Friday, 5 June 2015

June 10th Chat - Palliative Care (A Joint Chat with #hpm )


Graphic by Christian Sinclair

This month on June 10th (9pm EST) we will be discussing Palliative Care. We are so happy to be hosting a joint chat with the #hpm (Hospice and Palliative Medicine) community. The #hpm chat founder, Christian Sinclair (@hpmchat / @ctsinclair) a palliative care and hospice medical doctor at the University of Kansas Medical Center and editor at Pallimed will be joining us. We also will welcome #hpm moderators Ashley and Niamh.

Our discussion will be guided by the following questions:

T1: What does the term "palliative care" mean to you? How do you think palliative care differs from hospice?
T2A: Have you discussed palliative care with your doctor? Who brought it up? How did it make you feel?
T2B: When in the patient's treatment do they tend to get referred to a palliative care specialist? When is ideal?
T3: Are there medical / insurance requirements to obtaining palliative care?
T4: What do you wish you would have known about palliative care? Doc's: What do you wish your patients knew?
T5: For those with experience with palliative care, what were the positives / negatives?

To prepare for the chat you may read this palliative care fact sheet from the NCI (@NCI).

Also this article from Cancer.Net (@cancerdotnet).

And this journal article Comprehensive Care in Gynecologic oncology: The importance of Palliative Care. 

Remember if you want to learn more about how to participate in tweet chats you can read this blog post. For this joint chat, include both #gyncsm and #hpm in your tweets.

We look forward to having you join our discussion or come and "lurk and learn".
Questions? Contact us at gyncsm@gmail.com.

Dee
#gyncsm co-founder and co-moderator


Wednesday, 13 May 2015

Advances in Personalized Medicine for Gyn Cancers - May 13,2015

Forty-five participants joined us for our May chat as we discussed Advances in Personalized Medicine. We were grateful to have Dr. Scott Richard (@sdr2md), Director of the Division of Gynecologic Oncology at Hahnemann University Hospital, and Kelly Mellott and Dr. Juan Avila from Helomics™ Corporation (@HelomicsCancer) share their expertise on this important and timely topic. Other participants included our health care moderators, researchers, health care providers, survivors and advocates. Chat analytics may be found here.

I've highlighted just a few of the tweets in response to our discussion questions.

T1A: What are some misconceptions you've heard about personalized medicine?

T1B: What personalized medicine options are currently available to gyn cancer patients? What is tested - tumor tissue, blood?



T2: How does genetic testing impact treatment decisions? What genetic tests are recommended for gyn cancers?

T3: How can I discuss personalized medicine options with my cancer care team? What if my doctor doesn't believe in these options?


T4A: How do you think the President’s Precision Medicine Initiative will affect patients/ research?

T4B: What are the challenges to bringing the benefit of personalized medicine to gyn cancer patients? How will patient care change?

If you want to read more of this informative discussion you may find the transcript here .

A list of resources shared by participants during the chat may be found at the end of this post.  

We hope you will join us on June 10, 2015 as we join with #hpm for a chat on Palliative Care. And be sure to watch for #gyncsm in tweets reporting the latest from the ASCO Annual meeting (#ASCO15, May 29-June 2).

Dee
#gyncsm co-founder and co-moderator

RESOURCES:

Precision Medicine and Targeted Therapy overview via @theNCI: http://t.co/OvBNHgBinH

Overview of immunotherapy tactics and trials for cervical and ovarian http://t.co/50EGJ4929S

@myriadgenetics: Companion Diagnostics Visit http://t.co/vjcgk78Kne

Personalized Cancer Therapy - MD Anderson https://pct.mdanderson.org/

Organizations active w/ GYN cancer Precision Medicine @HelomicsCancer @ClearityFnd @FoundationATCG @myriadgenetics @carisls @AmbryGene

Research explores new, personalized #ovariancancer treatments http://t.co/uGCZXNadXD

National Society of Genetics Counselors http://t.co/HJ6EgbJjxa

ASCO 2015 abstract PM and endometrial cancer- more to learn http://t.co/oJFl6EV8IG
ASCO abstract for PM and cervical cancer http://t.co/eSL3RnIXCv
ASCO abstract for ovarian cancer and PM http://t.co/PimP9Mx6aX

@CancerTodayMag article lists good questions to ask your Doctor http://t.co/zZrCctRxml

How to Talk so your Doctor Will Listen (not specific to PM) http://t.co/2VFICJBQDO

Patient resource for PM / olaparib treatment for #ovariancancer http://t.co/ovlGNH2J5F

Helomics™ Corporation :
patient section currently http://t.co/2vzrfni8gF
questions for your doctor for #ovariancancer: http://t.co/IllLM0Mav4
checklist to talk to your doctor for #endometrialcancer or #uterinecancer: http://t.co/gPQgDPYGmx

@myriadgenetics
“Personalizedmedicine is a game changer – it’s the future of medicine.”video   http://bit.ly/1OUi62f
#ovariancancer patient discussing PM http://t.co/8V7qPTjAtN

@permedcoalition The Case for Personalized Medicine - 4th Edition w/ Drugs/Relevant Gene Chart http://t.co/aYvmmjKmY3
Pg 6: % pts whose tumors driven by certain mutations could be targets for specific drugs, by cancer type http://t.co/Nm6Fg0wgLg

Bombarded w/Changes in Health Care & Beyond, Gyn Oncologists Prepare for the Challenges Ahead http://t.co/JcftUtVO0…

Fact Sheet President's Precision Medicine Initiative : https://t.co/A85dgI6S0E

#PARP inhibitors: A new era of targeted therapy #ovariancancer  http://t.co/73WAO2zmlM

Image of key pathways in #ovca  http://t.co/qR4qXxJBJS

Immune-Based Treatment Shows Promise against Metastatic Cervical Cancer http://t.co/4y4nFEGqkF

ovarian cancer FANG vaccine http://t.co/QXUAKclm6d

SGO genetic testing in gyn cancers: ovarian cancer https://t.co/lp5gWgW8FD
SGO Lynch testing statement for endometrial cancer https://t.co/lp5gWgW8FD
SGO statement on Next Gen multi- gene sequencing panels https://t.co/Mu8zBe3Y8r

Saving Tumor Tissue @OCRF Webinar http://t.co/FeYvQbk7Rq

@OncLive Search for Immune-specific biomarkers is in full swing: http://t.co/JXZRr00vPG

Imprecise marketing of precision medicine: Advertising may be running ahead of science http://t.co/cl1SKHbOvQ

Lecture by Dr. Funda Meric-Bernstam  MDACC https://t.co/n6w6exQQEf

Liquid Biopsies may change cancer care #gyncsm http://t.co/VD3MutGt78

@WSJhealth : A New Way to Use Old Tools Against #OvarianCancer http://t.co/L8dFeYl5h5

Friday, 8 May 2015

May Chat : Advances in Personalized Medicine for GYN Cancer

Our October 2013 chat topic was "Genetics and Personalized Medicine". Many new developments and initiatives have occurred since then. During our May 13, 2015 (9pm EST) chat we will provide an update on advances made in personalized medicine and how they impact the care of patients with gynecologic cancers.

In addition to our regular Health Care Moderators, Dr. Scott Richard (@sdr2md) Director of the Division of Gynecologic Oncology at Hahnemann University Hospital and Kelly Mellott and Dr. Juan Avila from Helomics™ Corporation (former known as Precision Therapeutics; they will be tweeting as @HelomicsCancer) will join us for this important discussion. Helomics™ Corporation is a healthcare company that develops innovative diagnostics for the oncology field. PLEASE NOTE: Helomics' participation in this chat is NOT an endorsement of the company's products or services by the #gyncsm community or our health care moderators.

The discussion questions are:

T1A: What are some misconceptions you've heard about personalized medicine?
T1B: What personalized medicine options are currently available to gyn cancer patients? What is tested - tumor tissue, blood?
T2: How does genetic testing impact treatment decisions? What genetic tests are recommended for gyn cancers?
T3: How can I discuss personalized medicine options with my cancer care team? What if my doctor doesn't believe in these options?
T4A: How do you think the President’s Precision Medicine Initiative will affect patients/ research?
T4B: What are the challenges to bringing the benefit of personalized medicine to gyn cancer patients? How will patient care change?

To prepare for our discussion you may read  President Obama's Precision Medicine Initiative Fact Sheet . Additional articles/resources may be found on the CDC's Public Health Genomics page and on the NCI's Precision Medicine and Targeted Therapy page.

We look forward to having you join our discussion or come and "lurk and learn".

Dee
#gyncsm co-founder and co-moderator

Tuesday, 28 April 2015

World Ovarian Cancer Day - May 8, 2015




The #gyncsm community is pleased to once again partner with the cause World Ovarian Cancer Day (WOCD).  WOCD will be held this year on May 8, 2015. This year’s theme is “Celebrate Women”.

WOCD, was first held in 2013. It unites organizations from around the world in their efforts to raise awareness of ovarian cancer. The reasons a special day is crucial for the effort include the lack of an early detection test for the disease, symptoms similar to less serious illnesses, and high mortality rates.  

Many of our followers know the stats for the US. An estimated 22,000 women will be diagnosed with ovarian cancer and 14,000 women’s lives lost each year. (http://seer.cancer.gov/statfacts/html/ovary.html) 

Do you know the global impact?

A quarter of a million women are diagnosed worldwide with ovarian cancer and the disease is responsible for 140,000 deaths each year. While 89% of the women diagnosed with breast cancer survive five years only 45% of women diagnosed with ovarian cancer survive that long. 

What can you do?

Celebrate the women in your life by visiting the www.ovariancancerday.org.  While on the site you can pledge your support of WOCD and share information about the disease and the Day with five of your friends.  Read the personal stories of women from around the world at http://ovariancancerday.org/personal-stories/

Follow WOCD on facebook at https://www.facebook.com/WorldOvarianCancerDay), 

Follow WOCD on Twitter https://twitter.com/OvarianCancerDY and share tweets such as these:



Thanks for joining our efforts to raise awareness of ovarian cancer worldwide and don't forget to wear teal on May 8th.

Dee
#gyncsm co-founder



Monday, 13 April 2015

Survivor's Story: GTD and Me – A Story of Diligence, Persistence, and Grace

During the recent tweet chat (#CancerFilm) which took place during the viewing of the documentary the Emperor of All Maladies, Christina conversed with Katie Smith, who was diagnosed with GTD (Gestational Trophoblastic Disease). Gestational trophoblastic disease (GTD) is defined by the National Cancer Institute (NCI) as a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. Trophoblast cells help to connect the embryo to the uterine wall and help to form the placenta. GTD, in most cases, is benign but some cases may be malignant and spread to nearby organs. Please see the NCI site for additional information. We are pleased to have Katie share her story with our community. 


GTD and Me
A Story of Diligence, Persistence, and Grace

I was 28 years old in the winter of 2005.  I had a beautiful one year old son that my husband and I had waited on for almost four years, a new job, and was excited about possibly having more children in the future.  Little did I know my world was about to be turned upside down.

After having my son, my monthly menstrual cycles became quite painful.  But, I just attributed it to getting older.  I also began having a thick discharge, but attributed it to post nasal drip (I have horrible allergies and thought that was the culprit).  In February 2005, I went to the doctor about the painful periods and an ultrasound was performed.  The doctor saw something in my uterus, but stated it was a fibroid.  Traditionally, fibroids can cause intense periods so this made sense.  I was sent home.

The next month, I noticed that my “pregnancy nose” had returned.  You know – that ability to smell someone eating a cheeseburger in the neighboring town.  At that point, I got a little scared.  While I wanted more children, I wasn’t prepared to have one now.  When I took a home pregnancy test, it showed faintly positive.  So, off to my OB/GYN doc I went.

The blood pregnancy test indicated that I had been pregnant but had a miscarriage.  This was devastating!  According to the doctor, my HCG levels were low which indicated that there may still be remnants in the fallopian tubes.  I was given a very light dose of Methotrexate to help flush out any remaining items.  I was again sent home, but was asked to come back in a couple of days for another HCG level check.

But, when I came back a couple of days later, my HCG levels were starting to creep up.  I was asked to come back in two more days for another check.  This went on for about 1 ½ months (including a stronger dose of Methotrexate thrown in there).  For some reason, my levels would not go down.  At this point, my OB/GYN doctor became concerned.  She said, “I really don’t think this is cancer, but I want you to go see my doctor.  He is a Gynecological Oncologist who can rule out cancer and figure out what this is.”

Dr. Don Hall, the Gynecological Oncologist, immediately sent me for an ultrasound.  The Ultrasound Tech stated, “I see a fibroid in there.  That’s it.”  But, Dr. Hall had a feeling that this was more than just a fibroid.  After multiple urine and blood tests, along with a PET scan, the diagnosis was found.  While all of this was going on, I became engrossed in finding out what this could be.  I stumbled across a Gynecological Disease website and found something called “Gestational Trophoblastic Disease”.  The symptoms sounded like the ones I had been experiencing.  Could it really be cancer?

It was a Friday afternoon and I was called in for my results.  With my mother on one side of me and my husband on the other, Dr. Hall delivered the news.  I had a Placental Site Trophoblastic Tumor, which is in the GTD family of cancers.  Less than ½ of 1 percent of women have this type of tumor, and it forms where the placenta attaches to the uterus.  He had already scheduled my hysterectomy for the following Wednesday.  I would be in the hospital for 3 days and on leave for 6 weeks minimum.  I would have a long scar starting from my belly button down, and they may have to remove part of my intestine.  The PET scan had indicated the tumor had protruded through the uterus and was wrapped in the intestine.

Part of me was relieved to have a diagnosis but the other part of me was terrified.  In addition, our insurance was completely maxed out (this was in the day of annual maximum amounts and before the ACA).  We would have to pay for the entire surgery and any other treatments that I would have to go through.  Funny enough-I didn’t worry about the money part.  I just wanted to be alive to see my son grow up.

When Dr. Hall went in to do the surgery, he discovered that the tumor had not protruded but was fully contained in the uterus.  It was removed and sent off for growth rate testing.  If the growth rate was low, no further treatment would be necessary.  If the growth rate was high, I would have to take chemotherapy and radiation.  In addition, it was discovered I had really bad endometriosis and one of my ovaries was removed because it was badly damaged. 

The results of the growth rate testing showed that the tumor was growing at a slow rate.  However, I had to come back every month for HCG testing.  Each time I went it, I would get very anxious.  I had ghost symptoms constantly and stayed panicked.  But, the first year went by with no increase in HCG.  In July 2015, I will be 10 years cancer free. 

There is a very slight chance it could recur as lung cancer, with an even slighter chance of breast cancer occurrence.  But, thanks to God, the concern of my OB/GYN doctor Rebecca Walker and the diligence and persistence of Dr. Hall,  I’ve been able to experience 11 years of bliss with my son. 

What can you take from this story:  Listen to your body.  It will tell you when something is wrong.  If something is wrong, don’t blow it off.  Have it checked out – it might just save your life.

- Katie Smith (@katielizsmith)


Thank you so much Katie for sharing your story with us. 

Dee 
#gyncsm co-moderator 


Supplements / Vitamins Are they helpful? May 8, 2019 Chat

We were pleased to have Stacy Kennedy MPH,RD (@stacykennedyrd) join us for this informative chat on vitamins and supplements.  You may find ...