Chemotherapy-induced alopecia, or hair loss, is a common side effect of many chemotherapy treatments for cancer. 

Chemotherapy works by targeting rapidly dividing cells, such as cancer cells. However, hair follicles also divide rapidly and are therefore affected by the treatment. As a result, hair loss can occur anywhere hair grows –– on the scalp, face and body. Not everyone who receives chemo will experience hair loss, but for those who do, it can be distressing.

For many people, hair is an important aspect of self-expression and identity, and losing it can be emotionally difficult. As she recalls her experience with chemotherapy for breast cancer, Lauren Thorse remembers that when she was told she would need chemotherapy, “my first thought was that my hair is gonna go.” 

As someone who reports struggling for years with self-confidence, Thorse, of Naperville, Illinois, found the impending hair loss upsetting. Having always had long blond hair, seeing it fall out in clumps and finding it around the house led her to decide to shave it. With the support of her father, and her mother and sister via FaceTime, her husband shaved her hair off.

After finally coming to terms with losing her hair, she then had to wrap her head around the fact that “it’s going to take years to get back to where it was.”

Cancer survivor Jessica Gardner of Youngstown, Pennsylvania, also took matters into her own hands when she began losing her hair from chemotherapy. After being diagnosed with breast cancer while 33 weeks pregnant and undergoing a bilateral mastectomy not long after having a cesarean section, she felt that she wanted to have control over something — and that was her hair loss. While livestreaming the shaving of her head, she felt as if she was getting some of her power and control back.

Once their hair was gone, both Thorse and Gardner felt frustrated over the lack of resources that were available to women their age, in their early 30s, with young children. They found that many of the resources were for older women and didn’t quite meet them where they were in life. 

Thorse recalls, “I felt like the wigs I was directed to were more for older women.”

Because Gardner found local support groups difficult to connect with, she created the group Cancer Is a Mother on Facebook. She found that this was a way to do something positive with her cancer diagnosis. “It was something I needed to do personally to feel better about cancer and where I was as a survivor.”

Hair loss can be gradual or sudden, and it can begin within a few weeks of starting chemotherapy treatment.

Some patients may experience thinning of the hair, whereas others may experience complete baldness. In some cases, hair may only thin or fall out in certain areas, creating patchy hair loss. This is most often temporary, and the hair will grow back once chemotherapy treatment is completed. 

However, in rare cases, some patients may experience long-term or permanent hair loss. The risk of either of those is generally low, but it can depend on the type and dose of chemotherapy used. Certain chemotherapies, such as taxanes, are associated with a higher risk of long-term or permanent hair loss.

Now that a full year has gone by since completing chemotherapy, Thorse states that although her hair is growing, she doesn’t look like she used to. “Every now and then I do mourn for myself if I do see a picture. It’s been a year, but I still have a long way to go.”

Chemotherapy isn’t the only cancer treatment that can affect hair. Hormone therapy for cancer treatment can target hormones that help cancer cells grow, such as estrogen and progesterone. It can be used to block the production of these hormones, or block the receptors that respond to them, or lower their levels. This changes the balance of hormones in the body and causes hair thinning. This also causes hair follicles to shrink, leading to thinner, weaker hair.

Lisa Opalweski, of Fond du Lac, Wisconsin, has experienced hair loss multiple times during her cancer journey. Initially diagnosed with breast cancer in 2012, she notes, “Yes, I knew I was going to lose my hair; yes, I was going to run around bald for a while. I knew it was going to come back.” 

After being diagnosed with metastatic cancer in 2019, she has been treated with hormonal therapy and targeted therapy. “I used to have extremely thick, curly hair. Now I have baby thin hair.”

temporary solution for hair loss. Many cancer centers and support groups have resources for obtaining wigs or hairpieces at little or no cost. However, there are now ways to help manage hair loss through scalp cooling. Cooling the scalp during chemotherapy treatment decreases blood flow to the scalp and reduces the amount of chemotherapy drugs reaching the hair follicles. By reducing the amount of chemotherapy that reaches the hair follicles, patients experience less hair loss.

According to the results of one study led by Dr. Julie Nangia, a breast oncologist and an assistant professor of medicine at the Lester and Sue Smith Breast Center and Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston, women receiving chemotherapy for early-stage breast cancer were enrolled in a study to evaluate the effectiveness of scalp cooling on hair loss. Of those who underwent scalp cooling, 50.5% had some preservation of their hair after four cycles of chemotherapy. In those who did not use scalp cooling, no one experienced hair preservation.

There are currently a couple of ways to cool the scalp. One way is through the use of cold caps, which uses tight-fitting caps placed on the head to cool the scalp during chemo- therapy infusion. The caps are stored in a special freezer and must be changed throughout the infusion to keep the scalp at a sufficiently cold temperature. In order to successfully use the caps, a patient will need to have help to change the caps at the instructed intervals during treatment.

Another method of scalp cooling is through a device that circulates coolant through the cap to keep the scalp at a consistently cool temperature. The hat is placed once at the beginning of treatment and the coolant will continue to keep the temperature consistent. 

According to Dr. Nangia, cooling the scalp starts 30 minutes before chemotherapy and the cap continues to be worn until 30 to 90 minutes after chemotherapy has been completed. 

It is also important to practice good hair care with scalp cooling therapy. This can include using a gentle shampoo, avoiding heat styling tools, and being gentle when combing or brushing the hair.

Dr. Nangia notes that the biggest barrier to scalp cooling is the cost. If insurance does not cover the therapy, out-of-pocket costs can be over $2,000. She states that the National Comprehensive Cancer Network, which provides guidelines for cancer treatment and supportive care, has added scalp cooling to these guidelines as a method to be considered for those who may experience chemotherapy-induced alopecia. 

With this recommendation from the network, Dr. Nangia hopes that insurance companies will start covering the cost of this therapy so more patients can benefit.

The rate of hair regrowth can vary for each patient, but typically hair starts to regrow within a few weeks to a few months after completing chemotherapy treatment. Regrowth may be slow at first, but it should become more rapid over time. It can take several months to a year for hair to fully regrow and regain its previous texture and color. In some cases, hair may not fully regrow or may regrow with a different texture or color.

Chemo curls, also known as “chemo waves,” is a term used to describe the changes in hair texture that some patients experience after chemotherapy. The term refers to the curls, waves or kinks that can develop in the hair as 

it regrows. This can be caused by the chemotherapy treatment and the changes in the hair

structure. It is not exclusive to scalp hair and can occur on hair all over the body. The new hair growth is usually soft and thin at first, and it may take several months for the hair to return to its pre-treatment thickness and texture. 

Some people may experience complete regrowth of their hair, whereas others may have patchy or thin hair growth. It also might take one to two years for hair to appear as it was before chemotherapy, and this can vary from person to person. Overall, hair growth after chemo is a gradual process, and it can take time for hair to fully recover.

Many members of the health care team are involved during cancer treatment. However, one area that is often overlooked and underutilized during this time is dermatology. 

Dr. Adam Friedman, professor and chair of dermatology at George Washington University in Washington, D.C., knows what dermatologists can offer patients experiencing hair loss during cancer treatment, but they are not often a part of the cancer experience.

He suggests prevention of hair loss through scalp cooling may offer the best results if someone is experi- encing complete hair loss, but there are other options for those with thinning hair that may be helpful. Applying topical minoxidil to the scalp can keep the hair in a constant state of growth. Friedman notes that it must be used consistently for best results and can be difficult to apply. 

He cautions against the use of supplements unless they are specifically approved by the health care team. Some supplements, such as biotin, can interfere with some blood tests, and may not
be safe for some patients to use. He also notes that the off-label use of Latisse (bimatoprost) can be helpful for regrowth of eyelashes and eyebrows after chemotherapy.

One of the most important things voiced by cancer survivors is that they want hair loss to be a topic that is brought up and discussed, and not glossed over, during visits. Megan Harman, FNP-C, with SSM Health in Lake St. Louis, understands this. She understands that hair loss can be a harsh reality the patient with cancer has to live with. It can be difficult for patients to fully prepare mentally and emotionally for hair loss until it happens. When talking with patients during this time, she often directs them toward various resources
and allows them the time to voice their feelings about their situation.

It is notable that much of the research about alopecia focuses on breast cancer survivors in comparison with other cancer survivors. One reason is that breast cancer is the most common cancer among women and the second most common cancer overall, so a large number of patients undergo chemotherapy treatment for breast cancer. Additionally, hair loss is a common and highly visible side effect of chemotherapy treatment, and it can have a significant impact on a person’s quality of life. Breast cancer survivors, especially women, tend to be more concerned about hair loss due to chemotherapy as hair loss affects their appearance and self-esteem.

Another reason is that breast cancer research has traditionally been well funded, which has allowed for more research to be conducted on the effects of chemotherapy on hair loss in breast cancer survivors. This has resulted in a greater understanding of the mechanisms behind hair loss and the development of new hair loss prevention and treatment methods specifically tailored for patients with breast cancer.

For more news on cancer updates, research and education, don’t forget to 

Many survivors see significant hair changes during cancer treatment, leaving a difficult reminder when they look in the mirror. 

Managing Chemotherapy-Induced Hair Loss

Julie Scott, D.N.P., ANP-B C

It is with great pleasure that I nominate Amy Wallace, RN, OCN, an exceptional oncology nurse at The University of Texas MD Anderson Cancer Center in Houston, for the Extraordinary Healer Award. Amy has dedicated her life to providing compassionate care and support to patients with lung cancer, embodying the qualities of empathy, expertise and dedication.

As a practicing thoracic medical oncologist at The University of Texas MD Anderson Cancer Center, I have known Amy for two years now as my primary nurse in my thoracic medical oncology clinic. Together, we have cared for hundreds of patients with lung cancer and their families who are not only from the state of Texas, but also travel from other national and international locations to meet with us.

What sets Amy apart is her profound understanding of the challenges faced by patients with cancer, as she has personally experienced the impact of this disease within her own family. Having lost a family member to cancer, she channels this poignant experience into her work, fostering a deep connection with her patients and their loved ones. This unique empathy creates a comforting and understanding environment, helping patients feel heard and supported.

Amy is renowned for her calming presence, which becomes immediately apparent when patients meet her. Many of our patients and their loves ones are understandably anxious at our initial medical oncology visit. Amy’s ability to instill a sense of peace and reassurance is invaluable, especially in the challenging journey that is a cancer diagnosis. Patients often express how her comforting demeanor has a positive impact on their overall well-being. They look forward to not only meeting with me at follow-up visits but also Amy.

Furthermore, Amy goes above and beyond to personalize the scheduling of appointments for her patients. Recognizing the significance of maximizing quality of life and minimizing time spent at our cancer center, she tailors their schedules with meticulous attention to detail. This thoughtful approach showcases her commitment to enhancing the overall patient experience.

In preparation for patient visits, Amy demonstrates exceptional dedication. Her thorough preparation ensures that each patient receives personalized and effective care. Moreover, her commitment extends beyond the clinic as she diligently follows up with patients, ensuring they feel supported and addressing any concerns that may arise post-appointment as they continue through their cancer treatment journey.

What truly sets Amy apart is her team approach to patient care. She collaborates seamlessly with other health care professionals, as the care of a patient with lung cancer is very heavily focused on multidisciplinary care, fostering an environment of comprehensive support for patients and their families. This collaborative spirit enhances the overall effectiveness of the care provided and reinforces the sense of community within the health care team.

. Her compassion, expertise and commitment to personalized patient care for patients make her a shining beacon of hope and healing for those battling lung cancer.

I am honored to nominate Amy Wallace, RN, an oncology nurse at The University of Texas MD Anderson Cancer Center in Houston, for the CURE Extraordinary Healer award. Amy embodies the essence of exceptional nursing care, compassion and dedication to her patients and colleagues. With over a decade of experience in oncology, she has developed a unique expertise in cancer care, providing individualized attention to each patient’s physical and emotional needs. Her unwavering empathy and kindness create a safe and supportive environment for patients and their families during their most vulnerable moments.

Amy’s exceptional clinical skills are complemented by her leadership and mentorship. She actively participates in professional development, staying updated on the latest cancer treatments and best practices. She eagerly shares her knowledge with colleagues, fostering a collaborative work environment that benefits patients and staff alike. Her tireless advocacy for patients extends beyond the bedside, driving improvements in cancer care policies and protocols.

I strongly believe that Amy deserves recognition with the CURE Extraordinary Healer award for her outstanding contributions to the nursing profession and her unwavering commitment to cancer care. She is an inspiration for everyone, but especially for me. I look up to her to become an extraordinary, caring, kind and devoted nurse like Amy. I wish everyone could have a nurse like Amy. She is a wonderful nurse.

subscribe to CURE®’s newsletters here.

Two colleagues of Amy Wallace, an oncology nurse, nominated her for the Extraordinary Healer Award based on her care of patients with lung cancer.

Guiding Hope for Patients With Lung Cancer

Dr. Eric K. Singhi

What would I tell my newly diagnosed self? I would say it’s okay to be angry, scared and all the other negative feelings we fight so hard against. And that your cancer doesn’t have to be some part of a bigger picture, a bigger plan to have a positive impact on the world. Because fighting for your life is hard enough, you don’t need to add the pressure of being an inspiration into the mix.

I’ve always been a fixer. I know this about myself. If I encounter a problem, I immediately try to fix it. If a friend tells me about a problem they are facing, same thing, I try to fix it for them, too. You may be thinking that isn’t such a bad quality to have. And usually, it isn’t. But there were times when I should have slowed down and processed what I was feeling because of that problem instead of bulldozing through it; because, inevitably, those feelings I fought so hard to minimize always come back to bite me in the a**. Cancer was no different.

In 2021, one month after turning 39, I received the call that forever changed my life. I had breast cancer. When I hung up, I didn’t cry right away. The first thought that ran through my head was, “Okay, now what.” At the time, my kids were ages 3 and 9, and my biggest concern was that I had to protect them from this awfulness.

I decided to be positive, stay positive and think nothing but positive thoughts.

Again, you might think that that’s not a bad way to be, especially when facing something as horrible as cancer. And it wasn’t. To this day, I believe my positive outlook hugely contributed to my success in beating the beast. But, on those days that I wanted to give up, the days I just wanted to spend the day in bed and cry myself into oblivion, I couldn’t. I had already gained the persona of being positive, upbeat and some people would say, an inspiration. And that was exhausting. I convinced myself that my cancer diagnosis was because I was meant for a greater purpose and that I had to turn this negative into a positive. So much so that I didn’t allow myself to feel the negative.

Being positive became such an automatic response that I didn’t really know how to act or respond differently. And the thing was, most people seemed to think that was okay. They’d say, “Wow, you’re such an inspiration,” or “You’re handling this with so much grace,” or something else along those lines. I know they meant well, but truthfully, I think they didn’t want to see it any other way. They didn’t want to see me suffering, and they didn’t want to know the mental and physical pain I was experiencing. And, if I’m being honest with myself, I didn’t want them to see that side of me either. Because then I wouldn’t be brave and inspiring anymore. And I definitely didn’t want to be seen as broken or weak.

Even now, nearly 3 years since I fought that battle, I feel guilty… guilty because I didn’t write the next great awe-inspiring book on how I beat cancer through the power of positivity. Guilty that I survived when so many others didn’t, and yet, here I sit living the same life I did pre-cancer. And mentally exhausted from trying for so long to be the person that everyone else sees me as being.

So newly diagnosed me…feel everything, the good, the bad and the ugly. Don’t put pressure on yourself to do anything but fight for your survival, because that already is more than anyone should have to do. And once it’s all done, don’t feel guilty because you made it through to the other side. Just take a deep breath and let the warm tears roll down your cheeks. And find something joyful in each extra day you’ve been given on this earth.

I truly am thankful for all those who supported and continue to support me through my cancer journey. And for those that push me to be a better version of myself than I was yesterday. Especially my children - their strength and resilience inspires me every day.

Fighting Cancer Is Enough, You Don't Have to Do More 

Amy Smart

On October 16th, 2023, my husband Dan was diagnosed with pancreatic cancer. At that moment, life became blurry, and all I could hear was a whooshing in my ears. I have fuzzy memories of follow-up medical appointments and phone calls to loved ones for what felt like years, though it was only a couple days, and I was beginning to believe that I would be on my own to figure out the next steps. It was then that I heard the voice of Jill May, B.S.N., RN, OCN.

She was on the phone with my husband as I returned home from picking up our daughter, and just the sound of her voice triggered my tears. She heard my pain and immediately offered me grace and kindness. She knew that though Dan was in for the battle of his life, his path would be dictated by the professionals and my path would be all but forgotten by most.

She came to my aid by telling me that she knew how I felt and that it would all be OK, but that is not what she said. In fact, she has never uttered those platitudes. Instead, she told me that she knew it felt like a five-alarm fire, and yet all the helpers were just standing in the parking lot and watching. She calmly explained that the urgency I felt wasn’t being disregarded, but rather the precision of the diagnosis and treatment plan needed to take priority.

She walked Dan and I through staging and creating our care team. She then said something that has stuck with me and will remain with me throughout this entire journey. She said, “I know right now that this feels like taking a drink from the fire hose, but I promise you things will start to calm down and make sense.” In that moment, I didn’t believe her. Now I know that she spoke the truth, and that sentence has become my mantra.

Since that first phone call, Jill has been walking with us, side by side. She checks on all of Dan’s needs, asks about my wellbeing and checks in on our daughter. She is able to make us feel seen, heard and honored while maintaining a full caseload. I have never been so impressed as I was when I saw her with a room full of patients, and they all felt as honored and seen as we do. She shows up for us all during our hardest moments, as if we are the only people on earth.

As I count my blessings during this terrible journey, I know that what I am most thankful for is Jill’s guidance and warmth.

I have had the privilege of working closely with Jill May, B.S.N., RN, OCN, care coordinator for our liver and hepatobiliary cancer program at Abbott Northwestern in Minneapolis. I have been consistently impressed with her exceptional skills, dedication and compassion. Jill takes the time to know not only the medical aspects of each patient’s case but also their personal lives, including their caretakers, hobbies and stressors. This holistic approach to patient care has undoubtedly contributed to the positive outcomes and enhanced quality of life for those under her care.

One of Jill’s standout qualities is her remarkable ability to act as a liaison between patients with cancer and their entire medical team. She has cultivated strong relationships with professionals in interventional radiology, oncology, surgery and various other specialties. Her extensive network and open lines of communication ensure that every aspect of a patient’s care is seamlessly coordinated. Jill has all key personnel on speed dial, facilitating quick and efficient collaboration, which is essential in the complex landscape of cancer treatment.

In addition to her exceptional organizational and communication skills, Jill consistently demonstrates a genuine and heartfelt concern for the well-being of her patients. Her caring and thoughtful approach create a sense of trust and comfort, helping patients navigate the challenging journey of cancer treatment.

In conclusion, I wholeheartedly recommend Jill for this award. Her skills, dedication and compassionate approach make her an invaluable asset to our team.

As a registered nurse new to oncology, I could not have asked for a better role model than Jill May, B.S.N., RN, OCN. Jill has been with the Liver, Pancreas and Bile Duct Program at Allina Health Cancer Institute for 15 years and was in oncology nursing for 18 years before that.

Her role here has been the surgical HPB Oncology Nurse Navigator. She has led numerous support groups, given many educational presentations on her specialty and cared for countless patients. Jill exemplifies what it means to be an oncology nurse. With her patients, she is never afraid to have difficult conversations. She has mastered the ability to be both stern yet humble, and direct yet kind. She helps patients open their perspectives again to see themselves as more than just their cancer diagnosis and instead as a whole person — something that is important yet challenging.

She is often the first person patients and clinicians alike turn to for resources, as her depth of knowledge and years of experience are unmatched and invaluable. She is the powerhouse of our program, and the reason many patients are sent our way. As a nurse new to the program, I have gotten used to walking into clinic rooms and facing looks of disappointment from my patients, who inevitably ask, “Where is Jill?”

I believe she is the reason that many of our patients not only are compliant but have the strength to carry on. Many of our patients have challenging treatment plans with poor prognoses, and yet so many do well. She motivates patients by believing in them, meeting them where they are at and helping them navigate the course when obstacles come up. She is the kind of caregiver any facility would be proud to have, and any nurse would be proud to be.

I met Jill May, B.S.N., RN, OCN, when I was diagnosed with stage 1B pancreatic cancer in 2019. After receiving a confirmed biopsy, I was told that a surgical consult was my next step. Within hours, I was contacted by Jill, who explained the journey I was starting and set me up with a top-notch surgeon. Learning I had pancreatic cancer was daunting to say the least, but Jill's compassionate and thorough approach gave me great comfort. In fact, after my first call with her I nicknamed her "Jill the Hug."

Over the past five years, I have experienced her exceptional follow-through, and I know I can count on her to ensure that I get the care I need. For example, after Whipple surgery, I had lost 30 pounds in a matter of weeks (I am 5’ 2”), and I called Jill. She immediately set me up to meet with my surgeon the next morning, which was followed by exploratory surgery with a gastroenterologist.

There are so many moving parts when dealing with cancer, and I’m so fortunate to have had Jill to keep me organized, moving forward and healing. She is adamant that patients get the best possible care and doggedly tracks down whoever is needed to solve an issue.

She has played a critical role in both my physical and mental state. She was there whenever I’ve been admitted to the hospital. This was especially important to me when I my cancer reappeared, and surgery was needed to remove the rest of my pancreas and spleen in 2021. COVID-19 was very active, and the hospital was not allowing any visitors. I was nervous and sad to be there without my family, but Jill was there when I checked in with a pair of socks with tigers on them and again after surgery. I’ve continued to get the value of her time and insight when I join in a survivors’ meeting every month that Jill co-chairs.

All of her effort, skill and caring have been so important to me as I’ve journeyed through chemo, radiation and surgeries and the resulting “chemo brain.” In my heart, I know that Jill has been key to my survival.

Jill May, B.S.N., RN, OCN, is an exemplary oncology nurse at Abbott Northwestern Hospital. She epitomizes dedication and compassion in her profession. Her life’s work revolves around going beyond the conventional boundaries of nursing care to ensure the well-being of her patients.

Jill’s commitment not only extends to the patients themselves but also encompasses a genuine concern for the families affected by the challenging journey of illness. What sets Jill apart is her unwavering focus on both the quality of life and quality of care for her patients. She approaches her role with a holistic perspective, recognizing that the emotional and psychological aspects are as crucial as the physical ones.

For patients facing terminal illnesses, Jill possesses a unique ability to navigate the delicate terrain of preparing them for everything that lies ahead. In these instances, Jill’s approach is marked by empathy and a deep understanding of the profound emotional challenges associated with end-of-life care. She engages with her patients and their families with sensitivity, providing not just medical support but also emotional support during these difficult times. Jill becomes a beacon of comfort, guiding her patients through the uncharted territory with abundant grace and compassion.

Her impact extends far beyond the hospital walls, leaving an indelible mark on all of the lives that she touches. Jill stands as a testament to the profound difference that a healthcare professional with genuine empathy and dedication can make in the lives of those facing the formidable challenges of illness and the prospect of saying goodbye.

For over a decade now, Jill May, B.S.N., RN, OCN, has provided unrelenting care as a hepatobiliary oncology nurse to patients with some of the worst diagnoses you can get in the cancer world.

Even though we work for separate health systems, I have been lucky to share many patients with her as I work as a RN liver transplant coordinator. We have shared many wins and unfortunately many loses together over the last decade. During this time, I have witnesses firsthand her extraordinary organizational and execution skills, her compassionate caring and expert communication with patients, and her no holds barred advocacy to ensure each and every patient get the care and treatment they deserve. All this has been done despite the reality that patients with hepatobiliary cancer can and do provide a major mental burden on their caregivers. It is common to review imaging in the morning that shows progression of disease in one patient, and then an hour later, you celebrate a disease-free report with another patient.

The mental health challenges presented by patients isn’t the only issue that Jill — and nurses in general — routinely deal with. All the above, and more, is done, even though she must do more, with fewer resources. Lay-offs, nursing strikes and a decreasing budget has provided its own issues. These have all happened, sometimes multiple times, over the last decade. This leads to the difficult decision of working overtime without getting paid overtime or allowing patients to suffer as a result.

I can attest that she has never taken the easy path. Most weeks she will work overtime, while knowing she won’t get paid more, to ensure patients get the care and information they deserve. Given my role as a liver transplant coordinator, and sharing many patients with hepatocellular carcinoma with her, I have heard directly from mutual patients the benefits Jill provides to them.

However, I have also seen and heard this on a personal level. A friend I play hockey with was taken too soon by pancreatic cancer. I have been told numerous times by his brother (who I still play hockey with), his family and from other friends the extraordinary care and treatment he received from Jill.

Jill simply is everything you would want in a care provider. She is extremely knowledgeable in her field, she is compassionate and caring to no end, and it is an absolute guarantee that she will never allow anything but the best to happen to her patients. She will fight right alongside each one until the end. She is the first person I would call if any one of my family members needed help.

Jill May, B.S.N., RN, OCN, is a highly respected oncology nurse known for her exceptional dedication, compassion, and holistic approach to patient care. Her role as a care coordinator involves seamless collaboration with multidisciplinary teams, ensuring comprehensive care for patients with complex cancer diagnoses. Jill's ability to connect with patients and their families on both medical and personal levels fosters trust and comfort. Her unwavering commitment extends beyond clinical duties, providing emotional support and advocacy, even amidst challenging healthcare environments and resource constraints.

Several colleagues, patients and caregivers nominated Jill May, B.S.N., RN, OCN, for the 2024 Extraordinary Healer Award for her dedicating to caring for those with gastrointestinal cancers.

Taking a Drink From the Fire Hose

Stephanie Streveler, RN, BSN

By my fifth and final colonoscopy, I already knew what was coming.

But prior to that moment, I had stubbornly refused to get a colonoscopy for years. The doctors would set up the appointment and be very stern with me, but I would cancel. I even met with the gastroenterologist once and still canceled. Eventually, they didn't want to set up the appointment for me, but they persevered.

For several years I was sure nothing was wrong. I have lived a pretty healthy life. I didn’t smoke. I didn’t drink, except socially. And, I didn’t do drugs.

Plus, I could not get over the idea of someone inserting a camera into my butt. Besides, other than my mother’s breast cancer that never returned after a lumpectomy, there was no cancer history in my family. So, doing this colonoscopy was just one of those things they made me do just because I turned 55. And, I was fine.

Each time I would fill the prescriptions for the colonoscopy prep to drink the night before. But I would cancel the day before. In fact, I canceled four times over the course of three years. The doctors even sent me home with various ways to take a sample of my bowel movement and mail it in. I never did this simple procedure either.

I did not know it at the time, but something terrible was happening. I've had a hemorrhoid since my son was born decades earlier. Occasionally it bled. And by late 2018, I realized I was bleeding more heavily. In fact, I was bleeding with almost every bowel movement. But it wasn't until the fatigue set in that I took this seriously. I was tired all the time. And then I lost 10 pounds very quickly. I am a large woman and that never happens.

Despite this, I still found one more way to delay a colonoscopy. In late 2018 I told my husband I would wait until the new year because of insurance. I canceled the fourth appointment and rebooked it for January 9, 2019.

My gastroenterologist performed so many colonoscopies he didn't meet with some patients until the day of the procedure. Instead his nurses called, sent you a long application form to fill out and return, told you how to prepare and sent in the prescription of cherry flavored yuck to drink. As it turned out, this was my kind of doctor. Because if I canceled this time, I was canceling a surgical room and staff.

The night before my procedure, I drank all the gross cherry flavored liquid preps that friends had told me is the worst part. But I didn’t agree. I think sticking the IV in me and having it take three different nurses to finally get it done the next day was the worst part.

After the IV was set, I was given something intravenously and started to relax quite a bit. I was rolled into the room for the procedure and finally met the doctor. He was sitting and reading my written information I had sent in a few days earlier. He noted my meds and asked me about what I had eaten recently (nothing, and I was ready for an In-N-Out burger as soon as this was over) and if my bowel movements were clear (they were).

The night before my procedure, I had a deep cleansing of my bowels with an urge every hour or so to hit the bathroom. It was simple and I didn't understand why I kept canceling this.

Just before I was put completely under, I admitted out loud for the first time to my doctor, whose face I could not see behind his surgical mask, what my instinct was telling me. I was pretty sure he was going to find cancer and told him why. He told me if he found any, he would be waiting for me to wake up and let me know immediately. I didn't find that particularly reassuring, but OK.

There is too much mystery surrounding a colonoscopy and I'm here to tell you it's completely unwarranted. By the time I was in the room I was completely relaxed. They had me turn onto my left side with the doctor and nurse behind me along with TV screens. The anesthesiologist asked me about an upcoming planned trip to Europe and by the time I said “London and Tusc...” I was out.

I don't remember anything else. After the 30-minute procedure, I was gently awakened by a nurse. My husband was sitting there too. As I began to grasp my surroundings and remember what I was doing in the hospital, the gastroenterologist stuck his head around the curtain and said matter-of-factly, and I'll never forget it, “Denise, we did find cancer. It's five centimeters. We're taking you for a CAT scan now."

After her colonoscopy, Denise talks about what her doctor said that changed her life.

I’ll Never Forget My Doctor’s Words After I Woke Up from My Colonoscopy

Denise Tallman

Reginald Tucker-Seeley, MA, ScM, ScD, concludes the program with advice for caregivers and patients with prostate cancer to maximize the benefit of treatment.

Advice for Patients With Prostate Cancer

This is a synopsis of an Educated Patient Sound Bites series featuring Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute; Rashid K. Sayyid, MD, MSc, of the University of Toronto; and Reginald Tucker-Seeley, MA, ScM, ScD, of ZERO Prostate Cancer.

Dr Reginald Tucker-Seeley emphasizes utilizing the full healthcare team beyond just physicians, including nurses and social workers, to answer questions. Community organizations like ZERO also provide critical patient education and advocacy. He advises fully understanding the care journey ahead of time to avoid surprises. ZERO offers resources mapping out the prostate cancer process.

Dr Tucker-Seeley stresses no one should navigate a cancer diagnosis alone given its life-altering nature. Bringing someone to appointments allows a second set of ears, notetaking, and post-visit discussion to ensure comprehension, as the initial news can overwhelm patients.

In closing, Dr Tucker-Seeley thanks viewers for learning about prostate cancer, hoping they found the patient education program informative.

*Video synopsis is AI-generated and reviewed by CURE editorial staff.

Reginald Tucker-Seeley, MA, ScM, ScD

Causes of Thyroid Cancer- Differentiated thyroid cancers – also known as papillary and follicular thyroid cancers – don’t play by the same rules as other cancers. Although in advanced forms of the diseases, external beam radiation and chemotherapies may be called for, they tend to be treated with partial or complete thyroidectomies, and sometimes followed by radioactive iodine. While these treatments tend to be less harsh than other forms of cancer, trust me when I say that they are no walk in the park. To add to this, the medical community is at odds as to how long to follow patients for possible recurrences, as some recurrences have been documented to be as many as thirty-five years out!

With those issues in mind, let’s takes some time today to discuss what causes differentiated thyroid cancers (DTCs), how and how often they are diagnosed, and a glimpse at discussions in the medical community concerning what is termed “overdiagnosis.”

The simplest answer to this question is that scientists don’t really know what causes thyroid cancer. There are many theories and risk factors at play such as:

Iodine (too little may contribute to follicular thyroid cancer, while too much may contribute to papillary thyroid cancer)

I want to take a moment to visit about obesity and its role in the development of DTCs. In an article released in May 2020, Johnathan Fussey and his colleagues examined data from patients in Europe, to determine if obesity could be a cause of benign thyroid nodules or DTCs. Their research did not reveal a causal relationship between obesity and either condition; however, there was a link found between Type 2 Diabetes and thyroid cancer. It is important to note that a link does not imply a cause one way or the other – but it gives justification for more investigation.

Another interesting study was released in February 2021 by Cari Kitahara and her colleagues examining the effects of certain conditions of our mothers while we were babies in the womb. Looking at data from Norway, Denmark, Finland, and Sweeden over years spanning up to 1967-2015, they found that mothers with thyroid disorders (hypothyroidism, hyperthyroidism, goiter, and even benign thyroid nodules) were more likely to have children that would one day be diagnosed with thyroid cancer.

In 2021, there are projected to be about 44,280 new cases of 

 diagnosed in the United States, with about one quarter in men and three quarters in women. Fortunately, Lamartina and Handkiewicz-Junak (2020) tell us that the overall risk of death due to differentiated thyroid cancer is very low, at less than 2%. They also give us encouraging information in that the majority of DTCs (about two-thirds of diagnoses) are considered “low risk,” with an estimated rate of recurrence of only 5%. What is concerning though, is that while most recurrences happen within five years, there is data showing that some recurrences have occurred as much as 35 years out! With this in mind, treatment teams must look at a variety of information concerning the patient’s outlook and need for possible lifelong surveillance. Factors that determine a follow-up include: type, size, and spread of the initial disease, what treatment methods were used initially, how the patient responded to those treatments, and a variety of laboratory and imagine markers and tools. If you are interested in more on this topic, please take a look at 

Lamartina and Handkiewicz-Junak’s article

Doctors and researchers have been saying for many years that thyroid cancer is overdiagnosed and that it is a big problem. So, what is overdiagnosis? The answer to that is fairly simple, but the term leaves something to be desired. Overdiagnosis is a true diagnosis of cancer that has been confirmed by biopsy, but it is found in a person that is expected to outlive cancer (that the person would likely die of other natural causes before cancer does). Clear as mud, right?

So, if it’s a true diagnosis – then what’s the big deal?

Well, that’s where we get into things such as treating a disease that won’t affect a person in any appreciable way. This is huge in terms of not only monetary costs, but also stress and anxiety on the part of the patient and loved ones, and also utilization of an already stressed healthcare delivery system. Think of it this way – say you have a bunion that doesn’t really bother you at all. Do you treat it now, or wait till it's bothering you? I know that a bunion is in no way, shape, or form even close to cancer, but it’s the first analogy that popped into my head.

With that, doctors and scientists have been revising the criteria for performing a biopsy on thyroid nodules and suspected cancers, especially in low-risk populations (those folks without significant risk factors), such that fewer cases will be “overdiagnosed,” which could help ease the burden on both patients and healthcare systems.

As always, much love, many prayers, and abundant blessings to all of the warriors out there!!

New research sheds lights on the causes of thyroid cancer, overdiagnosis of PTC

Causes of Thyroid Cancer

Kathryn E. Vinson, MS, CCRC

Diagnosis of Prostate Cancer

Genetic Counseling for Prostate Cancer 

Impact of BRCA Mutations in Prostate Cancer

FDA Approved PARP Inhibitors for Prostate Cancer

Quality of Life With Prostate Cancer

Patient’s Role in Decision-Making for Prostate Cancer

The Future of PARP Inhibitors in Prostate Cancer

Expert Connections: Hereditary Prostate Cancer

Nicholas J. Vogelzang, MD, FASCO, FACP, Comprehensive Cancer Centers of Nevada

Improved outcomes were seen with magrolimab plus docetaxel in patients with metastatic non-small cell lung cancer (NSCLC) who had higher CD47 expressions, according to a presentation on the phase 2 ELEVATELung&UC trial at the 2024 Society for Immunotherapy of Cancer (SITC) Annual Meeting.

Magrolimab is a type of monoclonal antibody that targets CD47 by binding to it, according to the National Cancer Institute. When the drug binds to CD47, it helps destroy the cancer cells directly. In the study, magrolimab was combined with docetaxel, a type of chemotherapy. 

The study included 31 patients with metastatic NSCLC who previously received treatment in the second- or later-line setting. Researchers found that patients with NSCLC with confirmed partial responses (PRs) or complete responses (CRs) to magrolimab plus docetaxel had higher baseline levels of CD47 expression.

Among patients with CD47 expression on more than 50% of tumor cells, the median progression-free survival (PFS) was 8.9 months versus 2.6 months for those with baseline CD47 expression below 50%. The median PFS in the NSCLC population treated with magrolimab plus docetaxel was 5.4 months.

“Despite a limited sample size, the correlation between CD47 expression and better outcome in both [ELEVATELung&UC] and in Tempus real-world data of patients treated with chemotherapy and/or [immunotherapy] suggests a positive prognostic role for CD47 in metastatic NSCLC,” lead study author Nick van Buuren, of Gilead Sciences and coauthors, wrote in a poster of the data.

Among the 31 patients with metastatic NSCLC in the study who received treatment (intent-to-treat population; ITT), the median age was 65 years. Most patients were male (77.4%), White (90.3%), had stage 4 disease (96.8%), had an ECOG performance score of 1 at baseline (54.8%) and were former smokers (58.1%). The best overall responses to magrolimab plus docetaxel in this population included CR or PR (19.4%), stable disease (SD; 38.7%) and progressive disease (PD; 16.1%).

The biomarker-evaluable population was a subset of 24 patients with stage 4 NSCLC who had reportable baseline CD47 results. The patient characteristics and best overall response rates reflected those observed in the ITT population. In this population, the median age was 64 years. Most patients were male (75%), White (87.5%), had an ECOG performance score of 1 at baseline (62.5%) and were former smokers (50%). Best overall responses to magrolimab plus docetaxel in this population included CR or PR (20.8%), SD (37.5%) and PD (12.5%).

The ELEVATE-Lung&UC trial evaluated the safety, tolerability and effectiveness of magrolimab plus docetaxel in patients with metastatic NSCLC, metastatic small cell lung cancer and metastatic bladder cancer.

Patients with mNSCLC must have received one or two prior lines of platinum-based chemotherapy, a checkpoint inhibitor or both.

Patients received magrolimab at a priming dose of 1 milligram per kilogram (mg/kg) on cycle one day one, followed by a weekly dose of 30 mg/kg from cycle one day eight to cycle two day 15. After, patients received a maintenance dose of 60 mg/kg every three weeks from cycle three day one onward. Docetaxel was given at 75 mg per square meter every three weeks.

In February 2024, Gilead announced a global pause in enrollment to studies investigating magrolimab in patients with solid tumors, including ELEVATELung&UC, to review the risk-benefit profile of magrolimab across the trials. The FDA subsequently requested a partial clinical hold on these trials.

Gilead later decided to terminate the ELEVATELung&UC trial.

“Biomarker analysis of magrolimab plus docetaxel in patients from ELEVATE-Lung and UC, a phase 2 multicohort study” by Nick van Buuren, et al., 2024 SITC Annual Meeting.

For more news on cancer updates, research, and education, don’t forget to 

The ELEVATELung&UC trial demonstrated improved outcomes in metastatic NSCLC patients with high CD47 expression treated with magrolimab plus docetaxel. Magrolimab, a monoclonal antibody targeting CD47, showed enhanced efficacy in patients with over 50% CD47 expression, achieving a median PFS of 8.9 months compared to 2.6 months in those with lower expression. Despite promising results, the trial was terminated following a global pause and FDA partial clinical hold due to safety concerns. The study highlighted CD47's potential prognostic role in metastatic NSCLC.

Patients with metastatic non-small cell lung cancer and high CD47 expression showed improved responses to treatment with magrolimab plus docetaxel. 

Magrolimab-Chemo Combo Improves Responses in Metastatic NSCLC

Ashling Wahner

I'm 75 years old and was diagnosed with renal cell carcinoma in 1990 at age 43.

My story begins in 1987 when I woke up one morning with severe back pain and high fever.Hoping the discomfort would pass, I stayed home from work for two days. On the third day, with little improvement, my wife insisted I see a doctor.

I went to consult a local general practitioner in my neighborhood who made a diagnosis which proved to be wrong, prescribed some pills and sent me home.

Choose a doctor you know and trust. If you're unsure, go to the ER.

Nevertheless, after a few more days, I started to feel better and returned to my regular routine.

Eighteen months later, I was at my local post office where I almost passed out with the same symptoms. This time, I went to see a nephrologist (a kidney specialist) who prescribed some tests to be done at a local hospital. Again, I received a wrong diagnosis.

If you go to the right doctors and they still get it wrong, there's not much you can do. Doctors are human and make mistakes, it's just bad luck.

Another 18 months went by, and then I almost passed out on the subway returning home from work. This time my doctor ordered a CT scan which revealed a mass on my right kidney.

If you suspect your doctor screwed up, find another doctor pronto.

Through a connection, I got hooked up with one of the top urology surgeons in New York City who removed my kidney, and through him, a top oncologist for follow up.

 Try to find the top doctors in their specialty where you live.

Six months later, a follow up chest X-ray and CT scan revealed nodules in my lung. My oncologist sent me to the National Cancer Institute in Bethesda, Maryland for a clinical trial of an immunology therapy, IL-2.

In May 1991, after six months of treatment, scans revealed the cancer had been significantly reduced, and I have not been treated for kidney cancer since that time.

 A clinical trial may be a promising treatment option.

Doctors and other medical workers are just like other professionals; most are excellent, some are average, and some are below average. The trick is to get hooked up with those that are excellent. Even though I was misdiagnosed early on, I wouldn't be here if it wasn't for some exceptional doctors.

 Learn about your disease, if you have any doubts about what a doctor is telling you, get a second opinion.

Dedicated doctors and scientists are working hard to find cures every day. It's possible that something they are working on may be effective for you. You must have hope. Cancer is survivable. I am living proof.

This post was written and submitted by Ira D. Wasserman. The article reflects the views of Ira D. Wasserman and not of CURE®. This is also not supposed to be intended as medical advice.

For more news on cancer updates, research and education, don’t forget to 

I was misdiagnosed twice before receiving my kidney cancer diagnosis, and along the way, I learned the importance of expert doctors and clinical trials.  

My 6 Rules for Navigating Cancer and Medical Misdiagnoses

Ira D. Wasserman is a 75-year-old from Staten Island, New York, who was diagnosed with renal cell carcinoma in 1990.

Contributors

Latest News