person stories of people who are living with cancer, including personal diaries and honest, moving essays. cancerhealth.com/stories
Basics
Whether you’re newly diagnosed or a long-term survivor, check out our Basics section on cancer treatment, how to manage side effects and more. cancerhealth.com/basics
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Learn about the latest treatment and prevention advances, cure research and conference news. cancerhealth.com/science-news
Cancer
Health Digital
Scan the QR code (left) with your smartphone to check out the digital issue of Cancer Health online, or go to cancerhealth.com/digital to read past issues and the entire Smart + Strong digital library.
Janet and Euvon Jones share their wisdom.
16 “MY STORY IS A STORY OF WHAT NOT TO DO.”
After a Stage IV prostate cancer diagnosis, Euvon Jones turned his life around—with help from his wife, Janet. BY JENNIFER COOK
20 MOVEMENT IS MEDICINE
Exercise lowers cancer risk, improves quality of life and more.
Plus: What about weight-loss drugs? BY LIZ HIGHLEYMAN
2 From the Editor Personal Goals
4 News
“Weird Looking Stools” | sports icons | liquid biopsies and MRIs | NCI’s new leader | a $2 billion gift
6 Care & Treatment
Can the COVID vaccines boost immunotherapy? | treatment gets easier with injectable options | shorter radiation therapy | federally funded clinical trials play a vital role
8 Voices
Jackie Lantry learns French and packs for Paris despite chemo brain.
10 Basics Leukemia and Lymphoma
12 A Leukemia Diary
Todd Bushmaker’s CLL journey
26 Can Heal
Artist Pauline Decarmo offers a portrait of self-empowerment.
28 Solutions
Five simple movement snacks
30 Your Team An expert on women’s side effects
31 Resources Sarcoma and bone cancer websites
32 Good Stuff Energize and strengthen yourself.
33 Reader Survey
Tell us about your exercise habits.
Personal Goals
DO YOU KEEP A BUCKET LIST?
If you’re like me, you’ll get inspired to do just that after reading this issue of Cancer Health. Compiling a checklist of lifetime goals can motivate. Plus, the ability to pursue those dreams FDQUHŴHFW\RXUTXDOLW\RIOLIHZKLFK LVWKHWKHPHRIRXUZLQWHULVVXH 6LQFH-DFNLH/DQWU\ZDV\HDUV old, she yearned to visit France and learn the language. Life, of course, LQWHUYHQHG)DVWIRUZDUGVHYHUDO decades: As Jackie approached retirement, she began tackling her never-forgotten goals by studying French and booking an extended stay abroad. Then a routine mammogram detected breast cancer. The resulting WUHDWPHQWFDXVHGFKHPREUDLQZKLFK muddled her ability to think clearly, let alone in a foreign language. What happened next? Turn to her Voices HVVD\RQSDJHWRƓQGRXW
When Euvon Jones, our cover subMHFWZDVGLDJQRVHGZLWKPHWDVWDWLF SURVWDWHFDQFHUKHDQGKLVZLIH-DQHW HPEDUNHGRQDZKROHOLIHPDNHRYHU Not only is Euvon cancer-free today, but the family also enjoys healthier KDELWVDQGEHWWHUTXDOLW\RIOLIH*R WRSDJHWROHDUQKRZWKH\GLGLW
Quality of life issues also surface LQRXU&DUH 7UHDWPHQWQHZVRQ SDJHZKLFKFRYHUVVKRUWHUUDGLDtion therapy and easier treatment RSWLRQV,QRXU<RXU7HDPLQWHUYLHZ on page 30, Mary Jane Minkin, MD, shares an encouraging message IRUZRPHQGHDOLQJZLWKPHQRSDXVH and sexual side effects of cancer. The /HXNHPLD'LDU\RQSDJHIROORZV Todd Bushmaker’s inspiring journey
through numerous clinical trials and regimens. And our latest Can Heal FROXPQRQSDJHSURƓOHVDUWLVW 3DXOLQH'HFDUPRZKRIDFHVGHELOLWDWing side effects yet creates inspiring SRUWUDLWVDQGHQMR\VDIXOƓOOLQJOLIH 0RUHVWXGLHVVKRZWKDWPRYHPHQW really is medicine—and that it boosts treatment effectiveness and improves TXDOLW\RIOLIH2XUVFLHQFHHGLWRU Liz Highleyman, unpacks the data RQSDJHLQFOXGLQJDORRNDWZHLJKW loss drugs. Tell us about your exercise habits by taking the Survey on page 33. $QGƓQDOO\RXU6ROXWLRQVFROXPQRQ SDJHRIIHUVƓYHVLPSOHPRYHPHQW snacks that’ll get you off the couch— and ready to tackle that bucket list.
Patrons at bars and coffee shops in Georgia were spurred to talk about colon cancer thanks to a statewide awareness campaign called “Weird Looking Stools” that featured, well, exactly that. For WKHDWWHQWLRQJUDEELQJLQLWLDWLYHQRQSURƓW*HRUJLD CORE (Center for Oncology Research and Education) partnered with visual artist Julian Scalia, who designed uniquely shaped and painted stools (the kind you sit on) that represent real-life colon cancer
THEY GOT GAME
Like many celebrities before them, a new roster of sports heroes are sharing their cancer journeys to educate the public and raise awareness.
Painted stools in Georgia CORE’s colon cancer awareness initiative
symptoms, such as blood in stools, narrow or pencil-thin stools, persistent abdominal pain, XQH[SODLQHGZHLJKWORVVDQGLURQGHƓFLHQF\ (anemia). The stools were placed in over 30 locations across Georgia, and next to each stool was a QR code that folks could scan with their phones to get linked to resources and local screening information. “Colon cancer is one of the most preventable cancers if caught early,” says Georgia CORE president and CEO Lynn Durham. “This campaign is about making people stop, look and take action.”
pretty well, don’t they?”
In his memoir, Heartbeats, legendary Swedish tennis player Björn Borg, 69, shared that in 2023 he was diagnosed with an “extremely aggressive” prostate cancer and is now in remission after an operation. “Now I have a new opponent in cancer—one ,FDQōWFRQWUROŐKHZURWHŏ,ƓJKW like every day is a Wimbledon ƓQDO$QGWKRVHXVXDOO\JR
Stateside on the gridiron, Denver Broncos Coach Zack Grossi found a winning team at the University of Colorado Cancer Center, where he underwent treatment for a yolk sac tumor, a rare cancer that affects germ cells and starts in the chest. After chemo and the removal of 15% of his right lung, Grossi is now cancer-free.
Similarly, in the 1HWŴL[GRFXPHQ tary series America’s Team: The Gambler and His Cowboys iconic Dallas
From left: sports stars Jones, Grossi and Borg beat cancer
Cowboys owner Jerry Jones, 82, revealed that in 2010 he was diagnosed with Stage IV melanoma, a skin cancer, and that an immunotherapy clinical trial saved his life. “You don’t like to think about your mortality, but I was so fortunate to have some great people that sent me in the right direction,” Jones told the Dallas News.
“I got to be part of a trial that was propitious. It really worked.”
Can a Single Blood Test Detect Multiple Cancers?
What about whole-body MRIs?
“Liquid biopsies” make headlines for their potential to detect multiple cancers in their earliest stages, but it’s too soon to tell whether the tests are accurate and safe enough for widespread use, according WRƓQGLQJVRIDV\VWHPDWLFUHYLHZSXEOLVKHGLQWKH$QQDOVRI,QWHUQDO 0HGLFLQHŏ1RFRQWUROOHGVWXGLHVDUHFRPSOHWHGWKDWUHSRUWEHQHƓWV RIVFUHHQLQJZLWK>PXOWLFDQFHUGHWHFWLRQ@WHVWVŐZURWHWKHVWXG\ DXWKRUVDGGLQJŏ(YLGHQFHZDVMXGJHGLQVXIƓFLHQWWRHYDOXDWH KDUPVDQGDFFXUDF\$FFXUDF\YDULHVE\WHVWDQGVWXG\GHVLJQŐ /LTXLGELRSV\WHVWVLGHQWLI\YDULRXVFDQFHUUHODWHGELRPDUNHUVŋ VXFKDVSURWHLQVDQGWXPRU'1$ŋLQERG\ŴXLGVOLNHEORRGVDOLYD RUXULQH7KHWHVWVDUHFKHDSHUWKDQPDQ\RWKHUVFUHHQLQJVDQG PD\GHWHFWFDQFHULQHDUOLHUVWDJHV&RQVLGHULQJWKDWRIFDQFHU GHDWKVDUHFDXVHGE\PDOLJQDQFLHVIRUZKLFKWKHUHDUHQRHVWDEOLVKHGVFUHHQLQJWHVWVOLTXLGELRSVLHV LIDFFXUDWH FRXOGLPSURYH HDUO\FDQFHUGHWHFWLRQUDWHV
:KROHERG\05,VDUHDOVRWRXWHGLQQHZVDQGVRFLDOPHGLDDV DOLIHVDYLQJVFUHHQLQJPHWKRGIRUDV\PSWRPDWLFSDWLHQWV LQWKH PLQLPDOO\LQYDVLYHSURFHGXUHPDJQHWLFUHVRQDQFHLPDJLQJFUHDWHV KLJKUHVROXWLRQLPDJHVRIVWUXFWXUHVLQVLGHWKHERG\ $JURZLQJ QXPEHURIIRUSURƓWFRPSDQLHVRIIHUWKHVFDQVRIWHQIRUDFRXSOH thousand dollars. Is it worth it?
5DGLRORJLVWV%ULDQ1'RQWFKRV0'DQG0DQMLUL'LJKH0' H[DPLQHGQXPHURXVVWXGLHVRQWKHWRSLF,QRQHUHYLHZWKH\IRXQG WKDW RISDWLHQWVZKRKDGWKHVFDQVVKRZHGDEQRUPDOƓQGLQJV EXWRQO\RIWKHPUHTXLUHGIXUWKHUHYDOXDWLRQDQGRQO\ RIDOOSDWLHQWVKDGDPDOLJQDQF\:ULWLQJIRU)UHG +XWFK1HZV6HUYLFHWKH\QRWHG ŏ/RQJWHUPSDWLHQW RXWFRPHVDQGFRVWHIIHFWLYHQHVVDUHQRWIXOO\HYDOXDWHGŐ:KDWōVPRUHŏ1RFRPSDUDWLYHWULDOVRU PRGHOLQJ>KDYHFRPSDUHG@ZKROHERG\05,V ZLWKRWKHURUJDQVSHFLƓFVFUHHQLQJWHVWVŐVXFK as mammograms and colonoscopies.
A $2,000,000,000 GIFT
Letai
NCI GETS A NEW LEADER
Amid much turmoil at federal health agencies, $QWKRQ\/HWDL0'3K' was sworn in this fall as director of the National Cancer Institute (NCI), part of the National Institutes RI+HDOWK/HWDLKDVVHUYHG as professor of medicine
DW+DUYDUG0HGLFDO6FKRRO and a medical oncologist at the Dana-Farber Cancer Institute. His research has OHGWRWKHGHYHORSPHQW RIVHYHUDOWUHDWPHQWVDQG a better understanding of tumors. “Letai has been on the cutting edge of how we think about cancer treatment,” said NIH GLUHFWRU-D\%KDWWDFKDU\D 0'3K'ŏ+LVGULYH LQWHJULW\DQGH[SHUWLVH make him the right leader to harness the resources DQGWDOHQWDW1&,WRUHYHUVH America’s cancer crisis.”
As federal and state funding for health programs shrinks, the Knight Cancer Institute at Oregon Health & Science University just hit the jackpot: A $2 billion donation from Nike cofounder Phil Knight, who once attended the school, and his wife, Penny. It’s the largest single gift to a university in U.S. history. “This gift,” said OHSU president Shereef Elnahal, MD, MBA, “is an unprecedented investment in the millions of lives burdened with cancer.”
Get more cancer news: cancerhealth.com/news
Phil and Penny Knight
DO COVID VACCINES BOOST IMMUNOTHERAPY?
Messenger RNA (mRNA) COVID-19 vaccines may improve the effectiveness of checkpoint immunotherapy, according to a study presented at the European Society for Medical Oncology Congress. In preclinical studies, mRNA vaccines increased production of type I interferon, a cytokine that enables innate immune cells to prime the activity RIFDQFHUƓJKWLQJ7FHOOV,QDGGLWLRQYDFFLQDWHG cancer patients showed increased expression of the PD-L1 protein on tumors, the target of many immune checkpoint inhibitors.
An analysis of medical records from more than 1,000 cancer patients showed that those who UHFHLYHGD0RGHUQDRU3Ɠ]HU&29,'YDFFLQHZLWKLQ 100 days of starting checkpoint inhibitors were twice as likely as unvaccinated people to live for three years. Vaccine recipients with advanced lung cancer had a median survival time of 37 months, compared with 21 months for unvaccinated people; 56% and 31%, respectively, were still alive at three
years. Likewise, among people with metastatic melanoma, the median survival was 27 months for unvaccinated patients but not yet reached for those who received the vaccines because a majority were still alive; three-year survival rates were 44% and 68%. The improvement was especially notable for people with immunologically “cold” tumors that don’t respond as well to immunotherapy. In contrast, the researchers did not see the same survival advantage for cancer patients who received QRQP51$YDFFLQHVVXFKDVŴXVKRWV
“This study demonstrates that commercially available mRNA COVID vaccines can train patients’ immune systems to eliminate cancer,” says Adam Grippin, MD, PhD, of the University of Texas MD Anderson Cancer Center. “When combined with immune checkpoint inhibitors, these vaccines produce powerful antitumor immune responses that are associated with massive improvements in survival for patients with cancer.”
Treatment Gets Easier With Injectable Options
Cancer patients receiving immunotherapy now have the option of brief subcutaneous injections rather than lengthy intravenous infusions. In September, the Food and Drug Administration (FDA) approved Keytruda Qlex, an injectable formulation of the blockbuster immune checkpoint LQKLELWRUSHPEUROL]XPDEZKLFK restores T-cell activity against tumors. Like the original formulation, Keytruda Qlex is approved for multiple malignancies, including melanoma, non-small-cell lung cancer, colorectal cancer,
liver cancer and triple-negative breast cancer. A Phase III trial of lung cancer patients showed that Keytruda Qlex works as well as IV infusions, with similar response rates and survival.
In September 2024, the )'$JDYHWKHQRGWRWKHƓUVW injectable checkpoint inhibitor, 7HFHQWULT+\EUH]DDQLQMHFWDEOH IRUPXODWLRQRIDWH]ROL]XPDE soon followed by Opdivo Qvantig, an injectable version of nivolumab. To create injectable formulations, the drugs are combined with hyaluronidase,
DQHQ]\PHWKDWLQFUHDVHVWKH permeability of tissue under the skin and enables the antibodies to be dispersed and absorbed into the bloodstream.
The injections cut treatment time from half an hour or more to mere minutes. What’s more, injectable checkpoint inhibitors can be administered in a docWRUōVRIƓFHRUFRPPXQLW\FOLQLF UDWKHUWKDQDVSHFLDOL]HGLQIXsion center, making treatment more accessible and convenient and letting hospitals free up limited infusion slots.
Shorter Radiation Therapy Reduces Side Effects
Shorter radiation regimens are better tolerated and do not compromise treatment effectiveness, according to research presented at the American Society for Radiation Oncology annual meeting.
One study found that a single dose of precisely targeted radiation after surgery provides the same local disease control DVWKHVWDQGDUGƓYHZHHNFRXUVH for patients with non-small-cell lung cancer, but with fewer side effects. Another study showed that stereotactic body radiation therapy (SBRT) or surgery led to similar survival outcomes at 10 years for patients with earlystage lung cancer, with radiation RIIHULQJTXDOLW\RIOLIHEHQHƓWV
SBRT is a type of hypofractionated radiation therapy that gives larger doses in fewer sessions, delivering more radiation to tumors and a minimal amount to surrounding heathy tissue.
A third trial found that men with intermediate-risk localized prostate cancer who received ƓYH6%57VHVVLRQVZHUHVOLJKWO\ more likely to experience disease progression at three years PRVWO\ULVLQJSURVWDWHVSHFLƓF antigen levels) than those who underwent 20 or 28 sessions, but fewer patients reported declines in bowel, urinary and sexual function. Earlier this year, Swedish researchers reported that a two-week course of radi-
ation for prostate cancer was as safe and effective as an eight-week course after 10 years of follow-up.
Finally, a study published in The Lancet Oncology showed that a shorter, less intense course of radiation and chemotherapy after minimally invasive surgery for human papillomavirus–positive oral cancer led to fewer side effects while maintaining high cure rates. “This is a game FKDQJHUIRUSDWLHQWVŐVD\V'DQLHO Ma, MD, of the Mayo Clinic Comprehensive Cancer Center. “This shorter, less intensive regimen allows patients to return to their lives more quickly and with a EHWWHUTXDOLW\RIOLIHŐ
Federally Funded Clinical Trials Play a Vital Role in Cancer Care
Federally funded clinical trials provide crucial support for essential areas of cancer care that are not well funded by pharmaceutical companies, according to new research presented at the 2025 ASCO Quality Care Symposium.
Joseph Unger, PhD, of Fred Hutchinson Cancer Center, and colleagues looked at data from the National Institutes of Health’s ClinicalTrials.gov registry from 2008 to 2024 to identify U.S. trials of drugs or biological agents for cancer treatment. Of the more than 10,000 trials included in the analysis, 17% were federally funded, while 83% were industry funded. Government-funded trials more often involved rare cancers and pediatric cancers. Federally funded studies were more likely to be early and mid-stage (Phase I or II) clinical trials, which assess
For more care and treatment news: cancerhealth.com/science-news
pharmacokinetics, safety and preOLPLQDU\HIƓFDF\,QGXVWU\VWXGLHVLQ contrast, were more often Phase III trials, which test new therapies in larger populations to support regulatory approval. While companies funded more single-agent drug trials, the government funded more studies of combination regimens and dose de-escalation trials, which aim to reduce the intensity of treatment to minimize side effects and cost while maintaining effectiveness.
ŏ)HGHUDOWULDOVƓOOFULWLFDOJDSVOHIWE\LQGXVWU\Ő Unger says. “Sustained or increased funding is essential to maintain progress in these areas and to maintain a healthy cancer research ecosystem that balances federally sponsored and industryVSRQVRUHGWULDOVŐ
Bucket Lists and Chemo Brain
Breast cancer and side effects didn’t deter Jackie Lantry from life goals: living in France and learning the language.
I GREW UP IN A TINY AMERICAN TOWN WHERE EVERYONE looked like me and spoke only English. One day, I heard Julia Child on PBS talking to a famous Parisian baker—in French! I was 12 years old and vowed then and there that I would one day visit France. I took French in high school but lost my elementary ability to communicate soon after I graduated. Fast-forward to my 20s. An art teacher friend with the summer off asked me if I’d like to go to Europe for two weeks. I started packing my bags while still on the phone.
The trip was amazing. I returned to the United States and put ŏŴXHQWLQ)UHQFKŐRQP\EXFNHWOLVW,WRRNFRXUVHVKHUHDQGWKHUH but between kids, jobs, elderly relatives and life in general, my VSRUDGLFDWWHPSWVDW)UHQFKŴXHQF\NHSWJHWWLQJQXGJHGIDUWKHU and farther down the list.
As I approached retirement, my bucket list came into sharp focus. I made a plan to escape the cold New England winter and spend some time on the French Riviera. I created a list of cities based on the cost of living and walkability. I signed up for Duolingo and committed to a daily French lesson.
In May 2022, I found a small apartment in Nice, France, available from mid-January to the end of March 2023, and I booked it. I was excited and nervous, not having been out of the United States in years and never for more than a couple of weeks at a time. I considered myself the luckiest person alive.
,Q-XQH,KDGP\UHJXODUPDPPRJUDP+DYLQJƓEURF\VWLF breasts—characterized by lumpy, ropelike tissue—I always get called
back for additional images, sometimes even a biopsy. In early July, they requested an ultrasound. When the tech looked at the image on the screen and said, ŏ,ōPJRLQJWRJHWWKHGRFWRUŐ it didn’t concern me at all.
Within 24 hours, I found out I had breast cancer. The next few weeks were a blur of appointments, including what I call the ŏ%UHDVW&DQFHUŐPHHWLQJ which lasts about three hours and includes social workers, nurse practitioners, oncologists, radiologists and surgeons.
The only thing I took to the meeting was my calendar, the one with the dates I’d be in France.
“You’re not going to France, -DFNLHŐWKHRQFRORJLVWVDLG “Not this year and probably not QH[W\HDUHLWKHUŐ
I canceled the apartment and P\ŴLJKWV,VWXFNP\QHZVXLWcase in the back of the closet, where I couldn’t see it.
Instead of going to France, I got a portacath, immunotherapy and chemo. I was neutropenic— I had low levels of infectionƓJKWLQJZKLWHEORRGFHOOVŋIRU 24 weeks. I lost my hair, my ƓQJHUQDLOVDQGWRHQDLOVDQG 40 pounds. I didn’t have the energy to make my bed. When WKHFKHPRZDVƓQDOO\ƓQLVKHG I had a bilateral mastectomy. The portacath stayed in so I could continue immunotherapy for another six months.
I kept up Duolingo until chemo brain (or, as the doctor calls it, “chemo-related cognitive imSDLUPHQWŐ NLFNHGLQ$IWHU months of chemo, my brain no longer worked like it used to.
désolé. Je ne parle pas français. Parlez-vous anglais?” +HOOR ,ōPVRUU\,GRQōWVSHDN)UHQFK 'R\RXVSHDN(QJOLVK" ,ZDV VKRFNHGZKHQKHVDLGŏJe suis désolé, madame, je ne parle pas anglais.Ő ,ōPVRUU\PDGDP ,GRQōWVSHDN(QJOLVK ,WRRNDGHHSEUHDWKDQG EDVLFDOO\WROGKLPWKDW,VWXGLHG DWDVFKRRODQGZRXOGWU\7KH FRQYHUVDWLRQZHQWOLNHWKLV ,ōOOVSDUH\RXWKH)UHQFKDQG SUHVHQWWKHEURNHQ(QJOLVK
:KHQ,JRWEDFNWRWKH8QLWHG 6WDWHV,GXJRXWWKHWDWWHUHG QRWHERRNFRQWDLQLQJP\EXFNHW OLVWDQGUHZURWHŏEHFRPHEL OLQJXDOLQ)UHQFKŐDWWKHYHU\WRS J’étude tous les jours. Mon objectif est d’atteindre le niveau B-1 avant mes 70 ans (février 2026). Je suis presque sûr d’y arriver! ,VWXG\HYHU\GD\0\JRDOLV WREHFRPHOHYHO%E\P\WK ELUWKGD\LQ)HEUXDU\,ōP SUHWW\VXUH,FDQGRLWQ
Jackie Lantry is retired and lives in southern New England. After 14 months of treatment, she has no signs of breast cancer DQGLVQRZRQDƓYH\HDUKRUPRQH therapy regimen.
Leukemia and Lymphoma
Many people with blood cancers can be successfully treated and have long-term remission.
LEUKEMIA AND LYMPHOMA are both blood cancers, but they have some distinct characteristics and different therapies. With ad vances in treatment, many people with these malignancies can be successfully treated, and for some patients, “watchful waiting” may be an option.
Leukemia affects bloodforming stem cells or immature blood cells, mostly white blood cells that carry out immune responses. Abnormal cells can grow out of control in the bone marrow and enter the bloodstream before fully developed, crowding out mature, functional blood cells.
/HXNHPLDLVFODVVLƓHGE\WKH type of affected cells, whether it is acute (fast-progressing) or chronic (slow-growing) and whether it strikes adults or children. The four main types are acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and chronic myeloid
leukemia (CML). Overall, leukemia occurs most often among people over age 60, but ALL is the most common childhood cancer.
Lymphoma occurs when white blood cells known as lymphocytes grow out of control. It usually involves B cells, but some forms affect T cells or natural killer cells. Lymphoma starts in the lymphatic system, the network of lymph vessels and organs that play a role in immune function and waste removal.
There are two types, Hodgkin lymphoma and non-Hodgkin lymphoma (NHL), each of which has several subtypes. In Hodgkin lymphoma, large abnormal lymphocytes called Reed-Sternberg cells build up in the lymph nodes. The most common type of aggressive NHL is called diffuse large B-cell lymphoma, while follicular lymphoma is the most common indolent, or slow-progressing, type.
Sometimes the distinction between leukemia and lymphoma is not straightforward. CLL, for example, is basically the same disease as small lymphocytic lymphoma (SLL), but abnormal B cells are more likely to be found in the bloodstream in people with CLL versus the lymph nodes in those with SLL.
Treatment for leukemia and lymphoma varies according to the type of
disease, how fast it’s progressing, how much it has spread and the patient’s age and previous treatment history.
In some cases, treatment for less aggressive disease can be delayed while a patient is monitored for signs of disease progression, known as active surveillance. Those who need treatment typically receive some combination of chemotherapy, targeted therapy, immunotherapy and sometimes radiation, often moving from one regimen to the next as relapse occurs. A stem cell transplant may be an option after other therapies have failed. While some people respond well to treatment and experience long-term remission, recurrence is common.
Cancer treatment has improved dramatically in recent decades, and leukemia and lymphoma have led the way. Gleevec, approved in 2001 to WUHDW&0/ZLWKDVSHFLƓFPXWDWLRQ ZDVWKHƓUVWWDUJHWHGWKHUDS\ that inhibits a protein that drives FDQFHUJURZWK7KHƓUVWWZR CAR-T therapies—which involve reprogramming a patient’s T cells to attack their cancer— were approved in 2017 for children and young adults with ALL and adults with large B-cell lymphoma. Building on this momentum, many clinical trials are underway to test new experimental therapies for these and other blood cancers. Q
A Leukemia Diary
Todd Bushmaker, 55, an architect in Green Bay, Wisconsin, has lived with chronic lymphocytic leukemia for more than 22 years.
I’M AN ARCHITECT, AND I LIVE IN GREEN BAY, Wisconsin, where I was born and raised.
To learn more, visit CALQUENCE.com or scan the QR code with your phone’s
Important Product Information
CALQUENCE is a prescription oral treatment for adults with chronic lymphocytic leukemia or small lymphocytic lymphoma. Can cause serious side effects including: serious infections, bleeding problems, decrease in blood cell count, new cancers, heart rhythm problems, and liver problems. Some may lead to GHDWK7HOO\RXUGRFWRULI\RXH[SHULHQFHLQIHFWLRQVVXFKDVŴXOLNHV\PSWRPV XQH[SHFWHGEOHHGLQJVXFK DVEORRGLQ\RXUVWRRORUXULQH KHDUWUK\WKPSUREOHPVVXFKDVIDVWRULUUHJXODUKHDUWEHDW RUOLYHUSUREOHPV such as stomach pain, dark urine or yellowing of your skin. Use sun protection when outside.
Please read Brief Summary of Prescribing Information on adjacent page. You are encouraged to report the negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088
• CALQUENCE is a prescription medicine used to treat adults with: chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). It is not known if CALQUENCE is safe and effective in children.
Before taking CALQUENCE, tell your healthcare provider about all of your medical conditions, including if you:
• have had recent surgery or plan to have surgery. Your healthcare provider may stop CALQUENCE for any planned medical, surgical, or dental procedure.
• have bleeding problems.
• have or had heart rhythm problems.
• have an infection.
• have or had liver problems, including hepatitis B virus (HBV) infection.
• are pregnant or plan to become pregnant. CALQUENCE may harm your unborn baby and cause problems during childbirth (dystocia).
° If you are able to become pregnant, your healthcare provider may do a pregnancy test before you start treatment with CALQUENCE.
° Females who are able to become pregnant should use effective birth control (contraception) during treatment with CALQUENCE and for 1 week after the last dose of CALQUENCE.
• are breastfeeding or plan to breastfeed. It is not known if CALQUENCE passes into your breast milk. Do not breastfeed during treatment with CALQUENCE and for 2 weeks after your last dose of CALQUENCE.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking CALQUENCE with certain other medications may affect how CALQUENCE works and can cause side effects. Especially tell your healthcare provider if you take a blood thinner medicine.
How should I take CALQUENCE?
• Take CALQUENCE exactly as your healthcare provider tells you to take it.
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• Your healthcare provider may tell you to decrease your dose, temporarily stop, or completely stop taking CALQUENCE if you develop certain side effects.
• Do not switch (interchange) your CALQUENCE tablets with CALQUENCE capsules.
• Take CALQUENCE 2 times a day (about 12 hours apart).
• Take CALQUENCE with or without food.
• Swallow CALQUENCE tablets whole with a glass of water. Do not chew, crush, dissolve, or cut tablets.
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What are the possible side effects of CALQUENCE?
CALQUENCE can cause serious side effects, including:
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• Bleeding problems (hemorrhage) have happened in people treated with CALQUENCE and can be serious and may lead to death. Your risk of bleeding may increase if you are also taking a blood thinner medicine. Tell your healthcare provider if you have any signs or symptoms of bleeding, including: blood in your stools or black stools (looks like tar), pink or brown urine, unexpected bleeding, or bleeding that is severe or you cannot control, vomit blood or vomit that looks like coffee grounds, cough up blood or blood clots, dizziness, weakness, confusion, changes in your speech, headache that lasts a long time, or bruising or red or purple skin marks.
• Decrease in blood cell counts. Decreased blood counts (white blood cells, platelets, and red blood cells) are common with CALQUENCE, but can also be severe. Your healthcare provider should do blood tests to check your blood counts regularly during treatment with CALQUENCE.
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• Heart rhythm problems (cardiac arrhythmias) have happened in people treated with CALQUENCE, and can be serious or lead to death. Tell your healthcare provider if you have any of the following signs or symptoms: fast or irregular heartbeat, dizziness,
feeling faint, chest discomfort, or shortness of breath.
• Liver problems. Liver problems have happened in people treated with CALQUENCE, and can be severe or life-threatening, or lead to death. Contact your healthcare provider if you experience stomach pain or discomfort, urine of dark color or yellowing of your skin. Your healthcare provider will request tests to monitor your liver function during treatment with CALQUENCE.
The most common side effects of CALQUENCE include: diarrhea, upper respiratory infection, headache, muscle and joint pain, lower respiratory infection, and tiredness.
These are not all of the possible side effects of CALQUENCE. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store CALQUENCE?
• Store CALQUENCE at room temperature between 68°F to 77°F (20°C to 25°C).
Keep CALQUENCE and all medicines out of the reach of children.
General information about the safe and effective use of CALQUENCE.
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use CALQUENCE for a condition for which it was not prescribed. Do not give CALQUENCE to other people, even if they have the same symptoms you have. It may harm them. You can ask your healthcare provider or pharmacist for more information about CALQUENCE that is written for health professionals.
joined a clinical trial testing a new immunotherapy.
Jones
MY STORY IS A STORY OF WHAT NOT TO DO. “ ”
After a diagnosis of Stage IV prostate cancer, Euvon Jones turned his life around— with the help of his wife, Janet.
BY JENNIFER COOK
EUVON JONES IS A SELF-PROFESSED guy’s guy. That means, in part, “if it don’t hurt, don’t fix it,” he says. For years, he and a partner ran an HVAC company, doing complicated commercial jobs in 35-story high-rises, hospitals and research facilities, putting in 12- to 18-hour days, six days a week, as Euvon provided for his wife, Janet, and their four kids in Maryland. And he was admittedly cavalier about his health.
“When you start work at four o’clock in the morning, you need that wake-up-call sugar hit. I’d pull that vending machine lever like it was a slot machine to get my Almond Joys, Tastykakes, Sno Balls—anything that had highfructose corn syrup in it,” recalls Euvon, now 74. “So the way I ate, I always felt that I was doing good. And I laughed at our kids and Janet when they started to matriculate over to the organic side. I said, ‘You don’t have to do that. You know, look at me. I’m cut. I’m strong. I’m in good shape.’”
When it came to caring for his health, Euvon says, “I didn’t. Because I felt good. Getting screened? Blood tests? Never happened. Until I was 59 years old.”
That autumn, in 2011, he had a pain in his right hip he couldn’t get rid of. “I couldn’t fake it, couldn’t exercise it away, could not stop limping,” he says. An orthopedic surgeon gave him cortisone shots, but they only masked the pain. So one day after work, he got an MRI scan.
“It looked like Bugs Bunny cartoons when Yosemite Sam shot him up and he’s tattered,” Euvon says. “There were spots all over the place—in my bones, my blood, my lymph nodes, my back, my hips, down my legs, in my chest.” Alarmed, the technician called Euvon’s orthopedic surgeon, who had ordered the tests, and set up an immediate appointment. There, he learned that he might have multiple myeloma—a type of blood cancer—and not the hip arthritis he’d anticipated. That doctor, in turn, sent him straight to an oncologist, who also thought the evidence pointed to multiple myeloma.
HOLDING IT TOGETHER
Afterward, when Euvon arrived home, neither he nor Janet cried or bared their hearts to each other. “We were both in the Twilight Zone,” he says. “I was doing everything I
could to try to keep it together because I couldn’t believe that the big C was a part of my life now. And why? I thought I did everything right.” e couple had never had a conversation about cancer, even though Euvon’s dad and all nine of his dad’s siblings had had cancer. Maybe if they didn’t talk about it, it wouldn’t be real.
But they couldn’t remain in denial for long. Euvon returned to the oncologist for more tests and then, a couple of weeks later, the results. “ e good news is, you don’t have multiple myeloma,” she told them. “ e bad news is you do have Stage IV prostate cancer.” When Euvon asked how many stages there were, she told him there were no more stages beyond the fourth and that the cancer had metastasized, or spread. His prostate speci c antigen (PSA) test score was 398; healthy results depend on a man’s age, but they are generally under 10.
“I never talked about it,” Euvon says. “But I was a dead man walking.”
e next step was a biopsy of his prostate and bones to con rm the diagnosis. After a quick prayer, the couple decided to have it done at Georgetown University Hospital, which had been a client of Euvon’s and has a comprehensive cancer center. ere, they found an oncologist who specializes in Stage IV prostate cancer. She came up with a treatment plan: two types of androgen deprivation therapy plus injections to strengthen his bones and prevent fractures.
Euvon had limited treatment options because his cancer had already spread so widely. “I wasn’t a candidate for chemo, radiation or surgery,” he says, “because they would’ve had to dice me up like a lleted piece of sh.”
e drugs worked for about a year and brought his PSA down to 0.1. But near the end of 2012, it started to rebound. “Once again, it got real somber, crickets in the house,” Euvon recalls. at’s when his oncologist suggested he participate in a clinical trial for an immunotherapy that the Food and Drug Administration had recently approved as the rst therapeutic cancer vaccine.
HOPE WILL GIVE YOU A DESIRE TO BE PROACTIVE AND TO DO RESEARCH.
“Our culture is not one that gravitates toward clinical trials,” Janet says. “But we said, you know, we have nothing to lose. Let’s go for it.”
In 2013, in three sessions over six weeks, Euvon’s blood was drawn and the T cells (a type of white blood cells) were taught to attack prostate cancer cells before being reintroduced to his body to reboot his immune system. Since then, he’s been on a second-line medication plus a continuation of the sex-hormone-suppressing shots he’d been on earlier.
In 2019, Euvon’s oncologist called the couple into her o ce, and, according to Janet, she said, “I don’t know what is going on here. ere is no precedent, but we can’t nd the cancer. Your lymph nodes are clearing up; your bone marrow is replenishing itself.”
While other men have lived an extra six years following this particular immunotherapy, Euvon has survived nearly 15 years—perhaps, in part, because the vaccine has been more e ective among African Americans.
A WHOLE-LIFE MAKEOVER
Another contributor to Euvon’s exceptional survival could be the changes that Janet introduced to the couple’s lives. His diagnosis initially led her to prayer. “I’m losing my husband, and I had to ask, What do I do to keep my sanity?” she says. e answer: become a student of the diagnosis. So she started looking up what prostate cancer is, what the symptoms are. “It gave me something to do, and it took away some of my sadness because I had to concentrate.”
Her research on the internet led Janet to focus her energy on their diet and nutrition. “ e more I learned, the more I felt that I could at least give him quality of life while he was getting these treatments.
“I was looking up everything,” she recalls. She read labels. “If I couldn’t pronounce it, I wouldn’t buy it.” She read about cancer-causing chemicals in charcoal-grilled food, and they stopped grilling. She determined which foods needed to be organic or grass-fed to avoid pesticides. She checked mercury levels before buying seafood.
What she didn’t nd in her searches was a lot about caregiving for prostate cancer patients. “You really have to get to know your husband or father or son or brother on a whole other level,” she says. “You’re reintroducing yourself to someone who has cancer. And it’s a male thing, so it deals with their manhood.” She was sensitive to how bad Euvon was feeling and wouldn’t let him fall into a hole because of “how I should have done things di erent,” he says.
“ e worst thing that can happen to a man is to get
through life and feel like all the things that we did to try to make things better, we lost,” he continues. “And losing in this life journey was a tough place to be…. I just didn’t want to think about not being here around my family.
ose were some of the toughest feelings I ever had.”
Janet involved Euvon in organic cooking and growing their own produce. “I included him so he could be interested in what was going on and could appreciate eating di erently. So now we’re a team,” she says. Farmer Brown, as she playfully calls him, “has a wonderful green thumb, and he has grown tomatoes, cucumbers, peppers and herbs, like oregano and rosemary. We use all of them on a daily basis because they’re cancer ghters.” ey have incorporated her research into a way of eating that still includes foods like the steak he loves, but cooked with garlic, sweet peppers, onions, celery and plenty of herbs, along with salads of arugula, romaine, kale, baby spinach or endive. ey enjoy oatmeal. Greek yogurt. Pomegranates. Ceylon cinnamon—the healthiest, she says.
But Janet didn’t stop there—she tackled potential toxins in their home environment too. “We ended up pulling up our carpets and putting down ooring. I changed the shower lters. We put in air puri ers. And I started making our deodorant,” Janet says. She also replaced plastic food storage containers with glass and silicone ones.
GIVING BACK
Euvon and Janet are both involved in advocacy to help other African American men get screened for prostate cancer, go for health checkups, understand their genetic susceptibility and learn about immunotherapy. ey have worked with numerous nonpro t orga-
JANET JONES’S TIPS FOR CAREGIVERS
Janet compiled notes about her and her husband’s story into a faithbased book she published in 2015 titled The Trial of Stage IV Prostate Cancer Some of her suggestions include:
• Connect with other caregivers. “I have a couple of cousins who also were caregivers, so we were able to exchange ideas, cry, talk and even party together,” she says.
• Watch a comedy. When you’re feeling down and out, watch a classic like It’s a Mad, Mad, Mad, Mad World or Abbott and Costello or The Three Stooges— something that makes you laugh.
• Rediscover a passion. Return to an activity you enjoyed when you were young. Janet was in an a cappella group in the 1970s, and they are back together singing again.
• Concentrate more on living. Create a list of things you want to do in life from here on out. Make sure there’s a balance between caregiving and taking time for yourself.
nizations, including the Prostate Cancer Foundation, Zero Prostate Cancer, Prostate Health Education Network and Emmanual Health Education, through which they’ve done outreach to Black fraternities across the United States. “We’ve spoken to rooms of 200; one of the largest was 400 guys,” Euvon says.
“When I talk to people about immunotherapy, it’s like it’s the rst time they’ve heard of it—and this thing was approved 15 years ago.” ey have also advocated for research and funding from Congress. Euvon spoke with Representative John Lewis about the need for cancer legislation six months before he died of pancreatic cancer.
“When you receive a devastating diagnosis, you still have to respond with a sense of hope,” Janet says. “Hope will give you a desire to be proactive, to do research, to be willing to cry and scream, to share your hurt.
“It’s a team e ort, a team battle. You cannot ght it alone. If you don’t have family, you have a friend,” she continues. “ ere are support groups. Be active if you can, and if you can’t, nd someone who can on your behalf.”
“Humble yourself. Talk to yourself rst,” Euvon says. “Admit your stu and then realize that you gotta have some skin in the game. And that starts with making sure you get screened. Stay on top of your health because you’re not helping anybody if you never get checked up. As I did. Once again, my story is for What. Not. To. Do.
“But now that I do know what to do, oh my goodness. I feel like I live at the doctor’s. But that allows me to be able to laugh,” Euvon says. “I know where I am. I know what’s going on. I have information. I have things to be proactive about. And by the grace of God, I have support.” Q
Exercise lowers cancer risk, boosts treatment effectiveness and improves quality of life for patients and survivors—and you don’t have to run a marathon to benefit.
BY LIZ HIGHLEYMAN
WHAT IF A SINGLE INTERVENTION COULD
lower the risk of developing cancer, help treatment work better, lessen side e ects, boost mental health and even reduce the risk of disease recurrence and death? A growing body of research shows that physical activity is just such an intervention, and the data are so compelling that more and more doctors are prescribing exercise for cancer patients and survivors.
Exercise enhances physical tness and helps maintain a healthy weight. It has other bene ts as well, such as improving energy levels, sleep, mood and cognitive function. Conversely, more sedentary time has detrimental e ects. Even among people who get enough physical activity on a weekly basis, prolonged sitting is considered a health hazard.
“Exercise is the best medicine someone with cancer
can take in addition to their standard cancer treatments,” says Prue Cormie, PhD, an exercise oncology researcher at the Peter MacCallum Cancer Centre in Australia.
“If the e ects of exercise could be encapsulated in a pill,” Cormie continues, “it would be prescribed to every cancer patient worldwide and viewed as a major breakthrough in cancer treatment.”
CANCER RISK
Nearly a decade ago, the Centers for Disease Control and Prevention (CDC) reported that overweight and obesity are associated with 13 di erent malignancies, including breast, colon, kidney, liver, ovarian, pancreatic and stomach cancers.
Only smoking is a bigger risk factor. Around 75% of Americans are overweight or have obesity, and some experts think this contributes to rising cancer rates among young adults.
Body fat, or adipose tissue, is metabolically active, pumping out hormones and in ammatory cytokines that can spur the development of cancer. But obesity isn’t the whole story. Regardless of weight, physical activity improves in ammation, insulin regulation and immune function, deterring the emergence and spread of malignant cells.
Back in 2016, an international team of researchers reported that leisure-time physical activity was associated with lower risk for many types of cancer—and this held regardless of body size or smoking history. More recently, a 2025 study of more than 85,000 adults in the United Kingdom found that people with the highest level of moderate- to vigorous-intensity physical activity had a 26% lower risk for cancer compared to those with the least. People who engaged in light activity (such as household chores), had higher daily step counts or substituted an hour a day of sedentary time with physical activity also saw bene ts. Another UK Biobank study found that even brief bursts of vigorous activity totaling less than ve minutes a day reduced cancer incidence among people who did not exercise regularly.
BENEFITS OF EXERCISE
e bene ts of exercise for cancer patients and survivors are clear. In the past, people facing cancer were often advised to rest and limit their activity, but we now know that this was the wrong approach.
Physical activity helps reduce treatment side e ects and improve quality of life. Exercise can alleviate fatigue, decrease depression and anxiety, relieve insomnia, reduce the risk of disabling falls, boost the health of the gut microbiome and improve cardiovascular health. Studies have shown that physical activity improves sexual function in men with prostate cancer, relieves peripheral neuropathy pain in women with ovarian cancer and lessens chemotherapy-related cognitive impairment (chemo brain) in those with breast cancer. Exercise can also help breast cancer patients regain a full range of arm motion after surgery, and resistance training was found to improve lymphedema, or post-surgery swelling. One study found that patients who participated in virtual mind-body tness classes not only reported less fatigue and depression and fewer treatment side e ects but also had fewer urgentcare visits and unplanned hospitalizations and shorter hospital stays.
EXERCISE IS THE BEST MEDICINE SOMEONE WITH CANCER CAN TAKE.
“ e idea of accruing short bouts of moderate to vigorous activity through daily living activities makes physical activity much more accessible to people who are unwilling or unable to take part in structured exercise,” says study author Matthew Ahmadi, PhD, of the University of Sydney in Australia.
While brief bursts of activity can be bene cial, more is better. CDC guidelines say adults need at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous activity each week, along with strength training on at least two days. e American Cancer Society (ACS) goes further, recommending 150 to 300 minutes of moderate activity or 75 to 150 minutes of vigorous activity per week, along with limiting sedentary behavior and maintaining a healthy weight. ACS researchers estimated that if people reach the 300-minute target, more than 46,000 cases of cancer could be averted each year.
e bene ts of exercise extend to people with advanced cancer, who are more prone to frailty. e large PREFERABLE-EFFECT study evaluated a supervised exercise program that included twice-weekly sessions of aerobic exercise and strength and balance training for nine months. At the 2023 San Antonio Breast Cancer Symposium, Anne May, PhD, of University Medical Center Utrecht in the Netherlands, reported that metastatic breast cancer patients who were randomly assigned to the program reported decreased fatigue, less pain and shortness of breath, improved health-related quality of life and better social functioning. is year, she reported that structured exercise led to increased muscle mass and improved physical performance, including balance and strength.
“ e results from our study are important since lean body mass is linked to better treatment tolerance, prognosis and overall health, and increased muscle strength correlates with improved quality of life and lower mortality risk,” May says.
Physical activity has been shown to slow the growth of tumors, and exercise may boost immune function and enhance the e ectiveness of cancer therapy. In one study, men with prostate cancer who participated in a yoga program before and after surgery showed improvement in several measures of in ammation and immune function. Another study showed that exercise was associated with changes in gene expression in breast cancer patients, especially in pathways involved in in ammation and immune regulation. Other researchers at the University of Turku in Finland found that breast cancer and lymphoma patients who exercised for just 10 minutes showed increases in cancer- ghting CD8 T cells and natural killer cells.
“Cancer treatments can make you tired and lower your motivation for exercise, which is why it is comforting to know that just 10 minutes of cycling or walking to a supermarket, for example, can be enough to boost the body’s immune system,” says lead author Tiia Koivula, PhD.
RELAPSE AND SURVIVAL
Looking at treatment e cacy, the LEANer (Lifestyle, Exercise and Nutrition Early After Breast Cancer) trial found that women starting treatment for Stage I to III breast cancer who participated in a homebased exercise and nutrition program while undergoing presurgery chemotherapy were nearly twice as likely to experience a pathologic complete response, meaning no remaining evidence of disease.
FITNESS TIPS
standing ovation. e study enrolled 889 colon cancer patients who had undergone surgery and completed chemotherapy. ey were randomly assigned to either participate in a structured exercise program or receive health education materials. At ve years, people in the exercise group had a 28% lower risk of cancer recurrence, new malignancies or death and a 37% improvement in overall survival.
• Stretch and warm up before exercising to avoid injury.
• Build up slowly—for example, by walking a few more minutes or lifting a bit more weight.
• Vary your activities to prevent boredom, taking advantage of the weather and seasons.
• Boost your activity by taking the stairs instead of the elevator or parking farther away and walking.
• Break up long periods of sitting with a short walk or a “movement snack.”
• Use a wearable device, such as a Fitbit, to track your activity.
• Listen to your body: It will tell you when you can step up the pace or need to slow down or take a break.
• Get enough sleep, eat a healthy diet and drink plenty of water before, during and after exercising.
• Check in with your health care team before starting or changing your exercise routine.
Two decades ago, observational studies rst showed that physical activity was associated with reduced mortality in people with breast or colon cancer, and the evidence has continued to build.
Results from the CHALLENGE trial, presented at the 2025 American Society for Clinical Oncology annual meeting, were so impressive that they prompted a
Investigator Christopher Booth, MD, of Queen’s University in Ontario, noted that the bene t was comparable to or exceeded that of many standard medical therapies. “As oncologists, one of the most common questions we get asked by patients is ‘What else can I do to improve my outcome?’ ese results now provide us with a clear answer: An exercise program that includes a personal trainer will reduce the risk of recurrent or new cancer, make you feel better and help you live longer,” he says.
In another study, Jessica Lavery, MS, of Memorial Sloan Kettering Cancer Center, and colleagues looked at the relationship between exercise and mortality among 11,480 participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. ose who got the recommended amount of exercise saw a 21% reduction in cancer mortality and a 25% reduction in all-cause mortality compared with those who did not. People who exceeded the recommendation further lowered their risk of death, but even those who didn’t reach the target saw some bene t.
“[E]xercise is medicine, and these results support this,” Stacey Ken eld, ScD, and June Chan, ScD, of the University of California, San Francisco, wrote in the Journal of Clinical Oncology. “ is underscores that exercise (in addition to standard therapies) is one of the best daily pills cancer survivors can take to optimize their longevity.”
GET GOING
Despite these bene ts, getting enough exercise can be a challenge. One study of more than 10,000 cancer survivors found that over a quarter did not meet the ACS goal for adequate physical activity. Even though exercise ultimately boosts energy, fatigue can make it hard to get started. Busy lives, work or family commitments and emotional stress can be added barriers. e cost of equipment, training or a gym membership can also be prohibitive.
But you don’t need an elaborate workout regimen to bene t from physical activity—every little bit of movement helps. Some people like participating in classes or team sports, while others prefer solo activities. One study found that cancer survivors who participated in a communitybased pickleball program not only increased their physical activity and fitness but also reported more social support.
JUST 10 MINUTES OF CYCLING OR WALKING CAN BOOST THE IMMUNE SYSTEM.
Gentle exercises, such as yoga, tai chi or qigong, may be especially suited for older people, those who are recovering from surgery and those struggling with treatment side e ects. Don’t forget that routine daily activities, such as gardening, shopping or walking the dog, count toward the total activity tally. For those who don’t have much time to exercise, brief “movement snacks” can be a good option (see Solutions, page 28, for some ideas).
Almost everyone can nd a level and type of activity that’s safe and bene cial, but some cancer patients may have limitations. ose with cancer in the bones, for example, might need to avoid high-impact activities that could lead to fractures. ose with peripheral neuropathy,
or nerve damage, in the feet should be careful when doing activities that require balance.
Beyond the individual level, structural changes are needed at the community, provider, health system and policy levels to help cancer patients and survivors up their activity. ACS guidelines recommend that tness assessment and physical activity counseling should start as soon as possible after diagnosis. Yvonne Wengström, PhD, and colleagues at the Karolinska Institute in Stockholm stress the importance of o ering support and information “in a careful way that does not stigmatize those who cannot perform physical activity and who may already feel that their lifestyle has caused their cancer.”
Policy changes include health insurance and Medicare coverage for counseling and structured exercise. As the CHALLENGE trial showed, a structured exercise program “is empowering and achievable for patients, with much lower costs than many of our therapies, and is sustainable for health systems,” says Booth. at study also showed that simply telling people to exercise is not enough. “Facilitating physical activity engagement requires a multifaceted approach,” Jasmine Yee, PhD, of the University of Sydney, and colleagues wrote in a JAMA Oncology editorial. “Creating safe, accessible and enjoyable spaces for physical activity engagement, including walkable urban environments and active transport options, can further encourage physical activity. Although such initiatives may appear costly, promoting and normalizing physical activity may help improve health outcomes and lower health care costs.” Q
WHAT ABOUT WEIGHT-LOSS MEDS?
GLP-1 AGONISTS CAN REDUCE CANCER RISK AND IMPROVE TREATMENT OUTCOMES.
KNOWING THAT OBESITY contributes to more than a dozen malignancies, an obvious question is whether weight-loss drugs can reduce the risk. Early studies suggest that they can—and they may also improve outcomes for cancer patients and survivors.
Glucagon-like peptide-1 (GLP-1) receptor agonists mimic natural hormones that suppress appetite, regulate insulin and slow emptying of the stomach. They also have DQWLLQŴDPPDWRU\HIIHFWV7KH most widely used meds, semaglutide (Ozempic or Wegovy) and tirzepatide (Mounjaro or Zepbound), are once-weekly injections, but next-generation oral meds are in the works. Around 12% of Americans reported using GLP-1 meds in a 2024 KFF Health survey. Older GLP-1 agonists— initially approved to treat diabetes—have been in use for more than a decade, enabling scientists to look for links to cancer. Researchers at Case Western Reserve University compared the incidence of 13 obesity-associated malignancies among more than 1,650,000 people who were prescribed various diabetes medications between 2005 and 2018. They found that people who used GLP-1 agoQLVWVKDGDVLJQLƓFDQWO\ORZHU risk for 10 of these cancers compared with insulin users. For example, gallbladder cancer was reduced by 65%, liver cancer by 53%, colorectal cancer by 46% and multiple myeloma by 41%.
In a study presented at the 2025 American Society of Clinical Oncology annual meeting, researchers analyzed medical records from more than 170,000 adults with diabetes and obesity who used either GLP-1 agonists or another class of diabetes drug. Overall, people who used GLP-1 meds had a 7% lower likelihood of developing obesity-related cancers, with the largest risk reductions seen for colon cancer (16%) and rectal cancer (28%). What’s more, GLP-1 agonist users had an 8% lower risk of death.
In another large study, Hao Dai, PhD, of Indiana University School of Medicine, and colleagues looked at health records from more than 86,000 people with obesity. Those who used GLP-1 agonists had a 17% lower risk for obesityassociated cancers over 10 years of follow-up. The risk reduction was greatest for ovarian cancer (47%), endometrial cancer (25%) and meningioma (31%). The exception was kidney cancer, with a nonsigQLƓFDQWLQFUHDVHGULVN
Turning to cancer treatment, Sai Yendamuri, MD, of Roswell Park Comprehensive Cancer Center, and colleagues assessed outcomes among lung cancer patients with overweight or obesity. GLP-1 agonists were associated with delayed recurrence after surgery and improved progression-free and overall survival in those treated with immune checkpoint inhibitors.
It is not yet clear whether
WKHEHQHƓWVRI*/3DJRQLVWV are primarily attributable to weight loss, but one study found that people who used the drugs had a 39% lower risk for obesity-related cancers compared with a 22% lower risk for those who underwent bariatric surgery.
It’s biologically plausible that GLP-1 agonists have more direct effects. Laboratory studies have shown that they inhibit proliferation of prostate, endometrial and ovarian cancer cells. One study found that tirzepatide slowed breast cancer growth in mice. A small trial of 20 people with obesity showed that semaglutide improved natural killer cell immune function—even in people who didn’t lose much weight. Liver cancer is a special FDVHDVWKHGUXJVƓJKWIDWW\ liver disease, a leading cause of cirrhosis and hepatocellular carcinoma.
While it’s too soon to recommend GLP-1 agonists for cancer prevention or treatment, the many people at risk for or living with cancer who are taking these meds to manage diabetes or REHVLW\FRXOGVHHH[WUDEHQHƓWV
“Given that more than 137 million individuals in the U.S. are currently eligible for GLP-1 therapies, even modest changes in cancer risk could have substantial public health implications,” Dai and colleagues wrote.
Champion and Blue Sky, both from 2024
A Portrait of Empowerment
New York artist Pauline Decarmo transforms several bouts with cancer—and debilitating side effects—into paintings and a lifestyle that inspire.
WHEN PAULINE DECARMO, a painter and art instructor in New York City, went for a regular mammogram in 2017, she “had no symptoms at all” and wasn’t expecting the initial diagnosis: ductal carcinoma in situ (DCIS), also referred to as noninvasive Stage 0 because the cancer hasn’t spread. She didn’t need chemotherapy or radiation, but further tests revealed “crystallizations all over,” she recalls, “and they couldn’t save the right breast.” It was removed, along with several lymph nodes. The plan was to take tamoxifen, a SLOOIRUƓYH\HDUVZKLFKLVQRW uncommon for breast cancer, but she elected to stop after experiencing side effects. But cancer wasn’t done yet.
Decarmo—who was born in Guyana, South America, and raised in Queens, New York— says, “In 2021, they found precancerous cells in my uterus. It was a different kind of cancer, so they took out everything, every female part, in a total hysterectomy with salpingo-oophorectomy [removal of Fallopian tubes and ovaries]. Then in April [2025], I was diagnosed with an aggressive type of basal cell carcinoma [a type of skin cancer] that only occurs in about 1% of people of color. It turned out to be a very big part in the back of my head—2 inches and 13 stitches—but they got it all, I hope.”
Decarmo also developed lymphedema, or swelling of the
limbs, which got so bad that she couldn’t use her dominant arm to paint. Yet she persevered, transforming her experiences into art. Her work has been displayed in solo and group shows, and she’s currently an adjunct lecturer teaching introduction to drawing and painting at the City College of New York.
In January 2026, Decarmo turns 60, a fact she doesn’t try to hide. “People say, ‘You’re OK sharing that?’ And I’m like, ‘Yes! I’m alive!’” Cancer Health spoke with Decarmo for the latest installment of our Can Heal column—the empowering phrase “Can Heal” is right there in our magazine’s title. Our interview has been edited for clarity and length.
Let’s start with the period after your mastectomy. Tell us about your decision to stop your planned treatment. I took tamoxifen for several months, but it did not work for me. It caused bad side effects. I felt so awful and couldn’t talk or function or work, and I developed aphasia, where I couldn’t get the words out. It was a terrible H[SHULHQFH,FRXOGQōWWDNHƓYH years of feeling like that and still have a chance cancer could come back. But that’s just me.
2WKHUSHRSOHDUHƓQHWDNLQJLW
Did you start any cancer treatments after the hysterectomy and the procedure to remove the skin cancer?
No. But after they took lymph nodes [during the breast cancer operation], that caused troubles. I developed lymphedema. With that, you have to be careful and work on your circulation. After the cancer medication, I also developed itching and hives. I still deal with that every day and have to take a cetirizine pill [Zyrtec] once a day.
The cover subject of our last issue—Emily Rubin, who shared her current experiences with a second breast cancer diagnosis after 15 years in remission—
wrote about being inspired after seeing your painting Champion, which depicts a female boxer with a mastectomy scar. Is that work typical of your style?
I have many styles, but I love GUDZLQJƓJXUHV:KHQ,GLGWKDW painting—it’s acrylic on wood panel—I was working on a commission and couldn’t do it because I couldn’t paint with my right hand. I got so frustrated I picked up the paintbrush and started another with my left hand. I was feeling so discouraged, so sad and angry. But to PHDVORQJDV\RXōUHƓJKWLQJ the battle, you’re a champion. And I want to acknowledge how I feel when I look in the mirror and see myself. I liked my breast and wanted to keep both. But I have to look for the beauty in this new situation. So I have these two parts of me now that I love—like a tomboy and a girl— and I’m in the middle.
Then there’s the Blue Sky painting where I’m leaning against the window, looking at the beautiful blue sky outside my studio, thinking, I have a studio! I was feeling hopeful.
Cancer opened a lot of doors for me because I explored it in my art and people responded to it. People send me emails
saying, “I love that painting. I’ve been there. That’s how I feel or how I want to feel.”
Finally, what’s your advice for anyone facing cancer?
Have someone go with you to your appointments to help take notes and pay attention—I’d get nervous and scared I was going to die. And I suggest mental health therapy. I struggled a lot being around people after the surgery because I could tell people were looking at me, and they’d say things like, “Why didn’t you get the other breast removed?” I’d say, “My surgeon VDLGŌ,ILWōVQRWEURNHQGRQōWƓ[LWōŐ
Be assertive with your doctors. My dermatologist thought the basal cell carcinoma spot was a mole the same color as my skin. I knew my cancer history and should have insisted on a biopsy earlier. Then it would have been caught when it was smaller. Do physical therapy. Eat well and sleep well. Look into local and community groups for help. BreastCancerOptions.org provides acupuncture once a month for free. It’s absolutely helpful. And I found an $8,000 grant for artists who’ve had life-changing events. I was out of work for a year and a half, and if I don’t paint, I don’t get paid. Also: Take care of yourself. I take walks and practice tai chi and do exercises for my arms. And I socialize a lot and hang out with friends. I’ve got a pretty nice life. It’s simple, but I don’t need a lot. Cancer helped me realize what is necessary and unnecessary. Q
Pauline Decarmo
Sit Less, Move More
Cancer survivors benefit from reducing sedentary behavior. These five movement snacks can help keep you active.
SITTING LESS IS JUST AS IMPORTANT AS exercising more. Even if you meet daily exercise recommendations, prolonged sitting is linked to worse health outcomes, including heart disease, type 2 diabetes and some cancers.
While awareness of the role of physical activity in cancer survivors has increased, reducing sedentary behavior has been less emphasized. Studies indicate that cancer survivors with more sedentary time have worse physical functioning and general health. In other words, higher physical activity levels are linked to better quality of life, while prolonged sitting is associated with poorer outcomes. This is especially the case for people with multiple chronic conditions.
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sedentary time can potentially add years to your life, short-term improvement is also very attainable with small habit changes, such as daily movement snacks.
Movement snacks are short, planned exercises that last 30 seconds to several minutes. They help activate your muscles, move your joints and get your heart pumping. (For more cancer research on
CHAIR SIT-TO-STANDS: In addition to regular standing and moving throughout your day, try to complete as many sit-to-stands as possible within one minute. You can place your hands on your legs or on the arms of the chair if needed, but focus on pressing through your heels, looking forward and standing all the way up for each repetition.
physical activity, see our feature story on page 20.)
Sitting less does not mean you must make drastic lifestyle changes. Movement does not require a gym membership or hours of exercise. It’s about making small, intentional choices that add up over time. Reducing sedentary time is a simple yet powerful step in a healthy direction. Start ZLWKRQHRUWZRPRYHPHQWVQDFNVWKDWƓWLQWR your routine and build from there.
If you’re new to this movement technique, here DUHƓYHLGHDVWRJHW\RXVWDUWHG
COUNTERTOP PUSH-UPS: This exercise works your upper body and core. Place your hands slightly wider than shoulder width on the edge of a countertop, step one or both feet back and lower your chest to the counter as close to touching as possible. Keep your body in a straight line and press away from the countertop. Do this while waiting for your coffee to brew or your lunch to heat up.
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Addressing Menopause and Women’s Sexual Side Effects
Mary Jane Minkin, MD, is codirector of the Sexuality, Intimacy & Menopause Program at Yale Medicine’s Smilow Cancer Hospital. She shares an encouraging message.
Cancer and its treatment can affect women’s sexual health in many ways. What are some of the questions and issues you address?
Is the patient’s treatment going to put her into menopause? Or if a woman who’s on menopausal hormone therapy is diagnosed with breast cancer, is she going to have to stop estrogen? How can we help these women have a comfortable vagina so they will be able to have sex?
Is this something that will directly affect the patient’s sexual organs? For example, people who’ve had radiation therapy for intestinal cancers or genitourinary cancers may have direct scarring issues, which we can usually deal with.
If they’re having a mastectomy, it’s psychologically devastating for many women. They’re going
to be losing a sexual body part. Body image is important. Trying to make sure that women realize they’re much more than just their breasts is important.
What about the side effects of cancer treatment in this area of women’s lives?
For some women, chemotherapy and other types of treatment will put them into menopause. And for some women, although not everybody, they’ll stay in menopause. If they have an estrogen receptor–positive breast cancer, most oncologists won’t be super thrilled with us giving estrogen therapy. Then we have alternatives that we can use to treat the menopausal symptoms. We now have a whole bunch of medications that are really pretty good DWWDNLQJFDUHRIKRWŴDVKHV including a whole new class of nonhormonal drugs called NK3 receptor antagonists.
can help stretch things. We can do all sorts of cool stuff to help. We’re very big on telling all our patients that they have to have a vibrator. Vibrators actually have therapeutic value because WKH\LQFUHDVHSHOYLFEORRGŴRZ So not only is it fun, but it’s also good for your pelvis. If a woman has a surgical procedure for a gynecological cancer that shortens her vagina, there are soft rubber rings that actually act as bumpers so that the penis can’t SHQHWUDWHWRRIDU,WōVDWHUULƓF gadget. So almost any kind of cancer can have an impact, but the good news is we can take care of most of the stuff.
What is your message for people with cancer who are dealing with changes in sexual health and intimacy?
It doesn’t mean the end of your life as a woman. And it doesn’t mean you’re going to be miserable with menopausal symptoms forever. We have a lot of new things that weren’t available five years ago, let alone 20 years ago.
Mary Jane Minkin, MD, helps women with cancer.
What are some other options you can offer for these issues? We can give many of these women estrogen replacement therapy. For vaginal issues, we can often prescribe vaginal estrogen, and we can recommend they use dilators, which
With the treatments that you can offer, do you see patients once again enjoying normal sex lives?
Absolutely. No question. We can make sex more comfortable. Q
Who’s on your team? cancerhealth.com/team
6DUFRPDDQG%RQH Cancer Resources
%21(6$5&20$2535,0$5<%21(&$1&(5 originates in the bone tissue. It doesn’t include cancer that starts elsewhere in the body and spreads to the bones. Sarcomas also occur in soft connective tissues, LQFOXGLQJIDWEORRGYHVVHOVFDUWLODJHDQGPXVFOHV%RQHFDQFHULVUDUH accounting for just 1% of all cancers. The most prevalent type of primary bone cancer, osteosarcoma, mostly affects older children and young adults. Early detection and treatment of cancer boosts the likelihood of long-term survival. Visit these sites for information on this cancer.
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The American Cancer Society raises awareness about bone cancer through a wealth of information about prevention, early detection, treatment and survival. Its website offers links to clinical trials, risk factors, life after treatment and more.
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Cancer Care offers specialized resources for bone cancer patients, such as support groups, community programs and virtual educational workshops. Connect with an oncology social worker for support and advice on treatment via the free Hopeline at 800-813-HOPE (4673).
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The pediatric osteosarcoma QRQSURƓW0DNH,W%HWWHUIRU .LGV:LWK2VWHRVDUFRPD 0,% Agents) helps support and unite a range of patients, families, doctors and researchers. Its site offers patient and educational resources, volunteer opportunities, information about grants and family funds and more.
Discover more resources: cancerhealth.com/resources
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Rein in Sarcoma raises awareness, funds research, offers support groups and educates the public and health community about sarcomas. Its Sarcoma Patient Guidebook includes information on sarcoma prevention, diagnosis, survivorship and mental health as well as support for children, adolescents and young adults.
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The Sarcoma Alliance offers several patient resources, including an up-to-date list of medical centers and hospitals specializing in sarcoma treatment. Its New Patient Guide offers answers to common questions about wellQHVVSDLQPDQDJHPHQWƓQDQFHV and quality of life.
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Located in Santa Monica, California, the center is home to experts from nearby medical institutions. The website offers a collection of inspiring patient stories, links to patient support networks tailored to these
unique cancers and the latest news and treatment updates.
6ƭƮƩƢƝ&ƚƧƜƞƫ Stupid Cancer supports adolescents and young adults with cancer through community events, meetups and educational materials. Its website offers information on mental health, nutrition and how to thrive with cancer.
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The Osteosarcoma Institute’s OSI Connect is an easy-to-use free resource that links patients and their families to experienced osteosarcoma physicians who give advice about treatment, getting the most out of medical visits and more.
2ƬƭƞƨƬƚƫƜƨƦƚ1ƨư Osteosarcoma Now informs and connects the osteosarcoma community with resources that help patients and their families navigate a cancer diagnosis. Online tool kits offer information on important terms, accessing medical records and getting a second opinion.
ENERGIZE & STRENGTHEN
Get out of your comfort zone and build confidence— and muscle!—with fitness classes and products.
Many cancer care teams urge their patients to be physically active before, during and after cancer treatment. Engage your muscles and get your blood pumping from the comfort of home with a WELLFIT Incline Treadmill with Handle ($399). This lightweight and compact WUHDGPLOOƓWVHDVLO\XQGHUDEHG sofa or desk, making storage effortless, fast and clutter-free. WELLFIT also partners with the American Heart Association to help fund lifesaving cardiovascular research.
Too much time spent sitting can decrease body function, weaken muscles and reduce range of motion.
Livestrong offers cancer surviYRUVRQOLQHƓWQHVVFODVVHVOHG E\SHUVRQDOWUDLQHUVFHUWLƓHGLQ exercise oncology. Each CancerFit class is uniquely designed to help cancer survivors rebuild VWUHQJWKHQHUJ\DQGFRQƓGHQFH DIWHUWUHDWPHQW7U\\RXUƓUVWFODVV free with code TRYCANCERFIT.
Take a live video class with a trainer for just $5, or check out the library of on-demand exercise videos for just $5 per month.
The American Cancer Society recommends between 150 and 320 minutes of yoga per week to speed recovery or defend against cancer occurrence or recurrence. (But, of course, you should speak with your health-care provider before engaging in new activity.) Yoga4Cancer helps people manage cancer side effects such as fatigue and stress via beginnerfriendly online yoga classes. Its website features a shop offering athletic wear, water bottles and more. Whether you’re exercising, stretching or meditating, the anti-slip rubber Yoga is Medicine Yoga Mat ($50) with microsuede top will spark joy while providing stability and comfort.
Resistance band training can help boost strength, build endurDQFHDQGLPSURYHŴH[LELOLW\ Hope Fitness Gear’s Full Mini Loop Kit ($18.99) includes heavy-duty resistance bands in ƓYHUHVLVWDQFHOHYHOV0DGHIURP eco-friendly natural latex—known for its superior elasticity and durability—the versatile resistance EDQGVVXLWDOOƓWQHVVOHYHOV3OXV a portion of every purchase supports single mothers living with metastatic breast cancer.
Look and feel good with items from the American Cancer Society’s EverYou shop, which offers dozens of fashionable and functional gifts, including high-quality hairpieces, headwear and recovery products. The Slick Chicks Accessible Hoodie ($74.99) features a hidden opening designed for tube routing and a magnetic zipper opening for those with limited hand dexterity. 7KHRYHUVL]HƓWDQGUHOD[HG waistband will provide comfort throughout the day.
Find more products to make life easier: cancerhealth.com/good-stuff
EXERCISE
Exercise helps reduce cancer risk, improve energy, boost mood and support recovery. Take our survey and let Cancer Health know about the role of exercise in your life.
Have you ever been diagnosed with cancer?
TYes TNo
Were you physically active before your cancer diagnosis?
TYes TNo TNot applicable
Did you know regular physical activity may lower your risk of cancer or recurrence?
TYes TNo
How many days per week do you currently engage in physical activity?
T0 T1–2 T3–4 T5 or more
What type of physical activity do you engage in?
TRunning TSports
TStrength training T Swimming
TWalking TYoga/stretching
TOther (Please specify.): ________________
TI don’t engage in physical activity.
Have you experienced any side effects WKDWPDNHH[HUFLVLQJGLIƓFXOW"
TYes TNo
Were you advised to limit or stop physical activity during treatment?
TYes TNo TNot applicable
Has regular exercise improved your physical or emotional well-being?
TYes TNo TNot applicable
What are some of your biggest barriers to exercising? (Check all that apply.)
TFatigue TFear of injury
TLack of guidance TLack of motivation
TLack of time TPain
TOther (Please specify.): ________________
TNone
TI don’t engage in physical activity.
Have you worked with a physical therapist or an exercise specialist?
TYes TNo
What year were you born?
What is your gender?
TMale TFemale
TTransgender TOther
What is your current level of education?
TSome high school THigh school graduate
TSome college TBachelor’s degree or higher
What is your annual household income?
TLess than $15,000 T$15,000–$34,999
T$35,000–$49,999 T$50,000–$74,999
T$75,000–$99,999 T$100,000 or more
What is your ethnicity? (Check all that apply.)
TAmerican Indian/Alaska Native
TArab/Middle Eastern TAsian
TBlack/African American THispanic/Latino
T1DWLYH+DZDLLDQ3DFLƓF,VODQGHUTWhite
TOther ___________________________
What is your ZIP code?
Scan this QR code with your smartphone to take this survey at cancerhealth.com/surveys. Or email a photo of your completed survey to website@cancerhealth.com.
THE PROBLEM WITH CANCER RESEARCH THAT FOLLOWS CONVENTIONAL WISDOM IS THAT THERE’S NOTHING CONVENTIONAL ABOUT CANCER.
At the Damon Runyon Cancer Research Foundation, our research focus is singular: High-risk, high-reward. We believe that only by pursuing and investing in the most audacious and ambitious ideas, and the young scientists who have those ideas, will we achieve real and lasting victory over humankind’s deadliest enemy. To learn more, visit damonrunyon.org
