Once & Again

Urine collection cups? Check. Needles for blood draws? Check. Dog? Check

Man’s best friend may not be a typical item on an oncologist’s list of tools, but as cutting-edge techniques emerge across the spectrum of cancer research and treatment, dogs are poised to lend their uncanny talents to the field of precision diagnosis.

In the spring 2017 issue, CURE featured an article about studies employing painstakingly trained dogs to detect cancers — including breast, ovarian, lung, prostate, thyroid, colorectal and melanoma — from patients’ breath, urine, plasma and blood. With their profoundly sensitive sense of smell, dogs may be able to con- tribute to better health outcomes in people with cancer by making early diagnosis possible when other methods are inadequate.

The story about this line of research was one of many CURE brought to the forefront in 2017, highlighting scientific advances, care trends and insights about the state of diagnosis, treatment and survivorship. Our offerings — including advice to “snowbirds” about cancer care while wintering away from home, analysis of the language that is used to discuss cancer, and, of course, glimpses into the latest treatments for cancer subtypes — were meant to inform and inspire, leaving readers more confident and better prepared when meeting with doctors, researching potential treatments and searching for clinical trials. We also sought, in both feature articles and personal essays, to offer comfort and stimulate discussion by sharing the thoughts of those affected by cancer.

In this final issue of the year, we review some of the most compelling topics and images we presented, touching on many of the programs, decisions, ideas, care tactics, challenges and advocacy efforts that changed life for those affected by cancer in 2017.

Here, we recap lifestyle, survivorship and advocacy stories.

LIFESTYLE

What kinds of lifestyle changes or supportive programs can boost emotional and physical health for people affected by cancer? We found an array of answers to that question in 2017.

In our summer issue’s “Staying on Track," we noted that wearable fitness trackers are being explored for their potential to improve health during and after cancer treatment. These devices can track activity level, heart rate, sleep patterns and calories burned, and some allow doctors to monitor the results remotely. Researchers believe that the wearables may help doctors determine which patients are the most active and able to tolerate aggressive treatments. The devices also may pro- mote physical activity that can help patients endure therapy and fight cancer, as well as contribute to weight loss that plays a role in preventing recurrence.

“Grand Gestures," also in the summer issue, chronicled the experiences of patients moved by their diagnoses to undertake extraordinary activities. After learning she had stage 2 breast cancer, psychologist Paulette Sherman vowed to write 22 books. Kelli Parker, a patient with metastatic breast cancer, began working with advocacy group METAvivor to stage Metsquerade balls and raise hundreds of thousands of research dollars. Ian Toothill climbed Mount Everest to raise money for charity, despite having stage 4 bowel cancer. And Clay Treska trained for an Ironman World Championship while preparing for, and then recovering from, a stem cell transplant for stage 4 testicular cancer.

“Most people cope by falling back on what they’ve always done, whether it’s to be spiritual, to be intellectual, to find comfort in family,” clinical psychologist Laura Howe-Martin, Ph.D., told CURE. “A few take on extraordinary things: They start charities or start running triathlons. They divorce, or they quit what they thought was their dream job. They get more religious or less religious. People who have cancer are ready — ready to make meaningful changes.”

Maybe you can’t judge a book by its cover, but, nonetheless, physical changes caused by cancer and its treatments can be emotionally difficult, and programs created to boost patient appearance often do even more to lift spirits. That was the gist of our fall cover story “More Than Skin Deep," which detailed Look Good Feel Better and other appearance and fashion programs that go beyond looks to help restore the dignity that cancer can steal. The article listed several free services, what they pro- vide and to whom, and shared reflections on the programs.

“This isn’t frivolous stuff,” said patient Linda O. Williams. “People with cancer don’t have time for nonsense. Everything we do that allows us to get through another day is important. Moments like these, that lift your spirits and make you feel beautiful, truly matter.”

Quality of life improves when side effects are kept in check, and that’s why CURE devoted 2017 coverage to strategies designed to keep patients comfortable. The spring article “A Dose of Caution” looked at the balancing act involved with using opioids to control cancer pain during a national epidemic of misuse of the drugs. “Opioids are our greatest tool in managing pain, but they are accompanied by risk and must be used with respect,” said Jeannine Brant, Ph.D., APRN-CNS, AOCN, FAAN, an oncology clinical nurse specialist and nurse scientist. One strategy for doctors: Poll patients about their risk of addiction before opting for opioids. Another: Prescribe naloxone, a prescription antidote to opioid overdose, for patients to keep on hand.

Palliative care offers another way to ease painand increase functionality in those experiencing side effects, CURE reported in “Easing the Pain” in April’s special issue on women’s cancers. A palliative care team might include physicians, nurses, physical therapists, pain management experts, massage therapists, chaplains, dietitians, social workers and psychologists, and it can help patients with any kind of cancer. Experts agree that this kind of care should be instituted as early as possible after diagnosis so that it can supplement and support medical treatments.

Side effects of treatment affect not just the body and mind but also the wallet. Cancer treatments can be expensive and are not always fully covered by health insurance. Meanwhile, patients and their family caregivers may experience income loss or even bankruptcy due to the illness. Our winter article on crowdfunding, “A Virtual Safety Net," mentioned websites, such as YouCaring and GoFundMe, that provide platforms for patients and others who want to raise funds.

“We were surprised at how many people shared our story, and also at how many people we don’t even know who donated to our cause, left messages of encouragement and otherwise offered to help,” said Lauren Carman Evans, who was treated for breast cancer. “This has been one of the silver linings we’ve experienced throughout this whole ordeal.”

SURVIVORSHIP

When it comes to survivorship, there are countless issues people might confront, from treatments that continue indefinitely to long-term side effects.

We explored issues faced by people with metastatic cancer in our spring article “Life, Redefined." Although some face shortened life spans, others live for years or decades due to improved treatments. But one thing is true for many: Treatment and surveillance will continue for life. The article discussed the feelings of uncertainty that tend to come with this status, along with the importance of seeking professional and peer support, making the effort to stay physically strong and coming to terms with the possibility of end of life.

A challenge that can face men after prostate cancer — as well as bladder, colon, rectal or penile cancer — is nerve and other damage that impairs sexual function. Our winter article “Hitting a Nerve” discussed treatments that can cause this problem, therapies that help some regain function and other types of support for men with this problem.

“Men need to have correct and full information to make an informed choice (about treatment),” said patient Jim Schraidt, who experienced sexual side effects after under- going a prostatectomy due to prostate cancer.

Women treated with mastectomy for breast cancer or a predisposition to the disease often struggle to make a decision about breast reconstruction. In a cover story for our October special issue on breast cancer, “Flat, But Not Flattened” (curetoday.com/link/51), we reported that a growing number of women are opting against reconstruction due to surgical risks and other factors, deciding instead to “live flat.”

“For some women, reconstruction is the right thing,” said Barbara Kriss, founder of BreastFree.org. “But then there are others, like me, who really feel like they don’t need it.”

ADVOCACY AND AWARENESS

Advocating for specific populations with cancer, or raising awareness about their concerns and needs, takes hard work, but many are committed to it. Often, they use great creativity to meet their goals, and CURE ® covered a number of their efforts and accomplishments in 2017.

Cindy Stowell knew she was dying of metastatic colorectal cancer when she appeared on the TV show Jeopardy! She approached her lifelong dream with a goal in mind: Win $100,000 and donate it to cancer research “to help others.” Despite feeling ill and having a fever, Stowell accomplished her goal, winning six games and just over the amount she had envisioned. The money was donated to the Cancer Research Institute (cancerresearch.org), CURE reported in “A Lasting Legacy” in a March special issue on gastrointestinal cancers. Stowell died eight days before her first Jeopardy! appearance aired.

A CBS tribute video included Stowell’s comment on her contestant experience: “Even when you think the odds are completely against you, somehow, via luck or something, things can work out.”

Many in the cancer community have heard of music therapy, but the band N.E.D., profiled in “Banding Together” in the winter issue, takes an unconventional approach. Composed entirely of gynecologic oncologists, the band plays original music to raise funds for awareness initiatives. As of last winter, the group had released three studio albums, been featured in an award-winning documentary — and raised over $500,000.

The effort is as therapeutic for the doctors as it is for the cancer community. “This has added years to my career because I can get away from my day job,” said band member William Winter, M.D. “In this industry, you lose a lot of good women. It is some- times a heavy burden to face, day in and day out, without another outside release.”

Awareness is also the goal of the Serenity Project over- seen by METAvivor, a group focused on the concerns of those with metastatic breast cancer. “The Whole Picture," an article in the October breast cancer issue, reported that the project is sharing interviews with 16 people who have the disease, along with fanciful photos of the interviewees under water and adorned with body paint. The interviews, which shed light on the experience of living with this disease, are being shared via social media, and the photographs appear in a 2018 calendar.

“When all 16 of us pass away, die in our physical selves, these images and these stories — the way they impact other people — are going to live on far beyond death,” said METAvivor President Beth Fairchild.

Lack of awareness can affect patients not only emotionally but also medically, a problem often encountered by patients who are lesbian, gay, bisexual, trans- gender or queer/questioning. A summer story titled “Health Care in Transition” explained that this group faces a higher risk of some cancers. It noted that some medical questions affecting this population have no answers due to a lack of research, and members of this community may not get proper care because they fear discrimination from providers. Now, however, some health systems are putting programs into place to meet the needs of this group.

“If a patient’s first encounter walking in the door is negative, they are not going to be comfortable seeking care,” said Rebecca Hirsh, M.D. “It’s our responsibility to ensure that all our LGBTQ patients receive the courtesy and respect they deserve."

Moving Mountains for Multiple Myeloma, an advocacy effort by CURE, was also featured in the pages of the magazine. This spring, “The Peak Is Just the Beginning” gave details about the second annual climb up Mount Kilimanjaro, in Tanzania, by survivors, doctors, research professionals and patient supporters. CURE Media Group collaborated on the adventure with Takeda Oncology and the Multiple Myeloma Research Foundation to raise awareness and research funds.

“What a bonding experience that will last a lifetime — which I hope is a long time,” survivor Terry White said. “You make those kinds of friendships over some- thing like this. This is a life-changing experience.”