Breast Cancer: Screening Tools and Controversies

Wednesday, February 29, 2012

Join NCFCCC members from your office or home for a live “lunch and learn” online presentation. Featuring Julia Marshall, MD, Faculty and Clinical Assistant Professor in Radiology at the Breast Center UF Academic Health Center. CEUs for participation.

12 to 1 pm on Wednesday, March 21, 2012

Register today! Contact Lindsey Redding at 352-313-6500 x 105 or lredding@wellflorida.org

Press Release: Prostate Cancer Screening and Treatement Options

Men at higher risk for prostate cancer should be well informed about screening and treatment options
GAINESVILLE, Fla. (February 29, 2012)—Prostate cancer is the second leading cause of cancer deaths among men. The presence of risk factors in men should guide screening and treatment options, according to Dr. Johannes Vieweg, MD, of the University of Florida Department of Urology and Prostate Disease Center.

As guest speaker at The North Central Florida Cancer Control Collaborative (NCFCCC) 2012 Kickoff, Vieweg presented current screening recommendations and advocated for a risk-based treatment approach for patients diagnosed with the disease. The NCFCCC 2012 Kickoff took place on Feb. 29, 2012 at the Haven Hospice E.T. York Care Center in Gainesville.

Risk factors for prostate cancer are age, race/ethnicity and family history of the disease. Up to 63% of all prostate cancer cases are diagnosed in men over 65 years old. Men have a higher chance of getting the disease if they are 50 years old or older, are African American, or have a father, brother or son who has prostate cancer. Other risk factors include diet and level of physical activity.

Two tests are commonly used to screen for prostate cancer—the prostate specific antigen (PSA) test and the digital rectal exam (DRE). The PSA test measures the level of PSA in the blood, a substance made by the prostate and which may be higher in men who have prostate cancer. A DRE is when a doctor or nurse checks the size and shape of the prostate. Follow-up tests typically include biopsies.

“Although PSA and DRE-based testing is not always able to detect or diagnose prostate cancer, at this point, both tests still remain the accepted gold standard for determining the risk of harboring prostate cancer in an individual”, said Vieweg. “The TRUS-guided needle biopsy is the most reliable method to diagnose prostate cancer and aid in risk assessment and therapy.”

Screening for prostate cancer is controversial because of the cost, uncertain long-term benefits to the patient and potential risks. Risks include false positive test results (the test says you have cancer when you do not), treating prostate cancer that may never affect your health, and side effects from prostate cancer treatment, according to the Centers for Disease Control and Prevention.

The potential benefit of screening is that prostate cancer will be found early, when treatment may be more effective.

“Due to PSA testing, approximately 90% of all prostate cancers are currently diagnosed at an early stage, and, consequently, men are surviving longer after diagnosis,” said Dr. Vieweg.

According to the National Comprehensive Cancer Network, men at high risk of developing prostate cancer should start being screened in their 40s while regular screenings should start at age 50. The American Urological Association recommends the PSA test be offered to well-informed men aged 40 years or older who have a life expectancy of at least 10 years.

“The presence of risk factors, age, patient preference and pathologic features of the biopsy should guide treatment recommendations,” said Vieweg.

NCFCCC is a community-based collaboration administered by WellFlorida Council. The purpose of NCFCCC is to improve access to cancer care and reduce the burden of cancer in North Central Florida. For more information, please visit www.ncfcancercontrol.org or call Lindsey Redding at 352-313-6500 ext.105.


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Earn CEUs at NCFCCC's 2012 Kickoff with Special Guest Speaker

Monday, February 27, 2012

Join us for North Central Florida Cancer Control Collaborative's 2012 Kickoff. The event will be held on Thursday, February 29 from 10:00 am to noon at Haven Hospice. Haven Hospice is located at 4200 NW 90th Blvd. in Gainesville, Florida. CEUs available for participation.

A presentation by Dr. Johannes Vieweg, Chairman, Department of Urology, University of Florida on Prostate Cancer: Current Screening Policy Debates and Recommendations will be the main agenda item for the event.  More details will soon follow.

Please plan to attend and bring a friend. If you have any questions, do not hesitate to call Lindsey at WellFlorida:  (352) 313-6500 ext. 105 or 1-877-678-9355 (toll-free).

Post Peg - Pre Chemo

Monday, February 20, 2012

Hywel

Actually, the title is a little misleading. Nothing is ever straightforward in my case and I couldn’t just have a simple surgical procedure to insert a feeding tube in my stomach.  PEG stands for Percutaneous Endoscopic Gastrostomy whereby a tube is pushed down your throat into your stomach to inflate it with air. As my esophagus is closed up so much they couldn’t get a tube down my throat, so the only alternative was to make an incision through my stomach muscles. To date, without a shadow of a doubt, the most painful op I’ve had so far.

Feeding time. Can't wait for the next romantic night out!
I spent four miserable nights in hospital counting every hour that went by to the time I’d be allowed home on Monday February 13th. It was so difficult watching everyone else on the ward eating normally whilst I only managed to get a few morsels of food down my throat coupled with the new regime of bolus feeding, which is feeding myself with a syringe via my new tube. A very strange experience and one I’m still not fully comfortable with.

I spent the rest of the week gearing myself up to a five night in-patient stay during my chemo treatment starting on Feb 23rd until a phone call on Friday the 17th changed all that. My head and neck oncologist and my lung oncologist had a long meeting on the afternoon of the 16th. The biggest problem every medical team involved in my case face is that still no one is really 100% sure whether my cancer is of the lung or head and neck. The one thing they’re positive about is that it’s Squamous Cell Carcinoma. The problem with facing a chemo regime is that certain chemo drugs target specific body areas better than others. The original combination of chemo drugs on offer to me - a concoction of Cisplatin and 5FU - is specifically aimed at head and neck cancers. After a long discussion the oncologists decided to offer me an alternative regime - a concoction based on Carboplatin and Taxol. This is aimed more at lung cancer but Taxol is also used to treat head and neck cancers.  I also had a good response to Carboplatin before - although it gave me a rough ride it did shrink my tumours significantly.

There are pluses and minuses to both regimes. The original would see me as an in-patient thereby taking some pressure off Cathy and allowing the medical staff to monitor me closely as I had such a violent response to the chemo last time.

My second option of Carboplatin and Taxol would see both drugs being infused over one day, then nothing for three weeks. No in-patient stays, and believe me there’s no place like home. The down sides of this regime are an increased risk of infection, that lovely drug Carboplatin will be seeping into my veins again (the one that caused my blood clot last time) albeit at a lower dose to start off, and the wonderful Taxol will definitely see me lose all my hair and eyebrows. It also means that Cathy will have to keep a close eye on me and alert the hospital if she thinks there’s a problem. I’m not very good at admitting there is a problem as she will happily tell you, but I’ve promised to try harder this time! Ah well, at least I’ll resemble what most people seem to expect a cancer patient to look like.

I had a long think about this coupled with the advice of good friend, Professor Gordon McVie, one of Europe’s leading cancer specialists - I’m lucky to be able to call on someone like him - and have decided on the Carboplatin and Taxol regime. It starts Tuesday February 21st.

I have to cope with this on top of trying to get over abdominal surgery and feeding myself through a tube. Happy days indeed.


Cathy

Poor Hywel.  Yet again a potentially straightforward procedure was not as straightforward as we’d hoped. We’d been warned the team might have trouble putting the feeding tube in endoscopically, but they wanted to try this option first. Boy were they right on the trouble.

Hywel had a four inch incision in the centre of his tummy where they put the tube in to blow air into his stomach and hold it against his abdominal wall, whilst another incision was made to the right where the feeding tube was pushed directly into Hywel’s stomach. There is a round plastic disk stitched to the outside holding the tube in place, and a small balloon filled with 5mls of water undertaking the same task on the inside. The stitches on the disk will be removed after two weeks so the stomach has time to adhere to the abdominal wall and stay in place. The balloon has to be regularly emptied and refilled to hold the pipe in from the inside. Hywel asks me how I will still find him attractive when he has a tube poking out of his stomach and a tongue that isn’t quite straight anymore? The first thing I see when I look at Hywel is my loving, warm, funny, gorgeous husband and I am just so grateful these procedures will mean he can be with us a little longer. I don’t really see anything else.

Hywel was in a great deal of pain after the op. I knew there was a problem as I’d been told he shouldn’t be away from the ward for more than two hours. He went down at 4.30pm and still wasn’t back by 6.30pm. The nurses rang the recovery room and I was told he shouldn’t be too long but they were trying to manage his pain before bringing him back. I felt so upset for him. He’d been through so much and it had been a really difficult decision to have the tube. He looked really pale when they wheeled him back on the ward. The sister told me he’d been given a maximum dose of morphine but was still in discomfort. She promised they would do their best to make him comfortable. He hadn’t been given any of his regular pain killers since early in the morning as he’d waited so long to go down for his op so I asked whether he could have any of those. He was given one other drug but they wouldn’t let him have any of the others on an empty stomach. I was allowed to stay with Hywel for an extra half hour after visiting as it had taken so long to bring him back up to the ward. I just held his hand and stroked his face until he relaxed a bit and I left him dozing and in a bit less pain.

When I got home Luke and Elliott were watching a film so I made myself some food and a cuppa. I got Elliott to bed around 10pm and finally went to bed myself. Oh my, the floodgates really opened this time. I cried non-stop for about three hours. I was exhausted after ten hours at the hospital and I kept seeing Hywel’s face looking so pale, frightened and obviously in pain. Being unable to take his pain away was hard. All the bad news we’d been dealing with over the last few weeks seemed unbearable when Hywel was in the hospital and I was alone in our bed. I finally fell asleep about 2am. I looked like I’d been in a fight the next morning! I also rang the school and kept Elliott home the next day so he could come with me to visit Hywel at 2pm and to let us both have more sleep. I phoned the ward and was told Hywel had been fairly comfortable overnight and had managed a bit of breakfast. In contrast, I spoke to Hywel who said the night had been rough and he’d only managed a mouthful of weetabix! Elliott and I visited and I returned on my own later. Hywel told me he’d never had so much pain from an operation before. He hated every minute of being in hospital this time and it was a real low point for him. He came home on Monday and has gradually been improving both physically and emotionally. A feeding tube takes a bit of getting used to. You need to try and get into a routine which is sometimes hard to stick to, as we’ve been receiving lots of visits from health professionals as well as family and friends. Once underway however, the process takes less time than I imagined and as long as I bring everything that’s needed in together and wash everything up straight after it only takes about fifteen minutes in all.

We had another big choice to make on Friday when the oncologists gave Hywel treatment options to consider. It seems when one big decision is made another confronts us. Hywel has opted for the new regime of chemotherapy as it will mean less time in Velindre hospital and more time at home. I’m quite nervous about monitoring him at home as he’s much weaker and more poorly starting the treatment than last time. I had to insist on contacting Velindre a couple of times last time even though Hywel didn’t want me to, and I’m worried this could happen again. He’s promised me he’ll alert me to any problems earlier on but I know I’ll have to watch him like a hawk. I’m hoping Hywel will manage a much lower dose and it won’t be as bad this time. We have booked a table at Tenovus’ Annual Ball on March 2nd (ten days after the treatment) which we are both really looking forward to so we will try and focus on Hywel being well enough to attend that. We are taking Hywel’s eldest children and their partners and some special friends. Our choir is singing at the event again and I am hoping to sing with them. Hywel won’t be joining in but it will be the first time he gets to listen to a proper performance.

Cancer Connections Feb. Meeting

Thursday, February 16, 2012

Please join us for Cancer Connections on Wednesday, February 22nd, at Hope Lodge at noon.

Dr. William Slayton, U.F. pediatric oncologist, will be discussing childhood leukemias.

Please RSVP to Barb Thomas at bnbbarb@aol.com
For those who RSVP by Monday the 20th, we will provide a healthful lunch (a $3 donation OR a healthful dish to share).  If you can't RSVP in advance but find that you are able to join us, you are more than welcome to bring your lunch with you.

How and Where To Begin a Yoga Practice

Friday, February 10, 2012


How and Where To Begin a Yoga Practice
Where do I start?   What do I need to know to begin a yoga practice? One day at a time is where you start so not to set yourself up for failure. Start simple and small so a positive tone for each day is encouraged and then re-enforced. Find a reputable yoga teacher that specializes in breast cancer recovery or some great well recommended DVDs. 
Now let’s begin:
  • Set a specific time each day (preferably mornings)  Begin with consistency.
  • Brush and floss your teeth, empty your bladder, and begin on an empty stomach
  • Find a quiet and well ventilated space. This space will become your sacred space for healing
  • Dress comfortably; no belts and tight jeans
  • Play music that is soothing or maintain silence
  • Adjust the lighting to be soft or enjoy the natural sunlight
  • Create a room decor as uplifting as possible
  • If possible have a mat, blocks and other props for support
  • Start small, maybe 5 minutes at first and then gradually add onto your time
The benefits of relaxing the body while giving time for the mind to consciously rest often induce deep relaxation. The deeper the tensions of mind and body the greater overall detrimental effect on the mind and body. Yoga props will assist in allowing for this relaxation to occur.
Good thoughts produce good reactions and negative thoughts drain the energy right out due to the excess tension. Be open to experience yoga and the positive flow of life energy that comes through the practice.
By: Diana Ross, E-RYT 500
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Into the Valley of.......

Thursday, February 9, 2012

After spending many arduous nights considering state of flux that is my future, decisions have been made. Firstly, I’m having a feeding tube placed in my stomach. I really can’t wait for this one. I’m so looking forward to the next romantic meal out with my wife when she can sample the culinary delights on offer at the restaurant, whilst I pop a bag of liquid that looks like paint into a machine and let the contents dribble into the tube which sits outside my jacket, before finally entering my stomach. I can picture the scene now; horrified onlookers thinking, "What the f**k is he up to?", whilst I can only drool at the smell and sight of what everyone else is having.


You simply don’t realise what a simple pleasure eating a meal is until it’s taken away from you.

All I can manage now is purified food, the odd cereal, soup and yoghurt. And these take an age to get down. The swallowing system is quite simple. You pop the food in your mouth, chew for a bit and then swallow. That’s it. For me? Well I pop the food in my mouth then I struggle to chew because the tumour at the base of my tongue is boring through the muscle so it sticks out to one side. every time I eat I tend to piss someone off standing to my left as they think I’m poking my tongue out at them. Then it has to pass my voice box which, is damaged again and my speaking is now back to square one. Having a paralysed vocal cord is bad enough, but it actually affects your swallowing as well as your voice so the food has to dodge these obstacles. Next up is my esophagus which is well and truly buggered. Every morsel that reaches this spot faces the same struggle as the poor salmon trying desperately to get upstream to lay eggs.


Eating is now a monumental task and while it is nice to be able to taste the food, I simply cannot get enough down me to satisfy my hunger. The pure joy of enjoying home cooked food, something I have always done due to Cathy’s amazing abilities in the kitchen, is now gone.


All this leads to my decision to undertake that journey into hell called chemo again. I sometimes ask myself, What on earth possessed me to take this decision after the horror trip I had last time? Well, if the chemo works the one thing they hope it will achieve is the shrinkage of the tumour in my chest, and the ones squashing my esophagus from either side. It may actually allow me to eat more normally again, but that’s a big IF. I haven’t thought about the effect of the chemo on the one on my tongue or the tumours in my spine. First things first eh?


This time there'll be different chemo drugs and I'm being kept as an in-patient for five days so they can watch over me, which I think will take the pressure off myself and Cathy. The chemo is due to start on February 20th but to me that’s a long way off. One step at a time and the first one starts with the feeding tube on February 9th. My eighth general anaesthetic. Wish me luck. Here goes......

Yoga Helps Breast Cancer Recovery

Wednesday, February 8, 2012


Yoga creates harmony of mind and body. It has become center stage in the offerings of complementary therapies for breast cancer recovery. Yoga is now offered in conjunction with other standards of medical care.
Physically yoga can be an extremely important part of recovery wellness. It helps remove unwanted debris and toxins from the lungs, skin and colon.  By moving the body, stretching muscles and breathing deeply the toxins are physically released. This undoubtably helps cleanse the body. Yoga will eliminate ama (toxic residue) from the cells, move the lymph through the lymphatic system, and bring the mind into clarity. This clarity of mind encourages good decisions which then encourages more good decisions.
Emotionally yoga will remove anger, sadness and fear. It will give you a sense of inner strength, balance and mental flexibility. The Autonomic Nervous System becomes balanced especially when synchronizing with the breath and the movement. Resulting in the mind settling down and the body feeling energized.
Make sure you begin with your  physicians approval. Find a well qualified yoga teacher.  Do what you can; maybe starting with a gentle or restorative yoga practice first.
By: Diana Ross, E-RYT 500
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NCFCCC Kickoff - Prostate Cancer Update

Monday, February 6, 2012

Save the date for North Central Florida Cancer Control Collaborative's 2012 kickoff. The event will be held on Thursday, February 29 beginning at 10:00 am at Haven Hospice. Haven Hospice is located at 4200 NW 90th Blvd. in Gainesville, Florida.

A presentation by Dr. Johannes Vieweg, Chairman, Department of Urology, University of Florida on Prostate Cancer: Current Screening Policy Debates and Recommendations will be the main agenda item for the event.  More details will soon follow.

Please plan to attend and bring a friend. If you have any questions, do not hesitate to call Lindsey at WellFlorida:  (352) 313-6500 ext. 105 or 1-877-678-9355 (toll-free).

Complementary/Alternative Cancer Therapies Conference

Annie Appleseed Project's 5th Evidence-Based Complementary/Alternative Cancer Therapies Conference
Registration deadline: Feb. 20
Date of event: March 1
Location: Embassy Suites, West Palm Beach
CEUS and CNEs available for many professions
Learn more at: http://www.annieappleseedproject.org/5thevcocath.html