Up close: Cancer cells on the move

Some scientists have said the search for CTCs is like looking for a needle in a haystack. One millimeter of blood contains a few million white blood cells, around a billion red blood cells, and – perhaps – one to 10 circulating tumor cells. (illustration by Dan Cameron)

Some scientists have said the search for CTCs is like looking for a needle in a haystack. One millimeter of blood contains a few million white blood cells, around a billion red blood cells, and – perhaps – one to 10 circulating tumor cells. (illustration by Dan Cameron)

“You’ve got to respect the complexity of cancer,” Dario Marchetti, PhD, reminded researchers who gathered for his lecture at the Upstate Cancer Center recently. Marchetti is the director of the biomarker research program at the Institute for Academic Medicine at the Houston Methodist Research Institute.

Upstate frequently hosts guest speakers.

Marchetti spoke about efforts to detect the presence of circulating tumor cells, known as CTCs. These are cells that break off from a tumor and travel through the bloodstream. Most die in the blood, but some embed in tissues of distant organs, where they may form new tumors.

That’s what happens most often in the case of brain cancer. Marchetti says just one in 10 cases arise from a tumor that originated in the brain. The rest are cancers that spread from other parts of the body.

The Food and Drug Administration has approved one CTC test, CellSearch, which helps doctors monitor patients with metastatic breast, colorectal or prostate cancers by tracking the volume of CTCs in the blood. But it is not designed to find all CTCs.

Other methods of isolating CTCs are in development. Researchers want to be able to analyze CTC DNA to identify tumor progression and potential drug targets. That would allow doctors to determine the most effective medications without subjecting the patient to a tissue biopsy.

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

 

 

 

 

 

 

 

Posted in cancer, health care, research | Tagged , ,

These recipes make use of cruciferous vegetables

Upstate family physician Kaushal Nanavati, MD, says research shows cruciferous vegetables can potentially reverse the buildup of plaque in arteries, helping to improve circulation.

“We don’t have medications that can do that,” he says. “And yet, this food can be of benefit.”

And not just for heart health.

Cruciferous vegetables are rich in nutrients including carotenoids, vitamins C, E and K, folate and minerals. They’re also high in fiber.

The National Cancer Institute explains that during food preparation, chewing and digestion, the glucosinolate in cruciferous vegetables breaks down into biologically active compounds that are being examined in research laboratories for their anticancer effects.

So, here’s your shopping list: arugula, asparagus, bok choy, broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale, radishes, rutabaga, spinach, turnips, watercress and wasabi.

Here are four recipes featuring cruciferous vegetables (to read how Nanavati includes healthy eating as part of one’s overall wellness, click here):

fresh broccoliEasy Baked Broccoli Tots

Ingredients

2 medium heads broccoli, cut into florets

¼ cup onion, finely diced

¼ cup finely ground bread crumbs or gluten-free pretzels

1 large egg

¼ cup grated Parmesan cheese

Ranch dressing or ketchup, for dipping

Nutritional information per 6 tots

60 calories

2 grams total fat

25 milligrams cholesterol

120 milligrams sodium

8 grams carbohydrate

1 gram fiber

1 gram sugar

4 grams protein

Preparation

Preheat the oven to 350 degrees. Grease a nonstick baking sheet with cooking spray.

Bring a large pot of water to a boil. Add the broccoli florets to the water and cook just until fork tender, about 5 minutes. Thoroughly drain the florets and transfer to a food processor. Pulse the broccoli for a few seconds just until the it breaks down into small pieces. (Do not overmix the broccoli or the mixture will be too wet to form into tots.)

Measure out 3 packed cups of the broccoli and add it to a large bowl. Add the diced onion, bread crumbs, egg and Parmesan cheese and mix until thoroughly combined.

Using your hands, portion out about 2 tablespoons of the mixture and mold it into a tater-tot shape.

Arrange the tots on the prepared baking sheet, spacing them about 1 inch apart.

Bake the tots for about 20 minutes. Then flip them once and bake them an additional 10 to 15 minutes until crisped. Remove the tots from the oven and serve them with ketchup, ranch dressing or hummus for dipping.

Source: JustaTaste.com

bowl of coleslawAngie’s Dad’s Best Cabbage Coleslaw

Ingredients

1 medium head cabbage, shredded

1 large red onion, diced

1 cup grated carrots

2 stalks celery, chopped

1 cup white sugar

1 cup white vinegar

¾ cup vegetable oil

1 tablespoon salt

1 tablespoon dry mustard

Black pepper to taste

Nutritional information per serving

131 calories

8 grams total fat

Zero cholesterol

364 milligrams sodium

14 grams total carbohydrate

1½ grams fiber

12 grams sugars

1 gram protein

Preparation

In a large bowl, combine cabbage, onion, carrots and celery. Sprinkle with 1 cup sugar and mix well. In small saucepan, combine vinegar, oil, salt, dry mustard and pepper. Bring to a boil. Pour hot dressing over cabbage mixture and mix well.

Cook’s note: Best if made ahead, from a day to two weeks. Just drain juice prior to serving. This makes 20 servings.

Source: AllRecipes.com

grapefruitRaw Kale, Grapefruit and Toasted Hazelnut Salad

Ingredients

2 pink grapefruit

½ small red onion, thinly sliced, divided

fresh kale¼ cup fresh lemon juice

½ cup fat-free plain yogurt

2 tablespoons extra-virgin olive oil

½ teaspoon kosher salt

¼ teaspoon black pepper

8 ounces kale, very thinly sliced or  baby kale leaves

1 ounce toasted hazelnuts, chopped (1/3 cup)

Nutritional information per serving

184 calories

12 grams fat

bowl of hazelnuts1 milligram cholesterol

18 grams carbohydrate

3 grams fiber

179 milligrams sodium

5 grams protein

Preparation

Peel and segment grapefruit, reserving 3 tablespoons juice in a large bowl. Mince 2 rings onion. Add to grapefruit juice, with lemon juice, yogurt, oil, salt and pepper. Whisk until well mixed.

Then, toss in kale. Top with remaining onion, grapefruit and hazelnuts. Makes four 1¾ cup servings.

Source: Health.com

green peasCauliflower Risi e Bisi

Ingredients

2 tablespoons extra-virgin olive oil

½ cup sliced scallions

3 cloves garlic, minced

4 cups cauliflower rice, fresh or frozen

bowl of grated Parmesan cheese2 cups peas, fresh or frozen

½ teaspoon ground pepper

¼ teaspoon salt

2 tablespoons water

1 cup whole milk

2 teaspoons cornstarch

½ cup grated Parmesan cheese

2 tablespoons chopped fresh parsley, plus more for serving

Nutritional information per 1-cup serving

160 calories

8 grams fat

10 milligrams cholesterol

256 milligrams sodium

15 grams carbohydrates

4 grams fiber

6 grams sugars

7 grams protein

Source: EatingWell.com

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

Posted in diet/nutrition, health care, recipe

Mind-set to thrive optimizes quality of life

Kaushal Nanavati, MD, leads meditation in the meditation room at the Upstate Cancer Center. In the back, from left, are medical students Megan Taggart and Alison Stedman and intern Amani Mike. (photo by Susan Kahn)

Kaushal Nanavati, MD, leads meditation in the meditation room at the Upstate Cancer Center. In the back, from left, are medical students Megan Taggart and Alison Stedman and intern Amani Mike. (photo by Susan Kahn)

BY AMBER SMITH

A cancer diagnosis can produce stress, no doubt. How a person responds to that stress impacts his or her quality of life.

Family medicine doctor Kaushal Nanavati, MD, is medical director of integrative therapy at Upstate. He reminds his patients who have cancer that no one is guaranteed to live another day, regardless of whether they have cancer.

“If we distress about the fact that we might not have a tomorrow, we’re missing out on the today,” he says“That sounds very simplistic, but when you live it, it shifts your thinking, and it shifts your biochemistry.”

A recent study from the National Human Genome Research Institute showed that social interaction during cancer treatment can affect a patient’s response to treatment. That finding does not surprise Nanavati.

He also believes a calm, nurturing treatment setting can have an impact and that being around people who exude positivity is beneficial — although neither have been proven scientifically.

What we do know is that people who are stressed or anxious trigger a stress response in their body that increases heart rate, blood pressure, respiration and muscle tension — conditions that can be detrimental if they become chronic.

Nanavati promotes a “core four” for wellness that consists of stress management, good nutrition, physical exercise and spiritual wellness. He’s liable to prescribe yoga, or meditation, along with conventional medical care. And he helps patients learn how to optimize their quality of life after they receive a diagnosis of cancer. He helps them believe they can not only survive, but thrive.

HealthLink on Air logoCancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine. To hear Kaushal Nanavati, MD, discuss overall wellness in podcast/radio interviews, click here and here.

Posted in alternative/integrative medicine, cancer, diet/nutrition, fitness, health care, mental health/emotional health, spiritual care | Tagged

A dad’s perspective on his child’s cancer

Theron Blair’s elder son, Trey, 7, has leukemia. In the two years since his son’s diagnosis, Blair has learned what it takes to be the parent of a kid with cancer. He shares his insights:

Theron Blair of Baldwinsville with his sons Tyler, 5 (left), and Trey, 7. Chemotherapy left Trey bald for a while, and now that his hair is growing back, he's not cutting it. Now, Trey has daily oral chemotherapy medication and sees pediatric oncologist Andrea Dvorak, MD, and nurse Yvonne Dolce monthly at the Upstate Cancer Center. (photo by Robert Mescavage)

Theron Blair of Baldwinsville with his sons Tyler, 5 (left), and Trey, 7. Chemotherapy left Trey bald for a while, and now that his hair is growing back, he’s not cutting it. Now, Trey has daily oral chemotherapy medication and sees pediatric oncologist Andrea Dvorak, MD, and nurse Yvonne Dolce monthly at the Upstate Cancer Center. (photo by Robert Mescavage

  • Answer the phone when your wife calls

My wife phoned from the grocery store and said she’d gotten a call to take Trey to the hospital. We’d taken him to the pediatrician because his legs hurt and his stomach was bothering him. A blood test showed Trey’s iron was low.

When we got to the Upstate Golisano Children’s Hospital, they sat us down and explained that he had acute lymphoblastic leukemia (see box, below). Within

24 hours, Trey was in surgery having a port put in his chest for chemotherapy.

It was April 23, 2015.

  • Shave your head

Early on, when Trey had heavy chemo treatments, his hair started falling out. I’ll never forget him saying, “Dad, why is this happening to me?” as he looked in the mirror. That day, I shaved my head, so we’d be matching bald guys.

Last April, his brother, Tyler, shaved his head to raise money for pediatric cancer research.

  • Learn to give shots

Everything is hard when your child has cancer, but giving chemotherapy injections at home is really difficult. Your child is going through a lot, and you have to put him through more. But you’ve got to learn to do it, and do it well, so he can get healthy.

  • Invest in paper towels

Everything needs to be extra clean, so you can avoid exposing your child to infection. Wash your hands. Use paper towels and disinfectant wipes. (Sponges and cloths spread germs.) Don’t be afraid to tell friends and neighbors, “You have a runny nose? Don’t visit!”

  • Pay attention to both sons

“Doesn’t my brother like me any more?” was our younger son’s fear when Trey came home from the hospital. Tyler had welcomed Trey home with a punch which, in the past, would have led to wrestling, but Trey didn’t feel good.

Children understand more than you think, so listen and talk with them about what’s happening.

  • Be understanding

Trey had times when he couldn’t control his anger because he was on steroids. He would say, “Mommy, I’m yelling at you, and I don’t like it.”

Help your child understand that it’s the medication, and the condition, that are affecting his actions. Remind both children that they have good hearts.

  • Eat healthy

Steroid treatments made Trey crave salt. Salty foods made his edema (swelling) so bad that he couldn’t walk. We knew we had to change our diets, so we set ground rules. Now our sons know, “We have to eat something healthy first.”

Trey likes broccoli, and Tyler likes bell peppers. Once in a while, we have pizza and ice cream, but fresh vegetables are every day.

  • Stay positive

Try to stay positive, even when things are rough.

What kind of cancer is that?

Acute lymphoblastic leukemia, abbreviated as ALL and sometimes called acute lymphocytic leukemia, is the most common type of childhood leukemia.

ALL is a fast-growing cancer that develops in lymphoblasts, which are immature forms of the white blood cells called lymphocytes found in the bone marrow.

The cancerous cells can build up, crowding out normal cells, then spill into the bloodstream and spread to other parts of the body.

If not treated, ALL would probably be fatal within a few months.

The usual treatment is a varied course of chemotherapy that typically lasts two to three years.

Source: American Cancer Society

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

 

 

 

Posted in cancer, health care, mental health/emotional health, patient story, Upstate Golisano Children's Hospital/pediatrics | Tagged , , , ,

National media featuring Lola Muñoz raise attention for deadly brain cancer

Lola Muñoz hoped the treatment she received in a clinical trial would help other cancer patients. (photos by Moriah Ratner)

Lola Muñoz hoped the treatment she received in a clinical trial would help other cancer patients. (photos by Moriah Ratner)

BY AMBER SMITH

Photographs of a 12-year-old patient of Melanie Comito, MD, accompanied recent stories in the Washington Post and National Geographic magazine. Lola Muñoz lived for 19 months after her diagnosis with a deadly brain cancer called DIPG, diffuse intrinsic pontine glioma.

She died in April.

Upstate pediatric cancer chief Melanie Comito, MD, gives Lola a goodbye hug.

Upstate pediatric cancer chief Melanie Comito, MD, gives Lola a goodbye hug.

Lola chose to participate in a clinical trial of a new combination of chemotherapy drugs to treat DIPG, even though the treatments would make her sick. “I wasn’t doing it for me. I was doing it for all the other kids who suffered,” she told photographer Moriah Ratner, who recently graduated from Syracuse University’s S.I. Newhouse School of Public Communications. Ratner spent almost 18 months taking pictures of Lola and her family, including parents Melissa and Agustin Muñoz.

DIPG is a tumor of the nervous system that forms in the glial tissue of the brain and spinal cord. It typically grows rapidly, spreading through the brain stem, making treatment difficult. Surgery is usually not an option because of the precarious location of the tumor. Radiation can shrink the tumor, but it usually grows back within the year.

Comito, chief of pediatric hematology and oncology at Upstate, was one of Lola’s doctors. For 20 years she has not been able to offer much in the way of treatment for children with this type of brain cancer. She recently attended a medical symposium and felt the excitement in the room as researchers discussed the potential of a new targeted therapy they want to try.

One of the reasons research focuses on DIPG is because of families like the Muñozes, who share their story to raise awareness, Comito says. “She was a very special person,” she says of Lola, “and I think Moriah captured that in her photos.”

(Related story: Teen with DIPG launched H.O.P.E.)

Nurse Kristen Thomas draws Lola’s blood for tests at Upstate after six weeks of radiation.

Nurse Kristen Thomas draws Lola’s blood for tests at Upstate after six weeks of radiation.

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

 

 

 

 

Posted in brain/neurology, cancer, drugs/medications/pharmacy, health care, patient story, Upstate Golisano Children's Hospital/pediatrics | Tagged ,

How to protect yourself from colorectal cancer

Jiri Bem, MD

Jiri Bem, MD

Sekou Rawlins, MD

Sekou Rawlins, MD

 

 

 

 

 

 

 

 

BY AMBER SMITH

Colorectal cancer kills some 50,000 men and women in America every year. The death rate could decrease by 90 percent, says Jiri Bem, MD, medical director of Upstate’s colorectal oncology program.

“If everybody would be compliant with recommendations in terms of screening and surveillance, the number would drop to 5,000, which is clearly a striking difference,” he says.

Cancers of the colon and rectum are largely preventable. The majority of these cancers begin in polyps that can be removed — if they’re found before they’ve developed into cancer and spread. Most cancers found at screening are curable.

Screening recommendations

Bem recommends people at average risk of colorectal cancer start screening at age 50 and continue at least through age 79. Those at higher risk may need to begin screening earlier, and several gastroenterology societies say African-Americans should start at age 45.

People at increased risk of colorectal cancer include those with a personal history of colorectal cancer or certain type of polyps, a family history of colorectal “cancer, a personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), a confirmed or suspected hereditary cancer syndrome or a personal history of radiation to the abdomen or pelvis to treat a previous cancer. (Hear Bem speak about colorectal cancer and its prevention in this podcast/radio interview.)

Types of screening tests

Stool tests can be used to detect blood or to examine genetic changes that may occur in colon cancer cells.

Two options provide a look at the structure of the inside of the colon and rectum for abnormal areas that might be cancer or polyps. In a colonoscopy, the doctor inserts a flexible camera into the rectum to inspect the interior walls of the intestine. A virtual colonoscopy is an imaging scan. For both tests, the patient must empty his or her colon by consuming only liquids and a bowel preparation solution prior to the test.

Signs and symptoms

“Many people who are diagnosed with colon cancer don’t have any symptoms, which is why the screening strategies are so important,” says Upstate gastroenterologist Sekou Rawlins, MD. “A lot of people felt perfectly normal, and then they had their cancer found.” (Hear Rawlins discuss colorectal cancer screening and colon health in this podcast/radio interview.)

Contact your doctor if you notice

— A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days.

— A feeling that you need to have a bowel movement that’s not relieved by having one.

— Rectal bleeding with bright red blood.

— Blood in the stool, which may make the stool look dark.

— Cramping or belly pain.

— Weakness or fatigue.

— Unintended weight loss.

Prevention

These steps may help reduce your risk, but there’s no sure way to prevent colorectal cancer.

  • Maintain a healthy weight.
  • Participate in regular moderate physical activity.
  • Eat a diet high in vegetables, fruits and whole grains, and limit your intake of red meats and processed meats.
  • Avoid excessive alcohol use.
  • If you smoke, quit.

Do you need an appointment?

For help scheduling a colonoscopy, contact the Upstate Cancer Center at 800-464-4673 or Upstate Gastroenterology at 315-464-1600.

Cancer Care magazine summer 2018 coverHealthLink on Air logoThis article appears in the summer 2018 issue of Cancer Care magazine.

 

Posted in cancer, digestive/gastrointestinal, health care, prevention/preventive medicine

15 words for the newly diagnosed

abstract display of letters of the alphabet

Understanding this vocabulary may help you understand your cancer

Active surveillance – a treatment plan that involves closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse.

Adjunct therapy – treatment used together with the primary treatment.

Adjuvant therapy – additional treatment given to lower the risk that cancer will return.

Acute – symptoms that begin and worsen quickly; opposite of chronic.

Biopsy – a procedure in which cells are removed from a suspicious area, so they can be looked at in a laboratory to see if cancer cells are present.

Chemotherapy – treatment using drugs that stop the growth of cancer cells, either by killing the cells or stopping them from dividing. Depending on the type and stage of cancer, drugs may be given by mouth, injection, infusion, or absorbed through the skin.

Clinical trial – a research study that tests how well new medical approaches work in people.

Combination therapy – therapy that combines more than one method of treatment; also known as multimodality therapy.

Immunotherapy – treatment that stimulates or suppresses the immune system to help the body fight cancer, infection or other diseases.

Metastasize – to spread from one part of the body to another.

Oncology – the branch of medicine specializing in diagnosis and treatment of cancer.

Prognosis – likely outcome or course of a disease.

Radiation therapy – killing cancer cells or shrinking tumors through the use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources.

Stage – the extent of cancer in the body, usually based on tumor size and whether nearby lymph nodes contain cancer.

Tumor – also known as neoplasms, tumors are abnormal masses of tissue that result when cells divide more than they should or do not die when they should. Some are benign (not cancerous), and others are malignant (cancerous).

Source: National Cancer Institute

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

Posted in cancer, health care | Tagged , , , ,

Giving hope to youth affected by cancer

Charlie Poole at the H.O.P.E. event in May at the Baldwinsville YMCA with, from left, his mother, Lynda Poole, and Upstate Cancer Center nurse Kristen Thomas and social worker Stephanie Barry. In a Facebook post the day Charlie died, his mother said he would want nothing more than for the rest of us to appreciate the life we have, “to stop, look around and feel the wonder surrounding us.” (photos by Robert Mescavage)

Charlie Poole at the H.O.P.E. event in May at the Baldwinsville YMCA with, from left, his mother, Lynda Poole, and Upstate Cancer Center nurse Kristen Thomas and social worker Stephanie Barry. In a Facebook post the day Charlie died, his mother said he would want nothing more than for the rest of us to appreciate the life we have, “to stop, look around and feel the wonder surrounding us.” (photos by Robert Mescavage)

BY SUSAN KEETER

Charlie Poole, 16, went hiking in Highland Forest last spring. It was an accomplishment for a young man who, 26 months earlier, was diagnosed with a brain tumor that left him with weakness in the right side of his body, vision problems and a host of other challenges.

“I like walking in the woods and just listening to the birds,” Poole explained during a H.O.P.E. social event held in May at the Baldwinsville YMCA.

H.O.P.E. (Helping Oncology Patients and Families Engage) represents another accomplishment for Poole. He championed the idea of organized social activities for children and teenagers treated at the Upstate Cancer Center, “so we can get to know other people who understand the whole cancer situation.”

Levi Haddad, 4, plays with a puppy from Pet Partners of CNY at the H.O.P.E. event at the Baldwinsville YMCA.  Levi and Alayah (below) are both being treated for acute lymphoblastic leukemia at the Upstate Cancer Center and Upstate Golisano Children’s Hospital. They became friends at the May event.

Levi Haddad, 4, plays with a puppy from Pet Partners of CNY at the H.O.P.E. event at the Baldwinsville YMCA.  Levi and Alayah (below) are both being treated for acute lymphoblastic leukemia at the Upstate Cancer Center and Upstate Golisano Children’s Hospital. They became friends at the May event.

Poole talked with Upstate social worker Stephanie Barry, nurse manager Molly Napier and nurse navigator Kristen Thomas about his idea. Other patients and families shared Poole’s interest, and H.O.P.E. was created.

The first event, held in January 2018, featured a group discussion and practice of stress management techniques led by Kaushal Nanavati, MD, medical director of integrative therapy at the Upstate Cancer Center.

The second event was all fun and treats. Mothers painted landscapes together, families had portraits taken, and children played board games. The young cancer patients “shopped” for Mother’s Day gifts from a treasure trove of donated gifts. Poole chose a handmade bracelet for his mother. Pet therapy dogs snuggled, licked and played ball. Everyone enjoyed pizza and gourmet cupcakes.

Throughout the evening, Poole watched his idea come to life and reflected on how it came to be.

Poole was a member of the track team at Fayetteville-Manlius High School. “I started leaning to one side when I ran,” he recalled. “When one of my teammates gave me a friendly shove, I fell to the ground and couldn’t get up. I got nauseated when I laid on my back.

“My pediatrician saw that my pupils were different sizes and sent me to the emergency department at Upstate,” he continued. It was Feb. 2, 2016.

Emergency doctors ordered a magnetic resonance imaging scan. Because metal would interfere, Poole’s braces had to be removed.

Alayah Green, 4, kisses her mom, Katie Green, while she and other mothers of cancer patients paint landscapes at the H.O.P.E. art session led by Ally Walker.

Alayah Green, 4, kisses her mom, Katie Green, while she and other mothers of cancer patients paint landscapes at the H.O.P.E. art session led by Ally Walker.

The results of the scan arrived with a flood of specialty doctors. Poole had diffuse intrinsic pontine glioma, known as DIPG. It’s a lethal brain-stem tumor. Unlike most pediatric cancers, which have an overall survival rate around 83 percent, only about 10 percent of people diagnosed with DIPG survive for two years after diagnosis. Poole died Aug. 6, 2018, two and a half years after his diagnosis.

When Poole was diagnosed, he learned that surgery was impossible because of the location and type of tumor. Treatment — to improve his quality of life, not cure the cancer — was radiation, which could be done on an outpatient basis.

Poole and his parents, Keith and Lynda, went home to absorb the news. With his doctors’ permission, they took a weeklong family vacation before their son started treatment in 2016.

Six weeks of five-day-a-week radiation took the hair off the back of Poole’s head and affected his sense of smell. His wavy, ash-blond hair returned, but Poole’s sense of smell and taste were still affected.

His parents spent hours online, connecting with other families affected by DIPG and searching for options. With support from his oncologist, Irene Cherrick, MD, Poole enrolled in a 14-month clinical trial at the Cincinnati Children’s Hospital, testing the effects of chemotherapy drugs on DIPG.

“My tumor stayed stable,” noted Poole. “But I’m not sure it helped.”

In June 2017, near his 16th birthday, Poole learned that his tumor was growing again. After careful consideration, Poole was given 10 more radiation treatments. Because of the gravity of his condition, his family chose to try an experimental treatment in Mexico, which involved traveling back and forth for four months. In October 2017, Poole had a setback at home and was unable to return to Mexico for treatment.

Cherrick later prescribed two new chemotherapy medications, one of which required permission from the manufacturer and the U.S. Food and Drug Administration. Poole’s follow-up imaging scans showed that his tumor had changed shape.

“Being told that I am going to die has changed me for the better,” Poole said in May. “I am more caring and compassionate.”

One reminder of his compassion: the H.O.P.E. events, which connect strangers with one another.

About H.O.P.E. 

H.O.P.E. events are open to any pediatric cancer patient and his or her family. Contact nurse Kristen Thomas for details: 315-464-7227.

Funding for the H.O.P.E. event was provided by the Upstate Foundation (Paige’s Butterfly Run and Ozzie’s Army funds) and by On My Team16. That new non-profit was inspired by Jack Sheridan, a student athlete at Le Moyne College and a cancer survivor who was treated by Irene Cherrick, MD, at the Upstate Golisano Children’s Hospital. Click here to read Sheridan’s story.

Cancer Care magazine summer 2018 coverThis article appears in the summer 2018 issue of Cancer Care magazine.

 

Posted in adolescents, brain/neurology, cancer, drugs/medications/pharmacy, health care, patient story, Upstate Golisano Children's Hospital/pediatrics, volunteers | Tagged , ,

Baseball-loving former patient, family pitch in to comfort kids with cancer

Baseball pitcher and cancer survivor Jack Sheridan, now a sophomore at Le Moyne College, is shown in the team colors of his high school, Christian Brothers Academy. He is a board member of On My Team16, a charity to help children hospitalized for cancer. (photos by Robert Mescavage)

Baseball pitcher and cancer survivor Jack Sheridan, now a sophomore at Le Moyne College, is shown in the team colors of his high school, Christian Brothers Academy. He is a board member of On My Team16, a charity to help children hospitalized for cancer. (photos by Robert Mescavage)

BY JIM HOWE

In a baseball movie, Jack and Jordan Sheridan’s story might sound something like this:

Pitcher goes on injured list, recovers and, together with energetic manager and support staff, helps and inspires his teammates.

The pitcher is Jack, the manager is his sister Jordan, the support staff is their family and friends, and the teammates are any kids hospitalized with cancer.

Jack and his sister Jordan, the driving force behind setting up the charity he inspired. Their parents are Andy and Kim Sheridan of Fayetteville.

Jack and his sister Jordan, the driving force behind setting up the charity he inspired. Their parents are Andy and Kim Sheridan of Fayetteville.

But this is no sports movie; it’s the real story behind On My Team16, a charity founded in 2017 by Jordan Sheridan of Fayetteville, with the support of family and friends, to help comfort pediatric cancer patients at the Upstate Golisano Children’s Hospital.

The charity has an optional bonus for sports fans: You can make donations as if it were a fantasy sports league. On My Team16 will take any sports statistic you can think of and keep track of it for you to pledge, say, $10 for every home run hit by your favorite pro or college player. And athletes are encouraged to help, which they have done individually and as teams, through sending notes to children or visiting the hospital.

Jack, 19, went through three years of chemotherapy for acute lymphoblastic leukemia (see “What kind of cancer is that?” below). He was diagnosed during the 2014 baseball season, when he was a 15-year-old student at Christian Brothers Academy, where he pitched for the varsity team and wore the number 16.

Headaches, fatigue and fever led to tests, then to Golisano, where he started weekly, later monthly, chemo treatments that would last until September 2017, when he was declared cancer free. His tests since then have all been good, and “as of right now, I feel as close to normal as possible,” he said recently.

When Make-A-Wish Central New York asked Jack what he wished for, he wanted to give something back to his school. The result was this bullpen and batting cage, which debuted in 2016 at the CBA baseball field.

When Make-A-Wish Central New York asked Jack what he wished for, he wanted to give something back to his school. The result was this bullpen and batting cage, which debuted in 2016 at the CBA baseball field.

His illness delayed his CBA graduation from 2016 to 2017, and he returned to the pitcher’s mound in 2018 as a freshman at Le Moyne College. He will likely miss the 2019 season, though, after a baseball-related arm injury.

His sister Jordan, 23, who pitched for her CBA and St. Lawrence University softball teams and now works in social media for a local company, was a driving force in setting up the charity to carry out Jack’s wish to help other young cancer patients.

“When I was in high school, I did a program called Strike Out Hunger,” Jordan said. “Whenever I got a strikeout, we donated a certain amount of money to the Samaritan Center (a Syracuse soup kitchen), so for my whole life I’ve been involved in fundraising.

“But then, once he was diagnosed, I kind of changed who I wanted to help and focused on pediatric oncology patients, because of so many people, organizations and families that helped us when he was first battling cancer,” she said.

Brian Langdon

Brian Langdon

“It’s nice to see what you can do  as an athlete that’s more than just winning a game or performing. It’s nice to be able to give back,” she said.

On My Team16 is a tax-exempt organization, and several friends and family members pitch in to help track finances, create spreadsheets to track the sports statistics, plan fundraisers and maintain the website. Jack and Jordan’s younger sister, Charlie, a softball pitcher at CBA, serves as the charity’s photographer and record keeper.

The ambassador for the “patient care” side of things is Jack, “just because of the experience I’ve had. I can relate to the patients because it’s all stuff I’ve been through,” he said.

Jack noted that he became friends with a pediatric cancer nurse at Golisano, Brian Langdon, during his treatment, and Langdon will sometimes help put him and Jordan in touch with a patient who could use a visit or pep talk, after checking with the parents. Parents sometimes reach out directly to On My Team16 through its website, onmyteam16.com, or social media.

“So that’s how most of the relationships start, and they just build from there,” Jack said. He told of one boy, now a young teenager, they followed through his whole cycle of treatment, who was presented a bat signed by his idol, former Yankee Derek Jeter, when he rang the bell signaling the successful end of his cancer treatment.

Langdon, who has a grandson about Jack’s age, shared his love of baseball with Jack during his various hospital stays. “I saw him when he was very sick and when he laughed and things were good,” Langdon said.

He praised On My Team16 for helping morale among the young patients and for getting athletes involved in their efforts. “Not all parents can stay there all day, so they are happy they (Jack and Jordan) can spend some time with their child,” he said.

“They’re wonderful, responsible young adults who are just trying to ease the burden of what goes on in a chronically ill child, Langdon said, and the patients are grateful for the gifts. “They’re totally mesmerized, they’re smiling from ear to ear, so happy … and the parents are also very happy because their child is having a good day.”

Jack and Jordan are unsure of their career plans but said they would love to make a full-time job out of helping kids with cancer.

What kind of cancer is that?

Acute lymphoblastic leukemia, abbreviated as ALL and sometimes called acute lymphocytic leukemia, is the most common type of childhood leukemia.

ALL is a fast-growing cancer that develops in lymphoblasts, which are immature forms of the white blood cells called lymphocytes found in the bone marrow.

The cancerous cells can build up, crowding out normal cells, then spill into the bloodstream and spread to other parts of the body.

If not treated, ALL would probably be fatal within a few months.

The usual treatment is a varied course of chemotherapy that typically lasts two to three years.

Source: American Cancer Society

On MyTeam16 wristbands

On MyTeam16 wristbands

Little gifts for little patients

Examples of things offered byOn My Team16 to young cancer patients:

  • a personal chat by Jack and/or Jordan with a newly diagnosed, and scared, child and family members.
  • a visit by a local or national sports figure, such as Cicero-North Syracuse graduate Pat Corbin, now a pitcher for the Arizona Diamondbacks.
  • A pair of comfy, fuzzy socks for hospital wear, along with an inspirational message.
  • an iPad or a book.
  • little comforts like a ChapStick, a stress ball to squeeze or hand sanitizer.
  • tickets to a sporting event, which nurses distribute to the patients and their families.
  • a customized package, if they know a child’s sports team or other special interest.

Cancer Care magazine summer 2018 cover

This article appears in the summer 2018 issue of Cancer Care  magazine.

Posted in cancer, fundraising, health care, patient story, Upstate Golisano Children's Hospital/pediatrics, volunteers | Tagged , , , , , ,

Do you always need chemotherapy for breast cancer?

Oncologist explains research that informs, personalizes treatment options for women

BY AMBER SMITH

Results of an international study — which includes some Central New York women who are patients at Upstate — are helping oncologists determine which breast cancer patients can skip chemotherapy.

Cancer specialist Abi Siva, MD (photo by Susan Kahn)

Cancer specialist Abi Siva, MD (photo by Susan Kahn)

“There is a subset of patients who will benefit from chemotherapy, but the majority of patients might not have to go that route,” explains Upstate oncologist Abi Siva, MD. She’s referring only to women with hormone-positive breast cancer that has not spread to the lymph nodes. The research does not apply to all women diagnosed with breast cancer.

Women with hormone-positive breast cancer typically have surgery to remove their tumor. Then a sample is sent to a specialized laboratory where the tumor cells are analyzed for specific genetic mutations in a test called Oncotype.

The test predicts the likelihood of recurrence and whether chemotherapy would help.

Women with a low score are considered low-risk and not recommended for chemotherapy. Those with a high score are recommended for chemotherapy. What about those in between?

“It was challenging for physicians to make a decision about chemotherapy for these women because we really didn’t know what to do until this study came out,” Siva says. “Now we are more confident.

“This is very personalized treatment for each patient, based on her score. We think now we are able to spare about 70 percent of the patients who fall into this category from chemotherapy.”

For the study, led by a cancer researcher at Montefiore Medical Center in New York City, half of the women received chemotherapy and endocrine therapy. The other half received just endocrine therapy. Both groups fared well, with one exception — women under age 50, whose cancer is likely to be more aggressive, were found to derive benefit from chemotherapy.

The study, which began in 2006 and has involved more than 10,000 women, was published in the New England Journal of Medicine and presented at the American Society of Clinical Oncology in Chicago this past spring. Paid for largely by the United States and Canadian governments and philanthropic groups, the research received some funding from Genomic Health, the company that makes the Oncotype tumor test, according to The New York Times.

This is important information because chemotherapy —used to treat a variety of cancers — can take a toll. Side effects can include infections, alterations to kidney and liver function, nausea and vomiting, hair loss and neuropathy, or tingling in the hands and feet. Long-term effects may include difficulty with focused thinking, heart and/or lung problems, muscle weakness, bone and joint problems and secondary cancers or blood disorders.

After surgery to remove the tumor, a woman with hormone-positive breast cancer may face chemotherapy or radiation, both or neither. Regardless, she will receive endocrine therapy, which is designed to suppress the effect of the hormone estrogen.

“Even though we know the surgeon was able to remove the breast tumor, our concern is that there could be microscopic cells left behind in the breast or elsewhere in the body that could come back as a problem, five or 10 years down the road,” Siva explains.

Hormone-positive breast cancers in young women are driven by the ovaries, where estrogen is made. Often these patients receive the medication Tamoxifen, which works by blocking estrogen receptors in breast cancer cells.

In post-menopausal women, cholesterol can be converted into androgens and then estrogens, so doctors often use an aromatase inhibitor medication to block that conversion and decrease the amount of estrogen production.

Siva say studies are underway to determine how many years women should take aromatase inhibitors for the best protection against recurrence.

Cancer Care magazine summer 2018 coverHealthLink on Air logoThis article appears in the summer 2018 issue of Cancer Care magazine. Hear a podcast/radio interview with Abi Siva, MD, in which she discusses which breast cancer patient can skip chemotherapy.

 

 

Posted in cancer, diabetes/endocrine/metabolism, drugs/medications/pharmacy, health care | Tagged , , , , , ,