Month: December 2022

What is mantle cell lymphoma?

Posted on by Julie Scott, DNP

Mantle cell lymphoma is a type of non-Hodgkin’s lymphoma cancer that grows in the lymphatic system. The lymphatic system is responsible for moving fluids around the body and transporting the immune system. Mantle cell lymphoma is not common and is responsible for less than 10% of lymphoma diagnoses. It’s most often diagnosed in men in their 60’s or 70’s.

Symptoms

Initially, there may not be any symptoms of the disease. Symptoms of Mantle cell lymphoma can vary for each person, but some common symptoms can include the following:

  • Lymph node swelling, especially in the throat or neck area, under the arms, or in the groin
  • Loss of appetite
  • Weight loss
  • Vomiting
  • Heartburn
  • Enlarged abdomen
  • Fever
  • Night sweats
  • Fatigue
  • Decreased blood counts
  • Easy bleeding or bruising

Diagnosis

The ultimate diagnosis of mantle cell lymphoma will be made once a biopsy is obtained. Imaging tests will likely be ordered when someone is suspected of having lymphoma. Standard imaging tests can include X-rays, CT scans, MRIs, and PET scans.

A biopsy often removes part or all of an enlarged lymph node. In some cases, a bone marrow biopsy may be done as well. Once mantle cell lymphoma is diagnosed, additional testing of chromosomes and other markers is done on the tumor to help determine the cancer’s grade and other characteristics.

Treatment

The exact treatment for mantle cell lymphoma will be determined once the diagnosis is made and the cancer stage is known.

For some with a very slow-growing mantle cell lymphoma type, no treatment may be needed at first. They may undergo routine imaging and lab studies to evaluate the state of the disease.

If you have been diagnosed with mantle cell lymphoma, it is important to learn as much as possible about the disease and treatment options to make the best health decisions.

GIST(Gastrointestinal stromal tumor)- What You Need to Know

Posted on by Julie Scott, DNP

What is GIST?

Gastrointestinal stromal tumor, also known as GIST, is a type of cancer that develops within the gastrointestinal (GI) tract. Most GIST cancers start in the stomach wall, but they can also start in the intestines, though this isn’t as common. Exactly why GISTs start to grow is not known, but some tumors have been found to have mutations in particular genes, including KIT and PDGFRA genes. These genetic changes have been found to lead to the development of cancer.

Symptoms

Symptoms of GIST can vary from person to person but can include the following:

  • Throwing up blood or substance that looks like coffee grounds
  • Blood in the stool
  • Stool that looks dark or tarry
  • Feeling very tired
  • Pain in the abdomen
  • Nausea and vomiting
  • Decreased appetite
  • Weight loss

Diagnosis

When GIST is discovered, a tumor biopsy must be obtained to get the specific diagnosis. The stage or extent of cancer needs to be determined as well to help determine the exact treatment that will be best.

Imaging tests used to help determine the extent of cancer can include CT scans, MRIs, and PET scans. Other studies include upper endoscopy and colonoscopy, where a camera is inserted into the stomach and intestines to see if there are any suspicious areas of cancer.

Blood tests to evaluate blood cell counts as well as kidney and liver function.

Treatment

The oncologist will order the exact treatment for GIST once the diagnosis is made and the cancer stage is known.

Surgery is often recommended for GIST, especially if they are smaller and haven’t spread to other areas. During surgery, the tumor and healthy tissue around the tumor are removed.

A medication called imatinib (Gleevec) might be recommended after surgery if the tumor has high-risk features that may make it more likely to come back. This medication is often taken for a few years after surgery. Sometimes imatinib is given for a period of time before surgery to

help shrink the tumor. It can also be used if cancer is metastatic or has grown in other body areas.

Other medications that can be used to treat metastatic GIST include:

  • Sunitinib (Sutent)
  • Regorafenib (Stivarga)
  • Ripretinib (Qinlock)
  • Sorafenib (Nexavar)
  • Dasatinib (Sprycel)
  • Nilotinib (Tasigna)

 

If you’ve been diagnosed with GIST, talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

The information in this blog post should serve as an educational resource to be aware of the signs and symptoms of this disease.

Gastric cancer: types, symptoms, and treatments

Posted on by Julie Scott, DNP

Gastric cancer is a type of cancer that grows in the stomach, in the cells lining the stomach wall. Factors that can make someone at higher risk of developing gastric cancer include:

  • Increasing age
  • Chronic inflammation of the stomach
  • History of H. pylori infections
  • History of Epstein Barr viral infection
  • Family history of gastric cancer
  • Tobacco use
  • Diets containing high amounts of smoked foods

Symptoms

Symptoms of gastric cancer can vary for each person, but some common symptoms can include:

  • Stomach pain
  • Feeling bloated, especially after eating
  • Indigestion
  • Nausea
  • Weight loss
  • Decreased appetite

Diagnosis

The ultimate diagnosis of gastric cancer will be made once a biopsy is obtained. Imaging tests will likely be ordered when someone is suspected of having gastric cancer. Standard imaging tests can include CT scans, X-rays, MRIs, and PET scans.

Another imaging test that will likely be needed is an upper endoscopy. During this exam, a gastroenterologist inserts a long flexible scope with a camera into the mouth and the stomach. This camera allows them to visualize any suspicious areas for cancer. During an endoscopy, a biopsy of a suspicious lesion can be taken to be tested for cancer cells.

In addition to imaging, blood tests to evaluate blood cell counts, as well as kidney and liver function, are often done as well.

Once a diagnosis is made and imaging studies are done, the cancer is given a stage to describe how advanced the cancer is.

Treatment

The exact treatment for gastric cancer will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended for gastric cancer. This surgery can include removing the part of the stomach containing the tumor or the entire stomach. Surgery may also remove lymph nodes around the stomach to check for the spread of cancer to those areas.

Radiation therapy is a treatment that may be used as well. During radiation, high-energy beams are directed at the cancer cells to kill them.

Chemotherapy is another treatment that may be recommended as well. Chemotherapy is a medication that is given to kill cancer cells. Sometimes chemotherapy is used before surgery to help shrink the tumor and allow the surgeon to perform less aggressive surgery.

For gastric cancer that has spread into other areas of the body (metastasized), targeted therapies, which target specific proteins on the cancer cells, might be useful. Immunotherapy is another treatment that helps the immune system see and attack cancer cells.

If you’ve been diagnosed with gastric cancer, talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

Understanding gastric cancer and its various treatments ensures that you or your loved ones receive the best care.

What is a bone marrow transplant?

Posted on by Julie Scott, DNP

Why a Bone marrow transplant may be recommended for certain cancer patients?

Acute myeloid leukemia (AML) is cancer affecting blood cells. When the myeloid cells become abnormal, these cells then grow uncontrollably. White blood cells are often affected, but red blood cells and platelets can also be affected. As these abnormal cells grow, they crowd out the bone marrow. This prevents healthy cells from having room to grow.

A treatment that may be recommended for AML can include a bone marrow transplant. This may also be referred to as a stem cell transplant.

AML is often treated with chemotherapy. Although chemotherapy can kill cancerous cells, healthy cells can be killed by the chemotherapy as well. When trying to cure AML, high doses of chemotherapy may need to be given, which puts the patient at risk for complications from the effects of the chemotherapy on the bone marrow.

The procedure for a bone marrow transplant may differ at each treatment center but generally follows a similar path.

  • Blood is removed from either the patient who needs the transplant or from a donor.

○ Autologous transplant uses cells from the patient

○ Allogeneic transplant uses cells from a donor

  • The stem cells (cells that will help the bone marrow make more blood cells) are removed from the blood that was taken, and is frozen and stored until needed.
  • High doses of chemotherapy are given to the patient to kill the cancer and cells in the bone marrow.
  • Whole body radiation may be used to kill these cells as well.
  • The frozen cells are then thawed and infused into the patient.

If cells from a donor are needed, the transplant center will try to find the closest possible match, to help the transplant be successful and decrease the risk of transplant failure. If the match isn’t close, the patient’s immune system can recognize that they are foreign and destroy the healthy cells.

The transplant process may require the patient to stay in the hospital for weeks, for the high dose therapy and then following the transplant for close evaluation of any complications that may develop after transplant.

It may take a few weeks for the new stem cells to “engraft”, or begin working to produce blood cells. Until that happens, transfusions of blood and platelets may be needed frequently to maintain acceptable levels.

If you’ve been diagnosed with AML, talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it .  If you or someone you know is considering a bone marrow transplant, it’s important to learn as much as possible about the risks and benefits of the procedure.

We hope this article has helped provide some basic information about bone marrow transplants. For more detailed information, please consult your doctor.

What are clinical trials and why are they important?

Posted on by Julie Scott, DNP

Clinical trials are research studies to help find new cancer treatments. Every medication or treatment must go through clinical trials to be approved. Clinical trials are an important part of cancer care.

There are different phases to clinical trials.

Phase I trials are also called dose-finding trials. During this phase, the safe dose and administration of a new medication is determined.

Phase II trials are done after the safe dose is determined after a phase I trial. During phase II, the medication is given to see what the effect of the medication is on cancer and to see if there are any negative effects that the medication causes.

Phase III trials are done to see how the new medication compares to the currently available treatment. During these trials, the safe dose and administration are known, and people are observed for how their cancer responds to the treatment. This is often compared to the currently used treatments to see which is better.

Clinical trials are closely observed by many people and organizations while they are taking place to be sure they are completed safely. These can include the institutional review board (IRB), the research team, and the Data and Safety Monitoring Board.

Clinical trials cannot be done without the consent of the patient. No one will participate in a clinical trial without their knowledge and informed consent. Before enrolling in a trial, the risks and benefits of the trial will be reviewed, and the patient will have the opportunity to ask questions. Once they feel fully informed and want to proceed, they will be enrolled in the trial.

If you’re interested in looking for a clinical trial, the first step would be to speak with your cancer care team. Clinical trials are not done at every cancer center; you may need to go elsewhere for a trial.

Each trial has specific qualifications someone has to have in order to enroll in the trial. If you’re selected to enroll, the trial team will discuss all of the details with you. This may include the schedule of medication administration, the number, and timing of lab tests and office visits, as well as the schedule of imaging.

There are many potential benefits to participating in a clinical trial, but it’s important that you make the decision that is right for you. Be sure to talk to your cancer care team about any questions or concerns you may have. Thank you for reading, and we hope this article was educational.

You can also visit www.clinicaltrials.gov for more information on open trials near you.

 

 

The importance of advanced directives

Posted on by Julie Scott, DNP

What is advanced care planning?

Advanced care planning is something every person should consider for themselves, even if they are not currently faced with a life-threatening illness. Advanced care planning allows you to make healthcare decisions for yourself, even if you’re in a condition in which you’re unable to speak for yourself due to illness or emergency. Making these decisions and having them documented can be helpful for loved ones who would otherwise have to make those decisions for you.

Some of the decisions that are determined in advanced care planning can include the following:

  • The use of CPR (cardiopulmonary resuscitation)
  • Feeding tube placement or other artificial nutrition and hydration
  • Use of a breathing machine (ventilator)
  • Organ donation

There can be multiple documents that are involved in advanced care planning.

Living will

The living will is a written document that states your personal decisions on healthcare interventions, to be followed when you are in a condition where you cannot speak for yourself. Each state may have different rules on what needs to be present on what makes the document legally binding. Your healthcare provider can give you a blank living will for you to fill out. This document will state your wishes on healthcare interventions for things such as CPR, feeding tubes, and dialysis. Contact a lawyer for any specific legal questions you may have about the document.

Durable Power of Attorney (DPOA)

A DPOA for healthcare is a legal document in which you appoint someone to make medical decisions on your behalf. This appointed person would then make medical decisions for you if you were in a state where you could not make decisions for yourself. Having a conversation with your DPOA about your wishes is a good idea.

Do Not Resuscitate (DNR)

A DNR is an order in which medical staff is instructed NOT to perform life-saving measures such as CPR or breathing machines when going into cardiac or respiratory arrest. This is most important in the hospital setting and should be documented in the chart by the healthcare provider.

Another type of DNR, called an outside-the-hospital DNR, is a document that can be completed and is available in the home. In the instance of a cardiac or respiratory arrest at home, the outside-the-hospital DNR is shown to any emergency responders and would allow them not to do CPR. Each state may have different forms and signatures required for this.

Advanced care planning is a vital but often overlooked aspect of healthcare. These discussions are crucial to have while one still has the ability to speak for themselves. If you or a loved one is considering making a living will or DPOA, please contact a lawyer or social worker at your cancer center for help in completing the necessary documentation.

Having these difficult conversations now can save your loved ones from making tough decisions later on.

 

 

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