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The Reimagine online symptom self-management curriculum may significantly improve some of the symptoms associated with chronic pain among breast cancer and other cancer survivors, according to a study published in Supportive Care in Cancer.

Chronic pain, a common adverse associated with cancer survivorship, has been associated with reduced physical functioning, quality of life, depression, and fatigue. Despite adherence to treatment guidelines for pain management with opioids and other pharmacologic options, treatment is often ineffective; coping skills and other mind-body therapies may improve outcomes among survivors.

For this randomized control trial, investigators enrolled 89 adult breast cancer survivors, either no evidence of disease or in remission, and assigned them to the Reimagine group or usual care. Patients also completed electronic surveys at baseline and 18-weeks after intervention that assessed outcomes such as pain severity/interference, depression, fatigue, and satisfaction.

The authors concluded that “Reimagine has an effect on depression and fatigue symptoms for breast cancer survivors. Online programs can be a feasible and effective alternative to in-person support. Additional research is recommended with larger and more diverse samples.”

For a copy of the complete study, please click here.

 

 

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Posted by on in Health: Breast Cancer

Over the years, I have taught my Create to Heal classes to many women with metastatic breast cancer; so, when I saw Dr. Erika Hamilton, the Associate Director of the Breast Cancer Program at Sarah Cannon Institute of Research in Nashville, being interviewed regarding a new breast cancer vaccine, I decided to blog about the growing field of Immuno-Oncology.

According to Dr. Hamilton, the early trial of this vaccine is very promising. The vaccine which is being developed at Washington University in St. Louis, fights against Mammaglobin-A, a protein that is expressed on the cell surface of 40 - 80% of cancer cells. The primary objective of the trial was to see if this vaccine is well tolerated. Based on the results, it is and in half of the 14 patients, their cancer did not progress. Based on these promising results, researchers at Washington University are planning a more in-depth study .

Dr. Hamilton and others at the Cannon Institute are pioneering a new class of therapy, designed to boost the immune system so the body can better fight the disease. Immunotherapy may offer an effective and safe approach to fighting cancer; patients will receive the same or better results as chemotherapy without the side affects. 

Since Immuno-Oncology is a rapidly advancing field, with several cancer vaccines already approved, will we see the end of chemo and radiation? Not immediately, according to Dr. Hamilton, but down the road, yes. 

 

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I am very fortunate to be affiliated with Glendale Adventist Medical Center's Oncology unit. I started my Create to Heal (tm) program in early 2010 and Glendale Adventist was the first medical center to embrace my teachings and classes. I am now working very closely with the oncology unit and their incredible nursing staff ... who are some of the finest, most compassionate, competent health care professionals you will find anyway.  I learn a lot from them and from their patients. Yesterday, we had a discussion on Angelina Jolie's decision to have preventative surgery because of the BRCA gene.
 
Here are their thoughts on the Jolie effect:

"Her risks are high, she already has children, she does have the money for excellent reconstruction. However, many other women are not as fortunate. They do not have the resources to cover the test and the surgery."
 
"Some people are influenced by a celebrity's decision to do something. I am influenced by my professional role models in medicine."
 
"Based on the evidence and research on breast cancer, she made a wise choice.  AND, she was right to announce her decision - the press would have eventually found out about this.  It would be nice if she could use her celebrity to influence the availability of the BRCA gene test and ultimately the costs associated with the surgery, so other women can have the same options."
 
"Good decision.  She has her children and the resources. AND, she is bringing more awareness to early detection and helping women to feel better about the surgery and their bodies."
 
"Health care professionals will always choose LIFE. Patients may see the vanity in things, but we are always going to save the persons life.  Its nice that one of the most beautiful women in the world chose surgery, and she did it for the right reasons: she chose life."
 
"Brave choice, that helps you with your mental state. If you are always worried that you might get cancer, you are less ready to fight the disease. We are constantly witnessing the power of a positive mental state.  If a patient's mental state is good, they do well with their treatments.  If they are negative, they don't do well with their treatments.  It's that simple."
 
"Sparking a debate and awareness of health issues is a good thing. And, everybody is different - they respond to treatments differently, they have different circumstances and these types of decisions are very personal."
 
"I recently met a mother who battled cancer. Her two daughters decided to have the BRCA gene test. One daughter has the gene, the other does not. The daughter with the gene is now more aware and able to monitor her health in a proactive fashion. This type of knowledge can be invaluable."


 
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Posted by on in Health: Breast Cancer
For those of you who don't know, I work very closely with cancer patients - many are going through treatment for breast cancer and ovarian cancer. When I heard the Angelina Jolie news, I was wowed at first by her decision as one of the most beautiful women in the world. This could encourage women to realize that without breasts, they can still be beautiful. I hear from many women that breast cancer surgery is "mutilation" and reconstruction "painful" with "less than optimum results." Then I got to - are there any guarantees she won't get cancer anyway? And then realized that her mother died of ovarian cancer, which is even deadlier, because it is so hard to detect. Will she opt to take out those as well? I polled a number of women who are survivors, (no evidence of disease) and those who are still in treatment. 
 
Here are their thoughts: 
 
"It's a personal decision based on your situation. There's no right answer. Angelina chose her kids over her body image. And you're right about her still getting cancer, it might happen." "I think she should have skipped the surgery. She's in a position to have great medical care and as frequent pre-screening as much as she likes. Also access to the latest medical technology. So much of this is based on early detection." 
 
"I think Angelina Jolie's issue is based more in fear and anxiety than the actual illness. I feel that there are many other ways to prevent cancer instead of a double mastectomy. Getting rid of the breasts are not the perfect solution because the cancer can strike anywhere. (Even though the breast cancer cell is different type from other kinds of cancer.)" 
 
"My first reaction was, 'Oh! I would do the same thing'. After that, a lot of ideas came to my head, for example: 'It doesn't surprise me that Angelina made that decision, but I also think this is going to have a different type of impact on women; for example, they will now probably place more attention on breast cancer; but the other side of this preventive approach could become the perfect excuse for aesthetic surgery in teenagers, and women in general. The first reaction from the ladies in our cancer support group was 'I would do the same thing,' because they have been through the experience already." 
 
In my next blog, I will be sharing reactions from oncology nurses and doctors to Jolie's decision.
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