Fortunately, our partner, Fight Colorectal Cancer, along with Genomic Health came together to design a mobile app that assists colon cancer patients with a personalized treatment, diagnosis, and links to external sources. The app is titled My Colon Cancer Coach, and is free to download to iPhones and Android smartphones. However, if you don’t own those mobile devices, no worries! You can go to My Colon Cancer Coach website to access same functions.

So, what does the app do?

The app is essentially a digital version of a diary with extra resources. Once you agree to terms and conditions of the app, you’ll have a list of options to choose from depending on what you want to do: Learn about your treatment, record questions to ask your doctor, journal, glossary, and external links.

Learn about your treatment

The essence of the application is My Colon Cancer Coach, Coach for short, which helps you understand colon cancer no matter what stage it is at. In this section you’ll be prompted to answer a few questions about your type of cancer. For this you’ll need to know,

- The stage of your cancer

- Your tumor’s MMR/MSI status (stage II)

- Whether or not your tumor contains a mutated KRAS gene (stage IV)

- Whether or not your cancer has metastasized (spread to areas beyond your colon)

Once you complete the questionnaire, a report will be generated with treatment options that are appropriate for you. At this point you have an option of emailing the report, reviewing your treatment summary, and learning details of the report; which involves a detailed description of certain terms and procedures.

Record questions for your doctor

Avoid forgetting addressing your concerns. This is a nice tool to keep track of questions you may have for your doctor, along with a list of suggested questions to ask.

With this function you can either type the questions you have or voice record them. The same can be done with the answers. For example, you can record your doctor’s response to your question, and review it to make sure you don’t miss essential information.

Journal

This function is designed to help you keep track of doctor appointments, personal notes, and take photos if needed. Journal entries are automatically dated and timed, all you have to do is title the entry and write up your notes or voice record.

Glossary

Alphabetical access to definitions of cancer terminology right at your fingertips.

Resources

Credits, list of organizations, and external links.

Get Your Rear in Gear hopes that this will help you decide whether this app can be of benefit to you. As always, we want to provide you with as many helpful tools and information to help prevent and treat colon cancer. For more information, you can visit our website.

For more information you can read a summary from the Boston Globe on Wednesday, October 19, and the news release from the Dana-Farber Cancer Institute.

Or watch the video below from the study’s senior author, Matthew Meyerson, MD, PhD, of Dana-Farber and the Broad Institute.

The study was published in the Nutrition and Cancer journal. Lead author of the study Yessina Tantamongo, MD,  summarized in a media release from the university:

“While a majority of past research has focused on broad food groups, such as fruits and vegetables, in relation to colon cancer, our study focused on specific foods, as well as more narrowed food groups, in relation to colon polyps, a precursor to colon cancer. Our study confirms the results of past studies that have been done in different populations analyzing risks for colon cancer.”

You can read the summary of the study here.

The study’s lead author is Dr. James J. Biagi, a medical oncologist and head of the oncology department at Queens University, in Kingston, Ontario. The study was presented at the annual meeting for the American Society of Clinical Oncology, and published in the June 8, 2011 edition of the Journal of the American Medical Association. Findings indicate that patients who begin chemo therapy four weeks following surgery for colorectal cancers have higher chances for survival than those who wait just four weeks longer.

“What our research has indicated is that giving chemo early rather than later after surgery is associated with improved survival,” stated Dr. Biagi. “Giving it later appears to be detrimental. But at the same time, we also believe that it still might be worthwhile having a patient look to chemotherapy even if they wouldn’t be starting until the three-month point.”

A good summary of the study appears here.

Complete text of the study can be found in the June 8 edition of the Journal of the American Medical Association here.

Researchers from the NYU  Langone Medical Center found that even low intensity exercise such as walking can have a significant impact on one’s risk for developing pre-cancerous polyps.

Read the story from the Los Angeles Times here.

Walkers in a recent Get Your Rear in Gear event. One hour of exercise per week may reduce the risk of colon polyps by one-third. Photo by Gary Westlund.

On Monday evening, May 16, from 8-9 p.m. ET, Fight Colorectal Cancer will host a webinar entitled “Treating Liver Metastases.” In most patients, the liver will be the first place where colorectal cancers metastasize. This webinar will educate colon cancer patients on how to manage tumors in the liver with directed therapies that have evolved over the last two decades and offer patients with metastatic or primary liver tumors many new treatment options.

Dr. Andrew Kennedy, co-medical director for Wake Radiology Oncology Services in Cary, North Carolina and a leading researcher in liver metastases will address the latest in treatments for liver tumors. He will also take questions from webinar participants.

You can read about the webinar and register for it here.

View past patient webinars hosted by Fight Colorectal Cancer here. Past topics include:

• Personalizing Personalized Medicine
• A Report from the January 2011 GI Cancers Symposium
• Does Colorectal Cancer Run in Your Family
• Stage II Colon Cancer Decision Making
• Health Care Reform and You
• Improvements to Care & Screening for Colorectal Cancer

All webinars are free for unlimited viewing.

Imagine you or someone close to you were diagnosed with cancer, and your doctor could tell you ahead of time what treatment would respond best based on a genetic analysis of the cancer found. That’s what researchers are working towards with a next-generation blood test technology announced last month by Massachusetts General Hospital and partner Johnson & Johnson. In trials right now with cancer patients at four medical centers in the United States, the predictive blood test may personalize cancer treatment, improve quality of life, and eliminate biopsies. GYRIG previously discussed the impact on treatment with a version of this test currently available to patients with advanced colon cancer.

“If doctors can use circulating tumor cells (CTCs) found in the blood to tell patients that a drug is not going to work ahead of time, then you’ve spared the patients toxicity and allowed them to move on to something else,” said Dr. Howard Scher of Memorial Sloan-Kettering Cancer Center at a National Cancer Institute conference.

Scientists will study the genetics of circulating tumor cells which, its hoped, will enable doctors and patients to monitor treatment effectiveness during early phases of therapy. Development of this next-generation CellSearch Circulating Tumor Cell (CTC) microchip technology received $30 million dollars from Johnson & Johnson in January, and a $15 million dollar grant from money raised by the Stand Up to Cancer telethon this fall.

CTC test available to colon cancer patients with metastatic cancer

Metastatic colon cancer, breast and prostrate cancer patients and their doctors are using a current version of the CTC CellSearch blood test at clinics like Georgetown University’s Lombardi Comprehensive Cancer Center, advanced CTC/molecular labs in Germany, and the Mayo Clinic to monitor treatment effectiveness, as GYRIG looked at earlier.

Dr. Daniel Haber, one of the CTC CellSearch test inventors, and director of Massachusetts General Hospital’s cancer center, reviews the current and potential impact of this technology on cancer treatment at a conference at MIT’s Koch Institute for Integrative Cancer Research.

There are also a dozen or so CTC blood test technologies in development, as discussed by The National Cancer Institute.

Future as cancer diagnostic tool?

Will the CTC blood test be available at the doctor’s office as a diagnostic tool to screen for cancer, as news headlines suggest? The consensus is not now.

“The technology, although its great, I think it needs to be perfected. We don’t have the sensitivity, in another words the ability to pick up enough cells, to use it as a screening method,” said Dr. Minetta Liu, a breast cancer specialist at Georgetown University’s Lombardi Center. Her dream, she says, would be to use it as a diagnostic test to tell they average person, or someone who’s completed cancer treatment, ‘you don’t have cancer.’ “We’re not there yet,” she said.

Caution about overdiagnosis

Others in the medical community also express caution over its use as a general diagnostic tool.

“The conventional wisdom is people either have a disease or they do not. But, in fact, there are a lot of people somewhere in between,”  says Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice, and Medical Screening Expert for The Today Show and The New York Times, in a piece with CNN.  He cites the PSA blood test for prostrate cancer, as example, saying it resulted in overdiagnosis and “put men at risk of complications from unnecessary treatment.”

“What we have to be careful of with this new technique, is over-treating the dormant cells which were never going to give us any problem, in our attempt to get every cell we can see. We all have cancer cells in our bodies that are not really causing any problem,”  said breast cancer specialist Dr. Susan Love, president and medical director of the Susan Love, MD, Breast Cancer Foundation, and clinical professor of surgery at the David Geffen School of Medicine at UCLA.

Current trials are expected to run five years.

Interested in more?

• “On-Conversation with Dr. Massimo Cristofanilli, Principle Investigator of the CellSearch Circulating Tumor Test
• For an in-depth look, Dr. Haber speaks to the National Institutes of Health (NIH) discussing the technology and its potential for revolutionizing cancer treatment.

Have you had experience with CTC blood tests? Or want to share your view? Join the conversation and tell us what you think at www.facebook.com/getyourrearingear

Patients with advanced colon, breast and prostate cancer got a green light from the FDA to use the current version of the CTC (Circulation Tumor Cell) blood test only a few years ago. Some researchers are calling it a revolutionary tool for guiding treatment decisions and for predicting prognosis.

The Cleveland Clinic ranked it as the “Top Medical Innovation of 2009”, predicting “it will have a significant impact on health care.”

GYRIG rounds up opinion from doctors, scientists and the media who’ve
weighed on the technology’s impact on cancer care.

What’s the test? How does it work?

The CellSearch Circulating Tumor Cell (CTC) test currently in use with metastatic cancer patients counts the number of cancer cells shed by the primary tumor that circulate in the blood and spread to other parts of the body. The rise or decrease in these cells helps doctors determine in real time how a therapy is working.

Inventors say the test can:

• Detect a single cancer cell among a billion healthy ones

• Requires just a teaspoon of blood

• Can be performed quickly and repeatedly

The next-generation CTC test in development runs blood samples through a microchip with bristles to capture whole cancer cells shed by tumors that circulate in the blood, enabling researched to study their genetics.

While normal blood cells pass through, the circulating tumor cells stick to one of the 78,000 tiny posts coated with glue.

“It’s like a pinball machine – the blood has to flow through all of these columns to get to the other side,” said Dr. Daniel Haber, director of the Massachusetts General Hospital Cancer Center and and one of the test’s inventors.

Watch CTC Chip Dream Team video

Personalized cancer treatments

With the ease and speed of test results, doctors have expressed keen interest in its use as a tool chart personalized treatment for cancer patients.”That’s what got the scientific community’s interest,” said Dr. Mark Kris, lung cancer chief at Memorial Sloan-Kettering Cancer Center in New York. “Doctors can give a drug one day and sample blood the next day to see if the circulating tumor cells are gone.”

Compared to CTC test results in eight hours, doctors looking for tumor shrinkage after initiating treatment often have to wait several months with current tests such as the CT scan, MRI, X-ray, according to the Mayo Clinic.

“If you could find out quickly, ‘this drug is working, stay on it,’ or ‘this drug is not working, try something else,’ that would be huge,” said Haber.

Eric P. Winer, M.D., from the Dana–Farber Cancer Center and Harvard Medical School, expresses caution, saying, “I don’t feel the data [on CTCs] are sufficiently mature.”

Current use for metastatic colon cancer treatment

Currently centers like Georgetown University’s Lombardi Comprehensive Cancer Center, advanced CTC/molecular labs in Germany, and the Mayo Clinic use the CTC technology for monitoring and treating colon, breast and prostate cancer patients with metastatic disease (or cancer that has spread).

In a study published in Clinical Cancer Research, Dr. G. Thomas Budd, professor of medicine at the Cleveland Clinic in Ohio, reported that the “number of CTCs in the blood was a better indicator of disease progression than traditional imaging techniques such as computed tomography and magnetic resonance imaging; CTCs were more reproducible, were better predictors of survival, and estimated disease progression earlier.”

“It’s widely available and most insurance providers are covering it. Unfortunately I don’t think it’s being used as widely as it could be,” said Dr. Minetta Liu, a breast cancer specialist at the Lombardi Center who uses the CTC blood test routinely in her practice along with scans, and feels its aids day-to-day decisions with some patients.

The next-generation of CTC blood test in development by Massachusetts General Hospital and partner Johnson & Johnson, in trials right now with cancer patients at four medical centers in the United States, holds promise as a predictive blood test. As GYRIG examines in a second article, doctors could then see ahead of time which treatments would offer the best response based on genetic analysis of the cancer found, sparing the patient toxicity and side-effects from therapies that would be ineffectual.

Have you had experience with CTC blood tests? Or want to share your view?
Join the conversation and tell us what you think at www.facebook.com/getyourrearingear

Using profanity has been proven to increase pain tolerance

One of the most difficult aspects of fitness training is learning to tolerate discomfort. While some leisure activities such as a walk or easy bike ride might be pleasant, the tough workouts that make a real difference require that you push past your comfort zone. Sports psychologists teach athletes to use visualization and other psychological techniques to manage pain. But these can take years to master. Wouldn’t it be great if there was a quick one-shot step to pain tolerance? Well, there might be.

Recently, researchers at Keele University in England found that swearing increases our ability to tolerate pain. As part of a study, 64 subjects were required to submerge their hand in ice cold water for as long as possible while repeating a swear word of their choice. A control group submerged their hands while repeating a more benign word. The subjects who were allowed to swear kept their hands submerged for a longer period of time. The researchers believe that an “increase in pain tolerance occurs because swearing triggers the body’s natural “fight-or-flight” response.” They also suggest that “swearing may increase aggression (seen in accelerated heart rates), which downplays weakness to appear stronger or more macho.”

While this technique may have its merits, I wouldn’t recommend it at the gym. One uncensored expletive in the weight room might prompt gym staff to move your workout to a more private spot in the parking lot.

Photo source: Timsamoff on Flickr!

The New York Times research page summarized the findings of the study.

“The improvements in outcomes were striking. Patients with colorectal cancer who regularly used aspirin before and after a diagnosis were almost one-third less likely to die of the disease than non-users. Patients who initiated aspirin use only after a diagnosis did even better and had half the risk of dying from the cancer, possibly because of differences in their tumors.”

The study found that results were most significant in patients with tumors that overexpress COX-2. COX-2 is an enzyme that is responsible for inflammation and pain. Aspirin is a COX-2 inhibitor.