EXPERT VOICES

Timely insight on cancer topics from the experts of the American Cancer Society

American Cancer Society Expert Voices

The American Cancer Society

Adults Need Vaccines, Too

September 22, 2014

By William Schaffner, MD


As I like to tell my patients, the best approach to everyday health is a proactive one, and that means staying up-to-date on recommended vaccinations in addition to annual checkups.

Many adults don't visit a doctor unless they feel ill, nor do they think about vaccination as part of their routine, preventive healthcare. This leaves them needlessly vulnerable to diseases that can cause severe health complications or even death. 

Vaccines are a safe, effective way to help prevent a number of diseases at any age-from 6 months to 60 years, and beyond. In fact, there are several vaccines recommended specifically for adults because of their risk for certain infections.

It's important for all adults to check with a healthcare professional about which vaccines are recommended for them, as we all need some vaccinations as we age. For example, the chance of having complications from the flu, or getting shingles or pneumococcal disease (see below for more information) increases with age. In other cases, a weakened immune system or the presence of underlying illnesses like cancer, heart disease, or diabetes can make us more susceptible to diseases.

Many adult vaccines are readily available at primary care medical offices and in pharmacies, and the cost of vaccination is usually covered by Medicare and most private insurers. So, there are no excuses for not staying up-to-date!

Vaccines and the immune system


If you have a weakened immune system due to cancer or related treatment, there are vaccines you should receive - and some that you should not receive.

Vaccines come in two forms: inactivated or live. Inactivated vaccines only contain killed viruses or bacteria and can be used for those with compromised immune systems. Live vaccines, such as the flu nasal spray (but not the shot, which has inactivated virus) or shingles, contain weakened but live components. While this does not pose a risk for people with a healthy immune system, live vaccines are not recommended for people whose immune system is weakened by certain cancers, cancer treatment, or other factors. 

Cancers like leukemia, lymphoma, and Hodgkin disease interfere directly with the immune system. In most cases, however, it's not the cancer itself, but the cancer treatment, that changes the immune system. Some cancer treatments, such as radiation, certain chemotherapies, and transplantations, prevent your immune system from responding the way it should to infections. If you aren't sure whether your immune system is being affected, talk to your doctor or other healthcare professional before you or anyone you spend a lot of time with gets any vaccines. More...

Filed Under:

General | Survivorship

After Prostate Cancer Treatment Ends

September 11, 2014

By Rebecca Cowens-Alvarado, MPH


According to the American Cancer Society, there are nearly 3 million prostate cancer survivors in the United States today and this number is expected to increase to almost 4.2 million by 2024.  Most prostate cancers (93%) are diagnosed at the local or regional stage, before the cancer has spread to surrounding organs. Treatment at these early stages is often very successful, and the 5-year relative survival rate approaches 100%.

Treatments for prostate cancer patients vary based on age and stage of diagnosis, but the majority of prostate cancer patients younger than aged 65 are more likely to be treated with radiation, radical prostatectomy, or a combination of both. Some patients may also be treated with androgen deprivation therapy (ADT), while others may simply undergo active surveillance, or "watchful waiting," to see how the prostate cancer progresses before choosing a treatment option. While the survival rate for prostate cancer is high, being diagnosed and treated for prostate cancer may cause a number of physical, psychological, and social side effects that can last (or develop) long after treatment ends.

Common issues faced by prostate cancer survivors who underwent surgery or radiation include: difficulty having an erection and decreased interest in sex, which may impact sexual intimacy; needing to urinate quickly or not being able to control when they urinate; bowel problems such as not being able to control or having diarrhea; and distress or depression. Prostate cancer survivors who are on ADT may also experience lack of interest in sex, hot flushes, weakening of the bones (osteoporosis) and increased risk of heart attack or diabetes. And for those undergoing active surveillance or watchful waiting, the anxiety and distress from waiting for the results of frequent prostate-specific antigen (PSA) tests are very real. More...

Filed Under:

Prostate Cancer | Survivorship

How electronic health records can help on your cancer journey

August 20, 2014

By Simone Myrie

Ed. note: This guest post by Simone Myrie of the Office of Consumer eHealth, Office of the National Coordinator (ONC) for Health Information technology, US Department of Health and Human Services. In it, she explains how electronic health records and Blue Button can help cancer patients, survivors, and caregivers as they navigate their cancer journey.


No two experiences with cancer are alike, but there are certain things that almost all cancer patients and their loved ones share in common. From getting a diagnosis, to coordinating care among doctors and at home, and on to long-term survivorship plans, the cancer experience is one centered around information. Some of the information we seek is mostly objective: What can I expect this disease to do? What are my treatment options? How can I improve my odds of beating cancer?

But some of the most important information you can gather, keep track of and share is information unique to you: Your own health records. The visit summaries, clinical notes, test results, medication lists, treatment histories, and other documents represent a critical picture of your individual cancer experience. This information has implications for your individual choices, your professional care, and the care you receive from loved ones. More...

Filed Under:

General | Survivorship

Can we predict who will become addicted to cigarettes?

July 24, 2014

By Victoria Stevens, PhD

Every day in the United States, nearly 4,000 young people under the age of 18 smoke their first cigarette, according to the Centers for Disease Control's Youth and Tobacco Use Fact Sheet. About 1,000 of these kids will go on to become daily smokers, which is the next step on the pathway to becoming addicted to nicotine. Over the course of a year, that is 365,000 new daily smokers. About 60%, or almost 220,000, will still be regular smokers 7 to 9 years later. 

When they tried that first cigarette, did they expect to become dependent on nicotine and unable to quit smoking whenever they want to? Of course not, because they feel young and invincible. In fact, only 3% of the regular smokers expected to be still smoking 5 years later. 

Is nicotine addiction in our genes?

A paper published in JAMA Psychiatry may give some clues to why so many young people continue smoking after that first try. Please note: the research is preliminary, and much more needs to be done before any conclusions are reached and recommendations made. But it's also intriguing. More...

E-Cigarettes – It’s Complicated

June 24, 2014

By Thomas J. Glynn, PhD

Editor's note: This blog is the last one frequent contributor Dr. Glynn will write before his upcoming retirement. We wanted to thank him for his expertise and ability to break down a topic and offer insight, as well as his excellent writing. We offer him best wishes for a long, happy retirement.


In May 2011, I had the opportunity to write the first Expert Voices blog on what was then a new, but growing, public health concern - the emergence of e-cigarettes.

At that time, I wrote that "e-cigarettes have been described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health;" that they "are a source of controversy;" and that we need "to put science to work (and) obtain, solid, independent data" regarding e-cigarettes.

Now, 3 years later, more than 1,000 research papers, commentaries, and opinion pieces have been published about e-cigarettes. There's been continuous public debate about and media attention paid to e-cigarettes, and there's a proposed FDA rule regarding e-cigarette regulation.

Now, it is finally possible, at long last, to say that... e-cigarettes continue to be described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health; that they remain a source of controversy; and that more independent, objective data are needed.

Consensus remains elusive

Yes, the old French adage - plus ca change, plus c'est  la meme chose  (the more things change, the more they remain the same)-- is an apt description for the state of affairs regarding e-cigarettes in June 2014. Despite the considerable research, debate, media attention, Congressional hearings, and, yes, blogs, over the past 3 years, the public health, advocacy, scientific, and medical communities are little closer to a consensus regarding e-cigarettes than they were in May 2011. More...

The Same, Only Scarier -- The LGBT Cancer Experience

June 05, 2014

By Liz Margolies, LCSW


Getting a diagnosis of cancer is frightening for everyone. But for many lesbian, gay, bisexual, and transgender (LGBT) patients, the immediate concerns about treatment options and survival are compounded by an additional set of worries: 

  • "Should I come out to my healthcare providers?"
  • "Will I be safe if I do?"
  • "Will my chosen family be welcome?"
  • "Will I be able to find the information I need to take care of my relationship, my sexuality, my fertility and my family?"

LGBT cancer patients and survivors are underserved and that is partly as a result of being underreported. No cancer registries collect information about gender identity or sexual orientation, leaving LGBT cancer survivors buried in the data and often invisible to healthcare providers. Treatment facilities and social service organizations may also be unaware of the true number of LGBT people they serve because their intake forms do not invite disclosure (coming out as lesbian, gay, bisexual, transgender), and fear of discrimination keeps many patients in the closet. As a result, the healthcare system often fails to recognize LGBT patients and isn't trained to meet their needs.  

The American Cancer Society estimated in January 2014 that there were approximately 14.5 million Americans living with a history of cancer. Approximately 4% of Americans identify as LGBT, and LGBT people are known to have increased cancer risks and decreased screening rates. Considering all these factors, the National LGBT Cancer Network, estimates that there are more than 1 million LGBT cancer survivors in the country today. You might even know one or more of them. More...

Filed Under:

Disparities | General

Indoors or outdoors, there's no such thing as a safe tan

May 22, 2014

By Gery P. Guy Jr., PhD, MPH


If you read no further, know this: there is no such thing as a safe tan. Indoor tanning is just as dangerous, if not more, than tanning outside in the sun. In fact, indoor tanning injures thousands of people each year badly enough to go to the emergency department. Indoor tanning can cause sunburn and damage to your eyes that could lead to vision loss. Indoor tanning can also cause premature skin aging, including loss of elasticity, wrinkling, age spots, and changes in skin texture.

Most dangerous of all, indoor tanning is a recognized cause of skin cancer, including deadly melanoma. Skin cancer is the most common form of cancer in the United States. Approximately 3.5 million cases of non-melanoma skin cancers are treated each year, and more than 70,000 melanomas are diagnosed yearly. While many cancers have been on the decline in recent years, rates of melanoma, which causes the most skin cancer-related deaths, have been on the rise. Increased exposure to ultraviolet radiation (UV) through indoor tanning may be partially responsible for the continued increase in melanoma, especially among young women. Indoor tanning is particularly dangerous for younger and more frequent users.

Tanning myths


There are a lot of misconceptions about indoor tanning, so it's important to know the following:

  • Tanned skin is not healthy skin. That "healthy glow" from the tanning bed indicates damage to your skin. Whether tanning or burning, you are exposing yourself to harmful UV rays. In fact, every time you engage in indoor tanning, you increase your risk of melanoma. The truly healthy glow is your natural skin color. More...

Cell Phones, Bras, and Breast Cancer Risk

May 13, 2014

By Ted Gansler, MD, MPH

 

Like other contributors to the Expert Voices blogs, I am occasionally asked to reply to questions from journalists about various cancer-related topics. The most recent question I received is whether it is true that women who carry a cell phone in their bras are at increased risk for developing breast cancer.

This kind of question is surprisingly difficult to answer. It's relatively easy to write about things that are known to cause cancer. It's more difficult to be confident that something does not cause cancer, but one can still provide some guidance if there have been at least a few carefully-conducted epidemiologic studies with negative results. The most challenging requests we receive are often about questions that researchers have not addressed by scientific studies of humans populations. This is one such question.

Cause or Coincidence?


There are a few known instances of breast cancer in young women who have kept cell phones in their bras. (Even when cell phones are not being used for conversation or texting, if they are on then they still periodically emit low energy electromagnetic signals to stay in touch with nearby cell towers.) Because breast cancer is an uncommon and tragic occurrence among young women, these cases have received significant attention on television and on the Internet. But it is the nature of these media to emphasize unusual events, so of course we don't hear much about the millions of women and men who carry phones close to various organs and still remain healthy. More...

What we can do to end health disparities

April 15, 2014

By Kassandra I. Alcaraz, PhD, MPH

During National Minority Cancer Awareness Week and National Minority Health Month, the American Cancer Society, health agencies, and other organizations seek to raise awareness of health disparities, or health inequities, among racial and ethnic minority groups. Most of us have probably seen or heard the phrase "health disparities." But what, exactly, does this phrase mean? And why is it important?

The U.S. Department of Health and Human Services defines a health disparity as "a particular type of health difference that is closely linked with social or economic disadvantage." 

These disadvantages include things like racial discrimination, racially-segregated neighborhoods, and social stratification (the inequitable distribution of privilege, power, wealth, and resources in our society), and they have resulted in unequal access to quality health care, health information, and health programs for racial and ethnic minority groups. These "root causes" not only make the nation unhealthier as a whole but also present real challenges to eliminating disparities.

Although health disparities are not limited to racial and ethnic minority populations, this particular month gives us a dedicated time to better understand disparities among these groups. In the United States, racial and ethnic minority populations bear a disproportionately high burden of disease such as cancer. Generally these groups have worse outcomes than non-Hispanic whites when diagnosed with the same disease. More...

Filed Under:

Disparities

What to keep in mind when you see STUDIES SAY

March 31, 2014

By Alvaro Carrascal, MD, MPH

You may have seen some of these headlines recently in national newspapers and online:

More coffee linked to higher mortality rate: study

Four cups of coffee a day may raise early death risk in younger adults

4 Cups of Coffee a Day Can Be Deadly

New Study: Coffee Can Kill You

Under 55? Think twice before you reach for that extra cup of coffee, researchers say

After seeing these reports on the web and morning news, I had a thought as I reached for my morning cup of joe: Should I consider tea instead?

As a person who grew up drinking 2-3 cups of coffee a day, should I change my habits based on these news reports? What would happen if I don't? Should these reports stop my life-long friendship with Juan Valdez? More...

Filed Under:

General

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