**A continuation of our series on breast cancer and nutrition.

Creating a prevention diet is an important part of your transition from breast cancer treatment to an after-therapy life, says Hopkins Kimmel Cancer Center nutritionist Mary Eve Brown.  She notes five hallmarks of a smart prevention diet: 

  • Unprocessed, plant-based foods
  • High-fiber foods with whole grains, like brown rice and quinoa
  • Foods low in saturated fat, since saturated fat can be a trigger for some tumors
  • Plenty of vegetables, in an array of colors, aiming for 2 cups per day
  • Mindful amounts and sources of animal protein, using the leanest cuts possible with the fat trimmed, and avoiding processed meats. Prefer white meat poultry or fish to red meat, and make sure your portion looks about the size of a deck of cards.

What does that look like on a plate? Brown suggests these menu items for your meals throughout a typical day:

  • At breakfast, reach for steel-cut oatmeal for fiber, with dried cranberries for fruit and fiber, walnuts for a healthy fat, and skim milk for a low-fat start to the day.
  • At lunch, fortify yourself with lean protein, like a tuna fish salad on a 100% whole wheat roll, accompanied by fruits and vegetables like lettuce, tomato, and fresh strawberries. Finish with a non-fat yogurt, and have some water to stay hydrated.
  • At dinner, try a plant-based protein like bean chili, accompanied by cornbread for fiber, a spinach salad loaded with colorful vegetables with homemade vinaigrette, and hot green tea. You’ll get more phytochemicals if you brew loose green tea rather than the kind that comes in tea bags. Having some vegetarian meals during the week helps to cut down on the amount of animal protein you’re consuming.

You can find out more about nutrition and your breast cancer journey in Brown’s recent free webinar, What’s Food Got to Do With It? Eating Well Before, During and After Treatment.

Videos from Mary Eve Brown:
Colon Cancer and Nutrition

Pancreatic Cancer and Nutrition

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--This post is written by Kerri Kaplan, executive director of The Lustgarten Foundation

I’m often asked about new developments in the research landscape of pancreatic cancer, the nation’s most lethal cancer. As executive director of The Lustgarten Foundation, the nation’s largest non-profit foundation dedicated to funding pancreatic cancer research, I have seen tremendous progress made in the fight against this disease. The most encouraging transformation I have witnessed in my seven years at the Foundation is the rapid growth of collaboration among our highly motivated researchers and scientists, working together to find a cure.

When The Lustgarten Foundation was first formed in 1998, it was surprisingly difficult to attract researchers interested in studying pancreatic cancer since only a handful worked on studies related to the disease. A lack of funding and a lack of knowledge were also contributing factors. Thankfully that has changed, and today, there are more than 1,000 researchers who dedicate their careers to pancreatic cancer research. 

Collaboration has always been part of the Foundation’s mandate, and we work to ensure that these researchers no longer operate in ‘silos,’ separate and alone.  We recognize that in order to advance our understanding of pancreatic cancer, cooperating on research is essential.

Our partnerships with many leading organizations, foundations and institutions have helped to accelerate the rate of research discovery. In 2010, we established the Pancreatic Cancer Research Consortium, which comprises six world-renowned medical institutions (including Johns Hopkins University School of Medicine), and is designed to advance the most promising research initiatives aimed at ultimately finding a cure. Another consortium member is Cold Spring Harbor Laboratory (CSHL), with which we partnered again last year to establish The Lustgarten Foundation Pancreatic Cancer Research Laboratory. The laboratory focuses exclusively on pancreatic cancer research, with initial studies centered on early detection, drug development and drug delivery. The Consortium and dedicated pancreatic cancer research lab represent two significant steps forward in collaborative research.

We also are witnessing encouraging results through other collaborative efforts. For example, our long-term partnership with the National Cancer Institute and Johns Hopkins’s Cancer of the Pancreas Screening program [CAPS] led by Dr. Marcia Canto, resulted in important findings in the area of early detection. This multi-year collaboration of medical centers provided patients who have an inherited predisposition for pancreatic cancer with greater access to screenings. Many more researchers were able to tap into the data from this national study and they learned that monitoring in high-risk families using endoscopic ultrasound was one of the best options available to test for this disease and it could save lives. 

We also look forward to the results of our collaboration with the Cancer Research Institute, to co-sponsor a new clinical trial led by Dr. Carl June and Dr. Gregory Beatty at the Perelman School of Medicine at the University of Pennsylvania. The trial focuses on a new way to treat pancreatic cancer by altering and training a patient's immune system to target and eliminate cancer cells. A first in the pancreatic cancer research world, this trial would not have happened without shared funding and scientific expertise.

Similarly, we are now collaborating with Stand Up to Cancer, so its Pancreatic Cancer Dream Team can extend important research initiatives into clinical trials, which will include investigating a variety of drug combinations for pancreatic cancer patients to improve treatment options.

Research offers hope that, one day, early diagnosis of pancreatic cancer will require nothing more than a routine blood test, and that better treatments can be found, eventually leading to a cure. Working together, we move closer to realizing that goal every day.

Kerri Kaplan is executive director of The Lustgarten Foundation, the nation’s largest non-profit foundation dedicated to funding pancreatic cancer research. The Foundation has played a critical role in the evolution of pancreatic cancer research since its inception in 1998, contributing more than $65 million to more than 175 research projects at more than 50 medical and research centers worldwide. Every dollar donated to The Lustgarten Foundation goes directly to pancreatic cancer research because Cablevision, a leading media and telecommunications company, underwrites all of the Foundation’s administrative costs.  The Lustgarten Foundation and Cablevision are also partners in the curePC public awareness campaign. For more information, visit www.curePC.org

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***This blog post was written by Dena Battle.

My husband Chris was on a gurney in the hallway when I got to the emergency room at our local hospital.  Balking on drinking the contrast.  Sometimes a doctor or a nurse would drop by.  They’d ask him if his pain was managed.  He more or less nodded.  The pain was in his abdomen.  On the right side.  Had to be appendicitis.

But, the CT didn’t show appendicitis.  “It’s not your appendix.” said Dr. Brown.

Dr. Brown was as plain and non-descript as his name.  Balding.  If you asked me now how old he was, I couldn’t narrow it down to a decade.  He was nice, even friendly.  But, he didn’t mince words when he told us the results. 

“You have a large mass on your kidney.  We believe it’s renal cell carcinoma.”

He said some other things too, but I only remember hearing “carcinoma.”  Because “carcinoma” sounds like cancer.  Like something you get from smoking or being doused with agent orange.  Carcinogen has been burned into our brains with anti-smoking campaigns for long enough – I knew that carcinoma was bad like a pack of cigarettes.

“We’re going to get you into a room and get you comfortable.  Then we’ll get an x-ray, do a brain scan.  I’ll talk to the surgeon – we need to get that kidney out.” 

We didn’t ask questions, we just nodded in agreement.  The next few days were a blur.

Chris had been home from the hospital recovering from surgery for about a week when he called me at work.  “I need a fax number – the doctor has my pathology report.”

What happened next was what I would call a panic attack.  One of my friends though is always quick to point out that he thinks it’s probably a normal reaction to a spouse being diagnosed with cancer.  I started to sweat profusely and my speech was sort of garbled.

“You want to fax it here?  I don’t know if I really have a fax.  Who uses faxes anymore?”  My heart was pounding out of my chest.  I had been worried about what the pathology report would say and now I was going to have it, delivered to me, alone at my office. 

“Dena?  I really need the fax number.”

Not aware that I was melting into my chair, Chris was becoming slightly impatient – not angry, but sort of frustrated at my inability to give him a number.  I finally relented.

I was on the floor beneath my desk when Chris called me to discuss the results.

The pathology report wasn’t good.  I had tried to avoid reading what I could about Chris’s cancer, but I’m a researcher by nature and I knew enough to know that it was bad.  The tumor was big – 11 cm.  The designation for a stage 2 tumor is 7 cm.  Chris’s was almost double.

The Fuhrman grade tells you how aggressive the cancer is.  On a scale of 1 to 4, 1 is the least aggressive and 4 is the most aggressive.  Chris’s tumor was a grade 3 out of 4. 

Chris was methodical.  Analyzing each detail.  I was a babbling mess.  He talked through the results, I cried.

“This isn’t great – it’s grade 3. I really was hoping it was grade 1.”  Like he’d gotten a B+ instead of an A on an exam.

“I’m sure that if it was really bad, the doctor would have called us, right?”  But, I knew in my heart that it wasn’t right.  I knew that our doctor wasn’t the expert we needed.  I wanted so badly for everything he said to be true. 

“You’re cured!” Those were his words after the surgery.  He was so confident.  “I got it all!” 

Over the next few weeks, we processed differently.  Chris poured through medical journals, looking at survival algorithms, studying necrosis and hemorrhaging of tumor tissue. 

I cried.  I went through our refrigerator and threw away everything that had been bought before cancer.  I cried some more.

After a few weeks of this, Chris sat down with me and showed me a chart he had made.  “We’re smart people, Dena.  We both have good research skills.  I’ve divided up areas that each of us will focus on.”  And he had.  There were two columns – his and mine.  I was assigned treatment analysis, he was going to research lifestyle changes.

The day before Easter, I sat down at the computer to begin my research.  After a few searches, I found a group called SmartPatients.  Suddenly, I was “meeting” patients from all over the world who were dealing with kidney cancer.

Everyone said the same thing: “A chest x-ray isn’t sufficient, you need a CT scan – with contrast.  You need a different doctor.  You need an oncologist, preferably a specialist in kidney cancer.”  They also said things like this: “You will survive. You’re strong.  Chris will fight.  We will help you.”

The doctor who had performed Chris’s surgery was recommending that Chris come back for an x-ray in six months.  He didn’t want to do any other testing and he was mostly focused on Chris’s remaining kidney.

Four doctors later, we finally found an oncologist who would perform a CT scan with contrast.  The results showed that Chris had metastatic disease in both lungs. 

My heart dropped when I heard the words.  The numbness that I’d felt at the original diagnosis crept back in.  But, then the doctor said something else, “We need to get you set up on chemotherapy.”

That numbness faded and anger seared behind my eyes.  This was our fourth doctor – the one who finally had given us the scan that we needed.  And one thing I knew for certain was that kidney cancer did not respond to chemotherapy.  Armed with new information, I was no longer a frightened caregiver, one that would simply nod at a doctor’s suggestions. 

I didn’t even look at Chris.  I just said, “No. I don’t think so.  This cancer doesn’t respond to chemotherapy.”

We left the office in the same way we had left the offices of the doctors who only wanted to do an x-ray.  We just walked out, washing our hands of bad advice.  My eyes were red and swollen and I had a headache.  But, I wasn’t panicked and I didn’t crawl under my desk this time.

That day, I told Chris a theory that I had – kidney cancer is just common enough that every doctor thinks he knows how to treat it and just rare enough that only a specialist does. That day we began a quest for a doctor and a place that would fight this battle with us – not for us.  That’s the search that led us to Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

Chris Battle ultimately lost his fight with kidney cancer.  However, his wife Dena maintains the blog they founded together and still advocates for other kidney cancer patients.  For more on their journey go to: http://kidneycancerchronicles.com/ 

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**A continuation of our series on breast cancer and nutrition.

If weight loss is among your side effects during breast cancer treatment, you can use good nutrition principles to create a plan to manage your weight loss, says Hopkins Kimmel Cancer Center nutritionist Mary Eve Brown.  Weight loss can occur due to the tumor itself, from side effects, and because your body is burning more calories and needs more protein to replace what you’re losing during treatment, she notes.

Beverages can be an important way to add calories if you drink nourishing liquids instead of just water, Brown says. It’s important to stay hydrated, but when weight loss is an issue, make sure you are preferring fruit or vegetable juice, instant breakfast or protein drinks, yogurt-based smoothies and even milkshakes. An easy way to boost nourishment from liquids is to fortify liquid milk by mixing ¼ cup dry milk into 1 cup of liquid milk. You can drink the fortified milk and use it in your cooking and smoothies as well.

Snacks, chosen wisely, also can help you maintain a healthy weight if weight loss is one of your side effects. Snack between meals and at night, and choose nuts, dried fruit, cheese, nut butters, fruit muffins or bread. Try mixing nuts and dried fruits together for a nutritionally dense trail mix.

Healthy oils also are a smart way to add calories when you are combating weight loss. Think about olive oil when you’re cooking or add some to your next smoothie—you’ll gain 100 calories per tablespoon. Avocado oil is also a healthy way to add calories.

You can find out more about nutrition and your breast cancer journey in Brown’s recent free webinar, What’s Food Got to Do With It? Eating Well Before, During and After Treatment.

Videos from Mary Eve Brown:
Colon Cancer and Nutrition

Pancreatic Cancer and Nutrition

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It’s not just a swim. It’s not just a fundraising event. It’s a window into people’s lives. People who are young and not-so-young brave and fighting hard against cancer, inspiring even more people – people who are swimming, people who are giving: their time, talents and resources; people who are doing research in a lab and in a hospital; people who are watching and waiting, people who are hopeful. 

The fourth annual Swim Across America - Baltimore pool and open water events raised more than $425,000, all going to support cancer research in the Swim Across America laboratory at the Johns Hopkins Kimmel Cancer Center. Despite the impending rain and eventual downpour during the pool program at Meadowbrook Aquatic Center, spirits were high and celebrating extraordinary people doing extraordinary things. Like Karen Kruger. Karen marked the one year anniversary of having a bone marrow transplant by swimming a mile in an Olympic-size pool side-by-side with Lucas Townsend. Lucas, a competitive swimmer, flew in from Michigan to swim at Karen’s side for her first mile swim. Swim Across America has many “swim angels,” seasoned swimmers who pair up with newbies. But, Lucas has an even deeper connection with Karen. He was her bone marrow donor. Because of Josh’s selfless act, Karen was given a chance to live a life free of cancer. Extraordinary people doing extraordinary things.

The open water event, held the next day at the beautiful High Tide Farm on the Magothy River in Pasadena, Md., brought together Olympic swimmers and 300 others  to complete a one and three mile course. The day was crisp and beautiful and the sun shone brightly as Baltimore Opera singer Jarrod Lee sang the National Anthem. At the end of the day, donations to the swim as well as jelly fish stings were tallied. But most memorable were the inspiring words of a pancreas cancer survivor who spoke to the crowd about her remarkable cancer journey including participating in a clinical trial developed by Hopkins’ physician-scientist and made possible with Swim Across America funding. Extraordinary people doing extraordinary things.

Read more about Karen and Josh’s amazing story.

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**A continuation of our series on breast cancer and nutrition.

Constipation’s another breast cancer treatment side effect that most people don’t want to discuss. Some chemotherapy drugs can result in constipation, particularly the anti-nausea treatments. But Hopkins Kimmel Cancer Center nutritionist Mary Eve Brown has useful ways to cope with constipation, using smart nutrition tactics: 

  1. Hydration is vital to fighting constipation. Make sure you’re drinking plenty of water daily; to find out how much you need, divide your weight by 2.2 to determine the number of ounces of water you need to consume daily.
  2. Physical activity is an easy way to combat constipation. Even walking every day can help.
  3. Particular foods and drinks can help ease constipation. Drink warm prune juice, a natural stimulant for the gut, or eat foods that are high in magnesium, like pumpkin seeds, bran cereal, halibut or spinach. Or, make your own laxative, combining 1/3 cup each of baby-food prunes, applesauce, and unprocessed bran. Mix well and store in the refrigerator. Take 1-2 tablespoons at night with 8  ounces of water.

You can find out more about nutrition and your breast cancer journey in Brown’s recent free webinar, What’s Food Got to Do With It? Eating Well Before, During and After Treatment.

Videos from Mary Eve Brown:
Colon Cancer and Nutrition

Pancreatic Cancer and Nutrition

 

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**A continuation of our series on breast cancer and nutrition.

You may not want to think about diarrhea as a side effect of your breast cancer treatment, but Hopkins Kimmel Cancer Center nutritionist Mary Eve Brown recommends you get ahead of it with a management game plan include these steps:

  •  Plan to eat foods that are easy to digest, like baked potatoes without the skin, baked chicken, applesauce, bananas, cooked vegetables like carrots or green beans, or Cream of Wheat.
  • Stay hydrated with your own rehydration drink, made with a ½ cup of orange juice for potassium, 2 quarts of water, ½ cup of sugar, and a ½ teaspoon of salt for sodium and chloride. This is important because diarrhea can easily dehydrate you, so you may need more than your basic amount of nutrition. Why add sugar? It helps the hydration get into your cells faster, Brown says.
  • Avoid fiber, fat and spicy foods. Foods that are easier to digest and on the bland side will help keep diarrhea at bay. Many people think they need more fiber, but in fact, a high-fiber diet can make diarrhea more likely.
  • Eat small meals frequently, rather than a few big meals, to make it easier for your body to digest the food.

You can find out more about nutrition and your breast cancer journey in Brown’s recent free webinar, What’s Food Got to Do With It? Eating Well Before, During and After Treatment.

Videos from Mary Eve Brown:
Colon Cancer and Nutrition

Pancreatic Cancer and Nutrition

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I heard a story about actors Martin Short, Steve Martin, and Tom Hanks forming a colonoscopy slumber party of sorts.  They get together at one of their homes the day of the bowel prep and bring in a caterer to make them broth and gelatin, play poker all night, and the next day they have their colonoscopies. Personally, I would just grab a few cans of Campbell’s and some Jell-O from the grocery store and call it a day, but they are celebrities after all, so it’s catered consommé for them.   Short reported that they do this “every three to four years” to encourage each other to get this colorectal cancer screening test done and make something many do not look forward to, well fun. 

I’m not sure why they are having colonoscopies every four years.  If they are screening colonoscopies, the recommendation is to have the first one at age 50 and every ten years thereafter, as long as it’s normal.  Of course, it is important to speak to your doctor because when and how often to have a colonoscopy, or any cancer screening test for that matter, is largely dependent upon family history and other risk factors, such polyps in the colon.

Anyway, it made me think that maybe the buddy system might be one solution to improving low cancer screening participation.  Experts say it works with weight loss and fitness.  Those who have a workout partner are more successful at sticking with their diet and exercise routines.  Maybe it could work for cancer screening too!

Now, I for one really do not want to do the whole colonoscopy prep thing with a group of friends, but that’s not the only way to employ the buddy system.   It could be as simple as calling your family and friends on their 50th birthdays and saying, “Happy birthday.  Don’t forget to talk to your doctor about getting a colonoscopy.”   Maybe friends can make an agreement to nudge each other about cancer screening.  Maybe Short, Martin, and Hanks are on to something.  If we add a perk that makes something we don’t like to do a little more tolerable, we might be more likely to do it.  So ladies, let’s think about getting our best girlfriends together for a day of mammograms or Pap tests followed by lunch and shoe shopping.  Guys, how about prostate exams followed by a round of golf? 

I’ll admit cancer-screening tests are not fun, but let’s remind ourselves that cancer is even less fun.  When we talk about a cure, prevention should be number one on the list.  On a positive note, our investigators are making great progress in developing simple and easy cancer screening tests we expect will one day eliminate the need for many of these unpleasant and invasive screening tests.  Until that day, it is important to remember that most cancers can be prevented and cured if they are detected early.  Talk to your doctor about cancer screening and start thinking about who you want to be in your colonoscopy club, your prostate party, your mammography merrymaking.  Well, you get the idea.

For information from Johns Hopkins on cancer screening:

The Johns Hopkins Colon Cancer Screening Clinic, 410-502-0793

Prostate Cancer Screening and Detection and The Johns Hopkins Brady Urological Institute, 410-955-6100

Johns Hopkins Breast Center screening mammography,  410-955-4100

The Johns Hopkins Breast Evaluation Program for women at high risk of developing breast cancer,  443-287-BRST (2778)

The Johns Hopkins Breast and Ovarian Surveillance Service (BOSS), 410-502-7082

The Johns Hopkins Center for Cervical Dysplasia, Colposcopy/Pap Test, 410-955-6700

 

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**A continuation of our series on breast cancer and nutrition.

A sore mouth is one side effect of some breast cancer treatment. Hopkins Kimmel Cancer Center nutritionist Mary Eve Brown says you can manage it better if you: 

  • Eat soft, moist foods, such as yogurt, eggs, avocadoes, soups, fruit cups, pudding, hot cereal, cottage cheese, applesauce, hummus, baked beans, soft pasta, mashed potatoes, and mashed vegetables such as sweet potato, carrot or squash.
  • Avoid foods that require lots of chewing, or with acid, spice, or sharp edges.
  • Rinse your mouth every 3 hours with this recipe: 1 cup of warm water, 1/8 teaspoon of salt and ¼ teaspoon of baking soda. During treatment, you may become susceptible to yeast infections of the mouth, which can make eating painful or give foods an off taste, and this rinse will help control the overgrowth of yeast and keeps your mouth healthy.
  • Inspect your mouth to stay aware of its condition. Do this every morning when you are brushing your teeth. Look at your tongue and the roof of your mouth, notice any white patches, and discuss changes with your health care team.
  • Drink your nutrition along with your hydration.

The taste of foods can change throughout your treatment or your taste buds may change, Brown notes. This common but often misunderstood side effect might prompt you to stop eating, but she advises “Don’t give up.”  Experiment with different foods to find the taste sensation that is most enjoyable for you. For example, if sweet tastes work well for you, add  healthful sweet tastes like smoothies or fresh fruit, or by marinating other foods in fruit juices or adding fruit to other dishes. Too sweet? Balance overly sweet foods by adding a little salt. Avoid metal and meats if they are affecting your taste. You may need to switch to plastic utensils, drink through a straw, and substitute dairy, beans or nuts for meat during this time.

Nausea can be a distressing side effect of some breast cancer treatments. It may not seem as if nutrition can help with nausea, but here are some tricks of the nutrition trade Brown recommends:

  •  Take your anti-nausea medications as prescribed, even if you are not experiencing nausea. Alert your health care team if the medications are not working for you
  • Eat cold foods, which have less aroma and may help you avoid nausea.
  • Sip on clear liquids to lessen the feelings of nausea.
  • Don’t forget protein-rich foods, like baked chicken, eggs or dairy, cottage cheese or yogurt.
  • Make your own ginger tea: Boil 4 cups of water with sliced ginger root for 20 minutes. You can add lemon or honey to your taste. Or, let the tea cool and add club soda to make your own “ginger ale.”

You can find out more about nutrition and your breast cancer journey in Brown’s recent free webinar, What’s Food Got to Do With It? Eating Well Before, During and After Treatment.

Videos from Mary Eve Brown:
Colon Cancer and Nutrition

Pancreatic Cancer and Nutrition

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In this month’s Cancer News Review podcast, Dr. William Nelson, director of the Johns Hopkins Kimmel Cancer Center, discusses top cancer stories on research about diabetes drugs linked to pancreatic cancer, African American men with prostate cancer, patient-centered drug development, and the link between omega three fatty acids and breast cancer risk. First, on the podcast, Nelson discusses reports linking diabetes drugs and pancreatic cancer in some people. Research on the potential link between type II diabetes as a risk factor for pancreatic cancer is underway, however there is not enough definitive data that diabetes drugs are directly related to causing pancreatic cancer, he says. Nelson says it is a cause for concern that should be studied, not only for these drugs but any new drugs.

Next on Cancer News Review, Nelson reviews a recent article in the Journal of Clinical Oncology that examines active surveillance of prostate cancer in African American men. The study reviews the type and location of prostate cancer typically found in African Americans. Dr. Nelson also discusses patient-centered drug development, focusing on the variability in reactions to new treatments among patients. He stresses the importance of collecting accurate patient reports on reactions to new cancer treatments.

Finally, the podcast concludes with a discussion on a study from China that tested the association between omega three fatty acids in fish and plant-based foods and their effect to reducing breast cancer risk. The study concluded that eating fish containing omega three fatty acids reduces breast cancer risk by 14 percent. The reduction in risk was not seen in plant-based foods containing the compound.

Program notes:

0:11 Do new medications for diabetes cause pancreas cancer?
1:13 Don’t have definitive data
2:11 Mechanism isn’t understood
3:05 African American men with prostate cancer different
4:05 More likely in anterior part of gland
5:21 How drug development could be more patient centered
6:21 We need to collect patient reported effects of treatment
7:21 Patient experience should be factored in
8:01 Can omega three fatty acids reduce breast cancer risk?
9:05 In general fish helpful in diet
9:36 End

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