his experiences, sharing easy-to-understand information, interviews and more. Last year, he went from being “the Uniballer” to “the Girl Dad” and is devoting time to fatherhood. But his blog posts can still be found at CancerHealth.com.
$ƦƞƫƢƜƚƧ&ƚƧƜƞƫ6ƨƜƢƞƭƲ cancer.org
The American Cancer Society offers a wealth of information about testicular cancer—from prevention to diagnosis to treatment—via articles, quizzes, videos and diagrams. Visit its online Cancer Statistics Center for updates on current research, survival rates and latest statistics.
&ƞƧƭƞƫƬƟƨƫ'ƢƬƞƚƬƞ&ƨƧƭƫƨƥ
cdc.gov
Although there is no standard screening test for testicular cancer, early detection is crucial for long-term survival. The CDC
Discover more resources: cancerhealth.com/resources
offers up-to-date information on self-exams, monitoring health and testicular cancer symptoms.
1ƚƭƢƨƧƚƥ&ƚƧƜƞƫ,ƧƬƭƢƭƮƭƞ cancer.gov
This government site is an excellent source of information on testicular cancer treatment, clinical trials and current research. The site also features in-depth information on risk factors, coping with a diagnosis, prevention and treatment for childhood testicular cancer.
1ƮƭƬŻ%ƨƥƭƬ nutsandbolts.movember.com
This online resource center offers informative articles and videos about testicular cancer treatment and its common side effects, fertility, sex during and after cancer, testimonials from survivors and more.
7ƞƬƭƢƜƮƥƚƫ&ƚƧƜƞƫ
testicularcancerawarenessfoundation.org
TCAF raises awareness about testicular cancer through educational programs, support groups
and research studies. Its website empowers patients with current resources on risk factors, medication management, testicular implants and more.
TCS, which has won awards for its awareness campaigns, offers materials on diagnosis, patient QDYLJDWLRQƓQDQFLDOVXSSRUW options and more. Its mobile app, Ball Checker, provides current facts about testicular cancer and teaches users how to perform a testicular self-exam.
7ƞƬƭƢƜƮƥƚƫ&ƚƧƜƞƫ)ƨƮƧƝƚƭƢƨƧ testicularcancer.org
This organization provides compassionate support to men affected by testicular cancer. TCF’s site offers early detection initiatives, educational guides, weekly survivor and patient support meetings and even yoga classes (via Zoom). TCF has also collaborated with the Charlotte, 1RUWK&DUROLQDQRQSURƓW6DYH a Nut to spearhead the Cojone Club, a network for survivors of testicular cancer.
Word of Mouth
Cancer treatment often causes unique—but treatable— oral problems. Your health care team and dentist can help.
CHEMOTHERAPY, TARGETED MEDICATIONS AND RADIATION work by killing fast-growing cancer cells. But these lifesaving treatments can also directly harm healthy cells in the mouth, glands and bones, especially among people with head and neck cancers. What’s more, these treatments often cause oral side effects, such as pain; dry mouth; burning, peeling or swelling of the tongue; infections; and changes LQWDVWHŋDOORIZKLFKFDQPDNHLWGLIƓFXOWWRHDWWDONRUVZDOORZ&DQFHUWUHDWPHQWVPD\DOVRZRUVHQ existing oral and dental problems, including cavities, loose crowns and gum disease. However, you can address these common downsides in a number of ways.
1. Before starting treatment, visit your dentist. Dealing with existing issues, such as a broken tooth or cavities, helps lower the chance of complications during cancer WUHDWPHQW&RQVLGHUDGGLQJDQ oncology dentist to your care team. These specialists provide dental care to patients with cancer and can work with others on your care team to help prevent, monitor and manage treatmentrelated oral complications. If you already started treatment before seeing a dentist, then schedule a visit with one as soon as possible.
2. Step up your oral hygiene during cancer treatment. This will decrease the risk of complications. &KHFN\RXUPRXWKGDLO\IRUDQ\ problems, such as sores or dry
mouth. Use an extra-soft toothbrush to clean your teeth, tongue and gums after each meal and at bedtime. If brushing hurts, then soak your brush in warm water beforehand. Use a ŴXRULGHWRRWKSDVWHDQGDOFRKRO free mouthwash, and gently ŴRVVGDLO\DYRLGLQJVRUHVDQG bleeding areas. Rinsing with a solution of a quarter teaspoon of salt or 1 teaspoon of baking soda in one cup of warm water can help soothe pain. And don’t forget about your lips: Keep them moisturized.
3. Choose foods carefully, and eat slowly. Opt for nutritious foods that are soft, moist and easy to chew and swallow. (Think scrambled eggs, mashed potatoes, cooked cereals, yogurt and foods softened with gravy or broth.) Be sure to take small bites, chew your food slowly and sip liquids throughout your meals. Avoid potentially irritating foods, such as sharp-
edged chips, citrus fruits and juices, soda, alcoholic drinks and sugary candy. Also avoid using toothpicks and skip all tobacco products. If your mouth is dry, sip water, chew sugarless gum or ice chips, suck on sugarfree candy or lozenges or ask your doctor to recommend an over-the-counter saliva substitute.
4. Speak up, and don’t suffer in silence. Inform your health care team of any oral problems you experience. Providers can help ƓQGWKHPRVWHIIHFWLYHPHGLcines to manage oral pain, dry PRXWKGLIƓFXOW\VZDOORZLQJ changes in taste and more. These issues can be more than painful inconveniences. They can trigger malnutrition, dehydration and other complications.
Finally, here’s news to make you smile: Most oral side effects improve when cancer treatment ends. Q
NURTURE AND REVITALIZE
Feel better with self-care essentials, including a weighted pillow and nutritious home-cooked meal packages.
When Marti Wymer’s mother was diagnosed with cancer, she sent her mom the next best thing to a hug: a cozy bowl of soup and tasty desserts. Spoonful of Comfort continues to honor the memory of Wymer’s mother by sending handcrafted meal packages to those who may not be able to prep meals. The Thinking of You Package (starting at $99.99) is sure to satisfy with a full meal of soup, rolls, soft cookies and a keepsake ladle. Looking for something less savory? The Thinking of You Cookie Package (starting at $44.99) includes one or two dozen baked treats and a personalized card.
After losing her husband to cancer, author Stacy Ryan wrote a three-part series about navigating grief, her own cancer
GLDJQRVLVDQGVORZO\ƓQGLQJ herself again. Ryan’s Whole New Life books ($6.99, Kindle; $16.99, paperback; free, Audible with trial) detail the pivotal moments in her life that empowered her to beat breast cancer, cope with her husband’s death and live life to the fullest. The books are available in paperback, eBook and audiobook (narrated by Ryan). Also worth checking out is Ryan’s podcast, Whole New Life, on which she candidly discusses her grief and UHŴHFWVRQOLIHōV ups and downs.
Natural Life’s inspirational self-care gifts soothe while giving back to charitable causes. For a loved one with cancer, the warm hug of the Cozy Weighted Pillow ($35) featuring faux fur can alleviate stress and anxiety during or after treatment. Natural Life also offers playful kitchen tools, stationery, home decor, clothing and more.
Launched by two friends supporting each other while they underwent cancer treatment, My Care Crew sells custom apparel and accessories and personalized journals. Its Chemo Countdown: Ring-A-Ding-Ding Sweatshirt ($39) will help make chemo a little more bearable, while the empowering quotes and thoughtful prompts of the Courage in Every Step Journal ($12) will inspire courage and distract from life’s worries.
Whether you’re shopping for someone with cancer or a caregiver, Dear Ava’s unique jewelry and gift boxes deliver joy and strengthen bonds. The Cancer Compass Necklace Gift Box Set ($30), for example, reminds loved ones that they are not alone and deserve self-care. The set includes a lavender candle, two bath bombs, a gold compass necklace, a greeting card, an engraved wood heart and more.
TREATMENT TIME
It can often be challenging to understand your options and make decisions about treatment after receiving a cancer diagnosis. Take our survey below and let Cancer Health know your thoughts about starting cancer treatment.
What type(s) of cancer do you have?
Are you currently receiving cancer treatment?
TYes TNo
:KLFKIDFWRUVLQŴXHQFHG\RXUGHFLVLRQRQ when to start treatment? (Check all that apply.)
TDoctor’s recommendation
TType or stage of cancer
TAvailable treatment options
TPersonal health status
TEmotional readiness
TFamily/friends
TFinancial considerations
TOther ___________________________
Did your doctor discuss different treatment options with you?
TYes TNo
Did you get a second opinion about your treatment options?
TYes TNo
$UH\RXVDWLVƓHGZLWKWKHLQIRUPDWLRQ provided about your cancer treatment options?
TYes TNo
How soon after your diagnosis did you start treatment?
TWithin a week
TWithin a month
TWithin a year
TI have not started cancer treatment.
Do you feel like you had enough time to consider your treatment options?
TYes TNo
How important is your input in the decision on when to start treatment?
TVery important
TSomewhat important
TNot important
What year were you born?
What is your gender?
TMale TFemale
TTransgender TOther
What is your current level of education?
TSome high school THigh school graduate
TSome college TBachelor’s degree or higher
What is your annual income?
TLess than $15,000 T$15,000–$34,999
T$35,000–$49,999 T$50,000–$74,999
T$75,000–$99,999 T$100,000 or more
What is your ethnicity? (Check all that apply.)
TAmerican Indian/Alaska Native
TArab/Middle Eastern TAsian
TBlack/African American THispanic/Latino
T1DWLYH+DZDLLDQ3DFLƓF,VODQGHUTWhite
TOther ___________________________
What is your ZIP code?
Scan this QR code with your smartphone to take this survey at cancerhealth.com/surveys. Or email a photo of your completed survey to website@cancerhealth.com.
THE PROBLEM WITH CANCER RESEARCH THAT FOLLOWS CONVENTIONAL WISDOM IS THAT THERE’S NOTHING CONVENTIONAL ABOUT CANCER.
At the Damon Runyon Cancer Research Foundation, our research focus is singular: High-risk, high-reward. We believe that only by pursuing and investing in the most audacious and ambitious ideas, and the young scientists who have those ideas, will we achieve real and lasting victory over humankind’s deadliest enemy. To learn more, visit damonrunyon.org
