Jul 20, 2023 | Southern Arizona
According to the American Cancer Society, about 2 million new cancer cases are expected to be diagnosed in 2024. More than 18 million Americans will be living beyond cancer. The American Cancer Society reports a majority of cancer survivors (69%) were diagnosed 5 or more years ago.
Prostate, breast and colorectal cancers are the most common diagnoses among survivors. The increase in survival rates over the last 5 years can be attributed to early detection methods for cancer screening, and advancements in identifying new targeted cancer therapies. As cancer detection and treatment continue to improve on disease free survival, it is estimated that there will be 26 million survivors by 2040.
Who is a survivor?
There are many definitions of a cancer survivor but most agree that an individual is considered a cancer survivor from the time of diagnosis through the balance of his or her life. The cancer patient generally moves through three distinct phases.
- The first phase, often the shortest, is from diagnosis to the completion of initial cancer treatments. To cure cancer or to extend quality of life requires intensive oversight of the patient and accompanying symptoms and side effects. This phase is frequently the most physically and emotionally distressing for patients to navigate and results in heavy reliance on healthcare professionals and one’s support network.
- The second phase transitions the patient from treatment to extended survival with evidence that the disease is responding to treatment. During this phase, cancer survivors may worry, fear a recurrence, or develop a feeling of isolation as they transition out of active cancer therapy and into surveillance. Imaging, laboratory studies and appointments become less frequent and patients may be prescribed additional therapies to prevent the recurrence or spread of the cancer.
- The final phase constitutes long term survival. Patients may see their oncologist annually or be followed by their primary care physician. Patients may or may not continue to take medications to minimize recurrence.
Most cancer patients are ecstatic when they complete active treatment. Patients were educated about what to expect during chemotherapy, after surgery or with radiation. They were reassured that all efforts would be made to minimize side effects during treatment. Unfortunately, as a health profession, we haven’t done a great job in preparing the patient about what to expect once this phase is completed.
In 2005, the Institute of Medicine and the National Research Council released the report “From Cancer Patient to Cancer Survivor: Lost in Transition” which highlighted gaps in the care for cancer survivors and recommendations for survivor- ship care. Many survivors experience physical, emotional, and psychosocial effects of cancer and it treatment. Fortunately, oncology practices have started responding to the unique needs of survivors and are now focusing on survivorship as a distinct entity of cancer care.
It is imperative that survivors continue to follow cancer screening recommendations, practice healthy habits, and meet regularly with their primary care physician.As a cancer patient moves further away from active treatment, it’s difficult to remember all the treatments and studies one has undergone. Patients completing primary treatment are provided a comprehensive care summary and follow-up plan with healthy maintenance recommendations written by the primary oncology provider(s). It is a useful tool that patients can refer to throughout the remainder of their lives and provide to their providers.
Cancer survivors are at risk for side effects from treatment that linger such as neuropathy, fatigue and memory problems. Survivors are also at risk of effects that can develop months to years after treatment such as osteoporosis, infertility, heart problems, and second cancers. Each patient’s risk profile is unique and directly related to their health status, family history and the types, as well as duration of treatments.
Survivors need to focus on wellness, diminish the effects of cancer and control any personal comorbidities such as diabetes, obesity and heart disease. It is imperative that survivors continue to follow cancer screening recommendations, practice healthy habits, and meet regularly with their primary care physician.
Being a cancer survivor is a lifetime commitment to living well and minimizing risks. Many survivors, their families and friends thought that once treatment was over, life would revert back to the way it was before a cancer diagnosis. Survivors find that there is now a new normal which involves negotiating roles with families, friends and employers, making lifestyle modifications and coping with fluctuating emotions. Cancer survivors, empowered and partnered with their providers, are emerging from their cancer journey more resilient than ever.
Originally posted in 2017, updated 2024.
Jul 18, 2023 | Southern Arizona
Ways to Minimize Side Effects from Cancer Treatment
Because of advances in cancer treatment, more and more people can expect to reach remission or to live a long life with cancer. This is wonderful news! However, going through cancer treatment often isn’t easy. Cancer medications and radiation treatments can cause a variety of side effects that can be difficult to deal with. Here are some things you can do at home or with the help of your doctor to minimize side effects from cancer treatment.
Appetite Loss. People being treated for cancer often don’t feel hungry. But when you don’t get enough nutrients, you can become weak, dehydrated, or lose too much weight. If you are experiencing appetite loss from cancer treatment, try these tips:
Drink lots of liquids. If eating a full meal seems too much, opt for smoothies, healthy shakes, broths, and plenty of water.
Choose high-nutrient foods. If you are eating less, it’s more important than ever to focus on healthy, nutrient-dense foods that are high in protein and calories. Fruits and vegetables as well as whole grains are good choices, along with modest amounts of meat and dairy products. Arizona Oncology offers nutrition services to help with appetite loss and other nutritional issues during cancer treatment. Talk to your treatment team for more information
Eat your biggest meal when you are most hungry. If you don’t ever feel hungry, try eating several small meals or snacking throughout the day.
Bleeding and Bruising. Some cancer treatments make you more prone to bruises or bleeding by lowering the platelet count in your blood. Some things you can do to reduce your risk of bruising or bleeding include:
Avoid certain medications. Common, over-the-counter medications that increase bleeding risk are ibuprofen and aspirin. Your doctor can provide you with a more comprehensive list.
Brush your teeth gently. Make sure your toothbrush is labeled “soft”.
Use an electric shaver. This will avoid you nicking your skin with a razor.
Be extra careful. Take extra care when you are in the kitchen, doing sports, or working with tools.
Nausea and Vomiting. Feeling sick to your stomach or vomiting are common side effects of cancer treatment. Depending on what is causing the upset, your doctor may recommend one or more of the following steps:
Anti-nausea medication. Nausea and vomiting can be caused by different things, so there is not a one-size-fits-all approach. Your doctor will recommend a medication and let you know when and how often to take it. You may need to take the medication even on days when you don’t feel sick. Tell your doctor if you aren’t getting relief, because a different medication may work better for you.
Avoid certain foods. Greasy, fried, spicy, or sweet foods may make you feel sick. Eating foods cold can be easier on your stomach. Sometimes the smell of certain foods alone can upset your system. If this is the case, consider asking someone else to prepare your food.
Time your meals around your treatments. Pay attention to how eating before treatments affects you. For some people, a small snack before treatment helps calm their stomach, while others need to avoid eating before treatment altogether. Wait at least an hour after treatments before eating or drinking.
Complementary medicine. Acupuncture, deep breathing, relaxation techniques, hypnosis, and guided imagery are complementary practices that may help with nausea and vomiting. Ask your treatment team for more information on these services if you are interested in trying one of these therapies
Skin and Nail Changes. Radiation, chemotherapy, stem cell transplants, immunotherapy, and targeted therapy can all cause skin-related changes. Depending on the treatment type, these can show up as dryness, itchiness, irritation, rashes, or blisters. It is important to tell your doctor about any skin changes you experience. At home, the following tips can help minimize skin and nail issues related to cancer treatment:
Use mild soaps. Mild, fragrance- and dye-free soaps are best for irritated skin. Your nurse can recommend specific skin products.
Moisturize. Moisturize after showers while your skin is still wet. Your nurse can recommend specific moisturizers and ointments to deal with especially dry, irritated skin.
Use warm, not hot water.
Wear gloves.
Don’t get a manicure or pedicure during treatment.
Use medications for rashes if your doctor recommends them.
Insomnia. If you are having problems falling asleep or staying asleep during cancer treatment, you are not alone. Sleep problems can be a side effect of treatment or the result of medications, stress, or other factors. If your sleep issues are due to pain, urinary issues, or diarrhea, your doctor can help. You may also want to try some of the recommendations below:
Practice good bedtime habits. Avoid electronics at least two hours before bed. Keep your room cool, dark, and quiet. Don’t eat or drink a lot before bedtime. Get your exercise earlier in the day, not at night.
Cognitive behavioral therapy (CBT). If your thoughts are keeping you awake at night, a CBT therapist can help you manage negative thought patterns and calm your mind. Relaxation therapy. Guided imagery, muscle relaxation, and self-hypnosis can also help you get a good night’s rest.
Sleep medicication. Medication to help you sleep can be prescribed on a short-term basis if other strategies don’t work.
Having strategies to minimize side effects can help you feel more in control as you undergo treatment for cancer. Some side effects cannot be controlled, such as hair loss, but there are ways to cope with them. For more tips on dealing with side effects from your cancer treatment, visit https://arizonaoncology.com/cancer-treatment-tips/chemotherapy-side-effects/.
Jul 9, 2023 | Southern Arizona
Often times, when people hear the word “cancer”, sarcoma isn’t one that quickly comes to mind. Some may not even know what a sarcoma is–so it’s no surprise that it’s considered the “forgotten cancer.” To bring it to the forefront, July has been declared Sarcoma Awareness Month. Now, more than ever, is the perfect time to learn more about this rare disease.
What is Sarcoma?
Sarcomas can be broken into two main types: soft tissue sarcomas and bone sarcomas. There are, however, more than 50 different subtypes that fall under these two categories.
Soft tissue sarcoma is a broad term for cancers that start in soft tissues – such as muscle, tendons, fat, lymph and blood vessels, and nerves. These soft tissue cancers can develop anywhere in the body but are found mostly in the arms, legs, chest, and abdomen.
Sarcomas account for 1% of all adult cancers and 15% of all childhood cancers. The American Cancer Society estimates about 13,590 soft tissue sarcomas will be diagnosed in the United States in 2024.
What to Look For
Sarcomas are rare tumors that are often difficult to detect or diagnose until they have reached more advanced stages. There are, however, certain signs to pay attention to.
See a doctor right away if you experience any of these problems:
- A new lump or a growing lump anywhere on your body
- Abdominal pain that continues to get worse
- Blood in your vomit or stool
- Black, tar-like stools
In many cases, these symptoms are caused by something other than sarcoma. However, it is important to have it verified by a medical professional. Your doctor may use a variety of tests including X-ray, CT scan, MRI, ultrasound, PET scan, and biopsy to determine whether or not you have soft tissue sarcoma.
Related Reading: Mandy’s Story: A Journey with Ewing’s Sarcoma, a very rare cancer.
Surgery is the first-line treatment for soft tissue sarcomas. Once the tumor has been removed, radiation and/or chemotherapy may be given to help stop it from spreading.
Can Sarcomas Be Caught Early?
Screening tests and exams are not typically recommended for detecting sarcoma, unless you have a strong family history of soft tissue sarcomas or other cancers. If you feel as though you are at a genetic risk, you may want to talk with your doctor about whether or not you would benefit from genetic testing.
Sources:
Originally posted in 2018, updated in 2024.
Jul 7, 2023 | Southern Arizona
Approximately 228 Americans are diagnosed every day with bladder cancer. July is recognized as National Bladder Cancer Awareness Month, and Arizona Oncology would like to remind all men and women to speak with their healthcare providers about the signs and symptoms, as well as screenings, for the disease. By finding cancer early, treatment is more effective.
According to the American Cancer Society, it is estimated that nearly 83,190 new bladder cancer cases are expected this year, and more than 16,800 people will lose their lives to the disease. Knowing the signs and symptoms of bladder cancer can aid in early detection and increase the opportunity for survival. Symptoms include:
- Blood in the urine
- Frequent urination
- Feeling the need to urinate, but not being able to
For people with certain risk factors, screening should begin earlier or repeated more frequently. While the exact cause of bladder cancer is unknown, risk factors for the disease include:
- Smoking – smoking is the greatest risk factor for bladder cancer. Chemicals from tobacco can enter the blood stream, through the lungs, and are filtered by the liver and collect in the bladder. These chemicals damage the cells that line the inside bladder wall.
- Work exposure – some professions are more susceptible to harmful chemicals. These occupations include: dye makers, hairdressers, truck drivers, machinists, printers, painters, leather workers and rubber manufacturers.
- Race – Caucasians are twice as likely to develop bladder cancer as African Americans or Hispanics.
- Gender – men develop bladder cancer four times as often as women.
- Age – the risk of developing bladder cancer increases with age.
- Family history – the chance of developing bladder cancer rises when immediate family members have or had the disease.
- Chronic bladder inflammation – urinary infections, kidney stones and bladder stones do not cause cancer, but they are linked to the disease.
- Arsenic – this chemical in drinking water is linked to an increased risk of bladder cancer.
- Inadequate liquid intake – people who drink plenty of liquids each day have a lower risk of developing bladder cancer.
- Bladder birth defects – very rarely, a connection between the belly button and the bladder doesn’t disappear as it should before birth and can become cancerous. There is another very rare birth defect called exstrophy, which can also lead to bladder cancer.
- Earlier Treatment – some drugs or radiation used to treat other cancers can increase the risk of bladder cancer.
As a member of The US Oncology Network, one of the nation’s largest networks of integrated community-based oncology practices dedicated to advancing high-quality, evidence-based cancer care, Arizona Oncology is able to enhance patient access to the latest advances in therapies, clinical research and technology to patients in the community.
(Updated May 2024. Originally published July 2014.)
Jun 26, 2023 | Southern Arizona
If you’re recovering from breast cancer, the medicines that are part of your treatment program can have unwanted effects. You and your oncologist have chosen a path for your breast cancer treatment, but it’s also important to add things to your routine that will help you feel better both mentally and physically. These are called complementary therapies. Yoga is an exercise and breathing therapy that has been proven to help breast cancer patients and survivors.
What is Yoga?
Originating in India over 5,000 years ago, yoga began as a complete lifestyle that combined exercise with ethics and meditation. Today, there are many different forms of yoga. Most types practiced in the U.S. focus on the effects of controlled breathing and exercise without the expectation of a lifestyle change.
If you’ve seen people with years of experience practice yoga, it may look difficult or even impossible for a beginner, especially if you are ill. However, yoga is designed to be gentle enough for people of all ages at any activity level to participate. With over 100 variations of yoga to choose from, it is possible for each patient to find the right level of activity in a class.
What to Expect
It’s important to seek a beginner’s class if you’re not a regular yogi. And if you are, be sure to talk to your instructor. Or, in many cases, you can find a class meant for cancer patients and survivors. An experienced instructor will have the expertise to work with your limitations. During the class, you will learn a series of stretches or poses and some deep breathing techniques to go along with the exercises. If you’re new to yoga, the poses may feel difficult or awkward at first. Be careful to pay attention to your body and not push past your limits. The stretches should never cause pain.
During the session, your instructor will describe how to manage the poses and offer modified or easier versions for participants who can’t reach the full pose. Sometimes pillows or foam shaped into a block will be used to help you get into a modified position. The instructor may also give deep breathing instructions during the class. Even if you feel clumsy and out-of-place at first, yoga can be relaxing and enjoyable.
Benefits of Yoga for Patients with Breast Cancer
Many studies have been conducted on the benefits of yoga for patients recovering from breast cancer. Since yoga poses can be adapted for all levels of fitness, patients who are unable to participate in more demanding exercises can often participate in yoga and feel the positive effect it can have.
A study conducted on 200 women showed significant improvements in the long-term effects of fatigue and inflammation many patients experience in the months following rigorous treatments for breast cancer. Additional smaller studies have shown many positive benefits for patients in all levels of treatment. Some of these benefits include:
- Increased sleep quality. All forms of exercise help improve restful sleep. However, it is likely that the calming effects of deep breathing and a meditative state used in the practice of yoga enhance these benefits.
- Decreased stress and anxiety. A cancer diagnosis obviously brings about considerable anxiety. Treatment can multiply this effect since it has such a large impact on the body. Yoga forces the mind to concentrate on the body which helps quiet the mind and promote a feeling of calm.
- Improved function and mobility. Inflammation and neuropathy associated with treatment can limit mobility. Yoga increases oxygen and circulation throughout the body helping to eliminate this.
- Decreased fatigue. Breast cancer treatment can be particularly harsh on the body, and it’s common for patients to suffer severe fatigue and a decline in respiratory fitness. Yoga helps eliminate these effects avoiding a long-term cycle of lowered energy.
- Reduced depression. From diagnosis, to treatment, to recovery; cancer is a battle every step of the way. Depression is common in all long-term illnesses and cancer is no exception. The improvement in physical symptoms and the ability to participate in a group activity can help relieve this depression.
- Improved quality of life. An improvement in physical symptoms can lead to the ability for patients to participate more in other aspects of their life. Restful sleep and decreased anxiety lead to increased happiness as well.
Potential Complications
When beginning any kind of exercise program or alternative treatment, it’s important to talk to your doctor. Many patients with breast cancer can participate in the yoga program they choose. However, sometimes there are important complications to consider.
Personal Limits
Treatment for breast cancer can cause extreme fatigue and a reduction in respiratory fitness. If beginning yoga classes are too tough to handle, you may need to ask your instructor about restorative yoga (a gentle form of yoga designed for healing).
It’s common for breast cancer to metastasize (spread) to other parts of the body. These cases sometimes require additional treatment or other risks to consider. Many patients suffering from breast cancer have lymph nodes removed. This can lead to an increased risk of lymphedema when strenuous activities are performed. Lymphedema is a condition that causes swelling due to a build-up of lymph fluid in other areas of the body. Sometimes, breast cancer spreads to the bones. This could lead to an increased risk of fracture. It’s important to discuss these concerns with your doctor and your yoga instructor before beginning yoga sessions. It may be necessary to adapt your routine to fit your personal needs.
Qualified Instructors
There is a wide range of difference in the level of qualifications of yoga instructors. Some instructors may study the practice for only days while others have years of training. If you’re unsure of the classes available, ask your oncologist to recommend a qualified teacher. Some yoga programs are even targeted toward cancer patients and may be able to help you with costs that aren’t covered by traditional insurance.
Originally posted in 2019, updated in 2024.
Jun 14, 2023 | Southern Arizona
One in seven men will be diagnosed with prostate cancer, the most commonly diagnosed cancer in men excluding skin cancer. Men, aged 65 or older, have a family history of prostate cancer, a female relative with a BRCA positive breast cancer, or are African American, have a greater risk of being diagnosed. Though prostate cancer can be a serious and scary diagnosis, many men are not likely to die from prostate cancer.
Signs and Symptoms of Prostate Cancer
Prostate cancer in its early stages usually has no symptoms. As the cancer grows, men may have difficulty urinating, urinate more frequently, have blood in the urine, experience erectile dysfunction, complain of pain in the hips and back, and feel weakness or numbness in the legs. Many of these symptoms are more often attributed to other health issues. Read more about prostate cancer risks, signs, symptoms and screening.
Prostate Cancer Screening
Recommended guidelines for when men should have the prostate specific antigen (PSA) blood test, and if it’s necessary to have a digital rectal exam (DRE), are not in agreement. One of Arizona Oncology’s medical oncologists explains, “I recommend that for men with an average risk, a conversation occurs with his primary care provider that outlines the risks and benefits of screening at the age of 50. For those with a higher risk, screening may begin at age 40 or 45. Additionally, not every man needs to have a PSA annually or for the remainder of his life. Some scientific evidence indicates that the DRE may not even have value and many men find it uncomfortable and embarrassing. I believe the DRE, when consistently done with the PSA, has value in determining whether the prostate is enlarged or if a nodule has been detected.”
Prostate Cancer Treatment Options
If, after a prostate cancer workup, a man is diagnosed with prostate cancer, treatment options need to be explored. There are three different specialists who may provide interventions: the urologist, the medical oncologist and the radiation oncologist. Treatment options can include observation, surgery, radiation, hormonal suppressive therapy and chemotherapy.
Medical oncologists provide a unique consultative role when men are diagnosed with early disease. Often men are faced with choosing between surgery or radiation at this stage. The oncologist provides unbiased insights that can assist the man in making a decision that supports his quality of life. The oncologist has a more direct role when the patient is diagnosed with more advanced or aggressive disease. Treatment options then include hormonal suppressive therapy and chemotherapy. If men have unresponsive or advanced disease, oncologists can provide access to international clinical trials that are investigating the role of targeted therapies and immunotherapy.
Arizona Oncology, a leader in Arizona in providing comprehensive, compassionate cancer care, offers a state-of-the-art treatment for prostate cancer. Patients who require radiation treatments can now receive the SpaceOar® (OAR stands for “organ at risk”) System, a temporary injectable gel that protects the rectum in men undergoing radiation therapy for prostate cancer either with external radiation (IMRT) or even with internal treatment aka Seeds. It was FDA approved April 2015. SpaceOar® hydrogel is made of polyethylene glycol (PEG). PEG is widely used in cosmetics and drugs because it is non-toxic and well tolerated by the body. SpaceOar® hydrogel the PEG is injected as a liquid that, within seconds, solidifies into a soft, gel-like synthetic material that expands and creates space between the prostate and rectum. Because it contains mostly water, it is called a “hydrogel.”
Approval occurred after the results of a phase III trial that demonstrated a significant reduction in the dose to the rectum which translated into a significant decrease in side effects. The reduction in dose to the rectum was approximately 75% with zero patients having grade 2 or greater rectal toxicity 3 years after treatment.
The SpaceOar® System is placed in a patient prior to external radiation therapy through a minimally invasive, outpatient procedure. The SpaceOar® hydrogel is injected through a small needle into the space between the prostate and rectum while the patient is under local or general anesthesia and is inserted during the same procedure where small gold markers (called fiducials) are placed in the prostate to localize it prior to each radiation treatment or immediately following placement of the radioactive seeds used in brachytherapy.
Ultrasound imaging allows the physician to see and place the hydrogel in the proper location. On average, SpaceOar®hydrogel creates about 0.5 inch (or 1.3 cm) space between the prostate and rectum, permitting treatment to the prostate with much less rectum radiation injury and fewer complications. The gel remains in place for about three months during radiation treatment, and then liquefies, is absorbed and cleared from the body in the patient’s urine.
“Providing the best possible treatment to patients is our top priority, which is why we are one of the first centers offering SpaceOar® hydrogel,” said Curtis Mack, MD, radiation oncologist with Arizona Oncology. “Creating space between the prostate and rectum is an important advance that significantly diminishes the rectal dose during radiation treatments, and thereby reduces the likelihood of side effects. Currently, I am using it on patients being treated with daily intensity modulated radiation therapy as well as those patients who choose brachytherapy (seed implant).”
Dr. Mack is the only physician certified in Southern Arizona to offer SpaceOar® hydrogel placement as part of radiation treatment for prostate cancer.
Originally posted in 2017, updated in 2024.
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