Category: Cancer support

Cancer is work. It’s not a goal, something you study or train for. It’s not enjoyable or an aspiration. There is a whole lot that this stinkin’ disease is not. For all of its impact on you and your family, you would think that there should be benefit or a payday. We can’t even view it as a hobby – something to practice and get better at. We have a lot of experience developing, moving, engaging, honing skills, and enjoying benefits of success. We overcome challenges. Frankly, we have no frame of reference for this new dynamic. You read, search, get opinions, ask friends, maybe travel for care, but it’s very discombobulating.

Patsy is p….d. She is now ready to enjoy a well earned retirement. “Doc, I’ve worked since I was 14!!! I cared for my husband before he passed, raised children, helped with grandchildren. I am ready to relax, travel, and make new friends. This is derailing my plans“. I understand the disappointment and even anger.

“Patsy, you will manage this just as well as you did everything else in your life. You will succeed because you did screenings and found it early. You will do the work because you are diligent and you will now be an inspiration. Cancer will open doors. You will embrace your new dynamic, spreading your unique cheer and optimism in the center to the staff and other patients. You will be a hero to your family. You will gain strength, knowledge and wisdom.”

No, disease is never invited or enjoyable, but there are so many aspects of this development that will stretch and grow you. You didn’t even know what part of your spirit you could tap into. For Patsy, and others, there will be fear and concern, but there will also be a renewed purpose – not just to manage and heal herself. When the person, now patient faces the challenge of a deadly disease, even if it’s treatable or “curable“, the opportunities for self discovery are tremendous. No, it’s not something to which we aspire, but every effort in life and experience has led you to this point. Be curious and open to the adventure. Trust that you have a vast fortitude and resiliency. No, you did not sign up for this, but my own experience with patients bears witness, you are really good at it and a diagnosis is not an identity – it can however, actually enrich your life.

Is it possible that developing breast in Northeast Florida could bestow super powers? Three high profile women in our area from Jacksonville to Ponte Vedra have revealed their diagnosis, two just last week, and will inspire us all. This is a perfect topic as we celebrate Women’s History Month.

Donna Deegan is Mayor of Jacksonville. I met Donna when I first arrived here 18 years ago. She developed metastatic breast cancer and is a three time survivor. She started the nation’s first breast cancer marathon “The Donna” which draws many thousands every February. It raises funds with researchers at Mayo clinic here. Donna was a news anchor, but her new title is Mayor of the largest land city in the US. The beach run lifts everyone, family, friends and patients from across the US. The joy and exuberance is infectious.

Last week another famous news anchor and Health watch reporter with twelve Emmys, a Peabody and two Edward R. Murrow Awards, Jeannie Blaylock revealed her own diagnosis. Jeannie started “Buddy Check” over 30 years ago to increase awareness for women to do self exams. We raised money for screening at our cancer center over the years. She started the program when a friend was diagnosed in her 20’s. Still going strong decades later, Jeannie will tackle her own diagnosis head on and with tremendous grace.

Susie Wiles, from Ponte Vedra, and now one of the most powerful women in the US as Chief of Staff, revealed her diagnosis last week, reminding us that no one is immune as one in eight women will face this demon and can do it with determination and grit.

All shapes, sizes, ages, genetics, careers and responsibilities. Women don’t allow these perky appendages to hinder them. Instead they are fierce in the face of drama as if they strap into those comical conical breast plates from sci fi movies. They put hands on hips like wonder woman and inspire. The thousands of women I have cared for (I prefer to “treated”) bear witness to the strength and power of adversity. As if to say, ” Breast Cancer?, oh please, I’ve got this!…… “.

Think even the nasty forms can intimidate us? Triple negative breast cancer is taking center stage recently due to many new therapies, battling the most aggressive form. BRCA positive patients ( 15%) may respond to PARP inhibitors, Keytruda (immunotherapy) helps us to increase immune system instead of just killing the cancers. Antibody drug conjugates deliver therapy right to the tumor.* All new in the past decade…. Donna was right its all about the research.

You don’t need to be famous. You don’t need to lead the charge. You will inspire, guide, grow, aid and comfort many women in your own family and circle by your courage if you are confronted with this insulting disease. You are not alone. In 2025 there were 4.3 million breast cancer survivors- and what a fiesty bunch they are! Didn’t this disease get the memo? Don’t mess with a woman! Good news is, 5 years survival for early stage is 95-99%, 86% for regional spread ( nodes), 77% for triple negative, but 30% for distant spread. (source Moffitt).

You or someone you know will, has or is in the process of the tackle. There is super power in numbers. There is a massive collective voice for improvements. There is resilience and recovery. There is joy and comfort knowing that a band of sisters (and a few good men each year) will be undeterred in their life missions. Go Girls! Make more History!

• Find more at BCRF.org

A lifetime of chasing dreams : School, career, relationships, marriage, hobbies and activities, committees and organizations, moving and travel, generational family growth, even rest and retirement, the constantly shifting and expanding components of life have trajectory. The growing, development, searching and explorations define our lives. There is little if any room for drama, sickness or tragedy. Suddenly, we are faced with a shift, sometimes subtle, but often profound. Caring for people at one of the most critical times in their lives has presented me with thousands of opportunities to bear witness, engage and guide.

Even among your friends and family, each of you is independent in your responses. I have seen the range from busy, frenzied, information gathering, multiple opinions, to almost catatonic. I will offer that, as you and loved ones navigate, please also respect each other other’s path. Recognizing that support and love is far greater at a difficult time then demands and direction, which can be intimidating.

As a cancer physician, I want you to be engaged. I want you to now chase the best treatments for your best outcomes. Honestly, not everyone is up for that and respecting their point of view is critical, not just for success, but also for comfort and acceptance.

The family gathered in the exam room, one holding their mother‘s hand while her husband is on the exam table. He had been receiving spinal injections for back pain for almost a year before the jaundice led to a very different diagnosis. A presenting symptom for pancreatic cancer is often back pain. Schedules were made. The chase was on: surgery, chemo, radiation, immunotherapy, a plan was set quickly in motion. Paul is defeated and exhausted. The pain taking its toll, the jaundice and ascites contributing to the weight loss and frailty. At 62 he had not even had a chance to retire. Two children are still in college. The shock is evident in all of their faces. Everyone wants to fight. We will be there for Paul if he wishes to as well, but with this devastating diagnosis, nothing is guaranteed.

We’ve talked here often about how inflammation influences cancer. The development of the disease, the effect or ineffectiveness of treatments, the trajectory, the outcome. It has been found that within a matter of days in pancreatic cancer, elevated inflammation, can spread the disease rapidly cause increasing ascites (fluid) and make successful treatment essentially impossible.. It’s as if the cancer has conspired against us all. New research is looking at attacking inflammation and allow the body’s immune system to battle disease rather than just trying to treat the tumor.

Many patients, and now even friends, are dealing with this difficult new reality and questions arise. Could more have been done? Could the disease be found sooner and curable? Why did the chase for treatment get so derailed? Once again, we are reminded how truly humbling this disease can be. Take heart that research is advancing at very microscopic, nano particle levels for every disease even the toughest to treat. Frankly, this may not benefit all of us now, but therapy for the next generation will be dramatically different. The chase is on to make cancers that do develop, even the worst of the worst, a chronic disease, one that is survivable..

The best hope for Paul now is not to manage the disease, not to chase treatment. It is instead for loved ones to gather and know that it is not a new immunotherapy that will hold his hand, relieve his mind or comfort his heart. It is his knowing that his life well lived will now bring him support and devotion. There will be grieving, but there will be acceptance and memories to honor. Love may not cure but it always heals.

The title is misleading because this post is about the bowel and very rarely is there any pain associated with colo-rectal cancer. Since there is information in the news lately, especially surrounding younger people, I thought we would explore a bit. You may brush this blog aside as not pertinent to you. But data says otherwise and you may want to gain knowledge as to encourage your adult children to not miss the signs. This is the number one cancer in men and women combined (prostate number one for men, breast number one for women, but together it is colo-rectal, and second leading cause of death after lung cancer).

March is colo-rectal awareness month so pay attention, there may be a test at the end of this. Good news about cancer is that overall it is on the decline. Bad news is that colo-rectal cancer seems to be increasing in the younger population with a 1 to 3% increase in people in their 40s. The fact that we have screening recommendations for those over the age of 50 (and then finally we moved it to age 45) still will not catch all of those at the earliest stages. Because there is rarely pain involved, it will take real attention to find these cases early and curable.

Since the bowel has the capacity to expand, people can get large tumors before they know they have a problem. It is not unusual to find very elderly people, often in nursing homes, with large bowel cancer and requiring surgery. For younger people, especially those who are fit, they often believe that they’re change in bowel habits could be related to lack of hydration from exercise, nervousness around events, lack of fiber, etc. For James Van der Beek, it was a change in habits that he did not realize was related to an actual obstruction in the bowel. I am not a fan of the kits used to detect colo-rectal cancer and here is why: a colonoscopy can go in and actually remove polyps. If those polyps continue to grow they could form cancers so it is actually a diagnostic and therapeutic test. Researchers are also investigating possible vaccines.

Finally (Oh thank God Joanne! ) Awareness is key, especially in these cancers found at early stages by screening. Family history of colon cancer? Get checked early before 40 by GI. There are genetic testings available to see if you have Lynch and other syndromes that make you susceptible to disease.

Everyone will not have their diagnosis found early. Everyone will not have curable disease. What patients often regret, as witnessed by several folks giving interviews now, is lack of attention and awareness earlier. You have insurance. Go to the doctor and bring your list of concern. They are not mind readers and the 9 pages of symptoms you fill out in the waiting room, can still miss the “money shot”. No one regrets paying attention, only dismissing until a multitude of symptoms can no longer be ignored- true for every disease.

The early age onset is contributed to unhealthy diet and microbiome, obesity, chemicals in environment, alcohol, antibiotic use and sedentary lifestyle. To reduce risk, cut down on red meat, a processed and bbq meats, increase fruits and vegetables, whole grains, fish. Don’t ignore rectal bleeding it is the early sign and not always hemorrhoids, so get checked out. Change in stool, chronic constipation, even loose stools, rectal pressure (tenesmus) need attention.

So, please be your own attentive advocate. You know you best, so always be responsible for yourself. Your body will thank you.

Resources: American Institute for cancer research is a good online place to find diet information. ACS (American cancer society has recommendations for screening and for each specific cancer. AACR.org for updates on research for detection and treatment.

What I love about the Olympics is the profound joy captured. Sometimes we forget in the throws of drama that we ever felt that. Alysa Liu’s fantastic personality, generous spirit and pure joy and excitement for the figure skating gold made us all smile.

I happened to be in Miami airport when US hockey won in overtime and the thousands stranded with cancelled flights and blizzard drama forgot their distress for a few moments. The cheers flooded the airport as if each of us scored the winning goal. A moment to enjoy regardless other issues.

These times of national pride and so many more, even those who trained, battled but did not win hardware, are a gift as we extend our good will to others with pride in our hearts and admiration. I really love the interviews with parents saying they didn’t necessarily hope for the wins, they hoped their children are happy.

Youth does not have the exclusivity for exuberance. When Harvey rang the bell after prostate treatment, he beamed and we all felt his relief and excitement. It was his own gold medal moment. Then he surprised us, saying that it’s the second time. How so? He smiled even broader and said that he rang the bell at the shelter when he adopted his now beloved abandoned senior dog.

Moments like these remind us that you will rejoice, laughter will lighten, and you will heal your heart, often.

Cancer cannot steal your exuberance. There is opportunity for more moments ahead and you are well prepared to recognize and celebrate them. For those and their families facing comfort care and leaving active treatments, know that even at this time, you have control. Patients still hear long after they cannot respond. Pain control is paramount and well managed in hospice care. Holding a hand and kissing a forehead gives strength to the person for their next journey.

Be strong my friends. Celebrate with exuberance. Recognize and honor your own strengths, make good decisions to help another move on. During and after treatment regain control through PT to enhance your own abilities. Never be a victim. Power is always yours.

Note: As national cancer screening month of February come to a close, take the reminder to screen and prevent cancers. The most common cancers can be screened for so don’t blow them off: breast, prostate, colorectal, skin, and now lung… at least X-ray even for non-smokers. Treatment is in the doctor’s hands, prevention is in yours.

With another blizzard due to hit the Northeast this weekend, looks like Punxsutawney Phil was right adding six more weeks of winter. But many in the northern regions, just brush the snow off their shoulders and shrug. I found after many years, you could actually get used to temperatures in the teens and shoveling daily. We never closed the centers and when the morning radio would announce 13 inches, the school buses still ran. We all learned to manage and even thrive. The weather provides another lesson for people with all sorts of challenged lives now. I encourage you to have faith that you are resilient.
Have you noticed a shift in conversations lately? Yes you’re not imagining, at a certain age in life, you can’t meet up with friends and family without hearing someone describe their new cancer journey. It seems ubiquitous.

When Mark and Jane came to the center, their faces showed the dismay since they both have been diagnosed this past month. We triage what is most urgent, since family is far and they will try to care for each other. We tag team scans for efficiency and send both for bloodwork and discussed managing the cancers in tumor boards. .After a few weeks, the shock is over and the work begins. They hold hands as one heads to the chemo unit and the other to radiation. I overhear their discussions of running errands and picking up at the end of treatment. What we witness is developing acceptance, strength, and confidence. Their devotion to each other and focus to the tasks at hand is beautiful to witness. At one point, while Mark is perched on the exam table, Jane surprises me by saying “I am glad we are going through this together”.

Mark and Jane teach us that we are stronger than we know. Healthcare and diagnoses don’t scare us. We are more powerful because we are prepared for every storm. We can dig in and be part of solutions instead of fearing and fighting. This week, a new friend at an event, knowing my career, whispered that she is having whole body scans this week because of new abnormal blood work. Her demeanor of concern changed with my comment, “ Good. Then you will have knowledge and a plan. Don’t fear the scans. Be grateful for them. It’s the first step in healing“.
Life changes in many forms are going to happen, trust that you are well armed for them. You got this. Once again, stay safe my friends.

If you have been enjoying the talent, dedication, twists and turns of the wonderful winter Olympics this week, then you know that the podium is often just split seconds or centimeters away.

It’s like cancer. Really, Joanne isn’t that a stretch? Nope. Just like the cross country skier risking a major groin strain, stretching his ski just ahead to gain second place at the finish line, so too, the smallest maneuvers matter.

Last week the ACRO meeting was filled with ways to address cancers with minimal side effects and minimal doses of radiation and chemo. Even the benign disease category of treating various arthritis regions (not spine yet) presented by a professor from Germany was detailing minute doses for maximum effect. The “TARGET” trial at MD Anderson is finding that hanging our hats on immunotherapies may only garner limited effects. So a study is out for GBM, hard to treat, with ways to kick the T cells in the ass and keep them responsive to treatments, instead of having the cancer win.* Again, small tweaks in an already burgeoning area make all the difference.

It is one of the reasons I don’t object to AI in the cancer fight. It takes thousands of iterations in record time to find the minutia that matters. No longer one bench scientist at a desk. However that doctor must use his amazing mind to even consider options or paths to reconfigure cells for treatment.

Medicine and cancer treatment have become extremely nuanced. No, everyone will not be cured. Sadly bringing the light to colo-rectal cancer in younger people found us losing that battle for James Van Der Beek. Why didn’t new therapies do the job? Too often many factors still unknown are part of the complexity in younger people for all cancers. As we age, we expect illness, a wearing down of sorts, less ability to snap back or even respond or tolerate therapies. For young, fit people, there are still unknown factors that interfere, even with the best of medicine.

So, is there hope? Is there a chance that you can face a difficult time and still succeed and enjoy life? Yes, because that day begins today. Love your loved ones, embrace your family and friends, pray and trust, make plans even if they do not come to fruition, because anticipation and joy is a big part of wellness. We do not give up hope, even if the obstacles seem insurmountable. The definition of success is in the effort, not the result. Just look to the Olympians for inspiration. Their spirit, energy, and determination remind us that winning lies within, even in the tiny moments of a smile, a held hand, words of support and comfort. We can all be champions and recognize that we can champion others. God Bless my friends and family on this journey and you and your families, dear reader. Valentine’s (my grandfathers name!) Day is a great time to remember that even when the body fails, love triumphs.

PS: Since it is Valentines Day weekend, even a smooch minutia will brighten someone’s day, so give freely, with love in your heart…… everyday.

*Lang,et.al, Clinical Cancer Research, Systemic immune correlates of long term survival after Delta 24-RGD based on Therapeutic Adenovirus for recurrent Glioblastoma Effect Trial ( TARGET), Jan.29,2026.

While many bundle up in the fierce snows and wind chills even in south Florida, the falling iguanas may require us to invest in more gear! No one needs a clonk on the head by an enormous creepy lizard with a long tail and claws when we are already dealing with other surprises in life. However, after a week or two, even down here, we begin to adjust. Why is that? Because we have all become masters of acclimation. Haven’t we learned in life that complaining doesn’t move the needle? The tough stance and bravery necessary for success starts with the first shiver of a diagnosis, but we are quickly wrapped in support, knowledge, strength and we confidently meet expectations everyday,

We actually begin to develop muscle memory quickly. You gather the necessary gear, adjust behavior, nutrition, activities and search for knowledge. Gradually, you become less bothered. The weather, travel, and commute are less threatening. If undergoing care, the side effects are dismissed quickly and you develop patience with each treatment and even find they are less noxious.

Take Amy- her triple negative breast cancer mets are met with a shrug. New treatments are on her agenda as she seeks spending as much time as possible with her three teens. Jasper’s son transferred from a University in Arizona to on line classes while he helps his Dad run the business, realizing there is no promise of time. Peggy is quickly retooling plans as more data shows systemic therapy is in her future following her colon cancer surgery.

Every single patient is plugged in and adjusting. As varied as cancer scenarios are, the common thread that binds and leads – no fear, just determination.
The chill these weeks is dismissed, the iguanas can be dodged, the trepidation can be avoided. You acclimate and empower yourself, because cancer isn’t all that you have, you choose more.

PS, As the Winter Olympics begin, good luck awesome team USA; show us what determination looks like.

Wouldn’t you love to reach your full potential? It’s a great goal, not just for you, but your children and grandchildren. Well, now researchers are finding ways to help your immune system work to its full potential. No, there is not a pill and it will take some time, but tweaking our mRNA, bone marrow, and waking up dormant cells are action items for controlling the immune process of aging, super charging T cells and helping us fight inflammation and infectious diseases. Much of the research came from Covid and studies at NIH allergy and infectious diseases, evaluating how to target immunity to slow aging. Scientists at MIT have found ways to boost immunity with mRNA therapy, even making cancer immune therapy work better. Stanford is examining swapping out and transplanting cells to revitalize immune systems. Not to be ignored, even the brain gets involved with neuroscientists uncovering immune cells in brain by clearing toxic debris that accumulates.

All of this work is so exciting because for years we blamed aging on genetics and environment, and we too often worked on diseases after the fact. Most of medical care is finding disease and treating, especially cancer. To avoid disease and improve the integrity of our own systems to stay healthy longer is game changing.

While the mice are mostly getting all of the attention in these studies, trust rapid improvement in trials and roll out to humans quickly. So, what can you do in the meantime? Step into making yourself the best specimen for treatment. MD Anderson last month offered 6 simple ways: eat healthy, exercise regularly, get enough sleep, reduce stress, stay up to date with vaccinations.

“Very Well Health” this month added, manage weight, wash hands regularly, get a pet ! , build social networks, finds ways to laugh, no smoking, avoid alcohol, Harvard doubled down on all of above.

The mice can’t do all the work. What I like about the research is how this is now a priority and at just the right time. Too bad we had to go through covid to find the exciting mRNA data. However we do have to take some responsibility. We can’t expect to get a thymus transplant (filled with fresh T cells) but then not make good decisions. So, plump up your immune system for longevity. If you have cancer, you want to be able to maximize your response to immune therapy (used for many even hard to treat cancers today).

While we will not live forever, even with cancer, we should still demand the very best from ourselves. Take responsibility and plan that, when improved treatments do arrive, such as the immunotherapies, biologics, and soon anti aging therapies, we are our very best specimens. Spend the time that we do have with enthusiasm and joy, ultimately reaching our full potential daily.

Please take note: check with your Doc if you are on immune treatments. Be sure they know everything you are taking. There are over the counter meds found to interfere with them… From Duke Health, Jan.7, 2026 researchers published that some widely used drugs like acetaminophen, stomach proton pump inhibitors ( like Prilosec or nexium) and steroids can reduce efficacy of immunotherapy. While antihistamines, statins, antidepressants (SSRI) may enhance immune therapy. (from JCO, Dr N.DeVito).

While the fierce snow, ice and chaos reign in much of the US this weekend, I recall practicing in snowy NW PA. I quickly learned to navigate treacherous roads, throw the shovel in the car and show up. Nothing deterred patients with cancer. They were already brave, so the center (and even schools) never closed. I leaned on their bravery. I was also the director of the hospice program and had concern for the nurses driving into rural areas. The chief nurse said, “Dr. Dragun, it is no problem. Just go.” Funny how many times that phrase comes to mind. The literal directive in hurricanes and storms here in Florida, the psychological or emotional moments of confusion and crisis, and even at times of pain and distress. Plowing ahead through challenges is something we have all gotten pretty good at.

People learn to navigate quickly and soon the threat is less intense. The challenges are faced down. You continue again and again to “ Just go” and never look back. You value time, friends, loved ones, even work and a daily walk more. You become resilient with renewed power and focus. You never cower. For some, you may need the snow plow, blower and shovel to make your way, but you get on that road and expect success at every turn.

You surprise your spouse and family and they also breathe relief as you power through whatever comes your way. They can hug you again and again but they no longer need to pat your head. You are lifting everyone, helping them all to just go.

The news and weather channel reports this weekend are leaning into fright and dismay. At least they keep people from heading out foolishly. But, if you have cancer and the center is open, if there are tests and treatments, if you in the midst of your struggle, we know you will be there. You are never frightened. You never give up or give in, because you have learned in a long life of successes and challenges, that the directive to “ Just go” will propel you to victory.

Stay safe friends and family. This storm is a good reason to tuck into a cozy Sunday of playoff football. Don’t overdo the shoveling. Perhaps even enjoy the wintery beauty, but most of all, let nothing deter your own mission. God Bless.