Complete Guide to Nutrition for Cancer Survivors - Helpful Book

A useful guide to nutrition for cancer patients and survivors:

American Cancer Society Complete Guide to Nutrition for Cancer Survivors: Eating Well, Staying Well During and After Cancer
Abby S. Bloch PhD RD (Editor), Barbara Grant MS RD CSO LD (Editor), Kathryn K. Hamilton MA RD CDN CSO (Editor), Cynthia A. Thomson PhD RD (Editor)



Dieticians can be extremely helpful for people who have cancer. Many cancer patients do not have access to nutritional counseling. This helpful book can serve as a useful resource.

Written for consumers, patients, and families seeking reliable information about nutritional support for people with cancer, this comprehensive guide offers the latest information about using nutrition to optimal advantage during the cancer journey. Also discussed is the role of sound nutritional choices before, during, and after cancer therapy and how they can help bolster energy levels, strengthen the immune system, fight off infection, and minimize the side effects of treatment. Charts, information on special diets, and level-headed advice about dietary supplements make this a valuable tool for maintaining a healthy lifestyle.

About the Authors
Barbara Grant, MS, RD, CSO, LD, is the outpatient clinical nutritionist at the Saint Alphonsus Cancer Care Center and is a board-certified specialist in oncology nutrition. Abby S. Bloch, PhD, RD, is executive director of programs and research for the Robert C. and Veronica Atkins Foundation, was on staff at Memorial Sloan-Kettering Cancer, and was chairperson for the American Cancer Society Advisory Committee on Nutrition and Physical Activity. Kathryn K. Hamilton, MA, RD, CDN, CSO, is an outpatient clinical oncology dietitian with the Carol G. Simon Cancer Center at the Morristown Memorial Hospital in Morristown, New Jersey; an assistant professor at College of St. Elizabeth in Morristown; and a board-certified specialist in oncology nutrition. Cynthia A. Thomson, PhD, RD, is an associate professor at the University of Arizona department of nutritional sciences, a board-certified specialist in oncology nutrition, and was a nominee for the Sidney Salmon Memorial Award for Cancer Research in 2009.

Breast Cancer Lymph Node Treatment Protocol Updated: For Up to 20% of Patients Removal of Cancerous Nodes Yields No Survival Advantage

A somewhat surprising and counterintuitive recommendation is the result of a multiyear breast cancer study: approximately 20% of women with breast cancer should not have cancerous lymph nodes from under their arms removed. This new approach to treatment was adopted by Memorial Sloan-Kettering, a renowned cancer treatment hospital in New York City in September 2010. Dr. Monica Morrow, chief of the breast service at Sloan-Kettering is one of the author's of the study supporting this new protocol which was published in the Journal of the American Medical Association on 2/9/11. The study found that the survival rate for patients whose lymph nodes were removed is very similar to the survival of patients whose lymph nodes were not removed.

The study concludes that taking out the lymph nodes does not change the treatment plan, improve survival, or make the cancer less likely to recur. Often, the removal of lymph nodes causes dangerous, painful and potentially disabling complications such as infection and/or lymphedema.

Chemotherapy and radiation treatment are now standard therapy for women whose breast cancer has traveled to the lymph nodes. It is believe that this treatment is effective for wiping out any disease in these lymph nodes.

Importantly, the new results do not apply to all patients, only to those whose women who meet the specific criteria as laid out in the study with regard to lymph node descriptive details.

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For more information you can refer to:
The article by Denise Grady in the NY Times entitled “Lymph Node Study Shakes Breast Cancer Treatment” dated 2/9/11
The article in the Journal of the American Medical Association entitled "Auillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and Sentinel Node Metastasis" with multiple authors including Armando E. Giuliano, MD
A followup article to the 2/9 article in the NY Times, also by Denise Grady "Implications of Study on Breast Cancer"

Shortages for Some Generic Drugs used for Cancer Chemotherapy Treatment

The U.S. Food and Drug Administration is seeing "a record number of shortages" this year, said Valerie Jensen of the FDA's drug shortage program. This is putting pressure on hospitals and doctors which in certain cases have been forced to search for acceptable alternative treatments. Most shortages are for injectable medications (also called sterile injectibles), including several for cancer, Ms. Jensen said.

Doxorubicin, a generic drug also known as adriamycin, is a common treatment for some breast cancers and lymphomas, is in short supply causing some patients to receive alterhative regimens.

The drug cisplatin is also in short supply. Cisplatin is a mainstay treatment for testicular cancer, and is also used for other cancers.

Shortages also exist for Leucovorin which is frequently used in combination with fluoruracil to treat cancers such as colon and rectal, head and neck, esophageal, and other cancers of the gastrointestinal tract. It can also be used as an antidote to effects of certain chemotherapy drugs such as methotrexate.

Bleomycin is a chemotherapy drug that is administered for the treatment of several types of cancer, including squamous cell carcinomas, testicular cancer, head and neck cancers, and lymphomas. It works as an antineoplastic drug, meaning that it is a tumor antibiotic and is toxic to fast growing cells. Some hospitals are experiencing difficulting in procuring Bleomycin.

In a recent MSNBC online story, Jensen said 40 percent of the shortages are due to manufacturing problems, 20 percent because a firm stops making a drug and 20 percent from production delays. The basic cause, she said, is the drugs are not as profitable as newer ones. According to a report on Fierce Pharma drugs run short for a variety of reasons: Increased demand for a particular treatment, short supplies of active ingredients, manufacturing problems, recalls...and because some older drugs are only made by a handful of manufacturers, when one company's production slows or stops, that affects the entire supply. For instance, the cancer drug cisplatin is made by three companies--APP, Teva Pharmaceuticals and Bedford--and both Teva and Bedford report manufacturing delays, while APP, understandably, is struggling to keep up with increased demand.

It is important to be vigilant and to inquire about the availilbity of enough medication to complete your prescribed regimen if a generic injectible cancer medication is prescribed.

For further information you can refer to these articles:
NCI Cancer Bulletin
http://www.cancer.gov/ncicancerbulletin/011111/page2
ONS Connect
http://www.onsconnect.org/2011/01/whats-up-with-all-these-cancer-drug-shortages
Seattle Times
http://seattletimes.nwsource.com/html/health/2014118438_webdrugs04.html
Wall Street Journal
http://seattletimes.nwsource.com/html/health/2014118438_webdrugs04.html

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