Posts

Palliative Care: Myths vs. Facts

I just returned from the Pancreas Club 2018 conference in Washington D.C., where I listened to 63 oral abstracts regarding ongoing research. It was a lot to sit through! The final presentation on the second and last day was titled “Utilization of palliative care services among patients with pancreatic cancer.”

I find it ironic that palliative care was recommended to Nikki very near the end of her life and the conference pushed this presentation to the very end as well. Nikki and I spoke many times about the need for palliative care early in a cancer diagnosis. Why not utilize all avenues to strengthen and improve your quality of life and build up a support system? I believe doctors and patients lack education on this extremely important and helpful type of care.

So, what is Palliative Care?  PALLIATIVE CARE IS “NOT” HOSPICE CARE.

Palliative care is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

5 Myths and Facts of Palliative Care

  1. Myth: Palliative care hastens death. 
    Fact:
     Palliative care does not hasten death. It provides comfort and the best quality of life from diagnosis of an advanced illness until end of life.
  2. Myth:Palliative care is only for people dying of cancer.
    Fact: Palliative care can benefit patients and their families from the time of diagnosis of any illness that may shorten life.
  3. Myth: Palliative care is only provided in a hospital.
    Fact:Palliative care can be provided wherever the patient lives: home, long-term care facility, hospice or hospital. 
  4. Myth:Taking pain medications in palliative care leads to addiction. 
    Fact: 
    Keeping people comfortable often requires increased doses of pain medication. This is a result of tolerance to medication as the body adjusts, not addiction. 
  5. Myth:Palliative care means my doctor has given up and there is no hope for me.
    Fact: Palliative care ensures the best quality of life for those who have been diagnosed with an advanced illness.

The last myth is a big pet peeve of mine. I have heard people comment, “If your doctor mentions palliative care, then get a new doctor.” They think this means the doctor has given up on them, but this is flat out incorrect. If a doctor recommends palliative care, then you have a progressive doctor seeking to treat the whole person and ultimately, their loved ones. That is the kind of forward-thinking doctor I’d want for myself.

This type of care treats pain, depression, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, anxiety and any other symptoms that may be causing distress. The doctor will help you gain the strength to carry on with daily life and improve your quality of life.

Nikki’s first visit with her palliative care doctor was amazing! He sat and listened to her for a very long time, asked many questions and listened to her answers. He then formulated a plan specifically for her and gave her the tools she needed to move forward. When she felt better, physically and mentally, she wasn’t a cancer patient, she was just Nikki…

For more information on palliative care, click HERE (scroll to the end) and HERE.

Post by Rhonda Miles

Exosomes may be a key in diagnosing and treating pancreatic cancer

Exosomes, once thought to be only cell waste, play an important role in cell-to-cell communication, and could help treat pancreatic cancer patients or detect pancreatic cancer at an earlier stage.

Read more about these virus-sized molecules here: Q&A: What are exosomes, exactly?

Modifying exosomes to treat tumors

Valerie LeBleu, assistant professor of cancer biology at the University of Texas MD Anderson Cancer Center is leading a team that is working on modifying exosomes to target genes associated with pancreatic cancer, delivering molecules that can destroy tumors. Using the technique in mice, they were able to stop tumor growth and therefore extend life.

Read the full article here: What Was Once Considered Cell Waste Could Now Treat Pancreatic Cancer

Additional articles: Exosomes facilitate therapeutic targeting of oncogenic KRAS in pancreatic cancerInnovative therapy strategy for pancreatic cancer uses engineered exosomes targeting mutated KRAS gene

Early detection of pancreatic cancer

In addition to treatment, exosomes could detect pancreatic cancer before it becomes untreatable.   Read the article here: Exosomes as a platform for ‘liquid biopsy’ in pancreatic cancer

Jamey Johnson’s 6th Annual Golf Tournament and Benefit Concert Raises $270,000

Montgomery native Jamey Johnson’s sixth annual Homecoming Golf Tournament and Concert, held at the Cottonwood Golf Club, raised more than $200,000 to help those battling pancreatic cancer through the Nikki Mitchell Foundation.

The event also accepted donated toys for the Montgomery area Marine Toys for Tots.

The event’s grand finale was an outdoor concert that featured Johnson as well as Donica Knight, Rob Hatch, Gina Gailey, Tony Joe White, Keith Gattis and Chris Hennessee.

“The golf tournament and concert raise money for the Nikki Mitchell Foundation for all of the wonderful things they are doing to help those fighting pancreatic cancer, such as providing gas cards, groceries, bill paying or whatever,” says Johnson, who was a close friend of Nikki Mitchell and serves as the non-profit organization’s founding artist. “They offer all of these custom services to help people with pancreatic cancer.”

“The idea down the road is to raise enough money to fund research. Right now, we are taking care of the things we can take care of. The golf tournament every year funds a lot of that activity, as do the various concerts we do throughout the year.”

Rhonda Miles, president of the Nikki Mitchell Foundation, says, “We are completely humbled by the support and generosity shown to NMF this past weekend. We want to thank everyone involved.  We definitely know Nikki sent her magic to this event. The funds raised will guarantee our Bridge of Wings program will continue to relieve some financial burdens of our Pancreatic Cancer patients.”

Gilbert Carrillo, Adam Carrillo, Tony Medellin and Tim Henderson from Nitro Oil were on the golf tournament’s winning team.

For more information about NMF or Jamey Johnson’s Homecoming Golf Tournament:

Contact: Ariane Watkins

Phone: 615.982.6802

Email: ariane@nikkimitchellfoundation.org

Website: www.facebook.com/JameyJohnsonGolf

Photo by Lisa Harris

“Outlaw Country Jam” Raises Funds for NMF

Friends of Nikki Mitchell Foundation hosted the “Outlaw Country Jam” at the Pendleton County Fairgrounds in Falmouth, Kentucky on August 19th. Those performing included Chris Hennessee with some members from the Jamey Johnson band, Brothersmith and young local talent Ashley Cooper. The day had beautiful weather at the outdoor event and a large crowd attended. The show was sponsored by Melinda’s Wholesale Primitives, Cooper Funeral Home, R & R Roofing, Utz Plumbing, Dales Hauling, The Smoking Pig, Donald Wells Attorney, Johnson Heating & Cooling, Chucks Auto Body, Sunrise Corp., David Dunaway Auction, O’Hara Trucking and Precision Pressure.

 

For more information on hosting an event benefitting NMF, contact Ariane Watkins:
Phone: 615.982.6802
Email: ariane@nikkimitchellfoundation.org

 

What is Chemo Brain?

Photo credit: iStock.com

Photo credit: iStock.com

What Is Chemo Brain?

Chemotherapy can help you beat cancer, but side effects are almost certain. It’s common for you to have a cloudy mind, called “chemo brain,” during and after treatment. Maybe you have a hard time remembering names or can’t multitask as well as you used to.

As many as 3 out of 4 people with cancer say they’re not as mentally sharp. It’s often caused by chemotherapy medicines, but it can come from the cancer itself or other problems like infection, low blood counts, fatigue, sleep problems, or stress.

Symptoms

Chemo brain can cause thinking and memory problems. Symptoms include trouble with:

  • Concentrating and paying attention
  • Remembering names, dates, and everyday things
  • Finding the right word or doing simple math (like balancing your checkbook)
  • Doing more than one thing at a time
  • Mood swings

Diagnosis

If you’re in a mental fog, talk to your doctor. They will ask about your symptoms and will also want to know when your problems started and how they affect your everyday life.

Your doctor may ask what makes your symptoms worse and better. Do you, for example, feel better in the morning than at night? Does it help when you’re active, when you eat, or after you’ve rested?

Bring a list of all the medicines you take, even if they aren’t for cancer.

Treatment

If chemo brain is disrupting your daily life, your doctor may suggest a counselor or psychologist. There are other things that can help too, including:

  • Some stimulants and antidepressants
  • Exercise — even 5 minutes a day
  • Plenty of sleep and rest
  • Exercising your brain with puzzles, playing an instrument, or learning a new hobby

Memory Aids

Simple strategies can help with memory loss and confusion. Try these tips:

  • Carry a daily to-do list with reminders.
  • Don’t multitask. Do one thing at a time so you’re not distracted.
  • Put sticky notes around your home and office. Set reminders on your smartphone, too.

How Long Does It Last?

Often, the fogginess will fade when your chemo ends. But for some people, the fuzzy feelings will linger for several months or sometimes a year or more.

If you still have chemo brain a year after chemotherapy and you’ve tried all the self-help tips, talk with a neuropsychologist. This is a doctor who specializes in the brain and can help with attention span and memory. He will find areas where you need help and tell you if other treatable problems like depression, anxiety, and fatigue are to blame.

Remember, It’s Real

You’re not just imagining this. Studies show that cancer and its treatment causes changes in the brain. What you’re going through is normal.

Don’t be afraid to ask your family and friends for support and gentle reminders. Support groups are another great idea.

Article reposted from WebMD.com

Light scattering spectroscopy helps doctors identify early pancreatic cancer

Image from WebMD

Image from WebMD

Pancreatic cancer has the lowest survival rate among all major cancers, largely because physicians lack diagnostic tools to detect the disease in its early, treatable stages. Now, a team of investigators led by Lev T. Perelman, PhD, Director of the Center for Advanced Biomedical Imaging and Photonics at Beth Israel Deaconess Medical Center (BIDMC), has developed a promising new tool capable of distinguishing between harmless pancreatic cysts and those with malignant potential with an overall accuracy of 95 percent. The team’s preliminary data was published online in the journal Nature Biomedical Engineering.

The new device uses light scattering spectroscopy (LSS) to detect the structural changes that occur in cancerous or pre-cancerous cells by bouncing light off tissues and analyzing the reflected spectrum. The results could help guide physicians’ decision making when considering whether the presence of pancreatic cysts requires surgery, a high-risk procedure. Today, because of the lack of less-invasive diagnostic methods, more than half of these procedures turn out to have been unnecessary.

“About one-fifth of pancreatic cancers develop from cysts, but not all lesions are cancerous,” said Perelman, who is also Professor of Medicine and Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. “Considering the high risk of pancreatic surgeries and the even higher mortality from untreated pancreatic cancers, there’s an obvious need for new diagnostic methods to accurately identify the pancreatic cysts that need surgical intervention and those that do not.”

In Perelman and colleagues’ series of experiments, the LSS technique achieved 95 percent accuracy for identifying malignancy. Cytology — the only pre-operative test currently availably — is accurate only 58 percent of the time. While the new technique requires further testing, LSS could represent a major advance against pancreatic cancer.

“This tool is a technology that is transformative in the evaluation of pancreatic cysts,” said co-lead author Douglas K. Pleskow, MD, Clinical Chief of the Division of Gastroenterology and Director of the Colon and Rectal Cancer Program at the Cancer Center at BIDMC. “It provides a high level of precision in the detection of potential malignant transformation of these cysts.”

Pancreatic cysts are common, and today’s high-definition scanning technologies like MRI and CT imaging are detecting them with increasing frequency. Despite their high resolution, these scanners provide doctors with limited information about cysts’ malignant potential.

Currently, physicians rely on minimally-invasive fine needle aspiration (FNA) biopsies to test pancreatic cysts for malignancy. The biopsy removes fluid from the cysts, which is then analyzed for cancer cells and other telltale signs of the disease, a process called cytology. However, the test fails to detect cancer about half the time, leaving high-risk surgery as the current gold-standard means of diagnosing pancreatic cysts.

To test the accuracy of the LSS system, Perelman and colleagues collected and analyzed the reflected light from 13 cysts taken from recent surgeries. Next, they compared their findings with the results from pre-operative imaging, FNA biopsies and post-operative tissues analysis. In all cases, the LSS diagnosis agreed with the post-operative analysis.

In a second experiment, the LSS tool was tested in 14 patients with pancreatic cysts who were undergoing the standard FNA biopsy. Measuring less than half a millimeter in diameter, the miniature experimental LSS fiber-optic probe was inserted in the FNA needle. Physicians spent two minutes or less measuring optical spectra from the internal cyst surface before collecting fluid from the cysts as part of the traditional biopsy. Out of nine patients whose cysts had been definitely diagnosed as either cancerous or benign, all were correctly identified by LSS.

Next, the researchers will assess the LSS system’s accuracy by continuing to analyze post-operative tissues as they become available.

Article from Science Daily, Story source: Beth Israel Deaconess Medical Center

Acute pancreatitis may reveal pancreatic cancer at earlier stage

Surgical intervention after 24.5 days of acute pancreatitis may be beneficial for reducing postoperative complications.

Surgical intervention after 24.5 days of acute pancreatitis may be beneficial for reducing postoperative complications.

Acute pancreatitis may be an indicator for pancreatic cancer at an earlier stage, according to a study published in Medicine.

Shaojun Li, M Med, and Bole Tian, PhD, from the West China Hospital in Sichuan, China, identified 47 consecutive patients with  pancreatic cancer who presented with acute pancreatitis between January 2009 and November 2016. Of the patients, 35 (74.5%) were men with a mean age of 52 years. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were recorded from the database.

Clinical features of acute pancreatitis include abdominal pain, jaundice, and weight loss. The timing of surgery was identified by receiver operating characteristic (ROC) curve. Preoperative, intraoperative, and postoperative parameters were collected to determine operative timing of surgical intervention. Survival curves were plotted using the Kaplan—Meier method, and survival data were analyzed using the log-rank test.

Of the 47 patients included, acute pancreatitis was clinically mild in 45 (95.7%) and severe in 2 (4.3%). Radical surgery was performed in 32 (68.1%) of cases, palliative surgery in 7 (14.9%), and biopsies in 8 (17.0%). A total of 2 (8.0%) patients were needed for vascular resection and reconstruction. The diagnosis of pancreatic cancer occurred at a median of 101 days, and 27 (57.4%) patients were diagnosed in less than 2 months after acute pancreatitis diagnosis.

The timing of surgery was calculated from the date of the first attack of acute pancreatitis to the surgery. The best cutoff point was 24.5 days according to the ROC curve. A total of 25 (64.1%) patients received surgery at or before 24.5 days from diagnosis of pancreatic cancer. Postoperative complications occurred in 12 (30.8%) patients. The median follow-up for patients was 24 months with a patient survival rate at 1 year of 23.4%. The median survival in patients with vascular resection and reconstruction was 18 months, compared with 10 months in patients without vascular resection.

According to the authors, “this retrospective study supports the assumption that acute pancreatitis is the early presenting clinical symptom of pancreatic cancer.”

By Madeline Moore at Clinical Advisor

Nutrition’s Role In Managing Pancreatic Cancer Symptoms

imagesDecember 12, 2016

Nutrition, though often overlooked, plays a key role in mitigating the symptom burden of patients with pancreatic cancer. 

When diagnosed with pancreatic cancer, one of the last things on a patient’s mind may be diet and nutrition, yet these are two key components that medical experts say can affect the outcome of treatment.

Patients with pancreatic cancer often experience weight loss, loss of appetite, fatigue, nausea, as well as back and belly pain. The cancer itself plays a large role in preventing patients from having a normal diet and nutrition.

During a live broadcast of CURE Connections, held during the Seventh Annual Ruesch Center Symposium: Fighting a Smarter War on Cancer on Dec. 3 in Washington, D.C., a panel that included an oncologist, a nurse, an oncology dietitian and a patient advocate discussed the importance of nutrition when trying to manage a long list of symptoms.

“These cancers are well-known to release hormones that we don’t fully understand that rob a patient of their appetite,” said Michael Pishvaian, M.D., director, Phase 1 Clinical Trials Program, Division of Hematology/Oncology, Georgetown Lombardi Comprehensive Cancer Center. “It makes them feel like they don’t want to eat or drink anything. It robs them of their calories even if they are very conscientious about getting enough nutrition in. It can even cause changes to taste, so a patient with pancreatic cancer will often complain about an abnormal taste sensation long before they even start chemotherapy.”

Pishvaian explained that the pancreas creates digestive enzymes that help digest food properly. When the cancer invades the pancreas, this disrupts proper digestion. The lack of digestion also leads to bacterial overgrowth lower down into the gastrointestinal (GI) tract and can cause a lot of discomfort, gassiness, bloating and diarrhea, he added.

There are ways to try to manage these symptoms before, during and after the cancer journey. The panel recommended patients make it a priority to meet with a dietician one-on-one. Some cancer centers already have a dietician in place.

“Often pancreatic cancer patients will undergo a surgery called a Whipple Procedure (pancreaticoduodenectomy), which can impair a patient’s ability to digest certain foods like fats, carbohydrates and proteins – particularly in fats,” said Rachel Wong, R.D., oncology dietician, Georgetown Lombardi Comprehensive Cancer Center.

She added, that this is where digestive enzymes, which help break down fats, proteins and carbohydrates, should be consumed with meals and snacks.

Patients should consume energy-dense nutritious foods such as quinoa, oatmeal and avocado, which all have healthy fats. As far as sugars go, they should continue to eat fruits, but stay away from simple sugars like candy bars.

It is also recommended that patients with pancreatic cancer eat small, frequent meals, eat slowly and also keep a diary of everything they are eating and drinking each day.

Patricia Reilly, a holistic health counselor, nutrition expert and patient advocate, says the best way a caregiver can be there for a loved one with pancreatic cancer is to help with nutrition. She became that person for her husband, who had pancreatic cancer.

“We recognized that he wanted to feel good every day. As a caregiver, I looked at the foods,” Reilly said. “I want my doctor to know about those clinical trials. I want him to be on top of that and let me create a team to support my husband in terms of what he’s eating for breakfast, lunch and dinner, again looking for nutrient-dense foods that will support him to be stronger so he will get to that clinical trial.”

The panel also opened up the discussion on marijuana and if there is a benefit there for patients with pancreatic cancer, which they agreed there is.

“We are seeing that their appetite goes up, their sense of well-being is greater and their pain levels are reduced,” said Pishvaian. “It is not a treatment for their cancer, but universally makes them feel better. Try things, see what works and stick with it.”

By Katie Kosko for Curetoday.com

Coping with Cancer During the Holidays

1419370395896Holidays are traditionally viewed as a time to celebrate. Many people enjoy reuniting with family and friends, giving and receiving gifts, and celebrating religious traditions during this time. However, sometimes people with cancer and their loved ones feel “out of step” from the rest of the world during the holidays. In fact, the holiday season can prompt new questions, such as: How do I take care of the holiday rush and myself at the same time? How can I celebrate when I have so many other things on my mind? What will my life be like next year? Sharing these concerns with the people you love and who love you can help you feel more connected.

Here are some additional tips for coping with cancer during the holidays:

Make plans to get together with friends, family or co-workers over the holidays. Trying to celebrate alone can be very difficult, so accept some invitations from others, or join an organized group activity through your local YMCA, YWCA, church or synagogue. Find the right balance between celebrating with family and friends and spending the time you may need on your own. Give yourself permission to pace your activities and to decline an invitation or two so that you have the energy to enjoy the gatherings that are most important to you.

Create a new holiday season tradition that makes the most of your energy.Change your usual holiday activities so you relieve yourself of some of the pressures of entertaining. Have a “pot luck,” with family members each bringing a dish for the meal, have someone else host the meal, or suggest eating out at a favorite restaurant.

Enjoy special moments. Try to focus on new traditions that have been established, rather than dwelling on how cancer has changed a holiday or special occasion.

Talk to your health care team about upcoming special events. They may be flexible about appointments in order to accommodate travel or other needs.

Be an innovative shopper or gift giver. Use mail order catalogues, shop over the telephone, or try online shopping this year. You can also make a gift of sharing your thoughts and feelings. Write a short note or make a phone call to let others know that you are thinking about them.

Express your feelings in ways that help you receive the support of the important people in your life. Tears can bring a sense of relief. Laughter can be relaxing. Sharing can be comforting. It is common to experience a mixture of anticipation, excitement and apprehension about the future. Let your feelings breathe, and talk them over with a loved one, friend or professional counselor.

Celebrate strengths you and your loved ones have developed. Many families who face the day-to-day challenges of cancer discover strengths and courage they didn’t know they had. Reflect on the strengths you have developed, and build on them during the holidays.

Article reposted from cancercare.org