This is Part 2 in our 3-part coverage of the Employers Cancer Care Summit, held in February at Toronto’s Sutton Place Hotel.
A survivor of prostate cancer and past chair of the Prostate Cancer Canada Network – Toronto support group, Aaron Bacher is a strong advocate of cancer awareness and prevention programs. In particular, he encourages employers to promote prostate cancer education through initiatives such as lunch-and-learn events and offering coverage for PSA (prostate-specific antigen) testing, which is not covered by most provincial health plans.
The PSA test screens for a protein that helps indicate whether cancer activity is occurring in the prostate. The simple blood test is controversial because it is not 100% accurate. Nevertheless, “it is still the only game in town,” noted Bacher.
Men who have been diagnosed with prostate cancer can benefit greatly from a supportive workplace—even though many men will initially think they do not need any support. “It’s just that ‘male’ thing, when you’re expected to be macho and be able to handle anything that comes your way on your own,” said Bacher. But because of how much time everyone spends in the workplace, support from the employer is crucial.
Treatment options for prostate cancer vary depending on the individual and the stage of the cancer. Men who require surgery may be off work for four to six weeks, while those who have radiation may be able to continue working throughout their seven to eight weeks of daily treatments. Whatever the treatment, though, employers need to remember that it can be extremely difficult both emotionally and physically.
“Some men will say and/or think that [treatment] is no big deal, but, privately, they could be going through their own personal kind of hell,” said Bacher. “That’s why I believe that it is very important that other people know about your situation. Having others aware of what you are dealing with will allow them to understand better, and it might also allow them to think about taking better care of themselves.”
Opening doors
Treatment for cancer is constantly evolving, offering improved outcomes and fewer side effects. Advances are particularly evident in the treatment of lymphoma, as outlined by Dr. Michael Crump, a professor of medicine with the University of Toronto and attending physician, division of medical oncology and hematology, with Princess Margaret Hospital, University Health Network.
Until the mid-1990s, lymphoma was traditionally treated with a combination of chemotherapies known as CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone). Over the years, various “recipes” of drugs have been added to CHOP with little difference in progression-free survival (time until relapse) or overall survival (time until death).
Around the turn of this century, improved understanding of the biology underlying lymphoma led to new treatment discoveries. Researchers developed an antibody that specifically targets the protein on the outside of all B-cell lymphomas (which represent 90% of all lymphomas) and inactivates the cancer cells. Because it is a humanized antibody, it carries no toxic side effects. Added to the older chemotherapy recipes, the new treatment, called rituximab, offers improved results with no added toxicity.
Bendamustine is another drug showing promising results in lymphoma treatment. When used in combination with rituximab, bendamustine has been shown to improve progression-free survival rates in previously untreated patients or in those who become resistant or unresponsive to other standard therapies.
The key to these new treatments is the discovery that not all lymphomas are the same. “Research is getting better at defining lymphomas and targeting the appropriate gene,” said Crump. These new therapeutic targets open the door to more effective drugs and improved outcomes for patients. “This signals only the beginning of a broader rational approach to lymphoma therapy,” he added.
Looking to the future, Crump predicts that the next decade will show “small steps” in research developments, not the major leaps of recent years. And rather than one therapy that fits all, the best hope for lymphoma will likely be found in multiple, defined treatments.
Elizabeth Garel is a freelance writer and editor based in Toronto. editor47eg@yahoo.com
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