2013healthcareguide

2013 HEALTH CARE GUIDE Century mark American Cancer Society turns 100 years old — find highlights, resources and more inside

Eat this Consumption of healthy fats might prolong lives of prostate cancer patients

Comparative research Research method has potential to change health care

Remember this A supplement of Suburban Newspapers Inc. July 31, 2013

Research shows that cancer treatments and therapies are linked to memory problems

Cancer and the brain Treatments and therapies are linked to memory problems This study is unusual because its subjects are women who have definitively not undergone hormone therapy, thus making it easier to determine what therapy is contributing to the complaints. ctw

health care guide

By Rachel Graf

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CTW Features

ost-treatment, early-stage breast cancer patients report higher complaints about their memory and their higher-level cognition than do women who have not undergone treatment, according to an April 2013 study by researchers at the University of California, Los Angeles.

The study is one of the first to demonstrate that patients’ self-reported memory complaints are backed by objective test results.

“In the past, many researchers said that we can’t rely on patients’ self-reported complaints or that they are just depressed, because previous studies could not find this association between neuropsychological testing and cognitive complaints,” said Patricia Ganz, director of cancer prevention and control research at UCLA’s Jonsson Comprehensive Cancer Center. “In this study, we were able to look at specific components of the cognitive complaints and found they were associated with relevant neuropsychological function test abnormalities.”

The researchers’ subjects were 189 breast cancer patients with an average age of 52. The patients had

completed the initial cancer treatments but had not yet undergone hormone-replacement therapy.

These patients completed a self-report questionnaire about cognitive abilities. Generally, women with breast cancer reported higher complaints regarding memory than the control group of healthy women about the same age who do not have breast cancer. About 23 percent of the women with breast cancer reported greater complaints about memory and about 19 percent of these women reported greater complaints about higher-level cognition and problem-solving ability. Women who had undergone both chemotherapy and radiation were especially likely to report memory problems compared to women who had undergone only chemotherapy or only radiation.

“The statistical modeling that was done shows that it was a combination that was associated with the complaints,” Ganz said.

Neuropsychological testing that was also conducted supports the results of these self-report questionnaires.

Patients who reported even subtle memory changes showed significant differences in neuropsychological testing

The women completed about two hours of standardized tests that included many questionnaires. For example, the women may have been asked to read a story without any further initial instruction. About 15 minutes later, the testers would ask these women what details they could recall from the story. Women who had undergone therapy performed worse than those who had not.

Most other studies that have examined chemotherapy and cognitive problems have looked at patients who have undergone chemotherapy but might have undergone hormone therapy as well, Ganz said. This study is unusual because its subjects are women who have definitively not undergone hormone therapy, thus making it easier to determine what therapy is contributing to the complaints.

These results are part of a larger study that aims to determine the effects of hormone therapy on cognitive ability of breast cancer patients.

“As we provide additional reports on the follow-up testing in these women, we will track their recovery from treatment, as well as determine whether hormone therapy contributes to worsening complaints over time,” Ganz said.

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American Cancer Society sets goals for the next century

By Tom Knox

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SUBURBAN NEWSPAPERS INC.

ouldn’t it be nice if the American Cancer Society were out of business?

That the organization was so successful in reaching its goal of ridding the world of cancer that there was simply no reason for its existence any longer?

That is the goal in the next 100 years for the organization, which turned 100 this year.

“Our goal is to finish the fight in the next 100 years. We believe we can do it,” said Brian Ortner, regional communications director with the American Cancer Society.

The American Cancer Society, founded in 1913, has launched a new national campaign with hopes to do just that.

Maybe you have seen the commercials featuring celebrities such as singer Mary J. Blige and others.

From a regional office near Westroads Mall, the organization serves cancer patients in Sarpy County and the greater Omaha metro area with several programs and support services.

One such service includes Road to Recovery. Volunteers will provide a ride to and from appointments for cancer patients.

“They’ll come to your house, pick you up, take your to your treatment center and then pick you up and return you home,” Ortner said.

A help line is available 24/7 for cancer-related questions, concerns and needs; 800-227-2345.

The phones are answered by trained cancer information specialists who can help with transportation questions, financial or insurance matters and more.

The organization’s website, cancer.org, is available for help in finding information and local and national resources. metro c r e at i v e C O N N E C TIO N

1 0 0 y ears O LD resources and programs Look Good, Feel Better: A free program that teaches beauty techniques to women in active treatment to help them combat the appearance-related side effects of cancer treatment. Look Good? Feel Better sessions are held monthly and are facilitated by volunteer cosmetologists trained by the American Cancer Society. Informational Booklets are also available for men and teens.

Visit www.lookgoodfeelbetter.org.

Reach to Recovery: A program that provides support and information to anyone facing breast cancer through one-on-one contact with trained American Cancer Society volunteers, who are themselves, breast cancer survivors.

Personal Health Manager (PHM): PHMs are provided to health care professionals to be distributed to newly diagnosed patients. The PHM is a kit where patients can keep information including their appointments, treatment information, test results, questions to ask, medications, resource information, insurance and bills, and follow-up care information.

Guest Room: Rooms are provided free of charge for individuals receiving outpatient treatment for cancer at local motels/hotels which have a signed contract to participate in the program.

(Patients must live at least 50 miles from treatment.)

Road to Recovery: American Cancer Society volunteer drivers provide cancer patients transportation to and from their scheduled medical appointments.

Wig Banks: Wig banks are located across Nebraska, including at the American Cancer Society Office, to provide free wigs, turbans, hats and accessories to cancer patients.

Cancer Educational materials and Information: The American Cancer Society provides resources, information, and guidance for all cancer-related needs. Educational materials are available to patients free of charge. See Educational Materials List for details.

Circle of Sharing: A way to find cancer information and resources online, and safely share information with friends and loved ones. Visit www.cancer.org/ CircleofSharing for more information.

Patient Service Center: This service is available 24/7 for all cancer related needs. Patient navigation is available to help guide patients and families to find answers, resources, and tools that can help. This service is provided by trained cancer information specialists.

Common topics include: information, transportation, financial or insurance related questions and more.

If you have questions about American Cancer Society programs or services, please contact the local office at: 402393-5801 or the national call center 800-227-2345.

Omaha Office: 9850 Nicholas St., Suite 200, Omaha, NE 68114. www.cancer.org Source: American Cancer Society

HIGHLIGHTS 1913 — Fifteen physicians and businessmen in New York City create the American Society for the Control of Cancer, later renamed the American Cancer Society.

1946 — Philanthropist Mary Lasker and colleagues raise more than $4 million for the Society, $1 million was used to establish research programs.

1947 — The first successful chemotherapy treatment was discovered, producing remission in childhood luekemia.

1954 — Publishes a study confirming the link between smoking and lung cancer.

1959 — Cancer Prevention Study - 1 is launched.

1969 — Reach to Recovery program is launched, with trained breast cancer survivors offering hope and help to women facing a new diagnosis.

1971 — The organization helps lead passage of the National Cancer Act. 1976 — The Geat American Smoke Out is born with an event in California.

1982 — CPS-2 begins.

1985 — Relay for Life is launched when Dr. Gordy Klatt raised $27,000 by walking and running around a track for 24 hours.

1995 — Cancer.org is launched.

1997 — Mortality rate of cancer falls 1.6 percent between 1991 and 1995.

2006 — CPS-3 is launched. Enrollment continues through 2013.

2012 — Cancer death rates down 20 percent between 1991 and 2009.

Source: The American Cancer Society

Cancer Prevention Study - 3: CPS-3 is under way and volunteers are being registered through December of 2013. The American Cancer Society is looking for “men and women between the ages of 30 and 65 years who have no personal history of cancer.” The organization would like to have 300,000 people of various ethnicities and backgrounds from across the United States participate in the study. For more information about the study email CPS3@cancer.org or call toll-free 1-888-604-5888.

BY THE NUMBERS 1 million: Free transportation services granted nationally by volunteers with the organization.

3 million: Volunteers helping to fight cancer.

1 million: Average number of calls answered each year at the organization’s helpline. $3.8 billion: Research grant dollars that have been awarded since 1946 by the organization.

Source: American Cancer Society; numbers are from fiscal year 2011.

Research method has potential to change health care

By Sandy Kleffman the Contra Costa Times

WALNUT CREEK, Calif. — It was a nuisance and David Gassman put it off for three weeks, but he finally put a little stool sample into a tube and mailed it to a Kaiser Permanente lab. It’s a good thing he did. The test indicated he had colon cancer.

The 68-year-old Oakland resident, who is recovering from surgery, can thank an emerging field known as comparative effectiveness research. It’s an idea that sounds so obvious it’s hard to believe it isn’t already routine: Rather than simply analyzing whether a drug or treatment method works, researchers compare options to determine which ones do the best job for patients.

Many experts say the approach has such potential to transform the U.S. health system that the federal government will spend $3.5 billion on it through 2019 under national health reforms.

After Kaiser’s comparative research revealed that a low-cost, mail-in stool test is more effective than previous stool tests, the health system began offering it widely to patients in the mid-2000s, aware that many would find it more appealing than an intrusive colonoscopy.

Kaiser screening rates jumped from less than 45 percent to nearly 85 percent, potentially saving hundreds of lives.

Critics have complained that comparative effectiveness research could lead to health care rationing. But the Kaiser Permanente Division of Research in Oakland, with 550 employees, has been doing it for decades

to improve patient care and is considered a national leader in the field.

Why is it needed?

Drug companies spend millions of dollars testing their next blockbuster drug, and the federal government devotes large sums to studying diseases, but little is spent on research to help doctors and patients answer such crucial questions as: · Does a costly new drug work better than the less expensive medication that has been around for decades? · Should I spend thousands on a painful back surgery, or would physical therapy work just as well? · What offers the best results for treating a sleep disorder?

“Patients and clinicians often are forced to make decisions without good evidence,” said Dr. Joe Selby, executive director of the Patient-Centered Outcomes Research Institute, an independent nonprofit that Congress set up to oversee the program.

The United States has had major gaps in comparative effectiveness research, said Dr. Tracy Lieu, who directs Kaiser’s Northern California research division. “Drug companies are not particularly eager to fund studies that might find that their drugs should be used on fewer patients,” she said.

Although Gassman had never heard of such research, it may have saved his life. He had a sigmoidoscopy several years ago, and he says it could have been several more years before his doctor recommended a colonoscopy. The mail-in stool test, which Kaiser sends out annually to its 50- to 75-year-old members, enabled doctors to catch his colon

cancer early.

If the test finds blood in the stool, a sign of cancer, the results are confirmed with a colonoscopy. Gassman had surgery in May and now jokes that he has a semicolon.

“We have to continue monitoring the situation to be sure it doesn’t return, but supposedly we got it all,” he said.

Kaiser has changed its colon cancer screening policies over the years as a result of comparative effectiveness research. In 1993, when many patients weren’t being screened, Kaiser invested millions of dollars to offer sigmoidoscopies, which are similar to but less invasive than a colonoscopy, after finding that it could save lives. The study was headed by Selby, who was director of Kaiser’s Oakland research division before he was tapped to head the national institute.

But in part because many patients find sigmoidoscopies uncomfortable, Kaiser could never get its screening rates above 45 percent.

A later Kaiser study found a new version of a stool test identified more cancers and polyps and had fewer false positives than older stool tests, said Dr. James Allison, an emeritus investigator in Kaiser’s research division. Screening rates soared when Kaiser made the mail-in stool tests widely available in the mid-2000s. Today, Kaiser urges its members to take a yearly stool test, or a colonoscopy every 10 years, or a sigmoidoscopy every five.

The screening has had results: Kaiser found 331 cancers among the 340,000 stool tests it analyzed for its northern California members in 2011.

m cc l a t h c y n e w S P A P ER S

David Gassman of Oakland, Calif., learned he had colon cancer because of a mail-in stool test offered by Kaiser Permanente as a cheaper alternative to a colonoscopy.

Prostate cancer patients might prolong lives with healthy fats The researchers examined men participating in the Health Professionals Follow-up Study who were diagnosed with prostate tumors between 1986 and 2010.

During the quarter-century of research, 1,064 men died, mainly of heart disease.

Those who reported eating an additional serving of oil-based dressing each day were 29 percent less likely to die of prostate cancer, with a 13 percent lower risk of dying from any causes. A daily serving of nuts cut prostate cancer death by 18 percent and death from any cause by 11 percent.

The research isn’t a randomized trial

By Michelle Fay Cortez Bloomberg NEWS

Men with early stage prostate cancer may live longer if they eat a diet rich in heart-healthy nuts, vegetable oils, seeds and avocados, researchers said. Their analysis of 4,577 men found those who reported eating vegetable fats were less likely to develop fatal tumors or die from other causes than those with diets high in animal fats and carbohydrates. The study, published in JAMA Internal Medicine, is the first to analyze fat consumption after diagnosis and the risk of death.

There are several possible explanations for why healthy fats may slow the progression of prostate cancer and boost survival, said lead researcher Erin Richman, a post-doctoral scholar at the University of California, San Francisco. Nuts and vegetable oils increase levels of antioxidants, which protect against cell damage, and reduce inflammation and oxidative stress that’s related to aging, she said.

“Based on this study, combined with extensive literature on cardiovascular disease, it’s appropriate to recommend that men with prostate cancer consume a heart healthy diet with unsaturated fats that comes from nuts, healthy oils like olive and canola, seeds and avocados,” she said.

Unsaturated fats are heart healthy, and previous research shows they also help patients with advanced prostate cancer.

HOW A R D K . M A R C U S WORL D - HER A L D n e w s s e r v i c e

Nuts and other foods that contain unsaturated fats might help slow the progression of prostate cancer.

Common Tumor While one in six men will be diagnosed with prostate cancer, making it the most common type of tumor, most don’t die of it.

There are currently 2.5 million men living in the U.S. with the cancer today, according to the American Cancer Society.

and doesn’t conclusively prove that men with early stage prostate cancer can reduce their risk of dying by changing their diet, wrote Stephen Freedland, from Duke University Medical Center in Durham, N.C., in an editorial. The only proven link to death from prostate cancer is obesity, he said.

“Avoiding obesity is essential,” he wrote.

“Exactly how this should be done remains unclear.”

The data suggest that substituting healthy foods such as vegetable fats for unhealthy foods, such as carbohydrates might have a benefit, he said.