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May 21, 2019 Success Stories

At the age of 22, Ashley McRoy was diagnosed with stage 4 colon cancer and given a 20 percent chance of survival. Doctors at Hunterdon Regional Cancer Center made sure she made it to her wedding day — and beyond.

It was a joyous, teary-eyed day at Kleinfeld, the famous New York City bridal boutique and setting for TLC’s hit show, “Say Yes to the Dress.”

Bride-to-be Ashley McRoy, 28, radiated grace in her sleek white gown. Even her father, Jerry, the group’s harshest critic, glowed. Trying on wedding dresses is a dream come true for most women; but for Ashley and a team of Hunterdon Regional Cancer Center doctors and nurses, this made-for-TV moment represented so much more.

That’s because Ashley has now been cancer-free for 18 months, and she credits Hunterdon Regional Cancer Center with her recovery from a rare and deadly form of cancer.

Seven years ago, Ashley was attending Raritan Valley Community College. She was also just starting her modeling career when she felt a hard knot by her belly button. Two weeks later, the knot had grown bigger. Ashley’s mother, Louise, called the family doctor, which led to a CT scan and the shocking news: Ashley had stage 4 signet cell adenocarcinoma in her colon.

“The cancer was incredibly rare and high risk,” says Myron Bednar, M.D., Medical Oncologist and Director of Clinical Trials at Hunterdon Regional Cancer Center. Ashley was given a 20 percent survival rate.

“Her type of colon cancer wasn’t typical,” explains Dr. Bednar. “This one featured more aggressive cells.”

Hunterdon Healthcare staff began treatment right away. Cancerous tumors were removed from Ashley’s colon and abdominal cavity. After the surgery, she utilized Hunterdon Regional Cancer Center’s considerable resources.

“She benefited from our social services to help her cope, though she did a great job on her own,” Dr. Bednar says. “She worked with a dietitian for nutritional help while going through biological therapy, and she got state-of-the-art chemotherapy and radiation treatments.”

It was a long journey: The cancer recurred in October of 2012, and had spread to part of her kidneys. She needed a second surgery, and then returned to Hunterdon Regional Cancer Center for follow-up care.

After a final round of chemotherapy and radiation, Ashley at last received the news she longed to hear: the cancer was gone. Today, with cancer behind her, the Wilhelmina-represented model and graphic designer is continuing to model, and wants to share her story with others.

Most importantly, she wants to savor life, starting with her April 5 marriage to boyfriend James Disney, who was constantly by her side throughout treatment. In fact, Ashley was featured on “Say Yes to the Dress” in part because of her incredible cancer recovery.

“I’ve been so incredibly blessed,” she says. “I want to move forward, to look at life more positively. I’m learning to see the glass as half-full.

“Everyone at the Hunterdon Regional Cancer Center treated me amazingly,” she adds. “They are my family.” In fact, Dr. Bednar, along with gastroenterologist Samuel Bae, M.D., and surgeon John Bello, M.D., were invited to Ashley’s wedding.

“James and I have been through a lot,” Ashley jokes. “We can survive being married!”

CONCERNED ABOUT YOUR RISK FOR CANCER? Learn more about the Family Risk Assessment Program (FRAP) at Hunterdon Regional Cancer Center by calling 908.237.2330.

 


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May 21, 2019 Cancer Treatment

According to the American Cancer Society, lung cancer is the second most common cancer among men and women and the leading cause of death in the United States. In 2014, it is estimated that 224,210 people will be diagnosed with lung cancer. Hunterdon Regional Cancer Center was selected as the only cancer facility in New Jersey to offer a clinical study on a new lung cancer investigational drug called Nivolumab, which is made by Bristol-Myers Squibb.

“This clinical study uses immuno-therapy as a new approach for treating lung cancer. This therapy uses the patient’s own immune system to attack the cancer cells,” stated Myron Bednar, M.D., Medical Oncologist, Hunterdon Regional Cancer Center. Dr. Bednar further explained, “Nivolumab works by blocking the protein called PD-1. The PD-1 antibodies stop lung cancer cells from blocking the body’s natural immune response to cancer. A drug that can inhibit PD-1 may be able to treat a variety of cancers, which is very exciting.”

Patients who may be eligible for the study have been diagnosed with advanced stage lung cancer and have undergone at least one therapy prior to entering this trial. “The benefit from standard therapy is limited for this patient population. Our hope is that this drug will keep the cancer from growing and have the patient’s immune system do the work of killing the cancer cells, versus drugs that may have many side effects, said Kenneth Blankstein, Medical Oncologist at Hunterdon Regional Cancer Center. Dr. Blankstein also mentioned, “We are pleased to be able to provide this trial in our community. We are not only the only cancer facility in New Jersey testing this drug in a clinical trial, but the only one in the tri-state area. The next closest facility is in Tennessee.”

Pictured left to right: Kathy Robbins, RN, MSN, OCN, Clinical Research Nurse at Hunterdon Regional Cancer Center works closely with patients on clinical trials. Kathy talks to Daria Shepherd and provides comfort and education during her treatment at Hunterdon Regional Cancer Center.

Daria Shepherd of Kingwood Township was diagnosed with advanced stage lung cancer in December. Ms. Shepherd had gone to her family doctor because of a pain she was having on her side. An ultrasound showed that the pain was the result of a cyst on her ovary, but the test also found a spot on her lung. A chest scan and a biopsy determined it was cancer. “I started chemotherapy, but it wasn’t effective for my type of cancer, so Dr. Bednar thought I would be an ideal candidate for the Nivolumab clinical trial,” stated Ms. Shepherd. Shepherd added, “This is my second week receiving the drug and I feel good, it has not had any side effects that have interfered with my life.” In fact, Ms. Shepherd was heading out to Spruce Run to fish with her family after her treatment.

Through Hunterdon Regional Cancer Center’s partnership with Fox Chase Cancer Center in Philadelphia, physicians have access to many clinical research trials, which are administered by specially trained staff. Current trials offered at Hunterdon Regional Cancer Center include new treatment protocols for lung cancer, breast, gastrointestinal cancers, as well as lymphoma and melanoma. To learn more about clinical trials at Hunterdon Regional Cancer Center, call Kathy Robbins, RN, MSN, OCN, Clinical Research Nurse at Hunterdon Regional Cancer Center at 908-237-2330 ext. 2.


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May 21, 2019 Press

Dr. Kenneth B. Blankstein, an oncologist in Flemington, N.J., is treating a woman for lung cancer. She responded well to the first chemotherapy drugs he prescribed. When her health was stable, he gave her a “temporary break” from chemo to spare her some of its side effects.

But when he tried to return her to the treatment, the insurer balked, saying that the “temporary break” was evidence that the treatment had failed. Despite Blankstein’s protests, the insurer said she would have to move next to Tarceva, another treatment.

“She had under a 5 percent chance of a response on Tarceva,” he said. “Yet they insisted, so we had to.”

As Blankstein expected, the patient did not respond, but instead of letting her return to the first chemo cocktail, the insurer insisted she try another drug first.

The patient ultimately switched to Medicare, which covered the first chemotherapy protocol. Her health is stable.

“The patient’s being told to use a drug we know isn’t going to work, but we have to use it anyway for someone with terminal illness? To me that’s just insane, but it’s the way they do things,” Blankstein said. “It’s taken away clinical judgment. It’s managing by algorithms.” Read the whole article.


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April 2, 2019 Cancer Treatment

Cancer immunotherapy uses the immune system or the body’s defense system to fight cancer. Before learning more about immunotherapy, you may want to read a quick overview of how the immune system works.

Immune System Overview

The immune system protects the body against diseases. Immune system cells called antigen-presenting cells patrol the body. When antigen-presenting cells find foreign cells, such as viruses and bacteria, they send a signal to special cells called T-cells, which attack the foreign cells. After all foreign cells have been killed, an immune system regulator called a checkpoint sends a signal to T-cells to stop their attack. This prevents T-cells from killing healthy cells.

What is immunotherapy for cancer?

Cancer cells are different than viruses and bacteria because they disguise themselves as normal, healthy cells. Antigen-presenting cells are not able to detect cancer cells, so a signal is never sent to T-cells. Thus, cancer cells multiply and spread and cancer progresses into more serious stages.

Immunotherapy stops immune cells from being tricked. There are different types of cancer immunotherapy. Each helps the immune system recognize cancer cells and start an immune response against them. This treatment approach is new and promising because it uses the body’s own resources, rather than surgery, radiation, or chemotherapy, to treat cancer. In many cases, this means there may be less unwanted treatment side effects.

How effective is immunotherapy?

Cancer immunotherapy may help cancer go into remission, or even cure it in some cases. It may not work for all patients and all cancers. And because it is a relatively new treatment option, more research needs to be done to determine exactly which patients can benefit.

Still, there are certain tests that doctors can perform that may help them decide if immunotherapy can help a patient. Protein level tests and genetic tests are the two most common. High protein levels and DNA changes in cancer cells may predict that cancer will respond well to immunotherapy.

What is the difference between immunotherapy and other types of cancer treatments?

Each cancer treatment option works differently. The five treatment options are:

  1. Surgery. Cancer tissue is surgically removed.
  2. Radiation therapy. X-rays break DNA in cancer cells, which prevents them from growing and spreading.
  3. Chemotherapy. Drugs destroy cancer cells.
  4. Targeted therapy. Drugs target cancer cells’ genes and proteins to stop them from working properly, which can stop cells from growing, or even kill them.
  5. Immunotherapy. Different types of treatments are used to start an immune response against cancer cells.

Certain treatments may be used for certain cancers. In some cases, multiple treatments may be used.

Distinguishing features of each type of cancer treatment are:

  • Surgery may be effective for some early stage cancers
  • Radiation therapy and chemotherapy destroy healthy cells, which may cause unpleasant side effects
  • Targeted therapy and immunotherapy may only be effective for some patients and some cancers

A board-certified and fellowship-trained oncologist works with patients to find the most appropriate treatment option(s).

What types of cancer can be treated with immunotherapy?

Cancer immunotherapy has been tested on many of the most common types of cancer. An oncologist may recommend immunotherapy to treat:

  • Bladder cancer
  • Breast cancer
  • Head and neck cancer
  • Kidney cancer
  • Lymphoma
  • Prostate cancer
  • Small cell lung cancer
  • Melanoma/ Skin cancer

Research is being done to test immunotherapy on other types of cancer.

How is immunotherapy treatment given?

Cancer immunotherapy treatment is given at an oncologist’s office or an outpatient hospital unit. An overnight hospital stay is not necessary. Treatment may be administered:

  • Intravenously
  • Orally
  • Topically (for skin cancers)
  • Intravesical (through the bladder)

The patient’s response to treatment is closely monitored. Physical exams, blood tests, and scans are performed to see if cancer cells are responding to treatment.

How long does it take for immunotherapy to work for cancer?

Depending on the type of immunotherapy, treatment may be given daily, weekly, or monthly. There may be a break in treatment to give cells a chance to rest. Another therapy cycle may start after the break. The number of cycles a patient receives depends on the type of treatment and the type of the cancer. In some cases, immunotherapy may be combined with other cancer treatments.

The amount of time it takes for cancer immunotherapy to work is different for every patient. As previously mentioned, each patient’s response to treatment is closely monitored. Patients visit their oncologist frequently while undergoing treatment. The oncologist asks the patient questions about their symptoms and health. Answers to the questions and the medical study results give the oncologist important information about how well the immunotherapy is working.

More about cancer immunotherapy…

This article is the first of a three-article series on cancer immunotherapy. In the next article, you will learn more about different types of immunotherapy in detail.

 

Sources:
National Cancer Institute: “Immunotherapy to Treat Cancer“

Cleveland Clinic: “Immunotherapy: Is It Right for Your Cancer Type?”

WebMD: “How Immunotherapy Works to Kill Cancer Cells“


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March 7, 2019 Cancer Treatment

Strides in medicine have increased our understanding of its many forms

The American Cancer Society predicts that one in eight women will be diagnosed with breast cancer. Although much less common, they predict that in 2019, 2,670 new invasive breast cancer cases will be diagnosed in men. If you or a loved one has been diagnosed with breast cancer, it quickly becomes apparent the term ‘breast cancer’ can have a complicated definition. The last decade has seen huge strides in the disease’s diagnosis and treatment.

An important factor in making such progress has been an increased understanding of the different types of breast cancer. Two useful markers that differentiate the many types of breast cancer are the roles of hormone receptors in the disease’s growth and the location of the disease in the body.

Types of Breast Cancer Based On Receptors

Hormone Positive (HR-positive) and Hormone Negative (HR-negative) Breast Cancer

If a cancer has been labeled HR-positive, its cells have receptors for estrogen and progesterone hormones. Scientists believe these cancer cells grow because they are responding to signals sent by these hormones. If the cancer is labeled HR-negative, the estrogen and progesterone receptors are not present. In addition to isolating the type of hormones that may be driving cell growth, physicians also test for HER2 proteins.

HER2 Positive (Her2+) and HER2 Negative (HER2-) Breast Cancer

The HER2 protein indicates the activity of the HER2 gene. This gene plays a central role in breast cell growth. When there is too much protein present, the diagnosis is said to be HER2+. When little or no protein is present, the cancer is HER2-. HER2-negative cancers tend to grow at a slower rate that HER2+ cancers.

Triple Negative Breast Cancer

Triple negative breast cancer is both estrogen and progesterone negative, as well as HER2 negative. The term ‘triple negative breast cancer’ is not an official medical term, but it is commonly used to describe the approximately 10-20% of cancers that fit into this category. This cancer is associated with the BRCA1 gene and is more likely to affect young people.

Types of Breast Cancer Based On Location

Invasive Lobular Carcinoma

One of the most common types of breast cancer is invasive lobular carcinoma. This cancer is in the breast lobules, which are the areas that produce milk. This cancer most often occurs in women who are 60 years old or older. Unlike other manifestations of cancer that form in lumps, invasive lobular carcinoma spreads in lines though fatty tissue – which can sometimes make it more difficult to detect. Fortunately, it is common for this cancer to be HR+, which means medication can be taken to block the effect of hormones on the cells.

Invasive Ductal Carcinoma

Ductal carcinoma is the most common type of breast cancer and begins in the milk ducts. In many cases it is non-invasive. However, when the cancer spreads outside of the milk ducts, it is then invasive ductile carcinoma. Unlike lobular carcinoma, this disease usually manifests as a mass or lump.

Cancer Treatment

Fortunately, there are now many options available for cancer treatment, and they can be broken down into two broad categories: local and systemic.

  • Local treatments concentrate on removing or shrinking tumors in a specific location – without affecting other parts of the body. Surgery and radiation are standard methods for local cancer treatment, and they are frequently used in the early stages of cancer.
  • Systemic treatments are drugs taken by mouth or injection that reach cancer cells throughout the body. This type of cancer treatment includes chemotherapy, hormone therapy and targeted therapy. Depending on what is needed, they can be administered before, during or after local treatments. If treating the disease with surgery or radiation is not an option, they may be used as the primary form of therapy.

Have you or a loved one recently been diagnosed with one of the many types of breast cancer and have questions regarding diagnosis or treatment? Our cancer specialists are dedicated to making strides in the fight against cancer. Hunterdon Hematology Oncology is home to the nationally recognized regional breast-care program at the Hunterdon Regional Cancer Center. Call us today to schedule an appointment with one of our oncologists.


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February 26, 2019 Cancer Treatment

When we think of breast cancer, the prevailing thought is that it only applies to women. This, however, is not true. Men also experience breast cancer, even though it is much less common with only approximately 1% of all breast cancers occurring in men. In 2019, about 2,670 men are expected to be diagnosed with this disease. For men, the lifetime risk of being diagnosed with breast cancer is about 1 in 1,000.

Though men do not have what we typically think of as breasts from a physical perspective, they do still have breast tissue. Men typically will not grow entire breasts because of the lack of breast-stimulating hormones. As a result, their breast tissue usually stays flat and small. Men can sometimes develop real breast gland tissue because they take certain medicines or have abnormal hormone levels.

What Increases the Odds of Male Breast Cancer

  • When the man is between the ages of 60 and 70
  • A close female relative has breast cancer
  • History of radiation exposure of the chest
  • Enlargement of breasts (called gynecomastia) from drug or hormone treatments, or even some infections and poisons
  • Taking estrogen
  • When the man has Klinefelter’s syndrome, a rare genetic condition
  • Severe liver disease, called cirrhosis
  • Diseases of the testicles such as mumps orchitis, a testicular injury, or an undescended testicle

Symptoms of Breast Cancer in Men

Breast cancer symptoms in men are similar to those in women. A lump in the breast area is a symptom of breast cancers in men. Other symptoms can include nipple abnormalities such as inversion or nipple discharge which could even include blood. When this happens it is important to see your physician as soon as possible to be properly assessed to avoid any delay in diagnosis.

Diagnosis and Treatment

We use the same techniques that are used to diagnose breast cancer in women to diagnose men. These include physical exams, mammography, and biopsies. In addition, we employ the same forms of treatment for female breast cancer — surgery, radiation, chemotherapy, biological therapy, and hormone therapy — to treat breast cancer in men. The one major difference is that men with breast cancer respond much better to hormone therapy than women do. About 90% of male breast cancers have hormone receptors, meaning that hormone therapy can work in most men to treat the cancer.

Hunterdon Hematology and Oncology, as part of the Hunterdon Regional Breast Care Program (HRBCP), specializes in a coordinated approach to breast cancer care, in both men and women. If you or someone you know is in need of breast cancer care, contact us today to schedule a consultation




About HHO


Hunterdon Hematology Oncology is a community oncology group, dedicated to fighting cancer in this community and across the region. Our Doctors, Physician’s Assistants and Nurses work tirelessly. They fight hard so that you can win.




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