The Complexity of Caregiving
- UFC Fighter Philip Rowe, 32, is set to fight next during UFC Fight Night on ESPN this Saturday. And though he’s focused on his game, his main concern is his mother’s health. Earlier this year, she wqas diagnosed with both multiple myeloma and breast cancer.
- Pastor Tom Evans of the Brick Presbyterian Church says caregivers should “remember that you can’t care for someone else properly unless you’re strong. So don’t hesitate to find those times.”
- Multiple myeloma is a blood cancer involving plasma cells – a certain kind of mature white blood cell in the bone marrow that helps fight infection. This cancer can lead to things like fatigue, bone fractures and kidney damage.
- There are many treatment options for people with breast cancer, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
Rowe’s newt fight will go down on Saturday night as a part of UFC Fight Night on ESPN. His opponent will be Niko Price who’s a veteran fighter returning to the ring after more than a year off for knee surgery.Read More
A UFC Fighter Turned Cancer CaregiverAnd getting home is so important to Rowe because that’s where his mother is facing a fight of her own. She was diagnosed with multiple myeloma and breast cancer earlier this year, just weeks apart. She’s been being treated separately for both diseases. Last week, Rowe shared that her multiple myeloma was under control.
And now, she’s waiting for PET scan results to see if her cancer is in remission after completing her last treatment of this round of chemotherapy earlier this month.
“I fight, no matter what,” Rowe said of his commitment to fight while caregiving for his mother. “I’ve trained every day for the past 11 years. Every day I clock in and clock out. I’m blessed to do what I do and be good at it. But I know how minuscule this is compared to my other obligations to my family.”
The Complexity of Caregiving
When you take on a caregiving role like Philip Rowe, there’s a lot that can fall on your plate. It’s important to understand your loved one’s diagnosis and help them follow the instructions from the cancer-care team.
“I encourage caregivers to come in to visits with my patients, because in that way, the caregiver is also listening to the recommendations — what should be done in between these visits, any changes in treatment plans, any toxicities [side effects] that we need to look out for, changes in dietary habits, exercise, etc.,” Dr. Jayanthi Lea, a gynecologic oncologist at UT Southwestern Medical Center, previously told SurvivorNet.
That being said, it’s natural that filling this role can bring up a whole host of emotions.
Tom Evans, a pastor of the Brick Presbyterian Church located in the Carnegie Hill neighborhood of New York City, previously spoke with SurvivorNet about the complexity of caregiving.
“When you find yourself suddenly having to care for somebody, to be the primary lifeline for them, you very well could have mixed emotions,” he said. “Maybe it’s anger. Maybe this person never cared for you in the past, and now you have to do it for them. And maybe you’re gonna feel like you’re selfish when you need a break.”
But Evans wants caregivers to prioritize their own wellbeing too and remind people filling this role that no one can be a caregiver 24/7.
“It’ll break anybody,” Evans said. “Just remember that you can’t care for someone else properly unless you’re strong. So, don’t hesitate to find those times.”
He also added that caregivers need to find time away from caregiving and even find time for others to help them. They also should, in his opinion, make sure the emotions they feel throughout their caregiving journey are being heard.
“In those frustrations and that anger, take time to find someone to express that to,” he said. “Whether it’s a friend, whether it’s a pastor, whether it’s a neighbor, because as you work that out of your system, you’ll be better, able to be there for them.”
Understanding Multiple Myeloma
Now that we’ve discussed the complexity of caregiving, let’s learn more about the cancer Philip Rowe’s mother is fighting – multiple myeloma.
Multiple myeloma is a type of blood cancer involving plasma cells – a certain kind of mature white blood cell in the bone marrow that helps fight infection by producing proteins that help your immune system fend itself against germs. So, in order to understand multiple myeloma, it’s important to talk about the bone marrow.
“The bone marrow is the factory that makes all of the cells that wind up in our bloodstream,” Dr. Mikkael Sekeres, the chief of the Division of Hematology at the University of Miami Sylvester Comprehensive Cancer Center, previously told SurvivorNet.
The bone marrow makes red blood cells which bring oxygen to our tissues, white blood cells which fight infections and platelets which help stop bleeding. For people with multiple myeloma, cancerous plasma cells, or myelomas, grow uncontrollably in the bone marrow and crowd out healthy white blood cells. This, in turn, inhibits the immune system’s ability to fight off infection which leads to fatigue.
Eventually, the myelomas grow too large in the bone marrow which can cause bone fractures. Myelomas can also lead to kidney damage because these cancerous cells release abnormally high levels of antibodies into the bloodstream which eventually build up in the kidney since its unable to process these extra proteins.
University of California at San Francisco hematologist-oncologist Dr. Nina Shah says cases of multiple myeloma can be grouped into categories that help physicians decide on the appropriate courses of treatment.
“We tend to [divide them] based on how risky the myeloma is, whereas other cancers will be staged based on how far the cancer has spread,” Dr. Shah previously told SurvivorNet.
The three stages of myeloma include the following:
- High risk multiple myeloma – when a patient’s cells contain missing segments of DNA or switched segments.
- Intermediate risk multiple myeloma – when some of these DNA changes are not present but a patient has elevated levels of certain proteins in the blood.
- Low risk multiple myeloma – when a patient has none of these changes.
Technically, there is no cure for this disease, but recent advances in medicine have made room for hope – especially with early diagnoses.
“This is still considered an incurable disease,” Dr. Shah said. “But we want to make sure we make people understand that it’s a disease that you can live with – not necessarily have to die of.”
Learning about Breast Cancer
Now that we’ve discussed multiple myeloma, let’s talk about breast cancer.
Breast cancer is a common cancer that has been the subject of much research. Many women develop breast cancer every year, but men can develop this cancer too – though it is much more rare, in part, due to the simple fact that they have less breast tissue.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
It’s important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer. Regardless, you should always speak with a doctor promptly if anything ever feels off or you’re experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
It’s also important to be on top of self breast exams. If you ever feel a lump in your breast, you should be vigilant and speak with your doctor right away. Voicing your concerns as soon as you have them can lead to earlier cancer detection which, in turn, can lead to better outcomes.
There are many treatment options for people with this disease, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
“These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells,” Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet.
One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.