“Useless treatments common in young, terminal cancer patients”

That’s the headline of a story I’ve just reread that was written by Dennis Thompson of HealthDay -  http://www.chicagotribune.com/lifestyles/health/sc-useless-cancer-treatments-terminal-health-0622-20160607-story.html

 

This news makes me wince uncomfortably.

Thompson reports that “An analysis of insurance records found that cancer patients often undergo chemotherapy, radiation therapy or surgery in their final 30 days.”

I’m trying to better understand this and having trouble. Does this mean that concerned doctors are trying to save patients right up to the last second? Or does it mean that doctors are giving patients medicine that cannot help them, but makes $$$ for ______ (I’ll let you fill in the blink).

Thompson further reports that “In 2012, ASCO issued a set of guidelines for physicians that recommended against using aggressive measures in patients with advanced cancer who are unlikely to benefit from such treatment. Instead, doctors should focus on easing the patient's pain and symptoms, the guidelines say.

He also quotes Dr. Andrew Epstein, an ASCO expert in palliative care, saying, "Much more often than not, these types of care at the end of life are not helpful, and they are emotionally and physically harmful for patients, and emotionally harmful to the patients' loved ones." Epstein is a medical oncologist at Memorial Sloan Kettering Cancer Center in New York.”

To see if these guidelines are being followed, researcher Dr. Ronald Chen -  associate professor of radiation oncology at the University of North Carolina at Chapel Hill - and his colleagues reviewed claims data for more than 28,000 terminally ill cancer patients younger than 65 who died between 2007 and 2014. The patients lived across 14 different states and had been diagnosed with advanced lung, colon, breast, pancreatic or prostate cancer.

Guess what?

The investigators found that between 71 percent and 76 percent of patients received some form of aggressive care at the end of life, depending on their type of cancer.

Somehow this just makes me sad. Not only are these victims dying, it seems like they aren’t allowed to go peacefully.

I could be wrong. Maybe all of these victims want to fight to their last breadth no matter what the odds are.

Read the article and decide for yourself.

“Brain Tumor’s Genetic Makeup Critical in Treatment”

If you haven’t read it, here’s a link to article by Benedict Carey in the NY Times reporting on progress in prescribing more individualized brain cancer treatment based on genetic characteristics of the victims.

Carey writes that “Doctors can more effectively treat many brain tumors by first ascertaining their genetic characteristics, rather than studying tissue samples under a microscope, the standard practice, two teams of researchers reported on Wednesday.”

He goes on to note that: “Prognosis is going to be more accurately delineated by these kinds of genetic subtypes, outstripping the value of looking through a microscope,” said Dr. David J. Langer, the chief of neurosurgery at Lenox Hill Hospital in New York, who was not involved in the research.

His article refers to some new studies — one coordinated by the National Institutes of Health, the other led by the Mayo Clinic and the University of California, San Francisco — in which “…research teams performed multiple genetic analyses on 1,380 tumors. Both teams found that the tumors could be grouped into a few categories, which could be determined by looking at a handful of genetic glitches.”

Here’s the part that make me think we’re making progress: “Tumors with one genetic profile, for instance, were relatively slow growers and responsive to drug treatment, making them good candidates for chemotherapy alone, rather than combined with radiation. Tumors in another category grew relatively slowly but were not as responsive to drugs, suggesting that combined therapy was best.”

Aha! This new information is insightful and pragmatic. Doctors can start helping victims right away.

Here’s a link to the article: http://www.nytimes.com/2015/06/11/health/brain-tumors-genetic-makeup-critical-in-treatment-research-finds.html?_r=0

Describing Life on Chemo

Here’s a particularly articulate description of enduring chemo treatments by blogger and brain tumor victim Mark Green excerpted from a post on his blog, moosevt: http://moosevt.wordpress.com/

 

“The opportunity to reflect is a gift: what was, what could’ve been, what might be, becomes part of a deeply tumultuous swirl of emotion from places within I didn’t even know existed. Because of this cancer I’ve been given this time, this heretofore unwelcome ‘gift.’ And there is nothing like Jackson Browne to reach inside my heart and pull everything right up to the front, like the deep roots of some primeval tree, to unleash a torrent.”

Later in the same posting he says “After enduring two weeks of chemo in the hospital and a third to begin Tuesday I’m feeling a little bit like a  punchdrunk boxer in the ring: DeNiro in Raging Bull with fists coming slow, hard and unrelenting. I know I’ve referred to the Native American character in “One Flew over the Cuckoo’s Nest” who in the end ripped the sink from the flooring and smashed through the wall, releasing the patients from the asylum. 

While certainly my hospital stays are nothing of the sort, the doctors, staff and nurses all being top- rate, being tethered (and often entangled like a fish caught in a driftnet) to an IV pole day after day, having it wrapped around my legs and arms having to unplug every time I have to go to the bathroom trying to get there before it’s too late, having it pull on my PIC-lined arm is not a friend I wish to be attached to. The notion of tossing the entire IV pole through the plateglass window comes to mind quite often.”

Honest. Insightful. Painful to read, but well worth doing so.

“New Trial Delivers Chemotherapy to Brain Tumor Through Artery in Leg”

Here’s a fairly recent press release which says that “Capital Institute for Neurosciences Begins Clinical Trial Delivering Chemotherapy Directly to Brain Tumors Starting with Incision in Leg.”

So why is this news?

For me, this goes back to Barbara Strauch and her well-researched book entitled “The Secret Life of the GROWN-UP Brain” in which she points out that “For years, scientists believed diet had little impact on our brains because they thought most nutrients didn’t cross the blood-brain barrier.”

The same is true for medications that would whack brain cancers, they have a hard time permeating the blood-brain-barrier.

That’s where the Capital Institute’s idea becomes interesting, according to the press release, “During the procedure, done at Capital Health Medical Center – Hopewell, Dr. Erol Veznedaroglu, an endovascular neurosurgeon, threaded a tiny catheter through the patient’s femoral artery in the leg, up through the body and neck and into the brain. Once the catheter reached the brain, chemotherapy was released to the blood vessels that feed the tumor. The drugs were carried by the natural blood flow of the vessels to infuse the tumor with the cancer-fighting agent.”

Interested? Here’s a link: http://www.prweb.com/releases/2014/07/prweb12010651.htm

Copyright: <a href='http://www.123rf.com/profile_hfsimaging'>hfsimaging / 123RF Stock Photo</a>

Great ABTA Conference Agenda

This is a terrific agenda for first session of the upcoming American Brain Tumor Association annual “Patient and Family Conference. I like the focus on new treatments and technologies, the top name presenters and the range of topics, especially the inclusion of immunotherapies in the opening session. 

I’ve been to this conference and, based on that experience, can tell you that the ABTA does a great job with this conference. If you are a brain tumor victim, caretaker, friend or family member, you may find this wonderfully informative.

I won’t be attending this year. If you do, please shoot me an email and tell me about what you saw and heard. 

John