Tuesday, May 22, 2012


Combining art forms: spirit masks and poems

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Stages of Griefmask1.jpgBy Janet Ruffin

Janet Hull Ruffin is an artist, arts educator and poet. She is finishing a book of poems showing what it's like to work with critically ill children in a major cancer center. She focuses on hospital culture, the therapeutic nature of art and spirituality.

She retired from MD Anderson in January 2009 after serving as the art teacher in the Children's Cancer Hospital for more than 10 years. Her position was special because the time she spent with patients and their families was not about diagnoses, examinations or treatments. They made art together. Currently, she volunteers with the Children's Art Project working with pediatric patients.


One of the most powerful forms of creative expression is achieved by combining art forms.

I practiced this concept working on a spirit guides mask project with the pediatric patients in the Children's Cancer Hospital. Spirit guide is a term used to describe an entity that remains a spirit in order to act as a guide or protector to a person.

The children and I began by reading a story about spirit guides and discussing what kind of information we would want from our guide.

Next, we brainstormed to decide what our guides would look like. Adhering plaster gauze to plastic molds of the human face made the masks. It was necessary to build out features on some of the masks, like the dragon and cobra masks. An eagle and angel mask had wings attached. There were also bear, clown and a superhero masks.

Painting and decorating each mask took weeks because I met with each student individually at different time and in all different places.
Turning action into words
To add a second dimension to this project, I turned the patients and their masks over to the Writers In The Schoolsprogram facilitators. The WITS teachers had the students write stories and poems about their mask.

This process deepened the experience of the child in relationship to their mask. Their words were staggering; everything from rage and bitterness to peace and acceptance.

Below is a poem that I wrote in response to one of the masks. I have not used the patient's real name.

Jamal's Mask 
He plasters over
the mold of a human
face, uses crumpled
newspaper and masking
tape to build a lower jaw
with fangs, then the massive
upper jaw.        Jamal forms

black horns above orange eyes
with yellow slits, paints the
inside of the mouth a red that
spills over the sides, bleeds
onto the fangs.        This is

his spirit guide, protector and
killer, destroys monsters that
inflict pain, dries up the poison
of snakes with his fire breath.

                                    Jamal knows

his dragon can turn on him,
what choice does he have?

Ekphrastic Poetry is writing that comments upon another art form.

Try it, feed your creativity. Write a poem about one of your favorite pieces of art, sculpture or song?

Read more posts by Janet Ruffin

Spring 2009: Denny Bixby – Surviving the Odds

Denny Bixby, Cancer Survivor

Three and a half years ago, the staff and board of The Minnie Pearl Cancer Foundation bid a fond farewell to colleague and director of development Sally Dadmun Bixby. After calling Nashville their home for nearly 18 years, Sally and her husband Denny decided to move back to Denny’s hometown of Portland, Oregon. Not only were they anticipating the birth of their first grandson in Portland, they were anxious to move back to be near family. In the prior year, Denny had been diagnosed with stage IV melanoma, a daunting diagnosis that, understandably so, had forced them to carefully consider how they wanted to spend their time.
Denny’s story with cancer began in 1999 in Nashville with a dark mole on his back that, when removed by a dermatologist, proved to be melanoma. Once clear margins were established (meaning there were no bad cells in the surrounding tissue), the melanoma became a somewhat distant memory. Then four and a half years later, Denny discovered a small lump on his right side. Although he was advised to watch and wait, another lump soon followed under his right arm and Denny went for medical consultation. Surgeries to remove the masses pointed to the stage IV melanoma that immediately began dictating Denny’s life. He quickly learned the harsh odds for his survival, that he had the worst form of skin cancer, and that his type of cancer was one that usually doesn’t respond to traditional methods of radiation and chemotherapy. With no clear-cut answer as to what needed to be done or how to proceed, Denny formed the strongest support team available to him: his wife Sally and his sister Linda. Together, with great determination and focus, they researched and met with surgeons, oncologists and melanoma research specialists in Nashville and across the country. Denny calls their immediate access to the caring support and sources of information at TMPCF “an unbelievable stroke of good fortune.”
Denny says, “I had to develop my mental strategy. I was relatively young at 54, very healthy other than having cancer, and had a strong will to live. I believed that I was as prepared physically, mentally and spiritually and as good a candidate for overcoming cancer as anyone could be.”
Denny underwent surgery and focused radiation and hyperthermia. He consulted with a Chinese physician for acupuncture to strengthen his immune system, took prescribed herbs, and embraced a diet loaded with antioxidants. Within a few short months, rejoicing in the news that he had no evidence of disease, Denny and Sally knew that the time was also right for making that move back to Portland to be closer to family. However, the relief was brief because within two months of his move in the fall of 2005, his scans were again positive for melanoma. Denny’s next step towards survival, this time in Portland where studies for treating late-stage melanoma with bio-agents had been conducted for 15 years, was inhospital treatments of Interleukin. Interleukin ramps up the immune system. At that point in Denny’s treatment, Interleukin was partially successful about 17% of the time and completely successful 5% of the time. With a mantra of “why shouldn’t I be in that small group of people for whom the treatment works” and believing that with his whole being, Denny opted for in-hospital stays for three courses of treatment that spanned several months.
Denny had a complete response to the Interleukin and has just passed the five-year mark since his diagnosis, which cancer survivors know is a critical milestone in survivorship. Additionally, statistics are that melanoma only recurs 1%–2% of the time in patients like Denny who experience a complete response to Interleukin. Denny attributes his near-miraculous recovery to not allowing hopelessness to overcome him, assembling his support team, taking swift and aggressive action to navigate his diagnosis and treatment, considering the benefits of both Western and Eastern medicine, practicing positive thought and prayer, and embracing healthy habits. He’s not resting on his laurels though—he continues to be watchful for new occurrences, sees a dermatologist routinely, and wears sun-protective clothing and 50 SPF sunblock (particularly while fly-fishing or during those beloved winter vacations on the Yucatan Peninsula). Denny also attributes his positive prognosis to sheer good luck, but luck which he helped make possible through his thoughtful approach to coping with an incomprehensible diagnosis. Today Denny continues to play music, and he and Sally spend lots of time with their two grandchildren and anticipate the arrival of another grandchild this year.

Latinas with BRCA gene mutations may have harder-to-treat breast cancers, researchers find


Latinas with BRCA gene mutations may have harder-to-treat breast cancers, researchers find 

 


By Shawn Le


City of Hope researchers confirmed that Latinas with certain inherited gene mutations that raise their risk of breast cancer are more likely to develop breast cancer that responds poorly to hormone therapy.
Breast cancer risk genes
Findings from the multicenter study were presented by City of Hope researcher Jessica Clague DeHart, Ph.D., M.P.H., assistant research professor in the Division of Cancer Etiology, during the 2012 Annual Meeting of the American Association for Cancer Research in Chicago in April.
The researchers studied Latinas who had what are known as BRCA gene mutations — genetic alterations that significantly increase their risk of developing breast and ovarian cancers.
In a previous pilot study, they found that Latinas with BRCA mutations were more likely than their white non-Latina counterparts to have breast cancers that were negative for progesterone receptors (PR). The most recent study expanded and confirmed those findings.
PR negativity means that the cancer does not depend on the hormone progesterone to grow. Some of the most successful modern breast cancer therapies that block hormones, like tamoxifen, are far less effective against these tumors. The prognosis for these cancers is poorer, and additional treatment may be necessary.
“Since PR negativity has been associated with how a patient’s breast cancer responds to endocrine therapy, further study of this condition in Hispanic women is warranted,” said Clague DeHart, who conducted her analysis under the guidance of senior study author Jeffrey Weitzel, M.D., director of City of Hope’s Division of Clinical Cancer Genetics.
Researchers in the multicenter trial enrolled 746 Latinas, of which 610 were diagnosed with invasive breast cancer. One out of every four of the women with breast cancer had either a BRCA1 or BRCA2 mutation. Overall, about half of the breast cancer cases were PR-negative.
Analysis revealed that the rate of PR negativity among Latinas with BRCA mutations was much higher than rates reported in other studies of white non-Latinas.
The study is the largest to date of high-risk Latino families in the U.S. with complete genetic profiling, clinical data and ethnic ancestry. The team is currently collecting data on white non-Latinas for a direct comparison.
The multicenter study is being conducted by the Clinical Cancer Genetics Community Research Network, an association of 19 hospitals and institutions around the country. It is supported by grants from the American Cancer Society and the National Cancer Institute (NCI).
NCI grants: CA085771 and CA153828

Breast Cancer Treatment Options

A patient's cancer treatment is dependent upon the type and size of the cancer diagnosed, the stage of the cancer, age, health status, previous cancer treatments, and any additional personal characteristics. Treatment may involve lumpectomy (surgical removal of the tumor) or a mastectomy (surgical removal of one or both breasts). Treatments may also include radiation, chemotherapy, surgery and other alternative programs.

When a sample of tissue is removed during a needle biopsy or during surgery, a team of pathologists dedicated specifically to analyze pathologies for breast cancer will examine the results thoroughly. To ensure accuracy, each specimen is read by two different pathologists on the breast cancer team. The pathologist report provides your doctor with a detailed description of the sample. This Pathology Reportis intended to be read by your doctor, so it is quite comprehensive and written in medical language.

Every breast cancer case at Alta Bates Summit is reviewed by a multidisciplinary panel of clinicians to determine the best course of treatment for individual patients. The multidisciplinary breast pre-treatment board includes radiologists, pathologists, breast surgeons, radiation oncologists and medical oncologists. In each board meeting the specialists review the medical status of the patient and analyze scans and pathology reports before discussing treatment options. This open, collaborative discussion allows for multiple clinicians to combine past experience and skills in treating breast cancer to come up with a treatment plan that best fits each individual patient’s situation.

Alta Bates Summit Medical Center has produced a series of videos on risk, diagnosis and treatment for breast cancer, and you can select from the topics to the right. The purpose of these videos is to guide you through the stages of evaluation of this disease, describe factors that affect prognosis, and discuss various treatments which may be appropriate for you.

We do not endorse or recommend one course of treatment over another, but rather provide this information to help you understand your options before you consult with your doctors about your treatment plan. Please note: Viewing these videos works best over a high-speed internet connection. If you'd prefer to receive a DVD copy, please call Markstein Services at (510) 869-8833.
View Our Educational Videos:

Reviewed 09/2010

Touched by an Eagle


Not many people get a picture of this proud bird snuggled up next to them.
Freedom and Jeff
Freedom and I have been together 11 years this summer.
She came in as a baby in 1998 with two broken wings.
Her left wing doesn't open all the way even after surgery,
it was broken in 4 places.

When Freedom came in she could not stand
and both wings were broken. She was
emaciated and covered in lice. We made the
decision to give her a chance at life, so I took
her to the vet's office.  From then
on, I was always around her. We had her in a
huge dog carrier with the top off,  and it
was loaded up with shredded newspaper for her to
lay in.  I used to sit and talk to her,
urging her to live, to fight; and she would lay
there looking at me with those big brown eyes.
We also had to tube feed her for weeks.

This went on for 4-6 weeks, and by then she still
couldn't stand. It got to the point where the
decision was made to euthanize her
if she couldn't stand in a week. You know you don't
want to cross that line between torture and
rehab, and it looked like death was
winning.  She was going to be put
down that Friday, and I was supposed to come in
on that Thursday afternoon. I didn't want to go
to the center that Thursday, because I couldn't
bear the thought of her being euthanized; 
but I went anyway, and when I walked in everyone
was grinning from ear to ear. I went
immediately back to her cage; and there she was,
standing on her own, a big beautiful
eagle.  She was ready to live.  I was
just about in tears by then.  That
was a very good day. 

We knew she could never fly,  so the director
asked me to glove train her.
I got her used to the glove,
and then to jesses, and we started
doing education programs for schools
in western Washington . 
   We wound up in the newspapers,
radio (believe it or not) and some
TV. Miracle Pets even did a show
about us.

In the spring of 2000, I was diagnosed with
non-Hodgkin's lymphoma. I had stage 3,
which is not good (one major organ plus
everywhere), so I wound up doing 8 months of
chemo.  Lost the hair - the whole
bit.  I missed a lot of work. When I
felt good enough, I would go to Sarvey
and take Freedom out for walks. Freedom would
also come to me in my dreams and help me fight
the cancer. This happened time and time again.

Fast forward to November 2000

the day after Thanksgiving,
I went in for my last checkup.
I was told that if the cancer was not
all gone after 8 rounds of chemo, then my last
option was a stem cell transplant. Anyway, they
did the tests; and I had to come back Monday for
the results.  I went in Monday, and I was
told that all the cancer was gone.

 So the first thing I did was get up to Sarvey and
take the big girl out for a walk. It was misty
and cold. I went to her flight and jessed her
up, and we went out front to the top of the
hill.  I hadn't said a word to
Freedom, but somehow she knew. She looked at me
and wrapped both
her wings around me to where I
could feel them pressing in on my back 
(I was engulfed in eagle wings), and she
touched my nose with her beak and stared into my
eyes, and we just stood there like that
for I don't know how long .  That was a
magic moment.  We have been soul mates ever
since she came in.  This is a very special bird.

On a side note:  I have had people who
were sick come up to us when we are out, and
Freedom has some kind of hold on
them.  I once had a guy who was
terminal come up to us and
I let him hold her.
His knees just about buckled and he
swore he could feel her power course through his
body. I have so many stories like that..

I never forget the honor I have of being so close
to such a magnificent spirit as
Freedom.

Hope you enjoyed this!

Cancer is a strange disease. You can go along for years in remission
and then one day it pops its head up again.
If you ever have it you will never be free of it.
Pray for the day there will be a permanent cure

                                                A small request...



93% won't forward this, but I hope you will.
 
All you are asked to do is keep this circulating, even if it's only to one person.
In memory of anyone you know who has been
 struck down by cancer or is still living with it.

Thursday, May 17, 2012


Antipsychotic medication relieves chemo-related nausea

New research presented Wednesday highlights drugs to make cancer therapy easier but also underscores the difficulties that patients may encounter after treatment.
  • Renee Nicholas, 37, had a double mastectomy after being diagnosed with cancer four years ago.
    Joel Salcido for USA TODAY
    Renee Nicholas, 37, had a double mastectomy after being diagnosed with cancer four years ago.
Joel Salcido for USA TODAY
Renee Nicholas, 37, had a double mastectomy after being diagnosed with cancer four years ago.

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A commonly used schizophrenia drug, Zyprexa, reduced the number of patients suffering from chemotherapy-related nausea and vomiting by more than half, according to a study of 80 patients presented in advance of the annual meeting of the American Society of Clinical Oncology.
The study focused on patients getting a heavy, triple-drug chemo combination, during which vomiting and nausea are very common, even among patients getting the best possible anti-nausea medications.
In the new study, led by Rudolph Navari of the Indiana University School of Medicine-South Bend, 68% of patients randomly assigned to be treated with a standard drug called Reglan, or metoclopramide, ended up vomiting, compared with 29% of those assigned to take Zyprexa, sold generically as olanzapine.
About 76% of those taking Reglan still became nauseated, compared with 33% of those taking Zyprexa, the study says. Patients took the drugs orally for three days, Navari says. While taking Zyprexa long-term can cause side effects, such as weight gain, doctors didn't note any major problems in patients taking this short dose, he says.
Nausea and vomiting are serious problems for many cancer patients, even causing some to stop taking their medications, says Sandra Swain, president-elect of ASCO. The group's annual meeting will take place June 1-4 in Chicago. For others, the side effects disrupt their lives and make it hard to work or take care of their families.
Swain says "this is a huge advance" that ranks alongside high-tech advances in drugs and so-called "targeted" therapies. "Even in this era of 'precision medicine,' we are still reminded that we need to improve the patient experience."
Chemotherapy causes nausea and vomiting in a different way than a stomach virus, says Andrew Putnam, an assistant professor of oncology and medicine at Georgetown Lombardi Comprehensive Cancer Center. Instead of upsetting the digestive tract, chemo activates the brain's "vomiting center," Putnam says. That's why an antipsychotic drug such as Zyprexa, which works on the brain, is able to help. He's recently tried prescribing it to his patients, with good results.
Breast cancer survivor Renee Nicholas, 37, says the nausea that accompanied her therapy was debilitating. "I tried every anti-nausea drug available," she says. "I even tried acupuncture once or twice a week."
Another study presented Wednesday, however, shows that doctors haven't made as much progress as they'd like.
Many primary care doctors — and even some oncologists — aren't informed about important health issues affecting cancer survivors, according to a study by Larissa Nekhlyudov of Harvard Medical School.
While cancer patients are typically seen by specialists during treatments, they often return to their family doctors or other generalists when they finish therapy, says Michael Link, ASCO's current president.
But finishing cancer therapy doesn't mean that patients are care-free, Link says. Cancer treatments can be highly toxic, saving lives at a punishing cost to the heart, bones and even the brain. Some therapies can push patients into early menopause, while others can cause new cancers.
Because patients are likely to be seen by their primary care doctors when these problems crop up, it's important that generalists know how to watch for these complications and monitor patients, Nekhlyudov says.
Her results show awareness was low:
• Only 15% to 17% of primary care doctors knew that a common type of chemo, cyclophosphamide, sold under the brand name Cytoxan, can cause premature menopause and second cancers.
• About 22% of primary care doctors knew that another drug, oxaliplatin, also sold as Eloxatin, can cause nerve problems and pain in the fingers and other extremities.
• About 27% knew that the drug paclitaxel, or Taxol, can cause these nerve problems as well.
• And 55% knew that the drug doxorubicin, or Adriamycin, can damage the heart muscle.
Yet even oncologists were unaware of some side effects, correctly identifying these complications 62% to 97% of the time, the study shows.
The study illustrates why it's important for every cancer patient to receive a treatment summary and survivorship plan when finishing active therapy, Link says. Those documents can concisely inform future doctors about which drugs, surgeries or radiation therapies patients have undergone, and which screening tests or other care they need to stay healthy. The study also reinforces the need to expand the use of electronic medical records to make sharing this information easier.
Nicholas, who was 33 when she was diagnosed with breast cancer, is thankful that her treatment went well but knows that she's at risk for future complications, such as heart problems related to her chemo and bone loss associated with another long-term breast cancer drug. And because she's so young, she has a long time ahead of her for problems to develop. Nicholas says she's grateful that her doctors monitor her so closely, checking her heart regularly and measuring her bone density once a year.
But overall, Nicholas says these are good problems to have, because they show she's survived a potentially lethal disease.
"This is really a problem created by our success," Link says. "There are now 12 million cancer survivors who are a testament to our success in cancer care."