An invitation to help create Rhode Island's next 5 year cancer prevention and control plan
If you are a survivor or a caregiver, we are writing to ask you to help us by sharing your ideas and suggestions for improvement in the areas of cancer care and survivorship supports. We would like to know about what has worked well for you, and what has challenged you, or presented roadblocks-- what can be improved. Your first-hand knowledge of cancer prevention, diagnosis, treatment, caregiving, and/or survivorship, and your experiences with the health systems that impact care, are important considerations as we develop this five-year plan to improve prevention efforts and our state’s cancer-related systems of care.
Please note: The link below works well with Chrome, Android, and iPhone browsers. It does not work with Internet Explorer.
https://ri-cancer-control-rihealth.hub.arcgis.com/
Thank you in advance for sharing your ideas and thoughts with our program. We look forward to creating a five-year plan that includes the ideas and reflects the priorities of those most impacted by cancer. We also hope to promote evidence-based strategies that will reduce the burdens of cancer in our state.
Best,
The Partnership
Quarterly Meeting
Dear Partnership Member:
You are cordially invited to attend a Quarterly meeting of The Partnership to Reduce Cancer in RI. You will meet other cancer survivors, caregivers, and providers and learn about the ways in which The Partnership is working to improve quality of life for survivors and caregivers. There will also be a presentation by the RIDOH.
When: Wednesday, December 11, 2019
Where: RI College School of Social Work
(Building 9 SSW) East Campus
600 Mt. Pleasant Avenue
Providence, RI
401-456-8042
Time: 5:30 pm – 7:15 pm
Refreshments will be served. Please RSVP to jdziobek@prcri.org. Hope to see you there!
Sincerely,
Jim Willsey, Board Chair
Joe Dziobek, Director
Check out our Community Event Calendar to see what we are doing and join us if you are interested! For our full calendar, click here.
Cancer as a Social Disease
Tuesday, November 12, 2019
Don Dizon MD and Aditya Bardia MD, MPH
Maybe it's because I also lecture on cancer survivorship, and on sexual health after cancer, but I've come to realize that I am rarely treating only the one with cancer—I am also treating that patient's loved ones because I've come to understand that cancer is a social disease. It's part of what makes this profession so special. We not only meet people at their most vulnerable, we meet those important to her. And we get to know everyone. If we are fortunate, these relationships span years, and we get to really understand patients as people—sharing in their joys and celebrations and their sorrows. I've seen women with ovarian cancer attend their children's weddings and meet their first grandchild. I've seen young women with breast cancer marry and have families. I've treated women born around the same time as me, and I've met their kids, who are around the same age as my own. I've watched their kids grow, as I and my patients grow gray. I wish it happened often, but sadly, it doesn't. And to me, it's hard because when a patient dies, not only does that special relationship cease, so do the relationships that I've built with that patient's circle. I've said goodbye to many people after their loved ones have died, and it can almost feel like they've walked into another world—one where I no longer fit.
I wondered if this was something others also experienced, and whether my colleagues also found themselves thinking about the families and friends that came in to our lives because of one person's cancer, and left once that person had died. I decided to talk with Dr. Aditya Bardia about it. Aditya is a friend and colleague I met when I was at Massachusetts General Hospital. He is also an accomplished clinical researcher who serves as the Director of Precision Medicine at the MGH Center for Breast Cancer. His work focuses on integrating precision diagnostics and therapeutics, including the clinical application of circulating tumor cells and DNA as "liquid biopsy," to significantly improve the outcomes of men and women treated for, and living with, breast cancer. Recently, his work on the antibody drug conjugate (ADC), sacituzumab govitecan, was published in the New England Journal of Medicine. More than this, Aditya is also an incredibly kind clinician—thoughtful, deliberate, and empathic. His dual roles in drug development and early trials and as a busy clinician made him the perfect person to ask about this.
"For me, not seeing a patient's family or friends after they've died is tough," he stated. "Over the years, I establish a deep bond with the patient and their families. It's something forged through the times I've helped them cope at their most vulnerable, the times weve laughed and shared significant life events, and those times when we worked through cancer treatments not working. The patient and caregivers essentially become like a part of an extended family."
That made sense to me. I remember in my early days as an attending, I had met a young woman with an aggressive breast cancer. She had come in with her family. I got to know all of them pretty well—even learning that the kids were from a prior marriage. For a while we would see each other during 3-month checkups. They barely felt like medical visits because we would just tell stories about our lives and laugh. Then she developed metastatic disease. She restarted treatment and our visits became more somber. Despite our best efforts, she didn't respond to treatment and died a few months after her diagnosis. I still remember that her husband came back to see me a week after her funeral. He just needed to talk— he felt like a lifeline had been cut. He explained how the cancer center had been his only other family during that period and that he hadn't realized how much those visits meant to him. We talked for a while that day, even discussing starting a group for men whose wives had died of cancer. But life got busy and I didnt hear from him again, but that didnt mean I stopped thinking about him.
I had felt an obligation to take care of him, but I didnt know how to. I asked Aditya about it as well. "I do think we have an obligation as providers—and as extended family members-- to support the patients family after someone we cared for dies. Its such a difficult and challenging time. What that means might range from sending a sympathy support card, to making a phone call, to attending the funeral, or even making a personal visit. I have done all of these in one form or another and feel it not only helps the family members but it helps me as well. I think cancer centers can do more, especially since we know that families are as important as the person with cancer. Whether that is formal programs to support caregivers or after care programs after a loved one dies, these are needs that should be met. At the end of the day, it is about doing what we can to heal the patient, and that includes their families."
I agree as well, and we are starting to see those voices in programs. At Lifespan Cancer Institute we have formed Patient and Family Advisory Councils to help steer patient—centered care. Their input will become essential to identifying and meeting the needs of caregivers and spouses throughout the cancer trajectory. We just need to ensure that access continues for caregivers and families, even after the patient him- or herself has died.
Read the full article at http://theoncologist.alphamedpress.org/site/blog/Cancer_as_Social_Disease.html
What is the JUUL?
August 7, 2019
Medically reviewed by Andy Tan, MPH, PhD
JUUL is a brand of electronic cigarette, or e-cigarette, that enables users to inhale vapor infused with nicotine, flavorings, and other compounds. Introduced in 2015, JUULs work much as other e-cigarettes do, but because they’re small and sleek — resembling a USB flash drive — and come in a variety of flavors, critics have charged that they’ve been specifically targeted to young people.
Research by the Centers for Disease Control and Prevention shows them to be the most popular brand of e-cigarette on the market.
Because they deliver a hit of nicotine — an addictive drug that provides a pleasurable sensation — without the cancer-causing tar found in tobacco products, JUULs (pronounced “jewels”) have been touted as a safer alternative to smoking. Juul Labs, Inc., the maker of JUULs, defines its mission as “improving the lives of one billion adult smokers by eliminating cigarettes.”
Research shows, however, that not only do most e-cigarette users continue to smoke traditional cigarettes, but that e-cigarette use can actually make young people more likely to take up smoking, according to the American Lung Association.
JUULs consist of a battery-powered vaporizer that connects to a cartridge, or “pod,” filled with liquid containing nicotine salts, flavorings, and other substances such as glycerol, propylene glycol, and benzoic acid. One of the features that distinguishes JUULs from similar products is their small size — easily enclosed in the palm of the hand — compact design, and relatively small plume of vapor. They initially gained notoriety for the high nicotine content in their pods, although other manufacturers have largely caught up, research by investigators at Stanford University has shown.
Study Finds Nicotine Vapes Linked to Lung Cancer
Smoke from e-cigarettes has been found to cause lung cancer in mice, according to a study published in the American journal Proceedings of the National Academy of Sciences.
Prof Moon-shong Tang of New York University led the research in which 9 out of 40 mice (22.5%) exposed to vape smoke containing nicotine for 54 weeks developed lung cancer. In contrast, none of the 20 mice exposed to nicotine-free vape smoke developed cancer.
“Tobacco smoke is among the most dangerous environmental agents to which humans are routinely exposed, but the potential of vape smoke as a threat to human health is not yet fully understood,” said Tang.
He urges caution when it comes to interpreting his study’s findings, though, as it was conducted with a relatively small sample of mice susceptible to developing cancer over their lifetimes. The mice also did not inhale the smoke in the same way a human would, but instead were surrounded by a cloud of it.
“Our study’s results in mice were not meant to be compared to human disease, but instead argue that vape smoke must be more thoroughly studied before it is deemed safe or marketed that way,” Tang said.