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08 February 2007 @ 01:09 pm
Hope or: Cancer Sucks

Again and again, I have been touched by the smallest kind gestures - a squeeze of my hand, a gentle touch, a reassuring word. In some ways, these quiet acts of humanity have felt more healing than the high-dose radiation and chemotherapy that hold the hope of a cure.- Kenneth B. Schwartz

I went to a Schwartz Center Rounds last week and the topic was Hope, it was very lovely and empowering, but to me it lacked that kick-ass spunky attitude I crave.  

Schwartz Rounds are open to all hospital staff (try to sneak in and sit in the back)  sites include:


Current Rounds Sites


California
Scripps Mercy Hospital, San Diego
University of Southern California, Norris Cancer Center, Los Angeles

Colorado
Longmont United Hospital, Longmont

Connecticut
Lawrence & Memorial Hospital, New London
MidState Medical Center, Meriden
St. Francis Hospital & Medical Center, Hartford
Yale Cancer Center, New Haven

Delaware
Christiana Care Health System, Newark

Florida
Florida Hospital Cancer Institute, Altamonte
Florida Hospital Cancer Institute, Orlando
M. D. Anderson Cancer Center, Orlando
Mayo Clinic, Jacksonville
Moffitt Cancer Center, Tampa
Mt. Sinai Cancer Center, Miami Beach

Idaho
Saint Alphonsus Regional Medical Center, Boise
St. Luke’s Mountain States Tumor Institute, Boise

Illinois
Comer Children's Hospital, Chicago
Evanston Northwestern Healthcare, Evanston
Northwestern Memorial Hospital, Chicago
University of Chicago Hospitals, Chicago

Indiana
Indiana University Cancer Center, Indianapolis

Louisiana
Tulane University Health Sciences Center, New Orleans

Maine
Maine Medical Center, Portland

Maryland
Johns Hopkins – Sidney Kimmel Comprehensive Cancer Center, Baltimore
Western Maryland Hospital Center, Hagerstown

Massachusetts
Baystate Medical Center, Springfield
Beth Israel Deaconess Medical Center, Boston
Boston Home, Dorchester
Boston Medical Center, Boston
Bowdoin Street Community Health Center, Dorchester
Brigham & Women’s Hospital, Boston
Caritas Good Samaritan Medical Center, Brockton
Caritas Norwood Hospital, Norwood
Carney Hospital, Dorchester
Children’s Hospital, Boston
Dana-Farber Cancer Institute, Boston
Emerson Hospital, Concord
Falmouth Hospital, Falmouth
Faulkner Hospital, Jamaica Plain
Hancock Manor Nursing Home, Dorchester
Harvard Vanguard Medical Associates, Watertown
Health Alliance Hospital Hospitals, Fitchburg
Hebrew Rehabilitation Center for the Aged, Boston
Heywood Hospital, Gardner
Joseph M. Smith Community Health Center, Allston
Lahey Clinic, Burlington
Life Care Center of Nashoba Valley, Littleton
Martha's Vineyard Hospital, Oak Bluffs
Massachusetts General Hospital, Boston
MetroWest Medical Center, Framingham
Mount Auburn Hospital, Cambridge
NE Sinai Hospital & Rehabilitation Center, Stoughton
Newton-Wellesley Hospital, Newton
North Adams Hospital, North Adams
North Shore Medical Center, Salem
Rehabilitation Hospital of Cape Cod & the Islands, Sandwich
Saint Anne’s Hospital, Fall River
Saint Vincent Hospital, Worcester
South Shore Hospital, South Weymouth
Spaulding Rehabilitation Hospital, Boston
Tufts-New England Medical Center, Boston
UMass Memorial Healthcare, Worcester
VA Boston Healthcare System, Brockton
VA Boston Healthcare System, West Roxbury
Winchester Hospital, Winchester
Youville Hospital, Cambridge

Michigan
Henry Ford Hospital, Detroit
Ingham Regional Medical Center, Lansing
MidMichigan Medical Center, Midland
Providence Cancer Institute, Southfield
Saint Mary’s Health Care, Grand Rapids
University of Michigan Medical Center, Ann Arbor
William Beaumont Hospital, Royal Oak
West Michigan Cancer Center, Kalamazoo

Missouri
St. Luke’s Cancer Institute, Kansas City

Nebraska
University of Nebraska Medical Center, Omaha

New Hampshire
Dartmouth Hitchcock Medical Center, Hanover
Exeter Hospital, Exeter
Frisbie Hospital, Rochester
Wentworth-Douglass Hospital, Dover

New Jersey
Ocean Medical Center, Brick
Overlook Hospital, Summit
Valley Hospital, Ridgewood
Virtua Health-Memorial Hospital, Mount Holly

New York
Mount Sinai Hospital, New York City
Roswell Park Cancer Institute, Buffalo
University of Rochester Medical Center, Rochester
VA New York Harbor Healthcare, Brooklyn
VA Western New York Healthcare System, Buffalo

North Carolina
University of North Carolina at Chapel Hill

Pennsylvania
Lehigh Valley Hospital, Allentown
University of Pennsylvania Medical Center/Presbyterian Hospital, Philadelphia

Rhode Island
Miriam Hospital, Providence
Rhode Island Hospital, Providence

Tennessee
East Tennessee State University, Johnson City
Saint Thomas Hospital, Nashville
Vanderbilt University Medical Center, Nashville

Texas
M. D. Anderson Cancer Center, Houston

Vermont
Fletcher Allen Health Care, Burlington

Virginia
Vinson Hall Corporation, McLean

Wisconsin
Froedtert Memorial Lutheran Hospital, Milwaukee


 
 
Clinical trials involving humans, that's right... experiments on YOU.



You may be asked by your doctor, or nurse, if you would be interested in participating in a "Clinical Trial". Why? Usually because the medical community wants to know if they are doing everything they can to give you the best possible treatment for you. That's easy. But what if the best treatment is a "maybe it will work" or "it works in the test tube!"



I have been involved in three clinical trials in my life.

1. When I was in college I volunteered to help test the reliability of polygraph machines. I was wired up strapped in and then experimented on. I remember signing something, I didn't read it beforehand though. (I have NO faith in the ability of a polygraph machine to accurately predict truthfulness in humans... none).

2. I volunteered to try an experimental nasal-pathway anti cancer drug, to test for efficacy (does it work well enough to change the way things are currently administered). I remember looking at the consent and knowing what it was. The doctor explained it so well that I didn't really read it when I took it home that night; the next day I said I did read it though...

3.  I volunteered to be measured all over and followed for a long time to see if my body changed in predictable ways. I was working in the field by then so I couldn't WAIT to read the consent and compare and contrast what what written with what the doctor had said, with their language compared to the language we use in our consents, it was great fun! (didn't meet the eligibility requirements for that study though)


Like every other "after the fact" guy, I want folks to pay more attention than I did.

How many NCI trials are listed in Physician Data Query (PDQ®) database for the four major types of cancer?
  • 133 for lung cancer (including 95 for non-small cell lung cancer, 33 for small cell lung cancer, and 3 for pulmonary carcinoid tumors),
  • 192 for breast cancer (including 152 for female breast cancer and 40 for male breast cancer),
  • 90 for prostate cancer
  • 57 for colon cancer.
Where do I go for information?

NCI-designated Comprehensive Cancer Centers


Clinical Trials Cooperative Groups

American College of Radiology Imaging Network
Bruce J. Hillman, M.D., Chair
Suite 1600
1818 Market Street
Philadelphia, PA 19103
http://www.acrin.org

American College of Surgeons Oncology Group
Heidi Nelson, M.D., Co-Chair
David M. Ota, M.D., Co-Chair
2400 Pratt Street
Durham, NC 27705
http://www.acosog.org

Cancer and Leukemia Group B
Richard L. Schilsky, M.D., Chair
Suite 2050
230 West Monroe Street
Chicago, IL 60606
http://www.calgb.org

Children’s Oncology Group
Gregory H. Reaman, M.D., Chair
440 East Huntington Drive
Post Office Box 60012
Arcadia, CA 91066–6012
http://www.childrensoncologygroup.org

Eastern Cooperative Oncology Group
Robert L. Comis, M.D., Chair
Suite 1100
1818 Market Street
Philadelphia, PA 19103
http://www.ecog.org

European Organisation for Research and Treatment of Cancer
Françoise Meunier, M.D., Director General
Avenue E. Mounier 83, BTE 11
B–1200 Brussels
Belgium
http://www.eortc.be/default.htm

 

Gynecologic Oncology Group
Philip J. DiSaia, M.D., Chair
Suite 1020
Four Penn Center
1600 John F. Kennedy Boulevard
Philadelphia, PA 19103
http://www.gog.org

National Cancer Institute of Canada, Clinical Trials Group
Joseph L. Pater, M.D., Director
Queen’s University
10 Stuart Street
Kingston , Ontario K7L 3N6
Canada
http://www.ctg.queensu.ca

National Surgical Adjuvant Breast and Bowel Project
Norman Wolmark, M.D., Chair
Fifth Floor
East Commons Professional Building
Four Allegheny Center
Pittsburgh, PA 15212–5234
http://www.nsabp.pitt.edu

North Central Cancer Treatment Group
Jan C. Buckner, M.D., Chair
200 First Street, SW.
Rochester, MN 55905
http://ncctg.mayo.edu

Radiation Therapy Oncology Group
Walter J. Curran, Jr., M.D., Chair
Suite 1600
1818 Market Street
Philadelphia, PA 19103
http://www.rtog.org

Southwest Oncology Group
Laurence H. Baker, D.O., Chair
24 Frank Lloyd Wright Drive
Post Office Box 483
Ann Arbor, MI 48106
http://www.swog.org


 
 
22 January 2007 @ 04:24 pm
How hard its it to change your course when you have a really big ship?

Paul Levy has this to say: http://runningahospital.blogspot.com/2007/01/infectious-behavior.html

"Wash your hands, and the rest will follow..." I always say, but I'm a little guy. This is a big guy, in a big hospital. And he came out SWINGING! There are infections in every medical environment out there. Like schools,however, how hospitals deal with the problem is like how parents decide where the little tykes get enrolled.


This ship is larger than any single hospital; even the biggest. It is all about how WE act when we're in a hospital. And when I say we I mean WE!  That means every single man, women and child out there. Kids swap cold germs every time they swap toys in school. That doesn't mean you don't TRY to make them wash their hands, and you TRY to have environments where wiping things down are a part of how you act. I wasn't going to a gym for very long before a understood that wearing shower-slippers is good for everyone. I wouldn't THINK of going to a salad bar with out a sneeze guard, and I treat my work environment with a healthy caution.

We need to shake hands when we meet people, it's a part of being human. But I feel just as comfortable saying "I'm getting over something right now", when I'm not sure if I'm still contagious after a cold.

We need to touch doorknobs, elevator buttons and hand rails, so I try to minimize how often I touch my face.


If I'm going INTO a treatment area, I wash my hands and try to be respectful of people's personal space. I work in oncology and some of these folks don't need any more germs coming at them.

 
 

Came upon this in my reading. First, as always, who can read this stuff! Second, PIRATES!


"In addition, HHV-8 has a number of genes such as ORF K12 (encodes the highly expressed transcript, kaposin), and ORF K1, a transmembrane protein that interacts with immunoreceptor kinases, which are likely to play a role in tumorigenesis. Functional studies suggest that these pirated genes may help the virus to evade immune responses, prevent cell cycle shutdown and interrupt activation of apoptotic pathways. This strategy has been referred to as "molecular piracy" of host cell genes. Like many complex DNA viruses, HHV-8 encodes a number of immunomodulatory factors:

Jack Black Fas signalling in (virus-infected) target cells is triggered by Fas receptor multimerization on binding with membrane-bound Fas-L. Subsequent recruitment of the adaptor molecule Fas-activated death domain (FADD) leads to upstream caspase (caspase 8) autoactivation and release, leading to downstream effector capsase activation (caspase-3, -6, -7) & apoptosis. Death-receptor triggered apoptosis can be inhibited at several points: at the initiator stage by FLIP or in the amplification loop by bcl-2. HHV-8 v-FLIP block apoptosis in virus-infected cells. In addition, the vius also encodes a decoy (non-signalling) Fas receptor.
(Rezaee SA, et al. Kaposi's sarcoma-associated herpesvirus immune modulation: an overview. J Gen Virol. 2006 87: 1781)

Plus, Pirates just kind of... GO with oncology
http://haikuoftheid.blogspot.com/2005/12/pirates-arrrrrgh.html
 
 
12 January 2007 @ 12:37 pm
Dr. Henry Koon has a lot to say about AIDS related Kaposi's Sarcoma, Chronic Myeloid Leukemia (CML) and Gastrointestinal Stromal Tumors (GIST) and about Cancer  - In General.

Cancer was presumed to be  "of  a kind" like Kubrick's "2001: A Space Odyssey" Big Black Monolith. All the same, impenetrable and unknowable... with dire consequences for mankind.



Along comes a clinical trial that says "Hey, This type of Cancer, and only this type, needs an exact thingy to grow. Lets make sure it doesn't get any of that thingy and see what happens. Viola! Cancer dies. What does this mean? Well, not only are cancers different because:
1. You can catch them (HPV) or you can't (Pancreatic)
2. You can increase your odds through contact (Asbestosis) or behavior (smoking)
3. You can be genetically vulnerable (Colorectal) or not (Melanoma)
But you can be everything or nothing all at once! (Breast)

Old timey oncologists:


New timey oncologists:


This means we may not rid the world of cancer in YOUR lifetime, but we are going to whittle away at the monolith by helping people identify which behaviors to avoid (unprotected sun exposure) and which behaviors to do (EAT RIGHT!!!!!!); what cancers we are likely to get (genetic testing). And which TYPE of cancer we have, to tailor our chemo, like our clothes, just for us.  Like Time Magazine said, this time it's all about YOU!


 
 
 
27 November 2006 @ 06:08 pm


"Health physicists are establishing safe procedures for a promising experimental brain-cancer therapy which uses a radioactive version of a protein found in scorpion venom. For many, this will conjure images of Spiderman's nemesis, the Scorpion. The purpose of this work is not science fiction, but rather to help to develop a promising new therapy for brain cancer. The venom of the yellow Israeli scorpion preferentially attaches to the cells of a type of essentially incurable brain cancers known as gliomas."







Radioactive Scorpion Venom
as a treatment for brain cancer! Apparently, making it radioactive gives it the punch - but the question is... why is scorpion venom attracted to cancer cells? Is this a first time case of two wrongs making a right? 

And another question... who thought this up? What is the conversation around that water-cooler like?

Joe Scientist/Physicist: Yeah, vacation was a hoot. Mary and the kids went hiking but I stayed in the tent to nap. I got bit by a horribly ugly little desert critter and after nearly dying I only ended up with a headache! Thank god I never go anywhere without my pocket-lab. That anti-venom I made only took seven minutes, I had THREE whole minutes to spare. Science rules!

Jill Scientist/Physicist: A headache you say? Hummmmm... I wonder if that's the T-cell Tram-34 carrier we've been looking for. Quick! Someone get me some venom and radiate it, before I forget to write this down.

It could happen, Scientist/Physicists are capable of saying just about anything and making it appear normal.



These are seriously smart folks, just the sort we want  theorizing about venom and it's possible uses to improve mankind.
They are the MacGyvers of the medical world. They just know how to do things.
 
 
20 October 2006 @ 05:04 pm
Look!
Down on your plate of food!
Able to stop mutation with a single bound!
Able to fly at the source of Cancer DNA!
It's Super Vitamin B - FOLATE!



Dietary Supplement Fact Sheet: Folate   Yes FOLATE (One of the B vitamin complexes) It's in the food we should be eating anyway, and the good news just keeps piling up! I was thinking about diet the other day. I sat down to a dinner of corn, just corn, and thought back to being a child and imagining what it would be like to make dinner for myself! Cakes and cookies, ice cream, goodies, olives (weird, I know, but my niece liked them as a toddler too... so it must be genetic) I never once pictured myself sitting down to a meal I had chosen for myself, that even INCLUDED veggies, let alone consisting of ONLY veggies! Either I am an adult or I have had some kind of extreme brain DNA mutation - WHICH COULD IT BE? Do we really hate vegetables as youngsters, or do we just react to all the anti-veggie propaganda around us? Kids are supposed to hate vegetables...right? Who's kidding who? NO sugar, NO fat, NO salt: OF COURSE KIDS SHOULD HATE VEGGIES! And that's why we adults have to do our duty, and take every opportunity to SHOVE THEM DOWN THIER LITTLE THROATS! Trust me, they'll thank you when they're older... or they won't. Either way, feed them greens and they'll be around long enough to hate you for it! And that's the point.




Fun with veggies!
 
 
06 October 2006 @ 10:47 am
New outreach. New times. Old  Nemesis: "she whom none can escape".

Says WHO?   After far too long , awareness equals RESULTS. Get your mammograph, do your self check-up and SAVE YOUR LIFE.


The word Nemesis originally meant the distributor of fortune, neither good nor bad.
 
 
Now THIS I've heard before! Find someone who does something better than everyone else and then hire them for the job. Only now, after you locate them, clone a bunch more.

 
 
31 July 2006 @ 11:45 am


http://www.massgeneral.org/cancer/care/adult/thoracic/developments.asp

 Laser guided targeting, 4D topography, Smart targeting cabilities... This is WAR! And it's being fought  Here & Now, Not STAR WARS... but  CANCER WARS.

It seems to have taken a few short years for the Strategic Defensive Intiative (or Star Wars) to blunder and crash  into obscurity, but the the promise of the technology lives on - like the rebel alliance. Small pockets of under-funded, under-staffed and under-equipped rebel thinkers, bending the powers of their combined thoughts to one task - a laser and drug guided radiation system that ZAPS the cancer cells and leaves the healthy tissue undamaged. May the force (In this case, NIH dollars) be with them!

I like to think of radiation oncologists as Yodas, wise men and women with a shaky grip on language and a super-steady, very DEADLY grip on the laser beam. Destroy this menace I will!


The battle rages on all around us...