Healthline October 2014

Complimentary

October 16, 2014

MONTHLY

HealthLine Of Northern Colorado

SPECIAL EDITION: Breast Cancer Awareness Month + Reconstruction: Post-mastectomy options + What about fertility? Planning for the future + The impact of physical activity on breast cancer risk

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contents

RECONSTRUCTION: Know your post mastectomy options Page 10

PREPARING TO SURVIVE: considerations for life after cancer Page 12

also inside A broken heart and a mountain peak....................................................................... 4 UNCOMMON SENSE: Differences in expectations cause strife in grandmother’s relationships with her daughters .............................................................................. 6 FITNESS: Study links moderate activity to lower breast cancer risk .......................... 8 Body Mass Index associated with breast cancer, regardless of body shape............. 13 NUTRITION: The EdgyVeggie - Healthy recipes with plant-based foods are weapons against cancer ...................................................................................................... 14 Health Briefs & Calendar....................................................................................... 16

Health Line of Northern Colorado is a monthly publication produced by the Loveland Daily Reporter-Herald. The information provided in this publication is intended for personal, noncommercial, informational and entertainment purposes only and does not constitute a recommendation or endorsement with respect to any company, product, procedure or activity.

You should seek the advice of a professional regarding your particular situation.

For advertising information contact: Linda Story, advertising director: 970-635-3614

For editorial:

Misty Kaiser, 303-473-1425 kaiserm@reporterherald.com

on the cover Breast Cancer Awareness Month October is Breast Cancer

Awareness Month and this edition of HealthLine we tackle many issues breast cancer patients and survivors may face.

October 16, 2014

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HEALTHLINE 3

A broken heart and a mountain peak Avid hiker climbs back to the top after heart surgery

By Karla Oceanak For UCHealth

Sometimes when you’re least expecting it, life knocks you from the summit to the bottom. And sometimes it takes you back up again.

A couple of years ago, when Joel Alpers was 55, he went to see a doctor about a sore toe and ended up learning that while his toe did need attention, what really needed fixing was his heart.

“I was very surprised,” said Alpers.

An Estes Park resident since 2004, Alpers had long been a construction worker and Rocky Mountain National Park hiker. He was active, and except for a bit of fatigue that he attributed to aging, felt just fine. In fact, he’d summited Longs Peak twice in the past two years.

Alpers didn’t know it, but he had a common condition called mitral valve prolapse.

One of the doorways that separate the heart’s four chambers, the mitral valve controls blood flow between the left atrium and the left ventricle. If the valve is prolapsed, that means it bulges upward or back into the left atrium when the heart contracts. As a result, blood can leak backward through the valve and cause symptoms ranging from an irregular heartbeat to dizziness, shortness of breath, chest pain, and, oh yes, fatigue.

Many people live with mitral valve prolapse their

4 HEALTHLINE

While in recovery from open-heart surgery, Joel Alpers determined that he would climb Longs Peak on the first anniversary of the operation. Photo courtesy of Joel K. Alpers.

entire lives without needing treatment. But sometimes, as in Alper’s case, the valve deteriorates to the point that surgery becomes necessary.

“The heart is an amazing organ,” said Dr. Mark Douthit, a cardiothoracic surgeon at the University of Colorado Health Cardiology and Cardiothoracic Surgery group. “It can put up with a lot. Often it doesn’t start to let the patient know there’s a problem particularly a fit, healthy patient — until it’s pretty far along.”

When Alpers met with Douthit and his surgical colleague Dr. Mark Guadagnoli, they explained to him that he would need open heart surgery at Medical Center of the Rockies in Loveland.

Dr. Douthit would repair the valve, and Dr. Guadagnoli would assist. Tests revealed that Alpers had coronaryartery blockages, as well, so while they were in there, they would also do a triple bypass.

And so Alpers went from being unaware he even had a heart problem to a surgical gurney in a matter of days.

His mitral valve repair surgery, on Aug. 1, 2012, was successful. “I’d go with Douthit and Guadagnoli again in, well, a heartbeat,” said Alpers. “And the staff at MCR and at cardiac rehab were great — really wonderful people. They save lives.”

After a hospital stay of six days, Alpers returned home and began the long process of healing from open-heart surgery. As instructed, he walked, he rested, he walked some more. About five weeks post-surgery, he requested permission from his cardiologist, Dr. Todd Whitsitt, to return to his current job as an IT professional for IBMC College.

“I started working again, but I felt really wiped out by the end of the day,” said Alpers. “It took time to get my stamina back.”

But all the while, during those long fall and winter months of his recovery, Alpers kept slowly upping his activity level. He completed cardiac rehab. He walked farther and farther. He chainsawed and stacked wood.

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He joined a health club and worked out. And he dreamed of his return to Longs Peak.

At 14,259 feet, Longs Peak is quite literally the pinnacle of Rocky Mountain National Park. The sevenmile, 5,000-foot elevation gain, hike to the top is really more of a potentially dangerous climb.

“It’s intimidating. But I’d done it before, so I knew what to expect,” said Alpers.

“And I knew I needed to train.”

By early summer 2013, Alpers began to hike shorter trails in Rocky Mountain National Park. He worked his way up to longer trails.

At first his wife, Karla, hiked with him, but soon she was concerned that she might be holding him back. Alpers was ready to challenge himself with even harder and longer hikes.

On Aug. 1, 2013 — the one-year anniversary of his open-heart surgery—Alpers again climbed Longs Peak.

“It was magical to stand on the summit and think, ‘One year ago today I was lying on a table with my chest cut open,’ “ he said. “It was emotional to realize, ‘Wow. I’m here.’ “ In fact, Alpers’ first postsurgery hike up Longs was so successful that he did it again a few weeks later.

Alpers has a message for anyone who finds themselves facing a cardiac diagnosis: “There can be life after heart surgery.” And the view from that life can be pretty darned spectacular.

October 16, 2014

Breast cancer

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Women with breast cancer often have no symptoms.

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October 16, 2014

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HEALTHLINE 5

HL

UNCOMMON SENSE

Differences in expectations cause strife in grandmother’s relationships with her daughters Dear Dr. Beth, I am 62 and the proud mother of two daughters, both of whom are married and have children. One has two children, ages 3 and 5.

The other has two kids also, ages 2 and 7. My problem is that one of my daughters thinks I’m a terrible grandmother, but the other one thinks I’m just fine. It seems like my disappointed daughter is always angry at me and constantly criticizes how I treat the kids—I bought the wrong outfit, I don’t babysit the children enough, etc. I love both my daughters and all four of my grandchildren. I give and do the same for both families but one daughter is fine with it and the other daughter isn’t. I’m about to tear my hair out. What can I do?

A variety of factors can influence adult children’s reactions to your grandparenting style. Three elements tend to influence these reactions.

This first is the differences in each child’s personality; the second is each one’s personal history in relation to your mother-daughter relationship, and third, what it means to each of them to have a grandparent in their children’s lives—i.e., their expectations. It is hard to say how much of a role each of these factors may play in how this drama is unfolding.

First, with respect to per-

6 HEALTHLINE

sonality differences: It is obvious and yet often surprising to parents to recognize how even children close in age to one another can be raised in the same household and can have incredibly different interests and personalities.

One child may be active and outgoing while another may be shy and introverted. One child may be able to let slight hurts and disappointments roll off her back while another may be extremely sensitive and have a hard time letting go of resentments about past events that hurt or angered her.

The second factor is your relationship history and current relationship with each daughter. While I believe that you do love both of your daughters and all four of your grandchildren a great deal, it is natural that parents

often feel more affinity and similarity with one child than another. Even doing your best to be equally attentive to both of them, there can be slight differences in the tone and quality of your relationship with each child that leads to very different relationships with each of them. These relationship differences may also originate with how your daughters treat you: how each one expresses love and handles conflict and the impact this had has on your relationship over time. Such differences can form the basis for different perceptions, expectations and reactions.

Third, different adult children may have very different perspectives on family and the role that grandparents should play in the lives of their grandchildren. Some adult children feel strongly

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that being a truly loving grandparent means giving lots of attention and having lots of involvement with the adult child’s family. To these children, this may look like having her parents prioritize time with the grandchildren over their own personal interests and taking the load off the parents by offering to babysit and give them frequent breaks from their parenting responsibilities.

To another adult child; being a grandparent may include very different expectations. If the grandparents have busy lives of their own and show their love for the family with lesser degrees of involvement, their attentions are still perceived as very loving even if the time spent and the roles taken in their adult children’s family life is more limited.

Obviously, grandparents differ widely in their own preferences and images of what it means to be a grandparent.

Most grandparents truly love their grandchildren, but they may show it in very different ways. You get to choose how much to conform to each of your daughter’s expectations, but ultimately you have to be true to yourself and your own personality and life priorities to be happy. Ask yourself what you need in order to be fulfilled in living the remainder of your older adult life.

For most people, happiness includes a balance of individual satisfaction and family involvement and that balance varies a great deal from one

October 16, 2014

person to another.

It may be helpful to talk about expectations with the adult child who is so critical of your style, both to make her expectations more explicit and to let her know how you see your role as a grandparent. However, you need to realize that she may or may not be open to having this conversation. It is probably a sensitive and perhaps volatile subject for her and she may end up venting feelings about the distant or recent past that are hurtful for you to hear. You need to be prepared for this.

Do your best not to be defensive if she expresses anger or disappointment in you as a parent and/or grandparent. These may be things she needs to get off her chest in order to move forward. Hopefully, she will be able to hear your perspective on these events as well.

If this communication can happen in a healthy way, talking about these issues may help clear the air.

While it is hard to resolve issues that are not openly discussed, if she is not able to do so you may not have a choice other than to accept that you are not going to be perceived in the way that you see yourself. You may have to accept her disappointment in you and your own disappointment in her as well. If possible, try to do so without either rejecting her entirely or giving in to her expectations in ways that betray your true needs. It is a difficult balance to strike when each of your

October 16, 2014

expectations and needs are so different. Continue to be the best grandparent you can be in a way that is authentic for you.

There are no easy answers to this dilemma. It is helpful that you have another adult child that is able to accept and appreciate you as you are. This situation may lead to you choosing to have more involvement with the accepting child’s family, which may actually reinforce the other daughter’s resentment and perception of favoritism.

Do the best you can to continue to give what you are able to give to each of your daughters and to both sets of grandchildren, but realize that there are limitations in how much you as an individual can do to resolve any problem that is actually a problem between two people. Even if you and your daughter never resolve your own relationship, there is still a great possibility of having special and rewarding relationships with her children— your grandchildren. I wish you the best in meeting this challenge.

Uncommon Sense with Beth Firestein Dr. Beth Firestein is a licensed psychologist. She has 27 years of therapy experience and has practiced in Loveland for more than 16 years.

She may be reached by calling her office at 970-635-9116, via email at firewom@webaccess.net or by visiting www.bethfirestein.com.

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HEALTHLINE 7

HL

FITNESS

Study Links Moderate Activity to Lower Breast Cancer Risk

Walking an hour per day associated with lower risk

A large new American Cancer Society study adds to increasing evidence that physical activity reduces the risk of breast cancer in postmenopausal women. Researchers say moderate recreational activity was associated with a 14 percent lower risk and high physical activity with a 25 percent lower risk of breast cancer compared to women who were active at the lowest level. The study appears in the October 2013 issue of Cancer Epidemiology, Biomarkers, and Prevention.

A large body of evidence shows that women taking part in regular physical activity have an approximately 25 percent lower risk of breast cancer compared to the most inactive. But still unclear are issues such as whether moderate intensity activity, like walking, imparts a benefit in the absence of vigorous exercise. Also unclear is whether the association differs based on tumor features, such as hormone receptor status, or by individual factors such as a woman’s body mass index (BMI), weight status, and use of postmenopausal hormones. In addition, while prolonged periods of sitting

have been associated with the risk of some cancers, the relation between sitting time and postmenopausal breast cancer risk is not well understood.

To learn more, American Cancer Society researchers led by Alpa Patel, Ph.D. compared exercise and breast cancer status in 73,615 postmenopausal women taking part in in the CPS-II Nutrition Cohort, a prospective study of cancer incidence established by the American Cancer Society in 1992. During the 17-year study, 4,760 women in the study were diagnosed with breast cancer.

About one in ten (9.2

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percent) women reported no recreational physical activity at the beginning of the study. Among those who were active, the average expenditure was equivalent to 3.5 hours per week of moderately-paced walking.

Physically active women engaged primarily in moderate intensity activities, like walking, cycling, aerobics, and dancing rather than vigorous-intensity activities like running, swimming, and tennis. Among all women, 47 percent reported walking as their only recreational activity. Physically active women tended to be leaner, more likely to maintain or lose

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weight during adulthood, more likely to drink alcohol, and less likely to currently smoke. They were also more likely to use postmenopausal hormone therapy and to have had a mammogram in the past year.

Among those who reported walking as their only activity, those who walked at least seven hours per week had a 14 percent lower risk of breast cancer compared to those who walked three or fewer hours per week. Consistent with most prior studies, the most active women had 25 percent lower risk of breast cancer than the least active.

The associations did not differ by hormone receptor status, BMI, weight gain, or postmenopausal hormone use. Also, sitting time was not associated with risk.

“Our results clearly sup-

port an association between physical activity and postmenopausal breast cancer, with more vigorous activity having a stronger effect,” said Dr. Patel. “Our findings are particularly relevant, as people struggle with conflicting information about how much activity they need to stay healthy. Without any other recreational physical activities, walking on average of at least one hour per day was associated with a modestly lower risk of breast cancer. More strenuous and longer activities lowered the risk even more.”

Current guidelines recommend adults get at least two-and-a-half hours per week of moderate-intensity activity, or 75 minutes per week of vigorousintensity aerobic

activity for overall health. But studies indicate less than half of U.S. adult women are active at these minimum levels. “Given that more than 60 percent of women report some daily walking, promoting walking as a healthy leisure-time activity could be an effective strategy for increasing physical activity

among postmenopausal women,” added Dr. Patel.

Article: Hildebrand JS, Gapstur SM, Campbell PT, Gaudet MM, Patel AV. Recreational physical activity and leisure-time sitting in relation to postmenopausal breast cancer risk. Cancer Epidemiol Biomarkers Prev; 22(10); 1906–12.

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HEALTHLINE 9

H L BREAST CANCER AWARENESS: FEATURE RECONSTRUCTION: Know your

post mastectomy options

By Judy Finman, healthline Magazine

The American Cancer Society has estimated for women in the United States about 232,570 new cases of invasive breast cancer this year, and about 62,570 new cases of carcinoma in situ, the non-invasive, earliest form of breast cancer. Other than skin cancer, breast cancer is the most common cancer for U.S. women.

Among the possible treatments for women with breast cancer is mastectomy, which is surgery to remove all or part of the breast. For healthy women known to be at high risk for breast cancer, this surgery is sometimes done bilaterally (on both breasts) as a cancer-preventative measure.

The Women’s Health and Cancer Rights Act (WHCRA) helps protect many women with breast cancer who choose to have their breasts reconstructed after a mastectomy. This federal law requires most group insurance plans that cover mastectomies to also cover breast reconstruction, reconstruction of the other breast to give a more balanced look, breast prostheses, and treatment of physical complications at all stages of the mastectomy.

So a woman planning to undergo a mastectomy, in consultation with her physician, should review all of her

10 HEALTHLINE

options, and the benefits and risks of each one. She and her doctor will decide together whether she should have breast reconstruction, and when to have it.

Some questions women may ask their doctors before a mastectomy are: Can I have surgery to create a new breast after my mastectomy? What are the different choices? Which choice will look more like a natural breast? Can I have breast reconstruction during the same surgery as my mastectomy? If not, how long do I need to wait? Will I have a nipple also? Will I have feeling in my new breast? What are the risks of each type of

breast reconstruction? If I do not have reconstruction, what are my options? Does breast reconstruction make it harder to find a tumor if the breast cancer comes back?

TYPES OF BREAST RECONSTRUCTION There are two common reconstruction procedures.

Depending upon the situation and the surgeon’s recommendation, a woman may be able to choose implant-based breast reconstruction or autologous breast reconstruction techniques.

Breast Implant Reconstruction

with implants account for most breast reconstruction procedures.

In implant-based breast reconstruction, a saline or silicone implant is used to recreate the breast form in order to reproduce the desired shape and volume of the breast and to restore to the best degree possible reasonable symmetry of the breasts. Breast reconstruction using an implant can be completed in one of two ways: in a one-stage reconstruction (also known as a Direct-toImplant Reconstruction), or a two-stage reconstruction (known as a Tissue Expanderto-Implant Reconstruction).

Breast reconstruction

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October 16, 2014

Autologous Reconstruction Autologous reconstruction uses tissue – skin, fat, and sometimes muscle – from another place on the woman’s body to form a new breast. The tissue (called a “flap”) usually comes from the belly, the back, the inner thighs, or the buttocks. Since it requires the transfer of muscle, it is more involved and complex than implant reconstruction.

The tissue can be completely separated from its original blood vessels and picked up and moved to its new place in the woman’s chest. Or the tissue can remain attached to its original blood vessels and moved under the skin to her chest.

In both cases, the tissue is formed into the shape of a breast and stitched into place.

Keeping the tissue attached to its blood vessels increases the chances that the transplanted tissue will be healthy and thrive in its new location.

Breast reconstruction using tissue from someplace else on the body is popular because it usually lasts a lifetime. Implants normally have to be replaced after 10 or 20 years. Also, the tissue on the belly, buttocks, and upper inner thighs is very similar to breast tissue and feels very natural. But as with implant reconstruction, the new breast will have little, if any, sensation.

A woman may have autologous reconstruction at the same time as her mastectomy (immediate reconstruction), after mastectomy and other treatments (delayed reconstruction). Or she might have the two-step approach that involves some reconstructive surgery being done at the same time as mastectomy and some being done after (delayed-immediate reconstruction).

OTHER POSSIBILITIES Many women choose not to have breast reconstruction or implants. They may use a prosthesis (an artificial breast) in their bra that gives them a natural shape, or they may use nothing.

RESULTS OF A RECENT STUDY A new study has found that only 42 percent of women opt for breast reconstruction after mastectomy. The reasons for such a decision vary, according to the results of the study, published in August 2014 in JAMA Surgery.

More than 48 percent of those who decide against reconstruction say they don’t want to undergo additional surgery, almost 34 percent say reconstruction isn’t important and 36 percent cite a fear of breast implants.

One reason cited was a fear that breast implants would prevent detection of a recurrence; a fear that experts say is unwarranted.

LOCAL MATTERS! www.columbinehealth.com October 16, 2014

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HEALTHLINE 11

HL

BREAST CANCER AWARENESS: FEATURE

Preparing to survive: considerations for life after cancer (BPT) - Today in the U.S., there are nearly 14 million individuals who have overcome cancer. Although more than 70,000 young adult Americans ages 15-39 are diagnosed with cancer each year, the number of survivors is expected to increase by 30 percent in the next decade.

This means there is a real need for patients to consider life after treatment and how to make survivorship as meaningful as possible.

The art of survivorship

An important first step in creating meaningful survivorship after cancer is talking to your health care team about the future. Many cancer survivors will tell you that with proper planning and a strong support system, life after cancer can be full of possibilities.

Before starting treatment, patients should have an honest conversation about their expectations. It can be overwhelming for patients to stop and think about the future when they are faced with cancer treatment decisions that will need to be made rapidly. However, simple questions such as “How will my cancer treatment affect my health in the future?” can have a big impact on future quality of life.

Fertility preservation

One of the most important topics of discussion for those diagnosed with cancer is the possibility of bearing children in the future. However, according to cancer survivors of

12 HEALTHLINE

childbearing age, fewer than half of patients recalled discussing fertility or the effects of their treatment on their future fertility upon being diagnosed with cancer.

In considering a cancer treatment plan, it is imperative to discuss fertility preservation options with your reproductive endocrinologist and oncologist prior to treatment. This is important because fertility can be impacted even after the first course of therapy. Fortunately, there are a variety of fertility preservation options available including egg freezing and embryo cryopreservation using in vitro fertilization (IVF).

“After a cancer diagnosis, patients can be uncertain about what the future will hold,” says Dr. Jane Ruman, Director of Medical Affairs

and Reproductive Health at Ferring Pharmaceuticals Inc. “For many young adults, having or expanding their family is a lifelong dream. Talking with your doctor prior to cancer treatment is one of the best ways to increase your chances of making the dream of parenthood a reality.”

When having a conversation with your doctors, some questions you might ask, include: 1. How will the treatment plan impact my fertility?

2. Are there alternative treatments that could be less toxic to my reproductive health?

3. What fertility preservation options are available to me?

Patient support resources Navigating the dialogue around fertility preservation can be quite overwhelm-

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ing. Given the changing landscape, it is important for individuals who are considering fertility preservation to be aware of the many different resources available to them: • The Alliance for Fertility Preservation is an organization made up of cancer and reproductive professionals. Its mission is to promote dialogue between oncologists, reproductive medicine specialists, and patients in order to optimize cancer patients’ reproductive health expectations and quality of life related to fertility. More information about fertility preservation and options for both men and women can be found at www. allianceforfertilitypreservation.org.

• There are also financial support programs, such as Ferring’s Heart Beat program, that can help ease some of the financial burden associated with fertility preservation for eligible patients prior to cancer treatment.

Lastly, advocacy groups provide a great source of information and support for those considering fertility preservation. Organizations such as Fertile Action, LIVESTRONG Fertility and The Scott Hamilton CARES Initiative, and more, have detailed information about fertility preservation on their websites.

October 16, 2014

Body Mass Index associated with breast cancer, regardless of body shape Large, Prospective Study May Clarify Association between Obesity and Breast Cancer A study of predominantly white women finds a larger waist circumference is associated with higher risk of postmenopausal breast cancer, but not beyond its contribution to BMI. The study, by American Cancer Society researchers, fails to confirm previous findings that body shape itself is an independent risk factor for breast cancer. The current study appears in the April 2014 issue of Cancer Causes and Control.

A significant body of

research has linked abdominal obesity to a number of conditions, including heart disease, type II diabetes, and breast and other cancers.

Those studies have led to the theory that having an “apple shaped” body, with weight concentrated in the chest and torso, is riskier than having a “pear-shaped” body, with fat concentrated in the hips, thighs and buttocks.

To explore the theory, researchers led by Mia Gaudet, PhD, analyzed data from 28,965 women participating in the Cancer Prevention Study II. Among those women there were 1,088 invasive breast cancer cases diagnosed during a median

11.58 years of follow-up.

They found a statistically significant positive association between waist circumference and postmenopausal breast cancer risk; however, when they adjusted for BMI, the association disappeared.

“The message is that if you have a high BMI, regardless if you are pear or apple shaped, you are at higher risk of breast cancer,” said Dr. Gaudet. “Most prior studies on this issue looked at BMI or at waist circumference, but had not looked at them together. This study brings some clarity to the association between obesity and risk of breast cancer.”

Dr. Gaudet says the data

could help women focus on what’s important in what has been a confusing array of potential risk factors for breast cancer. “We know being overweight, particularly when the weight gain happened during adulthood, is one of the important modifiable risk factors for breast cancer in post-menopausal women.

This new data indicates it’s not what shape you are, it’s what kind of shape you are in that probably ought to be their focus.”

Article: Waist circumference, body mass index, and postmenopausal breast cancer incidence in the Cancer Prevention Study-II Nutrition Cohort, M. Gaudet, B Carter, A Patel, L Teras, E Jacobs, S Gapstur, Cancer Causes & Control, April 2014 doi 10.1007/s10552014-0376-4

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afmfc.com/womens-care October 16, 2014

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HEALTHLINE 13

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NUTRITION: THE EDGY VEGGIE

Healthy recipes with plant-based foods are weapons against cancer

By Ellen Kanner, The Miami Herald(MCT)

Pink is the official color of Breast Cancer Awareness Month, but the foods recommended for breast cancer prevention are green, white, red, yellow and brown.

They’re all — no surprise — the foods of the earth: fruits, vegetables, herbs, spices, nuts, seeds. October is, conveniently,

also Vegetarian Awareness Month. This is not a matter of overbooking; health and plantbased food go together.

Behold, your cancer-fighting all-stars: • Broccoli: A 2011 University of Michigan study found the plant sterols in broccoli reduce breast cancer stem cells. Broccoli’s just coming into season here, so buy local and eat up.

• Coffee: Java junkies and cold-brew fiends, this one’s for you. A 2011 Breast Cancer Research report shows the antioxidants in 2 cups a day protects cells from cancer growth.

• Parsley: This ubiquitous garnish is high in vitamin C and apigenin, another phytonutrient we never knew about before.

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Apigenin may be cancer’s WMD, according to findings by the University of Missouri.

Celebrate with some parsleyrich tabbouli.

Pomegranate: In season now, these sweet-tart beauties can arrest cancer cell growth and destroy existing cancer cells, according to a University of California study. The fine print: You need to consume a lot of pomegranate, about 3 cups a day, for the goodness to kick in.

Soy: Organic whole soy, the way they eat it in Asia — tempeh, tofu, edamame and miso — has received the blessing from the American Institute for Cancer Research. Choose that rather than the GMO soy isolates present in much American processed food.

Turmeric: Gold dust. Antiseptic, anti-inflammatory and antioxidant, this wonderful warming spice seems to inhibit or erase cancer cell growth, according to a 2011 Cancer Prevention Research study.

Walnuts: High in omega-3s, the same awesome antiinflammatory amino acid in salmon. A joint study by the journal Nutrition and Cancer and the American Institute for Cancer Research found walnut consumption reduces breast cancer risk and retards cancer cell growth.

WAFUU CURRY

Broccoli and tofu, two of the greatest cancer-fighting foods are, ironically, often the ones people most resist eating. Here they come together in a golden, mild (and mildly sweet) Japanese curry known as wafuu. The dish gets its richness from two other cancer fighters: turmeric and miso. It’s Japanese comfort food that just happens to be good for you. Serve with brown rice for extra whole-grain goodness.

Makes 4 to 6 servings.

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•3 tablespoons canola, grape seed or other neutral oil •1 1/2 teaspoons fresh ginger, minced •2 cloves garlic, minced •1 medium onion, chopped •3 tablespoons unbleached flour •1 teaspoon turmeric •1 tablespoon curry powder (preferably S&B brand, see note) •3 cups vegetable broth •2 tablespoons tomato paste •1 carrot, peeled and chopped •1 apple, peeled and finely chopped •1 teaspoon agave •1 tablespoon white miso •1 head of broccoli, chopped into florets, stems thinly sliced •1 pound firm tofu, pressed and cut into 3/4-inch cubes •Sea salt and freshly ground pepper to taste •1 handful fresh cilantro, chopped for garnish (optional) ————————————— In skillet, heat oil over mediumhigh heat. Add the ginger, chopped onions and garlic, cooking for about 5 minutes, or until onions are softened and translucent. Sprinkle in flour, turmeric and curry powder.

Stir, so the vegetables are coated in the flour and spice paste. Add the broth and tomato paste, and stir, incorporating all the crusty bits stuck to the bottom. Bring to a boil.

Gently add the broccoli florets and stems and chopped tofu.

Reduce heat to medium-low, and cover. Simmer, until broccoli is tender and the sauce has reduced and deepened in color to a burnished pumpkin shade, about 30 minutes. Stir in the finely chopped apple, which will incorporate into the sauce, the agave and miso.

Season with sea salt and freshly ground pepper and garnish with the optional chopped cilantro.

Note: S&B is a mild Japanese curry powder available at Asian markets at some natural food stores.

(Ellen Kanner is the author of “Feeding the Hungry Ghost: Life, Faith and What to Eat for Dinner.”) PHOTO (from MCT Photo Service, 312-2224194)

October 16, 2014

y

ydo I Where turn when it comes

Myfamily’s health? is that

to my health?

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DISEASE.

medication

safe?

treatable?

technology?

WhodoI TALKTO

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y

As someone with cancer, how do I know if participating in a clinical trial is right for me?

What’s the latest

about this?

What are my OPTIONS

now?

Clinical trials are an important part of cancer research. Participation in clinical trials benefits patients, physicians and researchers and brings the latest research findings to the community.

Ask the

Expert

Clinical trials are research studies conducted with actual patients to test new drug treatments or new approaches for diagnosing, controlling or preventing cancers.

Trials are usually based on your cancer type and are conducted in phases, with the first phase focused on patient safety.

Before you decide to participate in a clinical study, your doctor will discuss the potential benefits and risks.

McKee Medical Center is an affiliate of the Colorado Cancer Research Program, sponsored by the National Cancer Institute and offers clinical trials close to home.

Speak with your physician about possible participation in clinical trials at McKee Medical Center.

Samuel Shelanski, M.D. Oncologist Banner Health Clinic specializing in Cancer and Oncology Services 2050 Boise Ave., Loveland Appointments: (970) 679-8900 www.BannerHealth.com/COCancer

October 16, 2014

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HEALTHLINE 15

H L HEALTH CALENDAR & BRIEFS BLOOD PRESSURE SCREENING

BREAST-FEEDING SUPPORT GROUP

Have your blood pressure checked by a Wellness Specialist.

Where: McKee Wellness Services, 1805 E. 18th St. Suite 6 When: Monday - Thursday, 8 a.m.-4:30 p.m.

Cost: FREE Call: 970.669.9355

When: Mondays, Wednesdays and Fridays (except holidays), 10-11 a.m.

Cost: FREE. No need to register Call: 970.669.9355

CAREGIVER CANCER SUPPORT GROUP

Where: McKee Conference and Wellness Center When: Meets twice per month. 10:30 a.m. -12 p.m.

Cost: FREE Call: 970.635.4129 for specific dates

BREAST CANCER SUPPORT GROUP Where: McKee Cancer Center Conference Room B When: Second Thursday of each month. 5:30 - 7 p.m.

Cost: FREE Call: 970.622.1961

CAREGIVERS SUPPORT

For caregivers of elderly adults, particularly those people with Alzheimer’s and memory impairment.

Where: First Christian Church, 2000 N. Lincoln Ave. When: 3rd Thursday of the month, 1:30-3:30 p.m.

Cost: FREE. Care of elderly adult family members or friends is available through Stepping Stones Adult Day Program during meeting times at no charge.

Call: 970.669.7069

CHRONIC OBSTRUCTIVE PULMONARY DISEASE Where: McKee Conference and Wellness Center, Boise.

Ave. When: Tuesdays, 1-3 p.m.

Cost: FREE Call: 970.635.4015

Fall

DIABETES INFORMATION GROUP

Festival

Free ConCert

with Darren Motamedy 4:00 to 5:30 p.m.

• Free Hayrides • Free Pumpkin Painting • Refreshments/Popcorn/Food available

Offering information, resources, and support to people with diabetes and the general public.

Where: McKee Wellness Center, Kodak Room When: 4th Thursday of every other month, 7- 8:30 p.m.

Cost: FREE

GENERAL CANCER SUPPORT

Where: McKee Cancer Center Conference Room B When: Tuesdays (except holidays), 5:30-7 p.m.

Cost: FREE Call: 970.635.4129

8426 S. Hwy. 287/Ft. Collins

www.resthavencolorado.com 16 HEALTHLINE

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PROSTATE CANCER SUPPORT GROUP

Where: McKee Cancer Center Conference Room B When: 4th Thursday of each month, 5:30 -7 p.m.

Cost: Free Call: 970.622.1961

SCLERODERMA SUPPORT GROUP

Open to all scleroderma patients, family, caregivers, and friends looking for a forum to share feelings, concerns, and information.

When: 4th Sat. of even numbered months, 10 a.m.-12 p.m.

Where: Medical Center of the Rockies, Poudre Canyon Room October 19 - 2014 Scleroderma Patient Education Day Where: National Jewish Health, Molly Blank Conference Center. Registration required. Contact Cyndy Besselievre at 303.806.6686 or cbesselievre@scleroderma.org.

October 25 – Jacqueline Adolph of the Biofeedback Clinic, Fort Collins Contact: Judy Laible, 970.

622.9498, jlaible@frii.com

TOTAL JOINT EDUCATION

Physical therapists and occupational therapists prepare patients for surgery.

This program is coordinated through your physician’s office as part of the surgery scheduling process.

Where: McKee Conference and Wellness Center When: Thursdays, 3 p.m.

Cost: FREE Call: 970.635.4172 to register

October 16, 2014

WISE WOMEN DISCUSSION GROUP

A supportive environment for women to explore the rewards and challenges of aging. Facilitated by Dr. Beth Firestein.

When: Tues. October 21, Weds. November 5, 11:15 a.m.-12:30 p.m.

Where: Perkins Restaurant (W. Eisenhower) in Loveland Cost: FREE Info: visit bethfirestein.com, email firewom@webaccess. net or call 970.635.9116.

YOGA SUPPORT GROUP

For anyone touched by cancer.

Where: McKee Medical Center Cancer Center Lobby When: 1st and 3rd Thursday of every month, 5:30 - 6:30 p.m.

Cost: Free Call: 970.635.4054 to register

BATTLE OF THE BLAH-ZZZ

Sleep is an integral, and arguably the most important, part of the Big Three - eating healthy, exercising, and getting enough sleep.

When: Thursday, Dec. 4 , 5:30 - 7:30 p.m.

Where: Location TBD RSVP by Dec. 1 at 970.

203.6631

PARKINSON’S LSVT “BIG” EXERCISE REFRESHER CLASS

Open to anyone with Parkinson’s disease who has completed the LSVT “Big” program with a physical or occupational therapist and wants to practice exercises.

October 16, 2014

Where: McKee Conference and Wellness Center, Boettcher Room When: 3rd Tuesday of every month beginning Oct. 21, 5:30 - 6:30 p.m.

Cost: FREE Information: 970. 635.4171

BANNER HEALTH IMPLEMENTS VISITOR RESTRICTIONS Restrictions set due to Enterovirus D68 Banner Health has implemented visitor restrictions at its Greeley and Loveland hospitals because of the current Enterovirus D68 outbreak. Restrictions will likely remain in place through the flu season, roughly the end of March.

The restrictions at North Colorado Medical Center in Greeley and McKee Medical Center in Loveland Banner Health asks community members to abide by include: • Do not visit the hospital if you have fever, cough, vomiting or diarrhea • No visitors under the age of 13 • Siblings, who do not have cold and flu symptoms, may visit a new baby on the Obstetrics unit, but may be screened for illness by staff before being allowed to visit • Children 12 and under must be supervised by an adult at all times in pubic waiting areas and cafeterias • Please wash or sanitize your hands frequently while at the hospital

According to the Centers for Disease Control and Prevention website, symptoms of Enterovirus D68 may include a include fever, runny nose, sneezing, cough, and body and muscle aches.

As of Sept, 17, a total of 140 people had been infected across 16 states.

Additionally, the CDC website states infants, children and teenagers have a higher risk of being infected with Enterovirus D68 likely because they have not built up immunity from previous exposures to these viruses.

Children with asthma are at higher risk for severe illness.

To avoid becoming sick, the CDC recommends washing hands with soap and water frequently; avoiding contact with eyes, nose and mouth with unwashed hands; and disinfecting frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

MCKEE MEDICAL CENTER RECEIVES CERTIFICATION McKee Medical Center is proud to announce the re-certification of its cardiac rehabilitation program by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). McKee Medical Center was recognized for its commitment to improving the quality of life by enhancing standards of care.

Cardiovascular rehabilitation programs are designed to help people with cardiovascular problems (e.g., heart attacks, coronary

Reporter-Herald — ReporterHerald.com

artery bypass graft surgery) recover faster and improve their quality of life. These programs include exercise, education, counseling, and support for patients and their families.

McKee’s cardiac rehabilitation program participated in an application process that requires extensive documentation of the program’s practices. AACVPR Program Certification is the only peerreview accreditation process designed to review individual programs for adherence to standards and guidelines developed and published

by AACVPR and other professional societies. Each program is reviewed by the AACVPR Program Certification Committee and Certification is awarded by the AACVPR Board of Directors.

AACVPR-certified programs are recognized as leaders in the field of cardiovascular rehabilitation because they offer the most advanced practices available. AACVPR Program Certification is valid for three years. McKee was originally certified in 2011.

Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation is a multidisciplinary organization dedicated to the mission of reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management.

Central to the core mission is improvement in quality of life for patients and their families.

HEALTHLINE 17

PAID ADVERTORIAL

Genetic Testing It’s a thought that

the general population.

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In addition, the Insti-

ten as they begin dealing

tute notes that women

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with a harmful BRCA1

agnosis: Are my children

mutation face a 39

more likely to have cancer

percent risk for ovarian

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cancer. The ovarian can-

Genetic testing is a

cer risk for women with

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science and technology

tion is 11 to 17 percent.

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That compares to just 1.4

point that a blood test or cheek swab can yield a treasure trove of cancer risk data. According to the National Cancer Institute, inherited genetic mutations play a role in the development of 5 to 10 percent of all cancers.

But that doesn’t mean everyone is an appropriate candidate for a genetic cancer test. Alice Wood, MD, a medical oncologist/hematologist at the McKee Cancer Center in Loveland, conducts about two genetic cancer tests a week. Each costs between $3,000 and $5,000, and the tests are not always covered by insurance. The decision to conduct a genetic test is based on a number of clinical considerations.

“I take a detailed patient history,” Dr. Wood said. “Sometimes the decision to take a genetic test is based on the kind of cancer they have, the patient’s age at the time of diagnosis, or just the fact they have an extensive family history.”

And nobody should receive a genetic test without significant genetic counseling so they can make informed decisions based on the results.

18 HEALTHLINE

The National Cancer Institute notes that more than 50 hereditary cancer syndromes have been identified, meaning genetic mutations have been linked to increased risk for a variety of different types of cancer, including female breast, ovarian, prostate, pancreatic, colorectal, small intestine, stomach, brain and many more.

To keep things in perspective, Dr. Wood notes that a small percentage of her patients have a hereditary form of cancer. But those who are at increased risk have difficult choices to make – choices that sometimes extend to their offspring and siblings.

For instance, women who carry a harmful mutation of the BRCA1 gene or BRCA2 gene face a much greater risk of developing breast cancer or ovarian cancer in their lifetime. According to the National Cancer Institute, between 55 and 65 percent of woman with the harmful BRCA1 mutation and 45 percent of woman who inherit the harmful BRCA2 mutation will develop breast cancer by age 70, versus just 12 percent of women in

percent of women in the general population who develop ovarian cancer in their lifetimes.

Many women who test positive for these genetic mutations elect to have preventative surgeries, such as removal of their breasts (bilateral mastectomy) or removal of their reproductive organs (hysterectomy and oophorectomy).

Dr. Elizabeth Howell, an obstetrician/gynecologist with Banner Health Clinic specializing in OBGYN gives a handout to every new patient with a series of risk factors for cancer and discusses genetic testing options for those at risk.

“Genetic testing improves our ability to recognize people who can benefit from known prevention and early detection strategies,” she said.

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To determine whether you are an appropriate candidate for a genetic cancer test, please contact your physician.

October 16, 2014

Post a Pink Note!

Sponsored by McKee Medical Center

Sign the interactive PINKBoard page at www.reporterherald.com/business/all-in-pink To help raise awareness of National Breast Cancer Awareness Month, the Reporter-Herald has created an interactive PINKBoard.

Visit reporterherald.com/business/all-in-pink through October 22 and sign the interactive PINKBoard page with notes of encouragement, support and remembrances of loved ones affected by breast cancer or share your own story! Hosting an event or fund-raiser during for Breast Cancer Awareness Month? Share that with us too!

Messages posted online will be printed on special ALL IN PINK pages every Sunday in October.

All In Pink PRESENTED BY

Support • Recognition Education • Celebration

We’re ALL IN PINK together!

To sponsor ALL IN PINK, call 970.669.5050.

URGENT CARE The doctor can see you NOW.

Our name has changed, and we've moved upstairs, but the caring providers you have come to know and trust at Loveland Urgent Care are still the same.

We're here for all your minor emergencies and unexpected illnesses.

Monday through Friday, 8 a.m. - 6 p.m.

Saturday, 9 a.m. - 5 p.m.

Sunday, 9 a.m. - 3 p.m.

Urgent Care 3850 N. Grant Ave. (Located near 37th St. and U.S. 287 in north Loveland) 970.624.5150