Clearing the confusion about mammograms

The bottom line: Mammography saves lives. Various organizations may not agree perfectly on screening recommendations, but don’t use that as an excuse to throw up your hands and do nothing.

Pink ribbon

October is Breast Cancer Awareness Month. This year, an estimated 209,060 Americans will be diagnosed with breast cancer; more than 40,000 will die from the disease.

“Mammography is one of the few screening tools that has been proven to save lives. Every woman over 40 should at least begin a discussion about screening with her doctor,” says Mark Helvie, M.D., director of breast imaging at the U-M Comprehensive Cancer Center.

Here’s what everyone does agrees on:

  • All women 50-74 should receive regular mammograms.
  • Mammography may be the right choice for women in their 40s. While many groups, such as the American Cancer Society and the National Comprehensive Cancer Network, continue to recommend routine screening, others advocate a discussion between women and their health care providers.
  • Yearly or every other year? Many groups continue to recommend annual exams. The difference of opinion comes down to a balance between benefit and harm. Annual screening saves more lives but at a cost of more harms. Talk to your doctor about your options.
  • Women at very high risk for breast cancer may benefit from additional screening with MRI. Continue reading

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.”

Read the rest of this story

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