Posts Tagged ‘md chat’

How We’re Working to Cure Multiple Myeloma

Over the past ten years, I have seen the treatment of multiple myeloma dramatically improve because of new drug therapies that have come out of clinical trials. I am now leading a clinical study to learn more about the genetic components of multiple myeloma and how we can use that knowledge to come up with better, more targeted drugs and individualized therapies for patients. I think this landmark study will lead to treatments that effect long-term remission, or even cure, from the cancer.

In the CoMMpass study, launched by the Multiple Myeloma Research Foundation, we will follow 1,000 newly diagnosed patients with multiple myeloma over the course of eight years. We will study the genomic changes in their disease while they receive frontline treatments, and continue studying those changes through remission stages or relapse. One of the questions we hope to answer is why some patients do well on a specific drug, while others do not and may need multiple drugs to keep their myeloma from advancing.

The first step in the study is mapping out the molecular characterization of a patient’s tumor using sequencing at the time of initial diagnosis, and then following what happens in the sequencing information during and after treatment. If the disease comes back, we want to know if there were changes in the disease or new mutations that were influenced by the therapy or by the original mutations themselves?

As we learn more about cancer and its various types, we do less lumping them together and more splitting them into individual diseases. Lymphoma is a good example. It used to be that the disease was characterized as six or seven different types, and now we know there are at least 50 different variations of lymphoma. We look at the molecular characterization of lymphoma and create subtypes that are potentially treated in different ways. We may need to do that in myeloma. In the CoMMpass study, we will be able to have individual tumor specimens molecularly sequenced, which has never been done before, and we will learn much more about the cancer and its number of subtypes.

We are also looking at the impact of side effects on quality of life issues in this trial. There may be molecular characteristics of a patient’s tumor that can tell us whether that patient will have side effects from a specific treatment, so mapping a patient’s molecular subtype might influence the type of drugs he gets.

We have seen the life expectancy of multiple myeloma patients double in the last ten years. I think that there are probably some patients we are curing now and I believe that CoMMpass will help us to identify the best drugs and the best targets to increase the cure rate in this disease. We hope this study will help push the barrier to cure even further, but do it in a way that does not compromise a patient’s quality of life.

To learn more, watch this video as Dr. Lonial further explains Multiple Myeloma and treatment options for the diease.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Related Links
Understanding Multiple Myeloma
Phase I Trials – Where All Anticancer Drugs Begin

 

Understanding Multiple Myeloma

While still a relatively uncommon cancer, multiple myeloma has recently received attention surrounding the diagnosis of popular news reporter, Tom Brokaw. This year, an estimated 24,000 people in the United States will be diagnosed with multiple myeloma, and there are about 77,600 people now living with this blood cancer.

About Multiple Myeloma

Multiple myeloma is a type of cancer that forms because of a disorder in the plasma cells, which live in the bone marrow and are the producers of antibodies. These antibodies are what provide protection from infections after vaccination, but in myeloma, the plasma cells become malignant and grow out of control, crowding out the normal bone marrow.

When plasma cells grow uncontrolled by the normal immune system, the consequences can include:

  • Anemia, a condition caused by low red blood cell counts due to crowding in the bone marrow.
  • Bone lesions, as myeloma cells like to create “holes” in the bones.
  • Kidney problems, because the antibodies produced by the plasma cells can clog up the kidneys.
  • Elevated blood calcium level, typically as a consequence of the bone issues.

Multiple Myeloma Symptoms

The most common symptoms for patients are typically fatigue, weakness, bone pain, anemia, or frequent unexplained infections. Multiple myeloma affects both men and women but is more common in men and there is a higher occurrence of multiple myeloma among African Americans than among Caucasians.  It is a disease typically seen in patients who are older than age 65, although it occurs in African-American patients about ten years earlier, and it affects a fair number of younger patients.

Multiple Myeloma Treatment

Treatment for patients with multiple myeloma has changed dramatically over the past decade. As we have developed more effective drugs to target the plasma cells, we also have significantly improved overall survival. Fifteen years ago, the average survival was 3 to 4 years, whereas the average survival is now over 7 years, and for many patients, expected survival is more than 10 years.

The keys to this improvement in overall survival are related to several factors. First, we have better tools to combat myeloma. There have been 6 new drugs approved for treating myeloma over the past decade, and these agents are more effective at treating the disease than the standard mixtures of chemotherapy we had before. The second factor that has improved survival for certain patients is the use of high-dose chemotherapy and autologous stem cell transplantation, in which the patient’s own stem cells are given back to the patient’s body after receiving high-dose chemotherapy. Finally, we now have a better understanding of the biological changes that occur in a myeloma cell and this is helping us to better target treatment needed among these patients.

As we discover new tools and expand the options available for treating multiple myeloma, we see encouraging advancements in both survival and quality of life for these patients. The multidisciplinary treatment team at Winship at Emory has been recognized as a national and international leader in both transplant and non-transplant based approaches to treatment therapies, patient outcomes and clinical trials.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Though Common, Prostate Cancer is Often Very Treatable – Join Our Q&A Chat for Details

Prostate Cancer Q&A ChatDid you know that prostate cancer is the second most common cancer experienced by men, after skin cancer? The good news is that, when caught early, it can often be treated with great success.

Millions of men are living today as survivors of prostate cancer. Being armed with good information in advance is a key ingredient in protecting yourself or your loved ones from this disease.

Join Emory Chairman of the Department of Urology, Dr. Martin Sanda, on Tuesday, September 24, for an online web chat to discuss “Prostate Cancer.”

Prostate Cancer Chat Sign Up

Dermatologist #1 Skin Care Rule – Wear Sunscreen!

Melanoma Web MD ChatIt’s almost summer time, and many of us are already spending more time outside enjoying the warm weather. Most of us don’t consider the consequences of increased sun exposure on our skin, even indirect exposure. Skin cancer is the most common type of cancer in the United States, with about one million new cases every year. The three common forms of skin cancer are distinguished by the types of cells affected: melanoma, basal cell and squamous cell. While melanoma is less common than basal and squamous cell cancers, it is the most dangerous. If caught early, melanoma can be treated; however, if left untreated, melanoma can spread to other parts of the body.

What is Melanoma?

Melanoma is a cancer of melanocytes, which are cells whose primary function is to make pigment. These cells are located in the layers of epidermis, or the outer layer of skin. Melanocytes are also responsible for making birthmarks and freckles; however, in those cases, the cells are not cancerous. Melanomas can form on any part of the skin but are most commonly found on the chest and back in men, and the legs in women. Melanomas can also develop on the neck and face, and they sometimes occur in the eye and in mucosal surfaces, such as the mouth and bowel.

Why do dermatologists recommend applying sunscreen daily?

Skin cancer is most commonly a result of excessive exposure to the sun’s ultraviolet (UV) rays. The sun contains two types of these rays: UVB, which are responsible for sunburns, and UVA, which cause cell aging and long-term skin damage. Both rays cause damage to skin cells’ DNA, resulting in abnormal cell growth. Here are some tips to protect your skin from the sun’s harsh rays and prevent skin cancer:

  • Use a broad spectrum SPF of a level 15 or higher, which is a type of sunscreen that protects the skin from both UVA and UVB rays.
  • Avoid outdoor activity between 10 a.m. and 4 p.m., when the sun’s rays are most intense.• Wear protective clothing as well as a hat and sunglasses to protect more sensitive parts of the body.
  • Remember, the UV rays can go through light clothing, windshields, windows, and clouds.
  • While shade offers some protection, the sun’s UV rays can still penetrate through clouds and trees and have harmful effects.

Check yourself!

Remember, skin cancer is generally treatable if detected early. If you haven’t done so, give your body a quick scan, and repeat this practice at least once a month. Get to know the pattern of moles, spots, freckles, and other marks on your skin. If you notice any new moles or changes in shape or color to existing ones, please contact your healthcare provider.

Have additional questions? Join Dr. Suephy Chen on May 14, 2012 at 11:30 AM EST for a live online discussion about diagnosing and treating melanoma.

For more information about melanoma and other skin cancers, visit Winship Cancer Institute of Emory University.

Related Resources:

Raising Lymphedema Awareness in Honor of “D” Day

Lymphedema Web ChatMarch 6 marks the official awareness day around one of the least understood but most commonly faced conditions among cancer patients—Lymphedema. If you’re unfamiliar with the term, you’re not alone. Essentially, Lymphedema is a condition that occurs when the lymph system is blocked or impeded, which results in the build up of fluid in the body’s soft tissue. This fluid buildup results in swelling–usually in the arms and legs–which is the most common symptom of Lymphedema. Lymphedema can be genetic, but it is often caused as a result of some cancers and their respective treatments. In regards to the latter, according to the National Cancer Institute (NCI), “Lymphedema is one of the most poorly understood, relatively underestimated, and least researched complications of cancer or its treatment.”

Because of the relatively high frequency of Lymphedema among cancer patients and its implications for potential decline in patients’ quality of life, Lymphedema is a condition that clinicians and survivorship programs have begun to place a larger emphasis on.  In the spirit of raising awareness around Lymphedema and helping those who suffer from it and the family members supporting them better understand it, Lymphedema therapist, Stephanie Kirkpatrick, of the Winship Cancer Institute will be holding an online chat on the topic of Lymphedema on “D” Day*.

Stephanie will cover Lymphedema causes, types, treatments, and coping strategies and answer questions from participants during the chat, which takes place on Tuesday, March 6 at noon EST.

*UPDATE: View the Lymphedema chat transcript.

 

 

Lung Cancer MD Chat Follow-up Questions Answered

Dr. Taofeek Owonikoko

Dr. Taofeek Owonikoko

Dr. Kristin Higgins

Dr. Kristin Higgins

Doctors Kristin Higgins and Taofeek Owonikoko held a live web chat on the topic of lung cancer this month. From that chat, there were several unanswered questions that we wanted to circle back with the answers for. You’ll find them below in a Q&A format. If you’re interested in checking out the rest of the conversation from the chat, check out the lung cancer chat transcript.

Rhonda asked: Is there any lung cancer treatment program for people without health insurance?

Dr. Owonikoko: Depending on where this person resides, the state may have a program for indigent cancer patients. Also, the American Cancer Society has some patient support programs for indigent patients to support cancer care. Here is the webpage to the support options on the ACS website.

Marjorie asked: My sister has been treated this year for non-small cell lung cancer in the RUL, that was inoperable. she underwent 6 months of radiation and chemotherapy, and has been told that she is now in remission. what are the odds that she will remain in remission for 5 years or more?

Dr. Owonikoko: This is not a medical advice; best to discuss with the treating oncologist. However, depending on the exact stage of the cancer, 20-30% of patients treated with chemoradiation will survive past 5 years.

Marjorie asked: Also, can you comment on outcomes from radiation induced pneumonitis?

Dr. Higgins: Radiation pneumonitis arises in about 20-25% of patients that are treated with radiation and chemotherapy.  It typically resolves with a course of steroids but sometimes requires hospitilization for more intensive monitoring and supplemental oxygen.

Hank asked: There seems to be some controversy about the use of radiation therapy for lung cancer depending on the stege. What are the pro’s and con’s?

Dr. Owonikoko: There is not much controversy about the benefit of radiation for patient with locally advanced lung cancer. The discussion is more about the best way to give the radiation and how much. Radiation is generally not needed for patients with stage I lung cancer of the non small cell subtype but may be useful for symptom palliation in patients with stage IV non small lung cancer.

Dr. Higgins can provide additional insight on the radiation questions.

Dr. Higgins: A form of local therapy is needed to cure lung cancer that has not yet spread to distant sites, whether it be radiation or surgery.  Surgery is the best option for early stage lung cancer.  New techniques of radiation, particularly SBRT, have been used in patients with early stage lung cancer that are not medically fit for surgery. Outcomes have been very good with SBRT, however surgery and SBRT have not been directly compared and surgery remains the standard of care.  There are trials underway that are directly comparing SBRT vs. surgery.
Again I want to stress that surgery remains the standard of care for early stage lung cancer, but pros to SBRT include minimal recovery time and a less invasive procedure.

Do you have other questions for us related to lung cancer? Leave them in the comments below & we’ll be sure to post responses here.

Dr. Styblo Follows Up with Answers to Breast Cancer Questions

We held a chat on the topic of breast cancer with Dr. Toncred Styblo in October. From that chat, we got lots of great questions and feedback and even a couple questions we couldn’t get to in the chat’s allotted time. Dr. Styblo has taken the time to answer those questions for this follow up blog post, mostly covering questions related to ductal carcinoma in situ (DCIS), a type of breast cancer typically found in the lining of the milk ducts that has not yet invaded nearby tissues.

Below are the questions Dr. Styblo has covered in this post:

  • How long does one continue to follow up with oncologist and surgeon after DCIS diagnosis and resultant mastectomy?
  • What is the risk of recurrence in other breast after DCIS and mastectomy?
  • Does that include blood work for Ca27-29, and how often?
  • I’m interested in risk of recurrence after DCIS diagnosis. If you continue to follow your patients for life (which Dr. Styblo mentioned in the chat that she does), that suggests a moderate risk for recurrence.]
  • What would you suggest in the case of multifocal DCIS?

Answers from Dr. Styblo:

Toncred Marya Styblo, M.D.DCIS, intraductal cancer and in situ ductal cancer are names for stage “0″ breast cancer. Stage 0 breast cancer is cured by removing it completely with surgery, but does not have any affect on the risk of developing a second breast cancer in that breast or the other breast.

The surgery to remove the cancer may be a lumpectomy or it might be a mastectomy.  This risk of a patient developing another breast cancer post-surgery is dependent on many factors and the risk is best assessed by your doctor.  The subsequent follow up and recommendations about screening and risk reduction will be dependent on additional factors including the pathologic features of the DCIS and the patient’s risk of developing a second breast cancer.

Because DCIS is stage 0 breast cancer, follow up is primarily to screen for another breast cancer rather than recurrence.  The screening includes breast imaging and clinical exam, there are no blood tests indicated.


Dr. Styblo also received a question on the topic of support in the chat: What role, in your opinion does emotional support play in achieving the best possible outcome after breast cancer? Where or how do you recommend patients find advocates? The Winship Cancer Institute has several programs for survivors and support, including the Peer Partner Program which “matches cancer survivors and caregivers with cancer patients and caregivers dealing with a similar diagnosis of cancer, pre-cancerous condition, or benign tumor.”

Breast Health & Breast Cancer Related Resources:

 

 

2 Ways to Lower Your Lung Cancer Risk Today

Lung Cancer Awareness Month
More people in the U.S. die from lung cancer than any other type of cancer. Lung cancer is responsible for approximately 30% of cancer deaths in the United States. In fact, it’s actually the cause of more deaths than breast cancer, colon cancer and prostate cancer combined. November is Lung Cancer Awareness Month and we’d like to share with you some important information and tips for how you can lower your lung cancer risk.

Quit Smoking

Obviously, if you smoke, the most important step you can take to lower your risk for lung cancer is to quit smoking. Quitting smoking:

  • Lowers your blood pressure and your heart rate – Within 20 minutes of quitting, your blood pressure and heart rate are reduced to almost normal.
  • Repairs damaged nerve endings – Within 48 hours of quitting, damaged nerve endings begin to repair themselves, and sense of taste and smell begin to return to normal as a result.
  • Lowers your risk for heart attack – Within 2-12 weeks of quitting, your heart attack risk is lowered.
  • Lowers your risk for lung cancer – According to a 2005 study by the National Institute of Health, within 10 years of quitting smoking, your risk of being diagnosed with lung cancer is between 30-50% of that for the smoker who didn’t quit.

Smoking accounts for ~90% of lung cancer cases. If you smoke, this is the critical first step in lowering your lung cancer risk. If you have a history of smoking and are between the ages of 55-75, you may be a candidate for a Lung CT Scan.

Eat a Wider Variety and More Fruits & Veggies

In November 2007,  the American Institute for Cancer Research (AICR) and the World Cancer Research Fund published Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective, the most comprehensive report on diet and cancer ever completed. The study found evidence linking diets high in fruit and their ability to lower lung cancer risk to be probable. This is one of the core reasons that the AICR recommends consuming at least five portions a day of fruits and vegetables. After evaluating approximately 500,000 people in 10 countries in Europe, another study demonstrated intaking a variety of produce may also help lower lung cancer risk, so make sure to vary the color on your plate!

Chat Online with Dr. Suresh Ramalingam

Lung Cancer Web ChatIf you have specific questions about lung cancer, whether they’re related to prevention, risk factors, symptoms, diagnosis, treatment, support, or otherwise, Dr. Ramalingam is hosting a free 1-hour online web chat about Lung Cancer on Thursday, November 17th. Dr. Ramalingam will also be fielding questions on the topic of Lung CT scanning, a lung cancer screening mechanism that studies have shown may help lower the risk of lung cancer mortality.

You can ask as many questions as you’d like in the chat, or feel free to sign up to check out Dr. Ramalingam’s answers to other participant questions. We hope to see you there! UPDATE: Lung Cancer Chat Transcript

Breast Cancer Questions? Dr. Styblo Has Your Answers

Breast Cancer Doctor Chat

Breast cancer is the second most common cancer affecting women. In fact, 13% of all women will develop breast cancer in their lives. Many women are concerned about their risk for breast cancer, and are unsure what their next steps should be. Our doctors frequently get questions such as, Is getting yearly check-ups sufficient? At what age should I start scheduling regular mammograms? What symptoms should I look out for?

Are you concerned about breast cancer? If you have unanswered questions related to breast cancer, look no further. To kick off October as Breast Cancer Awareness Month, surgical oncologist and breast surgeon at the Winship Cancer Institute, Dr. Toncred Styblo will be hosting a live 1-hour web chat to answer all of your breast cancer questions.

Wonder if you’re at high risk for developing breast cancer and what you should do? Dr. Styblo will provide guidance on how to determine if you are high risk and steps you can take if you are. And as an expert in surgical oncology, Dr. Styblo will also be able to answer questions related to breast cancer treatment and surgical options.

Don’t forget, early detection is key to providing the best chance for cure. So take action and control of your health by scheduling your mammogram today and remind a friend to do the same! And, make sure to sign up for Dr. Styblo’s breast cancer chat and bring your questions with you. We’ll see you on October 4th for what’s sure to be a great discussion!