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Entries in chemotherapy (22)

Saturday
Apr202013

Family Misses Chemo Appointment Due to Boston Lockdown

iStockphoto/Thinkstock(BOSTON) -- Jane Roper was supposed to head to Boston Children’s Hospital Friday morning so that her 6-year-old daughter, Clio, could receive a round of chemotherapy to treat her leukemia. But instead of getting treatment, Clio and the rest of Roper’s family were stuck indoors after the lockdown of Boston and its surrounding suburbs.

In the neighborhoods next to Roper’s Medford, Mass., home, numerous law enforcement officers were going door-to-door in search of Dzhokhar Tsarnaev, the remaining suspect in the Boston Marathon bombing.

While Roper said a slight delay in Clio’s chemotherapy treatment shouldn’t affect her health, Roper’s nerves have been frayed in the aftermath of the Monday’s bombings and now the violent manhunt that resulted in the death of one suspect and an MIT security officer.

“It all hits so close to home,” said Roper. “This is crazy. You never expect to see the whole area under siege.”

Roper and her twin six-year-old daughters, Clio and Elsa, were at mile 25 of the Boston Marathon cheering on runners as they neared last mile of the race, but left before the bombs went off.

Roper heard about the explosions while headed towards Boston Children’s Hospital with Clio. The 6-year-old had been hospitalized for a week with fevers and other complications from her chemotherapy.  Clio had been given special permission by her doctors to attend the race for a few hours.

On Thursday, Clio was released from the hospital, and the family hoped to take her out for breakfast with her sister on Friday morning before chemotherapy. It would have been a bit of normalcy for a family going through its own ordeal. But instead, Roper woke up to find that residents of Boston and its suburbs were advised to remain indoors with the doors locked. The family field trip for breakfast would have to wait for another day.

Cooped up indoors with her children, Roper was relying on social media for news because the televised news could scare her girls. But even with that extra safeguard, Roper said, her daughters still know not everything is normal.

“One of them just said, ‘This day is weird,’” said Roper. “This is a day unlike any other day, and I don’t want to experience it ever again.”

Copyright 2013 ABC News Radio

Thursday
Dec272012

Study: Cancer Drug Shortage Leads to Less-Effective Substitute Drugs

St. Jude's Children's Research Hospital(NEW YORK) -- Abby Alonzo was eight weeks into treatment for Hodgkin lymphoma and doing great when her doctor informed the 9-year-old's parents that one ingredient in the cocktail of chemo drugs she was receiving was no longer available and they would have to use a substitution.

"It's scary, and I was alarmed but I didn't really have a sense of how critical this drug was," said Katie Alonzo, Abby's mother.  "When something like this happens, you have to put your faith in the doctors."

But by 12 weeks into treatment, Abby relapsed.  Rather than receiving a planned break from treatment, she was rushed into emergency "salvage therapy," which involved more chemo, a bone marrow transplant and radiation.

The doctors at St. Jude Children's Research Hospital in Memphis, Tenn., who treated Abby, attribute her relapse to the shortage of the drug mechlorethamine, also known as nitrogen mustard.  

In Thursday's New England Journal of Medicine, the St. Jude doctors, along with colleagues from the Dana-Farber cancer institute in Boston and the Lucile Packard Children's Hospital in Stanford, Calif., highlight how the scarcity of this medication has been linked to a higher rate of relapse among children, teenagers and young adults with Hodgkin lymphoma.

The 40 patients in the study who received the substitute drug cyclophosphamide experienced complications at about twice the rate of the 181 patients studied who didn't have to switch drugs.  This is the first randomized study to compare the differences in treatment outcomes between the two medications.

None of the patients died, but the authors emphasize that they're only 18 months out from treatment and could still be hit with adverse effects.

"It's too soon to know about problems and success rates," said Dr. Michael Link, one of the lead investigators and a Stanford University pediatric oncologist.  "Even if they're cured, they underwent intensive treatment they would have otherwise avoided and this puts them at greater risk for long-term effects such as infertility and secondary cancers."

Dr. Amy Billet, a pediatric oncologist at Dana-Farber who was also part of the study, said it's not possible to say beyond a shadow of a doubt that the drug swap was responsible for the higher rate of relapse, but she and her fellow investigators could think of no other credible explanation.

"You can never know what happened to one individual patient.  You can only say there is an increase risk in the group who got the substitution drug," she said.

According to Link, this latest study only confirms what doctors have suspected for years: swapping one drug for another, even when the two are similar, isn't always ideal.

"We thought this one was a no-brainer because the drugs were so alike, but we discovered to our dismay that the substitution didn't work as well.  This takes the problem out of the hypothetical and we can point our finger at exactly which patients suffered as a result of the shortage," he said.

Reasons for the shortage aren't entirely clear.  It's likely a combination of factors such as limited manufacturing, lagging production time and lack of profits from these drugs.

The Food and Drug Administration has tried to step in to remedy the problem.  For example, after President Obama issued an executive order in 2011 to reduce the dire drug shortages, the FDA broadened its reporting of potential drug shortages and expedited regulatory reviews that sometimes made the shortages worse.

The New England Journal of Medicine authors said the FDA's efforts should be commended but said more needed to be done.  They said that the shortage of mechlorethamine eased up shortly after their study ended, with no explanation.  However, they warn there's no guarantee there won't be another shortage later.

Copyright 2012 ABC News Radio

Tuesday
Aug212012

Teen at Center of Abortion Debate Dies After Chemo Delay

Comstock/Thinkstock(SANTO DOMINGO, Dominican Republic) -- A pregnant 16-year-old in the Dominican Republic took center stage in the abortion debate when she died last Friday of leukemia complications amid reports that doctors had delayed chemotherapy out of fear that it could terminate her pregnancy. The Dominican Republic has a strict anti-abortion law.

But the young woman's doctor at Semma Hospital in Santo Domingo told ABC News that the hospital had postponed chemotherapy not because of the country's abortion ban but because they were waiting for her bone marrow test results to come back from a hospital in New Jersey to determine what kind of leukemia she had.

The young woman, whose name has not been released, was admitted to the hospital on July 2, Dr. Tony Cabrera told ABC News. She told doctors she'd missed her period, and they immediately gave her a blood test and pelvic sonogram to determine she was pregnant.

Since chemotherapy interrupts tumor progression by halting the rapid division of cancer cells, "it's likely to also have an adverse effect on a rapidly dividing organism, such as an embryo," said Christina Chambers, at the Organization of Teratology Information Specialists' Collaborative Research Center in San Diego.

Dr. Lauren Streicher, an obstetrician at Northwestern University Hospital in Chicago, said doctors practicing in the United States generally recommend that cancer patients requiring chemotherapy terminate their pregnancies in their first trimester, "given the limitation of information about what generally happens at 10 weeks."

The young woman's mother, Rosa Hernandez, had urged doctors to give her daughter an abortion so she could undergo chemotherapy immediately, according to CNN, but Article 37 of the Dominican Republic's constitution prohibits abortion, claiming "the right to life is inviolable from conception until death." The doctors did not perform an abortion.

"My daughter's life is first. I know that [abortion] is a sin and that it goes against the law...but my daughter's health is first," Hernandez told CNN in July.

Cardinal Nicolas de Jesus Lopez Rodriguez, an archbishop in Santo Domingo, spoke out about the case after a Mass in late July, saying that a "direct abortion" was wrong, but "everything possible" should be done to save the life of this young woman, according to the news organization Dominican Today.

"Her situation can be saved, but we don't agree with performing an abortion directly," Rodriguez said.

Once the doctors received the test results from the Carol G. Simon Cancer Center in Morristown, N.J., they learned their patient had acute lymphoblastic leukemia, which Cabrera said had a "very poor prognosis," especially for children more than 10 years old. (For its part, the Carol G. Simon Cancer Center has not confirmed that it ever processed these tests.)

The doctors started chemotherapy when the young woman was nine weeks' pregnant, just as her first trimester was ending, in late July, Cabrera said.

Speaking generally, said Dr. Brian Druker, an oncologist at the Oregon Health and Science University, a short delay in administering chemotherapy should not in itself drastically affect a patient's outcome.

"A delay of a couple of weeks should have no bearing on the outcome unless there was a complication that made someone's medical condition less able to handle therapy," said Druker.

But last Thursday night, the young patient had begun to cough up blood and was moved to the intensive care unit, where she was placed on a respirator, Cabrera said. She also had vaginal bleeding and severe respiratory distress.

She underwent a blood transfusion, but by 2 a.m. Friday, she'd miscarried, Cabrera said. A few hours later, she went into cardiac arrest. Doctors were able to revive her, but she died at 8 a.m. Friday.

Death was attributed to hypovolemic shock (not enough blood or fluid), alveolar hemorrhage, acute respiratory distress syndrome and acute lymphoblastic leukemia, Cabrera said.

After her daughter's death, Hernandez told CNN, "They have killed me. I'm dead, dead. I'm nothing....She was the reason for my existence. I no longer live. Rosa has died. Let the world know that Rosa is dead."

Copyright 2012 ABC News Radio

Thursday
Aug162012

Study: Chemotherapy During Pregnancy Doesn't Cause Complications

Comstock/Thinkstock(NEW YORK) -- There is growing evidence that pregnant women with cancer aren't putting their babies at risk by undergoing chemotherapy treatments.

A new study that followed more than 400 pregnant women in Europe who were diagnosed with breast cancer, found little to no evidence of negative health effects on infants whose mothers underwent chemotherapy -- good news for the one in a thousand women who are pregnant and also suffering from cancer.

Infants whose mothers were treated with chemotherapy weighed less than those that weren't exposed to chemotherapy, but they were not at higher risk of birth defects, blood disorders or loss of hair.

According to the German Breast Group, which led the study, premature birth -- not the chemotherapy treatment -- was responsible for babies being born at a low birth weight and with other complications.

"More complications were reported in the group of infants exposed to chemotherapy than in the group not exposed to chemotherapy," the study said.  "However, most complications were reported in babies who were delivered prematurely, irrespective of exposure to chemotherapy."

Incidences of pregnant women with cancer are growing and it may be because many women are delaying childbirth until later in their lives.

"I would say it is an increasing problem because people are generally delaying pregnancy," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York.  "Women want to have careers before they start a family, so women are getting pregnant later."

Additionally, pregnant women are often diagnosed with cancer at a more advanced stage because cancer symptoms can sometimes be mistaken for signs of pregnancy, making treatment more complex, Bernik said.

In the past, women have been told by their doctors that chemotherapy could harm their baby and were sometimes advised to terminate the pregnancy.  However, recent studies have found that chemotherapy treatment after the first trimester -- when most of the baby's critical growth occurs -- can be safe for baby and mother.

It was also initially feared that the high hormone levels present during pregnancy could cause a specific kind of hormone-sensitive breast cancer to reoccur.  But a recent, first-of-its-kind study found that it is safe for women to become pregnant after they were treated with this form of cancer -- which accounts for about 60 percent of all breast cancer cases.

The study by the German Breast Group confirmed other research indicating that chemotherapy treatments carry fewer risks to an unborn child than was originally assumed.  But more research needs to be done on the potential physical and mental effects of chemotherapy drugs on a child later in its life.

Copyright 2012 ABC News Radio

Saturday
Jun022012

Leukemia Survival: The Younger You Are, the Better Your Chances

(NEW YORK) -- In the 1950s -- a heady time for scientific and medical advances -- the color television was introduced to the American public and Jonas Salk discovered the polio vaccine. But a diagnosis of acute leukemia, the most common form of childhood cancer, would have been a sure death sentence.

Only 40 years later, scientists were not only busy cloning sheep and sending space probes to Mars, but they could also boast an almost 4,000 percent increase in survival rate for children with leukemia -- a figure that continues to rise.

More than 3,000 children are diagnosed with acute lymphoblastic leukemia every year, and while the cancer is more common in children younger than 5 years old, more than 12 percent of those diagnosed are older than 15.

In general, the prognosis for all of these young patients is good, with more than 85 percent still alive after five years. But for some reason, adolescents and teens don't seem to fare as well as their younger counterparts. How much worse they fared was not really known until today.

This revelation came with the results from the largest clinical trial to study how well chemotherapy worked against leukemia in adolescent and young adult patients, presented at the American Society of Clinical Oncology annual meeting in Chicago.

Researchers found that the five-year survival rate for adolescents and young adults was 80 percent, compared with younger children who enjoyed an 88.4 percent rate of survival. Moreover, those older than 15 were also about twice as likely to relapse or die from the treatment itself.

Leukemia is a cancer of the blood cells. These rapidly reproducing cells travel quickly through the blood stream wreaking havoc and invading every nook and cranny of the human body, unless they are stopped. Normal treatment, using chemotherapy, takes three years to complete, isn't without its own downsides, and it doesn't work as well in some as it does in others.

Dr. Eric Larsen, medical director of the Maine Children's Cancer Program and lead study author, said in an ASCO news release that one reason older teens and young adults tend not to do as well is that not all types of leukemia are created equal -- in other words, older patients tend to have more deadly, less curable forms of the disease. He also noted that not only do these older patients tend to have a disease that is more resistant to chemotherapy, but they also experience more toxic side effects from the treatment they receive.

Other doctors said this double whammy deserves more consideration when treating teens and young adults with ALL.

"It's really a double-edged sword," says Dr. Peter Adamson, chairman of the Children's Oncology Group, the world's largest organization devoted to childhood and adolescent cancer research. "Their outcome isn't good, and their ability to tolerate treatment isn't good either."

Exactly why these differences exist in the first place is less clear. Adamson said the underlying disease may have different biological characteristics. Additionally, an important component of treatment involves taking a pill every day for more than two years.

"Compliance is harder for adolescents and young adults" Adamson says, explaining that this may also contribute to worse outcomes in this population.

And then there is the state of the research. More than 90 percent of children who get leukemia in the United States participate in studies like this one -- a "major factor" that has led to better cure rates, says Adamson. But, he notes, "One of the gaps has been in the older adolescent and young adults, where participation is not as high."

Whatever the reasons, Adamson says the results reported at today's meeting will help guide the Children's Oncology Group in designing additional clinical trials to both enhance leukemia control and reduce the toxicity of treatment in this sub-group of patients.

Copyright 2012 ABC News Radio

Monday
Mar122012

New Molecular Discovery Could Mean Fewer Chemo Side Effects

iStockphoto/Thinkstock(DURHAM, N.C.) -- While it can often work wonders against invading cancer cells, chemotherapy can also bring on very undesirable side effects, such as hair loss, nausea and vomiting.

But the recent discovery of the structure of a certain molecule could potentially lead to the development of new drugs that could target tumors while avoiding damage to healthy tissue, resulting in possibly fewer side effects.

The molecule, known as a transporter, can carry specific anti-cancer and antiviral drugs directly into cells.  The drugs can then prevent tumor cells from dividing and multiplying.

"If you really know what this transporter looks like, you can potentially design a cancer drug to be recognized by this transporter and carried into the cells, and you can lower the dose of cancer drugs and decrease the side effects as a result," said Seok-Yong Lee, an assistant professor of biochemistry at Duke University School of Medicine and lead author of the research, published online in the journal Nature.

Experts not involved with Lee's research say development of such drugs is still a very long way off, but focusing on the ability of a drug to get into cancer cells makes scientific sense.

"If it could be manipulated to help with drug delivery or avoiding the toxicity of these drugs.  It could have clinical relevance years from now," said Dr. Minetta Liu, director of translational breast cancer research at the Georgetown Lombardi Comprehensive Cancer Center in Washington.  "We have these very effective drugs, and the question is can we make them even more effective by giving them the homing devices for cancer cells so they can avoid normal cells?"

"There are two newer compounds that are doing that now.  They can invade cells so we don't have to give as much of it to target tumors," said Dr. Stefan Gluck, a professor of medicine at the University of Miami's Miller School of Medicine.

Many other drugs that treat cancer, however, are administered intravenously and are distributed throughout the body.

"We need to achieve specific levels in cancer tissues, but at the same time, that level will be reached in normal tissues.  Some of the normal tissues are sensitive to chemotherapy and can be harmed," Gluck explained.  Damaging normal tissues can lead to a number of the effects often associated with chemotherapy.

Copyright 2012 ABC News Radio

Thursday
Feb232012

12-Year-Old Boy to Halt Cancer Treatment to Be with Family

AbleStock[dot]com/Hemera Technologies(SHELBYVILLE, Tenn.) -- A 12-year old boy who has battled a rare form of cancer since he was 7 has made a bold decision: He is stopping his treatments so he can go home and be with his family.

Alex Rodriguez is aware of what his decision means.  So is his hometown of Shelbyville, Tenn., which has rallied around the boy.

“I had the opportunity to meet Alex this summer,” Dr. Tracy Lampley, principal of Harris Middle School told ABC News.  “He is a very courageous young man to have a very mature adult outlook on life.  It’s amazing as a 12-year old he is really able to face the opportunities and challenges that he has in his remaining time.”

“He’s just a wonderful little boy,” Rodriguez’s grandmother Carolyn Camacho said. “He’s always happy.  No matter what he’s always happy and he doesn’t like to talk about his cancer.  It makes him sad and he wants to be happy.”

Rodriguez's school and neighbors have been touched by his choice and are trying to make his last days cheerful, raising money for his hospice care and taking care of his bucket list.

He has two wishes, to tour the Coca Cola factory in Atlanta, Ga., and go to the indoor water park at the Wilderness Resort in Tennessee.  He will see one of them come true over the weekend when he visits the Coca Cola factory Saturday morning, in a limo, the ride donated by a businessman.

Rodriguez was diagnosed with rhabdomyosarcoma, a rare form of cancer, when he was 7.  This type of cancer is made up of cells that normally develop into skeletal muscles and is more common in children than adults, according to the American Cancer Society.

He had surgery on his spine and had a bar and two “cages” -- cylinder devices in the spine to replace discs -- put into his back.  He had to learn how to walk again after the surgery and received radiation as well as chemotherapy.

The treatments worked, but only for two years.

When Alex was in the sixth grade, “He went for all of his scans and tests and they said everything was gone,” his grandmother said.  “Then two or three months later it came back and it hit him pretty hard.”

Once the cancer returned, Rodriguez again resumed chemotherapy and radiation, but the tumors kept coming back.

With only one choice left -- traveling to Texas for experimental treatments -- Rodriguez opted to stay home so he can be with his family.

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Copyright 2012 ABC News Radio

Friday
Feb102012

Treating Cancer Doesn't Mean Terminating Pregnancy, Studies Find

Comstock/Thinkstock(LEUVEN, Belgium) -- Chemotherapy for breast cancer can be safe during the second and third trimesters of pregnancy, according to a new report in The Lancet. Also, terminating the pregnancy does not appear to improve the mother's prognosis.

"The situation remains challenging since in some situations an advanced cancer can be fatal for mother and fetus," said Dr. Frédéric Amant of the Leuven Cancer Institute in Belgium, lead author of the report. "The patient and her partner should be informed about the different treatment options and the physician should explain that termination of pregnancy does not seem to improve maternal outcome, but the decision to continue or end the pregnancy is a personal one."

In a separate study published in The Lancet Oncology, children whose mothers underwent chemotherapy during pregnancy were found to be normal on measures of general health, behavior and growth out to 18 years of age.

Although pregnancy does not increase the risk of breast cancer, the decision by some women to delay motherhood might be increasing the number of pregnant women with cancer, according Lillian Shockney, a breast cancer nurse at Johns Hopkins Hospital in Baltimore.

"We know age is a risk factor and so is having your first child after age 30," said Shockney, who is also an associate professor of surgery, gynecology, oncology and obstetrics at Johns Hopkins University School of Medicine.

Pregnancy also causes breast changes that can mask the signs of cancer, delaying the diagnosis.

"I think a key message for women having babies if they see something different about their breasts -- even if a doctor says, 'Oh, your breasts are going to change because you're pregnant' -- go to a breast center for a clinical exam," she said.  "Changes in one breast, not both, are a classic sign that something's wrong.  Follow your instincts."

Copyright 2012 ABC News Radio

Tuesday
Jan172012

Studies: Combining Chemotherapy Meds Shrinks Breast Cancer

Comstock/Thinkstock(BOSTON) -- Combining heavy hitting medications for early stage patients with an aggressive form of breast cancer can shrink the tumor and stop its progression, according to two new studies released Monday in the journal Lancet and Lancet Oncology.

An estimated 20 percent of women with breast cancer have a type known as HER2 positive, which is among the fastest growing and most aggressive.

Therapy agents such as Tykerb or Herceptin are typically used for later stages of the disease when the tumor is considered inoperable.  These treatments have been shown to downsize the tumor enough to perform surgery.

The trials, in its third phases, found that even patients in the early stages of the disease -- who are considered operable -- can benefit from these types of medications before undergoing surgery.

The first study, published in The Lancet Oncology, suggests the chemotherapy medication Tykerb is less effective taken on its own compared to Herceptin.

In the other study, researchers at Massachusetts General Hospital in Boston assigned patients in three groups with HER2 positive breast cancer with either the chemotherapy medication Tykerb, Herceptin, or a combination of both medications before undergoing surgery.

The tumors in those who received the combination treatment before surgery were on average 20 percent smaller after six weeks compared to patients who took either of the medications alone, according to the study, which was first presented at the 2010 San Antonio Breast Cancer Symposium.  There were far fewer side effects and they were less severe compared to standard chemotherapy.

These studies add to mounting research looking at tackling aggressive tumors early in the process.

"These studies represent a paradigm shift in breast cancer research where you're studying these therapies up front," said Dr. Jose Baselga, chief of oncology at Massachusetts General Hospital, and lead author of the study published in the Lancet. "This will cut down the time significantly of bringing these therapies to the public."

Many experts said that studying these medications given in earlier stages will help researchers see how tumors are responding to various treatments before and after surgery.

But even though these therapies have been shown to shrink a tumor, no evidence suggests they can improve survival in patients with the disease.

Copyright 2012 ABC News Radio

Thursday
Dec292011

Teen Gives Birth, Dies Days Later After Losing Fight to Cancer

Comstock/Thinkstock(NEW YORK) -- In early November, 17-year-old Jenni Lake gave birth to her son Chad Michael Lake Wittman.  Twelve days later, the  teen mom died from the brain tumor that she had been fighting for more than a year.

The migraines had started about a year before, when Jenni was a sophomore at Pocatello High School in Idaho.  After doctors found a two centimeter mass on her brain from an MRI scan, she was diagnosed with stage three astrocytoma, a tumor that affects the brain and spinal cord.  Doctors gave her a 30 percent chance of surviving two years with treatment.

Only weeks after Jenni was diagnosed with cancer, she found out she was 10 weeks pregnant.  Doctors told her she had to terminate the pregnancy or stop treatment while pregnant for the safety of the baby.  Jenni reportedly did not consider terminating the baby.  She decided to forgo radiation and chemotherapy while pregnant.

Her family documented the heartwrenching year through a series of YouTube videos titled, “Jenni’s Journey.”

“I don’t know how long this is going to last and I just want it to go away,” Jenni said in one of the videos uploaded on Nov. 20, 2010.

While the ability to conceive during cancer therapy is dependent on the type of therapy, Dr. Ian Holzman, chief of newborn medicine at Mount Sinai School of Medicine in New York, said he has seen mothers who are either on cancer treatment or have postponed it until after delivery.  But, the risk to the baby from some toxic anti-tumor medications are indeed “real,” said Holzman.

According to Hope for Two, an organization designed for pregnant women with cancer, chemotherapy has been given to women in their second and third trimester, after the fetal organs have developed.  Cancer affects as many as one in 1,000 pregnancies, according to the organization.

A study published in September found that children born after their mothers were treated with chemotherapy during pregnancy appeared healthy, although many were born pre-term, which researchers said affected many of the children’s cognitive development.

But again, each mother’s case is individual to her diagnosis and treatment.

“The decision on how to proceed is a very personal one,” Holzman wrote in an email.  “The mother/family need to weigh possible maternal death against fetal/neonatal death and/or malformations. I would never 'recommend' one or another choice without having agonizing discussions with the family about their beliefs and goals. In some cases, the data are clear that cancer treatment, if not started immediately, will fail and in other cases it is less clear.  Similarly, the fetal/neonatal risks are clear and in others less clear.”

Copyright 2011 ABC News Radio







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