You've Survived Cancer... Now What?

National Cancer Survivors Day is around the corner on Sunday, June 7 and it marks a day of celebration. Yet, at the same time, it can evoke so many emotions as survivors reflect on all they have experienced since being diagnosed with cancer. More so, it can also be a reminder of the uncertain journey ahead. Many survivors ask, "What will my future look like?"

Many aspects of a cancer survivor's life have been forever altered and the medical community is now more than ever is recognizing the need to provide individuals with a Cancer Survivorship Plan (CSP). In 2005, it was first recommended by the Institute of Medicine and National Research Council to provide a CSP to be written by the provider that coordinated the oncology treatment.

The American Cancer Society estimates they are approximately 14.5 million people with a history of cancer living in the United States. People are living longer after a cancer diagnosis because of advances in early detection and treatment. They expect by 2024, the population of cancer survivors will increase to almost 19 million. According to Cure Magazine, as the number of survivors continues to increase, the number of oncologists can't keep pace; meaning fewer oncologists and primary care physicians will be involved with long-term follow-up care. Therefore, it means that survivors need to become their own advocates.

I have listened with so many survivors talk about the winding and often bumpy road their cancer experience takes them on. Most survivors desperately want to resume their normal routines but that isn't always easy. According to Susan Leigh, a Cancer Survivorship Consultant and Founding Member of the National Coalition for Cancer Survivorship said, "After a cancer diagnosis, individuals and loved ones begin a journey of survival through stages that require different choices, decisions and resources. A shift from passive patient to proactive survivor helps foster a sense of hopefulness and cautious optimism when planning for life, though and beyond cancer."

Cancer survivors often tell us there are many debilitating emotions that accompany a cancer diagnosis such as, depression, anxiety and fear of occurrence. By advocating for themselves, survivors feel more empowered to live their best life. Cancer becomes their 'wake-up' call and it's not unusual to see a cancer survivor who has changed the direction of their lives by improving relationships, volunteering, embarking on a new career or pursuing their dreams. Since we established Friends of Mel in 2006, I've been amazed to see how many cancer survivors have founded non-profit organizations and many others that choose to volunteer - through that process cancer becomes secondary and giving back becomes their passion.

Woman credits ‘Grey’s Anatomy’ with saving her life after breast cancer diagnosis

An Israeli woman who was originally cleared for cancer after a routine breast exam says the TV show “Grey’s Anatomy” compelled her to return to the doctor— which ultimately saved her life, the Times of Israel reported.

Sarit Fishbaine, 34, a marketing director from south Israel, watched the show about six months after her first breast exam and felt the episode had an important message for her. In the episode, the fifth in the third season of the series, a young mother arrives at Seattle Grace Hospital to have a mastectomy done after doctors mistook her breast cancer for milk collecting in her breast.

“I couldn’t fall asleep that night — it felt like a huge warning sign,” Fishbaine told Yahoo Parenting. “I had stopped nursing a few months prior and my breast tissue had softened up, but there was definitely a lump on my left breast.”

Fishbaine sought a second opinion with a separate specialist the next day, and the doctor sent her for an urgent mammogram and biopsy, which revealed she had developed stage 3 breast cancer that spread to her lymph nodes, TimesOfIsrael.com reported. According to the American Cancer Society, stage 3 breast cancer has a five-year relative survival rate of 72 percent.

After undergoing chemotherapy, radiation and a mastectomy of her left breast, Fishbaine was completely cleared of the cancer, the news website reported.

Fishbaine told her story on her Facebook page on Sunday.

“Television isn’t educational. Television rots our brains. Watching television is a complete waste of time,” she wrote, before explaining her story of watching “Greys” then getting a second opinion on her health. “This is what can happen when you enjoy watching television. So remember— television isn’t educational,” she concluded.

Shonda Rhimes, creator of “Greys,” shared the Yahoo story on her own Facebook page with the caption “Humbling….” The post had nearly 4,960 likes as of Wednesday afternoon.

Valerie Harper: Lung Cancer Deadlier Than Breast

Yesterday, Sandra Lee announced she had breast cancer and was going to have a double mastectomy. Her cancer was detected via routine mammogram. Twenty years ago, it's unlikely Lee would have announced her diagnosis and surgery, or knew to get annual mammograms. Thanks to the Susan G. Komen Foundation, Breast Cancer Walks, the pink ribbon and free mammograms, breast cancer awareness has reached mass proliferation.

This week, to coincide with National Women's Lung Health Week, the American Lung Association's Lung Force initiative is raising awareness about an even bigger, deadlier health concern for women. Lung cancer is the number one killer of women. Twice as many women die of lung cancer than all other cancers, and yet only one percent of women have this disease on their radar. The long-held belief is that only smokers get lung cancer and that getting sick is just a consequence of that choice. Not true. Two-thirds of new cases are in women who quit many years or never smoked.

Valerie Harper is among them. She was diagnosed with the disease in 2009, and had surgery to remove a two centimeter tumor in her lung. She went public with her condition in 2013 when a recurrence appeared in the meninges membrane around her brain. Her oncologists gave her three months to live. Harper decided to use what time she had left to share her story and raise awareness about lung cancer. Two years and four months later, she's still doing the good work.

Harper spoke about her cancer fight at a Lung Force event in New York City yesterday. She looks fabulous and told the audience she feels great. Tarceva is keeping her disease at bay. During a panel discussion, she was vibrant and laughing, full of energy and warmth. You'd never think this seventy-six year old has cancer. After the event, we talked about her health and goals.

VF: Breast cancer uses a pink ribbon. Lung Force uses a turquoise swirl. Why?

VH: Turquoise is the color of air, of breath. The swirl is like the movement of air. We want people to breath freely, and to blow away cancer. More women are dying of the disease than all other cancers, including breast.

How were you originally diagnosed?

I needed an operation on my wrist, but before they let me on the table, they said, "You have to get a chest X-ray." When my doctor saw it, he said, "It could be nothing. I could be something horrible." I was shown the X-ray and saw a little round moon on the top lobe of my lung. I thought, What are you doing there? I had surgery and that was it. No chemo, no radiation. Four years later, I was at rehearsal one day, and I got a headache and couldn't remember my lines. It felt like Novocain on my head. It turned out to be a tumor in the meninges, a recurrence of the original cancer. People have asked me, "Aren't you mad at your doctor for not doing chemo the first time?" I'm not. I was cancer free for four years and I'm doing fine now. I do yoga and get acupuncture. I listen to my brilliant doctors. I've been lucky.

Had you been getting regular scans?

Yes! The initial lung X-ray saved my life. Since then, I get scanned every six months. That the tumor turned up in my meninges was totally random. I think everyone, rich or poor, with insurance or without, should get scanned. The importance of annual mammograms is ingrained. People should think the same way about annual lung screenings. Use your intuition. If you feel something isn't right, get checked.

According to the American Lung Association, a woman dies of lung cancer every eight minutes. In 2015, 71,000 U.S. woman will die of the disease.

It's almost an epidemic. I think it's due to the environment. Poor eating habits, not exercising enough. There's also a genetic factor. I never smoked and I got it. My mother never smoked and she died of it. My mother was diagnosed in her seventies, around the same age I was.

There are breast cancer genes, and colon cancer genes . . .

It's entirely possible there's a lung cancer gene, too. We need more money for research to find out. That's the goal of the Lung Force campaign. Also to spread the word far and wide, coast to coast, so awareness is as common as pizza. Women are dying in alarming number but only one percent are concerned. We can't let this be. No one deserves cancer. If anyone tries to blame a patient for getting sick, screw them. Stigmatizing an illness keeps people and organizations from donating to find a cure. All three of my mothers had lung cancer. My mother, my father's wife Angelica, and Nancy Walker, Rhoda's mother. I've been surrounded by it. I realized the other day that I should have been getting screenings earlier. I should have known better. But people are ashamed and afraid to talk about lung cancer. That has to change.

Kylie Minogue: Having cancer made me endearing

Kylie Minogue thinks having breast cancer made her endearing.

The 46-year-old pop princess was diagnosed with breast cancer in 2005, and, nine years after she was given the all-clear, has cited it as a reason that people like her, as it's changed "the way people look at" her.

When asked why she thinks she has managed to endear herself to straight men, gay men, and women, Kylie said: "Being diagnosed with cancer is the most devastating thing but there is also something incredibly positive. It changes you, it changes the way people look at you.

"Once I had breast cancer I realised things had changed. I met women on the street and they way they looked at me was different. I knew they weren't seeing 'Kylie', they were seeing me as a woman who'd gone through breast cancer. It was like these women were looking right at me. It definitely gave me this connection."

Kylie went on to say that another reason that she thinks she is relatable and popular with men and women alike is that she hasn't had children, and has never been married.

Speaking to Event magazine, the 'Spinning Around' singer said: "You look at a woman who seems to have everything and then you see this terrible thing has happened to her.

"Plus, I've got a really successful career but I haven't got everything. I haven't got the relationship. I haven't got children. It just didn't happen for me."

On Medicare and Assessing the Value of Lung Cancer Screening

You smoked for years. Maybe you still do. Now that Medicare promises to begin covering lung cancer screening, should you sign up?

That’s a difficult question.

The eligibility requirements seem fairly clear-cut: You can receive an annual low-dose CT scan if youare 55 to 77 years old, have a smoking history of at least 30 “pack years” — meaning that you smoked a pack a day for 30 years, or two packs a day for 15, and so on — and still smoke or quit only within the past 15 years.

More than 10 million Americans will be eligible for screening, the United States Preventive Services Task Force, an independent, volunteer panel of national experts, has estimated, though many of those millions aren’t yet Medicare recipients.

But screening will not help everyone who is eligible, experts warn. Like any medical test or procedure, it will subject some patients to harm.

“How do you make a blanket coverage decision about something that’s a good idea for some people and not so good for others?” said Dr. Michael Gould, a pulmonologist and senior research scientist at Kaiser Permanente Southern California, and a nonvoting member of Medicare’s coverage advisory committee.

That committee voted last year against covering the procedure, saying it found insufficient evidence of benefit. A few months earlier, the preventive services task force had come to precisely the opposite conclusion and recommended annual screening, which made coverage mandatory for private insurers but not for Medicare.

Overriding its own advisory committee, Medicare approved coverage but decided to require — a first — a “counseling and shared decision-making visit” with a physician or other medical professional before reimbursement for a scan.

“Because the follow-up testing is invasive, biopsies and such, and lung cancer has such serious mortality and morbidity risks, we wanted to ensure that Medicare beneficiaries were informed,” said Dr. Patrick Conway, chief medical officer at the Centers for Medicare and Medicaid Services.

Lung cancer, overwhelmingly caused by smoking, still causes more deaths than any other cancer, in part because it is hard to detect at more curable stages.

Unlike lumps in breasts, for example, “nothing in your lungs allows you to sense the presence of a nodule or mass,” said Dr. Douglas Arenberg, director of the lung cancer screening program at the University of Michigan Medical School.

With treatment, usually surgery, 70 percent to 80 percent of patients with Stage 1 lung cancer, and half of those with Stage 2, survive for at least five years. But most lung cancer is diagnosed when the disease is more advanced, leading to lousy overall mortality rates: Just 18 percent of all lung cancer patients survive for five years.

Pulmonologists have tried for years to find ways to detect lung cancer earlier. Experiments using ordinary chest X-rays proved disappointing. Then in 2011, researchers running the National Lung Screening Trial, involving 53,454 smokers and former smokers ages 55 to 74, reported encouraging findings: Patients who received a low-dose CT scan annually for three years were 20 percent less likely to die of lung cancer over an average of 6.5 years than those tested with X-rays.

Those results led to the preventive services task force’s endorsement and, eventually, to Medicare’s approval. “We’re covering evidence-based preventive services for beneficiaries, which will save lives,” Dr. Conway said.

How many lives? While the overwhelming number of people with lung cancer are or were smokers, most smokers don’t develop lung cancer. So although a 20 percent reduction in mortality sounds impressive, it represents a small number of people.

In the national trial, those screened with chest X-rays had about a 1.7 percent chance of dying from lung cancer during the study period; in the CT scan group, it was about 1.4 percent.

For every thousand people screened with a low-dose CT, three fewer died of lung cancer.

Lay people struggle to grasp these kinds of numbers. “They look at me and say, ‘Doc, just tell me what to do,’ ” Dr. Arenberg said. Or they give a how-can-it-hurt shrug and opt in: Maybe they’ll be among the three in 1,000 saved.

The problem is, testing can cause harm, too.

First, a high proportion of those tests will trigger a false alarm. CT scans can’t distinguish well between small nodules that aren’t dangerous and those that become lethal.

In the national trial, close to 40 percent of participants got positive results from at least one of their three CT scans, but more than 96 percent of these nodules weren’t cancerous.

False positives usually require additional scans, over several years, to determine whether nodules are malignant. Meanwhile, “you have to be willing to live with that uncertainty,” Dr. Gould said.

Worse, some positive results require more invasive follow-up, particularly biopsies, which also have risks, though low ones. Twenty to 25 percent of the time, a biopsy causes a pneumothorax, or collapsed lung, which usually heals on its own but occasionally requires hospitalization. Biopsies can also produce false negatives or dangerous bleeding.

For older people, the odds shift somewhat. Their cancer risk rises with age, so the scan will detect more lung cancer, according to an analysis of the national trial participants over age 65. But their rate of false positives rose, too, making invasive diagnostic procedures more likely.

At older ages, these procedures may not be trivial.

Elayne Green, a retiree in Boca Raton, Fla., learned this in 2013, when she was 76. Because she’d smoked for 30 years, before hypnosis helped her stop at 43, her health care provider recommended lung cancer screening. She agreed and paid $95 out of pocket. (She wouldn’t meet Medicare eligibility requirements now.)

The CT scan found a “hot spot,” she was told. Regular follow-up screenings “felt like a guillotine over my head,” she said. So Mrs. Green had diagnostic surgery called wedge resection, which found no cancer but caused considerable pain.

“I couldn’t wear a brassiere for three months,” she recalled.

Among the 65- to 74-year-olds getting CT scans in the national trial, moreover, many had other serious health problems — heart disease, diabetes, hypertension, pulmonary disease — which probably contributed to only 55 percent surviving five years, compared with 64 percent among those under age 65.

Researchers call it “competing mortality.” Finding lung cancer is a hollow victory if patients endure testing and treatment, then die of another illness before the cancer would have killed them.

Most older adults, especially smokers, have multiple chronic diseases. “If I find a teensy lung cancer in a 77-year-old with heart disease, I may not have done him any favor,” Dr. Arenberg said.

In fact, if screening finds cancer, some seniors won’t withstand the surgery, usually a lobectomy, that may cure it. The post-surgical death rate in the national trial was just 1 percent, but that involved major medical centers with specialized radiologists and surgeons — the ideal setting.

Nationally, deaths from this operation run two to four times higher, and they increase with the patient’s age. And the trial provides no information on screening results for those older than 77.

So those required “shared decision-making visits” with doctors will involve lots of very individual questions and judgments. Researchers are developing decision aids to guide physicians and consumers beginning to struggle with lung cancer screening. (A University of Michigan team has put a helpful one online at shouldiscreen.com.) And Medicare has established a registry to see how well large-scale screening works.

But it is worth remembering that however effective it is, screening can’t ward off disease. It only finds the damage already done.

“The only way to prevent lung cancer or reduce your risk,” Dr. Gould said, “is to stop smoking.”

What Cancer Patients Need to Know

Kathy Giusti is a multiple myeloma patient, founder of the Multiple Myeloma Research Foundation (www.themmrf.org). Kathy suggests you consult with your doctors on all of these topics.

Despite the fact that one in every two men and one in every three women will be diagnosed with cancer in their lifetime, no one ever expects it to happen to them. I surely didn't.

I was an otherwise healthy 37-year-old when I was diagnosed in 1996 with multiple myeloma, the same rare cancer Tom Brokaw has. Back then, the prognosis was grim: I was given three years to live.

The news was shattering. Like everyone, I had many moments of despair where I was certain my battle was over even before it had begun. But the thought of my beautiful little girl, just a year-old, gave me the determination to live.

Luckily, with the support of my family and friends, I was able to make several smart choices, like learning as much as I could about my cancer and getting second and third opinions, that empowered me as a patient. I didn't know it at the time, but these choices gave me the best chance of beating the lethal enemy.

Becoming an empowered patient is just as important—if not more so—for the estimated 1.7 million people who will be diagnosed with cancer this year. Our healthcare environment is incredibly complex and is changing rapidly. At the center of this new world is the patient, who increasingly plays an active role in his or her care and who ensures that they or their loved one benefit from today's research innovations or bold breakthroughs that have not yet been achieved.

Many people don't know the choices to make to empower themselves as patients. Here are a few things I have learned that I think you need to know:
Start by learning as much as you can about your cancer.

This not only brings a much-needed sense of control, but can help you begin your cancer journey on the right foot. Finding the most up-to-date information is key. Search for a reputable foundation that focuses specifically on your cancer—for example, the Multiple Myeloma Research Foundation, www.themmrf.org, is dedicated solely to multiple myeloma—or visit www.cancer.net, a great resource for all cancers from the American Society of Clinical Oncology.
Get a second or third opinion.

Being treated by a doctor who specializes in your kind of cancer is so important, especially for those of us who have rare or very rare cancers. They will have access to newer treatment options that may be offered only at big academic cancer centers so you don't miss out on treatments that could help you. But how do you know who's who? Again, contact a foundation that focuses on your cancer; they will likely already have a network of doctors who they can recommend.
Bank your tissue. This is perhaps the most important thing you can do.

While blood tests or body scans may have provided very strong hints to your cancer, your doctor will likely also need to collect a small piece of your tissue, called a bone marrow aspirate, to confirm your diagnosis. This is a pivotal moment because it is your one and only chance to have your doctor collect an extra sample of tissue before you have treatment. This tissue can be stored in a tissue bank and used throughout your cancer journey as a reference point; comparing your original tissue sample with those taken, for example, if you relapse, can help your doctor learn what treatment may work best for you in the future.

And finally, sequence your genome.

Banking your tissue will also allow you to have your cancer genome sequenced. Although not yet routine, many cancer centers have the technology to sequence some or all of a patient's cancer genome. This can provide massive amounts of valuable information about your cancer, including whether you have genetic mutations and other abnormalities for which new drugs are available. Even if it is not possible to have your genome sequenced today, having your tissue banked ensures that your genome can be sequenced at a later date.

These are choices that all cancer patients can—and should—make to give them the best chance of beating their cancer. We've made it a priority at the MMRF to better understand where, why, and how patients are getting stuck in their choices and, more importantly, what we and the cancer community as a whole can do about it.

A Fish With Cancer Raises Questions About Health Of Susquehanna River

Late last year, an angler caught a smallmouth bass in the Susquehanna River near Duncannon, Pa. That fish, officials from the Pennsylvania Fish & Boat Commission said this week, had a malignant tumor. It's the first time this type of tumor has been found on a smallmouth bass in the river, the agency says.

Cancerous growths and tumors on fish are "very, very infrequent," John Arway, the agency's executive director, said in an interview.

"These cancers can be initiated by contaminants," he said.

Scientists with the state's Department of Health say there is no evidence that carcinomas in fish present a health hazard to humans, but "people should avoid consuming fish that have visible signs of sores and lesions."

Catch-and-release regulations for smallmouth bass are already in place for the portion of the river where the fish with cancer was caught.

The state of the fish in the river could point to broader concerns over the health of the more than 400-mile-long Susquehanna, the longest river on the East Coast. Intersex fish — male fish that carry eggs — have also been found in the river.

Sources of pollution include nitrogen and phosphorous from fertilizers, discharge from sewage treatment plants and unused pharmaceuticals flushed down toilets.

In 2005, scientists began noticing young bass in the river with sores and lesions, leading to increased mortality rates.

"The weight-of-evidence continues to build a case that we need to take some action on behalf of the fish," Arway said in a statement on his agency's website.

Since 2010, Arway told NPR, the agency has asked the state to put the Susquehanna on a list of impaired waterways, a move that would pave the way for a restoration plan for the river.

"The state still doesn't think it has that information," he said. "But a new study is underway that will hopefully answer the question this fall."

The state's Department of Environmental Protection is expected to release its 2016 list in September. Arway says he hopes the Susquehanna will finally qualify.

"We are urging them once again," he said in the statement, "to follow the science and add the Susquehanna River to the list."

Ovarian Cancer Health Center

Survival Odds Improving for Ovarian Cancer
Women diagnosed today 50 percent less likely to die than they were in the 1970s, researchers say

Women diagnosed with ovarian cancer, traditionally viewed as an aggressive killer, are much more likely to survive the disease than they were several decades ago, new research shows.

"Ovarian cancer, unfortunately, is associated with a very high death rate," said study author Dr. Jason Wright, a professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons in New York City.

But that seems to be changing, he said.

"We wanted to do this study because there have been a number of advances in the treatment of ovarian cancer," Wright said. "There is better surgery, better chemo and better ways to deliver the chemo. More recently, there has also been a better understanding of the biology and genetics of the cancer."

To see if these advances have made an impact on survival rates, Wright's team evaluated nearly 50,000 women who were diagnosed with the disease between 1975 and 2011. All of the data came from a large national cancer database.

"We compared survival for women with cancer compared to women without cancer [in the general population]," he said.

After accounting for advances in general medical care, Wright said, "women diagnosed in 2006 compared to those diagnosed in 1975 are about 50 percent less likely to die from their ovarian cancer."

Survival improved for all stages of ovarian cancer from 1975 to 2011, Wright found. Women with stage 1 cancers were 49 percent less likely to die of the cancer in 2006. Those with stage 3 and 4 cancers were about 51 percent less likely to die.

The study is published in the June issue of Obstetrics & Gynecology.

About 21,000 women in the United States will get a diagnosis of ovarian cancer in 2015, according to the American Cancer Society, and about 14,000 women will die of the disease. Symptoms can be non-existent or vague, such as bloating and abdominal pain, so the cancer is often diagnosed in its late stages.

A new approach to diagnosing ovarian cancer, which looks at blood levels of a protein linked to the cancer over time, is under study and could speed diagnosis, British researchers reported recently at a medical meeting.

One expert was heartened by the findings of the new survival study.

"I think this data is actually quite exciting, to see that the life expectancy is actually better," said Dr. Don Dizon, clinical co-director of gynecologic oncology at Massachusetts General Hospital in Boston.

He called the improvement in survival "quite significant."

However, Dizon said, he believes the gains are not always coming about by cure.

"Patients are living longer due to advances in medicine in general," Dizon said. And "we have widened treatment options for women." However, "even when the cancer is not cured, we are often able to continue treating it to control the disease rather than cure it," he added.

"I think the public health message [of the study] is a good one," Dizon said. "Ovarian cancer is no longer a death sentence."

Young friends battling cancer together get grim news

The mothers of two little girls with cancer are grateful for the friendship they've forged while fighting the disease.

Ava Garcia, 4, was diagnosed last August with cancer of the kidneys. Right next door to her at Texas Children's Hospital was three-year-old Penny Smith. Doctors told her family she had a skeletal muscle cancer in May 2014. The two girls became fast friends. They recovered from surgery together and then saw each other every week during their chemotherapy treatments.

"It was like a playdate. Even though she was getting chemo, she was getting poked, it was stressful. It was easy going (to the hospital) knowing she was having fun," said Cindy Sagan, Penny's mother.

"It just made her more comfortable. She wasn't scared because she looked like her," added Ava's mother, Christina Garcia, referring to when she lost her hair.

Ava Garcia and Penny Smith became fast friends during their cancer treatments


The two mothers had hoped to be celebrating their daughters' remission together, but Penny's health has gotten worse.

"Are we looking at months? No, you're looking at weeks left with her," Sagan recalled of the recent conversation with her doctor.

Now Penny's in hospice at her northside home, where Sagan cares for her.

While she's still here, the mothers wanted to share the girls' story because they believe others can learn from them about friendship.

"They are best friends through tragedy but they found each other and they're going to hold on to each other for as long as possible," said Sagan.

"Penny got to enjoy enjoy having a best friend. Ava got to enjoy that and Penny will forever be in our hearts and we will always remember her," Garcia said.

Rare Cancer Discovered in Pennsylvania Smallmouth Bass

It's the first confirmed case of its kind in the Susquehanna River

A rare cancerous tumor was discovered on a smallmouth bass pulled out of the Susquehanna River.

The fish was caught last year, and the Pennsylvania Fish and Boat Commission confirmed the case this week. Fish are not particularly susceptible to cancer, and it’s the first such case in the species in that location, though fish were previously found with sores and lesions, the Washington Post reports.

The disease may be the result of pollution, and officials want the river to be included on the EPA’s list of “impaired waterways.” The EPA, however, says it bases that list on water quality, not the health of species living there.

A Pennsylvania Department of Health official said that consuming fish with cancer should not pose a risk to humans, but urged fishers not to eat those with sores and lesions.

A mother’s choice: Woman sacrifices life for unborn child after cancer diagnosis

When Max and his late wife, Liz, decided to participate in a documentary chronicling 13 families’ pregnancy journeys, they simply thought they were participating in an effort to shed light on the trials, tribulations and joys that come with conceiving and growing a child.

But when Liz Joice was diagnosed for the second time with undifferentiated sarcoma— a very rare cancer of the tissues that usually occurs in childhood— 13 months into her pregnancy, and then died six weeks after giving birth to their daughter, the footage soon took on a whole new meaning.

“I always want you to know how important you are— you’re bigger than me. She’s bigger than me,” Liz tells her unborn daughter, Lily, now 1, in footage included in the documentary “40 Weeks.”

Liz’s sacrifice made international headlines in spring 2014, when she succumbed to her cancer at age 36, but now, as Max, 35, raises Lily, he plans to use the video to teach his daughter about the mother with whom she shared too little time.

‘We saw ourselves as survivors’

Max and Liz met on election night 2008, and bonded over a love of politics and food culture. They each had rocky childhoods and saw one another as survivors.

Over Labor Day weekend in 2010, Liz was diagnosed with undifferentiated sarcoma. Max proposed the same day.

“We wanted to get married quickly given that she was afraid of losing her hair, and also on the practical side, we wanted me to be able to advocate for her more while she was going through treatment,” Max said.

Liz underwent chemotherapy, befriending other patients and inspiring them to stay strong, her husband recalled.

“She had the highest tolerance for pain and discomfort,” Max said. “One of the things that was so amazing was how positive she was— and there’s a lot to be said for how that helped her respond to the treatment.”

In spring 2011, Liz was cleared of cancer— but the treatment had induced early menopause. Her OB-GYN said there was “no way” she would ever get pregnant.

About two years later, Liz asked Max to go into the bathroom, saying she remodeled it as a surprise. When he walked in, he spotted two home pregnancy tests sitting by the sink. There were two tiny blue lines on each.

“Our minds were blown,” Max said. “We sort of felt like we deserved a miracle after what we’d been through, and we’d got it.”

Liz enjoyed every moment of growing a new baby, and Max was equally overjoyed.

“[Pregnancy is] harder on some women than others,” Max said, “There was rarely anything negative, and she was so happy throughout the whole time.”

‘The world’s cruelest joke’

While pregnant, Liz had frequent morning sickness, which reminded her of chemo side effects, but she didn’t think much of it— until she found a lump in her back in the same place as her previous tumor. It was then that everything shifted into focus.

“It was like the world’s cruelest joke,” Liz described in “40 Weeks.”

“She had a lot of guilt, not just with me but for putting everyone through it,” Max said. “And it was misplaced because she had nothing to feel guilty for.”

“Anger” was a useless emotion, Liz would always say. Instead, she channeled her positivity and focused on her and Max’s unborn child.

“I got a lot more reasons to fight now than I did before, and I did a pretty good damn job the first time, so I don’t expect this will be any different,” she said in the video. “I’m in mama bear mode— you’re messing with my cub, and I’m gonna take you out.”

Shortly after Liz learned she was pregnant, they were recruited for “40 Weeks,” a documentary featuring diverse women sharing their pregnancy stories.

Director Christopher Henze said he felt a personal connection with all the couples who are featured in the film, but that he felt an “elevated bond” with the Joices.

“They were just so open, and generous, and beautiful, and caring and smart,” Henze told FoxNews.com.

According to Lisa Singer, the “40 Weeks” casting director and Liz’s former running coach, her friend didn’t see cancer as a major complication.

“Even in her worst of times, even when she didn’t have her hair— every single thing, it wasn’t the end-all for her,” Singer said. She would say, ‘It’s OK, it’s a little blip in my life,’ and I truly thought she would beat it.”

‘She put a lot of faith in herself’

Liz planned to undergo surgery to have the tumor removed but also would need treatment to fully eradicate the cancer. But the contrast dyes used for full-body MRIs to determine whether the cancer had spread posed a big risk: possible damage to the fetus.

Various doctors gave Liz and Max three options: to continue the pregnancy without treatment and hope it didn’t spread; to terminate the baby and immediately begin chemotherapy; or to undergo chemotherapy during the pregnancy, which also risked harming the fetus.

“Liz put a lot of faith in herself and her ability to fight, and she was really hopeful it would turn out like the first time,” Max said.

In November 2013, Liz had the tumor surgically removed from her back, but she and Max chose to skip more invasive treatment to avoid possibly hurting the baby.

But around 33.5 weeks into her pregnancy, an X-ray scan showed that cancer had returned, spreading to her lungs, providing visual evidence for Liz’s increasing trouble with breathing. Doctors moved up her C-section six weeks so she could undergo treatment immediately, and on Jan. 23, Liz gave birth to baby Lily.

Further scans after Liz gave birth revealed the cancer had spread to her abdomen and her heart.

The first-time mom got six weeks with her daughter— a time Max described as “hellacious, certainly being at both ends of the spectrum, being so ecstatic and happy and amazed, but terrified and sad and scared.”

On March 9, 2014, Liz passed away after losing her battle with undifferentiated sarcoma. The “40 Weeks” crew followed her and Max right up to Liz’s labor, when she gave birth to Lily— delivered weighing 4 pounds, 3 ounces— at week 33 in Liz’s pregnancy. The camera crew also captured the family at home after Lily spent three days in the NICU.

‘It was unspoken’

In “40 Weeks,” which was released on DVD in December 2014, the Joices discuss how fortunate they felt that they were able to bring Lily into the world.

“A lot of people never get to experience the kind of love that we had for Lily and for each other … and even though it didn’t end how we wanted it to, not everybody gets to experience what I did,” Max told FoxNews.com.

Singer always knew her friend would be an inspiration for cancer patients who feared they wouldn’t have children, but she never expected Liz’s story to turn out this way.

“She was supposed to be the happy, positive role model, and she still will be but not in the way she was supposed to be,” Singer said.

Henze and Debroux have made videos to help Lily learn about her mom as she grows up.

“Everything happens for a reason,” Singer said, “and maybe the reason that I cast her in the movie is that [Lily is] able to have all this footage of her mom. And Max will always be able to remember them as a couple and the happy times, and Lily will always know how much her mother loved her and that she gave up her life for her.”

In the future, the footage will play an important role in Lily’s life, Max said.

“It was unspoken that she wanted Lily to know how much her mother loved her,” he said, “and was willing to sacrifice for her and how much good came out of that sacrifice.”

In honor of Mother’s Day, on Saturday, May 9, Big Belli— a virtual community for expecting mothers that was created by Henze and his wife, co-producer Dominique Debroux — is hosting a fundraising walk in New York City in honor of Liz Joice. Donations from the second annual event will benefit The Sarcoma Foundation of America.  

Killing cancer with a virus

Phil Bauman was 48 years old, with a wife and young son, when the worst headache of his life turned out to be a fast-growing, incurable brain cancer, galled glioblastoma. “It was scary stuff, you know, said Phil, “my kid was 8.” Survival for patients is measured in months. If the tumor can be removed, 14 months is considered a good prognosis.

Phil opted for surgery to remove the tumor, but, as doctors predicted, the cancer came right back. “Characteristically they come back every 6 months, mine did,” said Phil.

His wife Misty was terrified, “They multiply so fast they grow so fast they can't catch up, and that's how people die.

With nothing to lose and his family to live for, Phil enrolled in a clinical trial at M.D. Anderson, that would use the common cold virus, as a weapon. His neurosurgeon was Dr. Frederick Lang.

“We take the virus and we inject it directly into the tumor, we drill a hole in the patient's skull we pass a needle in and inject the virus.”

It sounds more like science fiction than medicine.

Within the medical community, there was no shortage of doubters. Dr. Juan Fueyo put it this way: “People thought we were crazy.” In fact, it almost didn't get off the ground, because no one wanted to fund it. Says Fueyo: “In the beginning, nobody understood the concept, everybody thought it was very dangerous.” This is a "live" virus, we're talking about, and a massive dose.

Dr. Lang said they put thirty billion viral particles into the patient, and, normally, if you injected that much virus into a patient, the person would get very sick. But this virus is genetically- engineered to attack only cancer cells, not healthy ones. they named their virus "delta 24."

Dr. Fueyo said: “it's like a German submarine!” Once it's inside the tumor, that "submarine" virus goes to work. Doctors say it gets into a couple of cells, replicates, makes a lot of copies of itself, bursts the cell, kills the tumor cell, and all of the viral particles are now released, and can go infect more tumor cells. The ability to make copies of itself, the very thing that makes a virus harmful, is what makes it the perfect cancer-killing weapon; like an army that's constantly making more soldiers. Dr. Lang said they are “exploiting nature's natural processes to overcome cancer.”

“With each round of this infection release, you kill the tumor cell,” he said, “but you get more virus, which can go on and infect more cells, and, that way, the virus can theoretically spread through a large tumor.” They chose the cold virus because it didn't need to be altered too much to make it safe for the patient, yet effective against the cancer.

For Phil and 24 other patients with terminal brain cancer, the virus was not just their best shot it was their only shot. “All these drugs we give, says Lang, “the tumor is smarter than the drug. But the virus might be smarter than the tumor, or at least it can play in the same game.”

Against all odds, Phil Baumann's tumor started to go away. Said Phil, “You're truly in disbelief that you may have a chance to beat this.”

He wasn't alone. Two other glioblastoma patients also saw their tumors vanish. People who had already planned their own funerals now had a total absence of cancer.

Dr. Lang said the chance of having a tumor completely go away in a phase 1 clinical trial “is almost zero."

That was 3 and a half years ago, and today, Phil, who had only months to live, remains cancer-free: “To be able to say you have no active tumors and I've had no active tumors now for 3 years? Unbelievable.” His Wife Misty tears up when she thinks about it: “He's a miracle! It just doesn't happen. We cried happy tears”

Cody Baumann who thought he was going to lose his dad had this perspective: “If God wanted my dad up in heaven with him, he would have already took him.”

Not everyone was so lucky. 50% of the patients had only a "partial response,” and the 2 other patients whose tumors went away, have had a recurrence. Phil Baumann isn't just A patient, he is THE patient. doctors think, in Phil's case, the virus worked with his immune system to inoculate him against the cancer. Dr. Lang said: “We are almost creating a vaccine, inside the brain, specifically against the tumor.

And that's what they hope to do with patients in the next phase. They are even using a word cancer doctors almost never use. The word “cure.”

Dr. Fueyo is optimistic: “Maybe we can generate a perfect cancer vaccine, that maybe will cure cancer.”

Not just glioblastoma, but all cancers. “Pancreatic cancer, it looks like it can kill those tumors, but we think this could be used against breast cancer, lung cancer, and many cancers that metastasize to the brain and to other organs,” said the doctors.

Phil baumann knows how fortunate he is: “With M.D. Anderson holding my one hand and the lord holding the other, I really think it's pulling me through.”

He marvels that the trial that saved his life could one day make all cancers a thing of the past. “It's blessed me what they're learning,” says Phil, “and I hope it helps other people.”

For more information about the clinical trial and the charities that support it, you can visit the “Katie McCall Fox 26 Facebook Page.”

The realities of metastatic prostate cancer survival

Here’s the thing you want to know about this book: Author Paul Steinberg — a District sports psychiatrist and sometimes writer — says he has had metastatic prostate cancer longer than any man in history.

That may not be provable. He got his diagnosis three decades ago at age 35. To treat the disease, he faced castration at 40. Today he describes himself as “dying on the installment plan.”

Steinberg’s short, lively, memoir (“A Salamander’s Tale: My Story — How I Survived and Thrived for Thirty Years With Prostate Cancer”) starts with medical details accompanied with tough-guy talk: Because he and his wife wanted to have more children, his first response to the diagnosis was to ask the doctor, “How about if I spend tonight and whatever time I have before surgery masturbating so that we can collect and save my sperm?” The pragmatic response takes him somewhat aback, though: “You are facing a lethal disease. . . . This is not the time to think about having another child.”

There’s a lot of frank discussion about the sexual and other physical effects of prostate cancer and of its treatment. But the tone moves on to that of a man contemplating life, death, biology, psychology, responsibility, the universe.

“Prostate cancer has created a new reality, it has taken me away from my previously unacknowledged delusions and denials, it has forced me to transform my inner life,” he writes.

Chapter 1 is titled “The wonders of irony and paradox and ambiguity.” He quotes the Old Testament, G. K. Chesterton, Aldous Huxley, Benjamin Disraeli. He gets into monotheism and quantum theory.

Then closes out the book with a bawdy “Ode to Androgens.” (Those would be the male hormones.)

The salamander of the title, by the way, comes from his model for surviving after serious injury or disease: “Salamanders have a capacity to regenerate their tails, legs, retinas, even their spinal cords and parts of internal organs like the heart.”

Like the salamander, Steinberg has had to come back from serious damage. And he’s still here.

Doctors warn of gel nail polish dangers, potential cancer risk

Doctors are warning that artificial gel nail polish may be dangerous to your health.

The polish itself is not the main cause for concern but the way nails are dried could potentially cause skin cancer.

Doctors say the chemicals used in gel manicures could have other health risks, according to WHNS.

For many women, having their nails professionally done is a part of their beauty routine.

While a visit to the nail salon may seem like a safe way to unwind, upstate dermatologist Dr. John Humeniuk cautions the potential dangers associated with gel nail polish.

“Some concerns were raised several years ago about the possibility of skin cancers from using ultraviolet lights,” Humeniuk said.

He says a gel manicure consists of hardening a gel on top of the nail using a light.

“These ultraviolet units are actually the same kind of bulbs essentially that you see in tanning beds,” Humeniuk said. “Which does cause wrinkles and skin cancers if you do use it for a lot of exposure.”

If you want to get a gel manicure, the doctor recommends going to a salon that uses LED lights instead.

“They produce very little UV,” Humeniuk said.

In addition to using potentially harmful UV lights, the doctors said gel manicures require fingers and nails to be soaked in strong acetone to remove the excess gel residue.

“The use of these gels these acrylics the light will actually cause the original nail plate to actually separate from the bed and now you have a gap where moisture or bacteria and yeast can grow, so this actually is more of the bigger problems,” Humeniuk said.

Despite the potential dangers associated, gel nail polish is very popular because they last longer than other polishes, resists chipping and it’s quick.

“The LED light is a very fast cure. It’s a 30 second cure. For us, as a therapist, we need to get you in and out,” MG Grand Day Spa owner Manisay Gabbard said.

Some salons are now moving toward more organic polishes that are less dangerous.

“It dries just like the gel nail without using any light. It cures by natural light,” Gabbard said.

K-State Researcher Finds Exercise Aids In Cancer Recovery

A Kansas State University researcher has found that fast-walking or a light jogging on a regular basis can improve cancer treatments.

The university announced Monday that Associate Professor of Exercise Physiology Brad Behnke found a link between moderate exercise and better recoveries in cancer patients.

Behnke and his co-researchers had a $750,000 American Cancer Society grant and found that moderate exercise improves blood flow to tumors and enhances the effectiveness of radiation treatments. Existing research has found that moderate exercise can also help cancer patients counteract some negative side effects of treatment like fatigue, low blood count and muscle atrophy.

But Behnke said that too much exercise can be counter-productive.

Behnke and his fellow researchers have published their findings in the Journal of the National Cancer Institute.

African Diet May Lead Away From Colon Cancer

A change in diet for just two weeks alters gut bacteria in ways that may reduce risk of colon cancer, according to a new study in Nature Communications.

Researchers asked 20 African-Americans in Pittsburgh and 20 rural South Africans to switch diets for two weeks. The Americans ate a traditional African diet, high in fiber and low in fat, with plenty of fruits, vegetables, beans and cornmeal, and very little meat.

The Africans ate the equivalent of American fast food — a diet high in fat with generous quantities of meat and cheese.

“We made them fried chicken, burgers and fries,” said Stephen J. D. O’Keefe, a gastroenterologist at the University of Pittsburgh and one of the study’s authors. “They loved it.”

After the swap, the researchers performed colonoscopies on all the volunteers. African-Americans who ate the traditional African diet had reduced inflammation in the colon and increased production of butyrate, a fatty acid that may protect against colon cancer.

Conversely, after two weeks, Africans who ate the Western diet experienced changes in gut bacteria consistent with an increased cancer risk.

In Western countries, colon cancer is the second-leading cause of cancer deaths. It is diagnosed in 150,000 Americans annually; African-Americans are disproportionately affected. The disease affects few people in rural Africa.

Rural Africans eat food that they grow themselves, because it is less costly. But as populations increasingly move into cities for work, diets will change, Dr. O’Keefe noted.

“We’re trying to find out what aspects of their diet should be maintained,” he said.

Once A Year, Cancer Research News Comes In A Flood, Not A Trickle

News about cancer therapies usually comes out in medical journals with the regular rhythm of an IV drip. But every now and then information comes out in a flood.

That's the case this weekend. The American Society of Clinical Oncology is holding its 50th annual meeting in Chicago. The convention typically attracts 30,000 attendees, making it one of the biggest cancer meetings of the year. And the amount of new information must be bewildering for even the most intrepid doctors.

The society says it received 5,530 proposed presentations for the meeting. Of those, 2,900 will get a hearing at the meeting as a talk or a poster. And another 2,200 will be published online. Clearly this process is nowhere as selective as getting a paper published in a major journal, so caveat lector.

And the choices of what to pay attention to are so staggering, even the organizers seem to be gobsmacked. "We have a wonderful group of talks this year," Dr. Gini Fleming, chair of the cancer education committee, writes on the meeting's web page. Duly noted.

Some presentations may rise above the noise with help from press releases. For example, the University of Colorado in Denver draws attention to a study conducted there that concludes there's no reason to keep giving statins to ward off heart disease to patients who are in the late stages of cancer. In fact, this study showed that people taken off the widely used cholesterol-lowering drugs had a better quality of life and saved money.

A few presentations at the meeting get singled out by the New England Journal of Medicine, which has opted to publish research as it is presented at the meeting. Those papers include updated results for the medication ibrutinib, which the US Food and Drug Administration approved for chronic lymphoid leukemia (CLL) in February.

A new study tested ibrutinib head-to-head with another drug, ofatumumab, in patients who had previously been treated for CLL but had relapsed or hadn't responded to the traditional treatment. The study found that 90 percent of the patients given ibrutinib lived for at least one year, compared with 81 percent of the people given the alternative treatment.

A second report from the meeting, also published in the New England Journal of Medicine, finds that women with a specific type of breast cancer were less likely to have a recurrence when treated with the drug exemestane instead of tamoxifen. In this case, 91 percent of women given the exemestane lived at least five years, compared with 87 percent of the women with tamoxifen. We are not talking big breakthrough here.

The meeting is a reminder that cancer therapy rarely improves in leaps and bounds, but rather in small increments. That's a challenge for journalists, since small steps are generally not newsworthy. Yet we do want to recognize advances in cancer treatment, because they can add up over time.

The real test is not whether a study makes headlines, but whether the 30,000 or so practitioners gathering in Chicago are able to find new ideas that help improve the lives of people with cancer.

New skin cancer drug hailed 'paradigm shift' in treatment

A new treatment for advanced skin cancer has been hailed as a paradigm shift after it boosted one year survival chances from just one in ten to almost three in four

Around 13,300 cases of malignant melanoma are diagnosed in the UK each year and cases have increased fivefold since the 1970s, thought to be due to the rise in sunshine package holidays and sunbeds

A new drug has increased survival chances from advanced skin cancer seven fold and been hailed a paradigm shift in cancer therapy, it has been announced.
The results of early tests using a drug to prompt the body's own immune system to attack the cancer has found that 74 per cent of patients were still alive after one year, compared to just ten per cent currently.
Dr David Chao, Consultant Medical Oncologist, Royal Free Hampstead NHS Trust, said: “Pembrolizumab looks like it has potential to be a paradigm shift for cancer therapy.
“The survival results seen in the study which are the most meaningful measures of success to doctors and patients alike, are very promising and could benefit the many patients with advanced melanoma in the UK.”
Around 13,300 cases of malignant melanoma are diagnosed in the UK each year and cases have increased fivefold since the 1970s, thought to be due to the rise in sunshine package holidays and sunbeds.

Advanced skin cancer, which has spread to other parts of the body, has a poor prognosis and currently only one in ten people live for a year after diagnosis.
However some people have lived for two years while receiving the new treatment.
The new drug is being evaluated for use in 30 types of cancer.
The study, presented at the annual meeting of the American Society of Clinical Oncology (ASCO 2014), showed three quarters of patients responded to the drug.
The drug is an antibody that allows the body's immune system to once again 'see' the cancer as a foreign invader and so attack it.
Several companies have begun making similar drugs and have been testing them in a variety of cancers.
One called ipilimumab (Yervoy) is already on the market for advanced malignant melanoma and can increase average survival from six months to ten months when compared with standard treatment.
The new drug was found to increase survival in those patients whose cancer had started growing again after treatment with ipilimumab.
Gillian Nuttall, Founder of Melanoma UK said: “Advanced melanoma is a terrible disease with a poor prognosis.
"Pembrolizumab represents the latest advance in a whole raft of new treatments in advanced melanoma which have come through over the past few years.
"The pembrolizumab results are really exciting and could represent a turning point for patients affected by advanced melanoma giving them a greater chance of survival.”
The makers, MSD, are hoping to apply for a European licence by the end of the year and it has been accepted for a fast-track licencing procedure in America.
Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “It’s exciting to see the range of new treatments that are emerging for people with advanced melanoma. These new therapies harness the body’s own immune system to fight this cancer that has previously been so hard to treat effectively.
“Melanoma can only grow by finding a way to escape detection by the immune system. One way it does this is by triggering a shut-off switch on immune cells when they get close to the tumour.
"This treatment blocks the cancer cells' ability to use this switch, allowing the immune system to recognise and destroy the cancer. We are seeing a whole range of these immune treatments coming into the clinic, based upon the great progress we are making in our research into the immune system.”

Pancreatic cancer will be second deadliest cancer in U.S. by 2030

Pancreatic cancer will become the second deadliest cancer in the United States by 2030 overtaking prostate cancer and breast cancer currently considered as the second deadliest cancer for men and women respectively, projections made by researchers from the Pancreatic Cancer Action Network in California and The University of Texas M. D. Anderson Cancer Center in Texas show.

Lung cancer currently holds the top position as the most dangerous cancer in the U.S. and data from the research "Projecting Cancer Incidence and Deaths to 2030: The Unexpected Burden of Thyroid, Liver, and Pancreas Cancers in the United States" which was published in the American Association for Cancer Research journal Cancer Research on May 19 show that it will retain its position 16 years from now. Pancreatic cancer and liver cancer, however, will take the second and third top spots as deadliest forms of cancer by 2030 overtaking breast cancer, prostate cancer and colon cancer.

For their projection, the researchers took into account changes in the country's demographics such as the advancing age of the population, the availability of effective screening and prevention methods as well as the prevalence of risk factors such as certain diseases and smoking. The availability of better and advanced screening methods, for instance, is projected to reduce the number of prostate, breast and colorectal cancers incidences.

"Advances in screening, prevention, and treatment can change cancer incidence and/or death rates, but it will require a concerted effort by the research and healthcare communities now to effect a substantial change for the future," the researchers wrote.

The number of pancreatic cancer related deaths increases partly because of the advancing age of the population and the increasing prevalence of type 2 diabetes, which could occur when the pancreas has difficulty producing insulin for the body. The declining mortality rate of other types of cancer is also partly responsible to pancreatic cancer moving to the second deadliest spot.

While better detection methods are already available for prostate, breast and colorectal cancers, no effective screening methods are yet available to reliably detect pancreatic tumors and this results in most pancreatic cancer cases being detected only when the disease is already in the advanced stage when the odds for successful surgery and treatment are small.

"The projections for deaths from pancreatic and liver cancers are startling," said study author Lynn Matrisian, from the Pancreatic Cancer Action Network. "This study is a call to action to the scientific and clinical communities, as well as the population at large, to increase attention, awareness, and ultimately progress in the fight against pancreatic cancer."

Qiagen wins U.S. approval for test to accompany Amgen cancer drug

U.S. health regulators on Friday approved Qiagen NV's gene-testing kit to identify those colorectal cancer patients most likely to benefit from Amgen Inc's drug, Vectibix, Qiagen said.

In addition, the Food and Drug Administration expanded the approval of Vectibix to allow its use as a first-line, or initial, treatment for colon cancer in combination with the widely used FOLFOX chemotherapy regimen, Amgen said.

The expanded Vectibix approval is for patients who have a non-mutated, or wild type, KRAS gene after clinical trials demonstrated that those patients were most likely to be helped by the drug.

The FDA approval for the genetic test marks the third U.S. approval for a Qiagen companion diagnostic for use in combination with a specific drug, a key growth market for the German company.

Both approvals could pave the way for increased use of Vectibix, which has been largely a disappointment for Amgen. It means the drug can be used earlier in the disease and would be accompanied by a standarushdized diagnostic to help doctors pinpoint patients that would best respond to the medicine.

Amgen had $389 million in sales from Vectibix last year, $126 million of which came from U.S. sales.

Close to 40 percent of colorectal cancer patients have tumors with mutated forms of the KRAS gene, which make them poor candidates for Vectibix. The rest have the non-mutated, or wild, forms and stand a better chance of benefiting from the drug, which was approved in the United States in 2006.

(Reporting by Ludwig Burger in Frankfurt and Bill Berkrot in New York. Editing by Andre Grenon)