In the September issue of the International Journal of Radiation Oncology-Biology-Physics, researchers at the University of Pennsylvania Department of Radiation Oncology in Philadelphia and the Radiation Oncology Branch of the National Cancer Institute in Bethesda, Md. published an article stating that most cancer patients currently receive insufficient pain management therapy.

The conclusion was determined with information from an internet-based questionnaire given to patients of radiation treatment.  One-hundred and six patients completed the survey which evaluated their medication use, pain control and attitudes toward pain medication, including prescription and over-the-counter pain medications.

For some patients, cancer pain is caused by the disease itself or chronic inflammatory changes or infections.  In other cases, cancer treatment can be the source of pain.  When managed improperly, pain can cause unnecessary anxiety, thus perpetuating illness.

The study found that 58 percent reported pain from their cancer treatment and 46 percent of patients reported pain directly from their cancer, yet 80 percent of those patients said that they did not use medication to manage their pain.  According to Science Daily, "Most patients said the main reason they did not take pain medication was because their healthcare provider did not recommend it. This reason was followed by a fear of addiction or dependence and the inability to pay. Some patients also reported using alternative therapies for pain relief, including physical therapy, massage and acupuncture."

The researchers said the key to proper pain management is effective communication.  "To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications," said Charles Simone, M.D., a resident at the National Cancer Institute Radiation Oncology Branch in Bethesda, Md. and lead author of the study.

Sixteen years ago, neuroscientist and physician David Servan-Schreiber discovered during one of his own brain scanner experiments that he had brain cancer.  The diagnosis was an enormous shock, but David proceeded with chemotherapy and radiation, which he says saved his life.

When the treatment finished, he was at loss.  The chemo was was complete but David wanted to do all he could to prevent the cancer from returning.  He says, "As soon as you stop the chemo, you feel stripped, and you think, 'Wow, what do I do now?' And then everybody asks their doctor ... and this is when 99 percent of us get the standard answer, which is, 'Nothing in particular. Live your life like you always did.' "

So David investigated methods of preventing cancer from returning, and found a wealth of information his doctor had not mentioned.  "There's tremendous evidence that physical exercise helps prevent cancer, and also helps people who already have cancer prevent a recurrence," he says.

According to David, herbs and spices such as garlic, turmeric, rosemary, thyme, mint, and green tea help make the body less fertile for cancer. For instance, "When you put a little bit of garlic extract on cancer cells, they die."

He says vegetables and fruits such as brussel sprouts, asparagus and raspberries can target specific cancers, at least in test tubes.

"Your body knows how to fight cancer," David advises. "Help it with the right nutrition, with physical exercise, with managing stress better, and avoiding contaminants that feed cancer. And if you do these things, which are very simple, you're greatly increasing your chance of beating the odds."

David recently authored a best-selling book, Anti-Cancer: A New Way of Life, to share his story with other patients.

A recent study conducted by Dr. Suzanne Audrey, at the University of Bristol, and her colleagues found that patients with incurable cancer are often not clearly informed of what they stand to gain from palliative chemotherapy. As a result, patients may lack sufficient knowledge to make a decision based on informed consent.

The researchers observed and recorded 9 oncologists and 37 patients during consultations in which palliative chemotherapy for advanced lung, pancreas, or colon cancer was first discussed. The researchers found that in all cases, patients were told that their cancer was incurable. They were also informed about treatment options, common side effects and the associated risks in the different treatment options. However, in 8 cases, survival was not discussed at all. In an additional 18 cases, information was "vague," involving comments such as "about 4 weeks, a few months extra, and buy you some time." Moreover, only 6 patients were given numerical data about how much longer they would likely live if palliative chemotherapy were used.

"If the oncologist focuses on the benefits of palliative chemotherapy in terms of control of symptoms and quality of life, but omits information about survival benefit, the patient might assume much greater potential to prolong life than is likely to be the case," Audrey and colleagues suggest.

The authors of this study believe that oncologists should not evade the subject of life expectancy. Instead, they recommend that oncologists receive coaching on how to inform patients without taking away hope.

After a year of chest pain, Anita Steiner was ultimately diagnosed with mesothelioma. She had surgery to remove some of the cancer from her right lung, and doctors gave her only 12 months to live. Although the news was devastating, Steiner was determined to stay positive and was put on a course of palliative chemotherapy to delay the aggressive disease. The positive attitude paid off when doctors told her she was cleared of cancer.

As Steiner celebrated the great news, she suddenly got another scare. "I was trying to unpack boxes in our new house and I just kept throwing up," she recalls. "I thought I might have come out of remission - it was an awful feeling.” Steiner’s blood test came back positive but not for mesothelioma. She was in fact pregnant, something her and her husband had been trying to do with in vitro fertilization before she got sick.  "This is one miracle, meets a second, meets a third, really," says her oncologist, Ian Haines. "The pregnancy part of this is quite extraordinary, let alone it following chemotherapy for mesothelioma, which put her into remission."

At five months pregnant, Steiner is aware of the risk that her cancer will return. She refuses to think about the negatives but does get tested regularly to be safe.” I don't think it helps to dwell,” she said. “Until I get the results of these tests, I feel stressed, but most of the time I just think about the future and having a child. I want to be with that child as he or she grows up." In addition to preparing for the birth of her child, Steiner is devoting her time to warning others about the dangers associated with asbestos.

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Recently we wrote about how the combination of the drugs Alimta and Paraplatin showed an improvement in the survival rates of people with mesothelioma. Another breakthrough has been released about the combination of two treatments that resulted in effective palliative care for mesothelioma patients. Researchers from Denmark have reported that the combination of Navelbine® (vinorelbine) and Platinol® (cisplatin) is highly active in patients with newly diagnosed non-resectable malignant pleural mesothelioma. Overall, the one-year survival was 61%, the two-year survival was 31%, and the three-year survival was 4%.

The study evaluated a regimen of Navelbine and Platinol for the treatment of 54 patients with non-resectable mesothelioma. The median number of cycles of chemotherapy administered was four and there were two complete responses and 14 partial responses. The median survival was 16.8 months, and the median time to tumor progression was 7.2 months.

The researchers have concluded that these results were as good or better than currently used combinations for treatment of mesothelioma. Therefore, this drug combination merits further investigation as the results appear to be superior to previous studies with Gemzar-based combinations.

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