Laura Ann

Melinda, Glad you decided to stay. It's good to be thick skinned....I've been taken to task myself a few times on this board but I still come because I care about the people here too. Laura

Wow!!! I think LCSC needs a new forum for those who enjoy **Word not allowed**! Perhaps Eppie can be the moderator. Laura

Smoking after diagnosis affects outcomes and research Source: (cancerfacts.com) Tuesday, November 29, 2005 HOUSTON – Nov. 28, 2005 – A pair of new studies show that many patients continue to use tobacco after a cancer diagnosis and that such use during therapy may thwart better outcomes. The information is of particular importance for clinical trials that test new agents, which might show greater effectiveness in populations that are tobacco-free during the trial. "Tobacco use after cancer diagnosis has now become the elephant in the room," says the lead author of both papers, Dr. Ellen R. Gritz, professor and chair of the Department of Behavioral Science at University of Texas, M.D. Anderson Cancer Center. "It is a huge issue in oncology that many in the field are ignoring." One study, scheduled to appear in the January issue of the journal Cancer, but was published online in an early-release, Nov. 28, suggests that the time to help tobacco users quit is the moment they are diagnosed with cancer. The other report, an editorial published in the October issue of the journal Cancer Epidemiology, Biomarkers & Prevention, suggests that researchers conducting clinical trials should assess whether patients are using tobacco while participating in the study because the detrimental health effects of smoking could negatively influence overall results. Both reports highlight the growing connection between tobacco use after cancer diagnosis and poorer treatment outcomes, however, the authors stop short of suggesting that patients who use tobacco should be excluded from these studies. Rather, they emphasize that smoking should be seen as another critical variable that could have an impact upon study outcome. In the Cancer study, the researchers say an ideal time to help patients quit smoking is at the time they are diagnosed with cancer. It notes that, without help, up to one-half of cancer patients either continue to smoke after diagnosis or resume smoking after stopping for a short time. "One thing we want people to realize is that many cancer patients are highly motivated and interested in quitting smoking at diagnosis," says co-author Dr. Michelle Cororve Fingeret. "This creates a teachable moment in which patients are more receptive to smoking cessation treatment and therefore are more likely to successfully quit." It has long been known that one-third of all cancers are associated with tobacco use, but new research demonstrates that if patients quit before treatment or participation in a clinical trial, their success rates, quality of life and chances of not developing a second primary cancer greatly improves. According to Gritz, the studies that she and other researchers have conducted demonstrate that using this "teachable moment" can help up to 70 percent of patients quit using tobacco, whereas the typical success rate for tobacco cessation in the general population is only about 20 percent. "This demonstrates that the diagnosis of cancer is a wake-up call to many patients, one which demands our support if we want to provide the best outcomes possible," she says. Evidence from research studies cited in the article also demonstrates that for two of the major cancer treatment modes - radiation therapy and surgery - smoking has been found to diminish treatment effectiveness, exacerbate side effects and interfere with wound healing. These adverse effects are found both in patients with smoking-related cancers and in those with nonsmoking-related cancers. Similar adverse effects are likely to occur with chemotherapy, but few studies have looked at this. Despite such studies, the "teachable moment" that can help patients stop smoking is not being used nearly enough in the service of patient health, Gritz says. While many doctors ask if their cancer patients smoke, they don't have the resources or the background to do more than to urge the patients to stop. "Most physicians are not trained in treating behavioral dependencies, and when cancer is diagnosed, doctors and patients are immediately focused on treating the malignancy," she says. "Because smoking is so damaging to patients' health, it needs to be addressed in the treatment plan." The issue is now vitally important, Gritz says, because research shows that smoking-related complications can be significantly reduced when patients stop smoking before surgery, and that the longer the interval between smoking cessation and initiation of cancer treatment, the better the prognosis. In the Cancer Epidemiology, Biomarkers & Prevention article, the researchers show how ignoring tobacco use in patients participating in a clinical trial can affect conclusions on the effectiveness of an experimental agent or treatment. "Now that we know that smoking produces detrimental effects on treatment outcomes, it makes sense that this is a contributing factor that could affect the success of a clinical trial," says Gritz. But despite the critical relevance of smoking to cancer outcomes, most oncology clinical trials do not collect data on smoking history and status unless the malignancy is widely acknowledged to be smoking related, she says. These data often are collected only when the patient registers for the clinical trial, the researchers say. Subsequent changes in smoking status for all patients during treatment or follow-up are monitored in very few trials and are not often reported in discussions about the outcome of the study, Gritz says. "We can't ignore the obvious anymore," she says. "Tobacco use is a critical variable that affects cancer treatment and outcome, and it needs to be addressed." Copyright © 2001, 2002, 2003, 2004, 2005 NexCura, Inc. All rights reserved. Republication or redistribution of cancerfacts.com content, including by framing or similar means, is expressly prohibited without the prior written consent of NexCura. NexCura® is a registered trademark and cancerfacts.com™ is a trademark of NexCura, Inc. or its affiliates. Copyright © 2001, 2002, 2003, 2004, 2005. All rights reserved. This information is for educational purposes only.

I believe that Fay had every right to her opinion. The fact that she started her own thread instead of posting on the "cancer is a gift" thread shows respect to those with a different view. If people were willing to be intellectually honest, they would have to admit that the phrase "Cancer is a Gift" sounds ridiculous. I remember a while back there was a similar thread titled "making friends with cancer" or something to that effect. I couldn't understand that one and I don't understand this one either. It's a bad choice of words. Laura

Hi Lynda, Sorry to hear about your mother. My mother suffered from the exact same nausea that you describe. Compazine and Phenergan did nothing to give her relief. We finally tried a drug called Zofran that took away all the nausea, it was unbelievable. Zofran is extremely expensive. At the time, mother was on Medicare and there was no prescription drug coverage so we ended up ordering it from Canada for about 65% less. It was still very expensive, but when you are talking about life and death you do what you have to do. My mother was literally to the point of starving because she could not bear to think of eating. All she could do was lay on the couch. Once she started taking Zofran she was able to start eating. Hope this helps. Laura

I have been very relunctant to post about Hospice, however since Fay opened the door I will say that the our family's experience with Hospice was a nightmare. I did find a web-site(after mother passed away) that had much information about Hospice. The web address is : www.hospicepatients.org Hope this helps. Laura

When my mother was ill these words never came from anyone except Hospice. I guess I don't understand why nutrition and staying hydrated is stressed and emphasized so much by the nurses and physicians when a patient is actively receiving treatment but when Hospice comes in, it is no longer important. I have read over and over on this board about how a caregiver's loved one would not eat(because of lack of appetite)but once the food was prepared and placed before them their appetite might be stimulated and they would then eat. There are meds that will help a persons appetite. My mom used Megestrol and Marinol(before Hospice), and I honestly believe that these meds helped extend her life. Once a person stops eating and drinking they begin on a downward spiral. You know your husband better than Hospice and you know yourself, if you think you need to encourage him to eat and drink that is your right and you should do what you think you need to do. Laura

Hi Cindi, My mother had brain mets(3) and they were discovered through MRI after she complained of having terrible headaches. I hope this is not what's causing your headaches, though. Laura

Hi Fay, I've been thinking about this and how I would like to respond. Not knowing all that the e-mail said it seems as if the person sending it wants a reason to give up. Maybe the fight is too difficult for this person. Perhaps they have no reason to go on. It sounds like they need an excuse to give up. See Fay, you make it hard for those with that attitude. Everything that I have ever seen you write has to do with life and how IT IS WORTH LIVING AND FIGHTING FOR. Your courage and amazing strength in the face of adversity is an example for us all...those who have this horrible disease and those who do not. Thanks for your wisdom and generosity in sharing so much. Laura Ann

My mother's favorite movie was Fried Green Tomatoes. Laura

Is Bill opposed to calling Hospice? Is this something you have talked about? What ever the answer might be I think it is very important to respect the patients wishes regarding Hospice. I think a lot of people equate Hospice to "the end of the line". I know that's the way it is perceived my most people I know. I admire the love and devotion you have shown for your husband. I'm so sorry this has happend to your family. Laura

Thanks, Randi. That's all I was trying to say. Laura

I know I don't post often, but I do read often and I do appreciate the web-site and what it has done for so many of those affected by this terrible disease. I would like to post my opinion regarding Curtis being upset about his post being moved to a different forum other than the one he intended it to be on. I don't blame Curtis for being upset. I would have been a little miffed myself had that happened to me. If every single post was scrutinized for making sure it was in the "correct" forum, more would be moved. Now I am going to say something that I do not want anyone to take the wrong way, but lately it seems like there have been many topics that are more on the lines of "fun and games". I have no problem with this at all, my only point is that it is posted under the "general" forum that comes under the heading of Lung Cancer catagories. As I said, I have no problems with this. I do however, believe that for the first time visitors or relatively new users this can seem to take away from the legitimacy of the site. Maybe there needs to be a forum for "off the topic" or "long time members forum" for side-bar conversations. These are just my thoughts and observations. I am just trying to put myself in the place of someone finding this site for first time and really needing answers and support regarding lung cancer. Please I have to say this once again, I have no problem with anyone's post. I just felt compelled to respond when I saw that Curtis' post was moved because it was viewed by one of the moderators as being in the wrong forum. Laura

Since it's on Snowflake, I believe I'll have a mocktail any way you want to fix it. Laura

That was my grandmother. Just kiddding Laura

Greg, How is Melanie? Laura

Well Berisa, our Supreme Court chief justice, William Rehnquist passed away this morning from thyroid cancer. I can tell you that it's just matter of time until someone figures out a way to somehow blame his death on President Bush. The other morning my husband was walking through the kitchen and stubbed his toe. He yelled out "that d**n George Bush"! I responded with, what the heck are you talking a about? He said "isn't everything bad that happens George Bush's fault"? Laura

I do need to mention that in addition to my mother, my maternal grandfather died from lung cancer in 1978. Laura

Connie, Are you upset about my question? Laura

I posted this question for my sister. She is concerned because our mother smoked the whole time we were growing up including the time she was pregnant. I know about all the risks, and that there is no one cause for lung cancer. I also know that there is a lot written about second hand smoke. I am not asking anyone to say that they got their cancer from second hand smoke, I was just curious about the members(never smoker) on this board's history. Obviously there are too few here, to even establish a correlation. It was just a question. My sister knows I use this board for information and she ask me to post the question....nothing more, nothing less. Laura PS If you have seen any of my past post you will see that I have never been a fan of the "blame game".

Were any of you, as a child growing up, exposed to second had smoke on a regular basis? Thanks, Laura

I sent this e-mail to Dana Reeve via her web-site. I hope she gets the info. Message: Hi Dana, I am sorry to hear of your cancer. When my mother was waging her battle with LC I found a support web-site that had answers to every possible question one could ask about LC. These people know because they are victims, survivors, and caregivers of loved ones living with lung cancer. This site is dedicated to lung cancer alone. There are thousands of members sharing information and support. It will make a difference in you life and your will to live. The site is www.lchelp.org. Please check it out, you will not regret it. Laura Roberts

Peggy, The first thing that came out of my mouth was, OH MY GOSH. I am sorry that this happened so suddenly. I'm sure that you never dreamed when he went into the hospital that he wouldn't be coming home. There really are not words now that are going to comfort you. All I can say is that I'm am very sorry for the loss of your husband. Laura

Val, I am very sorry to hear that your mother has passed. Take strength in knowing that you did all you could for her, this will carry you through the hard times. Laura

Peggy, I sent you a PM. Laura