|CANCER & TREATMENTS FOR CANCER CENTER PATIENTS PREVENTION & RISK ASSESSMENT CLINICAL TRIALS & RESEARCH LIVING WITH CANCER|
Progress Summer, 1998
Thanks . . .
to patients and staff for making March's National Nutrition
Month a great success! In addition to the wonderful generosity
of the Great Harvest Bread Co., contributors including Bio-Foods,
Busch's Valuland, Ensure, Kroger and Noble World Wide Sales
and Resource donated hundreds of nutritional food items given
out to Cancer Center patients. Watch for more fun activities
It is comforting to know that your service is available
and will be of help to others in need of information about
current treatment options.
Facing Cancer with Style
When you look good, you feel better. Thats the simple idea behind a new program for women undergoing chemotherapy and radiation treatment at the University of Michigan Comprehensive Cancer Center.
The Look Good, Feel Better program offers simple tips and tools to help patients cope with often-traumatic treatment side effects such as hair loss, and regain a sense of self-confidence and control over their lives. The free program is sponsored nationally by the American Cancer Society, the Cosmetic, Toiletry and Fragrance Association Foundation, and the National Cosmetology Association.
Women of all ages attended the first group session at the U-M Cancer Center in April. Several trained cosmetologists helped women perform their own make-over using $200 worth of complimentary cosmetics and skin care products. They learned how to pencil in eyebrows, even out skin tone with foundation and blush, and emphasize lashless eyes with carefully applied eyeliner.
After their faces were picture perfect, cosmetologist Pam Hahn demonstrated creative techniques for disguising hair loss using wigs, turbans, scarves, hats and even old T-shirts. Good for a bad no-hair day, joked Hahn, who became a trainer for the program after both her husband and father were diagnosed with cancer.
As a hairdresser, I see a lot of people in my chair who are going through treatment, said Hahn. This program gives me an opportunity to give back to my wonderful clients and others. Its been very rewarding and a lot of fun.
Rebecca Roberts had just started chemo-therapy when she attended the first session. Breast cancer and its treatment really affects how you feel about your femininity, said Roberts, 38. Ive learned so much from this one session and its a wonderful group of people.
Laughter, camaraderie and exchanging of phone numbers proved the success of the first session to Lynn Dworzanin, M.S., R.N., C.S., the U-M nurse practitioner who was instrumental in organizing the Washtenaw community program in conjunction with the McAuley Cancer Center.
I felt strongly about offering Look Good, Feel Better to our patients, said Dworzanin.
Women who feel good about their looks demonstrate more self-confidence and empowerment, continued Dworzanin. These characteristics are intrinsic in helping women with cancer face the many challenges associated with their disease and treatment.
Cancer Center Named Finalist in Quality Cup Competition
The University of Michigan Comprehensive Cancer Center recently was honored at USA Today headquarters in Arlington, Va., for reaching the finalist level in the health category of the annual Rochester Institute of Technology (RIT) and USA Today Quality Cup Competition.
This national award recognizes teams making significant contributions to the improvement of quality products or services in an organization by applying principles of quality management.
Were very pleased to be one of only two finalists in the health category, says Marcy Bohm Waldinger, M.H.S.A., administrative director of the U-M Cancer Center. This award is a reflection of our faculty and staffs dedication to providing our patients with the highest level of care in a welcoming and efficient environment.
In preparation for opening a new outpatient facility in May 1997, the Cancer Center undertook a complete work redesign of the structure and process for diagnosis and treatment of cancer patients. Redesign concepts included the creation of six physician-lead teams organized by cancer type, improved convenience and comfort for patients receiving chemotherapy, and the creation of a clinic coordinator position to coordinate all scheduling and customer service training for staff.
Our primary goals were to be patient-focused, team-based and cost-effective, says Waldinger. Nearly one year after opening the facility, we continue to receive glowing feedback from patients, families, physicians, clinic staff and others.
For the seventh annual Quality Cup competition, 176 nominations were received from Fortune 500 companies, government agencies, educational institutions, health care organizations and small businesses nationwide. Judging, including a site visit to each semi-finalist, was conducted by USA Today editorial staff, RIT professors, consultants, academics and industry quality experts.
Promising radioimmunotherapy results
Its particularly encouraging that with a single therapeutic dose, patients were able to achieve molecular remissions a remission state which is believed to coincide with prolonged, durable responses to treatment, says Mark Kaminski, M.D., associate professor of internal medicine at the U-M Cancer Center. Molecular remissions are a rarity in patients treated with conventional chemotherapy. Non-Hodgkins lymphoma affects the blood and lymph tissues. According to the National Cancer Institute, approximately 270,000 Americans are afflicted with non-Hodgkins lymphoma each year. Of that total, it is estimated that about 92,000 people have low-grade or transformed low-grade disease, an incurable form of non-Hodgkins lymphoma.
Exploring long-term effects of breast cancer treatment
As part of this National Cancer Institute-funded study, long-term survivors complete a questionnaire about their medical history, specific cancer treatments, and any long-lasting side effects, in particular lymphedemapainful arm swelling that may result from surgery and radiation. Information on pain, secondary cancers and menopause also is collected, and participants are given a physical examination.
Based on information that will be collected from approximately 200 long-term survivors, researchers will develop a standardized tool for assessing lymphedema that can be used in future studies to measure the effectiveness of lymphedema treatments. It is important to know the long-term effects of breast cancer treatments in order to improve them, as well as to be able to counsel recently diagnosed women about the risks and benefits of treatment, says Schott.
Improving quality of life for survivors and families
Cimprich, along with Mark Chesler, Ph.D., U-M professor of sociology, received a research award from the National Cancer Institute to study the quality of life and related service needs of long-term cancer survivors.
Cheslers research focuses on discovering the psychological and social experiences of young and older survivors of childhood cancer, leukemias and lymphomas and their family members. Cancer is a family disease, and it has an impact on all family members quality of life, says Chesler. His work is a continuation of a study of 304 survivors of childhood cancer treated at the U-M C.S. Mott Childrens Hospital and their parents and siblings, and a 10-year follow up of 170 adult survivors of leukemia and lymphoma and their families.
Women living with a past diagnosis of breast cancer represent
one of the largest groups of survivors in the United States.
Cimprichs research focuses on gaining an in-depth understanding
of how breast cancer may affect quality of life including
physical, psychological and social experiences of 150 long-term
survivors of breast cancer who were diagnosed at younger,
middle and older life stages.
Experts Offer Eye-Opening Look at FatigueFighting cancer is a difficult process in the best of conditions, but very often severe fatigue becomes an overwhelming part of a patients daily life. Exhaustion, listlessness and an overwhelming need to sleep are common symptoms.
Many factors can contribute to cancer fatigue emotional stress, depression, anxiety, and changes in sleeping and eating patterns. Chemotherapy and its side effects can lead to anemia (a decreased number of red blood cells), which is a common cause of fatigue.
Too often, fatigue is accepted as an inevitable part of treatment by both patients and health care professionals, says Shon Dwyer, patient health educator at the University of Michigan Comprehensive Cancer Center. This doesnt have to be the case. There are ways cancer patients can feel more focused, alert and awake.
All of the eye-opening facts recently were presented at a free Cancer AnswerNight offered by the University of Michigan Comprehensive Cancer Center and sponsored in part by Ortho Biotech. A panel of experts lead by moderator Denise R. Reinke, R.N., B.S.N., O.C.N., taught patients how to fight fatigue using restorative activities, nutrition, exercise and daily planning.
Here are some highlights of what the experts had to say:
Bernadine Cimprich, Ph.D., R.N., C.S. Director of Cancer Center Behavioral Oncology Program and Assistant Professor of Nursing
Martha DeRoeck, M.S., R.D. Cancer Center Nutritionist
Sheila Crowley, M.S., R.N., C.S., O.C.N. Doctoral Student, U-M School of Nursing
Viola Wittersheim, Cancer Patient
A Gemstone of Support
The Patient Education Resource Center (PERC) offers free information on survivorship issues, support services, treatment options and community services referrals. The PERC is open to the public and staffed by a team of dedicated volunteers, many of whom are cancer survivors. Emily Hollenberg has volunteered at the Center since it opened its doors. She is a registered nurse, wife, mother of two, gourmet cook and a four-year survivor of breast cancer. Recently, Emily spoke with Maxine Solvay, the Cancer Centers Promotion Coordinator about her cancer journey and her involvement with the PERC.
Q. What type of cancer did you have and when were you diagnosed?
Share Your Hope and Humor!The U-M Comprehensive Cancer Center's Web site has a new section entitled 'Share the Hope and Humor.' It is for patients, survivors and loved-ones to share the inspirational messages that have helped them on their cancer journey. Please send poems, short stories, inspirational quotes and humorous items to Maxine Solvay, U-M Cancer Center, 427 Med-Inn, 1500 E. Medical Center Dr., Ann Arbor, MI, 48019-0843 or Email: email@example.com Trademarked and copyrighted material can only be used with written permission of the publisher. Materials will become the possession of the Progress editor and cannot be returned.
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Current Events In CancerWhat is the Breast Cancer Prevention Trial?
The Breast Cancer Prevention Trial is a clinical trial designed to see if the drug tamoxifen can prevent breast cancer in women who are at an increased risk of developing the disease. The National Cancer Institute-funded study began recruiting participants in April 1992 and closed enrollment in September 1997; 13,388 women ages 35 and older are enrolled at more than 300 centers across the United States and Canada, including the University of Michigan Comprehensive Cancer Center.
What is tamoxifen?
Tamoxifen is a drug, taken by mouth as a pill. It has been used for 25 years to treat patients with advanced breast cancer. Since 1985, it has also been recommended in the U.S. for adjuvant or additional therapy, following surgery and/or radiation for early-stage breast cancer. Tamoxifen works against breast cancer, in part, by interfering with the activity of estrogen, a female hormone that promotes the growth of breast cancer cells. In treatment, the drug slows or stops the growth of these cells.
Why was tamoxifen tested to prevent breast cancer?
Research has shown that taking tamoxifen as adjuvant therapy for breast cancer not only helps prevent the original breast cancer from returning but also helps to prevent the development of new cancers in the opposite breast. Researchers believed that tamoxifen might have a similar beneficial effect for women at increased risk of breast cancer. While tamoxifen acts against the effects of estrogen in breast tissue, it acts like estrogen in other body systems. Tamoxifens estrogen-like effects include the lowering of blood cholesterol and the slowing of bone loss.
Who participated in the prevention trial?
Women at increased risk for developing breast cancer participated in the study. These included women 60 years of age and older who qualified to participate based on age alone, and women between the ages of 35 and 59 with an increased risk of breast cancer equivalent to or greater than that of a 60-year-old woman. At age 60, about 17 of every 1,000 women are expected to develop breast cancer within five years. Participants were randomized (selected by chance) to receive either tamoxifen or a placebo. In a process known as double blinding, neither the participant nor her physician knew which pill she was receiving. This allowed researchers to see what the true benefits and side effects of tamoxifen are without the influence of other factors.
What are the initial results of the prevention trial?
Women on the trial have been followed for about four years. Results show 45 percent fewer diagnoses of invasive breast cancer in women who were randomized to take tamoxifen compared to women who were randomized to take the placebo (85 cases in the tamoxifen group versus 154 cases in the placebo group). Women on tamoxifen also had fewer diagnoses of non-invasive breast cancer. Eight women have died of breast cancer, three women in the tamoxifen group and five women in the placebo group. Tamoxifen did increase the womens chances of three rare but serious health problems. There were 33 cases of endometrial cancer (cancer of the lining of the uterus) in the tamoxifen group versus 14 cases in the placebo group; 17 cases of pulmonary embolism (blood clot in the lung) in the tamoxifen group versus 6 cases in the placebo group; and 30 cases of deep vein thrombosis (blood clots in major veins) in the tamoxifen group versus 19 cases in the placebo group.
Why was the study unblinded?
Participants and their physicians were informed what pills the participants had been taking when the National Cancer Institute, the National Surgical Adjuvant Breast and Bowel Project and an independent committee assessed the data, which showed clear evidence of a reduction of breast cancer incidence in the tamoxifen group. It was agreed that any additional information that could be gained from continuing the study in its current form did not outweigh the benefits of making the treatment available to the participants in the placebo group and other women at an increased risk of breast cancer.
Should women at increased risk of breast cancer take tamoxifen?
As with any medical intervention, the decision to take tamoxifen is an individual one in which the benefits and risks of the therapy must be considered. The balance of these benefits and risks will vary depending on a womans health history and how she weighs the benefits and risks. Therefore, even if a woman is at increased risk of breast cancer, tamoxifen therapy may not be appropriate for her. Women who are considering tamoxifen therapy should see their health care provider.
Get Involved in The MarchOn Sept. 26, individuals across the nation will pause to recognize the impact of cancer on our society. A grassroots campaign called THE MARCH: Coming Together to Conquer Cancer has been organized to make cancer its treatment and cure a national priority.
The campaign kick-off will be held on the Mall in Washington, D.C., where survivors and their families, physicians, researchers and elected officials will come together for a candlelighting ceremony and rally. The goal is to raise awareness that cancer is everyones problem and demand greater funding for cancer research and increased access to quality care for all people with cancer.
The University of Michigan Comprehensive Cancer Center is planning several exciting events in conjunction with national activities, including a Survivors March on the U-M Football Stadium during the Michigan State University game. For more information, please call (800) 742-2300, ext. 9268.
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M Personal TouchBreast surgery and other cancer treatments may alter a womans appearance and leave her emotionally shaken. M Personal Touch, a division of the U-M Health System, offers a program to meet the special physical and emotional needs of women confronted with a diagnosis of breast cancer.
Services and products available through M Personal Touch help restore a womans appearance and renew her self-confidence. This program is committed to helping women with special needs pursue the lifestyle they choose. For more information or to schedule an appointment for a personalized fitting, please call (734) 973-2400.
Max S. Wicha, M.D.
This publication is now a part of the Cancer Center's News Archive. It
is listed here for historical purposes only.
U-M Comprehensive Cancer Center