U-M Cancer Center develops program with Cancer Support Community to help patients and caregivers cope

For 44 years of marriage, Karen and Larry Ganzini have balanced each other. Karen is a talker; Larry is quiet. Larry isn’t keen to show his soft side; Karen feels worse when she bottles up emotions.

Karen and Larry Ganzini said the FOCUS program helped them both to cope better with the uncertainties of cancer.

Karen and Larry Ganzini said the FOCUS program helped them both to cope better with the uncertainties of cancer.

Nearly 10 years ago, Karen was diagnosed with breast cancer. Although Karen says that cancer almost feels like second nature now, issues due to the couple’s differing communication styles have cropped up as the disease has progressed to stage IV. Karen and Larry support each other, but it was still difficult to talk about certain aspects of Karen’s cancer.

When Karen learned about a new pilot program to help patients and their caregivers cope better, the Ganzinis signed up. The program was offered by the Ann Arbor branch of the Cancer Support Community, a nonprofit organization dedicated to providing education and support to people with cancer.

“I asked the question about hospice, and my husband really didn’t want to go there at this point. He doesn’t like to talk about the end, and I understand that,” Karen said. “But I need to know what it’s going to be like.”

By enrolling in the pilot program, Karen got her answers, and both Ganzinis agreed that the experience helped them feel better about their situation. The program, called FOCUS, is based on University of Michigan Comprehensive Cancer Center research that has shown that patients and caregivers benefitted from meeting with a nurse to provide them with information and support.

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Patient & Family Advisory Board provides opportunity for input at the U-M Cancer Center

Laura Galunas and Anne Marshall meet with Karen Hammelef.

Laura Galunas and Anne Marshall meet with Karen Hammelef about the Patient & Family Advisory Board.

On the day of her first appointment at the University of Michigan Comprehensive Cancer Center, Anne Marshall remembers pulling into the parking lot, nervous and afraid. She had been to the center many times before with her mother, who was diagnosed with breast cancer in 2006; but pulling into the circle drive felt different when the breast cancer diagnosis was her own.


Then she met Cleon Abrams, a longtime parking attendant at the Cancer Center.

“I was surprised he remembered me,” said Marshall, who is a social worker. “He just had this perfect smile and said, ‘Be encouraged.'”

Those two words made all the difference to Marshall. Not only did they give her the boost she needed at that moment, but it led her to become more engaged in the Cancer Center and its efforts to provide the ideal patient care experience.

Recently, Marshall was a member of a task force to establish bylaws for the Cancer Center’s new Patient & Family Advisory Board. The board is designed to offer patients and families a formal role in providing input into the institution’s initiatives and operations. Continue reading

U-M pharmacists, doctors collaborate to ensure patients get drugs they need, despite shortages

After Shawn Burr became a patient at the University of Michigan Comprehensive Cancer Center, his doctor asked an unusual question: Would he be able to bring his own chemotherapy drug?

The Cancer Center — like many institutions throughout the country — was facing a daunting shortage of cytarabine, a generic chemotherapy drug that is instrumental in treating acute myeloid leukemia, the form of cancer Burr has. Two of the three companies that make cytarabine had run into manufacturing problems: One couldn’t obtain the raw materials necessary; the other had to recall batches because of quality concerns. The third company couldn’t keep up with the resulting demand.

And so, when it became clear to Sherry DeLoach, a pharmacist who coordinates drug purchasing for the U-M Health System, that stocks were running low, she notified the oncology pharmacists. They, in turn, met with the doctors whose patients use cytarabine to develop a strategy to ensure that every patient who needed the drug received it. One piece of this plan, among many others, was to ask newly referred patients if they could obtain the drug from their current health-care provider.

U-M would have provided Burr with the drug regardless of his answer. But Burr’s care team at St. Joseph Mercy Port Huron Hospital was able to lend U-M enough cytarabine to accommodate his treatment.

“It’s a pretty hopeless feeling,” Burr said. “Usually, you think health care is all about money, but when it comes to generics, there’s not a lot you can do if drug companies decide they aren’t going to make a drug anymore. There needs to be some policy put in place to protect patients.”

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Visit Thrive, the U-M Comprehensive Cancer Center’s patient publication at mCancer.org/thrive.

Bone deep: Learn how to keep bones strong, even if cancer treatment increases osteoporosis risk

The results of Susan McDonald’s bone mineral density screening were troubling. Bone density had decreased 3 percent in her spine and 3.6 percent in her hips since a scan done two years earlier. Given her history of breast cancer and the potential that related treatments might further sap her bones’ strength, McDonald needed a plan to improve her bone health.

Her oncologist, Catherine Van Poznak, M.D., outlined some options to address the thinning in her bones, which in the case of her hips had progressed to a precursor of osteoporosis called osteopenia. McDonald, a 72-year-old Ann Arbor resident, decided to make a concerted effort to increase her walks from 20 minutes to 30 minutes per day, covering about a mile-and-a-half to a mile-and-three-quarters during each outing.

Two years later, McDonald’s bone mineral density was much improved.

“I’m a small, fine-boned woman who’s likely to get in trouble with bone problems,” McDonald said. “But they were talking about osteopenia in my hips two years ago; they’re not saying that anymore.”

Bone health may be of particular concern for people with a history of cancer, said Van Poznak, a University of Michigan Comprehensive Cancer Center oncologist who specializes in breast cancer’s relationship to bone. People with breast or prostate cancer who undergo treatments that block specific hormones may be at higher risk of thinning bones. Also, certain chemotherapy drugs used to treat these or other cancers may induce ovarian failure in younger women, causing bones to thin as a result of early menopause and estrogen deprivation. In addition, steroids may also accelerate bone loss in both men and women.

Although cancer treatment may increase the likelihood of developing osteoporosis — which may lead to painful bone fractures — many options are available to prevent it, Van Poznak said. The key is to talk to your doctor early to develop a plan of action. Here are six steps you can take to improve your bone health. Continue reading

What’s the fallout: U-M radiologist answers questions about commonplace radiation exposure

For some cancer survivors, commonplace exposure to radiation induces pangs of worry. Will the chest X-ray ordered by a family doctor or a trip through the airport’s new security scanner increase your chance of developing a secondary cancer? What can you do to reduce your risks?

In the latest issue of Thrive, the University of Michigan Comprehensive Cancer Center’s patient publication, we talked with Ella Kazerooni, M.D., U-M professor of radiology, about what people with cancer should know about everyday radiation exposure. Find out what she had to say.


PsychOncology Clinic offers tools for coping

After Michael Daly was diagnosed with cancer, he felt alone. He didn’t know what to expect with his treatment and, in the early days, some of his doctors didn’t offer much encouragement about his prognosis.

Daly was prescribed a medication to treat his anxiety and depression, but after a while, it stopped working.

“I found myself not wanting to get involved in my life and just vegetating,” Daly said. “I wanted to get back into control of it, because I didn’t want to spend my days waiting to die. I needed to get over that hump.”

By then, Daly had chosen a new approach to treatment that brought him to the University of Michigan Comprehensive Cancer Center. His oncologist suggested he consult with the Cancer Center’s PsychOncology Clinic.

Staffed by social workers, psychiatrists and nurse practitioners, the PsychOncology Clinic provides assessments to Cancer Center patients to determine their level of distress and individual needs. The team then develops an action plan to help patients get the assistance that’s right for them. Continue reading