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.

Does smoking cigarettes mean getting lung cancer? Just ask John Wayne. What a contrast between these two videos from one of the greatest actors who ever lived (and who did over 200 movies). The first video was shot in 1952 as an ad for promoting “good-tasting” Camel cigarettes, and the second was 20 years later, when he did a public service announcement for the American Cancer Society about his lung cancer. Watch these short clips and continue reading below.

According to various sources, John Wayne was a six pack a day chain smoker starting as a young adult. As he stated in the Camel ad: “I have been smoking for 20 years” and that Camel cigarettes were: “cool, mild, and good-tasting”.

Sure enough, in 1964 he had his entire left lung removed because of “a baseball size cancer”. Fortunately for the Wayne family, and for his fans worldwide, his surgeon did a great operation and he had a successful outcome. John Wayne beat lung cancer in 1964; however he died 15 years later after a struggle with cancer of the stomach. During this difficult period, he became passionate about helping others fight this terrible disease.

To honor his memory, the Wayne Family created the John Wayne Cancer Foundation (JWCF). Their mission is to bring courage, strength and grit to the fight against cancer. The JWCF funded the John Wayne Cancer Institute in Santa Monica california, under the direction of Dr Donald Morton one of the premier surgeons in the world.

John Wayne was “True Grit”. What is grit? As described on the JWCF website, “Grit is bravery. A fighting spirit. Guts. Determination. It’s standing up for what you believe in and taking care of the people you love. John Wayne put it best when he said, “courage is being scared to death but saddling up anyway.”

John Wayne’s legacy lives on, his cancer crusade is finally taking hold, and his story about smoking and lung cancer from decades ago is still timely and relevant today!

On a related note, see Peter Jenning’s last broadcast before his death from lung cancer.

For more information about lung cancer, go to our companion website.  For more information about the John Wayne Foundation, go to http://www.jwcf.org, and for more information about the John Wayne Cancer Institute, go to http://www.jwci.org

I recently saw a re-run of an interview on Oprah with Christina Applegate, and she explained why she chose a double mastectomy for the treatment and prevention of breast cancer. I cannot share the Oprah video, but above is another good segment discussing this topic.If you want to see a text version of her interview, go here to Oprah’s website.

Christina Applegate and Sheryl Crow both had breast cancer, but they chose a different surgical treatment for their disease. Christina chose double mastectomy with breast reconstructive surgery while Sheryl Crow chose a lumpectomy only. See my blogs on Sheryl Crow at http://mycanceradvisor.com/2009/04/20/121/ and http://mycanceradvisor.com/2009/06/28/cheryl-crow-talks-with-her-surgeon-about-her-experience-with-breast-cancer/.

As Christina Applegate discussed on the Oprah Winfrey Show, she was very satisfied with her choice and with the results. Likewise, when Sheryl Crow discussed her results on YouTube (with her surgeon no less) she was very satisfied with the symmetry of her breast after surgery. These two stars illustrate how different choices can lead to appropriate results in individual breast cancer patients. Sometimes the size or multiple areas of breast cancer will medically necessitate a mastectomy. In other circumstances a woman may choose a single mastectomy (or a double mastectomy) out of concern for recurrences in the breast at a later time. In effect they are choosing a form of cancer prevention through a mastectomy. On the other hand, a lumpectomy (almost always with breast irradiation) is another equally good option for other women who want to keep their breasts in tact and understand that there is a possibility (of 8-10%) that their breast cancer will return in one or the other breast. Women who have a strong family history, who have had multiple biopsies, who have difficult breasts to follow on X-ray, or who have inherited susceptibility genes (BRAC-1/2), or certain types of breast cancer (especially Lobular Carcinoma) are at increased risk for having a second breast cancer at a later time. If a woman chooses this option, then careful follow-up with screening and chemo prevention (with hormone therapy) should be their treatment plan.

For Christina Applegate, she won’t ever have to have a mammogram again or worry about the prospects of recurring breast cancer or of dying from it. Both choices are medically appropriate and must be tailored to the “risk avoidance” philosophy of the patient and their own perception about how the surgical choice affects their quality of life.

She has formed a Foundation that helps women at high risk for breast cancer that do not have adequate insurance or financial capability to cover essential breast screenings get financial help. See her website at http://www.rightactionforwomen.org/.

For more information about this subject see my previous blogs on Surgical Treatment Options for Breast Cancer and In the Operating Room: Breast Reconstruction. For detailed information about breast cancer staging and treatment go to our companion website, patientresource.net.

This is a revealing and poignant video about actress Farrah Fawcett’s battle with anal cancer that was filmed in the weeks before her death. After fighting a three-year battle with cancer, Fawcett died in California on June 25, 2009.

Farrah was a Texas native and former model who starred in many movies on both the big screen and on TV. A multiple Golden Globe and Emmy Award nominee, Fawcett also appeared off-Broadway.The 62-year-old Fawcett became popular with her role in Charlie’s Angels, the 1970s private eye television show. Fawcett was also a pop culture figure whose hairstyle was emulated by millions of young women and whose poster sales broke records, making her an international sex symbol in the 1970s and 1980s.

This was Peter Jennings’ final broadcast before his death from lung cancer. He said he smoked for years, and in this video he offers some words of wisdom for his viewers. Here’s more information from patientresource.net:

Common symptoms of lung cancer include a cough that gets worse over time; constant chest pain; coughing up blood; shortness of breath, wheezing, or hoarseness; repeated bouts of pneumonia or bronchitis; swelling of the neck and face; loss of appetite or weight loss; and fatigue.

Soraya was one of my favorite singers! Unfortunately, she had a very strong family history of breast cancer, including in her mother and her sister. She developed breast cancer while she was in her 30s. Soraya became a well-known breast cancer advocate and was a spokesperson for the Susan B. Koman Foundation for the Cure She died in 2006 at age 37. Watch this video to hear her story and her message about breast cancer.

Melissa Etheridge is a Grammy Award winning singer who developed breast cancer that spread to a lymph node. After surgery, she had adjuvant (added) chemotherapy. This video is an A&E Biography of the Year (2005) segment in which Melissa describes discovering the breast lump, her surgery, and her ordeal with chemotherapy. She came away from her experience with a strong appreciation for her life and her health, which she captured in some of her songs.

Here’s more information from patientresource.net:

Chemotherapy for breast cancer is most commonly used as adjuvant treatment; it may also be used as the primary treatment for metastatic breast cancer or as neoadjuvant therapy for large tumors. Chemotherapy is usually given as a combination of two or three drugs, sometimes given together and sometimes given after one another (sequentially).

Most chemotherapy drugs for breast cancer are given through an injection in a vein (intravenously), with the infusion lasting 30 to 90 minutes, depending on the drug. Chemotherapy is usually given in the doctor’s office or an outpatient clinic.

Chemotherapy is given in cycles, which consist of a treatment period (usually 1 day) followed by a recovery period (usually 3 weeks). The recovery period allows the noncancerous cells in your body to repair themselves from damage caused by chemotherapy before you receive more treatment. Some cycles may be shorter or longer (such as 14 or 28 days). A typical course of treatment is four to eight cycles, but the number of cycles can vary depending on the type of treatment and the response.

Some chemotherapy regimens are preferred because of their effectiveness in terms of response and survival, but other combinations are also often effective. Choosing a chemotherapy regimen involves considering not only whether there is benefit but also how much benefit in relation to the side effects. In addition, certain drugs or types of drugs may be more effective for tumors with specific characteristics. For example, anthracycline drugs (doxorubicin, epirubicin, or pegylated liposomal doxorubicin) have improved survival for women with HER2-positive tumors but not HER2-negative tumors. Researchers continue to study various combinations of chemotherapy drugs, as well as the genetic make-up of tumors, to determine which regimens offer the best chance of a long period of disease-free and overall survival for women with specific types of tumors.

As with radiation therapy, chemotherapy drugs may damage healthy cells that divide rapidly, and you will have blood drawn before each treatment session to check the level of your blood cells. Treatment may be delayed until your blood cells reach a healthier level. You should tell your doctor about side effects you have from chemotherapy. If the effects become severe, another chemotherapy drug may be more appropriate and you can feel better during treatment.

For women receiving chemotherapy for late-stage cancer, the disease response to treatment will be evaluated to ensure that the chemotherapy regimen is effective. If it is not, your doctor will select another regimen for second-line therapy. The chemotherapy regimen can also be changed if breast cancer recurs during adjuvant treatment for early-stage cancer.