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There are many publications and sites that write about cancer. We want you to know we don’t produce the news items you can read in this section, they belong to the MD Anderson Cancer Center. This section only intents to inform you about what is out there.

However, we are working on the first edition of the Pink Ribbon Magazine as well as in the production of featured articles that will be published here.

 

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How hospitalists fit into cancer care

Being admitted to the hospital for complications related to cancer or your treatment can be scary and stressful. But hospitalists will help you during your stay.

These specialized members of the medical team often have a background in internal medicine but they’re specialized in order to coordinate care seamlessly and help patients navigate through their time at the hospital.

To understand the role our hospitalists play in a patient’s cancer treatment and care, we spoke with Marina George, M.D. Here’s what patients and caregivers should know.

What does a hospitalist do?

The hospitalist is your attending physician while you’re in the hospital. Our job is to synchronize all of your care — including diagnose you, treat you, help you recover — and make your hospital stay as smooth as possible. When our patients check into our hospital, they aren’t just coming with cancer – they have an entire medical history that we take into consideration, such as diabetes, heart disease or arthritis. The hospitalist coordinates your regular clinic or outpatient care team – such as your radiation oncologist, surgeon and/or medical oncologist – and also your inpatient care team, such as nurses and any specialists you may need to see. And we care for you during your entire hospital stay, from when you walk through the door to when you’re discharged. Our goal is to getting you recovered, out of the hospital and back to your cancer treatment in an outpatient setting as quickly and safely as possible.

How do hospitalists coordinate care?

We’re your medical voice. Patients don’t always know the questions to ask to have an informed, meaningful discussion with their care team. But as hospitalists, we have the medical knowledge and the time to spend with you to help you fully understand the situation and your options, so you can make a confident choice about your care.

For example, if you’re on chemotherapy, but come to the hospital because your tumor has grown and now obstructs your bowel, I’ll coordinate with your medical oncologist as well as a surgeon. I’ll hear the risks and benefits of a surgical intervention, and then meet with your medical oncologist to gather his or her recommendation. I’ll then bring all options to you, explain the pros and cons, and help you make a choice that’s in line with your values and wishes.

Hospitalists also help coordinate communication with your family. If necessary, we hold family meetings with you and your caregivers to ensure everyone is on the same page about your care.

What questions should I ask my hospitalists?

It’s your time to ask anything. I tell my patients to ask me all the questions they’ve always wanted to ask, but haven’t had the chance or didn’t feel comfortable. You’ll have the time to think about things while you’re in the hospital, and I have the time to answer your questions or find you the answer.

Most importantly, don’t be afraid to ask questions. That’s what I’m here for.

Does it complicate things if I’m enrolled a clinical trial?

No. We take care of patients on clinical trials exactly the same way we care for patients who aren’t. We’ll let the principal investigator of the trial know you’ve hit a road bump in your care and have been admitted to the hospital, but our goals are still the same – to get you recovered and back to your cancer treatment.

What’s your advice for a patient who’s going to be hospitalized?

The first thing you should do is ask for the name of your hospitalist. You want to make sure you know who is in charge of your care so that you remain informed and confident in what’s going on. When you meet your hospitalist, ask that individual to explain the status of your care in detail. Ask them to explain your care plan for the hospital stay and what medications you’ll be on. Then you can start planning together what support you’ll need once you’re home, such as home care, medical equipment or therapy.

Second, bring all of your medications with you to the hospital. We can work together to organize things and potentially consolidate what you’re taking.

Is there anything else you want patients to know about hospitalists?

Know that we’re on your side. Your hospitalist is your advocate. We’re going to communicate with the rest of your care team about your goals and priorities while we coordinate your medical care. We will act in your best interest.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

 

4 lessons I’ve learned from the other side of the stethoscope

As a pediatrician, I’m not sure if my familiarity with disease has made my fight against colorectal cancer easier or harder. What I can tell you is that I’ve learned more about health and well-being from being on the other side of the stethoscope than I ever could’ve by just going to medical school.

Here are the four biggest lessons I’ve learned.

Don’t ignore your body’s warning signs.

Fortunately, I’ve never had to diagnose colorectal cancer in one of my own patients. However, I did learn the warning signs in medical school. Bloody stools, bowel changes and abdominal pains are all symptoms of colon cancer. And I experienced all three for months before I finally sought treatment. But I was only 37 at the time. So I explained away my symptoms or minimized them. I realize now that I was in denial.

Use every tool you have to fight back.

After being diagnosed with colorectal cancer, I studied the connections between diet and disease extensively. I learned that while conventional cancer treatments do save lives, diet, exercise and mindfulness are also powerful medicines. I started preparing and enjoying more whole-food, plant-based dishes. I exercised when I could, and I took up meditation. The benefits were immediate. When I ate properly, my energy returned much more quickly after chemotherapy. I also felt better and my complexion improved.

Find a friend or family member who can advocate for you.

This is someone who can help you remember information at appointments, and make sure your needs are being met when you’re really sick or just not thinking clearly. My strongest advocate is my wife of 17 years, Stephanie. When I experienced unusually severe side effects during treatment, her pushing led to a blood test that revealed a rare enzyme deficiency.

Take advantage of support systems.

When I felt hopeless and ready to give up after suffering a relapse, Stephanie insisted I see a counselor. That turned out to be one of the best things I ever could’ve done. My counselor was also a cancer survivor, so she’d gone through many of the same roller coaster emotions I had. And when I told her how powerless I felt, she shared some resources that had helped her get through similar battles, some of which helped me, too.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Stereotactic body radiation therapy: a new option for pancreatic cancer patients

A decade ago, pancreatic cancer was treated with five to six weeks of radiation therapy and chemotherapy. Patients often experienced side effects that drastically impacted their quality of life and saw little survival benefit.

But a type of radiation therapy called stereotactic body radiation therapy (SBRT) is now offering some pancreatic cancer patients a better option. We spoke with Joseph Herman, M.D., to learn more.

What makes stereotactic body radiation therapy different?

Standard radiation therapies use a wider beam with a lower dose over a longer period of time. But SBRT is like a laser beam. We can deliver a more precise, higher dose of radiation in a shorter amount of time. So, whereas standard radiation therapy requires weeks of treatment, SBRT requires only five days, preferably consecutively. And each session is about 40 minutes, so there’s much less disruption to patients’ lives.  

Also, because SBRT is so effective, it may reduce the need for long-term chemotherapy for some patients.

How is stereotactic body radiation therapy more precise?

SBRT has a narrower beam of radiation that allows us to more precisely target the tumor.

Also, when a patient breathes, the tumor moves about a centimeter. To protect normal tissues from radiation exposure, we can track the tumor’s movement during breathing and activate the radiation beam only when the body is in a certain position. Or we can have the patient hold his or her breath for a few seconds and radiate the tumor when the body is still.

And to better target the radiation beam, we can implant two or three fiducials, which are gold markers the size of rice kernels. They’re inserted directly into or near the tumor endoscopically in an outpatient procedure that’s similar to a biopsy. They remain in the body unless the tumor is removed surgically after radiation. They make treatment more effective by helping ensure we destroy the tumor without harming any nearby tissues.

What are the side effects of stereotactic body radiation therapy?

Because SBRT is such a short course of radiation, patients don’t experience many side effects like they do with other radiation therapies. For instance, patients don’t have skin changes and only a few experience nausea. However, there’s a slightly higher risk of development of ulcers in the bowel, which may show up around three months after the treatment is complete.

How can these side effects be minimized?

We’re very careful when identifying patients who should receive SBRT to ensure that these patients aren’t at high risk for these long-term complications. For instance, SBRT is not the best option for a patient whose tumor is close to the bowel or stomach. If the tumor responds too quickly to the treatment, it can leave a hole in the digestive system. Because we better select patients based on this knowledge, we’ve been able to reduce the risk of ulcers from 10% to less than 2%.

Who’s a good candidate for SBRT?

Because stereotactic body radiation therapy delivers such a high dose of radiation and we want to limit radiation exposure, the best candidates are patients whose cancer hasn’t spread beyond the pancreas.

SBRT may also be a good option for patients who may not be candidates for surgery because their localized pancreatic tumor is touching a blood vessel. By shrinking the tumor with SBRT first, we’re able to offer surgery to more patient. And of the patients that receive surgery, we can successfully remove the entire tumor in 90% of patients, which reduces their risk of the cancer coming back.

But if a patient isn’t well-suited for surgery, SBRT can still be an option. It can help stabilize the growth of the tumor and prevent it from causing an obstruction in the bowel.

What stereotactic body radiation therapy research is underway?

We’re examining if we can safely give a higher dose to reduce the treatment time even further. If that’s not feasible, we’re studying whether there’s a drug that allows us to give a lower dose of radiation but with better results.

Additionally, Cullen Taniguchi, M.D., Ph.D, has a clinical trial that’s exploring raising the SBRT dosage while minimizing the risk of ulcers with the use of a potential radiation protector in pancreatic cancer patients.

We’re also combining SBRT with other therapies. For example, we’re studying if immunotherapy can jumpstart the immune system’s reaction to a tumor and make radiation therapy more effective. We’re also exploring targeted therapies to see if they will make a tumor respond better to radiation therapy.

What’s your advice for pancreatic cancer patients?

As doctors and researchers, we’re really excited about using stereotactic body radiation therapy to treat pancreatic cancer. Because we’re able to treat these challenging tumors with more precision in less time, we’re seeing our patients live longer with fewer complications. That’s incredibly rewarding.

But if you’re considering SBRT, choose a cancer center like MD Anderson that specializes in it for pancreatic cancer. It’s a relatively new therapy that’s just being expanded to treat this difficult disease. And it’s not just the doctor’s expertise that counts. Look for a whole team that’s experienced to ensure you’re getting the best treatment possible for the best possible outcome.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

Leukemia specialist: Identifying new treatments is the most gratifying part of my job

Because standard treatments have failed for so many patients, our goal at MD Anderson is to have a clinical trial available for everybody who walks through the door.

Whether they involve entirely new therapies or new combinations of approved drugs, clinical trials are intended to be an advance in medicine — to offer patients something better than what’s currently out there.

That’s why it’s so important to get an accurate diagnosis from the beginning. Different types of even one disease can call for vastly different treatment protocols. And we want to provide our patients with the right therapies from the outset — because our goal is to cure the disease, not just treat the symptoms.

The MD Anderson difference: expertise and personalized care

Any patient who walks through our doors — whether it’s for their first consultation or a second opinion — is going to get a complete workup. And because we perform tests that aren’t usually done by doctors elsewhere, such as bone marrow biopsies and genetic mutation tests, about 20-30% of the time, patients’ diagnoses will actually change. Once we know definitively what each patient has, we can individualize and personalize the best treatment for them, based on their disease’s characteristics.

With leukemia — which is my specialty — there are essentially two types: chronic and acute. Acute leukemia is aggressive and very fast-growing, so it usually causes a quick change in someone’s health. Often, those patients need urgent treatment. Chronic leukemia, on the other hand, is slower-growing, so it doesn’t always need treatment right away. It’s usually picked up during a routine physical exam.

The best way to find out exactly which kind of disease someone has is to visit a high-volume cancer center like MD Anderson. Each of our departments is large enough that its doctors can focus on a particular type of leukemia, rather than just leukemia in general. And our physicians’ high degree of expertise means we are able to treat not only the common cancers, but also the rare ones.

The best part of my job as a leukemia specialist

Early drug development is tricky, and a lot of pre-clinical work goes into developing a clinical trial, but leukemia has seen many advances over the years due to clinical trials that have set new standards of care.

In some cases, new leukemia treatments have brought not just hope, but life, to my patients — who otherwise would not have survived. And that’s why identifying new therapies is the most gratifying part of my job.

William Wierda, M.D., Ph.D., specializes in treating leukemia.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.

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