Ink for Pink 2013

Ink for pink A special publication in honor of Breast Cancer Awareness Month

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We may be moving health care in a new direction, but the best specialty physicians can be found right here ... in St. Joe.

Warren E. Hagan, MD Reconstructive and Plastic Surgery

Dr. Hagan performs reconstructive facial surgery for skin cancers, hand surgery, breast surgery (enhancement and reconstruction) , Botox and dermal fillers and facial rejuvenation by laser, chemical and surgical techniques.

Jonathan C. Amspacher, MD Reconstructive and Plastic Surgery

Rebecca L. Chain, MD Dermatology

Common conditions Dr. Chain treats include skin cancer, acne, psoriasis, rashes and warts. Procedures she performs include skin biopsies, treatment of cancerous and precancerous lesions, and cosmetic procedures including Botox, fillers and chemical peels.

To make an appointment call

Dr. Amspacher performs breast cancer reconstruction, breast augmentation, facial rejuvenation, abdominal contouring and injects Botox and the latest generation of facial fillers.

816.383.8180.

5204 N Belt Hwy, Suite A Saint Joseph, MO 64506 myMosaicLifeCare.org

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A survivor’s story

4

Another surgery

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A triple benefit

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Area woman’s experience shows no two breast cancers are the same

Know your options for breast reconstruction

Komen Grants bolster ‘triangle of care’

Another tool in the fight 12 Fundraising for next generation technology

An excellence adventure 14 The Breast Center becomes a Certified Quality Breast Center of Excellence

Call your local American Family Agent www.amfam.com ©2012 American Family Mutual Insurance Co. and its Subsidiaries Home Office - Madison, WI 53783

005502 10/12

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(The doctor) said, ‘It’s not good.

You have cancer. It’s a very aggressive form. You’re going to be OK, but it’s going to be a rough year.’

— CAROLYN SAMPSON, cancer survivor

A survivor’s story Area woman’s experience shows no two breast cancers are the same

SAIT SERKAN GURBUZ | St. Joseph News-Press

Breast cancer survivors Carolyn Sampson and her mother, Carole Dye.

See story on PAGE 6

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A Mission of Compassion. A Vision of Excellence.

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The Breast Center at Heartland Regional Medical Center is Accredited by the 1DWLRQDO $FFUHGLWLQJ 3URJUDP IRU %UHDVW &HQWHUV DQG LV D &HUWLÀHG %UHDVW &HQWHU of Excellence through the National Quality Measures for Breast Centers.

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By ERIN WISDOM

I

A story of survival

St. Joseph News-Press

t wasn’t her mother’s breast cancer.

This was one of the first things Carolyn Sampson heard after receiving her diagnosis – just a year and a half after her mother had undergone treatment for her own breast cancer. But beyond the name, nothing much about their cases was alike. “(The doctor) said, ‘It’s not good,’” remembers Ms. Sampson, who owns an American Family Insurance office in South St. Joseph. “’You have cancer. It’s a very aggressive form. You’re going to be OK, but it’s going to be a rough year.’”

Unlike with her mother’s case, Ms. Sampson’s cancer wasn’t detected through a mammogram.

Rather, just a few months after receiving clean mammogram results, she found a lump in her left breast while showering. After two weeks passed and it hadn’t gone away, she began the series of medical tests that led to her diagnosis in June 2011, at 51 years old.

The good news was that, since the cancer hadn’t gone undetected until her next mammogram, she and her doctors caught it before it had a chance to spread. But this didn’t mean her treatment was

easy. While her mother’s treatment had consisted of surgery followed by a pill a day for the next five years, Ms. Sampson had to undergo six difficult months of chemotherapy before having surgery in January 2012 to remove her cancer. Nearly seven weeks of daily radiation treatments followed, and she then came full circle, with another set of treatments in the chemotherapy room at Heartland Regional Medical Center.

“I was shocked” by this treatment plan, says Ms. Sampson, whose treatment concluded in July 2012.

“They did treat my mother totally different than me.”

In this, her story illustrates the fact that no two breast cancer cases are totally alike. It also shows the life-saving potential of breast self-exams; Ms. Sampson notes that although she hadn’t been performing an exam that day in the shower, she was familiar enough with her body from having performed them in the past to know that something was wrong when she came across the lump.

Also noteworthy about Ms. Sampson’s case is the way it shows the value of team-based care. While one doctor had been unconcerned with the results of a sonogram she received prior to her diagnosis, the sonogram technician sought out a second opinion from another doctor who insisted on a biopsy.

“Her fate wasn’t up to one opinion,” Tracey Clark, Heartland Health media and community relations

coordinator, says. “It’s very much team-based care.”

Now cancer-free for nearly two years (as she considers her January 2012 surgery the date of this milestone), Ms. Sampson continues to receive care at Heartland in the form of visits to her oncologist every three months and an appointment at the Breast Center once a year. And she continues to appreciate the emotional support she receives there, as well.

“I came out (after a test) one day and told my husband I thought every one of those people could be my best friend,” she says. “They were just so caring.”

Ms. Sampson adds that she also received incredible support not only from her husband and family but even from complete strangers. In this respect, she found that dealing with breast cancer came with a support system stronger than what seems to come with other cancers. She speculates that this may be due to the fact that one in eight women go through breast cancer — meaning most people have been touched by it in one way or another.

“It’s a horrible statistic,” she says. “But I had a good outcome. And I hope my story helps someone else.”

Erin Wisdom can be reached at erin.wisdom@newspressnow.com.

Follow her on Twitter: @SJNPWisdom.

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Know your options for breast reconstruction

By BROOKE WILSON St. Joseph News-Press

“They’re being hit by a very strong weight of self-image and physical harm, potentially, by cancer. But we can come in, the earlier the better, and hopefully at least let them know that on the other side of that portal they have something to

look forward to.”

This is the opinion of Dr. Warren Hagan of Mosaic Life Care Plastic Surgery and Dermatology. He, Dr. Jonathan Amspacher and their team of nurses and caregivers are committed to providing breast cancer patients and survivors the option of having breast reconstruction after undergoing a mastectomy, whether they had cancer this year or 20 years ago.

Most breast reconstruction surgeries are a two-step process that involve inserting tissue expanders into a patient’s chest to stretch the skin and muscles, then going back in and inserting permanent silicone implants later. Some procedures use natural tissue from other parts of the body instead of silicone, but those surgeries often are riskier and have a longer recovery.

Low-impact procedures can repair dents or bumps in the skin and breast tissue caused by radiation by filling them in using fat grafting.

According to statistics from the American Society of Plastic Surgeons, only about 17 percent of women elect to have breast reconstruction. Their hesitance can come from a variety of factors.

“I think it’s a pretty complex issue, and it’s different from woman to woman,” Dr. Amspacher says.

Stress, fear of additional pain, lack of education or financial difficulty all can contribute to a woman’s decision to put

reconstruction low on the priority list. Dr. Amspacher and Dr. Hagan want women to know that federal law mandates reconstruction to be a health benefit that is covered by all insurance companies as part of complete breast cancer care.

They also encourage wary patients to discuss reconstruction options with their doctors and learn more about their options so they have a better idea of how reconstruction can be a positive part of recovery. Even if a patient decides to forgo reconstruction at first, they always can choose it later on.

“Certainly we aren’t forcing reconstruction on anyone. If they feel like they can be complete and whole and be a survivor, but not necessarily be reconstructed, it may be that 10 or 15 years when that risk to their existence has been allayed and their fears have been alleviated, then they can say, ‘OK, I’ve gotten on with my life, now let’s rebuild and restore the things that nature took apart by this disease,’” Dr. Hagan says.

He goes on to explain that his main priority is curing the cancer first; reconstruction always is secondary. Dr. Amspacher says the good news is that today, most breast cancer patients are survivors of the disease. Reconstruction is an added benefit that can help survivors feel more whole, no matter their age.

Roberta Parent, 76, is one of Dr. Hagan’s patients. She had one of her breasts removed 12 years ago. When she was diagnosed again a year and a half ago and had her second breast removed, she decided she wanted reconstruction this time.

“I’m happy with them and happy that I’ve had it. ... I’m kind of brave, I’ll go for stuff that I think is gonna do good things for me, and it has. It’s just kinda spiced my life up,” she says.

Brooke Wilson can be reached at brooke.wilson@newspressnow.com.

Follow her on Twitter: @SJNPWilson.

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TODD WEDDLE | St. Joseph News-Press

Dr. Jonathan Amspacher, left, and Dr. Warren Hagan provide breast reconstruction services to patients at Mosaic Life Care Plastic Surgery and Dermatology.

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Komen Grants bolster ‘triangle of care’

By SHEA CONNER St. Joseph News-Press

In April, the Susan G. Komen Foundation of Greater Kansas City gave $959,901 in grant funding to deserving recipients around the area. In case your math skills are rusty, that’s just less than $1 million, making it the highest dollar amount ever doled out by the regional foundation and a clear testament to the kindness of the area’s supporters. “Everyone you know has either had a breast cancer diagnosis, or their friend has or their family member has. Everyone knows someone who’s had a diagnosis of breast cancer,� says Kristen Thatcher, the breast health nurse navigator for Heartland Regional Medical Center in St. Joseph. “And that’s why it pulls on peoples’ heartstrings, and that’s why they’re so generous in our community.�

Of the 17 grant recipients, three were from St. Joseph: the Breast Center at Heartland Regional Medical Center, the Social Welfare Board and the YWCA of St. Joseph. That’s good news for the community because Komen studies also indicate that Buchanan County has a lower-than-average screening rate and a higher-than-average late-stage diagnosis rate, which leads to a higher mortality rate.

Heartland’s Breast Center received $23,808 for its new program called Bridging the Gap: Access for All Women, which helps qualified women in Doniphan, Buchanan, Clay and Platte counties afford screening and diagnostic services. This program provides breast health services for women who have undergone financial counseling and are identified to not meet requirements for other pro-

grams. In addition, this program provides monthly community outreach about breast health and opportunities for community members to sign up for mammograms. “What we identified was there’s a certain subset of patients in our community that either don’t qualify for existing resources, or on paper, they have what you would consider enough funds to qualify for a mammogram and pay it out of pocket if they had to,� Thatcher explains. “But in reality, when you hear their story, they just don’t have the funds available. And that’s why it’s important that we’re able to help them.�

In a similar vein, the Social Welfare Board received a $116,057 grant to provide clinical breast exams to low-income women in Buchanan County who are uninsured. The grant also has been applied toward “educational parties� where clinicians promote breast self-awareness in private settings.

The 2013 grant was slightly less than the $133,544 the Social Welfare Board received from the Komen Foundation in 2012. Fortunately, the YWCA of St. Joseph was given $34,890 for its ENCOREplus program after not receiving a grant in 2012.

ENCOREplus focuses on breast health education (in English and Spanish) for underserved women in Buchanan County. This program also provides Spanish interpretation and transportation services to approximately 250 individuals. Through collaborative efforts with Heartland and the Social Welfare Board, this program includes a 24-hour “Mammathon� where mammograms are provided, reminders are given and future appointments can be scheduled.

What this means for St. Joseph women is that

nearly $175,000 of these Komen Grants went toward local breast health education and, more prominently, making screenings affordable for women of all ages and incomes. “It’s kind of like a triangle of care,� Thatcher says. “The YWCA goes out and educates patients and drives them to the Social Welfare Board or shows them how to get their funding and get their mammograms. And then, the Social Welfare Board refers to us and we help provide the care and the mammograms. Once there’s a diagnosis, we get them into treatment and make sure they have resources there as well.� “It works really well — that continuum of care between the three of us,� adds Marcy George, Heartland’s coordinator of grants, awards and special projects. “... With the grant, we were able to help those people who fell on the outside of that continuum, because there was a group of people who just didn’t qualify for any help.�

In an area of the country where women need them the most, the Komen grants have greatly helped Heartland, the YWCA and the Social Welfare Board stress the importance of mammograms. All women need to do now is ask how they can get them. “Every woman’s situation is different, and their actual financial situation may not be as it looks on paper,� George says. “If you don’t qualify for anything else, these funds are available. ... If you really think you don’t qualify, you should ask because that’s what the money is there for.�

Shea Conner can be reached at shea.conner@newspressnow.com.

Follow him on Twitter: @stjoelivedotcom.

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Fundraising for next-generation technology

By JENNIFER HALL St. Joseph News-Press

With just a year under its belt, the development team at Heartland Regional Medical Center already has set its sights on a big project. The group hopes to raise enough funds to purchase a digital tomosynthesis unit.

Pronounced to-moh-SIN-thah-sis, this three-dimensional X-ray machine is the next generation for early detection of breast cancer.

“Every year we have close to 150 breast cancer patients diagnosed,” says Kristen Thatcher, breast health nurse navigator at Heartland Regional Medical Center.

That number grew last year to 174.

“You always hear, ‘If only they had caught that sooner, the prognosis would have been different,’” says Kristine Gibson, development team leader at Heartland.

Digital tomosynthesis can increase early detection by up to 40 percent, she said. It also can decrease the number of call backs from a standard mammogram because doctors can get a clearer picture the first time around.

According to BreastCancer.org, the digital tomosynthesis takes multiple X-ray pictures of each breast from different angles. The breast is positioned the same way it is in a conventional mammogram with minimal pressure to keep the breast in place. The X-ray tube moves in an arc around the breast while 11 images are taken during a seven-second examination. Then the information is

sent to a computer, where it is assembled to produce clear, highly focused three-dimensional images throughout the breast.

And the digital tomosynthesis won’t necessarily replace current mammogram technology. The two are very different. It’s comparing a circle with a ball in terms of how the two view breast tissue.

“It’s something (doctors) were really wanting to get here at Heartland,” Gibson says.

But the state-of-the-art piece of technology comes with a $500,000 price tag.

“Unfortunately, we don’t have an unlimited budget,” Gibson says. “Fundraising truly takes a hospital to that next level.”

Currently, St. Luke’s East-Lee’s Summit and the University of Kansas Medical Center have digital tomosynthesis units. The technology was only recently approved by the FDA and has been on the market for about two years.

“If we could get one here, it’s in our backyard,” she says of the women in Northwest Missouri. “We want our women served here and not have to go an hour away.”

Buchanan County has one of the highest mortality rates in the greater Kansas City metropolitan area, according to research by the Susan G. Komen Foundation. Yet, some women still don’t get tested despite statistics showing that one in eight women will have a diagnosis of breast cancer some time in their life.

Gibson says that Heartland reaches more than just the women in St. Joseph. Having the digital tomosynthesis will help treat women who live in the numerous rural communities, too.

• Extensive inventory of post-mastectomy bras available in assorted styles, brands and colors

“But the cost is huge,” she says.

Campaigning began in May with employees and was successful. The Blacksnake Roller Girls donated $4,600 of proceeds from an event as well.

Now, Gibson says the development team will start involving the community, reaching out to those that might have an interest in bringing this piece of technology to St. Joseph.

“My philosophy is that you have to support your local hospital,” she says. “The most wonderful aspect of fundraising is it truly makes a difference. It takes the organization from great to exceptional.”

Heartland isn’t alone in establishing an in-house fundraising group. A majority of medical centers around the country do events to raise funds for needed items.

“Everyone has a budget to work with,” Gibson says. “So when you only have $24 million to put back into your company and more than $100 million in requests, something gets cut.”

The development team looks at those items that get cut and sees if there is an opportunity to raise funds to still get those things at Heartland.

“The goal of the department is to look for programs, technology and services that would benefit the patient. We’re able to look at the things that were cut, and all of it goes 100 percent back into getting that here.”

For information on the digital tomosynthesis unit or how you can donate, contact Gibson at 271-6720.

Jennifer Hall can be reached at jenn.hall@newspressnow.com.

Follow her on Twitter: @SJNPHall.

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The Breast Center’s excellence adventure

By ANDREW GAUG

And the organization has been able to achieve that.

“We have that down to about a week. That’s kind of the first premise and then all this other stuff with First, a local breast cancer center learned how to accreditation kind of came along,” Thatcher says. shorten patients’ waits. Now it has the accolades to The idea behind getting the accreditation of a Breast show for it.

Center of Excellence was to turn the center into a wellSince its inception in 2008, The Breast Center at oiled machine of communication and discussion.

Heartland Regional Medical Center has become a Thatcher says it took a lot of reworking old progiant feather in the city’s cap when it comes to help- grams, including having the right information for ing breast cancer patients. patients.

In 2009, The Breast Center became a Certified “It pretty much took revamping the whole process.

Quality Breast Center of Excellence through the Na- We look at lots of different things, as far as were we tional Quality Measures for Breast Centers, making doing the right things for the patient as far what we recit one of the only breast centers in a several-state ommended, are we doing it in a timely manner, are we region to be given the designation. To go along with providing the right resources for patients?” she says. that, it has a three-year full accreditation desigThe accreditation looks at breast centers in severnation by the National Accreditation Program for al different categories, including providing the right Breast Centers, a program administered by the care at the right time, having the right education for American College of Surgeons. the staff, research available to patients and making While these designations may sound like nice, sure leadership takes accountability for decisions. prestigious titles to display on the figurative manStriving for the accolade, Thatcher says changes tel, what it really signifies is the center’s dedication were made not only at The Breast Center, but also in to comprehensive breast cancer care. the entire Heartland system.

A mere five years ago, it wasn’t this way. Kristen “This was system-wide. It’s not only The Breast Thatcher, breast health nurse navigator, says a breast Center, it’s the radiology department, it’s the surcancer patient noticed the exceedingly long wait time gery department, the radiation/oncology departbetween getting an initial mammogram, then having ment and medical/oncology department,” she says. to go see a doctor, followed by an additional mamWhen a patient is undergoing care at The Breast mogram, then an ultrasound and a biopsy. The total Center, like an average of 150 people do annually, their length before that last step was eight weeks. case is not seen by a few doctors, but is discussed by Championing the creation of The Breast Center, an entire conglomerate of professionals weekly.

Dr. Edward Andres, now retired and replaced by Dr. “Instead of a doctor managing a patient’s care, it’s George Mulder, wanted to shave down that time and a group of doctors that manage a patient’s care. That give Breast Center patients more comfort and ease. group comes together at a weekly conference,” she says.

St. Joseph News-Press

Speaking anecdotally, Thatcher says she has seen how much more at ease breast cancer patients have become knowing that their case is being discussed often.

“When they walk through the door of that next doctor, they have an idea of ‘OK, I remember this case. We talk about it at our conference,’” she says.

Tracy Clark, media relations and communications coordinator for Heartland Health and Mosaic Life Care, said it is expected to become the norm throughout the entire hospital system.

“We, as an organization, are kind of moving toward that in all areas,” she says.

The Breast Center will be up for re-accreditation as a Breast Center of Excellence in August 2014, and there already is new criteria to meet. That will include post-op areas such as talking to patients opting to have a mastectomy about plastic surgery and offering them an appointment to discuss it with a doctor. “(It’s) not that we weren’t doing it before, but we’re calculating it now. We’re making sure it’s happening,” she says.

Being able to compare The Breast Center’s work with other Breast Centers of Excellence in the U.S., it’s a good feeling knowing that they’re side-by-side with some of the best health care out there when it comes to breast cancer.

“We know that we’re doing the right thing for our patients because we’re held to look at quality measures and kind of calculate if we’re doing the right things,” Thatcher says. Then it’s kind of like ‘Yep, we are doing what we’re supposed to be doing.’”

Andrew Gaug can be reached at andrew.gaug@newspressnow.com.

Follow him on Twitter: @SJNPGaug.

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10 | 13 | 13 Ink for Pink 15

Have you had your Mammogram this past year?

Are you 35 to 64 years of age?

Are you uninsured with annual earnings $34,470 or below?

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Women's Health Clinic

for an appointment 816-344-5233 (English) 816 -273-6665 (Spanish) 75011142

Buchanan County has the highest rate of late-stage diagnosed breast cancer in Northwest Missouri.

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