Breast Cancer Awareness October 2020
October 2020 BREAST CANCER
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INDEX Cover story: Heather Jones survivor story . . . . 3 Janet Jorden survivor story . . . . . . . . . . . . . . . . . 5 Menstrual history and breast cancer risk . . . . 10 Pregnancy and breast cancer . . . . . . . . . . . . . . . 11 COVID-19 and breast cancer guidelines . . . . . 12 Sandra Ward, Breast Cancer Survivor . . . . . . . 13 Pain medications during treatment . . . . . . . . . 14
ON THE COVER: OSF Moeller Cancer Center certified breast cancer navigator, Heather Jones, RMA CN-BC, right, a survivor herself, works with a patient in her office at the Moeller Center in Alton. As a navigator Jones goes to patients’ first visits with oncologists, organizes transportation for patients if needed, finds resources for financial assistance and outreach, schedules all the hospital’s diagnostic imaging for breast cancer and all of the surgical procedures for pre-op, as well as attends procedures on the day of surgery when patients are taken back to the operating room.
October 2020
Breast cancer survivor gives back to her community as breast cancer navigator and support group leader Certified navigator-breast cancer, survivor pays it forward By Jill Moon jill.moon@hearst.com ALTON — More and more resources are coming available for patients with breast cancer — and a survivor is testament to that on a human level. It’s not about the myriad of doctors and nurses who visit a room, but a guide through the unknown. OSF Moeller Cancer Center certified navigator for breast cancer (CN-BC), Heather Jones, RMA CN-BC, is a survivor. When Jones started working at Alton’s Saint Anthony’s Health Center, now part of the OSF HealthCare system, in 2010 in a physician’s office as a registered medical assistant (RMA), she had no idea the impact she’d have on future breast cancer patients, one of whom she herself would become as a RMA in 2011. But that’s not what prompted her to enter the medical field. “My journey started when my kids were little,” said the mother of four, whose youngest is 12. “I was married with three little ones at home, and my husband was diagnosed with leukemia. “That got me my backbone, of wanting to give back,” recalled Jones, who was 31 when her husband was diagnosed. “On the caregiver side, I saw how people needed that.” As a medical assistant at OSF Saint Anthony’s Health Center, in a unit of the surgeons’ department, she discovered a
breast lump. Due to early detection, Jones’ cancer was stage I. Jones became a non-certified navigator for breast cancer in 2015, as a RMA with history of breast cancer. “I took the job as a breast cancer navigator about three years after I went through my treatment,” Jones recalled. She started certification for breast cancer navigation after her third year as a navigator. She completed certification in 2018. “Because of the new Moeller Cancer Center coming, I felt it would be a great time to get my credentials to add to our program here at OSF,” she explained. “I went through breast cancer treatment as a single mom, three were still at home,” Jones recalled, “without anyone guiding me through it, facing a lot of barriers along the way. There’s a lot of folks going through the same thing I went through.” Now, Jones celebrates her tenth anniversary this year as a breast cancer survivor. But she still experiences mild anxiety and had a computerized tomography (CT or CAT) scan done to detect the source of bone pain, which turned out to be arthritic in nature. “There’s always underlying anxiety for a cancer patient, you have to try to deal with,” said Jones, which is where a breast cancer navigator also is beneficial. “I can have a cough for three days, and think, ‘Oh my gosh, it’s in my lungs, it’s cancer’” she said. “So I also work with patients about what they have anxiety
October 2020 BREAST CANCER
OSF Moeller Cancer Center’s Heather Jones, RMA CN-BC, a certified navigator for breast cancer, photographed sporting a pink wig for an event in which she participated last year.
about, coping if cancer returns and thinking about if or when it’s going to come back. This is something that is normal for cancer patients.” When the Saint Anthony’s position of a breast cancer navigator came up, Jones was encouraged to apply. “I was, like, ‘I’m not credentialed,’ but I went ahead,” said Jones, now certified through National Consortium of Breast Cancer Inc. Jones does not regret her experience, as a matter of faith. “God put me through something for a reason, he had plans for me,” she said. “It was all providential and now I’m a certified breast cancer navigator. I’m filling those gaps for patients walking through that process instead of five different doctors.” Jones goes to patients’ first visits with oncologists and also organizes transportation for patients if needed and finds resources for financial assistance and outreach. She also does all the hospital’s scheduling portion for diagnostic imaging for breast cancer and all of the surgical procedures for pre-op, as well as attends
National Breast Cancer Awareness Month is a chance to raise awareness about the importance of finding breast cancer early. Make a difference! Spread the word about mammograms, and encourage communities, organizations, families, and individuals to get involved.
procedures on the day of surgery when patients are taken back to the operating room. “I’m constantly with them as we go,” she said, “so they know they have that one person they connect to.” Jones did not have the benefit of a navigator at Barnes-Jewish Hospital while she underwent chemotherapy and radiation at the same time. “I didn’t have one, so that was why I feel it is so important to have one,” she said. “I did have a nurse with me for the biopsy, which was very helpful.” She went back to work after two surgeries within two weeks, for which cancer tissue was also removed around the margins of the lump, and had the second surgery on New Year’s Day. She underwent six rounds of chemo, and 32 radiation treatments. “It took about six months to rebound back to my body,” she recalled. “I lost my hair and weight; I was fatigued. After that I got really involved in Sisters of Survivors, a Relay for Life team, and once I started as a navigator, I started leading Team Hope as a captain.”
Find support Caring Circle Women’s Cancer Education and Support — A support group for all women currently diagnosed with cancer or in remission. Meets monthly. Call 618-4635623 for more information.
Heather Jones, RMA CN-BC
4 Five years ago she began leading a women’s support group, Caring Circle. Now 20 to 30 women attend the support group, which meets the third Saturday of every month usually at the OSF Moeller Cancer Center in Alton, but due to COVID-19 the group met at Glazebrook Park, in Godfrey, this summer, maintaining 6-feet social distance. “It depends on how many we can see for a visit whether we meet at the Moeller Center,” explained Jones, who leads the group with registered nurse Karen Boyd. “We lead it together and come up with a topic or discussion and host. We send out a letter to members whether we are meeting at the center or somewhere different.” Over the course of her career, Jones has become like family with her patients. “Once you navigate a person for nine months, talk to them every day, patients go to church with me, go to the movies, you become family with some people,” she said. “Some people say, ‘I can never do that.’ I’ve lost some along the way, that’s the hard part. But you want to give them the special time in their life while you can.” Most of her patients had an abnormal image to begin with. “I get a fax copy and run with it from there,” she said of how the navigation process starts. “If it’s breast cancer, especially from one of our doctors, the doctor hands them to me if a patient is just needing to connect for support. I take calls from patients on weekends and evenings, just because they need to talk to somebody. It’s never too busy if you really need me. Families have asked me to come make a decision on life. That’s part of my job to take a hospice program. “My upcoming goals are to take a hospice class and a counseling program to help with my service.” Patients have Jones’ cell phone number, office number and email. “You have your ups and your downs,” she said. “I stay pretty positive. I found it early, got early treatment and combated it, but nothing is guaranteed. I live life to its fullest and for my kids. I’m living for Christ and while I’m here I’m going to do whatever I can, and do His will.” Jones’ email is heather.e.jones@osfhealthcare.org and office telephone number is 618-474-6791.
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My Story By Janet Jorden, Breast Cancer Survivor 2020 I am a “69 and holding” year old female that actually entered a 7th decade this year, but considering I have much to do yet in this lifetime, I am attempting to slow it down by going into a hold mode. I have shared My Story with friends and family because I am so blessed to be in the throes of cancer treatment at OSF Moeller Cancer Center. I am sharing it with others because I want others to know this wonderful care is available close to home, saving many trips to St. Louis for excellent cancer care. Upon routine mammogram two years ago at my physician’s office, a growth was seen in my left breast. The radiologist said that it needed regular monitoring, but did not recommend any further testing or treatment. I had a mammogram and ultrasound (US) every 6 months, and for two years it remained essentially the same. Two days before my scheduled knee replacement in December of 2019 I had my 6 month mammogram and ultrasound expecting it to be the same as 6 months prior. After knee surgery, I received a call from the radiology office that I needed the breast growth biopsied as it had changed. I knew that OSF HealthCare’s newly opened cancer center offered state-of-the art equipment and that the staff would be able to treat my condition. I was pleased to have the breast biopsy done in radiology as well as having a Mag Seed implanted by the radiologist in preparation for upcoming surgery. I understand that OSF HealthCare in Alton is the only facility in the area with this technology. I was introduced to OSF HealthCare’s Breast Navigator, Heather Jones, on the phone and I actually chose to follow-up at OSF Health-
Care because Heather was so kind and helpful. She was informative and knowledgeable and able to educate me in the process of diagnosis and actually made appointments for me. I was able to have the breast biopsy on an out-patient basis, which Heather prepared me for, by answering my questions and explaining the procedure to me. She even met me and accompanied me to the procedure(s). The biopsy was positive for malignancy so with Heather’s assistance (and recommendations from my RN granddaughter who was a nurse in OSF’s ICU), I met with a wonderful OSF HealthCare general surgeon, Dr. Alejandro Sanz and he performed a lumpectomy (which is technically a partial mastectomy) and lymph node(s) excision in January 2020. After my test results were available, Dr. Sanz gave me the results and referred me to Medical Oncology for chemotherapy follow-up. I chose to see Dr. Manpreet Sandhu, a top notch OSF HealthCare Medical Oncologist, who explained my follow-up treatment options in great detail. We worked out a treatment plan that would all be accomplished at Moeller Cancer Center. That treatment plan included chemotherapy followed by radiation therapy. My chemotherapy began in March 2020 (every 3 weeks) and an antibody infusion continues every three weeks until March of 2021. I had a porta-cath placed in my right chest for these infusions by Dr. Sanz at OSF HealthCare. I was getting to know the Day Surgery and surgical staff better than I wanted to by this time. They were all prepared each time and were friendly and professional, making these experiences nothing to dread.
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October 2020
October 2020 BREAST CANCER I have also come to realize how grateful I am that this entire saga came together in just the nick of time - prior to the COVID-19 Pandemic limiting “elective” surgeries and treatment implementation. So many folks have had to wait several months to have diagnostic and surgical services available and I am one of the blessed ones that was able to get right to the treatment phase. I began my round of radiation therapy in June of 2020 at OSF Moeller Cancer Center (same building as the chemotherapy) under the direction of Dr. James Piephoff, Radiation Oncologist. I had 28 radiation treatments that were completed at the end of July 2020. The radiation staff as well as Dr. Piephoff and the Radiation Oncology nurse, Karen Boyd, did not disappoint in their care and services. All staff were professional, kind and efficient, and made daily visits as convenient and comfortable as possible. The OSF Moeller Cancer Center is also beautiful on the outside. Located just outside the chemotherapy windows is a beautiful flower garden. It is lovely and calming as one spends quite a bit of time in that area for treatments. Patients can even go into the outside area with their IV poles & sit during their chemotherapy treatments, if one so desires. The oncology nurses are all wonderful. They are compassionate and make each patient feel comfortable, always offering blankets, drinks, snacks and lunch when appropriate, in addition to their many nursing duties. The atmosphere is always calm and welcoming, which is so important to patient care.
My husband and I have commented many times how blessed we are to receive such great care close to home. Several friends have experienced care and treatment plans through other healthcare systems and have to travel to St Louis. Care is sometimes exhausting, and I can’t imagine tripping out of state for care. I have helped transport friends and family for daily radiation treatments, which causes patient’s to feel extra stress during their treatments. I also have the advantage of being 10 miles or less to OSF Healthcare from my home, which allows me to drive myself to and from radiation and these final infusion treatments. Most folks going through cancer treatments find it stressful having to rely on friends, family or others, and do not want to feel like a burden. That is not to say family and friends are not essential in being a part of this journey. It is indeed not a path one wants to take alone. The journey is not only a physical one but emotional, mental and spiritual one as well. One must deal with the stress of the words cancer, malignancy, surgery, and chemotherapy & radiation therapy from physical and emotional standpoints, but waiting on results and prognosis and recovery from a spiritual standpoint is just as real. A great, all powerful God and wonderful, supportive family, church family, friends and neighbors helps make the cancer journey one of growth and gratitude to grow oneself as well. The impact of this entire experience in my life has been a great learning experience. Actually experiencing a diagnosis of cancer and being on the “patient end”
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7 BREAST CANCER of things has been an eye opener for me (I am a retired nurse). This experience has served to only strengthen my faith and make me more empathetic to others who are experiencing similar experiences. I hope my experience will be used to
October 2020
spread encouragement and hope to others I meet. My deepest respect and admiration to the entire OSF Moeller oncology staff: doctors, nursing, and so many ancillary staff that dedicate their lives to such a worthy practice!
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October 2020 BREAST CANCER
Menstrual history and breast cancer risk
October is National Breast Cancer Awareness Month
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Various factors can affect a woman’s puberty. The breast tissue of girls who risk for breast cancer. Some of these facbegin menstruating at a younger age tors, including whether or not a woman tends to be immature and sensitive to is physically active, are within her conhormonal influences, which is associated trol. But others are not, and those include with a higher risk of breast cancer later when a she started to menstruate. in life. According to Breastcancer.org, women Women may not be able to control who started menstruating prior to age 12 when they start and stop menstruating, LifeGuard Backing™ protects your by keeping have a higher Spill-proof risk of developing breast butflooring they caninvestment control certain factors that spills contained from soaking through the pad and subfloor. cancer later in life. But that’s not the only cantomake them less likely to menstruate link between menstruation and breast early. Breastcancer.org notes that maincancer risk, as women who go through taining a healthy weight, exercising regumenopause when they’re older than 55 larly and eating nutritious foods are some years of age also have a higher risk of lifestyle choices that girls and women can developing breast cancer later in life. make to keep their risk for breast cancer Breastcancer.org notes that, over the as low as possible. last two decades, girls have begun puberVarious factors can increase a woman’s ty at younger ages than girls in previous risk of developing breast cancer. Undergenerations. Researchers have linked that standing the link between those factors phenomenon to the obesity epidemic and and cancer risk can help women make broad exposure to hormone disruptors. healthy decisions that benefit both their A rise in hormones triggers the onset of short- and long-term health.
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Pregnancy and breast cancer
Breast cancer affects millions of women across the globe every year. While some women may be at greater risk of breast cancer than others, no woman is immune, and that includes expecting mothers. The National Breast Cancer Foundation, Inc.ÂŽ notes that pregnant women can be diagnosed with breast cancer, though such diagnoses are rare. In fact, Breastcancer.org notes that instances of women developing breast cancer during pregnancy are so rare that only small studies have thus far been conducted in regard to treating pregnant women with the disease. However, there are various treatment options for expecting mothers diagnosed with breast cancer. Each woman is different, and treating breast cancer in pregnant women will depend on a host of factors. The NBCF notes that the size of the tumor, its location and the term the pregnancy is in will help to determine the safest, most effective treatment plan. According to Breastcancer.org, a mastectomy with axillary lymph node dissection will likely be recommended to women who have been diagnosed with breast cancer during the first trimester of their pregnancies. That recommendation will be based on guide-
lines established by the National Comprehensive Cancer Network. Surgery will be recommended because radiation therapy is not safe during pregnancy. Once women have undergone successful surgery, the NCCN guidelines suggest waiting until the second trimester to begin chemotherapy. Doctors treating women diagnosed with breast cancer during the second trimester of their pregnancies may recommend either mastectomy or lumpectomy, a surgical procedure in which a lump is removed from the breast. Such recommendations align with NCCN guidelines. In addition, women who receive a lumpectomy would wait until after their children are born to receive any necessary radiation therapy or hormonal therapy. That’s because radiation is not safe during pregnancy and the NBCF notes that the effects of hormone therapy on unborn children are not entirely understood. The NCCN guidelines advise that women diagnosed with breast cancer during the third trimester of their pregnancies undergo a mastectomy or lumpectomy with axillary lymph node dissection. Chemotherapy is safe during the third trimester, but radiation and hormone therapies will be delayed until after the child is born.
Pregnant women are only rarely diagnosed with breast cancer. But as scary as such a diagnosis can be, women
October 2020
should rest assured that treatment is safe, even if it entails a combination of therapies.
October 2020 BREAST CANCER
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COVID-19 and breast cancer guidelines The novel coronavirus COVID-19 first appeared in late 2019 and has changed life for the forseeable future. While many people are quick to focus on the ways COVID-19 has impacted their abilities to shop, visit with friends and relatives or travel, the virus has made life especially difficult for people with preexisting health conditions. Medical News Today reports that the symptoms of COVID-19 may be more severe for breast cancer patients. Furthermore, the Centers for Disease Control and Prevention notes that undergoing cancer treatment can weaken the immune system, further increasing a person’s vulnerability to infection. Specifically, targeted therapies, chemotherapy and radiation can weaken the immune system and compromise its ability to fight off the coronavirus. Furthermore, these treatments also may cause lung problems that can exacerbate COVID-19 symptoms, particularly among breast cancer patients whose
cancer has metastasized to the lungs. In April 2020, new guidelines for the prioritization and treatment of breast cancer patients during the COVID-19 pandemic were released, compiled by a group of U.S. medical organizations, including the National Accreditation Program for Breast Centers, the American College of Radiology and the Comprehensive Cancer Network. At hospitals where resources and staff have become limited due to COVID-19 treatment efforts, doctors have had to define which breast cancer patients need urgent care and which can have delayed or alternative treatments. These measures can help balance maintaining positive survival outcomes as well as reducing risk of exposure to the virus, according to the American Society of Breast Surgeons. Breast cancer patients have been broken down into priority levels of A, B and C for urgency of care. • Priority A: A patient has conditions
that are immediately life-threatening or require urgent treatment. • Priority B: A patient has conditions that don’t require immediate treatment, but he or she should begin treatment before the end of the pandemic. • Priority C: A patient has conditions for which treatment can be safely put on hold. Breast cancer patients are further urged to take extra caution in their daily activities to help reduce the risk of contracting COVID-19. That means always wearing a mask or another face covering when
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interacting with other people. This advice may be applicable even if a six-foot distance can be maintained. Wash hands frequently, especially when coming in from public places. If possible, ask a friend or family member to do your shopping or run errands for you to limit exposure to other people and crowds. Breast cancer patients may have to discuss the possibility of altering or delaying treatment for breast cancer with their oncologists because of increased risk factors presented by COVID-19. Together, patients and doctors can work
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October 2020
Sandra Ward Breast Cancer Survivor I was diagnosed with Breast Cancer in 2016. I had surgery soon thereafter, and after 2 rounds of chemotherapy and 33 radiation treatments, I won my battle over cancer.
I cannot stress enough how very important it is to do your breast self-exams and get your mammograms. Early detection is absolutely key to survival.
The exams, the tests the doctors – yes, it can all be scary. I admit that whole-heartedly. To me, not knowing is scarier. Not taking simple preventative measures into my own hands and owning my health is what would terrify me. You have to take ownership of your health and your life, and put your faith over fear. You cannot fight what you don’t know is there. You cannot survive if you don’t fight for YOU. This battle with cancer is not a journey that you want to take alone. You need family, friends and community by your side to support you along the way. I was fortunate to have all of those to push me through. There are two amazing support groups in our community and I urge everyone bat-
tling breast cancer to take advantage of these resources. OSF HealthCare hosts a support group called Caring Circle that meets the third Saturday of every month. Roberta’s Lovely Ladies Boutique also hosts a support group called Caring Sisters every first Saturday of the month. The support, love and strength that I received from the ladies in these support groups was instrumental to my path to that bell. I was fortunate enough to assemble the best team to rally around me during this difficult time. I had my family, my friends, my support groups, my amazing medical team at OSF Moeller Cancer Center and I had my faith. Prayer is powerful. My faith guided me through this journey and is still showing me the way today.
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October 2020 BREAST CANCER
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How to manage pain medications during breast cancer treatment Breast cancer researchers have worked tirelessly over the last several decades as they work to eradicate the disease once and for all. While breast cancer still affects millions of women across the globe each year, advancements in treating the disease have dramatically improved five-year survival rates, providing patients and their families with hope as well as a realistic expectation of a long, healthy life after cancer. According to Breastcancer.org, women diagnosed with breast cancer in 2020 and beyond have an array of treatment options to fight their disease. That marks a stark contrast from recent history, when treatment options were considerably more limited. Though treatment options have expanded and improved survival rates, women diagnosed with breast cancer can still expect to confront some side effects as they navigate their way through treatment. Pain is one of the more common symptoms breast cancer patients experience, both before diagnosis and during treatment. In fact, breast cancer treatment plans typically include strategies to address pain. Breastcancer.org notes that most breast cancer patients can get complete relief for their pain. However, it may take some time before the right formula is found and patients can return to enjoying daily activities. The American Cancer Society notes that medication is typically part of cancer patients’ pain treatment plans. Breast cancer patients unaccustomed to taking medication each day can consider these tips to effectively manage their medications as they progress through their treatments. • Take your medication on a regular schedule. The ACS advises cancer patients who have been diagnosed with chronic pain to take their medications around the clock on a schedule, rather than taking it only when pain is severe. Schedules can be adjusted, but patients should not do so on their own. Pain medication schedules should only be adjusted after speaking with a physi-
cian. • Familiarize yourself with pain medication side effects. Pain medications may produce side effects such as sleepiness and dizziness. The ACS notes that these symptoms typically improve after a few days, but cancer patients must recognize the threat they pose. Patients may need help getting up or walking, and the ACS discourages patients from driving while on pain medication until they are sure of the effects of the medi-
cine. • Do not crush or break pills. Many medicines are time-release medications in pill form. Taking broken or crushed pills can be very dangerous. Only patients who get the go-ahead from their physicians to take crushed or broken pills should do so. • Monitor your side effects. No two people are the same, so some cancer patients may react differently to pain medications than others. Keep track
of any abnormalities and side effects you experience while taking pain medicine. Discuss them with your cancer care team during each doctor visit, and report severe or uncomfortable symptoms to your physician immediately. Pain medication can help breast cancer patients overcome a common side of effect of both their disease and their treatments. Learning to manage pain medications is vital for patients as they recover from their disease.
15 BREAST CANCER
October 2020
Breast cancer prevention is key. While breast cancer is a serious health concern, it can be successfully treated. Learn about your breast cancer risks and how to take preventative steps today.
Visit
ssmhealth.com/BreastHRA to take your breast cancer health risk assessment.
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To learn more, visit To learn more, visit osfhealthcare.org/cancercare. osfhealthcare.org/cancercare.