George’s Journal

I’ve been thinking about the enormous number of people personally affected by cancer.  Not just cancer patients and survivors, but also their families and friends.  Many of you have shared your cancer stories with me (too many to mention!), your own struggles with this vile disease, or a situation involving a close family member or friend.  I feel a strong connection with you. We’ve shared our faith in God, and how our powerful belief sustained us and kept our hopes alive. From my own experience, I know that you – my family and friends – rallied to lovingly support me and bolster my spirits and faith throughout my battle. Amazingly, your friends – many who I didn’t know until recently – came to my cause and provided me another extremely valued source of care and concern. Thank you all!

Lately, I’ve conducted some research on the most prevalent cancers in the United States (US), and included the level of National Cancer Institute (NCI) funding for the 10 most common types of cancer in the US (scroll down).  I found statistics from the American Cancer Society that shows the number of new cases of cancer expected in 2010 by cancer type, along with the (grim) estimates of death for each.  I also read a couple articles in the June 20th, Parade Magazine that provided some insights I’d like to share.

“NO EVIDENCE OF DISEASE”

Regarding Non-Hodgkin Lymphoma cases in the United States, on January 1, 2007, there were 438,325 men and women alive who had a history of NHL — 226,855 men and 211,470 women. This includes any person alive on January 1, 2007 who had been diagnosed with NHL at any point prior to that date and also persons with active disease and those who are “cured” of their disease. Over 400,000 people have a history of NHL, and NHL is just one of the top 10 most common cancer types.  The number of people in the US battling cancer (survivors) or “cured” (“no evidence of disease”) is just mind-boggling!

Most Sundays, I glance through the L. A. Times. Some sections (news, editorials, sports, travel, business) receive more attention than others. On June 20th, I noticed the front of Parade Magazine featuring legendary cyclist Lance Armstrong holding a child cancer patient under the title, “Cancer in America.”

One of the articles was authored by Judith Newman, the subject was “Living After Cancer.” As you know, my first post-Bone Marrow Transplant cancer screening revealed “no metabolic activity/no cancer,” and I’m praying that my second screening in August will confirm that result. Below, I freely share information gleaned from Ms. Newman’s article (link: Living After Cancer), along with my own research, while sprinkling in some personal tidbits.

LIVING AFTER CANCER

According to the NCI, there are 12 million cancer survivors in the U.S. alone, based on 2007 records.  The number of survivors has more than quadrupled since 1971!!  “Cancer treatments are more successful,” says Dr. Catherine Alfano, program director of the National Cancer Institute’s Office of Cancer Survivorship. “We also have an aging Baby Boomer population, and more people will be diagnosed and treated for cancer than ever before.”  However, as Dr. Alfano points out, “Even while we have more diverse types and more successful treatments, they all still exact a toll on the body.” As a result, long-term survivors are the subjects of considerable medical attention and research.

Livestrong is the nonprofit group founded by Lance Armstrong to support cancer survivors. What I found particularly interesting, is the feedback Livestrong received from its recent survey of more than 2000 cancer survivors.  Ruth Rechis, the foundation’s Director of Evaluation and Research, reports that “even up to 20 years out, no one had all their issues resolved.” While the problems survivors face vary according to their disease and treatment, here are a few of the major health issues reported.

Fatigue: Many people know that chemotherapy treatments can cause profound tiredness, but they may not realize that fatigue can persist in some survivors for years. “We’re not entirely sure, but it may be due to unchecked inflammation in the body,” says Dr. Patricia Ganz, a professor at UCLA School of Medicine. Treatment could possibly push the immune system into overdrive, and in certain patients, the resulting inflammation could increase fatigue “as if the body were constantly fighting off a bad flu,” Dr. Alfano adds.

My fatigue has resulted from the Bone Marrow Transplant. My oncologist, Dr. Robert Chen, advised me that for many BMT patients, it could take a year or so to overcome their fatigue.  Chemo and radiation treatments during my various hospital stays, and as an outpatient, affected my energy level, but not nearly as much as my BMT.  Two months post-BMT, I’m pleased to report that my energy level is improving daily, and I’m feeling increasingly well.

Pain:  Kenechi Udeze was 4 seasons into playing defensive end for the NFL’s Minnesota Vikings when searing migraines sent him to his physician in 2008. The headaches turned out to be a symptom of acute lymphoblastic leukemia. Udeze underwent a BMT and was declared cancer-free. But the nerve damage, or neuropathy, from the aggressive treatment he underwent ended his football career. “Nerves regenerate very slowly, and my feet, my grasp, they just weren’t what they were,” explains Udeze, now 27. Neuropathic pain can be caused by some forms of chemotherapy. Radiation and surgery may also leave the patient with scar tissue, leading to painful tightening of the skin’s surface or internal adhesions. “Many cancer survivors need pain control,” Dr. Ganz says.

I’m dealing with neuropathy in my right leg, most specifically in my calf, ankle and foot.  According to Dr. Chen, a combination of blood clots in my right leg and chemo, have damaged the veins and nerves in my leg.  The tumor was located in my lower right abdomen, so the blood flow was impeded in my right leg by this significant blockage.

Other cancers:
Of the 12 million survivors, 25% ended up having multiple cancers – not just recurrences but, rather, entirely different cancers, according to Doug Ulman, President and CEO of Livestrong. “We don’t know what roles genetics and treatment play, but we know treatment has an impact,” he says.

THE BEST “NEW NORMAL”

As research on cancer survivors proceeds, solutions to their problems will likely be discovered or devised. For now, Dr. Alfano says, “physicians shouldn’t talk about patients going back to normal after treatment.” Rather, physicians are focused on helping people find the best “new normal.” “Oncologists never use the word ‘cured’ anymore,” Beth Silverman, 32, a breast-cancer survivor adds, “They say there is ‘no evidence of disease’ or what we survivors call “NED.”

FUNDING FOR 10 MOST COMMON TYPES OF CANCER

My intentions are for you to know some key facts about the pervasiveness of cancer in the US, by type, and the level of funding provided by our primary governmental cancer research organization (NCI). An underlying message is that we should all do what we can to support cancer research and organizations dedicated to eradicating the various types of cancers. Scroll to the bottom to see a few of these terrific groups (website included). This topic will most likely be featured in a future journal entry. The below table shows the NCI’s spending in fiscal years ‘06, ‘07, and ‘08 for the 10 most common types of cancer in the US, excluding basal cell and squamous cell skin cancers. Other federal agencies funding cancer research include: the Centers for Disease Control and Prevention, and the Department of Defense. Fortunately, there are hundreds of industry-related and private organization research efforts.  In the table, the cancers are listed in decreasing order of incidence; i.e., from highest number of new cases per year to lowest. The source of this information is the NCI Office of Budget and Finance (OBF).

Cancer Type 2006 Spending
(in millions)
2007 Spending
(in millions)
2008 Spending
(in millions)
Lung $242.9 $226.9 $247.6
Prostate 293.2 296.1 285.4
Breast 584.7 572.4 572.6
Colorectal 244.1 258.4 273.7
Bladder 24.4 19.8 24.1
Non-Hodgkin
Lymphoma
114.1 113.0 122.6
Melanoma 108.0 97.7 110.8
Kidney 33.0 31.4 43.4
Leukemia 223.5 205.5 216.4
Uterine 19.4 16.6 17.1

Note: Information about funding for other types of cancer can be found in the NCI Annual Fact Book at http://obf.cancer.gov/financial/factbook.htm. For more info about NCI’s budget, go to  http://obf.cancer.gov/index.htm.

ESTIMATED NUMBER OF NEW CANCER CASES IN 2010

The below list of common cancer types in the US shows cancers that will be diagnosed with the greatest frequency in 2010, as well as the estimated deaths per type. Cancer incidence and mortality statistics reported by the American Cancer Society and other resources were used to create the list.

To qualify as a common cancer, the estimated annual incidence for 2010 had to be 40,000 cases or more.  The most common cancer in the US is lung cancer, with more than 222,000 new cases expected in 2010.  The cancer with the lowest incidence on the list is leukemia – it’s estimated that 43,050 new cases will be diagnosed in the US in 2010. Because colon and rectal cancers are often referred to as “colorectal cancers,” they are combined.

Cancer Type Estimated New Cases Estimated Deaths
Bladder 70,530 14,680
Breast (Female – Male) 207,090 – 1,970 39,840 – 390
Colon and Rectal (Combined) 142,570 51,370
Endometrial 43,470 7,950
Kidney (Renal Cell) Cancer 49,504 11,084
Leukemia 43,050 21,840
Lung (Including Bronchus) 222,520 157,300
Melanoma 68,130 8,700
Non-Hodgkin Lymphoma 65,540 20,210
Pancreatic 43,140 36,800
Prostate 217,730 32,050
Thyroid 44,670 1,690

WE’RE THE LUCKY ONES

Another Parade piece, written by Jeffrey Zaslow, was about Lance Armstrong and Livestrong. Armstrong is the most mentally-tough person I’m aware of.

Not long after he was diagnosed with testicular cancer in 1996, he got a note from a U.S. soldier who also had cancer. “You don’t know it yet,” the man wrote, “but we’re the lucky ones.” Armstrong was taken aback. “I didn’t understand what he meant,” he recalls, “but he ended up being right.” Though he’d never want to repeat his cancer odyssey, Armstrong says, “It enriched my life.”  I would certainly echo Armstrong’s sentiments.

Armstrong’s story is truly inspirational: He fought off tumors that had metastasized to his lung and brain and went on to win the Tour de France – perhaps the most grueling sporting event in the world – a record-breaking 7 times. He also started Livestrong, which aims to empower cancer patients, survivors, and their communities. No doubt you’ve noticed the ubiquitous yellow Livestrong wristbands. I’ve been sporting mine since September.  Armstrong is now 38, and the father of 4.  He’s once again riding in the Tour de France as leader of Team RadioShack. His advice to survivors: In treatment and recovery, continue to do what you love. After chemo and surgery, he was only strong enough to go on 30-minute rides, but he says, “I told myself the disease would not cut off my passion” Furthermore, “surround yourself with positive people. There’s only room for those who can pump you up. It doesn’t help to be around anyone who is a drain on your energy, time or spirit.”  That’s what I have done with YOU – you all are so uplifting!

There are so many terrific non-profit cancer-fighting organizations, including:  Susan G. Komen for the Cure at www.susangkomen.org, The V Foundation for Cancer Research at www.jimmyv.org , Livestrong at www.livestrong.org, and The Leukemia & Lymphoma Society’s Team In Training at www.teamintraining.org.  I urge each of you to check out these groups, and please let me know of other organizations that you support.

I greatly appreciate you taking the time to read this rather lengthy post.  I have cherished your support throughout my journey. For those of you who have donated to my family’s fund, Cheryl and I extend our deepest, heartfelt thanks!

God bless you and yours,

George

…”With God all things are possible.” (Matthew 19:26)


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