Expert Analysis Highlights:

• Mr. Douglas was diagnosed with an advanced stage cancer at the base of the tongue
• Douglas tells Matt Lauer that he feels good now that the treatment is over
• Like many cancer patients I have worked with, he has come to appreciate loved ones with a particularly deep appreciation
• Head and Neck cancers are often caused by tobacco and alcohol use and manifest as a persistent sore throat, difficulty swallowing, or a lump in the neck

Five days-a-week for 7 weeks, Michael Douglas went to a hospital to receive radiation treatments for his throat cancer.  He lost 32 pounds and felt tired frequently, but he kept his spirits high.   Mr. Douglas tells Matt Lauer that he feels good now that the treatment is over.  He looks forward to spending more time with his family.  Most impressive, Mr. Douglas describes what’s truly important in life during this difficult chapter.  Like many cancer patients I have worked with, he has come to appreciate loved ones with a particularly deep appreciation.  I have also heard some of my cancer patients share the wise saying that living like you’re dying is the best way to live.

Head and Neck cancers are often caused by tobacco and alcohol use and manifest as a persistent sore throat, difficulty swallowing, or a lump in the neck.   In his case, Mr. Douglas was diagnosed with an advanced stage cancer at the base of the tongue.  He will now have throat exams and periodic scans every few months to monitor for tumor recurrence.  For now he is not allowing a what is normally a poor prognosis to get in the way of his enjoying life—a model attitude for all cancer patients.

Expert Analysis Highlights:

• Martina Navratilova describes her initial reaction when informed she had ductal carcinoma in situ (DCIS) breast cancer
• “This was my personal  9/11″ says Navratilova
• For those of you just confronting the diagnosis of cancer, read below for a list of what I would recommend

This interview of Martina Navratilova with Robin Roberts (herself a breast cancer survivor) describes the initial emotional reaction that women go through when informed: “you have breast cancer”.  In her case, there was a “good news/bad news” circumstance, for her diagnosis was “ductal carcinoma in situ” (DCIS). This is actually a precursor of invasive breast cancer and associated with a very low risk of relapse or dying of breast cancer. Nevertheless, the diagnosis can strike fear and uncertainty because breast cancer can be a “silent killer” and it can occur – and recur – without warning or symptoms.

I can imagine how Martina felt when informed that she had breast cancer.  She is one of the most athletically fit women in the world and is the Health and Fitness Ambassador to the American Association of Retired Persons (AARP). She exercises regularly, has a healthy diet, drinks very little alcohol – and yet that doesn’t protect her against cancer.

Listen to the emotional reaction as she described her initial encounter with the diagnosis of breast cancer in this interview:  “This was my personal  9/11”…. “I couldn’t think, couldn’t move”…..“The emotions took so much strength out of me.” She is no doubt an emotionally strong person in other domains of her life, but facing the diagnosis of cancer is very unsettling. These are typical reactions of women and men when confronted with the diagnosis of cancer.

• First: “I made a plan.”
• She engaged a support system around her. As Martina stated, it is difficult sometimes to ask for help, especially among women who are inherently caregivers themselves. Her friends accompanied her to the surgical treatment and supported her through the experiences.
• She talked about it in a public forum. It was not only therapeutic for her, but her message is vitally important for other women.

The treatment options for DCIS vary enormously. They range from a lumpectomy (or segmental mastectomy) alone, to lumpectomy plus radiation, to mastectomy. What is right for you depends upon the size of the tumor and other features of the tumor such as the “nuclear grade”.  Martina revealed that she had a Grade 3 DCIS tumor, which is associated with a higher rate of relapse within the breast after lumpectomy alone.  So she and her doctors elected to add radiation therapy to the breast in order to reduce the risk of relapse.

In another article titled “Why Are Biomarkers Important for DCIS Breast Cancer Patients?“, I have discussed a new advance in using biomarkers in patients with DCIS that can help partition patients with this condition into very low risk for breast relapses (and therefore more safely allow for conservative treatments) compared to other presentations of DCIS associated with a higher risk of breast relapses for which breast radiation therapy or even mastectomy might be appropriate.

In retrospect, should she have done anything differently? Well, yes. She skipped a few years and did not have an annual mammogram, as we have recommended for someone of her age of fifty-two years old. “I let it slide. Everyone gets busy, but don’t make excuses,” she said. A central theme of her message (which I totally support) is: “Everyone (in my age group) should have a mammogram every year.”  Good advice!!!

For those of you just confronting the diagnosis of cancer, here is what I would also recommend ( in addition to the valuable advice above):

• Be a student of your cancer. Learn the basic facts from reliable sources, including our own websites www.patientresource.net
• Know the stage of disease and the details of the pathology report
• Know  the options for treatment that would apply to your circumstance. For example, if you have breast cancer look at the charts of treatment options from our companion website patientresource.net
• Be prepared to engage your cancer doctors with good questions and an attitude that you are a partner in the decision-making. You and your doctor will make a “joint decision” that blends together the doctors medical opinion plus your input in selecting treatment options (when they are equal in outcome) that takes into account your own philosophy about potential benefits and risks of various options when they are available.

I’m convinced after 35 years of counseling and treating cancer patients that an informed, educated patient will always get better care and enjoy a better quality of life. Make sure you are focusing on information that is pertinent to your own diagnosis and stage of disease. Don’t get misled by information that is too general or by reading about aspects of diagnosis and treatment that don’t apply to you. It can lead to unnecessary anxiety or, conversely, to unjustified complacency.

Cancer is a complex and diverse collection of diseases, so getting the right information from trusted and reliable sources that is directly pertinent to your situation is key. Look at comprehensive websites for cancer patients, such as www.patientresource.net,  www.cancer.net, and www.cancer.org as starting places for information. Be sure to talk with your doctor and the staff in order to be sure that the information you are gathering correctly applies to your situation.

This video features a CBS News special about Randy Pausch, a professor at Carnegie Mellon University who lost his battle with cancer after 22 months. His public speeches about death and dying that are highlighted in this 8-minute segment are some of the most memorable and inspiring ones ever put on video. He is a role model of dignity, composure and compassion. I recommend this video for everyone facing the possibility of dying from any cancer, as well as for family and friends.

For inspiration from cancer survivors, visit patientresource.net and watch videos of their Featured Survivors.

Ruth Bader Ginsburg underwent pancreatic surgery for cancer performed by Dr Murray Brennan, a world-renowned surgical oncologist at Memorial Sloan-Kettering Cancer Center in New York City. The pundits looked into their smoky crystal balls and declared that she had almost no chance of beating pancreas cancer (they said that almost everyone dies of this disease) and that President Obama had better start looking for a replacement.

Well, her tumor was small and completely removed. She had a fairly rapid recovery and returned to the bench in just weeks after surgery. So much for trying to predict outcomes in individual patients. Some doctors might have thought that surgery was too dangerous and they might have been reluctant to even offer such a big operation to someone in her 80s.

Too many observers generalize the facts about pancreas survival rates to all patients. Some of the news broadcasters and political pundits I heard hadn’t checked on the fact that pancreas cancer patients who have an operable tumor have a 25% to 40% chance of living 5 to 10 years or more. While these aren’t great odds, they are still a whole lot better than some of the predictions by newscasters I heard that claimed she might not live more than 6 months! Boy, were they wrong!