Archives for June 2013

Why Clinical Trials?

Why Clinical Trials?

Clinical trials are essential to the improvement and advancement of medical care. Research studies explore whether a medical strategy, treatment or device is safe and effective. Ultimately, it is objective evidence that helps guide our decisions toward strategies and treatments that work best.

Many of my patients express fears or concerns about participating in clinical trials. Most initially say they dislike the idea of being randomized or taking a placebo (sugar pill) drug, or they don’t want to travel to another institution. Most say “I don’t want to be a guinea pig.”

What patients and lay people often don’t know are the real benefits that come with participating in a trial such as access to promising treatments before they are available to the public. These treatments are often free or subsidized by the trial. While a patient is enrolled in a study, a research team closely monitors both care and side effects.

NO clinical trial is going to withhold the gold standard treatment option for a patient. Many trials are just surveys asking about your experience. Some trials ask to use your tumor tissue to look for new clues to fight cancer. In trials that do involve treatment, the trial often consists of using the recommended treatment option and combining it with new drugs or using it in new ways to try to improve the way it works.

Not every doctor or hospital has access clinical trials. Those who do offer trials are usually recognized by the experts in the field and are part of leading health facilities.

In 2002, the NCI (National Cancer Institute) chose a select few oncology groups around the country to bring clinical trials to smaller communities. Green Bay Oncology was one of the chosen few. Green Bay Oncology works closely with academic centers such as UW- Madison, Froedert in Milwaukee and Mayo Clinic to bring trials close to home so patients do not have to travel hours or across state lines to have access to cutting edge medical treatments.

Today there are more than 130 active clinical trials through Green Bay Oncology. For over 10 years we have been able to offer these options to our patients.

Remember that everything we as physicans recommend to you regarding your diagnosis, prognosis and treatment is based on someone before you having participated in a clinical trial. I hope you will consider and encourage those you know with cancer to find out if there is a clinical trial that might be right for them.


Qigong: Improving Quality of Life in Women Undergoing Radiotherapy for Breast Cancer

Qigong: Improving Quality of Life in Women Undergoing Radiotherapy for Breast Cancer

Qigong (“qi” or “chi”= energy flow, “gong”= skill or achievement) is a practice with its roots in Chinese medicine, martial arts and philosophy. It involves rhythmic breathing coordinated with repetition of fluid movements and a calm mindful state guiding “qi” through the body. There are many million practitioners of Qigong in China and the rest of the world. When I travelled to China a few years ago, it was amazing to see hundreds of Qigong practitioners simultaneously engage in their fluid exercises at a park or other public location.

In a study recently published in the journal Cancer, researchers from China, the United States and Germany examined the benefits of regular Qigong practice in Chinese women undergoing radiation therapy for breast cancer.

In this study, women were scheduled to undergo breast radiation therapy for 5 to 6 weeks. About half of the women receiving radiation also practiced Qigong weekly for forty minutes.

Women with depressive symptoms at the outset showed improvements in depression, fatigue, and overall quality of life after participating in Qigong. I am intrigued by the data as Qigong appeared to help women with cancer who showed high baseline depressive symptoms.

Based on a recent review, there also appear to be positive effects of Qigong on patients undergoing chemotherapy.

Watch for more information about the practice of Qigong as it becomes more common worldwide.

The Greatest Gift

The Greatest Gift

My aunt passed away after a short illness. She had a large extended family, but no children or spouse to handle her affairs. I knew ahead of time that I was her chosen power of attorney for health care and for her finances as well as the administrator of her will. What I didn’t know ahead of time was the gift that she had already given me.

Aunt Mert was the most private of people. She was very upset that in order to have me listed as her POA, her lawyer insisted that she let me know that I was being given that job. She was not the type of woman to have a discussion about what she wanted to happen “when that time comes”.

When I received the call that Aunt Mert was incapacitated and that I, as her power of attorney for health care, needed to make some decisions, my heart skipped a beat…and another as I realized that not only her life, but her quality of life, was now in my hands. What did she want? Did I have the knowledge and strength to make the decisions that needed to be made?

As I read back over the document she had prepared, I realized that while we had not discussed in great detail what her desires were, the short conversation we had along with the decisions noted on the form were enough for me to make sure the life she had left was lived according to her wishes…and her death was according to those wishes, too. The decisions made were not mine, they were hers carried out by me. I did ultimately have to make the detailed decisions in the moment, but with the information held in the power of attorney paperwork as well as within our relationship, I know those decisions were the right ones.

Had she not given me the pathway to follow – the paperwork, the brief discussion, the trust – Aunt Mert may have been subject to more medical intervention than she wanted to have, to a lesser quality of life after intervention, to a death on someone else’s terms. Health decisions could have been left to a court-appointed guardian – maybe someone outside of our family.

As I went home the evening that she passed away, I thought about the love and the gifts she had given me through the years. I realized, at that moment, the most important gift of all was that she gave me the tools and the trust to carry out her wishes.

The question I often ask my friends and family now is whether they have given their family those same gifts. Have you?

Power of attorney paperwork for Wisconsin can be found at:

Power of attorney paperwork for Michigan can be found at:

Treatment for Medullary Thyroid Cancer

Treatment for Medullary Thyroid Cancer

Medullary thyroid cancer is a rare form of thyroid cancer. On November 29, 2012 the FDA announced the approval of an oral drug called cabozantinib (brand name Cometriq) for the treatment of patients with medullary thyroid cancer where the cancer has spread to other sites in the body. It is a tyrosine kinase inhibitor blocking multiple pathways important for medullary thyroid cancer cells.

In one study with 330 patients, those who received cabozantinib lived for 11 months without their cancer worsening compared to four months for patients who received a placebo. There are some significant side effects patients need to be monitored for as listed in the actual prescribing information.

If you have any questions about this or any other treatment, please talk with your physician.