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A difficult conversation: Talking to children about breast cancer

2018-05-15T07:01:00

(BPT) – At some point, many adults will have to face a difficult conversation with a young child (aged 5-8) who is important to them, whether it is about bullying or trouble in school. But most adults never imagine needing to explain something quite as serious as breast cancer unless they are faced with a diagnosis in the family.

This year, thousands of families will be challenged with sharing the news of a breast cancer diagnosis with children.[1] An already trying topic can become that much more difficult when complicated questions or unexpected reactions arise. For those about to undertake such a discussion, it helps to prepare, to be open and honest, and to feel confident in having this conversation.

Of course, talking about cancer isn’t a “one and done” situation — discussions may take time and be ongoing — but opening the dialogue and acknowledging a child’s concerns are important first steps.[2]

A first-of-its-kind mobile app in the U.S. is now available to support families facing these difficult conversations. The Celgene Magic Tree mobile app, developed with input from patient advocacy groups and doctors, is an interactive tool designed to help families and their children (ages 5 to 8) have meaningful and open discussions about a breast cancer diagnosis.

The app features age-appropriate animated videos that address common questions young children may have about cancer, such as:

  • What is cancer?
  • Can I catch cancer?
  • Is it my fault?
  • How do you treat breast cancer?

Each video is paired with an interactive one- or two-player game to help keep children engaged. A child-friendly glossary of common terms, as well as a discussion guide for parents, help to navigate this difficult conversation.

When talking to young children about cancer, here are some tips you may want to keep in mind in initiating conversations:

1. Start with the basics

Without proper context, a child may be overwhelmed when they hear the word “cancer.” Asking what they already know or believe about cancer can break the ice. Once you’ve established your starting point, you can help fill in the gaps or address misconceptions.

2. Be honest about what you know

Cancer is complicated; even science still can’t fully explain how and why cancer occurs, and you aren’t expected to either. If you don’t know the answer to a question, assure children you will do some research and let them know what you learn.

3. Explain that breast cancer is not something they can “catch”

Some children may think that a healthy person can “catch cancer,” like a cold or the flu. Letting children know that cancer is not contagious can help ease concerns. Specifically naming what kind of cancer you or your loved one is dealing with can provide additional context.

4. Explain possible changes

There are different options for breast cancer treatment and each approach may be accompanied by changes in behavior or appearance.[3],[4] While it may not be necessary to go into detail on how a treatment works, it may help to provide an understanding of some basic side effects, such as hair loss and weight loss, to help reduce confusion if changes occur.[4]

5. Remind them that it isn’t their fault

Children may feel partially responsible when a family member has breast cancer. Reassurance that it isn’t their fault can help ease anxieties.

To offer further support about talking to children about cancer, as well as about breast cancer overall, the Magic Tree app provides a list of resources including links to several breast cancer organizations.

The Magic Tree app is available for download in the U.S. on both Apple and Android devices.


[2]Care.com. Difficult Conversations with Kids. Available at https://www.care.com/c/stories/3447/difficult-conversations-with-kids/. Accessed March 2018.

[3]American Cancer Society. Treating Breast Cancer. Available at https://www.cancer.org/cancer/breast-cancer/treatment.html. Accessed March 2018.

[4]American Cancer Society. Chemotherapy Side Effects. Available at https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html. Accessed March 2018.


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Hope for ‘suicide headache’ sufferers

2018-05-14T07:01:01

(BPT) – While all of us have experienced the dull pain of a headache and some know the recurrent pulse and throbbing of migraine, few people can understand the severity of pain associated with cluster headache, also known as “suicide headache.”

What is cluster headache?

Cluster headache is an extremely painful primary headache disorder characterized by recurring unilateral attacks, or attacks that occur on one side of the head. It is called “cluster” headache because headaches typically occur in bouts (or “clusters”) for 6 to 12 weeks, often at the same time each year or day, and are more frequent at night. It begins as sharp pain centered at the eye, temple or forehead, and can be as brief as 15 minutes or as long as several hours. Attacks can strike up to 8 times a day.

The condition, which affects about one to two people in every 1,000, predominantly occurs in males, with symptoms typically manifesting by the age of 30. Those at greater risk of cluster headache include heavy smokers and individuals with a family history of the condition.

“Cluster headache is one of the most painful conditions an individual can experience, known for being potentially more excruciating and debilitating than migraine,” said Stephen Silberstein, M.D., from the Jefferson Headache Center at Thomas Jefferson University in Philadelphia, Pennsylvania. “Sadly, patients diagnosed with cluster headache commit suicide twenty times more than the national average as the pain can be described as unbearable.”

Diagnosis and treatment

Unfortunately, diagnosis of cluster headache may be delayed significantly due to patients and physicians mistaking the end of a bout for resolution of a separate, standalone condition.

Historically, even after the proper diagnosis is made, there have been very few viable therapies for cluster headache, making prevention and treatment strategies a challenge. While the exact cause of cluster headache is unknown, it is typically treated with injectable sumatriptan, a combination of oxygen and various drugs and/or nerve blocks. These methods are associated with barriers to use including a myriad of pharmaceutical side effects. Not surprisingly, 79 percent of patients have been dissatisfied with available treatment options.[1]

Today, patients now have a novel treatment option called gammaCore®(nVNS). gammaCore, the first non-invasive vagus nerve stimulation therapy applied at the neck for the acute treatment of pain associated with migraine and episodic cluster headaches in adult patients, offers a way to treat symptoms without many of the side effects and dose limitations observed with commonly prescribed treatments or the need for invasive and costly procedures. Patients prescribed gammaCore can have reliable access to treatment for up to four cluster attacks per day for 30 days.

“gammaCore has shifted the paradigm by allowing patients to self-administer non-invasive vagus nerve stimulation therapy for acute treatment of cluster headache, resulting in the reduction of pain,” notes Dr. Silberstein. “gammaCore’s efficacy and safety profiles, along with its self-administered mode of delivery, have the potential to not only reduce the side-effect burden associated with other medications but also bring much needed relief to patients.”

For more information on cluster headache and treatment with gammaCore (non-invasive vagus nerve stimulator), please visit http://gammacore.com/.

Important Safety Information

gammaCore (non-invasive vagus nerve stimulator) is indicated for the acute treatment of pain associated with episodic cluster headache and migraine in adult patients.

  • The safety and effectiveness of the gammaCore non-invasive vagus nerve stimulator (nVNS) has not been established in the acute treatment of chronic cluster headache.
  • gammaCore has not been shown to be effective for the prophylactic treatment of migraine headache, chronic cluster headache, or episodic cluster headache.
  • The long-term effects of the chronic use of gammaCore have not been evaluated.
  • Safety and efficacy of gammaCore has not been evaluated in the following patients, and therefore is NOT indicated for:
    • Patients with an active implantable medical device, such as a pacemaker, hearing aid implant, or any implanted electronic device
    • Patients diagnosed with narrowing of the arteries (carotid atherosclerosis)
    • Patients who have had surgery to cut the vagus nerve in the neck (cervical vagotomy)
    • Pediatric patients
    • Pregnant women
    • Patients with clinically significant hypertension, hypotension, bradycardia, or tachycardia
  • Patients should not use gammaCore if they:
    • Have a metallic device such as a stent, bone plate, or bone screw implanted at or near their neck
    • Are using another device at the same time (e.g., TENS Unit, muscle stimulator) or any portable electronic device (e.g., mobile phone)

Note: This list is not all inclusive. Please refer to the gammaCore Instructions for Use for all of the important warnings and precautions before using or prescribing this product.

gammaCore is available by prescription only. U.S. Federal Law restricts this device to sale by or on the order of a licensed healthcare provider.


[1] *Survey conducted in October 2016 to assess the impressions and perspectives on current treatments and interest in new acute treatment options. A total of 291 subjects participated in the survey, with 177 of them suffering from episodic cluster headaches and 111 suffering from chronic cluster headaches, and 3 patients refrained from answering this question.


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Approved treatment provides an option for adults with follicular lymphoma when the disease has come back after treatment with at least two prior medicines

2018-05-14T07:01:01

(BPT) – Recently, World Cancer Day was commemorated, which is an annual effort focused on raising awareness of cancer and those impacted by the disease around the world. This day is another reminder of the impact the progress being made in oncology has on the cancer community, particularly patients facing the need for additional treatment options. One patient’s story truly showcases just how the lives of people impacted by cancer are improved with a curative resolve through science and innovation.

Receiving a diagnosis of follicular lymphoma (FL) felt “like getting hit in the face with a brick,” recalls Brenda Montgomery of Carrollton, Kentucky. Active and healthy throughout her life, Montgomery never expected a routine gynecological checkup to lead to a nine-year battle with FL, the most common form of indolent non-Hodgkin’s lymphoma.1 Nor could she have guessed she would relapse after receiving first- and second-line treatment, leaving her with few options until the U.S. Food and Drug Administration (FDA) approval of another treatment option for patients like Brenda.

“When I was first diagnosed, my husband and I had a three-day pity party,” she says of her initial diagnosis. “I wondered why me, when I’d been so healthy my whole life. I felt like I was too young to die, so when we were done with our pity party, we got up and decided ‘What are we going to do next?’ and we started treatment.”

Some patients, like Montgomery, experience initial success with first- and second-line treatments, only to find out later on that their disease has come back.

“Often, patients who are diagnosed with lymphoma initially know little about the disease, and those diagnosed with a rarer form, such as follicular lymphoma, may be even less aware at first what their diagnosis means,” says Dr. Don Stevens, Medical Oncologist, Norton Cancer Institute, Louisville, KY, Montgomery’s physician and investigator in the clinical trial of this treatment that led to its approval. “They may have experienced no symptoms prior to diagnosis, or they may be diagnosed when their follicular lymphoma is in a more advanced stage. Many patients’ follicular lymphoma may come back after first- and second-line forms of treatments, but currently, only a small portion of patients receive systemic therapy in third-line and beyond after initial treatments fail. It’s important for these patients to know they now have another treatment option in the third-line that has been FDA-approved.”

A different option

In February 2016, Montgomery made the decision to participate in a clinical trial of Aliqopa (copanlisib) 60 mg vial for injection. The study, known as CHRONOS-1, was investigating the safety and effectiveness of Aliqopa in 104 adult patients with FL when the disease has come back after treatment with at least two prior medicines.2 Fifty-nine percent of patients (61 of 104) had a response to the drug in the clinical trial, and the average duration of response was about one year (median of 12.2 months).2

Following an FL diagnosis

If you’ve been diagnosed with FL, it’s important to know some basic facts about the disease, including:

  • Often, people with FL have no obvious symptoms of the disease at diagnosis; however, some common symptoms may include enlarged lymph nodes in the neck, armpits, abdominal area or groin. You may experience fatigue, feel short of breath, have night sweats or unexplained weight loss.3
  • Relapse is common, although remission may last for years.3

If your FL has come back after two prior treatments, consider talking to your doctor about Aliqopa as an appropriate treatment option.

What is ALIQOPA?2

ALIQOPA is a prescription medicine used to treat adults with follicular lymphoma (FL) when the disease has come back after treatment with at least two prior medicines.

Aliqopa went through a faster FDA approval process because of how it caused FL tumors to shrink. Data gathered from an additional trial may be needed for continued approval of its current use.

It is not known if ALIQOPA is safe and effective in children.

Important Safety Information

ALIQOPA can cause serious side effects, including:

Infections: ALIQOPA can cause serious infections that may lead to death. The most common serious infection was pneumonia. Tell your healthcare provider right away if you have a fever or any signs of an infection during treatment with ALIQOPA.

High blood sugar (hyperglycemia): High blood sugar is common following ALIQOPA infusion and can sometimes be serious. Tell your healthcare provider if you develop any symptoms of hyperglycemia during treatment with ALIQOPA. Symptoms of hyperglycemia may include being very hungry, being very thirsty, frequent urination and headaches.

High blood pressure (hypertension): High blood pressure is common following ALIQOPA infusion and can sometimes be serious.

Lung or breathing problems: Your healthcare provider may do tests to check your lungs if you have breathing problems during treatment with ALIQOPA. Tell your healthcare provider right away if you develop new or worsening cough, shortness of breath, or difficulty breathing.

Low white blood cell count (neutropenia): Neutropenia is common with ALIQOPA treatment and can sometimes be serious. Your healthcare provider will check your blood counts regularly during treatment with ALIQOPA. Tell your healthcare provider right away if you have a fever or any signs of infection during treatment with ALIQOPA.

Severe skin reactions: Skin peeling, rash, and itching are common with ALIQOPA and can sometimes be serious. Tell your healthcare provider if you develop skin peeling, itching, or rash during treatment with ALIQOPA. Your healthcare provider may withhold treatment, decrease your dose, or permanently stop treatment if you develop severe skin reactions during treatment with ALIQOPA.

Before receiving ALIQOPA, tell your healthcare provider about all of your medical conditions, including if you:

  • have an infection
  • have lung or breathing problems
  • have high blood pressure (hypertension)
  • have diabetes or high blood sugar (hyperglycemia)
  • are pregnant or plan to become pregnant. ALIQOPA can harm your unborn baby.
    • Your healthcare provider will perform a pregnancy test before starting treatment with ALIQOPA.
    • Females who are able to become pregnant should use effective birth control (contraception) during treatment with ALIQOPA and for at least 1 month after the last dose of ALIQOPA. Talk to your healthcare provider about birth control methods that may be right for you. Tell your healthcare provider right away if you become pregnant or think you are pregnant during treatment with ALIQOPA.
    • Males with female partners who are able to become pregnant should use effective birth control (contraception) during treatment with ALIQOPA and for at least 1 month after the last dose of ALIQOPA.
  • are breastfeeding or plan to breastfeed. It is not known if ALIQOPA passes into your breast milk. Do not breastfeed during treatment with ALIQOPA and for at least 1 month after the last dose of ALIQOPA. Talk to your healthcare provider about the best way to feed your child during treatment with ALIQOPA.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Certain other medicines may affect how ALIQOPA works.

Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

What should I avoid while receiving ALIQOPA?

  • Avoid taking St. John’s Wort during treatment with ALIQOPA.
  • Avoid drinking grapefruit juice during treatment with ALIQOPA.

The most common side effects of ALIQOPA include:

  • low white blood cell count (leukopenia)
  • low platelets in your blood (thrombocytopenia)
  • diarrhea
  • decreased strength and tiredness
  • lower respiratory tract infection
  • nausea

These are not all of the possible side effects of ALIQOPA. Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088.

For full prescribing information, visit:

http://labeling.bayerhealthcare.com/html/products/pi/Aliqopa_PI.pdf

1Cancer.net. Lymphoma – Non-Hodgkin: Subtypes. http://www.cancer.net/cancer-types/lymphoma-non-hodgkin/subtypes. Accessed March 2018.

2Aliqopa™ injection [Prescribing Information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals, September 2017.

3Lymphoma Research Foundation. Follicular Lymphoma. 2017. Available at:

http://www.lymphoma.org/site/pp.asp?c=bkLTKaOQLmK8E&b=6300155. Accessed March 2018.

PP-860-US-0252


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How to Protect Your Heart Health This Mother’s Day

2018-05-11T11:01:00

(BPT) – Worldwide, cardiovascular disease remains the number one killer of women and men.[i] In the U.S., the disease leads to one in every three deaths — one death approximately every 38 seconds.[i] Although both genders suffer from the disease, women can experience more subtle symptoms than men, which may go unnoticed. That’s why it is important for women to know the heart disease risk factors that are specific to them. Here are four steps women should take to protect their heart health:

  1. Know the Signs.

Chest pain is the most common heart attack symptom for women, but women are more likely than men to experience symptoms unrelated to chest pain including shortness of breath, nausea or vomiting, sweating, lightheadedness/dizziness, or pain or discomfort in the neck, stomach, one or both arms, back, or jaw.[ii]

  1. Don’t Stall, Get Help Immediately.

Recent research found women have a higher risk of death in the first year after a heart attack than men.[iii] If you recognize any of these signs or symptoms, it is important to get help immediately. Stalling may worsen your condition.

  1. Prevention is Key.

Heart disease is preventable. Knowing and watching your heart health indicators, such as diet, exercise, smoking and alcohol consumption, are a few ways to protect your heart. If lifestyle modifications are not enough to lower your risk, you may need to speak with your doctor about alternate solutions.

  1. Talk to Your Doctor.

High triglycerides (fat in the blood) are an indicator of cardiovascular risk.[iv],[v],[vi] You should talk to your doctor about your triglyceride levels as well as your cholesterol, blood sugar and blood pressure levels — all important cardiovascular risk factors that can impact your heart health.


[i] American Heart Association/American Stroke Association. Heart Disease and Stroke Statistics 2018 At a Glance website. https://healthmetrics.heart.org/wp-content/uploads/2018/02/At-A-Glance-Heart-Disease-and-Stroke-Statistics-2018.pdf. February, 2018. Accessed April 29, 2018.

[ii] American Heart Association. Heart Attack Symptoms in Women website. http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp#.WvHCjqQvzRY. July, 2015. Accessed May 8, 2018.

[iii] Ubrich R, Barthel P, Haller B, Hnatkova K, Huster KM, Steger A, et al. (2017) Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies. PLoS ONE 12(10): e0186783. https://doi.org/10.1371/journal.pone.0186783

[iv] Miller M, Cannon CP, Murphy SA, Qin J, Ray KK, Braunwald E, for the PROVE IT-TIMI 22 Investigators. Impact of Triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 Trial. J Am Coll Cardiol. 2008;51;724-730.

[v] Faergeman O, Holme I, Fayyad R, Bhatia S, Grundy SM, Kastelein JJP, LaRosa JC, Lytken Larsen M, Lindahl C, Olsson AG, Tikkanen MJ, Waters DD, Pederson TR, on behalf of the Steering Committees of the IDEAL and TNT Trials. Plasma triglycerides and cardiovascular events in the treating to new targets and incremental decrease in end-points through aggressive lipid lowering trials of statins in patients with coronary artery disease. J Am Coll Cardiol. 2009;104:459-463.

[vi] Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, Goldberg AC, Howard WJ, Jacobson MS, Kris-Etherton PM, Lennie TA, Levi M, Mazzone T, Pennathur S. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2011;123:2292-2333.