Frequently Asked Questions about Cancer in Pets

Expert answers to common questions regarding caring for your pet with cancer.

Veterinary Cancer

Veterinary Social Workers Question What is the role of the social worker in veterinary oncology? Christina Bach, Oncology Social Worker at Penn Medicine, responds: Veterinary social workers and bereavement counselors are available at many large academic veterinary hospitals. There are also many bereavement counselors who specialize in pet loss counseling and support.
Veterinary Chemotherapy precautions Dear OncoLink "Ask The Experts," My wife is pregnant with our second child, and she is in her second trimester. Our Golden Retriever is starting chemotherapy on Friday. The vet advised my wife to "avoid metabolites" as they could be teratogenic due to the metabolized chemotherapeutic agents in them. Can you give us some concrete advice on
Where to Get Veterinary Oncology Care Question Do I have to go to a specialty center like the University of PA to get treatment for my dog's cancer or is that something all vets do? Lili Duda, VMD, MBE, DACVR Veterinary Radiation Oncologist- University of Pennsylvania, responds: Answer The best place to start with your pet is your primary care veterinarian. They know your pet best,
Pain Relief Options for Veterinary Bone Cancer Dear OncoLink "Ask The Experts," My Yellow Lab just turned 9 (June) years old and was diagnosed back in March with bone cancer - front leg, upper part of her shoulder. She is on Gabapentin, Tramadol, and Previcox. She is still eating, drinking and in good spirits, but is walking with a considerable limp. Is there any other pain medication or
Two Primary Cancers to Occur in the Same Patient Colon Cancer and Small Cell Lung Cancer I am writing about a male patient 61 years old who was diagnosed with cancer in two primary sites. The oncologist does not know how to treat this. The two sites are lung and colon (with the colon adenocarcinoma metastasized to the liver). Both lungs have been diagnosed by one pathologist as having oat cell or small cell carcinoma, but a second
Alcohol and Cancer Risk Question My husband is a heavy drinker and I am concerned for his health. Is there a link with alcohol and cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Many people are aware that heavy alcohol use can cause health problems such as cirrhosis of the liver, hepatitis, high blood pressure, heart disease and
Weight and Cancer Risk Question I know being overweight can lead to many health problems, how is it connected with cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: While what we eat is probably linked to cancer development, being overweight and having a diet high in fat is clearly related to the development of certain cancer types.
Thyroid Cancer Treatment After RAI Question What happens after my cancer stops responding to radioactive iodine? Answer Marcia Brose, MD, Director of Thyroid Cancer Therapeutics Program at Penn Medicine responds, There are many new agents in clinical trials and some that might be available outside of clinical trials. In the last 5 years, many patients have had successful
Radiation for Cancer Treatment and Second Cancer Risk Question Does getting radiation for one cancer, put me at risk for developing more cancer? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine, responds: Unfortunately, yes. Anytime radiation therapy is received by an individual, that individual is at a small but real increased risk of developing a second cancer from that
Symptoms and Diagnosis of Thyroid Cancer Question What are symptoms of thyroid cancer? How can thyroid cancer best be diagnosed? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds: Thyroid cancer is often asymptomatic. When symptoms occur, they can range from a visible mass to voice dysfunction. Thyroid cancer is rarely associated with symptoms that are typical of thyroid
Thyroid Cancer Specialist Question What kind of doctor do I go to if my family doctor thinks something is wrong with my thyroid? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds: If your family doctor believes that you have a thyroid problem. You should schedule an appointment with an endocrinologist. To make sure the appointment is as valuable as possible, you
Is a Cancerous Mole Painful? Question Are skin cancer moles usually painful? Answer Christopher Miller, MD, Dermatologist & Moh's Surgeon at Penn Medicine and Rachel Woods, RN, Nurse for the Surgical Dermatology Program at Penn Medicine respond: Skin cancer moles are usually not painful, especially in their early stages. Pain can associated with a dangerous mole.
Dangers of Smokeless Tobacco Question My son uses "chew" (smokeless tobacco), is this harmful even though there is no smoking involved? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Chew as well as dip, spit, oral/spitless tobacco and dry/moist snuff (snus) are all still tobacco products. Many people mistakenly think smokeless tobacco is a safe
Reducing Your Risk of Colon Cancer Question I have a distant family history of colon cancer, aside from colonoscopies, what else can I do to decrease my risk of getting cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Colorectal cancer is the third most common type of cancer in the Western world. About 80% of colorectal cancers are diagnosed in
Sun Exposure and Cancer Risk Question I work outside most of the year, how can I avoid getting skin cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Even though you must work outside, can do a lot to protect yourself from damaging UV rays and to detect skin cancer early. Start by practicing sun safety, including using a broad-spectrum
Is the risk of breast cancer increased due to ovarian cancer? Dear OncoLink "Ask The Experts," My wife is an ovarian survivor. She finished chemo three years ago and we have been told she should live a long life. She is now Undergoing tests for Breast cancer. Is the risk of breast cancer increased due to ovarian cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology
What is my risk for other cancers after colon cancers? Dear OncoLink "Ask The Experts," What is my risk for other cancers after colon cancers? James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the University of Pennsylvania,
Is there an association between thyroid cancer and colon cancer? Dear OncoLink "Ask The Experts," I had thyroid cancer and have diverticulosis. What are my risks? Should I be tested more often? James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the
Risk of other cancers after cervical cancer Dear OncoLink "Ask The Experts," Is there an increased risk for other types of cancer after a diagnosis of invasive cervical cancer, and if so what types of cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:At this point, we do not know of any
PET Scan in Lung Cancer Follow-up Question Can you address the use of PET scans for follow up after surgery? Answer Charles B. Simone II, MD, Radiation Oncologist at Penn Medicine, responds: There are no recommendations that are widely agreed upon for how to follow patients once they have completed therapy for lung cancer. The options are to use chest x-rays, CT scans, or CT-PET
Detecting Lung Cancer Early (Screening) Question I smoked a lot for a long time, but I quit 5 years ago. Is there anything I can do to prevent getting lung cancer or to increase my chances of getting it detected early? Answer Anil Vachani, MD, Pulmonologist at Penn Medicine, responds: A recent large randomized study has demonstrated that CT screening can lead to decreased mortality from
Risk of Skin Cancer After Basal Cell (BCC) Question If someone has a basal cell skin cancer, are they at risk to get other skin cancer spots or a more serious cancer like melanoma? Answer Christopher J. Miller, MD, Assistant Professor of Dermatology at the Abramson Cancer Center of the University of Pennsylvania, responds: Christopher Miller, MD, Dermatologist & Moh's Surgeon at
Skin Cancer Diagnosis & Treatment Question How is skin cancer diagnosed and treated? Will I need to see a dermatologist or a cancer doctor? Answer Rachel Woods, RN, Nurse for the Surgical Dermatology Program at Penn Medicine responds: Skin cancer is definitively diagnosed through a biopsy. Treatment differs with the type and severity of the cancer. See your dermatologist and he
Cancer Risk with Cigars Question My friends and I enjoy a few cigars when we get together, is there a risk of lung cancer with cigars? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Many people view cigar and pipe smoking as safer than cigarette smoking, but this is not true. Cigars are often thought to be safer than cigarettes because
Radiology Tests and Cancer Risk Question Are patients who get a lot of Ct scans and MRIs at increased risk for cancer? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: Recently, there has been much talk in the media about the risk of developing cancer due to radiation exposure from radiology tests, such as CT scans. While there have not been studies
Microwaved Foods and Cancer Risk Question Do you think microwaving foods causes cancer? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine responds: This is another great question. The short answer is no, there is no definitive evidence to suggest that microwaves cause cancer. However, microwaves to emit radiation that can theoretically be harmful.
Homosexuality and Cancer Risk Question Does being a gay man put me at a higher risk for cancer? I have heard that may be true, but I am unsure of what the reasoning is. Can you explain? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: What sexual practices increase risk? Higher numbers of sexual partners and earlier age of first sexual encounter,
Reducing Risk of HPV-Related Oral Cancers Question How can you reduce the risk of HPV related oral cancers? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: That is a great question - you cannot protect yourself 100% but this previous answer talks about prevention using dental dams. Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, adds: While
Hormone Replacement Therapy and Cancer Risk Question I am worried about taking hormone pills to help with menopause symptoms. Do they cause cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Hormone replacement therapy (HRT) was commonly prescribed for menopausal women to reduce hot flashes, vaginal dryness, and risk of bone fractures and heart disease. In
Evaluating Breast Cancer Risk Question How do I know if I am at risk for breast cancer? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine responds: Breast cancer is the most common solid cancer in women. Approximately 1 in 8 women will developed breast cancer during their lifetime. Other than female gender, the most common risk factor for developing
Cancer Screening Tests Question What is meant by "cancer screening tests"? Who should get them? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Cancer screening tests are designed to find cancer or pre-cancerous areas before there are any symptoms and, generally, when treatments are most successful. Various organizations have developed
Chemotherapy and Pharyngeal Cancer Question Is it safe to go to a dentist when I am getting radiation or chemotherapy for pharyngeal cancer? Will my dentist know what to do or even want to see me? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: We recommend seeing a dentist prior to starting chemotherapy and radiation. The known side effects of
Chemotherapy and Radiation at the Same Time for Laryngeal Cancer Question I have to have chemotherapy and radiation at the same time for laryngeal cancer. Why do them at the same time (seems like it will be pretty hard) and why is this done before my surgery? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: A large study has shown that chemotherapy and radiation, given at the same
Mammogram After Breast Cancer Treatment? Question Do I still need to get a mammogram after breast cancer treatment? If so, how often? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: If you have had breast conservation surgery for your breast cancer, then mammograms once per year are recommended. If you had a single mastectomy, with or without reconstruction, the opposite
Pregnancy and Breast Cancer Question Does pregnancy make you more likely to develop breast cancer? I have been hearing more and more about women who find out they have breast cancer when they are pregnant. Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: Pregnancy does not increase the risk of getting breast cancer. Women do get breast cancer during
Safety of Pregnancy After Breast Cancer Question How long after breast cancer treatment is it safe to become pregnant? Will the hormones of pregnancy increase the risk of my cancer coming back? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: First, the hormonal situation during pregnancy does not appear to increase the risk of cancer coming back. Second, there is no
Risk of Breast Cancer With Family History Question How much more likely is a person with a family history of breast cancer to get it than the rest of the population? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: In general, a woman in the United States has an approximate 1 in 9 chance of developing breast cancer by the age of 80. A family history in a first
Soy Foods After Breast Cancer Question I do not eat soybeans, tofu, tempeh, flax seeds. I do not consume any soy supplements. I am looking for a complete list of those foods that are no-no's for ER 100% patients re: estrogens, phytoestrogens, xenoestrogens. I have a list from www.dietaryfiberfood.com, which lists foods high in phytoestrogens and lignans (content and amounts
Talking to Your Employer About Cancer Diagnosis Question Can you help me in how to talk to my employer about my diagnosis? Answer Jodi Sandos, MSW, LSW, Oncology Social Worker at Penn Medicine, responds: It a good idea to know your options for employment whether or not you choose to work through your treatment. Many people continue to work through their treatment, while other people decide
Balancing Life and Cancer Question I would like some advice on how to balance work, family, kids, etc. while facing breast cancer and treatment. Where can I go for help/support? Answer Jodi Sandos, MSW, LSW, Oncology Social Worker at Penn Medicine, responds: Often trying to balance everything in our life while going through treatment can be quite challenging. It is a
RAI After Surgery for Recurrent Thyroid Cancer Question I just had my third surgery for recurrent papillary carcinoma, this time found in two lymph nodes. What are your thoughts about RAI after this round for me? My surgery was a month ago. Endo suggests reviewing my thyroglobulin level in three months then deciding. Answer Marcia Brose, MD, Director of Thyroid Cancer Therapeutics Program at
Iodine and Iodized Salt and Cancer Risk Question Is it better to have a diet with or without iodine products to prevent thyroid cancer? Does using iodized salt increase your risk of cancer? Answer Kolin Hoff, MD, Endocrinologist at Penn Medicine responds, Iodine deficiency increases the risk of goiter but does not increase the risk of cancer. Nodular goiters have about a 5% or less
Thyroid Cancer Awareness Question My friend was just diagnosed with thyroid cancer. How can I help raise awareness about the disease? Answer Michelle LeBeau, Thyroid Cancer Survivor and Founder of REACT Thyroid Foundation responds: I think it's great that you are inspired to help create awareness for thyroid cancer. There are lots of ways to help but one idea could be
Support Organizations After Thyroid Cancer Question What are some good organizations for support of thyroid cancer patients and survivors? Answer Michelle LeBeau, Thyroid Cancer Survivor and Founder of REACT Thyroid Foundation responds: There are several organizations available for support but one of the best I have found is ThyCa (www.thyca.org). Their website is full of great content
Radiation Exposure Only Cause of Thyroid Cancer? Question Does getting thyroid cancer have to do with a history of it in your family? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds: Some thyroid cancers are associated familial cancer syndromes. Those are unusual. Most thyroid cancers are sporadic meaning they are not associated with a family history of thyroid cancer. That said, a
Life After Thyroid Cancer Question Can you give me some advice on getting on with life after someone has gone through thyroid cancer? I feel like I just don’t fit into my life anymore. I am always worrying about my cancer coming back. Answer Michelle LeBeau, Thyroid Cancer Survivor and Founder of REACT Thyroid Foundation responds: I have found the best way to get on
Lung Cancer and Mesothelioma Question Is it possible to have lung cancer and mesothelioma? Answer Melissa Culligan, RN, Nurse with the Mesothelioma and Pleural Disease Program at Penn Medicine, responds: Yes, is it rare but possible to have both lung cancer and mesothelioma? You can learn more about both types of cancer on OncoLink. This question and answer was part of
PET Scan for Lung Cancer Question I am a medical student. I heard a lot of discussion of using PET scans as a diagnostic tool for staging non small-cell lung cancer. Can you provide me more information? Thanks! Answer Li Liu, MD, OncoLink editorial assistant, responds: Lung cancer is the leading cause of death from cancer for both men and women in the United States.
Treatment for Stage IIIB Non Small-Cell Lung Cancer (NSCLC) Question My mother has been diagnosed with stage IIIB non-small cell lung carcinoma with cancer also in the lymph nodes. There is a mass in her right upper lung and it is inoperable because of the stage it is in. They are treating her with radiation therapy and chemotherapy. I want to know what this treatment is going to do exactly – cure
Brain Metastases from Lung Cancer Question A good friend of mine was recently diagnosed with brain metastases from his lung cancer, adenocarcinoma type. The neurosurgeon said to him that surgery is the treatment of choice for his case. He was also seen by a radiation oncologist who claimed that radiation therapy is just as effective as surgery. Could you help him? Answer Li Liu,
Lung Cancer Surgery and Seniors Question Would you recommend lung cancer surgery on an 80 year old with non-small cell lung cancer who is in good health? What type of surgeon should do this procedure? What steps would you recommend for the most aggressive approach? How can a non-oncologist be knowledgeable enough to perform such an intense surgery? Answer Charles B. Simone
Surgery for Stage IIIB Non-Small Cell Lung Cancer (NSCLC) Question Our mother was just told that she has stage IIIB poorly differentiated non-small cell lung cancer. They cannot do surgery because it is too close to her aorta. We live in a small town and we are wondering if there is a chance that if we went to a larger hospital, or to a different doctor in a bigger town that they may consider doing
Treatment for Stage IIIA Non-small Cell Lung Cancer (NSCLC) Question My 69-year-old mother-in-law was recently diagnosed with Stage IIIA (T3N1) non-small cell lung cancer. She also has emphysema with low lung volume but very good lung function. She is going to undergo 3-4 weeks of chemo (taxol and carboplatin once a week) plus daily radiation therapy treatments. The thoracic surgeon will then perform
Progression of Non Small-Cell Lung Cancer Question My husband was diagnosed with stage IIIB adenocarcinoma, which presented with superior vena cava syndrome. He has received radiation treatment concurrent with chemotherapy and is now receiving full strength chemotherapy. We were told at the time of diagnosis that the treatments were to "buy time", not cure. I have searched many web sites,
"Remission" of Stage IIIB Non-small Cell Lung Cancer (NSCLC) Question My mother was diagnosed with non-small cell lung cancer stage IIIB. She has completed her 6 treatments of chemotherapy (taxol). The tumor has shrunk from 4cm to about the size of a thumbnail. Her doctor has now told us that he will do follow-up scans and blood work and that we will see him in 6 weeks. Is this stage considered remission or
Does lung cancer spread when exposed to air? Question My father has been diagnosed with Stage I non-small cell lung cancer. We are considering surgical resection. Is there any truth to the claim that cancer spreads when the "air hits it"? Answer Blair Marshall, MD, Thoracic Surgeon, responds: There is no scientific data that supports that theory. That concept stems from rumors, most
Treatment of Stage IIIB Non-small Cell Lung Cancer with Bevacizumab Question I recently discovered that my dad has stage IVA non-small cell lung cancer with a malignant pleural effusion. He is scheduled to undergo chemotherapy using carboplatin and paclitaxel, and his medical oncologist is also considering adding the angiogenesis (VEGF) inhibitor called Bevacizumab. Should he receive Bevacizumab with the
Non-small cell lung cancer with neuro-endocrine features Question I recently was diagnosed with metastatic non-small cell lung cancer with neuro-endocrine features. I am unable to find any information on the web about this type of cancer. Can you give me more definitive information? Answer Barbara Campling, MD, Medical Oncologist, responds: Some kinds of lung cancer have features of neuroendocrine
Follow Up for Stage IIIA Non-Small Cell Lung Cancer (NSCLC) Question After therapy for stage IIIA NSCLC, my doctors said we would do follow up chest x-rays every 3 months for the next 2 years, and then twice a year for 3 years. I questioned why they would not do CT and or PET scans, and I was told that if metastasis is discovered, it would not change the result or the amount of time I would ultimately
Sheep Virus Linked to Lung Cancer? Question My husband lived and worked on a farm in South Africa with sheep for many years. He has just been diagnosed with Stage IV non-small cell lung cancer. I have been searching on the web and found a website about a disease that sheep in South Africa get called "jaagsiekte". It states that there might be a link to that sheep disease and human
Small Cell Lung Cancer Concerns Question Recently my 58-year-old father was diagnosed with small cell lung cancer. He has undergone chemotherapy and radiation therapy. He smoked 40 of his 58 years. My father is unaware of the lifetime effects this cancer has, and that he has no chance of cure. The doctor has chosen not to tell him this information unless he asks. This is in an
Small Cell Lung Cancer Metastasized to the Brain My mother was diagnosed with small cell lung cancer in January of 2001. She has been through Chemo and radiation and the tumor in her lung did shrink to approx 1 1/2 cm. She was doing well, went back to work part time. In November, she began to have tremors. I took her to the Emergency room where we were told that she has 4 tumors on her brain.
Treatment Options for Extensive-Stage Small Cell Lung Cancer Question My 51-year-old husband has just been diagnosed with small cell lung cancer that has metastasized to his liver. They are treating him with three days of chemotherapy every third Monday. No radiation therapy, no surgery. Yet the doctor says he has not probably had this even 6 months. What else should we do? Are they giving up on my husband
Causes of Small Cell Lung Cancer Question My spouse recently passed away from lung cancer at the age of 43. He was a smoker for many years. I understand that small cell cancer is microscopic. Are there any findings that small cell lies dormant? I am trying to understand why the small cell cancer all of a sudden developed in my spouse. Could some exposure, either recent or from his
Treatment Options for Recurrent Small Cell Lung Cancer Question I am a 42-year-old male who has been treated for small cell lung cancer. I had a large tumor in my right upper lobe, as well as cancerous lymph nodes on both sides of my neck. I received 6 cycles of chemotherapy with carboplatin and etoposide on a 3-week cycle, along with radiation therapy to my upper lung and chest beginning with my
Third-Line Treatment for Small Cell Lung Cancer Question I was diagnosed with small cell lung cancer with metastasis to the liver. After a couple of cycles of topotecan and paclitaxel, I improved, but my cancer later progressed. My chemotherapy was changed several months ago to cisplatin and irinotecan, which seemed to significantly help me. However, in the last month I started feeling worse,
Fatigue After Lung Cancer Treatment Question My father-in-law has received chemotherapy and radiotherapy treatment for small cell lung cancer in both lungs and his head. He has been told that the tumor in his lungs has been burned away with part of his lung. He is now anemic and very tired and constantly feels unwell. His doctor will not give him any medication to help even though
Prognosis for Extensive-Stage Small Cell Lung Cancer Question My Mom was diagnosed with small cell lung cancer in January. They found some spots around her aorta, in her lymph nodes, and in the spine. She is just completing her 4th cycle of chemotherapy. The doctor said now we stop treatment and watch and wait. My question is, what are the chances of recurrence? We were told that there is a 50%
Small Cell Lung Cancer Treatment and Prognosis Question My father-in-law has small cell lung cancer. He was treated with chemotherapy and radiation therapy. They then discovered a metastasis in his brain. So, he was started on radiation to his brain. As far as I know, the cancer is only in the left lung and one site in the brain. Will you please tell me what is the average time he may survive?
Prophylactic Cranial Irradiation for Small Cell Lung Cancer Question Can you give me information and statistics on prophylactic cranial irradiation for prevention of small cell lung cancer? My husband is in remission and this procedure has been recommended. Thank you. Answer Barbara Campling, MD, Medical Oncologist, and Stephen M. Hahn, MD, Professor of Radiation Oncology at Penn Medicine, respond: It's
PET Scan for Small Cell Lung Cancer I would like to know the role of PET scan for small cell cancer. I was told by my doctor that small cell cancer not sensitive to FDG avidity. Please advise, thank you. Peeyush Bhargava, MD, Assistant Professor of nuclear medicine physician at both St. Luke's Roosevelt Hospital Center at the University Hospital of Columbia University College of
Treatment for Small Cell Lung Cancer My mother was recently diagnosed with extensive stage small cell lung cancer and has been offered chemotherapy with cisplatin and VP-16. What is the most up to date treatment for this disease? Barbara Campling, MD, Medical Oncologist at the Abramson Cancer Center of the University of Pennsylvania, responds:Small cell lung cancer occurs almost
Cure from Small Cell Lung Cancer Question I was a long-time smoker and diagnosed with small cell Lung cancer in 2003. I was told I could not have surgery on my lungs, but I did have a brain tumor due to this cancer that was removed with no difficulties. I had chemotherapy and radiation therapy shortly afterwards. It has been almost five years now and I want to know if I'm almost
Depression After Cancer Surgery Question My father recently had a surgery for his lung cancer. The doctor said his cancer was Stage I. I have noticed that he has been quite depressed since the operation despite his doctor's assurance of a high cure rate for his cancer. Is depression common in patients with lung cancer? Thank you. Answer Li Liu, MD, Editorial Assistant for
Loss of Appetite During Lung Cancer Treatment Question What should a lung cancer patient do if they are losing too much weight? How can they overcome a loss of appetite? Answer Ellen Sweeney, RD, Registered Dietitian, responds: Many lung cancer patients are noted to have lost weight prior to their cancer diagnosis, which is often due to the effects that the disease itself has on their body.
Itching associated with lung cancer with liver metastasis Question My cousin has been diagnosed with lung cancer and now has liver cancer and cancer in her lymph nodes. She has severe itching and has these little scabby spots all over her body from itching. Can the itching be connected with the cancer? Thanks for your help. Answer Barbara Campling, MD, Medical Oncologist, responds: It is hard to know what
Smoking Cessation after Diagnosis of Lung Cancer Question My question is about terminal lung Cancer. What are the benefits of smoking cessation if the patient is terminal? I am wondering if the stress of withdrawal will reduce their quality of life. If you know of any references that could help me out, I would appreciate it since I have not been able to find any journal articles. Answer Mitchell
Can Stage 3B Lung Cancer Be Treated by Surgical Resection? I have a friend that was recently diagnosed with non-small cell lung cancer. He has a tumor within the sac lining the right lung. He has been told that this type of tumor is non-surgical b/c it is within the sac around the lung and not in the lung itself. His wife recently heard of a doctor that did some surgery on a friend's mother to remove
What to Expect in End Stage Lung Cancer My mother has lung cancer for the last several years and now has brain cancer. She has undergone radiation treatment and is currently still getting chemo treatment for her lung cancer. Our family understands that she only has a little time left with us but no one seems to know what she can expect in her final months. I don't want to focus on the
Age-Related Lung Cancer Risk Question At what age can you get lung cancer? Answer Barbara Campling, MD, Medical Oncologist, responds: The median age of diagnosis of lung cancer is in the mid 60's. This means that half of the people who get lung cancer are above this age and half are below it. This does not mean that only older people get lung cancer. The youngest patient that
Ex-smoker wants to decrease risk of lung cancer I smoked 1 pack of cigarettes between the ages of 17 and 26. I am now 37 years old, in good health with a good fitness regime. As an ex-smoker I am interested in my current risks of developing lung cancer and how I can continue to minimize those risks. Barbara Campling, MD, Medical Oncologist at the Abramson Cancer Center of the University of
Low Sodium and Lung Cancer Question Is there a link between low sodium levels and adenocarcinoma of the lung? Answer Barbara Campling, MD, Medical Oncologist, responds: Patients with lung cancer can develop low sodium levels (hyponatremia) for the same reasons as other patients. These reasons can include heart failure, liver cirrhosis, use of diuretic medications, adrenal
Blood Test to Detect Lung Cancer Question I recently saw a story on the news that a blood test can detect lung cancer early. Can you tell me more about this test? Answer Anil Vachani, MD, Pulmonologist at Penn Medicine, responds: Unlike other blood tests typically used to detect cancer, this test does not look for substances produced by cancer cells as they grow (such as PSA for
Esophagitis during Lung Cancer Treatment Question My father was recently diagnosed with stage IV lung cancer. He is undergoing chemotherapy and radiation therapy. He has started having severe pain in his esophagus and tried "magic mouthwash" unsuccessfully. Is there anything that can help relieve some of the pain for him? Answer Beth Sandy, MSN, CRNP, OCN, board certified nurse
Treatment for Stage IV Lung Cancer Question Are there any treatments for a person with Stage IV lung cancer? Answer Charu Aggarwal, MD, MPH, Medical Oncologist at Penn Medicine, responds: There are several treatments for patients with late-stage or metastatic lung cancer. While these treatments are not able to cure the cancer, treatments for Stage IV lung cancer can improve
Proton Therapy for Lung Cancer Question Is proton radiation used for lung cancer treatment? Will my insurance pay for it? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine, responds: Proton radiation therapy is a relatively newly utilized type of radiation therapy that has the potential to decrease the radiation dose to normal tissues that are next to the
Small Cell Lung Cancer Question What is the difference between small cell and non-small cell lung cancer? Are they treated the same way? How do I know which one I have? Answer Charu Aggarwal, MD, MPH, Medical Oncologist at Penn Medicine, responds: Small cell cancer of the lung is a subtype of lung cancer, which is different from non-small cell lung cancer. Non-small
Radon and Lung Cancer Risk Question How is exposure to radon linked to lung cancer? Answer Taine Pechet, MD, Thoracic Surgeon at Penn Medicine, responds: Radon is the 2nd leading cause of lung cancer in the United States according to the Surgeon General's report, distantly following tobacco exposure. Radon is a colorless and odorless gas that results from the breakdown of
Side-effects After Lung Cancer Surgery Question What side effects will I experience after surgery to remove part of my lung? Answer Taine Pechet, MD, Thoracic Surgeon at Penn Medicine, responds: Side effects after surgery depend, among other things, on how much lung is removed, how the operation is performed, a given patient's preoperative condition and lung function, as well as any
On Oxygen for Life After Lung Cancer? Question If I have lung cancer, will I have to be on oxygen for the rest of my life? Answer Anil Vachani, MD, Pulmonologist at Penn Medicine, responds: Most patients that are treated for lung cancer do not end up requiring supplemental oxygen. There are some patients with underlying lung disease, such as chronic obstructive pulmonary disease or
Role of the Nurse Navigator in Cancer Treatment Question My cancer center has a nurse navigator. What can she do to help me get through treatment (stage III Non small cell lung cancer)? Answer Linda Miller, RN, BSN, Oncology Nurse Navigator at Penn Medicine responds: Each center functions a little differently in how their nurse navigator functions in relationship to the thoracic team. In
X-Ray Screening for Lung Cancer Question My father died of lung cancer at 57 years old. He was a 3 pack a day smoker. I am now 52 years old and have been an on-again, off-again smoker (1 pack a day) for 30 years. I had quit once for 7 years and two other time for 1-2 years. I no longer smoke. Would you suggest that someone in my position get an xray because I am at risk? Thank
Flu Shots for People on Cancer Treatment Question I recently finished my chemo after surgery. Wondering if I should have a flu shot or anything else preventive? Answer Suzanne Walker CRNP, MSN, AOCN, Nurse Practitioner for Thoracic Malignancies at Penn Medicine responds: It is usually safe to get a flu shot once the chemotherapy has finished. You can talk to your oncologist about it
Mutation to Guide Treatment in Lung Cancer Question The surgeon who did my biopsy said they will look for "mutation" and my treatment will depend on the result. What does this mean? Answer Linda Miller, RN, BSN, Oncology Nurse Navigator at Penn Medicine responds: Your physician is referring to the different molecular markers that your specific tumor may contain. Determining those
Questioning Faith After Cancer Diagnosis Question Since my mother was diagnosed with lung cancer, I feel that my faith has been challenged. I feel angry and then guilty for feeling that way and for thinking what kind of God would make my mother be so sick. Can you help me? I feel I don't know what to think. Answer Kava Schafer, MDiv, MA, Chaplain at Penn Medicine responds: Rosanna, I
Navigating Care After a New Cancer Diagnosis Question What tips can you give a person with a new diagnosis on how to best navigate care, keep everything straight and go through treatment? Answer Linda Miller, RN, BSN, Oncology Nurse Navigator at Penn Medicine responds: You can look to see if the institution where you would be receiving treatment had a patient or nurse navigator who can
Eating Well During Lung Cancer Treatment Question My son is being treated for lung cancer. He is surviving on crackers. I just want to help him eat to keep up his strength. What advice do you have to maybe improve his appetite or make foods that won't make him nauseous, hurt his sore throat from radiation or that he might think tastes good? Answer Valaree Williams, MS, RD, LDN,
Difficulty Breathing With Lung Cancer Question I have done ok through my chemo so far. My most bothersome problem is feeling like I can't get my breath. Is there anything I can do to help that feeling? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: It is important to assess why you are having trouble breathing. The reasons could include anything from growth
Controlling Pain in Cancer Question My mother had advanced lung cancer and is starting to have significant pain. She is very hesitant to take anything – she says she doesn't want to be an addict. I am pretty sure that is not a reasonable fear, but I am not expert. What are the facts? Answer Suzanne Walker CRNP, MSN, AOCN, Nurse Practitioner for Thoracic Malignancies at
The Role of the Chaplain in Cancer Treatment Question When I was in the hospital for lung cancer surgery and then with complications of treatment, I had a wonderful chaplain who provided me great support. I am glad to see a chaplain on your panel and would like to hear her thoughts on her role with the person with cancer. Also wondering, how many hospitals/cancer centers have chaplains
Neuropathy After Cancer Treatment Question I had chemo for lung cancer last year. I am doing well except that I have neuropathy in my feet from the chemo that makes it difficult to live life, work, etc. Are there any treatments/therapies that can help improve the neuropathy? I do take neurontin. Answer Linda Miller, RN, BSN, Oncology Nurse Navigator at Penn Medicine responds:
How to Help Someone with Cancer Question What can I do to help my cousin who was just diagnosed with lung cancer? I feel I don't even know what to say to her, she is only 54 years old. Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: Please stay at the end and watch Donna Lee's video, she talks a bit about how just being there can be so helpful.
Anxiety and Depression After Finishing Cancer Treatment Question Even though I finished treatment now, I still feel depressed and anxious. Is this normal? What can I do about it? I just can't stop thinking, what if this comes back? Answer Kava Schafer, MDiv, MA, Chaplain at Penn Medicine responds: I appreciate your question and I am a chaplain and would like to weigh in on your question. Maybe I have at
If I Don't Burn, I won't Get Skin Cancer Question If you don't get burned, then you can't get skin cancer: Fact or Myth? Answer Rachel Woods, RN, Nurse for the Surgical Dermatology Program at Penn Medicine responds: MYTH!! Any person can get skin cancer. Fair skin, red hair, and blue eyes are the highest risk people, but even dark skin is susceptible. This question and answer was
Raw Diet for Pets with Cancer Question I've read that a diet free of grains may slow the cancer, is this accurate? what are the panel's thoughts on the Budwig diet or flax oil/cottage cheese combination? Erika Krick, VMD, DACVIM, Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer There are no clinical studies of grain free diets in dogs with cancer.
Common Symptoms of Pet Cancer Question What are signs and symptoms that my pet may have cancer? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Some common signs of cancer in pets include a lump that you can see or feel, wounds that do not heal, and unexplained weight loss, decreased appetite, or loss of energy. More
Cancer Symptoms in Cats Question Do cats have different symptoms of cancer than dogs? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Cats sometimes act more ill compared to dogs, but overall the common signs of cancer are similar between the 2 species. Cats are more likely to have intestinal tumors, so they are
Tests to Diagnose Cancer in a Pet Question My dog has a new lump growing on his leg. What tests can be done to find out if it is cancer? Can they be done economically? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Tests that your vet may recommend (after examining the lump and your dog) include a needle aspirate or a
How Animals Tolerate Cancer Treatments Question How do dogs tolerate cancer treatment? Do they get sick like people do? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Dogs tend to tolerate cancer treatments (surgery, chemotherapy, radiation therapy) relatively well compared to people, but they can certainly still have side
Dealing with Cost of Cancer Treatment for Pets Question This treatment must be expensive. Does pet medical insurance cover cancer treatments? What if I don't have insurance for my pet- how do people afford this? Christina Bach, Oncology Social Worker at Penn Medicine, responds: Pet insurance is a fairly new and rapidly developing and changing business. There are many plans available, and
How Frequent is Cancer Treatment in a Pet Question How frequently (number weeks or days per week?) will a dog have to get radiation or chemotherapy? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer That depends on the type of cancer and treatment options. Learn more about treatment options for animals with cancer. This question and
Clinical Trials for Animals with Cancer Question Are there clinical trials for pets with cancer? If so, how do you find them? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer There are multiple ongoing clinical trials for pets with cancer. You can go to the Veterinary Cancer Society website at vetcancersociety.org for more
Children Around Pets Getting Cancer Treatment Question If a pet is getting treated for cancer, can he be around my small children? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania responds: It depends on the type of treatment your dog is receiving. The potential concerns would be any exposure of your children to vomit, urine, or feces after a pet has been
Diet Needs for Dog Being Treated for Cancer Question My dog is starting on chemo for lymphoma. Do you have suggestions for a diet that might help manage any side effects or keep him from losing weight? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Hill's has a diet for dogs with cancer called n/d that you could discuss with your
Pain Management for Pets with Cancer Question My dog was just diagnosed with primary bone cancer (yesterday in fact). She is already 3 legged so amputation is not an option and the vet said that the best we could is to just keep her comfortable until we feel it is time to put her out of her pain. Could you address pain management options and any suggestions as to how/ when to make
Which Canine Breeds Get Cancer? Question Do certain breeds of dogs get cancer more often? Do they have genetic tests like the ones used in people (BRCA, etc.)? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Some breeds of dogs are predisposed to certain types of cancer. For example, Golden Retrievers, Boxers, German
Can All Animals Get Cancer? Question Can all animals get cancer- like snakes, turtles, etc? We don't have your "usual" pets! Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Many different types of animals get cancer, including reptiles, birds, etc. This question and answer was part of the OncoLink Brown Bag Chat
Common Cancers in Pets Question What are common types of cancer in pets? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Lymphoma is common in both dogs and cats. Other common cancers in dogs include mast cell tumors, bone cancer, hemangiosarcoma, and mammary tumors, and other common cancers in cats include
Cancer Risk in Dogs Question My dog is 12. Is there a certain age when there is greater risk of cancer? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Older dogs in general are at higher risk for cancer, but specific age cutoffs depend on the type of cancer. This question and answer was part of the OncoLink
Cancer Prevention Research in Animals Question Is there any research into cancer prevention in animals? Erika Krick, VMD, DACVIM Veterinary Medical Oncologist, University of Pennsylvania, responds: Answer Most research related to cancer in veterinary patients focuses on cancer causes and treatment, not prevention yet. Currently there is no specific recommendation to prevent cancer
Foods to Avoid for Pets with Cancer Question For a dog with a history of mast cell tumors, are there any foods that should be avoided? I've read that there are certain foods that contain high levels of histamine? Lili Duda, VMD, MBE, DACVR Veterinary Radiation Oncologist- University of Pennsylvania, responds: Answer There are no specific diets we recommend for prevention or
Working During Cancer Treatment Question I have cervical cancer and will need weekly chemotherapy and daily radiation for six weeks. I am wondering if I should take time off from for the entire treatment course or try to work part time. Can you please give me some advice? Answer Tracy Lautenbach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: There are
Support on Balancing Work & Family and Cancer Treatment Question I would like some advice on how to balance work, family, kids, etc. while facing cancer and treatment. Where can I go for help/support? Answer Tracy Lautenbach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Balancing work, family, children and cancer treatment can be very challenging for some. This would be
Talking With Family & Friends About Cancer Diagnosis Question Can you help me in how to talk to my friends and family about my diagnosis of such a personal issue? Answer Tracy Lautenbach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Speaking with family and frineds may seem scarey but remember that if you dont share with them what is going on or how you are feeling then
Cancer As A Chronic Illness Question My Doctor mentioned that I should view my cancer (ovarian) as more of a chronic illness because there is no cure, however there are treatments and medicines that can help. What tips do you have for living with this uncertainty? Answer Tracy Lautenbach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Cancer can
Intimacy After Cervical Cancer Question Can I still be intimate with my partner after radiation for cervical cancer? Answer Nicole Ross, RN, MSN, OCN - Radiation Oncology Nurse at Penn Medicine, responds: YES! You can still be intimate with your partner after radiation for cervical cancer. During the first few weeks after radiation, the vagina can have changes that may
Osteoporosis Risk After Cancer Treatment Question My doctor told me I am at risk for osteoporosis because of my cancer treatment. Why is this and what should I do about it? Answer Nicole Ross, RN, MSN, OCN - Radiation Oncology Nurse at Penn Medicine, responds: Cancer treatments can put you at risk for osteoporosis. Osteoporosis is a weakening of the bones, that can put you at risk
Radiation Therapy For Ovarian Cancer? Question Why didn't I get radiation for ovarian cancer? I just had surgery and chemo. Would radiation have decreased the chance of my cancer coming back? Answer Michael Corradetti, MD, PhD, Radiation Oncology Resident at Penn Medicine, responds: Unlike surgery and chemotherapy, radiation therapy is not typically employed as part of the
Risk If Family Member Had Ovarian Cancer Question If my grandmother had ovarian cancer, what is my risk of developing it? Are my kids at risk? Answer Jill Stopher, MS, Certified Genetic Counselor at Penn Medicine, responds: Just having a grandmother with ovarian cancer has only a minimal impact on your risk of developing this unless there is a more extensve family history of cancer.
Family History Of Breast Cancer On Father's Side Question Does family history of breast cancer on my father's side put me at risk for cancer? Answer Jill Stopher, MS, Certified Genetic Counselor at Penn Medicine, responds: Even though breast cancer mostly affects women, risk for breast cancer can be passed down from both your mother and your father's side of the family. There are a number
Occupational Radiation Exposure and Cancer Risk Question I work as a radiologist, am I at increased risk for getting cancer? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: People in certain professions may be at increased risk for cancer due to occupational radiation exposure. These professions include medical radiologic technicians, aircrews, radium dial
Plastic Baby Bottles and Cancer Risk Question Do plastic baby bottles cause cancer? I heard I should get some special baby bottles but was not sure if that is true or not. Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine responds: There has been some evidence that drinking from bottles with bisphenol A (BPA) can be harmful. This chemical is similar to a
Cell Phones and Cancer Risk Question Has there been a definite conclusion with cell phones causing cancer? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine responds: That is a great question, but a very controversial topic. Cell phones emit radiofrequency energy, which is a non-ionizing electromagnetic radiation that can be absorbed by your tissues
Child Bearing after Cancer Treatment Question I'm getting radiation for rectal cancer and am concerned about being able to have children after treatment. What should I do before I start treatment to make sure my fertility is preserved? Can it be preserved? Answer Maggie Hampshire, RN, Oncology Nurse at Penn Medicine, responds: There are a few possibilities to help you stay fertile
Quitting Alcohol and Tobacco Use After Cancer Diagnosis Question My father was recently diagnosed with esophageal cancer and was told to quit smoking and drinking alcohol by his doctor. My father feels it won't make a difference at this point. What can I tell him to help him realize that quitting is important and why it is so important? Answer Christina Bach, Oncology Social Worker at Penn Medicine,
Chemoebolization for Liver Cancer Question My husband is getting "chemoembolization" for liver cancer. Why does he have to have this procedure rather than getting actual chemotherapy? What are the risks involved in this procedure? Answer Bruce Giantonio, MD, Medical Oncologist at Penn Medicine, responds: That is a good question. One of the remarkable things about
Lynch Syndrome and Colon Cancer Question Due to Lynch Syndrome, I had my colon removed and a complete hysterectomy. 3 tumors were found in my colon, 1 in my uterus. Since then my adrenal glans have shut down (Addison's) and I have been diagnosed with R/A. Are the 3 somehow connected? Is there any way to treat me as a whole? Answer Bruce Giantonio, MD, Medical Oncologist at
Cancer Treatment and a Living Will Question I am getting ready to start cancer treatment; do I need a Living Will? If so, how do I go about getting one? Answer Christina Bach, Oncology Social Worker at Penn Medicine: Indicating your wishes for medical care is important information for both your family and your healthcare team to have. It is not REQUIRED for you to have a living
Feeding Tubes and Radiation for Esophageal Cancer Question I had a consult with a radiation doctor for esophageal cancer. He said I need a feeding tube. That seemed kind of premature to me- do I really need that? Answer Liz Prechtel-Dunphy, Oncology Nurse Practitioner at Penn Medicine, responds: Feeding tubes are important in patients with esophageal cancer whether they are getting single
Out of Pocket Expenses during Cancer Care Question I'm worried about my out of pocket expenses for my cancer care. Where can I go to for help? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: Financial issues and the cost of cancer care are fast becoming one of the greatest sources of distress for cancer patients and caregivers. You should start with REALLY
Pancreatic Cancer and Genetics Question My mother recently passed away at the age of 49 after a 4-week battle with pancreatic cancer. I have read that certain types of pancreatic cancer can be genetic. What should my family watch out for? Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: There are familial cancer syndromes that can increase one's risk of
Spousal Support Groups for Cancer Treatment Question How can I find a support group for my wife going through cancer treatment? What about for spouses? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: There are support groups available in many communities, but also online. You can start by contacting the American Cancer Society (800-ACS-2345; www.cancer.org),
Weight loss and Pancreatic Cancer Question Could you discuss weight loss and pancreatic cancer? Lauren Ginipro, Registered Dietician at Penn Medicine responds: Pancreatic patients often have difficulty with early satiety and loss of appetite which in turn results in weight loss. Typically we promote small, nutrient-dense meals throughout the day. If you experience early satiety
"Warning Signs" of Pancreatic Cancer Question My grandfather was just diagnosed with metastatic pancreatic cancer. He was feeling completely fine until just few weeks ago. We are all so surprised by this. Could there have been any "warning signs" or test that could have been done before the cancer got to this point? Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine
Help Finding Resources During Cancer Treatment Question If my cancer center doesn't have a social worker, who can help me with financial concerns, insurance problems, co-pay assistance? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: You can access assistance with coping with financial concerns, insurance problems and co-pay assistance from a variety of
Hospice Care for Pancreatic Cancer Question My wife was just diagnosed with metastatic pancreatic cancer. There are no options for treatment and the doctor is recommending hospice. Can you help us find some resources for dealing with this and how we tell our family? Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: I have many patients that live longer with
Estate Planning and Legal Advice During Cancer Question Where can I go for help with legal issues in terms of estate planning and making sure my family is taken care of when I die? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: It is important to think about advance care planning early on in your cancer journey. Talk to an attorney who specializes in estate
Pancreatic Cancer and Family History Question I've heard that pancreatic cancer is rare. If that is true, what are the odds that I would have two relatives who both passed away from this disease? Answer Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: Pancreas cancer is not among the most common cancers (breast, lung, prostate, and colon) but it is among the
Diabetes After Pancreatic Cancer Question If I have pancreatic cancer, will I have diabetes? Answer Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: Some patients develop diabetes after pancreatic surgeries but usually only if they have had a total pancreatectomy. There are a certain population of patients that might be predisposed, that do develop
Finding Support for Kids During Cancer Treatment Question How can I help my kids deal with their dad's illness? Some say to keep things as normal as you can, but I feel nothing is "normal" anymore. Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: I know it is really hard to maintain normalcy after a cancer diagnosis---especially with your children. I talk to my
What To Say To Family Members With Cancer? Question If a member of my family has pancreatic cancer, what should I do? I feel so worthless. I want to help, but don't know what to do or say. Please help. Answer Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: The question regarding a family or friend with cancer is a very important one as well and I really appreciate
Are my Kids at Risk for Colon Cancer? Question I am 43 years old and was recently diagnosed with stage III colon cancer. Are my kids or other family members at risk for colon cancer since I am so young? How do I know if they should have genetic testing? Answer Liz Prechtel-Dunphy, Oncology Nurse Practitioner at Penn Medicine responds: Being diagnosed with colon cancer at a young
Life after Stomach Cancer Question Are there any long term concerns of having your stomach removed for stomach cancer? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: You can create a survivorship care plan to learn more at: www.livestrongcareplan.org Removal of all (gastrectomy) or part of the stomach (partial gastrectomy) leads to changes in
Helping your Children Cope During your Cancer Treatment Question Could you help us find some resources for support for our children to help them deal with my wife's cancer diagnosis? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: Being a well prepared parent is an important part of your family's coping with your wife's cancer diagnosis. The first advice I can give is to
Treatment Options for Stage II Colon Cancer Question I was diagnosed with a stage II colon cancer. I am really just ok with only surgery? How can my doctor be sure I don't need chemotherapy or radiation? Answer Liz Prechtel-Dunphy, Oncology Nurse Practitioner at Penn Medicine responds: Most often in patients with stage II colon cancer, chemotherapy is not recommended. The oncologists
Dietary Recommendations after Esophageal Cancer Treatment Question My husband is undergoing treatment for esophageal cancer and is losing a lot of weight. He barely has an appetite and finds it hard to eat when he does want something. Can you please give us some suggestions for nutrition? Katrina Claghorn, Registered Dietician at Penn Medicine responds: Unfortunately loss of appetite often occurs with
Cancer Treatment and Workplace Disclosure Question Do I have to notify my employer about my cancer diagnosis? I am worried about losing my job. Christina Bach, Oncology Social Worker at Penn Medicine responds: You are not legally obligated to inform your employer of your cancer diagnosis. If you are applying for FMLA coverage (which protects your job for up to 12 weeks), you will need
Retrograde Ejaculation after Radiation for Rectal Cancer Question My doctor said that a side effect of radiation for rectal cancer is retrograde ejaculation. What does this mean? Will it hurt me? Will it go away? Answer Bruce Giantonio, MD, Medical Oncologist at Penn Medicine responds: That is a good question. Retrograde ejaculation means that when you have an orgasm, instead of the sperm and other
Dry Mouth during Cancer Treatment Question I have such dry mouth. What can you recommend to help me with this? Sometimes it is so hard just to chew my food and get it down. Answer Patricia Dooley, Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: There are many different things that you can do to relieve dry mouth. One way is by using
Disfigurement after Throat Cancer Surgery Question Can you help me cope with the disfigurement I have and feel after surgery for throat cancer? I know I should be grateful to have made it this far, but I am having a hard time thinking of myself looking like this and I am afraid of how my husband feels looking at me. Answer Tracy Lautenbach MSW, LCSW, Oncology Social Worker at Penn
HPV and Head and Neck Cancers Question How does HPV virus cause cancers of the head and neck areas? How can you protect yourself from HPV? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: HPV infection leads to development of head and neck cancer, usually decades after the initial HPV infection. Your body clears the HPV infection, but HPV leaves a
Cancer Remission Question My doctor told me there is a chance that my cancer could come back. Will I have to get radiation and chemotherapy again? Answer Patricia Dooley, Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: If cancer returns in a previously radiated area, the best treatment, ideally, would be surgery. If
Removal of Voice Box after Laryngeal Cancer Surgery Question If I have surgery for laryngeal cancer and my voice box is taken out, how can I talk again? Is it true that my voice will be different? Answer Patricia Dooley,Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: If the entire voice box is removed, called a total laryngectomy surgery, you will
Fatigue after Ovarian Cancer Treatment My mother has stage 4 Ovarian Cancer. She can no longer eat and has a feeding tube. Since coming home she seems very tired, frustrated, and does not wish to engage in any activities. Do you have any hints how we could help her? It is a real exercise in tact. Thank you. Lora Packel MS, PT, Coordinator of Cancer
Hypercalcemia in Cancer Patients Dear OncoLink "Ask the Experts," My mother has breast cancer with spread to her bones. Recently she became disoriented and started to hallucinate. The doctor said that this is due to the high calcium level in her blood. Is this common in cancer patients? Why would cancer patients have high calcium level in their blood? Thanks.
Lung Cancer and Diet and Nutrition What would you recommend for a lung cancer patient, taking chemotherapy as far as diet and nutrition are concerned? Can diet and nutrition contribute to improvement? Katrina Claghorn, MS, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: The goal during chemotherapy is
Esophageal Reflux and gastric cancer in children Dear OncoLink "Ask The Experts," My daughter is 10 and suffers about four to five times a year of reflux and gastric problems. Her reflux and gastric problems are due to a lot of antibiotics that have been given with treatments of omeprazole and other medicines for more than a year. Can children suffer from cancer of the stomach or
Loss of appetite during cancer treatment Dear OncoLink "Ask The Experts," My mother in-law is undergoing chemotherapy for breast cancer. Her taste for food and her appetite are gone. She is becoming very weak. Is there anything we can do to boost her appetite, or what can we do to infuse the small portions of food she is eating to modify the nutritional value. Thank you in
Loss of appetite during lung cancer treatment Dear OncoLink "Ask The Experts," What should a lung cancer patient do if they are losing too much weight? How can they overcome a loss of appetite? Ellen Sweeney, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: Many cancer patients lose weight during their
Dietary recommendations for liver cancer Dear OncoLink "Ask The Experts," My partner is about to under go surgery for liver cancer. Are there any recommendations for diet before surgery and after surgery for liver cancer? Ellen Sweeney, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: There is no special pre-op
Antioxidant vitamin supplementation and cancer treatments Dear OncoLink "Ask The Experts," I administer chemotherapy and have recently heard of a new study that acknowledges vitamin therapy in cancer patients receiving chemotherapy as non-therapeutic. Some of my patients tell me that the study states that vitamins help enhance cancer growth and cell resistance to chemo. Do you know of this study and
Sugar and cancer Dear OncoLink "Ask The Experts," Does cancer feed off sugars in the body? In other words does sugar make the cancer grow faster? Katrina Claghorn, MS, RD, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds:There has been increasing interest about the impact of sugar on cancer. Recent studies suggest
Being proactive with your nutrition when receiving cancer treatment to the head and neck area Dear OncoLink "Ask The Experts," I have recently undergone surgery for removal of an encapsulated squamous cell tumor on the right side of my neck (and a small piece from the back of my tongue). The oral surgeons removed all of my remaining teeth as a precondition for the seven weeks of radiation and chemotherapy that I will begin next week. I am
Do Microwaved Plastics Cause Cancer? Dear OncoLink "Ask The Experts," I recently received an email claiming to have information written by Johns Hopkins University about the risk of cancer from plastic. The email claims that cooking in plastic containers in the microwave, putting water bottles in the freezer, or using plastic wrap in the microwave can all cause cancer. Is there any
Reishi During Treatment for Colorectal Cancer Dear OncoLink "Ask The Experts," After 6 months of symptoms related to colorectal cancer, my father had a colonoscopy last week and a 2-inch tumor was found at the rectum. Blood test and x-ray results haven't come in yet. A CT scan has been scheduled for this week. He started taking the Chinese herbal medicine reishi (Ganoderma Lucida) this
Glyconutrients for Cancer Prevention or Treatment Dear OncoLink "Ask The Experts," Is there any value to adding products called "glyconutrients" to the routine of a patient undergoing chemotherapy for advanced prostate cancer? Or is this another example of "quackery" via the Internet? Katrina Claghorn, MS, RD, Registered Dietitian at the Abramson Cancer Center of the University
Soy & Antioxidants After Breast Cancer Dear OncoLink "Ask The Experts," I was told not to take antioxidant vitamins C and E while I was taking chemotherapy for breast cancer. Supposedly, they are taken up by the cancer and used for growth. Should I take them now that I am no longer on chemo and Herceptin? I take Arimidex daily. Also, soy products, are they out also?Katrina Claghorn, MS,
Cooking Oils Causing Cancer? Dear OncoLink "Ask The Experts," I was diagnosed with an early-stage hormone-positive, pre-menopausal breast cancer. I have been increasing my intake of veggies, fruits, omega 3's. Recently, I heard that olive oil loses its nutritional content at high heats and can actually be a carcinogen. Is this true? What are the best oils to use for high heat
Flaxseed During Breast Cancer Treatment Dear OncoLink "Ask The Experts," I have been treated for the last 8 months for an invasive breast cancer (mastectomy and chemo). I am now on Tamoxifen and have been having quite the time with hot flashes. I have been reading about using flaxseed in your diet to help combat the hot flashes. I have found articles that are both pro and con on using
Nutrition for Cancer Patients after Gastric Bypass Surgery Dear OncoLink "Ask The Experts," My friend has stage II ovarian cancer and is currently undergoing chemotherapy - 2nd treatment following debulking surgery. Prior to her diagnosis, she had stomach reduction surgery. She is having an exceptionally hard time post chemo treatments with dehydration and low potassium level. I am an OC Survivor
Pain relief for bone metastasis from prostate cancer Dear OncoLink "Ask The Experts," My father is 65 years old and is suffering severe shoulder pain from metastatic prostate cancer. Is there something we can do for his pain? Erin McMenamin, MSN, CRNP, AOCN, Pain Medicine Nurse Practitioner and Program Manager at the Abramson Cancer Center of the University of Pennsylvania, responds:He should
Physical Therapy Modalities and Cancer Patients Dear OncoLink "Ask The Experts," I work in an outpatient chiropractic and physical therapy center. My question is: Is it safe to treat a patient with physical therapy modalities (i.e. US, E-stem, etc.) if they had or have any type of cancer? (Note: these modalities are a variety of treatment tools used by therapists to decrease pain, inflammation
Morphine and the Cancer Process Dear OncoLink "Ask The Experts," If a patient has lung cancer, and morphine is administered for the pain, does the morphine speed up the process? Erin McMenamin, MSN, CRNP, AOCN, Pain Medicine Nurse Practitioner and Program Manager at the Abramson Cancer Center of the University of Pennsylvania, responds:Morphine will not speed up the process of
Clean House while on Cancer Treatment Dear OncoLink "Ask The Experts," This may seem like an odd question. My mom is about to start chemotherapy for stage II breast cancer. The question is, will the condition/cleanliness of my mom's home impact her health during treatment? Mom has never been a neat freak as it's just not a priority for her, and up until now it hasn't caused her any
Safe handling of bodily fluids after cancer therapy Dear OncoLink "Ask The Experts," After chemotherapy treatment, are there recommendations for safe handling of patient secretions, urine, etc after the patient returns home? Thanks.Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:In most cases, chemotherapy is excreted in the body fluids for up to 48 hours after treatment,
Exposure to Children While Having Cancer Treatment Dear OncoLink "Ask The Experts," My mother-in-law was recently diagnosed with colorectal cancer. There is a 2 yr old child in the household, and I was wondering if her chemotherapy and radiation treatments will have any effect on the child being in that environment?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:This is a very
Antioxidants and Reducing Cancer Risk Dear OncoLink "Ask the Experts," Should I take antioxidants to reduce my risk of cancer? Katrina Claghorn, RD, Oncology Dietitian for The University of Pennsylvania Health System, responds: Antioxidants have been shown to have many health benefits. Besides reducing the incidence of heart disease and stroke,
Cancer Prevention Dietary Guidelines Dear OncoLink "Ask the Experts," What kind of diet should I eat to reduce my risk of cancer? Katrina Claghorn, RD, Oncology Dietitian for The University of Pennsylvania Health System, responds: The American Cancer Society has developed the following dietary guidelines: Choose most of the foods you eat from
Are Soy Products Linked to Cancer Prevention? Dear OncoLink "Ask the Experts," I read someplace that a woman trying to avoid breast cancer should have 35-60 grams of soy products per day. I bought some tofu powder (I can't abide the texture of real tofu!) and attempt to mask it in my morning oatmeal. How many grams of tofu powder is as effective as 35-60 grams of real tofu?
Hyperthermia Treatments for Liver Metastasis from Breast Cancer Dear OncoLink "Ask the Experts," I am trying to find information for a friend with breast cancer, which has spread to her liver. She had a bone marrow transplant that kept the disease at bay for six months. She now has a 3cm tumor in her liver. I saw that somewhere they are doing a new procedure which uses direct heat to the affected
Radiation therapy for breast cancer Dear OncoLink "Ask the Experts," My friend has lobular breast cancer and had six weeks of radiation treatment. She is wanting a source for understanding what to expect from her body as a reaction to radiation. Thanks for your help. Ken Blank, MD, and John Han-Chih Chang, MD, OncoLink Editorial
Neck stiffness and lack of saliva after radiation treatments for throat cancer Dear OncoLink "Ask the Experts," My dad had throat cancer about three years ago. He went through intensive chemotherapy and radiation treatments. His therapy has left him with no "real" saliva therefore making it almost impossible for him to swallow. He cannot eat or drink anything except for milkshakes and iced tea, no lemon. He has
Recurrent Cancer and Radiation Dear OncoLink "Ask The Experts," I've read that radiation therapy is seldom given to the same area twice. In this case, any recurrent cancer would have to be treated with chemotherapy, which seldom does more than provide temporary help. Is recurrent cancer thus fatal in most or all cases? Carolyn Vachani RN, MSN, AOCN, OncoLink's Medical
Bone Cancer Dear OncoLink "Ask the Experts," A friend has been diagnosed with bone cancer, but has decided to refuse any treatment. What are his chances? of recovery? of survival (and how long if diagnosed early)? He has taking up alcohol as pain relief. What overall effect will this have? He is obviously experiencing anger
Brain tumors & choosing a cancer center My cousin is affected by a brain tumor and is now under treatment at the European tumor center in Milan. We're looking for another center worldwide specialized in the treatment of such a tumor. Could you give your suggestion answering to this address please let me know if you need further information's to give your opinion. Thank
Hereditary Brain Cancer and Glioblastoma Multiforme Dear OncoLink, My mother has recently been diagnosed as having a glioblastoma. I wonder if you could suggest a source for information regarding genetic causes. I had an uncle die from the same tumor eight months ago. Can you make any suggestions? With Kind Regards, DS Nancy J. O'Connor, RN, MSN, CRNP,
Breast Cancer Genetic Testing Dear OncoLink "Ask the Experts," I had genetic testing performed and they found a change called N6OS in BRCA2. This was the first time this change had been detected. Although they said it occurred in the area of the gene thought to be functionally significant, since it was a substitution rather than a truncation, it was
Obesity and Breast Cancer I learned from your site and others that there are many risk factors for breast cancer. My question is whether larger waist size is a risk factor for breast cancer. Thanks! Li Liu, MD, OncoLink editorial assistant, responds: Dear D: Thank you for your interest and question. Obesity (large waist
Laterality of Breast Cancer Incidence Dear OncoLink, I know that it is much more common for breast cancer to begin, or only take place, in the left breast. My question for you is do we know why this is and if not, are any studies being done to show us why this seems to be the case. If I recall, the percentages are up around 85 or 90% for occurring in the left breast as
Tamoxifen Therapy for Estrogen Receptor Negative Breast Cancer Dear OncoLink "Ask the Experts," I am a medical student with a parent who is currently undergoing treatment for breast cancer. I understand that tamoxifen is used for breast cancers and is highly effective in preventing recurrence. However, what is the situation when a breast cancer is weakly estrogen receptor positive? What is the action
Does hormone replacement therapy increase the risk of breast cancer I have a very simple question. Does hormone replacement therapy increase the risk of breast cancer? Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds: Hormone-replacement therapy (HRT) has been an issue for women's health since its introduction in the mid-1970s. HRT's proposed benefits included menopause symptom
Breast Cancer Detection after Silicone Implants Dear OncoLink, Are mammograms safe to perform on silicon implanted breasts? Is it possible that silicone blocks visibility of tumors? Are there other methods in detecting cancer in such situations? Carolyn Vachani, RN, MSN, AOCN, OncoLink's Nurse Educator responds: Although silicone implants have not been approved for use
Pleural Effusion after Diagnosis of Breast Cancer and Pseudomyxoma Peritonei My wife has a history of breast cancer with left mastectomy in 1996 and diagnosis of pseudomyxoma peritonei in 1997. She now has right pleural effusion. Have you ever heard of the pseudomyxoma peritonei becoming more aggressive and growing outside of the peritoneum? Thanks, F. Li Liu, MD, OncoLink Editorial
Previous Breast Cancer and Secondhand Smoke I am a breast cancer survivor. I never smoked. But my husband smokes and often does it at home. Being a second hand smoker, am I at higher risk of dying from this? Thanks! Li Liu, MD, OncoLink editorial assistant, responds: Dear M: Thank you for your interest and question. Women who already have had
Large Breasts and Breast Cancer Hello, My girlfriend believes that she has heard that there is an increased risk of breast cancer among women with larger than average breasts. She is also under the impression that having her breasts reduced would lower that risk. I am wondering if you (or someone you could refer me to) are aware of any studies which might
Tamoxifen-induced Cancer? My sister has breast cancer. She has been on a drug called tamoxifen for about 2 years. She recently started bleeding as if having a period. She had a D&C and biopsy and the results showed she now has a tumor with some cancer cells in the uterus. I am curious about the medication: is it associated with cancer of the uterus?
Family History of Breast Cancer I have a strong family history of breast cancer in my family. My maternal grandmother had it, as did all three of her daughters, one of which is my mother. One of her daughters died from it, the other two, including my mother are still living. My grandmother is also still living. I am the only daughter out of the three daughters that have
Timing of Radiation and Chemotherapy with Breast Cancer Dear OncoLink "Ask the Experts," In patients with node negative breast cancer undergoing radiation therapy after lumpectomy, what is the best timing for radiation therapy with respect to chemotherapy (such as eight 3 week cycles of CMF)? The optimal timing of radiation therapy and chemotherapy under such circumstances
Efficacy of Tamoxifen for Metastatic Breast Cancer Dear OncoLink "Ask the Experts," How can you tell if the anti-cancer drug you are taking is working? For, example, I am taking Tamoxifen for metastatic breast cancer. How will I know if it is effective? Carolyn Vachani, RN, MSN, AOCN, OncoLink's Nurse Educator responds: In the case of most anti-cancer medications, the best way
Frequency of Mammograms After Breast Cancer Hi, I am 39 and had breast cancer two years ago. Cancer is high on both sides of my family. I found a lump in my other breast nine months ago. Mammogram was done at that time and showed no cancer. How often do I need to have a mammogram? Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of
Genetic Nature of Anaplastic Breast Cancer What is the correlation between the type of breast cancer the mother had and the type of cancer the daughter will get? In other words, am I at risk for the same exact type of cancer my mother had? Jill E. Stopfer, MS Certified Genetic Counselor for the University of Pennsylvania Cancer Risk Evaluation Programs, responds:
Tamoxifen and Radiation Therapy for Early Breast Cancer Dear OncoLink "Ask The Experts," I had a lumpectomy for a Grade 1 breast cancer of 12mm with lymph node clearance. I am now taking Tamoxifen and my surgeon and radiation oncologist are advising follow up radiotherapy, due to start within the next few weeks. My reading indicates this is probably beneficial. I would appreciate your
Treatment options for metastatic breast cancer Dear OncoLink "Ask The Experts," My mother was diagnosed with breast cancer in '99. She had a lumpectomy followed by 4 cycles of chemo (Taxol) and radiation therapy. The doctor told her the cancer was gone and she regularly did checkups. About 2 months ago my mother noticed her breast becoming red, swollen, and a rash developing. She
Weight gain after breast cancer treatment Dear OncoLink "Ask The Experts," My mom was diagnosed with breast cancer a year ago in July. She underwent an axillary dissection along with a lumpectomy. She had aggressive chemotherapy for 9 months. She has been on Tamoxifen for about 3 months. She has gained about 65lbs since she had started the chemo. She went from a size 8 to a
Signs of breast cancer recurrence Dear OncoLink "Ask The Experts," I was diagnosed with inflammatory breast cancer in May 2001. I had a radical mastectomy. My surgeons tell me I am free of cancer. I would like to know what I should be looking for in case of reccurrence. I am aware that the best indicator of reccurrence is how well I know my body and to detect any
Estrogen receptor negative breast cancers Dear OncoLink "Ask The Experts," Does breast cancer run along some continuum from estrogen-receptor positive to estrogen-receptor negative tumors? Are ER+ tumors a different disease than ER- tumors? I have been diagnosed with an ER- breast cancer and I am confused as to whether I am at increased risk of recurrence and general guidelines for
Radiation for recurrent breast cancer after prior radiation Dear OncoLink "Ask The Experts," My sister-in-law had breast cancer two years ago. It now has returned. She told me that she could never receive radiation again because she had it already. Is this true? Thank-you. Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania,
Mortality rates from breast cancer Dear OncoLink "Ask The Experts," I understand that the mortality from breast cancer has dropped. I would be grateful if you could tell me the reasons for this and what is the most significant factor, which has caused this drop? Kevin Fox, MD Assistant Director, Clinical Affairs and Associate Professor of
Risk of pregnancy after a diagnosis of breast cancer Dear OncoLink "Ask The Experts," Is it really a risk to become pregnant when diagnosed with metastatic breast cancer, which has been stable for 2 years? Is the breast cancer likely to "flare up" due to the increase in estrogen? Kevin Fox, MD Assistant Director, Clinical Affairs and Associate Professor of
Rash on the breast after cancer treatment Dear OncoLink "Ask The Experts," I had breast cancer 6 yrs ago. I had radiation at that time. Now I have a very sore rash in the same area. I have a high fever and flu like symptoms and fatigue. I take antibiotics but it comes back in 2 months time. The rash is also very painful. I want to know what is causing this. Lawrence
Safety of evening primrose oil for breast cancer patients Dear OncoLink "Ask The Experts," I had stage I breast cancer last year. I am presently on tamoxifen, and of course I began hot flashes and night sweats. I am premenopausal. My surgeon recommended I take evening primrose oil for the hot flashes, which works great. However, I'm getting conflicted reports lately that primrose oil has
Optimal treatment of breast cancer in an elderly patient Dear OncoLink "Ask The Experts," My mother was diagnosed with ductal carcinoma at the age of 85. A lumpectomy was performed and lymph nodes were clear. Radiation therapy has been recommended. We are trying to weigh the pros and cons to help her decide if radiation therapy is really necessary or appropriate at her age. Considering her age, can you
Recurrent breast cancer on the chest wall Dear OncoLink "Ask The Experts," Can you give me any information about breast cancer that has spread to the skin? I have recently been diagnosed with this recurrent disease after undergoing chemo and radiation plus mastectomy. James M. Metz, MD, Editor-in-Chief of OncoLink and Assistant Professor of Radiation Oncology at the Hospital of the
Chemotherapy Before Surgery for Breast Cancer Dear OncoLink "Ask The Experts," My mother has been diagnosed with stage 3-breast cancer. They are telling her that they want her to do chemotherapy before the surgery to remove her breast. Can you please explain to me why they would be doing this? Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of
Is Massage Safe for Breast Cancer Patients? Dear OncoLink "Ask The Experts," I have breast cancer and I would like to know if I could have reflexology and or massages done. I have been told not to do massages and I was wondering if that is true? Can you please tell me if this is true? Lora Packel MS, PT, Coordinator of Cancer Therapy Services for the Hospital of the University of
Optimal screening for a 23 year old with a family breast cancer history Dear OncoLink "Ask The Experts," What is the optimal screening for a 23 year old with a mother that was diagnosed with breast cancer at 29 years old? Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:Optimal screening
Treatment options for an ER+ premenopausal breast cancer patient Dear OncoLink "Ask The Experts," I have had a lumpectomy and lymph nodes removed, of 19 lymph nodes one was affected. The tumor was 1.2 cm; my cancer was diagnosed as ER+. I am now considering treatment specifically looking at the chemotherapy plus tamoxifen. I am premenopausal (46 years old). What are your comments based on this information.
Is implant removal necessary for breast cancer surgery? Dear OncoLink "Ask The Experts," I was diagnosed with stage 1 invasive ductal carcinoma in my right breast. I have already had a lumpectomy and now have to go for a wedge excision and lymph node axillary dissection. I have had saline breast implants since 1994 and my surgeon is concerned about the wedge excision surgery and the implant - mainly
Fertility after breast cancer treatment Dear OncoLink "Ask The Experts," I was diagnosed with hormone negative, stage II breast cancer at age 29. I was treated with CEF ( cyclophosphamide, epirubicin and fluorouracil) chemotherapy and then radiation. I am now 32 and was considering getting pregnant. I have heard chemotherapy may harm the ovaries or hormone production. Is there a test to
Considering breast implants with a family history of breast cancer Dear OncoLink "Ask The Experts," My wife is 25 years old and considering breast implants. However, she has a family history of breast cancer (mother, grandmother, and great grandmother) Would the implants decrease or increase her chance of getting breast cancer? Should she just have both breasts removed and replaced with them? Don LaRossa,
Radiation to the chest after previous radiation for breast cancer Dear OncoLink "Ask The Experts," My mother had radiation for breast cancer two years ago. She now has been diagnosed with lung cancer. She will have the spot removed, but one doctor said she needs radiation and the other said she could not have it again. Can you give us some feedback? Stephen M. Hahn, MD, Associate Professor of Radiation
Can trauma to the chest cause breast cancer? Dear OncoLink "Ask The Experts," I was in a serious car accident in January of 2004. I had massive trauma to my chest, so much that it collapsed my lung on the right side. Now I have lumps in both my breasts. On the right side the lump is about the size of a plum and on the left side it is about the size of a marble. Does trauma like this to the
Tamoxifen for weakly positive Estrogen and Progesterone breast cancers Dear OncoLink "Ask The Experts," I am a 31-year old ER negative and "weakly" PR positive breast cancer patient. I have had a mastectomy with no lymph node involvement and chemotherapy and now deciding whether to go on Tamoxifen. Does your practice recommend Tamoxifen for "weakly" PR positive patients?Julia Draznin Maltzman, MD,
Recurrent Breast Cancer Dear OncoLink "Ask The Experts," I am looking for treatment options for women who have had breast cancer, had a mastectomy, radiation, and chemo, only to find two years later that a cancerous tumor has appeared in the other breast. My aunt is the patient, and I know she tested negative for carrying the cancer gene. Her mother died at a similar age
E-String Use After Breast Cancer Dear OncoLink "Ask The Experts," I had a lumpectomy on Sept 7th and have ended 16 radiation treatments. Prior to my diagnosis, I had been taking Premarin 0.3 mg for approx 18 years. I stopped cold turkey when diagnosed. I have been having problems with vaginal dryness and would like to know what your opinion is of the E-string? Nancy Zieber, RN,
Inflammatory breast cancer Dear OncoLink "Ask The Experts," Can you please give me some information on inflammatory breast cancer? I recently had a relative diagnosed with this condition and I am not sure if it is different from regular breast cancer . Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Inflammatory breast cancer (IBC) accounts for 1 to 4% of
Male breast cancer Dear OncoLink "Ask The Experts," I am a 69 year old male who was recently diagnosed with breast cancer. My doctor has never seen this before in a man. How is this treated compared to a woman with breast cancer? Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Breast cancer in men accounts for about 1% of all breast cancers and
Pregnancy and breast cancer Dear OncoLink "Ask The Experts," How is breast cancer managed in a patient who just found out she is pregnant? Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Approximately 1 to 3 patients out of 10,000 deliveries will be diagnosed with breast cancer during their pregnancy. It is the most common cancer seen during pregnancy.
Breast Implants and cancer Dear OncoLink "Ask The Experts," I have had breast implants for 15 years. Can breast implants cause cancer? Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:The Institute of Medicine conducted a thorough report on the safety of silicone breast implants. The report states that breast cancer is no more common in women with breast
Chemo for Breast Cancer: Every 2 weeks or 3? Dear OncoLink "Ask The Experts," I am a 49-yr old woman who has just been diagnosed with breast cancer. Going for the whole wash, cut, and blow dry. My question is - reading about chemo, every two weeks works better than every three. One article says great, the other says the results were disappointing. What is the scoop? Kevin R. Fox, MD,
Breast Cancer Recurrence in the Skin Dear OncoLink "Ask The Experts," I had breast cancer 12 years ago, treated with a lumpectomy and Adriamycin-based chemo plus radiation. The breast cancer has recurred as skin cancer with little lumps all over my body. It has been determined that it is treatable with hormone therapy. Are there resources for information on this recurrence? Suzanne M.
Screening for Metastases in Breast Cancer Dear OncoLink "Ask The Experts," Having presented with back, shoulder and ear pain, together with loss of balance, I was referred for x-rays and scans, and metastases from the same "non-aggressive" breast cancer I suffered ten years earlier were found in the bones. A prognosis of two months plus was given. I have survived three years!
Nottingham Score for Breast Cancer Dear OncoLink "Ask The Experts," I do not understand my Nottingham score of 9, or the histologic grade of III/III. Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:The Nottingham histologic score is simply a scoring system
Itching a Sign of Breast Cancer? Dear OncoLink "Ask The Experts," I have read that itching of the breast may be a symptom of breast cancer. Is this a myth or is it true? Angela DeMichele, M.D., MSCE, Assistant Professor of Medicine and Epidemiology at the University of Pennsylvania and Senior Scholar in the Center for Clinical Epidemiology and Biostatistics, responds:Itching can
Oophorectomy to Lower Breast Cancer Risk Dear OncoLink "Ask The Experts," I am at high risk for developing breast cancer and am contemplating having my ovaries removed. How much would I be decreasing my risk if having this procedure done? Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of
Tamoxifen for Male Breast Cancer Dear OncoLink "Ask The Experts," Having had a mastectomy in July 2005, I was prescribed Tamoxifen. I am having difficulty in finding any information on the side effects in men. I appreciate that we are a small number , but information for breast cancer in men is limited. Can you please advise on any side effects of Tamoxifen in men? Carolyn
HRT for Breast Cancer Survivors Dear OncoLink "Ask The Experts," What is the current information regarding estrogen replacement therapy for former breast cancer patients? I am now in menopause and am affected both physically and emotionally. I was treated 12 years ago with radiation and chemotherapy for breast cancer with borderline estrogen receptor-positivity. Kevin R. Fox,
Pregnancy & High Risk for Breast Cancer Dear OncoLink "Ask The Experts," My mother died of breast cancer and secondary bone cancer in 1971, approximately a year after giving birth to my brother. She was 42. Her cancer was diagnosed 3 months after his birth. I am 40 and have 8-year-old twin girls. I have just discovered that I am pregnant, and am concerned about my increased risk of
Breast Cancer Screening Guidelines Dear OncoLink "Ask The Experts," What are the current guidelines for breast cancer screening?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:The American Cancer Society (ACS) and the National Comprehensive Cancer Network (NCCN) have both developed breast cancer screening guidelines which are quite similar. These recommendations
Tumor Marker for Breast Cancer Dear OncoLink "Ask The Experts," The Ca 27-29 blood test has a “normal” level below 30. Is it possible for the level to reach zero in a person who had invasive cancer with no lymph node involvement? Suzanne M. McGettigan, MSN, CRNP, AOCN, Board Certified Adult Nurse Practitioner and a Certified Oncology Advanced Practice Nurse,
Partial Breast Irradiation in Second Cancers Dear OncoLink "Ask The Experts," A friend has recently been diagnosed with invasive lobular breast cancer, HER-2/neu positive, ER/PR positive. She had invasive ductal cancer 10 years ago with a full course of radiation. She is considering lumpectomy + Mammosite OR mastectomy. Is there data on success rates for each choice for a person in her
Smoking After Diagnosis of Breast Cancer Dear OncoLink "Ask The Experts," Can you please provide more information on the subject of smoking while receiving chemotherapy and radiation treatment for breast cancer? What is the effect of continued smoking while receiving treatment, due to cigarette smoke containing over 4000 chemical compounds, hundreds of which are either poisonous or
Exercise After Breast Cancer Dear OncoLink "Ask The Experts," Although my wife and I have been told that squash and tennis (which my wife played before her mastectomy) is not recommended, I am curious to know why? Whereas weight training seems to be getting a cautious 'green light', are there specific reasons why racket sports and the type of arm movement involved would
Breast Cancer Recurrences Dear OncoLink "Ask The Experts," My oncologist once mentioned that roughly 75% of breast cancer recurrences are metastatic. If this is true, most patients who recur would eventually die after a recurrence. I can't find any substantiation for his remark. Can you tell me whether he is right or not? I am trying to decide whether or not to continue an
Metastatic Breast Cancer to the Liver Dear OncoLink "Ask The Experts," My mom was diagnosed with metastatic breast cancer to her liver last year. Her oncologist tracks her alkaline phosphatase level monthly, recently the numbers are climbing up, but her AST/ALT are stable. What could this mean? Kevin R. Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of
Swimming and Exercise While on Radiation Therapy for Breast Cancer? Dear OncoLink "Ask The Experts," I am about to start radiation therapy for breast cancer. Can I swim during this time? I have heard conflicting reports about exercise during therapy. Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:Your doctors, including the surgeon, medical oncologist,
Do I need to have breast reconstruction after my surgery for breast cancer? Dear OncoLink "Ask The Experts," Do I need to have breast reconstruction after my surgery for breast cancer?>Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:It is never medically necessary to have breast reconstruction. This is considered an elective procedure,
Are all women candidates for immediate breast reconstruction after breast cancer surgery or treatment? Dear OncoLink "Ask The Experts," Are all women candidates for immediate breast reconstruction after breast cancer surgery or treatment?Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:The vast majority of women are candidates for breast reconstruction. There are a
What are the major types of breast reconstruction available to patients who have had breast cancer surgery? Dear OncoLink "Ask The Experts," What are the major types of breast reconstruction available to patients who have had breast cancer surgery?Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:There are 3 major types of breast reconstruction. The first is a tissue
I am interested in breast implant reconstruction after my breast cancer surgery. What is involved? Dear OncoLink "Ask The Experts," I am interested in breast implant reconstruction after my breast cancer surgery. What is involved?Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:Implant reconstruction is almost always at least a two-step procedure. At the time of
I may need chemotherapy for my breast cancer. Can I still have breast implants? Dear OncoLink "Ask The Experts," I may need chemotherapy for my breast cancer. Can I still have breast implants?Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:Women who need post mastectomy chemotherapy are still candidates for implants. Sometimes we need to
Why do people choose flap reconstruction after breast cancer surgery? Dear OncoLink "Ask The Experts," Why do people choose flap reconstruction after breast cancer surgery? Doesn’t it take longer to recover from than breast implant surgery?Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:It is true that breast reconstruction using a
Resuming sexual relations after completion of chemotherapy and radiation therapy for anal cancer Dear OncoLink "Ask The Experts," I have just completed chemo and radiotherapy treatment for anal cancer I am worried about having sex again. Presently I have a yellow mucus discharge from my vagina and anus. It does seem to be getting better. Can I hope it will disappear and is it normal?James M. Metz, MD, Editor-in-Chief of OncoLink and Assistant
Proton Therapy for Anal Cancer Dear OncoLink "Ask The Experts," Is the new proton beam radiation a viable option for anal cancers? James M. Metz, MD, Editor-in-Chief of OncoLink and Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:Proton beam therapy is being explored as a possible form of treatment for a number of cancers.
Traditional Radiation vs. IMRT for Treatment of Anal Cancer Dear OncoLink "Ask The Experts," If you would please explain the difference in types of radiation machines used specifically for treating anal cancer--the linear accelerator and the IMRT--if there is a difference and whether all cancer treatment centers would utilize the same equipment type.James M. Metz, MD, Editor-in-Chief of OncoLink and
Anal Pap Testing and Cancer Dear OncoLink "Ask The Experts," How effective are anal pap tests that are offered in the gay community? Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds:I'm unclear on the efficacy of anal pap tests. There is a lot of controversy in the
Polyps and the Symptoms of Colon Cancer Dear OncoLink "Ask the Experts," Ten years ago I had polyps. They were not cancerous. Could they become cancerous? What are the symptoms of colon cancer? Thank you. JW James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior
Neurological Deficits and Colon Cancer Dear OncoLink "Ask the Experts," My mother underwent surgery for colorectal cancer 3 years ago. She was treated with chemotherapy as well as radiation. She did fine until one of her last radiation treatments. At that point, she started having pain in her hips, back and legs. She was diagnosed with a ruptured disk and had additional
Symptoms of Colon Cancer Dear OncoLink "Ask the Experts," I have abdominal discomfort, bloating, gas, constipation, nausea and pencil thin stools. I am 44 years old, female, and I have no insurance. Is it cancer? Do you have any idea what I can do without insurance to help find out what it is? Dr. Timothy Hoops, Clinical Assistant Professor
Family History and Risk for Colon Cancer Dear OncoLink "Ask the Experts," I am 31-year-old male. I have been reading a lot about hereditary colon cancer due to some recent symptoms of lower right-sided abdominal cramps. My family history is both grandparents on fathers side diagnosed at age 50-55. Great grandfather on father's side diagnosed at 75. Mom has no colon cancer
CEA Levels and Colon Cancer Dear OncoLink "Ask the Experts," What is a CEA test, how accurate or dependable is it? Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds: Carcinoembryonic antigen or
Family History Of Colon Cancer And Ulcerative Colitis Dear OncoLink "Ask the Experts," My mother suffered from ulcerative colitis from age 33-42. She finally had a j-pouch surgery in September.00 and is doing well. On her side, her brother and sister also both have ulcerative colitis... both diagnosed in their 30's. On my father's side, his father died of colon cancer at age 70, his
Radiation Prior to Surgery for Rectal Cancer Dear OncoLink "Ask the Experts," I have recently been diagnosed with rectal cancer. I was told that chemotherapy and radiation was required before surgery. The mass is approximately 10cm. Frankly I would rather have surgery first. I would appreciate your thoughts on this matter. Richard Whittington, MD, Associate
Stage 1 Colon Cancer Dear OncoLink "Ask the Experts," Hello, I am a 35-year-old female. I was diagnosed with Stage I colon cancer last year. My sister who is 45 was diagnosed 4 years ago in stage 4. We just found out that the cancer has spread to her liver and lungs. I am very scared. Does this mean I will have a recurrence? 6 Months ago 2 polyps were
Can hemorrhoids lead to rectal or colon cancer? Dear OncoLink "Ask the Experts," Can hemorrhoids lead to rectal or colon cancer? Thank you. James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the University of
Is Colon Cancer Hereditary? Dear OncoLink "Ask the Experts," I have just been diagnosed with a Dukes B adenocarcinoma of the colon, which has now been removed, and I am about to start a course of chemotherapy (5-FU). I am only 26 years old and have been told it is very unusual for someone of my age to get bowel cancer. Doctors are saying that it is most likely a
Prognostic Factors for Colon Cancer Including Genes Dear OncoLink "Ask the Experts," I understand that the presence or absence of some genes makes a significant difference in the effectiveness of therapies such as radiation and chemo. Is there a current test to determine whether these genes are present in an individual? I had Stage B colon cancer, last year, age 64, but I elected not to
Can Irritable Bowel Syndrome lead to Colon Cancer? Dear OncoLink "Ask the Experts," I am 33-year-old female diagnosed with Irritable Bowel Syndrome about 10 years ago. Can my condition lead to colon cancer? Dr. Timothy Hoops, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn
Rectal Cancer Treatment Options Dear OncoLink "Ask the Experts," My mother, who is 84 years old, was recently diagnosed with rectal cancer. The tumor is a flat malignancy that is attached to the back wall of her rectum. All test results show that the cancer has not spread, and is only isolated to the rectal wall. Her current surgeons see no alternative but to remove
Side-Effects and Recurrence Rates of Stage 3 Colorectal Cancer Dear OncoLink "Ask the Experts," I have a question for your panel regarding my father. He is 75 years old and is currently undergoing treatment for a Stage 3 colorectal cancer. The pathology report indicated the tumor to involve the full thickness of the mucosal wall, 2 of 25 local lymph node involved, and the tumor's position just below
Cutting Edge Cancer Treatments Dear OncoLink "Ask the Experts," I am currently being treated with oxaliplatin for metastatic colon cancer in the liver. Where do you think the most promising future colon cancer help will come from angiogenesis inhibitors, monoclonal antibodies, or vaccines? Thanks, B.M. James P. Stevenson, MD, Assistant
Guidelines for Colorectal Cancer Screening Dear OncoLink "Ask the Experts," I am a 26-year-old female. My grandmother was diagnosed with colon cancer at age 55 and died of the disease at age 60. My mother has been diagnosed with the disease at age 49. She was in Stage IV when her cancer was diagnosed. At what age should I have a colonoscopy? James D.
Chemotherapy and Follow Up After B2 Colon Cancer Dear OncoLink "Ask the Experts," I was diagnosed with stage II colon cancer in September 2000 at age 39. 21 lymph nodes were removed, all negative. No apparent spread. Angiolymphatic invasion present; B2 tumor. Bowel resection surgery performed. I am just completing 6 rounds of 5FU & Leucovorin. Is there any other treatment available
Treatment Options for Dukes Level C Colon Cancer Dear OncoLink "Ask the Experts," My father has just had surgery to remove a malignant tumor from the right side of his colon (they removed "half" of the colon, according to the surgeon). In the removal, the surgeon took out 20 lymph nodes around the colon; 12 contained cancer cells. The oncologist has rated my Dad on a "Dukes" scale as
Treatment and Follow-up Options after Colon Cancer Dear OncoLink "Ask the Experts," Would appreciate your help and guidance. My wife under went a colon resection to remove cancerous growth. One lymph node tested positive. Subsequent chemotherapy treatment (5 FU & leucovorin ) administered over a six-month period. What are the follow up testing procedures? What are the follow
Laxative Use and Colon and Rectal Cancer Dear OncoLink "Ask the Experts," I've heard that chronic constipation and laxative use is associated with colon and rectal cancer. Is that true? Thank you. Li Liu, MD OncoLink Editorial Assistant, responds: This is an excellent question. It has long been suggested that low bowel movement frequency, by
Colon Cancer Screening Tests Dear OncoLink "Ask the Experts," I am at high risk for colon cancer because my mother had colon cancer at age 37, my maternal great aunt had colon cancer, and my father's mother died of colon cancer. My question is if someone is at high risk and has had a normal colonoscopy, how often after that should he or she considers having another
Hereditary Colon Cancer Dear OncoLink "Ask the Experts," I am looking for a clinical study on hereditary connections for Colon Cancer. I have an intensive family history of colon cancer. My paternal Grandfather died from it in his 50's. My father has had 7 colon polyps removed and his two sisters have had colon cancer recently. I also have had 3 colon polyps
Rectal Bleeding and Rectal Cancer Dear OncoLink "Ask the Experts," I have had rectal bleeding for about one week. This has happened before several months ago and stopped. I am seeing a Doctor about this later this month and am convinced I have rectal cancer. What are the other causes of rectal bleeding? The OncoLink Editorial Team responds:
Ulcerative Colitis and Non-colorectal Cancer Dear OncoLink "Ask the Experts," I learned from your site (and others) that ulcerative colitis is associated with colorectal cancer. My question is whether ulcerative colitis could cause other malignancies. Thank you. Li Liu, MD, OncoLink editorial assistant, responds: Dear M Thank you for your interest
Hereditary Nonpolyposis Colorectal Cancer Dear OncoLink "Ask The Experts," I was diagnosed with uterine & cervical cancer in 1997, at age 34. I was told that I needed a colonoscopy because this cancer is sometimes followed by colon cancer. Is this true? How often should I be screened? Also, my father (deceased at age 44) brother, sister and nephew have had colon cancer.
Considering genetic testing for colon and breast cancers Dear OncoLink "Ask The Experts," I am a 48 yr.old white female who was diagnosed with adenocarcinoma of the colon contained within a polyp. I have a strong family history. My father died of pancreatic cancer at the age of 79. My mother was diagnosed with breast cancer at the age of 46. She was cancer free until 1988 when she was
Diet and the prevention of colon cancer Dear OncoLink "Ask The Experts," What role does diet play in the prevention of colon cancer? Thanks. Katrina Claghorn, MS, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: There has been a great deal of research on the impact of nutrition on colon cancer.
Frequency of colonoscopies with family history of colon cancer Dear OncoLink "Ask The Experts," My family has a history of colon cancer. I lost a younger brother to colon cancer when he was 48. I am 52. I had a colonoscopy at age 49 and no polyps were found. I have an older brother who had polyps at age 52 and a younger sister with polyps at 45. My grandfather on my father's side died of colon
Looking for a surgeon to treat colon cancer Dear OncoLink "Ask The Experts," My mother has just been diagnosed with colon cancer. She has been referred to a surgeon. What credentials should we look for in determining if the surgeon has the appropriate training and skills to treat her? What questions should she ask the doctors? What answers to those Questions should she listen for?
Does aspirin use prevent the development of colon cancer? Dear OncoLink "Ask The Experts," Does aspirin use prevent the development of colon cancer? James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the University of Pennsylvania,
What is the risk of developing colon cancer in a person with Chron's disease? Dear OncoLink "Ask The Experts," What is the risk of developing colon cancer in a person with Chron's disease? James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the University
How can I prevent getting colon cancer? Dear OncoLink "Ask The Experts," How can I prevent getting colon cancer? James D. Lewis, MD, MSCE, Assistant Professor of Medicine, Senior Scholar at the Center for Clinical Epidemiology and Biostatistics, and Senior Fellow in the Leonard Davis Institute of Health Economics at the University of Pennsylvania, responds: The
What are the Side Effects of Chemotherapy for Colon Cancer? Dear OncoLink "Ask The Experts," What are the Side Effects of Chemotherapy for Colon Cancer? Carolyn Vachani, MSN, RN, AOCN, OncoLink's Clinical Trials Coordinator, responds: Chemotherapy kills cells that divide rapidly. Unfortunately, this includes both good cells (hair follicles, mucosa of mouth and GI tract, red and white
Is impotence a side effect of radiation for colorectal cancer? Dear OncoLink "Ask The Experts," Is impotence a side effect of radiation for colorectal cancer? If so, how common and what is the usual time frame from completion of radiation until development of impotence? Is the impotence gradual or immediate? Thanks. Richard Whittington, MD, Associate Professor of Radiation Oncology at
Are pets a concern during cancer treatment? Dear OncoLink "Ask The Experts," I was just diagnosed with colon cancer and I am about to begin chemotherapy. Will my "house pets" (cat) cause any problems during chemotherapy? Carolyn Vachani, MSN, RN, AOCN, OncoLink's Medical Correspondent, responds: The reason that pets may be a concern to patients undergoing chemotherapy
What are the standard colon cancer treatment options by stage? Dear OncoLink "Ask The Experts," What are the standard colon cancer treatment options by stage? Carolyn Vachani, MSN, RN, AOCN, OncoLink's Medical Correspondent, responds: Stage I Stage I colon cancer is a tumor that has begun to invade the wall of the colon. This tumor is removed surgically and requires no further treatment.
Survival after 5 years for colon cancer Dear OncoLink "Ask The Experts," Are there survival statistics available for review by the colon cancer patient beyond the "generic 5 year overview"? What are the age guidelines for my three sons to be screened? I had surgery for a B2 T3 tumor with no lymph node involvement after the routine sigmoscope exam given to 50 year old. Timothy C.
Colonic Enemas and Colon Cancer Dear OncoLink "Ask The Experts," I suffer from chronic constipation. My mother, who also has suffered from constipation, has recently been diagnosed with colon cancer. I have recently found that colonics help alleviate the symptoms, but I am unsure about how effective this therapy may be for prevention of colon cancer. Also, how often are
Can surgery spread cancer? Dear OncoLink "Ask The Experts," My husband was diagnosed with Stage III colon cancer-he has had chemo and radiation. He developed incisional hernias and is scheduled to have them repaired. I am paranoid about this surgery because someone told me that having surgery after you are diagnosed with cancer is a way for the cancer to spread -is this
Do you need a colostomy for colon cancer? Dear OncoLink "Ask The Experts," Do you always need a colostomy for colon cancer? What is the difference between a temporary and a permanent colostomy? Carolyn Vachani RN, MSN, AOCN, OncoLink's Medical Correspondent, responds:You do not always need a colostomy for the treatment of colon cancer. In fact this has become less and less common as
Risks of colon cancer after multiple polyp removals Dear OncoLink "Ask The Experts," I am in my mid 30's and have had numerous colonoscopies over the last 10 years with polyps removed each time. I am now going every 3 years to get checked. Am I still at risk to get colon cancer even though I have the polyps removed? Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the
What are the risks of metastases to the brain with colon cancer? Dear OncoLink "Ask The Experts," My diagnosis is Stage III colon cancer. Lately I have been having severe headaches and have had no previous history of headaches. My question is whether or not there could be a connection. I have been told that the liver is the next target of colorectal cancer, but I'm wondering if colorectal cancer can
Hereditary Nonpolyposis Colorectal Cancer Surveillance Dear OncoLink "Ask The Experts," I was successfully treated at the age of 39, for uterine cancer. My father was successfully treated, at age 62 for non-polyps colon cancer. His mother was successfully treated for non-polyps colon cancer. Having had uterine cancer and coming from a family line of colorectal cancers, what are my risks of developing a
Frequency of colonoscopy after removal of cancerous polyp Dear OncoLink "Ask The Experts," I'm 54 years old and last October I had a routine colonoscopy and they found a medium size polyp and removed it. I was told the top part of the polyp contained cancer cells but not the stem so to be on the safe side my doctor recommended I have a sigmoid colon resection. Everything came out clean. I was told to
Relationship between HPV and rectal cancer Dear OncoLink "Ask The Experts," What can you tell me about the relationship between HPV and rectal cancer? Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:HPV infection is more related to
Clinical presentations of colon cancers Dear OncoLink "Ask The Experts," I would like to know the differences, signs and symptoms, that patients present with left sided, right- sided and sigmoid cancers. Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine
Treatment options for a 95 year old with rectal cancer Dear OncoLink "Ask The Experts," My mother is a very youthful 95 year old who lives independently. She was diagnosed last week with rectal cancer, an adenocarcinoma within 6 inches of the anus. Surgery with the possibility of a colostomy is the option of choice by her surgeon. She indeed has atherosclerotic cardiovascular disease, and had a total
Colon cancer screening for at risk children Dear OncoLink "Ask The Experts," My husband was diagnosed with colon cancer (stage 4) in 1998 at the age of 34 and had a total colectomy at the University of Pennsylvania. He had chemotherapy twice. He has been cancer free, even though he continues to find occasional polyps in his upper GI. We have three kids ages 15, 12, and 5. The 15 year
Transanal vs. abdominal surgery for rectal cancers Dear OncoLink "Ask The Experts," Is Transanal Endoscopic Microsurgery just as useful as the abdominal approach? I need to be sure that a cancerous polyp did not affect my blood vessels or lymph glands Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director
Rising CEA after colon cancer treatment Dear OncoLink "Ask The Experts," My mother had colorectal cancer 15 years ago. She had surgery, radiation and chemotherapy. She has been cancer free for the past 15 years. Her follow up has been to get her CEA levels checked every 6 months. After 15 years of these levels being at 1 or 1.5 they are now at 17 and climbing. My question is, is this a
End stage rectal cancer Dear OncoLink "Ask The Experts," I am a critical care nurse, with 17 years of nursing experience. My husband was diagnosed with recurrent rectal cancer 1 yr ago. He has undergone multiple Chemotherapy treatments, and due to growing tumors on lung, abdominal, and pelvic CT scans and the fact that his CEA is also rising. He may soon be starting
Young patient with colon cancer symptoms Dear OncoLink "Ask The Experts," I am 25 years old. I have tested positive for blood in my stool and my doctor has recommended that I have a colonoscopy. He told me that I definitely have small hemorrhoids. Would you consider me at risk for colon cancer? My symptoms have been stomach pain, extreme constipation and tiredness. Carolyn
Treatment for Stage IV Colon Cancer Dear OncoLink "Ask The Experts," My father was just recently diagnosed with Stage IV colon cancer. His oncologist has given him a good prognosis. He will start chemotherapy soon with 5-FU, Avastin and Oxaliplatin. He is very worried about this. How bad are the side effects? Do these drugs make you very sick? What can be done to lessen any negative
Colon Cancer Screening Methods for Young People with Family History Dear OncoLink "Ask The Experts," What is the most efficient and reliable method of screening, and is it possible for screening to be done too early in life for those with a history of colon cancer in the family?Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and
Correlation with uterine, colon and breast cancers Dear OncoLink "Ask The Experts," Is there any correlation with uterine, colon and breast cancers? My mother-in-law has had all three. She is currently anemic.Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor,
Rising CEA after stage II colorectal cancer Dear OncoLink "Ask The Experts," I was diagnosed in July 2001 with Stage II colorectal cancer, at age 33. I underwent surgery, radiation & chemotherapy. I was running CEA's of 1.9, but the last blood work just came back at 3.6. I was just wondering if there are any other factors that can lead to an increase in my CEA level? Timothy C.
Stage IV colon cancer Dear OncoLink "Ask The Experts," My brother has been diagnosed with Stage IV Colorectal Cancer. The tumor is a Mucinous adenocarcinoma and has spread into his abdominal area. He is a 55 year old Caucasian non smoker who was fit and healthy. His cancer was diagnosed when he developed an intestinal blockage. My question is do you know if there are
Recurrence statistics for Stage III Colon Cancer Dear OncoLink "Ask The Experts," I am vast approaching my three year surgical resection anniversary. I was Stage III colon cancer with 1 out of 23 nodes tested positive (40 years old) Colon resection with all normal margins. (1 ½ inches of rectum removed 5-FU and Radiation. My health has been very good. All Scans clear for three years.
Radiation for T1 Cancerous Polyp of the Rectum Dear OncoLink "Ask The Experts," I am 25 years old and had a T1 cancerous polyp removed from my rectum in December. They are now recommending radiation therapy. I am wondering what the long-term effects of radiation therapy are and also whether or not it is really necessary.Richard Whittington, MD, Associate Professor of Radiation Oncology at the
Signet ring cell colon cancer Dear OncoLink "Ask The Experts," My mother was just diagnosed with signet ring cell colon cancer. She had a right colectomy. She has one lymph node involved. I'm wondering what her prognosis and treatment options are?Julia Draznin Maltzman, MD, Attending Physician at the University of Pennsylvania School of Medicine, responds: The most important
Anal Sphincter Preservation or Replacement after Rectal Cancer Dear OncoLink "Ask The Experts," My brother was operated on for rectal cancer and had the anal sphincter removed. I was wondering if you know if anyone does rectal and sphincter reconstruction? Thank you very much.Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and
Nutrition for cancer patients after gastric bypass surgery Dear OncoLink "Ask The Experts," My friend has stage II ovarian cancer (OC) and is currently undergoing chemotherapy - 2nd treatment following debulking surgery. Prior to her diagnosis, she had stomach reduction surgery. She is having an exceptionally hard time with dehydration and low potassium levels after her chemo treatments. I am an OC
Symptoms After Colon Cancer Surgery Dear OncoLink "Ask The Experts," My father (65 years old) underwent a colon cancer surgery in December 2005. The proximal one-third of the colon (the cecum, ascending colon, and half of the transverse colon) was removed, and it was anatomized with the distal part of the small intestine. Although there was no lymph node involvement, he is
Cetuximab for Stage III Cancer Dear OncoLink "Ask The Experts," My father was diagnosed with stage III colon cancer earlier this month. He had surgery to remove the cancerous portion of the colon. He then consulted two doctors; one suggested using cetuximab in combination with the chemotherapy, and the other doctor ruled against it. The doctor who suggests using cetuximab felt
Anal Sex After Treatment for Anal Cancer Dear OncoLink "Ask The Experts," I received chemotherapy and radiation for anal cancer in 2006. As a gay man, is it safe to resume anal intercourse? Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds: I don't see any reason why someone would
Cancerous Polyp - Is Surgery Required? Dear OncoLink "Ask The Experts," I had my first colonoscopy last month at age 45. A malignant polyp was found and removed. I was told that I had a good chance it was contained to that polyp. However, because of my age and family history of colon cancer, I should have surgery, a colon resection, to make certain that there is no other malignancy
Esophageal Cancer Surgery Dear OncoLink "Ask the Experts," What are the options for esophageal cancer surgery? Thank you, M Kenneth Blank, MD, OncoLink Editorial Assistant, responds: Many surgical approaches exist for extirpation of esophageal cancer. The four most common are listed below, and differ in the location of the
Esophageal Cancer Dear Oncolink, My husband died 9 years ago of extensively metastatic esophageal cancer, which was found in a Barrett's Esophagus. He had a hiatal hernia, with many years of acid reflux. I'm very alarmed about our 12-year-old son, who has always burped easily and readily. Over the past 2 months, NOT RELATED to a full or semi-full
Gallbladder Cancer Treatment Options Dear OncoLink "Ask the Experts," My mother has just been told that she has gallbladder cancer and that the cancer also has spread to the liver. Her doctor tells her that she is incurable and he recommends no treatment other than pain treatment. She also has a gallstone and takes some type of analgesic to reduce her pain. She has no
Cholelithiasis and gall bladder cancer I recently had my gallbladder removed. The diagnosis was: "Cholecystitis" and "Cholelithiasi" I saw a reference to 'Cholelithiasis' and cancer. What is this? and is it related to/cause cancer? Maggie Hampshire RN, BSN, OCN, Managing Editor of OncoLink responds: The term cholecystitis refers to an inflammation of
Treatment Options for Metastatic Gastric Cancer I have a 33 year-old sister who has developed stage IV gastric cancer. The cancer was discovered last May 1999 and 85% of her stomach was cut out and 3/15 lymph nodes were positive. Recently, the cancer has come back outside of her stomach and has metastasized to her liver. Can you point me to any clinical trials? Li Liu,
Frozen Biopsy in the Diagnosis of Gastric Cancer Dear OncoLink "Ask the Experts," Is there a role for frozen section biopsy prior to definitive surgical resection in management of gastric cancer? Can the two procedures (frozen section and definitive resection) be done at the time of surgery or do they have to be done at different time intervals? Thank you, Dr. A.
Diagnosis of Gastric Cancer Dear Editors, My husband and I are stationed in England. We just recently received information from back home that my mother has been diagnosed with stomach cancer. We are in the dark being so far away from home. Could you help us find information about this disease and what complications may arise? If you could lead us in the right
Is There a Correlation Between H. Pylori and Gastric Cancer? Dear OncoLink "Ask the Experts," My mother was diagnosed with positive H. pylori. I understand that there is a correlation with gastric cancer. Are there initial screening methods to detect the early stage of gastric cancer and how significant is this correlation? Thanks! Li Liu, MD, OncoLink Editorial
Eating disorders and cancer Dear OncoLink "Ask The Experts," I am recovering from Bulimia and Anorexia and am worried that I have caused damage to my throat. Is it possible to develop cancer from prolonged purging? Katrina Claghorn, MS, RD, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds:You are to be commended for dealing
Blood Type A and Gastric Cancer Dear OncoLink "Ask The Experts," I have read that there may be an additional risk factor for gastric cancer for people with type A blood. If this is true, what if any preventive steps should be taken, and why is this true? Weijing Sun, MD, Assistant Professor of Medicine at the University of Pennsylvania, the Director of Upper GI and
Alcohol injections in the treatment of liver cancer Dear OncoLink "Ask the Experts," My mother is dying with advanced liver cancer. She is on chemotherapy. The pain and nausea are not presently a problem. they are under management. I was looking for treatment options. I have seen alcohol injected into liver tumors which had some effect on tumor growth. I have seem alcohol injection
The Etiology of Pancreatic Cancer Dear OncoLink "Ask the Experts," Hello. On Wednesday, I received the unfortunate news that my mother did indeed have a malignant tumor on her pancreas. The tumor has attached itself to the inferior vena cava and obviously cannot be removed. This is not the first time that I have experienced this in my family. Both of my mom's parents both
Heredity of Pancreatic Cancer Dear OncoLink "Ask the Experts," Is pancreatic cancer hereditary? What other risk factors are associated with pancreatic cancer? Thanks! Li Liu, MD, OncoLink Editorial Assistant, responds: Dear T, Thank you for your interest and question. It has been proven that pancreatic cancer is essentially
CA125 Cancer Antigen Test Dear OncoLink "Ask the Experts," My insurance company has denied payment for the CA125 cancer antigen test for my wife who died from pancreatic cancer. Her oncologist frequently used this test to provide an indicator of the effectiveness of the cancer treatment. My insurance company says that its value as a diagnostic tool for
Signet Ring Cell Cancer Dear OncoLink "Ask the Experts," My 72-year-old father is suffering from stomach cancer that has started to spread. It is a signet-ring cell cancer. The cancer was found incidentally, when he was undergoing surgery to remove a stricture in his duodenum. Unfortunately the disease is spreading rapidly. He will start with the chemo this
Therapy for Appendiceal Cancer Dear OncoLink "Ask The Experts," Weijing Sun, MD, Assistant Professor of Medicine at the University of Pennsylvania, the Director of Upper GI and Pancreatic-biliary-hepatic Cancer Group and the Associate Director of the GI Cancer Program, responds: There is no particular chemotherapy regimen for appendiceal cancers. In clinical practice, we
Is Hysterectomy for Cervical Cancer Necessary? Dear OncoLink "Ask the Experts," My sister has been diagnosed with cervical cancer and wasn't offered a hysterectomy. Every time we tell a doctor or nurse about this they seem to be shocked. Is there any reason a person with cervical cancer wouldn't be given a hysterectomy? Thank you. Christina S. Chu, MD, Assistant
Side effects of radiation for cervical cancer Dear OncoLink "Ask The Experts," Could you give me any information on any possible negative outcomes using radiation to treat cervical cancer? Could scarring occur in the vagina? Where would I find information or statistics regarding a choice of radiation versus hysterectomy as treatment for this condition? Ruth Collins, MSN, CRNP, OCN,
Signs and Symptoms of Cervical Cancer Dear OncoLink "Ask the Experts," What are the signs and symptoms of cervical cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds: Patients with cervical cancer may experience a thin, watery vaginal discharge that can be
Cervical Cancer Dear OncoLink "Ask the Experts," My mother was diagnosed with advanced cervical cancer. She has had chemotherapy and radiation therapy. We were told that her prognosis is not good. Is there anything we can do to help her? Sincerely, EM Ivor Benjamin, MD, Former co-Editor-in-Chief of OncoLink, responds:
DES Exposure and Gynecologic Cancer Dear OncoLink "Ask the Experts," I found your information on cervical changes and treatment options for abnormal pap tests very informative. In 1996 I underwent a LEEP procedure for the treatment of mild dysplasia and squamous intra-epithelial lesions. The first PAP (3 months) after the procedure, was not entirely normal, and the test was
Is Circumcision Related to Cervical Cancer Risk? Is a woman at a higher risk of developing cervical cancer if her spouse is uncircumcised vs. a spouse that is circumcised? Ivor Benjamin, MD, Former co-Editor-in-Chief of OncoLink, responds: Possibly. There is some medical evidence to support an increased risk for developing cervical cancer in women who have male
Timing of radiation after surgery for cervical cancer I would like to know the time gap required between radiotherapy and surgery regarding the management of a patient with cancer of the cervix. Thank you, Dr. S Ken Blank M.D., Editorial Assistant for OncoLink replies: The time interval between surgery and radiation is often at the discretion of the radiation
Radical vulvectomy for Bartholin's gland cancer Dear OncoLink "Ask The Experts," I have just been diagnosed with Transitional cell cancer of the Bartholin's gland. It seems that my Oncologist's decision for a radical vulvectomy is the most effective procedure. Does radical mean both left + right side? Will there be a normal sex life with just an abnormal appearing or will I no longer
Link between cervical and ovarian cancers Dear OncoLink "Ask The Experts," Twenty-three years ago I had cervical cancer and a hysterectomy was done. Now I have been diagnosed with ovarian cancer. Is there a link between the two and is my ovarian cancer a secondary cancer. I have been on hormone replacement for the past 10 years. Stephen C. Rubin, MD, Professor and Chief
LLETZ (Large Loop Excision of the Transformation Zone) for cervical cancer Dear OncoLink "Ask The Experts," I am a 24 year old with CIN III. My mum had cervical cancer 2 years ago when she was 48. I have been told that I need LLETZ (Large Loop Excision of the Transformation Zone) under general anesthetic. I understood that this was to be done under a local anesthetic and have not been able to find out why it is
Treatment for stage 1B cervical cancer Dear OncoLink "Ask The Experts," My wife has been diagnosed with cervical cancer stage IB. The pathology calls it adenosquamous carcinoma and poorly differentiated. A radical hysterectomy was performed. Twenty-three lymph nodes were removed and are free of cancer. The tumor depth was 0.6cm. The lower uterus was involved as well as the
Will cervical displaysia lead to cancer or infertility? Dear OncoLink "Ask The Experts," I have severe cervical dysplasia. How likely is the chance of cancer? Will this affect my chance of having children if properly treated? Thank you. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Risk factors for cervical cancer Dear OncoLink "Ask The Experts," I have been diagnosed with cervical cancer. Two conflicting opinions have brought me to you. Is it true that the only way to get cervical cancer is through a sexually transmitted disease? Are there are other risk factors? I am a smoker, and I am sure that is a much bigger risk for me than catching an STD.
Stage IB1 cervical cancer Dear OncoLink "Ask The Experts," My sister has been diagnosed with Stage Ib1 cervical cancer. She has had her second cone biopsy performed about a week ago and the tumor has been removed. The Oncologist was not happy with margins so has suggested a radical hysterectomy with pelvic lymph node dissection, in case the cancer has spread.
Multiple sexual partners as a risk factor for cervical cancer Dear OncoLink "Ask The Experts," I've read that "many different partners" may be a contributing factor of cervical cancer. Why this is so? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds: In the past, having many different sexual
Cervical cancer treatment while pregnant Dear OncoLink "Ask The Experts," I am 6 months pregnant and was told that I have cervical cancer. I go back to the oncologist in a month to have another colposcopy done, to see what grade the cancer is. I need to know what I should and shouldn't do everyday activities while I'm still pregnant? Christina S. Chu, MD, Assistant Professor of the
Breast and Cervical cancer screening for teens Dear OncoLink "Ask The Experts," Is there a certain age that you should be worrying about breast cancer and cervical cancer or should I be worrying about it as a teenager too? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:While teenagers are at low
Is cervical cancer hereditary? Dear OncoLink "Ask The Experts," I have a question. My mother recently died from cervical cancer. I'm I at a higher risk of having cervical cancer because she had it? Can it be inherited? Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:There is no evidence
Small cell cervical cancer Dear OncoLink "Ask The Experts," I was diagnosed with small cell cervical cancer. I underwent chemotherapy, a radical hysterectomy, and radiation. I have CT scans of the chest, abdomen, and pelvis every three months - is this enough? What is the chance of recurrence with small cell cervical cancer if the patient has had a
Lymphedema after cervical cancer treatment Dear OncoLink "Ask The Experts," I was diagnosed with cervical cancer in February 1998 and subsequently underwent a radical hysterectomy followed by cautionary radiation therapy. I now live with Lymphedema. I currently use a mechanical pump sleeve device; but it offers very little relief and I am still extremely limited in my mobility. Any
Does a combination of HPV and birth control increase your chance of cervical cancer? Dear OncoLink "Ask The Experts," I was diagnosed with HPV. I have read several studies showing that having HPV increases your chances of cervical cancer. Recently, I read that being on birth control and having HPV will increase your chances by 60%. My question is should I stop taking birth control due to the fact of having HPV? Or is the
Radiation after radical hysterectomy for cervical cancer Dear OncoLink "Ask The Experts," After undergoing a radical hysterectomy with the removal of lymph nodes and ligaments for cervical cancer with no evidence of spread, I am now faced with the possibility of 6 weeks of radiation therapy. This therapy has been recommended because of the position of the tumor (3 mm from the cervical wall). I am
Is squamous cancer of the cervix hereditary? Dear OncoLink "Ask The Experts," I am a cervical cancer survivor. I am very concerned about my 14-year-old daughter contracting this horrible disease when she gets older. I have been told that it is not hereditary, but I am having serious difficulty believing this. My grandmother, mother, aunt and myself all contracted this disease at 32 years of
Muscle Loss after Radiation for Cervical Cancer Dear OncoLink "Ask The Experts," I was treated for cervical cancer 18 months ago. During the treatments, I lost a good deal of muscle on the top of my thigh, in the back. I have been trying through exercise to rebuild it, but am not having much success. Is it possible for muscle to regenerate after treatments? If so, I would appreciate any help you
Sex during Cervical Cancer Treatment Dear OncoLink "Ask The Experts," Is it safe to have sex while on treatment for cervical cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:If you have completed treatment for cervical cancer, it is usually safe to have intercourse. Patients who have
Is Hycamtin Viable Treatment for Endometrial Cancer? Dear OncoLink "Ask the Experts," I have read the article on Hycamtin as a treatment of ovarian cancer. Can you tell me whether or not it would also be a viable treatment for Endometrial Carcinoma? Sincerely, B. M. John Han-Chih Chang, MD, Editorial Assistant for OncoLink responds: Dear BM, Thank you for
Uterine cancer risk factors Dear OncoLink "Ask The Experts," I have a patient who has developed uterine cancer in her 40's, and there is no known family history. Do you know of any association between asbestos exposure and an increased risk for uterine cancer? I have been searching the literature and have not found anything, but I don't want to overlook anything
Estrogen use for early stage endometrial cancer patients Dear OncoLink "Ask The Experts," A recent study showed that ERT does not increase endomentrial cancer recurrence. Based on this info, my gynecological oncologist recommends estrogen, to relieve my menopausal symptoms and yet my local oncologist and primary care provider recommend an aromatase inhibitor. I am 40 years old and recently had
Management of stage IB uterine cancer Dear OncoLink "Ask The Experts," I am a 49-year-old premenopausal woman who recently had a total hysterectomy with removal of ovaries and tubes because of a diagnosis of Atypical Hyperplasia with significant bleeding. I have not experienced any signs of sudden menopause as yet. I was just informed that the pathology report from surgery found
Is there a link between endometriosis and endometrial cancer? Dear OncoLink "Ask The Experts," My 68-year-old mother has Stage 2 endometrial cancer. She previously suffered from severe endometriosis, requiring extensive surgery. Could you please advise me of any links between endometriosis and endometrial cancer? My sister and I both have endometriosis. Thank you. Stephen C. Rubin, MD,
Surgical Options for Endometrial Cancer Dear OncoLink "Ask The Experts," I am 31 years old. I went to the doctor because I had a positive pregnancy test, but I was not pregnant. My doctor did an endometrial biopsy and those results showed I had hyperplasia. I had a hysterectomy. I was diagnosed with endometrial cancer. When he did the hysterectomy he just removed the endometrial. Now
Endometrial Cancer Staging and Surgery Dear OncoLink "Ask The Experts," My sister has just been diagnosed with stage I endometrial cancer. She is wondering that if she put off surgery for a month, would her cancer worsen dramatically? Is there a way to generally estimate the time between stage I to the next stage? Does endometrial cancer advance quickly? Thanks for any information you
Survival rates for endometrial cancer Dear OncoLink "Ask The Experts," My sister-in law was just diagnosed with endometrial cancer. She is having a CT, MRI, colonoscopy, hysterectomy and staging this week. The current rate of survival for stages 1-4 are not clear. I would just like an honest answer so that I can plan the direction of support for my family once she is staged. Thank
Metastatic Endometrial Cancer Dear OncoLink "Ask The Experts," My mother was diagnosed with Endometrial Cancer in 1993. She underwent surgery and went in remission. In 1998, they discovered that it had metastasized to her lungs and she was treated by chemotherapy. After chemo, she developed diabetes, and CHF. She was in remission until November 2003. A CT Scan then showed
Chemotherapy after Whole Abdominal Radiation for Endometrial Cancer Dear OncoLink "Ask The Experts," My partner has endometrial cancer - stage IIIA. She had a radical hysterectomy and has now completed whole abdominal and pelvic radiation. She is scheduled to have 3 rounds of brachytherapy starting next week. My question is that her radiation oncologist has suggested chemotherapy also. I know this is more
Just Diagnosed Endometrial Cancer Dear OncoLink "Ask The Experts," I've just found out from a biopsy that I have endometrial cancer, Grade 1. My gynecology doctor says the 1st thing that has to happen is a hysterectomy? Shouldn't I get a C T Scan first? Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System,
Tamoxifen After Endometrial Cancer Dear OncoLink "Ask The Experts," Given the risk of endometrial cancer with tamoxifen use, is the drug contraindicated for women who have previously had endometrial cancer, but now face breast cancer? I was treated with TAH/BSO for stage IB endometrial cancer 7 months ago, and now face the decision of tamoxifen for a new breast cancer diagnosis.
Risk of Secondary Cancers Dear OncoLink "Ask The Experts," What percent of heavily treated endometrial cancer patients (radiation and chemotherapy with carboplatin and taxotere) experience secondary cancers? At what sites? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds: Secondary
Symptoms of Ovarian Cancer Dear OncoLink "Ask the Experts," What are the signs of ovarian cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds: Patients with ovarian cancer often do not have symptoms until late in the disease process. Symptoms are
Consolidation Therapy for Ovarian Cancer Dear OncoLink "Ask The Experts," I have Stage IIIC ovarian cancer, had optimal debulking and then 9 rounds of IV/IP carbo/Taxol, the first three of which were all IV due to port problems. The oncologist is asking me to consider 24 weekly IV treatments of Taxol, which is said to have few side effects and may increase the disease-free interval. What
Clinical Trials for Ovarian Cancer Dear OncoLink "Ask the Experts," Do you have any information as to how I can be involved in the latest trials for ovarian cancer? My mother died 2 years ago with the disease and would therefore like to refer myself onto a screening program. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology
Genetic link for Ovarian Cancer Dear OncoLink "Ask The Experts," Please can you tell me if there is a known genetic link for ovarian cancer? My daughter- in-law is concerned because her mother died with the disease. She lives in the UK. Is there any way of calculating the risk? As far as I know there have not been other affected family members. Thank you in
Elevated CA125 after ovarian cancer treatment Dear OncoLink "Ask The Experts," In 1986 I had ovarian cancer with total removal of ovaries and uterus. For 15 years, the CA125 test has been part of my physical. It has been normal until this year and is now elevated. Simultaneously, I have a positive test for occult blood in the stool. They just did an abdominal CAT Scan, on which I
Preventing ovarian cancer Dear OncoLink "Ask The Experts," What is the best way to prevent ovarian cancer? I have a very high possibility of contracting it as my mother and several other close family members have died from ovarian cancer. Is it total hysterectomy with removal of ovaries or just removal of ovaries? What evidence supports your answer? At present I
Gemcitabine for the treatment of ovarian cancer Dear OncoLink "Ask The Experts," Have you or any of your colleagues used Gemzar in the treatment of ovarian cancer? I would like to know of any stats on the success of this chemotherapy for ovarian cancer. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health
Ovarian cancer detection Dear OncoLink "Ask The Experts," What are the tests for ovarian cancer? I have a regular yearly check up with Pap smear and I understand that ovarian cancer will not show up on this test. I have had several tests done for loss of appetite and weight loss (I have lost approximately 45 lbs), upper GI, MRI. I am now 51. Should I ask my doctor
Ovarian cancers of low malignant potential Dear OncoLink "Ask The Experts," I am a 34 year old who has just been diagnosed with borderline malignancy tumor of the ovaries. I am getting married in 3 weeks and while this is very overwhelming I am concerned with my potential to have children. What is known about borderline malignancy tumors and the ability to conceive? Is there a waiting
Primary peritoneal cancer Dear OncoLink "Ask The Experts," My mom just had a hysterectomy and we were told her diagnosis of Peritoneal Cancer mimics Ovarian Cancer. This is very rare; do you have any information about this disease? Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania
Successful pregnancy after ovarian cancer Dear OncoLink "Ask The Experts," My friend had ovarian cancer when she was 16, had one tube and one ovary removed. She's 22 now and is trying for a baby, however she is concerned that her chances may be very low or non-existent. Could you tell me realistically what her chances are of becoming pregnant? Thank you for your time.
Birth control pills may lower your risk for ovarian cancer Dear OncoLink "Ask The Experts," My mother died of ovarian cancer so as a precaution my gynecologist placed me on birth control pills. I am 48 and have not gone through menopause. With all the news about estrogen being a link to breast and ovarian cancer is it really a good preventive measure to be on a low dose birth control pill? Christina
Fertility drugs and borderline ovarian cancers Dear OncoLink "Ask The Experts," I was recently diagnosed and treated for borderline ovarian cancer. I am 47 years old and was told by my gynecologist oncologist that this tumor (mucinous) probably arose due to the ferility drug (clomid) I was prescribed 20 years ago. Do you agree there may be a connection? Stephen C. Rubin, MD, Professor
Symptoms of endometriosis and ovarian cancer Dear OncoLink "Ask The Experts," I have been researching both endometriosis and ovarian cancer. They seem like they have the same symptoms. How can you detect the difference and also do the symptoms on both appear around your cycle only? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of
Treatment of borderline cancers of the ovary Dear OncoLink "Ask The Experts," A close friend of mine was diagnosed with a Low Malignant Potential/Borderline Ovarian Tumor after a laparoscopy and had a complete hysterectomy. She has now been told that the LMP was also in the ovary, the fallopian tube, and in at least 1 lymph node. What is the recommended treatment at this point? Should I
Ovarian Cancer Surveillance Dear OncoLink "Ask The Experts," I am a 33-year-old female and have had treatment for CIN1 cells, which affected 3/4 of my cervix. I also have had my mother and grandmother die from ovarian cancer. I have been advised that I should have DNA testing to determine if I carry "The Gene". Upon going to the Genetics Specialist, was advised testing would
Clear Cell Ovarian Cancer Prognosis Dear OncoLink "Ask The Experts," Three years ago I was diagnosed with early stage Ovarian Cancer (Clear Cell) at the age of 32. Had chemo and surgery. I would like to adopt a child in a couple of years but I'm afraid I won't have a normal life expectancy. I have three aunts who died of breast cancer prior to the age of 65 and one had colon
Ascites in Ovarian Cancer Dear OncoLink "Ask The Experts," My sister has been diagnosed with ovarian cancer. She recently under went surgery to remove a massive tumor four liters of fluid were removed. She remains very bloated with what the doctors call "ascites" What is this "ascites?" I have searched the web and can't find any information. Christina S. Chu, MD,
Possibility of ovarian cancer after removal of the ovaries Dear OncoLink "Ask The Experts," I have had a complete hysterectomy with both ovaries and uterus removed 25 years ago. Yet I am experiencing severe bloating and unexplained weight gain. I need to know if a woman can get ovarian cancer if she has had a complete hysterectomy? Stephen C. Rubin, MD, Professor and Chief of the Division of
Standard Treatment for Advanced Ovarian Cancer Dear OncoLink "Ask The Experts," My mother was recently diagnosed with ovarian cancer. She had significant ascites, which caused her presentation to the hospital. She is to have two cycles of taxol/carbo combination and scheduled to undergo surgery in May. We want the most aggressive treatment for my mother. What are some questions to ask
Treatment options for recurrent ovarian cancer Dear OncoLink "Ask The Experts," My mother is currently battling her 3rd recurrence of ovarian cancer. She will start "Doxil" next week. What other options do we have? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:Recurrent ovarian cancer is a
Premarin cream and the risk for ovarian cancer Dear OncoLink "Ask The Experts," My wife is 58 and experienced menopause 5 years ago. Her GYN suggested that she use Premarin Cream to relieve a dry vagina problem and help when we have intercourse. I have heard of a link between Premarin and ovarian cancer. I am afraid for my wife to use the cream. Is my fear justified? Is there a "safe" cream
Consolidation therapy for ovarian cancer Dear OncoLink "Ask The Experts," My sister-in-law has stage 3c ovarian cancer. She has had surgical debulking and is now undergoing 6 carbo/taxol cycles. Do you have an opinion on consolidation therapy? I know it's controversial but could you address it for the rest of us? Christina S. Chu, MD, Assistant Professor of the Division of
Ovarian Cancer Recurrence Dear OncoLink "Ask The Experts," I've never really understood how or why my ovarian cancer could come back, but I'm well aware of the risk. I've had a negative second look and am in remission. Is recurrence due to undetected cancer being left behind, or is it due to cells dividing uncontrollably again once chemo effects wear off. Or could it indeed
Family history of ovarian cancer Dear OncoLink "Ask The Experts," I have a family history of ovarian cancer from both my mother and maternal grandmother I am frightened of getting cancer too. What can I do to make sure that if I detect it early enough to be treatable? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of
BRCA1 and BRCA2 testing for Ovarian Cancer Dear OncoLink "Ask The Experts," My mother had ovarian cancer at the age of 50, I am now 49 and of Jewish heritage. It seems that the genetic testing is no longer easily accessible. How would I go about getting genetic testing? Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health
Monoclonal Antibodies for Ovarian Cancer Dear OncoLink "Ask The Experts," My mother has had her first recurrence of ovarian cancer. I am trying to research the latest evidence for success with therapies using monoclonal antibodies. Can you tell me what the most recent evidence is or what your opinion is regarding this therapy? Christina S. Chu, MD, Assistant Professor of the Division
Chemoresistance in ovarian and primary peritoneal cancer Dear OncoLink "Ask The Experts," I have been fighting primary peritoneal cancer for 4 1/2 years with suboptimal debulking and continued chemotherapy. I had one 9 month remission in the beginning. At this point all the chemotherapies we have tried have not been working. I was told I am chemoresistant at this point. I am about to try etoposide. What
Testing for Ovarian Cancer Dear OncoLink "Ask The Experts," Would you please let me know what is the test or examination with the most accuracy to detect ovarian cancer? How efficient is the ultrasound to detect the malignancy? Thank you very much for your answer. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of
The most commonly used chemotherapy treatment for ovarian cancer Dear OncoLink "Ask The Experts," My wife's mother will begin chemotherapy for ovarian cancer this Thursday and is petrified of the side effects. Her oncologist is treating her every week with carboplatin and paclitaxel and has told her this will reduce the expected side effects due to the lower more frequent concentrations. My question is should
Treatment for recurrent ovarian cancer stage III C Dear OncoLink "Ask The Experts," My wife has epithelial ovarian cancer stage III C. She underwent surgery in January 2001 and chemotherapy with the standard Carboplatin/Taxol (paclitaxel) treatment. She had a recurrence within 18 months and again underwent treatment with the same Carboplatin/Taxol combination beginning in December 2002. She again
Vaccines for Ovarian Cancer Dear OncoLink "Ask The Experts," My name is Marius and I am from Romania. My girlfriend is 26 yrs old, and has been diagnosed with ovarian cancer and had surgery. Doctors said that the cancer is stage IIA and the cell type is G2. She has had several chemotherapy treatments, but the doctors are not giving her a good chance of survival. I read an
OncoGel and Ovarian Cancer Dear OncoLink "Ask The Experts," Do you have any knowledge or experience with use of OncoGel to deliver paclitaxel directly into ovarian cancer masses? I have recurrent disease. Thank you.Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:OncoGel is an experimental,
Hormone Therapy after Ovarian Cancer Dear OncoLink "Ask The Experts," I am 44 years old, and a 2-year survivor of Stage 1, grade 3 epithelial ovarian cancer (sporadic, as opposed to hereditary). You wrote that hormone replacement therapy does not increase the risk for ovarian cancer, therefore, why does my oncologist NOT want me on any hormones? Stephen C. Rubin, MD, Professor and
PET/CT for Ovarian Cancer Dear OncoLink "Ask The Experts," I was diagnosed with fallopian cancer January 2006 had surgery and 6 chemo treatments ending July 2006. My Gynecologic Oncologist ordered a PET/CT in February 2007. My insurance company is refusing to pay for the scan saying it is not a proven for my type of cancer. I'm looking for research data that will support
Follow Up for Primary Peritoneal Cancer Dear OncoLink "Ask The Experts," I am a Primary Peritoneal Cancer survivor (19 months in remission). I want to know which is best to have, CT scan or PET scan to check for recurrence of disease? Also if recurrence does occur, is it possible to have intraperitoneal (IP) therapy again? Stephen C. Rubin, MD, Professor and Chief of the Division of
Vaginal cancer treatment and causes Dear OncoLink "Ask The Experts," A friend of mine found out she has vaginal cancer. What is the best treatment today for this? Can this be related to her tonsil cancer from a few years ago? Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:Vaginal cancer is
Follow Up After Vaginal Cancer Dear OncoLink "Ask The Experts," I was diagnosed in 2004 with primary vaginal cancer. I had a vaginectomy with my lymph nodes removed. I also had reconstruction. I am followed up every 6 months with only Pap smears. Should I be getting any particular blood work, urinalysis, or scans other than my Pap smear to keep up with a cancer that may or may
Symptoms of Vaginal Cancer Dear OncoLink "Ask the Experts," I have a large lump in the vulva area. When I use the bathroom I have some mild pain there. Should I be concerned about having vaginal cancer stage 2? Peter Argenta, MD, OncoLink Editorial Assistant, responds: Fortunately, vulvar or vaginal cancers comprise a small percentage of
Vulvar cancer causes Dear OncoLink "Ask The Experts," Could you tell me if there have been any new findings as to the cause of vulvar cancer? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:There have been no recent new discoveries regarding the causes of vulvar cancer.
Prognosis for cancer of the vulva Dear OncoLink "Ask The Experts," I have recently had a biopsy for a lump on my vulva. It is strongly suspected that this is indeed cancer. What is the prognosis for this type of cancer? Is the only option surgery, and is it usually cured with surgical removal? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology
Origins of Fallopian Tube Cancer Dear OncoLink "Ask the Experts," Is there such a cancer as fallopian tube cancer? Or, is it ovarian cancer that starts in the fallopian tube? Thank you, F. Ivor Benjamin, M.D., Former co-Editor-in-Chief, OncoLink, responds: Dear F. Thank you for your question and your interest. Yes, there are
Risk factors for fallopian tube cancer Dear OncoLink "Ask The Experts," Are there any environmental factors associated with the rare fallopian tube cancer? I am undergoing chemotherapy for this and have recently met two other women within a 10 mile radius that also are undergoing chemotherapy for fallopian cancer. Stephen C. Rubin, MD, Professor and
Fallopian Tube Cancer Prognosis Dear OncoLink "Ask The Experts," I was diagnosed with Stage 1A fallopian tube cancer in July. The surgery was performed by a surgeon specializing in GYN Oncology. Why does your website say that the 5-year survival rate for Stage 1A is 51% (or thereabouts), whereas all other websites I've found quote 91% 5-year survival for Stage 1A fallopian tube
Treatment for Bartholin Gland Cancer I have a rare type of Gyn cancer: metastatic squamous cell cancer of the Bartholin gland. I am currently receiving radiation to the pelvis and weekly Cisplatin chemotherapy to be followed by interstitial brachy implants. I fear most the implants, as it will be the second surgery, since the tumor was removed. I am now told that it was unwise
Is there a correlation between cancer and shingles? Dear OncoLink "Ask The Experts," My mother and father died of cancer and both developed shingles within 6 to 9 months of dying. My sister has been diagnosed with uterine cancer. She just found out she has shingles. Is there a correlation between cancer and shingles? Stephen C. Rubin, MD, Professor and Chief of the Division of
Fertility Drugs and Cancer Dear OncoLink "Ask The Experts," Can you give me websites and information on the chances of getting cervical cancer from taking clomid? I took it for 1 1/2 years in the 1970's to help me get pregnant. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:As far as
Should I have a hysterectomy to avoid gynecologic cancers? Dear OncoLink "Ask The Experts," If a woman has already had breast cancer, wouldn't it make sense to have a hysterectomy to avoid getting other female types of cancer, i.e. ovarian and uterine cancer? I am currently 52 years old. Thank you. Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of
Is it Bartholin's Gland Cancer? Dear OncoLink "Ask The Experts," I have had Bartholin's cysts for over two years now on and off. Recently I had come across an article concerning Bartholin's gland cancer. How will I know if I have the cancer? Will it show up in the culture? Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of
Parotid Gland Cancer Dear OncoLink "Ask the Experts," My mother had noticed a lump in her right cheek for sometime. After a biopsy, she has just been diagnosed with cancer of the parotid gland. They are calling it an adenoid cystic epithelial carcinoma. On CT of the chest, there were two nodules in the right upper lobe of the lung. Please advise as to
Leukoplakia of the tongue, cheeks, and gums and cancer development Dear OncoLink "Ask the Experts," How long can a person have leukoplakia of the tongue, cheeks, and gums before cancer develops? Gregory S. Weinstein, MD, FACS, Founding Member and Associate Director of the center for Head and Neck Cancer, at the University of Pennsylvania Medical Center, responds: This is a good
Oral Cancer Dear OncoLink "Ask the Experts," My husband was told he has carcinoma of the tongue. Are there any articles on current treatment? He had chemotherapy for lg/small cell non-Hodgkin's lymphoma in 1998-1999. Will this affect any future treatment options? Thanks, EL David I. Rosenthal, MD, Director for Head and
Radiation Treatment for Larynx Cancer Dear OncoLink "Ask the Experts," My mom, age 75 has chosen to take radiation treatments instead of having her voice box removed. She has stage 3 larynx cancer and is still smoking during treatments. What are her chances to be cured at this stage? L. David I. Rosenthal, MD, Director for Head and Neck Radiation
HPV a Cause of Oral Cancers Dear OncoLink "Ask The Experts," My sister is 26 years old and has had a hoarse voice for as long as I can remember. Recently though her voice went away and she could barely whisper, but she had no difficulties breathing. She went to see a speech specialist who told her she may have HPV Papilloma on the larynx and sent her to a head and neck
Swallowing Evaluation after Surgery for Head and Neck Cancer Dear OncoLink "Ask the Experts," Is it common for all patients to have a swallowing evaluation done after neck cancer surgery? Cesar Ruiz, MA, Speech Pathologist at the Hospital of the University of Pennsylvania, responds: Although we can not comment on a specific cancer diagnosis or surgery, since none is
Swelling of the mucous-lining of the head and neck after treatment for epiglottic cancer Dear OncoLink "Ask The Experts," My husband has just undergone daily radiation and chemotherapy for epiglottic cancer. While the treatment was rough, we are finding the side effects to be even more grueling. He has a very thick mucous-he says like glue that almost chokes him continuously. His doctor suggested robutussin to break this up. He's been
Oral Trauma Causing Cancer Dear OncoLink "Ask The Experts," I am 28 years old and I have a bad habit of chewing on the inside of my cheeks, on the bottom inside of my mouth and on my tongue. I am really worried about getting oral cancer, but I just can't seem to control this habit. My PCP put me on an anxiety med that didn't help me stop the habit. What can I do to stop from
HPV Testing in Head and Neck Cancers Dear OncoLink "Ask The Experts," My husband is a 54 year-old non-smoker, non-drinker with stage I moderately differentiated squamous cell cancer of the tonsil. He is about to begin radiation therapy. Should he request HPV testing in the tonsil biopsy, and would this change his treatment at all?Pinaki R. Dutta, MD, PhD, Resident in the Department of
PEG Tube for Head & Neck Cancer Radiation Dear OncoLink "Ask The Experts," My husband is a 54 year-old non-smoker or drinker with stage I moderately differentiated squamous cell cancer of the tonsil. He is about to begin radiation therapy. He is 6 feet tall and 210 pounds and strong - is a PEG tube really needed? Pinaki R. Dutta, MD, PhD, Resident in the Department of Radiation Oncology
Alcohol Intake When Receiving Radiation for Head & Neck Cancer Dear OncoLink "Ask The Experts," When receiving radiation therapy for throat cancer, can you have a few beers on the weekend when you aren’t getting radiation? Pinaki R. Dutta, MD, PhD, Resident in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:Thank you for your question. It is a common
Nutritional Status Druring Treatment for Head and Neck Cancer Dear OncoLink "Ask The Experts," My father was recently diagnosed with epiglottis cancer, and he just had his first chemo treatment and the first week of radiation. Are there any suggestions that you have in regards to what he would be able to eat? Should we have a nutritionist? Your article was very informational, thank you. You told me things
Chance That Surgery Could Find Benign Tumor Question I am having surgery for a thyroid cancer found with a biopsy but I read online that they could do the surgery and find out it is benign. Is that really true? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds: The accuracy of the pre-operative diagnosis is dependent upon the cytologist that reviews the slides. It varies across
Follow Up & Monitoring for Recurrence Question If I had surgery to remove my thyroid and cancer, can it come back? How will my doctor know if my thyroid cancer comes back after I finished all my treatments/procedures and things seem ok? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds, Thyroid cancer recurs in 25% of people. The likelihood for recurrence depends of the
Secondary Leukemia after breast cancer treatment Dear OncoLink "Ask The Experts," My Mom has been recently diagnosed w/ AML and I was wondering if there was any information on "therapy related AML". Her bone marrow biopsy showed that her leukemia was caused by chemotherapy she had in 2/95 for breast cancer. Thank you for your time. Selina M. Luger, MD,
Cured from Cancer? Question At what point is someone considered cured from cancer? Answer Keith Cengel, MD, Radiation Oncologist at Penn Medicine, responds: That depends on the cancer. Typically, we have used 5 years for cancers of the lung or head and neck, but this is somewhat arbitrary. Other cancers, like breast cancer or certain lymphomas, have a pattern
Treatment for Stage IIIB Non-Small Cell Lung Cancer (NSCLC) Question My wife has just been confirmed through a biopsy of having stage IIIB non-small cell lung cancer. Lymph nodes in her neck and chest are involved. We have yet to see an oncologist. Hope to this week. What treatments are recommended? What other questions should we ask? The pulmonologist stated that he thought treatment would be
Mixed Small Cell/Non-Small Cell Lung Cancer Question My father was recently diagnosed with lung cancer, both small cell (limited stage) and non-small cell (Stage IIIA, T2N2M0). Apparently, it is rare to have both types of lung cancer at the same time. He is currently getting chemotherapy once per month for 3 days straight concurrently with daily radiation therapy for 7 weeks. My questions
Lung Cancer Screening I have learned from you site and others that lung cancer is the leading cause of cancer deaths. Does it make sense to screen general population with chest x-ray or CT scan so that patients can be detected earlier and hopefully cured? Thanks! P Li Liu, MD, Editorial Assistant for OncoLink, responds: This is an excellent
Why not radiate extensive stage lung cancer? Can radiation treatment be used on lung cancer? If so, to what dosage? To all areas of the lung? My father has small cell lung cancer that has responded well to chemotherapy. I'm wondering what would prevent treating his lung tumor with radiation? Mitchell Machtay, MD, Assistant Professor of Radiation Oncology at the Hospital of the
Reducing Secretions Related to Metastatic Lung Cancer Question What is the best way to reduce the copious secretions related to metastatic lung cancer? Answer James M. Metz, MD, Editor-in-Chief of OncoLink and Professor of Radiation Oncology at Penn Medicine, responds: The answer would depend on what type of secretions to which you are referring. You should discuss the secretions with your
Nausea During Lung Cancer Treatment Question My mother has lung cancer and is receiving radiation therapy, but she cannot receive chemotherapy until she is healthy enough. She has not been able to eat even before the radiation therapy started, and the cancer has spread so they need to hurry up and get her on to chemotherapy. She is taking Reglan for nausea but it is not helping. She
Lung Cancer Stages Question My Father-in-law was recently diagnosed with Stage IV Lung cancer. Could you tell me what that means? Answer Mitchell Machtay, MD, Radiation Oncologist, responds: The "stage" of a cancer indicates how advanced someone's cancer is. Early stage means that the cancer is relatively small and well confined, while very advanced stage cancer
Pipe smoking and the risk of lung cancer Question My husband smokes a pipe, and he is always dismissing the risks of getting cancer. Despite the recent death of a fellow pipe collector, he insists cancer is relegated to cigarette smoking. I am hoping you can connect me with some solid facts/ stats on cancer related to pipe smoking. He is now 50 years old, but he has been smoking for at
Smoking after Lung Cancer Diagnosis Question Does stopping smoking and/or drinking significantly improve lung cancer outcome? If a patient stops smoking after diagnosis, does his/her prognosis improve? Does smoking or drinking interfere with any cancer treatments? If a patient is terminal, will he/she then be permitted to smoke? At what point is the lung cancer patient allowed to
Support for Lung Cancer Patient Question How can I deal with a family member who has been told she has lung cancer? How can I help her and myself? Answer Barbara Campling, MD, Medical Oncologist, responds: One way to help would be to find out more about the type and stage of lung cancer that your family member has. There are a variety of types of lung cancer, but the most common
Smoking with Recurrent Lung Cancer Question My father (53 years old) was diagnosed with non-small cell lung cancer nearly a year ago. He responded to first-line treatment of chemotherapy and radiation therapy but his tumor recently began growing again. He is now receiving docetaxel. My father's oncologist said that smoking did not cause his cancer, even though he smoked for 43
Marijuana and cancer Question I am wondering if any cases of lung cancer (or other cancer) can result from smoking marijuana? Answer Barbara Campling, MD, Medical Oncologist, responds: Yes, there is evidence that marijuana smoking can cause cancer, in particular lung cancer. Smoke from burning marijuana contains many of the same carcinogens found in tobacco smoke, some
Inoperable Lung Cancer Question My brother-in-law was recently diagnosed with lung cancer. It has already spread to his brain, and they have told him it is inoperable. Could you tell me exactly what this means? If there is no hope of curing it, why does he have to go through chemotherapy and radiation therapy? Answer Barbara Campling, MD, Medical Oncologist, responds:
Lung Cancer Treatment Question My friend quit smoking and then later was diagnosed with lung cancer. She is in her early 40's and had 1/3 of her lung removed, but now the cancer has spread into several small tumors in different places. Due to her mother and younger sister previously dying of breast cancer and having side effects from their cancer therapy, she has
"Localized" Lung Cancer Question My father-in-law has small cell lung cancer. When I asked the oncologist what stage it was, he told me it is localized. I am not sure what that means. Could you explain what a localized cancer is and what stage it is? Answer Anil Vachani, MD, Pulmonologist at Penn Medicine, responds: Small cell lung cancer is staged differently than most
Marijuana Smoke and Cancer Risk Question Does smoking marijuana cause cancer? Answer Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds: This is an interesting question. There are a few things we know about marijuana smoke: It contains several of the same substances in cigarettes that cause cancer. Benzopyrene, a cancer-causing agent, is present in higher
Early Stage Lung Cancer Treatment Question I am a 49-yr-old white male in excellent health with a 35 pack-year history of smoking and a family history of lung cancer (father). I noticed blood in my sputum 5 weeks ago (the day I quit smoking). Three days later, I was told a CT scan revealed a mass in my lung. I since had a thoracotomy (of the right upper lobe) performed without
Secondhand Smoke and Lung Cancer Risk and Screening Question I am a 37-year-old female non-smoker. Although I have never smoked, both my father (at age 51) and paternal grandmother (at age 72) died of lung cancer and smoked heavily. I was exposed to years of second-hand smoke, as I lived in the same house as my father for 12 years and he averaged 3-5 packs of cigarettes a day. Am I at high risk for
Smoking and Exposure after a Diagnosis of Lung Cancer Question My father was diagnosed with stage IIIB lung cancer and will be undergoing chemotherapy. He quit smoking about 3 years ago and so did his wife. There are other individuals in the household that smoke and feel it is all right to smoke in a different room or when he is not home. My question is: Is this thinking logical? Will the residue
Stage IV Lung Cancer Prognosis Question I would like to request assistance for my dad and me. He is under treatment for lung cancer, Stage IV, and the doctor said treatment will be chemotherapy delivered on one day, followed by another dose after 21 days. The doctor said there will be another 5 doses to complete therapy, and that my father's life span is not more than 6 months
Fiberglass and Lung Cancer Risk Question I would like to know if there is a link between breathing in fiberglass particles and lung cancer? Also, is glass fiber-reinforced epoxy resin harmful? Where I work, these are used and the dust is freely dispersed into the air, causing some of my fellow workers considerable breathing discomfort. My employer has said it is as safe as adding
Maintenance Chemotherapy for Lung Cancer Question My sister's doctor told her she would be getting "maintenance chemo." Can you explain what that means? I have tried searching the web, but I cannot find anything about it. Answer Tracey Evans, MD, Medical Oncologist at Penn Medicine, responds: Maintenance therapy is therapy given after the initial cycles of chemotherapy to keep the cancer
Flu Shot on Chemotherapy? Question I have lung cancer and am getting chemotherapy. Can/should I get a flu shot? Answer Susie Stonehouse-Lee, MSN, CRNP, Nurse Practitioner at Penn Medicine, responds: Patients receiving chemotherapy should receive a flu shot. Compromise to the immune system, as chemotherapy may due by decreasing your blood counts, puts you in a higher risk
Coping With Co-Pays Question I am concerned about the cost of treatments. I have Medicare, but I am responsible for a 20% co-pay for every chemo infusion, not to mention other pills I take. What can I do? Answer Christina Bach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Thanks for asking such an important question. You are right to be
Support Groups for Lung Cancer Question There are so many support groups for women with breast cancer, but I am a woman with lung cancer. A generic support group just doesn't get it- I feel like they don't understand the way other people make you feel since I was a smoker (many years ago!). Are there groups for lung cancer? Answer Christina Bach, MSW, LCSW, OSW-C, Oncology
Minorities and Lung Cancer Question Is it true that African-Americans are more likely to develop lung cancer than other groups and also more likely to die from it? If so, why? Answer Chanita Highes-Halbert, PhD, Racial Disparities Expert, adds: Studies show that African Americans are more likely than whites to develop lung cancer and to die from this disease. The reasons
Radiation Therapy for Hodgkin's Disease and Breast Cancer Dear OncoLink "Ask the Experts," Your article on the long-term effects of radiation failed to mention the connection between radiation therapy and breast cancer. There have been many articles including the Journal of the National Cancer Institute, Journal of the American Medical Association, New England Journal of Medicine and the
Are swollen lymph nodes an indication of cancer? Dear OncoLink "Ask The Experts," Can you get a pretty good indication of whether a child might have lymphoma or a neuroblastoma from blood work? If a child has symptoms (swollen nodes-several and large, increasing in size). Would the blood work always show irregular if they had a Cancer that involves the Lymph nodes or could they still
Retinoblastoma and Secondary Cancer Dear OncoLink "Ask the Experts," I had bilateral (hereditary) retinoblastoma when I was a child. What is my risk of developing other cancers later in life? Janet L. Kwiatkowski, MD, OncoLink's Pediatric Oncology Section Editor, responds: Dear OncoLink Reader: Thank you for your question. Two forms of
Late Effects of Chemotherapy After Vaginal Cancer Dear OncoLink "Ask the Experts," My daughter had vaginal cancer at the age of 17 months. We have been clean of cancer for ten years but having a shortness of breath that doctors cannot explain. What are the late effects of bleomycin, etoposide and cisplatin? Thank you Anna Meadows, MD, pediatric oncologist at
Undescended Testes and Testicular Cancer Risk Dear OncoLink "Ask The Experts," At 10 months old, my son had undescended testicle surgery. At that time, I was told he will have a higher chance to develop testicular cancer around 10 years of age. He is 8 years old now. How common is this? I have been looking for answers, none to be found. Please guide me, I would sleep a lot better with some
Clodronate to Prevent Bone Metastases in Prostate Cancer Dear OncoLink "Ask the Experts," Are there any studies where clodronate has been used to prevent bone metastases in patients with advanced prostate cancer? In the situation to which I am referring, a radical prostatectomy has been performed, followed by radiation therapy. The use of Lupron and Casodex also has been instituted. Thus, the
Is Prostate Cancer Hereditary? Is prostate cancer hereditary? Thank you. T Li Liu, MD, OncoLink editorial assistant, responds: Dear T: Thank you for your interest and question. Familial patterns ("aggregations") of some cancers are not uncommon. Exposure to the same environmental factors within families and/or inheritance of cancer
Is there a link between hormonal therapy for prostate cancer and bone fractures? My father-in-law was diagnosed with prostate cancer. The doctor recommended hormonal therapy. He is very concerned of potential bone fracture as the side effect of hormonal therapy. Can you help him with this? Thanks. P Li Liu, MD, OncoLink editorial assistant, responds: Dear P: This is an excellent and
Post Radiation Treatment for Prostate Cancer Dear OncoLink "Ask the Experts," I am one of thousands of prostate cancer patients who have undergone treatment. An ultrasound biopsy detected a prostate cancer with involvement in both lobes. After consulting with several MD's, I decided to undergo radiation therapy. It has been 5 years since treatment and my PSA has slowly risen as
Early Detection and Screening for Prostate Cancer Dear OncoLink "Ask the Experts," I lost my husband in February of 1997 to prostate cancer. In April of 1995, he went to his doctor complaining of increased frequency of urination. The doctor did a PSA test and a digital rectal examination. The PSA test was 3.3. The doctor told my husband that he was fine. In December of 1997, he went for
Post-Radiation Therapy Treatment Options for Patients with Prostate Cancer Dear OncoLink "Ask the Experts," I have a question concerning radiation (external beam or seeds). If a man gets radiation for prostate cancer, can he have surgery after if the cancer comes back? If not, why? Li Liu, MD, Editorial Assistant for OncoLink, responds: Thank you for your interest and question. A
ProstRcisionTreatment for Prostate Cancer I've heard a new treatment called prostRcision for prostate cancer that is being advertised by some radiation oncologists. Can you give me some inside view on this? Any information would be helpful. Thanks! Li Liu, MD, OncoLink Editorial Assistant, responds: The term "prostRcision" was first coined by Frank
Prostate Cancer Treated With External Beam Radiotherapy Dear OncoLink "Ask the Experts," I am requesting information on prostate cancer. I had surgery in March of 1993. The doctor was unable to get to the gland to remove it. He took out the lymph nodes and they were negative. I had 39 radiation treatments. My follow-up results were good. I then progressed from 3 month exam intervals to 6
Treatment of Young Prostate Cancer Patients Dear OncoLink "Ask the Experts," Although there are comments and cases concerning younger (under 60) prostate cancer patients, there needs to be greater focus on these patients. As you well know, with PSA and free PSA tests, more and more younger patients are being diagnosed. The decisions that a younger man must face are a shift from
Implant Radiation for Prostate Cancer Dear OncoLink "Ask the Experts," What is Implant radiation (Brachytherapy) for prostate cancer? Maggie Hampshire, RN, BSN, OCN with Ken Blank, MD With Special Commentary from Dr. Richard Whittington, MD, Associate Professor of Radiation Oncology Respond: Implant radiation (Brachytherapy) for prostate cancer is
Support Groups and Prostate Cancer Dear OncoLink "Ask the Experts," My dad has prostate cancer. It is contained and his PSA is 15.9 - he has been offered two choices - radiation or surgery. We think we will go for surgery but would like to hear from other people who have had prostate surgery. We have a few questions: How did you feel after surgery, mentally &
Prostate Cancer Screening Programs Dear OncoLink "Ask the Experts," Hi Dr. Wein, please let me know what is your perception of an ideal prostate-screening program, what barriers are usually encountered while providing cancer screening? Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine
Hematuria after Radiation for Prostate Cancer Dear OncoLink "Ask the Experts," Where would we find information about urinary bleeding following radiation? therapy for prostate cancer? Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds: This happens for several reasons and it is
Prostate Cancer Screening Recommendations Dear OncoLink "Ask the Experts," Since free PSA tests are usually used in patients with total PSA values >4.0, what is the significance of a total value of <4.0 (2.8 in my case) with a free PSA of 15%? What type of screening would you recommend? Alan J. Wein, MD, Professor and chair of the Division of Urology at
Survival Rates Of Prostate Cancer When Treated With And Without External Beam Radiation And Seeds Dear OncoLink "Ask the Experts," My father was just diagnosed with prostate cancer and the impression is it's still in the early stage but aggressive. Radical prostatectomy is not recommended due to his past medical history. My father is 57 years old and re-occurrence rate is of major concern. His PSA level was 4, but the Gleason
Brachytherapy After External Beam Treatment for Prostate Cancer Dear OncoLink "Ask the Experts," I would like to know whether there are patients in America who have had brachytherapy for prostate cancer after external radiation treatment. What are the statistics on this? My husband would be the first person in Australia to under go this therapy. His PSA has risen sharply in the past 2 years and
Follow up after brachytherapy (interstitial radiation therapy) for prostate cancer Dear OncoLink "Ask The Experts," My father has undergone brachytherapy (interstitial radiation therapy) in combination with Lupron 5 months ago. We can find no information about the proper screening program to monitor for tumor recurrence. Is monitoring of PSA a useful modality? Should CT/MRI be done regularly? Thank you!
Significance of rise in PSA without a prostate cancer diagnosis Dear OncoLink "Ask The Experts," I am 53. My PSA has been in the mid 2's for several years. Last test jumped from a 2.3 to 7.1. Digital Rectal Exam (DRE) is normal. My question is: In prostate cancer, is it typical that a PSA would rise that fast in six months, or is this more likely something else? I will follow through with my doctor,
Prostate cancer and flaxseed Dear OncoLink "Ask The Experts," Is there harm to adding flaxseed, linseed oil or any other phytoestrogen to the diet for the man with prostate cancer in watchful waiting? Katrina Claghorn, MS, RD, registered dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds: Adding flaxseed to
Intensity Modulated Radiation Therapy (IMRT) vs. 3D conformal Radiation for prostate cancer Dear OncoLink "Ask The Experts," I have stage B1 prostate cancer (PSA 7.1, Gleason 6). I am trying to decide whether to undergo IMRT at the considerable inconvenience of traveling to a distant location or to have the standard 3D conformal radiation that is available locally. I would appreciate any information.
Biochemical failure after treatment of prostate cancer Dear OncoLink "Ask The Experts," A close friend of ours has been diagnosed with prostate cancer and had brachytherapy about 6 years ago. His PSA levels have been normal between that time and present, but a recent PSA test showed the level increased to 5.5. Bone scans show that there is some cancer present somewhere but cannot be pinpointed.
Is there a link between vasectomy and the diagnosis of prostate cancer? Dear OncoLink "Ask The Experts," Does the medical community feel that there is a link between vasectomy patients and prostate cancer? We are trying to make an educated decision about sterilization. Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of
Safety issues to your spouse after brachytherapy for prostate cancer Dear OncoLink "Ask The Experts," I've had brachytherapy 2 weeks ago with I 125. My wife is a non-Hodgkin's lymphoma survivor for 10 yrs. She is extremely concerned that I will trigger her lymphoma. My reassurances that the seeds only radiate a few millimeters out and will not be of any consequence to her fall on deaf ears. The risks have been
Temporary seed implants versus permanent seed implants for prostate cancer Dear OncoLink "Ask The Experts," Do you know of any stats that show the relative effectiveness of high dose radiation (HDR) temporary seed implants versus the more traditional permanent seed implants? Is there any advantage that you know of in the HDR method? Richard Whittington, MD, Associate Professor of Radiation Oncology at the University
Prognosis at a young age for prostate cancer Dear OncoLink "Ask The Experts," My son is 41 yrs. old and has been diagnosed with prostate cancer. Does his finding prostate cancer so young necessarily mean it's a bad sign for his future? Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:The answer is no.
Proton therapy vs. external beam radiation for prostate cancer Dear OncoLink "Ask The Experts," I am presently on hormonal therapy to shrink an enlarged prostate gland. Treatment plan is to follow with external beam radiation. I also have approval for treatment at the Loma Linda proton treatment center. Does data show conclusively that the proton treatment is a superior method to the external beam? Any
Treatment for Stage IV Prostate cancer Dear OncoLink "Ask The Experts," I have been diagnosed with stage 4 prostate cancer. Is it better to start total androgen ablation right away or first just leuitinizing hormone? David J Vaughn, MD, Medical Director of the Abramson Family Cancer Research Institute and Associate Professor of Medicine, Hematology-Oncology at the Abramson Cancer
Retreatment for recurrent prostate cancer Dear OncoLink "Ask The Experts," A 62 year old friend of mine had a prostatectomy (age 57) for a grade 6 Gleason tumor 5 years ago. His PSA has increased from undetectable (<0.1ug/ml) to 0.2ug in the past year. His surgical specimen 5 years ago showed what appeared to be a positive surgical margin however he decided not to proceed with adjuvant
Surgery for Cancer and Prostatitis? Dear OncoLink "Ask The Experts," I am a 69 year-old male in reasonably good health. I have just been diagnosed with prostate cancer, stage 1c. I have been looking at either radiation treatment or surgery. My urologist is suggesting surgery only because I also have prostatitis. I don't see how surgery will help me with my prostatitis. Can you assist
Timing for Hormone Therapy for Prostate Cancer Dear OncoLink "Ask The Experts," My father is currently being treated for advanced prostate cancer with a 10.8 mg depot of zoladex every 12 weeks. Is it essential that the renewal be given precisely within the 12 weeks indicated, or is it sufficient that the treatment be given roughly every three months? Michael Vozniak, PharmD, BCOP,
Reducing Prostate Cancer Risk Dear OncoLink "Ask The Experts," My father was diagnosed with prostate cancer at the age of 67. I am currently 40 years old. What types of things should I be doing to reduce my risk of prostate cancer?Neha Vapiwala , MD, Senior Editor of OncoLink and Chief Resident in the Department of Radiation Oncology at the Hospital of the University of
Chemotherapy for Prostate Cancer Dear OncoLink "Ask The Experts," I have prostate cancer that has progressed on hormone therapy. My doctor wishes to start chemotherapy. I know many men with prostate cancer and I have never heard of them receiving chemotherapy. What can you tell me about chemotherapy for prostate cancer?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator,
Satraplatin for Prostate Cancer Dear OncoLink "Ask The Experts," My husband has enrolled in a clinical trial for a drug called satraplatin. What can you tell me about it? Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Satraplatin is a member of the platinum family of chemotherapy drugs, which includes cisplatin and carboplatin. Satraplatin is given in a pill
How can I find out about clinical trials for my prostate cancer that is not responding to hormones anymore? Dear OncoLink "Ask The Experts," How can I find out about clinical trials for my prostate cancer that is not responding to hormones anymore?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:There are many clinical trials being conducted for patients with hormone refractory prostate cancer. OncoLink has a service, powered by
Who should I see about chemotherapy for my prostate cancer? Dear OncoLink "Ask The Experts," Who should I see about chemotherapy for my prostate cancer?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Chemotherapy is managed by a doctor called a medical oncologist. These doctors are trained in the administration of chemotherapy and managing of related side effects. You can find a medical
How is Mitoxantrone used for prostate cancer treatment? Dear OncoLink "Ask The Experts," How is Mitoxantrone used for prostate cancer treatment?Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:Mitoxantrone is a type of chemotherapy that is given through an IV (intravenous), typically every three weeks, when used for prostate cancer treatment. In clinical trials of men with hormone
Testosterone after Prostate Cancer Dear OncoLink "Ask The Experts," I was diagnosed with prostate cancer about 18 months ago and had radiation treatment. My PSA has dropped, and all seems to be going well. But my libido, erectile function, and general energy level are not what I'd like them to be. I'm 74 and in good health. My testosterone level is at the low end of the normal
Prostate Biopsy Spreads Cancer Cells? Dear OncoLink "Ask The Experts," A February 20, 2008 breaking news release entitled "Prostate Biopsy Spreads Prostate Cancer Cells" appeared in the Prostate/Prostate Cancer section on Medical News Today's web site. Is this news likely to revolutionize the way we diagnose and test for prostate cancer? Richard Whittington, MD, Associate
Proton Therapy for Prostate Cancer Dear OncoLink "Ask The Experts," I am seriously considering Proton Therapy for my recently diagnosed Prostate cancer. I am 55 years old, my Gleason Score is 6 (3+3), and my PSA is 4.5. The information I have been reading everywhere is very vague regarding side effects. Terms like "minimal" side effects or "largely spares surrounding
Rectal Bleeding After Radiation for Prostate Cancer Dear OncoLink "Ask The Experts," I had seed implants for prostate cancer 2 years ago. I have had rectal bleeding ever since. Sometimes it is with a bowel movement and sometimes I'll feel it running down my legs. It is bright red and it's enough to come through my pants. I had a colonoscopy and it did not reveal the cause. Have you had any patients
Cancer Free if PSA is 0? Dear OncoLink "Ask The Experts," I had a radical prostatectomy approximately 12 years ago. My PSA level increased from 5.5 to 7.5 ng/mL over 3 months. My doctor stated that this means that I have metastatic cancer and he started hormone therapy with Lupron. It has been 3 mo. since I had the shot and a repeat PSA test was undetectable. Does this
Is Heart Cancer Possible? Dear OncoLink "Ask the Experts," Could you please answer me why the heart is the only organ in the human body which is not attacked by cancer. What does the heart have to protect itself that the other organs don't? V Li Liu, MD, OncoLink Editorial Assistant, responds: Dear V: Thank you for your
Skin Cancer Dear OncoLink "Ask the Experts," I have a question about sun block products. What active ingredients should be present in a product to be effective and in what percentage. Also are their any products that you can suggest. Brand names can be helpful. Maggie Hampshire RN, BSN, OCN, Managing Editor of OncoLink replies:
Tanning Beds and Skin Cancer Dear OncoLink "Ask the Experts," Do tanning beds cause skin cancer? Thank you. Li Liu, MD, Editorial Assistant for OncoLink, responds: Dear F: Thank you for your interest and question. Tanning beds use both ultraviolet A and B. Ultraviolet B, the middle wavelength, starts the tanning process,
Kidney Transplant and Skin Cancers Dear OncoLink "Ask The Experts," I had a kidney transplant 26 years ago, and in the past 15 years, I have had many warts that have been biopsied and found to have basal or squamous cell cancer. These have been excised, but they heal very slowly. I wonder if there is anything I can do to prevent them? I am on immunosuppressive drugs (Imuran 100
Cancer Risk With Actinic Keratosis Question I have been told I have some spots on my skin called"actinic keratosis." Does this mean I will get skin cancer? Answer Rachel Woods, RN, Nurse for the Surgical Dermatology Program at Penn Medicine responds: If you have an AK, you are at risk for developing squamous cell cancer. AKs are precancerous and can be treated easily but it is a
Leptomeningeal Cancer from Melanoma Dear OncoLink "Ask The Experts," What are the treatment options for someone diagnosed with leptomeningeal cancer from melanoma? Suzanne M. McGettigan, MSN, CRNP, AOCN, Board Certified Adult Nurse Practitioner and a Certified Oncology Advanced Practice Nurse, responds:I did a search and found a single case study of a primary leptomeningeal melanoma
Link between Melanoma & Breast Cancer Dear OncoLink "Ask The Experts," I was diagnosed with malignant melanoma on my left wrist in June of 2005. Monday I had an OB-GYN appointment and a "lump" was found in my left breast. There is no history of breast cancer or melanoma in my family; however, there are numerous other types of cancer: colon, prostate and lung. Could the melanoma have
Alpha-fetoprotein Levels After Treatment for Testicular Cancer Dear OncoLink "Ask the Experts," Our 24 year old son has stage I non-seminomatous testicular cancer. Part of the follow-up is a check on the alpha-fetoprotein (AFP) in the blood every two weeks. The AFP is considered a marker for this type of cancer. We have not been able to pinpoint the acceptable level of AFP. To add to the confusion,
Signs and Symptoms of Testicular Cancer Dear OncoLink "Ask the Experts," Will you please tell me what are the signs and symptoms of testicular cancer? I know a lump might be one sign, but what else could there be? Kenneth Blank, MD, Editorial Assistant for Oncolink, respond: Dear OncoLink Reader: Thank you for your question. You are correct. A
BCG Treatment for Bladder Cancer and Hepatitis Dear OncoLink "Ask the Experts," I was diagnosed with bladder cancer in 1990, and had two transuretheral removals of tumors. After the second recurrence I received BCG treatment and had good results. This year I was diagnosed with Hepatitis C. A friend of mine, who is receiving the BCG treatment directed me to OncoLink Web site where
Bladder Cancer Dear OncoLink "Ask the Experts," I would like to find out any information you have on radical cystectomies for bladder cancer. I, specifically, would like to know what the red flags are indicating bladder cancer. How soon should they be investigated (i.e. does hematuria more than once usually tell a doctor to send you to a urologist
Inherited Tendencies of Urachal Cancer Dear OncoLink "Ask the Experts," My daughter died in 1994 of urachal cancer. Is this cancer inherited? Is there a cure? AB Ken Blank, MD and John Han-Chih Chang, MD, OncoLink Editorial Assistants, respond: Dear OncoLink reader: Thank you for your question. Urachal carcinoma is an extremely rare
BCG Treatment for Bladder Cancer Dear OncoLink "Ask the Experts," I am presently being treated with a drug named BCG for bladder cancer. The drug is placed into the bladder once a week for six weeks. The instructions make the material seem contaminating. Why does this material need to be treated so carefully? Thank you, TF John Han-Chih
Treatment options for stage III bladder cancer Dear OncoLink "Ask The Experts," My brother was diagnosed with stage three bladder cancer. He began a chemotherapy program scheduled to last three months. Within the last week he had a CT scan to determine if the cancer had spread and a visual scope of his bladder to determine the effect of the chemo. The scan showed no spreading and
Bladder Cancer: Side Effects of Radiation Dear OncoLink "Ask The Experts," My father is 76 yrs old and has bladder cancer. The family is concerned about the side effects of radiation therapy. I know the radiation may give him diarrhea & tiredness, but is urethral stricture & bowel adhesions a common side effect? Are there any other side effects we should be aware of while trying to
Companion Animals and Cancer Dear OncoLink "Ask the Experts," Do you have any statistics as to how many companion animals are diagnosed with cancer in their life time? What treatments are used? And, what is average cost of treatment? Thank you. Lili Duda, VMD, Editor of the OncoLink Veterinary Oncology Section Menu, responds:
Traveling with a Companion Animal with Cancer Dear OncoLink "Ask the Experts," I have a question. My parents have a cat that has cancer of the liver. She is currently getting chemotherapy once every 3 weeks. They are going to be traveling around the country in an R.V. soon with the cat. They are trying to figure out how to make sure the cat receives her chemo treatments as needed.
Thyroid Cancer in Dogs Dear OncoLink "Ask the Experts," Would you please direct me to information regarding thyroid cancer in dogs? I appreciate your time and effort. Thank you very much. J Lili Duda, VMD, Editor of the OncoLink Veterinary Oncology Section, responds: Thank you for your interest and your question.
Pancreatic Cancer in Dogs Dear OncoLink "Ask the Experts," I have a 12-year-old female doberman. She has been diagnosed with cancer of the pancreas with lesions in the liver also. She also has a low level heart condition. These problems have been diagnosed through ultrasound only. A biopsy is not recommended. They have given her 1 to 3 months. Is this an
Epilepsy and Cancer in Dogs Dear OncoLink "Ask the Experts," My beagle, Sassy, was diagnosed at the age of two with epilepsy. She very recently had an episode where she collapsed, lost the use of her back legs, the reflex in her left eye and several other distressing symptoms. She was taken to an animal emergency room, and then examined by a veterinarian
Bladder Cancer in Dogs Dear OncoLink "Ask the Experts," Our 10 year old Sheltie was just diagnosed with bladder cancer. The tumor appears to be about 1 1/2" and is located near the opening of the urethra. The bladder appears to be abnormally shaped. Could you possibly outline the likely treatment options? Lili Duda, VMD, Editor of the
Anal Sac Cancer in Dogs Dear OncoLink "Ask the Experts," My dog has been diagnosed with anal sac cancer. What should I expect from his treatment? Thank you, D Lili Duda, VMD, Editor of the OncoLink Veterinary Oncology Section, responds: Dear D., Anal sac adenocarcinomas are tumors arising from the apocrine glands
Leg Amputation Due to Cancer Dear OncoLink "Ask the Experts," I would like to find out info on helping my dog adapt to a front leg amputation due to cancer. Are there resources where I can get info or talk with people who may have had the experience? Is there rehab training for this? Lili Duda, VMD, Editor of the OncoLink Veterinary Oncology
Use of Prednisone in Cats' Cancer Treatment Dear OncoLink "Ask the Experts," My cat was diagnosed with mammary cancer 3 years ago and had surgery but no other treatment was suggested. Tumors recurred with a second surgery recently. She is now on a chemotherapy schedule but prognosis is poor. One of the drugs she is taking is prednisone (daily) and I would like to know what
Treatment and Prevention of Skin Cancer in White Cats I am a cat lover and owner of two geriatric cats. I have a question about how to prevent and treat skin cancer for a white kitty. Can you help us to help our feline friends? Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds: Skin cancer in white cats is due to excessive sun exposure
Cancer in pot-bellied pigs Dear OncoLink "Ask The Experts," Can you please tell me what different types of cancer a pot-bellied pig can get? Besides surgery, what are some of the treatments? Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds: Cancer in the pig is very rare. Melanoma has been reported to be
Heredity of animal cancer Dear OncoLink "Ask The Experts," I lost my dog to cancer. I would like to get another dog from the same breeder. I am unsure how much of a role genetics plays into the likelihood that a dog will develop cancer. I know there is no guarantee of a completely healthy dog (regardless of the breed) but I also do not want to set myself up for another loss
Tonsillar Squamous Cell Cancer in Dogs Dear OncoLink "Ask The Experts," I have 8-yr-old English Springer spaniel that was just diagnosed with anaplastic tonsillar squamous cell carcinoma with metastasis to a submandibular lymph node. Can you send me info regarding this disease, and if there is any form of radiation or other therapy? Lili Duda, VMD, Section Editor of the OncoLink
Cancer in a Horse Dear OncoLink "Ask The Experts," My 4 year-old mare has just had a growth removed from her throatlatch. The pathology report showed the growth as "spindle cell sarcoma". The growth was apparently benign. My local vet has not dealt with this before. Any suggestions? Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu,
Kidney Cancer in Cats Dear OncoLink "Ask The Experts," My 12.5-year-old cat was just diagnosed with cancer in his right kidney. Apparently there is a tumor, and the kidney biopsy showed that the kidney tissue was dying. What is the best next step to take? We were told it was carcinoma. Does Prednisone help at all? I have read a lot about that medication. Lili Duda, VMD,
Piroxicam and Bladder Cancer in Canines Dear OncoLink "Ask The Experts," Is there anything new related to the diagnosis and treatment for canine bladder cancer (transitional cell cancer, or TCC)? Our vet recommends surgery, then Piroxicam. After reading what I can find on the Web, I am reluctant to go the surgery route and have started her on Piroxicam instead. I read about a urine test
Diarrhea in a Dog on Cancer Therapy Dear OncoLink "Ask The Experts," My Labrador has been diagnosed with lymphosarcoma in the lower colon area and is undergoing chemotherapy treatments. However, she is experiencing chronic diarrhea. We hope the cause is the chemotherapy, however Imodium has not worked. I have read that Lomotil has been successful with dogs in this situation. Our
Environmental Link to Canine Cancers Dear OncoLink "Ask The Experts," My 52-year-old husband was diagnosed with multiple myeloma last year. Now, our 14-year-old Labrador retriever likely has some bone marrow cancer. Coincidence? Perhaps, but I want to be as sure as possible. Before we decide against a bone marrow biopsy (BMBx) for the dog, I want to make sure there is no connection
Kidney Cancer in a Dog Dear OncoLink "Ask The Experts," My four-year-old black lab had her left kidney removed due to an abnormality on ultrasound, and at the time of surgery, a 3 cm tumor was found with pathology revealing a renal papillary adenocarcinoma. Radiographs were taken prior to surgery showing no apparent spread of the cancer, and she has showed 100%
Lung Cancer in a Dog Dear OncoLink "Ask The Experts," My 3-year-old Australian healer has been diagnosed with squamous cell carcinoma in the lung. What does this mean exactly, and what are the survival rates? Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds:Primary lung tumors in dogs, or tumors that arise directly from the lung
Vaccinations in Dogs with Cancer Dear OncoLink "Ask The Experts," My 8-year-old cocker spaniel was diagnosed with Epitheliotropic Cutaneous T-cell lymphoma in February of this year, following a biopsy of a small lump on his lip. We declined chemotherapy after the vet advised that few dogs survived and that he may only live for around 3 months. Eight months later, he is healthy
Canine Thyroid Cancer Dear OncoLink "Ask The Experts," I have an 11-year-old neutered male Labrador retriever. He has a markedly elevated FT4 and very low TSH picked up on routine lab exam. His only noticeable symptom of hyperthyroidism is a 7-pound weight loss in a year. What is the efficacy of therapy for thyroid cancer? Is I-131 the only systemic therapy for canine
NSAIDS for Cancer Therapy Dear OncoLink "Ask The Experts," My wheaten terrier (11 yrs old) was diagnosed with TCC yesterday. She is prescribed Deramaxx. Is there any better treatment? Is this the same as Piroxicam? Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds:Piroxicam, an NSAID, is a non-selective Cox-1 and Cox-2 inhibitor and has
Canine Parotid Salivary Gland Cancer Dear OncoLink "Ask The Experts," I have been told my dog has parotid salivary gland cancer. He is a mini American Eskimo. His chest x-ray was clean for metastasis and his blood work was excellent. I have been recommended to get the gland removed and do radiation. I am not going to do radiation and am nervous about the surgery. I would do the
Immunizations and Boarding for Pets with Cancer Dear OncoLink "Ask The Experts," Can a pet receiving chemotherapy for lymphosarcoma receive regular immunizations? Can they be boarded?Lili Duda, VMD, Section Editor of the OncoLink Veterinary Oncology Menu, responds:In general, cats and dogs receiving chemotherapy for lymphoma or any other cancers should have their routine vaccinations deferred
Obtaining Financial Assistance for Cancer Therapy Dear OncoLink "Ask the Experts," A doctor has asked, on behalf of a patient who cannot afford treatment for diagnosed cancer, where to apply to find financial assistance. If the patient is being evaluated by a physician who is affiliated with a hospital-based practice, they may have access to social workers who could
Financial Issues Pertaining to Chemotherapy and Testicular Cancer Dear OncoLink "Ask the Experts," I am currently entering chemotherapy for early Stage III testicular cancer. There will be some days where I will have to take a private service to and from therapy sessions. I would like to know if there is any reimbursement programs or services available for transportation? My insurance carrier
What is the cost of cancer therapy in the US? Dear OncoLink "Ask the Experts," It is difficult to provide cost estimates for the treatment of cancer without having a more definitive idea of where and how a patient will be treated. The charge structure for medical services varies fairly significantly across the country. Even on a regional basis, you will find sizeable
PET for breast cancers and melanoma Dear OncoLink "Ask The Experts," Can you explain why PET is used in breast cancer and melanoma? Peeyush Bhargava MD, Chief Fellow in the Department of Nuclear Medicine at the University of Pennsylvania, responds:PET scans are very useful in both patients with breast cancers and patients with melanoma. In patients with breast cancers,
Can cancer patients be evaluated annually with PET scanning? Dear OncoLink "Ask The Experts," Why can't cancer patients be evaluated annually with PET scanning? If it is simply a matter of cost, can't a patient pay for one his/herself? It would be worth the cost for the peace of mind gained. Peeyush Bhargava, MD, Chief Fellow in the Department of Nuclear Medicine at the University of Pennsylvania,
F-18 FDG PET in the Evaluation of Hepatocellular Cancer Dear OncoLink "Ask The Experts," I just found out that I have liver cancer and the oncologist wants to do a PET Scan. She told me the reason for this test, but I'm not sure I understand. Can you explain? Peeyush Bhargava, MD, Chief Fellow in the Department of Nuclear Medicine at the University of Pennsylvania, responds:PET scans using FDG have
PET Scan Sensitivity for Colon Cancer Dear OncoLink "Ask The Experts," My husband was diagnosed with Stage 3 signet ring cell adenocarcinoma in December 2005 and had 5 months of chemotherapy. Within the past month, his CEA level has risen from 1.5 to 3.4. His doctor ordered a PET scan, and the results came back clear. It showed absolutely nothing. Are there any cancers that don't show
Pet Scan and Lung Cancer Size Dear OncoLink "Ask The Experts," How large does a lung nodule have to be for a PET scan to be accurate or the test of choice? Anil Vachani, MD, Attending Physician at the University of Pennsylvania Medical Center, responds:Pet is generally not recommended for lesions under 8mm. See Pulmonary Nodule on CT for more information.
PSA After Proton Therapy for Prostate Cancer Dear OncoLink "Ask The Experts," Prior to commencing 44 treatments of proton radiation therapy at Loma Linda Medical Center in January 2007 for prostate cancer, my PSA was 8.5 and Gleason score was 5. Almost 4 months after my last proton treatment, my PSA is 9.59. I never had symptoms before being diagnosed and still don't have any. When can I
Dating after breast cancer Dear OncoLink "Ask The Experts," I am 28 years old unmarried and going through breast cancer treatment. How will I ever be able to feel "normal" enough to date again? Linda Jacobs, PhD, CRNP, AOCN, BC, Clinical Assistant Professor at the University of Pennsylvania School of Nursing, responds:You have many things to cope with during
Fertility after testicular cancer Dear OncoLink "Ask The Experts," I am a 23-year-old man who has been diagnosed with testicular cancer. I know I should be grateful for an opportunity to survive but I am stuck on wondering whether or not I can have kids after treatment. I need surgery and chemo...can you help? David J Vaughn, MD, Medical Director of the Abramson Family Cancer
Birth defects and fertility after radiation for testicular cancer Dear OncoLink "Ask The Experts," I was diagnosed with stage I seminoma in December 2002 and had my left testicle removed shortly after. In March 2004, I was told I had to get radiation treatments because the cancer reappeared in the para-aortic lymph nodes. I received 27 treatments covering an area beneath the sternum to the pelvis. This
Familial/Genetic Risk for Testicular Cancer? Dear OncoLink "Ask The Experts," My father died of untreated testicular cancer at 63 years old. My brother was diagnosed and treated successfully 5 years ago for testicular cancer. What risk does that pose for myself (37 year-old female), for my younger brother, and for my son and nephews? There is very little info available on the web regarding
PDT (Photodynamic Therapy) for Breast Cancer of the Chest Wall Dear OncoLink "Ask The Experts," Can PDT be used to treat recurrence of breast cancer on the chest wall (the site of the mastectomy)? Do you know of any clinical trials for this use? Robert Lustig MD FACR, Clinical Associate Professor, Department of Radiation Oncology, University of Pennsylvania, responds:PDT has been used to treat the chest wall
Best Practice Guidelines for Advanced Lung Cancer Dear OncoLink "Ask The Experts," I am an APRN working in palliative care - inpatient and some homecare. I also have a special interest in lung cancer. I was wondering if there exist any "best practice guidelines" for advanced lung cancer? I am already aware of the NCCN guidelines. Beth Eaby, MSN, CRNP, OCN, Bboard certified nurse
HNPCC and Endometrial Cancer Dear OncoLink "Ask The Experts," I have recently been diagnosed with HNPCC after a resection of the transverse colon, at age 48. The genetic counselor has pulled quite a bit of information, and I see the recommendation is to possibly have a hysterectomy to avoid uterine cancer. My doctor. feels this would be the only way to avoid having to go
Genetics of Duodenal Cancer Dear OncoLink "Ask The Experts," My 28 year-old triplet daughter found out she has duodenum cancer. She had surgery last month. She has an identical sister who doctors want tested. They did a CT scan and ran blood work and she appears to be cancer free. How often should the unaffected sister be tested? Should the girls’ triplet brother be tested
Family History of Cancer Dear OncoLink "Ask The Experts," I come from a family of five: 3 girls and twin boys. My Mom is currently on Hospice; she started with stomach cancer and to the uterine and spots on the liver. Recently, she had two sisters die in the last 6 months, 15 days apart. One died from breast cancer that spread to her lymph nodes, bone, and brain, and the
Depression and Cancer Dear OncoLink "Ask The Experts," How can I tell if my spouse is "depressed" over his diagnosis or if what he is feeling is "normal"?Tracy Lautenbach, MSW, LCSW, Social Worker in the Radiation Oncology Department at the Hospital of the University of Pennsylvania, responds:Some degree of depression is common in people who are
Proton Therapy For Prostate Cancer Dear OncoLink "Ask The Experts," My friend is getting treated with proton therapy. What is the difference between that and regular radiation? Is it better?Neha Vapiwala , MD, Senior Editor of OncoLink and Chief Resident in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:Proton beams are considered a
Quitting Smoking After Lung Cancer Diagnosis Dear OncoLink "Ask The Experts," What is the point to quitting smoking when I already have lung cancer? My family is on my case to quit, but it seems pointless.Jared Weiss, MD, a Fellow in Hematology & Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:In the case of surgically curative disease, quitting decreases
Dietary Soy After Breast Cancer Dear OncoLink "Ask The Experts," I had an ER+ breast cancer that was treated 2 years ago. Is there any danger to eating soy products or other plant estrogens, like flax?Karen Wagner MS, RD, LDN, Clinical dietitian specialist for the Abramson Cancer Center, responds:The issue of soy and ER+ breast cancer is certainly confusing and we don't have all
Weight Gain After Breast Cancer Dear OncoLink "Ask The Experts," I have been gaining weight on tamoxifen, though my doctor says it is not related, I am sure it is. Do you have any tips for managing my weight for the next 5 years that I am on this drug?Karen Wagner MS, RD, LDN, Clinical dietitian specialist for the Abramson Cancer Center, responds:We are seeing more and more
New Therapy for Lung Cancer in the News Dear OncoLink "Ask The Experts," My wife is a never-smoker with metastatic lung cancer of the adenocarcinoma type. I saw the ABC news show on EML4/ALK. Is this an option for her? , , responds:EML4/ALK is an exciting discovery that I think shows where we are going in lung cancer therapy in that understanding a bit about how the cancer works is
Lung Cancer Spread to the Brain Dear OncoLink "Ask The Experts," My cousin had lung cancer and now has brain cancer- but he says it’s not brain cancer - is he just trying to make me feel better? , , responds:When you as an American travel to Mexico, we don’t start calling you Mexican. You’re still an American, you’ve just relocated yourself to Mexico. The same holds true for
HPV Vaccines Prevent Head & Neck Cancers Dear OncoLink "Ask The Experts," Does the same HPV cause oral & cervical cancer and does the vaccine protect you against oral HPV?Harry Quon, MD, MS (CRM), Assistant Professor of Radiation Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:There are many subtypes of HPV viruses much like the flu virus. The answer
Lifting Weight After Breast Cancer Dear OncoLink "Ask The Experts," There was a recent news story that it is ok for women to exercise and lift weights after breast cancer (which I had been told not to just 2 years ago). What guidelines can we follow? Andrea Richtel-Baranas, MSE, MPT, Lead Therapist at the Abramson Cancer Center of the University of Pennsylvania, responds:
Diet and Preventing Recurrence of Breast Cancer Dear OncoLink "Ask The Experts," I take a great deal of interest in my diet and want to do what I can to prevent relapse of my breast cancer. I was treated 6 years ago. I see that you speak about weight loss, changes in bone density and info on changes that may affect weight. I am interested in understanding these dynamics, so I can make the right
Soy Products After Breast Cancer Dear OncoLink "Ask The Experts," Do you reccomend that women with active breast cancer stay away from soy products (not whole soy foods)?Karen Wagner MS, RD, LDN, Clinical dietitian specialist for the Abramson Cancer Center, responds:The issue of soy during treatment for breast cancer is certainly confusing and we don't have all the information
Exercise Precautions During Cancer Treatment Dear OncoLink "Ask The Experts," I had stage 3 breast cancer, surgery and am now getting chemo. Surgeon has cleared me to resume working out- I always went to the gym at least 4x a week. I am sure I will need to do less and not as intense, but it will help me get a little normalcy back. My question is for precautions. Everyone mentions infection
Insulin Resistance and Breast Cancer Dear OncoLink "Ask The Experts," Is there any evidence that breast cancer is linked to higher insulin levels or insulin resistance? Should survivors of breast cancer eat like diabetics? Karen Wagner MS, RD, LDN, Clinical dietitian specialist for the Abramson Cancer Center, responds:These are great question. There is limited evidence that breast
Colon Cancer Screening Guidelines Dear OncoLink "Ask The Experts," How often do you recommend having a colonoscopy? I previously lived in NJ and the doctor there recommended every two years. I now live in NC and the doctor recommends every 5 years. Jenia Jenab-Wolcott, MD, PhD, Gastroenterologist at the Hospital of the University of Pennsylvania, responds: Recommendations for
Stool Testing for Colon Cancer Screening Dear OncoLink "Ask The Experts," What is the latest on stool testing to screen for colon cancer? Is this ready for prime time yet? Jenia Jenab-Wolcott, MD, PhD, Gastroenterologist at the Hospital of the University of Pennsylvania, responds:Jill Stopfer, MS, CGC, Certified Genetic Counselor, responds:Several tests are available for colorectal
Cancer Caused By Exposures At Work Dear OncoLink "Ask The Experts," I think my cancer was caused by exposure to chemicals at work. What can I do about it?Rodney N. Warner, Staff Attorney at The Legal Clinic for the Disabled, Staff Attorney at The Legal Clinic for the Disabled, responds:If it is a work related exposure, you would fall under your state’s workers’ compensation system.
Do I Have To Tell My Employer I Have Cancer? Dear OncoLink "Ask The Experts," Do I have to tell my employer I have cancer?Rodney N. Warner, Staff Attorney at The Legal Clinic for the Disabled, Staff Attorney at The Legal Clinic for the Disabled, responds:This shouldn’t be a topic of discussion during an interview. The employer can ask if you can perform the essential functions of the job,
Life Insurance After Cancer Can I still get life insurance if I am a cancer survivor?Gloria DiLullo, MSN, CRNP, OncoLink Medical Oncology Educational Content Specialist, responds: There are two great and very detailed articles available on OncoLink.org. One is entitled: "What Cancer Survivors Should Know About Obtaining Life Insurance" and the other, which is
Telling a Prospective Employer About Cancer Dear OncoLink "Ask The Experts," I am graduating college this December and starting to job hunt. I finished breast cancer treatment in January. What are my rights or what do I have to tell prospective employers about my cancer or what can they ask?Rodney N. Warner, JD, Staff Attorney at The Legal Clinic for the Disabled, responds:You don’t have to
Trouble Concentrating & Studying After Cancer Dear OncoLink "Ask The Experts," I just started my freshman year in college. I was treated for leukemia 2 years ago. I am having trouble studying and concentrating. I wonder if this is because of all my treatments. Do you have any suggestions of how I could find out more about this and get help? Rodney N. Warner, JD, Staff Attorney at The Legal
Oral Cancer & HPV Dear OncoLink "Ask The Experts," I was just diagnosed with cancer at the base of my tongue. I am a 37 year old woman. I looked it up on the Internet and it says the risk factors are smoking and drinking. I've never smoked and I only drink occasionally. My doctor says this may be a sexually transmitted disease. Is that true? How could that
Pregnant with Breast Cancer Dear OncoLink "Ask The Experts," I'm not sure whether I have breast cancer or not, and I also just found out I'm pregnant. Is this going to affect my baby in any way if it happens that I have breast cancer? Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: Unfortunately, breast cancer is found in about 1 in every 3000
Soy and Wine After Breast Cancer Dear OncoLink "Ask The Experts," I am so confused when reading about soy and if this should be avoided when being treated for breast cancer. Also- is an occasional glass of wine ok? So many conflicting points of view in my reading! Karen Wagner, MS, RD, LDN, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania,
Lung Cancer in Non-Smokers Dear OncoLink "Ask The Experts," Do we know why people who didn't smoke get lung cancer? Jared Weiss, MD Medical Oncologist & Assistant Professor at University of North Carolina's Lineberger Cancer Center, responds: This is a great question because it gets to the very nature of what cancer is. One of my patients once told me that she
Results from Lung Cancer Screening Trial Dear OncoLink "Ask The Experts," Results from Lung Cancer Screening Trial I saw a news story last week about the lung cancer screening study. Does that mean those of us who are/were heavy smokers should be getting screened now? Anil Vachani, MD, Attending Physician at the University of Pennsylvania Medical Center, responds:The news story last week
Working During Treatment for Lung Cancer Dear OncoLink "Ask The Experts," I was just diagnosed with stage 3 lung cancer. i feel great, but have to start chemo next week. can I keep working? I am the breadwinner for the family and not working will just add to everyone's stress. Rebecca Nellis, Director of Programs at Cancer and Careers (www.cancerandcareers.org), responds: There is
Lung Cancer Support Online Dear OncoLink "Ask The Experts," Where can I find online support for people with lung cancer?Tracy Lautenbach, MSW, LCSW, Social Worker in the Radiation Oncology Department at the Hospital of the University of Pennsylvania, responds:There are a variety of helpful resources for people with lung cancer. The American Cancer Society, American Lung
Lung Cancer Recurrence Dear OncoLink "Ask The Experts," My mom had small cell lung cancer last fall and this late summer she came down with a brain tumor. The doctors tried radiation to the brain. This seemed to lessen the brain tumor but she has been diagnosed with lung cancer again. She is losing weight, no appetite and is coughing alot. Doctors have not given us a
Nutritional Supplements During Cancer Therapy Dear OncoLink "Ask The Experts," Are there any herbals or other nutritional supplements that should be avoided during chemo/radiation? Do any help?Karen Wagner MS, RD, LDN, Clinical dietitian specialist for the Abramson Cancer Center, responds:The area of herbal medicine use during cancer treatment is exciting, but still very understudied.
Reiki in Cancer Care Dear OncoLink "Ask The Experts," What is Reiki and how can it help with cancer treatment? Kimberly Fleisher, RMT, M.S.Ed, Reiki Practitioner and Teacher at The Reiki School, responds: Reiki is a practice that comes from Japan and is primarily facilitated through gentle touch. There is nothing to ingest, no needles, and no physical manipulation,
Imagery and Cancer Dear OncoLink "Ask The Experts," I have heard of meditation and visualization as proven to help fight the cancer cells. Is there any truth to this and can you please explain how the visualization could possibly work? Thank you. Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:There are no scientific studies to support
Is Prostate Cancer More Common in African-American Males? Dear OncoLink "Ask The Experts," Is prostate cancer more prevalent in African American males rather than Caucasian males?Neha Vapiwala , MD, Senior Editor of OncoLink and Chief Resident in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:Looking at data over the 10-year period from 1997-2007,
Colon Cancer Risk With No Family History Dear OncoLink "Ask The Experts," I heard if I do not have anyone in my family who has had colon cancer that I don't need to do the screening. Is that true? Carmen E. Guerra, M.D., M.S., Associate Professor of Medicine at Penn Medicine, responds: Even if you do not have a family history of colon or rectal cancer, you have a lifetime risk of
Familial Colorectal Cancer Dear OncoLink "Ask The Experts," I was diagnosed with colon cancer at age 36, but have no family history of it. I am concerned for my 2 small children. When should my children start screening for colon cancer? Carmen E. Guerra, M.D., M.S., Associate Professor of Medicine at Penn Medicine, responds: Your young age at diagnosis is concerning for
How does having colitis affect colon cancer screening? Dear OncoLink "Ask The Experts," How does having colitis affect colon cancer screening?David Metz, MD, Professor of Gastroenterology at Penn Medicine, responds: People with long-standing colitis (especially ulcerative colitis but also Crohn's disease if it affects the colon) are at higher risk for colorectal cancer that develops after
Men And Colon Cancer Risk Dear OncoLink "Ask The Experts," Are men more likely to have colon cancer than women?David Metz, MD, Professor of Gastroenterology at Penn Medicine, responds: Yes, slightly higher. Please look at this link from the Centers for Disease Control showing the distribution according to gender and ethnicity. Note that the reason there is a
Red Meat & Colon Cancer Risk Dear OncoLink "Ask The Experts," Is it true that eating a lot of red meat causes colon cancer?David Metz, MD, Professor of Gastroenterology at Penn Medicine, responds: Eating a Western diet which includes a high proportion of red meat is probably associated with a higher incidence of colorectal cancer than not. However, it is difficult to
Skin Cancer After Radiation Treatment Dear OncoLink "Ask The Experts," Will radiation treatments for other cancers give me skin cancer?Suzanne McGettigan, MSN, CRNP, Oncology Nurse Practitioner at Penn Medicine, responds: Thanks for your question. Radiation can increase your risk for skin cancers in the area that received radiation. The most common types of skin cancers seen are
Skin Cancer Come Back In The Same Place? Dear OncoLink "Ask The Experts," Does skin cancer come back in the same place?Christopher Miller, MD, Assistant Professor in Dermatology and Director of the Moh's Surgery Program at Penn Medicine, responds: Skin cancer can grow back in the same place, if the original surgery failed to remove it all. The risk that the original surgery will fail to
Can CAM Treat Cancer? Dear OncoLink "Ask The Experts," Are CAM treatments to help with side effects or can they also help treat your cancer?Tony Meadows PhD MT-BC FAMI LPC is Director of Music Therapy at Immaculata University and Music Therapist at the Joan Karnell Cancer Center at Pennsylvania Hospital, responds: There are two different schools of thought. One
How To Relax During Cancer Treatment? Dear OncoLink "Ask The Experts," I am feeling very stressed about my cancer diagnosis. What is the best way to relax? Michael Baime, MD, Director, Penn Program for Mindfulness, responds: It's a really good question, and like most good questions, there isn't a simple answer. Here are some thoughts. First of all, take some time to think about
Can I Eat Red Meat If I Have Colon Cancer? Is it ok to eat red meat if I have colon cancer? Karen Wagner, MS, RD, LDN, Registered Dietician at Penn Medicine, responds: The research into red meat and colon cancer is certainly confusing. The strongest link between colon cancer risk and meat consumption seems to be particularly with processed or cured red meats, such as bacon, sausages,
Massage Therapist Get Special Training To Work With Cancer Patients? Can a massage therapist obtain special training to work with cancer patients? Wayne Mylin, Dipl. ABT (NCCAOM), AOBTA-CP is an Asian Bodywork Therapist specializing in Shiatsu and Acupressure at Pennsylvania Hospital, responds: There are some massage schools that provide 'certificate' programs to work with cancer patients - but not many and
What Are The Best Foods For Cancer Prevention? How do you know what foods are really good in terms of preventing cancer. It seems there is a new food every week that I should run out and fill my fridge with and then the next week the same food is no longer good for me! Debra DeMille, MS, RD, CSO, Dietician at the Joan Karnell Cancer Center at Pennsylvania Hospital, responds: Yes, the
What Type of Exercise During Cancer Therapy? What kind of exercise is good to do while undergoing chemo and/or radiation? Kathryn Schmitz, PhD, Penn Medicine researcher who specializes in the role of physical activity in lymphedema development and prevention, responds: According to the American Cancer Society, the American College of Sports Medicine, and the National Comprehensive
What Type Of Massage Is Better During Cancer Treatment? Are certain types of massage better than others if you are undergoing cancer treatment? Wayne Mylin, Dipl. ABT (NCCAOM), AOBTA-CP is an Asian Bodywork Therapist specializing in Shiatsu and Acupressure at Pennsylvania Hospital, responds: It is less a matter of what type of massage or bodywork, than it is a matter of the experience and
What Herbal Supplements During Cancer Therapy? What herbal supplements are good to take during chemotherapy? Karen Wagner, MS, RD, LDN, Registered Dietician at Penn Medicine, responds: The current research does not support taking any particular herbal supplement during chemotherapy. Some herbal supplements may be helpful for particular issues that can arise with chemotherapy, for
What Types Of Cancer Can Benefit? What types of cancer can be helped by acupuncture and reiki? Is it just solid tumors? Jun Mao, MD, MSCE, Family Medicine and Community Health Physician and Acupuncturist at PENN Medicine, responds: Acupuncture and reiki have potential benefits to help individuals with cancer regardless of cancer types (solid or liquid tumors). The benefits
Getting Back to Work After Cancer I had to stop working when I started cancer treatment. How can I get back into the work force, especially during this bad economic time? Will having a history of cancer really look bad for employment? Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: Getting back to work can be very challenging. You want to be honest, but
Getting Insurance After Cancer I am looking for information about life insurance policies when one has a diagnosis of cancer. Christina Bach, MSW, LCSW, OSW-C, Oncology Social Worker at the Abramson Cancer Center at Penn Presbyterian, responds: Accessing life insurance is not out of the question after a cancer diagnosis, but it will require some extra leg work and effort
Fertility and Cancer I would like to know more about Fertility and cancer. What are my options after treatment? Trish Gambino, RN, MSN, Nurse Navigator, responds: Fertile Hope is a great resource. Fertility should be addressed before you start your cancer treatments. However, sometimes this is not possible, due to the urgency of starting treatments. Many cancer
Accessing the American Cancer Society Resources How can I get access to the many services offered by the American Cancer Society? I hear they offer so many things, but I just don't know where to go on their website or what would be good for me. Christina Bach, MSW, LCSW, OSW-C, Oncology Social Worker at the Abramson Cancer Center at Penn Presbyterian, responds: The American Cancer Society
Carcinoid Patients & Kids at Higher Risk For Cancer? Dear OncoLink "Ask The Experts," Are carcinoid patients at higher risk for other cancers? Are children of carcinoid patients more likely to develop the disease? Weijing Sun, MD, Medical Oncologist at Penn Medicine, responds: Not necessarily. For patients with a genetic mutation (such as MEN I), then yes, they have increased risks as well
If Tumor Marker Is Higher, Does That Mean I Have More Cancer? Question If my tumor marker number is higher than another patient's, does that mean I have more cancer in me? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: Not at all- these results are specific to each patient and should only be compared to your own previous results, taking into consideration your condition,
Can other things besides cancer cause a tumor marker to be high? Question Can other things besides cancer cause a tumor marker to be high? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: Can other things besides cancer cause a tumor marker to be high? Absolutely, quite a few medical conditions can affect markers. Learn more about tumor markers affected by medical conditions:
Do Polyps Mean I Have Colon Cancer? Question I recently had a colonoscopy and my doctor told me I had some polyps, does this mean I have colon cancer again? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: No. This is good news- screening worked to find a polyp before it progressed to cancer. Not all polyps can become cancers. The majority of tumors
Breast Cancer Pathology Question I hear all these terms so often in regards to breast cancer: HR-positive/negative, HER-2/neu receptor, triple negative breast cancer. What do they mean and what is a "good" one to have? Answer Carolyn Vachani, RN, MSN, AOCN, OncoLink Nurse Educator, responds: These are all terms used to describe the activity of the cells and how they
Pathology Report Shows "Slow-Growing" Cancer? Question How can my doctor tell from the pathology report that a cancer is "slow-growing?" Answer James Metz, MD, OncoLink Editor In Chief, responds: It is difficult to tell how quickly a tumor is growing based on a pathology report. Some tumors can look more benign then others. However, the true test is time. If there are serial scans over
Non-Estrogen Options for Vaginal Dryness Question I am interested in something other than low dose estrogen to help with vaginal dryness and spotting. Is there something 'natural' - no estrogen, no phytoestrogen, no xenoestsrogen for ER 100% positive patients? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: There does not appear to be an immediate need for vaginal
Possible Herceptin Reaction Question I am undergoing a year’s worth of Herceptin infusions. My question has to do with a possible side-effect, though none of my doctors seem to be able to help. When I get hot (typically outside in the heat), I get a stinging and prickly feeling that starts at various sites on my body. When I cool off, the sensation goes away. There is no
Ten Year Survival With Aromatase Inhibitor Use Question What are the statistics of 10-year survival of Arimidex based on? Low risk breast cancer patients having lumpectomies? Single mastectomies? Bilateral mastectomies? Locations of tumors? etc. What were the circumstances in the studies and are they all lumped together when arriving at the statistics of improving odds from 85% to 91%? Answer
What is Standard Course of Herceptin Question Please comment on the Finnish protocol of giving 9 weekly administrations of Herceptin versus the 18 - three-weekly administrations that are currently done in the US. Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: The Finnish protocol treated a very small number of women, I believe fewer than 200. All of the other studies
Non-Hormonal Treatments for Hot Flashes Question Can you recommend non-hormonal treatments for hot flashes/symptoms of menopause? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: The non-hormonal treatments, which have been shown conclusively to help with hot flashes, include low doses of antidepressants (venlafaxine is the one we prescribe the most) or gabapentin. They
Tamoxifen & Radiation at The Same Time? Question I will be getting radiation and also tamoxifen treatment following a lumpectomy T2N0. Is there a downside to concurrent treatment? Answer Kevin Fox, MD, Medical Oncologist at Penn , responds: There have been several studies that have looked at concurrent versus sequential radiation and tamoxifen in early stage breast cancer. There
Follow Up After Bilateral Mastectomy Question What is the current advice on post bilateral mastectomy follow up, short term and long term (mammograms, manual palpation, mri's etc.? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: After a woman has undergone a bilateral mastectomy, the usual follow up is an examination by a heath professional twice a year and
Lumpectomy Versus Mastectomy Question I have been given the choice of lumpectomy and radiation vs. Mastectomy. Can you please give some advice to help me make my decision? Is one treatment better than the other? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: Lumpectomy and radiation have been proven in large, well done clinical trials to result in equal
Partial Breast Irradiation Versus Traditional Radiation Question Why do I have to come for radiation every day for weeks? I have heard about some radiation for breast cancer that is done in only 5 days- what is that and is it just as good? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: The purpose of delivering radiation therapy in a relatively small dose once a day for about 6
Using Lotions During Radiation Question Is it ok to put lotion on the area that is getting radiation to help with the dryness and burning? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: During radiation therapy to the breast, we recommend that you use a mild, unscented soap for washing each day. A gentle moisturizer can be used daily as long as not on the
How Long is Radiation Treatment? Question How long does it take to get a radiation treatment? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: A daily radiation treatment will usually take about 5-10 minutes. There is more time needed to set up a patient into the treatment position, check and double check the patient alignment, take verification films on
Stiffness in Area of Radiation Treatment Question I feel stiffness in the area where I had radiation. What can I do about this? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: Stiffness in the area of radiation is relatively common, depending on the site treated, the technique and equipment used, and the dose used. Most women with breast irradiation can have
Treating Blisters From Radiation Question What should I do for the blisters that I am getting from radiation treatment? Answer Gary Freedman, MD, Radiation Oncologist at Penn , responds: Radiation dermatitis can be treated with many approaches depending on the severity. Early mild redness can be treated with gentle lotions or creams. Areas of peeling or blistering can be
TRAM Flap and Future Pregnancy Question I am 31 years old and just diagnosed with an early stage breast cancer, but due to family history, my doctor is recommending a double mastectomy. If I have the TRAM flap surgery, will I still be able to have a successful pregnancy in the future? Answer Brian Czerniecki, MD, Breast , responds: In general with free flap reconstruction
When Must I Decide on Reconstruction? Question How long can I wait to make a decision regarding reconstruction after a mastectomy? Must I decide before I have my surgery? Answer Brian Czerniecki, MD, Breast , responds: You can do reconstruction at any point after treatment finished or can have immediate reconstruction at the time of mastectomy. You get best results with immediate
Chemotherapy Before or After Surgery Question Why did my friend get chemo before her surgery and I am supposed to get it afterwards? Answer Brian Czerniecki, MD, Breast , responds: We give chemotherapy prior to surgery to attempt to improve breast conservation surgery. You may or may not need chemotherapy after breast cancer depending on tumor size node status and receptor type
Nottingham Score and Recurrence Question My breast cancer came back just few months after lumpectomy. My pathology report says nottingham grade 3 of 3. What does this mean? Answer Brian Czerniecki, MD, Breast , responds: This means it is high grade. The significance of recurrence post lumpectomy and XRT depends on the type of radiation you received your age and other
When to Get a Wig? Question I was just diagnosed with breast cancer and told I will lose my hair from treatment. When is the best time to find a wig? How do I know where to go? Are there any resources to help pay for one? Answer Jodi Sandos, MSW, LSW, Oncology Social Worker at Penn Medicine, responds: The best time to get a wig is before your start your
Coping With Chronic Illness Question My Doctor mentioned that I should view my cancer (breast) as more of a chronic illness because there is no cure, however there are treatments and medicines that can help. What tips do you have for living with this uncertainty? Answer Jodi Sandos, MSW, LSW, Oncology Social Worker at Penn Medicine, responds: Cancer can become a chronic
Assistance With Medication Co-Pays Question I am self-employed and have no prescription coverage. I have not been able to work much since my diagnosis of cancer therefore my income has really been greatly reduced. One of my prescribed medication costs $30 per pill. Is there any help to receive medications at a reduced cost or at no cost? Answer Jodi Sandos, MSW, LSW, Oncology
Accuracy of FNA Question Is a fine needle aspiration (FNA) sufficient to diagnose thyroid cancer or do should I have a biopsy of the nodule? Answer Kolin Hoff, MD, Endocrinologist at Penn Medicine responds, In most cases FNA can diagnose malignancy or at least a suspicious nodule. In some cases only surgery can definitively diagnose a cancer. A biopsy that is
Partial Versus Total Thyroidectomy Question What is the difference between a total thyroidectomy and a partial thyroidectomy? What are the side effects of each? Where will the incision be made, how large will my scar be? Do I need a plastic surgeon? How long will I be in the hospital after surgery and when can I go back to work? Answer Rachel Kelz, MD, MSCE, at Penn Medicine
Thyroid Nodule Question If I have a thyroid nodule, does that mean I will get thyroid cancer? If I have the nodule removed, will it come back or will cancer develop? Answer Rachel Kelz, MD, MSCE, at Penn Medicine responds: Ninety percent of thyroid nodules are benign. You should be seeing a specialist to get information regarding your specific nodule(s).
Support for Newly Diagnosed Question My sister was recently diagnosed with metastatic thyroid cancer. How can I help her? What can I do/say? Answer Michelle LeBeau, Thyroid Cancer Survivor and Founder of REACT Thyroid Foundation responds: As a metastatic thyroid cancer patient myself, I have relied heavily on the support from my family and my sister. Her just knowing that
Enrollment in a Clinical Trial? Question My husband was recently diagnosed with lung cancer and is considering other treatment options or even enrolling in a randomized trial. I would be worried that if he does enroll in a trial, he would receive a placebo and not be treated properly. I am desperately seeking help – I want him to get the best treatment in the country.
Chemotherapy and Radiotherapy vs. Surgery Question Yesterday, my father was diagnosed with adenocarcinoma type of non-small cell lung cancer. A tumor the size of a lemon was found on his right lung and found to have spread to his lymph nodes. He will be receiving more tests next week to determine if has spread to his brain. The doctor recommends starting chemotherapy twice a week, every
Carboplatin/Taxol Weekly vs. Every 3 Weeks Question I was recently diagnosed with non-resectable Stage IIIB non-small lung cancer. My treatment to date has been 33 radiation therapy treatments concurrently with 7 low-dose carboplatin and taxol chemotherapy treatments given weekly with radiation therapy. There is a question as to the next course of treatment: low-dose chemotherapy (3 weeks
Paraneoplastic Limbic Encephalitis Question My mother was recently diagnosed with SCLC, limited stage. She started chemotherapy and was making good progress, but unfortunately had a complication called paraneoplastic limbic encephalitis. The doctors have said that it has reached a point where we should let nature take its course. Do you have any experience of PLE? We are trying to
How to Respond to the Smoking Question? QuestionThere are so many support groups for women with breast cancer, but I am a woman with lung cancer. A generic support group just doesn't get it – I feel like they don't understand the way other people make you feel since I was a smoker (many years ago!). Are there groups for lung cancer? AnswerChristina Bach, MSW, LCSW, OSW-C, Oncology
Draining Pleural Effusions at Home QuestionI have an effusion that keeps filling up, and I have been getting it drained every week at my doctor's office. They want me to have some type of catheter put in so it can be drained at home. That sounds risky – wouldn't I be more at risk of infection if I do it myself at home? AnswerAnil Vachani, MD, Pulmonologist at Penn Medicine,
Prophylactic Cranial Irradiation (PCI) Question My doctor is suggesting I have radiation to my brain to prevent cancer from going there. Is that standard practice? Should I be concerned about the effects on my brain's function? Answer Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine, responds: Radiation therapy to the brain when there is no known brain cancer there is
Quit Smoking Support Question How can I get help to quit smoking that actually works? How/where do I start? Answer Christina Bach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Congratulations on wanting to quit smoking! That is a very important first step. There are many options for getting help with quitting. I would first encourage you to
VATS Versus Open Surgery Question I had 2 surgery opinions – one would use !0VATS!1, the other would use a traditional open surgery. Are the two equal? I realize VATS may have fewer complications, but I wonder if that procedure compromises the treatment? Answer Taine Pechet, MD, Thoracic Surgeon at Penn Medicine, responds: Minimally invasive surgery using VATS, as
Dealing with Fatigue QuestionI feel so exhausted from my treatments. What can I do to give myself more pep? Some say I should exercise, but won't I get short of breath, since after all, I have lung cancer? AnswerCharu Aggarwal, MD, MPH, Medical Oncologist at Penn Medicine, responds: Keeping fit and staying healthy is important for you while you get chemotherapy. If
Chemo and Radiation Given Together Question Why can’t I get my radiation while I am getting my chemo? Why do I have to wait until I finish chemo? Answer Susie Lee, CRNP, Nurse Practitioner with Penn Medicine’s Lung Cancer Team, responds: In some instances, and it may depend on the stage of your lung cancer, it is recommended to give chemotherapy concurrently (at the same time)
Why Quit Smoking After Diagnosis? Question If I already have lung cancer, why should I stop smoking now? Anil Vachani, MD, Pulmonologist at Penn Medicine adds: Even if you have been diagnosed with lung cancer, you should still try and quit smoking. There is evidence to suggest that patients who continue to smoke may respond less well to their treatment and thus have worse
Lung CT for Screening Question I heard it is better to get a CT scan rather than an x-ray of your chest. If you are at risk for lung cancer, is this true? If so, why does my family doctor say my insurance will not pay for it? Answer Taine Pechet, MD, Thoracic Surgeon at Penn Medicine, responds: You are correct that the CT scan provides more information than the chest
How Much Chemo is Given? Question How much chemotherapy can a person do. I know sometimes the treatment has to be done more than once. Thank you. Answer Susie Lee, CRNP, Nurse Practitioner with Penn Medicine’s Lung Cancer Team, responds: This depends on the type of chemotherapy being administered. Some chemotherapy agents have a limited dose or number of cycles that
Neuropathy Due to Chemotherapy Question I have neuropathy in my feet from my chemo. Is there anything to help with this? Answer Christina Bach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Neuropathy can really impact quality of life during and after certain types of chemotherapy treatments. The symptoms of neuropathy often improve, as patients are
Difficulty Swallowing During Radiation Question I have a hard time swallowing food since starting radiation. What would be some good foods for me that are nutritious and easy to eat? Answer Valaree Williams, MS, RD, LDN, Registered Dietician at Penn Medicine responds: Effects from radiation can irritate the esophagus and cause swallowing difficulty. Simple diet modifications can
Precautions After Splenectomy Question What do you do with a lung cancer patient who lost his spleen who is on chemo? Anything special? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: We would treat someone with lung cancer and no spleen just like any other patient with lung cancer. However, people without a spleen have a higher risk for certain
Chemotherapy Pills Versus Intravenous (IV) Question Why are some lung cancer patients able to take chemo pills, but I have to get it in my veins? Is one kind better than the other? Answer Suzanne Walker CRNP, MSN, AOCN, Nurse Practitioner for Thoracic Malignancies at Penn Medicine responds: Some lung cancer patients are able to take a chemotherapy pill because they have a specific
Supplements or Vitamins to Better Tolerate Chemo and Radiation Question Are there supplements or vitamins that can help me better tolerate radiation and chemo for lung cancer? Answer Valaree Williams, MS, RD, LDN, Registered Dietician at Penn Medicine responds: We often receive many questions about herbal, vitamin, and mineral supplements to assist with tolerating treatments. Research on the use of
Chemo Before or After Surgery Question When is it appropriate to get chemo before surgery versus after? Answer Suzanne Walker CRNP, MSN, AOCN, Nurse Practitioner for Thoracic Malignancies at Penn Medicine responds: Most people will receive their chemotherapy after surgery ("adjuvant therapy"). Some people may receive their chemotherapy before surgery in certain
Hospice Care and Trouble Breathing Question My husband was recently put on hospice. He already had a lot of trouble breathing; will this get worse as he gets sicker/closer to death? What can we do to help him? Answer Suzanne Walker CRNP, MSN, AOCN, Nurse Practitioner for Thoracic Malignancies at Penn Medicine responds: The hospice team is usually very skilled at managing
Dealing With Life During the Stress of a New Diagnosis Question My sister was just diagnosed last week. It's like a whirlwind. Looking for ways to coordinate life for her (kids, house), manage appts. And just helping her through it all. Answer Linda Miller, RN, BSN, Oncology Nurse Navigator at Penn Medicine responds: The American cancer society has a great website that offers different resources.
Preventive Whole Brain Radiation Question My husband's doctor recommended whole brain radiation as a preventive treatment (he doesn't have tumor in his brain). What are the pros/cons to this? What about affect on memory, thinking, etc.? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: The good news is that the fact that they are offering PCI
Hospice Consultation Question If I am followed by the palliative care team but I want to explore (and possibly go onto) hospice, can the palliative care team do that too? Answer Kava Schafer, MDiv, MA, Chaplain at Penn Medicine responds: If you are followed by the palliative care team, it would be appropriate at any time of your choosing to ask to have a hospice
Family History of Melanoma Question Does having a family history of melanoma increase my chances of getting it? Answer Christopher Miller, MD, Dermatologist & Moh's Surgeon at Penn Medicine responds: A family history of melanoma does increase your chances of getting melanoma. If you have a first degree relative (e.g., mother, father, and sibling) with melanoma, your
Is My Pet Suffering? Question How do I know if my pet is suffering? Lili Duda, VMD, MBE, DACVR Veterinary Radiation Oncologist- University of Pennsylvania, responds: Answer Suffering is a hard thing to define and quantify, whether it is happening in a pet or a person. For our veterinary patients, we assume that if something would hurt or distress a person, it would
Nearing End of Treatment Fears Question I am nearing the end of my treatments and finding myself anxious and worried about my future. What if the cancer returns? Answer Tracy Lautenbach, MSW, LCSW, OSW-C, Oncology Social Worker at Penn Medicine, responds: Fear of recurrence or fear of your cancer coming back is one of the most common worries that anyone with a cancer
Feeling Tired After Treatment Question I have felt so tired since finishing my treatment, what can I do to get some energy back? Answer Nicole Ross, RN, MSN, OCN - Radiation Oncology Nurse at Penn Medicine, responds: Fatigue is a very common side effect of chemotherapy and radiation therapy. Typically, energy levels should start increasing slowly a few weeks after
Getting Back To Life As A Survivor Question Can you offer some advice on how to get back to life in a non-cancer treatment world for someone who has finished treatment and is now a "survivor?" I feel a bit disjointed and unsure how to get back to normal. Also, can you recommend some resources? Answer Michael Corradetti, MD, PhD, Radiation Oncology Resident at Penn Medicine,
Benefits of Quitting Smoking After Long History Question I have smoked for about 20 years, would it even matter if I quit now? Will I still get lung cancer? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Quitting is beneficial, no matter how long a person has smoked. While it is true that your risk of having lung cancer and other smoking-related illnesses and
Health Risks of Radon Question We are buying a house and the basement was tested and found to be high in radon. How is this harmful for my family? What should I do? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: After tobacco use, radon is the second leading cause of lung cancer in the United States. If radon is detected in levels above 4
Safety of Tanning Salons Question My daughter and her friends go to the tanning salon. Is this safer than being out in the sun? Answer Gloria DiLullo, MSN, CRNP, OncoLink Content Specialist, responds: Tanning salons are not a safe alternative to the harmful rays of the sun. Studies have found that tanning salons are very harmful and lead to an increased risk of
Nutrition and Chemotherapy after Gastric Bypass Surgery Question I had gastric bypass surgery about 5 years ago. Now I am about to start treatment for colon cancer with chemo. I am really worried about how to manage nutrition with this combination. Any advice appreciated! Answer Katrina Claghorn, Registered Dietician at Penn Medicine, responds: Managing your nutritional status during treatment may
Safety of Clinical Trials Question My doctor has asked me to consider a clinical trial as my treatment. Are these trials safe? Could it really be better than the treatment that most people get for pancreatic cancer? Answer Christina Bach, Oncology Social Worker at Penn Medicine responds: Participating in clinical trial is a personal decision but also an opportunity to
Nutrition and Diarrhea After Whipple Surgery Question I have had such a hard time with eating after Whipple surgery. Can you help me to get better nutrition and to deal with the diarrhea? Do certain foods make it worse? Is this going to be a permanent problem? Lauren Ginipro, Registered Dietician at Penn Medicine responds: After a Whipple procedure you will need to follow a low fat diet-
Safety With Oral Chemotherapy Medication Question I was given an oral chemotherapy to take at home. What should I know about safety regarding having a medication like this at home? Gloria DiLullo, Oncology Nurse Practitioner at Penn Medicine responds: Many people receive this type of chemotherapy at home and there are some important things you should know. We have some great
Pancreatic Enzymes and Suggested Doses Question Why is it important to take pancreatic enzymes? My doctor said I may have to adjust them and take more than initially prescribed. Why is this? How do I know when to increase my dose? Answer Lauren Ginipro, Registered Dietician at Penn Medicine responds: Pancreatic enzymes are necessary to breakdown the food we eat so that it can be
When to Take Pancreatic Enzymes Question When is the best time to take pancreatic enzyme tablets- before, during, or after a meal? Answer Lauren Ginipro, Registered Dietician at Penn Medicine responds: Pancreatic enzymes should be taken at the beginning of the meal or snack. This is very important for proper enzyme functioning. When taking multiple enzymes, take some at the
Rash From Tarceva Question I have a rash from Tarceva that looks like acne. Should I use acne products on it to make it go away? Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: The rash from Tarceva can be an odd rash - both oily and dry - so you have to be careful with traditional over the counter acne medications. I would ask your
The Effects of Chemotherapy and Radiation Therapy Given Together Question My doctor wants me to take chemo and radiation at the same time. Won't this make me too sick? Answer Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: When we deliver chemo-radiotherapy, the chemotherapy is dosed lower than we treat with chemotherapy alone. My patients have very few side effects attributable to the
Daily Radiation Question Why do I have to come in everyday for radiation? Can't it be more spaced out? Answer Ursina Teitelbaum, MD, Medical Oncologist at Penn Medicine responds: Radiation requires daily visits with an absolute minimum of interruptions to acheive its goal of cell death - it tackles the tumors cell cycle and blocks ability to grow and
Making a Survivorship Care Plan Question Now that I completed chemotherapy for my cancer, I am nervous to not have as much contact with my oncology team. What should I know about being a "survivor" and what to look for that would be concerning? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: It is not uncommon to have feelings of uncertainty when you
Chemotherapy Safety at Home Question I am taking chemotherapy (5-FU) via a pump connected to my port at home. What should I know about safety regarding having chemotherapy at home? Answer Gloria DiLullo, Oncology Nurse Practitioner at Penn Medicine responds: Many people receive this type of chemotherapy at home. Most pumps are pretty sophisticated and will alarm to let
Is 5FU Safe for Cardiac Patients? Question My mother is in her late 60s and has had heart problems in the past. Is it safe for her to get 5-FU for colon cancer treatment? Answer Liz Prechtel-Dunphy, Oncology Nurse Practitioner at Penn Medicine responds: There is no contraindication to 5-FU treatment in patients with heart disease. Patient's can experience angina like symptoms
African Americans should have Colonoscopy Screening at a Younger Age Question I recently heard that the screening age for African Americans to get a colonoscopy is starting at age 45. Why is it not 50 like other people? Answer Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds: African Americans are diagnosed with colorectal cancer at a younger age than other ethnic groups, and African- Americans
"Dumping Syndrome" after Surgery Question Can you help me better manage "dumping syndrome?" I have had such a hard time with eating after my stomach cancer surgery. Do certain foods make it worse? Is this going to be a permanent problem? Answer Katrina Claghorn, Registered Dietician at Penn Medicine responds: Dumping Syndrome is usually a temporary problem experienced after
Side Effects of Smoking and Drinking during Treatment Question The doctor said my husband has to stop smoking and drinking or it could make his side effects worse. Is this true? If so, how do I get a guy who has smoked for over 25 years and also drinks alcohol to quit? Is it true that smoking can increase the side effects of cancer treatment? Answer Alexander Lin, MD, Radiation Oncologist at Penn
Risks of developing Lymphodema Question My doctor told me I am at risk to get lymphedema because of them taking out so many lymph nodes in my neck, how can I prevent myself from getting this? Answer Carolyn Vachani, RN, MSN OncoLink Nurse Educator at Penn Medicine, responds: Unfortunately, although there are some things that can be done to reduce one's risk, there is no
Feeding Tubes During Treatment Question Why do I need to get a feeding tube before I even start treatment? Can't I just wait and see how it goes? Answer Valaree Williams MS RD LDN, Clinical Dietitian Specialist, Department of Radiation Oncology at Penn Medicine, responds: Adequate nutrition before, during, and after treatment is essential. Based on the individual's
Issues with Swallowing During Treatment Question I have a lot of trouble swallowing and feel like there is a lump in my throat. What can I do about this? Answer Patricia Dooley,Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: If you are having difficulty with swallowing, I would suggest talking to your doctor about your symptoms. A
Effects on the Tongue after Surgery Question Since my surgery, I feel like my tongue gets in the way of me speaking. Can you help me with this? Answer Patricia Dooley, Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: I would suggest an evaluation by a speech pathologist to determine the reason why your speech is affected. Oral
Simulation for Radiation Therapy Question What is "simulation" for radiation therapy mean? Is it painful? How long with this take? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: Simulation is simply the acquisition of a scan (such as a CT scan or PET/CT scan). These images are used by your radiation oncologist to identify areas which need to be
Effects on the Arms after Neck Surgery Question How can the surgery I had on my neck affect my arm? I feel such tightness and have trouble raising my arm like I did before? Is there anything I can do about this? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: In an effort to remove the cancer from your neck in a neck dissection, one of the nerves which
Dangers of Extended Radiation Treatment Question My sister is getting radiation every day- well, supposed to be- but at least once a week or more she takes a day off. Is this harmful? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: Yes. All efforts should be made to avoid treatment delays or interruptions. For each day that radiation is extended due to
Dry Skin and Radiation Question I have very dry skin on the side of my face/neck where I had radiation. What kind of lotion can I use on this that would actually help? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: As long as the area is completely healed, you might find a mild lotions such as Eucerin to be of help. If in doubt, feel free
Nutritional Supplements Drinks after Radiation Question My husband has trouble with thick secretions after radiation, but also we are trying to maintain his weight. People had suggested Boost, but I am worried that" a milk-like product" will only make things thicker. Are there other options? Answer Valaree Williams MS RD LDN, Clinical Dietitian Specialist, Department of Radiation Oncology
Thyroid Issues after Radiation Question How can radiation for my throat cancer affect my thyroid? What should I do to make sure I don't have a thyroid problem after treatment? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: Radiation, when delivered to the neck, can often lead to impaired thyroid function (hypothyroidism). In fact, some studies
Swallowing and Thick Liquids Question My sister was told to have only thick liquids to prevent her from choking since she can't swallow correctly. Wouldn't it be harder to swallow thick things than water or soup? Answer Patricia Dooley, Associate Director of the Division of Speech Language Pathology at Penn Medicine, responds: For some patients, based on the cause of the
Trouble Swallowing after Treatment Question I have an appointment with a speech and swallowing person next week in the hopes of getting help with my trouble swallowing since treatment for pharynx cancer. Can you give me some idea of what they can do for me or what to expect? Answer Patricia Dooley, Associate Director of the Division of Speech Language Pathology at Penn Medicine,
Mucus after Radiation Treatment Question Can you give any tips to dealing with the thick mucus I have after radiation for oral cancer? It has been 6 weeks and the mucous does not seem to be getting any better. Answer Valaree Williams MS RD LDN, Clinical Dietitian Specialist, Department of Radiation Oncology at Penn Medicine, responds: Adequate hydration using decaffeinated
IMRT vs Traditional Radiation Question Is there a benefit with IMRT versus traditional radiation therapy for head and neck cancer patients? I have met with 2 radiation oncologists with different approaches and wondering how to know which one is better for me? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: It depends on the area that needs to be
Communicating after Surgery Question I am so self-conscious about talking to people because of how I look after my surgery. I even feel like I can't communicate right in terms of my facial expressions. Can you help me deal with this? Answer Tracy Lautenbach MSW, LCSW, Oncology Social Worker at Penn Medicine, responds: Your "new normal" since your surgery may take some
Mouth Sores after treatment Question How can I prevent mouth sores or treat it before it gets too bad? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: The development of mouths sores may be inevitable, especially if areas in the mouth need to be irradiated due to cancer involvement. Strategies to minimize mouth sores include minimizing the
Eating after Treatment Question Will I ever be able to eat normal food again and not have to worry about it getting stuck? Answer Valaree Williams MS RD LDN, Clinical Dietitian Specialist, Department of Radiation Oncology at Penn Medicine, responds: Your tolerance and ability to eat a variety of foods will likely improve over time after treatment. You may find a
Pain Management during Treatment Question I am getting chemo & radiation. Should I tough it out with the pain during treatment? I'm afraid to start taking pain killers. Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: You should not "tough it out." There are many forms of therapy we can employ during therapy to minimize pain. By minimizing pain,
Appetite during Treatment Question Do you have any tips for helping my husband improve his appetite while on treatment? Answer Tracy Lautenbach MSW, LCSW, Oncology Social Worker at Penn Medicine, responds: To promote appetite it is important to create and follow a meal schedule with small, frequent meals/snacks every 2-3 hours. Treat your food like medicine and do not
Ringing in the Ears after Treatment Question Since getting treatment for my cancer, I have ringing in the ears. Is there anything that will make this go away? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: Platinum-based chemotherapy can cause ringing in the ears. If you are receiving this type of chemotherapy currently, you may want to discuss your
Dangers of extended radiation treatment Question My sister is getting radiation every day- well, supposed to be- but at least once a week or more she takes a day off. Is this harmful? Answer Alexander Lin, MD, Radiation Oncologist at Penn Medicine, responds: Yes. All efforts should be made to avoid treatment delays or interruptions. For each day that radiation is extended due to