EIRMC honoring cancer patients with tree lighting ceremony

Courtesy Coleen Niemann, Eastern Idaho Regional Medical Center

IDAHO FALLS – Eastern Idaho Regional Medical Center is holding their second annual Tree of Hope Lighting Ceremony on Thursday, Dec. 6 starting at 5 p.m. at the Idaho Cancer Center.

The event is meant to celebrate the lives of people who have suffered from cancer and encourage those who are still suffering by decorating a Christmas tree ornament.

“You can decorate for yourself, or you can decorate in honor of someone else,” said Coleen Niemann, director of marketing and community relations at EIRMC. “Anyone who wants to remember someone they may have lost to cancer, or even be inspired because they’re still battling cancer, can decorate an ornament.”

At 6:30 p.m., radiation oncologist Daniel Miller will discuss the meaning behind the lighted tree and how it relates to people who have died of cancer. Then the ornaments will be added and lights will be turned on the tree.

The event is free and refreshments will be provided.

[“source=medicalnewstoday]

GI Cancer Treatment Continues to Evolve, But Unmet Needs Remain

Cathy Eng, MD
Cathy Eng, MD

A number of unmet needs have been addressed in the gastrointestinal (GI) cancer space, but there are still large patient populations who rely on traditional treatment regimens, said Cathy Eng, MD.

For example, in colorectal cancer (CRC), immunotherapy has had a significant impact in patients who have microsatellite instability-high (MSI-H) tumors. However, the vast majority of patients who are microsatellite stable (MSS) are still treated with chemotherapy, noted Eng, a professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center.

Targeted agents, such as regorafenib (Stivarga), have made headway in the CRC paradigm. In the ReDOS study, investigators evaluated a dose-escalation strategy of regorafenib beginning at 80 mg and ending at 160 mg for previously treated patients with metastatic CRC.

Positive overall survival and progression-free survival data from ReDOS led to the recommendation of a starting dose of 80 mg/daily on days 1 to 7, escalating to 120 mg/daily on days 8 to 14, and concluding with 160 mg/daily on days 15 to 21. From there, subsequent cycles should comprise 160 mg of regorafenib on days 1 to 21 every 28 days, according to the National Comprehensive Cancer Network guidelines.

“This dosing strategy is something that academic physicians have been doing for a while, it just had not been in the FDA insert,” said Eng. “The ReDOS trial was conducted basically to confirm what we all had already been doing.”

In an interview with OncLive, Eng shared insight on the current paradigm of GI cancers, specifically sharing insight on CRC and hepatocellular carcinoma (HCC).

OncLive: How has immunotherapy impacted CRC treatment?

Eng: Immunotherapy has only affected a very small patient population. These are patients who have MSI-H tumors and who either have an inherited form of colon cancer or have hypermethylation due to somatic mutations. MSI-H is not the only biomarker for immune response, but these patients have a high mutational burden, and that is why they respond to this type of treatment.

The take-home message here is that MSI status is really agnostic, meaning it should be tested in all patients—not just patients with CRC or those who clinicians think may have Lynch syndrome.

What is the optimal treatment sequence for patients with CRC who have MSS tumors?

Nothing much has changed for them, unfortunately. The reality is that if they have MSS tumors, immunotherapy is not an option and the standard regimens remain. There is a greater recognition now that more patients can utilize FOLFOXIRI as part of their regimen because that has been found to result in high response rates and longer PFS. Could you speak to the ReDOS study and how it led to a new dosing standard for regorafenib in this patient population? The ReDOS study was conducted basically to confirm what we all had already been doing. The dosing strategy allows the patient to tolerate the treatment better. If you give regorafenib at the full dose, patients tend to develop what is called hand-foot-skin reaction within the first 2 months. This is more of a quality of life issue than anything else.

What are some other promising agents that are emerging in the CRC pipeline?

Larotrectinib (Vitrakvi) is one that has some promise. [Data on the agent] was previously published, and some data were recently reported at the 2018 ESMO Congress. It is kind of a unique drug because it targets a very rare fusion called TRK. Larotrectinib is a very selective oral agent because these fusions appear in less than 1% of patients, but we are seeing that when there is benefit with this drug, there is significant benefit. The drug also has very little toxicity. Therefore, like MSI-H, TRK is something that should be tested for in all patients.

The study that was presented at the 2018 ESMO Congress and reported in the New England Journal of Medicine has been very intriguing and they are adding more patients to it. The study is widespread across different tumor types.

What are your thoughts on TAS-102?

It is like regorafenib where it is currently being used in the refractory setting. Researchers are exploring it with different combinations in different GI cancers. We will see if this drug can be moved to an earlier setting as well.

What is the biggest unmet need in CRC or other GI cancers?

The biggest unmet need is still the average patients who have MSS tumors, specifically the ones with RAS mutations. This a run-of-the-mill patient population that needs to be addressed now. We seem to have more treatment options for the rarer patient populations.

Overall, what has been the biggest breakthrough in the GI cancer space in the past year?

It would probably be the fact that there are now several up-and-coming treatment options for patients with HCC, a malignancy for which there were not many options available in the past. Now, it has gotten to a point where there are so many different agents that researchers are going to have to look at sequencing strategies. There is going to be a big decision-making process for physicians who treat those patients.

Was there anything specific that led to the explosion of positive trials in HCC?

I don’t know if there is a true answer to that. The reality is that there are now several pharmaceutical companies that have put an interest in HCC. Many people felt like it was a lost cause for quite a bit. Now, they are realizing that it is an issue that needs to be addressed because HCC has a high incidence rate; it is also a global issue. This is a theme that we are seeing in many other cancer types.

[“source=medicalnewstoday]

Immunotherapy keeps some advanced head and neck cancer patients alive for over three years

Image result for Immunotherapy keeps some advanced head and neck cancer patients alive for over three years

A new immunotherapy can greatly extend the lives of a proportion of people with advanced head and neck cancer, with some living for three years or more, a major new clinical trial reports.

Overall, the drug pembrolizumab had significant benefits for patients, with 37 per cent of patients who received it surviving for a year or more, compared with only 26.5 per cent of those on standard care.

But the results were particularly exciting among the group of people who did respond to pembrolizumab – with a median length of response of 18.4 months, compared with five months for standard care.

The large international clinical trial was led by a team at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, and involved 97 medical centres in 20 countries.

The trial was sponsored and funded by Merck & Co., Inc., known as MSD outside the United States and Canada, and the results are published in The Lancet today (Friday).

The drug was evaluated in a trial of nearly 500 patients with very advanced head and neck cancer that had spread around the body and had already become resistant to platinum chemotherapy, the first-line treatment for the disease. Some 247 patients were randomised to pembrolizumab and 248 to standard of care – chemotherapy or the targeted agent cetuximab.

When chemotherapy or targeted therapies stop working, treatment options for people with advanced head and neck cancer are limited, and they are normally expected to survive for less than six months.

Patients on the trial who received pembrolizumab survived for a median of 8.4 months with pembrolizumab, and 6.9 months with standard treatment.

But a minority of patients responded extremely well to pembrolizumab – 36 patients saw their cancer partially or completely disappear, and some are still cancer free three years after first receiving the drug.

Pembrolizumab also caused fewer serious side-effects than currently approved drugs – 13 per cent of people who received the immunotherapy experienced serious side-effects, compared with 36 per cent of people given standard treatment.

Researchers at The Institute of Cancer Research (ICR) and The Royal Marsden hope pembrolizumab could be a much needed smarter, kinder treatment option for people with advanced head and neck cancer.

Pembrolizumab works by taking the brakes off the immune system’s ability to attack cancer cells, and is already approved for use in some people with lung cancer, skin cancer and lymphoma.

Professor Kevin Harrington, Professor of Biological Cancer Therapies at The Institute of Cancer Research, London, and Consultant at The Royal Marsden NHS Foundation Trust, said:

“Head and neck cancer is extremely hard to treat once it comes back or spreads, and the outlook for patients once other therapies have stopped working is very poor.

“Our findings show that the immunotherapy pembrolizumab extends the life of people with advanced head and neck cancer overall, and in a group of patients has really dramatic benefits. It is also a much kinder treatment than those currently approved.

“I would like to see pembrolizumab approved for use in the clinic, so that people with advanced head and neck cancer can be offered the chance of a longer life and improved quality of life. There is also an urgent need to work out how we can identify in advance which patients are likely to benefit, given that some of these people may do much better than they do on standard treatment.”

Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said:

“Immunotherapies are already revolutionising treatment for several cancer types, and I am excited to see the new drug pembrolizumab now showing benefit in advanced head and neck cancer.

“The next big challenge is to design immunotherapies that can work for many more people, so that more patients can benefit from the kinds of dramatic responses that we saw in some patients in this trial.”

Derek Kitcherside, 69, is alive and well after two years of treatment on the pembrolizumab trial at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. He said:

“I was first diagnosed with cancer of the larynx back in 2011 but quickly went into remission after having standard treatments. I went back to enjoying my retirement, until I started having symptoms again, like coughing up blood, in January 2014. I thought it was the reoccurrence of the same cancer, but it turned out three or four tumours had spread to my right lung. I was told I had squamous cell carcinomas of the head and neck, which was inoperable and probably incurable.

“The standard treatments of radiotherapy and chemotherapy weren’t really doing much for me this time around. My tumours were still getting larger and I was told there wasn’t much more the doctors could do.

“I was really lucky to get a place on The Royal Marsden’s pembrolizumab trial and started treatment in May 2015. I travelled down from Leicester every three weeks for two years. My tumour was shrinking all the time and I felt a bit better every time I went – it made a huge difference to my life and I was able to return to normality.

“Now I have CT scans every nine weeks, which are still showing stable disease and slight tumour shrinkage each time. It’s remarkable how I’ve responded to the drug and I don’t think I’d be here without it.”

[“source=medicalnewstoday]

Four out of five prostate cancer patients in Ireland showed no symptoms when they were diagnosed, new research shows

Prostate cancer is the most common cancer affecting men. Stock photo: Getty

Four out of five Irish men with prostate cancer showed no symptoms when they were diagnosed with the disease, according to new research.

The research funded by the health charity, The Movember Foundation, looked at 4,800 patients who were diagnosed with the disease in 2016 and 2017.

The study, carried out by the Irish Prostate Cancer Outcomes Research (IPCOR) group calls on men, especially those over the age of 45, to speak to their doctor about their prostate health.

The report also found that 1 in 5 men diagnosed with prostate cancer are under the age of 60, which conflicts with general perception that the disease affects men of an older age, further highlighting the importance of men receiving regular health checks.

Two thirds of patients were registered as being under 70, and two out of five are under 65.

The study also found significant differences in waiting times for diagnosis between the public and private health systems.

The report found a 24-day delay in receiving a biopsy in the public healthcare system compared to the private system (32 days vs 56 days).

Patients wait an extra 30 days to learn of the results (55 days vs 85 days) with the report’s author noting delays in access to MRI imaging as a possible contributing factor.

MRI imaging is considered important in performing an accurate biopsy. Those in private hospitals were three times more likely to access a MRI scan before their biopsy, which improves diagnosis and may reduce the need for further biopsies.

Commenting on the findings  Dr David Galvin, IPCOR Principal Investigator and Consultant Urologist, said: “The report’s findings show how important it is for men to have a conversation with their doctor about their prostate health.

“Generally, prostate cancer only causes symptoms when it becomes advanced. The best chance we have to treat and cure the disease, is to catch the cancer early, before symptoms develop. Therefore, we would encourage men from the age of forty-five to speak to their doctor about their prostate health.

“We want the findings in this years’ report to be a catalyst to enhance prostate cancer care, improve patient experience and maximise quality of life for men diagnosed with prostate cancer in Ireland.”

Cancer treatment facilities scanty

Motaleb Hossain turned up at the National Institute of Cancer Research and Hospital (NICRH) in the capital in October last year after he was diagnosed with lung cancer.

His cancer was in stage two, but with only six radiation machines, the hospital could not provide him with immediate radiotherapy as a large number of patients were already in queue.

Doctors advised him to return to the country’s lone specialised cancer hospital after two months.

Motaleb, 56, a businessman from Jhalakathi, returned to the NICHR and got himself admitted on January 12. He was scheduled to get the first radiotherapy on January 14, but died the day before, according to hospital documents obtained from his family.

His experience with the NICHR is not an isolated case.

About 650 patients visit the state-run hospital every day but a maximum of 550 patients get treatment immediately, said Dr Md Abdullah Al Noman of the radiation oncology department.

“A day’s wait can turn deadly as cancer germs spread rapidly in human body. Many patients die before taking the therapy,” he told The Daily Star.

The NICRH, which charges Tk 15,000-22,000 for a complete course of radiotherapy, is the go-to place for low-income cancer patients. Private hospitals charge up to Tk 2,00,000 for the treatment, he added.

Due to the rush, patients at the NICRH sometimes have to wait up to six months, said Mamun, a staffer at the hospital.

During a recent visit to the hospital, several patients said the same.

Samsur Mia, a farmer who came from Kishoreganj, had to wait three months to get radiotherapy; Sabita, a housewife suffering from mouth cancer, two months; and Zakir Molla, a farmer, had to wait for five months.

Currently, there are about 15 lakh cancer patients in the country. Some 1.5 lakh people get the deadly disease every year while 1.08 lakh die every year, said NICRH Director Dr Md Moarraf Hossen, citing World Health Organisation data.

Experts fear the number will rise further in the coming years due to various factors, including food adulteration.

But the number of treatment facilities and specialist doctors are inadequate compared to the rising number of patients.

There are only 145 cancer specialists in 20 hospitals, including 11 private hospitals in Bangladesh, said Dr Mollah Obayedullah Baki, president of Bangladesh Cancer Society.

The NICRH director said they faced a hard time treating the patients with the existing radiotherapy machines.

Of the six machines they have, one recently broke down, said a radiotherapy technician.

“So people have to wait. We feel for the patients. We always try to ensure therapy as early as possible but we cannot go beyond the machine’s capacity,” said the NICHR chief.

“We are trying to bring in more machines and the ministry has already taken an initiative,” he added.

He stressed the need of setting up cancer centres with sufficient manpower and equipment in hospitals across the country to ease patients’ suffering.

“Every district should have a cancer treating centre. Patients from all across the country come to us. It costs them more money and time,” he said.

[“source=medicalnewstoday]

Nanny fundraiser cancer mum leaves ‘trove’ of memories

Lisa Foster and her three children Zach, Scarlett and Ruby

A terminally ill mother who raised more than £50,000 to pay for a nanny to take care of her three children has died.

Lisa Foster, 38, was diagnosed with stage four bowel cancer in May 2017.

Her husband Craig said she had left behind a “treasure trove” of videos for her children to view when they hit milestones in their lives.

The 49 clips include their favourite stories, plus greetings for their 18th birthdays, wedding days and first children.

Mr Foster said she had spent her final months preparing Ruby, eight, Zach, six, and two-year-old Scarlett for life without her.

She also left scrapbooks and recorded “pep talks” which would last “for decades into the future”, he said.

Image copyright Foster family
Image caption Mrs Foster hoped to see Scarlett’s first steps and Zach on his first day at school (photographed here), which she did. L to R: Craig, Zach, Scarlett, Lisa, and Ruby with nanny Jane Key

Mr Foster, from Duffield in Derbyshire, said his wife had reminisced about old times and told him to “man up” if he was feeling sorry for himself.

She also said he was doing a great job and not to doubt himself.

“It is only since she has gone we realised how much Lisa had done to prepare us for a world without her,” he said.

When she was diagnosed with cancer Mrs Foster started a blog, which has been read by thousands of people.

“The strange thing was, over time, there was something about her spirit, her attitude, the way which she was fighting, that it seemed to grow over time and [more] people discovered it,” said Mr Foster.

“The last blog post she wrote more than 10,000 people read, in Australia, the US, all over the place.

“Lots of people made life changes on the back of reading it, [they] ditched partners or quit their jobs, which was strange to read.

“There was something about her message which made you realise life is short and none of us know how long we’ve got.”

Image copyright Foster Family
Image caption Mrs Foster said in a blog post all she “ever wanted was to be a mum”

Her last blog post started, “All I ever wanted was to be a mum”, and went on to talk about the “untold rounds of IVF” she went through to conceive her children.

She described being a mum as the “best job in the world” and said it was “heartbreaking to now know I can’t finish the job for Ruby, Zach and Scarlett”.

  • Incurable cancer mum seeks nanny
  • Mum ‘devastated’ over baby’s eye cancer
  • Donations help mum with cancer buy home

Mrs Foster launched the fundraising page with the aim of collecting £50,000 to fund a nanny to take care of her children after her death.

She hit the target in just six days and eventually raised £62,000.

The nanny started in June and Mr Foster said there was enough money left to pay for another 18 months of full-time care.

[“source=medicalnewstoday]

Thousands are told in A&E they have cancer

More than 41,000 new patients are diagnosed with cancer annually. Stock Image: Getty

More than 3,000 patients a year are only finding out they have cancer when they attend a hospital A&E department.

The alarming revelation comes as new figures show cancer has overtaken heart disease as the biggest killer.

More than 41,000 new patients are diagnosed with cancer annually including non-invasive forms of the disease, according to the annual report of the National Cancer Registry.

A growing and ageing population has contributed to an 85pc rise in cases since the mid 1990s.

However for thousands of patients the diagnosis will only be made after they present as emergencies and they account for 14pc of cases, excluding non-melanoma skin cancers.

This can result from lack of awareness of symptoms or being on a long waiting list for access to scans.

They usually have advanced disease, limited treatment options and poorer prognosis.

Overall, cancer claims the lives of 9,094 people annually with lung cancer the main killer for men and women.

Non-melanoma skin cancer, prostate cancer and breast cancer were the most commonly diagnosed cancers.

The risk of dying of cancer was about 34pc higher for men who tend to present later for care than for women.

The stark forecast is that cancer figures could almost double by 2045.

However,survival has improved markedly for cancers as a whole and for the most common cancer types since the mid-1990s.

The overall five-year net survival increased from 40pc for men during 1994-1998 to 62pc during 2010-2014.

Among women the five-year net survival increased from 48pc during 1994-1998 to 60pc during 2010-2014.

It means Ireland has a record 173,000 cancer survivors who were previously diagnosed with an invasive cancer other than non-melanoma skin cancer,

The top four most common cancers among survivors are breast cancer , prostate cancer, bowel cancer and melanoma skin cancer.

The survival rate for non-melanoma skin cancer is best at 99.8pc, followed by prostate cancer at 92pc.

Survival

Survival for breast cancer is 83pc, bowel cancer 63pc and for lung cancer 18pc.

An analysis of the report by the Irish Cancer Society shows show rates remain highest in the most deprived areas.

There is a greater risk in getting lung cancer in areas such as north-inner city Dublin and west Dublin as well as certain area of Donegal, Louth, Longford, Carlow, Galway, Limerick and Cork.

Lung cancer and head and neck cancer incidence is 1.7 times higher among the least well off. Cervical cancer incidence is 1.9 times greater among poorer communities.

Men in areas with the lowest education levels have a 32pc greater risk of lung cancer than men living in areas with the highest level, while it is 23pc greater for women.

It said that the designation of cancer into eight hospital centres have contributed to more survival, but more is left to do.

Cancer patients from the most disadvantaged communities are 50pc more likely to be diagnosed after attending A&E.

Responding to the figures, Averil Power of the Irish Cancer Society said they were a “wake-up call” that must prompt immediate action.

“While these projections are stark, they need not become a reality,” she said.

“By improving our lifestyles and availing of free screening each of us can dramatically reduce our risk of getting cancer.

“Four in 10 cancers are preventable. We can all reduce our risk of getting cancer by eating healthily, exercising and limiting our alcohol intake.”

She called for more measures to address health inequalities. “Disadvantaged groups are still more likely to get, and die, from cancer than more privileged groups,” she said.

“We won’t stand for that. We will continue to call for better access to cancer tests for all, increased uptake of screening programmes and no barriers to seeing doctors.”

[“source=medicalnewstoday]

RHOA’s NeNe Leakes Calls Husband Gregg ‘Mean’ and ‘Grouchy’ as He Battles Stage 3 Cancer

NeNe Leakes thinks her husband needs an attitude adjustment.

NeNe slammed Gregg Leakes for the way he is coping as he battles stage 3 colon cancer. The Real Housewives of Atlanta star called her husband out on Twitter for being “mean” and “grouchy.”

“I would just think if I have or had cancer, I would see life so differently!” she wrote. “Not being mean, grouchy and evil for no real reason! But that’s me. Pray for me.”

In a second tweet, she told her 1.93 million followers that the situation is more complicated than it appears.

“I’m ALWAYS the bad guy so I’ll take that if you only knew,” she wrote.

NeNe also expressed similar sentiments in the comments section of Gregg’s Instagram after he posted a message “to all my men” about loving forgiveness.

In since-deleted comments captured by The Shade Room, NeNe told Gregg to take his own advice.

“Well, u need to do everything you posted! Practice what you preach,” she before adding, “You need to pray for yourself! This mean, grouchy, evil stuff u pulling these days are NOT cool.”

NeNe previously opened up to PEOPLE about caring for Gregg as he continues to fight cancer, admitting that it’s not always easy.

“It’s very, very hard to be a caretaker,” she said. “People call and they say, ‘How’s Gregg doing?’ and I want to throw the phone and say, ‘How the f— am I doing? I’m going crazy over here, Gregg is wearing me out!’ I am not good at this s—! I would rather hire somebody. Gregg doesn’t wants me to hire somebody, but I’m just not good. I’m not good at fluffing the pillow; I’m good at buying the pillow.”

Nene Leakes/Instagram

Mostly, she said his illness has caused a bit of a divide in their marriage.

“He’s changed as a person, his attitude changed,” she said. “I feel like that day, I lost my husband. Our whole dynamic changed. Sometimes I forget that he’s sick and I need to remind myself because he’s so on the edge. He’s not nice, but he can’t help it.”

It’s reminded her of when they separated back in 2010 and divorced the following year, ending a then 14-year marriage (they would remarry in June 2013). “Back then, I would go upstairs at night and he would go to downstairs to the basement,” she said. “Now, he goes to the guest room on the main floor — we don’t sleep in the same bed. We’ll try to lay in bed together for a couple of hours but he freaks out if we sleep in the same bed. He’s like, ‘I don’t want to give you anything!’ “

“It’s been very tough and very lonely,” she continued. “You know how many nights I’ve been up there crying? I’ve really cried in my room because I was so used to him being there. We’ve been together over 21 years. And when we first got married, we were so in love that we got a queen-sized bed and said we never wanted to sleep in anything bigger because we always wanted to be close to one another. … And now he’s on an entirely different floor.”

[“source=medicalnewstoday]

Thousands are told in A&E they have cancer

More than 41,000 new patients are diagnosed with cancer annually. Stock Image: Getty

More than 3,000 patients a year are only finding out they have cancer when they attend a hospital A&E department.

The alarming revelation comes as new figures show cancer has overtaken heart disease as the biggest killer.

More than 41,000 new patients are diagnosed with cancer annually including non-invasive forms of the disease, according to the annual report of the National Cancer Registry.

A growing and ageing population has contributed to an 85pc rise in cases since the mid 1990s.

However for thousands of patients the diagnosis will only be made after they present as emergencies and they account for 14pc of cases, excluding non-melanoma skin cancers.

This can result from lack of awareness of symptoms or being on a long waiting list for access to scans.

They usually have advanced disease, limited treatment options and poorer prognosis.

Overall, cancer claims the lives of 9,094 people annually with lung cancer the main killer for men and women.

Non-melanoma skin cancer, prostate cancer and breast cancer were the most commonly diagnosed cancers.

The risk of dying of cancer was about 34pc higher for men who tend to present later for care than for women.

[“source=medicalnewstoday]

RHOA’s NeNe Leakes Calls Husband Gregg ‘Mean’ and ‘Grouchy’ as He Battles Stage 3 Cancer

NeNe Leakes thinks her husband needs an attitude adjustment.

NeNe slammed Gregg Leakes for the way he is coping as he battles stage 3 colon cancer. The Real Housewives of Atlanta star called her husband out on Twitter for being “mean” and “grouchy.”

“I would just think if I have or had cancer, I would see life so differently!” she wrote. “Not being mean, grouchy and evil for no real reason! But that’s me. Pray for me.”

In a second tweet, she told her 1.93 million followers that the situation is more complicated than it appears.

“I’m ALWAYS the bad guy so I’ll take that if you only knew,” she wrote.

NeNe also expressed similar sentiments in the comments section of Gregg’s Instagram after he posted a message “to all my men” about loving forgiveness.

In since-deleted comments captured by The Shade Room, NeNe told Gregg to take his own advice.

“Well, u need to do everything you posted! Practice what you preach,” she before adding, “You need to pray for yourself! This mean, grouchy, evil stuff u pulling these days are NOT cool.”

NeNe previously opened up to PEOPLE about caring for Gregg as he continues to fight cancer, admitting that it’s not always easy.

“It’s very, very hard to be a caretaker,” she said. “People call and they say, ‘How’s Gregg doing?’ and I want to throw the phone and say, ‘How the f— am I doing? I’m going crazy over here, Gregg is wearing me out!’ I am not good at this s—! I would rather hire somebody. Gregg doesn’t wants me to hire somebody, but I’m just not good. I’m not good at fluffing the pillow; I’m good at buying the pillow.”

Nene Leakes/Instagram

Mostly, she said his illness has caused a bit of a divide in their marriage.

“He’s changed as a person, his attitude changed,” she said. “I feel like that day, I lost my husband. Our whole dynamic changed. Sometimes I forget that he’s sick and I need to remind myself because he’s so on the edge. He’s not nice, but he can’t help it.”

It’s reminded her of when they separated back in 2010 and divorced the following year, ending a then 14-year marriage (they would remarry in June 2013). “Back then, I would go upstairs at night and he would go to downstairs to the basement,” she said. “Now, he goes to the guest room on the main floor — we don’t sleep in the same bed. We’ll try to lay in bed together for a couple of hours but he freaks out if we sleep in the same bed. He’s like, ‘I don’t want to give you anything!’ “

“It’s been very tough and very lonely,” she continued. “You know how many nights I’ve been up there crying? I’ve really cried in my room because I was so used to him being there. We’ve been together over 21 years. And when we first got married, we were so in love that we got a queen-sized bed and said we never wanted to sleep in anything bigger because we always wanted to be close to one another. … And now he’s on an entirely different floor.”

[“source=medicalnewstoday]