IMPORTANT INFORMATION FOR CANCER PATIENTS WHO CAN NOT AFFORD THE PAYMENT OF CANCER DRUGS

Many cancer patients are unable to pay for prescription drugs either because they are uninsured, under-insured, or simply can’t make the co-payments on their prescriptions. Because of this, some pharmaceutical companies have developed Prescription Assistance or Patient Assistance Programs (PAPs) that offer medications to some people who cannot afford them. The companies often restrict the programs to: U.S. citizens; people who make below a certain income; people who either lack prescription drug coverage or those with coverage whose insurer has denied coverage of a particular drug. However, if you are denied access to a program, you may appeal the decision. Be sure to let the company know your circumstances, as they may work with you to find a solution. More HERE

TRAVEL AND LODGING RESOURSES FOR CANCER PATIENTS

The following national organizations offer help for people with the traveling and lodging resources for cancer patients and their families. People should contact organizations directly to learn more about the specific programs and services. This list below is valid to US only. In addition to this national list, many organizations serve people in their local communities; talk with your health care team about the groups in your area that may be able to help.  

Air Care Alliance www.aircareall.org 888-260-9707	Corporate Angel Network www.corpangelnetwork.org 866-328-1313
Air Charity Network/Angel Flight America www.aircharitynetwork.org 877-621-7177	Hope Lodge www.cancer.org/hopelodge 800-227-2345
Air Compassion America www.aircompassionamerica.org 866-270-9198	Joe’s House www.joeshouse.org 877-563-7468
Air Compassion for Veterans www.aircompassionforveterans.org 888-662-6794	LifeLine Pilots www.lifelinepilots.org 800-822-7972
Angel Flight Samaritans www.angelflightsamaritan.org 800-296-1217	National Association of Hospital Hospitality Houses www.nahhh.org 800-542-9730
National Patient Travel Center www.patienttravel.org 800-296-1217

FINANCIAL RESOURCES FOR CANCER PATIENTS WITH FINANCIAL CHALLENGES

The following national organizations offer help for people with cancer with financial challenges. People should contact organizations directly to learn more about the specific programs and services, including eligibility criteria. This list below is valid to US only

General Financial and Co-Pay Assistance

American Cancer Society www.cancer.org 800-227-2345	HealthWell Foundation www.healthwellfoundation.org 800-675-8416	National Organization for Rare Disorders www.rarediseases.org 800-999-6673
CancerCare www.cancercare.org 800-813-4673	The Leukemia and Lymphoma Society www.lls.org 800-955-4572	Patient Access Network Foundation www.panfoundation.org 866-316-7263
CancerCare Co-Payment Assistance Foundation www.cancercarecopay.org 866-552-6729	Lymphoma Research Foundation www.lymphoma.org 800-500-9976	Patient Services Inc. www.uneedpsi.org 800-366-7741
Cancer Financial Assistance Coalition www.cancerfac.org	The MAX Foundation www.themaxfoundation.org 888-462-9368	Together Rx Access Card www.together-rxaccess.com 800-444-4106
CureSearch: Childhood Cancer Resource Directory www.curesearch.org/resources 800-458-6223	National Council on Aging www.benefitscheckup.org 202-479-1200	National Organization for Rare Disorders www.rarediseases.org 800-999-6673
Chronic Disease Fund www.cdfund.org 877-968-7233	National Marrow Donor Program www.marrow.org 888-999-674317	Partnership for Prescription Assistance www.pparx.org 888-477-2669
Partnership for Prescription Assistance www.pparx.org 888-477-2669	Patient Advocate Foundation www.copays.org 866-512-3861	Sarcoma Alliance www.sarcomaalliance.org 415-381-7236

WIN A COPY OF THE PROSTATE CANCER BOOK !

Just answering  the multiple choice question. Select the answer that you believe is correct. First three correct answers are winning!

What is true in prostate cancer?

1.   The prostate gland is a gland found in men exclusively

2.  A localized (no disseminated) prostate cancer have high probability to be cured with surgery or radiotherapy only

3.   The digital rectal examination and measurement PSA (prostatic specific antigen) levels are recommended strategies for early detection and prostate cancer screening

4.       All the above are correct.

Source: author of the blog

MANUAL OF PROSTATE CANCER

If you are a man 40+ years old, you should be aware that the risk of having a prostate cancer is increasing with the years. Everything that you should know about prostate cancer find in the educational book about it LINK

PREOCUPACIÓN EN LA LUCHA CONTRA CÁNCER DE PROSTATA

Según una encuesta llevada a cabo, los dos tercios de los hombres británicos no tienen ni idea de lo que realmente hace la próstata. Cada año, 35.000 hombres son diagnosticados con cáncer de próstata en el Reino Unido, por lo que es el tipo más común de cáncer en los hombres. Lo que todo hombre debe saber sobre el cáncer de próstata (prevención, factores de riesgo, prueba de PSA, tratamientos, etc) en el siguiente LINK (web del libro en español).

WHAT IS THE MOST SERIOUS AND FREQUENT COMPLICATION OF PATIENTS RECEIVING CHEMOTHERAPY?

Answer: Febrile neutropenia.

The word febrile means you have a fever.  A fever is defined as a single oral temperature of greater than or equal to 38.3°C (101 F), or a temperature of greater than 38.0°C (101.4 F) lasting at least an hour. NOTE: Patient may not present with fever, but may have symptoms such as hypotension, tachycardia or chills. Fever neutropenia occurs when a patient has a fever and a significant reduction in their white blood cells (neutropenia) that are needed to fight infections. Many patients when undergoing cancer treatment will have a reduction in their white blood cells that may be temporary or may persist for some time. The fever may be caused by an infectious agent, and when it is rapid treatment is required. A patient with febrile neutropenia needs assessment for the possible source and type of infection and treatment until the cause is found or it subsides.

What you should do if you have any of these signs?

Sometimes it is hard to tell if you have an infection. However, if you have any warning signs and your white blood cells count may be low, this is a medical emergency. Even if you feel fairly well, you must contact your doctor or nurse or go to your nearest hospital Emergency Room immediately!

What could happen if the physician confirms that you have a febrile neutropenia?

The first decision of the physician will be to hold the chemotherapy treatment. If the patient has febrile neutropenia then cultures and more blood tests will be taken to try to determine the presence and possible site of any infections. A decision will have to be made by the physician as to whether the patient should be admitted to a health care facility for observation and treatment. This decision will be based on the clinical state of the patient and the predicted length of the lowered white blood cell counts. Whether the patient is admitted or not treatment will usually include the use of antibiotics. Be aware that you physician may prescribe you the colony-stimulating factors (CSFs), which are glycoproteins that stimulate a fast repopulation of the white blood cells, for a faster control of the infection or febrile neutropenia .

What are the risks to develop a febrile neutropenia?

In addition to the risk of the chemotherapy treatment and the specific malignancy being treated, the following factors need to be considered when evaluating a patient’s overall risk for febrile neutropenia: Older patient, previous chemotherapy and radiotherapy, preexisting neutropenia or bone marrow dysfunction due to tumor involvement, poor performance status and poor renal and liver function.  If you are in one of such group of risk, your physician will recommend the use of CSF prophylactically in each cycle of treatment.

Luis Mendoza, MD, PHD

ANGELINA JOLIE´S DOUBLE MASTECTOMY

Actress and activist Angelina Jolie's recent decision to have a preventive double mastectomy highlights the difficult choices facing women who find out they have a high risk for breast cancer because of their genes.

Although relatively rare, mutations in the BRCA1 and BRCA2 genes raise the risk of breast cancer by as much as 80%, experts say. The mutations also raise the risk of ovarian cancer.

Jolie describes in a New York Times op-ed piece why she decided to go through with the surgery. At 37, the mother of six wants to stay healthy and active for her family -- and to reassure them that she is doing everything possible to avoid the disease that took her mother's life: cancer.

“I wanted to write this to tell other women that the decision to have a mastectomy was not easy,” Jolie writes. “But it is one that I am very happy I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”

Why do women undergo a preventive double mastectomy?

In Angelina Jolie's case, she had a mutation that puts her at very high risk for getting breast cancer at some point in her life. Right now the most effective prevention that we have for [this] BRCA mutation carrier is a prophylactic double mastectomy.

It is always a double mastectomy because both breasts are at risk and you don’t know which breast is going to get breast cancer when women have a BRCA mutation.

How many women have the BRCA mutation?

Only about 5% of all breast cancers are in women who have this genetic mutation.

Is the breast cancer linked with this mutation more aggressive than others?

Yes, BRCA mutations are associated with a more aggressive breast cancer that is known as "triple negative."

Do some experts think that performing a double mastectomy is too radical for those who test positive for BRCA mutations?

I think most breast cancer experts would agree that the choice is really the patient's to make, and I really want to emphasize, it is a choice.

Preventive mastectomy is one very excellent choice. But another choice women can consider when they know they carry a BRCA mutation is early detection. And that comes with more active screening. If a woman knows she has a BRCA mutation and does not want to have a mastectomy, a good alternative is to have a mammogram and a breast MRI every year. You can do both at once or choose to alternate. [For my patients] I choose to alternate, doing one test every 6 months.

It's not as effective because by definition you are picking up cancer as it develops. But it is effective at picking up cancer at a very early stage.

If a woman has a preventive double mastectomy, what are the benefits and risks?

In women at higher risk -- those with BRCA mutations -- preventive surgery can reduce the risk of breast cancer by 90%. If the [increased] risk is 80% as it is for many BRCA carriers, this can reduce the risk of breast cancer by 90%.

In other words, this can reduce the risk to that lower than the general population. The risks [of the mastectomy] are not that great. Most women having preventive mastectomies are younger patients, and many choose to get reconstruction. A lot of the risk has to do with the implants, like implant complications, or other risks [linked with surgery] such as infections or bleeding.

Who should consider BRCA testing?

The women who should absolutely consider it are those who themselves have had a triple-negative breast cancer, the kind associated with BRCA mutations, at an early age, under 45, people who have had both ovarian and breast cancer in family members, and people who have breast cancer in the family and are of Ashkenazi Jewish descent.

What is involved in testing for BRCA mutations?

It is a simple blood test, or they can swab the inside of your cheek. The best way to get this test is to go for counseling from a genetic counselor. Have them talk to you about the possibility of testing positive. Women really need to be counseled about what this means, what the results mean, what their risk is, and then to make the decision about whether to get the test.

If you only get tested for the three most common mutations, results take about 2 weeks. The more comprehensive test, where they do gene sequencing, can take a month.

What is the cost and who pays?

The cost is about $3,000. The cost of testing is covered by many insurance companies [if you are deemed high risk].

By Kathleeen Doheny

WebMD Health News

Reviewed by Michael W. Smith, MD

STUDY: BIENNIAL MAMMOGRAMS MAY BE BETTER FOR SOME WOMEN

Research suggesting that annual mammograms may not be best for most women received a fair amount of coverage online, and was featured on two of last night's national news broadcasts. Most sources point to the fact that advice on mammogram frequency varies among medical groups, and that these findings back up recommendations from the US Preventive Services Task Force. Meanwhile, some sources mention that certain groups were critical of the study.

        The CBS Evening News (3/18, story 8, 2:30, Schieffer, 5.58M) reported that a new study has "found that doing mammography every two years rather than every year did not increase the risk of advanced breast cancer."

        ABC World News (3/18, story 5, 2:05, Sawyer, 7.43M) reported that the study "revealed 60% of abnormal mammograms turn out to be false positives, not cancer at all, even though they can lead to biopsies, even surgery." During a second segment on the topic on ABC World News (3/18, story 6, 0:50, Sawyer, 7.43M), ABC's Dr. Richard Besser said, "I think this is one of the most important things you can do, with whatever serious illness you have. It's to ask this question. Say to your doctor, 'Before we go forward with any treatment, let's get a second opinion. And is there someone you can refer me to?' The best doctors are going to welcome another set of eyes, another way of looking at it."

        CBS News (3/19) reports on its website, "The results, which were published on March 18 in JAMA Internal Medicine, follow the 2009 recommendation by the US Preventive Services Task Force that advocated for biennial mammography for women in this age group instead of the previous suggestion of getting screened every one to two years." In the new study, "the researchers looked at data from 11,474 women with breast cancer and 922,624 women without breast cancer who underwent screenings at US facilities involved in the long-running Breast Cancer Surveillance Consortium (BCSC) from January 1994 to December 2008." The researchers fond that "women who went every two years for a screening were not associated with an increased risk of advance stage breast cancers or large tumors, even if the woman had dense breasts or used hormone replacement therapies, when compared with women who were screened every year."

        Bloomberg News (3/19, Cortez) reports, "The study found an exception for women 40 to 49 years old with extremely dense breasts." These individuals "were about twice as likely to be diagnosed with large tumors or advanced cancer if they skipped mammograms." Additionally, "they...had higher rates of false-positive results."

        Reuters (3/19, Steenhuysen) reports, however, that some groups, including the American College of Radiology, criticized the study, arguing that its methodology was flawed.

        False-Positive Mammograms May Have Negative Psychological Effects. The Los Angeles Times (3/19, Brown, Times, 692K) reports, "Long after learning that a troubling reading on a screening mammogram was just a false alarm, women continued suffering negative psychological effects, researchers in Denmark have reported" in the Annals of Family Medicine. Researchers found that, "six months after hearing they did not have breast cancer, women with these false positives experienced changes in 'existential values' and 'inner calmness' as great as for women who had cancer."

        On its website, ABC News (3/19, Moisse) reports that additionally, "women who had false positives were...more likely to report disturbances in sleep and sexuality, according to the study."

        The NBC News (3/19, Fox) "Vitals" blog reports that the researchers wrote, "False-positive findings on screening mammography causes long-term psychosocial harm: Three years after a false-positive finding, women experience psycho-social consequences that range between those experienced by women with a normal mammogram and those with a diagnosis of breast cancer."

UTILITY OF ADJUVANT ASPIRIN IN CRC NOW HAS BIOMARKER

A recent study points to a useful biomarker for patients with colorectal cancer who might benefit from adjuvant aspirin therapy.

Previous published studies have confirmed anecdotal observations of the benefit of aspirin therapy in improving outcomes in certain cancers. Researchers in Boston and Japan analyzed data obtained from the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) to determine if the regular use of aspirin had a significant effect on survival among patients with colorectal cancer.

Xiauyun Liao, PhD, and colleagues at the Dana-Farber Cancer Institute in Boston, selected 964 patients who had been diagnosed with rectal or colon cancer, reviewing data on survival, aspirin use before and after diagnosis, and tumor tissue data, including the presence of the PIK3CA mutation, present in 15%-20% of colorectal cancers. Biomarkers also were examined, including PTGS2 (i.e., cyclooxygenase-2), phosphorylated AKT, KRAS, BRAF and microsatellite instability. Results were published in The New England Journal of Medicine (2012;367:1596-1606, PMID 23094721).

Researchers hypothesized that regular aspirin use (defined as a standard dose taken two or more times a week during most weeks) may inhibit cancer cell growth and induce apoptosis by blocking the PI3K pathway. The results showed patients with thePIK3CA mutation who took regular aspirin had an increased survival rate compared with patients with wild-type PIK3CA, regardless of whether the aspirin therapy began before or after diagnosis.

In patients with the mutated PIK3CA gene who did not use aspirin, 23 of 90 died within five years of diagnosis, whereas only two of 62 died who had used aspirin (P<0.001). These patients had significantly increased cancer-specific survival (multivariate hazard ratio [HR] for death, 0.18; 95% confidence interval [CI], 0.06-0.61; P<0.001) and superior overall survival. Regular use of aspirin after diagnosis in patients with wild-type PIK3CA was not associated with cancer-specific survival (multivariate HR, 0.96; 95% CI; 0.69-1.32; P=0.076) or overall survival.

The authors noted the exact mechanism that causes these results needs to be clarified and that the heterogeneous nature of colon cancers may also affect outcomes. They conclude that colorectal cancer patients with the PIK3CA mutation would derive a benefit from aspirin as an adjuvant therapy, and that the mutation might provide a useful biomarker for such therapy.

From The New England Journal of Medicine