Donna G

I am so sorry for the loss of Joanie. The picture of Dana's wedding was so beautiful and it was only a half a year or so ago, and now she is gone. I pray for the peace of the family during this most difficult time. Donna G

Cindy, so happy to hear how well you are doing. Thanks so much for popping in and letting us know. Donna G

I must have missed it in March (In the scrapbook section). Boy that is great! So many pictures of so many of us. It really shows we are not stats! We are real people! Thanks for your efforts. Donna

I am getting there! http://www.youtube.com/watch?v=zqfFrCUrEbY Donna G

Kasey, what a gorgeous post, spring , new life and continued life! Even here in Minnesota we are enjoying flowers. My tulips are blooming, the lilacs, the dogwood trees, the crab apple trees and it is wonderful. So happy you can share your joy with us. Donna G

Read about this in my Nursing2007 magazine. Experts Detect Lung Cancer Using Color Sensor Breath News Author: Allison Gandey CME Author: Désirée Lie, MD, MSEd Release Date: March 2, 2007 March 2, 2007 — Lung cancer patients appear to have a unique chemical makeup to their breath and researchers are working to tap into this to develop a simple, inexpensive, and noninvasive new cancer screening method. Still in development, a group published in the February 26 Early Online issue of Thorax, report that their color sensor breath test detected lung cancer with more than 70% accuracy. "This method is showing promise," lead investigator Peter Mazzone, MD, of the department of pulmonary allergy and critical care medicine at the Cleveland Clinic in Ohio said during an interview. "But I don't want to fool anyone into thinking this is ready for clinical practice. We'd want to see 90 to 95% accuracy rates for that," he said. But the fact that the new colorimetric sensor array may be effective in detecting very early lung cancer is garnering attention and Dr. Mazzone told Medscape that already he has received a number of media inquiries about the test. In their article, the researchers point out that current screening programs have yet to lead to a reduction in lung-cancer–specific mortality or overall mortality and an advance to current diagnostic tools would be a welcome addition. The researchers tested the ability of the new sensor system to detect a pattern of volatile organic compounds unique to lung cancer. They suggest that metabolic changes within cancer cells can lead to changes in the production and processing of these compounds, which may be detected in samples of the exhaled breath of patients. The colorimetric sensor array has 36 spots composed of different chemically sensitive compounds on a disposable cartridge. The colors of these spots change based on the chemicals with which they come into contact. More than 140 individuals participated in the study. Of these, 49 had non–small-cell lung cancer, 18 had chronic obstructive pulmonary disease, 15 had idiopathic pulmonary fibrosis, 20 had pulmonary arterial hypertension, another 20 had sarcoidosis, and 21 people were included as controls. Identified Cancer With "Moderate Accuracy" Participants were asked to breathe room air for 12 minutes while exhaling into a device designed to draw their breath across the colorimetric sensor array. The color changes that occurred for each individual were converted into a numerical vector. The researchers statistically analyzed the vectors using a random forests technique to determine whether lung cancer could be predicted from the responses of the sensor. The group developed a prediction model using observations from 70% of the subjects. This model was able to predict the presence of lung cancer in the remaining 30% of subjects with a sensitivity of 73.3% and a specificity of 72.4% (P = .01). The researchers conclude that the breath test can detect the unique pattern of volatile organic compounds in the breath of patients with lung cancer with moderate accuracy. The results were not affected by age, sex, or stage of disease. They write, "Further work may clarify the nature of the distinct breath constituents. This would help to guide refinement of the sensor array and breath collection system to maximize the diagnostic accuracy of the test." "The problem we have now is an issue of numbers," Dr. Mazzone told Medscape. "We will need to study this method in larger patient groups with the same condition and stage of disease. We need more testing within each category," he emphasized. Thorax. Published online February 26, 2007. Clinical Context Lung cancer is often diagnosed at an advanced stage when treatment is less successful, and although advances in imaging allow earlier examination of lung nodules, there is a need for low-cost, accurate, and noninvasive diagnostic tests. Metabolic changes within cancers can lead to changes in production of volatile organic compounds, and studies have evaluated the use of gas chromatography and mass spectroscopy for detecting these changes, but these systems are expensive, require expert interpretation, and are not point-of-care tests. This is a study using a new colorimetric sensor array with chemically sensitive compounds that detect volatile organic compound changes with color changes and that can be easily administered to patients. The goal was to assess the sensitivity and specificity of the method for normal healthy controls vs patients diagnosed with non–small-cell lung cancer vs those with other lung diseases. The authors noted that this study differs from previous studies using gas sensors in the devices used, the method of breath collection, type of analysis, and study population. Study Highlights 143 subjects older than 18 years were enrolled, including those with lung disease such as sarcoidosis, idiopathic pulmonary fibrosis, pulmonary arterial hypertension (PAH), and chronic obstructive pulmonary disease (COPD), those with lung cancer, and healthy controls. Smokers and nonsmokers were included, and a group with indeterminate and undiagnosed pulmonary nodules (n = 29) was also asked to participate and later diagnosed using biopsy. Patients with COPD were required to meet the Global Initiative for Chronic Obstructive Lung Disease criteria for at least mild COPD. Those with PAH were diagnosed by right heart catheterization. Sarcoidosis was clinically or radiologically diagnosed. Patients with lung cancer had been diagnosed with non–small-cell lung cancer. Treatment of any disease was not an exclusion factor. Each subject performed tidal breathing of unfiltered room air for 12 minutes and exhaled into a mouth piece. The exhaled breath was drawn over the sensor array using a pump, and at the end of the 12-minute breath collection, air tubing and the sensor array were changed and a sample of room air drawn across the system for 12 minutes. The sensor array contained 36 chemically sensitive spots with different sensitivities to volatile organic compounds, and color changes were converted to numerical values for the change in red, blue, and green components, resulting in a 108-dimensional vector (3 values per spot). The difference between the exhaled breath and room air results was used in the analysis. The random forest method was used to develop a model for discriminating patients with lung cancer from those without lung cancer. Overall, mean age reflected the conditions being tested with a range from 47 to 65 years. Of those with lung cancer, 14% were stage IA, 14% were stage IB, 4% were stage IIA, 4% were stage IIB, 24% were stage II B, and 33% stage IV. 55% of those with lung cancer had well-defined adenocarcinoma, and 27% had well-defined squamous cell carcinoma. 70% of subjects had an error rate of 14.1%, and the method was validated using the remaining 30% (49). Validation showed a sensitivity of 73.3% and a specificity of 72.4% for the diagnosis of lung cancer (P = .01). The sensitivity and specificity were not influenced by age, sex, histology, tumor size, cancer stage, or smoking history. Of the 29 subjects with indeterminate lung nodules, 21 turned out to have lung cancer. Using the same model for diagnosis of lung cancer, the sensitivity was 100% and the specificity was 60% for this group of patients. Pearls for Practice The colorimetric assay for lung cancer diagnosis consists of detection of volatile organic compounds comparing patients' exhaled breath with room air. The sensitivity and specificity of the color sensor array for lung cancer diagnosis using healthy controls and those with lung disease are 73.3% and 72.4%, respectively.

Prayers going up for success and good pain control. Donna G

Hi Steve, sorry to hear about Kathy. I was told I had lung cancer in December, 12/3/97! So far I am still NED! (No Evidence of Disease) It took a lot of chemo , radiation and surgery but it worked. Keep us posted on how she is doing. Donna G

Welcome, welcome. Please keep us posted on how you are doing. We all know how hard it is to be told you have lung cancer and how it is to go through treatment. All of us need support and you will find it here. Donna G

Nodules, Nodules. Wish they had a sign saying "NOT TO WORRY ABOUT" hung on them. Great that the 1st one is behaving and not changing. Do you suppose it sent for a friend to keep it company as long as it is not going anywhere? Take care my friend. Donna G

Hi Charlotte. You guys should join our Pancoast tumor survivor club! I too went to the doctor thinking I needed an Orthopedic opinion! Have you got a game plan yet? I started with chemo and daily radiation to shrink the tumor before surgery and the plan included chemo after surgery again. As you can see this whole thing started 12/3/97 for me and I am still celebrating that I am cancer free today! Keep us posted. My story "Over the Mountain and to the Valley" is in that ribbon if you would like to read the whole thing. Best wishes and prayers, Donna G

Yes! It can be done. Congratulations. I was a professional quitter for over 20 yrs but a voice in my head kept saying things like "You need a cigarette if you move and have to go to closing" etc so always an excuse to begin again. It was all a lie, I have even gone to a closing and it went fine without a cigarette! It has been 9 and 1/2 years, I wish the same to you. Warning If you hear that voice in your head also, It is lying! Donna G

Today I was thinking that every women I have ever met who has had a thorocotomy does not enjoy wearing the "appliance". I really believe if any one has the talent to invent a bra that does not sqeeze a women around the chest right on the post op scar she could make a million or at least a lot on money! I have done a search on Google and find one million and one hits about post op bras but all for post op Mastectomies except one site they mentioned thorocotomy. It was a site for ostomy nurses so----I sent the site address to my friend Mary who is an ostomy nurse hoping that she can get on that site and find info. Would be really happy for info if any of you have found a site or place that handles comfort for us bras. Thanks Problem defined: Post-Thoracotomy Pain Syndrome Post-thoracotomy pain syndrome usually results from surgical trauma or fibrosis of the intercostal nerves. Thoracotomy is one the more painful procedures that a patient can undergo, and is one that is more commonly associated with long term pain. The pain is typically a neuropathic pain, usually in the distribution of the affected intercostal nerve. An important point, however, with the development of pain after a thoracotomy that has been performed for oncologic reasons, is that tumor recurrence must be ruled out. Management of the pain is similar to other neuropathic pain states, with the use of tricyclic antidepressants and anticonvulsants. The intercostal nerves are fairly accessible, and long term pain control can be achieved with repetitive local anesthetic and steroid blocks. For cancer patients with limited life expectancy, i.e., tumor found to be unresectable at the time of thoracotomy, implantation of an epidural portacath for home epidural infusion can be of undeniable benefit. Donna G

I agree, keep your pup. He wants to be with you! If in the future he must find a new home, he will deal with it but for now please keep him. Donna G

What is the station name or call letters, maybe they have a web site and we can see the interview! Donna G

keep us posted what the Neuro-Onc says. Prayers going up for your Mom and the family during this time of worry. Donna G

Hi Jen, I speak with an east coast accent, does that count? I started with chemo and radiation then like your Mom was able to have surgery. I have celebrated 9 plus years of survival and am still NED ( no evidence of disease) Please keep us posted. Donna G

Yes! Snickers with healthy peanuts, dark chocolate! Sounds really healthy as long as you are not Diabetic. Donna G

Nice! Donna G

I only knew him a short time but he was so much fun. I am sure you cherish all those happy memories and are so sad that you don't have him here with you. Prayers for you during this difficult time. Donna G

I heard it on the news this evening. I guess when I did a web search that they cause all kinds on cancer if you eat them regularly. Especially if you cook them crispy. It has got to do with the nitrates in them I think. Donna G

Thanks, I love it. Donna G

"If the Battle is Over, Why Am I Still In Uniform?" by Brenda Elsagher (comedian) I am going to a Cancer Survivor Celebration luncheon on the 21st of the month and this comedian, who wrote that book, will be the speaker. But isn't that really the answer to the question you ask? Just as if it was yesterday, I remember how devistated I was the day I was told I had lung cancer. I knew I was the walking dead. Even after my Onocologist told me he planned on curing me of this cancer the months that followed were so hard. I know how I needed help and support. I also realize how much women (and men) need to work to get the public to realize we need research and better treatment and money must be spent to do this! I can not imagine the day when I take off my "uniform" Donna G PS: I am an RN so I am used to wearing a uniform also

When you mention eye symptoms it makes me think he had better report these symptoms to his Onocologist. He may need a brain scan to check and be sure he has no brain metastasis to be safe. If so he could have them zaped with radiation. I had Cisplatin for chemo ( 2 rounds) and I blame it for being forgetful, as can't remember a name or word even though I feel it is just on the tip of my tongue. I don't learn things as easy as I used to. So it is fairly common problem after chemo. I still would advise you to have it checked out. Donna G

You wear a bra every day! Wow! That is one thing I really avoid. I can not say I am in agony all day long but every day my right chest wall reminds me of the thorocotomy and how lucky I am to be alive nearly 10 years later. Donna G