Long Name - Big Hearts

The local chapter of the Support for People with Oral, Head and Neck Cancer meets every 3rd Saturday at the Cancer Support Home in Fayetteville. Jack and Temple Igleburger share their knowledge based on their own personal cancer journeys, and provide a atmosphere of support for the folks who visit the group as they're going through their own treatment or learning how to deal with the "new normal" in the recovery phase. Here's an excerpt from the bio we shared last year when Jack received the Gentleman of Distinction award at our annual gala, the Bill Fleeman Gentlemen of Distinction. 

"Jack Igleburger had no experience with cancer before he was diagnosed with it himself. As he says, "Cancer wasn't on [his] personal radar...". He had no close family members or acquaintances who dealt with the disease and, like most people, took life and good health for granted. 

Jack had been dealing with a sore throat and raspy cough for several months when a lump appeared on his neck. He went through several attempts to diagnose the problem, including cough medicines and antibiotics for a possible infection. he was finally referred to an Ear, Nose and Throat specialist.

During his last week of work and just before his retirement party, he got a call from the new doctor who asked him to come to his office the next day to discuss his biopsy results. He was informed that he had stage 4 squamous cell carcinoma of the base of his tongue. The cancer had already spread to his jaw bone, esophagus and lymph nodes. But the words that left the biggest impression on Jack came next: the cancer was inoperable, and he had approximately a 50% chance of survival.

Jack made it through the treatment with the help of a good team of doctors, family, and his new wife and caregiver, Temple - herself a breast cancer survivor. They attended the Support for People with Oral, Head and Neck Cancer (SPOHNC) "Celebration of Life" in New York in August of 2006... At the meeting, the experience of meeting other survivors and facilitators of support groups was an emotional one that initiated some thought for Jack and Temple. On the flight home they decided they should create a SPOHNC chapter in Arkansas.

With the help of a few local organizations, including Hope Cancer Resources, they held their first SPOHNC meeting on September 23, 2006. Today, they still facilitate the only SPOHNC chapter in the state of Arkansas. Their support for people dealing with this disease creates a ripple effect in our community: several of the survivors in their group also volunteer their time at local oncology clinics, work one-on-one with newly-diagnosed patients in the "Been There" program, or participate in local fundraisers to help support the network of cancer support in our area."

Awareness of cancer usually centers around the understanding of symptoms, and one's own personal risk factors. In the case of Oral, Head and Neck cancers (and many others), the side effects can often be mistaken for other health issues - just as Jack's was. Here are some key points from the National Cancer Institute to be aware of:

• Most head and neck cancers begin in the squamous cells that line the moist surfaces inside the head and neck.
• Tobacco use, alcohol use, and human papillomavirus infection are important risk factors for head and neck cancers.
• Typical symptoms of head and neck cancers include a lump or sore (for example, in the mouth) that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice.
• Rehabilitation and regular follow-up care are important parts of treatment for patients with head and neck cancers.

 Follow the link above to learn more about common locations of head and neck cancers, detailed symptoms based on location, known causes and common side-effects of treatment.

Nutrition and the Cancer Patient

A recent article by Dr. Sanjay Gupta on MedPage Today calls for more efforts to be made on behalf of cancer patients to clarify and broaden nutritional recommendations found online. Dr. Gupta shares information compiled by Dr. Colin Champ of Thomas Jefferson University in Philadelphia, which showed not only that information is lacking, but that much of what is available is contradictory. From the article:

"A review of the websites of 21 National Comprehensive Cancer Network (NCCN) institutions revealed that only four (19%) provided nutritional guidelines. Another seven (33%) linked to external oncology sites -- but only 44% of these sites offered nutritional guidelines for cancer patients.

The real clincher, said senior author Colin Champ, MD, of Thomas Jefferson University in Philadelphia, was that many of the recommendations contradicted one another. Given that data suggest two-thirds of cancer patients go online for guidance, "it's imperative to fund randomized studies on diet and develop consistent, evidence-based nutritional guidelines for patients," Colin said."

We recently attended a video workshop with Michelle Morgan, MS RD CSO LD, a Clinical Dietician at University of Arkansas for Medical Sciences in Little Rock, Arkansas. She shared her professional recommendations for cancer patients who are battling side-effects of their treatment, but these tips can be helpful for cancer patients past treatment as well. As the National Cancer Institute states: "Nutrition in cancer care embodies prevention of disease, treatment, cure, or supportive palliation."

Here are some common (non-diagnosis-specific) side effects of treatment and tips on managing those effects:

Appetite Changes: 

• Increase intake to six small meals per day instead of three
• Delay drinking liquids until after your meals when you have eaten all you can
• Set an attractive table and make a meal an "event"
• Be as physically active as possible to keep your appetite up
• Eat high calorie, high protein snacks

Sore Mouth and Throat:

• Avoid tart, acidic, spicy or salty foods
• Choose soft, creamy foods over rough-textured or hard foods
• Choose lukewarm or cold foods
• Avoid alcohol, caffeine and tobacco which can dehydrate your body

Dry Mouth: 

• Drink 8-10 cups of liquid each day
• Take small bites and chew well
• Eat soft, most foods that are cool or room temperature
• Moisten foods with broth, soup, gravy or creams
• Suck on sugarless candy or chew sugarless gum
• Keep your mouth clean between meals
• Avoid commercial mouthwashes which contain alcohol
• Avoid alcoholic and acidic drinks and tobacco products
• Limit caffeine intake
• Use a cool mist humidifier
• Snack on fresh pineapple (unless you are also dealing with sore mouth)
• Ask your doctor about saliva substitutes

Taste and Smell Changes: 

• Use plastic flatware to reduce metallic taste
• Use fresh or frozen fruits and vegetables rather than canned
• Cook with tart foods and seasonings (unless you are also dealing with a sore mouth)
• Counter a salty taste with sweeteners
• Rinse mouth with baking soda and salt mouthwash before eating to neutralize it
• Keep your mouth clean and brush teeth regularly to reduce bad taste
• Serve food cold or at room temperature

Nausea: 

• Eat 6-8 small meals each day instead of three big meals
• Consume some dry foods upon waking and every few hours
• Avoid foods with strong odors
• Eat cold foods instead of hot or spicy foods
• Avoid foods that are overly sweet, greasy, fried or spicy
• Sit or recline for at least an hour after eating
• Sip clear (decaffeinated) liquids frequently to avoid dehydration

Diarrhea: 

• Drink mild, clear non-carbonated liquids through the day at room temperature
• Eat small, frequent meals
• Avoid greasy, spicy, fried or very sweet foods
• Limit milk or milk products
• Avoid drinks and foods that cause gas
• Drink and eat high-sodium, high-potassium foods
• Increase soluble fiber (click here for a definition and examples of soluble fiber)
• Drink at least 1 cup of liquid after each loose bowel movement
• Avoid sugar-free products

Fatigue: 

• Prioritize daily activities, and enlist friends who want to help
• Take short walks or get regular exercise
• Drink plenty of fluids
• Schedule some rest time during your day
• Avoid high-carbohydrate foods to reduce blood sugar fluctuation
• Increase protein in your diet
• Monitor daily caloric intake (ask your doctor for their recommendation based on your current physical situation, height and activity level)
• Avoid large doses of vitamins and minerals
• Manage stress, and seek out assistance to reduce the items on your "to-do" list

As you can see, many of these suggestions can be beneficial for more than one side-effect. For diagnosis-specific advice, seek out support groups either in your community or online to help you with your particular challenges, or talk to your doctor about your concerns.

Here's another blog post from last year that offers more suggestions on foods to keep on hand for a diet intended to help cancer patients remain healthy through treatment.

One for the Guys

It's not the most common form of cancer, nor is it the most deadly. In fact, it's pretty rare... but testicular cancer is the most common form of cancer diagnosed in American men between the ages of 15 and 34. The good news is that it is highly treatable, even if it has spread beyond the testicles upon diagnosis.

In 2012, it is estimated that 8,590 men will be diagnosed, and 360 men will die from testicular cancer. In order to skew the odds in your favor, get familiar with these symptoms and learn how to spot reasons for concern:

• A lump or enlargement in either testicle
• A feeling of heaviness in the scrotum
• A dull ache in the abdomen or groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or the scrotum
• Enlargement or tenderness of the breasts

Testicular cancer usually affects only testicle. Be sure to see your doctor if you notice any unusual pain, swelling or lumps in your groin, especially these symptoms last longer than two weeks. The American Cancer Society provides some instruction on how to perform a self-check.

Risk factors include:

• An undescended testicle (cryptorchidism). The testes form in the abdominal area during fetal development and usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer in either testicle than are men whose testicles descended normally. The risk remains even if the testicle has been surgically relocated to the scrotum. Still, the majority of men who develop testicular cancer don't have a history of undescended testicles.
• Abnormal testicle development. Conditions that cause testicles to develop abnormally, such as Klinefelter's syndrome, may increase your risk of testicular cancer.
• Family history. If family members have had testicular cancer, you may have an increased risk.
• Age. Testicular cancer affects teens and younger men, particularly those between ages 15 and 34. However, it can occur at any age.
• Race. Testicular cancer is more common in white men than in black men.

Small, but Growing.

In 2010, an estimated 16,640 adults in the United States were expected to be diagnosed with esophageal cancer. A huge portion of that projected number (13,130 to be exact) was attributed to males. This makes esophageal cancer the 7th most common cause of cancer deaths among men in the U.S.

While those kinds of numbers don't qualify it for a "common" status in our country, esophageal cancer has become the fastest-increasing cancer diagnosis in the U.S., up more than 400 percent in the past two decades, according to the Esophageal Cancer Action Network.

SIGNS AND SYMPTOMS of esophageal cancer include:

• Difficulty swallowing
• Losing weight without trying
• Chest pain
• Fatigue

Early esophageal cancer typically causes no signs or symptoms. If you've been diagnosed with Barrett's esophagus, a precancerous condition that increases your risk of esophageal cancer, ask your doctor what signs and symptoms to watch for that may signal that your condition is worsening. Also ask what screening tests you should consider.

There are two main types of esophageal cancer:

• Adenocarcinoma. Adenocarcinoma begins in the cells of mucus-secreting glands in the esophagus. Adenocarcinoma occurs most often in the lower portion of the esophagus. Adenocarcinoma is the most common form of esophageal cancer in the United States.
• Squamous cell carcinoma. The squamous cells are flat, thin cells that line the surface of the esophagus. Squamous cell carcinoma occurs most often in the middle of the esophagus. Squamous cell carcinoma is the most prevalent esophageal cancer worldwide.

RISK FACTORS: It's thought that chronic irritation of your esophagus may contribute to the DNA changes that cause esophageal cancer. Factors that cause irritation in the cells of your esophagus and increase your risk of esophageal cancer include:

• Alcohol
• Bile reflux
• Chewing tobacco
• Difficulty swallowing caused by an esophageal sphincter that won't relax (achalasia)
• Drinking very hot liquids
• Eating a diet low in fruits and vegetables
• Eating foods preserved in lye
• Gastroesophageal reflux disease (GERD)
• Obesity
• Precancerous changes in the cells of the esophagus (Barrett's esophagus)
• Radiation treatment to the chest or upper abdomen
• Smoking

As with any type of cancer - know your risks, know the symptoms, and talk to your physician if you are concerned.

Information for this post was gathered from the following websites:

Mayo Clinic
The Baltimore Sun
Esophageal Cancer Action Network

Gentlemen, pay attention!

April is not off the hook. Even with all of its promise of warmer days and spring awakening and new life it is also a month that we recognize a type of cancer and work to raise awareness. In fact, there are three kinds on the board this month, but this week we'll share some information about testicular cancer.

Compared with other types of cancer, testicular cancer is rare - which is a great thing! According to the National Cancer Institute, 8,480 new cases were estimated to be diagnosed last year. That said, testicular cancer is the most common cancer diagnosed in American males between the ages of 15 and 34. The good news is that is highly treatable! Of those diagnosed last year, there were 350 deaths. That is good news - but in our opinion even a small mortality rate warrants the need for being informed and knowing when to see a doctor.

The most common symptoms as listed by the Mayo Clinic are as follows:

• A lump or enlargement in either testicle
• A feeling of heaviness in the scrotum
• A dull ache in the abdomen or groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or the scrotum
• Enlargement or tenderness of the breasts
• Unexplained fatigue or a general feeling of not being well

Cancer usually affects only one testicle, which should make it easier to detect an abnormality. See your doctor if you detect any pain, swelling or lumps in your testicles or groin area, especially if these signs and symptoms last longer than two weeks. Make an appointment with your doctor even if a lump in your testicle isn't painful, as only a small percentage of testicular cancers are painful from the outset.