2010 Studies Reveal Many Advances in Thyroid Cancer Research

As an overview of medical research on thyroid cancer for 2010, EmpowHer published the top findings in the field. Among several advances in research, one important finding was that thyrotropin suppression therapy may not be necessary.

Researchers found in a randomized controlled trial in October that this therapy does not significantly increase disease-free survival time, according to the news source. They discovered that when the thyroid is completely removed, patients are often given synthetic thyroid hormones at high enough doses to suppress production of TSH, which is also called thyrotropin.

In addition, scientists found that Hashimoto's thyroiditis is associated with thyroid cancer. Researchers suggested observation of patients with Hashimoto's disease for development of the condition. This year, studies also revealed that ultrasound is effective for diagnosing medullary thyroid carcinoma.

Thyroid cancer is the fastest-growing cancer in the U.S., according to the American Cancer Society, which estimates that 44,670 new cases will be diagnosed nationwide this year. Additionally, the National Cancer Institute reports that there are 19,500 thyroid cancer diagnoses in the U.S. annually, and up to 1,500 will die from it. While the disease appears most often in people over 30, thyroid cancer can occur at any age.

Scientists Look for Repeats in DNA as Evidence of Radiation Exposure in Thyroid Cancer

It has been known for some time that exposure of the head and neck to radiation therapy increases the subsequent risk of thyroid cancer. Now, a pair of researchers from Germany and the UK are looking into the likelihood that papillary thyroid cancer - which features DNA changes that were once thought to be due to aging - can be caused by radiation exposure.

Their results, which appeared in the journal Clinical Oncology, suggest that it may be feasible to test papillary thyroid cancer samples for copy number alterations (CNAs), which could indicate damage caused by ionizing radiation.

CNAs are variations in the sequence of base pairs found in the DNA of a human cell. While some CNAs are relatively harmless, others may cause serious health risks.

The authors of the new study noted that when scientists sequence the genes of tumor cells, CNAs are often found within their DNA. That principle holds true for papillary thyroid cancer, which is the most common type of thyroid cancer, according to the Columbia University Medical Center.

Papillary thyroid tumors account for at least 70 percent of all diagnosed cases of thyroid cancer, the Center specifies. In the new medical review, the authors suggested that researchers consider looking for the CNAs that papillary thyroid cancer cells have in common, since their discovery might provide biomarkers that diagnosticians could use to determine how the cancer originated.

They said that the only effective way to determine which CNAs are radiation-related is to compare the sequencing results from a number of closely related cancer study cohorts. By "closely related," the researchers meant that papillary cancer CNAs should be studied based on samples taken from patients who are very similar in age, health status and genetic background.

The team also made suggestions for maximizing the potential of comparative genetic study, such as sequencing DNA with the best integrity or the least degradation from fresh biopsies or blood samples.

Researchers concluded that compiling a list of radiation-caused CNAs will have a number of benefits in the detection and treatment of papillary thyroid cancer.  Currently, nearly 1,700 Americans die of thyroid cancer each year, according to the National Cancer Institute.

Retreats and Getaways For Cancer Patients and Survivors

A growing body of clinical research shows that our innate ability to heal is deeply intertwined with a fundamental human desire for meaning, purpose and fulfillment. The data emerging from conventional medical research facilities around the world validates what many Eastern and Western mystical traditions have known for centuries: that the body’s physical recuperative abilities can be enhanced by integrative medical approaches that also facilitate mental, emotional and spiritual wellness.

Cancer retreats can be beneficial to a patient's healing process and helpful for caregivers. They provide a nurturing environment, often in a beautiful setting, that promotes stress relief, understanding your feelings, and learning how to cope with a cancer diagnosis in your life. Retreats and camps can be for patients, caregivers, family members, cancer survivors and even healthcare professionals who take care of cancer patients. Check with the program you wish to attend to determine who is eligible to participate and the per person cost.

• A New Beginning Cancer Retreat holds free retreats year-round in Ellston, Iowa, for cancer survivors of all ages. Family members and friends are also welcome with a charitable contribution requested. For more information, go to http://www.cancer-retreat.org/ or call 641-772-4276.

• ACS Adventure Weekends offers two retreats per year at the Sargent Center for Outdoor Education near Peterborough, New Hampshire for women with breast cancer. $15. 800-ACS-2345, http://www.cancer.gov/

• Dream is a free camp located near Missoula, Montana, for children age 6-17 and young adults age 18-25 with cancer. Camps are held in January and each summer with adult retreats held in the fall. There is a cost for adult retreats. For more information, go to http://www.campdream.org/ or call 406-549-5987.

• Camp Sunshine summer camp in Decatur, Georgia, for children with cancer is complemented by year-round programs for the rest of the family. For more information, call 404-325-7979 or go to http://www.mycampsunshine.com/

• Cancer as a Turning Point. 5 day residential workshops for people dealing with cancer, and those closest to them. Madison, CT. Contact Ruth Bolletino, 212-496-9136, email rbolletino@aol.com. or visit http://www.cancerasaturningpoint.org/

• Casting For Recovery has 20 locations around the country, with 30 FREE retreats for breast cancer survivors. 802-362-9181, http://www.castingforrecovery.org/

• Commonweal Cancer Help Program retreats are held throughout the year near Bolinas, California. Some scholarships are available. For more information, contact Waz Thomas, program coordinator, at 415-868-0970 or go to http://www.commonweal.org/

• First Descents is a motivational kayaking camp for young adult cancer survivors in Vail, Colorado. http://www.firstdescents.com/

• Harmony Hill offers 3 day retreats for women survivors, caregivers, lesbians, minority women and men in Olympic Peninsula, Washington. FREE. 360-898-2363, http://www.harmonyhill.org/ 

• Healing Odyssey offers four weekends a year in the Malibu Mountains of California for women survivors. $125. 949-951-3930, http://www.healingodyssey.org/ 

• Hilltop Retreat - 2 day spiritual weekend of renewal sponsored by the Mayo Clinic. Contact Mary Riley at 507-288-8354, $25.Life Beyond Cancer Participants will be selected based on their willingness to take what they have learned back to their communities and become involved in efforts to help others dealing with cancer. Scholarships are available. For more information, go to http://www.usoncology.com/

• Life Choices Wellnes Center A renewal retreat for women with breast cance in Saluda, North Carolina. 1-800-439-0083, sliding scale. One week retreats.

• Mending in the Mountains retreat for women survivors at Lone Mountain Ranch in Big Sky, Montana. To assist survivors in rediscovering joy and hope in life; to offer tools for empowering survivors to meet the physical, emotional, and spiritual challenges of cancer recovery; and to provide nurturing support from others dealing with similar life challenges. For further information please call The Big Sky Cancer Recovery and Resource Center at (406)388-4988

• Planet Cancer provides free weekend retreats for young adult cancer patients and survivors. The retreats are developed locally with the goal of growing a nationwide support network of young adults with cancer. For more information, call 512-481-9010 or e-mail headquarters@planetcancer.org 

• Second Wind Retreat located 2 hours north of Atlanta, GA. Rent-free use of cottage to those in cancer treatment. Medical referral needed. 404-348-4986 or http://www.secondwindretreat.org/ 

• Ski to Live - a 4-day skiing and snowboarding retreat for survivors and their families in Snowbird, Utah. Some scholarships available. Kristen Ulmer, 801-733-5003, http://www.kristenulmer.com/

• Smith Farm Cancer Help Program Retreat is a week-long retreat in Comus, Maryland, for cancer survivors (spouses are welcome) held throughout the year. Scholarships are available. For more information, go to http://www.smithfarm.com/ or call 202-483-8600.

• Stowe Weekend of Hope - One weekend each spring, the town of Stowe, Vermont opens its 55 hotels and lodges to cancer survivors and their families at no charge. AMTRAK provides a limited number of free seats for survivors to get to Stowe from Washington, DC. 1-800-GO-STOWE, http://www.stowehope.org/ 

• Sunstone Cancer Support Foundation offers numerous cancer retreats in Tucson, Arizona, year-round for cancer survivors and their families. Partial scholarships are available. For more information, go to http://www.sunstonehealing.net/ or contact Nan Rubin at 520-749-1928.

• Windriver Retreats. Western North Carolina. FREE. info@WindRiverServices.com 

• Women Beyond Cancer. Aiken, South Carolina. Two Sisters Farm. murfeebrwn@aol.com or call Chris Powers at (803) 646-0123. http://www.womenbeyondcancer.org/ 

• Yoga Retreat and  Workshops for Breast Cancer Survivors in East Hampton, NY. Throughout the year. FREE. 212-831-9592, www.thelibbyrossfoundation.com/events.asp

• Survivor's Retreat lists retreats that may not be listed here.

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Stevie JoEllie's Cancer Care Fund is working to develop and launch an access to care grant program for thyroid cancer patients and survivors nationwide. Please consider supporting our unique initiative that includes a set aside fund for healthcare access to assist thyroid cancer survivors with medical costs associated with follow up treatment, annual exams,  diagnostics and medications. 

SJCCFThyNet is a project of United Charitable Programs Inc., a 501(c) 3 Public Charity and as such all donations are tax deductible as allowed by law. 

[One time and recurring donations are fast and easy to set up.]

Gene alteration identified that predisposes to syndrome with high risk of cancer

Researchers have identified a new genetic alteration that predisposes individuals to Cowden syndrome, a rare disorder that is characterized by high risks of breast, thyroid and other cancers, according to preliminary research published in the December 22/29 issue of JAMA.

A majority of patients with Cowden syndrome, which occurs in approximately 1 in 200,000 live births, and a small minority of patients with Cowden-like syndrome, have mutations in the tumor suppressor PTEN gene. These mutations are associated with increased risk of various malignancies, approximately 10 percent lifetime risk for thyroid cancer, and as much as 50 percent lifetime risk for female breast cancer over the general population, according to background information in the article.

 "A large heterogeneous group of individuals with Cowden-like syndrome, who have various combinations of Cowden syndrome features but who do not meet Cowden syndrome diagnostic criteria, have PTEN mutations less than 10 percent of the time, making molecular diagnosis, prediction, genetic counseling, and risk management challenging."

Other mechanisms of loss of function could result in underexpression of PTEN or of KILLIN, a novel tumor suppressor gene lying right next to PTEN, which may account for the remainder of Cowden syndrome and Cowden-like syndrome.

"In the context of a difficult-to-recognize syndrome, identification of additional cancer predisposition genes would facilitate molecular diagnosis, genotype-specific predictive testing of family members who are as yet clinically unaffected, genetic counseling, and medical management," the authors write.

Included in the objectives of a study conducted by Charis Eng, M.D., Ph.D., of the Cleveland Clinic, and colleagues, was to determine the likelihood of KILLIN as a predisposition gene in patients with Cowden syndrome or Cowden-like syndrome, because of its similar function to PTEN.

The study included analysis of nucleic acids from 123 patients with Cowden syndrome or Cowden-like syndrome and 50 unaffected individuals without PTEN variants, which were genetically analyzed for expression of PTEN and KILLIN from August 2008 - June 2010. Prevalence of cancers between groups was compared.

Among the findings of the researchers was that KILLIN is a predisposition gene for Cowden syndrome and Cowden-like syndrome. Individuals with KILLIN-promoter methylation (turns gene off) had a 3-fold increased prevalence of breast cancer (35/42 vs. 24/64) and a greater than 2-fold increase of kidney cancer (4/45 vs. 6/155) over individuals with germline (the cell line from which egg or sperm cells [gametes] are derived) PTEN mutations.

"By discovering another cancer predisposition gene, we have added to the sensitivity of molecular diagnosis and predictive testing becomes possible. Importantly, genetic counseling and gene-informed risk assessment and management become evidence based," the researchers write. "The current national practice guidelines for individuals with PTEN germline mutations includes heightened surveillance of the female breasts and thyroid, but do not have awareness of renal cancer risk.

If our observations of 2- to 3-fold increased risks of renal and/or breast cancer with KILLIN germline methylation over those of PTEN mutation holds, then extra vigilance for the organs at risk, breast and kidneys, is warranted. The KILLIN-associated breast cancer risks would parallel those conferred by germline BRCAl/2 mutations."

"If these data can be and must be replicated independently, then a hypothetical schema for prioritizing gene testing could be as follows:

(1) individuals with classic Cowden syndrome should be offered PTEN testing first;

(2) those found not to have germline PTEN mutations should then be offered KILLIN epigenetic [affects expression of genes without mutation] analysis, in the setting of genetic counseling; and

(3) individuals with classic Cowden syndrome without germline PTEN mutation (80 percent are mutation-positive) and without KILLIN epigenetic inactivation (half of the 20 percent should have KILLIN epigenetic inactivation) should then be offered SDHB/D [a type of genes] testing (10 percent of the 20 percent should have SDHB/D mutation).

Altogether, therefore, PTEN, KILLIN, and SDHB/D should then account for 92 percent of all classic Cowden syndrome," the authors write.

SOURCE: JAMA and Archives Journals

Drug-like compound stops thyroid overstimulation

Researchers at the National Institutes of Health have identified a compound that prevents overproduction of thyroid hormone, a finding that brings scientists one step closer to improving treatment for Graves' disease.

In Graves' disease, the thyroid gland never stops. Thyroid-stimulating antibodies bind to receptors, activating them to keep the thyroid hormone coming and coming - like a broken traffic light stuck on green - and causing the body problems in regulating energy, controlling other hormones and maintaining cells throughout the body.

 

Attacking the problem at its root cause, lead researcher Susanne Neumann, Ph.D., and her colleagues at the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) have identified a chemical compound that binds to the receptors and acts as an antagonist, keeping the stimulating antibodies from their work and potentially allowing the thyroid cells to revert to normal function.

The findings, published this month in the Journal of Clinical Endocrinology and Metabolism, establish the effect of the receptor antagonist on human thyroid cells. The antagonist has not yet been tested in animals or people and still has multiple steps of toxicology and safety testing before it may be ready for human trials.

Though treatments are available for hyperthyroidism caused by Graves' disease, including surgery, radioactive iodine, and antithyroid drugs, the relapse rates for these treatments are 5 percent, 21 percent and 40 percent, respectively, and each comes with unfavorable side effects.

"Our goal is to develop an easily produced, orally administered, safe and effective drug with few to no side effects that can be used in place of some of the more invasive treatments of hyperthyroidism caused by Graves' disease," said Marvin Gershengorn, M.D., chief of the Laboratory of Endocrinology and Receptor Biology within NIDDK's intramural research program and the senior author on the paper.

Graves' disease is an autoimmune disorder, causing the body's immune system to act against the body's own cells and organs. Graves' disease typically first occurs in people under 40 and affects approximately 1 percent of the U.S. population, with women five to 10 times more likely than men to have Graves' disease.

The newly discovered compound, which is a receptor antagonist, may have the added benefit of helping those with eye problems caused by Graves' disease - called Graves' ophthalmopathy - experienced by more than 25 percent of people with the disease. Eye problems may include painful swelling in the eye sockets, double vision, tears or itchy eyes, and protruding eyes with swollen eyelids that can't be easily shut, increasing the risk for eye diseases. Because the swelling in the eyes is thought to be associated with the same overstimulation of receptors caused by the same thyroid-stimulating antibodies as in the thyroid, the potential thyroid treatment may have the added benefit of treating the eye problems as well.

The Gershengorn team is also at work on the flip side of thyroid regulation. By researching the thyroid-stimulating hormone receptor, they're hoping to use drug-like compounds to stimulate this receptor to treat people with thyroid cancer, who need more stimulation of thyroid cancer cells to increase the efficacy of iodine radiation. They've tested their discovery in mice and hope to perform pre-clinical studies and to develop human trials in the foreseeable future.

More information:

* Go to http://www.endocrine.niddk.nih.gov/pubs/graves/ to learn more about Graves' disease.

* Go to http://jcem.endojournals.org/rep.shtml/   to read the journal abstract.

* Go to http://www.clinicaltrials.gov/   to learn about clinical trials.

The NIDDK, a component of the National Institutes of Health (NIH), conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe and disabling conditions affecting Americans. For more information about the NIDDK and its programs, see www.niddk.nih.gov.

The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit  www.nih.gov.

SOURCE: The National Institutes of Health (NIH)

Understanding Cancer Care Disparities Today

While the United States offers the most advanced cancer treatment in the world, issues of race, culture, demographics, education, economic status, institutional prejudice and discrimination have lent themselves to the reality that not all Americans are offered the same resources for cancer prevention, diagnosis, treatment or follow-up. But in the past decade, cancer disparities in minority and underserved groups have become the focus of many of us in the cancer community.

Many of us acting as patient advocate pioneers in the nonprofit sector and/or medical field have implemented unique programs to improve cancer prevention through health education initiatives, access to care grants and programs, post treatment follow-up education and outreach in our communities and through social media networks. Many of us are very passionate and motivated by our own personal experiences or the experience of friends, family and loved ones.

While much attention has been focused in recent years to federal and state governments that provide nonprofits, medical clinics, hospitals and teaching institutions with annual grants and funding to create programs that assist the indigent with access to care and address the multicultural and psychosocial issues of general health education and cancer prevention the truth is these initiatives are simply not enough and have fallen short again and again from their stated goal -- they have made tremendous progress in their public relations and media image yet continue to "educate" patients "after the fact" and/or provide inadecuate services to their "target market".

In addition, research funded by the government aims to find underlying causes and solutions to overcome the barriers to equal cancer treatment (access to care) for all Americans. The statistics that prompted this funding initiative have been gathered by various entities for a number of years and will continue to be gathered, at the very least, for the next decade. The National Cancer Institute's Center to Reduce Cancer Health Disparities (crchd.nci.nih.gov), created to "reduce the unequal burden of cancer in our society" has gathered statistics showing that while all deaths from cervical cancer are preventable, 4,000 American women died of the disease as early as 2005.

What's more, researchers even know the predominant demographics of these women: African American women in the South, Hispanic women (specially along the Texas-Mexico border), Vietnamese women and Caucasian women in Appalachia and the rural Northeast. These findings should give us some pause for reflection and the clearly profound message the research has unwittingly revealed to us all. This is the United States of America yet we continue selectively ignore to openly discuss the racial divide that exists even in our most basic of human needs and rights, which is preventive healthcare.

Another study found that African American patients are less likely than whites to receive recommended chemotherapy for stage 3 colon cancer. Indeed, an African American man is more likely to die of cancer than his caucasian counterpart despite an overall decline in the rate of death from cancer. African Americans (regardless of sex) experience higher mortality with cancers of the prostrate, colon, breast, cervix and lung than a white patient with a comparable tumor and medical history !

Native Americans, which include more than 560 federally recognized tribes that speak 217 native languages, have the poorest survival rates from all cancers combined than any other ethnic groups here in the United States of America. Similarly, less educated Americans who live in rural areas are less likely to have a family doctor and follow prevention and screening recommendations for the general population.

Statistics for the Hispanic population are equally disappointing. According to data compiled by the Intercultural Cancer Council (http://www.iccnetwork.org/) cervical cancer incidence is two to three times higher in Hispanic women than in white women and only 38 percent of Hispanic women age 40 and older have regular mammograms. While Hispanics represent about 12 percent of the U.S. population, they make up 25% (percent) of the country's uninsured.

According to a report on cancer health disparities commissioned by the Department of Health and Human Services in 2005, minority and underserved populations are more likely to be diagnosed with and die from preventable cancers and be diagnosed with late stage disease for cancers that are detectable through screenings at an early stage !

In addition, these populations receive either no treatment or treatment that does not meet current standard of care practices and die of generally curable cancers because they do not have the benefit of coordinated specialty care early on in their cancer journey. What's more co-existing disorders are often untreated, they don't receive the benefit of adecuate pain management and/or palliative care.

The research in cancer healthcare disparities continues as the healthcare reform debate rages on. It may be many decades years, even decades before we fully understand and address this aspect of our national health crisis but as of today the general consensus is that there are multiple contributors to healthcare disparities ranging from language issues to biases based on cultural or racial differences, the complexity of the current healthcare system combined with the simple economics equated to the number of uninsured in America today versus the cost of effective cancer care.

No matter what you choose to believe as an individual, I, as a cancer survivor, caregiver and patient care advocate - see the issue clearly defined and ever present everydat as one of the simplest things to ignore and "dress-up" behind all the excuses, complicated research and political debate -- it boils down to the almighty dollar and something as basic as free access to community health education programs.

Thyroid Cancer a Concern Decades After Childhood Radiation

When children are exposed to head and neck radiation, whether due to cancer treatment or multiple diagnostic CT scans, the result is an increased risk of thyroid cancer for the next 58 years or longer, according to University of Rochester Medical Center research.

The study is believed to be the longest of any group of children exposed to medical irradiation and followed for thyroid cancer incidence. It was published in the December 2010 edition of the journal, Radiation Research.

The data also might provide some insight about why the rates of thyroid cancer continue to rise, as the general public is increasingly exposed to higher doses of radiation through more frequently used imaging tests such as computed tomography (CT), said lead author Jacob Adams, M.D., M.P.H., an associate professor in the Department of Community and Preventive Medicine at URMC

"Ionizing radiation is a known carcinogen and, in fact, about 1 million CT scans are performed every year on children five years or younger," Adams said. "Although CTs and other imaging tests are an important diagnostic tool and radiotherapy is an important treatment modality for cancer, with everything comes a risk. Our study attempted to measure the very long-term impact on thyroid cancer from medical irradiation. Our findings strongly suggest that those individuals exposed to irradiation from multiple CT scans to the head, neck and chest during early childhood and individuals treated with radiotherapy to the upper body as children have a lifelong increased risk of thyroid cancer."

Adams and colleagues indirectly evaluated the future risks of modern patients by assessing the rates of thyroid cancer in a group that was treated with lower-dose chest radiotherapy in Rochester, N.Y., between 1953 and 1987. The cohort had been treated during infancy for an enlarged thymus, a condition that physicians used to believe was a health problem. None of the radiation administered was for cancer, and thus the research is not confounded by a susceptibility to the disease.

Adams re-surveyed the population between 2004 and 2008, and compared the health status of the group to their siblings who had not received radiation. Thyroid cancer occurred in 50 of the 1,303 irradiated patients compared to only 13 of the 1,768 siblings. The association between radiation and thyroid cancer remained strong even after researchers accounted for other factors that could contribute to thyroid cancer risk.

Radiation doses in the mid-century group overlapped with current medical practices; however, in general, higher doses and less precision were used years ago. Doses at the lower end of the study cohort were comparable to a diagnostic pediatric chest CT given today, the study said. Not surprisingly, researchers found that thyroid cancer risk increased with higher doses of radiation.

The Rochester study confirmed the findings of a pooled review of five earlier population studies, and adds to the literature by showing that, at least in children, the risk of cancer due to radiation exposure continues for a median of 57.5 years.

The James P. Wilmot Cancer Center at URMC and the National Heart Lung and Blood Institute funded the study.

SOURCE: University of Rochester Medical Center

e-Fundraising Magazine Subscription Drive!

It's that time again! Welcome to our e-Fundraising Magazine Subscription Drive, this year you can purchase or renew subscriptions to your favorite magazines and publications (like Women's Health, Shape, Prevention,  TIME,  Sports Illustrated and more) at up to 85% off, or if you prefer you can enjoy exclusive offers on cookie dough, Restaurant.com eCertificates. and much more. 


Each time you make a purchase, Stevie JoEllie's Cancer Care Fund will receive up to 40% of the total sales price as a donation to support thyroid cancer patients and survivors nationwide!

Thyroid Cancer is the fastest increasing newly diagnosed cancer in America today, regardless of age, sex, race or ethnic background. Women are 3 times more likely than men to be diagnosed with thyroid cancer and sadly, childhood cancer survivors are also at an increased risk of developing the condition. They need our help and we need your support.

Don't delay renew your favorite magazine subscriptions today or browse our e-shop. You can also support Stevie JoEllie's Cancer Care Fund by sharing this page and spreading the word to friends and family. We appreciate any help you can provide in helping us reach our fundraising goal.

                   http://www.efundraisingonline.com/steviejoelliescancercarefund

Thank You! 

Thyroid Cancer: Paying for Your Care

There is a high price to pay for thyroid cancer, not only in terms of its side effects, fear, depression, and extreme fatigue, but also in terms of the cost of treatment, which could include the need for hormone replacement therapy and papillary thyroid cancer.

If you've got health insurance, it's time to get familiar with its customer service number and the details of what your plan covers — having insurance often doesn’t mean that every bill will be paid. And if you don't have insurance, you're tasked with finding a way to pay for your thyroid cancer treatment when you may barely have the energy to focus on getting better. Thankfully, there are a number of non-profit organizations to help you find ways to pay for your thyroid cancer care.

Working With Your Insurance Carrier

"In terms of working with insurance companies, many people don't know their insurance company benefits until they are diagnosed with cancer," says Carolyn Messner, DSW, director of education and training at CancerCare in New York.

Though most health care providers will ask questions to make sure that your insurance is accepted and that you have coverage, it's still a good idea to call the insurance company on your own and find out the details. Ask what's covered and what's not and whether you need pre-approval for any treatments, and check back to see that all necessary pre-approvals have come through. You want to know that, if you need them, procedures such ashormone replacement therapy with synthetic thyroid hormone and radioactive iodine treatment are covered and that there won’t be any surprises when the bill comes.

If your insurance company denies a medical procedure, don't assume that you can't appeal the decision and that they won't cover it, says Messner. A good strategy is to go ahead and appeal, and see what the outcome is.

Thyroid Treatment: Linking to Resources

There are many non-profit organizations that help people with cancer — finding support, taking care of their practical needs, or figuring out how to pay for their treatment. Three of the leaders are:

• The American Cancer Society, 1-800-ACS-2345 (1-800-227-2345)
• The National Cancer Institute, 1-800-4-CANCER (1-800-422-6237)
• CancerCare, 1-800-813-HOPE (1-800-813-4673)

"I can't stress enough the importance of connecting with these organizations," says Messner. "This is a whole area of knowledge and information, and you can't know all this when you're first diagnosed.”

These organizations can show you how to navigate the health insurance system and solve problems you may encounter through a wide variety of resources, such as a co-pay foundation to help cover costs that exist even when you have health insurance. Their missions include educating the public about how to find thyroid cancer treatment — procedures and medication — that are free or more affordable if you don't have insurance.

A number of public hospitals will provide care and are increasingly associated with cancer centers,” says Messner. There are also public entitlement programs, like Medicare and Medicaid.

Consider these non-profit organizations your link to cancer services. "They exist to help people get the care they need. People shouldn't think, 'If I don't have coverage, I can't get care' [or] 'I don't know what can be done for me.' We want them to know that a lot can be done,” explains Messner. “We don't want anyone to feel that they are alone."

The Silent Killer: Cancer Care Costs

“All bodies are slow in growth but rapid in decay."  Publius Cornelius Tacitus

The financial costs of cancer are great for both the person with cancer and for society as a whole. In 2009, the National Institutes of Health estimated the 2008 overall annual costs of cancer were as follows:

• Total cost: $228.1 billion
• Direct medical costs (total of all health expenditures): $ 93.2 billion
• Indirect morbidity costs (cost of lost productivity due to illness): $ 18.8 billion
• Indirect mortality costs (cost of lost productivity due to premature death): $116.1 billion

One of the major costs of cancer is cancer treatment. But lack of health insurance and other barriers to health care prevent many Americans from even getting good, basic health care. 

According to the early release estimates from the 2008 National Health Interview Survey: About 24% of Americans aged 18 to 64 had no health insurance for at least part of the past year. About 13% of children in the United States had no health insurance for at least part of the past year. And according to Cancer Facts & Figures 2009, "Individuals with no health insurance and those with Medicaid insurance are more likely to be diagnosed with advanced cancer." This leads to higher medical costs, poorer outcomes, and higher cancer death rates. 

This year, about 562,340 Americans are expected to die of cancer -- that's more than 1,500 people a day. Cancer is the second most common cause of death in the United States, exceeded only by heart disease. Cancer accounts for nearly 1 out of every 4 deaths in the United States. 

Cancer costs billions of dollars. It also costs us the people we love. Reducing barriers to cancer care is critical in the fight to eliminate suffering and death due to cancer. 

References: 
American Cancer Society. Cancer Facts and  Figures 2009. Atlanta, GA. 2009.

Some Mental Health Problems Associated with Thyroid Health Issues

Many women may be unaware of a common health issue that is caused by problems with the thyroid gland. EmpowHer reports that some mental health disorders are caused by a malfunctioning thyroid.

For example, people who are treated for bipolar disorder with lithium can experience symptoms such as depression, fatigue and weight gain, according to Mary Shomon, a thyroid patient advocate and author. However, they may be unaware that these are the symptoms of an underactive thyroid, or hypothyroidism, which is a side-effect of lithium.

Also, hyperthyroidism can cause anxiety or panic attacks, but many people are incorrectly diagnosed with panic disorder.   "It turns out that once their thyroid is properly treated, the panic attacks and the anxiety go away," Shomon told the news source. She added that "there's actually some physicians who consider it a standard practice, before they will put anyone on an antidepressant, to do a complete thyroid evaluation."

According to the Centers for Disease Control and Prevention, treatment for hypothyroidism usually requires the replacement of thyroid hormone by taking a single daily dose of synthetic hormone that is adjusted to produce normal levels.

Hurthle Cell Thyroid Tumor: A Different Type of Thyroid Cancer

Hurthle cell thyroid cancer is usually classified with follicular thyroid cancer, although it really is a distinct kind of tumor. It is an unusual tumor, making up about 4% of thyroid cancers and is only about one-fourth as common as follicular cancers.

• What is a Hurthle Cell?  A Hurthle cell is a kind of thyroid cell which has a distinctive look: under the microscope it is bigger than a follicular cell and has pink-staining cellular material.

• Is the Hurthle Cell Tumor Benign or Malignant?  Like follicular tumors, there are benign Hurthle cell tumors and malignant Hurthle cell tumors, and the pathologist tells the difference between them based on invasion of the capsule and the blood vessels.  Benign Hurthle cell tumors are not a threat at all and should not come back once they are removed.

• How Is Hurthle Cell Cancer Different from Follicular Cancer ? Hurthle cells look different than other types of thyroid cells, and they tend to occur in older patients. The median age is patients with Hurthle cell cancer is 55, about 10 years older than patients with follicular cancer. Like follicular cancer, Hurthle cell thyroid cancer infrequently spreads to lymph nodes (about 10%) but can recur locally (the cancer can come back in the neck) or spread to lung or bone.

Because younger patients with thyroid cancer tend to have a better prognosis than older patients with a very similar tumor, and because Hurthle cell cancers occur in older patients, they have the reputation of being more dangerous. However, if you control for age and other factors like size and initial extent of tumor (whether it has spread locally in the neck or elsewhere in the body), Hurthle cell tumors behave very similarly to follicular tumors. A small Hurthle cell cancer which does not have extensive invasion, especially in a younger patient (under 45), can have an excellent prognosis.

• How Is Hurthle Cell Cancer Treated?  Patients with Hurthle cell thyroid cancer, if there is more than minimal invasion, should generally undergo removal of all or nearly all of their thyroid tissue (see our article on the different types of thyroid surgery). In all areas of well-differentiated thyroid cancer, there is some disagreement about how extensive the surgery should be; however, because Hurthle cell tumors tend to occur in patients with more serious risk factors, the surgery is correspondingly more aggressive. If there are involved lymph nodes, they are removed, although this is uncommon.

Surgery may be followed with radioactive iodine. Radioactive iodine does not work as well for Hurthle cell cancer as it does for follicular cancer, because the Hurthle cells are less likely to "take up" the radioactive iodine and then be destroyed by it. However, it is well-tolerated treatment and may be helpful in some cases. Patients are then followed at regular intervals to check for recurrence, which can be dangerous in Hurthle cell cancer and needs to be watched for carefully.

About the Author: James Norman, MD, FACS, FACE, is recognized as one of world's foremost experts on parathyroid disease and the most experienced thyroid/parathyroid surgeon in the world. He is a Fellow of the American College of Surgeons (FACS) and one of only a handful of surgeons to also be a Fellow of the American College of Endocrinology (FACE). He is recognized as the inventor of minimally invasive radioguided parathyroid surgery in the mid-1990s and is credited with dramatically changing the way parathyroid surgery is performed.

Childhood Radiation Linked to Higher Likelihood of Thyroid Cancer

Research conducted by endocrinologists at the University of Rochester Medical Center has revealed that being exposed to radiation in childhood may increase a person's risk of developing thyroid cancer later in life.

Published in the journal Radiation Research, the study found that children who received low-dose chest radiation treatment for an enlarged thymus grew up to be more than five times more likely to have thyroid cancer.

The study's authors wrote that the enlargement of the thymus, a gland between the lungs that produces immune cells, is rarely considered a medical problem today. However, it was treated as one between the 1950s and the 1980s, when the study's participants received radiotherapy for it.

Even after adjusting their data for age, gender and history of goiter, the team found that childhood radiation therapy increases the risk of thyroid cancer for nearly 60 years after it is administered.

They added that the risk drops off after an individual has lived six decades beyond the original treatment. Lead author Jacob Adams suggested that the use of radiation-based medical scans may be at least partially to blame for the increasing rate of thyroid cancer in the U.S.

He wrote that computer tomography (CT) scans and magnetic resonance images (MRIs) are often used to diagnose medical conditions in young children.  According to the study, more than one million CT scans are taken of children aged 5 or younger every year in the U.S.

"Ionizing radiation is a known carcinogen," Adams said. He and his research team suggested that more attention be paid to the types and amounts of radiation being used to diagnose illnesses in children, even though current MRI and CT technologies use less radiation than earlier versions.

Researchers concluded that diagnostic irradiation of children under 5 should be avoided when possible. Over a lifetime, approximately one in 111 Americans develop some form of thyroid cancer, according to the National Cancer Institute.

Jeff Vereecke Relay for Life Co-Chair Battling Rare Form of Thyroid Cancer

Jeff and Karen Vereecke are the co-chairs of this year's Relay for Life.

Although thyroid cancer has a lower fatality rate than other tumors, there has been a 2.4-fold increase in its occurrence over the past 27 years. The Centers for Disease Control (CDC) reports that this form of cancer is more prevalent in women than men; however, men are still at risk.

For example, Relay for Life co-chair, Jeff Vereecke, has been suffering from complications of the disease since 2006 when he noticed a lump on his neck, The Daily Telegram reports. He went to his doctor, who diagnosed Vereecke with papillary and medullary thyroid cancer. Vereecke is one of the first documented cases of someone who has both types of cancer.

Soon after his diagnosis, Vereecke underwent surgery to remove his thyroid and surrounding lymph nodes. He then received radioactive iodine treatment, which involved taking a pill that destroys thyroid cells in the body. After taking the pills, Vereecke had to isolate himself from his wife and children for a few days due to his radioactivity.

Vereecke and his wife, Karen, have been coping with the disease by participating in Relay for Life, which raises funds for the National Cancer Society. Today, Vereecke is still battling complications related to cancer, as it has spread to his bones.

The CDC reports that both of these cancers may be hereditary, and family members of medullary cancer patients can benefit from getting tested for the gene.

Treatment Options for Thyroid Cancer

Thyroid cancer is like skin cancer in terms of prognosis: most cases are mild and cured easily with surgery, while others are deadly. Approximately 85 percent of thyroid cancer patients are diagnosed with limited disease that requires only surgical removal. The remaining 15 percent have persistent, recurrent, or metastatic disease. The lungs are the most common site for metastases, followed by the bones.

Treatment options depend on the subtype. Reference 1 explains how thyroid cancer can arise by several different pathways. Thyroid tissue contains two main types of cells: follicular cells, which produce iodine-containing hormones, and C cells, which perform support services. There are several genetic mutations by which follicular cells can transform into papillary carcinoma. Different pathways lead to follicular carcinoma. Either of these cancer cell types can transform, by further genetic mutation, into anaplastic carcinoma.

The C cell, on the other hand, can transform into medullary carcinoma. Papillary and follicular carcinomas are called “well differentiated”, and have the best overall prognosis. Medullary carcinoma is less common but more difficult to treat. Anaplastic carcinoma is rare, but is one of the most deadly cancers: the median survival time is less than one year.

After surgery, radioactive iodine can be used to kill well differentiated thyroid cancer cells. Thyroxine treatment is used to suppress thyroid stimulating hormone (TSH) production. This approach does not work for medullary and anaplastic carcinomas, because these cells do not take up iodine to produce the T3 and T4 hormones.

Chemotherapy and external beam radiation therapy are used in some patients, but their success rates are low. Current research is focused on targeted therapy drugs. These drugs are intended to disrupt the function of cancer cells specifically, while leaving healthy cells alone. Several of these have been approved for other cancers and are now being tested on thyroid cancer:

1. Sorafenib (Nexavar), approved for liver and kidney cancer

2. Sunitinib (Sutent), approved for kidney cancer and gastrointestinal stromal tumor

3. Gefitinib (Iressa), approved for non-small cell lung cancer

4. Vorinostat (Zolinza), approved for cutaneous T-cell lymphoma

5. Romidepsin (Istodax), approved for cutaneous T-cell lymphoma

6. Decitabine (Dacogen), approved for myelodysplastic syndromes

Check with your doctor to see what the latest results mean for you.

References:

1. Romagnoli S et al, “Targeted molecular therapies in thyroid carcinoma”, Bras Endocrinol Metab. 2009; 53(9): 1061-73.

2. Pacini F et al, “Targeted therapy in radioiodine refractory thyroid cancer”, Q J Nucl Med Mol Imaging 2009; 53: 520-5.

3. Woyach JA et al, “New therapeutic advances in the management of progressive thyroid cancer”, Endocrine-Related Cancer 2009; 16: 715-31.

SOURCE: Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

Thyroid Cancer Diagnosis Rates: The Facts

The number of people diagnosed with thyroid cancer is growing at an unprecedented rate and medical researchers don’t know why.  Thyroid cancer increased at a rate of 6.5 percent a year from 1997-2006 making it the fastest increasing cancer among women and men, according to recently released National Cancer Institute data. Over that same period, prostate, breast, lung and colon cancer rates decreased. The 2006 data is the most recent data available; the three-year lag represents the time it takes researchers to compile the statistics.

Experts can only speculate about what is causing a change in the thyroid cancer rate.

“We’re all concerned about this increase,” said Dr. Elaine Ron, a senior investigator at the National Cancer Institute. “We have set up a thyroid cancer working group to see what studies we’re already doing on thyroid cancer, what studies can we do to try and find out more about this increase, but at the moment we can’t really tell you.”

The thyroid, a butterfly-shaped gland that sits at the front of the neck just above the breastbone and overlying the windpipe, produces hormones responsible for controlling heart rate, blood pressure, metabolism and childhood growth and development.

There were approximately 410,000 men and women alive in the United States who had a history of thyroid cancer, as of Jan. 1, 2006. The American Cancer Society predicted more than 37,000 new cases of thyroid cancer were diagnosed in 2008, up from about 17,000 in 1999.

The good news is that thyroid cancer is highly treatable. The mortality rate has remained stable at .5 percent per year meaning about 1,500 people die annually from thyroid cancer.

As the reports of thyroid cancer increased over the past two decades, some experts said the increase was simply because of better diagnostic procedures. For instance, detection methods such as ultrasonography now allow doctors to diagnose thyroid cancer nodules smaller than 1 centimeter.

In their Journal of the American Medical Association article published on May 10, 2006, Dr. Louise Davies and Dr. H. Gilbert Welch wrote the detection of more “subclinical disease,” skewed the thyroid cancer rate. They wrote the increasing rate was “not an increase in the true occurrence of thyroid cancer,” but rather better detection allowed doctors to diagnose cancer that previously would have gone undetected.

Fast forward three years – new research proves there is more to the story than better detection.

More than better detection

Dr. Kenneth Burman, the chief of Endocrinology at the Washington Hospital Center and the current president of the American Thyroid Association, said his understanding and best guess is the increased frequency of thyroid cancer may be in large part related to detection, but it also represents some type of biologic change in the disease prevalence.

“Whether those represent environmental factors, such as radiation exposure, or genetic factors, no one knows,” Burman said. A new study analyzing National Cancer Institute data proves some unknown factor is contributing to the increasing rate of thyroid cancer. "It’s not just improved medical surveillance and diagnosis,” Ron said.

She came to that conclusion based on her review of the Institute’s Surveillance Epidemiology and End Results data. The data includes information on cancer incidence, mortality, survival, prevalence and lifetime risk statistics as well as the type and size of tumors reported.

The study focused on papillary cancer – the most common type of thyroid cancer – because that’s the type of tumor experts say is increasing consistently among all racial and ethnic groups.

“We’re seeing an increase in the larger tumors and also in tumors of regional stage, so it’s not just the very small, early tumors,” Ron said.

The increase in the number of tumors larger than 2 centimeters, and even 5 centimeters, suggests there is more to the increasing rate than better diagnostic procedures.

According to Ron, local stage and smaller tumors are generally picked up during image screening. In contrast, regional stage and larger tumors are generally diagnosed clinically during a physical exam of the neck.

Because of the increase in larger tumors, image screening can no longer be pointed to as the sole reason more thyroid cancers are being reported, Ron said.

The study – authored by researchers from the Institute, Walter Reed Medical Center and Brooke Army Medical Center – was published in the March issue of Cancer Epidemiology and Biomarkers and Prevention. Ron’s team analyzed data from 1980 to 2005.

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Stevie JoEllie's Cancer Care Fund is working to develop and launch an access to care grant program for thyroid cancer patients and survivors nationwide. Please consider supporting our unique initiative that includes a set aside fund for healthcare access to assist thyroid cancer survivors with medical costs associated with follow up treatment, annual exams,  diagnostics and medications. 

SJCCFThyNet is a project of United Charitable Programs Inc., a 501(c) 3 Public Charity and as such all donations are tax deductible as allowed by law. 

[One time and recurring donations are fast and easy to set up.]

Financial Assistance and Other Resources for Thyroid Cancer Patients

Cancer imposes heavy economic burdens on both patients and their families. For many people, a portion of medical expenses is paid by their health insurance plan. For individuals who do not have health insurance or who need financial assistance to cover health care costs, resources are available, including Government-sponsored programs and services supported by nonprofit organizations. Cancer patients and their families should discuss any concerns they may have about health care costs with their physician, medical social worker, or the business office of their hospital or clinic.

Listed below are Government agencies, organizations, and programs that are designed to provide assistance for cancer patients and their families. However, resources provided by individual organizations vary, and it is important to check with a specific group to determine if financial aid is currently available. Organizations that provide publications in Spanish or have Spanish-speaking staff have been identified. This fact sheet is divided into four sections: Cancer Treatment, Practical Needs, Other Resources, and International Resources.

CANCER TREATMENT

• Hill-Burton: A program through which hospitals receive construction and modernization funds from the Federal Government. Hospitals that receive Hill-Burton funds are required by law to provide a reasonable volume of services to people who cannot afford to pay for their hospitalization and make their services available to all residents in the facility’s area. Information about Hill-Burton facilities is available by calling the toll-free number or visiting the Web site shown below. A brochure about the program is available in Spanish. Telephone: 1–800–638–0742 (Maryland residents call 1–800–492–0359)Website:http://www.hrsa.gov/hillburton/default.htm

• Medicaid (Medical Assistance): A jointly funded, Federal-State and State health insurance program for people who need financial assistance for medical expenses, is coordinated by the Centers for Medicare & Medicaid Services (CMS). At a minimum, states must provide home care services to people who receive Federal income assistance such as Social Security Income and Aid to Families with Dependent Children. Medicaid coverage includes part-time nursing, home care aide services, and medical supplies and equipment.
  
  
  Information about coverage is available from local state welfare offices, state health departments, state social services agencies, or the state Medicaid office. Check the local telephone directory for the number to call. Information about specific state contacts is also available on the Web site listed below. Spanish-speaking staff are available in some offices. Telephone: 1–877–267–2323 Website: http://www.cms.gov/medicaid/consumer.asp

• Medicare A: Federal health insurance program also administered by the CMS. Eligible individuals include those who are 65 or older, people of any age with permanent kidney failure, and disabled people under age 65. Medicare is divided into two parts, Part A and Part B. Part A pays for hospital care, home health care, hospice care, and care in Medicare-certified nursing facilities. Part B covers medically necessary services, including diagnostic studies, physicians' services, durable home medical equipment, and ambulance transportation; Part B also covers screening exams for several types of cancer. To receive information on eligibility, explanations of coverage, and related publications, call Medicare at the number listed below or visit their Web site. Some publications are available in Spanish. Spanish-speaking staff are available. 
  
  
  Telephone: 1–800–633–4227 
  Website: http://www.medicare.gov/ 

• The State Children's Health Insurance Program (SCHIP): Federal-State partnership that offers low-cost or free health insurance coverage to uninsured infants, children, and teens. Callers will be referred to the program in their state for further information about what the program covers, who is eligible, and the minimum qualifications. In most states, uninsured children age 18 and younger whose families earn up to $34,100 a year (for a family of four) are eligible. For a list of health insurance coverage and eligibility by state, go to http://www.insurekidsnow.gov/states.asp 
  
  
  Telephone: 1–877–543–7669 
  Website: http://www.insurekidsnow.gov/

• The Veterans Administration (VA) Provides eligible veterans with treatment for service-connected injuries and other medical conditions. The VA offers limited medical benefits to family members of eligible veterans. The VA cancer program provides users of the veterans health care system easy access to cancer prevention, detection, and treatment services. Its Web site offers cancer facts, information about care, a list of VA-designated comprehensive cancer centers, and the VA's national cancer strategy. For more information about the VA cancer program, visit the VA Cancer Web page at http://www1.va.gov/cancer/index.cfm on the Internet. Some publications are available in Spanish. Spanish-speaking staff are available in some offices. 
  
  
  Telephone: 1–877–222–8387 (1–877–222–VETS) TTY: 1–800–829–4833 
  Website: http://www1.va.gov/health/

• CancerCare: A national nonprofit agency that offers free support, information, financial assistance, and practical help to people with cancer and their loved ones. Financial assistance is given in the form of limited grants for certain treatment expenses. Services are provided by oncology social workers and are available in person, over the telephone, and through the agency's Web site. CancerCare's reach also extends to professionals—providing education, information, and assistance. A section of the CancerCare Web site and some publications are available in Spanish, and staff can respond to calls and e-mails in Spanish. Information about financial assistance for all cancers is available at
  http://www.cancercare.org/get_help/assistance/cc_financial.php 
  
  
  Telephone: 1–800–813–4673 (1–800–813–HOPE) 
  Website: http://www.cancercare.org/

• NeedyMedsA 501(3)(c) nonprofit organization with the mission of helping people who cannot afford medicine or health care costs. The information at NeedyMeds can be obtained anonymously and is free of charge. NeedyMeds is an information source similar to the Yellow Pages; it does not supply medications or financial assistance, but helps people find assistance programs and other available resources. 

          Website: http://www.needymeds.com/

• The Patient Advocate Foundation (PAF) provides education, legal counseling, and referrals to cancer patients and survivors concerning managed care, insurance, financial issues, job discrimination, and debt crisis matters. The PAF also conducts outreach to African American and Hispanic/Latino American populations. 
  
  
  Telephone: 1–800–532–5274 
  Website: http://www.patientadvocate.org/

• The Co-Pay Relief Program provides limited payment assistance for medicine to insured patients who financially and medically qualify. 
  
  
  Telephone: 1–866–512–3861. 
  Website: http://www.copays.org/ 

• Patient Assistance Programs are offered by some pharmaceutical manufacturers to help pay for medications. To learn whether a specific drug might be available at reduced cost through such a program, talk with a physician or a medical social worker or visit the drug manufacturer's Web site. Most pharmaceutical companies will have a section titled “patient assistance programs” on their Web site.

WHAT ABOUT PRACTICAL NEEDS?

In addition to cancer treatments, many cancer patients need assistance paying for transportation to and from medical appointments and basic living expenses such as food and housing. Listed below are organizations dedicated to helping cancer patients and their families during and after the patient's treatment.

• Eldercare Locator is a referral service provided by the U.S. Administration on Aging, an agency within the U.S. Department of Health and Human Services. Eldercare Locator information specialists will link callers with state and area agencies on aging for information and referral to local agencies that provide a wide array of senior services. This service is available Monday through Friday from 9:00 a.m. to 8:00 p.m., Eastern time. 
  
  
  Telephone: 1–800–677–1116 
  Website: http://www.eldercare.gov/Eldercare/Public/Home.asp

• GovBenefits.gov is a partnership of Federal agencies with a shared vision to provide improved, personalized access to government assistance programs. This Web site's online screening tool is free, easy-to-use, and completely confidential. The user answers a series of questions, then the Web site generates a list of government benefit programs that the user may be eligible to receive, along with information about how the user can apply.
  
  
  Telephone: 1–800–333–4636 (1–800–FED–INFO)
  Website: http://www.govbenefits.gov/govbenefits

• The Social Security Administration (SSA) is the Government agency that oversees Social Security and Supplemental Security Income. Social Security provides monthly income for eligible elderly and disabled individuals. More information about these and other SSA programs is available by calling the toll-free number listed below. Spanish-speaking staff are available. Additional contact information for the SSA is available at http://www.ssa.gov/reach.htm on the Internet. 
  
  
  Telephone: 1–800–772–1213 TTY: 1–800–325–0778 
  Website: http://www.ssa.gov/

• Supplemental Security Income (SSI) is administered by the SSA and supplements Social Security payments for aged, blind, and disabled people with little or no income. It provides cash to meet basic needs for food, clothing, and shelter. Information on eligibility, coverage, and how to file a claim is available from the SSA. 
  
  
  The Benefit Eligibility Screening Tool:   https://s044a90.ssa.gov/apps7/best/benefits/ 
  Website: http://www.socialsecurity.gov/ssi

• The American Cancer Society (ACS) offers programs that help cancer patients, family members, and friends cope with the treatment decisions and emotional challenges they face. Information is also available in spanish> 
  
  
  Telephone: 1–800–227–2345 (1–800–ACS–2345) TTY:1–866–228–4327 
  Website :http://www.cancer.org/

• The Health Insurance Assistance Service (HIAS/ACS) aids cancer patients who have lost or are in danger of losing their health care coverage, along with identifying policy solutions to help others in similar situations. The service, a joint effort of the ACS and the Georgetown University Health Policy Institute, connects cancer patients who call the ACS cancer information number with health insurance specialists who work to address their needs.

• Hope Lodge, a temporary housing program supported by ACS, provides free, temporary housing facilities for cancer patients who are undergoing treatment. For more information about this program, or to find locations of Hope Lodges, call the ACS's toll-free number above or http://www.cancer.org/docroot/SHR/content/SHR2.1xHopeLodge.asp .

• The Road to Recovery is an ACS service program that provides transportation for cancer patients to their treatments and home again. Transportation is provided according to the needs and available resources in the community and can be arranged by calling the toll-free number or by contacting the local ACS office.

• The ACS offers Taking Charge of Money Matters , a workshop for people with cancer and their loved ones about financial concerns that may arise during or after cancer treatment, regardless of the person's health insurance coverage. The session provides an opportunity to discuss financial matters with guest speakers who are knowledgeable about financial planning. More information about this workshop is available on their Website 
  
  http://www.cancer.org/docroot/SHR/content/SHR2.1xTakingChargeofMoneyMatters.asp

• The ACS's "tlc" Tender Loving Care® publication contains helpful articles and information, including products for women coping with cancer or any cancer treatment that causes hair loss. Products include wigs, hairpieces, breast forms, prostheses, bras, hats, turbans, swimwear, and helpful accessories at the lowest possible prices. The publication strives to help women facing cancer treatment cope with the appearance-related side effects of cancer. 
  
  Telephone:1–800–296–1217 
  Website: http://www.patienttravel.org/

• CancerCare operates the AVONCares Program for Medically Underserved Women, in partnership with the Avon Foundation. This program provides financial assistance to low-income, under- and uninsured, underserved women throughout the country who need supportive services (transportation, child care, and home care) related to the treatment of breast and cervical cancers. 
  
  
  Telephone: 1–800–813–4673 (1–800–813–HOPE) 
  Website: http://www.cancercare.org/

• The LIVESTRONG™ SurvivorCare partnership between CancerCare and the Lance Armstrong Foundation provides financial assistance to cancer survivors. For patients who are 6 months post-treatment with no evidence of disease, limited financial assistance is available for transportation to follow-up appointments, medical copays, cancer-related medications, and neuropsychological evaluation 
  
  
  Telephone: 1– 866–235–7205 
  Websites: http://www.cancercare.org/http://www.livestrong.org/

• The National Patient Travel Helpline provides information about all forms of charitable, long-distance medical air transportation and provides referrals to all appropriate sources of help available in the national charitable medical air transportation network. 
  
  
  Telephone: 1–800–296–1217 
  Website: http://www.patienttravel.org/

• Ronald McDonald Houses, supported by Ronald McDonald House Charities, provide a "home away from home" for families of seriously ill children receiving treatment at nearby hospitals. Ronald McDonald Houses are temporary residences near the medical facility, where family members can sleep, eat, relax, and find support from other families in similar situations. In return, families are asked to make a donation ranging on average from $5 to $20 per day, but if that isn't possible, their stay is free. To search for a Ronald McDonald House location, go to http://www.rmhc.org/search_cm 
  
  
  Telephone: 630–623–7048 
  Website: http://www.rmhc.com/

OTHER RESOURCES

In addition to the Government-sponsored programs and organizations already listed, these general resources may also be helpful:

The Health Resources and Services Administration's (HRSA) Bureau of Primary Health Care offers Health Centers that provide health care to low-income and other vulnerable populations. Health Centers care for people regardless of their ability to pay. They provide primary and preventive health care, as well as services such as transportation and translation. To locate a Health Center, visit the "Service Delivery Sites" Web page at http://ask.hrsa.gov/pc/ on the Internet.

Some nonprofit community hospitals are able to provide care for patients in need of financial assistance. Other hospitals have indigent or charity care programs funded by state and local governments. For information about these programs, contact a hospital social worker, who will be able to explain these types of programs. Another type of assistance may be offered through your local health department. The National Cancer Institute's (NCI) Cancer Information Service may be able to provide information about local programs by phone at 1–800–4–CANCER. The NCI is a component of the National Institutes of Health.

State and local social services agencies can provide help with food, housing, prescription drugs, transportation, and other medical expenses for those who are not eligible for other programs. Information can be obtained by contacting your state or local agency; this number is found in the local telephone directory.

The Internal Revenue Service (IRS) can provide information about tax deductions for medical costs that are not covered by insurance policies. For example, tax deductible expenses might include mileage for trips to and from medical appointments, out-of-pocket costs for treatment, prescription drugs or equipment, and the cost of meals during lengthy medical visits.

Deductible-qualified medical expenses include those incurred by the patient, spouse, and dependents. Medical expenses may also be deducted for someone who would have qualified as a dependent for the purpose of taking personal exemptions except that the person did not meet the gross income or joint return test. Nursing home expenses are allowable as medical expenses in certain instances. If the patient, a spouse, or dependent is in a nursing home, and the primary reason for being there is for medical care, the entire cost, including meals and lodging, is a medical expense. The local IRS office, tax consultants, or certified public accountants can determine whether medical costs are tax deductible. 


Telephone: 1–800–829–1040 
Website: http://www.irs.gov/

Community voluntary agencies and service organizations such as the United Way of America , Salvation Army, Lutheran Social Services, Jewish Social Services, and Catholic Charities may offer help. These organizations are listed in your local phone directory. Some churches and synagogues may provide financial help or services to their members.