Waldenström Macroglobulinemia

Blood Cancers

Brain Cancer

Metastatic Breast Cancer

Breast Cancer

Childhood Cancers

Anal Cancer

Colorectal Cancer

Esophageal Cancer

Gallbladder Cancer

Gastrointestinal stromal tumor

Liver Cancer

Pancreatic Cancer

Gastrointestinal Cancers

Bladder Cancer

Kidney Cancer

Prostate Cancer

Testicular Cancer

Genitourinary Cancers

Cervical Cancer

Ovarian Cancer

Uterine Cancer

Vulvar Cancer

Gynecologic Cancer

Head & Neck Cancer

Immunotherapy

Acute Myeloid Leukemia

Leukemia

Mesothelioma

Lung Cancer

Follicular Lymphoma

Mantle Cell Lymphoma

Non-Hodgkin Lymphoma

Small Lymphocytic Lymphoma (SLL)

Lymphoma

Myeloma

Cancer of Unknown Primary

Carcinoid Cancer

Neuroendocrine Cancer

Rare Cancers

Sarcoma

Melanoma

Skin Cancer

Thyroid Cancer

News

Cancer Horizons

All News

Blogs

Caregiving

Diet and Exercise

Financial

Psychosocial

Recipes

Sexual Health

Side Effect

Survivorship

Videos

All Videos

CURE Connections

CURE Expert Connections®

CURE Speaking Out

CURE TV

Educated Patient Sound Bites

On Demand: Webinars

Conferences

Conference Coverage 

Conference Listing 

Events

CURE Adventures

CURE Awards

Educated Patient In Person Education

Educated Patient Virtual Education

Resources

Advocacy Groups

Art Gallery

Clinical Trial Corner

Heal®

Partners

Podcasts

Publications

Share Your Story

Subscribe

CURE provides access to the cancer news, latest oncology research & expert insights that serve as a guide to every stage of the cancer experience.

About

Advertise / Support

Contact

CancerNetwork.com

TargetedOnc.com

OncLive.com

OncNursingNews.com

Terms & Conditions

Privacy

Do Not Sell My Information

CURE - Oncology & Cancer News for Patients & Caregivers

Facebook

Youtube

Instagram

Spotlight

Breast Cancer Webinar Series

Cancer Type

Bladder

Breast

Kidney

Lung

Ovarian

Prostate

Skin

About CURE

Press Releases

Write for CURE

1rem

Authors

Tips and Resources for Easing the Financial Burden of Cancer Copayments

In honor of Colorectal Cancer Awareness Month, Dr. Zachariah H. Foda, who is the Assistant Professor of Medicine at Johns Hopkins School of Medicine in Baltimore, joined CURE to discuss the importance of early detection and prevention of colorectal cancer.

Throughout the conversation, Foda highlighted key warning signs that should not be ignored, such as rectal bleeding, unexplained weight loss and changes in bowel habits. These symptoms, particularly when combined, significantly increase the risk of a serious condition.

As colorectal cancer diagnoses continue to rise, especially among younger populations, Foda emphasizes the need for awareness and proactive screening, even for individuals under 50. The conversation also touched on how family history and lifestyle factors, like diet and smoking, influence screening recommendations and the overall risk of developing the disease.

CURE: What are some key warning signs and symptoms of colorectal cancer that patients shouldn't ignore?

 So, when we get concerned about colorectal cancer or other serious things that might be going on for an individual, there are certain signs and symptoms we'll look at, and things to worry about or focus on are things like bleeding from their rectum or bleeding with their stool, [or] if they're having weight loss that they can't explain or is unintentional, abdominal pain as well as change in bowel habits. But the most concerning of those findings actually would be some combination of those. And so, there have been studies to show that multiple, two, three out of that list of findings, if someone has that, it really increases the risk of something concerning going on that should trigger them to go see their physician.

What may be leading to this kind of outcome in younger patients getting diagnosed earlier and earlier, in your opinion? And is there any research being done to kind of look into why this might be?

So the short answer is, we don't know. There are many theories on why this is happening. And you know, some of these theories have been explored and are currently being explored, and [there is] actually lots of research. So, there are lots of resources throughout the country and throughout the world looking at what is sometimes called early-age onset colorectal cancer, or variably also called the birth cohort effect, meaning that it's not necessarily that it's just young onset cancer that's increasing in people born in later decades. It's actually all colorectal cancer is increasing by sort of later decades.

And so, because it is something that is happening to a large amount of people, or a whole cohort of people, the most likely explanation has something to do with something in the environment, whether that's new foods or new chemicals or changes in in lifestyle that are universal. We haven't been able to narrow it down. It'll probably take years, many years, to figure this out, because while the risk is increased, it is actually still exceedingly rare that young individuals have colorectal cancer. And therefore, in order to get enough people with colorectal cancer to do any sort of significant research on it, it takes many, many years to track this. And so, we have our theories, but it will be a long time before we're able to pick one over the other.

What age should individuals start their screenings, and how do risk factors, such as family history or lifestyle, impact the screening recommendations?

American guidelines, both from the American Cancer Society as well as all of the GI [gastrointestinal] professional societies, recommend that individuals start colorectal cancer screening at the age of 45 and that is average-risk individuals. And as you had mentioned, there are individuals who are at increased risk, and individuals that we would consider to be increased risk are those who have a first degree relative or family member, a mother or father, a sibling with colorectal cancer, a first degree relative with large or many colon polyps. And for those cases, we actually start recommending colorectal cancer screening starting at the age of 40. So, five years earlier.

And in terms of other risk factors for colorectal cancer, there are some adjustable ones such as lifestyle and diet. So, we do know that diets high in red meat and processed meat are associated with an increased risk of colorectal cancer, while diets high in fiber, high in calcium, high in yogurt, seem to be associated with the decreased risk of colorectal cancer. We know that smoking increases the risk of all sorts of cancers, and we do know that alcohol can increase the risk of colorectal and other cancers. And so while we don't recommend changes in screening guidelines based on people having those environmental or lifestyle risk factors, we do recommend that people try to temper them, or can adjust those in order to decrease their risk of colorectal cancer.

Transcript has been edited for clarity and conciseness.

For more news on cancer updates, research and education, don’t forget to 

Colorectal cancer awareness is crucial, especially as diagnoses rise among younger populations. Key warning signs include rectal bleeding, unexplained weight loss, and changes in bowel habits. Early detection and proactive screening are vital, with guidelines recommending screenings start at age 45 for average-risk individuals and age 40 for those with a family history. Lifestyle factors, such as diet and smoking, also influence risk. Despite ongoing research, the exact reasons for increased early-age onset remain unclear, though environmental factors are suspected contributors.

Dr. Zachariah H. Foda discusses key colorectal cancer warning signs, the rise in younger diagnoses and more.

Tumor

Gastrointestinal

Colorectal Cancer Awareness: Key Signs, Screening and Prevention

At the 42nd Annual Miami Breast Cancer Conference, CURE sat down with Kelly Grosklags, a Minneapolis-based clinical social worker focused on oncology psychotherapy and the founder and chief executive officer of Conversations With Kelly, an online and in-person forum dealing with mental health, grief and oncology.

Grosklags — a psychotherapist, a Philanthropic Cancer Board Member in Minneapolis and a senior advisor at Brighter Days Family Grief Center, in Eden Prairie, Minnesota — was among the presenters at this year’s Miami Breast Cancer Conference.

, who emphasized the importance of trust between patients and providers, discussed the importance of events such as the Miami Breast Cancer Conference and more.

Can you provide an overview of your discussion and what you're really hoping that the audience takes away from the presentation?

I think a lot of conversations in breast cancer can be difficult because it's a difficult diagnosis and it's a loss. When somebody is diagnosed with cancer, there is an immediate grief that takes place, meaning life will never be the way it was prior to the diagnosis. And when people are working with their providers, one of the things that can get sidetracked is if a patient, let's say, is angry, and everybody has the right to be angry if they're dealing with something difficult. And so, one of the things we're doing at our conversation today is we're talking and doing a role play of a patient who is angry and who does not want to talk to the team about palliative care or any other kind of issues, because they feel like that might be giving up.

So, the difficult conversations don't really have to get too difficult if we have them early on, if we can establish trust with our providers and have conversations that maybe up front feel a little uncomfortable. In other words, [asking the patient,] "What are your life goals? What are some of the things that you want to see happen? What kinds of information do you want? Are you someone that likes a lot of information? Do you want limited information?"

How can oncologists effectively guide patients through shared decision making while managing any expectations they may have or fears that they're bound to have?

I think it's important for providers to know that each patient, each person, is an individual. So, what worked for your 10 o'clock appointment may not work for your 1 o'clock appointment, [even if there is the] same diagnosis, same genetic makeup, same whatever it may be. So how can they help navigate? Ask, “What kind of information do you want? How often do you want to check in about this?” And get to know really what your patient wants.

I also tell patients it's really important that you can change your mind. Maybe when you're first diagnosed, you're so overwhelmed that you don't want to have these conversations, but then later on, as time goes on and you feel more grounded or comfortable in the situation, you may want to change your answer with the doctor and say, "I want a lot more information" than maybe they wanted in the beginning.

Oncologists, obviously, are a very important part of the wellness of a patient, the treatment of breast cancer or any cancer. And how can they help navigate? It's more honestly asking questions of that patient, and then if they get to a situation they're not comfortable with, maybe it's a spiritual component, and they refer to a spiritual person, or a chaplain or a social worker, or whatever that may be.

The thing is, I don't ever want anybody on the team to ever feel like they are the sole responsibility for getting this patient through this experience. And I think we put a lot of pressure on ourselves. One of the things that's in the documentary that I talked about that is going to show tomorrow, "Dying is Not Giving Up," is … about the perfect patient syndrome and how patients show up and want to be seen as doing OK and they don't want to rock the boat. There's also the perfect provider syndrome, where we as providers can get in this space of [thinking] "I have to have all the answers. I have to be the one that fixes this. I have to do that." And I don't think that's true. I think if the oncologist can bring in the team, and the team also [including] the patient, and collectively having discussions about how to get people through difficult situations, it really is the best approach. But I will say that that oncologist absolutely has to be part of the team, and the patients will feel abandoned by their providers if they're not part of those difficult conversations.

How can clinicians initiate these hard discussions in a way that respects patients' autonomy while still providing those realistic expectations of what might come?

So, it's check-ins that are often. The mistake I see by some clinicians is that they wait too long to have conversations about, again, progression, or things that might be difficult to talk about, and the conversation can happen up when you first meet the patient. You can say to a patient "This is our goal for today, some things can change. I think we should have check-ins quite often. I think every other month, or every three months when I see you, we should go down, see how things are going, look at your labs, look at your scans, whatever that may be," and then again, asking the patient, "Is this something that you would like from me? Is this something that would help you feel more comfortable?"

Now, the other thing is, we need to have buy-in from the caregivers, from the partners, from the family, from the children, whomever that may be, because these difficult conversations may only be happening with the patient in the room, but they're going to impact lots of people. So I always say, have these conversations early and have them often. And doctors might say to me, "Well, everything's looking really good right now. It's early-stage." I said, "That's the thing. We make these conversations uncomfortable. We don't have to in healthcare." We can say, again, that "There are several ways this can go. Sometimes it may look different than we thought. I want to have really good communication with you. Is this something you want me to talk to you about? Is this something you want to know?" And again, I think it's important. I think if we save conversations that are hard for the last part, it's going to be all this anticipation and difficulty, and the patients themselves are going to feel like this is out of left field, because they haven't been having these ongoing conversations, that this could possibly be a reality.

What role should oncologists and the care team play in helping patients navigate family dynamics, particularly when family members have differing choices on the treatment decisions and prognosis?

The family and the patient are one unit of care. However, the patient is our primary concern. They're the ones that, if they're competent, so to speak, and can make decisions, we really need to listen to the patient. Family dynamics are a given, every family that has more than one person in it is going to have a dynamic, and what I find under those difficult dynamics is fear and uncertainty and possibly they don't have the information that they need.

So, we sit down, and we talk with them. We ask them, "What are you scared of? What are the things that you maybe don't understand better?" And I have had situations where families say to the patient, "You can't give up. You've got to keep going. You've got to keep going. You have to keep going with treatment." And the patient is saying to me privately, "I can't do this anymore. This isn't quality of life for me, and yet, I'm feeling a lot of pressure, and I don't want to let my family down." So that's a family conference. Then the oncologist can call a team meeting with the family and sit down and have a discussion. Always pull in multi disciplines, pull in the social worker, pull in the chaplain, pull in palliative care, whomever that may be, and approach it as more of a team effect.

But I think a lot of times, rather than telling people, it's really good to ask people like, "What do you understand?" Because this is happening to them. So, they tend to know more than we give people credit for. When the family is really struggling with prognosis and treatment, that's coming from a place of love, but we then get the family extra support, because it's not the patient's job to try to navigate and manage all of this for family. They don't have the energy, and yet, many of the patients I've worked with over the years have tried to take that on, and it's been exhausting and makes them even sicker.

So, the oncologist should ask for referrals. The oncologist can encourage the family to get support outside of the patient, and try to get support for it. But also, what's really small but profound is when we acknowledge for those families that this must be scary and not consider it as adversary, but just this must feel scary to you, and let's talk about that.

Transcript has been edited for clarity and conciseness

For more news on cancer updates, research and education,

don’t forget to subscribe to CURE®’s newsletters here.

The discussion emphasizes the importance of trust and communication between patients and providers in oncology care. It highlights the need for early and ongoing conversations about treatment goals and expectations, tailored to individual patient preferences. Oncologists should facilitate shared decision-making by understanding each patient's unique needs and involving the care team in addressing complex family dynamics. The role of the oncologist extends beyond medical treatment, requiring collaboration with multidisciplinary teams to support patients and families emotionally and psychologically throughout the cancer journey.

CURE spoke with Kelly Grosklags of Conversations With Kelly at the Miami Breast Cancer Conference.

Conference

Why It’s Important to Have Hard Conversations in Breast Cancer Care

One of this year’s MPN Heroes® talked about the importance of a supportive care team, especially as every patient with MPN presents differently.

The Power of Voice in MPN Management

Patients with myeloproliferative neoplasms (MPNs) should be actively involved in understanding their disease and communicating specific needs and concerns to healthcare providers, an expert said.

Kathryn Johnson, clinical program manager for the MPN and leukemia programs at the Icahn School of Medicine at Mount Sinai in New York, is dedicated to providing care for patients with MPNs, while connecting them to the resources they need and advocating for them with insurance companies.

CURE also spoke with Johnson to learn more about how patients can lean into their care teams and trust them so that conversations about symptoms and side effects can be held in an effective manner.

Speak up. Especially with MPNs, you know, they do all manifest differently. There are things that we know that people have in common, but they're going to present differently for every person. And I think that there's a lot that people learn to grow with that they don't always realize is impacting them. So taking a good look at who they are, what their goals are, is going to be helpful to managing their care and making sure that they're vocalizing things that aren't sitting right.

And then also [I] always encourage bring a buddy, bring a sister, bring a parent, bring a spouse, bring an adult child, the people who love you, love you and support you and want to help you manage this that you're going through.

subscribe to CURE®’s newsletters here.

A health care professional talks about the importance of a supportive care team, especially since every patient with MPNs presents differently.

The utility of SpaceOAR Hydrogel, a polyethylene glycol-based hydrogel spacer placed between the prostate and rectum, led to a reduction in hazard of developing bowel disorders as well as a reduction in requirement of procedures such as colonoscopy in patients undergoing radiation therapy for prostate cancer, according to a study published in JAMA Network Open.

Because of the rectum’s close proximity to the prostate, radiation exposure due to prostate cancer treatment can lead to complications such as diarrhea, rectal bleeding and discomfort during bowel movements. In some cases, these side effects can be severe enough to require medical intervention, impacting a patient’s quality of life after treatment ends. 

In order to address these needs, investigators launched a retrospective cohort study of SpaceOAR to better understand the incidence of radiation-related bowel toxicity, including bowel disorders and related medical procedures, among patients who received radiation therapy for prostate cancer.

Dr. Ron Morton, the chief medical officer and vice president of medical affairs of Urology at Boston Scientific, sat down for an interview with CURE to discuss what these findings mean for patients considering radiation therapy, the broader implications for long-term bowel health and questions patients should ask their oncologists when evaluating their treatment options.

CURE: How does radiation therapy for prostate cancer impact bowel health, and why is minimizing bowel toxicity a critical concern for patients?

: Radiation therapy aims to kill cancer cells while avoiding damage to surrounding healthy tissue. But radiation to treat prostate cancer can cause damage to the rectum due to its proximity to the prostate, which can lead to issues with bowel function, including diarrhea, painful bowel movements and rectal bleeding.

These side effects can negatively impact patients’ quality of life. And in rare cases, these complications can be serious and require hospitalization or surgical intervention to manage.

Can you explain how SpaceOAR Hydrogel works and why it is an option for patients undergoing radiation therapy for prostate cancer?

SpaceOAR Hydrogel is an absorbable polyethylene glycol (PEG)-based hydrogel that temporarily creates space between the prostate and rectum. It’s designed to reduce the radiation dose delivered to the rectum during radiation therapy to help lessen damage to the rectum and minimize side effects.

The procedure to place SpaceOAR is minimally invasive and typically happens in an outpatient setting – a doctor’s office, hospital or clinic. It’s composed of biodegradable material and is naturally absorbed by the body after approximately six months. SpaceOAR is an option for patients because it may help maintain a patient’s quality of life and reduce the often frustrating and embarrassing side effects of radiation therapy.

The recent study published in JAMA Network Open found that patients receiving SpaceOAR had a 25% lower hazard of developing bowel disorders. What does this mean for patients considering radiation therapy?

In this large retrospective database review of patients with prostate cancer, those who received SpaceOAR as part of their treatment had a significantly lower chance of developing bowel complications due to radiation therapy as compared to patients that did not receive SpaceOAR as part of their treatment.

The findings of this study are consistent with other clinical trial results, further supporting SpaceOAR as a safe and effective treatment option that can potentially protect quality of life for prostate cancer patients. This is good news for patients who are considering radiation therapy for prostate cancer and want to minimize bowel-related side effects.

Many patients worry about long-term side effects of treatment. How does the use of SpaceOAR Hydrogel compare to not using it in terms of bowel-related quality of life years after treatment?

The study findings show that the use of SpaceOAR was associated with a significant reduction in the incidence of bowel disorders and related procedures in the four years after radiation treatment. A cancer diagnosis can be scary and overwhelming, and patients are often faced with having to make challenging decisions about their treatment plans. Knowing that SpaceOAR can help minimize long-term side effects of radiation therapy and maintain quality of life post-treatment can hopefully ease some of the concern’s patients may have as they make those important decisions.

This study also found that patients who received SpaceOAR had a 46% lower hazard of requiring procedures such as colonoscopies and rectal resections. How significant is this reduction for a patient’s long-term health and overall quality of life?

The significant reduction of bowel-related procedures in the SpaceOAR group compared to the non-SpaceOAR group is indicative of the ability of SpaceOAR to preserve normal bowel function and help protect quality of life for patients undergoing radiation therapy for prostate cancer. Anecdotally, what I’ve heard from fellow physicians is that because of the higher risk of bowel complications with stereotactic body radiation therapy (SBRT), many of them won’t perform SBRT without placing a perirectal spacer.

What should patients ask their oncologists about SpaceOAR to determine whether it is the right option for their specific case?

SpaceOAR Hydrogel is widely available in the United States and covered by many insurance plans. It’s also available globally in many countries where contemporary radiation therapy techniques are practiced.

I encourage patients to engage in shared decision-making with their care team about their prostate cancer treatment. Available options, including surgery, radiation therapy and watchful waiting should be considered. Patients who decide to undergo radiation therapy should discuss with their physician the risks and benefits of including a perirectal spacer such as SpaceOAR in their treatment plan.

“Bowel Disorder Incidence and Rectal Spacer Use in Patients With Prostate Cancer Undergoing Radiotherapy” by Dr. Michael R. Folkert, et al., JAMA Network Open

SpaceOAR Hydrogel, a polyethylene glycol-based spacer, reduces radiation-induced bowel disorders in prostate cancer patients undergoing radiation therapy. By creating space between the prostate and rectum, it minimizes radiation exposure to the rectum, thereby decreasing complications like diarrhea and rectal bleeding. A study in JAMA Network Open showed a 25% reduction in bowel disorder risk and a 46% decrease in procedures like colonoscopies for patients using SpaceOAR. This intervention supports long-term bowel health and quality of life, making it a valuable consideration for patients.

SpaceOAR Hydrogel reduced the risk of bowel disorders, the need for colonoscopy and rectal resection following radiation therapy in prostate cancer.

Reducing Bowel Complications Following Radiation in Prostate Cancer

Circulating tumor DNA (ctDNA) is described by The University of Texas MD Anderson Cancer Center website as DNA fragments which are released into the bloodstream from tumor cells and these fragments of tumor cells can often lead to minimal residual disease (MRD), which is when cancer cells remain in the body after treatment.

In a presentation given by Dr. Debu Tripathy at the recent 

Annual Miami Breast Cancer Conference and the Educated Patient Breast Cancer Summit

, he explained how ctDNA is used to in cancer detection and how it can also indicate the presence of MRD, a signal suggesting there is cancer in the body, according to the National Institute of Health.

“Tumors that are in the body are fed by blood vessels, and the veins also drain these areas, just like they drain other organs and tissues, and DNA that comes from the cells are present in the blood. They do get broken down eventually, but we can actually measure this, and we've been able to do this for a long time, but our techniques have become very sensitive, so that we can now pick up very small amounts of residual tumor that may ultimately lead to a metastasis.,” he explains.

Tripathy previously served as a professor and chairman of the Department of Breast Medical Oncology, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center, in Houston, and as the editor-in-chief at CURE, prior to his retirement in March of 2025.

Understanding ctDNA and its Applications in Oncology

For years, researchers have suspected that small clusters of tumor cells can exist in patients with early-stage cancer, contributing to late recurrences. In breast cancer, for example, recurrence can occur decades later, implying the presence of dormant tumor cells. Now, with recent advances in technology, investigators have been able to detect minuscule amounts of tumor-derived DNA in the bloodstream, even at single-molecule levels. This development has provided evidence that ctDNA generally signals an impending relapse.

Tripathy goes on to explain that by using highly sensitive techniques, researchers are beginning to distinguish tumor DNA from normal DNA. In recent studies, patients have been tracked over time to evaluate those with detectable ctDNA and those without; consistently, patients who have detectable ctDNA experience worse disease-free survival compared to those without.

“The big question is: how can we now really prove that we can not only measure tumor DNA? However, there's no point in doing it unless we can do something about it, of course. [Therefore], the goal here is to refine the technology to make it as sensitive and accurate as possible, and then to test different strategies to see if we can lower the risk of recurrence, as we have done over the last 50 years or so,” he emphasized.

Circulating tumor DNA (ctDNA) is a promising tool for detecting minimal residual disease (MRD) and predicting cancer recurrence. Advances in technology have enabled the detection of ctDNA at single-molecule levels, providing evidence of impending relapse. Liquid biopsies, which analyze ctDNA, offer a minimally invasive method to assess cancer status and guide treatment decisions. Ongoing research aims to refine ctDNA detection techniques and explore its potential in early cancer detection. Despite challenges in sensitivity, future trials will focus on integrating novel therapies to improve patient outcomes.

Dr. Debu Tripathy explains how ctDNA is used to in breast cancer detection and how it can also indicate the presence of MRD.

Michele McCourt, senior director, CCAF

Articles

Latest Updated Articles