Supporting the Valley’s Tetons ♥ Teton Valley News - October 21, 2010 - Page C1
Part three Recovery
Page C2 - October 21, 2010 - Teton Valley News ♥ Supporting the Valley’s Tetons
Take control of your Breast Cancer risk and diagnosis St. John’s Oncology Department offers information on: Screening & Education
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Supporting the Valley’s Tetons ♥ Teton Valley News - October 21, 2010 - Page C3
Exercise and cancer: Start moving! Anna Schwartz FNP, Ph.D, FAAN Exercise is one of the most important things cancer survivors can do both during and even many years following treatment. Scientific studies consistently demonstrate the benefits of exercise for cancer survivors during and following treatment. Studies of cancer survivors show statistically significant effects of exercise on heart and lung function, muscle strength, balance, fatigue, depression, body weight, bone density and quality of life. In fact, research shows that exercise may reduce risks for recurrence and development of other The American cancers. As a matter of College of fact, exercise is the best Sports Medicine intervention for cancerrelated fatigue. People Guidelines often say they are “too for exercise tired to exercise,” but recommend once they muster the that all cancer strength to get up and survivors, and move around they adults, get at are amazed at how least 150 minutes much better they feel of moderate both physically and aerobic exercise emotionally. per week. The American College of Sports Medicine Guidelines for exercise recommend that all cancer survivors, and adults, get at least 150 minutes of moderate aerobic exercise per week. Exercise as simple as walking around your house or around the block can not only make you feel better physically and emotionally, but also give you added health benefits. All cancer survivors, whether actively receiving treatment or many years beyond treatment, should be instructed to exercise. There
TVN file photo
are no physical limitations that Goals really help to keep you make exercise “impossible;” one motivated and give you a reason simply needs to learn to exercise to get up and move. Make short around his or her physical term, achievable goals and maybe limitations. even set a long-term goal, such Take a positive step forward as walking in a cancer charity in your survivorship and start event. It’s amazing the power and moving. Begin slowly, well below energy you will feel walking and the level of physical activity being with other survivors and that you think you can do. that energy will carry you forward Our brains always think we are to continue your commitment to super-human, but bodies that exercise. have been “resting” need time There’s no question that it’s to become strong and fit again. hard to change your lifestyle from If you aren’t sure where to start being sedentary to being active, or what to do, or have lingering but if you stick with exercise for problems from treatment, such even eight or 10 weeks, you will see Anna Schwartz as lymphedema or numbness impressive changes in your body, in your hands and feet, you mind and spirit that will buoy you might want to ask your health onward in your quest to being the care team for guidance on how to safely start an healthiest you can be. Getting through cancer exercise program. takes determination, courage and will that gives you the inner strength to successfully take the Let’s be frank, many of you find exercise steps to live a healthy physically active life. completely aversive and would prefer to sit and watch TV or work at your computers. But, if you Anna Schwartz, FNP, PhD is the oncology nurse start slowly and don’t push yourself to the point practitioner at St. John’s Medical Center and an of exhaustion and pain, then exercise won’t be unpleasant. Find a friend or take your dog and affiliate professor at University of Washington. She is head out the door for a short walk. The distance the author of “Cancer Fitness: Exercise programs for doesn’t matter, and if you only walk to the corner patients and survivors,” Simon & Schuster 2004. and back that’s OK. You will be taking your first step in moving forward to a healthier life.
Healing Moves
Exercise aids in breast cancer recovery By Taniesha Robinson Content That Works Features
Treatment for breast cancer often leaves survivors with stiffness and pain in their arms and shoulders, restricting movement. Fortunately, there’s an everyday solution to this common problem: exercise. Physicians have long prescribed arm and shoulder exercises after surgery to prevent pain in the areas surrounding the cancer, but a new review of 24 research studies comprising 2,132 breast cancer patients finds that exercise programs can also help patients recover shoulder and arm movement. Today, a team comprised of a wide range of health professionals including surgeons and oncologists work together to provide optimal care after breast cancer treatment. “This review demonstrates that early involvement of a new team member who manages exercise or physical therapy is also useful for the best outcome,” says Douglas Blayney, M.D., medical
director at the University of Michigan’s Comprehensive Cancer Center. According to the review, starting exercise within the first to third day after surgery might result in better shoulder movement in the early weeks following surgery. However, “starting exercise that soon after surgery may cause more wound drainage and require drains to remain in place longer than if exercise is delayed by about one week,” says lead review author McNeely, an assistant professor of physical therapy at the University of Alberta and clinical researcher at the Cross Cancer Institute, Canada. Wounds healed, on average, a day later with early exercise. Fourteen of the reviewed studies compared improvements in shoulder and arm movements of post-treatment groups of women who received an exercise pamphlet with those who did not. Those who followed structured programs including physical
therapy regimens in the early postoperative period showed a significant improvement in shoulder range of motion. Blayney said he finds few things as disheartening as witnessing breast cancer survivors in long-term follow-up who are burdened with a “frozen” shoulder or daily use of a lymphedema sleeve, an elastic compression garment worn over the arm to help move fluid and reduce swelling. “Implementation of modern primary treatment strategies— including early intervention with suitable exercises—should reduce the incidence of these heartbreaking complications,” Blayney says. The Cochrane Collaboration, an international organization that evaluates medical research, published this review, which drew evidence-based conclusions considering the content and quality of existing medical trials on the topic. © Content That Works Features
Page C4 - October 21, 2010 - Teton Valley News ♥ Supporting the Valley’s Tetons
It’s very disturbing that patients under 40 had the highest discontinuation and non-adherence rates, because those patients have the longest life expectancy. Dawn Hershman, MD, associate professor of medicine and epidemiology at Columbia University Medical Center Photo by Content That Works Features
Hormone holdout
An alarming number of breast cancer patients stop meds before treatment has ended Taniesha Robinson Content That Works Features It seems that breast cancer survivors are bringing new meaning to the descriptive phrase “young and rebellious.” A new study of women with early-stages of breast cancer finds that fewer than half of breast cancer survivors adhere to their prescribed hormonal therapy regimen. Those women under age 40 are even less likely to complete the term for medicinal treatment. “We were surprised to see that so many young women stopped treatment early, despite the fact that the therapy has a proven track record of reducing breast cancer recurrence,” says Dawn Hershman, MD, the study’s leader and associate professor of medicine and epidemiology at Columbia University Medical Center. “Perhaps we need to do a better job of making patients aware that to get the full benefit of treatment, they need to take their medications on time and
for the full duration.” Hormone therapy, such as tamoxifen and aromatase, commonly lasts up to five years, yet only 40 to 60 percent of women with hormonesensitive breast cancers finish the course of their treatment. Hershman and her colleagues examined automated pharmacy records of 8,769 women diagnosed with stage I, II or III of hormonesensitive breast cancer between 1996 and 2007. Thirty-two percent of women in the study had discontinued hormone therapy by the 4.5-year mark, and only 72 percent of those who continued actually finished on schedule. Women under age 40 were more likely to discontinue therapy. “It’s very disturbing that patients under 40 had the highest discontinuation and non-adherence rates, because those patients have the longest life expectancy,” Hershman says. “If we can better understand the issues surrounding compliance with hormonal therapy, this might help us understand why patients don’t adhere to other treatments that
are moving out of the clinic and into the home, such as oral chemotherapy, as often as we would like.” There are several factors that could be contributing to this trend, Hershman says. Joint pain, hot flashes and fatigue are all side effects that can push women to stop therapy. High insurance or medication costs and not completely understanding the benefit of therapy may also be factors, Hershman adds. “This new study reaffirms some worrisome trends for women completing hormonal therapy, and brings up the larger issue of non-compliance for cancer therapies in general,” says Jennifer Obel, an American Society of Clinical Oncology breast cancer expert. She adds that she and other researchers “need to identify reasons why patients don’t take their drugs before [they] can find ways to reverse this trend.” © Content That Works Features
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Supporting the Valley’s Tetons ♥ Teton Valley News - October 21, 2010 - Page C5
Even cowboys get breast cancer: Fred Crane’s story local voices Lisa Nyren TVN Staff Fred Crane doesn’t let anything get in his way. Not even cancer. A famed PRCA rodeo announcer and regular voice heard over the loudspeakers at the Teton County Fair Grounds, Fred, 59, was diagnosed with breast cancer last spring. He is one of the 1,970 men who have or will be diagnosed with breast cancer this year. But he’s over it now, and he’s moved on. He’s currently undergoing chemotherapy treatment, and that hasn’t slowed him down a bit. Last month he was featured in a television commercial promoting tourism in Wyoming doing what he does best— wrangling.
The TVN either. He was in and out interviewed Fred earlier of the hospital for surgery this month and he in one day. commented that chemo “I’m still waiting for the wasn’t that bad. big epiphany,” said Fred. “I went jet skiing “Pretty much everything I wasn’t Friday,” he said. is [still] the status quo.” in charge Fred is a familiar Except, he said, lifting his before I had face in the Valley. When white cowboy hat, he’s cancer, and he’s not announcing or suffering from “a bad case I ain’t in wrangling, Fred runs the of mange.” The chemo is charge now. Broken Spur in Driggs. doing a number on Fred’s He’s there most days with hair, like it does with most Fred Crane, Breast cancer his two dogs, Ozzy and patients. survivor Shorty. Fred will undergo The shopkeeper radiation when his chemo actually walked around treatments are over. with a fluid-like lump And the wrangler isn’t in his chest for five or six years. This worried about the future, or about a year, while in Rexburg for a skin possible relapse. check, Fred had the lump biopsied. “I wasn’t in charge before I had “I didn’t want it to be breast cancer, and I ain’t in charge now,” he cancer,” he said. said. Photo courtesy Fred Crane Fred had a radical mastectomy To contact Lisa Nyren e-mail Fred Crane shows his battle scars after on his left side. That didn’t stop him editor@tetonvalleynews.net. dealing with breast cancer.
Knowledge from experience: Kathy Rowbury tells her story local voices Lisa Nyren TVN Staff Kathy Rowbury knows cancer all too well. She’s battled breast cancer herself and is one of four siblings in her family who have had cancer, either of the breast or the ovaries. Both her grandmothers had breast cancer. An aunt on her mother’s side died of cancer. In 2005, one of her sisters succumbed to ovarian cancer shortly after being diagnosed. “It’s always been something I’ve known,” said the Child Nutrition Director for Teton School District. What’s interesting about Kathy’s story is that it points to research that still needs to be done, specifically on how heredity and genetics play a role in cancer development. After Kathy’s grandmother was diagnosed with cancer, Kathy’s mother was tested for the breast cancer gene (BRCA). There are two types, BRCA1 and BRCA2. These genes are part of a class of genes called tumor suppressors. Mutations in these genes increase the risk of developing breast and ovarian cancers, among others, in both men and women. Generally when family members develop breast cancer, others in the family will be tested for the gene. Kathy’s mother’s BRCA test was negative. Kathy was tested herself and received the same result. But it’s obvious that there’s something else that science has yet to discover. “I hope they find out whatever genetic thing is happening in my family,” Kathy said. Kathy’s lump was found after a mammogram, on her right side just below the nipple. This made her ineligible for a lumpectomy due to the lump’s location, she said. The lump was just over 2 centimeters and was invasive ductal carcinoma. It was also estrogen receptor positive. Because of this, Kathy, 52, now takes an estrogen blocker daily. Her diagnosis came in April of 2007. She had a mastectomy on May 1 and began chemotherapy on May 21. She underwent six chemotherapy treatments, which ended on Sept. 4,
2007. “You just do what you have to do and get on with life,” she said. In addition to the mastectomy, Kathy had all her lymph nodes removed during surgery because her doctor discovered that the cancer had spread to her sentinel node. The sentinel node is the lymph node closest to the tumor. Generally cancer spreads to lymph nodes first, so doctors will test the sentinel nodes in most patients. If the sentinel node is affected, it and surrounding lymph nodes are removed. Like other cancer patients Photo courtesy of Kathy Rowbury receiving chemotherapy, Kathy Kathy Rowbury with her husband, Craig, at the National Elk Refuge in December, 2007, three lost her hair. She waited to have months after Kathy completed chemotherapy treatment. it cut until “it was coming out in clumps,” she said. But she wore a wig afterwards that so closely resembled chemotherapy her natural hair, people who did treatments not know her well could not tell the after having a difference. Even so, going bald was mastectomy. difficult for Kathy. Clenna and “It was harder for me to lose my Kathy’s older sister, hair than to lose my breast,” she said. Annette, had her The chemo also caused Kathy to ovaries removed lose her appetite. And her body ached earlier this year, and all over. her doctors found “Even the hair I didn’t have on my cancer in one of the head ached.” ovaries. Luckily, But Kathy was not alone during her cancer was her treatment and recovery. Her contained. husband, Craig, was there by her side Their oldest Photo courtesy of Kathy Rowbury the whole time. And Kathy, Sue Beard, sister, Marlene, had Kathy Rowbury with her extended family in Salmon, Mother’s Day and another woman, who all attended ovarian cancer, but weekend, 2009. Back row from left to right: Ben (nephew), Kathy, church in Tetonia, were diagnosed she was diagnosed Beth (sister-in-law), Bryce (son-in-law), Eric (nephew), Rachel within months of each other. (niece), Becky (niece). Front row from left to right: Catherine too late to recover. (daughter-in-law), Devon (grandson) and Katie (niece). “It’s amazing how many people She received her [breast cancer] is affecting,” Kathy diagnosis on Sept. said. 1, 2005 and passed Through it all, Kathy has kept a away less than three experience.” positive outlook on life, and she values weeks later, on Sept. 20. And it didn’t hurt that Chip and every last one of her experiences. One sister in their family, Sherrie, Dales’ dancers handed out roses to all “If I had to give up the things I’ve is so far clear of any cancer, as is their the survivors, she added. learned [to not go through cancer], I’d brother, Clyde. Kathy’s advice to other women is do it all over again,” she said. “The Kathy has four children of her to get mammograms. whole experience taught me a lot of own, who are all grown and married, “They’re not that bad,” she said. things.” The most important to Kathy and who are cancer-free. She urges women to conduct self is her relationship with the Savior. “I Since her own treatment and breast exams while laying down and think I’ve become a better person,” she recovery Kathy attended a Susan while standing up. Do it before you said. G. Komen Race for a Cure event get out of bed and while your in the Kathy’s sisters have similar in Nevada a couple years ago. A shower, she suggests. stories. Her youngest sister, Clenna, company her son, Jared, works for, And if you develop cancer, keep a was recently diagnosed with ductal Roche Constructors, Inc., was her positive attitude. carcinoma that was HER2-positive. sponsor. Kathy attended the event with “Losing a breast is not the worst HER2 stands for human epidermal her daughter-in-law, Kylie, and her thing that can happen to you,” she growth factor receptor 2, and patients grandson, Dax. said. who test positive for this often have “It was a really good experience,” To contact Lisa Nyren e-mail aggressive forms of cancer. Kathy said. “It’s just an uplifting editor@tetonvalleynews.net. Clenna recently finished
Page C6 - October 21, 2010 - Teton Valley News ♼ Supporting the Valley’s Tetons
Community Cancer Screenings The best hope for treating and beating cancer starts here, with early detection. Take advantage of our FREE and reduced-cost cancer screenings.
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Photo by Content That Works Features
Many foods are touted as helping cancer survivors get and stay well Dawn Klingensmith
Content That Works Features
Foods that do the best job of nourishing our bodies may, at the same time, cause certain cancers to “starve�—at least in a figurative sense. For example, fresh or frozen berries might inhibit a tumor’s ability to form blood vessels, and without a blood supply, the tumor cannot survive. Other foods can help prevent cancer from forming in the first place. “The relationship between food and cancer is complex,� says Dr. Mark Fesen, a Hutchinson, Kan.-based oncologist and author of “Surviving the Cancer System� (AMACOM, 2009). Scientific studies can be confusing or even contradictory, but the consensus among doctors and researchers is that a daily diet rich in fruits, vegetables and whole grains can protect against a wide range of cancers. However, “Your total amount of calories eaten is the most important factor in the risk of developing cancer,� Fesen says. “Obesity is linked to several cancers, including prostate, colon and breast cancers.� Substitute fish, poultry and beans for red and processed meats whenever possible, advises epidemiologist Dr. Julia Greer, University of Pittsburgh School of Medicine. As for supplements, “The only one I recommend is vitamin D,� which reduces the risk of colorectal and breast cancer, says biochemist Richard Beliveau, chairholder in cancer prevention and treatment at the University of Quebec at Montreal. Not all of the following cancerfighting foods are suitable for people undergoing treatment. Cancer patients have special dietary needs they should discuss with their physicians. For example, “Your protein needs increase during treatment,� Greer says, “and because of side effects such as mouth and esophageal sores, eating acidic foods such as tomatoes and citrus fruit is a very bad idea.� Berries Berries are bursting with
compounds that can slow the growth and metabolism of cancerous cells. An antioxidant in raspberries has been shown to inhibit cervical cancer growth and may decrease pancreatic cancer risk and skin cancer cell division.
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Citrus fruits Rich in vitamin C,
which may fight breast cancer, citrus fruits may also reduce the risk of esophageal cancer. The fruits’ pectin may lower the risk of ovarian cancer and delay the growth of cancerous cells in men diagnosed with recurrent prostate cancer. Tomatoes Tomatoes contain
lycopene, which is linked to a decreased risk of pancreatic and prostate cancers. Go ahead and hit the sauce—heating tomatoes does not destroy lycopene; in fact, it enhances it. Ounce for ounce,
tomato paste, spaghetti sauce and ketchup contain more lycopene than a raw tomato, Greer says. Whole grains High intake levels
of whole grains correlate with reduced pancreatic, colon, endometrial and ovarian cancer risks. Grapes Red varieties contain
high levels of resveratrol, which can decrease or stop the growth of breast, prostate, pancreatic, stomach, liver and colorectal cancers. Tart cherries This fruit naturally
depletes the body of cancer-causing substances. They can also slow the growth of cancerous cells, particularly in the case of colon and breast cancers. Pomegranates Pomegranates
contain four chemical components that have been shown to inhibit prostate cancer cell growth. Antioxidants found in pomegranates and their juice may also help prevent breast and lung cancer cells from dividing and can even kill cancer cells. Leafy greens Leafy greens, such as
spinach, can decrease the risk of breast, colon, skin, lung, head, neck, ovarian and stomach cancers. “Watercress intake, in particular, is associated with decreased ovarian cancer,� Greer says. Garlic and onions Garlic may
reduce stomach cancer and women’s risk of colon cancer. Onions may play a role in fighting lung, colon, bladder, skin, prostate, stomach and endometrial cancers, as well as leukemia. Red and yellow onions pack the most nutritional punch. Nuts and seeds Nuts and seeds
contain healthy monounsaturated fat, which has been shown to protect against breast cancer. The mineral selenium—found in certain kinds of nuts—may inhibit the development or growth of prostate, lung and bladder cancer cells, while also protecting against colon cancer. Green tea “Tea is the best source
of anti-cancer compounds called catechins, and green tea contains about three times as much as black tea,� Greer says. One study showed that drinking three or more cups of green tea each day reduced the recurrence rate of Stage I breast cancer. Dark chocolate Extracts of dark
chocolate can inhibit the formation of breast, colon and prostate cancers, and can decrease the division rate of liver cancer cells. A 2003 Cornell University study compared the anticancer properties of certain beverages and found that unprocessed cocoa had nearly twice the amount of antioxidants as red wine and up to three times more than green tea. Š Content That Works Features
Supporting the Valley’s Tetons ♥ Teton Valley News - October 21, 2010 - Page C7
Navigating a relapse They made it through cancer once. How do you best help someone who has to do it all over again? Photo by Shelly Perry
Anna Sachse Content That Works Features There is no way to be ready for the unwelcome return of cancer—no matter how well a patient coped with and recovered from the illness the first time. Don’t assume the process will unfold the same way it did on the first go-around. “When cancer comes back, it usually gets harder and harder to treat, and the doctors have to pull out bigger guns,” says Kimberly StumpSutliff, registered nurse and associate medical editor for the American Cancer Society. The treatment will likely be more intense and the outcome may be different, so you have to be prepared for new and potentially more difficult physical consequences. Your loved one may also react differently from how they did before. While some patients might
When cancer comes back, it usually gets harder and harder to treat, and the doctors have to pull out bigger guns. Kimberly Stump-Sutliff, registered nurse and associate medical editor for the American Cancer Society
be ready to fight the cancer again as soon as they hear the news, it is also perfectly normal to feel disappointed, sad, anxious, depressed or angry at the doctor or their own body. “I always tell patients that they are entitled to those feelings—cancer sucks,” Stump-Sutliff says. “But then I tell them that they can’t live in that mindset, so let’s focus on what we’re going to do
Teton Valley News & Broulim’s have teamed together for
National Breast Cancer Awareness Month Go into Broulim’s during October to donate to the Susan G. Komen Foundation.
next.” Nevertheless, you ultimately have to allow your loved one to make his or her own decisions about the course of treatment. Be patient, open-minded, communicative and supportive. Some may choose to rally for another round of chemo. However, if a patient decides he or she no longer wish to continue treatment, you must respect those wishes, even if you don’t agree, Stump-Sutliff says. “Maybe that’s just how they feel right this second, and tomorrow they will wake up and be ready to fight it again. But you can’t make a cancer patient do something they don’t want to do.” Getting your loved one’s health care providers involved may also be helpful, as they can weigh in on the likelihood that further treatment will be effective. © Content That Works Features
these people who have already donated to the Susan G. Komen Foundation Broulim’s and the Teton Valley News would like to thank all those who donated to Breast Cancer Awareness last week. Kaitlyn Conner for Susan Conner Bette Vereloust Whitney Waddell Kadin Waddell Alisha Horrocks Jaymy Calilna Jane Mackay Peter Mackay Kimberly Day Mary Carol Staiger Laune Swan Jen Calder Macy Walker Amy Birch Ashlynn Hansen Karey Hoff Kelly Wood for Candi Palmer—Egin survivor 6 years! Seth Robinson For Martha Stoker R. Villers, England Dani, Hunter & Morgan Johnson Heather Holcomb Leanne Morse Lorraine Miller Jen Bandow Thomas Kincaid Kevin Bradshaw Tressa Brasher And Others
Page C8 - October 21, 2010 - Teton Valley News ♥ Supporting the Valley’s Tetons