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  • Understanding Clinical Trials

    Posted 10/21/2014 by hhill

      There are a lot of myths and misconceptions about clinical trials. Let's begin here with a short fact sheet that has been developed for our patients:

    BIDMC is an academic medical center and a founding member of the Dana Farber Harvard Cancer Center. This means that our commitment is both to excellence in patient care and participation in research to better understand and treat cancer.
    If you are interested in learning more about cancer clinical trials, the National Cancer Institute has an excellent website:
    As you and your doctors begin to consider the best treatment for you, here are some things to remember about clinical trials:
    ** Clinical trials are conducted in every Department throughout the Medical Center.
    ** Clinical trials are designed to help patients with all kinds of diseases and problems. They are not only for very ill people who have no other options.
    ** Everything we know about good treatment for cancer is because people have agreed to participate in trials in the past. Everything we are learning for the future is because people are now willing to consider being part of an appropriate trial.
    ** If you would like to know more, talk with your doctors.

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  • One Step Ahead of Cancer

    Posted 10/20/2014 by hhill
      As we all know, once cancer recurs/metastisizes, it is no longer curable. For most kinds of cancer, it is quite treatable, but this means that the patient faces a life-time of treatment--with a lot of frightening anxiety re the length of that life-time. Doctors often refer to recurrent/advanced cancer as a chronic disease, but that always feels not quite right to me. When I think of a chronic disease, I think of things like asthma or diabetes or high blood pressure which can often be treated to insure a normal life span. Except in rare instances, that is not the case with advanced cancer. Read more... Comments (0)
  • Dietary and Herbal Supplements

    Posted 10/17/2014 by hhill

      A few days ago, I wrote about the frequent use of CAM (complementary/alternative medicine) by cancer patients and survivors. The estimates of how many people use these modalities are varied, but we all know that most people at least think about the possibility. As I have said before, one really important thing is to make sure that your doctor (and any other practitioners whom you are consulting) knows what you are doing. For example, there is concern about anti-oxidants interfering with radiaiton therapy, and radiation oncologists ask their patients not to take more than a simple multi-vitamin during active treatment.

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  • Reducing Cancer Risk

    Posted 10/16/2014 by hhill
      Although it may seem a bit like the proverbial shutting the barn door after the horse has escaped, I suspect that we are all interested in cancer risk reduction. Just because we have had one cancer does not mean that we are magically protected against a second; we are concerned about those whom we love, and common sense suggests that strategies that reduce cancer risk might (note: no evidence for this) reduce recurrence risk, too. Read more... Comments (0)
  • Friends

    Posted 10/15/2014 by hhill
    I have been involved in a number of discussions this week about friends' reactions to our cancer. Each person who raised this topic felt that she was the only one with this problem and, upon learning how common it is, wondered why no one had warned her what to anticipate. The summary is that there are inevitably surprises about friendships. All of us are disappointed by some thought-to-be good friends and very pleasantly surprised by others whom we knew less well.

    Several people have recently described the loss of a best friend over the course of cancer treatment. In each case, the friend was not present in important times and ways. She may have not visited after surgery or not offered a ride and company for a chemotherapy appointment or just stopped calling. People with advanced/metastatic cancer too often find that friends gradually fall away. People can sometimes rally and actively help for a few months, but when the need goes on for months or even years, it is harder to sustain. Some "friends" hurt us with comments and stories about others whom they have known who have not had good outcomes with  cancer. On the flip side, there are always people whose reactions and involvement are unexpectedly wonderful. I often hear of acquaintances who offer to organize meals or rides, neighbors who thoughtfully call to ask if they can pick up something at the grocery store, or work colleagues who tactfully cover for us when we need a break. Former slight acquaintances may become close friends by sharing this time with us.

    A third group of "friend surprises" are those people whom we meet because of cancer. Lifelong friendships can begin in a support group or daily contact in the Radiation Oncology waiting room. I often overhear wonderful conversations in the Infusion Area. A man in one chair may be talking very intimately with a woman in the next.  Even if there are real differences between us, our shared diagnosis and experience make us close. We understand one another.

    When I meet a newly diagnosed man or woman, I sometimes suggest that s/he make a list of likely supportive friends. I tell her to list those people on whom she can depend and also those whom she expects to disappear. Then, I tell her, put that list away and don't look at it for at least six months. When she looks again, there are sure to be surprises--on both lists.

    It is easy to be glad and grateful for the new friends. It is harder to know what to do about damaged relationships. Sometimes, the only possibility seems to be to let go, to recognize that lives change and friends don't always last. Other times, a friendship has been so valuable that it is worth the (possibly) painful risk of reaching out and trying to talk about your disappointment and sense of abandonment. Whatever you choose to do, remind yourself that a friend's behavior is due to her issues, not yours. She likely was so frightened by your diagnosis that she could not cope. This is not an excuse, merely an explanation and reassurance that the change is not your fault. If you have lost previously good friends, treasure, even more, the new ones. And be prepared to use what you have learned to help your next friend who has a crisis.

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