A place to share news, thoughts, and feelings about cancer care for women.

Archive for October, 2010

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Dr. Marcia Boraas

Dr. Marcia Boraas

Here at Fox Chase, we’re constantly amazed by the incredible ways that family and friends of cancer patients choose to support and honor their loved ones. Equally inspiring are the ways that these people – regardless of their age – can make a difference in their communities.

I’d like to share with you a special story about how one patient’s experience inspired her daughter to make a difference in the breast cancer community by organizing a successful fundraiser for teens and their moms. Her work also resulted in the public recognition of the doctor who not only treated her mom, but who has made a positive impact in the lives of women throughout the Delaware Valley.

This is the story of Barbara Davis and her daughter Eliza, presented by Barbara’s doctor Marcia Boraas, MD, a surgical oncologist who recently returned to Fox Chase. We hope you find it as inspiring as we do.

Be Well,

Bob

TickledPinkLast November, I had the great honor of being recognized for “Outstanding Devotion to the Breast Health of the Women of the Delaware Valley” at the first annual “Tickled Pink” event sponsored by Susan G. Komen for the Cure. The event—a gala featuring an auction and survivor fashion show—was planned and launched by Teens for the Cure, a junior chapter of the local Komen affiliate that was founded by Eliza Davis, the youngest daughter of my patient Barbara.

I first met Barbara when she developed breast cancer in 2003 and I performed her surgery here at Fox Chase. Inspired by Barbara’s experience overcoming cancer, Eliza launched a Philadelphia chapter of Teens for the Cure and rallied friends and supporters to organize the area’s first Tickled Pink event. The highly successful event was attended by over 400 guests and raised an impressive $110,000 for Komen. Just as importantly, it offered breast cancer survivors, their families and friends the opportunity to come together and celebrate.

(left to right) Eliza Davis, Dr. Marcia Boraas, Elaine Grobman (President of Komen Philadelphia) and Barbara Davis

(left to right) Eliza Davis, me (Marcia Boraas), Elaine Grobman, the Executive Director, Susan G. Komen for the Cure Philadelphia, and my patient, Barbara Davis, at Tickled Pink 2009.

Most women with breast cancer are treated successfully, which is why offering hopeful care to my patients is one of the most rewarding aspects of my work at Fox Chase. Eliza and Barbara’s story reflects the importance of hope, and shows how an experience that is initially frightening—a breast cancer diagnosis—can turn into a source of inspiration and positive change.

I sincerely hope you’ll consider joining Barbara, Eliza, my daughter, Elisabeth and myself at this year’s Tickled Pink, which will be held at the National Constitution Center on Friday, November 19, 2010.

All the best,
Marcia Boraas, MD

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To learn more about this year’s Tickled Pink and to buy tickets (available through November 1), click here.

For more on Barbara and Eliza, read their stories:
Barbara Davis: Patient Testimonial
Eliza Davis: The Teen with the Dream

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Chances are that if you’re on this blog, you know something about Fox Chase’s Women’s Cancer Center.  Maybe you’re familiar with our expertise in breast and gynecologic cancer care, or you’ve visited our new offices in the Robert C. Young, M.D. pavilion.

For an in-depth look at our amazing facility—including details on the services we provide, from prevention to treatment to survivorship—I encourage you to check out our new webisode.

During this six-minute virtual tour, you’ll hear from me and a variety of different staff from around the Center as we explain exactly why the Women’s Cancer Center is the only one of its kind in the region.

See if you recognize a familiar face, or learn something new – and let us know what you think! We want to hear from you.

Be Well,

Bob

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

janepepper_banner

Jane Pepper

Jane Pepper

While many of you know Jane Pepper from her leadership as President of the Pennsylvania Horticultural Society and the celebrated Philadelphia International Flower Show, we know her as a devoted member of the Fox Chase Cancer Center Board of Directors.  She has made a great impact on our community.  In honor of Jane’s years of service and dedication to supporting our research and treatment efforts, Fox Chase has established our first Women’s Center symposium in her name.

The Jane Pepper Women’s Cancer Symposium, a free event slated for Saturday, November 6, 2010 from 2:30 – 4:00 pm, will convene oncologists, cancer survivors and their families, authors, and interested members of the public to discuss issues surrounding cancers that affect women and to celebrate survivorship. Join us from 4:00 – 5:30 pm for a catered reception and tours of the Women’s Cancer Center.

Reserve Your Spot Today!

This event is free and open to the public, however space is limited. Please respond by November 1 to Wanda Ford at 215-728-3163 or wanda.ford@fccc.edu.. We hope that you will join us for an inspirational and educational afternoon.

Meet the Moderator:

Mary B. Daly, M.D., Ph.D., FACP

Mary B. Daly, M.D., Ph.D., FACP

Fox Chase’s Dr. Mary Daly, chair of the Department of Clinical Genetics, will moderate a panel discussion featuring local attorney and ovarian cancer survivor Emily Beck, and authors Cathy Bueti and Kerri Conners, followed by a reception and tour of the Women’s Cancer Center.  These vibrant women have all contributed strong voices to cancer support and advocacy through their writing and speaking, and we know you will find their perspectives to be inspiring.

For a bit of background:

Emily Beck

Emily Beck

Emily Beck, 38, is a three-year survivor of Stage IIIA ovarian cancer and active young adult cancer advocate.  Emily is a strong voice within the cancer community, sharing her ongoing journey as a cancer survivor on the blog See Emily Play and volunteering with Imerman Angels to lend support to young adults currently undergoing treatment.

Cathy Bueti

Cathy Bueti

Cathy Bueti, a nine-year survivor, has been a panel participant at various cancer conferences and events to speak about her journey with breast cancer.  In May 2009, she published the moving memoir Breastless in the City to chronicle her experience as a young widow dating through cancer treatment.  She also maintains a blog and website, cathybueti.com.

Kerri Conner

Kerri Conner

Kerri Conner was diagnosed with an aggressive form of breast cancer at age 33.  The daughter of a breast cancer survivor and the mother of a young child, Kerri wanted to encourage women with breast cancer and other adults to have conversations with young children about the treatment process.  Kerry published My Mommy Has Breast Cancer but She is OK! this past February, and she is also the 2009 recipient of the Susan G. Komen Philadelphia chapter’s “Breast Cancer Survivor of the Year” award for her community efforts.

Tour and Book Signing

Following the panel discussion, we will host a reception and tours of the Women’s Cancer Center for those who have not yet seen our amazing new facilities since they opened this past Spring.  Cathy and Kerri will also have copies of their books on sale and will be available for book signings.

I hope to see you there!

Be Well,

Bob

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Robert Burger, MD

Robert Burger, MD

As Ovarian Cancer Awareness Month draws to a close, I wanted to share news of a study that was released earlier today in a special issue of The Lancet, a prominent medical research journal.

A European study of 1,442 women with ovarian cancer in remission found that contrary to popular belief, starting chemotherapy early did not improve survival or quality of life compared with postponing treatment until clinical symptoms of relapse were evident.  Specifically, “there was no evidence of a survival benefit with early treatment of relapse on the basis of raised CA125 concentration alone, and therefore the value of routine measurement of CA125 in the follow-up of patients with ovarian cancer who attain a complete response after first-line treatment is not proven.”

Click here for the article: “Early verus delayed treatment of relapsed ovarian cancer (MRC OV05/EORTC 55955) a randomized trial,” [The Lancet, Vol 376, Oct 2, 2010].

This study is the first randomized trial to investigate the timing of treatment for relapsed ovarian cancer.
Lancet

The study was based on CA-125 serum levels, which have been used to monitor patients after completion of primary therapy who appear to be without evidence of disease.  The level of the CA125 protein produced by ovarian cancer cells in the blood often increases several months before signs or symptoms of relapse appear in women with ovarian cancer. This study compared treatment started when the CA-125 value was twice normal with delayed treatment based on conventional clinical indicators.

Patients in the CA-125 monitoring group began second line treatment approximately five months earlier than the experimental group. Results showed that overall survival was similar in both groups, but that a worse quality of life was demonstrated in the in CA-125 monitored group, who experienced greater emotional and social side effects as well as fatigue associated with early treatment.

As you may know, current practices concerning whether or not regular CA125 tests are done and when to start second-line chemotherapy vary widely. While CA-125 is known in general to detect disease recurrence earlier than symptoms, imaging and physical examination, CA-125 is not specific for ovarian cancer (unlike PSA for prostate cancer, for example), and false positive tests are possible. Concerns about CA125 testing and the implications of positive results can cause patients considerable anxiety.

In addition, the downside of earlier treatment without documented evidence of recurrent disease by imaging or physical examination is that patients could be exposed to toxicity and financial burdens when impact on survival is unknown. It could also potentially exhaust treatment options once recurrent disease is documented by clinical and radiographic criteria.

As in all studies, results must be interpreted by the oncologist for his or her individual patient. This study may not be applicable to all patients with ovarian cancer or to those with ovarian cancer treated in other parts of the world.

For example, approximately 50 percent of the patients were randomized at nine months, indicating an early relapse group, with most of these women probably having higher risk disease (platinum-resistant disease). In this therapy-resistant subgroup, it is reasonable to hold off on treatment until patients become symptomatic or to treat with a non-toxic agent, such as tamoxifen or to enroll such patients in a clinical trial evaluating biologic therapies rather than cytotoxics. This trial has not answered the question for patients who relapse at 12 months or later.

Also, treatment standards in Europe may differ from those in the United States. At the time of initial diagnosis, most U.S. patients undergo aggressive surgeries prior to beginning front-line chemotherapy, whereas in Europe it is much more common for patients to have either chemotherapy prior to surgery or a less aggressive surgery. In addition, it is possible that a wider variety of active agents are available in the United States (see NCCN guidelines).

After the results of this study were presented at the 2009 ASCO meeting, the Society of Gynecologic Oncologists (SGO) issued a statement regarding the use of CA-125 for monitoring ovarian cancer.

SGO criticized the study for not including information on the amount of residual disease after initial cytoreductive surgery, for lack of remission confirmation by imaging before enrollment onto the study, and for lack of standardized treatment at relapse. Patients randomized to the CA-125 monitoring group may have had less effective treatment at the time of “recurrence.”

In addition, in a commentary in the Lancet issue in which the study is published, Robert T. Morris and Bradley J. Monk point out that contemporary therapies were not available to most of the trial participants because of the length of the trial which started in 1996 and required nine years to enroll the 1.442 patients; and to regulatory and financial barriers restricting access to all active compounds in the participating countries. The usefulness of the study, they argue, is in its challenge to the assumption that early treatment of relapsed disease must be better than delayed treatment, and the questions thereby raised.

The study, thenovarian, is informative but not definitive. Patients and their physicians should still have the opportunity to choose CA-125 monitoring as a philosophy of active management.

Please stay tuned to this space and let us know if you have any comments or questions. While it might be the official end of Ovarian Cancer Awareness Month, our discussion of issues in ovarian cancer will continue.

Be well,

Bob

P.S. Dr. Burger was qhealthdayuoted in a HealthDay article about this study.