Skin Cancer Archive

Personalizing breast cancer diagnosis and treatment has resulted in therapies that are more effective and less toxic than in the past.

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The federal government's "Cancer Moonshot," with the expressed goal of curing cancer, is getting a lot of press lately. While the initiative's stated goal may be overly ambitious because cancer is actually 200 or more individual diseases, it promises to increase research funding and speed the availability of new treatments.

Amid the excitement, it's easy to overlook the fact that there has already been great progress in treating many cancers. Patients are enduring fewer side effects and living longer. Breast cancer is a prime example. "There's no question that breast cancer treatment is improving," says Dr. Ann Partridge, senior physician at the Susan F. Smith Center for Women's Cancers at Harvard-affiliated Dana-Farber Cancer Institute.

Ask the doctor

Q: I have developed numerous small, thin veins over my legs. I would like to get rid of them. What is the most effective treatment?

A: Dilated superficial veins, known as reticular or "spider" veins, are a common problem as men get older. The preferred treatment is sclerotherapy, but laser therapy is gaining popularity. Sclerotherapy involves injecting fluid into the veins with a small needle. This liquid causes irritation and inflammation of the vein, leading to its collapse. Laser therapy uses intense pulsed light to cause heat-related damage to the veins. Both treatments involve some discomfort. Wearing compression stockings afterwards appears to help improve outcome.

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Q: I am 68 years old, and recently my PSA level (which was normal before) increased to 5.2 nanograms per milliliter (ng/ml). My doctor repeated the test one month later, and it was normal again at 3.3 ng/ml. Should I still be concerned?

A: One of the reasons that routine PSA testing is so controversial is the inability of the test to distinguish men with prostate cancer from those without it. A common cutoff is 4 ng/ml, but this is hardly a black-and-white answer. In fact, 30% of men with a PSA result between 4 and 10 have cancer. (The remaining 70% have benign causes, like an enlarged prostate.) In men with a "normal" PSA in the 2-to-4 range, 20% have cancer. So the risk is still present.

Music therapy can calm anxiety, ease pain, and provide a pleasant diversion during chemotherapy or a hospital stay.

It's almost impossible to find someone who doesn't feel a strong connection to music. Even if you can't carry a tune or play an instrument, you can probably reel off a list of songs that evoke happy memories and raise your spirits. Surgeons have long played their favorite music to relieve stress in the operating room, and extending music to patients has been linked to improved surgical outcomes. In the past few decades, music therapy has played an increasing role in all facets of healing.

What is music therapy?

Music therapy is a burgeoning field. People who become certified music therapists are usually accomplished musicians who have deep knowledge of how music can evoke emotional responses to relax or stimulate people or help them heal. They combine this knowledge with their familiarity with a wide variety of musical styles to find the specific kind that can get you through a challenging physical rehab session or guide you into meditation. And they can find that music in your favorite genre, be it electropop or grand opera.

There’s almost always something we can do to improve our health and well-being — even at the end of our lives. Palliative care is designed to improve the quality of life for people with life-threatening illnesses and their families by keeping a person comfortable and making sure his or her values and preferences guide the medical team’s actions. For this reason, good communication with your care team — and your loved ones — is essential, even before you or a loved one has developed a serious illness.

Last year, only months after announcing that he had an aggressive form of melanoma, former President Carter declared that he was cancer free — thanks at least in part to a recently approved immunotherapy drug. Immunotherapy is a type of targeted therapy that helps boost the body’s own immune response to cancer. It does so while sparing healthy cells, thus minimizing side effects.

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Targeted cancer therapies have limits, but some may offer a better option than standard chemotherapy.

Mention cancer treatment, and most men think of chemotherapy—complete with hair loss and extreme fatigue. But for some men, there is another option. Targeted therapies can sometimes treat certain cancers with fewer side effects and better outcomes.

In the journals

If you have suffered a heart attack and plan to undergo prostate cancer treatment, you may want to weigh the risks and benefits of androgen deprivation therapy (ADT). ADT decreases the amount of androgens in the body, which prostate cancer needs to grow and survive. It is also often used along with radiation therapy, and the combination has been shown to prolong survival in men with unfavorable-risk prostate cancer—defined as cancer with two or more high-risk factors, like a PSA level between 10 and 40 ng/mL, a Gleason score of 7 or higher, or biopsies with 50% or higher cancerous cells.

But a study in The Journal of the American Medical Association suggests that men who had a prior heart attack can increase their risk of a fatal one if they undergo both radiation therapy and ADT. Researchers compared overall survival and death from prostate cancer, fatal heart attack, and other causes in a group of 206 men with unfavorable-risk prostate cancer. The men received either radiation alone, or radiation and six months of ADT. The researchers also categorized the men into subgroups based on other health conditions, including heart disease.

Ask the doctor

Q . I am 68 and in excellent health. I eat a healthy diet, exercise every day, and do not drink or smoke. I'm on no medicines. The only pill I take is vitamin D. But I'm wondering: is there any benefit in that?

A. In a nutshell, here's what we know. Our skin makes most of the vitamin D in our bodies after exposure to sunlight. Because most of us are indoors most of the 24 hour day, many of us have relatively low blood levels of vitamin D.