What is a colostomy?

A colostomy is an incision (cut) into the colon (large intestine) to create an artificial opening or "stoma" to the exterior of the abdomen. This opening serves as a substitute anus through which the intestines can eliminate waste products until the colon can heal or other corrective surgery can be done. The bowel movements fall into a collection pouch.

Doctors that have touched my Body and Soul

J. Michael Guenther MD Dr. Guenther is a board certified general surgeon with a fellowship in surgical oncology. Dr. Guenther received his medical degree from the University of Michigan Medical School in 1987. He completed a residency in general surgery at the University of Cincinnati Hospitals and a fellowship in Surgical Oncology at the John Wayne Cancer Institute in Santa Monica California. Dr. Guenther worked at the Kaiser Permanente Medical Center in Los Angeles, California prior to joining The Cranley Surgical Associates in 2002.

Robert D. Cranley M.D. Dr. Cranley has been in practice with The Cranley Surgical Associates, Inc. since 1987. After receiving his medical degree from the University of Cincinnati in 1982, he completed his surgical residency and a vascular fellowship at Good Samaritan Hospital. Dr. Cranley is certified by the American Board of Surgery in general surgery, in vascular surgery and in surgical critical care. He is the Medical Director of the Cranley Surgical Associates Vascular Lab.

Robert M. Kindel, M.D. grew up in Cincinnati and attended Indian Hill High School.  He completed his undergraduate work at the University of Pennsylvania and received his M.D. from University of Cincinnati College of Medicine.  Bob was a resident  in the Department of Internal Medicine at the University of Minnesota Hospital and Clinics.  He continued his fellowship there in the Division of Gastroenterology, Hepatology, and Nutrition.  Dr. Kindel is Board Certified in both Internal Medicine and Gastroenterolgy.  Since 1996, Dr. Kindel has served as a staff physician at the Minneapolis Veteran Affairs Medical Center.  He joined Digestive Health Network in September, 1999 working out of our western offices.  His primary office is 317 Howell Avenue in Clifton.  In his leisure time you will find Bob on the golf course or with a fishing pole in his hand. http://www.digestivehealthnetwork.com

	Prashanth R. Kesav, M.D. Internal Medicine
	Dr. Prashanth Kesav received his medical degree from J.N. Medical College in Belgaum, India and completed his residency at Good Samaritan Hospital in Cincinnati. He is board eligible in Internal Medicine.

	Prasad G. Chandra, M.D. Internal Medicine
	Dr. Prasad Chandra received his medical degree from Jawaharlal Nehru Medical College in India. He completed his residency at Veteran's Administration Medical Center in Dayton. He is board certified in Internal Medicine.

	Dale J. LaHue, M.D. Internal Medicine
	Dr. Dale LaHue received his medical degree from the Medical College of Ohio in Toledo, and completed his residency at Jewish Hospital in Cincinnati. He is board certified in Internal Medicine

One of the most devasting diagnoses that a patient ever receives is the news that he or she is suffering from cancer. Cancer is the terrifying beast of nightmares to every patient. And once the initial diagnosis is made, the news that the treatment of choice for this disease is Radiation Therapy and/or Radiation Therapy conjoined with chemotherapy can conjure up even more terrifying images for the patient. Every patient has heard the scary stories from a friend or a relative of "burnt" skin, baldness, nausea and diarrhea. To some patients, the cure sounds worse than the disease.

What is radiation therapy? Radiation therapy is the careful use of high energy x-rays, gamma rays, or electrons to treat cancer. Radiation is effective in treating cancer because it damages cancer cells more than it does normal cells. However, normal tissues may also be damaged, which is one reason why side effects can occur. The goal of radiation therapy is to destroy the cancer with as little injury as possible to the surrounding normal tissues. The purpose of radiation therapy is often to cure the patient of cancer. Such treatment is called curative radiotherapy. To be curative, the treatment must eradicate every cancer cell or prevent them from growing and multiplying. High doses are often required when the aim of the radiation therapy treatment is to cure. Radiation therapy may also be used to relieve cancer symptoms, even when cure is not possible. This type of treatment is called palliative radiotherapy.

Before

After

Palliative radiotherapy may be given to relieve pain due to bone invasion, headaches due to brain metastasis, paralysis due to spinal cord compression, or to stop bleeding due to involvement of the skin, bladder, or bowels. Palliative radiation therapy usually requires fewer treatments than curative radiation therapy because not all of the cancer cells have to be eradicated to relieve the symptoms.

More than half of all cancer patients in the United States are treated with radiation therapy sometime during the course of their illness. About half of these are treated for cure, and half for palliation.

RADIATION THERAPY Radiation therapy is the use of high-energy X-rays, electron beams or radiaoactive isotopes to attack cancer. Radiation therapy causes cancer cell death by ionization or by damaging the chromosomes in the cell so that they cannot multiply.   Radiation therapy is a local treatment - aimed directly at the cancer. Even though the radiation is aimed only at the cancer, it must often pass through skin and other organs to reach the tumor. Thus, some healthy cells may become damaged, too. The body however is able to repair the healthy cells that have been damaged and restore them to their proper function. Aside from its use as a single treatment, radiation therapy has been shown to enhance the effects of chemotherapy. It can be used in combination with chemotherapy to shrink a tumor before its surgical removal. For tumors that are inoperable, radiation can be effective in reducing or alleviating the pain, bleeding or possible blockages associated with these tumors. Successful radiation therapy depends on delivering the proper amount of radiation to the cancer in the best, and most effective way. There are several types of radiation therapy. External Beam Radiation Therapy External beam radiation therapy is the most common form of radiation therapy. Before treatment begins, detailed planning or simulation is performed. During simulation, the radiation oncologist, physicist, and dosimetrist will use measurements from scans and calculations to determine the precise location to aim the radiation. Small tatoos are placed on the patient so that treatments can be properly directed throughout the entire course of radiation. Simulation may take several hours. During the treatment, the patient is positioned on a table so that a beam from a machine outside the body may be aimed at the tumor. The radiation treatment itself lasts only a few minutes and is generally given five times a week for several weeks. Some technical variations of external beam radiation are stereotactic radiosurgery (Gamma Knife), high dose three dimensional radiation therapy (HD3D), intensity modulated radiation therapy (IMRT), and intraoperative radiation therapy (IORT). These types of radiation therapy are highly specialized and used in very specific settings. Internal Radiation Therapy Internal systemic radiation therapy the process of injecting radioactive isotopes either into a vein or into an organ. One of the most common types of systemic radiation therapy is radioactive iodine (I-131) which is given for some types of thyroid cancer. Another type of systemic radiation therapy is the use of Strontium-89 (Metastron). This isotope is used to treat painful bone metastases most often from cancers of the prostate and breast. Interstitial radiation therapy (also known as brachytherapy) is the process of placing radioactive sources directly into the tumor. These radioactive sources can be temporary (removed after the proper dose is reached) or left permanently, as with I-125 for prostate cancer. Intracavitary radiation therapy is used most commonly in gynecological cancers, such as cancer of the uterus. In this procedure, radioactive sources are placed into applicators that are positioned into the uterus, while the patient is under anesthesia. These are left in place for 48-72 hours and then removed. The patient must stay in bed in the hospital while the radiation is in place. Radiation Therapy Side Effects The side effects of radiation therapy are, for the most part, specific to the area of the body being radiated. Some general side effects may include skin irritation and fatigue. Other side effects might include nausea and vomiting (for radiation given in the area of the stomach), hair loss (for radiation given to the head), sore throat and difficulty swallowing (for radiation given to the neck or chest) and diarrhea (for radiation given to the lower back or abdomen). There are medications and techniques that can be used to control side effects. Side effects should be discussed with the radiation oncologist so that they can be managed properly.

http://www.cancer.gov

What Is Chemotherapy?

Chemotherapy is the treatment of cancer with drugs that can destroy cancer cells. These drugs often are called "anticancer" drugs.

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How Does Chemotherapy Work?

Normal cells grow and die in a controlled way. When cancer occurs, cells in the body that are not normal keep dividing and forming more cells without control. Anticancer drugs destroy cancer cells by stopping them from growing or multiplying. Healthy cells can also be harmed, especially those that divide quickly. Harm to healthy cells is what causes side effects. These cells usually repair themselves after chemotherapy.

Because some drugs work better together than alone, two or more drugs are often given at the same time. This is called combination chemotherapy.

Other types of drugs may be used to treat your cancer. These may include certain drugs that can block the effect of your body's hormones. Or doctors may use biological therapy, which is treatment with substances that boost the body's own immune system against cancer. Your body usually makes these substances in small amounts to fight cancer and other diseases. These substances can be made in the laboratory and given to patients to destroy cancer cells or change the way the body reacts to a tumor. They may also help the body repair or make new cells destroyed by chemotherapy.

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What Can Chemotherapy Do?

Depending on the type of cancer and how advanced it is, chemotherapy can be used for different goals:

• To cure the cancer. Cancer is considered cured when the patient remains free of evidence of cancer cells.
• To control the cancer. This is done by keeping the cancer from spreading; slowing the cancer's growth; and killing cancer cells that may have spread to other parts of the body from the original tumor.
• To relieve symptoms that the cancer may cause. Relieving symptoms such as pain can help patients live more comfortably.

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Is Chemotherapy Used With Other Treatments?

Sometimes chemotherapy is the only treatment a patient receives. More often, however, chemotherapy is used in addition to surgery, radiation therapy, and/or biological therapy to:

• Shrink a tumor before surgery or radiation therapy. This is called neo-adjuvant therapy.
• Help destroy any cancer cells that may remain after surgery and/or radiation therapy. This is called adjuvant chemotherapy.
• Make radiation therapy and biological therapy work better.
• Help destroy cancer if it recurs or has spread to other parts of the body from the original tumor.

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Which Drugs Are Given?

Some chemotherapy drugs are used for many different types of cancer, while others might be used for just one or two types of cancer. Your doctor recommends a treatment plan based on:

• What kind of cancer you have.
• What part of the body the cancer is found.
• The effect of cancer on your normal body functions.
• Your general health.

What About Clinical Trials?

Clinical trials, also called cancer treatment studies or research studies, test new treatments in people with cancer. Clinical trials test many types of treatments such as new drugs, new approaches to surgery or radiation therapy, new combinations of treatments, or new methods such as gene therapy. The goal of this research is to find better ways to treat cancer and help cancer patients. There are different types of clinical trials, called Phase I, Phase II, and Phase III trials. Each is one of the final stages of a long and careful cancer research process. If your doctor does not suggest you take part in a clinical trial, you may want to ask about clinical trials as a treatment choice for you.

Possible benefits of clinical trials include:
 

• Clinical trials offer high-quality cancer care.
• If a new treatment approach is proven to work and you are taking it, you may be among the first to benefit.
• By looking at the pros and cons of clinical trials and other treatment choices, you are taking an active role in a decision that affects your life.
• You have the chance to help others and improve cancer treatment.

Possible drawbacks:

• New treatments under study are not always better than, or even as good as, standard treatment.
• Even if a new treatment has benefits, it may not work for you.
• In a study, if you are randomly assigned to have standard treatment instead of the new treatment being tested, it may not be as effective as the new approach.
• Health insurance and managed care providers do not always cover all patient care costs in a study.

Before deciding to join a clinical trial you will want to ask important questions such as: What are the possible short- and long-term risks, side effects, and benefits to me? How could the study affect my daily life? Will I have to pay for any treatment, tests, or other charges?

The National Cancer Institute's (NCI) booklet Taking Part in Clinical Trials: What Cancer Patients Need to Know lists questions you may want to ask your doctor and helps answers many of the questions you may have about clinical trials. It also informs you about your rights and protections. For example, you are free to leave a study at any time. You may order the booklet by calling NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

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OK, I'll be honest, being the ol' hippie I am, I have tried to get all these fine physicians to prescribe me to some of this stuff.  What the hell, if you are diagnosed with cancer, you might as well enjoy something out of it all.  But, no givers so far.  I think they keep it all for themselves.  LOL Marinol Oral Capsule 10 mg   GENERIC NAME DRONABINOL - ORAL (dro-NAB-in-all) COMMON BRAND NAME(S) Marinol   USES This medication is used to treat nausea and vomiting due to cancer chemotherapy.   HOW TO USE Take this medication by mouth as directed. Do not increase your dose or take this more often than prescribed. Do not drive, operate machinery or engage in activities requiring alertness while taking this medication.   SIDE EFFECTS Dizziness, drowsiness, irritability, mood changes, difficulty concentrating, distorted vision, dry mouth and changes in appetite may occur especially the first several days as your body adjusts to the medication. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop: skin rash, rapid heart rate, sleep disturbances, depression, memory loss, mental confusion, hallucinations, behavior changes, numbness or tingling of the hands or feet. Be aware that this medication may cause mood or behavior changes. If you experience any such effects, remain calm. Do not take any more doses until you contact your doctor. If you notice other effects not listed above, contact your doctor or pharmacist.   PRECAUTIONS Tell your doctor if you have: heart disease, high blood pressure, a history of depression or other emotional or mental conditions, allergies (especially to sesame oil). Long-term use of this medication may cause dependency. Withdrawal symptoms such as irritability, restlessness, sleeping problems, sweating, hot flashes, hiccups and loss of appetite have been reported when this medication is discontinued abruptly following long-term therapy. Do not drive, operate machinery or engage in activities requiring alertness while taking this medication. This medication should be used with caution in elderly persons as they may be more sensitive to the effects. This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Because this medication appears in breast milk, consult your doctor before breast-feeding.   DRUG INTERACTIONS Tell your doctor of any over-the-counter or prescription medication you may take, especially of: narcotic pain relievers, sleeping pills, sedatives, barbiturates, anti-anxiety medication. Avoid intake of alcoholic beverages while taking this medication since the risk of side effects will be increased. Do not start or stop any medicine without doctor or pharmacist approval.   OVERDOSE If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include drowsiness, dry mouth, fast heartbeat, mood changes, slurred speech, loss of coordination, and lightheadedness.   NOTES It is important that this medication be taken under supervision of a responsible adult since mood or behavior changes may occur. It may be necessary for the first dose or two to be taken in the doctor's office or while in the hospital so your response can be monitored closely.   MISSED DOSE If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.   STORAGE Store in a cool environment between 46 to 59 degrees F (8 to 15 degrees C). May be refrigerated. Do not freeze.   MEDICAL ALERT Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).     The information in this database is intended to supplement, not substitute for, the expertise and judgment of your healthcare professional. The information is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate, or effective for you. You should consult your healthcare professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment. This copyrighted material has been downloaded from a licensed data provider for consumer use and is not to be substituted for or distributed as medical advice in a professional healthcare setting.

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Thanks to Bridget, Kerri, Michael and Trisha with the OPN  (Oncology Partners Network) at Mercy Franciscan Mount Airy Campus Cancer Treatment Center for all their help and support with my cancer treatments.  

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