Preventing a Recurrence of Cancer

Another guest blogger.  Enjoy

According to the National Cancer Institute, there are over 12 million cancer survivors in the US today.  And that number is expected to grow, as the population ages, treatments improve, and tests find the disease earlier.  

Cancer survivors face a myriad of health challenges, not to mention the daunting fear the cancer will return.  However, once a patient is deemed "in remission," they are typically disconnected from care -- as well as any attending support -- and told to come back in three to six months where diagnostic scans or blood tests will determine if the cancer has returned.

We suggest a far more pro-active, empowered approach: a remission maintenance plan that offers cancer survivors a personalized program to regain control of their health, restore vitality and protect against the cancer returning. At the Block Center, once a patient has completed their treatment, we personally tailor a comprehensive Remission Maintenance program for them that includes: therapeutic nutrition, exercise, mind-spirit care, and anti-tumor therapies.

Understandably, after hearing that they are "in remission," patients may want to retreat psychologically to a "cancer- free" zone and never think about the disease again.  But this is why they shouldn't:  Cancer is as much a microscopic and molecular disease as it is a visible one. Thus, a patient in remission may still harbor malignant cells (ones that were resistant to chemotherapy or radiation, and therefore survived the attack phase). These cells unfortunately have the ability to show up with a vengeance, even when one least suspects. Not placing far greater emphasis on containing and addressing these cells from the get-go is a significant omission of mainstream treatment. But while preemptive treatment strategies may only exist in integrative clinics, when it comes to the diagnostic side, a new technology has begun demonstrating the relevance of these virulent escape cells.

Enter CTCs (circulating tumor cells)! Over a decade ago, the Block Center was one of a few that were performing bone marrow biopsies to evaluate for malignant cells in both the marrow and in circulation. It took several years, but eventually this evolving diagnostic technology made it into conventional care. While easier to perform today and more reliable as well, we continue to use this in our clinic. This technology allows us and others the ability to measure in our patients the number of these detached cells circulating freely from the main cancer mass.  Though not yet approved for all cancer, research studies have shown that an increase of these cells is prognostic of a patient's survival.

For instance, a CTC count may be a better prognostic indicator for survival among prostate cancer patients than a PSA level -- the test used presently to determine and follow the course of prostate cancer growth.

By comparing the levels of CTC in 37 men with metastatic prostate cancer, researchers at Thomas Jefferson University found that for the men with 5 CTCs or more, the median overall survival was only 8.4 months. Whereas, if these men were found to have less than 5 CTCs, the median survival was 48 months! 

The relevance of CTCs is also relevant to other cancers. For instance, CTCs were measured in 151 women with metastatic breast cancer. The MD Anderson Cancer Center's researchers found that those patients with 5 or more CTCs had a median survival of only 13 months, whereas those with less 5 survived over 29 months!

Controlling, preventing or overcoming these detached and disseminating cells is possibly the biggest conundrum facing cancer scientists. While these cells are generally addressed during treatment, the first steps of recurrence prevention should start with strategies to counter the survival of these residual cells and inhibiting their potential proliferation. In fact, CTCs that have gone through the onslaught of treatment and have nonetheless survived have the potential to evolve into more aggressive clones encouraging a more virulent malignancy. So what to do?

Aggressive Monitoring

We recommend regular monitoring of patients' status with lab tests and imaging to detect early signs of disrupted biochemistry or a recurrence of disease, especially in the year or two after remission.

Being "diagnostically aggressive" may allow us to be less invasive therapeutically. In the first years after remission, therefore, we recommend:

• Clinical visits with your oncologist, at least every three to four months in the first and second year and every six months for the next several years
• Scans and blood tests of tumor markers every three months.
• Complete blood count and chemistry test every three months.
• Nutrition status, including weight changes, body composition, and albumin levels, every three months.
• Internal terrain monitoring, every three to six months for the terrain factors that are most problematic.

While monitoring, there is no reason to wait anxiously for the other shoe to drop.  So immediately implement a full integrative program.

• Make sound dietary changes toward adherence of a whole foods diet.  Reduction in dietary fat has already been shown to cut recurrences in different cancers. Controlling refined flour, sugar and junk food is a necessary step to avoid the recurrence risk of elevated blood glucose and spiking insulin levels.
• Introduce aerobics, strength and flexibility training into your daily schedule. Yoga, pilates, chi gong or any number of fitness approaches is an essential step towards recurrence prevention. Considerable research supports that risk, response, recurrence and outcomes are tied to physical care.
• Mitigate stress through progressive relaxation, meditation, or simply easing the load on an excessive work schedule. Elevated cortisol levels are associated with poorer outcomes in breast cancer patients. So do what it takes to transform less healthy patterns.
• Get rest and adequate sleep. The more active you are in the daytime, the better you'll sleep at night. Few of us get enough sleep and the adverse consequences to an otherwise health promoting, cancer inhibitory environment can be devastating.

© 2010 Keith I. Block, M.D., author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment
Author Bio
Keith I. Block, M.D. is Director of Integrative Medical Education at the University of Illinois College of Medicine; Medical Director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois; and founder and Scientific Director of the nonprofit Institute for Integrative Cancer Research and Education. He is also editor in chief of the peer-reviewed professional journal Integrative Cancer Therapies and a member of the National Cancer Institute's Physician Data Query Complementary and Alternative Medicine (CAM) Editorial Board.

For more information, please visit www.lifeovercancer.com and www.blockmd.com. Become a fan of Life Over Cancer and the Block Center for Integrative Cancer Treatment on Facebook.

Dear Cancer...

I started thinking about this on the eve of an oncology appointment.  If cancer was here, in this room, what I would say to it.

Dear  Cancer,

I go between being really pissed at you and being grateful.  Pissed?  You are wondering why I am pissed at you?  You stole almost two years from me,  where instead of having surgeries, chemo, radiation, nausea, constipation, insomnia, anger, having my pee turn red, having mouth sores, being bald, not being able to work as much as I used to when I should have been playing hockey, riding my bike, being outside enjoying the weather, not being so fucking tired I wanted to sleep, then not being able to sleep because of insomnia, making dinner then not being able to eat because I felt like shit.

You make it hard for me to think, because of chemobrain.  I used to know the answers to things, but some days I just struggle to put sentences together. 

I have scars, both emotional and physical because of you. You made it hard for me to look at myself for the longest time, that has passed, but I am still angry about it.

You are the reason my friend Nick Corea is no longer here.  You took him from us too soon.  I still remember that day when I found out he was gone.  It was like it was yesterday.  You robbed the world of a great man.  For that you will never be forgiven.


You wonder why I am grateful?  I am not grateful for you, lets make that clear.  I am grateful that I found you early, early enough to get treatment to stop you.  I am grateful that I found strength that I never knew I had, Grateful that I have an awesome support system of friends, family and co-workers.  The medical staff that I had was the best anyone could ask for.

Grateful I found a voice not only for myself, but because of you, I can speak for those who can't, who are too afraid, too sick, too weak or just too afraid.

Grateful for the network of people that I have found who hate you as much as I do.  Who want to eradicate you as much as I do.

Grateful I have found a purpose.  Ha, you think you did all this for me?  I realized strength and determination was in me all along, it just took something as vile as you to bring it to the surface.

Now you can leave.  You can leave all my friends alone.  You can leave people I never met alone.  You can go away.  Never come back.


If you do the last five things I ask I will be eternally grateful.

Mel is the producer/co~host of The Vic McCarty Show.  Listen Live Monday~Friday 10am-noon eastern standard time on wmktthetalkstation.com

Check out my podcast The Cancer Warrior on Empoweradio.com available on demand now, and also available on itunes

Not exactly with the greatest of ease, but it sure was fun!!!

This is a picture of me doing a trapeze experience at a local resort that I used to work for. They have had the trapeze up every summer since I started working there in 2005. I never really thought about doing it until I had cancer. The resort allows the local media to try it for free then talk about it on the air, (how freakin cool is that really? get paid to talk about fun experiences that you do for free!!)

Last year two of my co-workers from the radio station tried the trapeze. I was still working at the resort at the time, and at the radio station. I was jealous that they were able to do it and I was not, I still had my port in and you are not supposed to do any contact sport when you have it in, yes it actually says that in the manual!!! I was not able to see how they did, but it looked like fun, and I vowed to myself I would do it this year.

When the time came I contacted person in charge of the trapeze and told him I wanted to do it, he set up a time and I went home excitedly and told my fiance that I was going to do it. The look on his face was what? really? why the hell would you want to do that?

I don't have a death wish, I don't want to climb mountains or do extreme sports (unless you consider hockey an extreme sport) I am not one of those people who wants to do something "just because it is there."

I had seen other people do the trapeze and I saw it was safe, you are harnessed in, there was a net underneath, and sure I had to sign the in event of death you do not hold us responsible waiver, in case of emergency contact, insurance info blah blah blah, ironically enough most of the same kind of paperwork you sign when you have major surgery. So after that was all taken care we stretched and got some instruction and were good to go.

The climb up the ladder wasn't so bad, and I am not afraid of heights, but I did forget one thing before I even decided to do this. I get motion sickness real easy, I usually have to sit in the front seat of a car or else I will be nauseous. You would have thought I would have remembered this little gem of information, but no I think the excitement of doing the trapeze made me totally forget about that.

The trick they have you do is stand all the way out on the platform with your toes on the edge, grab the bar with one hand,push your stomach out, grab the bar with your other hand and then on their signal jump off the platform then try, while moving, put your knees on the bar so you are hanging on it upside down.

Uh......ok.......

They said it was about momentum, not about upper body strength. Ya right, is that why my upper body feels sore today? I had 3 tries, was able to do it on the last one before the motion sickness took control and I had to stop.

Would I do it again? Probably, after a couple of months of serious upper body and core workouts and a lot of dramamine.

Mel is the producer/co-host of The Vic McCarty Show. Listen live Monday-Friday 10am-noon eastern on wmktthetalkstation.com

ICON

We have all heard about the sad death of Farrah Fawcett. Right now I am watching an episode of Charlie's Angels, the show that launched her to superstardom. She only appeared in the first season of the show but of course she made an impression.

People who didn't grow up in the 60s & 70s don't realize that there were not that many shows that had strong women as the leads on shows. I grew up with the Angels and Wonder Woman. We didn't have the shows with lots of strong female leads like today like Mariska Hartigay on Law & Order SVU or any of the Desperate Housewives.

I know people who watch the shows now will say it is dated and, during its time it was called jiggle tv, but still these ladies were my heroes none the less.

Farrah died of anal cancer. According to the American Cancer Society there are only 5,000 new cases of anal cancer every year, with about 680 deaths. The type of cancer she died of didn't have a walk or an awareness month. In fact, I, like most people I am sure, have never heard of anal cancer until Farrah Fawcett was diagnosed with it.

I watched, or I should say, I tried to watch Farrah's Story when it first aired. It was real, it was gripping, and for me it cut a little to close to home. Watching her story was difficult, I think everyone who has been diagnosed and watches someone who films their life or watches a movie of the week about someone who has cancer sees a little bit of themselves in that person, and I am no exception. Watching Farrah want to cut off her blonde locks that made her so famous in the 70's so that she would lose her hair on her own terms was a reminder of something that I had gone through (shaving my head that is) I couldn't watch the entire two hours of Farrah's Story. It was too hard for me to watch, although I was hoping to muster up the courage to watch the entire 2 hour movie and hopefully the sequel, but sadly that will never come.

Obviously how every person deals with cancer and chemo is different, but I could relate to a lot of the things she was going through, and I applaud her for going public with her very personal battle, bringing light to a disease, showing people that if an american icon like her can get this insidious disease then anyone can.

Farrah was only 12 years older than me when she passed. 12 years. That is not much older than me. That is first thru twelfth grade, barely a blip in time in the universe.

All three of the original Charlies Angels battled cancer, Kate Jackson and Jaclyn Smith had breast cancer, they battled the disease and both are currently in remission.

So as the night, and a tribute to Farrah comes to a close, I applaud you & thank you Farrah Fawcett, thank you for showing the world what cancer is like, I didn't see it from a celebrities perspective, just from a woman's perspective. You had a great impact on me when I was a young girl and you have had a far greater impact on me now.

Tiaras in Lansing

This is a picture of the 2008 Ms. Michigan Ashlee Baracy and I at the state capitol in Lansing, Michigan. I just came home from attending the Celebration at the Capitol for the American Cancer Society. We were there to talk to the legislators to convince them to make Michigan smoke free. We met with our Representative and Senator. One of them totally agreed with the bill, the other one didn't. While I have to respect the decision of our lawmakers, I don't have to understand it. Unless you have been touched by cancer in some way I guess you wouldn't understand why I would want Michigan smoke free.

Doesn't it make sense to have restaurants and bars smoke free? For the health of the workers and the patrons? Now some would say that if you don't want to breath smoke you should eat somewhere else, but don't I have the right to eat a meal with out worrying about getting another form of cancer? Some people will say the workers can just "get another job" Really? Have you tried looking for work now days? And what if they have been working at a restaurant or bar for years, should they just give up their seniority to find a job somewhere else?


Yes smokers have rights just like anyone else, but I have the right to go to eat and not breathe in their smoke.

Is it too much to ask not to be put at risk of cancer from second hand smoke when I go out to eat at any restaurant?

Mel is the producer of The Vic McCarty Show. Listen live weekdays 10am-noon eastern on wmktthetalkstation.com

Whatever gets you through the day....

Recently I was interviewed on a radio show to talk about how positivity kept me going during my treatment and survivorship. Like most survivors, I assume, I got through it using whatever I could to get me through the day. Humor, sports (mainly hockey) movies, friends, etc all that got me through. I am positive I would say 98% of the time (look out if you are around me for that dreaded 2%.)

I stay positive even though it seems like I have a hard time remembering things. Leave it to me again to acquire side effects after chemo. This is particularly hard for me because my memory is usually sharp as a tack. Now when some people ask me questions, even just the simplest ones I struggle to find the answer. My doc says that this will go away in time, ah yes this too shall pass.I know, a war was waged in my body and I fought and won, and this is all collateral damage from the drugs that were used to kill the cancer. I guess the hardest part is that look that people give you when you are searching for the answer to a simple question, and, if the person doesn't know you, they look at you like you are stupid.

This is part of the new me, for now. It is frustrating, and difficult, but I know, slowly I am getting back to normal, or as close as I can get to the old me.

So I stay positive, still, even though I see friends of mine and can't remember their names for the life of me, and trivia, which used to come to me like a breeze is missing from the computer in my brain. How can I stay positive? I don't know. I guess I don't know any other way to be.

Mel is the producer of The Vic McCarty Show. Listen Monday-Friday 10am-noon eastern standard time on wmktthetalkstation.com

Relay for Life spot

This is the Relay for Life spot I recorded in April. Me in Hi-Def, too funny. I tell the people who tell me that they have seen me on TV that they have to go to the Relay if they mention it.

Listen to Me on The Vic McCarty Show 10am-noon eastern standard time Monday-Friday on wmktthetalkstation.com