Author: suerochman

Fall 2016 Cancer Today

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For the news section of the Fall 2016 issue of Cancer Today, I developed and edited these articles:

  • Thyroid Tumor Gets New Name: Panel Reclassifies a Type of Thyroid Tumor, Says It’s Not Cancer
  • Rare Tumors Can Mimic ADHD: Tumors Tied to High Blood Pressure
  • Do You Know BRCA?
  • Making Decisions About End-of-Life Care: Study Finds Few Terminally Ill Patients Understand Their Prognosis
  • Many Cancers in HIV-Positive Patients Go Untreated: Study Suggests Need to Educate Patients with HIV and Their Doctors

See the full Fall 2016 Forward Look.

All About Overdiagnosis

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For the Fall 2016 issue of Cancer Today, I spoke with epidemiologist Pam Marcus on why cancer screening can have risks.

14-qa-with-pam-marcus-stock-art250x200-webAs my article notes, the premise of cancer screening seems straightforward: Save lives by finding cancers before they start causing symptoms, when they are smaller and often easier to treat.

But as scientists have learned more about how tumors grow and spread, the road from cancer screening to saving lives has taken unexpected twists and turns. Some cancers spread to other parts of the body while still small. Others are so aggressive that finding them early doesn’t change the outcome. And still others might never need to be found, or treated, at all.

This doesn’t mean cancer screening has no value. But it does mean that potential benefits must be weighed against risks. Read the full Q&A.

Resume

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Sue Rochman

2622 Sutter Street, San Francisco, California 94115
415.346.0414 • 415.290.8473
Sue.L.Rochman@gmail.com  • @SRochman

________________________________________________________________

I am a professional journalist covering health and medicine, with an eye toward overlooked and underexplored topics. My areas of expertise include women’s health, cancer, and health disparities. I have extensive experience working with writers, editors, and public relations specialists; identifying, assigning, and editing timely news and feature stories; and writing compelling feature-length articles. I am able to manage multiple projects simultaneously.

Career Highlights

Independent Health/Medical Journalist                                                1989 to Present

Write news and feature articles for national, regional, and special-interest publications and health websites. This includes:

    • Contributing writer and editor for Cancer Today, published by the American Association for Cancer Research. Move articles in the magazine’s Forward Look news section through full editorial process, from assignment through publication. Write news and feature stories.
    • Medical writer for Dr. Susan Love Research Foundation. Wrote content for website launch and re-launch. Write news articles for blog and website.
    • Medical writer for BreastCancerTrials.org. Wrote content for website launch and re-launch. Edit trial summaries. Wrote quarterly newsletter.
    • Health writer for Cancer Support Community. Wrote content for site re-launch (coming January 2016). Write guides for cancer patients and survivors.
    • Served as editor at large for HIV Plus, writing news and feature stories on HIV/AIDS.

My work has appeared in the Journal of the National Cancer Institute, SELF, The Advocate, MAMM, and the Los Angeles Times. I have written articles and reports for Remedy Health Media/Health After 50 and the UC Berkeley Wellness Report.

Communications Director, Gay & Lesbian Medical Association                      1998 to 2000

      • Responsible for creating and implementing strategic communications plans.
      • Developed and fostered relationships with local, regional, and national media.

Education

Master of Arts, Journalism

S.I. Newhouse School of Public Communications, Syracuse University

Bachelor of Arts, Women’s Studies

University of California, San Diego

Awards

Excellence in Journalism Award, Society of Professional Journalists Greater Philadelphia Chapter, 2011

Award for Excellence in Health Care Journalism, Association of Health Care Journalists, 2007

Cancer Seminar Fellow, National Press Foundation, 2003

Easing the Pain

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Pain and cancer frequently go hand in hand. Studies suggest between 20 and 50 percent of cancer patients are experiencing pain at the time of their diagnosis. But while pain is common in cancer patients, it’s not always easy to treat. In fact, pain management can be one of the more challenging areas of cancer care. That’s why I decided to write about it for the spring issue of Cancer Today.

24-pain-600x200-WEB

Easing the Pain

Pain is no gain for patients during or after cancer treatment.

 

In 2009, Mike Richardson was diagnosed with melanoma, an aggressive skin cancer, following removal of a suspicious-looking mole near his collarbone. He had surgery to remove the area around the mole, and all appeared well. But two years later, a biopsy of a swollen lymph node in his neck confirmed the cancer had returned. To corral the cancer, Mike had surgery to remove that node and others nearby, followed by radiation. That’s when the pain began.

“Mike started having general soreness,and then he started to have some pain,and then that pain began to become extreme,” recalls his wife, Eryn Richardson. “It was unbearable. He couldn’t sit or lay down. He would say ‘everything hurts.’ ” The pain would make the 40-mile drivefrom their home in Black Diamond, Alberta, Canada, to the Tom Baker Cancer Centre in Calgary seem even longer. Yet when her husband, who died in March 2013, told his oncologist about his discomfort, the physician had little to offer, Richardson says. “Her response was ‘just take some Tylenol or Advil,’ ” she says. “She didn’t seem concerned.”

But to those close to him, it was clear Mike was not doing well. After two months of chemotherapy, the 50-year-old had dropped 50 pounds, and his clothes hung on his 6-foot-plus frame. “He wasn’t the same person,” says Richardson. “He didn’t have a lot of go to him anymore and he didn’t have any drive. And he was frustrated because he didn’t feel his oncologist was taking his pain seriously. His complaints about pain didn’t seem to resonate with her.”

One day, following a routine appointment, a nurse handed Mike a pamphlet about support for cancer patients. Using a phone number on the pamphlet, he scheduled an appointment with a psychologist who had experience with melanoma patients. At the first meeting, the psychologist asked Mike to rate his pain on a scale of one to 10. “When Mike said eight,” says Richardson, “he was flabbergasted.”

The psychologist made an appointment for Mike at the pain clinic at the Tom Baker Cancer Centre for the following day. It took a few more weeks for the specialists there to get Mike on the right dose of the right medications. But after that, his pain was better managed. “He got his appetite back,” says Richardson, “and he began to feel more human.” Still, the Richardsons couldn’t help but wonder: Why had it taken nine months for Mike to get proper pain management?

Read the full article in the Spring 2016  Cancer Today.

Even NPR Doesn’t Always Get it Right

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If you listen to NPR, you may have heard this news story about how eating fiber can reduce a woman’s risk of getting breast cancer.

The reporter discusses this study, which was published online today in the journal Pediatrics, on dietary fiber and breast cancer risk. The data come from the Nurses Health Study II which is investigating the relationship between oral contraceptives, diet and lifestyle risk factors and overall health in 116,686 women. The researchers started following these women in 1989, when they were between the ages of 25 and 42.

In 1998, 44 263 of these women were asked questions about their diet during high school; since then, 1118 of these women have developed  breast cancer. Based on their analysis the researchers conclude,”Among all women, early adulthood total dietary fiber intake was associated (my emphasis) with significantly lower breast cancer risk.”

Note the words I emphasized: “was associated.” That’s precisely what this study showed. Why use the word “associated?” Because this is an epidemiology study. This type of study can show a correlation, but it cannot prove causation. It’s possible that the women who said they ate more fiber as teens had other aspects of their life–a good diet, exercise, not smoking, etc.–that also played a role in reducing their breast cancer risk.  It’s also possible that many of these women misreported what they ate as adolescents, since they were answering questions about what they ate as teens when they were between the ages of 35 and 52.

Before discussing their own research, the study’s authors explain, “Previous studies of fiber intake and breast cancer have almost all been nonsignificant, but none of them examined diet during adolescence or early adulthood, a period when breast cancer risk factors appear to be particularly important.” Yet, what’s the NPR headline: A Diet High in Fiber May Help Protect Against Breast Cancer.” Umm, not really.

And what does the NPR reporter say about the study: “… if you’re skimping on fiber, the health stakes are high, especially if you’re a teenage girl. A study published Monday in the journal Pediatrics concludes that eating lots of fiber-rich foods during high school years may significantly reduce a woman’s risk of developing breast cancer.” Umm, not really, either.

As you now know from what I explained earlier,  the study did not conclude “eating lots of fiber rich food may significantly reduce” breast cancer risk. It concluded, “a higher fiber intake was associated with lower breast cancer risk and suggests that intake during adolescence and early adulthood may be particularly important.”

We should all–adults and adolescents alike–eat a high fiber diet. It helps maintain a healthy weight and helps decrease risk for heart disease and diabetes.

We should all also pay close attention to the types of studies journalists report, and how they report them. Here’s what the researchers conclude:

The findings in this large prospective study support the hypothesis that consumption of foods high in fiber reduce breast cancer risk. These results also suggest that dietary fiber intake during adolescence and early adulthood may be particularly important. Our findings are in line with the American Cancer Society guidelines to consume foods rich in fiber such as fruits, vegetables, and whole grains, and indicate the importance of adopting these food choices during childhood and early adult life.

The reporter should have reached the same conclusion too.

Tip of the hat to MR for getting me to write about this by suggesting the headline.

A Storied Life

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Literary realist John Updike used the scaffold of his own life, including his lung cancer diagnosis, to explore the shared experiences of our time.
Many writers achieve fame. John Updike attained something more: As a novelist, short story writer, poet and critic, he conquered the literary world, becoming one of only three authors to win the Pulitzer Prize for Fiction not once, but twice.
36-Updike-Opening-Shot-600x200-WEBUpdike’s eye for detail emerged during his childhood in Shillington, Pennsylvania, a small town outside of Reading, itself about an hour’s drive from Philadelphia. Shillington was not a place of prominence. It mostly knew the day-to-day, the conversations that play out at work, with family or with oneself. There, Updike found an emotional frontier that he shaped into stories that spoke to millions around the world.
Read the full article

Honor Your Body

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Coming to terms with feelings and emotions about weight gain and weight loss is often part of a cancer patient’s experience.

48-body-Image-250x324-WEBWhen Laura Walker was diagnosed with breast cancer in October 2012, how much she weighed was the furthest thing from her mind. She was more concerned about the side effects of chemotherapy, surgery and radiation. Then, a year after her mastectomy, Walker, a mother of four from West Columbia, Texas, went to see a plastic surgeon at the University of Texas M. D. Anderson Cancer Center in Houston to discuss her breast reconstruction. The surgeon didn’t ask Walker to undress or take a look at her scar. “Just looking at me, she knew I was too big,” she says.

It was January 2014. Walker was 41 years old and weighed 328 pounds. Her body mass index (BMI) was 53. She had been overweight for more than a decade. To have surgery, she learned, her BMI would have to be 35 or less. “I didn’t even know what BMI was,” says Walker. “I was just living my life. I was happy. I gave no thought to what I was eating or what I weighed.” That would need to change. Her body was carrying a 100-pound obstacle that stood between her and a new right breast.

Read the rest of the article, which I wrote for the winter 2015/2016 issue of Cancer Today.

Breaking the Blood-Brain Barrier

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During the past five years, oncologists have reported an uptick in cancer patients with brain metastases—and it’s not clear why. I explored the impact of this development in my feature story “Breaking the Blood-Brain Barrier” in the Fall 2015 issue of Cancer Today.

Here’s an excerpt:

As the calendar turned to September 2014, Leslie Falduto was feeling at the top of her game. The cancer survivor was running six miles, three days a week. Her oncologist had recently told her she was doing great. And at work, Falduto, a registered nurse, was returning to her favorite post, the neonatal intensive care unit.

BrainMets_175x175Talking about her diagnosis of stage III breast cancer in September 2008 still made her feel anxious. But in the world of cancer, five-year survival is one of those measures that is supposed to make you think, OK, maybe now I can pop the champagne. And Falduto, a mother of two from St. Paul, Texas, has passed that marker the year before. 

But on Sept. 7, when she went to leave the neonatal unit, an odd thing happened. “I couldn’t remember how to open a door,” recalls Falduto, 38. After that, “I couldn’t remember how to walk.” Her right leg started shaking uncontrollably. Then, she passed out. When she awoke, Falduto was in the emergency room, where she was told she’d had a seizure. A neurosurgeon requested an MRI. The scan revealed a tumor the size of a pingpong ball—metastasized breast cancer–deep in her brain.

Read the full story.

The DCIS Dilemma

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Yesterday’s news was filled with seemingly conflicting interpretations of and responses to a new study in JAMA Oncology that looked at breast cancer deaths following a diagnosis of ductal carcinoma in situ (DCIS), alternately referred to as a precancer or stage 0 breast cancer.

25-DCIS-600x200The varied take-aways to the study by reporters aren’t surprising. They reflect the state-of-the-state when it comes to treating DCIS.

With mammography’s introduction as a screening tool in the late 1970s and early 1980s, DCIS diagnoses began to increase rapidly. Today, DCIS is the fourth most common cancer diagnosed in women. If left untreated, some DCIS lesions will go on to become invasive cancers, while others will never leave the duct. But despite decades of effort, doctors can’t yet tell a woman which type she has. As a result, breast specialists recommend all DCIS be treated with surgery, often followed by radiation and hormone therapy.

You can learn more about DCIS in my article The DCIS Dilemma in the summer issue of Cancer Today.

The Ways We Approach Death

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On Thursday, the California state Senate passed a measure that would give terminally ill patients the legal right to end their lives with a doctor’s assistance. The measure now heads to the Assembly.

Only three U.S. states—Oregon, Vermont and Washington—have laws that allow doctors to give mentally competent, terminally ill adults a prescription medication that ca36-The-Way-We-View-Death-600x200-WEBn hasten their death. California is one of about two dozen states where lawmakers are considering similar legislation.

In many ways, this legislative activity is a direct result of the advocacy efforts of Brittany Maynard. After Maynard received a devastating cancer diagnosis, she and her family worked closely with the Colorado-based organization Compassion & Choices to publicize her decision to end her own life, on her own terms. This effort included the release of a six-minute video in which Maynard explained why she had moved from California to Oregon to take advantage of that state’s Death With Dignity Act. That video, along with a guest column for CNN and a People magazine cover story, captured the nation’s attention.

My article, “The Ways We Approach Death” in the Spring 2015 issue of Cancer Today uses the stories of Maynard and MTV star Danielle Michelle “Diem” Brown, another hard-charging young woman facing cancer, to explore the difficult decisions we all will face at the end of life. You can read the entire article here.