|CANCER & TREATMENTS FOR CANCER CENTER PATIENTS PREVENTION & RISK ASSESSMENT CLINICAL TRIALS & RESEARCH LIVING WITH CANCER|
Progress Spring, 1998
Playful Healing . . .
by Sheila Morris, activity therapist, Pediatric Hematology/Oncology Program
Many years ago, while pursuing a child development degree at the University of Pittsburgh, I was given a student placement on a pediatric unit. The first child I encountered was a delightful 8-year-old who had been a hospital resident during the past year as he bravely battled leukemia. In spite of harsh chemotherapy side effects (as comfortable anti-nausea medications had not yet emerged), painful procedures and long separations from family and friends, this boys spirit desired childhood experiences, relationships and special moments. He was uncompromising about relinquishing these gifts.
Several times a week, we would play, imagine, create and cope. Through many channels he expressed his being and imparted his childhood wisdom. I often think of this child and his influence on my professional and personal commitments to enriching life for seriously ill children. Through him, I have also had the privilege of viewing the field of Child Life emerge from a playroom-based program for ill children to a respected service of the care-giving team, extending comprehensive patient and family support.
As an activity therapist for the Child Life Services Program, I provide opportunities for the continuation of healthy growth and development within the medical setting supporting young patients and their families as they incorporate illness and therapy into their lives. Warm and up-lifting treatment environments, where young people can play, learn, master, create and foster peer friendships, diminish the fearfulness children often associate with medical care. In encouraging children to explore feelings and further understand their illness and treatment, I often engage in hands-on medical play and support the emergence of caring, trusting relationships with other members of the medical team. Planning special events and seasonal or holiday celebrations are other components of my role. Each day the Cancer Centers Pediatric Infusion activity area, where children receive their outpatient treatments, is alive with sounds and sights of patients and siblings (and often moms and dads!) involved in various activities.
Assisting young people as they re-enter their communities after diagnosis is another of my rewarding responsibilities. Frequently, I visit our patients schools and speak on behalf of the medical team to initiate a supportive partnership, as well as educate staff, classmates and others closely involved in the childs daily experiences. Often, community members with talents, skills, recreational possibilities and a desire to help become involved in our program.
One of the most fulfilling and energizing aspects of my role is traveling with a family as they grow through the experience of this harsh illness. Families arrive at their first appointments in the Cancer Center completely overwhelmed, fearful and unsure of their ability to cope and comprehend the information necessary for their childs at home care. The child usually clings to the parent and pulls away from friendly gestures and invitations to join in activities. In time, relationships with the medical team develop, supportive programs introduced by the hospital staff are continued, and the treatment environment becomes a not-so-frightening place. Youngsters excitedly inquire about the days activities and events, and families become empowered and certainly knowledgeable. They define coping methods and determine to what degree they will allow illness to impact the quality of their childs life. Reaching out to other families in this process, I believe emotional healing begins. The efforts of Child Life and all the specialties of the care-giving team strengthen families as they journey through the experiences of a childs illness.
U-M Debuts Interactive Health Kiosks
A new network of interactive computer kiosks is linking residents with up-to-date information on breast cancer, prostate cancer screening, smoking, bike helmet safety and immunization. Complete with touch-activated screens and custom software, the kiosks display a highly interactive program, called HealthoVision, developed and continually updated by experts at the University of Michigan Comprehensive Cancer Center.
The $1 million first-of-its-kind project, which debuted at sites around Michigan in October, is funded by proceeds from the state tobacco tax.
For more information, call (800) 742-2300 ext. 7855, or visit the HealthoVision website at http://hov.cancer.med.umich.edu
Cancer patients who undergo an allogeneic bone marrow transplant not only receive the donors healthy bone marrow, but also lymphocytes a very important part of the immune system. T-cells are one type of lymphocyte known for their unflinching ability to attack and destroy virus-infected cells, foreign tissue and cancer cells.
Pediatric oncologist John Levine, M.D., is studying a new immunotherapy aimed at helping the 20 percent to 50 percent of pediatric patients whose leukemia returns following an allogeneic transplant. The treatment involves collecting and injecting additional lymphocytes from the donor into the patient to mount a second attack on the leukemia cells. Of the 38 patients studied in this multi-center trial to date, nearly 25 percent have gone into complete remission following the lymphocyte injection. Typically only a slim 10 percent of patients who relapse following a bone marrow transplant achieve a lasting remission.
Levine found several factors to be important. Patients who did not respond to additional chemotherapy given before the injection to reduce the amount of cancer did not respond to the subsequent lymphocyte injection, says Levine. And of great interest, patients were much more likely to go into remission if they developed and were treated for graft versus host disease, a potentially dangerous condition in which the donors lymphocytes attack the BMT recipients organs. Based on these results, Levine and his colleagues will soon begin studies to more reliably induce this effect, as well as to treat patients at high risk of relapse with scheduled lymphocyte infusions after their bone marrow transplant.
Lab Research Unravels Mysteries of Common Childhood Cancer
According to pediatric oncologist and researcher Valerie Castle, M.D., neuroblastoma is particularly challenging to treat because it quickly becomes resistant to standard treatments such as chemotherapy and radiation, which work by triggering a cells normal death process. Her research team is exploring ways to make proteins in the laboratory that speci-fically enhance this cell death process in neuro-blastoma cells.
Daniel Wechsler, M.D., Ph.D., is also studying the pediatric cancer neuroblastoma. Neuroblastoma cells contain high levels of a protein called MYC, which signals neuroblastoma cells to grow. Wechslers team is developing ways of slowing the growth of neuroblastoma cells by expressing a gene called MXI1 that normally works to suppress cell growth. They hope this approach will counteract the effects of the MYC protein.
One Familys Journey
The Longest Year
At age 5, John and Julie Svinickis son was diagnosed with rhabdomyosarcoma, a cancer of the soft tissue that usually occurs in the arms, legs, pelvic area or head. Christophers radiation treatments were followed by chemotherapy that entailed six days in the hospital every three weeks for a year. As Julie describes, It was the longest year of our lives. When youre here for six days at a time, its almost like home.
During his treatment at the University of Michigans C.S. Mott Childrens Hospital, the Svinickis of Jackson, Mich., set about creating a comfortable home for Christopher. Dad stayed with Christopher on weeknights, showered and dressed in the hospital and went straight to work in Ann Arbor. Mom drove in from Jackson after taking 8-year-old daughter Nancy to school. She spent the day with Christopher and drove back to Jackson when Dad returned to the hospital after work. On weekends the routine was reversed Mom spent the nights with Christopher and Dad was at home with Nancy.
For the most part, someone was with Chris 24 hours a day, John explains.Being at the hospital all day, we were his advocates. As his parents, we understand how he feels and could make sure everything went well. It felt good that we could actively participate in his care.
The Svinicki family spent many weekends at the Med-Inn, U-Ms on-site hotel, so everyone could be together. Julie and John were determined to keep daughter Nancy from getting lost in the shuffle. She visited often and even spent a night with her little brother in the hospital after complaining that its just not fair, he gets to watch the cable and play video games in the hospital. The Svinickis arranged for Nancy to sleep on the couch in Christophers room. She found out quickly it wasnt so much fun, recalls Julie.
Holidays at the U-M were special occasions for the entire family. Using a private consultation room, the Svinickis threw a New Years Eve party complete with hats, noise makers, confetti, silly string, sparkling cider and food. The nursing staff continued Christophers care in the midst of the festivities.Life goes on just because we happen to be getting chemotherapy, that doesnt stop New Years Eve, Julie says. You dont just say were going to bed early because youre sick. Whats that telling him? No, its an occasion to party.
Although Christopher finished his treatments last May, a small portion of the tumor remains deep in his brain. Surgery may be in Christophers future, but for now the doctors are monitoring the situation, John reports. Every three months Christopher returns to U-M for an MRI, bone scan and other tests. Even though he is finished with treatment, we still come back for the Halloween party and Christmas celebration. I think it is important that Christopher stays involved with the hospital because he could be back here very soon. It would be misleading him if we dont keep him involved, says Julie.
The Svinickis have worked hard to keep their family together, even transporting their home to the hospital.This is not a scary place for Christopher to come, its fun. He even looks forward to it. People are very friendly, and there is always something different to do, says Julie. Christopher is so at home in the Cancer Center he now refers to many of the procedures he has endured as a piece of cake!
Maxine Solvay, Cancer Center Promotion Coordinator
Golf enthusiasts have another reason to hit the courses this summer to support research and patient care at the University of Michigan Comprehensive Cancer Center. Join the fun, and dont forget your sunscreen!
5th Annual Loretta Matthews Memorial Fund Golf
14th Annual Strokes Against Cancer
16th Annual Brian Parker Memorial Golf Tournament
Center Director Leads National Cancer Organization
Cancer Center Director Max S. Wicha, M.D., is the new president of the Association of American Cancer Institutes. The association is one of the nationšs oldest and most prestigious cancer organizations with a membership of more than 100 cancer centers. Its main goal is to strengthen the nationšs cancer centers and provide additional funding for labora-tory and clinical research at these leading institutions of discovery. The organization also collaborates on cancer issues with the National Cancer Institute, the American Cancer Society, the National Coalition for Cancer Research and other national and international cancer organizations.
The Art of Emotion
Navajo Indians use them for healing rituals. Tibetan monks use them for meditation practices. Now cancer patients are exploring the use of mandalas (mun´da-lays) in a new art therapy class offered by the University of Michigan Comprehensive Cancer Center.
Mandalas are circular shapes that typically contain an icon or image thats important to a person, says art therapist Shannon Scott. We use them in class as a model for journaling -- telling about an emotional experience by creating art.
Art therapy is all about exploring emotions: anger, hope, fear, sadness. Shannon sets the tone for each one-and-a-half hour class by identifying a theme such as feelings or healthy living. She offers artists a range of tools in which to express themselves -- hazy watercolors, bold oil pastels, soft chalks, simple pencils and markers.
It always amazes me how diverse the art- work is, even though the directive is the same.
Art therapy focuses on an individuals strengths and on the development of positive coping skills. The process allows a person to engage their creative resources and energies of expression through visual arts.
You can learn a lot about a person by what they put down on paper, explains Shannon, who holds a M.A. in art therapy, a graduate degree that combines artistic training with a psychology background. And they learn a lot about themselves, she continues. Some patients say visualizing their art work even helps them get through difficult treatments or experiences.
Shannons classes are designed to explore the emotional changes that occur for people living with cancer. Working in a group setting allows the members to relate and share common experiences.
Four women of various ages and different stages of treatment participated in the first six-week session, which was held on Tuesday mornings at the Cancer Center. Shannon says each woman expressed a strong interest in art and jumped right in, focusing on colors, relaxation and journaling.
I was used to expressing myself with my hands, says Rebecca Peapples, a class participant who makes beads and does beadwork as a hobby. So art wasnt scary to me, and I wanted all the support I could get, in as many different ways as possible.
The class gave me a chance to talk about my feelings, Rebecca continues. When we interpreted the symbols in our drawings, it helped us confront our illnesses, which is so healthy.
And what about those patients who may shy away from art therapy because they dont think of themselves as artistic?
The class is about using art as an expressive tool, not about creating beautiful art, says Shannon, who also works with children at C.S. Mott Hospital. Everyone has creative ability!
See the Calendar of Events on page 7 for information about the next Art Therapy session or call Shon Dwyer at (734) 936-1869.
To learn how you can support this important new program, please call (734) 764-7170.
A public awareness and grassroots organizing campaign known as The March is being organized at the national level and in communities throughout the country. This campaign will educate the American people about the devastating impact cancer has on our society and encourage our government to increase funding for research. The campaign will culminate in a monumental March in Washington, D.C. For more information, call toll-free (888) 937-6227.
Congratulations to the Breast Care Center! named one of the "most innovative breast care centers in the country" by Self magazine's 7th Annual Breast Cancer Report!
French Family Honors Wife and Mother, Advances Cancer Research
A gift to honor the memory of Mary Lou Willard French has been made to the U-M Comprehensive Cancer Center by her husband, James L. French of Sheboygan, Wisc., and their children David J. French, Brian J. and Julie French, Jeanna French, and Robert and Paula French Van Akkeren.
The $1 million gift will advance the Cancer Centers new Fund for Discovery, which supports young physician researchers as they explore new, untested ideas in the prevention, diagnosis and treatment of cancer. The French family also gave a $1.2 million gift to the U-M School of Nursing for an endowed professorship in cancer research focused on understanding nursing care for cancer patients and their families.
After much searching for a meaningful way to honor Mary Lous life, the family is very pleased with our decision to support both of these exciting programs at the University of Michigan, says James French.
It is our hope that these gifts in her memory will help in the search for improved treatment of cancer and in the quest for its ultimate prevention.
For information on supporting the Cancer Center, please call us at (734) 764-7170.
Max S. Wicha, M.D.
This article is from a publication now a part of the Cancer Center's News Archive. It
is listed here for historical purposes only.
U-M Comprehensive Cancer Center