Tons of entries. Please feel free to peruse our site. Simply scroll down to the bottom of each page and click on “older entries.” What you’re looking for is probably somewhere in our haystack.
Archive for the ‘Uncategorized’ Category
James Fallows, senior editor of the Atlantic, interviews Eric S. Lander, one of the leaders of the Human Genome Project in the January/February issue of the magazine. It’s a splendid discussion about how scientists are investigating underlying causes of cancers. Not only an important read but an urgent plea for investing in a generation of brilliant young scientists who can help us ultimately find cures for cancers.
Cancer patients plagued with sleep troubles find insomnia and disturbed sleep can interfere with their therapeutic and supportive care measures. So it’s imperative that doctors offer patients reliable and effective interventions. It’s estimated that almost half of all cancer patients have sleeping problems. In large part, the trouble stems from pain and/or side effects of treatment. And such problems are best dealt with on an individual basis.
While it’s true that there are effective drugs that can help insomnia, many cancer patients don’t want to take additional medications—either because they have concerns about additional side effects or because they are afraid of developing a dependence on medication(s). There are two behavior interventions offered to help get sleep relief, and we can look at the latest findings relating to each of them.
The so called “gold standard” treatment is called cognitive behavioral therapy or CBT-I while the newer intervention is known as Mindfuness-Based Stress Reduction or MBSR. CBT is a psychotherapeutic approach that deals with dysfunctional emotions and maladaptive behaviors. Most therapists work with patients to allay anxiety and depression and these are problems that cannot be controlled through rational thought. It is effective to treat a variety of conditions—such as mood, anxiety, personality eating, substance abuce, tic and psychotic disorders. The therapist helps the patient deal with the “here and now’ to alleviate both the symptoms and the patient’s vulnerability.
MBSR, the second intervention, evolved into a complementary medicine that addresses a variety of health problems. Proponents say it brings together mindfulness meditation and yoga. It generally involved an 8-week intensive training in medication tries to produce a greater awareness of underlying emotiona, physical and spiritual health. The MBSR program started at the University of Massachusetts Medical Center in 1979 and is now offered in over 200 medical centers, hospitals and clinics around the world.
A new study just completed by researchers associated with the University of Pennsylvania found that both CBT-I and MBSR dramatically reduced insomnia and sleep deprivation. Their research involved 111 cancer patients recruited from a cancer center in Calgary, Alberta, Canada, to one of two randomly assigned interventions for their insomnia, either CBT-I (47) or MBSR (64). When assessed 3 months after completing an 8-week treatment protocol, researches found that both CBY-I and MBSR reduced insomnia across each group. However, the effects in the CBT-I group occurred more rapidly whereas the MBSR group tended to show more gradual improvement over time.
The conclusion the scientists reached suggests we should not apply a one size fits all model to the treatment of insomnia and stresses the need to individualize treatment based on the patient’s characteristics and preferences.
Details can be found online in the current Journal of Clinical Oncology.
From the Duke University Medical Center word that an investigational prostate cancer treatment slows progression of the disease and may increase survival. Researchers say this is especially true among men whose cancer has spread to the bones.
The study (Clinical Cancer Research, Nov 19, 2013) concerns the drug tasquinmod, a new candidate for treating advanced and recurrent prostate cancer. It is an oral therapy that activates the body’s immune system to fight the cancer. Its mechanism is not fully understood, but it is known to block tumore blood vessel growth. This study completed phase II clinical trials and works with men whose form of disease does not respond to hormonal therapy. The lead investigator, Andrew J Armstrong, MD, says the study found that men taking the drug saw no cancer progression for an average of 7.6 months, compared to 3.3 months for placebo. Men whos cancer had already metastasized to their bones and took tasquinmod remained progression free for even longer—8.8 months compared with 3-4 months for placebo. Dr. Armstrong believes that if phase III trials are safe and effective, the drug could open the door for evaluating the immunotherapy in other cancers.
Our blog was originally designed to help update readers on the latest advances in research and treatment of prostate cancer. Essentially, it helps us update our book—PROSTATE CANCER SURVIVORS SPEAK THEIR MINDS: Advice on options, treatments and aftereffects— and keep the lay audience informed.
By and large our readers are patients, their loved ones and close friends. And we make every effort to keep the language understandable. But we’ve also discovered that some who peruse the blog are doctors and research scientists who are anxious to know what results have just come from the laboratory. Many of those results involve clinical notes, trial information, beta findings, information yet to be proven—requiring further research and confirmations. New ideas that can be shared among the scientific community we believe can offer promise and hope for new inspirations. So we’ve decided to set aside special notes to the research and treatment communities that casual readers are free to read or skip over. We’ll call them NEW TRACKS.
We hope NEW TRACKS will lead scientists and scholars in new directions in the fight to eradicate prostate cancer.
NOTICE TO PROSTATE CANCER SCIENTISTS:
The American Association for Cancer Research (AACR) will hold an important Foundation Conference on Advances in Prostate Cancer Research
January 18-21,2014 at t he Manchester Grand Hyatt Hotel in San Diego.
Please check the link below for details.
About the Conference
The AACR and the Prostate Cancer Foundation are pleased to offer this conference to discuss the latest advances in prostate cancer research. A full range of topics from basic science to clinical research will be included in the program. The conference will also feature ample opportunities for young investigators to share their work and network with colleagues.
Continuing Medical Education Activity AMA PRA Category 1 CreditsTM available
M. Celeste Simon, Abramson Cancer Research Institute, University of Pennsylvania, Philadelphia, PA
Mary Helen Barcellos-Hoff, New York University School of Medicine, New York, NY
Michele De Palma, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
The following article is by Ram Meyyappan, Social Security Disability Help
Prostate Cancer and Social Security Disability
When you apply for Social Security Disability benefits, a representative of the Social Security Administration (SSA) reviews the Blue Book listings to determine whether or not your disability claim meets the criteria for a condition that has been published in the Blue Book. The Blue Book is a list of all of the conditions that could possibly qualify an individual for Social Security Disability benefits, as well as the criteria that must be met under each listing.
In the case of prostate cancer, the condition is listed under section 13.24 of the SSA’s Blue Book, Prostate Gland Carcinoma. According to the Blue Book, in order to qualify for disability benefits as a result of prostate cancer, your case of cancer must:
· Be progressive or recurrent despite initial hormonal intervention; or
· Have metastasized to other internal organs of the body.
If you can prove through medical documentation that you meet the above-listed criteria, your chances of being awarded disability benefits during the initial stage of the application process will be increased.
If you have small cell cancer of the prostate, then you will qualify for the compassionate allowances program. The compassionate allowances program is designed to speed up the application process for those with severe medical conditions.
SSDI and SSI
When you apply for disability benefits from the SSA, there are two programs that you may qualify for including SSI (Supplemental Security Income) and SSDI (Social Security Disability Insurance).
In order to qualify for SSDI, you must have earned enough work credits. For most people, this means working at least five of the past ten years. If you are not old enough to have worked a full ten years, you will have to have worked half of the time you have been able to work since age 18. For example, if you are 24, you will have had to have worked three of the past six years in order to have earned enough work credits to qualify for SSDI.
If you do not have enough work credits to qualify for SSDI, you may be able to qualify for SSI. You do not need work credits in order to qualify for SSI. Instead, SSI is a needs-based program and whether or not you qualify will depend upon your financial information in addition to meeting the disability requirements. In order to financially qualify for SSI benefits as of 2013, you must earn no more than $710 per month as an individual or $1,066 per month as a couple. You must also not have more than $2,000 in assets as an individual or $3,000 in assets as a couple.
For more information on SSDI and SSI visit: http://www.ssa.gov/disability/
Applying for Social Security Disability Benefits
You can apply for Social Security Disability benefits at your local Social Security office or online at the SSA’s website (http://www.socialsecurity.gov/pgm/disability.htm). When you submit your application for benefits, it is crucial that you provide substantial medical evidence to prove that you meet the criteria listed above. This can be done by providing the SSA with copies of your medical records including clinical histories, lab results, and treatment histories. When you submit your application, make sure you are very detailed when providing answers to the questions you are asked. The answers you provide will be used to help determine whether or not you qualify for disability benefits. Written statements from your treating physicians can also help you in your claim for disability benefits. It will take approximately three to six months from the date of your initial application to receive a determination regarding your disability claim.
Appealing a Denial
If the SSA denies your claim for Social Security Disability benefits, you have a right to appeal the decision. You must, however, do so within 60 days of the date of your denial notice.
When filing an appeal, it may be in your best interests to retain the services of a disability attorney. Your attorney can help determine why your initial claim was denied and address any weaknesses in your claim. He or she will then file a Request for Reconsideration. The SSA grants very few reconsideration requests. So if you are denied your initial claim it is likely that you will have to attend a disability hearing before an administrative law judge. This will be your best chance of being approved for benefits.
For more information on applying for disability benefits with prostate cancer, please visit: http://www.disability-benefits-help.org/disabling-conditions/prostate-cancer
As many readers know, the controversy over whether men should be tested for prostate cancer is ongoing. The PSA (prostate specific antigen screening test) has taken a lot of heat from some medical panels and physicians, ( the U.S. Preventive Services Task Force) and yet the American Urological Association, the American College of Physicians, many medical institutions, Johns Hopkins included, as well as many urologists throughout the country believe screening should not be ruled out for everybody. The consensus can be summed up this way. For younger men with minimal (low risk) cancer, annual PSA testing may not be recommended. Dr. David Samadi, chairman of Urology at Lenox Hill Hospital in New York is among physicians who say men should get a baseline test in their late 40s or 50s because follow up then becomes much more meaningful. For men over 55, if the PSA is considered high, the doctor may suggest or recommend active surveillance. However, there is almost general agreement that for high risk patients, which includes African Americans and men with a family history of prostate cancer, screening is advised, and probably early, at around age 40 or so. In any case, the decision whether to get screened or not, and the options open to patients with even minimal prostate cancer should be a joint decision–in other words, men should partner their courses of action with their physicians. Because every decision should be a personalized one. A shared decision. Prostate cancer is not a one size fits all disease and the course a patient decides to take is downright personal.
A recent national health survey suggests that the majority of men do not discuss prostate cancer screening with their doctors. In particular, 64 % of the men in this study never discussed the pros and cons of the PSA test with their doctors! Moreover, 88% claimed they were not given a choice about whether or not to screen for prostate cancer. That is a patient’s right and one he should insist on.
As reported in the July 14 NYTimes Sunday Review front page story (Do Clinical Trials Work), billions of research dollars are spent on drug tests that yield little in the way of critical information. Staggering, but true. We urge you to read the complete story for complete understanding. What does it boil down to? We’ll try to explain the basic facts.
Drug trials on humans generally involve 3 phases. Phase I evaluates the safety of a new experimental compound on a small number of patients. How best to deliver it. Phase II involves a larger number and safety factors are again monitored and does the drug appear to be working. Most drugs fail before they ever get to Phase III! But if they do, the clinical trials involve hundreds or thousands of additional patients. This time, the outcomes of the new drug are compared head to head with outcomes of those who now get a placebo. Strict tests are performed to make sure the drug is not only safe, but demonstrates the benefit is genuine and not simply the result of chance. Here’s the hard part: chance is a difficult thing to rule out! John P.A. Ioannidis, a professor of medicine at Stamford says, ” Chance often is the difference between whether a drug is deemed to work or not.” In randomized, controlled studies it’s often impossible to determine with certainty if a drug is working or not. The critical factor is frequently the size of the pool of patients in each group. Often patients seem to benefit from an experimental drug and others benefit on placebo. So how do you tell what is working, much less why? If a drug manages to get to Phase III the payoff can be so huge, pharmaceutical companies will roll the dice.
The fundamental challenge in designing clinical trials is trying to figure out how to design an experiment on a sub population of the world that is thought be be generalizationable to the overall universe. Testing a drug’s efficacy, for instance, on a younger generation of patients that may show the drug to be “successful” may not work at all on an older generation of patients for which the drug is ultimately being designed. So what is the solution?
Investigators say the strategy may be for subtypes of disease that are already known, to design small clinical trials and then enroll only those who have the appropriate genetic or molecular signature. The present piecemeal approach, they say, is too slow and too arduous. So the idea is to match drugs with patients with particular genetic and molecular structures. The plan, being tried by Genentech/Roche, uses in a statiistical technique called Bayesian analysis that lets doctors quickly glean the information about which therapies are working best. Researchers say there is no certainty in the assessment, but doctors get to learn during the process and then incorporate that knowledge into the ongoing trial.
Scientists are coming to understand just how much individualized human physiology and human pathology really are. On a genetic level, tumors in one person with, say, pancreatic cancer almost never will not be identical to those in any other person. The variability between individuals can be great, meaning that any two patients may have starkly different reactions to a drug. Bottom line: clinical trials and procedures are for now still on trial themselves.
Much research attention is being directed to the treatment of advanced prostate cancer. The Prostate Cancer Institute in Newport Beach, California has outlined a comparison of new treatments in cases patients encounter castrate-resistant metastatic prostate cancer.
Provenge This is one of the relatively new treatments used with minimal or no symptoms from their cancer. It is generally used after other therapies have been tried. Provenge is an immunotherapy. Special immune cells are removed from the body, in a way one donates blood. The cells are then modified and returned as in a infusion. Side effects sometime produce flu like symptoms: chills; fatigue;fever; joint pain; headache; muscle aches and pains; nausea
Xofigo Again, this drug is used for advanced prostate cancer but is a radioactive injection that is given in instances where the cancer has metastasized to the bone or where there has been a failure of medical or surgical treaatments to lower testosterone levels. Xofigo is the first radio active drug therapy for advanced prostate cancer that offers a survival benefit–about 4 months–and is well tolerated by patients. Common side effects: nausea; diarrhea; vomiting; swelling.
Xtandi This is one of the newer treatments for patients who have already received docetaxel. Xtandi works by killing prostate cancer cells, slowing their growth, and decreasing t he size o f the cancer. It differs from the other treatments (above) in that it’s taken as a pill. Most men are given 4 pills daily. Survival rate is somewhat over 4 months. In clinical trials, a few patients experienced seizures. Otherwise, common side effects: back pain; diarrhea; swelling; headache; upper respriatory infection; dizzinesss; insomnia.