MD-UPDATE Issue #95

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divide and act abnormally,” Moss says. One example of these targeted drugs is ibrutinib. It is an oral drug that is targeted against a protein within that cell-signaling process called bruton tyrosine kinase. “Nobody expects it to be a cure, but people are living much longer and with much less toxicity than they ever did with what would have been our second line chemotherapy agent,” Moss says. “In one patient, if we didn’t have this drug, I would be having hospice conversations with him. But now I can help him and get him back to his baseline quality of life.” Similarly, myeloma prognosis and survival are much better thanks to relatively new drugs. Moss tells of a patient who had fractured several of his vertebrae due to the myeloma destroying his bones. Treatment included radiation, steroids, and two drugs that have just come into use in the last decade – bortezomib and lenalidomide. “One of the doctors rounding on him at that time told him that he would be dead within a year,” Moss says. “This was over two years ago. That man has gone into

complete remission. Initially, he and his wife didn’t want to go through this ‘toxic’ treatment since they were told he would be dead. I had to do damage control and say ‘no, really, we have better treatments now.’ But if you haven’t been in the oncology field, you haven’t seen that necessarily.” A death sentence isn’t the only misconception that comes with a cancer diagnosis. Another is how sick the treatments will make you. While the targeted drugs are much less toxic, the supportive care drugs are also much more effective against nausea, vomiting, and infection. “I tell people, if you have vomiting, I’ve failed,” Moss says. “I expect you to have a functional independent life. If your quality of life is so poor that I’m doing more damage by the treatment than the cancer would have done to you, then I’m not doing the right thing.” Patients aren’t the only ones with misconceptions about cancer treatments and prognosis. Physicians see oncologists like Moss in the hospitals treating the sickest of the sick, but not the ones that come to her clinic every day.

“It’s easy for other doctors to think all oncology patients are like those in the hospital, but that is less than 10 percent of my patient population,” Moss says. “Most of my patients will either be cured or will live for years, maybe even decades with their diagnosis.” A scalpel instead of a machete. A disease instead of a death sentence. ◆

Hematology and Oncology Associates 3470 Blazer Parkway, Suite 150 Lexington, KY 40509 P: 859.629.7110

PARTNERS IN HEALING THE WHOLE PERSON LIVESTRONG® at the YMCA helps people move beyond cancer in spirit, mind and body. This is a research-based program that offers people affected by cancer a safe, supportive environment to participate in physical and social activities focused on strengthening the whole person. Participants work with YMCA staff trained in supportive cancer care to achieve their goals such as building muscle mass and strength; increasing flexibility and endurance; and improving confidence and self-esteem.


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