Avera Cancer Institute Magazine - spring summer 2017 by Avera

Avera Cancer Institute FACING CANCER WITH

FACTS FAITH and

A STORY OF HOPE:

LIFE IS A GIFT THE BENEFITS OF BEING THERE

IN PERSON REACHING OUT FOR HELP, 24/7 SPRING/SUMMER 2017

DEAR READERS, At Avera, we want people to be constantly aware of cancer prevention as well as all the hopeful treatments and supportive programs for people impacted by this disease. In this issue, we lift up colorectal cancer awareness. This is a serious disease that can be life-threatening. It’s also one of the most preventable and treatable diseases if caught in its earliest stages. But that can only happen if men and women alike get their recommended screenings beginning at age 50. So we appreciate the fact that Bob Polly of Mitchell was willing to share his story. I hope you’ll also read Erika Allen’s heartwarming story. Erika had a very serious diagnosis that was successfully treated with bone marrow transplant, allowing this young mom of two to become a mom of three with the birth of her third child, appropriately named “Hope.” Thankfully, people who are diagnosed with blood cancers such as leukemia, lymphoma or multiple myeloma don’t have to travel far for this level of care. It’s all right here, at Avera. We’ve collected some common questions and answers about cancer care. We hope you’ll find interest in other articles about gynecologic oncology, radiation treatment, outreach services and 24/7 communication channels that support patients and their families. When the diagnosis is cancer, we at Avera strive to offer a seamless experience through the entire journey. Read to discover how Avera does cancer care differently – through the latest science, advanced technology, interconnectedness of the Avera system, and compassionate care for the whole person – body, mind and spirit. Please visit Avera.org/cancer to learn more.

ONE AVERA CANCER INSTITUTE. SIX REGIONAL CENTERS. Aberdeen 305 S. State St. Aberdeen, SD 57401 605-622-5000 Marshall 300 S. Bruce St. Marshall, MN 56258 507-537-9000 Mitchell 525 N. Foster Mitchell, SD 57301 605-995-5756 Pierre 801 E. Sioux Pierre, SD 57501 605-224-3100 Sioux Falls 1000 E. 23rd St. Sioux Falls, SD 57105 605-322-3000 Yankton 1115 W. Ninth St. Yankton, SD 57078 605-668-8000

Thanks for reading! In good health,

Tad Jacobs, DO Chief Medical Officer, Avera Medical Group

Several of the cancer programs and services you’re reading about are supported by generous donors from across the Avera system. To learn how you can help support local cancer patients through the Avera Cancer Institute, visit Avera.org and click on Donate to Avera.

CONTENTS Avera Cancer Institute SPRING/SUMMER 2017 WHAT’S NEW

Across The System.................................................................... 2

DECIDING TO FIGHT Powerful Weapons Against Cancer............................................ 4

WE’RE HERE FOR YOU

Communicate with Your Care Team 24/7 .................................. 6

THE REWARD OF FAITH

Bone Marrow Transplant Patient Shares Story of Hope ............ 8

EDUCATING PATIENTS ABOUT BONE MARROW TRANSPLANT..................................... 10 PATIENT Q AND A............................................................... 11 FACTS AND FAITH

Bob Polly is ‘Super Thankful’ for Care and Support.................... 12

DEDICATED AND INNOVATIVE CARE FOR GYNECOLOGIC CANCER........................................ 16 THOUGHTS ABOUT SURVIVORSHIP

From Survivors.......................................................................... 19

OUTREACH:

The Benefits of Being There ‘In Person’.................................... 20

WHAT’S NEW ACROSS THE SYSTEM: Marshall

Yankton

WORKING TOWARD ACCREDITATION

The Avera Cancer Institute Cancer Committee in Marshall began meeting in January with a goal of reaching Commission on Cancer accreditation in late 2018. Accredited centers must meet a host of standards of care: • Access to a multidisciplinary team approach to coordinate the best cancer treatment • Assessment of treatment options based on evidence-based national guidelines • Access to patient-centered services such as navigation • Access to genetic assessment and counseling and palliative care • Information about clinical trials and new treatments • A cancer registry for the collection of data • Follow-up care

CATTLE INDUSTRY SUPPORTS CANCER FUNDING Thanks to the generosity of the ranching industry in the Mitchell area, the Avera Queen of Peace Foundation has raised $15,000 in the past two years as part of its Cattle for Cancer program. The once yearly fundraiser was created when a local cattle producer wanted to provide a donation through Avera Cancer Institute

The Avera Sacred Heart Foundation raised almost $94,000 for Avera Cancer Institute in Yankton during its annual Simply d’Vine event in October. The ninth annual event featured an auction and a variety of specialty drinks and foods including desserts, wine and craft beer. Funds are used to assist cancer patients treated in Yankton with transportation, food and lodging. Additionally, contributions fund massage therapy and exercise programs to help with stress relief and overall wellness, and the Avera Cancer Institute Navigation Center.

the sale of a head of cattle. In November, the Foundation held its third annual event, raising over $7,000 in seven minutes.

Mitchell

SIMPLY D’VINE FUNDRAISER CELEBRATES NINTH YEAR

Spring / Summer 2017

Proceeds benefit a variety of programs in the Mitchell region, including patient and caregiver meals and free cancer screenings. DIETITIAN SERVICES ADDED IN MITCHELL Avera Cancer Institute in Mitchell recently added a dietitian to its support team. Nancy Miller, MS, RD, LN, CDE, has more than 18 years of experience and will work with patients to maintain their health and strength during treatment and beyond.

Sioux Falls GAMMA KNIFE EXCEEDS EXPECTATIONS

In May 2016 the Avera Cancer Institute began using the Gamma Knife™ for stereotactic radiosurgery to treat both malignant and benign intracranial lesions. The Gamma Knife was designed specifically to treat tumors and other conditions without a surgical incision. The technology employs 192 small highly focused beams of radiation with great precision and accuracy. It ablates, or removes the tumor or lesion, while causing minimal damage to surrounding normal tissue. Treatment is delivered as an outpatient procedure and in most cases lasts less than four hours. The first year of Gamma Knife treatment has far exceeded expectations. While leaders expected to see about 12 cases the first year, there have actually been over 40. Many cases have included non-cancerous lesions, such as arteriovenous malformations, trigeminal neuralgia, and acoustic neuroma, said James Simon, MD, Avera Medical Group Radiation Oncologist.

Aberdeen TOP NOTCH VALET SERVICE FOR PATIENTS

Since its opening, Avera Cancer Institute valet employees have been parking and retrieving patients’ cars for convenient drive-up service. Valet Manager Todd Koller and employee Tim Beck recently went above and beyond the call of duty when a patient got a flat tire. The two put on a spare for her, and Todd drove to the dealership and helped coordinate the repair. For Todd and Tim, it’s just part of the job to make sure people get the service they need. Whether it’s helping patients out to their cars, fixing a tire or jump-starting a car, Todd said they help out when they can. “I just wanted to get her home,” he said. “I wouldn’t feel right about myself if I just called AAA and said ‘see you later.’ If you can help, then you should.”

Pierre MATCHING FUNDRAISING BEGINS IN PIERRE Avera St. Mary’s Foundation recently kicked off The Helmsley Center Challenge to residents across central South Dakota to raise $2.5 million to match the generous matching gift from The Leona M. and Harry B. Helmsley Charitable Trust. In addition to the $2.5 million in matching funds, The Helmsley Charitable Trust is granting $7.5 million for comprehensive cancer treatment, including a linear accelerator for radiation treatment. The Avera Cancer Institute in Pierre will be home to state-of-the-art cancer care so area residents can have access to critical treatments near home. It will be housed in the Helmsley Center, which will also have clinic space

for primary and specialty care. Avera St. Mary’s Hospital and Avera Health will invest up to $19 million to complete the Helmsley Center project. For more information on how to donate, go to AveraStMarysFoundation.org Spring / Summer 2017

Avera Cancer Institute

DECIDING TO

FIGHT “I want to live; I want to fight this thing through.”

When Gary Larsen received the news that he had stage IV esophageal cancer, his first reaction was “a desire to go to a corner and cry.” It all started in January 2016, when a cold that just wouldn’t go away was eventually accompanied by pain in the chest and throat. Chalking it up to the winter weather, Larsen was shocked to learn it was so much more. “It’s just my sister, my mother and me, and we’re very close. We started to make plans as to what we were expecting to happen,” said Larsen. “But then I thought, ‘I want to live; I want to fight this thing through.’” Larsen was referred to the Avera Cancer Institute in Marshall, under the care of Mark Huber, MD, Avera Medical Group oncologist and hematologist, and Barbara Schlager, MD, radiation oncologist, both of whom Larsen described as “absolutely excellent.”

GARY LARSEN

Avera Cancer Institute

He underwent both radiation therapy and chemotherapy. “Performing radiation and chemotherapy simultaneously enhances the reaction of one another, killing the tumor cells and reducing the obstruction in Gary’s throat,” explained Schlager.

Spring / Summer 2017

Radiation therapy and chemotherapy combine as powerful weapons

BARBARA SCHLAGER, MD RADIATION ONCOLOGIST

“The blockage in his throat was life threatening due to the fact he couldn’t eat,” said Schlager. As treatment reduced the size of the lump, Avera Marshall dietitians worked with Larsen to bring his weight up nearly 30 pounds, from a low of 160 – way too low for his height of 6 foot, 4 inches.

Little by little, things started to change for the better. A late summer CT revealed that no new forms of cancer had developed within his body. In the past, cancer patients in the rural Marshall, Minn., area would travel hours and stay in hotels to receive radiation therapy. The opening of the new Avera Cancer Institute in Marshall in early 2015 has helped change that, serving a wide geographical area, from Granite Falls to Windom to Pipestone. Larsen appreciated the fact that he could stay at his sister’s house only 45 minutes away in Montevideo. “The closer you can get to your treatment center and team, I think, the less time and energy you spend changing up your life to deal with cancer,” said Larsen.

Avera Cancer Institute in Marshall

Today, Larsen receives chemotherapy at home. A small device, about the size of a large calculator, straps to his side and pumps chemo right into the bloodstream for about 46 hours. He appreciates how far modern medicine has come to allow him to stay home for treatment. “When you get that diagnosis, you think about all of the things you may not be able to do again; and then you think about the things you WILL be able to do. And that list is so much longer,” Larsen said. “The positive things outweigh the negative, and that’s when you tell yourself that you’ll never give up.” 

Spring / Summer 2017

Avera Cancer Institute

We’re Here for You Communicate with the Avera Cancer Institute Care Team 24/7

When you or a loved one is affected by cancer, questions and concerns come up at all times of the day or night.

Avera Cancer Institute Navigation Center Regardless of where you live or receive treatment within Avera’s five-state region, the Avera Cancer Institute Navigation Center offers free, 24/7 information and support. Simply call 888-422-1410. You don’t have to be an Avera patient to call. “We hope to make each person’s cancer journey more successful,” said Jamie Arens, Director of the Avera Cancer Institute Navigation Center. Avera Cancer Institute Navigation Center is the first and only of its kind to offer such a comprehensive list of support services in one setting.

Avera Cancer Institute

Spring / Summer 2017

If you’re receiving treatment at any Avera location, Navigation Center staff can look up information and answer questions regarding your specific care plan – thanks to the integration of all Avera Cancer Institute electronic medical records. The Navigation Center also makes outbound calls during pivotal moments of the cancer journey, for example, after the first survivorship appointments. “This check-in point gives patients an opportunity to ask questions about what’s next,” adds Arens.

24/7

Communication Channels for Cancer Patients Avera Cancer Institute Navigation Center 888-422-1410

AveraChartCancer Avera Cancer Institute patients now have 24/7 access to AveraChartCancer – a new and secure online portal that allows them to stay up-to-date on every aspect of their cancer treatment from the convenience of a home computer or mobile device. “It’s convenient, quick and provides much more instantaneous communication.” says Nathan Hruby, Clinic Manager and Oncology EMR Manager. Through the portal, patients can send secure and confidential messages to anyone on their Avera Cancer Institute care team, including: • Nurse navigators and social workers at the Navigation Center

• Oncologists

• Patient advocates for financial questions

• Registered nurses

• Research coordinators

• Scheduling team for new appointment requests

• Advice and information related to your care • Information about cancer physicians or services • Emotional support and referrals to resources • Help finding insurance specialists and financial resources • Recommendations for local lodging or transportation

AveraChartCancer Avera.org/cancer

Those who aren’t as comfortable with technology can designate a trusted representative. “When you send a message, you have access to an entire multidisciplinary oncology team doing everything they can to be responsive and help you,” adds Hruby. “In addition to your oncologist and nurse, there’s a team working behind the scenes for you too.” 

Call to get

• Send secure and confidential messages to your care team • View your information: - Diagnosis - Test and lab results - Clinical instructions - Upcoming appointments - Health record

To activate your AveraChartCancer account, call 877-335-3277. If you already have an AveraChartCancer account, Spring / Summer 2017 Avera Cancer Institute visit Avera.org/cancer to log in.

The

Reward of Faith Bone Marrow Transplant Patient Shares Story of Hope

Avera Cancer Institute

Spring / Summer 2017

Photos courtesy of Amy Oyler of Legacy Photo and Design, Rapid City.

When Erika Allen looks down into the smiling face of her daughter Hope, she smiles back as she reflects on the journey – one with many scary chapters – that led to this amazing little person she sees as a gift from God. “Once you are a survivor of cancer, you never really go back to being who you were before,” said the 35-year-old mother of three. “My husband and I really see Hope as a reward for our faith through all the dark times. God saw us through the cancer, the transplant – and on the other side of that battle, we were blessed with her.”

Allen said she never felt alone, even with the travel across South Dakota with her mom and the nights on Avera McKennan Hospital & University Health Center’s third floor, where she recovered as her immune system rebuilt itself after her stem cells were reinfused.

Allen’s battle began in 2010 when she found a lump in her right underarm while doing a routine self-exam of her breast at her home in Rapid City. “After an ultrasound the doctors saw it as a cyst, but I just felt terrible, almost all the time,” Allen said. “I felt anxious all that winter, and in the spring, it had not improved, and I had another ultrasound, a CT scan and a biopsy.” These tests confirmed that Allen had a rare non-Hodgkin’s lymphoma. “I was scared to death and the news, to me, seemed like a death sentence,” she said. “My care team in Rapid City recommended that I look into going to Omaha, but it seemed so far away.”

the tumor. That surgery began the process that led her to an autologous bone marrow transplant. Autologous means the patient will donate his or her own stem cells to be reinfused. Stem cells are collected through a process called apheresis, similar to giving blood. After chemotherapy to kill the cancer cells, the patient’s stem cells are reinfused to grow new healthy blood cells.

“We all had to fight, but I had many allies in the battle,” she said. “From the gift shop in the Prairie Center, to the hospital nurses, to Kelly and my other doctors – I felt like they were fighting alongside me.” The transplant took place in 2011, and slowly but steadily she began to get her life back, to regrow her hair and to return to her full-time role as mom to son and daughter, Luke, 9, and Lily, 7.

That’s when she met Kelly McCaul, MD, at the Avera Cancer Institute – “Kelly” as he insisted she call him.

“He explained everything to me, my husband, Nic, and my mom and dad. He sat with us for two hours during that first meeting. I felt from that instant that he would fight for me. It gave me the hope that I could battle this thing and win.”

“It was a godsend, I really feel God put him in my life,” she said.

Three hours later, she was in an operating room to remove

Hope was born in February 2016, and she embodies her name. Allen says her message for those who face the same news is clear: find a doctor who will fight for you, and then together fight fiercely. “There’s so much to live for and it’s not easy,” she said. “When I look at Hope, I realize all the sickness, the travel, the surgeries – it was all worth it.”

Spring / Summer 2017

Avera Cancer Institute

Compassionate, Careful Education for Bone Marrow Transplant Patients

Patients who face life-threatening blood cancers often don’t realize the range of care available to them. Kelly McCaul, MD, hematologist with Avera Medical Group Hematology & Bone Marrow Transplant, not only provides insight and information as a doctor, he often must clearly spell out things as a teacher. “It’s like establishing the foundation of a home, because we want our patients, their families – everyone who has a role in their cancer journey – to realize what they face,” McCaul said. The careful explanations and answers to questions are game-changing moments. “Thousands of Americans are diagnosed with lifethreatening diseases for which bone marrow transplantation may be the best – and only – hope for a cure,” McCaul said. “We offer the Dakotas’ only bone marrow transplant program, and for diseases such as leukemia, lymphoma, multiple myeloma and more, bone marrow transplantation offers the best chance for survival by replacing malfunctioning blood-forming stem cells found in the patient’s bone marrow.” Midwestern patients can get the same high level of care in Sioux Falls as at nationally known cancer centers, much closer to home. “It gives people real hope,” McCaul said. “We have found that the stress of the treatment is greatly lessened when people have a better understanding of the whole journey. No one does this alone.” 

What is Bone Marrow Transplant? Blood-forming stem cells are found in the bone marrow. For a transplant, healthy stem cells can be collected from the bloodstream through a non-surgical process called apheresis. Some transplant patients can use their own cells; other patients need a well-matched donor. After cells are collected, the patient is given chemotherapy and/or radiation therapy to kill the cancer cells. Healthy stem cells are then infused back to the patient, resulting in normal growth of healthy new blood cells. An autologous transplant uses a patient’s own stem cells while an allogeneic transplant uses stem cells from a close relative or donor from the registry who is a close match.

12 10

Avera Cancer Institute

Spring / Summer 2017

Q&A

PATIENT

While a cancer diagnosis raises lots of questions, we want to help you fully understand your options.

What is a clinical trial? Clinical trials offer the latest, cutting-edge treatment options. A research study often starts in a lab where new ideas are developed and then moves to animal testing if deemed promising. Clinical trials are the next step and there are typically several phases. Patients are informed of all considerations, and taking part is a patient’s choice. Patients are always offered standard treatment in addition to clinical trials.

What is genomic medicine? Genomic medicine sequences your DNA to determine the best ways to treat your cancer based on specific genetic changes in the tumor.

What do the stages mean? • Stage 0: abnormal cells are present but have not spread to nearby tissue.

WRITTEN BY RICHARD CONKLIN, MD, MEDICAL ONCOLOGY AND HEMATOLOGY

• Stages I, II and III: cancer is present; the higher the number the larger the tumor and the more it has spread to nearby tissue. • Stage IV: the cancer has spread to other organs or more distant areas of the body.

What questions should I ask my doctor? The questions you’ll have depend on the type of your cancer. Here are a few suggestions for what to ask your doctor: • What stage of cancer do I have? Where is my cancer? • What lifestyle changes should I make during and after treatment? • What are my treatment options? • What support services do you offer? • What are the short-term and long-term side effects of treatment? • Are there any clinical trials available? • Would genomic medicine be beneficial?

What are my surgical options? You may be eligible for removal of the tumor and surrounding tissue during an operation. In some cases surgery may also be useful in relieving symptoms. Your doctor will discuss your surgical options with you. In some cases a surgeon can use one or more small incisions through minimally invasive procedures, including advanced robotic surgery. Patients who receive advanced robotic surgery often experience shorter recovery times and less pain. 

Spring / Summer 2017

Avera Cancer Institute

Bob Polly and his wife, Betty, enjoy time at home.

FACTS

Faith and

Bob Polly is ‘super thankful’ for care and support

Avera Cancer Institute

Spring / Summer 2017

Bob Polly is a no-nonsense type. The 57-year-old Mitchell man hesitates to tell a touchy-feely story about facing cancer. He’s more of a facts guy. Bob also is a man of faith. He knows hope and attitude are crucial when facing disease, and his experience has given him perspective about his journey. Bob doesn’t like to say he’s cancer-free, even though his most recent scans have been clear. Instead he realizes this journey he’s on – one in which God has played a big role – is not finished.

“My last chemo treatment was in November, and that Thanksgiving was distinct. I have to say I’m super thankful,” he said. “Thankful my wife, Betty, was with me every step, never complaining. Thankful for my friends and family, for my church family’s support. I’m thankful for my medical care team, too.” When it started, Bob thought the pain in his stomach was a hernia. But it wasn’t a hernia, and his doctors scheduled a colonoscopy. He had postponed that screening exam when he reached the recommended age of 50. “If I can share anything, I’d tell men to stop listening to people who say colonoscopy and the preparation for it is terrible – it’s not!” he said. “Don’t be a baby. Get in and get it done.”

Timely Colon Cancer Screenings Save Lives Tad Jacobs, DO, Chief Medical Officer for Avera Medical Group, reminds all of the importance of timely colon cancer screenings.

“The gold-standard exam for colon cancer detection is colonoscopy, which is recommended beginning at age 50.“ dical Tad Jacobs, DO, Chief Me up Gro Officer for Avera Medical

“Early detection of colon cancer can basically cure this disease and prevent deaths,” Jacobs said. In fact, colonoscopy can prevent colorectal cancer when the test detects pre-cancerous polyps, which can be removed during the same procedure. “Colonoscopy has been the exam of choice for colon cancer for several decades,” Jacobs said. Other screening options include the fecal-immunochemical test, also called FIT, and the Cologuard test. These tests look for markers that indicate colon cancer. “Both the FIT and Cologuard allow for cancer tests using a stool sample from the patient, and they are less intrusive, as well as quick,” said Jacobs. “If either test comes back positive, however, physicians would recommend a colonoscopy. In any case, early screening is the key to the best possible outcome for all patients.”

Timing of colonoscopy depends on family history or other risk factors. “But waiting too long for colon cancer testing is something that can truly lead to a life-threatening situation,” Jacobs added.

Spring / Summer 2017

Avera Cancer Institute

“Every time I turned down the street to go to my chemotherapy treatment, I wanted to stop and go home. It never got easier. Cancer is a journey, but so is life. You have to know you have help.” - BOB POLLY

Colonoscopy Isn’t as Bad as You Think. Really. The screening itself only takes about 30 minutes.

Plus, you’ll be asleep. Polyps are often removed during the colonoscopy 12

AND THEN YOU’RE DONE.

Avera Cancer Institute

Spring / Summer 2017

You won’t need one that often. The general recommendation is every 10 years starting at 50. Varies according to risk.

In April of 2016, Bob found himself having surgery to treat stage III colon cancer. He had three inches of his colon removed as well as two dozen lymph nodes. Some nodes had signs of cancer, and he began chemotherapy with Avera Medical Group oncologist Kathleen Naegele, DO.

KATHLEEN NAEGELE, DO MEDICAL ONCOLOGIST

“Cancer is scary, so I try to talk openly about fears,” Naegele said. “Patients need to know all they can about their disease and their treatments. Communication is a key to a healthy outcome.” As someone who has been through colon cancer, Bob recommends that anyone age 50 or older get their screening colonoscopies as recommended. “If they show you have cancer, then focus on hope,” he said. “I prayed a lot through this. I knew God was giving me a challenge to teach me. I asked him to be easy on me.” As his journey continues, he knows he’s got great backing no matter what comes next. 

IT COULD SAVE YOUR LIFE.

People who do colon screenings have a The lights are down, you get a little medication, have a nice nap and then it’s over. The more we explain to patients what’s involved and how important it is for their health, the more willing they are to do it. Steve Condron, MD Avera Medical Group Gastroenterology

90%

reduced risk

of developing colon cancer

– Get a Colonoscopy. SCHEDULING IS EASY Go to Avera.org/colon or call 888-486-0218 to find a location near you. Schedule your appointment. / Summer Cancer Institute Pat Spring yourself on the 2017 back forAvera getting it done!

Dedicated and Innovative Care for Gynecologic Cancer

Avera Cancer Institute is the region’s only cancer program that offers two dedicated gynecologic oncologists – Luis Rojas, MD, FACOG and David Starks, MD, MPH. Their extensive training in obstetrics, gynecology and cancer care equips them to perform highly technical surgeries, administer chemotherapy and make radiation therapy recommendations for radiation oncologists to consider and implement when appropriate. “Patient well-being is our number one priority,” says Rojas. “We believe in treating them like we would treat our own family members.” Each patient benefits from having an entire team of cancer care experts who collaborate on their behalf. Each week this team – including radiologists, medical oncologists, gynecologic oncologists, radiation oncologists, pathologists, genetic counselors, patient advocates and social workers – gathers at the Gynecologic Oncology Tumor Conference to discuss specific cases. Rojas describes it as if each patient has a built-in second, third and fourth expert opinion. “Everyone reviews the cases and shares their opinions to try and achieve the greater good for the patients.”

Specialized care helps women experience the best possible outcomes in the case of ovarian, cervical, endometrial and other cancers of the female reproductive system.

“Clinical trials open new doors of treatment options to patients – options that are potentially better for their specific case than standard therapy.” - LUIS ROJAS, MD, GYNECOLOGIC ONCOLOGIST AVERA MEDICAL GROUP

Personalized & Innovative Treatment Avera’s gynecologic oncology team works together closely to develop customized treatment plans based on each woman’s specific diagnosis and needs. A standard therapy care plan may include a combination of surgery, chemotherapy and/or radiation therapy. If surgery is the best option, women can take advantage of advanced surgical techniques such as minimally invasive laparoscopic and robotic surgery. “With minimally invasive surgery, most women recover more quickly and are able to start chemotherapy or radiation therapy treatments sooner,” says Rojas. Women also have the option to pursue a clinical trial which provides them with access to therapies not currently available as a standard of care. Examples include new chemotherapy combinations and immunotherapy. In addition, Avera patients have access to genomic medicine through the Avera Cancer Institute Center for Precision Oncology.

Spring / Summer 2017

Avera Cancer Institute

Dawn Harter enjoys hiking and traveling, including this trip to Ireland in 2016.

CLINICAL TRIAL OFFERS NEW HOPE FOR PATIENT WITH OVARIAN CANCER After receiving her initial ovarian cancer treatment at another facility, Dawn Harter of Green Bay, Wis., started researching clinical trials and discovered one that gave her hope for preventing recurrence. At the time, Avera Cancer Institute was one of only two sites in the United States to have that particular trial open. Dawn chose Avera and asked to be enrolled. Although it’s difficult to know where Dawn would be without the clinical trial, the promising news is that she is now in full clinical remission. “I feel blessed to have found Dr. Rojas,” says Dawn. “He and his staff moved mountains to get me admitted. Everyone has been pleasant, kind and hopeful – qualities I was in desperate need of. I believe being part of the study has given me a new chance at life.”

Rojas describes this targeted therapy as a two-in-one punch. “We can hit the cancer with chemotherapy that kills the cancer cells. At the same time, we use the targeted therapy to hold the hands of the cancer cells, so they can’t defend themselves by mutating and becoming resistant to the treatment. I believe this is the future of cancer treatment. It’s here and now at Avera.”

Holistic Healing

Cancer treatment at Avera focuses on healing the whole person, not just the disease. “We recognize there are all the other aspects of a patient’s well-being to consider,” Rojas said. Patients can find comfort, hope and a better quality of life through a variety of support services, including: • 24/7 support and resources from the Avera Cancer Institute Navigation Center • Financial counseling • Integrative medicine services such as acupuncture, massage therapy and aromatherapy • Spiritual care Women can also look to their Avera care team and the Sexual Medicine Program with any questions and concerns about how cancer treatment may impact their sexual function. 

To learn more about gynecologic oncology at Avera, contact the Avera Cancer Institute Navigation Center at 888-422-1410.

Thoughts about

Survivorship – FROM SURVIVORS

“

God

runs the show.

I’m a faith-filled man. I know fear, and I know faith. I’d rather have faith … Everything is beneath the word; God does not put sickness upon us to teach us something, but God sent us his son to be the blessing for salvation and healing.” DOUG GANSEBOM COLON CANCER SURVIVOR OSMOND, NEB.

“

It’s not easy to hear the words, ‘you have cancer.’

“

Remember

PPT

(the power of positive thinking)!

That’s very frightening. Even as I’m undergoing treatment, I didn’t think I’d feel this good. I’m able to exercise, ride my horses, play with my grandchildren … Living with cancer is OK for me because I’m going to beat it.”

Let your faith be bigger than your fear. As Philippians 4:13 reads, ‘I can do all things through Christ who gives me strength.’ This is your time — be an advocate for yourself! Lean on your support system. I did; my husband, family, friends, coworkers and, most of all, my faith.”

MARY BOWDEN BREAST CANCER SURVIVOR SIOUX FALLS, S.D.

ANOLA KETELHOHN OVARIAN CANCER SURVIVOR SIOUX FALLS, S.D.

Spring / Summer 2017

Avera Cancer Institute

Outreach: THE BENEFITS OF BEING THERE ‘IN PERSON’ Advances in long-distance communications technology in health care are amazing, but patients and doctors will attest to the fact that sometimes, being together face-to-face is beneficial.

MOBRIDGE

PIERRE

That’s why Avera cancer physicians provide outreach services. These in-person opportunities allow patients to engage in giveand-take conversation. SREEKANTH DONEPUDI, MD MEDICAL ONCOLOGIST

Outreach reflects the compassion hewn into the very bedrock of medicine itself: the traveling doctor who crosses distance to provide care.

“In some situations, just being able to be in the room to start the conversation makes a huge difference,” said Avera Medical Group oncologist Sreekanth Donepudi, MD, a Pierre-based physician who began outreach services in Gregory, S.D., this year. “It’s rewarding in any setting, but outreach reduces travel burdens for patients. That can make all the difference for them.” Donepudi said in many cases, the presence of an oncologist provides a space where patients and their families can ask all of their questions. “We can provide answers on exactly what the diagnosis means. It’s more than just explaining – we can inform the patient’s famly and include them in our plan,” he said. “When a person hears the words ‘You have cancer’ it is substantial. When I’m in the same room, I can share information on expectations. With many people, I can give them hope. When it happens in a face-to-face situation, it’s the best way.” Ayham Deeb, MD, an Avera Medical Group oncology and hematology specialist, is planning to begin outreach for patients in the northwest Iowa area.

AYHAM DEEB, MD MEDICAL ONCOLOGIST

Avera Cancer Institute

“Patient care is always the priority, and shortly after I started practicing at my clinic in Sioux Falls, I realized

Spring / Summer 2017

“Explaining diagnosis and treatment options are just parts of patient care. Having a physician close to home and family is important. Outreach makes this possible.” - AYHAM DEEB, MD

WINNER

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FUTURE EXPANSION PLANS

FAULKTON REDFIELD

WATERTOWN HENDRICKS MARSHALL

HURON

BROOKINGS TYLER

South Dakota CHAMBERLAIN

Minnesota

PIPESTONE

WINDOM

MITCHELL

WORTHINGTON PLATTE GREGORY

PARKSTON

SIOUX FALLS

YANKTON

Nebraska

the high volume of patients traveling long distances for cancer care,” he said. Avera cancer physicians who take part in outreach know they are continuing a tradition that harkens back to early medicine – going to patients who may struggle to come to them.

ROCK VALLEY

SPIRIT LAKE SIBLEY

SIOUX CENTER

ESTHERVILLE SPENCER

Iowa

LE MARS

“People facing cancer need information so they know we can do things together to help them,” Donepudi said. “I know for people in many rural areas, this service is making a difference. It is exciting to be a part of that care, and to deliver it in person.” 

Spring / Summer 2017

Avera Cancer Institute

SAVE THE DATE FOR OUR

ANNIVERSARY RACE. Thank you for participating in the 29th Annual Avera Race Against Breast Cancer.

May 12, 2018

It’s Going to Be Huge. AveraRaceSiouxFalls.org

RiDe or Stride toward a cure

June 10, 2017 Red Baron Arena & Expo 400 Tiger Drive Marshall, Minn.

• 10K & 5K run • 1 mile and 5K walk • Family fun bike-ride

Avera.org/support/marshall-foundation Proceeds support cancer care

16-ACAI-4549