Arizona State University Study: Effects of Cancer Diagnosis on Sleep

If you are interested, Arizona State University asked me to invite you to participate in a study about a cancer diagnosis and its effect on sleep quality.  The link below is to a flyer about the study that will give you information on how to participate:

Arizona State University Sleep Study

This study is an 8-week intervention with a 4-week follow-up period. Interested participants complete an eligibility survey to see if they are eligible to participate. If they are, we have them review an online video providing an overview of the study, review an electronic informed consent, and then ask us any questions they might have before signing the consent and being randomly assigned to one of two different groups. Both groups participate in app-based activities for 8 weeks and then complete self-report symptom questionnaires at baseline, week 4, week 8, and week 12 (after a 4-week follow-up).

Vitamin D

I attended a presentation of Dr. Michael Holick’s at an annual meeting I attended of the American Association for Cancer Research.  Dr. Holick has studied Vitamin D for 30 years. He received the Linus Pauling Award for Health Research in 2009 related to his work (after he was fired from his professorship in dermatology for promoting healthy sun exposure).

His work brought many things to light.  Vitamin D is actually not a vitamin but a hormone, a hormone used by every cell in the body.  All immune cells have Vitamin D receptors.  Vitamin D deficiencies are now being associated with increased cancer risks, with autoimmune diseases like multiple sclerosis, rheumatoid arthritis and lupus and even with depression and psychological disorders.

Many of us living in the United States above Atlanta Georgia are vitamin D deficient, in part because we get so little sun exposure in the winter months.  We also have developed a phobia of sun exposure in the warmer months, so use sun block whenever we are outside in the summer, which prevents our bodies from developing our own natural Vitamin D.

It’s interesting that in some cancers are more prominent in the black population, whose skin pigmentation makes it more difficult for them to produce vitamin D when exposed to sun.  It’s also interesting that now obesity is seen as a risk for developing cancer, and vitamin D is sequestered in fat cells and not available for use in the body of those who are overweight.  Cancer is also a disease associated with aging, and as we get older, our bodies are less able to produce vitamin D from sun exposure.  The incidence of many cancers is greater for those who live in the northern United States.

Our bodies naturally produce 20,000 units of vitamin D in just 15 minutes when just our arms and legs are exposed to the sun in the  in the warmer months.   And there is no toxic effect from naturally produced Vitamin D.  It is felt that the current recommendations for vitamin D intake are too low.   We can’t obtain enough vitamin D from the foods we eat, so in the absence of sun exposure and without supplementing our vitamin intake, we will likely be deficient.  We can obtain enough vitamin D naturally with arms and legs exposed to sun in the summer months for 15 minutes 3 times a week.

As I have a history of cancer and autoimmune disease and live in the northern United States, I personally started taking large doses of vitamin D supplements, and several months after taking supplements asked my doctor to do lab work to see what my vitamin D level was….with supplementation, my vitamin D level was just in the middle of the normal range.  I encouraged my sister-in-law, diagnosed with breast cancer, to have her vitamin D level checked, her level was far below normal; her doctor has now put her on a prescription Vitamin D tablets.

Heat It To Beat It

Heat It To Beat It
Dr. Armando Sardi is on my organization’s Medical Advisory Board. Every year he does a walk, Heat it to Beat It, in Baltimore. I’ve been to at least 5 of them. Last year was the 10th walk. They have raised 1.2 million dollars so far with the walk.
I wanted to go this year, but with Covid, it has now gone virtual. Instead of the nice walk at the Baltimore Zoo, with a meeting of hundreds of survivors after, anyone who signs up can do 5000 steps in whatever way they want (I’d hike at Dunes State Park!).
Since they can’t have the usual in-person events, Dr. Sardi is doing an on-line magic show, his partner is doing a concert, they have several online events! Since everyone cannot get together, they will be doing a Zoom support group, like I am doing with my organization.
I love to attend, but this year I will probably be Virtual! If you look at the attached picture, that is the group picture of survivors who attended last year!
This is the link to the event: Heat it to Beat It

EPIC: Early Postoperative Intraperitoneal Chemotherapy

When I had appendix cancer, I did not receive HIPEC treatment, I received EPIC, early post-operative intraperitoneal chemotherapy.   When I was searching for treatment, I’d read about HIPEC and wanted HIPEC, but it was hard to find, and I didn’t want my surgeon to be the one I knew of that offered HIPEC.  Both EPIC and HIPEC are chemotherapy that is put directly  into the abdomen after cytoreduction surgery.  You receive several EPIC treatments after surgery vs. the one HIPEC treatment that is done while you are in surgery for the cytoreduction surgery.  I’d hoped for HIPEC as I’d read that the heat itself can kill cancer cells, that the heated chemotherapy is more able to penetrate cancer cells, and that the heat also potentiated the chemotherapy, i.e. made it work better.  The surgeon I chose, though, use EPIC.

EPIC is sometimes done 4-5 days after the surgery, but I insisted my first treatment be done within 24 hours of my surgery.  Scar tissue and adhesions that can interfere with the circulation of abdominal chemotherapy can occur within 4 days after cytoreduction surgery.  I had a portacath in my abdomen to infuse the chemotherapy.  I’ve read that often the EPIC chemotherapy is drained from the abdomen after a certain number of hours, but we did not drain mine at all, we just let my body absorb the chemotherapy and the solution.  I had a total of 6 treatments.  Was interesting, I’m a nurse so learned how to do my peritoneal treatment at MSKCC.  I only had my first two treatments at MSKCC and the last 4 done with my oncologist at home.  As I am a nurse, I had to train my home office how to do the peritoneal treatments, they had never done them before!

EPIC worked for me, I have been cancer free for 19 years.  Memorial Sloan Kettering, where I was treated, is doing a study comparing EPIC and HIPEC to see how they compare.  The study is ICARuS.  You can read of it here.  It was started in 2013 and is expected to be completed in September of 2021.    MSKCC offers EPIC, but not HIPEC that I am aware of.   It will be interesting to see the results of the study.

Some specialists use 5 treatments of EPIC after HIPEC, so they use both EPIC and HIPEC.  Studies have been done comparing HIPEC also to HIPEC and EPIC both used.  One study I read said the complication rate is higher when both are used, but I haven’t yet read any studies that compare the survival rate of using both HIPEC and EPIC together yet.  Most specialists now treating appendix cancer are using HIPEC for the benefits of the heat.