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I was immensely
relieved, as I began to comprehend that I might be able to see this treatment through. The entire staff of the Cancer Center, including the counseling team,
contributed to my emerging confidence, beginning with the receptionist’s welcome, the attendant nurses or my meetings with Dr. Malcolm or one of her physician’s assistants.
By CORI URBAN
SPECIAL TO THE REPUBLICAN
As a child in Eastern Europe during WWII, Gertraud Gutzmann experienced the reality of death and annihilation. To have survived war and violence in her childhood and youth to reach the age of 82 is a miracle to her. Then she was diagnosed with cancer. “I was in denial for a few days until my older daughter, a nurse, explained to me the aggressive nature of this cancer. I decided then to seek treatment,” said the Whately resident. Her primary care team at the Northampton Family Practice, friends and acquaintances recommended the Mass General Cancer Center at Cooley Dickinson Hospital. So she visited the home page of the center, gathered information about doctors, staff and procedures, and concluded that she would receive very good care from distinguished specialists who collaborate or consult with colleagues at Mass General Hospital in Boston. A former professor of German Studies at Smith College in Northampton, she described herself as “a retired professor of languages and literatures, but one illiterate in the medical field and its language.” She praised Dr. Alys Malcolm, “one of the truly outstanding medical professionals I have had the privilege to encounter in my long life,” who, from the day of their first meeting and consultation, spoke to her about her diffuse large B-cell lymphoma and the potential treatment in a way she could understand. At the same time, the doctor was subtle in her exhortations
that Gutzmann would be a major player in the treatment and healing process. “The clear instructions, personally and in writing … helped remind me of my part in the treatment,” she said. “I began to look forward to my meetings with Dr. Malcolm for her passion for her field of expertise and her dedication to her work are as infectious as they are inspiring.” Malcolm, medical director at Mass General Cancer Center at Cooley Dickinson Hospital, specializes in medical oncology and sees most often patients with solid tumors such as gastrointestinal (hepatobiliary, pancreas, colorectal) cancers as well as those of the prostate, lung, head and neck and breast. “These are generally challenging-to-treat cancers, though variability in behavior of different cancers may be expected,” she said. Nearly every type of cancer can be treated at Cooley Dickinson. “However, our philosophy is to provide the right care, in the right place, at the right time,” said Caitlyn R. Lundberg, director of the Mass General Cancer Center at Cooley Dickinson Hospital. “Therefore, there are situations where we feel that certain care is best delivered at Mass General Hospital in Boston.” Mass General Hospital, a top ranked hospital and cancer facility, has chosen to place one of its network sites in Northampton. “That means that providers at Cooley Dickinson Hospital can provide expert care, access to cutting-edge research and consultations with physicians leading the field in research
and development of new cancer treatment, right here in our patients’ back yards,” Lundberg said. Patients in Northampton have access to chemotherapy, immunotherapy, radiation therapy and certain surgical treatments with brachytherapy coming soon. The benefits of the hospital’s association with Mass General “are endless,” she continued. “Having a large academic center located in a community setting is the best of both worlds. Access to the best of the best in terms of physicians, treatment protocols and research, but in a
ence. “First, and above all: the expertise of the medical team, their professionalism and personal attention,” made a strong impact on her. “I felt encouraged during my days of treatment, but also in between infusions, to review difficulties I had in coping with effects of medications, with moments of discouragement. My messages on the Patient Gateway, or any phone calls, received prompt attention and useful responses,” she said. “To be sitting in the waiting room with many other cancer patients, all of whom were eventually greeted by their attending nurses in a warm,
journey,” said Malcolm, the medical director. “And they will see, feel and experience this every time they are at our center. They will be enveloped by very dedicated staff that take pride in helping and supporting them.” And while patients are able to get their chemotherapy and radiation therapy locally, closer to their home, they are still able to have the “eyes of Boston’s best” on their care process, she said. An additional benefit is access to clinical trials for the newest therapy options. There are many complex factors that affect cancer,
Malcolm urges people who think “something is not right” with their health not to ignore the feeling: “Reach out and see your provider; be your own advocate.” As for Gutzmann, a PET scan performed in March showed that the cancer is now in remission. At the recommendation of her doctors, she was to undergo a 3-week radiation treatment (April 27 to May 17) to eradicate any “lingering remnants” of the cancer. “I come from a culture where criticism is generally expressed more readily than praise,” she explained, offering context for the following comment: “Throughout the chemo treatment, I have not had one negative experience. After the first two infusions, I was immensely relieved, as I began to comprehend that I might be able to see this treatment through. The entire staff of the Cancer Center, including the counseling team, contributed to my emerging confidence, beginning with the receptionist’s welcome, the attendant nurses or my meetings with Dr. Malcolm or one of her physician’s assistants. I gained the sense that the entire team was well informed, prepared and ready Left: Mass General Cancer Center Relay for Life Team photo. to support me and to enhance my treatment.” Right: Dr. Alys Malcolm, medical director at Mass General Cancer Center at Asked if she would recomCooley Dickinson Hospital. (SUBMITTED IMAGES) mend Mass General Cancer Center at Cooley Dickinson smaller, more intimate setting welcoming manner, gave me not only its development but Hospital to others for cancer without the need for extensive the sense that I was part of a also its process in one’s body. care, Gutzmann replied, “I travel.” community of healers.” “While being healthy and certainly would do so, without The close-to-home location Indeed, the patients at Mass maintaining a healthy lifestyle hesitation or reservation.” was part of what appealed to General Cancer Center at is very important, having a Gutzmann when she chose to Cooley Dickinson Hospital positive mindset and nurFor more information, go to have her care in Northampare not alone. “Our entire turing our mind-body-spirit cooleydickinson.org. ton. But that is just one small cancer center team will be connection is essential,” she part of her positive experiwith them as they walk this emphasized.
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D2 | SUNDAY, MAY 16, 2021
Common
terminology
How to care for yourself after
surrounding
treatment
Cancer survival rates have improved dramatically over the last half century. According to data from the Journal of the National Cancer Institute, fiveyear survival rates for all cancers in the United States increased from just over 50 percent between 1970 and 1977 to 67 percent between 2007 and 2013.
tion and support during their illness while also noting that life after treatment posed some new questions and concerns. Life after successful cancer treatment may require an adjustment period, but the following are a handful of strategies that can improve quality of life and pave the way for a smooth transition into life as a cancer survivor.
· Ditch the bad habits.
cancer
fish, lean meat and eggs. Choose healthy carbohydrates, such as whole grain breads, over processed products. Processed carbs like white bread have most of their fiber, vitamins and minerals removed during processing. If your carbs are primarily processed foods, you may suffer from nutrient deficiencies.
· Get back to a healthy weight. The Mayo Clinic
Even if a survivor’s bad notes that many people lose or gain weight during habits were not believed to be contributors to their discancer treatment. Regardless of which way you went, ease, that does not mean they should continue to be it’s vital to get back to a a part of life after treathealthy weight, which can reduce your risk for various ment. The NCI notes that researchers have long since illnesses. linked smoking tobacco · Exercise regularly. and alcohol consumption to cancer. If you quit these Take it slow when returnhabits during treatment, ing to physical activity after cancer treatment, stay the course even after you’ve beaten cancer. but know that staying Doing so may reduce your active has myriad benerisk for cancer recurrence fits. According to the NCI, and will lower your risk for recent reports suggest that staying active after cancer other diseases, including heart disease and diabetes. can help reduce the risk for recurrence. In addition, · Eat healthy. The the Mayo Clinic notes that evidence overwhelmingly American Cancer Society urges cancer survivors supports the notion that The improved survival rates exercise benefits the heart, mean more and more people to eat at least 2.5 cups lungs and other systems of are living five years or more of fruits and vegetables every day. Fat also is vital the body. after being treated for cancer. to overall health, but the Some patients have trouble Caring for yourself after readjusting to life after diACS urges survivors to consume healthy fats like successful cancer treatment agnosis as they wonder how omega-3 fatty acids, which may be marked by some new to care for themselves after can be found in fish such challenges. Various stratovercoming their disease. egies can help people who In fact, the National Cancer as salmon and some nuts. When choosing proteins, have overcome the disease Institute notes that many opt for those that are low live long, healthy lives after cancer survivors acknowledge having lots of informain saturated fat, such as treatment.
Cancer affects tens of millions of people across the globe every year. Data from the International Agency for Research on Cancer indicates that roughly 19 million new cases of cancer were diagnosed in 2020. Though people confronting cancer recurrence might be familiar with various terms, the 19 million people with no such personal history who are diagnosed each year may find discussions with their cancer care teams a little confusing. A lack of familiarity with cancer terminology may be at the root of such confusion. The following are some terms, courtesy of the American Society of Clinical Oncology, that are often used by cancer care teams during discussions with their patients.
· Acute: Acute is not
specific to cancer, as it is often used to describe symptoms patients with various illnesses may experience. ASCO® notes that acute refers to symptoms that start and worsen quickly but do not last over a long period of time.
Get Well. We Can Help.
· Biopsy: A biopsy is
a test during which a small amount of tissue is removed for examination under a microscope. ASCO® notes that a biopsy is the only test that can make a definitive diagnosis of cancer.
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· Cancer: Cancer is an
umbrella term used to describe more than 100 different diseases, all of which are characterized by abnormal cell growth and the ability to invade nearby tissues.
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· Chemotherapy: Che-
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motherapy is a cancer treatment that involves the use of drugs to kill cancer cells.
· Clinical trial: Clinical trials are studies that test new treatments and/ or prevention methods to determine if they are safe, effective and potentially better than current standards of care. Some cancer patients may be eligible to take part in clinical trials, and they can discuss the pros and cons of doing so with their cancer care teams.
· Complementary medicine: This refers
to a diverse group of treatments, techniques and products that are used in addition to standard cancer treatments. Patients can discuss the various types of complementary therapies available to them with their cancer care teams.
· Hormone therapy:
This treatment removes, blocks or adds hormones to destroy or slow the growth of cancer cells. It is sometimes referred to as hormonal therapy or endocrine therapy.
· Imaging test: An
imaging test creates pictures of internal body parts, tissues or organs. These tests may be ordered to make a diagnosis, develop a course of treatment or to determine if treatment is working.
· Immunotherapy:
Immunotherapy is a type of treatment that aims to improve the body’s natural defenses to fight the cancer. Sometimes called biologic therapy, immunotherapy employs materials made by the body or in a lab to improve, target or restore immune system function.
· In situ: Cancer is
described as “in situ” when it has not spread to nearby tissue. This is also called non-invasive cancer.
· Invasive cancer: This is used to describe cancer that has spread outside the layer of tissue in which it started. Invasive cancer has the potential to grow into other tissues or parts of the body.
· Late effects: Late
effects refers to side effects that occur months or years after a cancer diagnosis. These may develop due to related treatments, such as chemotherapy, radiation therapy or surgery.
· Metastasis: The
spread of cancer from the place where it began to other parts of the body.
· Mortality rate: The number of deaths in a particular population during a specific time.
· Palliative care: This
refers to any form of treatment that concentrates on reducing a patient’s symptoms or treatment of side effects. Palliative care aims to improve patients’ quality of life and support patients and their families.
· Polyp: A growth of nor-
mal tissue that usually sticks out from the lining of an organ.
· Precancerous: This
refers to cells that have the potential to become cancerous.
· Relative survival:
The amount of time after treatment that a person with cancer lives, excluding all other causes of death but cancer.
· Remission: The disap-
pearance of the signs and symptoms of cancer but not necessarily the entire disease. Remission may be temporary or permanent.
· Staging: A way of
describing cancer, such as where it is located, whether or where it has spread and whether it is affecting the functions of other organs in the body.
· Tumor: A mass formed
when normal cells begin to change and grow uncontrollably.
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THE REPUBLICAN | MASSLIVE.COM
Food’s important
role in overall health
Nutrition is a popular topic of conversation, particularly among those embarking on a weight loss or maintenance plan. Individuals carefully study food macros and pore over various diets to get the most out of the foods they eat.
When the end goal is simply looking good, it may be easy to forget about the other benefits of nutritious diets, including their link to overall health. A close relationship exists between nutritional status and health. Experts at Tufts Health Plan recognize that good nutrition can help reduce the risk of developing many diseases, including heart disease, stroke, diabetes, and some cancers. The notion of “you are what you eat” still rings true. The World Health Organization indicates better nutrition means stronger immune systems, fewer illnesses and better overall health. However, according to the National Resource Center on Nutrition, Physical Activity, and Aging, one in four older Americans suffers from poor nutrition.
And this situation is not exclusive to the elderly. A report examining the global burden of chronic disease published in The Lancet found poor diet contributed to 11 million deaths worldwide - roughly 22 percent of deaths among adults - and poor quality of life. Low intake of fruits and whole grains and high intake of sodium are the leading risk factors for illness in many countries. Common nutrition problems can arise when one favors convenience and routine over balanced meals that truly fuel the body.
Improving nutrition
Guidelines regarding how many servings of each food group a person should have each day may vary slightly by country, but they share many similarities. The U.S. Department of Agriculture once
followed a “food pyramid” guide, but has since switched to the MyPlate resource, which emphasizes how much of each food group should cover a standard 9-inch dinner plate. Food groups include fruits, vegetables, grains, proteins, and dairy. The USDA dietary guidelines were updated for its for 2020-2025 guide. Recommendations vary based on age and activity levels, but a person eating 2,000 calories a day should eat 2 cups of whole fruits; 21/2 cups of colorful vegetables; 6 ounces of grains, with half of them being whole grains; 51/2 ounces of protein, with a focus on lean proteins; and 3 cups
of low-fat dairy. People should limit their intake of sodium, added sugars and saturated fats. As a person ages he or she generally needs fewer calories because of less activity. Children may need more calories because they are still growing and tend to be very active. Those who are interested in preventing illness and significantly reducing
premature mortality from leading diseases should carefully evaluate the foods they eat, choosing well-balanced, low-fat, nutritionally dense options that keep saturated fat and sodium intake to a minimum.
For the second consec tive “marking period,” Mercy Medical Center was awarded an ‘A’ in the Spring 2021 Leapfrog Hospital Safety Grade, a national distinction recognizing Mercy’s achievements in protecting patients from harm and providing high-q ality, safe health care. The Leapfrog Hospital Safety Grade is the only hospital ratings program based excl sively on hospitals’ prevention of medical errors and other harms to patients in their care.
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D4 | SUNDAY, MAY 16, 2021
THE REPUBLICAN | MASSLIVE.COM
The complicated link between
genetics and cancer
F
ew, if any, families have not been affected by cancer. Estimates based on data from the International Agency for Research on Cancer suggested that 19.3 million new cancer cases were diagnosed in 2020, which reflects the far-reaching impact cancer has on people across the globe. With so many instances of cancer across the globe, it’s no surprise that some families include more than one person who has had cancer. As a result, it’s not uncommon for some people to feel as if cancer runs in their family. Such a conclusion may not be entirely off-base, but it’s also not entirely accurate.
Why do some cancers seem to run in families?
The American Cancer Society notes that various factors may make it seem as though certain types of cancer run in families. For example, family members may share certain behaviors, such as poor diet, that can increase their risk for obesity, which in turn increases their risk for various diseases, including cancer. In such instances, it’s not the family’s genes that are the risk factor for cancer, but rather the shared poor diet. Other commonalities within families, such as smoking, can increase cancer risk, even if the families do not have a genetic predisposition to cancer.
Do genes ever affect cancer risk?
The ACS notes that some cancers are caused by abnormal genes being passed along from generation to generation. In such instances, the cancer is not inherited, but an abnormal gene is. However, such instances are somewhat rare, as the ACS reports only about 5 to 10 percent of all cancers result directly from gene defects inherited from a parent. These gene defects are called mutations.
one cell then divides many times, eventually becoming a baby. Since all of the cells that eventually form come from that first cell, the inherited gene mutation is present in every cell. That’s why it’s possible for gene mutations that lead to cancer to be passed down from generation to generation.
How do people know if a family cancer syndrome affects their families?
The ACS notes that cancer is a common disease that roughly one in three people in the United States will develAccording to the ACS, an op during their lifetimes. So inherited gene mutation is even if two family members present in the egg or sperm develop the same type of cancell that formed the child. cer, that does not necessarily When an egg is fertilized by sperm, it creates one cell. That mean a family cancer syn-
What are inherited gene mutations?
drome is present. However, cer in a single person, such the ACS reports that certain as a woman with both breast factors make it a family cancer and ovarian cancer syndrome more likely. Those · Cancers occurring in both of factors include: a pair of organs, such as both eyes, both kidneys, or both · Many cases of the same type breasts of cancer, especially if it is an uncommon or rare type · More than one childhood of cancer cancer in siblings, such as sarcoma in both a brother · Cancers occurring at youngand a sister er ages than usual. Age is a risk factor for many types of · Cancer occurring in the sex cancer, but the average age not usually affected, such as of diagnosis tends to be in breast cancer in a man adulthood. Many young people in the same family being · Cancer occurring in many diagnosed with a cancer that generations, such as in a is most often diagnosed in grandfather, father and son older adults is a potential indicator of a family cancer The relationship between syndrome. genetics and cancer is complicated. More information is · More than one type of canavailable at www.cancer.org.
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