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Adventure of Hope

by Terri Wingham

 

Two years ago, the words, “you have cancer” changed my life forever. At the age of 30, fighting cancer was physically draining and emotionally exhausting. But, no one prepared me for how hard it would be to pick up the pieces of my pre-cancer life and move forward after treatment ended.

 

When I walked out of the hospital after my final surgery in January of 2011, a nurse told me how to dress my wounds, but no one told me how to cope with the challenging emotions I faced on my way to survivorship. Well-meaning friends and family talked endlessly about how excited I must be for treatment to be over. But I didn’t feel excited.

 

Like many of the 12+ million cancer survivors in North America, I felt trapped in a post-treatment void. I had lost my sense of belonging to my pre-cancer world, my connection to myself and to my friends and family, and my sense of certainty about life. The support during my diagnosis and treatment faded, and I was left alone with my fears of recurrence, my worries about how returning to a stressful job could increase my risk of developing a secondary cancer, and my sense of loss over my breasts and my carefree past.

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Response to second-line erlotinib in an EGFR mutation-negative patient with non-small-cell lung cancer: make no assumptions

by I. Karam, B. Melosky

Abstract

Erlotinib—an oral tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR)— has commonly been used as a therapeutic option in metastatic non-small-cell lung cancer (NSCLC) patients in the second- or third-line treatment setting. A mutation in the EGFR gene (EGFR M+) confers an increased response to this class of drugs. In the first-line setting, use of tkis is restricted to patients having a mutation. The importance of this biomarker has been questioned in subsequent treatment lines.

Here, we report a case showing a positive response to erlotinib treatment in the second-line setting. The patient, an elderly male smoker with stage IV NSCLC, had a tumour that was EGFR mutation- negative (wild-type EGFR). Based on this clinical case, we discuss the controversy concerning the need for, and impact of, testing for EGFR mutation after first-line treatment.

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EGFR tyrosine kinase inhibitors in lung cancer: make no assumptions

by B. Melosky

The systemic treatment options and algorithm for stage iv non-small-cell lung cancer have changed tremendously since 2005, leading to improved survival and quality of life for this group of patients. But the changes have also led to confusion and complexity for the oncologist deciding on which treatments to use and the order of those treatments for the best benefit of their patients.

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Cancer Control: Life and Death in an Unequal World

by S. B. Sutcliffe

Cancer and non-communicable diseases ( ncd s) sharing common causal risk factors are not under control. Of 57 million deaths worldwide in 2009, cancer and ncd s (diabetes, mental illness, and heart and pulmonary diseases) caused 36 million, or almost 65%. Among 12.9 million patients with new cases of cancer, 7.6 million died of their disease (approaching 60%) 1. By 2030, 27 million new cases of cancer will have been recorded, along with 17 million deaths—again, almost 65%. During the same period, 80% of all deaths (52 million) will be caused by ncd s.

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