Download - 2015 vision may newsletter

VISION, MAY 2015

Collective South African Voices for Cancerwww.canceralliance.co.za

A state-of-the-art da Vinci Si robotic technology was used to assistin the surgical removal of the patient's cancerous kidney. The firstever-robotic assisted procedure of its kind in South Africa is knownas a radical nephrectomy and took place at Netcare WaterfallHospital in Midrand on 7 April 2015.

South Africa's first robotic assisted nephrectomy was a triumph.Three days later, the patient, a consultant who prefers not to benamed, was discharged home where he was able to quietly cele-brate his 51st birthday with his family. "I feel so much better," said arelieved 51-year-old father of five following his discharge 72 hoursafter having his cancerous kidney removed.

The highly complex operation was completed through small inci-sions in the skin and was by all appearances a great success, accord-ing to Dr Marius Conradie, an urologist who practises at the hospitaland who performed the surgery with the assistance of a team ofspecialists and nursing staff.

"The patient's right kidney, which was badly diseased, was removed.Despite the fact that a nephrectomy is a major procedure, thepatient had recovered to the extent that he was moved from inten-sive care to a general ward and had regained his mobility just 24hours after the operation. With traditional open surgery we expect apatient to take about a week to get back on his or her feet."

"The use of this robotic technology in this specific procedure is animportant development in the field of urology in South Africa. It wasa great honour to have been able to, for the first time on our conti-nent, assist a patient with cutting edge treatment that has beenproven internationally for its effectiveness."

The da Vinci Si system consists of a surgeon's console offeringthree-dimensional, high definition display and a patient side cartfeaturing robotic arms with wristed surgical instruments. Theseinstruments are controlled by the surgeon, improve and steady thenatural motion of the hands.

South Africa's first roboticassisted nephrectomy

Lonehill community supportCanSurvive and Cancer BuddiesThe Lonehill Village Fair kindly offered a stand to CanSurvive at theirevent held on 16 May so that we could promote support for cancerpatients and supporters. A lovely autumn day made it a pleasantouting for some of the committee and friends and many interestedpeople stopped by.

CanSurvive had intended to organise a Walk for Cancer in June, butthis has had to be postponed at the request of our sponsors. Moredetails of this exciting event will follow in our June issue.

The Cancer Alliance is a collective group of cancer control non-profit organisations and cancer advocates brought

together under a common mandate, to provide a platform of collaboration for cancer civil society to speak with one voice and be a powerful tool to affect change for all South African

adults and children affected by cancer.

Cancer Buddiesappoint newNational BuddyCoordinatorIntroducing Elfrieda Strydom, anoncology social worker, who is basedin Bloemfontein.

Elfrieda has extensive HIV aids experience and currently works part time in a private oncologyunit.

Cancer Buddies are very excited to have her on our team andlook forward to growing our Buddy network to cover more areas.

Elfrieda will be contacting existing Buddies to hear of their experiences and whether they have any ideas for improving andexpanding the service.

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Affordable medicine inSouth Africa

Get involved and help us advocate for

improved legislation

Have you struggled to get, or pay for, the medicine(s) you need?

Please take this five-minute survey to tell Doctors Without Borders,the Treatment Action Campaign, and SECTION27 about your expe-riences getting, and paying for, the medicines you need. This isapplicable for both public and private sector patients. Your participa-tion will help us to advocate for affordable medicine in South Africa.

About Fix the Patent LawsOften people don’t have access to the medicines they need inSouth Africa because life-saving drugs are priced out of reach. Thisaffects all types of drugs: treatments for drug-resistant tuberculosis,cancer, hepatitis, newer antiretroviral medications for HIV, contra-ceptives, mental health, and more.

Doctors Without Borders, the Treatment Action Campaign, and SEC-TION27 incorporating the AIDS Law Project, are together advocat-ing for the South African government to adopt laws which promoteaffordable medicine. With this survey, the campaign is seeking tofind people who have not been able to get the medicines they need,or are paying a lot out of pocket for their medicine. Please note thatall stories will be kept 100% anonymous and confidential ifrequired.

For more information on this survey or the campaign, please callDoctors Without Borders at 011 403 4440, and ask for Julia Hill([email protected]). Learn more at:www.fixthepatentlaws.org. Follow us on Twitter @FixPatentLaw

Patient survey: https://www.surveymonkey.com/s/GBP8C6Z

Doctor survey: https://www.surveymonkey.com/s/GKM7KVW

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Dr. Salwitz is a Clinical Professorat Robert Wood Johnson MedicalSchool.

He lectures frequently in the com-munity on topics related toHospice and Palliative Care andhas received numerous honoursand awards, including thePhysicians Leadership Award inPalliative Care.

His blog, Sunrise Rounds, can befound at http://sunriserounds.com

In the movies, pain is glorious. The runner pushing to the edge. Themagic of childbirth. The soldier battles impossible odds to conquer.Pain? “Suck, it up, maggot, pain is nature’s way of telling you thatyou’re alive.” But, to the cancer patient, in the real world? Pain isnature’s way of saying “you may soon be dead.”

For a patient suffering from the dread disease, pain means more thantorn tissues, invading needles and post-op wounds. It is more thannerves firing, fractures grinding and constricting bowels. To have painfor a cancer patient is to be reminded of the threat, the danger, thedeepest intrusion. It is to be reminded that you are acutely mortal.

Pain threatens not only the body, but the soul. Pain destroys life. Itsteals not only movement and healing, but hope. It is very hard, per-haps impossible, to truly live, let alone find peace or joy, while grippedwith pain from the dread disease. We must control pain.

Nonetheless, we are faced with a crisis of abuse and injury from pre-scription opioids. Each recent year, almost 20,000 people die in the USfrom legal narcotics and over 8000 die from heroin addiction, which isoften a descent from prescription oxycodone or morphine. Suchdestruction and waste is unacceptable, and is a true health care catas-trophe; it must be resolved. As such, a number of federal, state andlocal programmes are in process to address this problem.

We seem to be caught in a Solomon’s choice. Control pain and peoplewill become addicted and die. Limit access to prescription medicationsand allow our patients, friends and family to suffer the deepest sort ofagony. Our challenge is to avoid significant obstacles to access for des-perately needy patients while, simultaneously, we address addiction as adisease to be prevented and when it does occur, requires treatment.

The lion’s share of the responsibility for addressing this crisis falls toprescribing physicians. By practicing safe and adequate prescriptionprocedures, doctors can be the first and major champions both for paincontrol and abuse prevention.

First, they should confirm the need for these powerful agents in eachpatient. This means understanding these drugs, both their benefit andrisk. While opioids are incredibly valuable and, properly prescribed, safe,often anti-inflammatory, antispasmodic or non-pharmaceutical tech-niques can be used.

When there is any doubt about how a patient may use prescribedmedications, or if there is question whether the patient is actually tak-ing the drugs, physicians must endeavor to confirm compliance anddecrease the risk of deliberate diversion. A number of states now have

physician accessible online controlled substance databases. Good practice dictates that prescribers check those databases for patterns ofprescription fulfillment, duplication, and falsification, and repeat suchinquiries on a regular basis. In areas where online access is not avail-able, a phone call to the local dispensing pharmacy may be extremelyvaluable.

Prescribers should only write as many doses of medications as areneeded. For example, this might be six tablets of Percocet for a patientrecovering from a minor injury or surgery, instead of 30 or 40 tablets.The extra pills will lurk in a medicine cabinet awaiting the curious handof a teenager or anxious adult. If there is a risk that six pills may not beenough, having access to the doctor for renewals is important.

On the other hand, a patient with advanced cancer in continuous painshould never have to worry that they might run out of medication andshould have the flexibility to adjust their dosing based on immediateneed. Such a patient needs an adequate supply of medication. The riskof addiction or abuse in patients treated for cancer pain is extremelysmall, therefore our goal must be to preserve access for these needypatients.

It is vital that physicians educate their patients on the proper storageand disposal of drugs, especially addictive medicines. Meds should notbe stored in a place where people other than the patient can gainaccess. It is vital that drugs designed for a patient in need not be stolenor used by unintended individuals who would be at a significantlygreater risk for dependence and addiction.

Unused prescriptions should be discarded and destroyed in an effectiveand safe manner. Many states have “medicine drop” programmeswhere unused medications can be disposed at police stations or hospi-tals. When it is not possible to discard of narcotics in that way, theyshould be thrown-out using CDC recommended techniques, such asbeing mixed with used coffee grounds or moist kitty litter.

The prescription drug epidemic is a complication of needed therapyand we must prevent and treat addiction. At the same time, we mustrecognise that opioids give patients not only relief, but the opportunityto share each day with their families. They give not only the chance tomove, but also the opportunity to hope. When used properly, they givethe chance to live.

Of cancer, pain and addiction

The CanSurvive Head and Neck Support Group is for anyonewho has had trauma to the head or neck – not only cancerrelated – although that applies to the vast majority. The Groupis for patients who are just starting this journey, as well as thosewho are many years down the treatment and recovery road.

The objective is to provide information, share experiences, andhelp with coping mechanisms. It is run FOR the patients BY thepatients. There is always a medical member of the MorningsideHead and Neck Oncology Team present. Partners are encour-aged to attend the meetings as well.

The informal and supportive meetings are usually held on thefirst Thursday of each month at Rehab Matters, 1 De la Rey Rd.Rivonia from 18h00 to 20h00. The next meeting will be onThursday 8 September .There is also a Facebook group: SouthAfrican Head and Neck Support Group

For more information, contact Kim Lucas, on 082 880 1218 ore-mail: [email protected].

Head and Neck Support Group

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LET’S TALK ABOUT CANCER!

Join us at a CanSurvive Cancer SupportGroup meeting

- have a cup of tea/coffee, a chat with otherpatients and survivors and listen to an interesting

and informative talk. Upcoming meetings: starting at 09:00 at

MIDRAND - 23 May - in the Boardroom (follow the signs) at

Netcare Waterfall City HospitalHEAD and NECK Group - 4 June

at Rehab Matters, RivoniaPARKTOWN - 13 June, Hazeldene Hall

(opp. Netcare Park Lane Hospital)Enquiries:

Bernice 083 444 5182 or [email protected] 083 640 4949 or [email protected]

www.cansurvive.co.zaThe Groups are run in association withthe Johannesburg Branch of Cancer

Buddies and is hosted by Netcare. TheGroup is open to any survivor, patient

or caregiver. No charge is made.

Complementary therapiesPeople who are living with cancer may consider using complemen-tary therapy to reduce the side effects of cancer treatment andimprove their physical and emotional well-being. Complementarytherapies are added to conventional medicine. Complementarymedicine is also called integrative medicine. The American Societyof Clinical Oncology offers the following information on comple-mentary therapies that have been researched.

You may hear about many different types of complementary thera-pies. However, researchers have found that the following therapieswork to reduce pain and improve well-being:

p Physical activity. Participating in physical activity can help manypeople with cancer gain strength and endurance, relax, and copewith stress. Being active may help relieve pain, fatigue, anxiety,and depression. Research also shows that it may help lengthenthe lives of people with cancer after diagnosis. Talk with a physi-cal therapist or trainer experienced in working with people withcancer to find the best exercise plan for you.

p Acupuncture. This is the use of very tiny needles and/or pressureto stimulate points on the body. Research shows the therapyreleases chemicals in the brain, such as beta-endorphin andserotonin, to relieve pain. Acupuncture can help reducechemotherapy-induced nausea and vomiting. It may also helprelieve hot flashes, dry mouth, headache, fatigue, sleep prob-lems, appetite loss, diarrhea, constipation, weight changes, anxi-

ety during procedures, swallowing difficulties, and lymphedema.In addition, it may help people quit smoking.

p Yoga uses a combination of breathing exercises, meditation, andposes to stretch and flex various muscle groups. Researchershave found that yoga can relieve chronic pain, headaches, andinsomnia.

p Massage. Research shows that massage can reduce pain, ten-sion, and stress. It may also help with symptoms after surgery,anxiety, depression, sleep problems, and fatigue.

p Meditation. Meditation is a way for a person to learn to focusattention to calm the mind and relax the body. It decreaseschronic pain and improves mood and other aspects of a per-son’s quality of life. There are many different types of medita-tion, and it can be self-taught or guided by others.

p Music therapy. Trained therapists familiar with the emotionaland social concerns of patients and their families guide a personthrough music therapy. It can help with a patient’s recovery andgeneral well-being. It works well for patients receiving palliativetreatments and for those staying in the hospital.

p Nutrition. Professional nutrition counseling with a registereddietitian helps patients manage weight changes and cope withnausea. They can also learn about herbs and supplements thatmay interfere with cancer treatment.

It’s important to discuss with your doctor the types of complemen-tary therapies best for you, as it may depend on the treatment youare receiving. For instance, people who are using anticoagulantmedicine or are at risk of getting infections should be cautiousabout using acupuncture.

http://tinyurl.com/nx34dx3

CONTRIBUTIONS FOR PUBLICATION IN “VISION” NEWSLETTER

Comments, articles, letters and events submitted forpublication in VISION are welcomed and can be sent

to: [email protected].

Let us know what items you would like to see more of in VISION.

School education campaign - we need your help

During the second school term ending on 26 June, Cape Townschools are asked to help Can-Sir collect as many 10c coins aspossible as part of our Schools Education & Cancer AwarenessCampaign.

Use old plastic bottles, jam tins, coffee tins etc what ever youhave, and fill them with 10c coins to help us educate our youngscholars and higher learning girls and boys as to the dangers ofcancer.

Cancer education and early detection saves lives.....

Contact us on: 079 315 8627, email: [email protected] – ourwebsite is www.can-sir.org.za

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You don’t need to face cancer alone!

You are invited to join our Cancer Buddies Groups in: p Rondebosch Medical Centre, Klipfontein Road p Vincent Pallotti Hospital in the GVI Oncology unit:

Contact Linda Greeff 082 551 3310 p Bloemfontein: Contact Elfrieda Strydom 051

4008000p George: Contact GVI Oncology Engela van der

Merwe tel 04488400705p Nelspruit: Contact Winnie Stiglingh, 013-755 2145,

[email protected] Johannesburg. Contact Chris Olivier 083 640 4949,

[email protected] Johannesburg. Head and Neck Group. Contact Kim

Lucas, on 082 880 1218 or [email protected].

WE LOOK FORWARD TO MEETING YOU

We are here to help

Broccoli – more nutritiousraw or cooked?Actually, raw broccoli is not necessarily more healthful thancooked. Broccoli is part of the cruciferous vegetable family and agreat food to include in your diet either raw or lightly cooked.These vegetables provide many nutrients but their unique contri-bution is a group of compounds called glucosinolates. When wechew or chop these vegetables, glucosinolates are exposed to anenzyme stored elsewhere in the plant that converts these inac-tive compounds to isothiocyanate compounds which studiessuggest may reduce cancer risk.

The latest research shows that you can get high amounts ofthese protective compounds if you blanche the vegetables first.Blanching is a quick dip in boiling water, followed immediatelyby cooling. You can also preserve both nutrients and the enzymeneeded to form protective isothiocyanates if you steam broccolifor three or four minutes (just until crisp-tender) or microwavefor less than one minute.

Epecially if you won’t be consuming the cooking liquid (as insoup), boiling broccoli - or other cruciferous vegetable - is notthe optimal method. Boiling leaches out the vegetable’s water-soluble vitamins in these vegetables, such as vitamin C andfolate, as well as many of the glucosinolate compounds, whichare water-soluble, too. Moreover, too much exposure to hightemperatures destroys the enzyme that converts the inactiveglucosinolates to active compounds. Serving broccoli raw is anexcellent option, since it retains these nutrients and the enzymethat forms isothiocyanate compounds. Before serving on a relishtray or salad, quickly blanching and cooling allows you to geteven a bit more of these compounds. When you want cookedbroccoli, steaming or very brief microwaving are excellent choices.

American Institute for Cancer Research

battling cancer such as lymphoma, melanoma, pancreatic, ovarian,brain, lung, breast and colorectal cancer.

The move follows several collaborations with hospitals to pilot itsdata analysis technology for cancer treatment. For example, lastyear it worked with New York Genome Centre in a genomicresearch initiative for glioblastomas, an aggressive, frequentlymalignant brain tumour that kills more than 13,000 people in theUS each year. The idea for the initiative was that by applying cog-nitive computing power to the massive amount of clinical datausing the patient’s genomic data as a compass, IBM Watson’s tech-nology could help clinicians develop personalised treatments foreach patient.

Maine Centre for Cancer Medicine and New York’s WestmedMedical Group also worked with Watson to teach it how to inter-pret clinical information to diagnose lung cancer.

In an entry on the IBM’s Building a Smarter Planet blog, Dr LukasWartman, a clinician and leukemia survivor at McDonnell GenomeInstitute, said it would start using the Watson Genomics solutionwith patients when traditional treatment options prove ineffective.It will also use the technology in clinical trials of new medications.

“Ultimately, if it proves to be successful, oncologists will be able tohelp a great number of patients with cancer who have run out ofoptions and are running out of time,” he said.

IBM Watson researchescancer treatmentIBM Watson unveiled a new chapter in its cancer research work,this time for genomic analysis at the World of Watson conferencein Brooklyn in May. It will work with 14 institutions spanningresearch institutes to teaching hospitals to provide access to itsdata analysis tool.

Watson Genomic Analytics looks for variations in the full humangenome and uses Watson’s cognitive capabilities to examine datasources such as treatment guidelines, research, clinical studies,journal articles and patient information, according to a companystatement. It provides a list of medical literature relevant to thecase with drugs that have been identified in the literature. Thepatient’s doctor reviews the information alongside underlying evidence to make more informed treatment decisions. WatsonGenomic Analytics constantly gets smarter, as the system learnsfrom patient data, the statement said.

In the initial phase of the precision medicine programme, the 14organisations will apply Watson to the DNA data of patients who

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The psychological

effects of cancerThere are other effects of cancer and its treatment that are not sowidely known or discussed. I have only discovered this recently andthese are side-effects that affect not only me but also those close tome. These are the psychological effects of cancer that make every-thing doubly hard for everybody.

It was only when I was chatting to my cousin about cancer sufferedby another member of our family and the outbursts of temper theydisplayed, that I began to understand that cancer results not only inphysical, but also psychological effects. The emotional effects ofchemotherapy can be just as debilitating as the physical effects. Fromthe initial diagnosis of cancer to the final dose of chemotherapy,patients undergo levels of emotional distress well beyond a healthylimit. The emotional effects of chemotherapy can be directly relatedto the medication or to external factors such as family, work andsocial life. The range of emotional distress felt by patients depends alot on their particular support network and their rate of recovery.Emotions run high for the whole family during chemotherapy. Itmade sense when I thought about it, but I never had.

I asked my husband if I had ever displayed any outbursts of temper. Iwas sure I had not, until he reminded me of an uncharacteristic andugly diatribe to which I subjected my daughter during a telephoneconversation. I felt so guilty because he was right.

The outburst to which I subjected my daughter is not the only evi-dence of my fragile mental state during cancer treatment, at present.When the District Nurse arrived to clean my hickman line and takemy pre-chemo bloods at a time different to that arranged I lost theplot and ended up asking her to leave. Oh dear! The problem is it allseemed so logical at the time.

Chemotherapy can have an emotional impact on patients becausethe treatment itself is a sign of emotional self-preservation. Thechoice to fight cancer does not end with the first dose of the medica-tion and patients often feel emotionally taxed when recovery is slow.The physical side effects can contribute significantly to emotionaldistress. Insomnia, constant nausea, weight loss, hair loss and adiminished sex life can all make a patient feel emotionally distraught.Family and friends bear their pain too.

Chemotherapy also affects patients because of a perceived burden ofloss on family, friends and work. Patients may feel isolated from par-ticipating in family activities due to fatigue and medical appoint-ments. Social life is also dramatically affected by chemotherapy dueto fatigue and often shame. Therefore, some of the classical negativeemotions during chemotherapy include anger, fear, anxiety, depres-sion and isolation. The emotional distress from chemotherapy maycome from a sense of not having any control over the matter.Cognitive function and emotional health are strongly interconnectedand chemotherapy can take a serious toll on both of them. In somecases, emotional distress can affect cognitive function, while in othercases, impaired cognition can alter judgment and emotional respons-es during cancer treatment.

However, I have to confess that, perhaps unsurprisingly, my worstoutburst to date has been reserved for my long-suffering husband.This combination of temper and depression was my worst to date.When I asked my cancer nurse if this was a normal side effect shereplied in the affirmative. My husband just said very quietly, “But thatdoes not make if acceptable.” Of course he is right and none of thevictims of my temper deserved it.

Depression is a persistent sadness that interferes with usual activitiesand ability to carry out roles at home, work, community, or school.Depression may also be known as sadness, feeling “down,” despair, orhopelessness. Depression and its side effects affect both men andwomen. There are several risk factors that increase the potential fordevelopment of depression in the patient with cancer. Medicationscommonly prescribed for cancer patients can be one of those risk fac-tors. There are many classes of medications that may have depressionas their side effects. Some examples are: analgesics, anticonvulsants,antihistamines, anti-inflammatory agents, antineoplastics, chemother-apy agents, hormones, immunosuppressive agents, and steroids.

Depression during chemotherapy, and generally can be managed, butit has to be admitted first. You need to recognise what puts you atrisk of depression. Triggers include –

p History of depression in yourself or your family.p Pessimistic view of life.p Living with a chronic disease like cancer.p Stressful events in your life.p Effects of some medications & chemotherapy.p Lack of support from family or friends.p Unrelieved physical symptoms (like pain).p Alcohol or drug abuse.p Unrelieved grief (not working through feelings of angry about

how cancer and its treatment have affected your life).p Any persistent change in your mood, with the signs of depres-

sion listed above.p If you feel suicidal you must tell someone and get help. It is not

safe to be on your own at these times.

I am told it is not unusual to have times when you feel very low aftera diagnosis of cancer, and during or after treatment. Many people feelphysically and emotionally exhausted from the treatment, and thiscan lower their mood. However, for some people affected by cancertheir low mood may continue or get worse and they may need specialist help or treatment. Some people find that their sadnessgives way to a situation where their mood is low most of the time forseveral weeks or more, and they are depressed.

The relationship between cancer and depression is complex.Depression may be triggered by the diagnosis of cancer, other issuesrelated to the cancer and its treatment, or the impact of the canceron a person’s life. However, depression may occur by chance or berelated to other difficult events, either in the past or in the present,which are nothing to do with cancer, such as the loss of a loved one.Depression can develop slowly, making it very difficult for either youor your family to recognise when it started. In other cases it can seemto hit you suddenly – one day you wake up and realise that you feelhopeless and helpless and are engulfed in a ‘black cloud’ or, asWinston Churchill called it “black dog” of depression.

Depression can affect anyone at any age. It is extremely common –one in five (20%) people are affected by depression at some time intheir lives. Depression is not a sign of personal failure or inability tocope. You can’t ‘pull yourself together’ or ‘snap out of it’. Depressioncan usually be successfully treated. The first step to feeling better isto admit the problem, then to get appropriate help.

Valerie Penny is a writer and poet - an American, living inScotland who took early retirement for health reasons. Readher blog dealing with her journey through breast cancer athttps://www.survivingbreastcancer.wordpress.com.

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Art for cancerKuns vir kanker

In 2014 PLWC hosted the first Art for Cancer auction. It was anenormous success. With artists like : Conrad Theys, Louis Jansenvan Vuuren, Hennie Meyer, Ruan Huisamen, Shany van den Berg,dr Leonie Scholtz, Johan Coetzee, Theo Paul Vorster, Clare Menck,Cathy Layzell, Corné Weideman, Pierre Volschenk, YvetteMolenaar, Lize Beekman and others the standard was set high andguests enjoyed a homely lunch in the Oude Libertas Gallery withfoodie expert Annalize Buchanan and her well renowned cateringteam, in the colourful company of artists. Entertainment guestNiel Rademan needed no intruduction and not a single personcould have wished for a bigger surprise event.

Funds raised by this project help to fund the Cancer Buddy sup-port services.

Art for Cancer/Kuns vir Kanker 2015 proudly announce the partic-ipation of some of South Africa's most profound, versatile andamazing artists who will donate works to go on auction onSunday 1 November at Oude Libertas Gallery. Once again guestswill enjoy a Sunday lunch with caterer Annalize Buchanan anddecor specialist Flower Walker. Entertainment still to beannounced.

This year all the works will be on exhibition in the gallery from the22nd of October until the final event on the 1 November and willalso be exhibited online .

Supporting artists who have already committed to contribute tothis event are : Louis Jansen van Vuuren, Susan Grundlingh, MariéStander, Ruan Huisamen, Clare Menck, Cathy Layzell, Strijdom vander Merwe, Lien Botha, Coral Fourie, Roelof Rossouw, Ian Hunter,Lize Beekman, Ann Marais, Lee Molenaar, Koos Bronkhorst, WillieSteyn, Marion Geiger, Anet Pienaar-Vosloo (photography/art),Jeanette Unit

Art lovers, collectors and enthusiasts we proudly invite you to aSunday lunch in the company of artists and friends. A glamorousaffair.

Sunday 1st November from 11:00 -15:00

Tickets (only 80) now available at R585 pp including Distell wines.

All artworks on auction, directly from the artist.

For more information and to book your seat and ensure you arenot disappointed, contact Liesl Moore [email protected] orphone 021 5650039 during office hours.www.facebook.com/kunsvirkanker

Look forward to seeing you there!

Answering the questionsby Dr Bruce Campbell, a head andneck cancer surgeon at the FroedtertCancer Centre

Twenty years from now you will be more disap-pointed by the things you didn't do than by the ones you did do. Sothrow off the bowlines. Sail away from the safe harbor. Catch thetrade winds in your sails. - Mark Twain

Cancer physicians know when “The Questions” are coming. A casualconversation at a party or in the grocery store eventually turns tocareers. The pleasant exchange is replaced with talk of life-changingillnesses and impossibly difficult decisions. The other person’s browfurrows, the head shakes, the face darkens. “How can you deal withthat day after day?” they ask. “Isn’t it depressing? Why didn’t youpick something happier for a career?”

These are legitimate questions. As a medical student many yearsago, I enjoyed every rotation and wondered how I would ever beable to narrow down my choices and pick a specialty. Eventually, Idecided that I was most content when I was in an operating room.Even though I knew that I was going to be a surgeon, there were stilldozens of directions where my career might head.

One day in 1980, I was in a small conference room in Chicagopacked with medical students, residents, and surgeons who hadgathered to hear a presentation by a visiting out-of-town surgeon.He ran through his slide show, describing a procedure he haddevised to restore voice for patients who had undergone removal oftheir voice boxes. It was a complex operation that involved the cre-ation of tubes of lining tissues that shunted air from the trachea tothe back of the throat allowing the person to speak.

It was interesting, but at my level of training, I was confused by thedetails and diagrams. I was years away from doing any type of sur-gery on my own. At some point during his talk, I probably checkedmy watch, wondering when the conference would be over.

Then, the visiting surgeon flipped the controls and adjusted the vol-ume on a 16-mm movie projector. The light flickered as the filmmoved past the bulb.

There, on the screen, was a man who had undergone a total removalof his voice box. The surgeon asked him a question and the patientresponded by holding a vibrating device against his neck to createan artificial, machine-like sound that he shaped into words. He wasunderstandable but his voice sounded synthetic.

The next scene was filmed after the same patient had undergonethe voice restoring procedure. This time when he responded to thesurgeon’s question, he brought his hand up to his neck and cov-ered his stoma to redirect air from his lungs through the shunt andinto his throat. He was able to talk! The sound was natural and flu-ent. I was enthralled by the patient’s outcome and can stillremember his big smile at the end of the movie. The experiencedphysicians in the conference room asked questions about whetherthe procedure was practical or might cause more problems than itsolved. I, on the other hand, thought that the procedure was amazing.

I left the conference thinking, “I want to do something like that!”Although the procedure described by the visiting surgeon nevercaught on (there are much simpler techniques widely used today),

that meeting steered me toward a career devoted to patients withhead and neck cancer. I can trace my interest to that particular day.

I love my work even on the days I when I find my practice over-whelming. When someone outside of medicine scratches theirhead when I tell them what I do for a living, I explain how I feltwhen I heard that lecture many years ago. I describe the movieand the man’s huge grin. Over the years, I have seen more than afew of those grins on my own patients. It has, indeed, all beenworthwhile.

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Dates to diarise

May 201523 CanSurvive Cancer Support Group, Netcare Waterfall City

Hospital, Midrand, 09:00

28 Reach for Recovery, Cape Peninsula 10:00 Recurrence ofBreast Cancer.

June 20154 CanSurvive Head and Neck Support Group, at Rehab

Matters, 1 De la Rey Rd. Rivonia at 18h00

6 CHOC Ultimate Potjiekos Team Competition, PiratesSports Club, Parkhurst. Contact Sophie Ndhlovu on 073 469 6289 or 011 486 1212 Entries close 1 June.

7 International Cancer Survivors Day

13 CanSurvive Cancer Support Group, Hazeldene Hall,Parktown 9:00

23 CHOC Pamper day at Mowana Spa. Contact SophieNdhlovu on 073 469 6289 or 011 486 1212

27 CanSurvive Cancer Support Group, Netcare Waterfall CityHospital, Midrand, 09:00

27 Bosom Buddies, Hazeldene Hall, Parktown, 09:30 for10h00

July 20152 CanSurvive Head and Neck Support Group, at Rehab

Matters, 1 De la Rey Rd. Rivonia at 18h00


14 Reach for Recovery, Roodepoort Centre for the Aged,Robinson Street, Horizon14h00

15 Reach For Recovery, Johannesburg, 19 St John Road,Houghton 13:30

18 Wings of Hope, German International School, Parktown,09:30 for 10:00 - birthday.

21 Prostate & Male Cancer Support Group, Auditorium,Constantiaberg MediClinic, 18:00


30 Reach for Recovery, Cape Peninsula 10:00. Psychology andbreast cancer

August 20151 Bosom Buddies, Hazeldene Hall, Parktown, 09:30 for

10h00

6 CanSurvive Head and Neck Support Group, at RehabMatters, 1 De la Rey Rd. Rivonia at 18h00


18 Prostate & Male Cancer Support Group, Auditorium,Constantiaberg MediClinic, 18:00


27 Reach for Recovery, Cape Peninsula 10:00. Does deodor-ant cause breast cancer?

CONTACT DETAILS

Cancer Buddies Johannesburg branch, andCanSurvive Cancer Support Groups - Parktown and Waterfall : 083

640 4949, [email protected]

CanSurvive Head and Neck Support Group, Rivonia, Johannesburg.Contact Kim Lucas 0828801218 or [email protected]

Cancer Buddies/People Living with Cancer, Cape Town:076 775 6099, [email protected], www.plwc.org.za

GVI Oncology /Cancer Buddies, Rondebosch Medical Centre SupportGroup. Contact: Linda Greeff 0825513310

[email protected]

GVI Cape Gate Support group: 10h00-12h00 in the Boardroom,Cape Gate Oncology Centre.|

Contact: Caron Caron Majewski, 021 9443800

GVI Oncology Somerset West Group for advanced and metastaticcancers. Contact person: Nicolene Andrews 0218512255

Cancer.vive, Frieda Henning 082 335 49912, [email protected]

Can-Sir, 021 761 6070, Ismail-Ian Fife, [email protected] Group: 076 775 6099.

More Balls than Most: [email protected], www.pinkdrive.co.za,011 998 8022

Prostate & Male Cancer Support Action Group, MediClinicConstantiaberg. Contact Can-Sir: 079 315 8627 or Linda Greeff

0825513310 [email protected]

Wings of Hope Breast Cancer Support Group011 432 8891, [email protected]

PinkDrive: [email protected], www.pinkdrive.co.za, 011 998 8022

Bosom Buddies: 011 482 9492 or 0860 283 343,Netcare Rehab Hospital, Milpark. www.bosombuddies.org.za.

CHOC: Childhood Cancer Foundation SA; Head Office: 086 111 3500; [email protected]; www.choc.org.za

CANSA National Office: Toll-free 0800 226622

CANSA Johannesburg Central: 011 648 0990, 19 St John Road,Houghton, www.cansa.org.za

CANSA Pretoria: Contact Miemie du Plessis 012 361 4132 or 082 468 1521; Sr Ros Lorentz 012 329 3036 or 082 578 0578

Reach for Recovery (R4R) : Johannesburg Group, 011 487 2895.

Reach for Recovery (R4R) : West Rand Group. Contact Sandra on 011953 3188 or 078 848 7343.

Reach for Recovery (R4R) Pretoria Group: 082 212 9933

Reach for recovery, Cape Peninsula, 021 689 5347 or 0833061941CANSA offices at 37A Main Road, MOWBRAY starting at 10:00

Reach for Recovery: Durban, Marika Wade, 072 248 0008,[email protected]

Reach for Recovery: Harare, Zimbabwe contact 707659.

Breast Best Friend Zimbabwe, e-mail bbfzim@gmailcom

Cancer Centre - Harare: 60 Livingstone Avenue, HarareTel: 707673 / 705522 / 707444 Fax: 732676 E-mail:

[email protected] www.cancerhre.co.zw

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NNeewwss iinn bbrriieeff

ASCO cancer treatment and survivorshipCare Plans

ASCO has developed two types of forms to help people diagnosedwith cancer keep track of the treatment they received and medicalcare they may need in the future: a Cancer Treatment Plan and aSurvivorship Care Plan.

The ASCO Cancer Treatment Plan is a form that provides a conven-ient way to store information about your cancer, cancer treatment,and follow-up care. It is meant to give basic information about yourmedical history to any doctors who will care for you during yourlifetime.

Using the treatment plan, your current oncologist can enter thechemotherapy dose you received, the specific drugs that were used,the number of treatment cycles that were completed, surgeriesdone, and any additional treatment that was given, such as radia-tion therapy or hormonal therapy.

ASCO also offers a form called a Survivorship Care Plan. It containsimportant information about the given treatment, the need forfuture check-ups and cancer tests, the potential long-term lateeffects of the treatment you received, and ideas for improving yourhealth.

These forms are not intended to provide a complete medical record.And, no single treatment or survivorship care plan is appropriate forall patients due to the complexity of cancer care. Talk with yourdoctor for more information about your individual treatment andfollow-up care. The ASCO Cancer Treatment Plan and SurvivorshipCare Plan should be used with the guidance of your doctor.

Patients and other consumers may use ASCO’s Treatment andSurvivorship Care Plan templates without seeking permission fromASCO. They can be downloaded from http://www.cancer.net/sur-vivorship/follow-care-after-cancer-treatment/asco-cancer-treat-ment-and-survivorship-care-plans

Refining cannabinoids for therapeutic useLos Angeles startup Kalytera Therapeutics is taking the high out ofthe THC – refining cannabinoids so they can have broader therapeu-tic applications in conditions like osteoporosis, Prader-Willi syn-

drome, PTSD, obesity and weight loss associated with cancer.

There’s a litany of potential applications for cannabinoids as thera-peutics – epilepsy, pain management and cancer-associated weightloss being the most accepted. The underlying idea of Kalytera is tomodify cannabinoids, or the molecules that regulate the endo-cannabinoid system, to get rid of the psychoactive properties of thedrugs.

That way, the therapeutic’s focus is primarily on the condition itself.Kalytera’s candidates are still preclinical for osteoporosis, Prader-Willi and obesity, but it’s nearing phase 2 trials for cancer-associat-ed weight loss.

The startup’s chaired by Israeli organic chemist RaphaelMechoulam, who is credited by some as the “Grandfather ofMarijuana.” He was, after all, the first scientist to isolate THC as acompound back in the 1960s – back when the NIH was saying that“marijuana is not an American problem,” Vocativ writes in a profileon the scientist.

Muscle-building supplements linked to testicular cancerMen who use muscle-building supplements (MBSs) that containcreatine or androstenedione may have up to 65% increased risk ofdeveloping testicular cancer, according to a case-control study pub-lished online in March in the British Journal of Cancer.

This risk increased even more among men who began using MBSsbefore age 25, who used various kinds of MBSs, or who used themfor a long duration.

The study is the first to look at the epidemiologic associationsbetween MBSs and testicular cancer, the researchers note.

Young people, in particular, use MBSs, and the number of users isincreasing, according to senior author Tong Zhang Zheng, MB, ScD,who led the study at Yale University before joining the BrownUniversity School of Public Health as a professor of epidemiology.

"Although no population survey data exist to suggest just what per-centage of young people use MBSs, we do know that the MBS businessrakes in billions of dollars," Dr Zheng commented in an interview.

An international consortium is working to build an understandingabout the unclear etiology of testicular cancer.

Brachytherapy improves survival forinoperable early stage endometrial cancer

Women who have early stage endometrial cancer and are inopera-ble tend to live longer if they have been treated with brachytherapywith or without external beam radiation, according to new researchpresented at the 3rd ESTRO Forum in Barcelona, Spain.

Brachytherapy is a type of internal radiotherapy that involves put-ting a radioactive source close to, or in the tumour. Although it hasbeen used historically to treat inoperable endometrial cancer, thereare no guidelines based on randomised evidence to support thisapproach. Dr Sahaja Acharya told the conference: "To our knowl-edge, this is the first population-based study to compare outcomesfor patients who received brachytherapy, with or without externalbeam radiation, to those who did not receive brachytherapy andwere treated with external beam radiation alone."

Dr Acharya, a resident physician in the Radiation OncologyDepartment of Washington University in Saint Louis, USA, and her

Tollfree service for cancer patients

PLWC Cancer Buddies now has a tollfree number - it is

0800 033 337All cancer patients now have access to free cancer support and canask any questions about cancer and treatment of cancer; the emo-tional issues related to the cancer journey; questions about sideeffects of treatment; assistance with accessing resources like wigs,prosthesis, home nursing and hospice. Problems relating to accessto treatment or services delivery issues can also be reported .

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colleagues analysed data from the National Cancer Institute'sSurveillance, Epidemiology and End Results (SEER) for 460 womenin the USA who had been treated with radiation therapy between1998 and 2011 for inoperable stage 1 endometrial cancer.

Usually, early stage endometrial cancer can be removed surgicallyand has a good prognosis. However, sometimes it is inoperable andthis can be for a number of reasons, including if the patient has anumber of other medical problems that would make an operationrisky or if they are very overweight or obese. In these cases radio-therapy is the only remaining treatment option and the averagesurvival time is around three years.

The researchers found that brachytherapy was associated with abetter overall survival: death from any cause was 13% lower, with60% of women who had been treated with brachytherapy alivethree years after treatment compared to 47% of women who hadbeen treated with external beam radiation alone. They thenmatched women who received brachytherapy to those who did notreceive brachytherapy based on age, grade and year of diagnosis.After adjusting for these factors, they found that the survival benefitpersisted in favour of those who received brachytherapy.

http://www.medicalnewstoday.com/releases/293057.php?tw

Pepsi removes controversial sweetener from Diet PepsiAfter sales of Diet Pepsi fell by more than five percent last year,PepsiCo is removing the controversial artificial sweetener aspartamefrom their product and replacing it with sucralose.

Sucralose is a popular artificial sweetener, usually sold under thebrand name Splenda. It's not poisonous; it doesn't cause cancer, andit isn't a pesticide. Sucralose does not break down in the body, and itdoesn't release chlorine into your system.

It's manufactured from sugar, but it's approximately 600 timessweeter than sugar, so very little is needed. Most sucralose passesthrough your digestive system without being absorbed. The smallamount that's absorbed leaves the body through the urine.

http://www.nbcnews.com/nightly-news/video/diet-pepsi-to-ditch-aspartame-for-splenda-434078275857

Reverse prostate problems by treating gum diseaseTreating gum disease can reduce inflammation in the body, and itcould be a way of reversing arthritis and heart disease. And a newstudy demonstrates that it’s an effective way to treat prostateinflammation, or prostatitis.

With prostatitis, the prostate gland becomes inflamed, and urina-tion can be difficult or painful. It can heal in time, but drugs such asantibiotics, painkillers and anti-inflammatories are commonly pre-scribed to help treat it.

But researchers from Case Western Reserve University have success-fully treated the problem by reducing gum disease and inflammation.

In a study of 27 men with prostatitis, all had moderate to severegum disease. During the eight-week study period, they were treat-ed for gum disease, but not for their prostatitis, and yet 21 of the 27men had lower levels of PSA (an inflammation marker of theprostate gland) afterwards. Those with the highest levels of inflam-mation benefited the most, and their symptoms improved or disap-peared altogether. Just six of the men said there had been no

improvement in their prostatitis.

Source: Dentistry, 2015; 05(03); doi: 10.45172/2161-1122.1000284

Honey: Such a good wound-healer thatsurgeons are urged to use it Surgeons are being urged to apply honey to the patient’s woundsafter surgery. A new study suggests that it is one of the most effectivemethods for fast wound-healing, and may be every bit as good asantibiotics.

Wounds that are treated with honey regularly – either hourly or daily,depending on the severity of the wound – usually become sterilewithin three to 10 days. It’s especially effective for treating woundsthat become infected or fail to close or heal. Researchers at the NorthWest Wales NHS Trust in Bangor say it can also help heal wounds leftby laparoscopic, or ‘keyhole’, surgery to remove cancers.

Honey came out top of a review of 18 studies that looked at differentwound-healing therapies, including maggots. Some of the paperswere prepared more than 60 years ago, around the time whenresearch into honey stopped with the introduction of antibiotics.

Lead researcher Dr Fasal Rauf Khan commented: “It can be used tosterilise infected wounds, speed up healing and impede tumours, par-ticularly in keyhole surgery.”

Source: International Journal of Clinical Practice, 2007; 61: 1705-7

Early cancer detection: "Physicians andpatients need a good database"

Whether it is a mammogram, colonoscopy or a skin cancer screening– after a certain age, we are subject to various early cancer detectionscreenings. Yet many of us don’t know that these screening tests arealso associated with risks. This is something that Dr. Sylvia Sängerfrom the University Medical Centre Hamburg-Eppendorf discoveredin a study.

In an interview with MEDICA.de, Dr. Sänger talks about the reasonsfor this lack of knowledge, further study results and the point of dif-ferent early detection methods.

She says: "Every physician is obligated to educate his patients onexamination or treatment methods – this also applies to early detec-tion. He should introduce all options to the patient and explain theirbenefits and risks. Only then is it possible to ponder the purpose of ascreening test for the respective patient together. This approach how-ever, is still not practiced by all physicians.

"Many people trust their doctor and rely on his/her recommendation.If the physician therefore recommends a screening test, the patient

Don't die from embarrassmentAn article on www.healthworkscollective.com tells how, in hismemoir On Writing, Stephen King writes of his mother's 1971trip to Minnesota for her sister's funeral. On the plane, she beginsto bleed. She's long since entered menopause, but she simply tellsherself that she's having one last period. She acquires a tamponand mentions nothing.

It isn't until two years later that her doctor finally catches a veryadvanced case of uterine cancer. It will kill her within a year. Kingobserves that his mother Ruth, a religious and old-fashionedwoman, actually died of embarrassment.

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DISCLAIMER: This newsletter is for information purposes only and is notintended to replace the advice of a medical professional. Items contained in Visionmay have been obtained from various news sources and been edited for usehere. Where possible a point of contact is provided. Readers should conducttheir own research into any person, company, product or service. Please consultyour doctor for personal medical advice before taking any action that may impact onyour health. The information and opinions expressed in this publication are notrecommendations and the views expressed are not necessarily those of PeopleLiving With Cancer, Cancer Buddies, CanSurvive or those of the Editor.

usually undergoes the exam – 84 percent of study participants con-firmed this.

"It is good and important for the physician to be the first contact inthis type of situation. Yet both physicians and patients need a gooddatabase to decide together which exam makes sense on an individ-ual basis. People are also required to change their way of thinking inthis case. As a patient, I cannot just hand off my responsibility in thewaiting room like a coat and expect the doctor to tell me what Ishould do. This is not how joint decision-making works.

"Cancer screening makes sense especially when there is personal risk.If my mother has been diagnosed with breast cancer for instance, Iwould definitely want to get a mammogram and take advantage ofthis exam. However, the physician should still educate me on the riskfactors. Early cancer detection tests make sense on an individualbasis. Whether they make sense for the general population however,is something we as a society need to determine on a regular basis."

The full text of the interview can be found at:http://tinyurl.com/lcxjsff

Organic nanoparticles, more lethal to tumors Radiotherapy used in cancer treatment is a promising treatmentmethod, albeit rather indiscriminate. Indeed, it affects neighbouringhealthy tissues and tumours alike. Researchers have thus been explor-ing the possibilities of using various radio-sensitizers; these nanoscaleentities focus the destructive effects of radiotherapy more specificallyon tumour cells. In a study published in EPJ D, physicists have nowshown that the production of low-energy electrons by radio-sensitiz-ers made of carbon nanostructures hinges on a key physical mecha-nism referred to as plasmons - collective excitations of so-calledvalence electrons; a phenomenon already documented in rare metalsensitizers. This reseach was conducted by Alexey Verkhovtsev, affiliat-ed with the MBN Research Center in Frankfurt, Germany and A.F.Ioffe Physical-Technical Institute in St Petersburg, Russia and an inter-national team.

Nanoparticle radio-sensitizers are nanoscale compounds, typicallycomposed of rare metals such as coated gold, platinum, or gadolini-um. Alternatives sensitizers could be made of carbon-based nanos-tructures, such as fullerenes or nanotubes, provided they are biocom-patible and non-toxic. Previous studies have revealed that gold andplatinum nanoparticles produce a large number of electrons via theplasmon excitation mechanism. In the case of a carbon nanoparticle,this phenomenon yields electrons with higher energy than pure met-als, thus inducing greater biological damage.


Revealing kidney cancer's secretAn international team of scientists, led by UC Davis nephrologistRobert Weiss, have used a sophisticated combination of proteomicsand metabolomics to show how renal cell carcinoma (RCC) repro-

grams its metabolism and evades the immune system. In addition,the study found that cancer grade has a major impact on this repro-gramming. These results, published in the journal Cancer Research,point to new therapeutic options for this particularly deadly cancer.

"The mortality for someone with highly metastatic RCC is some-where in the 90 percent range," said Weiss, professor of nephrologyand internal medicine at UC Davis and chief of nephrology at the VANorthern California Health System in Sacramento. "We now knowthis cancer is actually reprogramming its environment to minimisethe immune response."


Moderate exercise may make cancertreatments more effective

Kansas State University kinesiology research offers encouraging infor-mation for cancer patients: A brisk walk or a slow jog on a regularbasis may be the key to improved cancer treatments.

Brad Behnke, associate professor of exercise physiology, and collabo-rators have shown that moderate exercise on a regular basisenhances tumour oxygenation, which may improve treatments incancer patients. Now Behnke is using an American Cancer Societygrant to study moderate exercise as a way to make radiation treat-ments more effective, especially for difficult-to-treat tumours.

"If we can increase the efficacy of radiation treatment, then thepatient's prognosis is enhanced," Behnke said. "An intervention likeexercise has almost universally positive side effects versus othertreatments that can have deleterious side effects. Exercise is a type oftherapy that benefits multiple systems in the body, and may perma-nently alter the environment within the tumour."

The National Cancer Institute at the National Institutes of Healthrecommends exercise for cancer patients and cancer survivors, butlittle research shows what happens within the tumours during suchexercise. Behnke and collaborators have published their exercise andcancer research in the Journal of the National Cancer Institute.

Wings of Hope were invited to assist at the Olivedale Hospital'soncology centre on the 4 May with the chemo pamper day.

Patients were made comfortable and treated with presents andsnacks. The Wings, represented by Jenny Aspinal and ChristelKlima, explained about cancer support and actively providedsupport to the chemotherapy patients.This service was highlyappreciated by both, staff and patients.

Wings of Hope pampering patients

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