Friday I went to a free conference on the future of cancer care sponsored by the hospital I go to. I think I blogged about it before. But it was Friday, I went and enjoyed it. I learned a lot. (And I learned I should not have sat in a crappy conference chair for four hours because it made my back hurt - a lot! But I took my drugs and suffered in silence until I got home and could whine to my husband and get an ice pack.)
The conference had three one hour sessions. You could choose your topics for the first two - I chose the breast cancer ones because I don't have lung or prostate, and the other stuff I didn't care to learn about.
The first one I went to was actually given by my surgeon and my medical oncologist. The surgeon talked about how breast cancer surgery has changed and is still changing. It is now focused on less is more. Studies have shown that in the majority of breast cancer diagnoses, a lumpectomy with radiation is just as good as a mastectomy. There is also concern for not taking the underarm lymph nodes even if there is cancer in 1-2 sentinel nodes. So now, even though I had one positive node, I probably would not have had the axillary node dissection which has since resulted in lymphedema. Also, decisions on chemotherapy and adjuvant (Tamoxifen/aromatase inhibitors)
The next session was by the head of the radiation oncology department. Times have changed here as well. Starting early this year, they are now offering partial breast radiation instead of full breast. The theory now is that they only need to target an area around the original tumor that is 1 cm around it. As opposed to radiating the whole breast which is more painful and takes weeks. The partial breast treatment can be completed in one week with twice a day treatment. This has been available in certain parts of the country in trials and not as a standard treatment until very recently. I probably would have had partial breast radiation as well. The decisions on partial or whole breast radiation are designed to involve the patient as much as possible. The focus is on educating the patient, getting them involved in decisions so they can regain some control over their bodies.
The final presentation was by Dr. Susan Love, who was very funny and provided a great presentation. She said the focus now is not as much as where the tumor is in your body - breast, lung, stomach - as much as its characteristics a/k/a hormone receptor status. Breast cancer is not the only kind of cancer that has hormone status.
In addition, she said there is now thought that cancer might be caused by a virus. A lot of research has been done over years and decades on finding a cure for cancer which we still don't have. But what if research changed and focused on finding the cause.
Using cervical cancer as an example, it has been found to be caused by the Human Papilloma Virus (HPV). Once it was found to be caused by a virus, a cure was developed. She is working on developing her Army of Women (www.armyofwomen.org) where she wants to have a million women and men to participate in surveys and studies that help figure out why some women and men get breast cancer and most don't. (Join if you haven't.) One of her theories is that if researchers had only focused on rats and mice in a lab, they never would have discovered HPV - rats and mice can't get the HUMAN Papilloma Virus because they aren't human....
Another take away from Dr Love is on prevention of breast and other cancers. The three key areas are:
- weight - not necessarily what you eat but what you weigh and not gaining weight.
- exercise - 3 hours each week of getting your pulse rate up.
- stress - we can't prevent stress but we can handle it better - this means therapists, talking, support groups, prayer, meditation or whatever works for you.
So get an exercise group together to workout, you keep your weight down and have an instant support group - her idea, not mine - but I like it and might steal it.
Overall, I was very surprised to learn how much had changed and how much hasn't changed in the past four years. Cancer studies can take years or even decades to publish results as they often follow the participants health for a long time after. This can slow treatment changes. But change has happened.
One note on the conference is that conferences run by doctors and hospitals provide healthy food. I went and was craving a chocolate chip cookie. I figured they would have something close to that. I was wrong. They had yogurt, 'shooters' of nuts and dried fruit and cup up apples with peanut butter. After they had had cheese and crackers and veggies and dip. I saw some fried egg roll things being passed around but there wasn't a chocolate chip in sight. In my evaluation I asked that they repeat the conference annually. Maybe I'll email and request cookies for next year - cancer people need cookies and Dr Love said it wasn't what we eat as much as what we weigh and I do have occasionally cookie cravings even though I eat my vegetables.