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Running For More…

The personal blog and website of Kristen Cincotta

Posts Tagged ‘Awareness’

2013 Mid-Year Check In Part 2: Goals Update

Saturday, July 20th, 2013

While you’re here, please click over and read the first part of my mid-year update on my running!

Back at the beginning of the year, I set a number of goals for myself for my running, my fundraising, and breast cancer advocacy in general. Then I finally got around to blogging about those goals at the beginning of March. Today, in the interest of public accountability, I’m going to write a bit about my progress (or lack thereof) on each of my goals.

Celebrating after completing my first half marathon in March!

Running Goals

  • Sub-30 minutes 5K – DONE. Seven times. Because I’m an overachiever, apparently.
  • 10K PR – DONE. After three years of progressively slower Peachtrees and one promising 10k last fall, I shattered my 10k PR at this year’s Peachtree, dropping my 10k PR from a 1:05:29 to a 1:01:02!
  • Complete two half-marathons – Halfway there! I ran the Publix Georgia Half Marathon on March 17th, a race that is still on my agenda to recap. I’m also still planning to run the AllState 13.1 Half Marathon in October.
  • Complete eight SEVEN Atlanta Track Club Grand Prix races – To date, I’ve finished four ATC Grand Prixes: the Peachtree City 5k in January, the Hearts and Soles 5k in February, the Spring has Sprung 8k in April, and the Dekalb-Decatur 4 Miler in July. I also had every intention of running the Women’s 5k in March that was called off due to lightening at start time. Because the ATC had to cancel that race, the magic number for “completing” the series is now seven races, which means I need to finish three more. Right now, it’s looking like that will be two 5ks in August and the Singleton 10 Miler in September.
  • Volunteer ten times for the Atlanta Track Club – Back in March, I was able to volunteer for the ATC four times in the span of about three weeks. However, due to my work schedule, I haven’t been able to fit in any volunteer opportunities since then. I was hoping to pick up a few more during the Peachtree Expo, but alas, all of the Expo volunteer ops that weren’t during my work hours were taken before I was able to sign up. With two big race expos in the fall (for the Atlanta Marathon and the Thanksgiving Half Marathon), I SHOULD still be able to complete this goal. I just need to be more proactive about signing up early before the shifts I can work get filled by others!
  • Total annual mileage of > 750 miles – I’m doing GREAT with this goal so far. As of July 13th, I was at 420 miles – 56% of the way to 750 miles. Provided my ankle doesn’t act up (it’s feeling much better after a week of rest!), half marathon training starts again tomorrow. 750 miles is easily within reach!

Fundraising Goals

  • Publix GA Half Marathon: Raise at least $1000 for the Upstate Medical University Capital Campaign by March 31st. – DONE. Thanks to the generosity of my friends and family, I actually raised over $1500 during this fundraiser. Details coming in my race recap later this week!
  • Race for the Cure: Raise at least $500 for Komen Atlanta between April 1st and May 31st. – FAIL. I didn’t actually do any fundraising for the Race for the Cure. I wish that I had. I was VERY busy in April and just never made the time. However, I had a great experience as Safety Chair, which I’ll ALSO be recapping later this week, time permitting.
  • Peachtree Road Race: Raise at least $1000 for the Breast Cancer Research Foundation between June 1st and July 31st. – This fundraiser is technically still ongoing, so I can’t say that I missed my goal yet. However, I’ve only raised $155 thus far and I’ve pretty much stopped promoting this fundraiser. If you would still like to donate (which I would greatly appreciate), you can do so here. Otherwise, stay tuned for a “lessons learned” post in early August about why this fundraiser fell apart and what I’m going to do differently the next time around.
  • AllState 13.1 Half Marathon: Raise at least $1000 for the American Cancer Society between September 1st and October 31st. – I’m still planning to do this fundraiser and have high hopes about reaching my goal. In fact, I’m actually hoping to reach at least $1500 to make up for dropping the ball on my BCRF fundraiser.

Advocacy Goals

  • Weekly fundraising updates and monthly training updates here on my blog – Obviously, this hasn’t happened. But hey! Two posts in one week this week. Hopefully, this will be the start of some more regular updates. Regular blogging will also probably help with some of my fundraising goals as well!
  • At least two blog posts per month not related to my races or fundraising to continue to spread the word about the need for more cancer research funding and how everyone can get involved. – Again, this hasn’t happened. See above.
  • Volunteer with Komen Atlanta or other local cancer not-for-profits at least six times this year (beyond my Race for the Cure and Community Grants commitments). – In all honesty, I kind of forgot I set this goal for myself. So far, I’ve only been able to volunteer with Komen Atlanta once outside of my Race for the Cure and Community Grants committee work. However, there are a lot of “cancer awareness” observances and events in September and October, so you can expect to hear about some more volunteer work then.

So that wraps up where I’m at with my goals for 2013 – still plugging away and relentlessly optimistic, as always!

How are you doing with your goals for 2013? Do you have any tips for successfully sticking with your goals?

Running For More on National Running Day!

Wednesday, June 5th, 2013

Me and my best girl enjoying our morning run today!

Me and my best girl enjoying our morning run today!

Happy National Running Day!

Celebrated on the first Wednesday of June every year, National Running Day is a day for runners everywhere to stand up and yell “I’m a Runner!” and tocelebrate the inherent craziness that goes along with that. There are group runs in cities across the country, race discounts to be found everywhere, and for many running and fitness bloggers, lots and lots of giveaways. Last year, I celebrated by going for a short run and then blogging a little bit about why I’ve come to love running so much. This year, I’ve got something bigger up my sleeve. This year, I’m unveiling my new blog name!

As of today, my new blog name is:

Running For More

So, why the new blog name? Well, Kristen Walks just didn’t feel right anymore. I picked that name back when my main breast cancer advocacy work was centered around the Susan G. Komen 3-Day for the Cure. I walked the the 3-Day three times between 2007 and 2010 and I’ve been a fairly visible member of that community ever since. However, in 2009, I got it in my head that I was going to try to run the Komen Atlanta Race for the Cure (with no idea how to train, it didn’t go well). Then in 2010, I decided I wasn’t just going to run the Race for the Cure again (with a training plan and everything!), I was going to Couch to 10K it all the way to my first Peachtree Road Race 10k. In 2011, staring at months of sitting on my butt writing my doctoral dissertation, I decided to be proactive and signed up for the Atlanta Track Club’s Women on the Move 5K training group. And the Women’s 5K race. And Race for the Cure. And Warrior Dash, because mud is fun. And the ATC’s Peachtree training group. And the Peachtree itself. So clearly, this running thing was becoming much more of “a thing”. That led to last year when I ran 18 different races, many of them with a charity component. I was officially a (self-declared) #RunningBadass.

Predictably, after I started my job late last year, I didn’t have as much time to blog. And when I did have time to blog, I found myself mostly wanting to write about running. Not about running in terms of “how to be a runner” or anything like that. There are plenty of bloggers that are much more knowledgeable about that sort of thing. I wanted to write about my training and my races, even when they didn’t have anything to do with my cancer advocacy. I felt that way even more strongly once I decided to try to do my own fundraising for my three big races this year, without the structure of an organization like Komen to guide me. Running is what I’m doing now and running is the major form that my advocacy is taking. In addition, with my position at the CDC, I have to be very careful about the public health and science information I post in public forums like this lest it be perceived as representing the CDC’s position on, well, anything. (To be clear: All the opinions and factual interpretations here on the blog are mine and are based on my professional perspective only. They are not necessarily representative of the CDC’s position on anything.) I also now have restrictions on my ability to persuade people to lobby the government, also on pretty much anything. So beyond the fact that I just plain don’t have time to research the types of posts I was starting to write last fall (like these), out of an abundance of caution, I decided to move away from any kind of post that could be potentially problematic. So that leaves me with writing about my running. Which meant that Kristen Walks as a blog name had to go.

So, how did I land on Running For More? I know this is going to come as a surprise, but it came to me on a run. I was running intervals on the track at Piedmont Park, to be specific, on a hot, dusty night. I had recently added new songs to my running playlist, and one of them was Melissa Etheridge’s song “Running for Life”. On her website, Melissa writes that:

Ford asked me to write a song for their “Race for the Cure” initiative to raise funds and awareness for breast cancer charities. I wanted to write a song that was personal; climb into people’s emotions and portray a woman who has had breast cancer but is out of it. The first verse is about a survivor. The second verse is from my own experience and the last verse is for those who have not been diagnosed or don’t know anyone with breast cancer yet. We are all running for answers and to make the situation better.

I’ve probably heard this song hundreds of times. I find it incredibly inspiring and always have. I also relate to many of the lyrics:

I run for hope
I run to feel
I run for the truth
For all that is real
I run for your mother your sister your wife
I run for you and me my friend I run for life

Those are all reasons why I run, which was what struck me during this particular run. So as I made my way around the track (probably not as focused on my pace as I should have been during speedwork), I started to think about whether any of those lyrics could work as a blog title. And none of them felt quite right. They didn’t quite encompass enough. They are all reasons I run but none of them are THE reason that I run. And then I got to the last lines of the song:

We will be running as we have before
Running for answers
Running for more

BINGO. Running for more. It was perfect. So I raced my butt home (ok, I had just done intervals – it was probably more of a trudge) and did a quick Google search. Miraculously, I didn’t find a single other blog using the name (if there is one, I apologize!). Even more astonishing, the URL www.RunningForMore.com was available. It was fate. And a short ten minutes later, it was mine.

So, what does Running For More mean? (I’m into the rhetorical question thing today!) To me, it truly encompasses all of the the things that I’m running to have more of in my life:

  • More AWARENESS of the need for more breast cancer research funding. And cancer funding in general. All biomedical research, really.
  • More EDUCATION on the risk factors for breast cancer, things you can do to protect your health, and the early signs and symptoms that something might be wrong.
  • More FUNDING for research, educational outreach, patient support, political action, and so many other aspects of the fight against breast cancer.
  • More HEALTH for myself so that breast cancer and other chronic diseases don’t steal years from my life like they have from my loved ones.
  • More EXPERIENCES through participating in great events, running in fun races, and volunteering for wonderful organizations.
  • More FRIENDS like those I have met through my advocacy and running.
  • More FUN!
  • And most importantly, more TIME. Time with my mom, time for other moms, time for everyone. Cancer has shortened too many lives. I’m O-V-E-R it. Through running and all those things I listed above, I’m running to give everyone, including myself, more time.

So those are the topics you can expect me to (try to find the time to) write about on here in the coming weeks and months. A lot more running, but still holding on to the best stuff from before. I’m excited about this. I hope you are too!

 2013 National Running Day Image

PS – Hey, graphic designer friends! I would love a new logo for that upper left hand corner, as well as possibly a new banner pic for the splash page. Anyone want to help me out?

Where I’ve Been and Where I’m Going – Goals for 2013

Monday, March 4th, 2013

So… I got a new job, blogged about getting said new job, and then promptly got so busy at said new job that I haven’t blogged anything in over two months. Whoops.

Ultimately, while I’m bummed that my blogging has slid by the wayside, I think it’s probably okay. I really want to build this short term fellowship opportunity with the Injury Center at the CDC into a full time job and a life-long career in public health, so disappearing down a hole to really focus on my work for a bit is exactly where my primary focus SHOULD be right now. For those who are curious, it has been going well. My project is really starting to take off and I continue to really enjoy both the type of tasks I’ve been assigned (and in some cases voluntarily taken on) and the type of thinking required to complete them. It’s been a challenge, but one that I’ve found very motivating. And I L-O-V-E being a part of the CDC community!

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This binder was my best friend for a while back in January.

I should also point out that while I haven’t been blogging, I haven’t completely given up my breast cancer activism either. Back in January, I spent a somewhat delirious week and a half absolutely buried in Komen Atlanta Community Grant applications, followed by a fascinating evening listening to really smart, engaged women discuss the merits of the various grantees. It was a great experience throughout and even though the final grantee list for 2013-2014 hasn’t been posted yet, I’m already looking forward to doing it again next year. I’ve also been attending committee chair meetings for the Komen Atlanta Race for the Cure that is fast approaching (May 11th – have you registered yet?). My committee work has been basically non-existant thus far (as Safety Chair, there isn’t much to do until closer to the race date), although that will change this month when my responsibilities really kick in. However, it’s been eye-opening to sit in and listen to the behind-the-scenes chatter of how all of the pieces come together for race day.

The other thing that has been eating up my time in early 2013 has been running. I have been running my butt off this winter. I’ve already notched two PRs and came dang close to a third one, all the while training for my first half marathon that will take place just 12 days from now (EEEK!). I’ve spent a little bit of time over on my Kristen Runs pages updating my race results thus far and I’m in the process of updating my 2013 race schedule as well. You can be sure that I’ll post a quick update once that’s all set, hopefully by next weekend.

All of which brings us nicely to what I HAVEN’T been doing and how I am about to rectify that, starting tonight. And that thing is FUNDRAISING.

Back in January, I had big plans for a post about New Year’s Resolutions and my personal training and fundraising goals for 2013. And then one thing (work deadline!) led to another (grant reviews are due!) led to another (I need to update the race results from last year first… ) led to another (business travel? what’s business travel?) led to another (the dog ate the furniture!)…. and it just never happened, despite having actually set my goals for 2013 weeks and months ago. I wasn’t honestly sure I was going to even dedicate a blog post to my goals this year, but then tonight I saw that no less than Dean Karnazes wrote on Runner’s World that for fitness goals and resolutions, March is the new January, so I’m taking it as a sign. Plus, I clearly need some public accountability since I’ve been slow to get off the ground with some of these. So, without any further fanfare, here are my 2013 goals for (1) Running, (2) Fundraising and (3) Advocacy:

Running Goals

Celebrating at the finish line of the Hot Chocolate 15K in January!

  • Sub-30 minutes 5K – Not to spoil the ending, but I’ve already done this TWICE this year after never breaking this barrier before!
  • 10K PR – Because I’m SICK of getting slower at the Peachtree every year.
  • Complete two half-marathons – I’m definitely running the Publix Georgia Half Marathon on March 17th (my birthday weekend!) and I’m planning on running the AllState 13.1 Half Marathon in October on Mike’s birthday weekend as well.
  • Complete eight Atlanta Track Club Grand Prix races – I really want that sweet end of the season shirt. We’ve completed two already!
  • Volunteer ten times for the Atlanta Track Club – This isn’t a random number; there are end of the year gifts for volunteering ten or more times and I’m annoyed that I didn’t know that last year.
  • Total annual mileage of > 750 miles – This is notch up from the 600 something miles I ran last year. With my half marathon training, I’m well on pace to hit this goal!

Fundraising Goals

Advocacy Goals

  • Weekly fundraising updates and monthly training updates here on my blog
  • At least two blog posts per month not related to my races or fundraising to continue to spread the word about the need for more cancer research funding and how everyone can get involved.
  • Volunteer with Komen Atlanta or other local cancer not-for-profits at least six times this year (beyond my Race for the Cure and Community Grants commitments). In particular, I’d really love to get more involved with the American Cancer Society.

So those are my goals. Out there for everyone to see and read. I have always been a very goal-oriented person. When I set goals, I intend to do everything in my power to achieve them, even when things get tough and the world seems to be working against me. I WILL reach each of these goals, even those I’m already behind on.

Speaking of which… if you just read my goals, you hopefully just said to yourself, “Wait, if you’re trying to raise $1000 for this Capital Campaign thing by the end of March, why haven’t I heard anything about it???” Well, the reason you haven’t heard anything about it is because it took longer than I anticipated to get everything for that fundraiser up and running. But the good news is, I’m finally ready to kick off that fundraiser, which I’m calling “Run for the ROC“. And I’m doing it TONIGHT, in my very next blog post!

My BIG News – Dr. C Got a Job!

Monday, December 3rd, 2012

So… I sort of fell off the #NHBPM wagon. The goal was to write 30 blogs posts in 30 days. And I promise, I had every intention of doing just that. But yet, it’s now December 3rd and I only wrote/published 3 posts. I feel sort of bad about that. But not too bad, because I had a REALLY good reason for not posting:

I GOT A JOB!!!

It was a very long hiring process, one that honestly stretches back to last December when I applied for a public health policy research position on a team working on Traumatic Brain Injury (TBI) at the Center for Disease Control and Prevention (CDC). As it turns out, I didn’t get that job. But my resume did catch the eye of the team lead, who also serves as the acting branch chief for the Health Systems and Trauma Systems Branch in the Division of Unintentional Injury Prevention (DUIP), which is a part of the larger National Center for Injury Prevention and Control (NCIPC). When the next possible opening on the TBI team came up in May, she got in touch with me and we had a phone interview that went great.

And then I didn’t hear anything more all summer, other than assurances that NCIPC/DUIP were re-organizing and they’d be in touch. In the mean time, I continued applying for other jobs (and hearing nothing… ), researching possible fellowship opportunities, and networking, networking, NETWORKING. Anyone that I came into contact with who had even the most remote connection to a place I wanted to work or experience in the fields I’m interested in, I was all over it. In August, I spent over an hour chatting up a very nice woman who happened to work at the CDC while hanging out at my friend Kristin’s pool. And that conversation was where I learned about ORISE fellowships.

ORISE is an acronym, that stands for Oak Ridge Institute for Science and Education, a Department of Energy (DOE) institute focused on recruiting scientists and engineers to work on a whole host of health, science, and engineering issues. ORISE itself is a physical place located in Oak Ridge, Tennessee that is managed by the Oak Ridge Associated Universities (ORAU) consortium. However, not all ORISE scientists work in Tennessee. Rather, ORAU also sponsors a series of ORISE fellowships at a number of member institutions and partners, including at the CDC here in Atlanta.

So, what does this have to do with my new job? Well, as part of the big reorganization over in the NCIPC/DUIP, a team working on public health policy relating to prescription drug overdose (PDO) was relocated into the Health Systems Branch, which, as I noted above, is currently under the direction of the head of the TBI team that I interviewed with. The PDO team happened to have openings for two ORISE fellows to work on a two year project evaluating a series of state-run prescription drug monitoring programs (PDMPs). And my contact, who was still looking for a way to bring me in, recommended that I apply for the position, which I did.

And then I didn’t hear anything for over a month.

Thinking that the lack of communication meant the fellowship was a long shot at best, I soldiered on, pursuing networking opportunities with a commitment that could best be described as “relentless fervor”. As part of this pursuit, I figured out a way to attend the Network for Public Health Law Conference here in Atlanta in mid-October. The conference was awesome and I learned A LOT. But more importantly, I met A LOT of people who were generous with their time and really went out of their ways to help me build my networks within the public health field. As it turns out, one of the people that I met at the conference just so happened to work on the PDO team at the CDC. And he went back to his team lead and talked me up, effectively moving my resume to the top of the pile.

[Side note: When you are looking for a job, everyone, and I mean EVERYONE, will tell you “It’s all about who you know!“. I was told this three separate times at my dental cleaning in early October alone. Reluctantly, I admit that they’re right. But what people don’t tell you is that you, and you alone, control who you know. So if your current network isn’t generating promising leads, get out there and meet new people!]

Shortly after I got back home from my networking trip to DC (like I said, relentless fervor!), I had a phone interview with the PDO team lead and another senior member of the team. It was on a Friday morning, it lasted 27 minutes, and I had no idea if they liked me or not. After a weekend of trying to convince myself I didn’t blow it while simultaneously preparing for another networking meeting with a public health lawyer at the CDC the following Monday (RELENTLESS FERVOR), I received an email on Monday morning that basically said “Congratulations on being selected as an ORISE fellow! Here’s 800 pieces of paperwork we need to start working on to get your hiring approved and processed.”

I was FLOORED. But I was also cautious. In all of my networking meetings, I had learned that opportunities with the federal government can fall apart just as easily as they come together. So I tried my best not to say anything until everything was finalized (although my mom leaked it to my 94-year-old grandmother who then posted about it on my Facebook wall… ), which happened the Tuesday before Thanksgiving. So while I was stuffing my face with turkey and potatoes and pie, I was also incredibly grateful that after a long, frustrating search, I had FINALLY landed a fantastic position where I will get hands on experience learning how public health policy is set at the federal level.

I’ve now been at work for a little over a week and I’m still really excited, even though all I’ve gotten to do so far is paperwork and background reading. I hadn’t really considered working in drug abuse policy, but I’m finding the material stimulating and intriguing. Prescription drug misuse and abuse is a huge public health problem across the country right now and different states are trying different things to counter it. My job, then, in a nutshell, will be to help figure out which interventions and controls are working (and why) and which aren’t (and why). It should be a fun challenge and I know I’m going to learn a lot!

The one caveat, though, is that as a guest researcher at the CDC, my understanding is that I need to be careful what I choose to blog about here. In terms of “reporting” on the fundraising and awareness events that I try to take part in on a regular basis, I think I’m fine to keep blogging away. Likewise, fundraising for private organizations like American Cancer Society and Komen for the Cure. However, there are obviously confidentiality issues relating to the work I’ll be doing at the CDC, so beyond what I’ve shared in this post, I probably won’t write much about that specifically. Additionally, I need to be careful that any health and science posts (like my “cancer awareness month” series) are not misconstrued as approved by or representing any kind of official position by the CDC, ORISE, ORAU, or the Departments of Energy and Health and Human Services. A simple disclaimer should do the trick, but I’ll probably err on the side of caution for a while just to be safe.

Finally, I strongly suspect (although I haven’t seen it confirmed anywhere yet) that I am not supposed to do any public advocating or politicizing on issues pertaining to government-funded research, including the current state of said funding and the potentially detrimental effects of sequestration on it. It is something of a conflict of interest to be advocating for protecting/increasing CDC funding when said funding levels have huge implications for the future of my fellowship and whether or not I get hired on as a permanent CDC employee. So PLEASE. Since this is the only thing I’ll be writing publicly about sequestration from this point on, do me a favor and look it up. Look up the effects that an 8% across the board cut in funding will have on NIH, NSF, FDA, AHRQ, and yes, CDC. If you do nothing else, read through this report from Research!America. Read the info that AAAS (especially this report), CIBR, and the Society for Neuroscience have compiled on the issue (note, those links will take you to their sequestration pages). This letter by the Coalition for Health Funding is also worth a read, as is this ACS CAN blog post on sequestration and breast cancer research. Read the Cures Not Cuts! website. And CONTACT YOUR REPRESENTATIVES. The US government funds the vast majority of biomedical research in this country, research that will find the cures for Alzheimer’s, Parkinson’s, multiple sclerosis, muscular dystrophy, diabetes, and yes, someday, cancer. These potential cuts to research investments will have ramifications for decades. We’re falling behind already. We cannot afford any more budget cuts to our science and research budgets and everyone needs to make sure their representatives know it. This PDF from Research!America includes sample letters, tweets, and Facebook posts that you can use as inspiration. Do it for me. Call it a “Congratulations on the new job!” present.

So that’s my biggest news. But I do, actually, have other news as well, this time on the volunteering front. The day before I found out that my fellowship was approved and I had a start date in place, I was asked to be on not one, but TWO important committees at the Atlanta affiliate of Susan G. Komen for the Cure, with whom I’ve been volunteering at health fairs and fundraising events since late last winter.

First, I will be serving as the Safety Chair for the Atlanta Race for the Cure which will take place at Atlantic Station in May (registration is now open!). That means that I’m responsible for lining up the medical and ambulance support for the race as well as making sure everyone is where they should be and everything runs smoothly on race day. As I’ve gotten more involved with the local running community here in Atlanta and I’m pretty comfortable with the medical community here as well, it’s kind of a perfect fit! Organizing, race planning, and health care – it’s a perfect fit! I thought I had my first planning meeting for Race for the Cure committee tonight (we meet on the first Monday of each month), but it turns out that doesn’t start until next month. As best as I can, I’ll try to post updates and you can be sure that come spring, I’ll be recruiting as many people as possible to take part in the race!

Second, I will also be serving as a member of the Community Grants Review Board, something I’ve been wanting to do for years. For those who don’t know, 75% of the money that the Komen affiliates raise throughout the year (including through the Race for the Cure) stays with the affiliates and is redistributed throughout the local communities in the form of community support grants. The majority of these grants go to fund breast cancer initiatives and patient support work at local healthcare providers, community support centers (like YMCAs) and cancer support organizations. I’m thrilled that I now have the opportunity to help direct how Komen Atlanta chooses to use their funds. I have grant review training on Thursday and will have until early January to review my assigned grants. Then in late-ish January, I will get together with the rest of the reviewers to decide on which grants to fund for 2013-2014. I’m really looking forward to experiencing this aspect of Komen’s work from the inside and as best I can, I’ll try to keep everyone posted. However, to avoid conflicts of interest and all of that, I will need to keep the specifics of much of this work private as well.

So that’s how the end of 2012 and the beginning of 2013 are shaping up for me. After my defense last December, I thought my whole life would just start moving forward immediately. I fully expected to have a new job in place well before I graduated in May. I never anticipated that I would be unemployed for as long as I was. Moreover, I had no idea how restricted I would be financially because of my lack of a job, which, in turn, restricted the charitable work I was able to do. In short, throughout most of 2012, I felt stuck in the mud when I all I wanted was to be finally moving forward. Well, after almost a full year of fighting to get unstuck, I can proudly say: I AM UNSTUCK. I have a new job that I’m really fired up about where I’m going to learn a lot about public health policy, law, and hopefully communications from inside the federal government. I have two great volunteering gigs where I’m going to have a real influence on how a large breast cancer not-for-profit does their work. I honestly haven’t been this excited for the coming year in such a long time. It’s such a great feeling to finally be on my way!

#NHBPM Post 3: Stomach Cancer Awareness Month!

Wednesday, November 7th, 2012

Note: This post is a part of WeGo Health‘s National Health Blog Post Month: 30 posts in 30 days challenge. The prompt for Day 3 that I’m responding to is “I don’t know about this, but I’d like to…”. To see the rest of my #NHBPM posts, please click on the image at the bottom of this post.

So, as noted in my #NHBPM header introduction, the prompt for “Day 3” was “I don’t know about this, but I’d like too… ” which seems like the perfect time to write another post in my Cancer Awareness Months series. As I’ve written before, while I choose to focus my efforts primarily on breast cancer awareness and advocacy, I feel that it is important for all cancer advocates to have some familiarity with each of the major cancer subtypes. So using the “Awareness Months” as my guide, I’ve been researching and writing brief synopses on different subtypes of cancer, which can all be found filed under the blog category “Cancer Awareness Months”. The month of November serves triple duty as Lung Cancer Awareness Month, Pancreatic Cancer Awareness Month, and Stomach Cancer Awareness Month, which is what I’m going to be writing about today.

Stomach Cancer Awareness Month was started in 2010 by the group No Stomach for Cancer. They chose November because it is “a month known for the pleasure of eating”. With so many of us thinking about our bellies this month, this is the perfect month to shine a spotlight on this widely overlooked type of cancer. In fact, while mortality has been declining over recent decades (especially here in the United States), stomach cancer is still the second leading cause of cancer death word wide.

About Stomach Cancer

Stomach cancer, which is also commonly referred to as gastric cancer, is any cancer that forms in the tissues lining the stomach. The stomach itself is actually made up of five distinct tissue layers:

  1. Inner layer/lining (or mucosa): the site of digestive enzyme production and the most common origination site for stomach cancers.
  2. Submucosa: the supportive tissue layer for the inner layer of the stomach.
  3. Muscle layer: the location of the muscles responsible for digestive contractions that keep food moving through the GI tract.
  4. Subserosa: the supportive tissue layer for the outer layer of the stomach.
  5. Outer layer (or serosa): the tissue that covers the exterior of the stomach and holds it in place within the abdomen.
Per the NCI page on stomach cancer, this type of cancer usually begins in the cells of the inner layer of the stomach and can, over time, grow and invade the deeper tissues of the stomach wall. This type of stomach cancer is called adenocarcinoma and accounts for 90-95% of all malignant stomach tumors. The other three less common types of cancer found in the stomach are:
  1. Lymphoma, which is a cancer of the immune system that is sometimes found in the wall of the stomach. Lymphomas (which I wrote about in more detail here) account for ~4% of all stomach cancers.
  2. Carcinoid tumors, which start in the hormone -making cells of the stomach. These tumors account for ~3% of all stomach cancers.
  3. GI stromal tumors (or GIST), which originate in a specific type of cell in the stomach wall known as the interstitial cells of Cajal. These types of tumors can be found anywhere along the GI tract, although they are most commonly found in the stomach. Even so, GI stromal tumors are very rare among stomach cancers.
Risk Factors for Stomach Cancer
While we don’t know the direct cause (or more likely, causes) of stomach cancer, a number of risk factors have been identified, the management of which has led to the aforementioned decline in stomach cancer mortality here in the United States. I’m going to go through a number of these risk factors in more depth, but in general, factors that contribute to gastric inflammation and poor nutrition (which itself contributes to gastric inflammation) can have a large impact on a person’s risk for developing stomach cancer. As a result, stomach cancer is much more prominent in less developed countries (and in the less well off segments of developed countries as well) where healthy food, clean water, and proper refrigeration are not widely available.
Some of the recognized risk factors for stomach cancer include:
  • Infection with Helicobacter pylori bacteria. H pylori is a very common infection of the inner lining of the stomach. It is estimated that up to two-thirds of the world’s population is harboring H pylori at any given time, the majority of whom will suffer no ill consequences of this infection. In order to survive within the acidic environment of the stomach, these bacteria actively convert nitrites/nitrates from our food into ammonia, which can irritate the stomach lining resulting in peptic ulcers, among other complications. When left untreated over the long term, this irritation to the stomach walls can leave those tissues at a greater risk for developing cancer. H pylori is spread from person to person via contaminated food and water or through mouth to mouth contact. While H pylori is still very common around the world, the increasingly widespread use of antibiotics to treat other infections in developed countries has had the incidental effect of reducing H pylori infection rates in those countries. You can read more about the connections between H pylori and cancer here.
  • Eating a poor diet consisting of high amounts of smoked/pickled/salted foods and low amounts of fresh fruit and vegetables. This type of diet is thought to increase risk for stomach cancer due to the high amounts of nitrites/nitrates in foods that have been preserved using these methods, which again can contribute to lower stomach acidity and long term inflammation of the stomach tissues. Fruits and vegetables, with their plethora of good for you vitamins and minerals are thought to counteract some of these ill effects and are generally easier on the stomach. The advent of refrigeration has led to a significant decrease in preservation via smoking/pickling/salting and, when coupled with the increased ability to keep fresh fruits and vegetables on hand year round, has led to a significant reduction in stomach cancer around the world, and especially here in the United States and in Europe.
  • Pernicious anemia. Pernicious anemia is a form of anemia that is caused by a deficiency in vitamin B12.
  • Previous stomach surgeries or illnesses. Because these operations or conditions can alter the enzymatic balance within the stomach and leave the tissues irritated, having a history of GI surgeries or distress is associated with a higher risk for developing stomach cancer. This includes having a personal history of other forms of stomach cancer, including lymphoma and GIST.
  • Smoking. Smokers have twice the risk of developing stomach cancer as non-smokers, likely to due increased irritation of the stomach tissues.
  • The usual suspects. As with most other forms of cancer, age, obesity, lack of physical activity, and a family history of stomach cancer are also considered risk factors for stomach cancer.

To learn more about the risk factors associated with stomach cancer, I highly recommend the American Cancer Society’s webpage on the topic, here.

The Statistics

It is estimated that 21,320 people will be diagnosed with stomach cancer in 2012, with the majority of those diagnoses (13,020) occurring in men. 10,540 people will die of stomach cancer in that same time period. 26.9% of all people diagnosed with stomach cancer live at least five years following initial diagnosis. One in 116 people will be diagnosed with stomach cancer at some point in their lifetimes, with diagnoses in men being more common. Thankfully, for reasons discussed in the previous section, the incidence rate has been steadily dropping since the 1930s when stomach cancer was the leading cause of cancer death here in the United States. However, due to lack of refrigeration, unhealthy diets, and contaminated water, stomach cancer is still very common in other parts of the world where it remains the second leading cause of cancer death. It is estimated that the United States spends ~ $1.6 billion annually on treating stomach cancer.

The NCI allocated $14.5 million (or 0.29%) of their budget for stomach cancer research in 2010, the most recent year for which those statistics were available.

Recommended Resources

If you would like to learn more about stomach cancer, I highly recommend reading through the NCI’s web pages dedicated to stomach cancer, which can be found here. Their “What You Need To Know” section is particularly informative, as is the “snapshot” report on stomach cancer, especially the section discussing recent research investments and findings. I also found the American Cancer Society’s Learn About Cancer: Stomach Cancer section to be very useful. All of the statistics cited in the post were from the Surveillance Epidemiology and End Results (SEER) fact sheet on thyroid cancer, which can be found here. These webpages were my primary sources of information for this blog post.

The American Association for Cancer Research does not have any specific recommendations for organizations dedicated to stomach cancer research, stomach cancer advocacy, or patient support for those diagnosed with stomach cancer. However, the following organizations are (to the best of my knowledge) considered to be leaders in the field and may be worth consulting:

No Stomach for Cancer, the founders of Stomach Cancer Awareness Month

Can’t Stomach Cancer

The Gastric Cancer Foundation

The Life Raft Group, an organization that focuses on GI stromal tumors.

As with all of these cancer awareness posts, I hope that everyone reading this found it helpful and informative. I know I learned a lot researching it and will be a more effective cancer advocate for it!

Note: While I am a biomedical scientist, I am not considered an expert (medical or otherwise) on stomach cancer. This post, as with all of my “awareness month” posts, is not meant to be an in depth review of stomach cancer. Rather, I only wanted to provide a brief overview of stomach cancer in order to help further the larger cancer community’s awareness of this common cancer. Moreover, while I provided links to a number of stomach cancer organizations at the end of this post, I have not researched these organizations to the extent that I do for my “Spotlight On” series of posts. Until I can research them further, I am not explicitly advocating financial donations to these organizations (although I certainly won’t advise you against it either should you find them worthy!). Instead, I am recommending them here because each organization is a well respected leader in these specific areas and is considered a reputable source for further information on stomach cancer.

 

#NHBPM Post 2: Where Do the Candidates Stand on Health, Science, and Research Issues?

Sunday, November 4th, 2012

Note: This post is a part of WeGo Health‘s National Health Blog Post Month: 30 posts in 30 days challenge. The prompt for Day 2 that I’m responding to is “Find a quote and use it for inspiration”. To see the rest of my #NHBPM posts, please click on the image at the bottom of this post.

“Whenever the people are well-informed, they can be trusted with their own government.” ~ Thomas Jefferson

Unless you live under a rock, you know that this coming Tuesday is Election Day here in the United States. While many people have already early or absentee voted, the bulk of Americans (including me) will be going to the polls to cast our votes for the next President of the United States, for our members of the House of Representatives, and for other elected officials at all levels of government. As a research scientist who has been funded by a federal grant from NIH, the platforms of our candidates on research investments and regulation are incredibly important to me. The US government is far and away the largest investor in science and health research in the country. As both advocates for and beneficiaries of this life changing (and economically stimulating!) research, I think it is important that everyone going to the polls takes a moment to understand where their chosen candidates stand on issues pertaining to science, health, and technology.

To help everyone be as informed voters as possible on the candidates’ positions on these issues, I’ve compiled a series of resources and reviews that I think present the candidates’ policies and positions as fairly as possible. If you feel that I’ve linked to a particularly biased source, please let me know in the comments. While I definitely have my own personal preferences for how this election will turn out, it is not my goal here to sway anyone’s vote towards or against a specific candidate. Rather, I just wanted to point out some solid resources for those looking to better understand the candidates’ positions before voting on Tuesday.

ScienceDebate.org

Science Debate is an initiative that was started a year ahead of the 2008 election by six concerned citizens (two screenwriters, a physicist, a marine biologist, a philosopher, and a science journalist) in order to help bring science and technology issues to the forefront of the political debate. As they note on their website, within weeks of its founding, the Science Debate initiative had been endorsed by more than 38,000 scientists (including me!), engineers, and other concerned Americans, including every major American science organization, dozens of Nobel laureates, elected officials, business leaders, and the presidents of over 100 major American universities.  Their “call to arms”, as it were, states:

“Given the many urgent scientific and technological challenges facing America and the rest of the world, the increasing need for accurate scientific information in political decision making, and the vital role scientific innovation plays in spurring economic growth and competitiveness, we call for public debates in which the US presidential and congressional candidates share their views on the issues of the environment, health, and medicine, and science and technology policy.”

While the movement has yet to persuade the candidates for President to take part in a physical debate on these issues, it has been successful at pushing the candidates to more clearly define their positions on science, technology, and research. Starting last year, the folks at Science Debate began crowd sourcing a collection of important science questions that scientists, engineers, and concerned citizens wanted to hear the candidates answer. Together with their partner organizations (you can find the list of these organizations on their website), Science Debate culled the list to 14 critical questions, which were then presented to President Obama and Governor Romney. A subset of 8 questions were also presented to 33 members of Congress who serve in leadership positions on committees or subcommittees dealing with science issues. The answers from both Obama and Romney can be found here and the list of Congress members who were surveyed along with links to their responses can be found here.

The questions that were asked cover a wide range of topics and include: Innovation and the Economy, Climate Change, Research and the Future, Pandemics and Biosecurity, Education, Energy, Food Safety, Water Safety and Availability, Internet Regulations, Ocean Health, Science in Public Policy, The Future of Our Space Program, Protection of Critical Natural Resources, and Vaccinations and Public Health. The responses from each candidate are presented side by side, making it easy to compare and contrast between their positions on these issues.

For more information, please visit the Science Debate website here. You can also find Science Debate on Facebook here.

AAAS.org and Science Magazine’s Review of the Republican and Democratic Party Platforms on Science

Following the completion of both the Republican and Democratic conventions in September, Science magazine, the primary publication of the American Association for the Advancement of Science (AAAS) and one of the pre-eminent science journals in the world, published this editorial reviewing the platforms of both the Republican and Democratic parties on issues relating to science, technology, and the environment. The article touches on the parties’ overall stance on research funding, as well as their positions on funding for embyronic stem cell research, climate change, the future of our space program, energy policy, immigrant scientists, the role of “politicized” science, and actual budgets for this work proposed by each party. I felt that this piece was both comprehensive and fair in its assessment of each party’s platform. Please note that while this article is free to read, you may need to register with the AAAS website in order to view it.

The same author also wrote this editorial for the ScienceInsider section of the AAAS website on Paul Ryan’s record on science and government following his selection as Mitt Romney’s running mate in August. This analysis focused heavily on the funding allotted for various science agencies and initiatives in the budgets that Congressman Ryan has proposed over the years in his position as the Chairman of the House Budget Committee. To my knowledge, this article does not require registration to view.

You can read more about AAAS on their website, here, and you can find the website for Science magazine here. You can follow AAAS on Twitter, here, while the Twitter feed for Science magazine is here.

Research!America’s Your Candidates – Your Health Initiative

Research!America is the nation’s largest not-for-profit public education and advocacy alliance committed to making research to improve health a higher national priority. Research!America recently completed some polling that showed that (to quote from their website) “while Americans consistently describe medical, health, and scientific research as important, just 8% of people say they are very well informed about their elected officials positions on these issues”. To help address this shortfall and to aggregate presidential and congressional candidates positions in one place for easy access, they launched the Your Candidates – Your Health questionnaire and website in 2006. In a similar vein to ScienceDebate.org, Research!America sent a letter explaining the initiative and a 13 question survey to every candidate for President or Congress who appears on the ballot this November. All of the responses that they’ve received to date have been published on their website unedited, where they are easily searchable by state, zip code, or name.

Questions in the Your Candidates – Your Health survey touch on: the role of health research investments in rising healthcare costs, investment in research and innovation as a job creation strategy, STEM (science, technology, engineering, and math) education, military investments in research, the budgets for science and technology agencies including the CDC, AHRQ, and the FDA, research and technology tax credits, the role of the government in prevention research, federal funding of embyronic stem research, and whether or not candidates have a science advisor.

It should be noted that Governor Romney chose not to answer each question individually, and instead released a statement summarizing his position on many of these issues, which can be found here. President Obama’s responses can be found here. You can find the responses of the candidates for congressional seats by searching here.

Starting in 2006, Research!America has also been collecting and posting the responses of the sitting members of Congress to these types of questions, on their Your Congress – Your Health website. It is worth noting the questions on the survey have changed over the years and some of the responses on the Your Congress – Your Health page are in response to questions that are no longer a part of the survey. For reference, you can find Congressman Ryan’s answers (submitted in June 2007) here. President Obama’s answers from when he was in the Senate (submitted in July 2007) can be found here. Vice President Biden did not respond the survey while he was still serving in the Senate.

You can find more information about Research!America on their website, here. You can follow Research!America on Facebook, here, and on Twitter, here.

CancerVotes.org

In recognition of the fact that cancer will kill more than half a million people in the United States this year alone, CancerVotes was started by the American Cancer Society’s Cancer Advocacy Network (ACS CAN) to help educate both the public and the candidates about the actions that lawmakers should take to make fighting cancer a national priority. As Chris Hansen, the president of ACS CAN, puts it:

“While we have made great progress against cancer, the disease continues to kill 1,500 people a day in this country. Lawmakers have the power to make decisions that directly impact the lives of cancer patients and their families, which is why it is important that the public understands where candidates for every office stand on issues critical to fighting and preventing this disease.”

As part of their work, CancerVotes presented Governor Romney and President Obama with four questions addressing the most pressing issues for cancer patients and their families prior to the first televised presidential debate. The candidates’ answers to these questions were then posted on the CancerVotes website, and can be viewed here under the title “US President Voter Guide”. The four topics covered in this guide are: the role of the government in leading the fight against cancer, cancer prevention, access to care, and protecting citizens from the dangers of tobacco consumption. The answers from each candidate are again presented side by side for easy comparison.

You can find more information on ACS CAN on their website, here. You can also follow ACS CAN on Facebook, here, and on Twitter, here. You can also follow CancerVotes on Twitter here.

I hope that everyone finds these resources informative and helpful as you all make your way to the voting booth on Tuesday. You are all going to vote, right?!

 

Getting Back on Track with #NHBPM!

Friday, November 2nd, 2012

So…

After a really dedicated month or two of blogging, I sort of fell off the regular posting train there, didn’t I? And during Breast Cancer Awareness Monthno less, when I had so many topics that I wanted to post about it. Alas, after a few months of relatively low key unemployment, my October got REALLY busy. Busier than I’ve been since my dissertation defense last December. Here’s just a sampling of what I was up to in October that kept me away from writing:

Taking meetings on The Hill!

  • I spent four days in Savannah with my family celebrating both my husband & a cousin’s shared birthday and another cousin’s wedding. It was a BLAST.
  • I spent three days volunteering at and attending the Network for Public Health Law conference here in Atlanta, networking my tail off and learning so much about this fascinating aspect of public health. If you follow me on Twitter, I was blowing it up with conference tweets there for a bit using the hashtag #PHLC2012.
  • I spent four days in Washington DC taking a series of informational meetings on public health careers within the federal government and government affairs that a long time friend and colleague of my mom’s generously offered to set up for me. I also got to see some of my closest friends from Atlanta, almost all of whom have relocated to DC over the years, including their cutie kids Alice and Soren!
  • I also had a series of informational meetings with folks working in public health here in the Atlanta area that came out of my networking at the NPHL conference.
  • I took part in a number of public health related webinars and web/twitter chats, something I’ve been doing regularly since last spring in order to learn as much as I can about the current state of public health and the big challenges facing those working in the field.
  • I volunteered at two health fairs on behalf of the Atlanta affiliate of Susan G. Komen for the Cure, helping to hand out important information on breast health care, mammography, and breast cancer, something I’ve been doing now for about seven months.
  • I volunteered twice with the Atlanta Track Club, helping them prepare for the Atlanta Marathon and Marathon Relay that took place on October 28th. I LOVE getting to know people in the Atlanta running community and being a part of these events even if I wasn’t running – so inspiring!
  • Speaking of running, I ran in the Winship Win the Fight 5K to raise money for the Winship Cancer Center at Emory University. I also walked in the American Cancer Society Making Strides event in Marietta and ran in another local race as well.
  • I cheered on my friends on the last day of the Atlanta 3 Day for the Cure, which unfortunately overlapped with my DC trip so I couldn’t take part on the other days.
  • And in the midst of all that, I got the worst head cold I’ve had in years that is still with me more than two weeks later. Ironically, I’m pretty sure I picked it up from the Health Policy Director for the Senate Health, Education, Labor, and Pensions committee.

Meeting “new” friends and #3DayTweeps at Closing Ceremonies for the Atlanta 3 Day!

Plus I was still trying to keep up with my usual job searching and training activities throughout all of that. As I said, it was a crazy busy month and I’m honestly not surprised I got sick in the middle of it. I haven’t been out running around like this in a pretty long time. And with all of that going on, something had to give and that something was my blog, just for a bit.

BUT! Looking at my calendar for November, things look a lot calmer. Things seem to maybe, possibly, be settling in on the job search front (no more details for now until things are more definite… ) and I’m not planning to attend any races or big advocacy events in November. In fact, the only really big thing on my calendar is my husband and I’s first trip home to New York for Thanksgiving in nine years. So my big goal for this month is to pick up where I left off with my blog. Which brings me to #NHBPM

#NHBPM is the Twitter hashtag associated with WEGO Health’s National Health Blog Post Month. WEGO Health is an online network of health activists that I’ve been keeping up with primarily via Twitter over the last few months. WEGO’s primary goal is to connect health activists using social media platforms  and to help health bloggers especially by providing useful resources and inspiration. WEGO Health also sponsors weekly twitter chats focused on various challenges facing online health activists that I’ve found pretty interesting, including one on breast cancer activism last week.

Inspired by other November writing challenges, like NaNoWriMo and BlogHER’s NaBloPoMo, National Health Blog Post Month is WEGO Health’s latest initiative to help foster conversations amongst the health activist community of which I consider myself a member. The challenge is relatively simple in concept: 30 health-related blog posts in 30 days. To help with this challenge, WEGO Health has set up different writing prompts for each day of November that I’m mostly going to try to stick to. I say mostly because I’ve looked over the prompts and there are some days where I’m just not inspired by either of the prompts that were given. So on those days, I’ll go “off script” a bit and instead post on the topics that I’ve been meaning to write about for a long time now. Knowing myself and how I work, I can already tell you that I won’t necessarily get a post up every single day either (like, uh, yesterday… ). But it’s my goal that by the end of November, I will have written and posted 30 different blog posts relevant to my little corner of the health activist world, which is breast cancer research advocacy.

Since I’m a day behind already, I’m going to roll my #NHBPM response for Day 1 right into this blog post. For each day of this challenge, there are two prompts and as bloggers, we’re challenged to reply to one of them. So, for Day 1 the prompt I’m choosing to start with is:

Why I write about [my] health…

First and foremost, I should note that I differ from the majority of WEGO Health’s bloggers because I generally don’t write about my own health (other than talking about my training for events) and I definitely don’t write about my experiences with a given health condition from the perspective of a patient. While I do choose to focus my efforts on one particular disease (breast cancer, natch), I instead write my blog from my perspective as the daughter of a cancer survivor, a biomedical health researcher, and a passionate research advocate. As I’ve dug further into the breast cancer advocacy community, I’ve come to realize that, through no fault of their own, health research advocates, while well meaning, are often ill-informed about the actual process and needs of biomedical research. Rather, I think this mis-information is the fault of scientists who have done an exceptionally poor job advocating for themselves and educating the public about why science and health research is so critical if we want to live in a world with breast cancer. Or diabetes. Or Alzheimer’s disease. Or any of these diseases that are stealing our loved ones from us far too frequently. So as a biomedical research scientist (I studied neural/immune control of heart function as an undergraduate and Alzheimer’s disease and mild cognitive impairment for my doctoral work), I decided it was time for me to heed the advice of Ghandi and be the change that I wanted to see in the world.

Ultimately, I have three primary goals that I’m working towards by writing this blog:

  1. I want to be the best advocate I can be by learning as much as I can about the current state of breast cancer research, funding, and policy. Researching and writing this blog helps me achieve that for myself.
  2. I want to help my fellow advocates be the best advocates they can be by helping them to understand the biomedical research community and its needs from an insider’s perspective. I don’t think I do this nearly enough, and I want to change that.
  3. I want to inspire those who are currently on the sidelines to get into the game when it comes to health advocacy, whether they choose to focus on breast cancer in particular or not. We are all human beings walking around in vulnerable bodies, which means we all stand to benefit from a better understanding of public health best practices and from more/better biomedical research. I hope that by highlighting various ways to get involved in advocating for improved health education, greater disease awareness, and increased research funding, I can motivate others to join me in my efforts.

So that’s why I choose to write about health issues. Hopefully with each post that I write, both throughout #NHBPM and beyond, I’m getting closer to achieving those goals!

Thyroid Cancer Awareness Month!

Thursday, September 27th, 2012

September was a busy month full of cancer awareness observances and I’m not quite done yet!

As I’ve mentioned in the introductions to the other “cancer awareness month” posts that I’ve written, I believe very strongly that even though I identify myself as primarily a breast cancer advocate, it is important for me to have some level of understanding of the other major cancer types. To help broaden my knowledge, I’ve been using the various cancer awareness observances as my guide for which cancers to research and write about. And as it turns out, there are A LOT of them in September. Over the course of the last few weeks, I’ve written posts touching on Childhood Cancer Awareness Month, Blood Cancers Awareness Month, Ovarian and Gynecological Cancers Awareness Month, and Prostate Cancer Awareness Month. Today, to wrap things up, I’m going to write a little bit about thyroid cancer in honor of Thyroid Cancer Awareness Month.

Thyroid Cancer Awareness Month was first initiated by ThyCa: Thyroid Cancer Survivors Association back in 2000. When it was originally founded, it was only a week long observance that was extended for the full month of September in 2003. As ThyCa puts it on their website:

Thyroid Cancer Awareness Month promotes thyroid cancer awareness for early detection, as well as care based on expert standards and increased research to achieve cures for all thyroid cancer.

In my reading, I came across some assertions that due its relatively low mortality rates, thyroid cancer was the “good” cancer to get. Well, that’s just ridiculous. All cancer sucks because all cancer can and does kill people. There is no such thing as a “good” cancer to get. And with the fastest increasing incidence rate of all cancers in both men and women, it’s time to pay more attention to thyroid cancer!

About Thyroid Cancer

Thyroid cancer, following the traditional naming conventions in oncology, is any cancer that forms in the thyroid gland. That part should be pretty straightforward by now. But what exactly is the thyroid gland? Well, the thyroid gland is a small organ at the base of the throat, just below the larynx (voice box) that makes hormones to regulate the rate of metabolism. The thyroid is shaped sort of like a butterfly, with two larger lobes connected by a small piece of tissue called the isthmus. In healthy individuals, the thyroid is a little larger than a quarter and can’t be felt manually through the skin. The thyroid is composed of two primary hormone producing cells:

  1. Follicular cells, which use iodine from the blood to make the not so creatively named thyroid hormone (TH). TH is produced in response to increasing levels of the also not so creatively named thyroid stimulating hormone (TSH), which is generated and released from the pituitary gland. Because TH is required for metabolism, improper levels of TH can have a whole host of side effects. Someone who has too much TH (called hyperthyroidism), for example, often experiences irregular heartbeat, trouble sleeping, nervousness, hunger, weight loss, and feeling to warm. Having too little TH (which is called hypothyroidism), on the other hand, can cause a person to feel slow and fatigued and to gain weight.
  2. C cells, or parafollicular cells as their also called, which are responsible for producing calcitonin, a hormone that helps regulate how the thyroid uses calcium.

Thyroid cancer can develop in either thyroid cell type, giving rise to four major subtypes of thyroid cancers: papillary carcinoma, follicular carcinoma, medullary thyroid cancer, and anaplastic thyroid cancer. Let’s go through each one, one at a time.

The most common subtype of thyroid cancer is papillary carcinoma, which develops from the follicular cells. Because these are glandular cells, this type of thyroid cancer is also sometimes referred to as papillary adenocarcinoma. Papillary carcinomas, which account for 86% of all thyroid cancers, are generally slow growing, although they are prone to spreading into the lymph nodes of the neck. These cancers are usually isolated to only one lobe of the thyroid, although not always. Papillary carcinomas can usually be treated and are rarely fatal.

The second most common subtype of thyroid cancer is follicular carcinoma, which accounts for 9% of all thyroid cancer diagnoses. Follicular thyroid cancer is very similar to papillary thyroid cancer in that both types of cancer originate in the follicular cells and are relatively slow growing. However, unlike papillary thyroid cancer, follicular thyroid cancer generally doesn’t spread to the lymph nodes. Follicular thyroid cancer is most common in countries lacking dietary iodine. The prognosis for individuals diagnosed with follicular thyroid cancer is generally good, although not quite as strong as for those with papillary carcinoma. This is at least in part due to the relatively poor prognosis for the Hürthle cell carcinoma subtype of follicular cancer. Because Hürthle cell follicular carcinomas do not readily absorb radioactive iodine, they are often diagnosed at later stages and are much more difficult treat.

The third major subtype of thyroid cancer is medullary thyroid cancer, or MTC. Unlike the previous two subtypes, MTC develops from the c-cells of the thyroid. MTC, which accounts for 2% of all thyroid cancers, often results in abnormally high levels of calcitonin. MTC is usually slow growing and is treatable if caught before the cancer spreads to other parts of the body. MTCs can be linked to inherited mutations in the RET. This form of MTC, which I’m going to talk about more later in this post, is known as familial medullary thyroid cancer and accounts for 25% of all MTCs.

The most rare form of thyroid cancer is anaplastic thyroid cancer, which accounts for approximately 1% of all thyroid cancers. Anaplastic thyroid cancer also develops in the follicular cells, and is thought to sometimes develop from an existing papillary or follicular cancer. Because anaplastic cancer cells are highly dysmorphic and do not resemble healthy thyroid cells when examined under a microscope, anaplastic thyroid cancer is sometimes described as “undifferentiated” thyroid cancer. Anaplastic thyroid cancer is the most aggressive form of thyroid cancer, rapidly invaded the neck and then spreading to other parts of the body. Because of this, anaplastic thyroid cancer is relatively hard to treat.

Finally, while it is not technically a form of thyroid cancer, I wanted to just briefly write about parathyroid cancer, which is any cancer that develops from the four tiny parathyroid glands located at the back of the thyroid. Parathyroid cancer is very rare (with less than 100 cases occurring in the US each year) and generally results in elevated levels of calcium in the blood due to calcium dysregulation. Parathyroid cancer is much more difficult to cure than thyroid cancer.

While the cause of every form of thyroid cancer remains unknown, there have been a handful of risk factors that have been identified. For as yet unknown reasons, thyroid cancer is three times more common in women than in men. Moreover, women tend to be diagnosed with thyroid cancer at a younger age, with the peak rate of diagnosis for women occurring in their 40s and 50s while the peak rate of diagnosis occurring in their 60s and 70s. Eating a diet that is low in iodine has also been shown to increase the risk of developing thyroid cancer, although due to dietary supplements like iodized table salt, this isn’t generally a concern here in the US. While exposure to radiation can increase your risk of developing cancer in general, radiation exposure seems to be particularly strongly linked to an increased risk for thyroid cancer. This includes both exposure to medical radiation as a child and nuclear fall out from living near atomic bomb testing sites and disasters such as the meltdown of the Chernobyl nuclear power station. Finally, there have been a number of genetic mutations linked to the various subtypes of thyroid cancer, which I’m going to talk about in the next section.

The Genetics of Thyroid Cancer

There are two primary types of genes that, when mutated, can result in cancer:

  1. Oncogenes: These are genes that promote growth and cell division. These types of genes are usually turned “off” and are only switched on under highly regulated circumstances. When an oncogene becomes mutated, it becomes permanently turned on (and in some cases turned way up!), resulting in uncontrolled cell growth and division.
  2. Tumor suppressor genes: These are genes that are normally responsible for turning off the oncogenes and stopping cell growth and division before it gets out of control. When tumor suppressor genes become mutated, the off switch essentially is broken, allowing cells to continue growing and multiplying. The rate of cell growth and division isn’t higher, it’s just that the stop light is busted. As a result, mutations in tumor suppressor genes generally result in less aggressive forms of cancer.

Different cell types in the body seem to have certain genes that are more vulnerable to cancer-causing mutations than others. These mutations can be either inherited (meaning you were born with a bum form of the gene) or acquired (meaning you picked up that damage at some point during your life). Cancer due to inherited mutations is known as familial cancer and cancer that is due to acquired mutations is known as sporadic cancer. One of the great challenges in cancer research, then, is to identify both the vulnerable genes associated with each cell type (and therefore associated with each cancer type) and to identify the source of the mutations in those genes. In the case of thyroid cancer, and especially MTC, we actually have uncovered the answers to a few of these genetic questions.

The primary gene that has been associated with thyroid cancer is the gene RET. The mutated form of RET is the oncogene PTC. Acquired mutations in RET have been found to play a role in some papillary thyroid cancers as well as in approximately 10% of sporadic MTCs. Inherited mutations in RET, though, underly almost all cases of familial MTC. Nearly everyone who inherits a mutated form of RET ultimately develops MTC. As a result, if someone has a strong family history of MTC, many doctors will recommend genetic testing and potentially prophylactic removal of the thyroid as a means of preventing thyroid cancer.

Other oncogenes that have been associated with thyroid cancers include:

  • BRAF (oncogene) – mutations in BRAF have been associated with 30-70% of papillary thyroid cancers
  • NTRK1MET (oncogenes) – less common than BRAF mutations, mutations in these two genes have also been linked to papillary thyroid cancer
  • RAS (oncogene) – mutations in RAS have been linked to follicular thyroid cancer
  • p53 (tumor suppressor gene), CTNNB1 – mutations in these two genes have been linked to anaplastic thyroid cancer.

Hands down, the most important breakthrough in cancer research has been the recognition that cancer is ultimately a disease caused by genetic mutations. While we still have a lot of questions still to answer when it comes to the genetics of cancer, seeing how far we’ve come in understanding the genetic basis of thyroid cancer gives me hope that those elusive answers for all cancers are closer to being discovered than ever before.

The Statistics

It is estimated that 56,460 people will be diagnosed with prostate cancer in 2012, with 43,210 of those diagnoses occurring in women. 1780 people will die of thyroid cancer in that same time period. 97.5% of all people diagnosed with thyroid cancer live at least five years following initial diagnosis. One in 97 people will be diagnosed with thyroid cancer at some point in their lifetimes. The NCI allocated $16.2 million (or 0.32%) of their budget for thyroid cancer research in 2011, the most recent year for which those statistics were available.

Recommended Resources

If you would like to learn more about thyroid cancer, I highly recommend reading through the NCI’s web pages dedicated to thyroid cancers, which can be found here. Their “snapshot” report on thyroid cancer is particularly informative, especially the section discussing recent research investments and findings. I also found the American Cancer Society’s Learn About Cancer: Thyroid Cancer section to be very useful. All of the statistics cited in the post were from the Surveillance Epidemiology and End Results (SEER) fact sheet on thyroid cancer, which can be found here. These webpages were my primary sources of information for this blog post.

The American Association for Cancer Research recommends ThyCa: Thyroid Cancer Survivors’ Association for additional thyroid cancer advocacy and patient support information. I also recommend the Light of Life Foundation for more information about thyroid cancer in general and to learn how you can get more involved in advocating for thyroid cancer research.

As with all of these cancer awareness posts, I hope that everyone reading this found it helpful and informative. I know I learned a lot researching it and will be a more effective cancer advocate for it!

Note: While I am a biomedical scientist, I am not considered an expert (medical or otherwise) on thyroid cancer. This post, as with all of my “awareness month” posts, is not meant to be an in depth review of thyroid cancer. Rather, I only wanted to provide a brief overview of thyroid cancer in order to help further the larger cancer community’s awareness of this common cancer. Moreover, while I provided links to a number of thyroid cancer organizations at the end of this post, I have not researched these organizations to the extent that I do for my “Spotlight On” series of posts. Until I can research them further, I am not explicitly advocating financial donations to these organizations (although I certainly won’t advise you against it either should you find them worthy!). Instead, I am recommending them here because each organization is a well respected leader in these specific areas and is considered a reputable source for further information on thyroid cancer.

Prostate Cancer Awareness Month!

Tuesday, September 25th, 2012

Pushing on with my series of cancer awareness months, today I’m going to be writing about prostate cancer in observance of Prostate Cancer Awareness Month. After writing long posts for Childhood Cancer Awareness Month, Blood Cancer Awareness Month, and Ovarian/Gynecological Cancer Awareness Month, this post is hopefully going to be a bit more concise. However, that doesn’t mean prostate cancer isn’t as important as these other cancers. In fact, prostate cancer is the most common cancer in men outside of non-melanoma skin cancer and is the second leading cause of cancer death in men. So as a cancer advocate, I think it’s important to learn a bit more about this very common form of cancer!

About Prostate Cancer

The prostate is a gland within the male reproductive system that is located in front of the rectum and just below the bladder, where it surrounds the urethra. The prostate is responsible for producing the liquid component of the seminal fluid that helps to carry the sperm out of the body as part of the semen. The prostate grows rapidly during puberty in response to a testosterone derivative called dihydrotestosterone (or DHT). The healthy adult prostate is generally the size of a walnut and does not continue to grow larger with age, although a variety of conditions can result in an enlarged prostate. The most common of these conditions is called benign prostatic hyperplasia (or BHP), which generally only results in serious medical complications when the enlarged prostate begins to squeeze and constrict the urethra.

Prostate cancer, then, is any cancer that develops in the tissues of the prostate. Almost all prostate cancers are adenocarcinomas; that is, cancers that develop from the glandular cells of the prostate. Other (very rare) subtypes of prostate cancer include sarcomas (soft tissue cancers), small cell carcinomas, and transitional cell carcinomas. It is important to note that BHP is NOT a form of prostate cancer. While some prostate cancers can grow and spread very rapidly, the majority of prostate cancer grow incredibly slowly. These slow progressing cancers are often present within the prostate for years to decades before they begin to have any kind of symptomatic effects on the individual harboring the cancer.

While prostate cancer is not known to be caused by HPV infection, the slow growth of prostate tumors results in a long precancerous stage that is similar to that seen in cervical, vaginal, and vulvar cancers. These precancerous changes are known as prostatic intraepithelial neoplasia (or PIN) and can be classified as either high- or low-grade PIN. It is estimated that nearly half of all men will develop some degree of PIN by age 50. Men with high-grade PIN have a 20-30% chance of harboring prostate cancer at another site within the gland. The relationship between low-grade PIN is much less clear and may not be related to prostate cancer at all.

The primary risk factor for prostate cancer is age, with two-thirds of all prostate cancers being diagnosed in men over the age of 65. Prostate cancer is very rare in men under the age of 40. Certain races also appear to have a higher risk of prostate cancer. For example, prostate cancer is more common in African American men, who are also twice as likely to die from the disease. The reason for this increased risk is unknown at this time. A family history of prostate cancer is also linked to a higher risk of developing prostate cancer, with 5-10% of prostate cancers having a known genetic basis. Interestingly, while mutations in the BRCA1 and BRCA2 genes are most commonly associated with an increased risk of developing breast and ovarian cancer in women, mutations in these same genes also appear to be associated with an increased risk of prostate cancer. Finally, it appears that a diet high in red meat and dairy and low in fruits and vegetables may lead to an increased risk of prostate cancer, although the specific components of that diet that underly this increased risk are unknown.

Prostate Cancer Screening

Because there has been a lot of confusion surrounding prostate cancer screening tests, I felt like a section dedicated to the topic was warranted. There are currently two methods for screening for prostate cancer that are generally used in tandem:

  1. The prostate specific antigen (PSA) blood test, which detects elevated levels of the prostate-produced substance PSA in the bloodstream. A healthy prostate will generally (but not always) produce PSA levels between 4ng/ml of blood and 10ng/ml of blood. Men with PSA levels in this range have a 1-in-4 chance of harboring prostate cancer, while men with PSA levels above 10ng/ml have a greater than 1-in-2 chance of harboring prostate cancer. It is important to note that low PSA levels do not mean that a man is cancer-free; rather, approximately 15% of men with PSA levels below 4ng/ml are found to have prostate cancer on biopsy.
  2.  The digital rectal exam (DRE), which is a physical examination in which the doctor manually inserts his fingers (or digits) into the rectum to directly check the prostate for changes that may be related to cancer. DREs are generally used to confirm or dispute PSA test results.

These tests have unequivocally been shown to find more prostate cancers, especially in the early stages of the disease, than would otherwise be diagnosed without regular screening, resulting in a significant decline in the death rate from prostate cancer since their implementation. So why is regular screening for prostate cancer not recommended for every man over the age of 40? Well, it’s complicated. Let’s try to sort through it all.

First and foremost, while the PSA and DRE tests are good at detecting cancer, the range of biological variability inherent in the prostate (and the levels of PSA produced by it) means that they can also be inaccurate. Some men have very low PSA levels even in the presence of cancer, resulting in false negative tests. Otherwise healthy men may have elevated PSA levels due to a host of other, non-cancer, conditions, resulting in false positive tests. And the DRE suffers from anatomical limitations, again resulting in a number of inaccurate test results. So while these screening tests can be useful, they are by no means ideal.

Moreover, as noted above, prostate cancer grows VERY slowly. Many otherwise healthy men are walking around with undiagnosed prostate cancer that due to its slow rate of progression, will never cause them medical problems during their lifetimes. Regular screening, then, leads to what many in the medical community consider to be an overdiagnosis of prostate cancer. While many of these men would likely opt to treat an asymptomatic cancer should they become aware of it, the reality is that a large portion of those treatments are medically unnecessary. Ultimately, there is a growing belief that because the side effects of treating prostate cancer can have a significant impact on a man’s quality of life (much more so than the cancer ever would!), the benefits of identifying and treating these cancers in their earliest stages are not sufficient to warrant those risks for the majority of men.

In May of 2012, the United States Preventive Services Task Force (USPSTF) updated their recommendations for prostate cancer screening. The USPSTF currently does not recommend PSA screening for any men, stating that there is “moderate or high certainty that the service has no benefit or that the harms outweigh the benefits”. You can read their full report here.

The Prostate Cancer Foundation strongly disagreed with the USPSTF recommendations, and summarized both their response to the USPSTF and their position on prostate cancer screening here. They also noted, in this synopsis of the prostate cancer screening debate, that, “in contrast [to the USPSTF], physician-led groups, such as the American Society of Clinical Oncology and the American Urological Association, maintain that PSA screening should be considered in the context of a man’s life expectancy and other medical conditions.” They further note that “most experts agree that there is no role for PSA screening for men expected to live less than 10 years”.

The official position of the American Cancer Society on prostate cancer screening is in agreement with the physician-led groups cited by the Prostate Cancer Foundation. Specifically, they state that:

At this time, the American Cancer Society recommends that men thinking about prostate cancer screening should make informed decisions based on the available information, discussion with their doctor, and their own views on the benefits and side effects of screening and treatment.

The ACS specifically recommends that men of average risk for developing prostate cancer and who otherwise have every reasonable expectation of living for at least another decade should discuss screening with their doctors starting at age 50. Men of above average risk (i.e. African American men, men with one first degree relative with prostate cancer) should start having these discussions at age 45 and men of high risk (that is, men with multiple first degree relatives with prostate cancer) should start having these discussion at age 40. For men who choose to undergo regular screening, the ACS recommends that men with PSA levels below 2.5ng/ml have follow up tests every two years while men with PSA levels above 2.5ng/ml should have follow up tests annually. Men should make decisions about biopsies and additional treatments based on marked and persistent changes in these test results in consultation with their doctors.

The Statistics

It is estimated that 241,740 men will be diagnosed with prostate cancer in 2012 and that 28,170 men will die from the disease. 99.2% of all men diagnosed with prostate cancer live at least five years following initial diagnosis, primarily due to the slow rate of progression of these cancers. One in six men will be diagnosed with prostate cancer at some point in their lifetimes and one in 36 men will die from the disease, making prostate cancer the most common non-skin cancer in men and the second leading cause of cancer death. The US spends an estimated $9.9 billion on treating prostate cancer annually. For comparison, the NCI allocated $300.5 million (or 5.9%) of their budget to prostate cancer research in 201o, the most recent year for which those statistics were available.

Recommended Resources

If you would like to learn more about prostate cancer, I highly recommend reading through the NCI’s web pages dedicated to prostate cancers, which can be found here. Their “snapshot” report on prostate cancer is particularly informative, especially the section discussing recent research investments and findings. I also found the American Cancer Society’s Learn About Cancer: Prostate Cancer section to be very useful. The Prostate Cancer Foundation’s section on prostate screening recommendations, which can be found here, summarizes this complicated topic very well. All of the statistics cited in the post were from the Surveillance Epidemiology and End Results (SEER) fact sheet on prostate cancer, which can be found here. These webpages were my primary sources of information for this blog post.

If you would like to read more about the current prostate cancer screening recommendations of the USPSTF, you can find that information here.

The American Association for Cancer Research also recommends the following prostate cancer advocacy and patient support organizations:

Finally, while they weren’t listed on the AACR website, I also recommend the Prostate Cancer Foundation for more information about prostate cancer in general and to learn how you can get more involved in advocating for prostate cancer research.

I hope that every reading this found this informative. I know I learned a lot researching it and will be a more effective cancer advocate for it!

Note: While I am a biomedical scientist, I am not considered an expert (medical or otherwise) on prostate cancer. This post, as with all of my “awareness month” posts, is not meant to be an in depth review of prostate cancer. Rather, I only wanted to provide a brief overview of prostate cancer in order to help further the larger cancer community’s awareness of this very common cancer. Moreover, while I provided links to a number of prostate cancer organizations at the end of this post, I have not researched these organizations to the extent that I do for my “Spotlight On” series of posts. Until I can research them further, I am not explicitly advocating financial donations to these organizations (although I certainly won’t advise you against it either should you find them worthy!). Instead, I am recommending them here because each organization is a well respected leader in these specific areas and is considered a reputable source for further information on prostate cancer.

 

Ovarian and Gynecologic Cancers Awareness Month!

Wednesday, September 19th, 2012

A busy September of cancer awareness continues!
Cervical, Ovarian, Uterine, Vaginal, Vulvar. Get the facts about gynecologic cancer.

As a part of my efforts to become the most effective cancer advocate that I can, I have challenged myself to expand my working knowledge of cancer beyond just breast cancer. Using the assorted cancer awareness month observations as my guide, I have been using my blog to share what I’ve been learning about a number of different types of cancer. I have already dedicated posts to Childhood Cancer Awareness Month and Blood Cancer Awareness Month, and I’m planning to dedicate posts to Thyroid and Prostate Cancer Awareness Months as well. Today, though, I am going to focus on ovarian and other gynecological cancers in honor of Ovarian Cancer Awareness Month as well as the more broad Gynecologic Cancer Awareness Month. With more than 80,000 women expected to be diagnosed with a gynecological cancer in this calendar year, I think this awareness month is one that all women need!

Gynecologic Cancer Awareness Month was first established back in 1999 by the Foundation for Women’s Cancer. The goal of this month, which is marked every September, is to increase awareness of these cancers in order to enable earlier detection, better treatment, and a greater chance of recovery for individuals diagnosed with a gynecologic cancer. With the exception of cervical cancer, there are no established, reliable screening tests for any of these gynecologic cancers. Moreover, the symptoms associated with these types of cancer overlap significantly with other common infections and diseases, including urinary and bladder infections, common STDs, kidney stones, and even PMS. Because of this, gynecological cancers are often diagnosed at a more advanced stage, making it much more difficult to treat these cancers. Therefore, it is critically important that all women are familiar with what is normal for their own bodies and are knowledgeable about the range of cancers that can occur in the female reproductive system. To that end, I am going to use this post to give a brief overview of each of the five primary gynecological cancers (ovarian, uterine, cervical, vaginal, and vulvar cancers), some important stats for each, and a list of links where you can find additional information. Even if you are familiar with these cancers, it can’t hurt to review this information again!

Ovarian Cancer

As you might have intuited, ovarian cancer is any cancer that develops from the cells within the ovary. There are three general cell types that make up the ovary: epithelial cells (which make up the general structure of the ovary), germ cells (which give rise to the eggs), and stromal cells (the cells that produce the female hormones estrogen and progesterone). Each of these cell types can develop into one of three corresponding ovarian cancer subtypes. The most common subtype of ovarian cancer is epithelial ovarian cancer, which accounts for 90% of all ovarian cancers. Germ cell and stromal cancers are both significantly more rare, accounting for less than 2% and approximately 1% of ovarian cancers, respectively. There is no recommended screening test for ovarian cancer and the symptoms associated with ovarian cancers can be especially hard to discern from those associated with more common gynecological and renal disorders, making ovarian cancer very difficult to diagnose. As a result, while ovarian cancer accounts for just 3% of all cancer in women, it is the fifth leading cause of cancer death.

While the cause of most ovarian cancers remains unknown, a number of risk factors for the disease have been identified. In general, it appears that the more ovulations that a woman experiences over the course of her lifetime, the higher her personal risk for developing ovarian cancer, likely due to increased exposure to estrogen. Therefore, a history of taking fertility drugs or estrogen therapy is considered a risk factor for ovarian cancer. The flip side of that coin, though, is that anything that reduces the number of lifetime ovulations a woman experiences can lower her risk. This includes having multiple pregnancies, breast feeding, taking birth control pills, or having a tubal ligation. Women who are obese are also at increased risk for ovarian cancer because fat cells are capable of converting certain other hormones into estrogen. A family or personal history of ovarian, breast, uterine or colorectal cancer is also a risk factor for ovarian cancer because the genes that predispose individuals to those cancers (including BRCA1 and BRCA2) are often associated with an increased sensitivity to estrogen. As with breast cancer, older women are at an increased risk of ovarian cancer, as are women who have a history of smoking and/or alcohol use. However, while each of these risk factors may increase risk of ovarian cancer, having these factors does not guarantee that an individual will develop the disease, just as the absence of these risk factors does not guarantee that a woman will not develop cancer.

In terms of the numbers, it is estimated that 22,280 women will be diagnosed with ovarian cancer in 2012 and 15,500 women will die of the disease in that same time period. One out of every 72 women will be diagnosed with ovarian cancer in their lifetimes. The 5-year survival rate for ovarian cancer is just 43.7%. In the US, we spend approximately $4.4 billion treating ovarian cancer every year.

The National Cancer Institute (my primary source for this information, along with the American Cancer Society) allocated 2.2% (or $112.3 million) of its budget in 2010 for ovarian cancer research.

The information in this section was provided to the public courtesy of the NCI and the American Cancer Society. The ovarian cancer homepage of the NCI can be found here and the ACS ovarian cancer section can be found here. All of the statistics came from the Surveillance Epidemiology and End Results (SEER) fact sheets on ovarian cancer, here.

Uterine Cancer

Uterine cancer, as follows logic, is cancer that develops in the tissues that make up the uterus. There are two primary layers of the uterus that each give rise to a corresponding subtype of uterine cancer:

  1. The inner layer (or lining) or the uterus is called the endometrium. This is layer that thickens and grows each month in preparation for gestation. Cancers of this layer account for 98% of all uterine cancers and are known as endometrial cancer.
  2. The outer layer of the uterus is made of muscle tissue and is known as the myometrium. Cancers of this soft tissue are known as uterine sarcomas and are very rare.
Endometrial cancers are the most common gynecological cancer and account for 6% of all cancers in women. Endometrial cancers can be sub-classified based on the specific types of cells involved and then further graded based on the degree of “abnormality” in the cellular phenotype (phenotype = what it looks like). Because endometrial thickening normally occurs in response to estrogen, it follows logic that many endometrial cancers occur as a result of an improper response to normal estrogen stimulation and/or an over-exposure to estrogen. These estrogen-sensitive endometrial cancers (which are classified as “Type I” endometrial cancers) are generally not very aggressive and are commonly diagnosed at less advanced stages. Type II endometrial cancers, then, are endometrial cancers that are not related to estrogen. Type II endometrial cancers are generally more aggressive and are more likely to metastasize.
Because many endometrial cancers are estrogen-sensitive, anything that results in a shift in the balance between estrogen and progesterone towards estrogen is considered a risk factor for endometrial cancers. Examples of these types of risk factors include:
  • The use of estrogen therapy to treat menopause without a concomitant use of progesterone.
  • Being obese.
  • Taking tamoxifen. Tamoxifen acts as an anti-estrogen in breast tissue, but acts as a pro-estrogen in the uterus.
  • A history of certain subtypes of ovarian tumors that are capable of producing estrogens.
  • Poly-cystic ovary syndrome (PCOS)
  • A high lifetime number of menstrual cycles, due to early puberty, late menopause, never being pregnant/breast feeding, or some combination thereof.
Because of the lifetime accumulation of residual estrogen in the tissues of the uterus, estrogen imbalances are particularly potent in post-menopausal women, making age a risk factor for endometrial cancer. Other non-estrogen risk factors for endometrial cancer include a family or personal history of breast or ovarian cancer and endometrial hyperplasia, a condition in which a woman naturally produces a very thick endometrium. There are currently no screening tests for endometrial cancer and as with ovarian cancer, the symptoms of endometrial cancer can be hard to detect, making early diagnosis very difficult.
Uterine sarcomas are a rare type of uterine cancer that forms in the muscles or other soft tissues of the uterus. There are two primary subtypes of uterine sarcomas:
  1. Uterine stromal sarcomas, which develop in the supporting connective tissues (or stroma) of the uterus and account for less than 1% of uterine cancers. Stromal sarcomas are generally low grade (not very abnormal, slow growing) and the prognosis for this type of cancer is generally good.
  2. Uterine leiomyosarcomas (LMS), which develop in the muscle cells of the uterus and account for approximately 2% of uterine cancers.
Unlike endometrial cancers, uterine sarcomas are not influenced by estrogens or lifestyle/genetic factors that influence estrogen. The only known risk factors for uterine sarcomas are a history of pelvic radiation and race (with uterine sarcomas being twice as common in African American women as in white/Asian women, although the reason for this remains unknown). As with endometrial cancer, there are no screening tests for uterine sarcomas either.
It is expected that 47,130 women will be diagnosed with one of the two major types of uterine cancer in 2012 and 8,010 will die from these cancers in that same period. Uterine cancer will affect 1 out of every 38 women, with more than half of all uterine cancer diagnoses occurring in women aged 50 – 69 years. The five year survival rate for uterine cancer is 81.5%. The US spends $2.3 billion annually treating uterine cancer.
The NCI allocated $14.2 million (or 0.28%) of its budget in 2010 for research on uterine cancers.

The information in this section was also provided to the public courtesy of the NCI and the American Cancer Society. The endometrial cancer homepage of the NCI can be found here and the uterine sarcoma homepage of the the NCI can be found here. The ACS endometrial cancer section can be found here and the ACS uterine sarcoma section can be found here. All of the statistics came from the Surveillance Epidemiology and End Results (SEER) fact sheets on uterine cancer, here.

Cervical Cancer

Cervical cancer is any cancer that develops from the tissues of the cervix, which is the organ that connects the uterus and the vagina. There are two primary subtypes of cervical cancer:

  1. Squamous cell carcinoma, which develops from the outer layer of the cervix (or exocervix) and accounts for 80-90% of all cervical cancers.
  2. Adenocarcinoma, which develops from the mucus-producing gland cells that line the inside of the cervix (which is also known as the endocervix).

Cervical cancer is generally slow growing and unlike the other gynecologic cancers that I’ve covered thus far in this post, can be detected even in the pre-cancerous stages of the disease with regular pap tests. In addition, we also know that virtually all cervical cancers are caused by infection with the human papilloma virus (HPV), making cervical cancer one of the only cancers with both a known cause AND a reliable screening test. As a result, while cervical cancer used to be one of the leading causes of cancer death in women, the mortality rate of cervical cancer has declined by over 70% since 1955.

While cervical cancer is generally pretty rare, infection with HPV is not. In fact, over 50% of all sexually active people have been infected with HPV at some point in their lives, making HPV the most common sexually transmitted infection in the United States. While we often talk about HPV as if it is a single virus, the reality is that there are actually more than 150 genetically unique but highly related HPVs, more than 40 of which are capable of being spread via skin-to-skin contact. These viruses can be divided into two primary categories of HPVs: low risk HPVs that do not cause cancer and are primarily associated with genital/skin warts and high risk HPVs that are known to cause cancer. There have been at least 12 high risk HPVs identified to date. Infection with a high risk HPV accounts for approximately 5% of all cancers worldwide, including virtually all cervical cancer (as I noted above), 85% of anal cancers, and more than half of all vaginal, vulvar, penile, and oropharyngeal cancers. There are currently two FDA-approved vaccines targeted at preventing high risk HPV prevention. Safe sex practices are also important and effective for preventing HPV infection of any kind.

It is important to note that most high risk HPV infections have no symptoms and go away on their own with no medical treatment. However, occasionally, the body is unable to clear the infection on its own, resulting in a chronic HPV infection. Chronic HPV infection can result in cellular changes and abnormalities that, if left to grow and reproduce unchecked over a long period of time, can result in cancer. This process can take as long as 10-12 years after the initial HPV infection, resulting in a lengthy “pre-cancerous” phase. Fortunately, regular pap tests, in which the doctor scrapes cells from the cervix and examines them under the microscope for cellular abnormalities, can detect the majority of pre-cancerous cervical changes that can then be treated well before they ever develop into full blown cervical cancer. A pap test that is positive for abnormal cervical cells coupled with a positive test for HPV is very effective at identifying both cervical cancer and pre-cancerous cervical cells. As a result, the American Cancer Society currently recommends the following cervical cancer screening guidelines, even for those who have been vaccinated against HPV:

  • For women aged 21 to 29: Pap test every three years. No HPV screen.
  • For women aged 30 to 65: HPV test every five years or pap test every three years.
  • For women over the age of 65, regular screening can be stopped unless the individual has a history of abnormal pap tests and/or detection of precancerous cervical cells.

In terms of statistics, it is estimated that 12,170 women will be diagnosed with cervical cancer in 2012 and 4, 220 women will die from the disease. One out of every 147 women will be diagnosed with cervical cancer in their lifetimes, a number that has been markedly reduced over the past few decades due to the development and improvement of pap tests and behavioral modifications to prevent HPV transmission. The US spends $1.4 billion treating cervical cancer every year.

The NCI allocated $76.5 million (or 1.5%) of it’s annual in 2010 for cervical research, with large portions of that research focused on better understanding how HPV causes cancer and the detection and treatment of pre-cancerous cervical cell changes.

The information in this section was also provided to the public courtesy of the NCI and the American Cancer Society. The cervical cancer homepage of the NCI can be found here and the ACS cervical cancer section can be found here. I also found this overview of HPV and cancer from the NCI to be particularly informative. All of the statistics came from the Surveillance Epidemiology and End Results (SEER) fact sheets on cervical cancer, here.

Vaginal and Vulvar Cancer

Because there are a lot of similarities between vaginal and vulvar cancers and because both of these cancer types are fairly rare (together, they only account for 6 – 7% of all gynecologic cancers), I’m going to tackle these two cancers together. Vaginal cancers are, as you would imagine, any cancer that forms in the tissues of the vagina. Vulvar cancers are any cancer that develops in the tissues of the vulva (the external female genital organs including the clitoris, the vaginal lips, and the opening to the vagina itself). There are four major subtypes of both vaginal and vulvar cancers:

  1. Squamous cell carcinomas, which develop from the epithelial cells of both organs and are the most common subtype of both vaginal and vulvar cancers. In both organs, squamous cell carcinomas are generally slow to develop and include a long pre-cancerous phase as in cervical cancer. In the vagina, these pre-cancerous changes are known as “vaginal intra-epithelial neoplasia” or VAIN and in the vulva, these changes are known as “vulvar intra-epithelial neoplasia” or VIN. The stage of VAIN/VIN is used to describe the extent of cellular abnormalities present, with Stage I VAIN/VIN being the least abnormal and Stage III VAIN/VIN being the most abnormal.VAIN/VIN can be detected using a pap test, as in cervical cancer.
  2. Adenocarcinomas, which develop in the glandular cells of the vagina or vulva. Adenocarcinomas account for 15% of vaginal cancers and 8% of vulvar cancers. In the vulva, adenocarcinomas generally arise in the Bartholin glands, which are located just inside the vaginal opening or in the sweat glands of the skin.
  3. Melanoma, which develops from the pigment-producing cells of the vagina or vulva. Melanomas account for 9% of vaginal cancer and 6% of vulvar cancer. Melanomas are generally more aggressive than squamous cell carcinomas or adenocarcinomas. Basal cell carcinomas, a common but less aggressive type of skin cancer can also occur on the vulva, although they are very rare.
  4. Sarcomas, which develop in the soft structural tissues of the vagina or vulva. Sarcomas account for 4% of vaginal cancers and less than 2% of vulvar cancers.

Approximately half of all vaginal and vulvar cancers are caused by HPV infections and as with cervical cancer, these cancers can often be detected via pap test in the pre-cancerous stage. The risk factors for both vaginal and vulvar cancer are highly similar and include HPV or HIV infection, a personal history of other gynecological cancers, and a history of smoking and/or drinking alcohol. The risk of developing either of the cancers increases with age, with over 50% of all vaginal and vulvar cancers occurring in women over the age of 70. Other risk factors for vaginal cancer include exposure in utero to diethylstilbestrol (DES, a hormonal drug given between 1940 and 1971 to prevent miscarriage) and vaginal adenosis (a condition that affects 40% of all women where there are hormonal glands present within the vagina). Other risk factors for vulvar cancer include Lichen Sclerosis (a disorder that causes the vulvar skin to become very thin and itchy) and a family or personal history of melanoma/atypical moles.

It is estimated that 2,680 women will be diagnosed with vaginal cancer in 2012 and 840 women will die from the disease. During that same time period, it is estimated that 4,490 women will be diagnosed with vulvar cancer and 950 women will die from the disease. One out of every 368 women will be diagnosed with vulvar cancer at some point in her lifetime. The equivalent statistic for vaginal cancer was not available. Details about the annual cost of treating these cancers in the United States and the NCI research budget for these cancers was not available.

The information in this section was also provided to the public courtesy of the NCI and the American Cancer Society. The vaginal cancer homepage of the NCI can be found here and the ACS vaginal cancer section can be found here. The vulvar cancer homepage of the NCI can be found here and the ACS vulvar cancer section can be found here. The statistics on vulvar cancer came from the Surveillance Epidemiology and End Results (SEER) fact sheets on vulvar cancer, here. The equivalent statistics from SEER were not available for vaginal cancer.

Recommend Resources

If you would like to learn more about gynecological cancers in general, or one of these types of cancers in particular, I highly recommend reading through the NCI’s web pages dedicated to ovarian, uterine/endometrial, cervical, vaginal, and vulvar cancers. The “snap shot” reports linked to in each subsection are particularly informative, especially the sections discussing recent research investments and findings. I also highly recommend the CDC’s section on gynecologic cancers, especially the Inside Knowledge fact sheets.

The American Cancer Society also has the following subsections of their “Learn About Cancer” webpage dedicated to gynecologic cancers:

The American Association for Cancer Research also recommends the following cancer advocacy and patient support organizations for each type of gynecological cancer that I’ve covered here:

 

Note: While I am a biomedical scientist, I am not considered an expert (medical or otherwise) on any of these types of cancer. This post, as with future planned “awareness month” posts, is not meant to be an in depth review of these types of cancer. Rather, I only wanted to provide a brief overview of each type of cancer in the gynecological cancer family in order to help further the larger cancer community’s awareness of each of these cancers. Moreover, while I provided links to a number of gynecological cancer organizations at the end of this post, I have not researched these organizations to the extent that I do for my “Spotlight On” series of posts. Until I can research them further, I am not explicitly advocating financial donations to these organizations (although I certainly won’t advise you against it either should you find them worthy!). Instead, I am recommending them here because each organization is a well respected leader in these specific areas and is considered a reputable source for further information on gynecological cancers.