Table of Contents

1. Purpose of Cancer Monthly
2. Searching is as Easy as 1, 2, 3
3. How to Sort Results
4. Accessing Treatment Details
   1. Survival
   2. Patients
   3. Toxicity Grade
   4. Treatments
   5. Drugs
   6. Country
   7. City/State/Province
   8. Hospital
   9. Journal
   10. Date
   11. Description
   12. E-mail to a Friend
   13. E-mail Physician
   14. More Information

Purpose of Cancer Monthly

The purpose of Cancer Monthly is to help cancer patients get the facts about the results of cancer treatments – both the successes and the failures so that they can have productive discussions with their doctors. The information is NOT intended, nor recommended as a substitute for professional medical advice, treatment advice or treatment recommendations.

In addition, the Search Results and Treatment Details contain only the highlights of the clinical results of specific therapies, not every detail. Your doctors can help you understand what a particular therapy means in treating your cancer based on all of the facts regarding your condition and all of the facts regarding that particular therapy.

As discussed below, for each treatment there is a link called “More Information.” When you click on this link another window pops up. This is the study’s abstract. It contains a medical summary about the treatment. If you are interested in this treatment, you should print-out the abstract, give it to your physician, and ask your physician questions about this particular therapy. If, for whatever reason, you are unable to find or print the abstract, then share the “Treatment Details” information with your doctor. None of the information presented by Cancer Monthly is a substitute for professional medical advice.

Searching is as Easy as 1, 2, 3

Searching is as easy as 1, 2, 3. First select a cancer type. Second, choose the types of treatments you are interest in. Third, select where you would like to be treated. Your search results are displayed with the treatments reporting the highest survival at the top.

How to Sort Results

Once your search results are displayed, you can sort the results by:

Accessing Treatment Details

If you find a treatment of interest, click on "Treatment Details" and you will be taken to the page that provides a summary of some of the key highlights of that treatment including:

You do not need a medical background to understand your Search Results. This "How to" guide you are now reading is designed to answer most questions. In addition, if you come across an unfamiliar medical term, click on the Cancer Glossary on the Tools button at the top of the navigation bar to find the definition. And if you want more information about a particular drug, the Drug Database (described below) will get you started.

Survival

Time Period - Survival is reported in months. In general, the time period being measured is from the time the treatment began (or the patient was enrolled in the treatment) to death.

Statistics and Median Survival - The survival numbers are based on statistical projections for the patients involved in the study. (Usually they are Kaplan-Meier survival curves). This means that these are statistical estimates based on different sets of assumptions and follow-up times. In addition, the survival numbers are typically median figures. For example, if one person survived 1 month, another 3 months, and another 12 months, the median would be 3 months (the number in the middle). Median numbers have half the patients on one side of the median, and half on the other side. If the numbers were written in order from smallest to largest (in our example - 1, 3, 12) the people on the right side of the median could be surviving many years past the median. Moreover, on some occasions, the survival numbers may contain other cancer types. It is important to remember that these figures are for general information only and do not specify your prognosis. Every patient is different. Your prognosis will depend on your own unique combination of variables including your general state of health, immune competency, age, diagnosis, cancer type, histology, whether the cancer was completely removed by surgery (fully resectable), prior treatments, and the extent of metastasis (if any). That is why this information is designed to be shared with your physician. Licensed medical professionals can assist you to understand your particular prognosis under various treatments. If you see a treatment of interest, click on the link "More Information," print out the abstract, and share it with your doctor.

No Response (N/R) - Response means that a tumor shrunk (or that a blood test indicated regression of the cancer). Some treatments resulted in no response at all. In those cases, doctors may not measure survival because they believe that their treatment has made no impact. When there is no response in any patients and survival is not discussed, N/R is used for "No Response."

Median Survival Not Reported - Some treatments do not state how long patients survived (median survival). This may be because there was not sufficient data to calculate this number, or the study was not designed to calculate survival (i.e. Phase I study). In these cases, the symbol ? is used.

Patients

Each treatment includes a brief description of the types of patients who were administered that specific treatment. Such a description may include the type of cancer, the grade, whether the patients had metastatsis, and whether the patients were newly diagnosed or recurrent (the cancer has returned).

Toxicity Grade

Grades - Toxicities (or side-effects) are graded from one to five. The higher the number, the more toxic were the side-effects for the treatment. There are a number of different toxicity scales (i.e. National Cancer Institute Common Toxicity Criteria version 2.0, World Health Organization) and they are all similar in respect to their grades and definitions. The scale is generally:

1 = Mild side-effects
2 = Moderate side-effects
3 = Severe side-effects
4 = Life Threatening or Disabling side-effects
5 = Fatal

A few clinical reports describe toxicities, but fail to grade them. Others report no toxicities. In those cases, the toxicity grade is left blank.

Cancer Monthly Grade Number is the Highest Grade Experienced - For most therapies, patients will experience different toxicities with different grades. For example, for one particular treatment, the side effect of nausea may be graded as 2, while the side-effect of neutropenia may be graded as a 4. The grade numbers reported in the Search Results (1-5) represent the highest grade for one or more toxicities reported for one or more patients. This means that even if only one patient had one example of a grade 4 toxicity and every other patient had grade 2, the grade for that treatment will be reported as a 4.

Treatments

Treatments have been divided into eight groups to make it easier to find specific types of therapies. (Note: some clinicians may classify individual treatments based on a different organization).

1. Alternative - Any treatments considered complimentary which may include herbs, vitamins, minerals, amino acids, peptides, and other natural non-toxic supplements.

2. Biologic Therapy - Where a targeted therapy is used to attack a particular protein, enzyme or other cellular component or process using inhibitors (i.e. anti-angiogenesis), monoclonal antibodies or other substances, or an analogue of a natural substance such as a vitamin is used. Radioimmunotherapy therapy (where radioactive substances are attached to a monoclonal antibody) and photodynamic therapy (a technique that uses non-thermal lasers to activate light-sensitive drugs) are also classified under this heading.

3. Chemotherapy - These are typically toxic drugs that work by killing both healthy and cancerous cells.

4. Gene Therapy - Where a gene or gene vector (a means of moving a gene into a cell) is used to try to try to reprogram cancer cells.

5. Hormone Therapy - Where the blocking of hormones (or their receptors) is used to treat some types of hormone dependent cancers.

6. Immunotherapy - This includes vaccine therapy (i.e. autologous vaccines - vaccines made from the patient) or a treatment that includes an immune cytokine. These treatments typically attempt to stimulate an immune response in the patient's body to fight the cancer.

7. Radiation - There are different types and methods for delivering radiation. For example, radiation such as x-rays or gamma rays may be delivered externally via external beam radiation. Radiation can also be delivered internally by placing radioactive substances such as cesium, iridium, and iodine near or into cancerous cells within the body or administering radionuclides systemically (into the bloodstream).

8. Surgery - Any surgical procedure.

Different Combinations - Some treatments use different combinations such as surgery followed by chemotherapy and radiation.

Past Treatments - It is important to note that many patients may have received other treatments before they were administered the treatment described. For example, some patients may have had surgery or chemotherapy before a biological therapy is administered. Such prior or "pre-treatments" may not be mentioned in the results.

Drugs

Drug Database - Specific drugs associated with specific treatments are linked to a Drug Database. The Drug Database is also available on the Tools button at the top of the navigation bar. The brand name associated with each drug is the name used by the FDA and is available from the FDA website. Nonetheless, manufacturers may use other or different brand names. For example, different brand names may be used in other countries. For this reason, both the brand name and trade (i.e. generic name) are provided.

"Drug Details" - By clicking on the name of the drug associated with that treatment, you will be taken to a "Drug Details" page that contains some information about specific drugs. This information may include

E-mail to a Friend - By clicking on "E-mail to a Friend" you can e-mail this drug information to a friend.

More Information - The "Drug Details" information is not complete or comprehensive for a specific drug. Only excerpts from the FDA label have been included. In addition, drug information is constantly changing and the drug information on the Cancer Monthly website may be outdated. If you are interested in reading up-to-date and comprehensive details about a specific drug, go to the FDA website for more information. The link "More Information" is provided for your convenience and links directly to the drug insert or FDA information for a specific drug. Most importantly, you should ask your licensed healthcare provider any questions you have about specific drugs.

Country

This is the country where the treatment was administered.

City/State/Province

This is the city/state/province where the treatment was administered.

Hospital

This is the name of the hospital where the treatment was administered. In many instances, other hospitals (in other cities or perhaps other countries), may have also administered this specific therapy.

Journal

This is a hyperlink to the abstract that provided the treatment information (i.e. where the results of the treatment were originally published).

Date

This is the date (month and year) when the results for that particular treatment were published.

Description

A description of each treatment is also provided. Typically it includes additional details about the types and numbers of patients who were administered this treatment, the treatment itself, and the most frequent and/or the most significant toxicities. (Note: Cancer Monthly may not list all toxicities associated with a specific treatment.)

Support - If a drug company supported the study and this information was published, it would appear here.

Correspondence - This is the name of the doctor involved in the study to whom correspondence should be directed. (This is the doctor the e-mail is forwarded to, when you click on "E-mail Physician.") For some treatments, there is no physician for correspondence.

E-mail to a Friend

This is a link that allows the user to send the Treatment Details page to a friend via e-mail.

E-mail Physician

This is a link that opens an e-mail screen and allows the user to send an e-mail directly to the doctor involved in the study. In some cases, there is no physician for correspondence so this link does not appear.

When e-mailing physicians involved in a particular study or treatment you may want to consider the following guidelines:

1) Be courteous. Although these doctors have published their e-mail addresses and appear as contacts for their respective studies, they may not be used to receiving e-mails from individuals who are not medical professionals. Be gracious for their time and attention.

2) Be specific. These doctors can not tell you whether a particular treatment is appropriate for a particular patient because they are unfamiliar with the patient. Therefore, questions like "would your treatment work for my mother" may not be answered. Instead, ask "treatment focused" questions such as:
a. Is your treatment available in other parts of the world and if so what institution should I contact?
b. Are you currently using this treatment on patients and if so do you have any additional data/information to report?
c. Could a patient come to your institution and be treated with this therapy?

We are not suggesting that you ask these specific questions, but the questions you ask (initially) should be "treatment focused" and not "patient focused" if you expect an answer.

More Information

This is a link where you can obtain more information on that particular treatment. When you click on the word "More Information" another window pops up. This is the study's abstract (a medical summary about the treatment) that resides on PubMed. Pubmed is a service of the National Library of Medicine and includes over 15 million citations for medical and scientific articles. If you are interested in this treatment, you should print-out the abstract, give it to your physician, and ask your physician questions about this particular therapy.