Breast Cancer Awareness • 7B
www.crossville-chronicle.com • Friday, October 24, 2014
Beauty pros help women to Look Good...Feel Better If you’re a woman going through cancer treatment, you know it can change the way you look and the way you feel about yourself. A free program from the American Cancer Society called Look Good Feel Better can help you overcome these challenges. Women learn beauty techniques and ways to enhance their appearance and self-image during cancer treatment. Upcoming local sessions include: Cumberland Medical Center Regional Cancer Center Nov. 10, 10 a.m.-noon 421 S Main St Crossville, TN 38555 Cookeville Regional Medical Center Cancer Center Dec. 11, 1–3 p.m. 1 Medical Center Blvd Cookeville, TN 38501
disease, but also the debilitating effects of cancer treatment on her skin, hair, nails and general appearance. These changes in appearance often affect a woman’s self-esteem, and many need help coping with the physical side effects of treatment. Licensed beauty professionals from all parts of the country are using their skills and positive energy to make a difference in these women’s lives. Working with the Look Good Feel Better program, specially trained beauty professionals help female cancer patients rescue their appearance and selfimage from the ravages of cancer treatment by teaching them hands-on beauty
and skin care techniques. As a result, patients feel better because they look good. According to the American Cancer Society, there are dozens of anti-cancer drugs in use today, each with its own set of side effects. Possible appearance-related effects of chemotherapy and radiation include hair loss on the scalp, eyebrows, or lashes; weight gain or loss; changes in skin pigmentation and texture; skin oiliness, itchiness or peeling; and alterations in nail texture and growth rate. The American Cancer Society recruits licensed professionals to volunteer See beauty page 10B
W E SUPPORT BREAST CAN CER AW AREN ESS!
For information or to register, call the American Cancer Society at 1-800photos submitted 227-2345. “Don’t get discouraged,” says survivor Karyn Henderson to those fighting the When a woman has battle against breast cancer like her. “There is a lot to deal with but worth it in the cancer, she has to deal not end.” only with the trauma of the
A dose of humor a day By Rebekah K. Bohannon Beeler Chronicle correspondent
Karyn Henderson, of Rockwood, is surviving. She works for the Cumberland County School system as an occupational therapist. Hard working and very active, Henderson liked to participate in Susan G. Komen 5K races and Buddy Walks. But last winter, at the age of 38, Henderson found a lump that she thought might be a cyst. She made an appointment with her general practitioner who planned an ultrasound and would then drain the cyst. “They don’t start mammograms until you’re 40,” said Henderson. “And I was 38 at the time. My doctor and I both thought it was a cyst.” But, when the ultrasound technician called in the radiologist, she became alarmed. The radiologist redid the ultrasound and things began to happen very quickly. The events following her diagnosis rearranged her entire existence. She was diagnosed with stage three ATR-2, an aggressive cancer that up until that point was not treatable. “Within two weeks, I was starting chemo,” Henderson stated. “A new drug had just been approved two weeks before I started treatments for that type of cancer.” She was informed the cancer was already present in her lymph nodes and had a six centimeter tumor. For her aggressive cancer, the aggressive new drug was administered. The chemotherapy was a cocktail of four different medicines that she took in six sessions every three weeks to reinforce her treatments and attack her disease. She lost her hair, her energy and her appetite, but not her drive. That regimen plus a double mastectomy and radiation treatments were a part of her fight and her survival. But, that’s only part of her story. Henderson has
Henderson finds laughter helps in fight against breast cancer
Karyn Henderson’s hair is growing back now, and her energy levels are higher. She hopes to participate in a Buddy Walk coming up soon. learned so very much, including how formidable she really is. She didn’t have to bear the burden alone. Her parents, brother, friends, and church family made sure of that. “I had a very good support system,” Henderson noted. “They would take me to my chemo treatments. My dad stayed a lot and my mom would stay nights with me after treatments.” She did struggle, though. She was fortunate that the treatments didn’t make her nauseas, but the mere thought or smell of food made it all the more difficult and something else with which she had to cope. “I was so hungry, but nothing was appetizing. I found that the only things I could eat were anything with tomatoes and Yoplait
yogurt,” said Henderson. “I still struggle to put food back in my diet.” The fight isn’t over for Henderson. She is healing from her surgery, still undergoing daily radiation and is still on a precautionary chemotherapy regimen, albeit somewhat less stringent. She has found some things to still be true, to still be wonderful, to continue to live in the midst all the madness. In order to achieve that, she found that staying busy was the solution for her. It was a semblance of normality, a way to keep what was still hers and not allow the cancer to be the biggest part of her life. Although she had to slow her work down and take off for her surgery, she worked as much as she could, traveled often and shopped. Family and friends were never far away. She had to remember not to push too hard because there would be days, especially after her chemo treatments, that she wouldn’t feel well. She had to allow herself to not feel well and let herself off the hook. “It was hard because I would get so tired,” Henderson said. “My endurance was lower than I needed it to be, but I learned to take a break when I can.” Henderson learned a great many things. She learned what was important and reprioritized accordingly. She learned to appreciate her family and friends See humor page 10B
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8B • Breast Cancer Awareness
www.crossville-chronicle.com • Friday, October 24, 2014
Chemo, hormonal treatments help stop spread of cancer cells, prevent recurrance By Heather Mullinix Chronicle assistant editor
When a diagnosis of cancer is made, a medical oncologist can guide areas of treatment through powerful medication and longterm follow-up. “Medical oncologists are oftentimes the captain of the ship when it comes to treating not only breast cancer patients but a lot of other cancer patients,” said Dr. Mark Hendrixson. Patients may see an oncologist before they have surgery or after, depending on the type of breast cancer they are diagnosed with. The oncologist will review testing, results of surgery, and other factors to help recommend treatment regimens. Lymph node testing that shows the presence of cancer cells generally means more aggressive treatment, including powerful medications that help to destroy cancer cells in other parts of the body, stop cancer from spreading to other parts of the body, slow cancer growth and relieve symptoms of cancer. “Treatment is less and less one-size-fits-all,” said Dr. Dirk Davidson. “When I came here 10 years ago, any woman I saw, of any age, who had a tumor a half-inch or bigger, even if the lymp nodes were negative, we generally said you really should take chemo because we really don’t know.” Oncotype testing can also be used to help determine likelihood of recurrence in patients with early stage breast cancer. In this test, tumor samples are analyzed for the expression of 21 genes to provide a
score for the patient that predicts the potential for breast cancer recurrence and the likelihood that chemotherapy would benefit the patient. “Someone could come in with a large tumor and positive lymph nodes. In the past we would have said, ‘We’re going to hit you as hard as we can,’” Davidson said. “Now, we can take this test and it will tell us, pretty accurately, what their real risk of recurrence is so that they can make an educated decision.” Sometimes, chemotherapy is used prior to surgery to help shrink large tumors or with advanced HER-2 positive breast cancer. “Most drugs enter the market in the metastatic setting,” Hendrixson said. “You wouldn’t put a newly diagnosed woman on experimental drugs when there are standard treatments. Most drugs enter through trials that have proven they are of benefit to women with advanced cancers.” Those trials can show the drug has a great deal of promise for patients at all stage of the disease and become a commonly prescribed regimen, such as Herceptin. “That drug was moved up into adjuvant therapy (treatment following surgery to lower the risk of cancer returning), and now all of the sudden, a whole group of women we though had a pretty bad prognosis were not that bad,” Davidson said. “Just by getting this drug after their surgery, you could make their prognosis much better.” There are additional drugs added to the regimen that have just become
Davidson
Hendrixson
available in the past two years. Those trials are also how Tamoxifen, a hormone blocking medication, entered the treatment regimen, showing that it slowed or stopped the growth of cancer cells in the body. The typical treatment for breast cancer is intravenous with Cytoxan and Adriamycin. These drugs have been around for some time, with generic options available. Treatments are given, usually, with four rounds at three-week intervals followed by 12 weekly treatments, for a total of about six months. Davidson suggests patients have their Vitamin D levels checked, as well, and take steps to remedy any deficiencies. “If you fix it, your chances of a recurrence are going to be less,” Davidson said. Bone-strengthen ing medications could also help, as well. “Smaller studies have suggested this,” Davidson said. Chemotherapy does have significant side effects, such as loss of hair, hot flashes, dry and sensitive skin, stomach upset
and inflammation. Some patients experience a mental fog, also called “chemo brain,” where their shortterm memory seems unreliable. It can be a side effect of decreased female hormones as well as stress, fatigue, anxiety and other factors. For most, these symptoms resolve when treatment is complete. “Quality of life is important,” Hendrixson said. “That’s a personal choice for the patient. “Nothing is dictated. Everything is discussed. Patients always have the option of saying, ‘I don’t think that’s for me.’” Hendrixson said. Following chemotherapy, patients may be referred to radiation oncologists for radiation therapy, which lasts about six weeks. Then, they return to the medical oncologist for hormonal treatment. “We manage patients through their hormonal treatments,” Hendrixson said of drugs that can block hormones that, in some patients, fuel the growth of cancer cells. Tamoxifen, Arimidex, Aromasin and Femara are among the commonly used drugs that stop the hormones from getting to
breast cancer cells. Those will continue five to ten years, with studies showing a statistical advantage to the longer therapy. “If you’re taking a pill and there’s no side effects, who isn’t going to take that advantage?” Davidson said. One form of breast cancer is the triple negative tumors, which are not receptive to hormones or HER-2. It’s an aggressive form of cancer that is treated with chemotherapy aggressively. Metastatic breast cancer is cancer which began in the breast but has spread to other organs in the body. It is also called stage IV or advanced breast cancer. About 10 percent of new diagnosis are stage IV breast cancer. Though the disease has spread, the drugs used to fight breast cancer are used to help slow progression of the disease and treat symptoms. Davidson said, “You might first put people on drugs and control it for a number of years without needing chemotherapy.” He doesn’t recommend combinations of drugs in most cases, which can lead to more harsh side effects. “You can pick an agent and use it as long as it works or they have side effects,” Davidson said. “If you find agents that aren’t toxic to them individually, they live a lot better.” Hendrixson said, “We do have a lot more options today than we did five or seven years ago. “Hopefully with continued genomic testing, small molecule drugs, we’ll have the ability to let women live even longer with a better quality of life.”
The medical oncologist is with his patient throughout treatment and into survivorship, helping to spot possible recurrence early and spearhead long-term follow up. Starting out, patients are see every three months following the completion of chemotherapy. That decreases over time to six months for the duration of hormonal therapy and two years afterward. After that, patients can continue to be seen on a yearly basis for a follow-up. “People are at risk for second malignancies,” Hendrixson said. “Breast cancer is one of the few cancers we do see that can crop up past that five-year magic window. It’s uncommon, thank goodness, but it does happen. That’s why I think it’s good to be vigilant for women who have had breast cancer.” One concern for patients is if their loved ones will be at risk for developing cancer, particularly daughters. Hendrixson said more women can access genetic testing for the BRCA1 and BRCA2 gene mutation, an uncommon mutation that dramatically increases the chance of developing breast and ovarian cancers or dealing with recurrent cancer. “Anyone under 50 who is diagnosed really should have that testing done,” Hendrixson said. “It not only helps them, it helps their immediate descendants as well as even nieces know if they are potentially at risk.”
after they have gone through menopause. Mucinous carcinoma is a less aggressive type of breast cancer than others and is less likely than other types to spread to the lymph nodes. As a result, it typically responds well to treatment.
the nipple and areola can and likely will become irritated, itchy, red, and scaly when a person has Paget’s disease, and these signs may be the first indicators that breast cancer is present. While Paget’s disease of the nipple is rare, the National Cancer Institute notes the importance of recognizing its symptoms, as 97 percent of people with Paget’s disease also have cancer elsewhere in the breast. Though the NCI notes that Paget’s disease can develop in both men and women, it is more common in women, among whom the average age for diagnosis is 62.
n Heather Mullinix may be reached at hmullinix@ crossville-chronicle.com.
Learn about lesser-known breast cancers Many people have been touched by breast cancer. Whether you have dealt with your own diagnosis or that of a friend or family member, the prevalence of breast cancer has left few people without a story to tell about a personal experience with this potentially deadly disease. According to Breastcancer.org, a nonprofit organization dedicated to proving reliable, complete and upto-date information about breast cancer, roughly one in eight women in the United States will develop invasive breast cancer over the course of her life, while the Canadian Breast Cancer Foundation notes the figures are slightly more optimistic in Canada, where one in nine women is expected to develop the disease during her lifetime. Many of the women who develop breast cancer will be diagnosed with invasive ductal carcinoma, or IDC,
which the National Breast Cancer Foundation notes is the most common type of breast cancer, accounting for between 70 and 80 percent of all diagnoses. While women and even men who develop breast cancer are most likely to be diagnosed with IDC, there are less common forms of breast cancer, and learning about these rare cancers may help save your life or that of a loved one.
Medullary carcinoma
Though medullary carcinoma diagnoses are rare, this is an invasive type of breast cancer that begins in the milk duct and spreads beyond it. The tumor that forms when a person has medullary carcinoma is a soft and fleshy mass. Medullary carcinoma cells typically appear like aggressive, abnormal cancer cells, but these cells do not grow quickly and often do not
spread outside the breast to the lymph nodes, which makes medullary carcinoma a relatively easy cancer to treat. Medullary carcinoma can occur at any age, though it typically affects women in their late 40s and early 50s.
cases of breast cancer before doctors feel a lump. Tubular carcinoma may feel less like a lump and more like a cushiony area of breast tissue.
Tubular carcinoma
Mucinous carcinoma is also a rare type of IDC in which tumors are made up of abnormal cells in mucin, which is a part of mucus. Many types of cancer cells, including the majority of breast cancer cells, produce some mucus, which lines most of the inner surface of the normal human body. But when a person is diagnosed with mucinous carcinoma, the mucin has become part of the tumor, so when examined under a microscope, the cancer cells appear to be scattered in pools of mucus. Mucinous cancer can affect people at any age, though it is especially rare in men and most often diagnosed in women
Tubular carcinoma is a type of IDC that starts as small, tube-shaped structures known as tubules that appear similar to normal, healthy cells. Tubular carcinoma cells grow slowly and are unlikely to spread outside of the breast, and, for that reason, tubular carcinoma typically responds well to treatment. Though tubular carcinoma once accounted for a very small percentage of breast cancer diagnoses, they are now being diagnosed more often, thanks in large part to the prevalence of screening mammography that has been catching
Mucinous carcinoma
Healthy habits can lower risk Certain types of cancer are more likely to strike certain types of people than others. For example, while men can be diagnosed with breast cancer, women are far more likely to develop the disease. But just because a person’s risk of developing cancer is low, that does not make that person immune from the disease. As a result, it’s important that men and women take steps to lower their cancer risk. One of the more effective ways to lower your risk for cancer is to ensure your lifestyle choices are as healthy as possible. Choosing habits that benefit your short- and long-term health can reduce your risk for cancer and a host of additional ailments. • Maintain a healthy weight. According to the American Cancer Society, men and women who are
overweight or obese are at a greater risk of several types of cancer, including cancer of the esophagus, pancreas, colon and rectum, breast, kidney, and thyroid. The National Cancer Institute defines obesity as someone with a body mass index, or BMI, of 30 or above, while someone with a BMI between 25 and 29.9 is considered overweight. Maintaining a healthy weight or shedding excess weight if you are already at an elevated risk for cancer can lower your risk for cancer and other potentially debilitating diseases, including diabetes, high blood pressure and stroke. • Quit smoking. Smokers might be surprised to learn that tobacco use, according to the ACS, is responsible for nearly 20 percent of all deaths in the United States. That might have something to do with tobacco’s role in
causing more than a dozen types of cancer and its link to heart disease, emphysema and stroke. But smoking can even harm nonsmokers unfortunate enough to spend time in the vicinity of smokers. Such nonsmokers take in nicotine and thousands
of additional chemicals, including carbon monoxide and cadmium, a chemical element used in batteries, when people smoke near them. In addition, a study published in the New England Journal of MediSee habits page 9B
We Support Breast Cancer Awareness... Just One Step Towards Survival
Paget’s disease of the nipple
Paget’s disease of the nipple is characterized by breast cancer cells that collect in or around the nipple. The cancer typically affects the ducts of the nipple first before spreading to the nipple surface and areola, which is the dark circle of skin around the nipple. Both
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Breast Cancer Awareness • 9B
www.crossville-chronicle.com • Friday, October 24, 2014
Radiation treatments offers option for breast conserving surgery By Heather Mullinix Chronicle assistant editor
Targeted radiation treatment is another step in the treatment of breast cancer, used following surgery to fight any cancer cells that may be left in or around the breast. Not all patients will need radiation treatment, though it can be part of treatment in cases where a patient has elected to have a lumpectomy to remove a tumor and radiation to conserve the breast or, in a few cases, after mastectomy “We offer external beam radiation therapy here,” explained Dr. Zach Fowler said. “The conventional treatment is a sixand-a-half-week course, with 33 treatments.” Radiation therapy does require treatments Monday through Friday over the course of several
Fowler
Johnson
weeks, but Cumberland Medical Center’s Regional Cancer Center is able to provide that service to patients in the area, saving time and energy in driving to other regional centers. “The benefits of radiation treatment depend on the cancer stage and other treatments they are having,” explained Fowler. “Of course, the general rule is the earlier it is found, the more successful
treatment is. That’s why we want women to get their screening mammograms.” In some cases, additional treatments may be necessary, but Fowler said that happens only rarely. A less common regimen includes 16 treatments, but there are nine criteria patients must meet to be candidates for this treatment. “It’s not done very
often,” Fowler said. Another type of radiation treatment is partial breast radiation, which is not offered in Crossville. If a patient needs that treatment, however, the CMC Regional Cancer Center’s affiliation with Thompson Cancer Survival Centers allows for easy referral to sites in Knoxville offering that service. Studies over the past 30 years or more have established the benefits of radiation therapy following a lumpectomy for patients who wish to conserve their breast, Fowler said. But patients can still reap the benefits of a mastectomy following lumpectomy and radiation therapy, if needed. “There’s no penalty for trying to go the breast conservation route initially,” he said. Patients often ask if it is safe for them to be around
other people following treatments. “There is no lasting radioactivity,” said Fowler. Radiation treatment takes about 15 minutes, most of which is spent adjusting patients on the table. The beam is on for
just a few minutes. CMC offers an Elekta Synergy linear accelerator. “It gives us a very good range of photons and electrons to use for treatment,” Fowler said. “It gives us See OPTION page 10B
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Reconstruction after surgery Apart from certain skin cancers, breast cancer is the most common form of cancer among women, particularly American women. It does not segregate based on race and ethnicity or even gender, as men can be diagnosed with breast cancer as well. Depending on the location of the cancer, its pervasiveness and the patient’s family history, various breast cancer treatments are available. A combination of radiation and chemotherapy may be necessary, but surgery may ultimately be the best option. Cancer removal surgery involves the surgical removal of breast tissue. Sometimes the nipple and the skin can be spared, but other times the entire breast and even the lymph nodes under the arm must be removed. Many women who undergo mastectomy procedures choose to have some sort of post-surgery breast reconstruction. Breast reconstruction employs plastic surgery to restore a breast to near-normal shape and appearance following a mastectomy. A few different procedures may be needed to reconstruct the breast, and surgery on the other breast may be done to improve symmetry. According to Cancer
Treatment Centers of America, many women are eligible to begin reconstruction at the time of mastectomy, which can reduce the number of surgical procedures women must endure and can eliminate time spent without a breast.
or buttocks to rebuild the breast. Fat, muscle and skin may be taken from the donation area of the body and used to rebuild the breast. A combination of body tissue and implant is sometimes necessary to perform the reconstruction.
Types of reconstructive surgery
Nipple and areola reconstruction
Reconstructive surgery generally falls into two different groups: Implantbased and autologous flap reconstructions. With implant-based reconstruction, a permanent implant is inserted to reform the breast. Some women may need to use a tissue expander for several weeks prior to the insertion of an implant. The tissue expander is gradually filled with fluid and helps stretch the skin to create a space for the implant. Others may not need the tissue expander and can have the implant inserted immediately. This is called a single-stage reconstruction. The majority of breast implants used today are filled with sterile saline, but silicone gel implants also are available. Autologous flap reconstructions use tissue from the stomach, back, thighs,
After the breast has been reconstructed, patients may want to have a nipple and areola added for a more natural look, particularly if these parts of the breast were removed in the original mastectomy. Skin grafting, in which skin is taken from elsewhere on the body to best match the color and texture of the breast, is often used to reconstruct the nipple and areola. Sometimes a nipple sharing reconstructive technique is used if the healthy breast has a large nipple and areolar complex. Tattoos to create the appearance of an areola and nipple may be designed to forgo the need for skin grafting.
What to expect
In the early stages of treatment, patients will meet with plastic surgeons to develop the best plan of action. Together they will discuss goals for reconstruc-
HABITS
• Continued from 8B cine found that nonsmokers exposed to secondhand smoke were 25 percent more likely to have coronary heart disease compared to nonsmokers not exposed to smoke. Secondhand smoke is especially harmful to children, as kids whose parents smoke around them get bronchitis and pneumonia more often than kids whose parents abstain from smoking in their presence. • Exercise regularly. The NCI notes that there is strong evidence that physical activity is associated with reduced risk of certain cancers, including cancers of the breast and colon. More than 60 studies published in North America, Europe, Asia, and Australia have indicated that physically active women have a lower risk of developing breast cancer than inactive women, with some active women reducing their risk by as much as 80 percent. Studies conducted around the world have produced similar findings with regard to colon cancer. Research has consistently indicated that adults who increase their physical activity, be it in intensity, duration or frequency, can reduce their risk of developing colon cancer by 30 to 40 percent relative to
Regular physical activity is associated with a reduced risk of certain cancers, including cancers of the breast and colon. adults who are sedentary. The ACS suggests adults include at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous activity in their weekly routines, though many studies have found that 30 to 60 minutes of moderate to vigorous physical activity per day is the most effective way to reduce cancer risk significantly. • Reduce alcohol consumption. While many adults may be quick to point out the benefits that a glass of wine can have with regard to a person’s risk of heart disease or stroke, the National Toxicology Pro-
gram of the U.S. Department of Health and Human Services as recently as 2011 listed the consumption of alcoholic beverages as a known human carcinogen. Alcohol consumption is a major risk factor for various types of cancers, including head and neck cancers, esophageal cancer, liver cancer, and breast cancer. Adults who continue to consume alcohol should do so in moderation, which the ACS defines as no more than two drinks per day for men and no more than one drink per day for women.
tion and how many procedures may be necessary. The potential risks and a prognosis will be discussed. Women should realize that, while breast reconstruction has advanced and can successfully rebuild the breast, there are some side effects. Visible incision lines will likely be present on the breast and any area of the body that provided donor tissue. The reconstructed breast may not be exactly symmetrical to the other breast, provided no work was done on the healthy breast. The reconstructed breast will not have the same feel and sensation as it once did, and healing may take several weeks, during which the breast shape and position will improve. A breast cancer diagnosis and subsequent surgery for treatment can be lifealtering. Thanks to advancements in plastic surgery, many women can opt for reconstruction and restore their figures to resemble what they were prior to being diagnosed. More information about breast reconstruction is available at http://breastreconstruction. org and www.cancer.org.
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10B • Breast Cancer Awareness
www.crossville-chronicle.com • Friday, October 24, 2014
HUMOR
“I want to pass that on.” Her advice is as sound as her disposition and as musical as her sweet voice. To the patient, Henderson said, “Take it day by day, and take care not to let things be overwhelming. I struggled with this, but it’s okay to ask for help and let people help you. Don’t hurt for no reason. If you are hurting ask your doctor what you can and cannot take. It could be as simple as taking ibuprofen. Pray and have a support list ready because it’s really nice when you have people acting as an information tree to relay progresses and updates for you.” For those who are the support system, Henderson said, “I didn’t need much. Sometimes I needed quiet.
But, just knowing someone was there and willing to clean or get the mail was a comfort because the little things are a big help. And be patient with the patient.” Her hair is growing back, her energy levels are higher and she hopes to participate in a Buddy Walk coming up soon. She adores Chemo Angels who partners patients with an anonymous angels who sends a weekly note or care package. “It is really, really nice and uplifting. They stay right with you even though you don’t know them,” she said. “Don’t get discouraged,” Henderson said affectionately to those fighting the battle just like her. “There Karyn Henderson began chemotherapy treatments two weeks after she was diagis a lot to deal with but nosed with an aggressive form of breast cancer, for which treatment had just worth it in the end.” become available.
OPTION
used because it allows the rapidly reproducing cancer cells to be damaged by the radiation while normal cells have time to recover before the next treatment. It limits exposure to normal cells and decreases side effects. Fowler meets with patients and reviews the side effects patients may experience before they begin treatment. “We go through that in detail when I first see them and all through their course,” Fowler said. Radiation treatment does have short-term and long-term side effects that are possible, including skin reaction around the breast and under the arm, fatigue and, rarely, nausea. “That’s uncommon,” he said. Skin changes can be long-lasting, with skin taking on the appearance of a sun tan or becom-
ing tough. The soft tissue could contract, and the combination of surgery and radiation could lead to the treated breast being smaller than before. “It’s a fairly easy treatment to go through for the patient,” Fowler said. “The skin reaction is the most common side effect for patients, so we always cover skin care recommendations.” Patients are advised to limit their sun exposure and avoid shaving or using chemical deodorant during treatment. Loosefitting clothing helps decrease irritation and avoiding heavily chlorinated water, such as from public pools or hot tubs, is recommended. On the mornings of treatments, skin should be free of oils or lotions. Prior to meeting with Fowler, patients have expressed anxiety because they don’t know what to
expect as they move into the new stage of treatment. “Once they see Dr. Fowler, their stress levels decrease greatly,” said Trish Vaughn, nurse navigator at CMC. “They know what’s going to happen. I think you do an excellent job with the patients I talk with because their questions are answered. They feel very comfortable about coming because they know what to expect.” Transportation can be a barrier to some patients, as they have to be at their appointments five days each week. The Cancer Center does have some assistance available to help patients with the cost of gas. Those funds come from community donations and through fund-raising efforts of the Lake Tansi Women’s Golf League, who holds an annual benefit golf tournament.
other accessories. The Look Good Feel Better program is offered as a partnership of the American Cancer Society, Personal Care Products Council Association
and Professional Beauty Association. The program does not endorse particular products, manufacturers or salons. For more information about Look Good Feel
Better or cancer, visit cancer.org or call 1-800-2272345.
• Continued from 7B even more and to take less for granted. She also learned that a dose of humor a day was a very effective treatment and said, “It is serious, but don’t take it too seriously. Humor goes a long, long way.” Henderson is very adept and candid about her treatments and recoveries. At the top of her goals are to complete her treatments and put it behind her, keep her priorities straight, not to stress the small things, and encourage others through her personal experience. “Maybe something in my experience can help others,” Henderson said, as she explained how others’ testimonies were helpful to her.
• Continued from 9B a lot of control over the depth we treat and minimizes the hot spots on the skin, letting us put the radiation where it needs to go to get good coverage of the areas at risk.” T he tech nology includes an on-board portable imager that offers medical imaging to help map the target area each week, or more often if necessary. “It used to be we had to take X-ray films and get them developed. That’s all gone now. It’s all digital,” Fowler said. He is able to compare imaging from earlier treatments at the machine or at his desk or the simulator in radiology or when planning the treatment. “We have access to it all over our department,” he said. The daily treatments are
BEAUTY
• Continued from 7B as facilitators. Once they have been trained and certified, the American Cancer Society works with community health care providers to initiate group sessions. During these free group sessions, the volunteers teach women how to cope with skin changes and hair loss using cosmetics and skin care products donated by the cosmetic industry. They also demonstrate beauty techniques that can enhance a patient’s appearance and self-image and help minimize the physical effects of cancer treatment. Free cosmetic kits are provided in various shades to accommodate most complexion types. Women also learn ways to disguise hair loss with wigs, scarves and
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