Online Resources

ASCO University
An educational resource for oncologists.
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Cancer-related Professional Information
A recent article in Community Oncology lists several web sites that can help one keep up with the explosive growth in cancer-related professional information, including CME, slide sets, professional meeting reports, and video presentations.
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OncologyTube

Research to Practice

Imedex E-Learning Center

Cleveland Clinic Center for Continuing Educati

Don't have a palliative care team but need help with symptom management?
Try the PAL-MED CONNECT Resource Hotline and talk directly to a specialist for free. The experts at the Institute for Palliative Medicine are available to provide resources and treatment options. This is a grant funded service and is free for healthcare providers to call when pain and symptom management issues arise.
Call 1-877-725-6334.
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The Cancer Support Community, Southern Connecticut Chapter

The Cancer Support Community (CSC) is a national organization that formed when The Wellness Community and Gilda's Club merged in 2010. The Southern Connecticut Chapter of CSC has a new website.

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Online Resources for Patients

The Ninth Annual Cancer Survivorship Series: Living With, Through and Beyond Cancer.

Free monthly (April 12 - July 12) one-hour telecourses for survivors and clinicians (CE for social workers).

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New Resources for Advanced Care Planning

Advanced Cancer Care Planning. Downloadable booklet from ASCO.

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Closure: Changing Expectations for End-of-Life. Guidance for talking with family and professionals about end-of-life wishes.

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Survivorship: During and After Treatment.
The American Cancer Society has reorganized its online resources for survivors.
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It's Never Too Late is an education campaign of the American Institute for Cancer Research that stresses that preventive measures lower cancer risk across the life span, even in elders.

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Recovery, Reappraisal, and Renewal After Cancer Treatment.

Article in Coping with Cancer by M. Tish Knobf, PhD, FAAN, AOCN of Yale School of Nursing.

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Continuing Education

Yale

Schwartz Rounds

Second Thursday of the month 12:00 PM

Lunch is provided. Smilow Cancer Hospital at Yale-New Haven in the Park St. Auditorium (CME)

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May 5

Nutrition and Cancer Survivorship: Separating the (Whole) Wheat from the Chaff

5th Annual Yale Survivorship Symposium

Yale's West Campus

Keynote Speaker: Suzanne Dixon. Continuing Education credits for physicians, nurses, registered dieticians, and social workers.

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Connecticut

October 20-21

End-of-Life Nursing Education Consortium (ELNEC): Geriatric Train the Trainer Course. Cromwell, CT. Sponsored by Connecticut Coalition to Improve End-of-Life Care and CT Department of Public Health. Stay tuned for details. (CNE)

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Elsewhere

May 20

Second Biennial Survivorship Research Symposium to Create Health Equality. Washington, DC.

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June 17 - 19

Cancer Survivorship and Sexual Health Symposium. Washington, DC.

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August 11 - 12

The Science of Compassion: Future Directions in Palliative and End-of-Life Care. National Institute for Nursing Research, Bethesda, MD.

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Online

What patients value when oncologists give news of cancer recurrence: commentary on specific moments in audiorecorded conversations (CME) from The Oncologist.

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April 2011 Volume 5 � No 4

Don't Rely on Supplements to Protect Against Cancer.

This month's title is taken from guidelines found in Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. It is probably human nature to look for simple, specific, even "magic bullet" solutions to major problems. Of course "major problems" are almost always complex and multifactorial - like cancer. We have learned a lot about specific nutrients and cancer over the past two decades, much of it is discouraging in the sense that each of the nutrients studied in large populations has not lived up to its promise, or have even proven to be harmful when given as supplements at higher doses than standard dietary recommendations.

Based on current knowledge, food in a well-balanced diet is the best source of vital nutrients. As Julie Lanford, a Registered Dietitian, writes in her blog, Cancer Dietitian, "It doesn't make much sense to take supplements if you aren't going to focus on the foods that you are eating!" Supplementation may be indicated for individuals who may be at risk of certain deficiencies based on diagnosis, treatment, co-morbidities, dietary restrictions, and the like.

It is possible that the recommended guidelines for certain nutrients need to be updated, based on newer information. This is a complex and controversial arena, as evidenced by the recent report (Brief Report also available) on vitamin D released, after an exhaustive review of the evidence, by a panel of the Institute of Medicine (IOM). Some groups were disappointed that the panel did not recommend significant increases in the amounts of vitamin D that we should consume. Susan Mayne, PhD, Associate Director for Population Sciences at Yale Cancer Center and Professor of Epidemiology and Public Health, and a member of the IOM panel, is co-author of an article on vitamin D and cancer prevention. Dr. Mayne and her colleagues report that, while there is strong evidence that vitamin D plays an important role in bone health, the evidence for efficacy in nonskeletal conditions is inconsistent and inconclusive. While they agree that vitamin D in cancer prevention is "biologically plausible," evidence from clinical trials is sparse. As with clinical trials of other isolated nutrients, trial design issues and conflicting outcomes make it difficult to identify strong enough trends to recommend vitamin D supplementation as a cancer preventative. And, as with some other trials of individual nutrients, there is evidence of potential harm (i.e., increased rates of some cancers) at higher serum levels of vitamin D. As their article title suggests, vitamin D supplementation for cancer prevention is not ready for prime time.

Dr. Mayne will be speaking on the topic of supplements for cancer survivors at the 6th Annual Yale Survivorship Symposium, Nutrition and Cancer Survivorship: Separating the (Whole) Wheat from the Chaff on May 5.

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Citation:

Manson JE, Mayne ST, Clinton SK. Vitamin D and Prevention of Cancer - Ready for Prime Time? N Engl J Med. 2011 Mar 23.

In the News

Riding for Cancer Survivors

Registration is open for two fundraising bicycle rides in southern Connecticut:

The 7^th Annual Connecticut Challenge will be held in Fairfield on July 24. Distances of 10, 25, 50, 75, and 100 miles are available.
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The inaugural Closer to Free ride on September 10 will raise funds to support the cancer services at Smilow Cancer Hospital at Yale-New Haven. Options for rides include 25 and 100 miles through scenic Connecticut Shoreline communities.
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The ASCO Cancer Foundation has become the Conquer Cancer Foundation.

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National Take Back Initiative, Saturday April 30

Due to the overwhelming success of the first Take Back day in September, the DEA and local agencies around the country are sponsoring a no-questions-asked opportunity for people to drop off unused medications for safe disposal. This effort will reduce the harm from accidental ingestion by children and others and prevent diversion of controlled substances.

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May is Oncology Nursing Month

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Latest CDC report on cancer survivor statistics.

The lead article in a recent Morbidity and Mortality Weekly Report (Mar 11, 2011;60(9):269-272) is devoted to the demographics of cancer survivors in 2007, the most recent national statistics available.

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Journal Watch

Survivorship

Robien K, et al. Evidence-based nutrition guidelines for cancer survivors: current guidelines, knowledge gaps, and future research directions. J Am Diet Assoc. 2011 Mar;111(3):368-75.

End-of-Life Care

Guenther MB. Healing: The Power of Presence. A Reflection. J Pain Symptom Manage. 2011;41(3):650-654.

Mahon MM. An Advance Directive in Two Questions. J Pain Symptom Manage. Mar 12, 2011.

Cummings GG, et al. Effectiveness of Knowledge Translation Interventions to Improve Cancer Pain Management. J Pain Symptom Manage. Mar 12, 2011. Read More >>

Palliative and Supportive Care

Alvarez A, Walsh D. Symptom Control in Advanced Cancer: Twenty Principles. Am J Hosp Palliat Care. Mar 10, 2011.

Jacobsen J, Blinderman CD. Subcutaneous Lymphatic Drainage (Lymphcentesis) for Palliation of Severe Refractory Lymphedema in Cancer Patients. J Pain Symptom Manage. Mar 12, 2011.

Lynch M, et al. Palliative Care Nursing: Defining the Discipline? J Hosp Palliat Nurs. 2011;13(2):106-111. Read More >>

Traeger L, et al. Parsing Depression From Fatigue in Patients with Cancer Using the Fatigue Symptom Inventory. J Pain Symptom Manage. Mar 12, 2011.

Other Articles of Interest

Buckman R, et al. Empathic responses in clinical practice: Intuition or tuition? CMAJ. 2011;183(5):569-571.

Fedirko V et al. Alcohol drinking and colorectal cancer risk: An overall and dose-response meta-analysis of published studies. Ann Oncol, 02/15/2011.

Luo J et al. Association of active and passive smoking with risk of breast cancer among postmenopausal women: A prospective cohort study. BMJ 2011 Mar 1; 342:d1016. http://www.ncbi.nlm.nih.gov/pubmed/21363864

o Boffetta, P, Autier P. Is breast cancer associated with tobacco smoking? BMJ. 2011; 342:d1093.

Wolin KY, et al. Physical activity and risk of colon adenoma: a meta-analysis. Br J Cancer. 2011;104(5):882-885.