KADCYLA WAS APPROVED BY FDA – A new alternative of treatment for women with HER 2-positive metastatic breast cancer!!

On February 22, 2013, the U. S. Food and Drug Administration approved ado-trastuzumab emtansine (KADCYLA for injection, Genentech, Inc.),for use as a single agent for the treatment of patients with HER2-positive, metastatic breast cancer who previously received trastuzumab and a taxane, separately or in combination. Patients should have either received prior therapy for metastatic disease or developed disease recurrence during or within six months of completing adjuvant therapy.

The approval is based on a randomized, multicenter, open-label trial enrolling 991 patients with HER2-positive metastatic breast cancer. Patients must have received prior taxane and trastuzumab-based therapy prior to enrollment. Patients who received these therapies only in the adjuvant setting were required to have disease recurrence during or within six months of completing this therapy. Breast tumor specimens were required to show HER2 overexpression defined as 3+ IHC or FISH amplification ratio ≥ 2.0 determined at a central laboratory.

Patients were randomly allocated (1:1) to receive ado-trastuzumab emtansine by intravenous infusion, 3.6 mg/kg, on day 1 every 21 days or lapatinib, 1250 mg/day orally once daily, for 21 days plus capecitabine, 1000 mg/m² orally twice daily, for 14 days. Treatment continued until disease progression, unacceptable toxicity, or consent withdrawal.

The co-primary efficacy endpoints were progression-free survival (PFS), based on tumor response assessments by an independent review committee (IRC), and overall survival (OS). A statistically significant improvement in PFS was observed in patients receiving ado-trastuzumab emtansine compared to those receiving lapatinib plus capecitabine [HR 0.65 (95% CI: 0.55, 0.77), p < 0.0001]. The median PFS was 9.6 and 6.4 months for patients in the ado-trastuzumab emtansine and lapatinib plus capecitabine arms, respectively. At the time of the second interim OS analysis, a statistically significant improvement in OS was observed in patients receiving ado-trastuzumab emtansine compared to those receiving lapatinib plus capecitabine [HR 0.68 (95% CI: 0.55, 0.85), p = 0.0006]. The median OS was 30.9 and 25.1 months in the ado-trastuzumab emtansine and the lapatinib plus capecitabine arms, respectively.

The most common (> 25%) adverse reactions observed in patients receivingado-trastuzumab emtansine were fatigue, nausea, musculoskeletal pain, thrombocytopenia, headache, increased transaminases, and constipation. The most common adverse events leading to ado-trastuzumab emtansine withdrawal were thrombocytopenia and increased transaminases. The most common (> 2%) Grade 3 – 4 adverse reactions were thrombocytopenia, increased transaminases, anemia, hypokalemia, peripheral neuropathy and fatigue. Serious hepatobiliary disorders, including at least two fatal cases of severe drug-induced liver injury and associated hepatic encephalopathy, have been reported in clinical trials with ado-trastuzumab emtansine. Other significant adverse reactions include left ventricular dysfunction, interstitial lung disease, and infusion-associated reactions.

A BOXED WARNING in product labeling describes the risk of hepatotoxicity, reduction in left ventricular ejection fraction, embryo-fetal toxicity and birth defects, and the need for effective contraception prior to starting ado-trastuzumab emtansine.

The recommended dose and schedule for ado-trastuzumab emtansine is 3.6 mg/kg administered as an intravenous infusion every 3 weeks (21-day cycle) until disease progression or unacceptable toxicity. Ado-trastuzumab emtansine should not be administered at doses greater than 3.6 mg/kg and should not be substituted for or with trastuzumab.

Source: FDA web page

PARENTING WHILE CARING FOR A PARENT WITH CANCER

If you are parenting young children while caring for a parent with cancer, you know firsthand the practical and emotional challenges. Here are a few tips to help you juggle your responsibilities and reduce your risk of burnout:

Simplify. Make a list of your obligations and activities, dividing the tasks into those you must do and those that can wait. Prioritize the activities that are most meaningful to your children. Eliminate the ones that you can, and delegate tasks (such as laundry, cooking, and cleaning) to others when possible. Ask your older children to help you choose which activities are important to them.

Organize. Create an organization system that works for you and that enables other people to support you and your family. Create a small portable file with telephone numbers for health care professionals, your local pharmacy and hospital, school teachers, and daycare providers, as well as numbers of relatives, friends, and neighbors who can help in an emergency. In addition, file copies of health insurance cards and legal documents you may need to access quickly, such as your parent's Power of Attorney. It can also help to use a calendar to keep track of all appointments and commitments for you, your children, your partner or spouse, and your parent. Find more tips for organizing care.

Ask for help. Don't be afraid to ask for assistance. Most friends and relatives are willing to help, particularly when given specific suggestions. Some people feel uncomfortable or guilty about not being able to do it all; however, you are helping your children, your spouse, and your parent by delegating tasks so that you can spend more quality time with them and keep yourself healthy. You may want to assign a “captain of kindnesses,” a close friend or family member who will be the contact person for others who would like to be helpful. He or she can both organize needed assistance and serve as a buffer against unwelcome intrusions in your parenting or family time.

Learn more about resources for assistance with caregiving responsibilities.

Tips for caring for your children

Create a safe, secure environment for your children by surrounding them with people who love them, giving them honest and clear information, and maintaining a routine they can count on. Some additional tips include the following:

• Maintain a predictable schedule and routine as often as possible. Most children find comfort in structure.
• Make regular times each day to give your children your undivided attention; even just 10 to 15 minutes can make a big difference to your child.
• Give your children age-appropriate explanations about your parent's illness, and encourage them to ask questions. Answer their questions honestly, and do not promise that things will be okay if they may not. Children give their trust freely, but it is difficult to regain once lost. If you are not sure whether your parent's treatment will be successful, you can say, “I'm not sure whether the chemotherapy will keep the cancer from growing. The doctors are following Grandpa closely, and we are hopeful. When he has his tests, I will let you know what they show.” Learn more about talking with your children about cancer.
• Let your children know that nothing they did caused the cancer. Also, let them know it is normal for people who care about a family member who has cancer to be worried and sad sometimes.
• Tell the daycare, nursery school, and parents of your children's friends about your parent's illness, providing updates when necessary. You may want to write a letter or send an e-mail, so adults who may interact with your children will have consistent, accurate information. Many parents find it helpful to guide other adults in how to talk optimistically with their children.
• Encourage your children to tell you if they have heard anything about cancer that they don't understand. Children often hear things about cancer from friends or television, and they may encounter misinformation.
• Give your children ways to express their feelings and worries, such as encouraging them to write a story or draw a picture or play with their toys.
• Enlist the help of neighborhood or school-based parent groups to help with carpooling, childcare, and keeping kids involved in afterschool activities.
• Make emergency contingency care plans for childcare, and inform your children about these plans beforehand. For example, tell them, “Aunt Susan will stay with you at our house if I need to take care of Grandma,” or “Mrs. Jones will pick you up from school when I am taking Grandpa to the doctor.”

It also helps to remember that, although caring for a parent who has cancer while parenting young children can be challenging, it is a unique opportunity to model for your children how families take care of one another when someone is sick. It teaches your children the value of sacrificing for the benefit of another.

Tips for caring for your parent who has cancer

Talk with your parents about their needs and expectations upfront; then, set up a time to reevaluate how things are going at least once per month. If this is a difficult conversation for you, ask a health care professional, family member, or member of the clergy to facilitate. You may also want to consider taking the following steps:

• Ask the cancer treatment center social worker, nurse, or doctor for referrals to resources in your community, such as transportation, home delivered meals, and home nursing care.
• Find resources for respite care or a homemaker service to care for your parent. This can help your parent with basic household tasks while you are at work or caring for your children.
• Request a home safety evaluation by a visiting nurse or occupational therapist; the provider will recommend devices and services to enhance your parent's safety and ability to function independently.
• Ask family and friends to rotate caring for your parent on a regular basis or to help with childcare while you are caring for your parent. Learn more about sharing responsibilities with family members.
• Make caregiving contingency plans so that a relative or friend can relieve you on short notice.
• Use technology such as cell phones and e-mail to stay in touch when you're not available in person.

Tips for taking care of yourself

Taking care of yourself physically and emotionally is essential to healthy caregiving. Try to incorporate some of the suggestions below:

• Use resources available through your employer, such as the Family and Medical Leave Act (FMLA) and Employee Assistance Program (EAP).
• Take advantage of local caregiver support groups, as well as online support groups and message boards.
• Make a balanced diet, regular sleep, and exercise a priority.
• Plan periodic activities with family or friends that do not involve discussions or tasks related to cancer.
• Allow yourself some time, even in small intervals, to rejuvenate in the ways that work for you. This may involve hobbies, writing in a journal, or daily quiet time.
• Maintain supportive social contacts as often as possible, and create time for you and your spouse, partner, or friends to stay connected.

Source: cancer.net

SUPPORTING A FRIEND WHO HAS CANCER II

Practical help

Your assistance with daily tasks and chores is valuable help to a friend going through cancer treatment. Be creative with the help you offer. Remember that your friend’s needs may change, so be flexible in shifting your plans as needed. Here are some suggestions:

• Shop for groceries and pick up prescriptions.
• Help with chores around the house, such as getting the mail, taking care of pets, cleaning, doing laundry, taking care of plants and flowers, and taking out the garbage.
• Cook dinner and drop it off at your friend’s house.
• Schedule a night of takeout food and movies together.
• Baby-sit children, take them to and from school and evening activities, and arrange for play dates.
• Organize a phone chain and/or support team to check on your friend regularly.
• Call, email, or text regularly. Let your friend know it’s okay if he or she doesn’t reply.
• Drive your friend to an appointment or a support group meeting. You can take notes during a doctor's appointment or keep your friend company during a treatment session.
• Go for a walk together.
• Think about the little things your friend enjoys and makes life “normal” for them. This could be helping to decorate for a holiday or weeding the garden. If there is something your friend would usually do, there are many ways you can make it a bit easier for him or her to do it.

Forming support teams

Organizing a support team is a great way to help a friend living with cancer. Some online communities offer tools to coordinate tasks among friends and caregivers, and shareable online calendars may help you organize activities among your group of friends and family. Or you can always make a paper calendar and write in the various activities and commitments by hand. Make sure your friend has access to the calendar so he or she knows what to expect and when.

Gift ideas

There may be times when you want to give your friend a gift. As with any gift, keep in mind the interests and hobbies of your friend and your relationship to that friend. For instance, a close friend may be able to give something really silly or unusual, whereas a neighbor or work colleague may want to stick with something more traditional.

While giving a gift is one way to show you care about someone, be careful not to give your friend anything that promotes a specific treatment or philosophy as a cure for cancer. People make decisions about their disease after a lot of thought so it’s important to respect their choices and their coping process, whether it is what you would do in the same situation or not. Keep gifts fun, interesting, serious, or light, depending on what your friend needs the most at that moment.

Some ideas include:

• Magazines, audio books, novels, books of short stories or poetry, or gift cards to purchase reading material
• CDs or gift cards for downloadable music
• DVDs of movies, TV shows, or documentaries
• Accessories (earrings, bracelets, scarves, ties, hats), makeup, or beauty items
• Crossword or Sudoku puzzles
• Note cards or a journal
• A video message from family and friends
• Gift certificates for massage, spa services, restaurants, or museum/art gallery passes
• Gift cards to grocery stores
• A housecleaning service
• Portable hobby supply kits (scrapbooking, drawing, needlepoint)
• Pajamas or robe
• Flowers or plants

Friendship makes a difference

Continuing friendships and regular activities after a cancer diagnosis is a great way to further the healing process. But don’t forget that friends also need encouragement and support after cancer treatment has finished. After treatment your friend will be trying to find his or her "new normal" in this next phase of life, and friendships are an important part of that. With these practical suggestions in mind, your friendship can make a lasting difference to a person living with cancer.

Source: cancer.net

SUPPORTING A FRIEND WHO HAS CANCER I

If you have a friend who has recently been diagnosed with cancer, or is living with cancer, you may be wondering the best way to support him or her. Even though you want to help your friend through this difficult time, it can be hard to know what to say or do. While there are no set rules when it comes to supporting a friend who has cancer, this article will help you find ways to show your support, including ideas of what to say and how to provide practical help, as well as suggestions for thoughtful gifts.

Preparing yourself

A good first step is to learn more about the diagnosis beforehand. Your friend may not want to talk about the details for many reasons, including that it is physically and emotionally tiring to repeat the same information to different people. If possible, the person’s spouse or a mutual friend may be able to give you the basics. Write it down and repeat it back to them to be sure you’ve gotten the correct information. And if there’s information that is unknown or not shared, don’t push for more.

Before a visit, you may want to remember a time when you were really scared or felt really sick. Think about what it felt like. What did you want to talk about? How did you want to be treated? You may also want to prepare yourself for changes in your friend’s appearance.Fatigue, weight changes, and hair loss are common side effects of cancer and many treatments. Start your visit by saying “It’s good to see you” instead of commenting on any physical changes.

Helpful tips when supporting a friend

Although each person with cancer is different, here are some general suggestions for showing support:

• Ask permission—before visiting, before giving advice, before asking questions. And make it clear that saying no is perfectly okay.
• Make flexible plans that can be easily changed in case something comes up or your friend needs to cancel or reschedule.
• Don’t be afraid to make plans for the future—this gives your friend something positive to look forward to. Be careful not to come across as pushy or demanding though.
• Be humorous and fun when appropriate and when needed.
• Allow for sadness—do not ignore uncomfortable topics or feelings.
• Make time for a weekly check-in phone call. Let your friend know when you will be calling, and let your friend know that it is okay to not answer the phone.
• Offer to help with specific tasks, such as taking care of children, taking care of a pet, or preparing a meal. Many people find it hard to ask for help, and your friend will likely appreciate the offer. However, if your friend declines an offer, don’t take it personally.
• Follow through on a commitment to help.
• Try not to let your friend’s condition get in the way of your friendship. As much as possible, treat him or her the same way you always have.
• Ask about interests, hobbies, and other topics not related to cancer—people going through treatment sometimes need a break from talking about the disease.
• If you aren't sure how to help, ask.

What to say

Here are some simple guidelines to use when talking with your friend.

Avoid saying

• I know just how you feel.
• You need to talk.
• I know just what you should do.
• I feel helpless.
• I don't know how you manage.
• I’m sure you’ll be fine.
• Don’t worry.
• How much time do the doctors give you?
• How long do you have?
• Let me know what I can do. (Instead, offer specific ways you can help or other things you can provide if they need it.)

Do say

• I'm sorry this has happened to you.
• If you ever feel like talking, I am here to listen.
• What are you thinking of doing, and how can I help?
• I care about you.
• I’m thinking about you.
• I don’t know what to say. (It is better to be honest than to simply stop calling or visiting out of fear.)

Source: cancer.net

MYTHS ABOUT CANCER IV

Myth: Microwaving plastic containers and wraps releases harmful, cancer-causing substances into food.

Fact: Microwave-safe plastic containers and wraps are safe to use in the microwave.

But plastic containers not intended for use in the microwave could melt and potentially leak chemicals into your food. So avoid microwaving containers that were never intended for the microwave, such as margarine tubs, take-out containers or whipped topping bowls. Check to see that any container you use in the microwave is labeled as microwave-safe.

Source: mayoclinic.com

 Myth: People with cancer shouldn't eat sugar, since it can cause cancer to grow faster.

Fact: Sugar doesn't make cancer grow faster.

All cells, including cancer cells, depend on blood sugar (glucose) for energy. But giving more sugar to cancer cells doesn't speed their growth.

Likewise, depriving cancer cells of sugar doesn't slow their growth.

This misconception may be based in part on a misunderstanding of positron emission tomography (PET) scans, which use a small amount of radioactive tracer — typically a form of glucose. All tissues in your body absorb some of this tracer, but tissues that are using more energy — including cancer cells — absorb greater amounts. For this reason, some people have concluded that cancer cells grow faster on sugar. But this isn't true.

Source: mayoclinic.com

JOSE CARRERAS´S LEUKAEMIA FOUNDATION

It was July 1987 and José Carreras was in Paris recording the film version of La Bohème de Puccini under the direction of Luigi Comencini. During the filming process Mr. Carreras began to feel unwell and went to hospital. After 48 hours came the big shock: leukaemia. It was a terrible diagnosis that came at a time when he was professionally and personally at his "peak". 

In 1988, during the treatment of his disease, Jose Carreras together with a great team of scientists and businessmen, and with the support of his family he created the José Carreras International Foundation to contribute to the search for a cure for leukaemia. When he was asked why he had created this project he responded: "the truth is that I started this project to say thank you. When I was sick, society came to my aid. I want to give back for all those demonstrations of affection, equally to people and to science". 

Since its beginnings the José Carreras Foundation against Leukaemia has pursued one great aim. In fact, it is more than that; it is a significant challenge both scientifically and socially: to reach a day when leukaemia is curable for all and in all cases. 

Leukaemia, like many other diseases, develops without warning and is therefore difficult to accept. In the first moments, like any other patient, José Carreras felt puzzled but quickly established a positive attitude towards the situation. He explains that "during all the treatment I felt that if there was one chance in a million then I needed to fight for it and never throw in the towel". 

For more than 25 years, José Carreras has been at the forefront of the Foundation's work and dedicates many concerts to the Foundation each year, in order to actively contribute to the financing of the organization's various projects. 

 Jose Carreras singing around the world years after the recovery of his leukaemia

LIVER CANCER

Cancer that starts in the liver is called hepatocellular carcinoma (HCC), or hepatoma. HCC is the 5th most common cancer in the world and the 3rd leading cause of cancer death. Most cases of HCC occur in Asia and Africa, but the number of people with HCC is rising rapidly in the U.S. and other western countries.

Liver cancer (HCC) is a tumor that starts in the liver cells (hepatocytes).

500,000 new cases of HCC worldwide every year.

HCC occurs more often in men than women, usually in people 50 to 60 years old.

HCC is one of the most common cancers in the world: it is the 4th most common cancer and 3rd leading cause of cancer death worldwide

80% of people diagnosed with HCC are in Asia and sub-Saharan Africa due to widespread hepatitis B virus (HBV) in these regions.

All HCC are due to liver damage (cirrhosis) from several causes: HBV, hepatitis C (HCV) infection, excess alcohol consumption, and certain genetic liver disorders.

A growing cause if HCC in the U.S. and other western countries, is fatty liver. Fatty liver can occur in people with diabetes, obesity, or combination of high blood pressure, high cholesterol, diabetes, overweight).

The U.S. incidence and death rate from HCC have been rising steadily since 1975 and there are 22,000 predicted new cases in 2012.

HCC incidence in the U.S. is predicted to increase 4-fold over the next decade or so, due to HCV and fatty liver.

Liver transplantation can offer a small percentage of patients (<10%) survival for several years, but >75% patients had advanced disease and are not eligible for transplantation, surgery or liver-directed therapies.

There is only 1 FDA-approved chemotherapy drug, sorafenib, available for HCC patients.

WHAT ARE THE MAIN CAUSES OF LIVER CANCER?

On average, smoker have a 50-60% higher risk of liver cancer than non-smokers. Heavy drinkers have around five times the risk of liver cancer of light or non-drinkers.

Chronic heavy alcohol consumption or infection with the hepatitis B or C viruses can cause cirrhosis, which greatly increases the risk of liver cancer.

People with diabetes have an increased risk of liver cancer.

Occupational exposure to vinyl chloride has been linked to liver cancer.

Aflatoxin – a toxin produced by fungi - can contaminate foodstuffs stored in hot, humid conditions and is a cause of liver cancer in many developing countries.

HOW MANY PEOPLE SURVIVE LIVER CANCER?

Liver cancer is often diagnosed late and so survival rates are poor. Around 5% of patients diagnosed with liver cancer survive their disease for five years or more or more.

One year survival rates for liver cancer have improved since the 1970s. Around 20% of patients survive their disease for at least one year, compared to less than 5% forty years ago.

MYTHS ABOUT CANCER III

Myth: Positive thinking will cure cancer?

Although a positive attitude can improve your quality of life during cancer treatment, there is no scientific evidence that it can cure cancer. Placing such importance on attitude can lead to unnecessary guilt and disappointment if–€”for reasons beyond your control–€”your health does not improve.

Source: cancer.net

 Myth: The medical establishment is hiding a cure for cancer.

The medical community is not withholding a miracle treatment. There is no one single cure for cancer. More than 100 types of cancer exist, and they respond differently to various methods of treatment. Those who work in the medical field have the same likelihood of developing cancer as the general population, and they are eager for new and better treatments to emerge.

Source: cancer.net

WORLD CANCER DAY

Cancer is a leading cause of death worldwide and accounted for 7.6 million deaths (around 13% of all deaths) in 2008.

World Cancer Day is marked on February 4 to raise awareness of cancer and to encourage its prevention, detection, and treatment. World Cancer Day was founded by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration, written in 2008. The primary goal of the World Cancer Day is to significantly reduce death and illness caused by cancer by 2020