 By
now everyone knows about the importance of regular mammograms, Pap
smears and colonoscopies. Such screenings can detect cancers early,
when they are most treatable.
Some cancers, however, not only lack a
routine testing system, but also have few warning signs or symptoms.
Leukemias, along with lung, pancreatic,
ovarian and brain are the cancers experts call the most dangerous in
adults.
"One feature of these cancers that
is important is they are fairly sneaky," says Dr. S. Vance
Strother, medical oncologist with Wheaton Franciscan Healthcare.
"They can reach a good size before it’s known."
That’s what happened to Kathi
Mullenberg. Her lung cancer already was inoperable when it was
discovered in August 2007. Mullenberg, 47, initially saw her doctor
due to menstrual irregularities and underwent several tests.
She had been a pack-a-day smoker since
age 15 and had an extensive family history of cancer. Still, when her
Caller ID display read "Oncology," Mullenberg was sent
reeling. "I don’t know the words to explain how I felt,"
she says.
Chemotherapy and radiation have reduced
her tumor’s size by two-thirds and dramatically slowed its growth.
Although unable to return to work, Mullenberg feels well enough to do
light exercise, go camping and attend her two daughters’ school
activities.
"Somebody’s on my side up
there," she says. "My whole thing was to keep positive for
the girls."
Doctors and patients alike say that
strong connections with family and friends can contribute to a patient’s
positive attitude in the face of unfavorable odds.
"Spiritual wellness and support
networks are things you can characterize but not quantify. They
certainly can’t hurt," says Dr. Peter H. Johnson, medical
oncologist and hematologist at ProHealth Care’s Regional Cancer
Center. "One thing I like to emphasize to folks is what
(projected survival time) they are given is an average, and they
themselves are not average. By definition, half do better and half do
worse."
After her pancreatic cancer diagnosis
in February, retiree Harriet Russell, 68, found support literally in
her own backyard. When spring came and she was undergoing chemotherapy
and radiation (and preparing for surgery), she recruited friends to
plant 30 pots of flowers and several garden areas at her River Hills
home.
"I got to see everything come to
life. Now, I do the weeding, pull hoses and do some lifting, which is
helping me build muscle," explains Russell, whose chemo is
scheduled to last until about December.
However, another pancreatic cancer
survivor, Peggy Barager of Wauwatosa, says it is unrealistic to expect
a patient to be positive all the time. About once a month, she
withdraws to "cry and watch mindless stuff on TV for two
days."
While Barager, 57, does lean on TV, she
has kept the promise she made to herself when she was diagnosed in
December: to not read any cancer information online. "I knew what
was out there would scare the beejeebers out of me," she says.
"I decided I’d save all my questions and ask my doctor."
Researchers, meanwhile, are trying to
develop more diagnostic tests and figuring out which patients could
benefit the most from each type of test. Testing only those at highest
risk, for instance, would catch just 25 percent of pancreatic cancers,
according to Dr. Douglas Evans, Froedtert & The Medical College of
Wisconsin pancreatic cancer specialist.
"Anything short of a blood test
(for large patient populations) is just not going to do it for
pancreatic cancer," he adds.
Then there’s the difference between
finding cancer and actually treating it successfully. "Our
capacity to detect cancer early isn’t by itself sufficient to
warrant screening if we can’t change the outcome," warns
Johnson.
With analysis of the DNA of the tumor
and identification of genetic markers carried by the patient,
treatment is personalized.
"The direction is we will use less
and less chemo and use more medications that help cancer cells die off
or reproduce more slowly," predicts Dr. Gilberto Rodrigues, a
general cancer and lung cancer specialist with Oncology Alliance.
"Ideally, you want to find out what made the cancer cell develop
and ask, ‘What is the antidote?’"
In other words, cancer some day might
be viewed as a chronic condition rather than a life-threatening
disease.
"How well and how long people
survive, not whether the cancer shrinks, is really the bottom line.
Then we’re looking at a stable disease," says Strother.
"If the growth isn’t reversed but is arrested, that’s a
pretty good result."
| Be Your Own Watchdog
An annual physical is one way to
keep tabs on your health. Day to day, know your body. You might
detect a problem that could mean cancer. Watch for:
• A bloated feeling or fluid
buildup in the abdomen (a common symptom of ovarian cancer).
• Unexplained weight loss.
• Unexplained pain.
• Loss of energy, dizzy spells.
• Fever (can indicate leukemia
or lymphoma).
• Headaches that don’t
respond to treatment (might mean a brain tumor).
• Severe night sweats for men
or nonmenopausal women.
• Jaundice (yellowed) or itchy
skin (could indicate pancreatic cancer).
• Elevated blood sugar (in
someone who does not have diabetes).
"If a symptom doesn’t get
better in a couple weeks, that’s not normal. They should seek
medical advice," says Dr. Gilberto Rodrigues.
Getting answers
Because her father and brother
both died of pancreatic cancer, Betty Ratchek of Twin Lakes
jumped at the chance to learn whether she was at risk.
As part of the new Familial
Pancreatic Cancer Initiative at Aurora St. Luke’s Medical
Center, Ratchek underwent genetic testing and had an ultrasound
that looked at the pancreas through the wall of the stomach.
"My doctor said, ‘You have
an opportunity most people don’t have,’" she says.
The ultrasound showed that
Ratchek, 66, had pancreatic cancer — but at an early,
treatable stage. She also learned that she and her daughters
carry the BRCA2 gene, likely explaining why she and one daughter
have had breast cancer. As a precautionary measure, her other
daughter has undergone a bilateral mastectomy. |
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