Cancer Wellness Magazine: The Men's Health Issue with Matt Iseman by cancerwellness

FALL 2019

“AMERICAN NINJA WARRIOR” HOST MATT ISEMAN’S UNCONVENTIONAL RISE TO FAME

ADAPTIVE DESIGN

THESE CLOTHES ADAPT TO YOUR CHANGING, POST-CANCER BODY

CANCER & EXERCISE THE WHAT, WHEN, WHY & HOW

ONE BAD APPLE

THE “ROUNDUP” ON MONSANTO, GMO & CANCER-CAUSING WEED KILLERS

Excellence puts patients first. Excellence equals many things at Rush. One that matters most is patient satisfaction: doing right by the people we serve. Every day, we seek patient feedback â&#x20AC;&#x201D; and act on it. Weâ&#x20AC;&#x2122;re proud that our patient satisfaction scores consistently place Rush doctors at hospitals in Aurora, Oak Park and Chicago among the top in the nation.

To find a Rush cancer doctor or to learn more, visit rush.edu/cancer or call (312) CANCER-1.

Excellence is just the beginning.

Cancer Wellness

letter from

THE EDITOR

Photo by Adrian C. Garcia

et’s talk about sex. Each year, more men die from cancer than women, and men of color fare far worse. With these statistics in mind, the Cancer Wellness team has artfully compiled a trove of articles intended to encourage thought and discourse on cancer-related concerns affecting men. The topic of men and cancer could hardly come at a more poignant time for me, personally, as Michael Everhart, a clever, dynamic schoolmate of mine who was profiled as “The Fighter” in our last issue, has gracefully finished his cancer journey and passed, surrounded by close friends and family. That testicular, prostate, colorectal, and pancreatic cancers affect more men than women may seem obvious, with a direct correlation to the basics of human anatomy. However, new and emerging research on gene mutation and expression, DNA disruption, and epidemiology are rapidly paving the way to better understanding cancer. When it comes to cancer, there are more similarities than differences. Dr. VanderWeele gives such an example in “Ask the Doctor” (pg. 28). BRCA1 and BRCA2 gene mutations can not only be passed down by male hosts, but also, like BRCA mutations in women, can predispose men to multiple cancer types, including male breast cancer. Fortuntely, engaging in open discourse about cancer is increasingly common. Sure, it takes balls to open up about cancer, but that is nothing new for the ultracreative and passionate Thomas Cantley aka Mr. Ballsy (pg. 61). In an impressive feat, Cantley has literally traversed the United States pushing a giant “testical” in his successful effort to increase awareness about testicular cancer. While the focus of this issue is on men, we certainly do not limit our pages to a single biological sex, gender, or sexual orientation. Cancer affects us all, and the sooner we can embrace and address the underlying causes of this unfortunate epidemic, the better. Speaking of causation, make sure to explore Alicia Betz’s article on Monsanto (pg. 96) and its abominable profiteering practices that led to the widespread proliferation of glyphosate in our ecosystem. If this article does not completely terrify you, it will, at the very least, make you consider your gardening routine.

I salute the brave men who have shared their personal experiences, revealing not only their physical and emotional journeys, but also unabashedly inspiring other men to favor action, from prevention to thrivorship. Our (gorgeous) cover star Matt Iseman (pg. 54) exemplifies this concept in every way. As the long-standing host of “American Ninja Warrior” and respected businessman, this chiseled Adonis would seem an unlikely target for cancer to pick a fight. His moving and inspiring story is a must-read.

@cayleiCW

Excellence is just the beginning. Cancer Wellness

FALL 2019

STAY & PLAY: BENGALURU

on the COVER

SPOTLIGHT 10

AROUND TOWN 44

106

THE FIGHTER

THE THRIVER

THE SUPPORTER

The cW team flew to LA for a quick midweek getaway to catch up with cover star Matt Iseman. He graciously offered his gorgeous bungalow off bustling Melrose Avenue in West Hollywood as the location for our shoot. When we arrived, we headed for the back patio, awash in sunlight, which led to an art deco fountain and a glittering blue pool. Maintaining professional courtesy and showing great restraint, we abstained from jumping in, shoes and all.

Cancer Wellness

CHARITIES WE LOVE

CW EVENTS

CALENDAR

FEATURES 30

BREAKING A SWEAT How can exercise and proper nutrition complement your treatment regimen?

AMERICA’S FAVORITE WARRIOR From his humble beginnings to becoming the host of “American Ninja Warrior,” Matt Iseman has always connected with audiences through the gift of storytelling.

ADAPT YOUR STYLE Staying fashionable while undergoing cancer treatments and surgeries isn’t hard with these new initiatives by some top fashion brands.

ONE BAD APPLE Recent lawsuits against agrochemical company Monsanto are alerting the public to the dangers of a common household weed killer.

FALL 2019

MATT ISEMAN

TRAVEL 66

CATCH TO RELEASE Reel Recovery changes lives with fly fishing retreats.

STAY & PLAY: BENGALURU Our comprehensive guide to the sights, sounds, and treatment options of one of India’s megacities.

INNOVATIONS & RESEARCH 74

CAMELS FOR THE CURE Nanobodies found in Camelidae animals may have a secret antitumor affect.

DR. MUAIAD KITTANEH We sit down with the Midwest’s only specialist in peritoneal mesothelioma.

90 NUTRITION 22

POWER LUNCH Hearty, nutrient-dense meals to sustain you through the transition to fall.

MIND & BODY 28

ASK THE DOCTOR Why men should also receive testing for the BRCA gene mutations.

COMPLEMENTARY MEDICINE 34

THE RIGHT MEDICINE How one family rewrote the law on allowing medical marijuana in schools.

BEAUTY 38

WHAT’S IN YOUR TOILETRY BAG? What to avoid and common replacements for your favorite skin-care products.

ENTERTAINMENT 60

DIRTY LAUNDRY, DEADLY RESULTS The “asbestos movie” brings harsh truths to light.

A WHOLE NEW BALL GAME One man’s journey from addict to cancer fighter to motivational thriver.

NEXT QUESTION, PLEASE Your guide to getting the right answers, right away.

HELPING ALL OF US Malecare’s programs for underserved communities are what make this nonprofit stand out from the rest.

CANCER & THE ENVIRONMENT 100

ALL WORK AND NO PLAY Could your job be killing you?

103

LEGACIES OF CHEMICAL WARFARE U.S. herbicide warfare programs continue to affect veterans and civilians. Cancer Wellness

CAYLEI VOGELZANG Editor-in-Chief

BRITT JULIOUS Editorial Director

NATALIA ESPINOSA Creative Director FEATURES Senior Editor CATHERINE EVES Editor-at-Large MIRELA STEFANESCU

CONTRIBUTING WRITERS ALICIA BETZ, PAYAL DHAR, HEIDI HONG, JASMINE JAFFERALI, DIANE SELKIRK, MARIA TRIPODIS, KATHRYN TRUDEAU, LIZ TUCKWELL

PHOTOGRAPHY ADRIAN C. GARCIA, JOHN KHUU, ORIANA KOREN, PETYA SHALAMANOVA

CREATIVE Media Manager ADRIAN C. GARCIA

MARKETING Account Manager EVE WIMPFFEN Social Media Manager ALLISON STERN

OPERATIONS Chief Operating Officer JACK SAXE-STARAL Web Developer KEVIN DAVIS Executive Assistant MELANIJA ERGARAC

EDITORIAL ADVISORY BOARD NATALIE CRAIG, DENA DODD PERRY, PARIS MENDES, DR. GAIL PRINS, DR. DIANA RANGAVES, MARIA TRIPODIS

DISTRIBUTION

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ALL RIGHTS RESERVED. NO PART OF THIS PUBLICATION MAY BE REPRODUCED IN WHOLE OR PART WITHOUT PERMISSION FROM THE PUBLISHER. THE VIEWS EXPRESSED IN CANCER WELLNESS ARE THOSE OF THE RESPECTIVE CONTRIBUTORS AND ARE NOT NECESSARILY SHARED BY CANCER WELLNESS AND ITS STAFF.

Cancer Wellness

CONTRIBUTORS ORIANA KOREN PHOTOGRAPHER

Oriana is an editorial and commercial photographer based in Los Angeles. With a background in documentary photography, Oriana creates embodied, attentive, and lucid imagery on location, in the studio, and across the globe. Their work has been featured in The New York Times, The Washington Post, and The California Sunday Magazine. They are a founding member of the Authority Collective and the architect behind the Lit List, a new award highlighting photographers of color.

ALICIA BETZ

PETYA SHALAMANOVA

Alicia is a professional writer and a high school English teacher. She earned her bachelor’s degree from Penn State University in 2012 and her master’s degree from Michigan State University in 2016. She specializes in writing articles and blog posts that help people live healthy lives, both physically and emotionally. When she’s not writing with a napping baby on her lap, you can find her baking, exercising, or spending time with her family and her German Shepherd.

Petya was born in Bulgaria and works in Chicago. She is a portrait and fashion photographer and artist working for various international clients and publications. Alongside her commercial and editorial work, she is also working on several long-term documentary and personal projects back in her home country, such as taking photos of gymnasts and wrestlers and documenting post-communism life. Petya’s favorite part of photography is interacting with others to make and communicate something honest, beautiful, and authentic.

WRITER

PHOTOGRAPHER

ADRIAN C. GARCIA MEDIA MANAGER

Adrian is a multimedia storyteller whose passion is to create compelling content impacting marginalized communities. Adrian received an honorary award for photography by the National Association of Hispanic Journalists. Before joining Cancer Wellness, he worked at Worker’s United, producing educational videos for union members. At Cancer Wellness, Adrian appreciates the opportunity to focus on a different community in need. He also volunteers with the nonprofit Chicago newspaper Tribuno del Pueblo.

MIRELA STEFANESCU

LIZ TUCKWELL

EDITOR-AT-LARGE

COLUMNIST

As one of the original visionaries of Cancer Wellness and the public relations manager of Vogelzang Law, Mirela has set out from the beginning to find new and unique stories for the pages of the magazine. Cancer has affected her personally in triumph and tragedy. Mirela is passionate about finding these stories through her many charitable, social, and professional connections for Cancer Wellness readers, so others don’t feel alone in their battle.

After Chicago-based healer Liz faced personal challenges, she realized painting could soothe her. She found power over her anxiety through meditation and energy work. Paired with her intuition, she began counseling using the tools of art and meditation. Liz offers 1-to-1 coaching sessions and assigns “art homework.” In addition to her online fine-art portfolio, she has created a website for art and spirituality, Art With Intention, where others can connect with their inner muse.

Cancer Wellness

#cW MANTRA

It takes a village. The people who have stuck around you through adversity are there for a reason. No one can do it alone. So why should you? @williamyank

Cancer Wellness

the fighter

BROOKE LONG AS TOLD TO BRITT JULIOUS

One day, my aunt called me from the road. She said, “I found a lump, and we’ve been watch-

ing it for a couple of years, but we’ve confirmed it’s [ductal carcinoma in situ], and I have breast cancer.” I remember [being] on the phone with her, pushing on myself, and thinking, I feel something. I go to check it out. A couple of days later, I got diagnosed: stage II invasive ductal carcinoma. In a way, [my aunt] saved me. We did a double mastectomy. Lymph node clearance. I did IVF, and then I did chemo right away. Fifteen rounds and then a month of radiation. I had to really rebuild [my] muscles and do physical therapy with pilates. By the end of 2018, I was able to do that, [but] my pecs were not healing. I had an appointment with my oncologist and said, “I did this workout the other week. I’m still sore.” Two more weeks go by, and I order my own CT scan. They said, “You have a 4 centimeter lesion that is eroding your sternum bone.” I flipped out. This cannot be real. We were just thinking of starting a family and really moving on with life. The biopsy list was three weeks out, and they said, “There’s nothing we can do. You just have to wait.” But what if this kills me? I got a new oncologist. The hope is we could put it into remission. I love that reframing. If you show up and you’re ready to meet it and grow from it and survive it, then you want to be aligned with someone who’s going to help you do that.

To hear more from Brooke, visit cancerwellness.com

Cancer Wellness

Instead of just firehosing my whole body, we irradiated it with ablative radiation. I’m on a really strong aromatase inhibitor injection regimen. And I take a daily pill called ibrance. It stands in the pathway of cell division, [stopping] it from replicating. If I can just buy time with this regimen, maybe two or five years, immunotherapy will be where it’s at. My needs are different, and that means my approach is different. Not just because of age, but because of the mindset, the culture, the anthropology of what it means to be sick right now. Get real comfortable with uncertainty because that is the only constant. I have so much to share.

Photo by John Khuu

Get real comfortable with uncertainty because that is the only constant.

GUIDE TO GRAINS Want to decrease your risk of cancer? Make pasta night a little more interesting by swapping white-flour products with nutritious whole grains. BY CATHERINE EVES

ou may be familiar with whole-wheat pasta and brown rice, but alternative grains offer different health benefits and textures to lighten up heavy, carb-based meals. Whole grains are an excellent source of fiber, which keeps you full longer and helps you maintain a healthy weight, but this isn’t the only benefit. According to the American Institute for Cancer Research, eating 90 grams of whole grains each day lowers colorectal cancer risk by 17 percent. Here, we’ve compiled a list of our favorite alternative grains to help ward off cancer.

BARLEY gives dishes a similarly nutty flavor and chewy texture as farro, but provides a significant amount of the mineral selenium, which plays a role in liver enzyme function and can help detoxify cancer-causing compounds in the body. Selenium also helps prevent inflammation, which may decrease tumor growth rates. Barley is one of the more forgiving grains, meaning it’s difficult to overcook. For this reason, barley holds up well in hearty winter stews and adds texture to light summer salads.

QUINOA is an excellent replacement for white rice in your favorite Mexican or Asian dishes. This edible seed can be black, red, yellow, or white. Indigenous to the Andean region of South America, quinoa has been cultivated for about 5,000 years, so it’s often referred to as an “ancient grain.” One cup of cooked quinoa provides eight grams of protein and five grams of fiber, and it contains all nine essential amino acids that our bodies don’t naturally produce. When cooking, try substituting chicken or vegetable broth for water to amplify the flavor, and add any vegetables, proteins, and spices for a versatile dish.

SPELT is a variety of grain that is most commonly seen in grocery stores as an alternative to white flour. Spelt flour can be used as a white-flour replacement for most recipes, including hearty breads and sweet baked goods. It’s a particularly good substitute in pizza crust, as it won’t become tough or leathery once baked. Spelt can also be found in whole-grain form, and is a great substitute for less nutrient-rich grains like white rice. Spelt’s protein and fiber levels are impressive, and it also contains significant amounts of iron, magnesium, zinc, and potassium, among other minerals.

FARRO is a nutty, chewy grain often used to replace arborio rice (a type of white rice) in risotto dishes. Traditional farro must be soaked overnight before cooking, but the semi-pearled and pearled varieties cut cooking time significantly. However, some of the bran has been removed from these varieties, so while it packs less of a whole-grain punch, any type of farro acts as an excellent replacement for rice when you crave a satisfying chew. Farro can be served at breakfast, with some berries and creamy yogurt, or at dinner, in your favorite risotto recipe.

TEFF is a fairly small grain—about the size of a poppy seed—that is most often ground into flour. Teff flour is used to make the traditional Ethiopian bread called injera, a pancake-like fermented bread that pairs well with spices like ginger, fenugreek, and turmeric. Teff provides the most calcium of any whole grain, which is essential for strong bones and teeth. Calcium also has positive effects on our muscles, heart, and blood. Teff makes a delicious breakfast porridge, or teff flour can replace white flour in recipes for more nutrient-rich baked goods.

Cancer Wellness

GENTLE YET EFFECTIVE In treatment for cancer? We’ve compiled a set of gentle yet effective exercises which allow anyone to reap the benefits of a solid workout. BY CATHERINE EVES

Cancer Wellness

If you or a loved one has limited range of motion and endurance, gentle stretches and exercises are not off the table. Here, we’ve compiled a few gentle, chair-based exercises to get the body moving. (The rush of endorphins will be worth it—we promise.) EDITOR’S NOTE: These exercises can be performed anywhere, at any time. We suggest using a straight-backed, dining room chair for seated exercises. However, if you’re performing these exercises at work, and don’t have access to a chair without wheels, a standard desk chair may be used— just be aware of the wheels, recognize the hazards, and stop any exercise immediately if you feel unsteady.

Photo by Adrian C. Garcia

fter rigorous rounds of chemotherapy, reinstating your regular exercise routine might be the last thing on your mind, but the benefits of exercise on healing are undeniable. According to the American Cancer Society (ACS), “Exercise has been shown to improve cardiovascular fitness, muscle strength, body composition, fatigue, anxiety, depression, self-esteem, happiness, and several quality of life factors in cancer survivors.” ACS notes a multitude of studies suggesting regular exercise lowers the risk of cancer recurrence and also improves survival. Even those with advanced-stage cancers can benefit from physical activity—what may be light exercise for some could be considered high intensity for others.

COR E

STR ENGTH

BA L A NCE

SEATED LEG LIFTS: 1. Sit nice and tall on the edge of a chair with your back straight and knees bent at a 90-degree angle. Relax your neck and shoulders, releasing any tension. 2. Lean back slightly from the hip to activate the lower abdominal muscles. 3. Slowly lift your right leg, keeping the knee bent. 4. Lift your knee about four inches off the chair—this will prevent engaging your leg muscles. 5. Bring your leg back down, returning the foot to the floor. 6. Repeat with your left leg. Complete 10 to 12 reps per leg.

SEATED HEEL SLIDES: 1. Sit on the front edge of your chair with your back straight and knees bent. Your feet should be placed slightly behind your knees for stability. 2. Start with your right foot: Extend your leg in front of you, so the leg is straight and your heel is touching firmly into the ground. 3. Maintaining this tension, slowly bend your knee and slide your right leg back to the starting position. You should feel this in your hamstrings (the muscles at the back of the thigh). 4. Do the same for the left leg. Complete 10 to 12 reps each leg.

STAND ON ONE LEG: 1. Stand straight and tall with soft knees and your belly button pulled to your spine. Make sure not to lock your knees. 2. Shifting your weight onto your left leg, bend the knee of your right leg and bring it behind you. Remember to maintain a soft knee in the standing leg. 3. If you should lose your balance, touch down with your foot, and then move back to the balance position. 4. Try to balance for a count of 30, then lower your leg, bringing your foot back to the floor. 5. Balance on one leg, then the other, for 30 seconds each.

SEATED TWISTS: 1. Sit nice and tall on the edge of a chair with your back straight and knees bent at a 90-degree angle. 2. Place your hands lightly on your ribs with your elbows back. Relax your neck and shoulders, releasing any tension. 3. Keeping your lower body as still as possible, slowly twist your upper body to the left, taking your eyes and nose with you, and look over your left shoulder. 4. Hold for a count of 5. 5. Return to the starting position, and complete the same motion on the right side. Complete 10 to 12 reps each side.

SEATED BICEP CURL: This exercise can be completed with or without hand weights—even a pair of water bottles will work well. 1. Sit on the front edge of your chair with your back straight and knees bent at a 90-degree angle. 2. With or without weights, your arms should be straight along your hips, hanging below the seat of the chair. When holding weights, make sure to keep the tension in your hands light (a light grip will activate your biceps more effectively). 3. Slowly bend your elbows and bring the weights up to your shoulders, and then lower the weights back to the starting position. 4. Complete 10 to 12 reps.

Always consult your physician before beginning any exercise program. *Exercises created by Cathy Skinner of Thrivors* Cathy Skinner is the author of The Art of Well’s “Exercise for Cancer Recovery.” She is the first certified American College of Sports Medicine cancer exercise specialist in Minnesota. She holds an M.A. in Organizational Development from the University of St. Thomas and a B.A. in Psychology from the University of California, Davis. In 2016, she launched a digital health company for cancer patients and their loved ones called Thrivors™. Visit Thrivors.com to learn more.

Cancer Wellness

APPLICATIONS OPEN SOON!

Kesem is the leading national nonprofit that supports children through and beyond their parent’s cancer. Kesem’s flagship program, Camp Kesem, operates over 100 free summer camps across the country for children ages 6 to 18 who have been impacted by a parent’s cancer. Kesem programs have a lasting impact on children by providing them a peersupport network that understands their unique needs, builds confidence and strengthens their communication skills. In 2019, Kesem served more than 10,000 children across the country—all funded by generous donations from individuals and corporate partners. Applications for Summer 2020 open December 10, 2019 for returning families and January 21, 2020 for new families.

KESEM.ORG/FALL2019 PHOTO BY ELI SUZUKI-GILL

AT TEND A KESEM EVENT

Magic Makers Ball Oct 12, 2019 Los Angeles, CA 14 Night CancerMagic WellnessFeb 27, 2020 San Francisco, CA

Magic Ball Mar 7, 2020 Chicago, IL Magic Ball May 2, 2020 Boston, MA

THE cW LIBRARY Acclaimed poet Anne Boyer’s new memoir documenting her experience in treatment for cancer will break your heart but leave you wanting more. REVIEWED BY CATHERINE EVES

qual parts prose, research, and memoir, Anne Boyer’s poignant examination of her experience in treatment for highly aggressive triple-negative breast cancer is powerfully rendered. Referencing literary figures who wrote of their illnesses, like Susan Sontag and Kathy Acker, Boyer’s document of the isolation and unavoidable pain of a cancer diagnosis is refreshingly honest. Her story, almost an ode to pain, speaks of the toxic drugs coursing through her system, the loneliness of losing friends, the difficulty in relating to others when navigating cancer and its treatment, the American health care system that prefers making money to saving lives, and the unrelenting rage that results from it all. In sparkling prose, Boyer’s poetic inclinations shine through: “I am like a baby being born into the hands of a body made only of the grand debt of love and rage, and if I live another forty-one years to avenge what has happened it still won’t be enough.” September 2019; Farrar, Straus and Giroux; $26.00

Book covers courtesy of the publishers

More reads from the cW library CANCER-FREE WITH FOOD

RADICAL

By Liana Werner-Gray

By Kate Pickert

Featuring 195 recipes created to promote healing, “Cancer-Free with Food” is a step-by-step guide for what to eat in the wake of a cancer diagnosis. Each recipe can be tailored to accommodate gluten-free, keto, vegan, and paleo diets. WernerGrey’s mission is personal: she lost both her grandparents to cancer, and her mother survived breast cancer. She was raised in Alice Springs, Australia—a city with a large indigenous population whose diet consists of mostly veggies and very little, if any, processed foods. “They taught me that food is medicine,” Werner-Gray writes.

If more money is spent fighting breast cancer than any other cancer, why does it continue to kill 40,000 women each year? As a health care journalist, Pickert was familiar with how cancer patients navigate the health care industry. When she was diagnosed with breast cancer herself, her reporting became personal. Through interviews with doctors, scientists, economists, advocates, and patients, “Radical” offers a history of breast cancer treatment—charting the progress and defeats—and shares an update on its research and treatment as it stands today.

April 2019; Hay House Inc.; $17.99

October 2019; Little, Brown Spark; $28.00

Cancer Wellness

nutrition

18 TIME TO EAT 20 EAT WELL TO LIVE WELL 22 POWER LUNCH Cancer Wellness

Cancer Wellness

Time to Eat

Intermittent fasting (IF) has been proven to affect glucoregulation, inflammation, obesity, and sleepâ&#x20AC;&#x201D;all of which can decrease breast cancer risk. But how exactly does it work? BY CATHERINE EVES

Cancer Wellness

ntermittent fasting (IF) is a new “diet” taking the eating schedule and found that regardless of diet, the health and wellness world by storm. Also known as mice remained healthy and did not succumb to disease. “time-restricted eating,” calling IF a diet isn’t quite This might be confusing, because it is well-documented accurate, because it’s not about what you eat, but when. (including in issue 2 of cW) that sugar is cancer’s preferred So, how long can one go without eating? An food. According to Dr. Anna Cabeca, a board-certified IF diet plan consists of a period of eating offset by a OB-GYN and author of “The Hormone Fix,” reducing period without calorie consumption, and has been the amount of glucose, or sugar, circulating in the body shown to positively influence prognoses of breast is imperative to stave off cancer. “IF helps us do that,” cancer. In an August 2016 study in JAMA Oncology, Cabeca says. nearly 2,500 women fasted overnight for a 13-hour Cabeca considers widespread insulin resistance period. According to the study, nightly fasting may be an “epidemic situation” in this country, common due a simple, non-medical strategy for reducing the risk of to the highly processed foods we eat. Insulin resistance breast cancer recurrence. results in our bodies needing more insulin to reduce In the study, half of the participants the amount of circulating glucose, fasted for more than 12.5 hours per “The timing of eating and can cause cardiovascular disease, night, and half fasted for less than 12.5 polycystic ovarian disease, and is like an external time diabetes, hours per night. The study found that worse menopausal symptoms, among cue that signals the those who fasted fewer than 13 hours a many other effects. But luckily, according night were associated with a 36 percent internal circadian clock to Cabeca, following an IF diet can higher risk of breast cancer recurrence. create insulin sensitivity. to keep a balance Although there is limited data on the Most simply, time-restricted eating association between time-restricted between nourishment promotes autophagy—healthy cell regeneating and tumor growth, the study eration—because our bodies adapt to a and repair.” says: “In rodents, calorie restriction certain pattern of eating and becomes is an effective way to reduce cancer better regulated at storing glucose. and cancer-related risk factors, and studies suggest that “Our bodies [are able] to get into this state [of] taking intermittent calorie restriction prevents mammary tumor out the garbage, essentially cleaning up the unhealthy development to a similar, or even greater, extent than cells,” Cabeca says. chronic calorie restriction.” Cabeca likens cancerous cells to a neighborhood. But how does breast cancer play into this? In an “Good neighbors have good boundaries and communicate August 2014 column, Dr. Marisa Weiss, the founder, with each other, but yet hold healthy boundaries,” president, and chief medical officer of Breastcancer.org, Cabeca begins. “If something’s going wrong, like your said overweight and obese women have a higher risk of dogs are running loose, [a good] neighbor will help developing breast cancer and a higher risk of recurrence, you out, [but] if you’re a bad neighbor, all of a sudden “especially if they carry extra fat in their midsection.” you’re going downhill—your weeds are overgrowing Extra fat cells make extra hormones that lead to extra [and] that affects the neighbor next door. […] That kind breast cell growth. “When you have higher levels of of seeps through the neighborhood, [destroying] one these hormones in your blood over time, the risk of cell after the next cell after the next cell.” IF can help cancer is increased,” Weiss writes. create healthy cells who can communicate with each Hormones are also closely related to our natural other. “Cell-to-cell communication is key,” says Cabeca. circadian rhythm. An article by Satchin Panda, Ph.D., “When you have damaged cells, they don’t communicate published by the University of California, San Diego, in well.” This can lead to cancer. September 2018 examines research about this rhythm. It’s easy to make IF part of your life. Typically, According to Panda, these “internal clocks” control time-restricted eaters fast overnight, maintaining at things like falling asleep, signal hunger cues, and affect least a 13-hour fast. The average 2,000 calorie diet could how we fight disease. “The timing of eating is like an be followed, but many fasters see weight-loss results by external time cue that signals the internal circadian combining a fasting schedule with a lower-calorie diet clock to keep a balance between nourishment and repair,” rich in whole foods and with limited intake of sugar, writes Panda. During a fast, the metabolism is geared unhealthy fats, and simple carbohydrates. towards “rejuvenation,” meaning unhealthy chemicals “Intermittent fasting, no snacking, and lots of are broken down, fat is burned, and damaged cells plant-based nutrients, as well as lifestyle factors that are repaired. When we go off a fast, the metabolism is reduce (the stress hormone) cortisol, [like] meditation, more focused on nourishment, meaning our bodies are getting out in nature,” begins Cabeca. “All of those better able to absorb nutrients, using or storing them things decrease our risk of cancer and improve our more effectively. longevity.” Eat well, fast often, and reduce your risk of One of the examined studies, published by the cancer. journal Cell Metabolism, placed mice on a time-restricted Cancer Wellness

Eat Well to Live Well Low-sugar, high-carb, high-fat, no-fat—there are many ways to adopt healthier eating habits. Here, we’ve rounded up popular diets to complement cancer treatment regimens. BY CATHERINE EVES

new cancer diagnosis comes with a trove of worries—most essentially, which foods should be avoided and which should be eaten in abundance. The American Cancer Society recommends a balanced diet with plenty of protein, fruits, vegetables, and whole grains for people currently undergoing treatment for cancer. Good nutrition is especially important, as cachexia (or wasting syndrome, involving extreme muscle 20

Cancer Wellness

and weight loss) can affect as many as 80 percent of people with advanced cancer, according to a December 2015 article in Nature. We’ve listed some popular diets that promote healing, maintain energy, and encourage overall wellness. Certain foods can interact with medication, so always consult with your health care provider before changing your diet.

ALKALINE

PALEO

KETO

Many are told cancer thrives in an acidic environment. Diets that are too high in acid-producing foods can also cause health issues like kidney stones and bone and muscle deterioration. The alkaline diet aims to reduce acidity by limiting consumption of alcohol, sugar, refined carbohydrates, and animal fats, while increasing consumption of water. The alkaline diet features plenty of fruits, vegetables, and whole grains.

The paleolithic diet features foods eaten by our ancient ancestors. Proponents of the paleo diet say chronic diseases like cancer arose from eating foods produced after the agricultural revolution. Those following a paleo diet limit processed foods, sugar, grains, legumes, and dairy (the rationale being that our hunter-gatherer ancestors did not produce sugar, harvest grains or legumes, or milk cows). However, eliminating food groups may contribute to overeating.

This diet follows a high-fat, low-carb meal plan—essentially a rebranding of the controversial Atkins Diet popular during the late-1990s. These dieters dropped weight fast, but with increased consumption of fatty meats and dairy, claims about the risks to the heart were not unfounded. The keto diet, however, emphasizes heart-healthy fats from a variety of sources to encourage the body to enter a state known as ketosis, where the body burns stored fat instead of glucose for energy.

Breakfast: quinoa and chia seed porridge made with hemp milk Lunch: avocado and pomegranate salad with apple cider vinegar dressing Dinner: kale pesto pasta made with zucchini noodles

Breakfast: egg and turkey sausage casserole Lunch: grilled chicken salad with cranberries and walnuts Dinner: beef and vegetable stew

Breakfast: scrambled eggs with mushrooms and spinach Lunch: no-noodle chicken and vegetable soup Dinner: pork chops with green beans and garlic

VEGAN

MACROBIOTIC

LOW-FODMAP

To many, veganism is not just a diet but a way of life. Strict vegans abstain from eating all animal products, but also incorporate the “diet” into other parts of life, such as not using makeup that has been tested on animals. It is difficult, but not impossible, to reach daily values of necessary nutrients—nuts, for example, are high in protein, but contain much less protein per gram when compared to meat. When first incorporating veganism into your lifestyle, track nutrients to make sure you are reaching your daily values.

Meaning “long life,” the macrobiotic diet emphasizes balance in the body. Drawing on the Taoist Chinese concepts of “yin” and “yang,” foods are classified and ingested in an equal balance. Sour foods are “yin,” and sweet foods are “yang”—both categories must be consumed in balance. High in fiber and free of red or processed meat, this diet avoids foods containing toxins and promotes the consumption of whole grains, fruits and vegetables, and soups made with vegetables, seaweed, legumes, and fermented soy.

The acronym FODMAP refers to five different types of sugars. Your doctor might recommend you try this diet if you experience digestive issues caused by malabsorption of these sugars. There are three phases to a low-FODMAP diet—1) Eliminate: Cut these foods from your diet; this phase will last three to eight weeks. 2) Reintroduce: Slowly add the foods, one at a time, back into your diet—this will help you determine which foods cause you trouble. 3) Liberation: Reintroduce tolerable high-FODMAP foods back into your diet.

Breakfast: mixed fruit smoothie with almond milk Lunch: avocado toast Dinner: hummus and vegetable wrap

Breakfast: steel cut oats with fruit Lunch: miso soup and wholegrain crackers Dinner: polenta with shrimp and vegetables

Breakfast: gluten-free blueberry pancakes Lunch: vegetable and lentil soup Dinner: baked chicken with quinoa and vegetables

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Power Lunch (and dinner, too!)

Celebrate fall with hearty, nutrient-dense meals to help you power through the changing seasons and harness your full cancer-fighting potential.

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BY MARIA TRIPODIS

ccording to the American Cancer Society, the most prominent cancers in men are prostate, colon, and lung cancer. The nutrients in our food play a big part in protecting our bodies from these cancers. The ingredients in these recipes feature anti-inflammatory and antioxidant properties that help combat cancer formation and growth. Evidence suggests certain nutrients—like omega-3 fatty acids, lycopene, flavonoids, carotenoids, vitamin C, selenium, magnesium, fiber, allicin, and curcumin—all play major roles in combating cancer. The omega-3 fatty acids in these dishes help fight inflammation and have been shown to reduce risk of colon and prostate cancer, according to studies in the European Journal of Cancer Prevention and in the Journal of Nutrition.

ANTI-INFLAMMATORY BREAKFAST BURRITO Yield: 4 burritos

Photography by Adrian C. Garcia

1 tablespoon olive oil 1 clove garlic, minced 1/2 medium yellow onion, chopped 1 cup kale, chopped with stems removed 1 cup shiitake mushrooms, chopped 2 eggs (preferably pasture-raised and organic) 1/2 teaspoon ground black pepper 1/2 teaspoon ground turmeric 2 tablespoons feta cheese, crumbled 4 large whole-wheat tortillas salt, to taste salsa, to dip (optional) plain greek yogurt, to dip (optional)

4. Remove vegetables from pan and let cool in a bowl. 5. Place sauté pan back on the stove and reduce heat to medium-low. Add another drizzle of olive oil and spread. 6. Crack the eggs into a medium mixing bowl and beat. 7. Pour eggs into pan. Add turmeric, a pinch of salt, and pepper. 8. Once the eggs begin to set, use a spatula to pull the edges towards the center of the pan. 9. Continue pulling the edges toward the center until eggs are firm, about 2 to 4 minutes. 10. Remove from heat and let cool in a separate bowl to prevent the eggs from overcooking. 11. Lay a tortilla on a plate. Place 1/4 cup of cooked vegetable mixture and 1/4 cup of scrambled eggs on the tortilla. Top with feta cheese. 12. To wrap, fold over the bottom half of the tortilla so it covers the toppings. Fold in the sides, and tightly roll into a burrito. 13. Heat sauté pan with olive oil on low heat. Add burrito to pan, fold side down, until golden brown (about 1 minute), flip burrito and brown the other side. 14. Remove from pan and cut in half. Enjoy warm. Dip in greek yogurt or salsa if desired.

LOADED BAKED SWEET POTATO Yield: 1 sweet potato 1 sweet potato 1/4 cup blueberries 1/4 cup walnuts, chopped 1 tablespoon shelled hemp seeds 1 tablespoon flax seeds, whole 1 tablespoon pumpkin seeds 1 tablespoon chia seeds 2 tablespoons unsweetened shredded coconut 1 teaspoon cinnamon 1 teaspoon nutmeg 1 tablespoon natural peanut butter (or an alternative nut butter) honey to drizzle (preferably local) PREPARATION: 1. Preheat oven to 400 F. Line a baking sheet with aluminum foil. 2. Wash sweet potato under running water to remove dirt. 3. Punch holes in the sweet potato with a fork, and place on baking sheet to bake for 45 to 50 minutes, or until tender. 4. Remove sweet potato from oven and let cool for 10 minutes. 5. Slice the potato open and top with remaining ingredients. Enjoy warm.

PREPARATION: 1. In a sauté pan, heat olive oil on medium. 2. Add minced garlic, chopped onion, and a pinch of salt. Sauté for about 3 minutes or until onion starts to soften. 3. Add kale, mushrooms, a dash of olive oil, and a pinch of salt. Sauté until kale and mushrooms are soft and wilted (about 5 to 7 minutes). Cancer Wellness

MEDITERRANEAN CHICKEN PITAS WITH TZATZIKI Yield: 4 pitas 2 raw chicken breasts (preferably pasture-raised and organic), cut into 1-inch cubes 2 whole-wheat pitas 2 cloves garlic, minced juice of 1½ lemons (about 3 tablespoons) 1 large cucumber, half roughly chopped and half grated 5 cherry tomatoes, quartered 1/2 small yellow onion, thinly sliced 1 red bell pepper, sliced 4 tablespoons olive oil 1 teaspoon salt 1/4 cup feta cheese, crumbled 1 cup plain yogurt (preferably grass-fed) 2 teaspoons dried oregano 1 sprig fresh dill, minced ground black pepper, to taste

PREPARATION: 1. In a large bowl, add chicken breast, 1 tablespoon olive oil, oregano, salt, half the garlic, and 1 tablespoon lemon juice. Mix until chicken is evenly coated; set aside to marinate for 20 minutes. 2. In a medium bowl, combine tomato, onion, bell pepper, roughly chopped cucumber, 1 tablespoon olive oil, 1 tablespoon lemon juice, feta cheese, salt, and ground black pepper to taste. 3. To make the tzatziki: In a medium bowl, combine plain yogurt, grated cucumber, 1 tablespoon olive oil, the remaining garlic, 1 tablespoon lemon juice, dill, and salt to taste. Set aside. 4. Heat a large sauté pan to medium heat and add 1 tablespoon olive oil. 5. Add chicken and sauté for about 5 to 7 minutes, until chicken is cooked (not pink in the center). 6. Cut pitas in half and open the pocket. Add the salad mixture, chicken, and top with tzatziki. Enjoy warm or cold.

BAKED LEAN TURKEY MEATBALLS Yield: 24 meatballs 2 pounds lean ground turkey 1 small yellow onion, chopped 1/2 cup spinach, chopped 2 cloves garlic, minced 10 - 15 basil leaves, finely chopped 1/2 cup seasoned whole-wheat bread crumbs 2 tablespoons ground flaxseed 1 egg (preferably pasture-raised and organic) 1 tablespoon tomato paste 3 teaspoons dried oregano 3 teaspoons salt 1 teaspoon ground black pepper 1/4 cup water olive oil to drizzle PREPARATION: 1. Preheat oven to 350 F. Line a baking sheet with aluminum foil, and drizzle with olive oil. 2. In a large bowl, combine recipe ingredients and mix. 3. Shape the mixture into 2-inch balls and place on oiled baking sheet. 4. Drizzle the meatballs with olive oil and place in the oven. 5. Bake for 20 minutes, or until you see browning. 6. Allow to cool for at least 5 minutes before serving.

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WILD GINGER SALMON WITH ASIAN SLAW Yield: 4 servings 1 pound salmon (preferably wild-caught) 2 bags broccoli slaw mix 2 tablespoons soy sauce 1 tablespoon sesame oil 1 tablespoon fish sauce 1 tablespoon rice vinegar 2 teaspoons ginger puree 3 stalks green onion, chopped 3 tablespoons sesame seeds

PREPARATION: 1. Preheat oven to 350 F. Line a baking sheet with aluminum foil and drizzle with olive oil. 2. Lay salmon onto baking sheet, skin side down. 3. In a medium bowl, combine soy sauce, sesame oil, fish sauce, rice vinegar, ginger puree, chopped green onion, and sesame seeds. 4. Coat the entire salmon filet with a quarter of the soy sauce mixture. 5. Bake for 20 minutes, and let cool for 10 minutes. 6. In a large bowl, combine the broccoli slaw with the remaining soy sauce mixture. Mix until slaw is evenly coated. 7. Serve salmon on top of slaw. Enjoy warm or cold.

Note: When it comes to produce, we are often told to buy organic, but the quality of our animal products matters as well. Not only are organic meat products free of growth hormones and antibiotics, but the respective animals are treated humanely and fed nourishing diets that account for more wholesome and nutrient-dense meat. Because it is easy to be fooled by the label, here are some quick tips to make sure your animal-sourced ingredients are the best quality out there. Eggs, chicken, and turkey: look for the labels “pasture-raised” and “organic” Fish and seafood: opt for “wild-caught” as opposed to “farm-raised” Milk and dairy: buy “grass-fed” dairy (most of the time, you will see this option for cow’s milk products) Red meat: look for the label “grass-fed”

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body

ASK THE DOCTOR A SQUEAKY CLEAN KITCHEN BREAKING A SWEAT ONE STEP AT A TIME

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Ask the Doctor

Chicago-based medical oncologist and cancer researcher Dr. David James VanderWeele answers your questions about the BRCA gene mutations in men. sister recently tested positive for the BRCA1 gene Q: My mutation, and her genetic counselor said the rest of her family members should get tested, too. But I’m a man. I thought BRCA was about breast cancer? Is there any reason why men should also be concerned about BRCA? We are learning more and more about BRCA1 and 2 mutations. Obviously we associate them more with breast and ovarian cancer, but we in the prostate cancer community have realized that it has strong implications for other cancers, too. Patients who inherit a mutation in BRCA1 or 2 from their parents also have a mutation in the cells in their body. They’re more likely to develop prostate cancer, just like their female relatives may be more likely to develop breast or ovarian cancer. That’s especially true for a BRCA2 gene mutation. They’re also more likely to develop a more aggressive form of prostate cancer.

in the past. For someone who has a known germline mutation or suspect they might, we are still trying to figure out the best way to do screening. For prostate cancer, you may consider getting a screening for prostate cancer through PSA testing.

inherited BRCA gene mutation. What should I do? For someone who is not diagnosed with prostate cancer but they have a family history of prostate, breast, ovarian, or maybe even pancreatic cancer, the first step is asking a family member who has one of those cancers to undergo germline testing. If the testing identifies a mutation that runs in the family, other family members can look for that specific mutation a little more easily. If a family member tests positive, this should lead to cascade testing. With cascade testing, additional family members will also get tested sequentially. For instance, if an aunt or an uncle is the family member to undergo initial testing, their siblings would be the next ones to get tested. If those siblings test negative, then all of their children are presumed to be negative, but if they test positive, then their children still have a 50 percent chance of having the gene mutation. Talk to a genetic counselor to think through all the implications of the testing, both for yourself and other family members. Your genetic counselor can let you know if it makes sense for you to get tested given your family history. Check to see if your insurance will pay for genetic testing. If not, there are other testing panels that are relatively affordable out of pocket compared to testing

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There are. There is a prostate cancer syndrome that seems to be linked only to prostate cancer and not other cancers, that we know of. There’s the strongest data for this in northern Europeans in a gene called HOXB13. It’s not clear if it’s very common in other populations. If you were going in for a testing panel that would include BRCA1 and 2, they likely would not include testing for HOXB13. At the moment, HOXB13 is only linked to prostate cancer and would probably have to be looked at specifically on it’s own. In addition, prostate cancers may also be more frequent in patients with Lynch syndrome, which is what we associate with colorectal cancer or endometrial cancer. This syndrome likely leads to an increased risk of other cancers as well.

ABOUT THE DOCTOR Dr. David James VanderWeele is a medical oncologist and clinical researcher at Northwestern University’s Robert H. Lurie Comprehensive Cancer Center. He received his medical and research training at the University of Chicago before moving to the National Cancer Institute where he sought to improve the treatment of prostate cancer based on a patient’s genetics.

Photo courtesy of Dr. David James VanderWeele

breast and prostate cancer seem to run Q: What if I don’t test positive for a BRCA gene mutation. Are there any other hereditary cancer syndromes I Q: Unfortunately, in my family. There is a strong possibility we have an should be aware of?

A Squeaky Clean Kitchen Our bodies shouldn’t be the only recipients of a toxin detox— common kitchen supplies could be ultimately harming your health. BY JASMINE JAFFERALI, MPH

hen many of us see the word “detox,” we automatically think of foods to eliminate from our diet. But other parts of your life might need a detox, too. Here, we’ll discuss ways we can reduce our toxic load in the kitchen. The rise of skin rashes like eczema and psoriasis may be due to food allergies, but the ingestion of metals such as nickel and aluminum from our pots and pans may be another cause, according to the Mayo Clinic and the Cleveland Clinic. Heavy metal toxicity is overlooked by the medical community as doctors aren’t always taught about environmental toxins in medical school, or about how these toxins can cause ill health. High levels of lead can cause developmental delays,

fatigue, constipation, blood pressure issues, and joint, muscle, and head pain in adults. According to the National Institutes of Health, aluminum is recognized as a neurotoxin leading to central nervous system issues. A 2013 study in Immunologic Research links aluminum to Alzheimer’s, ALS, and autism spectrum disorders. The chronic ingestion of metals from steel pots and pans used to cook food may put excess stress on one’s kidneys, liver, brain, and other vital organs, says a 2010 report in Environmental Health Perspectives. When these pots and pans are heated over 300 degrees, fumes from the metals release and leach into food. Additionally, nonstick cookware are covered by toxic coatings like perfluorooctanoic acid (PFOA).

WHAT STEPS CAN ONE TAKE TO STAY SAFE? 1. Say “no” to Teflon, aluminum, and other nonstick cookware. Nonstick cookware is generally made using poly- and perfluoroalkyl substances (PFAS). These substances release perfluorooctanoic acid (PFOA), a carcinogenic chemical when heated. PFOA is linked to potential cancer-causing substances, says the Canadian Cancer Society, and can even be found in human breast milk, according to South Korea’s Seoul National University. Look for companies that use cast iron, ceramic (not “ceramic coating”) or lastly, stainless-steel cookware. (If you have a nickel allergy, stainless steel may not be a good option for you.) 2. Don’t bake or roast in aluminum pans. Use tempered glass or ceramic dishes instead. 3. Toss out anything cracked, scraped, chipped, or worn. Contact your local municipality about how to go about doing this without harming the environment. 4. Use wooden or porcelain spoons. Wooden spoons wear down, but are inexpensive to replace. 5. Use stoneware items to bake your pizzas, breads, and other baked goodies.

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BREAKING A SWEAT A regular exercise routine can mean better treatment outcomes and reduced risk of recurrence, but how exactly does exercise manifest in the body? BY CATHERINE EVES

he positive effects of a regular exercise routine are undeniable. Increased physical fitness lowers the risk for a host of medical issues, including heart disease and diabetes, according to the Mayo Clinic. And the benefits for people currently in treatment for cancer are just as worthwhile—when paired with proper nutrition, exercise can help cancer fighters improve their response to chemotherapy, reduce the risk of cancer recurrence, and increase their quality of life. Cachexia, or muscle wasting, is a significant side effect of cancer treatment. According to Dr. Tina 30

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Skinner, a professor of clinical exercise physiology at Australia’s University of Queensland, cachexia is relevant to hormone-related cancers like breast and prostate cancers. Cachexia reduces hormone production—which is a positive effect for these cancers, as the tumor has nothing to feed on and grow—but also contributes to a loss of muscle mass, an increase in body fat percentage, and reductions in bone mass. “Those who have more muscle mass to start, [experience] less of those cachexia effects,” Skinner says. “There is a strong relationship between muscle loss and mortality from cancer.”

According to a June 2013 paper in the Journal what’s the type, and what’s the time of exercise required of Cachexia, Sarcopenia and Muscle, the cause-andto not only optimize either your ability to survive your effect relationship between cachexia and death is cancer and reduce disease- and treatment-related side widely unknown. “Despite the strong and consistent effects, [but also] reduce recurrence,” Skinner says. association of cachexia with mortality, no unifying The optimum dose, of course, is relative to every mechanism has yet been suggested as to why wasting person, and this is the question Skinner and her team conditions are associated with an exceptionally high are attempting to answer. Interestingly enough, an mortality risk,” the paper states. October 2018 study published in JAMA Oncology found Even so, the most significant benefit of regular the optimum dose of exercise to improve longevity for exercise on cancer patients is decreased body fat. people who survived cancer as children is around one “An increase in percent body fat increases your risk hour of brisk walking most days of the week. of not only cancer, but cancer recurrence,” says Dr. For current cancer fighters, exercise releases Harold Bays, the medical director of the Metabolic adrenaline, and higher-intensity exercises produce and Atherosclerosis Research Center in Louisville, higher levels of adrenaline responses, according to Kentucky. According to Bays, an increase in fat cells Skinner. “That higher release of adrenaline results in leads to inflammation, hormone dysfunction, and an kind of this myriad of other blood-related, antitumor increase in insulin production, all of which contribute effects,” says Skinner. This has a variety of positive to cancer. Bays advises proper nutrition and exercise to health effects on inflammation, blood glucose levels, maintain a healthy body weight and and insulin sensitivity—all compoward off cancer, or, for those in treatnents leading to cancer progression. Regular exercise in ment, promote the effects of their Of course, many forms of exercise cancer patients doesn’t are unattainable for some fighting treatment regimen and decrease the just help them drop risk of recurrence. especially aggressive cancers, but pounds or maintain a Skinner says it’s all relative to the The numbers don’t lie. A December 2018 study published in healthy body weight; it patient. “If we’ve got men who are JAMA Oncology says “the proportion unwell and unable to reach can actually decrease very of cancers attributable to excess body that optimum dose, [we’re trying to tumor size. weight ranges from 3.9% to 6.0% find] what’s the minimum amount of among men and from 7.1% to 11.4% exercise that would be able to optimize among women.” their outcomes,” Skinner says. The risks are a concern for people with prostates. And it’s best to start exercising now to continue While high-fat diets alone do not cause lethal diagnoses, a reaping the benefits later. An April 2019 article from January 2018 study published in Nature Genetics linked The New York Times considered a new study published high-fat diets with more aggressive prostate cancer diagin Frontiers in Physiology that researched participants noses, which are typically lethal. Prostate cancer can in an exercise study conducted ten years ago who still begin when a protective gene, PTEN, is mutated, shutting feel the benefits of exercise today. down its ability to control cancer growth. Nonetheless, Over the course of eight months, groups participated cancers with this singular event rarely spread beyond in regular exercise regimes ranging in moderate to the prostate. However, when consuming a high-fat diet, intense. Ten years later, the intense exercisers were the prognosis worsens. In the JAMA Oncology study, markedly more fit than the control group (those who researchers used mice with PTEN-driven prostate did not adopt a new exercise regime in the original study). cancer—when their diet switched from low-fat vegetarian to The moderate exercisers lost more fitness overall, but a high-fat “Western” diet (a diet of high-fat pellets made had healthier blood pressure and insulin sensitivity with sugar, starch, and other ingredients not found in the than the control group. More research needs to be low-fat pellets), their previously treatable prostate cancer conducted, but according to Dr. William Kraus, the significantly metastasized. lead researcher on the study, exercise “probably leaves Regular exercise in cancer patients doesn’t just help long-lasting imprints on our genes and cells that affect them drop pounds or maintain a healthy body weight; it health.” can decrease tumor size. “There’s new emerging evidence, At the core of it, exercise in any form is imperative really strong evidence, suggesting that [exercise] actually for quality-of-life factors for fighters who are well has a direct effect, not only on the tumor itself, but also enough to move about the world unassisted. “It’s a on the tumor marker environment,” says Skinner, who vicious cycle,” Skinner says. “When you can’t get out was on a team of researchers who conducted a study of a chair, then you lose your independence.” For some, examining the effects of moderate- and high-intensity regular exercise could lead to lasting improvements exercise on men with colorectal cancer. in both their mental and physical health, during and “What we’re trying to do in our lab is to [determine] after their cancer treatment. what’s the dose, what’s the frequency, what’s the intensity, Cancer Wellness

ONE STEP AT A TIME If you didn’t log your workout, did you even break a sweat? We’ve rounded up our favorite fitness trackers based on battery life, features, and aesthetics. REVIEWED BY CATHERINE EVES

itness trackers are gaining in popularity, which means the market is almost overrun with clunky watches claiming to change your life. Here, we’ve rounded up the best fitness trackers helping you create (and stick to) positive lifestyle changes for improved health and wellness.

BELLABEAT LEAF, $99.00 Sleek and chic, Bellabeat’s Leaf tracker is described as “smart jewelry,” and we think that’s quite apt. It can be worn as a necklace or a bracelet, and Bellabeat provides both the neck chain and wristband to accommodate. Besides step counting and activity tracking features, the Leaf also allows users to log their water consumption, sleep patterns, and reproductive cycle. We love that it doesn’t need to be taken off to charge and features a six-month replaceable battery with the hardware to help you change it yourself.

FITBIT VERSA, $199.95 The Fitbit Versa is like an alternative to the Apple Watch due to its wide variety of features. Worn around the clock, the Versa is shower- and swim-proof, lightweight and comfortable, and able to track sleep stages. Users can review the time each night spent in light, deep, and REM sleep and get personalized insights about how to get better shut-eye. Other cool features include Cardio Fitness Score, which assesses the wearer’s fitness and tracks improvements overtime, and personalized on-screen workouts that play straight from the device.

APPLE WATCH SERIES 4, $399.00 The mother of all fitness trackers, the Apple Watch includes pretty much any smart-tracking feature you can imagine. The watch’s fourth iteration takes a significant step towards heart health— featuring a heart rate tracker, the watch will send alerts to your phone if it detects low or high heart rates and irregular rhythms. You can also run an electrocardiogram whenever you sense an irregularity. Other safety features include fall detection and an emergency SOS. With daily goals (and the prominent buzzing when goals are reached) oriented to standing, movement, and activity, the Apple Watch significantly helps ward off a sedentary lifestyle.

GARMIN VÍVOSPORT, $169.99 The vívosport’s slim design means it fits comfortably on any wrist. (Larger fitness trackers, for instance, have been known to get in the way of exercises like push ups or some yoga poses.) With a built-in GPS, the vívosport is one of the most financially responsible trackers that is able to log runs, walks, and hikes without connecting to a phone. We love the Move IQ, which automatically detects when you’re breaking a sweat. Other features include daily fitness monitoring, stress tracking, and access to Garmin Connect—a popular online community that connects Garmin users to compete in challenges, find support, and encourage each other’s wellness triumphs.

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Complementary Medicine 34 THE RIGHT MEDICINE 36 BEING VERSUS DOING

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THE RIGHT MEDICINE

When 13-year-old Ashley Surin switched from prescription medicine to medical marijuana, her family had to rewrite the law to allow it on school grounds. BY CATHERINE EVES

shley Surin of Schaumburg, Illinois, was less After switching to medical marijuana, life improved than three years old when she had her first for the Surins—Maureen says before the switch, they were seizure. Maureen, Ashley’s mother, was driving living with the constant threat of having to rush Ashley to down the highway when it happened. “I pulled the ER. “I can’t say that there wasn’t a year we didn’t get over and I held her in my arms and I just prayed,” says in an ambulance from 2010 to 2017,” she says. But now, Maureen. Nine months prior, barely beyond infancy, everything is different. “We’re not surviving anymore, Ashley was diagnosed with acute myeloid leukemia we’re living.” (AML) and began a rigorous course of chemotherapy. However, the Surin’s trouble was far from over. The chemotherapy cured Ashley of her cancer, but for While medical marijuana may be legal in 33 states, it the next nine years, she would experience almost daily was still not legal on school grounds, which meant that seizures—until one of Ashley’s doctors recommended Ashley’s CBD-THC patch (that she wears on her foot, she try medical marijuana. under a sock and shoe, and is only seen and replaced at A May 2017 paper published in Epilepsy Behavior home) was against school rules. notes that, as far back as the 11th century, “crude Maureen talked to Ashley’s doctor. “[I asked,] isn’t marijuana extracts” were a viable medicine in treating that discriminatory? It’s a medicine, why can’t we bring convulsive disorders. The paper it to school?” she says. “[I asked,] what examined past reports on the effect if we sue? And [Ashley’s doctor] said, “When you see your kid ‘You’ll of marijuana derivatives on people be helping a lot of children.’ experiencing seizures, finding “the go from a comatose state And so I said, ‘Are you on board?’ and effects of several plant cannabinoids to living life actively, she said, ‘Absolutely.’” [...] in models of seizures, epilepsy, The Surins started writing what you’ll move to the ends would become “Ashley’s Law,” allowing epileptogenesis, and neuroprotection [are] consistent with reports of thera- of the earth to keep that eligible students to bring medical peutically beneficial effects of these marijuana products into public medicine going.” compounds in clinical studies.” schools, charter schools, and non More specifically, a landmark public schools throughout the state of December 2015 study published in The Lancet Neurology Illinois. The law took effect on Aug. 1, 2018. “[The] district found that CBD, the nonpsychoactive chemical in has been so supportive,” says Maureen. “That just made marijuana, reduced motor seizures (seizures that affect my heart so happy.” the muscles of the body) with similar success as other While a step in the right direction, the law is far from traditional treatments (and 2 percent of those studied comprehensive. “Any day now we should get a call to go became completely seizure-free). witness the signing of the amendment of Ashley’s Law,” “It has been life changing for us, for her,” begins says Maureen. The amendment would allow for more Maureen. “She can walk better, talk better, think better, people to administer the medicine as needed (currently, process better, interact better, look people in the eye, ask only two are allowed per student) and train nurses on how questions. [The benefits] go on and on and on.” Before to properly administer. “The law is getting polished up so switching to CBD, Ashley was on a “rolodex of meds,” says when Ashley goes to high school there’s no more wrinkles Maureen. The medicine made her irritable, lethargic, and we need to iron out,” says Maureen. sometimes almost comatose. “Sometimes they helped her But if so many children and teenagers are benefiting get through the day, but a lot of times they added more side from medical marijuana, why was this written into law effects we weren’t happy with,” Maureen says. only recently? Marijuana is classified as a Schedule 1 34

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Photo by Adrian C. Garcia

drug—shared by recreational drugs like heroin and LSD. But according to a May 2017 article in the Journal of Pediatric Pharmacology and Therapeutics (JPPT), by 1851, the United States Pharmacopeia had classified marijuana and its byproducts as legitimate medical compounds to alleviate symptoms of conditions like chronic migraines and pain—and epilepsy. Political propaganda of the 1930s attempted to debunk marijuana as medicine. The JPPT article chalks this up to a mixture of racism and competing fiber industries trying to prevent growth in the hemp industry. By 1970, marijuana had been labeled as a Schedule 1 substance. For this reason, investigation into practical uses and dosages of medical marijuana has been difficult. Marijuana products are not regulated in manufacturing, packaging, and labeling outside of clinical trials. However, organizations like the American Academy of Pediatrics supports further research into medical marijuana: The AAP website states, “Research and development should be conducted of pharmaceutical cannabinoids. The AAP recommends changing marijuana from a DEA Schedule 1 to a DEA Schedule 2 to facilitate this research.” There is much anecdotal evidence of medical marijuana improving quality of life. An exhaustive exposé in Time magazine (“Pot Kids”), for example, tells the story of a little girl diagnosed with a neurological disorder that manifested in about 200 seizures per day. Once her parents started treating her with medical marijuana—not yet legal in their state—her seizures dropped to about 20 per day.

In 2015, the CNN story of Charlotte Figi warmed the hearts of many. Charlotte had her first seizure at 3 months old. She would continue to have hourslong seizures, as many as 300 per week, that doctors couldn’t explain. Eventually, she was diagnosed with Dravet syndrome, a severe form of epilepsy that cannot be controlled by medication. When she was five, after exhausting all other options, Charlotte started being treated with an edible oil that was high in CBD and low in THC (THC is the psychoactive chemical in marijuana). Her seizures stopped immediately, and now they only occur two or three times per month. It is the advocacy work from people like Maureen that will continue to move medical marijuana into the mainstream, making it easier to conduct clinical trials and get proper and safe dosages approved for what some consider a “wonder drug.” Medical marijuana has given Ashley her life back. Without being allowed to consume the drug on school campus, Ashley wouldn’t be able to learn like other children do: in school, surrounded by her friends, teachers, and activities that will lead her down a path to success. “I don’t know what [Ashley is] going to do after high school, but the door is wide open,” says Maureen. “When you see your kid go from a comatose state to living life actively, you’ll move to the ends of the earth to keep that medicine going.”

Maureen, Ashley, and Jim Surin enjoying time together at Pembroke Park near their home in Schaumburg, Illinois.

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Being Versus Doing Does your outside world reflect an imbalance in your inner world? BY LIZ TUCKWELL

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(open to receive intuitive guidance, touch, support, and so on). When we are out of balance, it shows in our outer world.

It is extremely easy to feel out of balance in our goal-oriented and results-driven world. With too much male energy in your life, you may feel in constant action mode, wanting to rest but avoiding it to the point of exhaustion. We become stressed, overworked, and feel unloved by not accepting intimacy, connection, or rest. If we don’t control all aspects of our lives, we feel like our world will fall apart. Likewise, too much feminine energy can manifest in an inability to focus or take direct action. You may juggle a lot because you say “yes” too often. You may spend a lot of time in emotional limbo and find it difficult to make a firm decision. However, when these two energy systems are working in balance, our lives feel free. We receive intuitive guidance on what steps to take next and create firm and focused action plans and see them to completion. We are connected, creative, and in tune with the world around us, and find it easy to engage in our own world. We feel expanded, resilient, and loved. It is extremely easy to feel out of balance in our goal-oriented and results-driven world. We are surrounded by thoughts centered

on doing and achieving. Rarely are concepts of rest, relaxation, and intuition celebrated. If we are to truly live our lives in balance, we must make a conscious decision to do so. By doing so, we will be setting an example for those around us to do the same. When we make it a priority to connect with both our male and female energies, they can become powerful allies working in harmony within us.

IF YOU FEEL ONE OF YOUR POLARITIES IS OUT OF BALANCE, TRY THE FOLLOWING: TO ENGAGE YOUR FEMININE ENERGY: Create art and allow the process to flow without judgement. Meditate and sit in stillness for a few minutes every day. Laugh and seek ways to find humor in life.

TO WELCOME MORE MASCULINE ENERGY INTO YOUR LIFE: Perform physical activity, like rearranging your furniture. Engage in solving mathematical puzzles. Begin your day with a to-do list of items that you can accomplish.

Photo by Adrian C. Garcia

nce while speaking with a friend I said, “If only I could arrange to sleep for two months straight, then I could have the rest of the year free to work.” As I spoke, I caught myself mid-sentence, slightly horrified. In my perfect scenario, any time off was sequestered, and I would instead prefer to live in a constant state of work. This was entirely the wrong approach to living life harmoniously. In every area of our lives, finding balance is crucial. Whether it involves striking a work-life balance, creating a harmonious relationship, or simply balancing our finances, we must include our internal energy system in the goal. When our internal world is out of balance, it reflects within every area of our outer world. We experience our lives through dualities: night and day, on and off, positive and negative, hot and cold, light and dark. Our bodies also contain a duality: a “male” and “female” energy system. But this has nothing to do with assigned gender roles. Consider the yin and yang symbol. Yin is feminine, and yang is masculine. This Chinese symbol is made of a circle containing black and white swirls, each having a spot of the other within them. This is a symbol of opposite energies coexisting. Male energy is directed, focused, goal-oriented, productive, and female energy is creative, process-oriented, unstructured, still, and receptive

beauty

38 TOILETRY BAG 40 SUPER CLEAN SOLUTIONS

Cancer Wellness

What’s in Your Toiletry Bag?

If rounds of chemotherapy have left your skin dry and itchy, it’s time to pamper yourself, but are your go-to skin-care products doing more harm than good?

elf-care is essential for all cancer warriors. Taking time for yourself lends a beneficial boost to both your mental and physical health. Research published in Complementary Therapies in Medicine reveals that self-care practices can reduce the intensity of certain chemotherapyrelated symptoms as well as feelings of anxiety. Keeping up with beauty routines helps you retain a sense of normalcy, boosts your self-esteem, and promotes healing of your skin, but the limited amount of products marketed specifically toward men are often full of nasty chemicals that can be pro-carcinogenic. For example, 38

Cancer Wellness

certain ingredients in moisturizers (such as parabens) are endocrine disruptors, which can interfere with the body’s hormone systems. However, moisturizer is essential for addressing the skin issues often associated with chemotherapy, like dryness, cracking, and peeling. It’s a catch-22: Ignoring itchy dry skin isn’t ideal, but neither is covering your face in endocrine disruptors! The good news is that not all moisturizers are bad. Shea butter, for instance, can soothe dry skin without the use of carcinogenic ingredients. It’s time to give your toiletry bag a makeover. By making these substitutions you can prevent further irritation and promote healing.

Photo by Adrian C. Garcia

BY KATHRYN TRUDEAU

WHAT TO AVOID (and how to make smart substitutions)

FRAGRANCE

“Fragrance” is a catch-all term, and according to Laurie Neronha, a licensed esthetician and owner of Viriditas Beautiful Skin Therapies, “We don’t really know what’s in them.” Artificial fragrances can include harmful ingredients like phthalates and hydroquinone. Phthalates can increase your risk of metabolic syndrome (a cluster of conditions that increase risk of things like heart disease, stroke, and Type 2 diabetes), and the Environmental Protection Agency lists hydroquinone as a “known human respiratory toxicant.” Using scented products can damage your body, especially with repeated daily use. The solution: Choose an unscented product, or if you like scents, look for products scented with essential oils.

BHT

Butylated hydroxytoluene (BHT) is one ingredient often slipped into the generic term “fragrance.” Unfortunately, according to research published in Critical Reviews & Toxicology, BHT has been linked to bladder tumors in mice. Another study published in Toxicology found BHT enhanced both liver and colon tumor development in male mice. The solution: Look for organic colognes that derive their scents by distilling plants or flowers. Because natural colognes are not made with chemicals, you will need to reapply your scent throughout the day, but that’s a small price to pay. BHT can also show up in food, so check food labels for this preservative.

OXYBENZONE

One of the single most important products in your toiletry bag is sunscreen. Not only does sunscreen keep sunburns at bay, it can also prevent signs of sun damage and skin cancer. However, not all sunscreens are created equally. Oxybenzone is a chemical that reflects U.V. rays, but it’s not without risks. Oxybenzone can change your tissues at the cellular level, according to the Environmental Working Group, and it has been linked to reproductive organ toxicity as well as endocrine disruption. The solution: Instead of a chemical sunscreen, look for a physical sunscreen, which contains zinc oxide, a mineral that physically blocks U.V. rays from harming your skin.

SODIUM LAURETH SULFATE

When you brush your teeth and get that frothy, bubbly lather, it’s thanks to sodium laureth sulfate. It’s useful for creating lathers in shaving soaps and body washes, too. Unfortunately, this ingredient has been classified as a “moderate hazard” by the EWG’s Skin Deep cosmetic safety database. SLS has been linked to cancer, neurotoxicity, organ toxicity, skin irritation, and endocrine disruption. The solution: SLS-free toothpaste will work just as well as one that contains sodium laureth sulfate. And if you prefer a liquid body wash, consider using castile soap. Simply place castile soap (in a 2-1 ratio with water) into a foaming pump dispenser for an instant lather.

TRICLOSAN

As an antimicrobial, triclosan is most often used in hand sanitizers due to its ability to kill microorganisms like bacteria, viruses, or fungi. It’s tempting to grab products with antimicrobials to boost one’s immune system, but triclosan is a known endocrine disruptor. The solution: Use plain soap and water to wash your hands, or if you’re on the go, look for hand sanitizers that use natural botanicals—like leaves, flowers, roots, stems, or fruits—instead of triclosan.

PROPYLENE GLYCOL

According to the EWG, propylene glycol is used as a humectant (a moisturizing agent) in skin-care products, but it is also a petroleum derivative that can enter into your bloodstream and linger for 48 hours. Neronha notes skin-care products containing propylene glycol are particularly troublesome for individuals taking “cytotoxic chemotherapy drugs, [since] the skin is already extremely compromised.” Cytotoxic chemotherapy targets all cells, both healthy and cancerous alike. As a result, it’s not uncommon for patients to experience dry skin, rashes, tender cracks, and hyperpigmentation when the healthy skin cells cannot divide normally. Propylene glycol can make matters worse by triggering hives or contact dermatitis on already sensitive, inflamed skin. The solution: Look for natural deodorants without propylene glycol. Consider swapping gel-based deodorants for a stick. If you’re in a pinch, make your own: A blend of coconut oil, aluminum-free baking powder, and arrowroot powder functions well as a natural deodorant.

Cancer Wellness

Super Clean Solutions

Introducing some of our favorite clean-beauty products that soften and revitalize skin of all types—for men, women, and everyone in between. REVIEWED BY CATHERINE EVES

SAFELY SUN-KISSED

THIRST QUENCHER

JOSH ROSEBROOK NUTRIENT DAY

GOLDEN HOUR RECOVERY CREAM, $48

This day cream is good for all skin types. We like to include it in our daily cleansing routine—it’s unique in that it appears to be a thick, heavy lotion but it leaves skin feeling soft and silky without added weight. Those with darker complexions will appreciate that it doesn’t leave a white cast on skin. CREAM, $85

Cancer Wellness

This rich and silky night cream features meadowfoam oil, neroli oil, and calendula extract, which provide super intense hydration without being heavy. We love how it reduces redness and evens skin tone—it’s perfect for soothing irritated skin from prolonged exposure to sun or wind.

ALL-IN-ONE FOR ALL

Non Gender Specific was created by Andrew Glass, who worked at a skin-care line for men for five years before noting a gap in the industry. He launched NGS with this daily serum, which promises brighter, smoother skin and boasts a host of benefits, from improved skin elasticity to reducing the size of pores.

SILKY SMOOTH

You’ll love the light lather created by this shaving oil that keeps skin silky, which creates an ultrasmooth shaving surface and reduces the risk of irritation (which can lead to aesthetically unpleasant razor bumps or ingrown hairs). Plus, it’s good for both men and women.

NON GENDER SPECIFIC EVERYTHING

MARIE VERONIQUE MILDLY FOAMING

SERUM, $65

SHAVING OIL, $23

NGS serum photo by Adrian C. Garcia; others provided by Credo Beauty

PRODUCTS AVAILABLE AT CREDO BEAUTY IN CHICAGO

the thriver

ART “CHAT DADDY” SIMS AS TOLD TO BRITT JULIOUS

I was first diagnosed in January of 2010, and I basically thought I had a cold.

When I went to [my doctor’s] office, he did some blood work. He and I are friends, and he had tears in his eyes, and he said, “I think you have leukemia. You need to get to a hospital right away to find out.” I ended up going to [Cook] County Hospital, and that’s where I ended up finding out I had leukemia. It was extremely overwhelming at the time because I had lost all of my jobs due to the downturn of the economy. I had no medical insurance. I didn’t really have family support when I was diagnosed, so it was probably the most devastating [moment] in my life other than losing my mother. I never stopped working through the entire process. What people must understand [is] when you’ve been diagnosed with an illness, you’ve got to continue to keep moving. And you must work on faith and help your spiritual growth. Learn who you are. Find out what makes you happy. You’ve got to learn to channel your energy to heal yourself from your core. I’ve been in remission for over six years. If my blood stays clean for a year, we’re looking to diagnose me as cancer-free. Despite this, I’ve had so many issues as a result of the medicine [I still had to take] and the effects of the leukemia. One is joint pain. I’ve suffered with depression, anxiety, and sleep apnea. Last year, I decided [on] a holistic approach of not taking the cancer medicine anymore, and we’ve seen a great improvement in my health since I stopped.

Don’t give up. Find joy and happiness in everything you do. Count it all as joy.

To hear more from Art, visit cancerwellness.com

Photo by John Khuu

A lot of people are diagnosed, and they just want to curl up and die. You’ve got to really fight for yourself to stay alive. You’ve got to do your due diligence of finding ways to stay healthy. I’ve increased my level of meditation, yoga. My entire time in the media business, I’ve been an ambassador of happiness. When I got ill, people ran, so I had to learn how to practice what I’ve talked to other people about for years. Now, doing my radio show every night brings me joy. Don’t give up. Find joy and happiness in everything you do. Count it all as joy. Cancer Wellness

Cancer Wellness

44 SHARSHERET 46 ALEXâ&#x20AC;&#x2122;S LEMONADE STAND 48 CW EVENTS 50 CALENDAR

Photo by Adrian C. Garcia

Around Town

AMERICAN CANCER SOCIETYâ&#x20AC;&#x2122;S 13TH ANNUAL DISCOVERY BALL, HELD ON APRIL 27, 2019, AT THE HILTON CHICAGO.

Cancer Wellness

A Chain of Support Sharsheret, a national nonprofit founded to better provide resources for younger women of all Jewish backgrounds, offers support and education for those grappling with wholly specific religious, cultural, and genetic implications of a breast and/or ovarian cancer diagnosis. BY CATHERINE EVES

Sharsheret (pronounced shar-sheh-ret) is Hebrew for hen Rochelle L. Shoretz was diagnosed with breast cancer at age 28, she struggled “chain,” and symbolizes the connections between women, families, and communities facing breast and ovarian to find the proper resources and support cancer. “The concept was that each woman that we can for women like her—Jewish women connect to another is a link in our chain,” says Kleinerman. entering the “prime” of their life—until she founded One of Sharsheret’s main missions is connecting women Sharsheret in 2001. Sharsheret, a national nonprofit with one another to support each other through the cancer based in New Jersey, offers resources, support, and treatment process, because for people of Ashkenazi-Jewish education for people of all Jewish backgrounds affected descent, the risk is statistically alarming. by breast and ovarian cancer. According to Kleinerman, 1 in 500 individuals carry “When [Shoretz] was looking [for] support and the BRCA gene mutation—meaning they have a genetic knowledge of what was going on […] she wasn’t finding predisposition toward developing breast and/or ovarian a lot of resources for a combination of breast cancer and cancer, among others—but in the Ashkenazi-Jewish popbeing a Jewish woman,” begins Eve Kleinerman, the ulation, that number increases to 1 in 40. Peggy Cottrell, Illinois chapter’s regional director. “[Additionally], she Sharsheret’s genetic counselor, explains this is because of was a young, Jewish woman, [so] many of the resources three common gene mutations in this population, called for people with breast cancer as a whole were geared towards women who were quite a bit older than she was.” founder mutations, that occurred randomly and were 44

Cancer Wellness

passed down through generations. “Because of certain on this message from generation to generation, and have it population factors in Eastern Europe, the frequency of in the back of their mind,” she says. these three mutations increased,” she says. “Part of this is That’s why outreach education is such a big part of because the Ashkenazi-Jewish population was relatively Sharsheret. Licensed clinical social workers on staff with ‘closed,’ [meaning] that people didn’t migrate a lot, and insight into the religious, cultural, and genetic implicatended to marry only other Ashkenazi Jews.” tions for this population make themselves available for Ashkenazi Jews have up to an 80 percent risk of those looking for information and support. “The goal getting breast cancer in their lifetime, and up to a 45 of Sharsheret is having appropriate messaging,” says percent risk of getting ovarian cancer in their lifetime, Kleinerman. “We can actually educate the community on if they carry a BRCA1 or BRCA2 mutation, according things they need to be concerned about so they can take to Cottrell. “When the statistics are so high in the proactive steps for their health.” Ashkenazic-Jewish population, [that’s] where the need Cancer is not typically an easy discussion for comes from,” Kleinerman says. people of the Jewish faith. “Of course mammograms That’s why Sharsheret also offers genetic counseling— are so important and disclosing your health conindividuals are able to talk with Sharsheret and speak with cerns to your OB-GYN every year is important, but medical professionals about the genetic implications of those things are not always [something] people in the having Ashkenazi-Jewish heritage. “One thing that can be Jewish community are aware of or comfortable talking generalized to other religions but is about,” says Kleinerman. “We’re also prevalent when Jewish women “We’re really emphasizing really emphasizing creating a are diagnosed [is] what does that comfortable environment for men creating a comfortable do to your faith?” Kleinerman asks. and women in the community [to “What does that do for your belief in environment for men and realize] how important it is to take God? […] Does it make you question of their own health [and] women in the community control [if there is] even a God after all, if this actually save lives by empowering [to realize] how important it the women and men who hear our is happening to me?” Culturally, however, there are is to take control of their own programming to really take those practices that are entirely spesteps.” health [and] actually save cific to people of the Jewish faith. At its core, Sharsheret was lives by empowering [them] founded to provide more resources “There are a lot of things that come up in the Jewish community to really take those steps.” for younger women. “If you’re 65, when receiving breast and ovarian 70 diagnosed with cancer, your cancer diagnoses that don’t come up in the general immediate kind of every day implications are going to be population,” says Becky Koren, the Illinois chapter’s different—you don’t have little kids at home, you’re not program coordinator. Some people will lose their hair thinking about fertility or fertility preservation,” says during chemotherapy treatments, and opt to wear a wig. Kleinerman. Sharsheret provides information about When women in the Orthodox-Jewish community get fertility preservation and onco-fertility—“[Which] isn’t married, it is common practice to start wearing a wig. really a concern when you’re working with older women,” A woman wearing a wig during cancer treatment may she says. They also provide a “Busy Box” to families with now be confronted with unnecessary and sometimes young children—a collection of appropriate toys plus hurtful congratulations. resources that educate parents on how to speak with “This woman thought that she was going to go wig their children about cancer. shopping with her mother and mother-in-law [for her Providing education and resources for both older wedding],” Koren begins. “It was going to be an exciting and younger women diagnosed with breast and ovarian and beautiful time in her life, [but] here she is confronting cancer makes Sharsheret the number-one resource for this cancer diagnosis, and she has to wear a wig for that individuals from Jewish backgrounds. “It’s really nice, sad, scary reason instead of this meaningful right of no matter who calls, no matter what their profession, passage.” […] we have an individualized way to help them and Other cultural implications include things like tattoos. connect them with resources,” says Koren. The greater During radiation treatment, doctors will use tattoos Sharsheret’s reach, the more people will know what’s as markers to pinpoint the path for radiation, but in the available to them. “My vision is that everybody who Orthodox-Jewish community, tattoos are an unwelcome ever needs to avail themselves of our services—I hope body modification. According to Koren, many Jewish they would never have to—but they do understand that women believe they won’t be able to be buried in a Jewish we are here for them [and] we can support them,” says cemetery if they have a tattoo. “A lot of people have carried Kleinerman. Visit Sharsheret.org to learn more.

Cancer Wellness

when life hands you lemons Alex’s Lemonade Stand Foundation started with one little girl on a very important mission: Raising money for research to benefit the lives of others like her. BY CATHERINE EVES

Photo courtesy of Alex’s Lemonade Stand Foundation

lexandra “Alex” Scott was less than one year old families raising money through hosting their own when she was diagnosed with neuroblastoma. lemonade stands. She would spend her entire life fighting her With these funds, ALSF provides support programs cancer, until her death in 2004 at just eight for families dealing with childhood cancer. The “Travel years old. Alex inspired a legacy of tens of thousands for Care” program, for example, provides financial of volunteers to raise money for childhood cancer assistance for families who must travel to hospitals to research through Alex’s Lemonade Stand Foundation receive experimental treatments only offered by a few (ALSF), a nonprofit that has funded nearly 1,000 places around the country. cutting-edge research projects at 135 institutions in the Another of ALSF’s programs supports an often U.S. and Canada. underserved population. “SuperSibs” provides tools But let’s rewind. Before Alex’s fourth birthday, to help siblings of childhood cancer fighters during she received an experimental treatment called MIBG and after cancer treatment. “Studies show that if a therapy. Although it didn’t cure her cancer, it extended child survives their cancer, psychologically the siblings her life by four years. “It sort of changed her life,” fare worse than the survivor,” Scott says. According to begins Jay Scott, Alex’s father Scott, oftentimes siblings don’t underand co-executive director of ALSF. stand why their brother or sister is ALSF raises around “She was considered dying by three getting so much attention from their $25 million each year for parents, who must devote extra time hospitals, she was on morphine 24 hours a day, [but] when she childhood cancer research and energy to the cancer fighter. got this treatment, she came out “[SuperSibs] tries to empower [and] and ALSF’s support of the hospital three days later, make the sibling feel important and telling us that the treatment programs, with $3 million in control.” worked and that she was off pain ALSF uses this future-minded of that coming directly from medicine.” approach to raise money to fund Alex wanted others like her children and families raising research for immunotherapy, says to experience similar success. and finding more targeted money through hosting their Scott, Like many kids, Alex set up a treatments without side effects. own lemonade stands. lemonade stand in her front yard— “Chemotherapy is devastating to kids; but she had a mission. Through their bodies are growing, [...] they get her lemonade stand, Alex wanted to raise money to help brain damage, they get kidney damage, liver damage, fund research for experimental treatments that would heart damage from the chemotherapy, and we’re trying help others facing childhood cancer. “She raised a million to avoid that with immunotherapy,” says Scott. “We’re dollars before she died,” Scott says. “We thought that would looking for treatments that can cure kids but also not be the end of the lemonade stand, but the outpouring [of give them lifelong side effects like most survivors have.” support] from people, especially childhood cancer families, And their success is due to an incredible volunteer was even greater after she died than when she was alive.” force. “That’s the strength in our army, [the] tens of Fast-forward to today, and ALSF raises thousands of volunteers,” Scott says. For ALSF, it’s all around $25 million each year for childhood cancer about saving families from the fear of a childhood cancer research and ALSF’s support programs, with $3 diagnosis. “We give them a way to fight back, give them a million of that coming directly from children and way to feel empowered, we give them hope,” says Scott. Left: Alexandra “Alex” Scott at her lemonade stand. Visit AlexsLemonade.org to learn more.

Cancer Wellness

cW EVENTS

Taste of the Town BY ALLISON STERN

Cancer Wellness

Photos courtesy of A Silver Lining Foundation

hen Brent Carstensen walked into Sam’s Wine & Liquor some 17 years ago, he had no idea he would leave with a lot more than a bottle of champagne. As he walked up and down the store’s aisles, his soon-to-be close friend, Charles Edward Stanfield, spotted him. Stanfield, a champagne expert, noticed Carstensen’s breast cancer shirt and pointed to a pink ribbon on his own apron, proclaiming, “I’m a big supporter of the cause.” They soon realized they could do a great deal of good work together. Their collaboration would soon become known as Tasting Stars, an event benefiting A Silver Lining Foundation (ASLF). This year, as ASLF celebrated their 17th annual Tasting Stars event, the two men proved they still share a passion for what brought them together: champagne and finding a cure for KEEPING IT BUBBLY Clockwise: Dr. Sandy Goldberg, cancer. Since its inception in 2003, Marcus Riley, Eva and Dan Petrik, Julie Crumley; Tasting Stars has raised more than Christopher Grimes Temperly, $520,000 for ASLF. a nonprofit Todd Hess. organization dedicated to providing equal access to breast cancer education. ASLF is best known for their Buy A Mom A Mammogram® program, which funds cost-free mammograms and diagnostic testing to the uninsured and underinsured, because no one should be denied access breast health screening and education. The 17th annual Tasting Stars was held on June 22 at the DIRRT Environmental Solutions Showroom located in Chicago’s Merchandise Mart. Patrons toasted to ASLF’s achievements all night long, and enjoyed champagne and wine tastings, exquisite French food, and a live auction.

cW EVENTS

Photography by Adrian C. Garcia

“T

“he ‘H’ in H Foundation actually stands for Pam Hertz,” John Rot, the cofounder of the H Foundation, says about his friend and former colleague. “She was 31-years-old. She had a oneyear-old son. She was diagnosed with breast cancer. She was just one of those people who was full of life, and we decided we really wanted to do something that was in her name.” After Pam passed, Rot and his friends went on vacation and brainstormed ways they could honor her legacy. While sipping goombay smashes, a tropical drink, they were certain they knew how to do one thing very well: Throw a party. Nineteen years later, their party has turned into a massive Carribean-themed bash—Goombay Bash. More than a thousand people gathered at Chicago’s Navy Pier on Saturday, July 27, dressed in their favorite Hawaiian shirts and leis to celebrate cancer survivors and honor those they have lost. WGN Chicago’s Andrea Darlas and Pete McMurray co-emceed the night as attendees enjoyed tasty bites from a gourmet buffet. They were joined by celebrity guests including George Wendt of “Cheers,” former Chicago Bears player Otis Wilson, and former Chicago Bulls players Jeff Sanders and Craig Hodges, among others. The evening was packed with excitement as guests participated in raffle drawings, silent and live auctions, and watched a fireworks finale. Organizers raised $742,467 for basic science cancer research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

GET LEI’D Clockwise from left: Jonny Imerman, Shannan Hofman Bunting, Jeremy Roenick, Courtney White, Dan Fogarty, Erin Carillo, Pete McMurray, George Wendt.

Smash of a Bash BY ALLISON STERN

Cancer Wellness

SEPTEMBER 2019 SPOTLIGHT ON UPCOMING EVENTS IN THE COMMUNITY

UNCORKED: PULL A CORK FOR CANCER

5TH ANNUAL MRF CHICAGO GALA

Date: Friday, September 20 Time: 6:00 p.m. Location: The Drake Oak Brook Hotel Cost: $150 scoreboardcharities.com Enjoy a wine tasting, fashion show, shopping, and celebrity guests at this evening soiree to support the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and Camp One Step by Children’s Oncology Services Inc.

Date: Thursday, September 26 Time: 6:00 p.m. Location: Morgan MFG Cost: $200 melanoma.org Each year, Chicago’s most generous business and community leaders gather to support the mission of the MRF. Enjoy samplings from local restaurants, cocktails, and a silent auction at this evening gala.

Scoreboard Charities

Melanoma Research Foundation

Photo courtesy of Scoreboard Charities

2019 MESOTHELIOMA RACE FOR JUSTICE Vogelzang Law

Date: Saturday, September 21 Time: 9:00 a.m. Location: Lake County Forest Preserve Cost: $40 vogelzanglaw.com This 5K run and walk supports MARF, the Mesothelioma Applied Research Foundation, the nation’s leading charity organization dedicated to funding mesothelioma research. Photo courtesy of Vogelzang Law

CELEBRATION OF LIFE “A ROYAL AFFAIR” Cisco & Cisco Productions

Date: Sunday, September 22 Time: 3:00 p.m. Location: Hilton Chicago—Oak Lawn Cost: $65 ciscoandciscoproductions.com Proceeds from this night of dinner and dancing benefit breast cancer outreach programs, chemo-care bags, and youth health programs.

Cancer Wellness

To list or partner with Cancer Wellness on an event, please contact our executive assistant Melanija Ergarac mergarac@cancerwellness.com

OCTOBER 2019 A STERLING EVENT GALA

A WALK FOR THE BEAR Bear Necessities

Date: Sunday, October 20 Time: 9:00 a.m. Location: Lincoln Park—Grove 2 Cost: $25 bearnecessities.org Trick-or-treat and walk the three-mile trail dressed as your favorite warlock, witch, or wizard in support of pediatric cancer research.

A Silver Lining Foundation

Date: Saturday, October 5 Time: 6:30 p.m. Location: Hyatt Regency McCormick Place (Regency Ballroom) Cost: $300 asilverliningfoundation.org Support ASLF’s mission to provide costfree breast health testing at this elegant black-tie event, featuring cocktails and dinner, live entertainment and dancing, and live and silent auctions.

Photo courtesy of Bear Necessities

2019 FALL BENEFIT LUNCHEON Lynn Sage Cancer Research Foundation

Photo courtesy of A Silver Lining Foundation

Date: Friday, October 25 Time: 11:00 a.m. Location: Hilton Chicago Cost: $300 lynnsage.org All proceeds from this luncheon fund innovative breast cancer research and support advancing the treatments, education, and early detection of breast cancer. Photo courtesy of Sheri Whitko Photography

2019 ANNUAL GALA: ALL BETS ON PINK

MAKING STRIDES OF CHICAGO

Susan G. Komen

American Cancer Society

Date: Saturday, October 26 Time: 6:00 p.m. Location: Palmer House Hilton Cost: $275 komenchicago.org Komen Chicago’s annual fundraising gala includes a plated three-course dinner, an open bar, charitable gaming, a paddle raise, and both a live and silent auction.

Date: Saturday, October 19 Time: 9:00 a.m. Location: Soldier Field Stadium Green Cost: Donation cancer.org This charitable walk is ACS’s premier event to raise funds and awareness to fight breast cancer.

Photo courtesy of Devall Photography

Cancer Wellness

NOV & DEC 2019 BRUSHES WITH CANCER CHICAGO

TASTE OF HOPE

American Cancer Society

Date: Thursday, November 7 Time: 6:00 p.m. Location: Morgan Manufacturing Cost: $125 cancer.org Taste of Hope brings award-winning chefs and Chicago foodies together to celebrate the American Cancer Society’s progress in the fight against cancer.

Twist Out Cancer

Date: Saturday, November 2 Time: 6:00 p.m. Location: Moonlight Studios Cost: $150 twistoutcancer.org This art exhibition and gala is hosted by Brushes with Cancer, who provide psycho-social support to those touched by cancer to improve the quality of life for cancer patients, their family, and loved ones. Photo courtesy of Twist Out Cancer

CANCER WELLNESS FOR iOS & ANDRIOID We’ve launched a Cancer Wellness app for iPhone and Android! Visit CancerWellness.com/app for a free digital download of issue 4 — there’s no obligation.

Cancer Wellness

Excellence takes your cancer care to heart. Thanks to advances in diagnosis and treatment, more and more people are surviving cancer. However, some cancers and cancer treatments can also put your heart health at risk.

A leader in cardio-oncology

To address any heart-related concerns and complications, specialists in the cardiooncology program at Rush work closely with our oncologists and patients before, during and after cancer treatment.

“Cancer does not just affect one part of your body,” says Okwuosa. “It can affect your lungs, kidneys, liver, brain, heart and so on — which is why my philosophy is to focus on caring for the whole person.”

The program offers our patients the following services:

Okwuosa works closely with cancer specialists in the Rush University Cancer Center to develop personalized care plans that take both patients’ cancer treatment plans and their heart health into account.

•

Evaluation and medical care to enhance your heart function before cancer-related procedures or surgery

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Treatments to prevent or minimize damage to your heart while you are being treated for cancer (without interfering with your cancer treatment regimen)

•

Assessment of and treatment for heart damage caused by past cancer treatments

Rush’s cardio-oncology program is led by cardiologist Tochukwu Okwuosa, DO, a renowned leader in cardio-oncology.

“The beauty of Rush is that it is such a collaborative place for patient care,” says Okwuosa. “We are all willing to do whatever it takes to help our patients.” To make an appointment or for more information about the Rush University Cancer Center, visit rush.edu/cancer or call (312) CANCER-1.

Cancer Wellness

AMERICA’S FAVORITE WARRIOR

From his start in medicine to hosting “American Ninja Warrior” and raising millions for charity, Matt Iseman has always connected with audiences through the gift of storytelling.

Cancer Wellness

Custom suit élevée; Shirt Rufus; Shoes Rockport

BY CATHERINE EVES PHOTOGRAPHY BY ORIANA KOREN

att Iseman is a natural storyteller. This is clear producers [said] we want a guy who can talk sports but after watching him on television for just a few also has a sense of humor,” Iseman says. moments—either as host of “American Ninja And he delivered. Iseman’s ongoing stint hosting Warrior,” or as a contestant (and winner) of the “ANW” has made him a household name, but it is his eighth and final season of “The Celebrity Apprentice,” or positive attitude that has kept him busy for the last in one of his many televised comedy specials. 20 years in Hollywood. It’s no surprise that in 2017, And it was clear to me when I sat down with Iseman Iseman was invited to be a contestant on the eighth and at his leafy bungalow in West Hollywood, California, final installment of “The Celebrity Apprentice.” And one perfect July day to talk about his health struggles, he won, raising $573,329 for the Arthritis Foundation. his illustrious career (from working as a doctor in Iseman may have fallen in love with a life and career Denver to getting his “big break” in entertainment in world’s away from being a doctor in his hometown of Los Angeles), and his charity work. Denver, but it was his medical training that could have “Through sharing our stories, we bring people saved his life. Just a few years into his time in Hollywood, together,” says Iseman. “I think that’s how we start to at 32 years old, Iseman was diagnosed with Rheumatoid really make a difference.” As someone who lives with Arthritis, a chronic illness in which the body’s immune rheumatoid arthritis (R.A.) and has survived cancer, system attacks its own tissue and results in painful Iseman has raised millions of dollars for charities swelling in the joint linings. “It took a year and a half like the Arthritis Foundation and American Cancer to get a diagnosis,” Iseman says. “I’m a doctor, my dad’s Society—and he does this by a doctor, my friends are doctors, I sharing stories. “People rarely give have insurance. [...] I was seeing “Through sharing our money to a disease, they rarely give all the right people, but sometimes stories, we bring people money to a cause—they give money your body doesn’t cooperate.” It to a person,” he says. “And they do wasn’t until Iseman had experienced together,” says Iseman. it when people tell their stories.” debilitating symptoms for 18 months “I think that’s how we start Iseman’s success in Hollywood that his blood work reflected how is very much tied to his story- to really make a difference.” he was feeling, he tested positive telling ability, and on screen, he for R.A., and he finally got an seems so much a natural that it’s hard to believe his answer. But there was a lesson in this, too. career didn’t start in television. No, until Iseman was “Nobody cares about your health as much as you 28 years old, he was on the path to follow in his father’s do. You really do have to be your own best advocate,” footsteps and become a doctor. he says. Which is why, five years later, when Iseman “I loved med school, I loved the intellectual challenge, started experiencing chest pains, he booked an [and] I loved the idea of helping people, [but] my heart appointment with his doctor right away. He knew his wasn’t in it the way I needed it to be,” remembers Iseman. It R.A. medication was intense, known for weakening the was during his first year of residency that Iseman knew he immune system, so he was worried about an infection. needed a change. “I think medicine [is] a calling,” he says. A CT scan of his lungs just barely revealed a mass in his “When people’s lives are in your hands, it’s this sacred trust, kidney—it was renal cell carcinoma. and it’s an awesome responsibility [...] I found that was the “Mine is a story of blind luck,” says Iseman. “I had part I didn’t feel that I was living up to. [So] I had to step the best case possible, where I’m told I have [cancer] away—not just for my patients, but for me.” and I’m told I’m likely cured in the same breath,” he Iseman considered his options: He could travel the says. Surgery cleared Iseman of cancer, and after ten world for a year, or he could move to LA to pursue a career years of regular checkups, his cancer risk is “back to in something that, until now, had just been a hobby: normal.” stand-up comedy. Iseman’s first time performing comedy “I didn’t feel sick, [...] I wasn’t having any symptoms,” wasn’t until 1996, when he was 25, deep into his studies says Iseman. “[My doctor said], if they hadn’t caught this, to be a doctor. Four years later, in 1999, he made the big you probably would’ve come in five or six years when it move to Hollywood. “I wanted to try something different had metastasized.” And at that point, his survival rate to clear my mind,” remembers Iseman. “Within a couple would have dropped below 50 percent. weeks, I thought, oh my god, this is amazing.” Iseman urges people to take their health seriously After a handful of lucrative commercials, Iseman and trust themselves. “Nobody knows your body picked up hosting gigs—a home makeover show, a like you do, and if you feel something is wrong, keep television doctor, a week-in-sports recap series—until searching for an answer,” he says. His experience as a finally, in 2010, he landed the role for which he is best doctor only affirms this—he views the doctor-patient known: the host of “American Ninja Warrior,” a competition relationship as a partnership. “Otherwise, you’re show featuring “ordinary” people competing extraordinary putting your health in someone else’s hands. [...] Be a feats of strength in a series of obstacle courses. “The good patient and make the doctor be a good doctor.” Cancer Wellness

Oftentimes, patients are overwhelmed by the short time frame they have with their caregiver, and don’t demand the answers they need (if this sounds familiar, check out “Next Question, Please” on pg. 90 of this issue). That’s why Iseman takes every opportunity to share his story—of his tenacity in pushing for a diagnosis—and the stories of others like him as well, helping raise funds for organizations he believes in. It’s just one example of Iseman using his celebrity status for good. “[I think to myself], ‘Hey, you really do have a big platform, millions of people are watching “Ninja Warrior,” so what do you do with that?’” he says. “It’s really nice to feel that even though I walked away from medicine, I didn’t necessarily walk away from trying to help people.” It all comes back to sharing stories. “One of the most impressive things of our show is seeing how telling someone’s story can change the lives of so many other people,” begins Iseman. He recalls a moment from his time on “The Celebrity Apprentice”: One of the show’s editors had just recently been diagnosed with R.A., and she connected with Iseman over their shared diagnosis. “She just wanted to see somebody [who] was doing OK. [You] have these worstcase scenarios [and] she just wanted to see another possible outcome.” It’s a sentiment that has accompanied Iseman through his medical career, his start as a stand-up comic, and now in television. “I’ve just seen the power of telling stories, through ‘Ninja,’ through ‘Apprentice,’ through fundraising, [and] seeing how someone could be going through a difficult situation, feeling alone. [When you share] your story, then you can help that person keep fighting [cancer],” he says. “[It’s important] to know that you’re not alone when you’re in this fight.” Cancer, no matter the severity of a prognosis, can be terrifying. “It’s a glimpse at mortality, it’s a glimpse at how quickly things can change in your life, and the fact that at any point cancer can rear its head,” Iseman begins. “My story does have a happy ending, [so] I think it’s great to raise awareness and raise hope. [...] People should know this is a fight worth fighting, and it’s a fight we can win.” After our talk at his kitchen table, we head outside for the photo shoot, hoping to take full advantage of Iseman’s distinctly LA backyard. This is where the house really shines: The back door opens to a wide patio complete with seating, a formidable looking grill, and a wooden bar. A hallway of sorts, surrounded on either side by all different varieties of succulents leads straight to the pool, aquamarine blue and almost painfully inviting in the July heat. Back here: more seating, more plants, an intricately tiled fountain. Iseman says it’s his favorite part of the house. Melrose Avenue is right off Iseman’s property, but the constant LA traffic has been reduced to a low and pleasant hum, thanks to the design of the yard. Dramatic stalks of bamboo reach up to the sky, and Iseman tells us that around midday, the bamboo blocks the harshest rays, allowing bathers to comfortably bask in the warm shade. It’s truly idyllic. A place for quiet reflection to escape the drama of Hollywood. While Iseman gets comfortable on his outdoor sofa, I jokingly tell him, “I’m glad you didn’t utter the phrase ‘Laughter is the best medicine.’” Iseman smirks. “It’s not. Surgery worked a lot better for me.” 56

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Shirt All Saints; Jeans AG; Shoes Cole Haan Zerogrand Grooming by April Bautista; Styling by Taylor Massey

Cancer Wellness

Shorts Peter Millar

entertainment 60 DIRTY LAUNDRY 61 A WHOLE NEW BALL GAME

A still from the movie “Dirty Laundry”

Cancer Wellness

DIRTY LAUNDRY, DEADLY RESULTS

Zack Johnson and his film crew shine light on the everyday people affected by the deadly and aggressive cancer mesothelioma in the movie “Dirty Laundry.”

ack Johnson hadn’t seen or spoken to his grandmother in over five years—until one day, sifting through archival footage for his new movie, he came across an interview she gave for a deposition three days before her death. “I remember sitting there [and] hearing her voice for the first time in a long while; [it] was very, very hard,” says Johnson, who was very close to his grandmother before her death in 2012. It was this love for his grandmother that inspired him to create “Dirty Laundry,” penned “the asbestos movie” by its creators, with his cousin Conor B. Lewis and friend Bryan Lemon. Johnson’s grandmother passed away from the rare, painful, and aggressive cancer mesothelioma. As a stay-at-home mother, Iva Lewis was exposed to asbestos nearly every day—not by working a blue-collar job, but from doing the laundry, washing her husband’s work clothes. Stories like this were ones they knew they needed to tell: Fathers who put in a good day’s work at the factory, slowly poisoning themselves with asbestos; families who lived near asbestos dumping grounds without being alerted of the potential risks; loved ones who had to witness a member of their family slowly suffocating from the effects of this painful and incurable cancer. Until “Dirty Laundry,” there wasn’t much information available to the mainstream about mesothelioma and the tragic deaths of those who were unknowingly exposed to this deadly carcinogen. “We really saw a need in the world, because when [my grandmother] passed away, we didn’t think anything of it,” begins Johnson. “It wasn’t until a few years later, and we passively asked a few questions [and] found out more about meso and asbestos, and [thought], ‘Wait, this is a pretty big deal, why don’t people know about it?’” “Dirty Laundry” exposes the government cover-ups and lack of communication and safety measures to protect workers regularly working with asbestos— people like Johnson’s grandfather, who worked as an insulator at Shell Oil. “Dirty Laundry” is as fascinating as it is informative. This can be attributed to the way Johnson and his team prepared for and filmed the movie. Johnson and Lewis decided to cross the country by bike, from Oregon to 60

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New York, to gather interviews from families affected by asbestos, many of them living in small towns situated near toxic asbestos dumping grounds. The trip took 78 days and covered more than 4,000 miles. Originally, Johnson and his team intended for the cross-country ride to connect the personal and physical suffering of those living with mesothelioma, but after a few days, this idea dissolved. “No matter how big the mountain is that we’re climbing, no matter how hard it was, how hot it was, how tired we were, we always knew that the top of the mountain was coming, and all of the pain was going to be over soon.” For people with mesothelioma, Johnson realized, the suffering doesn’t go away. This is clear in the footage gathered by Johnson and Lewis. The two visit with surviving family members who talk of their loved one’s meaningless deaths; they stop by Ambler, Pennsylvania, to visit an asbestos dumping ground, but find a construction sign—a massive condominium building is about to go up, capable of housing 115 families, with little signage about the dangers of exposure right outside their front door. But the most poignant footage is of interviews with survivors currently living with mesothelioma. One woman, Julie Gundlach of St. Louis, Missouri, has been living with mesothelioma for 10 years. She was just 45 years old at the time of filming. Another man, Mike Mattmuller of Westminster, Maryland, was diagnosed five years prior. We see him enjoying time with his family—his wife and their one-year-old son— and speaking about his fear for the future. These are stories few have heard before. “All these stories have the same arch, but they’re all very different,” Johnson notes. Like Johnson, audiences are able to learn something truly worthy from watching “Dirty Laundry.” “I learned a lot about the human spirit,” Johnson begins. Cancer hits at random, often viciously, but with resources like “Dirty Laundry,” no one has to feel alone during their fight. “We wanted to make something that was, in a way, entertaining, heartfelt, and related to the people, the individuals who suffer, and their families,” says Johnson. “We saw that need and decided, hey, let’s give it a shot.”

Image courtesy of Zack Johnson

BY CATHERINE EVES

A Whole New Ball Game Thomas Cantley went from a New York City fashion photographer to a homeless addict to a stage III cancer survivor. Now, heâ&#x20AC;&#x2122;s eager to share what heâ&#x20AC;&#x2122;s learned about life with people around the world.

Photo and comic stills courtesy of Thomas Cantley

BY BRITT JULIOUS

Cancer Wellness

homas Cantley may be the star of the “Mr. Ballsy” comics series, but his true-to-life “superhero” origin story is a lot more frightening than what most people would read. Cantley, a writer, motivational speaker, and activist, has beat both addiction and testicular cancer. And now, he’s ready to share what he’s learned with an audience of fighters and survivors who may be struggling through their own cancer journey. Cantley’s life pre-cancer was a glamorous one. A fashion photographer based in New York City, Cantley often shot with a who’s who of top designers and clients, including Project Runway alum Christian Siriano. But the hard-partying lifestyle which often accompanies the fashion industry began to wear on Cantley, who said he went down a path of self-destruction. “I was someone living for myself and nobody else, pretty much damaging anyone around me without question or without knowing,” Cantley recalls. His lifestyle eventually took a toll, and Cantley ended up homeless. Although his girlfriend at the time left him, her connection to a breast and ovarian cancer fighter named Monica Knoll saved Cantley’s life. Upset after learning he was homeless, Knoll went searching for Cantley. She eventually found him, introduced herself, and allowed Cantley to detox in her apartment. After he began feeling “horrible” abdominal pain and one of his testicles “grew to the size of an orange,” Cantley went to the ER. After some testing, he learned he had stage IIIA testicular cancer, and it had spread to his lymph nodes. “I was described as emotionless, and it didn’t hit me,” Cantley recalls. A storyteller by nature, Cantley documented his recovery and treatment through Youtube, and he quickly gained a following around the globe. One fan, all the way in New Zealand, credited Cantley’s honest videos for helping him catch his own cancer early. “Immediately, it just shot this thrill through my body. It was like I changed instantly,” Cantley says. “The universe was speaking to me, and that was my drive for my whole mission. [...] We never met, but he went to the doctor and listened to me because he connected to me and

trusted me and went to the doctor. Having that impact on someone else’s life completely shifted my mindset.” Ten years later, Cantley is cancer-free and has dedicated his life to cancer activism. In 2014, he made international headlines by pushing a six-foot “testicular” ball across the United States to spread awareness about testicular cancer, garnering press from the Huffington Post, Men’s Health, and the “Today” show along the way. And in 2017, Cantley debuted “Mr. Ballsy Adventures,” a new comics series he wrote and created. “I didn’t want to write a book about myself,” Cantley says. Cantley stars in the comic and other characters include real-life cancer survivors. “The comic industry is a multibillion dollar industry. Everything comes from a comic or an artist,” Cantley begins. “So I figured I wanted to really work with and come up with something cool that could really reach out to this large demographic, connect with them, but still educate them.” But Cantley’s biggest motivation right now may be his desire to help “change the mindset” of other cancer fighters out there. “We get our bodies fit, but we don’t get our minds fit,” Cantley says. For the last five years, he’s been in the process of developing a program for cancer fighters. Many fighters struggle with the mental ramifications of a cancer diagnosis and the debilitating treatment process. “Everybody is different. Not one body is the same,” he says. “They don’t know how to channel this energy.” Cantley’s program aims to help cancer fighters change their mindset from negative into positive. “If you don’t accept the fact that you have it, how can you overcome it mentally?” he asks. “Mindset training is such a powerful thing.” Cantley aims to unveil the program soon, but until then, fans (especially men concerned about cancer) can catch up with all of his activities online, the same place where he began to build a community around cancer awareness. “A lot of men aren’t proactive, [but] the big thing is not being afraid and really owning up,” Cantley says. “They think showing any sign of weakness is not manly, but being proactive and being ballsy is being manly. You’re owning up to your body and to your health.”

Stills from Cantley’s new comic series “Mr. Ballsy Adventures,” which features the stories of cancer fighters. 62

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CANCER WELLNESS FOR iOS & ANDRIOID We’ve launched a Cancer Wellness app for iPhone and Android! Visit CancerWellness.com/app for a free digital download of issue 4 — there’s no obligation.

Cancer Wellness

travel

66 REEL RECOVERY 68 STAY & PLAY

Cancer Wellness

CATCH TO RELEASE

Reel Recovery provides free-of-charge fly fishing retreats (and the freedom and space to talk) for men with cancer.

“M

y primary goal in running Reel Recovery has been to create a place where people can be their best selves,” says Stan Golub, executive director of Reel Recovery, a national nonprofit that provides free fly fishing retreats for men with cancer. This year, Reel Recovery will host a total of 32 retreats in 21 states. Golub has been there since day one. “It’s not about cancer, it’s not about fly fishing, it’s about the generosity of spirit amongst all of our volunteers and staff that welcome these men, treat them like kings, and give them this life-changing experience that does transform them,” Golub says. Founded in 2003, Reel Recovery has helped more than 3,400 men connect with others who can relate to their experience dealing with cancer—and gives them the space to talk about it. “We started just purely from scratch, 66

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with four brain cancer patients, and it was a phenomenal experience for all of us,” Golub says. Reel Recovery was able to expand after receiving a grant from the Livestrong Foundation that same year. With currently more than 800 volunteers, each of Reel Recovery’s chapters organize two-and-a-half day fly fishing retreats for groups of 14 men diagnosed with all forms of cancer. “I think anybody who fly fishes will tell you that it’s an exceptionally peaceful and healing experience,” begins Golub. “To be out in nature, to be standing in a stream, the river flowing by, birds around, and the need to focus on your casting and on the fly on the water—it just takes you to another place, and you don’t think about anything else.” During the retreat, psychotherapists and social workers lead what Golub refers to as Courageous Conversations.“We give the men an opportunity to share their stories about their cancer experience,”

Photos courtesy of Reel Recovery

BY CATHERINE EVES

he says. “We don’t do therapy, we don’t do counseling, retreats accessible to more men dealing with cancer. This we’re not touchy-feely; we just allow each man the time is where he attributes their success. “We’ve stayed very to tell their story.” focused on a singular mission of serving men with cancer, And it works. Golub brings up the fact that men don’t [and] everyone who is involved brings an open-hearted, often feel comfortable talking about their vulnerabilities. caring sensibility [so] these men are treated well,” he says. At Reel Recovery retreats, this isn’t an issue. “Men are Because there’s nothing more difficult than reluctant to talk about their cancer, trying to maintain a semblance of they’re reluctant to join groups,” says normalcy after a cancer diagnosis. “To “We often hear, ‘We came give that gift to these men who are day Golub. “That’s why fly fishing is the together as 14 strangers, and to day going to hospitals, dealing with hook that gets them there.” Response has been overwhelmwe’re leaving as a band of treatments, getting them out in nature ingly positive. “[The men] say they got brothers.’ It is an incredibly in a totally different setting and then healing they never knew they needed. teaching them this skill and giving powerful, life-changing, They often say that now they don’t them the joy of catching a fish, which ‘best experience of their lives’ just gives them this smile and joy that feel like they’re alone,” Golub says. Fran Kirby, a former member of they haven’t experienced sometimes in type of experience.” the military, was diagnosed with a years,” Golub says. “That in itself is a terminal brain tumor in November gift.” 2017. A Reel Recovery retreat made it possible for him After their retreat, Golub says that many men will to keep fighting. “It saved my life, plain and simple,” stay in contact with each other and the coordinators of Kirby says. “[My doctor said], ‘Your projected timethe retreat, finally armed with a support network they line’s a year,’ and now here I am, 19 months later, still didn’t realize they needed. “We often hear, ‘We came kicking, and I think a lot of my outlook now is because together as 14 strangers, and we’re leaving as a band of Stan (Golub) and Reel Recovery.” of brothers.’ It is an incredibly powerful, life-changing, Looking to the future, Golub says they’re ‘best experience of their lives’ type of experience,” Golub focused on slow but meaningful expansion, making more says. “These men come home completely transformed.”

Reel Recovery retreats foster real friendships between men with cancer through fly fishing, guided conversations, and plenty of free time spent in nature. Visit ReelRecovery.org to learn more.

Cancer Wellness

STAY & PLAY

Bengaluru, in the southern Indian state of Karnataka, is a teeming metropolis with a friendly soul. Good food, great cultural experiences, and high-tech hospitals make it a preferred medical tourism destination. BY PAYAL DHAR

BENGALURU

Cancer Wellness

Photo courtesy of Soukya

ndia and its cacophony of sights, sounds, tastes, BEFORE YOU GO and smells can be an assault to the senses, often Most medical tourists to India are from the nearby South overwhelming for some. Others like the challenge Asian region, the Middle East, and Africa, followed by of navigating its mind-boggling diversity, and a growing number from Europe and the United States. many seek—and find—balms for a tired soul. But the long lines of treatment seekers at the immigration And then there are those who visit to heal their counters don’t reflect one particularly important reality bodies. As one of the top medical tourism destinations about India: The world-class medical services tourists today, India offers state-of-the-art medical technology seek are only accessible to the most affluent of Indians. combined with low treatment costs (60 to 90 percent The state has a public health care responsibility, but the lower compared to the U.S.). Nearly half a billion medical reality is different. Given the high proportion of out-ofvisas were issued in 2017. By 2020, the medical tourism pocket expenditures and low insurance coverage, only industry is set to touch the $9 billion mark. In response, the relatively wealthy are able to access the nation’s best India’s Ministry of Tourism has health services. Most traditional forms of developed the National Medical and Bengaluru has one great Wellness Tourism Board to look medicine, in India and the advantage: year-round good weather. into visa approvals, accreditations, February to April can get a bit hot allied services, and the marketing rest of the world, consider (the temperature can go up to 95 F), and promotion of medical and wellbut early mornings and evenings healing to be a lot ness tourism. usually stay cool. Ensconced in In addition to conventional more than symptomatic or the unspoiled environs of Soukya, (allopathic) treatments, medical targeted relief, whether however, this is unlikely to be much tourists can choose from accredited, of a bother as the greenery keeps the it’s for a headache or a common forms of medicine, like the place at least a few degrees cooler South Asian systems of Ayurveda, than the city. chronic ailment. yoga, Siddha, and Unani, as well Traffic in Bengaluru is notorious as Western ones like homeopathy and naturopathy. so any trips into the city are best taken outside of rush Doctors of allopathy in Bengaluru are largely supportive hour. Otherwise, it’s a warm, friendly city. Most people of alternative treatments, and many of these are available speak at least some English and there are plenty of outside by side in major hospitals. In addition, there are also of-town getaways if you need a break from the crowds. centers that specialize in holistic healing and general wellness. Soukya, in Bengaluru, Karnataka, is one of them. RESOURCES AT SOUKYA Dr. Issac Mathai’s International Holistic Healing Centre WHAT IS SOUKYA promises the healing of the mind, body, and spirit with A serene 30-acre property on the edge of a large and a combination of contemporary medical know-how and boisterous city, Soukya can offer an offbeat and relaxing traditional medicine from around the world, adminisexperience at the tail end of a medical trip. However, it tered by trained practitioners and therapists. Patients can also be a treatment destination itself. Soukya offers are required to undergo a “holistic health evaluation,” focused therapies for various ailments and conditions, which includes their physical, psychological, social, including cancer, with a nod to clean eating and living. nutritional, environmental, and, if required, spiritual

The lush surroundings of Soukya in Bengaluru.

Cancer Wellness

Photo courtesy of Wikimedia Commons

The front entrance Lalbagh Botanical Garden in Cubbon Park.

needs, following which a customized care package is developed. As a full-service residential facility, visitors are not required to arrange for any extra support services, special diets, or transportation to appointments. Most traditional forms of medicine, in India and the rest of the world, consider healing to be a lot more than symptomatic or targeted relief, whether it’s for a headache or a chronic ailment. Soukya’s approach is similar, and use a combination of treatments in Ayurveda, naturopathy, homeopathy, yoga, acupuncture, hydrotherapy, and more. ACCOMODATIONS AT SOUKYA Patients are required to stay on the premises for the duration of their treatment. Wellness tourists, on the other hand, can opt for a weekend package, day trips, or customized stays. Whatever you’re here for, the space is a balm for the soul, with its sprawling lawns and flowerbeds surrounding the treatment areas, offices, and residential complexes as well as vegetable gardens and orchards. Explorers can make use of the convenient mile-long walking track around the property. Accommodation is in cottage-like private rooms with lawns, outdoor showers, and natural, organic toiletries. Two-bedroom cottages are also available, with local, handmade furniture, cotton furnishings, a personal garden, and outdoor showers in the midst of banana groves. Meals are served in the open-air dining area, surrounded by lush lawns. Dishes are simple but delicious ovo-vegetarian South Indian fare, using homegrown organic vegetables and usually accompanied with unpolished red rice. The excellent staff will accommodate any dietary requirements. With a bouquet of therapies and massages, a pool, reading room, and games, you won’t have time to miss 70

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a television, and in some areas even a mobile phone signal. Soukya is a quintessentially Indian experience, but away from the madding crowd. That said, having come all the way here, an exploration of this historic city is definitely warranted. SIGHTS AND SOUNDS Once famously known as the Garden City of India, uncontrolled urbanization—driven primarily by the tech industry—has now made Bengaluru a garden of the concrete sort. However, there are still pockets, especially in the older parts, where you can experience its green splendor. One of these is the historic Cubbon Park, central Bengaluru’s green lung. This 100-acre park was built in 1870, and houses a number of colonial-era buildings and sculptures, not to mention a wide range of wildlife. Explore on foot or by bike, and don’t forget a picnic lunch. Lalbagh Botanical Garden is another well-loved green landmark, commissioned in the latter half of the 18th century by Hyder Ali, the sultan of Mysuru. Today, it contains one of South Asia’s largest collections of rare tropical plants; it’s also a birding destination. If you visit during January or August, you might be lucky enough to witness Lalbagh’s spectacular flower show in the Glass House. Another monument of interest is the Kempe Gowda Tower situated on a hillock of 3,000million-year-old peninsular gneissic rocks. Relatively new, the Indian Music Experience (IME) is the first interactive museum of music in India. It features exhibits tracing the origins of Indian music, interconnections between various music genres, influences from around the world (and influences to music from other regions), an instrument gallery, and much more. Plus, there are games to play to learn about ragas (patterns

of notes in Indian classical music), a mixing station, a recording studio to record your own voice, and an interactive outdoor sound garden. A small but satisfying cafe is located within the premises, as well as a gift shop to pick up some IME merchandise.

Saris are quintessentially Indian, and Bengaluru is one of the best places to buy the authentic silk masterpieces. Visit Vimor, a 40-year-old family-owned boutique that specializes in reviving heritage handloom saris in both silk and cotton, including those worn by the former prime minister, Indira Gandhi.

GETAWAYS There are numerous short trips around Bengaluru— TASTES both day excursions and overnight getaways. Since this To eat what the locals eat, the way they eat, and for the region produces some of India’s best wines, a vineyard prices they pay, a trip to Mavalli Tiffin Room (MTR) tour makes for a great day out. The Grover Zampa should be worked into the itinerary. They are famous Wine Tour in Nandi Hills includes lunch, a visit to the for the rava idli, steamed semolina cakes traditionally winery, and wine tastings in their cellar, surrounded made of fermented rice. MTR is said to have “invented” by oak barrels where their premium wines are aged. the semolina version when there was a shortage of rice Visitors are acquainted with the wine-making process, during World War II. The best way to eat at MTR is from crushing to filtering, proto opt for a set-menu meal (served cessing, fermentation, storing, Soukya is a quintessentially during lunch and dinner). The bottling, labelling, and packaging. food is simple, the service runs Chikmagalur, India’s coffee Indian experience, but away like clockwork, and you are capital, is a three-hour drive from expected to get up and leave as from the madding crowd. Bengaluru. Here, you will find as you finish, to make room That said, having come all soon coffee plantations, beautiful views for the next lot of eaters. (For of the Western Ghats mountain the way here, an exploration under $2 USD per person, that’s range, and some heritage temples quite fair.) It’s best to reserve a of this historic city is and historical sites to take in. Best spot unless you want to stand in definitely warranted. explored over a couple of days, you line. also have the option of staying For similar local fare but right inside a coffee plantation, with guided tours to in a bubble-wrapped experience, head over to Oota learn about how coffee is grown and processed and how Bangalore in Whitefield (oota means “meal” in Kannada, Indian coffee is different, both in the way it is grown (in the regional language of Karnataka). The restaurant shade instead of direct sunlight) and served (in a copper or is located on the premises of Windmills Craftworks, stainless steel tumbler-and-bowl set). both a microbrewery and cultural experience rolled into one. They serve their own beers, offer an al-fresco SHOPPING STOPS dining menu, and host live jazz acts. Seafood lovers Want something local? How about products of a 200-yearmight want to stop by Karavalli at the Gateway Hotel. old woodcraft tradition? Colourful wooden toys from the They are known for serving authentic coastal dishes of town of Channapatna, known as the region’s “toy town,” southwest India (Mangalorean, Konkani, Kerala, and and other ethically sourced handicrafts can be bought others). If you’d like to stick to the city’s iconic culinary at one of Varnam Collective’s showrooms in Bengaluru. haunts, The Only Place, tucked away on Church Street They also offer clothes, jewelry, and home essentials. in central Bengaluru, and Koshy’s on St Mark’s Road.

Photos courtesy of Mavalli Tiffin Room & Oota Bangalore

L to R: avalakki, uppittu, and kesari bath from Oota Bangalore; rava idli and khara bhath from Mavalli Tiffin Room.

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74 CAMELS FOR THE CURE 76 DR. MUAIAD KITTANEH

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Camels for the Cure

Mammals of the camel family possess unique antibodies with antitumor effects, which is why these furry friends are at the forefront of revolutionary cancer research. BY BRITT JULIOUS

lpacas are not just cute, furry, unusual looking animals. They may just be the future in fighting some of the most aggressive forms of cancer, including melanoma and colon. Teams of researchers across the globe—including professors at Vanderbilt University, the Massachusetts Institute of Technology, and the Boston Children’s Hospital—have launched multiyear research initiatives. Their aim? To study how the antibodies of alpacas (along with their fellow camelid brethren including camels and llamas) have unique antitumor properties. And their findings thus far show promising solutions. Two undergraduate students at the Free University of Brussels first discovered the unique properties of these animals in 1989. According to Science Daily, the two “stumbled upon” the previously unknown antibody after being asked to test frozen blood serum from camels. Through their research, they found the camels had something of a miniaturized version of a human antibody. But unlike human antibodies, which contain two light and two heavy chains, the camel antibodies contained only two heavy proteins. They later confirmed

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the antibodies were also found in llamas and alpacas. According to New Atlas, “Alpacas are one of very few animals that can naturally produce single-domain antibodies. These are much smaller than common antibodies and are often referred to as nanobodies. Cheaper and easier to mass produce than traditional monoclonal antibodies, nanobodies promise an exciting new future in drug treatments.” Hidde Ploegh, Ph.D.—an immunologist at Boston Children’s Hospital and senior investigator of a recent study in the journal PNAS—says this discovery is appealing for many researchers. “Their small size makes it easy to produce them in bacteria. Their small size makes it easy to install various tags that allow you to modify these proteins,” Ploegh says. “And most importantly, their small size makes it possible to be rapidly cleared from the bloodstream.” But despite these great discoveries, the patent for this information remained in Belgium until 2013. Since then, research efforts have exploded around the world surrounding these antibodies.

BARCELONA DISCOVERIES These nanobodies could work as a form of therapeutic treatment against overexpressed epidermal growth factor (EGF), which is associated with several cancers. Although researchers have previously developed several monoclonal antibody inhibitors to target EGF receptors, they are often not effective. Many patients also develop resistance to such treatments. New Atlas went on to report that researchers at the Institute for Research in Biomedicine in Barcelona have used alpaca antibodies to establish “that these unique nanobodies are an effective EGF inhibitor. The next stage is extensive study to find out whether these nanobodies actually have a pharmacological effect in animal models of cancer.” Although research is in its early stages, it does show signs of future therapeutic use. REGULATING ENZYMES AT VANDERBILT UNIVERSITY Back in the United States, other researchers have found additional unique ways to study these antibodies. For example, Vanderbilt University associate professors Ben Spiller, Ph.D., and Brian Wadzinski, Ph.D., along with Rich Breyer, Ph.D., the Ruth King Scoville Chair in Medicine, joined forces to launch Turkey Creek Biotechnology. As part of its initiative, the organization purchased a herd of alpacas and partnered with Litton Farms in Waverly, Tennessee. The team aims to utilize the animal’s unique antibodies to study human disease and, in the future, hopefully treat human patients. Through their research, they specifically aim to regulate the PPP2R5D enzyme using isolated fragments of the alpaca’s antibodies. PPP2R5D has been linked to autism, Alzheimer’s, and some cancers, says Vanderbilt University. “Alpacas have an exceptionally unique immune system,” says Wadzinski in a Vanderbilt University press release. “Their antibodies can be used for research, diagnostic, and therapeutic purposes and, because of the unique features of these antibodies, we’re able to harvest them. They’re acid stale, heat stale and there’s good evidence they pass the blood-brain barrier.” TAKING CAR T-CELL THERAPY TO SOLID TUMORS But one of the most significant discoveries was announced this year. Researchers at the Boston Children’s Hospital and MIT found alpaca nanobodies may be the key to making CAR T-cell therapies work against solid tumors. So far, CAR T-cell therapy has been most successful for blood cancers by “genetically engineering a patient’s own T cells to make them better at attacking cancer cells,” Science Daily reports. But they have been less successful at eliminating solid tumors.

“It’s been hard to find cancer-specific proteins on solid tumors that could serve as safe targets,” Science Daily reports. “Solid tumors are also protected by an extracellular matrix, a supportive web of proteins that acts as a barrier, as well as immunosuppressive molecules that weaken the T-cell attack.” However, the Boston team were able to create CAR T-cells containing nanobodies able to recognize specific proteins “in the tumor environment, bearing signals directing them to kill any cell they bound to.” It’s something of a revolutionary step forward. Researchers theorized they could create CAR T-cells to affect a tumor’s blood supply. “Given the fact that growing tumors require blood supply, if you could interfere with generating that blood supply and damage the blood vessel, perhaps you could set up a local inflammation that could help the immune response,” Ploegh says. “Perhaps you could deprive tumors of proper blood supply so they would be starved for nutrients.” Researchers also used a technique that utilized these animal antibodies as “targeting modules” to direct lymphocytes to where a tumor is located. The team uses PDL1, a marker often overexpressed on tumor cells, to engage with the PD1 protein on T-cells, blocking the PDL1 from functioning. “If you could make a CAR T-cell that recognizes this PDL1 marker on the tumor, you might accomplish two things in one fell swoop,” begins Ploegh. “First, you would actually attack the tumor by virtue that it expresses PDL1. And second, by binding to PDL1, regular T-cells would no longer have the chance to be silenced by PDL1 on the tumor. We find a significant antitumor effect in solid cancer.” THE FUTURE Although these discoveries are promising, there is still a great deal of work to be done in the application of camelid antibodies in humans. As Ploegh notes, “My lab is strictly basic science. We do not work with patients. We work with mice and proteins in test tubes. But I do think it provides a roadmap for a path forward.” That path forward includes making these nanobodies less immunogenic to reduce an immune response in humans. Then, researchers would “pick [their] favorite target.” “There’s every reason to assume if you made human T-cells that express this particular CAR, you might be able to achieve an effect similar to what we’ve seen in the mouse,” Ploegh says. Although he doubts simply creating these CAR T-cells would automatically eliminate a tumor, they might work synergistically with other forms of therapy. “In principle, there’s nothing to stand in the way from taking what we’ve done in the mouse and giving it a try in a human setting.” When it comes to defeating cancers like melanoma and colon, any step forward, no matter how small, is monumental. Cancer Wellness

An Unhealthy Predisposition

Research and advancements in treatment for rare cancers like mesothelioma is slow-going, but Loyola Medicine’s Dr. Muaiad Kittaneh is doing the work few else will. BY CATHERINE EVES

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Photo by Adrian C. Garcia

bout 15 miles from downtown Chicago, down lonely highways and across yellowed flatlands, sits Loyola Medical Center’s Cardinal Bernardin Cancer Center. A behemoth rising from an empty field, the suburbs tucked neatly behind to the east, the Cardinal Bernardin Cancer Center houses the part-time office of Dr. Muaiad Kittaneh, the only peritoneal mesothelioma specialist in the greater Midwest. Mesothelioma is a cancer usually caused by exposure to asbestos. It’s incredibly deadly, aggressive, and rare—and therein lies the problem. Its rarity makes it difficult to advance cures. But for the 3,000 people diagnosed with mesothelioma every year, more needs to be done, and sooner rather than later. According to the American Society of Clinical Oncology (ASCO), “The overall 5-year survival rate for people with mesothelioma is only 10% because it is usually diagnosed at a late stage.” There are very few treatments currently for mesothelioma, and there are not enough doctors with the necessary skills to find new, better treatments.

The rarity of the disease was what initially drew has been approved as a treatment option for people with Kittaneh to this specialization. “For somebody to build mesothelioma. The drug was first developed in 2004. a career in medicine on a rare disease, it’s a challenge,” Kittaneh continues, “In mesothelioma, unfortuhe says. “I’m somebody who is driven by challenge.” nately, treatment options are very limited.” There is Before Kittaneh got his start developing the meso- one option considered standard of care for treating thelioma program at Loyola, he worked in the field of this disease, and many patients are not candidates experimental therapy, determining dosages of newly for surgery. Even when surgery is an option, it’s not discovered or invented drugs. “During the course of a simple procedure. “It is one of the most aggressive that work I [saw] multiple different tumor types, including surgeries that we do in oncology care,” says Kittaneh. mesothelioma,” says Kittaneh. This is when he first For eligible patients, all visible tumors need to be became familiar with something called BAP1 tumor removed. For patients with peritoneal mesothelioma, predisposition syndrome. According to the NIH’s tumors have usually spread to multiple organs. After Genetics Home Reference (GHR), the BAP1 gene is operating, doctors infuse heated chemotherapy into the thought to help control cell growth and cell death. abdominal cavity. “You can imagine after this surgery “Although the exact mechanism is unclear, the BAP1 patients require close monitoring in the ICU and a long protein acts as a tumor suppressor. Tumor suppressor time to recover from the surgery and intra-abdominal proteins help prevent cells from growing and dividing chemo infusion,” Kittaneh says. too rapidly or in an uncontrolled This is why it’s so necessary to way,” the GHR website states. diagnose mesothelioma early and “Mesothelioma patients BAP1 tumor predisposition encourage more medical students deserve a specialist or syndrome, however, is a genetic to pursue specialization in mesosomeone who specifically thelioma. “Mesothelioma patients disease that increases the risk of cancers that occur in the skin, a specialist or someone treats the disease to advance deserve eyes, kidneys, and the tissue that who specifically treats the disease lines the chest, abdomen, and the the field, [but] because of the to advance the field,” Kittaneh says. outer surface of internal organs— But without the patients, there is rarity of the disease, it’s the mesothelium (hence the name little work to be done. “Because of difficult to find enough for the cancer formed in this the rarity of the disease, it’s difficult tissue: mesothelioma). volume of patients [for doctors] to find enough volume of patients According to GHR, people [for doctors] to develop experience.” to develop experience.” with BAP1 tumor predisposition Kittaneh has been working syndrome contract more aggreswith Dr. Wickii Vigneswaran sive cancers, however, “individuals with malignant at Loyola for the past two years, building the mesomesothelioma as part of the BAP1 tumor predisposition thelioma program and conducting clinical trials and syndrome appear to survive longer than those who have research. Vigneswaran and Kittaneh developed a team the cancer without the syndrome,” the website states. of surgeons, oncologists, pathologists, radiologists, and Kittaneh’s first encounter with a BAP1 patient is radiation oncologists who specialize in mesothelioma what triggered his interest in mesothelioma. “Although at Loyola Medicine. “We created a specialized mesoit’s a rare disease, [mesothelioma] is the most common thelioma tumor board where we meet on a regular cancer to have BAP1 mutations,” Kittaneh says. Which basis to review every case and discuss diagnostic is good news for the future of mesothelioma research, and treatment options to provide the best outcomes,” according to Kittaneh. “[Because] the prevalence of Kittaneh says. This team also maintains relationships BAP1 in mesothelioma is high, [it] may allow significant with patient-support programs to offer services across advances in the field,” he says. the country. Currently, no clinical trials are underway The most common type of mesothelioma is pleural at Loyola, but Kittaneh says they are on the horizon, mesothelioma, which begins in the lining surrounding remaining opaque for confidentiality purposes. the lungs. Peritoneal mesothelioma, Kittaneh’s specialty, Kittaneh closed our conversation with positive news begins in the tissue surrounding the abdominal area and an eye to the future. A new complementary therapy— and accounts for only 10 to 20 percent of mesotheliomas. called “tumor treating fields,” which sends mild electric Without enough manpower behind the disease, pulses through the skin to interrupt cancer cell’s ability progress for treatments and cures is slow. “There hasn’t to divide—was just recently approved by the U.S. Food been a lot of advances in the field of mesothelioma for and Drug Administration for mesothelioma patients. quite a long time,” Kittaneh says. Most recently, beva- “It’s a new addition which gives hope to patients,” Kittaneh cizumab, a drug which targets blood vessel formation, says.

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The global adaptive apparel market will reach $288.7 billion this year. Now, brands such as Tommy Hilfiger, Nike, and Zappos have entered the market with fashionable and functionable designs to tap into this emerging trend.

adapt your style BY BRITT JULIOUS PHOTOGRAPHY BY PETYA SHALAMANOVA SHOT ON LOCATION AT LAZY BIRD IN THE HOXTON CHICAGO

Models Raeghn Draper & Charlie Coffeen Makeup by Yvette Oduro Charlie’s sweater Tommy Adaptive; Raeghn’s dress & jacket Tommy Adaptive

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ancer and fashion are two words that seem like complete opposites, but a new range of adaptive design brands are bridging the gap between high-fashion style and the unique needs of someone undergoing treatment for cancer. Also known as adaptive clothing, adaptive design is fashion designed for people with physical, cognitive, and sensory issues. According to The Washington Post, “Adaptive design began some 40 years ago, mainly for seniors in long-term care facilities, not for young adults and children.” But unlike apparel of the past, today’s adaptive clothing is designed with style, age, comfort, and practicality taken into consideration. Many brands, like With Grace B. Bold, are designed to target a specific market, like those who’ve received a mastectomy. Megan Sullivan, the brand’s founder and designer, was inspired by her own mother’s breast cancer journey. “She said that the fact that she wore this [drain] home from the hospital that she didn’t know she was going to have to wear home, just completely altered how she saw this experience,” Sullivan told CancerWellness.com in an interview earlier this year. Some of her designs, like the Anne Elizabeth, include a pocket to hold a surgical drain, for example. Tommy Hilfiger’s adaptive clothing line, Tommy Adaptive, debuted in 2016. Originally targeted to young people with disabilities, the label debuted Tommy Adaptive for adults in 2017. Many of the brand’s designs, seen in our exclusive photo shoot on the following pages, include magnetic closures and soft fabrics. Other major companies hopped on board, including Target, who launched their sensory-friendly kids clothing brand, Cat & Jack. Zappos, the popular online shoe retailer,

launched an adaptive clothing vertical featuring designs by brands such as Tommy Adaptive, Nike, and 4Ward, their in-house brand. Coresight Research, a data-driven site focused on retail and technology, estimates the potential global adaptive apparel market will reach $288.7 billion this year and grow to $349.9 billion by 2023. Coherent Market Insights anticipates that number reaching $400 billion by 2026. In the United States alone, they anticipate a market of $47.3 billion in 2019, which could grow to $54.8 billion by 2023. Unfortunately, needs for the adaptive community are growing, not declining, despite advancements in the medical field. According to the U.S. Centers for Disease Control and Prevention (CDC), chronic disease is the leading cause of death and disability in the United States. As well, around one half of American adults have one or more chronic health conditions. It makes good business sense then for brands to enter the adaptive design market. According to Vogue Business, “The differently abled population in the US has a collective disposable income of around $490 billion, slightly below that of African-Americans at $501 billion.” Why then haven’t brands jumped on board? Part of it may be training. Although adaptive design has grown significantly from where it was even just five years ago, many of the current styles are not targeted toward working adult populations. Some schools, such as the famed Parsons School of Design in New York City, have partnered with nonprofits like Open Style Lab, which leads a class on designing for people with disabilities. It’s a major, necessary step forward, one we anticipate growing as the needs and size of customers grows, too.

cW APPROVED We’ve rounded up some of our favorite adaptive design brands—featuring everything from sneakers and hospital gowns to lingerie and streetwear—and where to purchase the styles. TOMMY ADAPTIVE Launched in 2016, Tommy Adaptive has become the go-to brand for pushing the adaptive design world forward. Now featuring designs for children and adults, Tommy Adaptive’s bold, Americana-inspired designs are youthful, playful, and contemporary. USA.Tommy.com or Zappos.com

NIKE The biggest athletic shoe brand in the country recently entered the adaptive design market with their FlyEase shoe, which includes smart adaptive features like heel zippers and Velcro closures. The designs now come in men’s, women’s, and children’s sizes. Nike.com or Zappos.com

CARE+WEAR Designed to “create more positive and effective healing experiences for people everywhere,” Care+Wear has partnered with a number of different brands, including Oscar de la Renta. From recovery bras and port access clothing to PICC-line covers and patient gowns, this start-up brand aims to address most any need of today’s cancer patient. CareAndWear.com

LYMPHEDIVAS Lymphedema is swelling, usually in one’s arms or legs, caused by the removal or damage to one’s lymph nodes. To address this common post-surgical side effect, founders and breast cancer fighters Rachel Troxell and Robin Miller partnered with designer Kristin Dudley to create cool compression sleeves. In addition to arm sleeves, the line now also includes gauntlets and gloves. Lymphedivas.com Cancer Wellness

Charlie’s hoodie Care+Wear; Reaghn’s bra & PICC-line cover Care+Wear; Jeans Tommy Adaptive

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Jacket & sweater Tommy Adaptive; Shoes Nike

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Jacket Tommy Adaptive; Shoes Nike

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resources 90 NEXT QUESTION, PLEASE 92 HELPING ALL OF US

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Next Question, Please

A stronger relationship with your health care provider can lead to better treatment outcomes. BY DIANE SELKIRK

y husband, like almost 80,000 other American men this year, was recently diagnosed with colorectal cancer. His prognosis is good, but after one recent appointment, he told me his doctor had put him on a new treatment path. But there was a problem: While Evan understood what the new treatment entailed, he didn’t have a clear idea of why his treatment changed. Just like he was never good at seeking directions before we got a GPS installed in our car, he lived up to another male cliché: He’s bad at asking medical questions. In Evan’s mind, his doctor is the professional. “He’s the one who went to school and reads all the journals, so he’s more up to date than me on all the best options,” Evan told me over dinner. But later that evening, I found Evan searching for information about his new treatment. What he found left him worried; the treatment seemed more aggressive than the original plan. Was his cancer more advanced than he realized? Did his relative youth make the doctor initially choose a more conservative approach? After a bad night’s sleep, he made a decision. At his next appointment, he’d actually chime in when the doctor asked, “Do you have any questions?” Developing effective doctor-patient communication is central in building a good health care relationship. Multiple studies show that people who are well informed about their cancer treatment options often have better outcomes and fewer side effects than less informed patients, and patients who understand what is happening are more medically compliant and more satisfied with their treatment.

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Talya Miron-Shatz, Ph.D., a scientist specializing in medical decision-making, says understanding your treatment gives you a measure of control. “At some level, you are actively involved in choosing your treatment,” Miron-Shatz says. Ideally, each patient would know enough about their illness and treatment to articulate why, for example, “they need to take that pill.” However, 50 percent of medication for chronic conditions is not taken as prescribed, and nonadherence to cancer treatment is expected to grow as the number of oral medications taken at home continues to increase. Reasons for noncompliance are multifaceted, but the core doctor-patient relationship plays a big part. “We expect patients to take an active role in their treatment, but there’s a power imbalance. One of us is sick, the other makes the decisions,” explains Miron-Shatz. In her research, Miron-Shatz discovered there’s more to the problem than just shy patients. “The first step is for medical professionals to invite the patient into the relationship,” Miron-Shatz explains. Doctors telling their patients they can ask questions is fine, but medical staff need to confirm patient comprehension. “We can’t expect everyone to know medicine,” Miron-Shatz says. B RIDGING THE COMMUNICATION GAP A combination of respect, embarrassment, intimidation, and distrust can keep patients from reaching out to medical staff. Likewise, blocks on the doctor’s side, including limited appointment time and lack of training in providing patient education, fuels a communication gap.

“While we encourage patients to become experts didn’t have access to an oncologist. Her doctor wasn’t in their disease, we now recognize that this is a heavy up to date on current research, and she didn’t know burden for someone already challenged by a cancer what questions to ask. The two went on to help develop diagnosis,” says Nancy Brook, a nurse practitioner the Lung Cancer Foundation of America’s “Hope With with Stanford Health Care. While it can be helpful for Answers” video series. a patient to prepare questions in advance, record each “Most educational videos are doctors talking to appointment (or bring someone to take notes), and doctors, and these can turn into lectures,” says Freemankeep all of their records in a binder, patients still need Daily. “But we wanted to model what a good doctorto know what kind of questions to ask in order to get patient relationship looks like, while still providing good good answers. information.” The hope is that the videos will empower “Because everyone has a cancer story, new patients patients to bring information to their appointments and tend to be inundated with information,” explains get comfortable with asking more questions. Sandy Pyle, a registered nurse and cancer navigator My husband Evan felt finding answers when he with Piedmont Healthcare. “But every cancer is unique, needed them to be the most difficult. His oncology and what worked for your neighbor’s uncle might not team provided him with an extensive binder full of work for you.” information and handouts, which he gave a brief skim. Pyle says new patients should first ask their medical Taking it all in while he was still coming to terms with provider about what resources they recommend. Often his diagnosis was too overwhelming. When symptoms a doctor will send patients to cancerappeared, he often couldn’t find the specific societies and websites or, information he needed. In a case of “We expect patients to when they have them, oncology out of sight, out of mind, he’d also team members who specialize in take an active role in their forget to bring up the issues at his treatment, but there’s a weekly appointments. specific concerns (i.e., a dietician, social worker, or physical therapist). power imbalance. One of Dr. Philip Marshall, co-founder Increasingly, cancer treatment of a health care conversation platus is sick, the other makes form called Conversa, says it’s this centers such as Piedmont, Cedarsthe decisions.” Sinai Integrative Health Program disconnect between doctor and in Los Angeles, and New York patient that spurred the development City’s Center for Comprehensive Wellness are using of his company’s conversational, artificial-intelligence integrative educational and supportive programs to technology. Programmed by each patient’s doctor, the supplement the information patients receive from their chatbot makes regular between-appointment calls to the doctors. These support programs (typically offered patient and checks in with supportive and educational as in-person groups and classes) have been found to options. “It can be used to help a patient prepare for improve patient compliance, prolong survival, and surgery or measure their symptoms, all while freeing up provide emotional support. the care team,” says Marshall. Spending time in a support group may not appeal While each call is different, patients generally to everyone, but Pyle says after a reluctant participant get a text which asks how they’re feeling and about shows up once or twice, they often recognize the symptoms based on their stage of treatment. The value. These groups can also help cancer educators chat is programmed to anticipate questions or side identify gaps in patient knowledge. “Topics will come effects as they arise. Rather than get a pamphlet about up in groups, like sexual dysfunction, that men aren’t appetite changes a month before you need it, patients comfortable talking to their doctors about,” she says. will receive a call as their symptoms are likely to begin, Groups can also help a patient identify a side effect or along with tips for how to manage them. concern that might warrant a visit to the doctor. Both the doctor and patient hold valuable information Not every patient will be attached to a cancer agency when it comes to treatment, and Miron-Shatz says or have a cancer association near where they live. This a patient’s idea of a successful treatment might not is where vetted online groups, videos, and apps may always match their doctor’s ideas. “The doctor has fill a need. Dr. Sunny Garg, a medical oncologist from the medical information and knowledge but a patient India, developed a chat group and education site named has his own set of values and preferences,” she says. CancerBro when he found his patients “needed more Successful communication happens when both parts empowerment in the form of education, motivation and of the equation are combined. The patient needs to social support.” understand and agree to the treatment—but he also Part of the need can be logistic. When patient needs to find a way to get his own feelings across and advocates Janet Freeman-Daily and Lysa Buonanno be heard. “It’s important to remember whose body it is were first diagnosed with lung cancer, Buonanno and whose life it is,” Miron-Shatz says. Cancer Wellness

HELPING ALL OF US

Malecare provides support services for people with prostate cancer, but their programs for underserved communities are what make this nonprofit stand out from the rest. BY CATHERINE EVES

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“P

art of our success is identifying niches and opportunities that no one touches,” says Darryl Mitteldorf, LCSW, executive director of Malecare. Malecare is a small but mighty nonprofit providing resources for people with prostate cancer, with a focus on helping populations that are traditionally underserved. Malecare’s main initiatives include support services, a research program, and traditional advocacy efforts. The nonprofit provides weekly, 90-minute, psychosocial support groups led by a social worker or psychologist who has or is in remission from prostate cancer, bringing together 10 to 15 men to talk about issues they face in treatment. “We basically debunk the idea that men don’t talk,” says Mitteldorf. “We find that sexist nonsense.” Through these support groups, Malecare is able to find out what resources are needed most. “The things that we do [are] generated by what we hear in the support groups. [...] We can sort of harvest ideas that not in a million years would any of us individually have come up,” says Mitteldorf. For the past 21 years, this New York City-based nonprofit has been branching across the country, and then the world. “We now consider ourselves a multinational organization because we partner with our counterparts in other parts around the world,” says Mitteldorf. “We like to think of ourselves as having influence from Iceland to South Africa.” Malecare also succeeds in spreading awareness about how different communities experience prostate cancer and its treatment. “If you ask a doctor how they treat their gay patients or their black patients, [they’ll say] ‘Well, I treat them no differently than any other patient,’” says Mitteldorf. “Which is really them saying, I treat them like the heterosexual, [white],

protestant, middle-class or upperclass patients that pay their bills and have insurance.” This is a common disparity in medical care, according to Mitteldorf, and one that Malecare is doing its best to fight. Despite the fact that African-American men die from prostate cancer at 2.4 times the rate of their white counterparts, there are very few nonprofits that put as much time and effort into educating this community as Malecare.

“We basically debunk the idea that men don’t talk,” says Mitteldorf. “We find that sexist nonsense.” “One of the great insults broader society does is when they say they’re going to do things better, [be] more accessible to people, [but they’ll] take the same brochure and just put black imagery on it,” begins Mitteldorf. “That’s not being inconclusive. [...] It’s nice, but it doesn’t even touch on what’s enough.” Malecare’s forthcoming resource “Prostate Cancer While Black” addresses many concerns black men might find when being treated for prostate cancer. These community-specific resources are reaching populations that few have worried about before. And this is similar for the LGBTQ+ community. Malecare’s 1998 program Gay Men with Prostate Cancer was hallmark in the prostate cancer treatment world. “It was the first time any LGBT-focused cancer support group was developed,” says Mitteldorf. According to Mitteldorf, prostate cancer treatment almost always impacts sexual health—many men experience erectile dysfunction (ED) due to cancer treatments that damage nerves and blood supply,

and hormone therapies that affect sexual desire—the response of which will be different for straight and gay people (as gay men are more likely to utilize the prostate during sex). It is knowledge like this that Malecare is spreading to make the doctor-patient relationship more easily navigable. “It’s about identity, it’s about who they are,” he says. Mitteldorf says that the results of their efforts are best understood by consistent donations from the community. “Titans of industry to homeless people—they reach into their pockets and pull out spare change and a dollar more,” he says. “It’s individuals, and we like that in the sense that it validates the work that we do.” Apart from support services, Malecare also participates in traditional advocacy efforts, such as writing to legislators to increase research funding, and their own research—Malecare’s “cancergraph,” a program for quality-of-life data collection, is being used around the world to document and improve treatment symptoms. But the work doesn’t stop there. Ultimately, Malecare’s mission is to “help men live longer and happier lives,” according to Mitteldorf. And it will take everyone working together to reach these goals. “People [need] to understand that to help one person is to help all of us, and that one person is someone other than yourself.”

Malecare’s Prostate Cancer Patient Conference will be held on Saturday, Oct. 5, 2019, in New York City at 237 Park Ave., from 8:30 a.m. to 6:00 p.m. Tickets are $40; register at this link: bit.ly/Malecare19 L earn more at Malecare.org Cancer Wellness

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cancer & the environment 96 ONE BAD APPLE 100 ALL WORK AND NO PLAY 103 LEGACIES OF CHEMICAL WARFARE

Cancer Wellness

One Bad Apple For years, agrochemical company Monsanto has been hiding the truth about the cancer-causing herbicide glyphosate, but recent lawsuits have brought the truth to light. BY ALICIA BETZ

Cancer Wellness

aybe you’ve heard the company name “Monsanto” in the news or sprayed the weeds around your home with Roundup, never thinking twice. Maybe you’ve seen food labeled “organic” or “non-GMO,” but never knew what those labels meant. Did you know these things are connected? Did you know glyphosate, the chemical found in Roundup, has now reached measurable levels in our air, rainwater, and bodies? Did you know that this chemical is classified as a probable carcinogen?

A HISTORY OF MONSANTO AND GLYPHOSATE

Founded in 1901, Monsanto is an agrochemical company selling genetically modified (GMO) seeds and pesticides. In the early 1900s, Monsanto began creating and selling chemicals and other products such as saccharin, aspirin, detergents, and cleaning products. By the mid-1900s, Monsanto began selling insecticides and other agricultural products, and in 1974, Monsanto created Roundup, a popular household weed killer containing the herbicide glyphosate. In 1996, Monsanto created the first GMO soybean seed, which was genetically engineered to be resistant to glyphosate. When farmers spray Monsanto’s Roundup, which contains glyphosate, on their crops (grown from Monsanto’s seeds), they are able to kill pests and weeds without killing their crops. For years, glyphosate was used by farmers and consumers. Because it was and still is so widely used, glyphosate is found in the air, rain, soil, and even in human urine, according to a study conducted by researchers at the University of California, San Diego. It is also found in a large portion of the food supply in the United States, including oats, corn, soy, and sugar—some of the most heavily sprayed crops. Tests from the Environmental Working Group (EWG) found glyphosate in many of these foods. The World Health Organization’s International Agency for Research on Cancer classified glyphosate as a Group 2A carcinogen in 2015, which means it “probably causes cancer.” Monsanto recently came under fire as thousands of people have filed lawsuits claiming glyphosate caused their cancer. To date, three separate juries have ruled that Monsanto is at least partially to blame for cancer (most commonly non-Hodgkin lymphoma), and that the company acted negligently by not warning consumers of the dangers of glyphosate. This summer, Monsanto was ordered to pay a California couple $86.7 million in damages because they both developed non-Hodgkin lymphoma after using Roundup for decades. According to court documents, in order to find Monsanto guilty, the jury had to be convinced that they “engaged in conduct with malice, oppression or fraud committed by one or more officers, directors or managing agents of Monsanto.” In March of 2019, Monsanto was found liable for the development of Edwin Hardeman’s non-Hodgkin lymphoma, which occurred after he began spraying Roundup on his property in 1986. Studies and reviews from organizations like Environmental Protection Agency (EPA), the International Agency for Research on Cancer, and others have shown a relationship between glyphosate and cancer, endocrine disruption, toxicity to cells, oxidative stress, genetic mutation, reproductive problems, and hormone disruption.

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One of the few arguments in glyphosate’s favor, as explained by Marla Cone for PBS NewsHour, is that it can’t harm humans because the enzyme that it disrupts to kill weeds isn’t made in the human body. However, this enzyme (cytochrome P450) is found in the bacteria that live in the gut. Anthony Samsel and Stephanie Seneff studied the effect of glyphosate on this enzyme for the journal Interdisciplinary Toxicology and found when this enzyme is disrupted, it can lead to leaky gut, which is associated with problems like vitamin and mineral deficiency, inflammation, poor immune function, and auto immune disease, among others.

Carey Gillam, investigative journalist and author of “Whitewash: The Story of a Weed Killer, Cancer, and the Corruption of Science” began covering Monsanto and other food and agriculture companies in 1998. Gillam notes once she began learning more about Monsanto, “It became apparent that GMO crops were not designed to save the world; they were designed to keep Monsanto’s market share up.” As a result of the cases raised against Monsanto, classified documents called the Monsanto Papers were released to the public in April 2019, revealing Monsanto covered up their knowledge that glyphosate was harmful and likely carcinogenic. 98

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Although the Food and Drug Administration says GMO foods sprayed with glyphosate are safe, the FDA does not test the safety of GMOs independently; they rely on the manufacturers of GMO foods to make sure they are safe for consumers. Monsanto tried to manipulate and pay the editor-in-chief of the Food and Chemical Toxicology Journal to conceal information and publish

that glyphosate is not harmful; Monsanto also avoided telling the public about studies that indicate glyphosate is toxic to humans. The company secretly authored papers showing glyphosate does not cause cancer while ignoring warnings from experts that glyphosate likely does cause cancer. Monsanto also allegedly worked with EPA officials to delay a toxicology review of glyphosate and admitted they manipulated data and knew glyphosate caused hormone disruption. Although the Food and Drug Administration (FDA) says GMO foods sprayed with glyphosate are safe, the FDA does not test the safety of GMOs independently;

they rely on the manufacturers of GMO foods to make sure they are safe for consumers. It would be almost futile to try to control every single thing that goes into and on your body. Unfortunately, there are some cancer and disease risks we can’t control. What you can do is focus your energy on what you can control. As Gillam says, “Pesticide exposure is definitely a cause that we can control if we try hard enough.” When you know better, you do better, and armed with this information, you can make small changes to start living a healthier life.

HOW CAN YOU PROTECT YOURSELF? 1. STOP USING ROUNDUP B usinesses are making it easier than ever. Costco, for example, has removed Roundup from their shelves, and there is a petition for Lowe’s and Home Depot to do the same. 2. WEAR PROTECTIVE CLOTHING I f you choose to use Roundup around your home or are required to use glyphosate for your job, make sure your skin is fully covered and shower as soon as possible after exposure. According to Gillam, “Roundup is

formulated to […] absorb rapidly into tissue of plants, and it does the same thing on human skin.” An email from Monsanto revealed moisture helps glyphosate absorb into the skin, so if you’re spraying Roundup on a hot day and sweating through your clothing, you may absorb more glyphosate into your body. If you need to spray Roundup, try your best to spray during the cooler hours of the day to avoid sweating. 3. BUY ORGANIC Food that is USDA-certified organic is not sprayed with any chemical fertilizers, pesticides, or artificial additives, which means these products

are not sprayed with glyphosate. Be careful with non-GMO food, though, because it can still be sprayed with glyphosate as a drying agent. The only way to know for sure that your food does not contain glyphosate is to buy items labeled USDA-certified organic. If you’re looking to make a cost-effective change, focus on buying organic for foods that are most heavily sprayed: wheat, corn, soy, and sugar. Another good strategy is to use the EWG’s “Dirty Dozen” and “Clean 15” list. Every year, the EWG tests produce to determine which have the most pesticide residue (the dirty dozen) and which have the least (the clean

15). Try to buy organic when you buy the foods on the dirty list, and worry less about buying organic when you buy the foods on the clean list. 4. BE AN INFORMED CONSUMER A company that sources their materials and creates products ethically isn’t going to hide it. If you see a report from a company that contradicts your common sense, look into the information to see if the authors of the report are affiliated with the company or if they are biased in any way. Look at the actual findings of the report as well—do they prove that one thing

The Monsanto Papers were released to the public in April 2019, revealing Monsanto covered up their knowledge that glyphosate was harmful and likely carcinogenic. causes another, or just that they are related? You can also do some fact checking by looking at the date of the report and checking to see if other articles or studies back up

the information. Talk to a trusted doctor or expert if the information you’re hearing doesn’t make sense to you. 5. FIGHT FOR CHANGE E ven if you take every single precaution to avoid exposure to glyphosate, you still may be exposed due to its ubiquity. It’s in the rain, it blows through the air from conventional farms to organic farms, and your neighbor might spray it right on your property line. Many people simply aren’t aware of the potential dangers. Talk to your neighbors, school board, and city council. Inform them of the potential dangers and

risks of using Roundup, and start a dialogue. Because of concerned citizens, major cities like New York, Miami, and Los Angeles are in the process of banning and limiting the use of glyphosate. Other towns and cities have started posting signs in parks warning citizens when pesticides are going to be sprayed—it’s the law to give proper notice in 23 states and Washington, D.C. You can fight for change by voting with your wallets as well. When consumers stop buying products that are unethically sold and manufactured, manufacturers will stop making them. Cancer Wellness

All Work and No Play

Hidden dangers in familiar occupations might be leading workers toward a deadly cancer diagnosis.

BY CATHERINE EVES

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ould your job be killing you? A 2017 study out of the University of Montreal found that work-related stress has been linked to an increased likelihood of lung, colon, rectal, and stomach cancer, as well as non-Hodgkin lymphoma. Some occupations, like firefighting, are obviously stressful, but things like fears of job insecurity at startups, frequent run-ins with irate customers in customer service jobs, and even difficult commutes (from suburbs to city and back again) can all contribute to work-related stress that may ultimately cause cancer. The Montreal study examined 3,103 men from 11 different workplaces and found that “prolonged exposure” (meaning 15 years or more) to workplace stress was associated with greater odds of cancer at five of the workplaces. This was one of the first studies of its kind, and the report concludes that prospective studies are necessary. Here, we more closely examine four occupations—some with obvious risk, and some without—that have been known to cause cancer.

TEACHERS

There are a number of toxins that school teachers might be exposed to—asbestos in the walls, carbon dioxide in the air, and lead in the drinking water, to name a few—which are usually a result of outdated infrastructure. Because teachers are often working in the same building for decades at a time, their risk of cancer is higher than that of the students who usually only spend one to six years in the same building. According to a December 2015 report from the office of Senator Edward J. Markey of Massachusetts, asbestos, a naturally occurring mineral, was first identified as a hazardous air pollutant in 1971. The Asbestos Hazard Emergency Response Act (AHERA) was enacted in 1986 to protect the nation’s students, teachers, and school staff from asbestos exposure. However, the office’s findings do little to quell fears. “Nearly 30 years have passed since AHERA became law, yet the extent of asbestos remaining in schools is largely unknown,” the report states. The report gathered data from 20 U.S. states—the remaining 30 did not respond to the office’s request for information— and ascertained that AHERA guidelines are not being properly enforced. In addition, “A majority of responding states (eight of fifteen) were unable to articulate a clear schedule used to inspect or audit each local education agency to detect asbestos hazards.” This is best reflected closer to home, in the state of Illinois: In March 2016, WGN reported that nearly 200 Chicago schools “have some sort of asbestos risk to teachers and students.” But a May 2017 joint report from Univision Chicago and the Medill School of Journalism at Northwestern University revealed that Chicago Public Schools (CPS) wasn’t taking necessary action to protect students, teachers, and

administrative staff. Investigative journalist Adriana Cardona-Maguigad shared that only 11 of the nearly 200 schools followed up with inspectors’ recommendations to update CPS facilities. Because of this, paired with the fact that asbestos-containing products are still used in construction today, it would be safe to say that America’s teachers are still at risk, with little changes likely in the near future.

NAIL TECHNICIANS

It was Sarah Maslin Nir’s scathing, Pulitzer-nominated piece in The New York Times documenting the travesties of New York City’s nail industry that first brought to light the health risks of nail salons—not for those who visit the salon for a manicure a few times a month, but for the employees who are often working as many as 10 hours a day, up to seven days a week. “The Price of Nice Nails” examines the various jobs available to the mostly young Asian and Hispanic women who staff NYC’s 2,000 salons—some of these women are “experts” at creating false nails, usually made of acrylic dust. “It is the most lucrative salon job, yet many younger manicurists avoid it because of the specter of serious health issues, including miscarriages and cancer, associated with inhaling fumes and clouds of plastic particles,” the article states. A June 2019 study from Environmental Pollution notes Colorado nail salon technicians’ exposure to “volatile organic compounds,” known as VOCs, lead to numerous adverse health effects—including cancer. They found that 70 percent of surveyed workers experienced at least one health issue due to their work as nail technicians. Which is no surprise: “In general, concentrations of aromatic compounds measured [in the salons] were comparable to those measured in studies of oil refinery and auto garage workers,” the article states. Long-term exposure to benzene, one of these “aromatic compounds,” has been proven to cause leukemia, according to the Centers for Disease Control and Prevention (CDC). Benzene exposure can also harmfully affect bone marrow and red blood cells, weaken the immune system, and result in irregular menstruation in women. This is why nail salons like Chicago’s Ezza are becoming more prevalent around the country. Ezza’s founder, Ale Breuer, became passionate about creating a business that was ethical and safe for her employees. Ezza does not offer acrylic nails, and they also use polishes that are vegan, organic, and cruelty-free. “One of the things I’ve learned, beyond wage exploitation and toxic work environments, is the toxicity that nail technicians were exposed to as part of the job,” Ale says. “Even driving some nail technicians to have miscarriages. To me, that was so alarming, and I could not imagine going to my job every day worrying about my baby and my baby’s health. [For] a lot of these women [...] it’s not an option to not go to work.” Cancer Wellness

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FARMERS

In regards to prostate cancer, there is no greater occupational risk than working in agriculture. A 2003 study by the Journal of American Epidemiology states, “Farming has been the most consistent occupational risk factor for prostate cancer,” and links exposure to insecticides, fertilizers, herbicides, and other agricultural chemicals. The study examined the exposure-response relation between 45 pesticides and prostate cancer incidence, and found the chemical methyl bromide to be the most significant culprit. Methyl bromide is a gas fumigant used to protect crops from insects, rodents, and weeds, among other agricultural pests. While the findings are consistent in linking methyl bromide exposure to prostate cancer, follow up is needed. A 2006 study from the University of Kentucky found “farming is more frequently associated with an increased risk of prostate cancer in North America than in other countries.” The study goes on to say: “Regarding specific farming activities, mixing or applying pesticides [...] were associated with an increased risk of prostate cancer compared with non-farmers.” Pesticides bind to steroid hormone receptors, which then induces proliferation of prostate cancer cells, the study says. But more research is needed for conclusivity. “The mechanism through which pesticide exposure may lead to prostate cancer is complex, probably differs by pesticide, and deserves attention in future research,” the article states. The ongoing Agricultural Health Study, an effort from the National Institutes of Health, has been active for the past 25 years, examining how pesticide use and other farm activities impact the health of farming communities in Iowa and North Carolina. More recently, the AHS found that daily use of diesel tractors is associated with increased rates of lung cancer, 102

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and use of the herbicide alachlor was associated with higher rates of laryngeal cancer, among others. But government safety and testing standards are, again, not up to snuff. A March 2019 article from The Nation found that more than 90 percent of Americans have pesticides and/or their byproducts in their bodies, and testing techniques are not comprehensive enough to properly assess risk. “[T]hough crops are often sprayed with multiple chemicals over the growing season, both agencies (the Department of Agriculture and the Food and Drug Administration) track pesticide residues one chemical at a time, to determine whether a specific chemical exceeds safety standards set by the Environmental Protection Agency,” the article states. “Since pesticide monitoring began about three decades ago, scientists have learned that even low doses of pesticides and other synthetic chemicals can harm children and that exposure to chemical mixtures, particularly during critical windows of neurodevelopment, may carry serious health risks that take years to emerge.” A 2014 report from the U.S. Government Accountability Office says the FDA’s approach to pesticide monitoring “has limitations.” For example, in 2012, the FDA tested less than one-tenth of 1 percent of agricultural imports. “Limitations in FDA’s methodology hamper its ability to determine the national incidence and level of pesticide residues in the foods it regulates, one of its stated objectives,” the report states. While everyone is exposed to pesticides daily in the food we eat, it is those working and living in agricultural communities who are most at risk.

MINERS

Coal mining may not be perceived as a “safe” occupation by the general public, but the full scope of health issues may be far worse than what is actually being reported. A 2018 investigation by NPR found that

hospitals and mines are massively underreporting numbers of victims suffering from pneumoconiosis, also known as “black lung disease.” According to NPR, 99 cases of advanced black lung disease were officially recorded in the U.S. from 2011 to 2016, but the reality is that more than 2,000 coal miners were suffering during that same time frame, and in only five states. Black lung is a fatal disease experienced almost exclusively by coal miners. Miners breathe in the toxic dust when cutting into coal seams, and as their immune system tries to protect the lungs, the build up of white blood cells leads to scar tissue that will eventually decrease lung capacity, causing cough, difficulty breathing, and worsening lung infections. Depending on where they work, miners can also contract other forms of pneumoconiosis from silica and asbestos. Pneumoconiosis from silica exposure can cause tuberculosis and rheumatoid arthritis, a form or arthritis that causes pain, swelling, and stiffness in the joints. Asbestos exposure is known to cause the rare and painful cancer mesothelioma. Based on a 2014 study from the journal Environmental Science and Technology, it can be assumed that people living in mining communities, even those who may not be miners themselves, are at a higher risk for developing lung cancer than the general population. In the study, human lung cells that were exposed to dust collected one mile from a mine adopted cancer-like properties, and when implanted in mice, promoted tumors. According to Dr. Edgardo Santos, an oncologist at Florida Precision Oncology, black lung disease “is totally preventable.” Santos notes measures miners can take to protect themselves—regular showers, use of dust monitors, avoiding eating or drinking in areas with coal dust, and proper ventilation systems in mines, but if regulations aren’t properly followed, rates of black lung will continue to rise.

Legacies of Chemical Warfare

More than 50 years after the Vietnam War, U.S. herbicide warfare programs have been associated with numerous health risks in veterans and civilians.

BY HEIDI HONG

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ocated 16 miles from Ho Chi Minh City, Bien Hoa Air Base is an obscure former South Vietnamese military base that is remembered in America only by military history enthusiasts. At Bien Hoa, U.S. air force pilots served alongside their South Vietnamese counterparts to battle North Vietnamese forces. Today, the air base is deserted and overgrown with weeds, surrounded by warning signs that mark the land as a dioxin-contaminated site with a few Vietnamese soldiers standing guard. Between 1961 and 1971, the U.S. military sprayed an estimated 18 to 20 million gallons of herbicides in South Vietnam, including about 11 to 12 million gallons of Agent Orange. Known as Operation Ranch Hand, the herbicide warfare program contaminated Vietnamese soil and defoliated roughly five million acres of forests during the war in Vietnam. The toxic effects of dioxin, a chemical compound found in Agent Orange, continue to linger for veterans who served in U.S. wars in Asia and civilians living in heavily contaminated regions. Developed after World War II to kill weeds, herbicides were quickly adopted by the military and used in exponential amounts to clear forests. The defoliation of trails in South Vietnam was intended to tactically increase visibility, improve U.S. bomb targeting in dense mountainous regions, and deprive North Vietnamese soldiers of access to crops. While Rachel Carson’s book “Silent Spring” first publicized the harmful human and environmental effects of insecticides and herbicides in 1962, it was not until 1975 that coalitions of environmental activists and scientists successfully pressured the U.S. government to ban the use of herbicides in war. Dioxin, created as a byproduct of Agent Orange, has been associated with birth defects, cancer, diabetes, autoimmune diseases, and other health concerns in American and Vietnamese war veterans, Vietnamese civilians, and their children. The United States Department of Veteran Affairs (VA) has recognized several types of cancer that are linked to Agent Orange exposure, including chronic B-cell leukemias, lymphoma, and prostate cancer (one of the most common cancers among men). “Veterans may be eligible for disability compensation if they have a disability related to Agent Orange exposure during service and were discharged under other than dishonorable conditions,” the VA says on their website. The VA’s Agent Orange Registry health exam also

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“alerts veterans to possible long-term problems that may be related to Agent Orange exposure during their military service.” However, some veterans and their family members say they could not receive compensation because their illnesses were not officially included in the VA’s presumptive disease list. Though the “presumptive service connection” policy does not require veterans to prove a direct incident of exposure to Agent Orange to demonstrate correlation, the policy still excludes Vietnam War veterans afflicted with currently unlisted diseases. Pegi Scarlett, widow of Vietnam War veteran John Scarlett, says her husband’s glioblastoma—an aggressive form of brain cancer—was not recognized for disability compensation. After creating a database of more than 270 veterans who have been diagnosed with the disease, Scarlett says she is ready for the VA to recognize these conditions “so that families, veterans, and widows will be able to submit a claim and receive the benefits that they deserve.” For the more than 2.7 million American veterans who served in Vietnam, many are only now experiencing the symptoms associated with dioxin exposure. More than 50 years later, scientists are still finding new ties between exposure to dioxin and its numerous complications. In March 2016, a study from the National Academy of Medicine identified bladder cancer as one of four new health conditions that are likely linked to Agent Orange. The VA has not yet announced a final decision about including these conditions on the presumptive disease list, which would allow affected veterans to access disability compensation and VA health care. I n January 2019, the U.S. Court of Appeals determined that Vietnam veterans who served on offshore ships—including sailors and marines—are eligible for the same disability benefits as those who served on land. The ruling, dubbed Blue Water Navy, emphasized the wide range of veterans responsible for the transport and disposal of the chemical across the Pacific. After Agent Orange was banned, the U.S. government incinerated most of the remaining chemical stock on Johnston Atoll, an unincorporated U.S. territory in the Pacific Ocean. Research on the enduring impact of dioxin on soil, water, and food supply has uncovered new concerns.

In an article published by the Open Journal of Soil Much of U.S. funding allocated to humanitarian aid Science, Dr. Kenneth Ray Olson and Dr. Lois Wright in Vietnam has been used in cleanup efforts, with only a Morton say the half-life of dioxin varies based on where small portion allocated to establish health and disability it is stored and can linger for as long as 20 to 50 years programs to assist civilians living in contaminated areas. in tropical subsoils and more than 100 years in water Moreover, children of both veterans and civilians sediments. In dioxin hotspots such as Bien Hoa Air continue to live with birth defects linked to Agent Base, dioxin contaminated soil and sediments have Orange. According to a 2016 study by ProPublica, spread from the military base to adjacent urban regions “The odds of having a child born with birth defects like Saigon and Bien Hoa City. were more than a third higher for veterans exposed to “Local Vietnamese living in nearby cities breathe Agent Orange than for those who weren’t.” However, the contaminated dust, cultivate dioxin contaminated the VA has not scrutinized its own data on these soil which can be absorbed by their skin, and still eat associated health conditions, and provides limited bottom feeding fish and mollusk harvested from lakes disability benefits for children of veterans. Vietnamese adjacent to the hotspots,” Olson children of civilians exposed to the and Wright Morton say. Their defoliant are vulnerable to physical studies show that dioxin bio- For the more than 2.7 million and mental disabilities at birth, American veterans who accumulates in fatty tissue, and and many develop serious health can travel through the food chain served in Vietnam, many are problems as adults. Nonprofit from aquatic species to small organizations such as the Vietnam only now experiencing the Association for Victims of Agent mammals and, eventually, to humans. symptoms associated with Orange (VAVA) operates day care Though the U.S. government for disabled children and dioxin exposure. More than centers has allocated some funds to rehabilitation, providing social 50 years later, scientists are and economic support for those clean up dioxin-contaminated bases in Vietnam, the remedia- still finding new ties between who face discrimination because tion process is long and expentheir disabilities. VAVA has exposure to dioxin and its of sive. While the U.S. completed filed three lawsuits in the U.S. numerous complications. a decontamination campaign at against the 37 chemical companies Da Nang International Airport involved in manufacturing Agent in 2017, efforts to clean up Bien Orange. However, the court ruled Hoa Air Base—regarded by the United States Agency that there was insufficient evidence linking these for International Development as the most contaminated health conditions to chemical exposures. remaining site—only began this year. Congress has To date, families affected by Agent Orange in appropriated approximately $255 million between Vietnam and the United States still face devastating 2007 and 2017 for Agent Orange remediation. physical, emotional, and financial costs. Linking the In Vietnam, more than four million people experiences of American and Vietnamese veterans and were exposed to Agent Orange during the war, with civilians across national and cultural borders, dioxin approximately one million living with health problems exposure is an urgent environmental concern that associated with dioxin, according to the Vietnamese demands collaborations between U.S. and Vietnamese Red Cross. However, there is insufficient funding for government officials, nonprofit organizations, and civilians living with disabilities related to chemical environmental scientists. While many of dioxin’s longexposure. term effects remain unknown, it is clear that more Vietnamese civilians with exposure-related diseases must be done for the human lives at stake. do not have access to disability compensation from the Vietnamese government, and the burden of caring for disabled civilians often falls on their family members.

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the supporter

JILL PEET SAPONARO AS TOLD TO BRITT JULIOUS

My husband was very young when he died from pancreatic cancer, and it was really awful.

He passed in May, and I saw that in October, all the buildings had pink lights for breast cancer. I loved it. I thought it was beautiful. And it wasn’t just a couple [of buildings]; it was many, so it made a statement. I just assumed the following month, in November, it would be purple for pancreatic cancer, and it wasn’t. I remember talking to my girlfriend and saying, “For breast cancer, the whole city was pink, and they can’t even do a building [for pancreatic cancer]?” So she said, “Well, do something about it.” And I was like, “Well, what can I do?” I was emailing [building owners]. I kept calling and asking what it [would] cost if I wanted to pay. I was writing action news, and nothing would ever happen. Then, one of my friends got a contact at the Merchandise Mart, and they said they would do it. And they gave me the property manager at Willis Tower, and she said not only would they do it, they would give us a free media event in the lobby, and I could use their P.R. people. It just blossomed. Long story short, we got over 20 buildings the first year, and it was a lot of work. We ended up getting a couple senators and the mayor to attend [the media event], and it was a big spiel. It was on the news, and [we’ve done it] every year since then (2010). We’ve come a really long way. Back then, my husband was only stage III. They told him [he had] maybe six months, and he lived for 15 months. I have a friend whose husband has [pancreatic cancer], and he’s going on year four. And he was diagnosed at stage IV. The survival rate was only 6 percent then, and now it’s 9. It used to be National Pancreatic Cancer Awareness Day. Now, it’s World Pancreatic Cancer Awareness Day.

To hear more from Jill, visit cancerwellness.com

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The older you get, the more loss that you have, and the more tragedy you come across in your life, you realize what’s important. I feel like my time and talents are best spent doing what I do. I’m just about getting stuff done. Give me an inch and I’ll take it further. I don’t know if I’ll make it to a mile, but I’ll make it to a foot.

Photo by John Khuu

The older you get, the more loss that you have, and the more tragedy you come across in your life, you realize what’s important.

THE FUTURE OF WELLNESS HAS MANY FACES

2019

Bill Bensley Bensley Architecture

Anna Bjurstam Six Senses Hotels Resorts Spas

Tonia Callender Global Wellness Institute

Peggy Chan Grassroots Pantry

Ronna Chao Novetex Textiles Limited

Dr. Marc Cohen Extreme Wellness Institute

Martha Collard Red Doors Studio Limited

Miwako Date Mori Trust Co, Ltd.

Patricia Dwyer The Purpose Business

Graham Earnshaw Spa China/China Economic Review

Susie Ellis Global Wellness Summit

Catherine Feliciano-Chon CatchOn

Henry Fersko-Weiss End of Life Doula

Irene Forte Rocco Forte Hotels

Divia Harilela The Dâ&#x20AC;&#x2122;Vine

Mark Hoplamazian Hyatt Hotels Corp.

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