When breast cancer treatment leads to breast cancer pain

breast cancer painmCancerPartner sat down recently with Norah Lynn Henry, M.D., Ph.D., assistant professor of internal medicine and a breast cancer specialist, to discuss breast cancer pain from treatment and how researchers are working on this pervasive problem.

mCancerPartner: Many breast cancer survivors are relieved to have moved past their surgery, chemotherapy and hormone treatments but now have the burden of pain from the treatment. What causes this pain?

Dr. Henry: Truthfully, as doctors and researchers we are not yet entirely certain, but we’re trying to find out. We know that peripheral nerve damage is common with chemotherapy and can cause numbness, tingling and pain. Chemotherapy may also affect the nerves in the brain and spinal column as well. Then there is the pain related to aromatase inhibitors (AIs), an anti-hormone treatment given to postmenopausal women.

mCancerPartner: What advice would you give to breast cancer survivors who are having pain as the result of their breast cancer treatments? Continue reading

Advancing research for brain cancer treatment

brain cancer

Malignant brain tumor

In recognition of brain cancer awareness month, the focus of my blog is on the latest developments in treating this particular cancer. Glioblastoma or glioblastoma multiforme is the most common brain cancer in adults. According to the American Brain Tumor Association, glioblastomas represents about 17% of all primary brain tumors. They can be difficult to treat because the tumors contain so many different types of cells. They tend to be both aggressive and fast growing. The National Cancer Institute says the mortality rate for brain cancer has remained largely unchanged over the past 30 to 40 years. Therefore looking at new ways to treat brain cancer is desperately needed.

One of the hottest areas of clinical research into brain cancer involves the use of immunotherapy, or stimulating the immune system to attack cancer. The National Cancer Institute defines Continue reading

Clinical trial tests targeting prostate cancer treatment


Are certain drugs more effective against some types of prostate cancers than others? Researchers know that not all therapies work for all patients – the next question is to figure out how to match the right treatments with the right patients.

A new clinical trial is testing whether an experimental drug can maximize the effect of current treatment and whether matching that drug to a genetic anomaly can lead to better, more personalized treatment for prostate cancer. The trial, led by investigators at the University of Michigan Comprehensive Cancer Center, is being conducted at 11 sites throughout the country. Continue reading

Screening for Colorectal Cancer: Time to Stop Avoiding the Colonoscopy

“Your doctor said you need WHAT?” People can feel a bit uneasy when a doctor mentions screening for colon cancer or rectal cancer.

Danielle Turgeon, M.D., is one of the University of Michigan gastroenterologists who perform colonoscopies.

Danielle Turgeon, M.D., is one of the University of Michigan gastroenterologists who perform colonoscopies.

But, according to the American Cancer Society, colorectal cancer is the third most common cancer in both men and women in the United States. Preventing colorectal cancer, and not just finding it early, is why doctors recommend colorectal screening tests, even though the subject may seem embarrassing to discuss.

Colorectal cancer starts in the colon or rectum, most often as a polyp, or small piece of tissue that projects from the inner wall. Screening tools can find cancer in people before symptoms show up, which is when colorectal cancer is most easily treatable. Some also can find and remove suspicious-looking polyps before they become cancerous, which may prevent colorectal cancer.

Who should be screened:

  • Starting at age 50, men and women of average risk for colorectal cancer
  • People with a personal or family history of colorectal cancer or pre-cancerous polyps
  • People with inflammatory bowel disease
  • People with certain other risk factors, including a known family history of a hereditary colorectal cancer syndrome

The American Cancer Society recommends the following screening tests: Continue reading

New Clinical Trial for Thyroid Cancer Patients

Many types of tumors can start in the thyroid gland, which is in the front of the neck, below the Adam’s apple. Most of them are benign (non-cancerous) but others are malignant (cancerous), which means they can spread into nearby tissues and to other parts of the body. The two most common types of cancer are papillary carcinoma and follicular carcinoma. There are other types of thyroid cancer, which are rare.

Thyroid cancer is commonly diagnosed at a younger age than most other adult cancers. Nearly two out of three cases are found in people younger than 55 years of age. About 2% of thyroid cancers occur in children and teens.

Ronald J. Koenig, M.D.

Ronald J. Koenig, M.D.

Most thyroid cancers can be cured by surgery and radioactive iodine. However, thyroid cancers not cured by those therapies present a problem. As a rule, thyroid cancers do not respond well to chemo. But unlike standard chemo drugs, targeted drugs attack certain targets on cancer cells. The targets they attack can be present on normal cells as well, but the goal is to find targets that help cancer cells grow and thrive.

Ronald Koenig, M.D., Ph.D., professor of internal medicine at U-M, heads a research team focused on developing targeted drug therapies for thyroid cancer. He talked with mCancer Partner about a new clinical trial that is opening enrollment for certain patients with thyroid cancer.


mCancer Partner: Can you tell me about your newest clinical trial?

Dr. Koenig: In this new trial, to be funded by the National Cancer Institute, we are investigating whether a drug, Actos (pioglitazone), is useful in treating a certain kind of thyroid cancer. Actos is approved by the FDA to treat diabetes, but has not been approved yet to treat any cancers.

mCancer Partner: Who can enroll in this clinical trial?

Dr. Koenig: We will enroll adults with a history of follicular thyroid carcinoma or follicular variant of papillary thyroid carcinoma. These people must have metastatic disease or disease that has recurred locally in the neck, and that cannot be cured by further surgery or radioiodine. We will treat them for at least 24 weeks with daily pioglitazone and measure for response using CT scans and blood tests.

mCancer Partner: Where can someone learn more about this clinical trial?

Dr. Koenig: Details, along with contact information for enrolling, are available through UMClinicalStudies. This is a helpful website allowing people to easily search and find clinical and health research studies happening at the U-M. Our study’s ClinicalTrials.gov Identifier is NCT01655719.

Learn more about the Cancer Center’s thyroid cancer program or call the U-M Cancer AnswerLine at 800-865-1125 to speak with a nurse.

Why is Pancreatic Cancer so Challenging?

The pancreas is located deep inside the body, so early tumors cannot be seen or felt by health care providers during routine physical exams. This makes it hard to see the pancreas with imaging technologies and sometimes makes it difficult to access to remove cells for a biopsy.

Pancreatic cancer is a relatively rare cancer and it typically affects people older than age 50. Pancreatic cancer is hard to diagnose because the early symptoms are usually vague. Early symptoms may be nothing more than a general feeling of discomfort in the abdomen or an unexplained weight loss.

Another factor that makes pancreatic cancer so deadly is its resistance to treatment. At this time, the only possibility for long-term survival is surgically removing the cancer. Researchers are working on ways to detect the disease earlier, because that might allow more people to be eligible for surgery.

What tests are used to diagnose pancreatic cancer?

  • History and physical exam
  • Computed tomography (CT, CAT) scan
  • Magnetic resonance imaging (MRI)
  • Somatostatin receptor scintigraphy(OctreoScan) – helpful in diagnosing pancreatic neuroendocrine tumors
  • Positron emission tomography (PET) scan
  • Ultrasonography (ultrasound)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Angiography
  • Blood tests– Elevated blood levels of the tumor markers CA 19-9 and carcinoembryonic antigen (CEA) may point to a diagnosis of  pancreatic cancer made of exocrine cells, but these tests aren’t always accurate
  • Biopsy – A patient’s history, physical exam, and imaging test results may strongly suggest pancreatic cancer, but the only way to be sure is to remove a small sample of tumor and look at it under the microscope. This procedure is called a biopsy.

When disease has advanced beyond surgery’s reach, chemotherapy is the standard treatment. Two drugs are FDA-approved for the treatment of pancreatic cancer: gemcitabine (Gemzar) and erlotinib (Tarceva).

Research focusing on pancreatic cancer is increasing. Researchers are investigating ways to more effectively screen for the disease and examining possibilities for better treatment options.

Continue learning about pancreatic cancer treatment and research at the University of Michigan Comprehensive Cancer Center