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February 10, 2021 Cancer Treatment

Fighting cancer is a full-time job all in itself, and the treatments can be harsh and physically draining. You’ve probably heard about chemotherapy and radiation therapy as treatment options at your appointments, but have you ever heard of immunotherapy?

At Hunterdon Oncology Hematology, our goal is to help you fight off cancer with the most up-to-date treatments. Our esteemed team of doctors specializes in many forms of cancer treatment, including immunotherapy, which fights your cancer with your own immune system.

What is immunotherapy?

Immunotherapy is a type of cancer treatment that helps your immune system fight off cancer cells in your body. The term immunotherapy encompasses several forms of treatment that essentially boost your immune response to better find and kill cancer cells.

Your immune system is made up of white blood cells, along with tissues and organs within your lymphatic system. One purpose of your immune system is to seek out and kill abnormal cells within your body that could potentially turn into cancer.

The problem with cancer cells is that they’re able to avoid your immune response in a number of different ways. One way is by changing their genetic code to be less visible to your immune system.

Cancer cells are also able to alter cells around your tumor, which makes it harder for your immune cells to find and attack them. They’re very good at disguising themselves.

Types of immunotherapy treatments

Our team offers many different forms of immunotherapy. Each one has a specialized way of helping your immune system attack the cancer cells that are making you sick. Some of the types of therapy we offer include:

Immune checkpoint inhibitors

There are checkpoints in your immune system to make sure you don’t constantly have an exaggerated immune response when you don’t need it. Immune checkpoint inhibitors block those checkpoints to allow your immune cells to overwhelm the cancer.

T-cell transfer therapy

This therapy is also known as adoptive immunotherapy or immune cell therapy. With this type of treatment, one of our doctors extracts the immune cells located within your tumor. In the lab, the best immune cells are separated from the rest and altered to make them attack cancer cells more aggressively. The lab grows a large amount of these T-cells, and then infuses them back into your body to fight off your cancer.

Immune system modulators

This type of immunotherapy increases your body’s own immune response to enhance the fight against your cancer cells. Essentially, this helps your immune system to not only seek out your cancer cells, but also to attack and kill them in large quantities.

Monoclonal antibodies

These antibodies are formulated in a lab and are made to detect specific parts of the cancer cells. In addition, antibodies can transport drugs and radioactive therapy to the cancerous tumor.

Treatment vaccines

These vaccines help to protect your body against diseases that cause cancer. The vaccine stimulates your immune system to protect your body and cells from being taken over by cancer cells.

The type of therapy that our doctors suggest depends on treatments you’ve already tried, along with the type and stage of cancer that you have.

Cancers immunotherapy can help treat

Immunotherapy is a very versatile treatment, meaning it can be used for a lot of different types of cancer. Of course, it may not be right for everyone, so discussing the treatment with one of our doctors is essential to finding out if it’s right for you. Some of the cancers that this type of treatment can help include:

  • Bladder cancer
  • Brain cancer
  • Breast cancer
  • Prostate cancer
  • Leukemia
  • Cervical cancer
  • Colon cancer

Immunotherapy doesn’t stop there; in fact, the list of cancers it can be used to treat goes on well beyond the above list. Like many other cancer therapies, though, it can have side effects. If our doctors are suggesting this type of treatment, it usually means that they believe the benefits considerably outweigh the side effects of the treatment.

If you think immunotherapy may be what you’ve been searching for, call our office in Flemington, New Jersey at 908-264-1798 to schedule a consultation. You can also reach out to us by using our online booking tool.


December 16, 2020 Educational

Skin cancer is something everyone should be aware of over the course of a lifetime. Melanoma is the most serious type of skin cancer, and it’s important to know what it looks like so you can seek medical care as soon as possible to prevent its spread.

Here at Hunterdon Hematology Oncology in Flemington, New Jersey, our expert oncologists explain the warning signs — commonly known as the ABCs of melanoma — and risk factors so you can get proper treatment in its early stages.

Melanoma isn’t common, but it spreads easily

You mostly hear about skin cancer in the summertime, but even in the fall and winter months, it’s just as important to protect your skin when you’re outside. Melanoma isn’t the most common type of skin cancer, but it can be the most dangerous type because of how quickly it can spread to other parts of your body if not treated soon enough.

There are several types of skin cancer that begin on the top layer, or epidermis, of your skin. These include:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma skin cancers

Melanoma skin cancer begins in the cells in your skin that normally make melanin — the tan color in your skin. These cells are called melanocytes. When you spend time in the sun or on a tanning bed, the ultraviolet (UV) radiation causes skin damage, which makes melanocytes produce more melanin.

If your skin absorbs too much UV radiation, or you get a bad sunburn, mutations can occur in the melanocytes that prompt these cells then grow out of control. The result is melanoma skin cancer. If not treated, melanoma may spread out of control and form a mass of cancerous cells.

Who’s at risk for melanoma?

According to the American Cancer Society, melanin helps protect the deeper layers of your skin from the harmful effects of the sun. If you’re naturally darker-skinned, you have less risk of developing melanoma, but it’s still possible. Fair-skinned people and women under age 40 are in the high-risk categories for developing melanoma.

Other risk factors include:

  • Family history of melanoma
  • Weak immune system
  • History of sunburns
  • Excessive UV radiation exposure
  • Having unusual moles

People who’ve lived closer to the equator or in an area of high elevation also have a greater risk of developing melanoma.

Recognizing the signs of melanoma: Know your ABCs

Melanoma typically develops on areas of your body that have the most sun exposure, such as:

  • Arms and legs
  • Face and neck
  • Chest and back

You can also get melanoma on the soles of your feet, palms of your hands, or even in your fingernails. When you know what to look for, you can seek treatment and decrease your risk of melanoma spreading throughout your body.

The first signs of melanoma often appear as a change to an existing mole or the development of a new, unusual-looking skin growth. The letters ABCDE can help you determine if you should seek medical care for a potential melanoma:

A is for asymmetry

Examine the moles and blemishes on your body to see what shape they are. Do you notice a mole that is asymmetrical in appearance? Melanoma could look like a mole made up of different irregular shapes.

B is for border

Do you have a mole with an irregularly shaped border? If most of the freckles and spots on your skin appear round, but you notice one that has a jagged edge, for example, that is a sign that it could be melanoma.

C is for color

A third indication of melanoma is the changing or uneven color of a mole or growth on your skin. Melanomas come in a variety of colors, including blue-black, pink, red, or brown. A melanoma may even appear white.

D is for diameter

Moles larger than a quarter-inch in diameter may be signs of melanoma. Don’t ignore the size of a mole. It’s best to get it checked out by one of our expert physicians before it continues to grow deeper into your skin.

E is for evolving

Do you notice a mole that seems to be changing over time? Changes may include color, size, and irritation, such as itching or bleeding.

Preventing melanoma and other skin cancers

While there’s no guaranteed method of completely preventing melanoma and other types of skin cancer, you can take precautions to reduce your risk. These include:

  • Limiting your exposure to UV rays
  • Wearing sunscreen all year long
  • Staying in the shade
  • Wearing a hat and sunglasses
  • Avoiding tanning beds

It’s a good idea to perform self-exams regularly to note any new moles, changes to your skin, and other growths that may indicate the presence of skin cancer.

If you notice anything unusual when watching for the ABCs of melanoma, schedule an exam with the expert team at Hunterdon Hematology Oncology as soon as possible, so we can evaluate your skin, diagnose any problems, and recommend an effective treatment plan. Call our office at 908-264-1798 to book an appointment today.


June 9, 2020 Cancer Treatment

Like many people, you may be concerned about your breast health, and how your wellness affects your family, loved ones and friends. We share your concern. As part of a comprehensive breast program, Hunterdon Hematology Oncology (HHO) combines a comfortable, supportive environment with first-rate, comprehensive diagnostic and treatment resources… all conveniently close to home.

A Coordinated Approach to Breast Care

At HHO, we take a coordinated approach to breast care, for both well care and breast cancer care. A highly skilled team of breast specialists from different medical disciplines provides diagnostic testing, treatment, surgery, psychosocial support, education and rehabilitation. This team also collaborates with family practice physicians, gynecologists, radiologists, oncology specialists, plastic surgeons, pathologists and counselors to ensure that the care you receive is the most comprehensive it can be.

Hunterdon Hematology Oncology, a part of the Hunterdon Regional Cancer Center, is a full-time care partner, providing surgery, reconstruction alternatives, radiation and chemotherapy, support and counseling every step of the way. A full-time, dedicated Nurse Coordinator experienced in breast health issues remains in contact with you, keeping you informed about test results. She serves as liaison if further treatment and evaluation are necessary, coordinating appointments in an expeditious manner. She is there to hold your hand every step of the way.

The First Step in Breast Care is Imaging

Before a regimen of care can be formulated, a clear evaluation or diagnosis of the condition of the breast must take place. And this involves imaging – a picture of what is going on within the breast. This can be done at Hunterdon Women’s Imaging.

Breast Imaging Tests

The most commonly used breast imaging tests at this time are mammograms, ultrasound, and breast MRI.

Routine Mammogram

A mammogram is a low-dose x-ray of the breast. It can detect a breast lump nearly two years before it can be felt. A routine mammogram is the main reason most women are referred to the breast program at HHO. Screening mammograms evaluate breast health in women with no symptoms, and are used for those who seek routine breast evaluation. Diagnostic mammograms are used to diagnose breast disease in women with symptoms of a breast problem: dimpling, or a change in texture of the skin of the breast, a lump, or discharge from the nipple.

Digital Mammogram

Digital mammography is the most advanced technology to date for detecting breast cancer. The digital mammography procedure is essentially the same as standard film mammography, but uses a computer and digital image instead of film. Digital mammograms allow the image to be acquired and displayed immediately, reducing the time that the patient must remain still. This expedited process provides the patient with a more convenient and comfortable mammogram. In addition, a digital image can be enhanced and altered to be seen more clearly and to make a more accurate diagnosis. This image manipulation eliminates the need for a woman to repeat her mammogram if the first image is deemed unusable.


The majority of lumps and abnormalities turn out to be benign, not cancerous. A way to determine if a lump is a benign cyst is to perform another imaging procedure called an ultrasound. Ultrasound works by sending high frequency sound waves into the breast. These sound waves produce a pattern of echoes that are changed into an image of the inside of the breast. Ultrasound is painless and can distinguish between tumors that are solid and those that are filled with fluid (cysts). It can also help radiologists evaluate lumps that can be felt but cannot be easily seen on a mammogram.

Breast MRI

Magnetic resonance imaging (MRI) of the breast — or breast MRI — is a test used to detect breast cancer and other abnormalities in the breast. A breast MRI captures multiple images of your breast. Breast MRI images are combined, using a computer, to create detailed pictures. A breast MRI usually is performed after you have a biopsy that’s positive for cancer and your doctor needs more information about the extent of the disease. For some people, a breast MRI may be used with mammograms as a screening tool for detecting breast cancer. That group of people includes women with a high risk of breast cancer, who have a very strong family history of breast cancer or carry a hereditary breast cancer gene mutation.

Emerging Imaging Techniques

Newer types of tests are now being developed for breast imaging. Some of these, such as breast tomosynthesis (3D mammography), are already being used in some centers. Other tests are still being studied, and it will take time to see if they are as good as or better than those used today.

Molecular breast imaging (MBI), also known as scintimammography or breast-specific gamma imaging (BSGI), is a type of nuclear medicine imaging test for the breast. A radioactive chemical is injected into the blood, and a special camera is used to see into the breast. This test is being studied mainly as a way to follow up breast problems.

Positron emission mammography (PEM) is a newer imaging test of the breast that is very similar to a PET scan. A form of sugar attached to a radioactive particle is injected into the blood to detect cancer cells. A PEM scan may be better able to detect small clusters of cancer cells within the breast.

Contrast-enhanced mammography (CEM), also known as contrast-enhanced spectral mammography (CESM), is a newer test in which a contrast dye containing iodine is injected into a vein a few minutes before two sets of mammograms (using different energy levels) are taken. The contrast can help the x-rays show any abnormal areas in the breasts.

Optical imaging tests pass light into the breast and then measure the light that returns or passes through the tissue. The technique does not use radiation and does not require breast compression. Studies going on now are looking at combining optical imaging with other tests like MRI, ultrasound, or 3D mammography to help look for breast cancer.

Electrical impedance imaging (EIT) scans the breast for electrical conductivity. It’s based on the idea that breast cancer cells conduct electricity differently from normal cells. The test passes a very small electrical current through the breast and then detects it on the skin of the breast.

Elastography is a test that can be done as part of an ultrasound exam. It’s based on the idea that breast cancers tend to be firmer and stiffer than the surrounding breast tissue. For this test, the breast is compressed slightly, and the ultrasound can show how firm a suspicious area is.


May 27, 2020 Cancer Treatment

If you were recently diagnosed with breast cancer, your head may be swimming and swirling with questions, that all boil down to this: What’s next? The breast cancer care professionals at Hunterdon Hematology Oncology, a part of the Hunterdon Regional Cancer Center, are able to answer that question in a uniquely powerful way. Hunterdon Hematology Oncology has an entire practice focused solely on breast cancer detection, treatment and eradication, and part of that charge will focus on answering your questions and putting your worries to rest.

First, a word about cancer survivability. “What are my chances, doctor? Am I going to survive?” And the answer today is very much more positive that it was 30 or 40 years ago. Today, the overall survivability rate for breast cancer is in the neighborhood of 70%. Scientific research and early detection techniques are improving the overall trends of both survival rate and quality of life, particularly for breast cancer.

Second, a few words about the treatment process for breast cancer. You may be confused about what you should do next, but the actual treatment process for breast cancer has a certain regularity about it: it usually requires radiation treatment or hormone treatment to shrink the size of the tumor, or chemotherapy, and/or surgery or some combination of these treatment modalities. It depends on the biology of the breast cancer tumor and varies by stage (I – IV).

A little more about cancer staging: Cancer treatment depends on the stage (severity of the tumor). Clinical stage is based initially on mammogram imaging and ultrasound imaging of the suspected tumor. Pathological staging is determined after surgery; after the tumor has been removed and a sample of lymph node tissue is taken. The cancer’s stage is based on the size of the tumor, and whether the lymph node is involved in (affected by) the cancer, as well as the grade of the tumor.

You also might be wondering whether it would be worth it to go to one of those national treatment centers that advertise on TV. The answer is no. Research data indicate no difference in outcomes between national and local cancer centers. First of all, the therapeutic approach for treating breast cancer is standardized across the entire country. Second, HHO specializes in the treatment of breast cancer. HHO has a team of excellent breast surgeons who are dedicated to treating only breast cancer patients. Patients at HHO are assigned a Nurse Navigator who helps the patient coordinate care, navigate the entire process and answer any questions the patient might have.

Also, getting treated locally at HHO has certain advantages over going to one of these large national centers. While getting the exact same level of care and specialization found at a national center, HHO provides a level of personalized attention and care that is difficult to find at a larger center. Being local means that if any issues arise, if you need to come back to the hospital, we are right here and can see you immediately. We offer genetics counseling, and you can come in and out to see him/her very easily. If you need to come in to get a blood count checked, we are right here. Need extra hydration? Ditto. Feeling extra-nauseous? Come on in. We also offer an oncology-certified dietician, with whom you can arrange a visit pretty much any time you want.

And finally, there are actually certain disadvantages to using a large national cancer center. If anything detrimental were to take place, a patient using a large national center might find themselves needing to go to a local ER, and there will be nobody there who is familiar with the patient’s case or will understand what is going on. This can actually be detrimental to their care.

To learn more about Hunterdon Hematology Oncology’s cancer care treatment center NJ visit our breast cancer care page.


October 30, 2019 Cancer Treatment

If you’ve been diagnosed with cancer, your head may be spinning with questions such as: How can I find out which cancer treatment center is best for my type of cancer? How can I locate the very best oncologist (cancer specialist) for my cancer diagnosis? What kinds of questions should I ask them? How should I go about choosing the best course of treatment when there are all sorts of options available? Let’s look at these questions, each in turn:

How to Choose a Cancer Treatment Center That Is Best for My Diagnosis

This question may seem a bit overwhelming at first, but it’s not really all that bad. It just takes a little bit of time and research effort, so start by relaxing and not worrying. Cancer care has improved so much that it’s nearly assured that you can find the best care available for your cancer diagnosis.

Start by asking around! Talk with friends, family, close co-workers, and especially your family doctor. Ask them if they can recommend any hospital or cancer treatment center highly, especially if they have some familiarity with your specific diagnosis. Your family doctor will probably know the most, but you never know.

Some important considerations to include in your search: First a very practical consideration: Is the hospital or cancer treatment center in-network for your health insurance? After all, unless you have unlimited resources, you don’t want to be left with a very large bill after treatment is completed. Then, locate a hospital or cancer treatment center, that has extensive (high volume) experience in successfully treating your specific cancer diagnosis. Generally, this will tend to be large hospitals (although not always) or a well-known cancer treatment center, like the Hunterdon Cancer Center at Hunterdon Hematology Oncology in Flemington, NJ!

Patients should make sure to ask whether the treatment center has access to the newest most precise medical options to treat their cancer. Further, its approach to treating your cancer should be multi-disciplinary, meaning that multiple kinds of cancer treatment specialists should work together as a unified team, focused jointly on treating your cancer with an approach that “passes muster” with all members of the treatment team. Here at the Hunterdon Cancer Center at Hunterdon Hematology Oncology in Flemington, NJ we focus on working as a team to offer you an optimal treatment experience.

One important-but-sometimes-overlooked factor to keep in mind is geography – i.e., distance. Some cancer treatments can potentially require a lot of visits to the treatment center. Some treatments require patients to come back to the infusion suite 2-3 times per week. Considering distance often turns out to be a big deal.

Finally, look for a hospital or center that is a National Cancer Institute (NCI) designated cancer treatment center, or one that is accredited by the healthcare-focused non-profit Joint Commission. Understanding the importance of these designations, Hunterdon Hematology Oncology is an affiliate of Fox Chase Cancer Center and also, as part of Hunterdon Regional Cancer Center’s Breast Program, has received full accreditation from the National Accreditation Program for Breast Centers (NAPBC).

How to Choose the Right Oncologist for My Cancer Diagnosis

Start with your family physician, who almost undoubtedly can refer you to one or more oncologists and/or surgeons who have extensive experience with your specific cancer diagnosis. Then, meet with at least two recommended oncologists/surgeons. Compare and contrast their recommendations. Find out whether they agree or not. If not, see another one (or two). Finally, meet once more with your family physician, who can help you sort through the options and select the right treatment and the right physician(s) for you.

What Questions to Ask Your Oncologist and/or Surgeon

In selecting your oncologist and/or surgeon, it is important to establish that he or she is board certified in your specialty area, how many patients they have treated with your kind of cancer, how many patients with this kind of cancer are seen at the center, and how many have you personally treated, and is there a multidisciplinary team that will work jointly to make decisions regarding the best kind of treatment for my cancer? Also, don’t forget to ask your oncologist if he/she can come to see you in the hospital if the diagnosis or symptoms/side effects of treatment result in an admission. The Hunterdon Cancer Center at Hunterdon Hematology Oncology works to make our patients feel comfortable and confident that they have made the right choice.

For surgeons, ask them: how many surgeries do you perform each year? (It’s important for a surgeon to have a minimum of 15 to 20 per year.) What are your complication rates? What is your 30-day operative mortality rate? (This is any death that occurred within 30 days after surgery, either in or out of the hospital.)

What Factors to Consider When Deciding on Your Cancer Treatment

A diagnosis of cancer can be very anxiety-inducing, but unless your cancer is very advanced, rushing immediately into the first kind of treatment that seems “right” can be a mistake. It is nearly always recommended to take a deep breath, let it out slowly, relax a tiny bit, and do some research.

The first consideration to weigh is the aim(s) of the treatment. These can include removing the cancer entirely or killing it entirely, stopping or slowing its rate of growth and spread, and/or palliative care (supportive care), i.e. managing symptoms and side effects. You need to have an in-depth discussion of these options with your physician and/or multidisciplinary team.

The next factor to consider is the type and stage of the cancer. From there the most important decision is deciding what treatment type best fits with your particular cancer situation. These options include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy, active surveillance, also called watchful waiting, palliative care, and participating in a clinical trial.

Another key consideration to weigh the risks and benefits of each type of treatment. Some factors to consider include the chances for a complete cure, the likelihood that the cancer may come back, short and long-term side effects, chances of living longer with and without treatment, and (importantly) the effect(s) of treatment on your quality of life and independence.

The Hunterdon Cancer Center team is here to guide you, offer our utmost support and provide detailed information to make these difficult decisions easier on you and your family. Contact us today to schedule your appointment.


October 16, 2019 Cancer Treatment

There are some unusual and interesting differences between men and women when it comes to the phenomenon of lung cancer. Not that cancer is interesting. It’s not. It’s disconcerting, to say the least. What we’re talking about are some thought-provoking differences between men and women when it comes to the rate of lung cancer and to the mechanism of how it develops, that are forcing the medical/cancer research community to reach some important conclusions about women and lung cancer treatment. Here are some important differences between men and women when it comes to lung cancer:

  • The rate of lung cancer among women who have never smoked is growing (15% – 20%), while the incidence of lung cancer among men who’ve never smoked is declining (10%).
  • The rate of lung cancer among women due to smoking is around one-half that of men.
  • Receptors for the female sex hormone estrogen have been detected on lung tumors among women.
  • Scientists studied populations of mice who underwent ovariectomies (surgical removal of ovaries). When treated with estradiol, they developed lung cancer; when treated with anti-estrogens, the process was reversed.
  • There is a growing body of research evidence pointing to the conclusion that combination hormone replacement therapy (HRT) may slightly increase the risk of both getting, and dying, from lung cancer.

One of the critical, fundamental differences between men and women is the presence and relative prominence of hormones; namely, estrogen and progesterone. Researchers began to wonder about whether the role of hormones might be a critical factor behind these differences in rates of cancer. The research data collected so far indicate that lung cancer in women is, at least in part, driven or conditioned or affected by the presence of female hormones.

Hormone Replacement Therapy (HRT)

In a study of 16,000 women, the Women’s Health Initiative (WHT) found that women with non-small lung cancer who are under a combined hormone replacement therapy (HRT) regimen, i.e. taking combined estrogen and progestin, are approximately 59% more likely to die from the disease. This effect was limited only to women who already had non-small cell lung cancer; it did not apply to women who did not have lung cancer or who had small-cell lung cancer.


Clearly, these results are very significant and important for every woman to know who has lung cancer, who has a higher risk for lung cancer (e.g. due to smoking), or who is considering HRT. The decision regarding what course to follow should be undertaken in close, intimate conversation with one’s doctor(s). There is no single “right” course of action to take, because it depends on one’s overall health, the nature of the condition being faced, and the risks of going in one direction versus another. The decision, while ultimately yours, should be an informed one, and that requires a frank, detailed discussion with your health team members. Contact us today to set up an appointment.


August 28, 2019 Educational

At one time in the not-so-distant past, a cancer diagnosis was something close to a death sentence. That is far, far less true these days. As our understanding of the wide variety of cancers grows, and the spectrum of treatment options widens, a cancer diagnosis is no longer regarded as a death sentence. In fact, there is now a great deal of realistic hope for a long and healthy prognosis.

While we may have a ways to go in fully understanding the underlying mechanisms of cancer and in creating effective treatment options for all of them, we have in fact learned much about how cancer works, about what makes some forms of cancer more survivable than others, about what diagnosis procedures have the most promise in helping to create a near-guarantee of survival, and what treatments provide an extremely positive prognosis (estimate of outcome). Here’s a snapshot: the following table illustrates how much has changed in the cancer landscape, and what cancers are most “survivable”.

Table 1. The most survivable cancers according to the US SEER database of cancers diagnosed between 2005 and 2011.

Cancer Type Median age at diagnosis 5-year relative survival
Skin (basal & squamous) unknown 99.9%
Prostate 66 99%
Thyroid 50 98%
Testis 33 95%
Melanoma of the skin 63 92%
Breast (female) 61 89%
Hodgkin’s Lymphoma 38 86%
All childhood cancers 0-14 83%
All cancers (excluding skin) 65 67%

So, what are the most important factors in determining whether a particular form of cancer has a higher (or lower) rate of survivability? Let’s take a look at 3 of the top factors.

  1. Early detection of cancer means earlier treatment and a higher cure rate

In other words, how soon do you feel sick? If unpleasant, odd or unusual cancer symptoms manifest early on in its development, it has a much higher chance of being detected early on in its growth and development. Then, it has a much higher chance of being effectively and completely treated. This is very good news.

First, if the cancer is located in a solid tumor and has not spread when detected, it can much more easily be completely removed/destroyed by the surgeon’s knife or effectively treated with some type of targeted radiation therapy.

Second, if the cancer is a blood cancer (and thus not removable by surgery), if it’s detected early on, hope is quite high for an effective treatment. Blood cancers tend to manifest unpleasant symptoms early in their life, so they tend to be detected and diagnosed early on in the process of disease progression. Again, this contributes to a high probability of very effective treatment.

  1. The more diverse a cancer’s acquired mutations, the more resistant the cancer is to treatment

This factor overlaps with the first one to a degree. The longer a cancer progresses along undetected, the larger the number and more diverse the acquired genetic mutations that will accumulate. And in general, the greater the diversity of genetic mutations, the more likely that one or more of those mutations will prove to be resistant to non-surgical therapy.

So, early detection means more effective treatments and higher rates of survival. Cancers that are detected early on tend to have a smaller, limited number of mutations, making it more likely that a non-surgical treatment (e.g. chemotherapy) will be effective in targeting and killing the cancer cells.

Thus, earlier detection of solid-tumor cancers means a smaller degree of diversity of mutations. This means that early treatment has a greater chance of success, whether that treatment is surgery or a non-surgical treatment such as chemotherapy.

As mentioned earlier, immune system (blood) cancers tend to have unpleasant symptoms quite early in the cancer’s progression, which results in early detection. Again, this means that the cancer has had only a relatively short time (a few months to a few years) to accumulate treatment-resistant genetic mutations. And again, this means that non-surgical treatments for blood cancer such as chemotherapy have a much higher chance of success.

  1. Indolence (slow growth) is a good thing

Certain cancers, such as prostate cancer and thyroid cancer, tend to be very slow-growing. Autopsies done in the US have shown that around 80% of men over 70 years old have some cancer living in their prostate; however, few of them died from this! Small nodules (tumors) of cancer living in the thyroid are so commonplace that they are looked upon as “normal”! Autopsy studies have shown that around 8% of the US population have minute nodules of thyroid cancer, which were not the cause of death either. All of these cancers are very slow-growing.

Let’s look at how these factors play out in several common cancers.

Skin Cancer

Skin cancer has a 99.9% 5-year survival rate, and it’s not hard to understand why. First, while skin cancer is quite common, it is also very easy to remove surgically. Second, since they are on the surface of the skin, skin cancers are also quite easy to detect, early on in the progression of the cancer. Early detection means early treatment, which means a high survivability rate. Surprisingly, this includes melanomas, which are one of the most mutated forms of all the cancer types, and which spread easily to almost anywhere in the body. Yet, the overall 5-year survivability rate for skin melanomas is 98%. Again, this is due to early detection of a skin anomaly or lesion, early skin cancer diagnosis, and early skin cancer treatment (i.e. surgical removal).

Prostate Cancer

Prostate cancer has a 99% 5-year survivability rate. This is because prostate cancers tend to be indolent (slow-growing): they either grow very, very slowly or do not grow at all. This often results in a treatment regimen called “watch and wait,” which means frequent exams to determine if the cancer has changed in any way, such as getting larger or more aggressive. If no change is detected, nothing is done until the next exam. If any change is detected, prostate cancer treatment is generally addressed through surgery or targeted radiation therapy, such as tomotherapy.

Thyroid cancer

Thyroid cancer has a 5-year relative survival rate of 98–100 percent at stages 1 and 2. The thyroid is a gland in the neck that produces hormones to support healthy bodily functions.

Most thyroid cancers grow slowly, which allows more time for treatment to take place. Even when cancer spreads into surrounding tissues in the throat, removing the thyroid gland can be an effective method of eradicating it.


These three cancers are just a sample of those with a greatly improving outlook for a cancer diagnosis and its ultimate prognosis. We are no longer in the dark about many of the underlying mechanisms and processes of cancer and its development, and we are learning more about them every single day. New medications, new forms of chemotherapy, new forms of radiation therapy, immunotherapies, and even more forms of treatment are just beyond the horizon. And we are here to support you in accessing these new and powerful cancer treatments.


You may have heard of immunotherapy, and at least understand that it represents a huge advancement in the treatment of cancer. You may also know that, in broad terms, immunotherapy works by helping the patient’s own immune system work more effectively in finding, attacking, and killing cancer cells. To learn more about what immunotherapy is, and how it works, click here.

Because immunotherapy simply trains the patient’s immune system to work more effectively, you might also think that immunotherapy has no side effects. What we are finding, however, is that that belief is incorrect. Immunotherapy does have a spectrum of side effects. Immunotherapy patients experience side effects approximately 5-10% of the time, and these cases of side effects are life-threatening around 1-2% of the time. Being forewarned is forearmed, so let’s explore the types of immunotherapy side effects that can occur.

Most common side effects: Fatigue & Inflammation

Just like other kinds of cancer treatment, fatigue is one of the most common side effects. Feelings of overall low energy, and/or becoming exhausted quickly and easily when exertion is required, are very common side effects. This kind of physical debilitation can occur within just a few weeks of commencement of treatment but can sometimes not happen until several months – or even years – have passed. Generally, this side effect tends to get better with enough passage of time. However, while this side effect does generally improve with the passage of time, you may not return 100% to your former levels of overall energy or stamina levels. There may be some lingering, low-level fatigue that remains.

Immunotherapy medications can also cause a variety of inflammations throughout the body. Skin inflammation can manifest as a rash, feeling itchy, or as pigment changes, sometimes without a rash. Inflammation of the colon may occur, causing diarrhea and/or abdominal pain. Inflammation of the lungs can occur, causing chest pain and a cough.

Rarer side effects: Diabetes, Endocrine system problems, and Hypophysitis

Side-effects that more rarely occur include development of diabetes (a chronic condition that negatively impacts how the body processes glucose, or in more severe cases, progresses to the point that the pancreas produces little-to-no insulin, the critically important hormone which regulates the amount of glucose in the blood).

Another rarely occurring side effect is damage to the body’s endocrine system, responsible for how the body produces and regulates hormones – all hormones, not just insulin. Another rare, but more concerning side effect is the inflammation of the pituitary gland, known as hypophysitis. Hypophysitis manifests in many different ways, so a definitive diagnosis requires blood work. Symptoms include headache, fever, or fatigue.

Side effects do not depend on cancer type

The side effects described above do not generally depend on the patient’s type of cancer. Rather, they depend more on the type of immunotherapy medication prescribed for cancer treatment.

Management of side effects

Research has found that the most appropriate treatment for the various side effects that occur depends on the severity of the effect. Many patients receiving immunotherapy have already received chemotherapy, so they have most likely already experienced the milder side effects like fatigue, rash, and/or cough. As a result, they have already developed the necessary coping skills and/or method of treatment for them.

When it comes to diarrhea, however, treatment approach is critical. The most highly preferred treatment approach is modification of diet. Limiting dairy products can be very important in this case. The reason that dietary changes are preferred is that anti-diarrheal medications can cause severe, even life-threatening, complications. If the diarrhea problem is severe, your doctor may recommend a temporary cessation of immunotherapy, and replacement with an immunosuppressant. This can help to reduce the inflammation behind the diarrhea to a safer level, yielding improvement in diarrheal symptoms.

Patients who develop diabetes may also require a temporary pause on the immunotherapy drugs, combined with insulin medication treatment. In any case, the temporary pause can help the body to recover, heal, and reduce the severity and/or existence of unwanted side effects. The ultimate goal, however, is to resume immunotherapy treatment; to attack and kill the tumor’s cancer cells.

Side effects have nothing to do with immunotherapy effectiveness

Patients often believe that the presence and severity of side effects is also a measure of the effectiveness of the immunotherapy treatment. This is not true. Patients whose immunotherapy treatment is highly effective often experience no side effects. This can lead them to suspect that they are only receiving a placebo medication in a secret clinical trial, or that the immunotherapy medication isn’t working at all. This is simply not true. Remember: only 5-10% of immunotherapy patients experience any side effects. So, 90-95% of immunotherapy patients have no side effects whatsoever!

Self-awareness is critical

So, the most important advice you can receive relative to the presence or absence of side effects is heightened self (and body) awareness. Pay attention to what your body is trying to tell you, right from the get-go! Make sure that your doctor, as well as your pharmacist, spend lots (and lots) of time with you, going over all the possible side-effects associated with your immunotherapy medication, and make sure you fully understand everything they are saying to you. Ask as many questions as you feel you need to and do not assume that you are a “burden” to them. After all, this is your treatment, and this is your life! You are the one whose life and well-being are being affected. It is your responsibility to ensure that you are completely comfortable with every aspect of your treatment. It is your doctor’s responsibility to ensure that you are, indeed, fully comfortable with all aspects of your treatment.


July 9, 2019 Educational

What is head and neck cancer?

Head and neck cancer is a collective label for cancers that develop in various areas of the head and neck. Most often they start to develop in the thin layer of moist, mucosal tissues that line the nose, throat, and mouth. These thin layers of tissue are made up of flat squamous cells. Most of the cancers that develop in these moist tissues are known as squamous cell carcinomas of the head and neck. More uncommonly, cancer can develop in the salivary glands, but this article will focus on the squamous cell carcinomas of the head and neck.

What causes head and neck cancers?

The two most important risk factors for developing head and neck cancer are drinking alcohol and using tobacco (in any form), particularly cancers of the oral cavity, oropharynx, hypopharynx, and larynx. 75% or more of head and neck cancers stem from alcohol and tobacco consumption. Also, as people get older, their risk of developing head and neck cancers increases. The majority of head and neck cancers develop in people who are older than 45. Further, head and neck cancers are more common among men. The reasons for this are not fully understood.

Another important risk factor for head and neck cancers is the human papillomavirus (HPV). HPV is most commonly known for causing cervical cancer, among others. HPV is particularly implicated in cancers that involve the base of the tongue and the tonsils. HPV-related head and neck cancers generally have a better prognosis (chance of recovery) than those stemming from alcohol and tobacco use.

What are the symptoms of head and neck cancer?

As noted earlier, head and neck cancers can develop in a variety of locations. Because of this, there are also a large variety of symptoms that may indicate developing head and neck cancers. These include symptoms such as:

  • Difficulty and/or pain when swallowing
  • A lump or a sore that does not heal
  • A lump in the neck
  • A sore throat or pain in the neck that does not go away
  • Changes in the voice or increased hoarseness of the voice
  • A white or red patch on the lining of the mouth, the tongue, or the gums
  • Trouble breathing or speaking
  • Sinuses that are blocked and do not clear
  • Chronic sinus infections that do not respond to antibiotics
  • Bleeding through the nose
  • Frequent headaches

It is important to note, however, that these symptoms can also be associated with other, less serious conditions. So, make sure that you first consult with your primary care physician or dentist to determine whether or not your symptoms are due to a less serious, non-cancerous condition or illness.

How are head and neck cancers diagnosed?

If less serious conditions are ruled out, and your doctor suspects that head and neck cancer is possible, the first steps in diagnosing it include an evaluation of your complete medical history, and possibly of your family’s history of cancer. Next will be a detailed physical examination of the entire head and neck area, including the mouth, throat and nasal passages, and possibly other diagnostic tests will be ordered. Ultimately, however, a conclusive diagnosis of head and neck cancer will require surgical removal and examination of a small sample of tissue (a biopsy) under the microscope.

Determining how advanced the cancer is (known as the Stage) will require further studies such as X-ray, other imaging studies such as computed tomography (CT scan) or a positron emission tomography (PET) scan, and laboratory tests. Determining the Stage (extent) of the cancer will aid your doctor or health care team in making an appropriate, effective treatment plan recommendation.

How are head and neck cancers treated?

Appropriate treatment depends on the exact nature of the cancerous tumor, and factors unique to the individual. These factors include the size of the tumor, its exact location, the stage (extent) of the cancer, and on the individual’s general health and age. Treatments for head and neck cancer include surgery, radiation therapy/treatments, chemotherapy, immunotherapy, and targeted therapy. It will often require a combination of more than one treatment. Effective treatment generally will involve an entire team of healthcare professionals, including doctors, nutritionists, and others.

What are the side effects of treatment?

The side effects of treatment for head and neck cancer depends on the type/location of the cancer, and on the type of treatment(s) followed. The most common side effects of radiation therapy can include fatigue, weight loss, difficulty and/or pain with swallowing, mouth sores, dry mouth, thickened saliva, redness and irritation. The common side effects of chemotherapy can include low blood counts, nausea, and changes or loss in taste (some foods may taste different, or be tasteless, after treatment). Loss of taste can have a negative effect on nutrition and needs to be watched carefully. Nausea generally improves soon after the chemotherapy treatments are over. Fatigue and problems with swallowing may take longer to get better.

Surgical removal of the tumor can change the patient’s ability to talk, swallow, or chew. The surgery may also cause swelling of the neck and/or face; however, the swelling generally dissipates after a few weeks. If lymph nodes were removed, this may cause additional swelling, which could last much longer. If the removed lymph nodes are in the neck, the neck and shoulder may become stiff and/or weak. If surgery includes removal of the larynx (laryngectomy) or involved other parts of the neck, the throat and neck may feel numb.

Long-term recovery requires the involvement of a competent team of medical professionals, not only in the treatment of cancer but also in managing recovery. Besides doctors, this team can include speech pathologists, dentists, dental hygienists, and dietitians/ nutritionists. They all play important roles in helping manage treatment side effects, both short and long-term. The patient may also choose to seek professional counseling and join a support group to aid in recovery.


May 29, 2019 Educational

Over many decades our understanding of how cancer starts and spreads has steadily improved. However, many myths and misconceptions about cancer remain and can be widespread. Here we try to dispel some of these myths that might cause you undue stress and lead you down the wrong road when learning about cancer.

Does Sugar Make Cancer Grow Faster?

Nope. While we do know that cancer cells “eat” (consume) more sugar than normal cells, there is no scientific evidence that eating more sugar will make your cancer worse, nor that eating less sugar will cause the cancer to grow more slowly. BUT – this is important – excess sugar consumption, which is epidemic in the United States, can increase the level of risk for gaining weight, and we know that obesity is a high risk factor for diabetes and for developing certain kinds of cancer. So, while sugar in itself does not cause cancer, is contributes to the development of conditions that can increase its risk and should be consumed within limits

How About Artificial Sweeteners (Chemicals)?

Nope. Scientists have conducted extensive research into this question and have discovered no evidence that artificial sweeteners cause cancer or cause it to grow faster. Studies have been done on aspartame (Equal®, NutraSweet®); sucralose (Splenda®); saccharin (Sweet ‘N Low®, Sweet Twin®, NectaSweet®); neotame; acesulfame potassium (Sunett®, Sweet One®) and cyclamate and found no evidence of cancer causation. All of these sugar substitutes (except cyclamate) have been approved by the Food and Drug administration.

Does My Attitude Help or Hinder Cancer Growth or Recovery?

A diagnosis of cancer can lead to a wide spectrum of emotions which are all perfectly normal. While your attitude doesn’t directly affect the growth or regression of a tumor, it can be very important in upkeeping physical activity (exercise), nutritional intake, and also maintaining a strong social support network which in turn can make an impact on how treatment is managed. We do know that with a positive attitude the treatment process can be easier to adjust to and can potentially make recovery itself better as well.

Can Biopsy or Surgery of a Cancerous Tumor Cause It to Spread?

Thankfully, the chance of that happening is exceedingly low. Nowadays, surgeons utilize methods and protocols and take many steps to ensure that that does not happen. As an example, if surgeons need to remove tissue from more than one place in the body, they use separate sterilized tools for each location to prevent this very thing from happening.

Is It Possible to “Catch” Cancer?

Not in general. Cancer is not contagious. You can’t “catch” it from another person and it doesn’t spread from person to person like a virus or bacterial illness. Remember, cancer is caused by a genetic mutation. The only exception to this is in the case of an organ transplant where the donor had cancer in that organ. This however doesn’t happen anymore since organ donors are screened for cancer and those organs cannot be donated.

There are certain viruses and bacteria (e.g. human papillomavirus, or HPV, and bacteria such as Helicobacter pylori) that can eventually lead to certain types of cancer. In some cases, like with HPV, there can be person to person transmission of the virus itself but not the cancer that it can lead to

Can My Cell Phone Give Me Cancer?

No, based on the scientific research studies done thus far. Cancer is due to genetic mutation and cell phone’s emission of low-frequency energy does not cause genetic mutations.

Can Power Lines Cause Cancer?

Once again, no, according to all the research done thus far. Just like cell phones, power lines emit low-frequency magnetic energy, and like cell phones, that magnetic energy does not cause genetic mutations. Besides, power lines are well-shielded and weakened by walls in homes or elsewhere.

Do Herbal Remedies Cure Cancer?

Contrary to certain belief systems that are widespread today, there are NO herbal products that cure cancer. There are a few studies that suggest that some herbal remedies may help patients to cope with cancer; however, they do not cure it. Before taking any herbal remedies, discuss it with your oncologist as some herbal products may in fact interfere with the effectiveness of chemotherapy or radiation therapy.

Can I inherit cancer?

90 – 95% of cancers develop because of cellular genetic mutations that take place during the patient’s lifetime – in other words, they are not inherited. They develop from the natural process of aging, or through repeated exposure to a carcinogenic substance in the environment, such as tobacco smoke. However, around 5 – 10% of cancers do result from inheriting a genetic mutation from a parent. In such relatively rare cases, multiple family members may develop the same type of cancer due to the inheritance of the harmful mutated gene from a parent. These are called “inherited” or “familial” cancers. Examples of this can be seen with breast and colon cancers.

Can Deodorants/Antiperspirants Cause Cancer?

In short, no. There is no scientific evidence that links the active ingredients in deodorants and antiperspirants to genetic changes resulting in cancer.

Does Hair Dye Cause Cancer?

To date, there is no scientific evidence that personal use of hair dye increases the risk of cancer. There are studies, however, suggesting that hairdressers/barbers who are more regularly and routinely exposed to hair dye in large quantities may have a greater risk of developing bladder cancer.

If Nobody in My Family Has Cancer, Am I Protected?

No. Remember that cancer develops from spontaneous genetic mutations that occur throughout life due to aging and repeated exposure to certain environmental factors, such as too much sun radiation, smoking tobacco, repeated exposure to dangerous chemicals, how you eat, whether or not you exercise, and simply the process of aging.

Is Cancer Practically a Death Sentence?

Not so fast. That may have been true during decades and centuries gone by. However, starting around the 1990’s, the likelihood of dying from cancer has steadily become less and less. For thyroid, breast and prostate cancers, the survival rate is now 90 percent or better. And the overall survival rate for all cancers combined has increased to around 67 percent.

Of course, this is aggregate data. In any individual case, several factors will alter those statistics, such as the rate of growth of the cancer cells, the degree to which the cancer has spread throughout the body, the availability of certain treatments, and your general health profile.


National Cancer Institute: “Common Cancer Myths and Misconceptions”

About HHO

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