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CATEGORIES [ GASTRIC CANCER ]

Making an impact for stomach cancer patients in D.C. and beyond

BY GUEST BLOGGER | APRIL 23, 2014

Debra Zelman

Everyone has a stomach and is therefore at risk of getting stomach cancer. I was diagnosed with stage 4 incurable stomach (gastric) cancer in April 2008 when I was only 40 years old. At that time, I was a practicing attorney with my own firm, had three young children and my husband was a physician. I was given only weeks to live and I knew that only four percent of people live five years after this diagnosis. However, instead of accepting this news as a death sentence, I began the fight of my life!

I shut down my law practice, had a port inserted and started getting heavy-duty chemo. I lost my hair, got neuropathy and was in bed for months on end. But I fought hard! My desire to be here for my kids was my first and foremost reason for my fight for survival. There were no resources available for stomach cancer patients and their families. During those months in bed, I realized that I wanted to raise awareness, provide education and support to others affected with stomach cancer, and advance funding for research.

Thirteen months after my diagnosis, I founded Debbie's Dream Foundation: Curing Stomach Cancer (DDF), a non-profit dedicated to raising awareness, advancing funding for research, and providing education and support internationally to patients, families and caregivers. Its ultimate goal is to make the cure for stomach cancer a reality. This drives me and my DDF Dream Team to help make an impact every day. DDF now has 20 chapters and helps patients all over the world.

We are also making a big difference in advancing research funding. We held the Second Annual Debbie's Dream Foundation: Curing Stomach Cancer (DDF) Advocacy Day in Washington D.C., on Feb. 27. Fifty-seven DDF advocates from all over the United States and Canada participated in over 70 congressional meetings to raise awareness and to fight for increased funding for stomach cancer research. Advocates included patients, survivors, family members, caregivers, healthcare professionals, researchers and advocates who all shared their stories with congressional members and staffers about how stomach cancer has impacted their lives.

Before our first Advocacy Day last year, nobody had been to the Hill to talk about stomach cancer, so it isn't getting the attention it deserves. The members and Hill staffers all told us last year that they didn't know stomach cancer was a problem and that no one had been to see them about stomach cancer. Debbie's Dream Foundation is changing the landscape for gastric cancer in the United States. It was an honor to meet with key legislators who are our champions in supporting increased funding for stomach cancer research.

The next day, we held the first ever Congressional Capitol Hill Stomach Cancer Briefing in cooperation with Sen. Peter Roskam, the American Gastroenterological Association and the American Cancer Society Cancer Action Network. Speakers informed attendees that the sad fact is that little attention is given to gastric cancer and, per cancer death, stomach cancer receives less money than any other cancer. This is a shame because stomach cancer is the fifth most common cancer worldwide and the second leading cause of cancer death.

Gastric cancer needs even more attention now because it is on the rise in young people in the United States ages 25-39 and we don't yet know why. Only research can tell us why. As we see from other cancer types, more funding equates to more research which equates to better overall survival and someday to a cure. Congress and the advocates will surely not forget these historic days.

Stomach cancer patient, their families and caregivers should endeavor to educate themselves about this diagnosis, and I believe that they want to take charge of their health. DDF empowers patients to do that with our free educational symposium that we offer each year. Our 4th Annual Stomach Cancer Education Symposium occurs on Saturday, April 26 in Fort Lauderdale, Fla. Registration is required for both in person attendance and for our worldwide webcast. We also celebrate our accomplishments all year long as well as the organization's anniversary that evening at our Dream Makers Gala. For more information about the Symposium and Gala and to register, go to DebbiesDream.org.

Join me and my Dream Team in the fight!

To learn how to let your elected official know how you feel about increasing funding for stomach cancer research, call us at 954-475-1200 or email your inquiries to admin@DebbiesDream.org.

Debbie Zelman is a stage 4 stomach cancer survivor and founder of Debbie's Dream Foundation: Curing Stomach Cancer (DDF), a non-profit organization dedicated to raising awareness about stomach cancer, advancing funding for research and providing education and support internationally to patients, families and caregivers. You can find more information at DebbiesDream.org or by calling 855-475-1200 or email to Info@DebbiesDream.org.

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CATEGORIES [ GASTRIC CANCER ]

A Conversation about Cyramza with Dr. Charles Fuchs

BY ELIZABETH WHITTINGTON | APRIL 23, 2014

Elizabeth whittington blog image

"Stomach cancer has not had sufficient attention in terms of drug development, efforts in finding new drugs or really in understanding the fundamental biology until recently," said Charles Fuchs, who leads Dana-Farber Cancer Institute's Gastrointestinal Cancer Center. "I've been pleased to see over the past several years that more attention has been paid to the disease."

That attention resulted in the Food and Drug Administration (FDA) approval of Cyramza (ramucirumab) on April 21 for patients with advanced gastric cancer or gastroesophageal junction adenocarcinoma (read the FDA announcement). Historically, gastric cancer treatment has been limited to chemotherapies developed for other cancers, Fuchs says. "That may seem like a subtle point, but most of the drugs used in gastric cancer were actually developed for other cancers and subsequently tested and approved for stomach cancer."

Moreover, Cyramza is the first drug approved for patients whose gastric cancers have progressed on first-line treatment. While oncologists have been treating patients in the second-line treatment setting for years, until now, there has been no standard of care. That unmet need was a catalyst for the priority review the FDA granted last year to help speed along the potential approval (read more).

The approval was based on the phase 3 REGARD study, in which Fuchs was a lead investigator. The study found that patients who received Cyramza had a 1.4 month improvement in median overall survival over patients receiving best supportive care (5.2 months compared with 3.8 months), in addition to better progression-free survival. Side effects included high blood pressure and diarrhea, but overall, side effects were well managed and tolerable, he says.

Fuchs points out that the risk of certain side effects, such as fatigue and nausea, were actually lower in the Cyramza arm than in the placebo arm. "That may seem a bit odd, but patients with stomach cancer who have progressed on first-line therapy have symptoms from the disease," he says. "What's also interesting is that when you look at the results of the REGARD study, which I was involved in, and you compare those results to similarly designed studies where they compared second-line chemotherapy to placebo, the benefit is almost exactly the same (to Cyramza)."

He concludes that the benefit of Cyramza appears to be comparable to standard chemotherapy, but with a better side effect profile. The next step may be combining the drug with chemotherapy, which was the basis for the RAINBOW trial. This trial looked at the combination of Cyramza and paclitaxel. Results showed an even greater survival benefit not previously seen in second-line stomach cancer, Fuchs says.

"It wasn't part of the approval because that study is more recent, but I hope the FDA, upon reviewing that study, will amend the approval to include the use of the drug with paclitaxel," he says. "In my own practice, I anticipate it will be the principal way I use it to treat patients in that setting."

Cyramza is also being examined for other cancers, including non-small cell lung, liver and colorectal cancers. A Cyramza study looking at the drug in patients with breast cancer did not show progression-free survival benefit.

Read more about the approval in gastric and gastroesophageal junction cancers from CURE here.

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CATEGORIES [ BREAST CANCER ]

The importance of reindeer pajamas

BY GUEST BLOGGER | APRIL 22, 2014

Carrie Corey

Living with cancer has forced me to know my limitations, even though it conflicts with my "can-do" personality. I simply can't be everything to everyone, and that's OK. So when fighting medication side effects and juggling doctor appointments, sometimes normal life tasks like folding laundry or running errands have to take a backseat.

Carrie Corey

When I take Henry to Mother's Day Out two days a week, most of the moms there are dressed for busy days filled with yoga and lunch dates. Me? Well, I'm either dressed to go downtown for a doctor's appointment, or I look like I just rolled out of bed, threw on some clothes and let my kid eat a PB&J for breakfast in the car.

Last week Henry needed an Easter basket for his classroom Easter egg hunt. Since anything he gets his hands on will be thrown, kicked, filled with dirt and possibly even chewed on, I picked out what I thought was the perfect Easter basket for the two-year old wild man: a plastic bucket with a picture of a yellow chic on the side. Then I held my head high as I placed his bucket on the table next to all the fancy pink and white gingham fabric-lined Easter baskets... apparently I was the only mom in his class who ran to the dollar store to cross that to-do item off her list!

Before I was diagnosed with stage four breast cancer, I was able to "power thru" when I was tired or not feeling my best. But that's just not the case anymore, and now if I overdo it, I suffer from what we call, "hitting the wall," because my body will quite literally STOP. Energy has become my most valuable commodity, and the more I spend running all over town searching for the perfect school bag, the less I have to spend with the people I love. Do you think Henry cares if his school bag has his name handwritten in black marker instead of monogrammed with cute letters? Because I KNOW he cares when Mom is too tired to play cars with him on the dining room floor!

Even though my pride hates to admit it, I have officially removed myself from the Super Mom competition. Because when I have to choose between spending time with my two favorite guys or looking like the mom who has it all together, my guys will win every time.

So if you see me in the grocery store, and Henry's wearing his reindeer pajamas in April because it was the last clean shirt in his drawer, don't judge until after you see the big grin on his face. He may not have Super Mom, but he is one happy kid. And that's all that matters to me.

Carrie Corey

Carrie Corey was diagnosed with stage 2 breast cancer at age 29 and with a stage 4 recurrence in 2012 at the age of 31. She is a wife and new mom living in Dallas, and will be reporting frequently on her cancer experiences.

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CATEGORIES [ GASTRIC CANCER, NEWS, TREATMENT ]

FDA approves new drug for gastric cancer

BY LINDSAY RAY | APRIL 22, 2014

Lindsay Ray blog image
On Monday, April 21, the Food and Drug Administration approved Cyramza (ramucirumab) to treat patients with advanced stomach cancer or cancer where the esophagus meets the stomach (gastroesophageal junction adenocarcinoma). This approval includes patients with inoperable cancers and those with metastatic disease after treatment with platinum- or fluoropyrimidine-based chemotherapy.

Cyramza is a type of drug known as an angiogenesis inhibitor, which means it blocks the tumor's blood supply.

This past October, the therapy was given priority review status (meaning the FDA would make a decision within six months) after promising clinical trial results and because it met an unfilled need. This approval makes Cyramza the first approved single-agent treatment for stomach cancer after it has progressed following initial therapy.

The FDA based the approval on results from the REGARD trial, an international, phase 3 study in which 355 previously treated patients with either stomach cancer or gastroesophageal junction adenocarcinoma were randomly assigned to receive either Cyramza or best supportive care. Treatment with Cyramza improved median overall survival by 1.4 months compared with those receiving placebo.

Earlier this year, data from another study pointed to further benefits of Cyramza therapy. The phase 3 RAINBOW trial looked at adding Cyramza to paclitaxel when treating these diseases after prior therapy. The combination extended median overall survival to 9.63 months compared with 7.36 months for patients who received paclitaxel plus placebo. Furthermore, the combination of Cyramza and paclitaxel also prolonged progression-free survival: 4.4 months compared with 2.86 months.

Common side effects of Cyramza include diarrhea and high blood pressure.

For more information, call 800-545-5979.

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CATEGORIES [ SURVIVORSHIP ]

ASCO publishes guidelines on survivorship -- finally?

BY KATHY LATOUR | APRIL 18, 2014

Kathy LaTour blog image

This week the American Society of Clinical Oncology (ASCO) issued three evidence-based guidelines for cancer survivorship. You can read them here. ASCO offers oncologists and others in the healthcare community recommendations on a vast array of issues. With these three added, there are now four guidelines concerning survivorship. The three areas they address in the new guidelines are neuropathy, fatigue and depression, and anxiety. Not that I want to sound ungrateful, but it's about time.

First, in regard to peripheral neuropathy. In the summer issue of CURE you will read my article on peripheral neuropathy and how sufferers are faced with a very debilitating long-term and late effect for which there is little effective treatment. In fact, the press release about the guidelines issued by ASCO says they "provide evidence-based recommendations for prevention and treatment of chemotherapy-based peripheral neuropathy."

Then, in the guidelines themselves, they say that due to "lack of high-quality, consistent evidence, no established agents are recommended for the prevention of CIPN in people with cancer undergoing treatment with neurotoxic agents." This means that they don't have any ways to stop CPIN from occurring – yet. There are some new ideas in the works but nothing has been approved.

For treatment, the guidelines say clinicians can offer Cymbalta (duloxetine), and then gives a list of other options that have shown some efficacy.

Ultimately, there is nothing new here. But what is new is that it is here. Getting ASCO to post guidelines, even if they don't give us anything helpful is a start in recognizing that survivors have a number of issues that impact our lives significantly, or as one professional says, we don't have cancer anymore but cancer has us.

In regard to fatigue, the second guideline they add, the recommendation is that survivors be screened for fatigue from point of diagnosis onward.

In addition, the guideline says that "given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors."

Read "exercise" there. The hopeful part of this guideline is that it will lead our cancer professionals to recognize that they need to know where to refer us to get help with fatigue. I am a major proponent of rehabilitation services for many of these needs as the rehab folks understand not only the physical but also the emotional changes that may need rehab.

For the third and final new guideline, Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer, the ASCO pros adapted a Pan-Canadian Practice Guideline. In general the guideline says cancer patients "be evaluated for symptoms of depression and anxiety at periodic times across the trajectory of care." Do we see a pattern here?

This evaluation should use good measures and different approaches depending on the levels of symptoms. It concludes with an overview of what happens when there is failure to identify and treat anxiety and depression. We feel rotten and have a much-reduced quality of life.

The options for care given with these guidelines are really thin, and my recommendation is that they use the Oncology Nursing Society Putting Evidence into Practice which seems to be ahead of ASCO in recommending interventions for each one of these.

Once again, the nurses beat the docs to the punch.

Overall these guidelines are a disappointment. They don't give us anything new and the disclaimer that runs with each one is double the length of the guideline. Come on ASCO, you can do better than this. We now have four, count them, four survivorship guidelines. The first one posted by ASCO in 2013 had to do with fertility and said oncologists should talk with patients of childbearing age about the impact of treatment and their options for preserving fertility.

A study late in the year says oncologists are not doing a great job of that.

Cancer survivors are growing in numbers and we would like to think that someone is paying attention to our quality of life and not just patting themselves on the back for keeping us alive. Fatigue, depression, anxiety, neuropathy and many other issues may follow us after treatment ends. It's time we put some energy into researching them and coming up with some real answers.

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CATEGORIES [ BREAST CANCER ]

Good medicine

BY GUEST BLOGGER | APRIL 17, 2014

Carolyn Choate

When I hear women in the locker room at the gym curse the day because of a broken nail or a parking ticket, I can't help but get sassy with them. "Let me get this straight," I might say, pointing at my chest where two perfectly formed breasts used to reside pre-double mastectomy. "I'm flat as a pancake, have chemo brain until noon, and my eye brows never grew back, but do you hear me complaining?"

"We don't know how you do it," they sigh, shaking their heads with a mixture of pity and ...well, pity. This is what kills me. That "civilians" – that's what my friend and fellow survivor, Noreen, calls the uninitiated – act like cancer survivors have a real choice in the matter. Like choosing the paint color for our car from the factory or selecting a new dish washer from Sears.

"Chutzpah!" I declare with a winning smile, "That's how I do it; chutzpah and good medicine keep me putting one foot in front of the other."

In spring 2004, I didn't think I had many steps left after a routine mammogram failed to detect a tumor the size of a golf ball. Thankfully, I noticed a change to the areola of my right breast a month later and quickly called my PCP. A biopsy confirmed my darkest fear but the prognosis after surgery was far worse.

Cancer had spread to my lymph nodes. That, coupled with the size of the tumor and my relatively young age – I had just turned 45 - lead my surgeon to determine that I had very aggressive breast cancer. Very apologetic, he predicted I had a 75 percent chance of dying within three years. I could feel the cancer goblins dancing on my grave within three minutes.

But then a funny thing happened on my way to the afterlife. I met my oncologist the following week for the first time, and she gave me a healthy dose of the medicine I needed most: hope. "I'm so excited to work with you," she said beaming, "with all the amazing treatments today for advanced estrogen receptor-positive breast cancer, you have a 25 percent chance or better of beating it."

With a "how do you do?" like that, I became 100 percent convinced that the odds were in my favor. I kicked kicking the bucket, truly excited for all the summer adventures that lay ahead with my husband and our two young daughters. Whether camping on the lake or camping out at the infusion center ingesting "cocktails" so exotic my hair fell out, my oncologist helped me see that it wasn't enough to merely accept treatment.

I wasn't a criminal resigned to serving my sentence. Quite the opposite, I saw myself as an eager and enterprising foreman, overseeing the biggest restoration project in my life, way bigger than remodeling our kitchen a few years prior. Cancer treatment or kitchen remodeling, if you don't have the right tools and know how to use them, chances are slim you'll get the results you wanted.

Survival is still an adventure all these years later, one that wouldn't be possible without continued pharmaceutical research and the dedication and encouragement of my oncology team. After an initial five-year course of the oral aromatase inhibitor, Letrozole, following chemotherapy and radiation, I recently completed an additional five years in a double-blind trial to determine if extended use of Letrozole gives added benefit. I won't find out the results until 2015 but, regardless, being part of such an important study in the fight against breast cancer recurrence has been an easy pill to swallow.

Carolyn Choate was diagnosed with stage 3B invasive lobular carcinoma more than 10 years ago. She is a long-time TV producer and on-air talent for WYCN in New Hampshire. A dedicated "coach potato" before cancer, Carolyn has since participated in the SheROX triathlon, is an avid kayaker with her daughters, and most recently rode her bike solo from Boston to Montreal to raise money for Rotary International's "End Polio Now" campaign. She is currently working on a memoir, Flat as a Pancake & Loving It.

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CATEGORIES [ BREAST CANCER ]

AACR update: Breast cancer studies offer more potential treatment options

BY DEBU TRIPATHY | APRIL 10, 2014

Debu Tripathy blog image

Two studies announced at this year's annual meeting of the American Association for Clinical Research are targeting unique molecular features that drive breast cancer. One study is testing the drug palbociclib, which targets an abnormality in the cancer cell cycle. The drug is being tested in hormone-positive breast cancer in combination with the aromatase inhibitor, Femara (letrozone). The combination significantly delays the time it takes for the cancer to continue growing. At the current time, it's not showing a survival advantage, but a phase 3 trial in progress may be the deciding factor for the drug's approval.

Another study is looking at a drug called neratinib, specifically in HER2-positive breast cancers. It's part of the I-SPY2 study, which is testing multiple new therapies before surgery, as neoadjuvant therapy. The results show that neratinib can result in complete disappearance of the tumor. This may represent a new drug for patients with HER2-positive breast cancer, including patients who have progressed on other HER2-targeted therapies.

Debu Tripathy is an oncologist and editor-in-chief of CURE. He is the co-leader of the Women's Cancer Program at Norris Comprehensive Cancer Center and Professor of Medicine at the Keck School of Medicine at the University of Southern California.

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CATEGORIES [ LUNG CANCER ]

AACR update: New immunotherapy drug shows benefit in lung cancer

BY DEBU TRIPATHY | APRIL 9, 2014

Debu Tripathy blog image

One of the areas that has progressed quite a bit recently is that of tumor immunotherapy. At this year's annual meeting of the American Association for Clinical Research, several papers have been presented in this area.

One of the most exciting is advances in lung cancer, which has been a traditionally hard to treat cancer. Recently there have been newer targeted therapies that work against growth factor receptors that show benefit, particularly in non-smokers. And now we're seeing advances in immunotherapy.

Now, a fundamental breakthrough in immunology has come with understanding the controls of the immune cells that allows us augment the natural immune response that white cells have against tumors.

One of the proteins blocked is the PD-1 receptor and PD-1 ligand. These proteins are important because the cancer cells can use them to block the immune system from attacking the cancer. There are several drugs being tested that inhibit this blockade, the so-called immune checkpoint, in trials not only for lung cancer, but also melanoma and other solid tumors.

One of the potential benefits of one of these drugs called MK-3475 is that it may work in people who have a history of smoking, people who have traditionally not benefited from these targeted therapies.

There is also some new information that we may be able to identify patients who have the best chance of responding to these drugs. There will be a more formal comparison and information on how the drug works in smokers coming hopefully very soon. We expect to hear those results at the annual ASCO meeting this summer.

Debu Tripathy is an oncologist and editor-in-chief of CURE. He is the co-leader of the Women's Cancer Program at Norris Comprehensive Cancer Center and Professor of Medicine at the Keck School of Medicine at the University of Southern California.

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CATEGORIES [ SURVIVORSHIP, YOUNG ADULTS ]

The other option: Surrogacy after cancer

BY GUEST BLOGGER | MARCH 26, 2014

Jen Rachman

At age 26, I was on my own, self-sufficient, secure and independent. I was already a few years into building my career as an adolescent therapist; a job that well suited me. I had my own apartment, and was about to move in with my boyfriend of several years. I took care of myself physically and emotionally. Life was pretty perfect, until the routine trip to the gynecologist that wound up saving my life.

When you hear the words, "you have cancer," there is truly no way to be prepared to absorb all that comes with it. My now unstable life became filled with terms like prognosis, oncologist, surgery, treatment and chemo. My doctors overwhelmed me with choices about what course of action to take. Suddenly, my secure sense of self became unraveled and presented me with a new identity – cancer patient. My oncologists' (who are wonderful) main goal was to rid me of cancer as quickly as possible. The recommended course of action when diagnosed with ovarian cancer is to have a complete hysterectomy.

Being only 26, the idea of parenthood wasn't even on my radar yet. But suddenly I felt forced to think about my fertility and my options. I was then hit with a double whammy: the idea that my cancer might render me infertile. I stressed to my doctors that while clearly the primary focus is to rid myself of cancer; I wanted them to make every attempt at preserving my fertility.

Over the course of seven months, I endured three surgeries and six rounds of chemotherapy. The treatment took my hair, put my body in menopause, and left me feeling twice my age. Unfortunately, the doctors weren't able to save my ovaries. I recovered and slowly acclimated to my new normal – survivor.

As I moved further away from my date of diagnosis, I became more accepting of my life as a survivor and it became less scary to invest in the idea of leading a longer, healthy life. My then boyfriend and I were married in 2005, and after several years were comfortable exploring the idea of having a family. I had come to terms with the loss of my fertility and began exploring my options to become a parent. I reached out to my oncologist and my supports in the cancer community about surrogacy and adoption.

I feared that with adoption, I might be discriminated against due to my cancer history and therefore it felt safer to me to explore the world of surrogacy. I also liked the idea that though our child might not be genetically mine; they could still be connected to my husband. As we researched, it quickly became apparent that there was a lack of information about surrogacy.

We met with a few agencies and decided on Circle Surrogacy in guiding us through this process. We signed our contract with them and moved on to the matching process. Within four months of meeting our surrogate, we were expecting our son. The entire experience felt "right," as I believe this is the way we were intended to become a family. Our surrogate is truly an amazing woman, who we felt connected to from the start. Going into the experience, I had some anxiety about feeling envious or jealousy toward our surrogate as she was able to bring our child into this world; something that I couldn't do. I remember feeling surprised that I didn't feel this way toward her at all. As we were awaiting the arrival of our son, I felt humbled and grateful that she was doing this for us.

The day our son was born was truly the most amazing day of my life. It was as if all the struggle, loss and upset caused by cancer had been undone, or perhaps more so, solidified the reason for the journey.

As I reflected on the experience, I remained troubled by the idea that there was little information in the cancer community about surrogacy. I began exploring ways to get information about this amazing way to become a parent after cancer to survivors. I am fortunate to have made this a career goal and work now as an outreach coordinator to educate others about surrogacy.

Though being a cancer survivor is membership to a club I never wanted; I wouldn't say that cancer was the worst thing that happened to me. How could that be when it has brought so much to my life both personally and professionally?

Jen Rachman is a social worker from New York City. She is a 10-year ovarian cancer survivor having been diagnosed at age 26 and a parent through surrogacy. She is currently working as an outreach coordinator for Circle Surrogacy to educate survivors about this family building option after cancer.

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CATEGORIES [ SURVIVORSHIP, YOUNG ADULTS ]

So much to celebrate

BY GUEST BLOGGER | MARCH 25, 2014

Rachel Baumgartner Lozano

Life has changed a lot for me since nominating my nurse, Tish Mullen, who became a finalist in the first Extraordinary Healer Award contest in 2007. From my essay, "My Own Fairy Godmother Nurse":

"...I was extremely sick and in the hospital for most of the second semester of my senior year of high school. Well, when prom came around, it was really touch-and-go whether I would be in the hospital or not. Because of Tish, I was not in the hospital, got to attend prom, stayed out late, and all of this without my ever-present I.V. backpack. This was quite a feat!

She came over right before I got ready and removed my I.V. and I.V. backpack as part of getting ready (sort of a substitute for doing my hair since there was none). I put on my flowing royal blue gown and was whisked off as a princess for the evening--putting the fact that I was going into an intense life-threatening stem cell transplant in a week in the back of my mind.

At about 4 in the morning, I arrived home from the after-festivities and called Tish, as I had been instructed to do. She came over and safely put the I.V. back in like it had never left.

This is a small example of the type of person Tish is--caring, selfless, and trying to help pediatric oncology patients with all of her resources..."

After the Extraordinary Healer contest, Tish did another overly generous thing for me. She transformed my mother's wedding dress into a custom dress for my wedding! This year, I am celebrating my six-year anniversary with Gabe Lozano, the man I took as my date to that awards ceremony in 2007.

I am also very excited to celebrate 10 years this May with no evidence of cancer. I'm still deciding how I may want to honor this milestone.

Last year, I completed a dual master's program in art therapy and counseling. I achieved my goal of becoming an art therapist, inspired by a woman who was my therapist during my cancer treatment. It was a long road as I had been in treatment on and off for so many years.

Recently, I began working in a residential facility for children and teens dealing with emotional and behavioral issues. The children inspire me so much every day, and I feel blessed to be there.

Combining my love for art therapy with helping others with cancer has led me to the opportunity of facilitating workshops for adults and children with cancer using art as the means of expression. I'm now helping plan a local young adult conference for people living with cancer this summer and will lead a session on art therapy.

I have continued to do inspirational speaking, which has taken me around the country and even to Europe. I have enjoyed meeting amazing people through all these experiences.

Although I still deal with many long-term side effects, I make the most of it, as I'd rather deal with them than the alternative. I'm even challenging myself to train with a program called Cancer to 5K to see how much I can push my body. It seems that if I'm busy with life, then I don't have much time to think about the lingering side effects.

As I reflect back on my experiences with CURE's Extraordinary Healer contest, getting the chance to honor such an amazing nurse who did so much for me has definitely been a highlight in my journey. I continue to see Tish occasionally, and she continues making the lives of children with cancer better and brighter. I hope to be more like her!

Rachel Lozano is an art therapist, artist and inspirational speaker. She is a three-time young adult survivor of Askin's tumor. Statistically, she had a 0 percent chance of survival the third time, but in May will celebrate 10 years of no sign of cancer. Feel free to contact her through her Facebook page, Rachel Lozano: Inspirational Speaker.

Editor's note: Nominate your nurse for CURE's 2014 Extraordinary Healer Award at curemagazine.com/healeraward. Deadline March 28, 2014.

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