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Fri, Mar 1 2:13pm · Debunking some myths about one of the most common forms of cancer

Colorectal cancer is one of the most common cancers in both men and women – but it needn’t be.

That’s because screening can find colon cancer early, when it’s easier to treat. And screening can prevent it from occurring at all. According to the American Cancer Society, about one in three people in the United States who should get tested for colorectal cancer don’t.

There are a lot of misconceptions and myths about the disease. Zev Wainberg, MD, associate professor of hematology/oncology at the David Geffen School of Medicine at UCLA and a researcher at UCLA’s Jonsson Comprehensive Cancer Center, recently discussed some of the most common misconceptions.

MYTH 1:  I don’t know anyone with colorectal cancer so it must not really impact that many people.

“Actually, colorectal cancer is the third most common cause of cancer in men and women. It affects 150,000 Americans a year and about 50,000 Americans end up dying from it.”

MYTH 2:  Colorectal cancer only affects people over the age of 50.

“This is false. We’re seeing more and more younger people getting colon cancer, and research suggests that there’s a larger group of people under age 50 getting colorectal cancer every year. The reasons for this are not yet clear. But it is happening and it’s something about which we all need to be aware.”

MYTH 3:  I know screening can help prevent colorectal cancer, but a colonoscopy is painful and unpleasant.

“A colonoscopy really isn’t as bad as it sounds, and it can help prevent a lot of difficult problems later. There are other screening methods that as good or nearly as good as a colonoscopy. But it’s different for everyone. You should talk to your doctor about approved, validated screening methods that are less invasive.  The important thing is to get screened. Every week I see patients in their 50s who are newly diagnosed with late-stage colon cancer that most likely would have been diagnosed at an early stage if they had an initial screening at the recommended age of 50. I see this way too often in my clinic.”

MYTH 4:  There’s nothing I can do to prevent colorectal cancer.

“There are lots of things you can do. Exercising and eating a nice healthy diet can help prevent many problems in life, and colorectal cancer is one of them. The biggest risk factors for colon cancer remain genetic predisposition, inflammatory bowel diseases and family history. While we are still at our infancy of understanding the mechanism of this disease and how it’s developed, there are many scientists here at the UCLA Jonsson Comprehensive Cancer Center who are devoted to better understanding this disease at a molecular level, which can lead to better diagnosis and treatments.”

Wed, Jan 2 11:06am · How one boy coped with loss of his father from cancer

Theo Tittle

Theo Tittle and family, on vacation

Theo Tittle grew up knowing his dad wasn’t like everyone else.

For starters, his father, Bently, battled a rare genetic form of kidney cancer that entailed three major surgeries, various cancer-fighting treatments and participation in a clinical trial. Beyond that, says Theo, his dad stood out as a “super irreverent” guy who embraced and loved everyone, especially those other people might view as oddballs.

When Theo was about a year old, his father was diagnosed with heriditary leiomyomatosis renal cell cancer, or HLRCC. The disease is extremely rare, impacting about 300 families worldwide, according to the National Institutes of Health. About 10 to 16 percent of those with the HLRCC disorder will develop that form of kidney cancer, the NIH says.

“For all those years, dad was the poster child for his form of cancer,” says Theo. “His case helped the clinical trial team understand the disease better. Dad also talked with many people about living with cancer and HLRCC. He always made people feel better.”

In 2013, Theo’s dad had another recurrence. But this time, he didn’t recover. In February 2014, a week after celebrating Theo’s 12th birthday, his dad died.

“Even though I went to a lot of chemo sessions and I was there for it all, I never thought he would actually die from it because he always recovered,” said Theo, now 16. “Stuff would flare up, but it never stopped him from surfing, painting, making films, teaching and just being his usual funny self.”

Not long after his father’s death, Theo and his family began receiving support from psycho-social professionals at the Simms/Mann-UCLA Center for Integrative Oncology, who specialize in helping families cope with the challenges of cancer. With their help, Theo has been able to get through such a difficult time in his life.

The Simms/Mann-UCLA Center,  part of the UCLA’s Jonsson Comprehensive Cancer Center and UCLA Health Oncology, was designed to help patients and family members optimize their wellness and address the challenges throughout the continuum of cancer care.

“Losing my dad was the biggest loss in the world. It’s a really hard thing for anyone to go through, but especially for a kid.”

Theo shared some advice on how he has coped with his father’s death.

It’s okay to not be okay.

“About a month after my dad died, I remember working on a project in school about connecting words to images, so I wrote, ‘happier than the happiest rainbow,’ which is just the opposite of how I was really feeling,” said Theo. “But I did that because I felt the need to show everyone that I was okay because people around me were wanting me to be okay. But when you lose a parent, it’s okay to not be okay.”

There’s no   “normal” way to cope with death

Everyone manages their grief differently, and don’t ever think a child is not feeling what’s happening, said Theo.

“There’s no feeling you’re supposed to feel. Some people think you should be crying every day and every minute and be really sad all the time. Yes, you’re sad, but you’ll still feel other things. You can still have fun with your friends and go out and play. You just have to do what’s right for you.”

Let out your feelings

“I did let it bottle up and when that happened, there were days where everything was hard and I just couldn’t do it,” said Theo. “Little things would tick me off, and it became kind of like a metaphorical cup that just kept filling up and then it all came pouring out. You can’t do that. It’s just not healthy. It’s okay to have those dark moments, you don’t need to hide them.”

It gets easier with time

“After a while, you feel different and things begin to normal out. You still have those intense feelings and every now and then, you’ll feel them again, but they’ve gotten smaller because you are moving on in your life. Your loss is still there, and you’ll still miss that person insanely. Your life may become more normal over time, but it won’t ever be the same. And that’s okay, too.”

Sometimes, just being there is enough

“I remember the night before my dad’s memorial, and my mom and I just kind of laid on the bed together. We were sitting there and she was just like this calm presence, and I felt like I had somebody there for me. She didn’t need something from me. She didn’t need me to pour out my feelings…. We didn’t need to talk. She was there to just be with me.”

Don’t compare losses

“People try to be comforting by saying something like, ‘I totally understand what you’re going through. My great, great, great, great grandpa died last year.’ But no loss is equal, and we shouldn’t try to compare them,” Theo said. “Something I really liked hearing was, ‘I can’t relate to this. I don’t understand. I’ve never been through anything like that. But I’m here for you.’”

***

To contact the Simms/Mann-UCLA Center: SimmsMannCenter@mednet.ucla.edu or 310 794-6644. The Simms Mann Center is located on the UCLA campus at 200 Medical Plaza, Suite 502, Los Angeles.

Oct 2, 2018 · Separating breast cancer facts from fiction

breast cancer myths

Many studies have found that physical activity has been associated with a reduced risk of breast cancer.

Knowing the facts about breast cancer treatment and prevention is crucial in reducing your risk. However, there are a number of misconceptions about the disease that can make it difficult to separate fact from fiction.

UCLA oncologist Dr. Parvin Peddi, assistant clinical professor in medicine and member of the UCLA Jonsson Comprehensive Cancer Center, discusses four myths regarding the most common cancer in U.S. women.

MYTH: No one in my family has cancer so I’m not at risk

FACT: “Less than 10 percent of breast cancers are linked to genetics or linked to genes that you get from your family,” Peddi said. “So just because no one in your family has breast cancer does not mean you cannot get it. In fact, more than 90 percent of breast cancers are not linked to any family history whatsoever.”

Learn more about the risk factors that makes someone a candidate for genetic testing.

MYTH: Sugar causes breast cancer

FACT: “While simple carbohydrates are not good for anyone, sugar does not cause breast cancer or any other cancer in particular,” Peddi said. “Therefore, there’s no reason to completely eliminate sugar from your diet.”

To help protect your health and reduce the risk of certain cancers, heart disease, diabetes and stroke, the American Cancer Society recommends that women eat mostly vegetables, fruits, and whole grains and to cut back on eating red meats, processed meat and sweets.

MYTH: There’s nothing I can do about reducing the risk of breast cancer

FACT: “Actually exercise, maintaining good body weight and limiting the intake of alcohol all have  been linked to decreased risk of breast cancer,” Peddi said.

In fact, even just a few alcoholic drinks a week is linked with an increased risk of breast cancer in women. Peddi recommends less than three drinks a week for women to help lower their risk.

Many studies have also found that physical activity has been associated with a reduced risk of breast cancer. The U.S. Department of Health and Human Services recommends that adults engage in at least 150 minutes of moderate-intensity aerobic physical activity every week.

MYTH: Early detection of breast cancer won’t change my prognosis

FACT: “When patients come to my clinic with early breast cancer, I can actually help cure them of the disease. When the cancer is discovered at a later stage, the chances of a cure are much less achievable,” Peddi said. “So it does make a difference to get your mammograms on time as recommended to help catch the disease at an early stage.”

The U.S. Preventive Services Task Force suggests women begin regular mammograms at age 50. The American Cancer Society recommends starting these tests at age 45. Talk with your doctor about  the best time to begin mammography screening.

Learn more about mammograms UCLA.

 

 

 

Sep 13, 2018 · Stem cell transplants: What you need to know

stem cells

Stem cell transplants transfuse healthy cells into a person after his or her own unhealthy bone marrow is treated to kill the abnormal cells.

Stem cell transplants, also known as bone marrow transplants, are used successfully to treat people with life-threatening blood cancers and other rare blood diseases, giving people a second chance at life.

More formally known as hematopoietic (of the blood) stem cell transplants, these procedures transfuse healthy cells into a person after his or her own unhealthy bone marrow is treated to kill the abnormal cells.

Dr. Joshua Sasine, an oncologist at UCLA’s Jonsson Comprehensive Cancer Center and director of UCLA’s CAR T cell program, shares essential information about these lifesaving transplants.

Who needs a stem cell transplant?

In order to qualify for a stem cell transplant, your medical condition must be sufficiently dangerous to your health to warrant the risks of the procedure. The most common diseases people have that justify the transplant include, but are not limited to: acute myeloid and lymphoid leukemias, aplastic anemia, Hodgkin’s lymphoma, diffuse large B-cell lymphoma, multiple myeloma and myelodysplastic syndrome.

What are the side effects of the transplants?

The most common side effects are infections and graft-versus-host-disease, which is when the new cells attack the patient’s healthy cells. Less common side effects include:

  • Treatment-related myelodysplasia/secondary leukemia
  • Secondary solid tumors
  • Cardiac and pulmonary disease
  • Diabetes/hypertension
  • Iron overload
  • Endocrine dysfunction, including infertility
  • Osteoporosis
  • Cataracts
  • Psychological effects of prolonged illness

How do you prepare patients for a transplant?

Prior to the procedure, patients undergo a conditioning regimen. It is composed of chemotherapy and/or radiation and meant to destroy the patient’s own bone marrow (and any residual cancer along with it, if the patient has cancer) and allow the body to accept the donor cells.

What are the different types of stem cell transplants?

There are two types of transplants: autologous and allogenic. The autologous version of the procedure uses cells from the patient; the allogeneic version uses cells from a donor.

Where do the donated stem cells come from?

A patient can receive cells from a few different types of donors. The main categories are matched sibling, matched unrelated, haplo (or “half-matched”) related, and cord blood. Some also use mismatched unrelated donors but this practice is uncommon outside of a clinical trial due to the frequency and severity of complications that arise, mainly graft-versus-host disease. A fully matched sibling is the preferred donor type, followed by matched unrelated (a donor from the registry).

How are blood-forming stem cells collected for the transplant?

For cord blood, the cells are taken right after birth and then frozen for storage. For other donors, the cells typically are collected from the donor’s blood after the donor is given a drug or combination of drugs to mobilize the stem cells out of the bone marrow into the blood. It’s rare for the cells to be taken directly from the bone marrow in a surgical procedure.

What are the pros and cons of using umbilical cord blood for a transplant?

The main advantage of cord blood is that is opens the door to transplant for those who would not normally have a donor. Cord blood requires less immunological match than other sources. The downside is that they generally take longer to engraft, increasing the risk for infections. The rate of graft failure is also higher than a matched sibling. If that occurs, the patient could be left without other options. This scenario, though rare, is very serious and often fatal.

What makes someone a perfect donor match?

There are many immune system genes we search for routinely to determine the “best” donor in patients with multiple donor options. To be a full match, they need to share all these immune genes. If a sibling is not a match, we search the donor registry. If no match exists there, we evaluate haplo and cord options.

Does a patient’s ethnic background affect finding a donor?

Ethnicity is not a factor directly. By that, I mean that it’s not a variable that goes into the match equation. If your donor is from a different ethnicity, that’s ok. It turns out that the likelihood of finding a match is related to ethnicity though. For example, the chances of a patient from European descent finding a match in the registry is higher than someone of African ancestry. This is partly related to the number people in ethnicities who volunteer to be on the registry, but it is also due to the relative immunological similarly within certain populations compared to others. This underscores the importance of increasing the donor pool in the registry, especially from underrepresented ethnicities. If you aren’t yet registered, please contact the National Marrow Donor Program to make yourself available to patients who might need your help!

 

 

 

Aug 31, 2018 · Five facts about ovarian cancer to share with friends, family

Ovarian Cancer Awareness Month

Dr. Sanaz Memarzadeh, a UCLA professor in obstetrics and gynecology and member at the UCLA Jonsson Comprehensive Cancer Center, helps us understand the basics of ovarian cancer.

A better way of diagnosing and treating ovarian cancer is on the horizon. Dr. Sanaz Memarzadeh, a UCLA professor in obstetrics and gynecology and member of the UCLA Jonsson Comprehensive Cancer Center, is convinced of it. She and her colleagues are focused on  discovering why epithelial ovarian cancer, one of the most common and aggressive subtypes of the disease, often reoccurs despite standard treatment.

Through a collaborative effort at UCLA, researchers are trying to restore the function of a key protein – known as p53 — that is commonly mutated in ovarian cancer. Memarzadeh and her collaborators are testing whether this approach, coupled with standard therapies, can prevent recurrence of ovarian cancer.

“My lab and I have really dedicated our focus and efforts to studying this disease,” said Memarzadeh, who is also a member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA. “By studying the biology of some of the most aggressive subtypes, we’re hoping to one day soon make a real difference in how we approach and treat ovarian cancer.”

Such commitment is vital. Although ovarian cancer is often considered a relatively rare cancer – accounting for only about 3 percent of all cancers in women – it causes more deaths than any other cancer of the female reproductive system. It’s also the fifth-leading cause of cancer death in the United States.

In September, also known as Ovarian Cancer Awareness Month, share these five facts with your friends and family:

  1. Ovarian cancer can’t be easily detected.

Ovarian tumors are responsible for a disproportionately large number of gynecologic cancer-related deaths, because no test can reliably detect the disease at an early stage, when it’s most easily treatable.

  1. Warning signs are often mistaken for more common illnesses.

The symptoms of ovarian cancer (such as feeling bloated or full, having stomach pain or trouble eating, and needing to urinate often) resemble other common ailments, which further impedes early detection.

  1. Treatment options for ovarian cancer are evolving and need to improve

For more than 40 years, ovarian cancer treatments, including surgery followed by chemotherapy, have remained largely the same. More recently new targeted agents are being incorporated into treatment regimens.

  1. Genetics can play a role.

Epithelial ovarian cancer, the most common type, occurs most often in women ages 50 to 65, sometimes running in families. Genetic testing for two genes typically associated with breast and ovarian cancer – BRCA1, BRCA2 and others – is recommended for those who have a strong family history of breast or ovarian cancers.

  1. More funding is needed to find better treatments for ovarian cancer.

Ovarian cancer is particularly underfunded and understudied compared with other cancers. For example, in 2016, the National Cancer Institute invested $95.6 million in ovarian cancer research. That investment was 60 percent less than prostate cancer research (which received $241 million) and 82 percent less than breast cancer research (which received $519.9 million), which kills a proportionally fewer number of people who are diagnosed.