Serving as a cancer caregiver for someone you love can be a tremendously rewarding experience. But trying to juggle your own life with your responsibilities as a caregiver can also take a huge toll on your physical and mental health. Many family caregivers place the needs of their loved one ahead of their own needs which is completely human and sometimes necessary. But failing to take care of yourself can leave you feeling stressed and overwhelmed which helps neither you nor the family member you are caring for.
Caring for the Caregiver
To be an effective caregiver for a family member with cancer, you must take care of yourself.
Use the following strategies to stay emotionally and physically healthy:
• Caregiving can be an isolating experience. Establish a good support network and enlist family and friends to help out. Accept help when it’s offered and call on your support team when you need a break.
• Know the warning signs of stress: exhaustion, irritability, trouble sleeping, forgetfulness, eating too much or too little and loss of interest in previously enjoyed activities. Chronic stress erodes your physical health and may lead to depression. Monitor your health and see your doctor regularly.
Cancer care has become so complex that many physicians lack “core competencies in caring for patients with cancer,” warns a recent report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, by the U.S. National Academy of Sciences Institute of Medicine (IOM). “Patients need to be asking, Is my doctor giving me appropriate treatment?” said cancer specialist Dr. Patricia Ganz of the University of California-Los Angeles. Gantz chaired the medical panel tasked with updating IOM’s 1999 report on the quality of U.S. cancer care. Progress has not been as great as hoped. “Barriers to achieving excellent care for all cancer patients remain daunting,” the new report notes.
Over the next two decades, an expected increase in new cancer diagnoses precipitated by the aging baby boomer generation and a predicted shortage of oncology specialists will make it more difficult to provide cancer patients with adequate care. But the growing complexity of cancer care in an age of genetic discovery is what most concerned the IOM panel.
As scientists continue to explore the genetic mechanisms of cancer tumors and the importance of the tumor microenvironment, highly individualized cancer treatments are expected to become the norm. The IOM panel expressed concern that the volume and speed of new cancer discoveries appears to be outpacing the ability of many physicians to keep up with new knowledge and apply it to patient treatment. That knowledge/treatment gap is only going to widen as cancer treatment moves away from one-size-fits all chemotherapy and radiation treatments and toward modern advanced targeted cancer therapies tailored to meet the specific individual needs of each cancer patient.
Cancer patients are often referred to as “warriors” who are “fighting” or “battling” cancer. Many cancer patients find strength and courage in creating an adversarial image that pits them against the evil nemesis of cancer. The desire to paint the gray uncertainties of cancer in the black and white colors of good and evil seems to stem from our very human need to define the things we fear in language that acknowledges our potential ability to conquer those fears.
Painting ourselves as heroes and the cancer therapies we use as weapons for good allows us to more easily visualize ourselves defeating the cancer we have cast in the role of evil villain. Many cancer patients find such battle images empowering and seem to draw strength and courage from such images.
But the good vs. evil scenario isn’t a comfortable fit for everyone. There are many cancer patients who prefer to consider their cancer experience a journey. Rather than a battlefield, they seek the peace of personal discovery that often accompanies the cancer experience. Many patients find peace and comfort in accepting cancer as part of their life experience rather than railing against it. But taking a kinder, gentler approach to the cancer should not be seen as fatalistic. In acceptance, these patients are not giving up but are freeing themselves to discover the small delights of ordinary days and focus on positive healing.
Researchers in Spain have discovered an unexpected similarity between the behaviors of cancer cells and the cells that form human embryos that could some day lead to new cancer treatments to prevent cancer from metastasizing. (Visit this link to read the original article by M. Angela Nieto of the Instituto de Neurociencias Consejo Superior de Investigaciones Cientificas published in Science magazine.)
When human embryos form, embryonic cells must migrate from the initial cellular core to new locations where they form different types of tissues and organs. When they are tasked to become heart cells or skin cells or bone cells, embryonic cells must undergo two complex genetic transformations that require remarkable cell plasticity.
In processes that involve gene splicing and micro-RNA networking, embryonic cells undergo a transformation that allows them to become mobile and move to specific designated locations in the developing body. Scientists call this process epithelial-to-mesenchymal transition, or EMT. Once embryonic cells have arrived at their designated location, they undergo a second transformation that restores their ability to replicate and allows them to assume their newly assigned differentiated form heart cells or skin cells or bone cells, etc. Scientists call this “reverse” process mesenchymal-to-epithelial transition, or MET.
Spanish researchers have observed this same two-step process – EMT followed by MET — when cancer cells metastasize. EMT occurs when cancer cells leave their primary tumor and travel to other parts of the body. When they arrive at new locations, MET occurs, allowing cancer cells to replicate and form secondary tumors. Other research indicates that changes in the tumor microenvironment may initiate these processes in cancer tumors.
As noted in our previous post, immunotherapy is redefining cancer treatment and providing answers to questions that have long puzzled cancer researchers. Of critical importance has been finding a way to pierce the shield that cancer cells use to hide from the body’s immune system attackers. In what is being heralded as a new era in cancer treatment, researchers are finding in personalized immunotherapy the key to unleashing the immune system’s super powers and smashing through cancer’s shields.
In studying the cancer genome, scientists have discovered that some cancer cells are able to thwart immune response by co-opting for their own use the molecular mechanisms that govern cell communication and turn on and off certain cell functions. In effect, these cancer cells seem able to disguise their biological signature in such a way that immune system defenders no longer identify them as invaders. However, by augmenting the natural power of the body’s immune system, immunotherapy is proving to be highly effective in unmasking these disguises and allowing immune system defenders to penetrate cancer’s shields and attack.
Top U.S. cancer researchers described the results being achieved with immunotherapy as “amazing,” “a game-changer” and “a watershed moment,” in interviews with the New York Times. According to the Times, “This period will be viewed as an inflection point, a moment in medical history when everything changed.”
A pioneer in the field of immunotherapy Dr. Josef Issels opened his first alternative cancer treatment center in Germany more than 60 years ago. We were among the first to demonstrate the success of immunotherapy in achieving long-term remissions of advanced and treatment-resistant cancers.
New discoveries in the field of immunotherapy are providing answers to a question that has bedeviled cancer researchers for more than a century: How are cancer cells able to evade the immune system and survive in the body? Advancements in genetic and cellular research are providing scientists with new insights into the unique ways cancer cells interact with the body’s immune system.
The immune system is the body’s first line of defense against disease, bacteria, viruses, abnormal cells and other harmful agents that invade and attack the body. When the body is attacked, the immune system mobilizes an army of white blood cells, including specialized T-cells and Natural Killer Cells, the Seal Team 6 of the immune system army.
In most cases, the immune system is extremely effective in hunting down and killing harmful invaders; but cancer cells seem to have a unique ability to clothe themselves in a shield of invisibility that allows them to evade immune system defenders. How cancer cells are able to do this is a question that has puzzled cancer researchers for more than a century.
Complicating the puzzle is the fact that when cancer cells are placed in a Petri dish and exposed to white blood cells in the sterile environment of research laboratories, the white blood cells immediately attack and kill the cancer cells. So why doesn’t this happen in the human body? How are cancer cells able to shield themselves from the immune system and how can the immune system break through that shield? Researchers are finding the answers in integrated immunotherapy.