Prom season: See photo galleries of local high school proms, online at masslive.com
Better Health D
|
ERIC CARLE MUSEUM: 20th anniversary celebrations planned, D9 FILM FESTIVAL: Easthampton to hold its first festival, D9 TREASURE HUNT: For excellence in education, flip a coin, D12
| SUNDAY, MAY 22, 2022
Lung Cancer Just because you don’t smoke does not mean you can’t get lung cancer.
(PHOTO COURTESY OF ISTOCK)
By CORI URBAN
Special To The Republican
Second-hand smoke, radon, family history and occupational exposures to such things as asbestos can also cause lung cancer. According to the Centers for Disease Control and Prevention, cigarette smoking is the number-one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80 to 90 percent of lung cancer deaths. Using other tobacco products such as cigars or pipes also increases the risk for lung cancer, which is the leading cause of cancer deaths for both men and women worldwide. Nearly 160,000 Americans die of lung cancer each year. “Oftentimes, the first thing someone asks when they find out someone is diagnosed with lung cancer is, ‘Did they smoke?’ While usually asked out of genuine curiosity, it implies that if the answer is ‘yes’ that the patient is at fault for their diagnosis,” said Ashley LeBlanc, RN, Nurse Practice Manager for Thoracic Surgery and Nursing Director of the Lung Cancer Screening Program, at Mercy Medical Center. “The number of lung cancer patients that are non-smokers/never smokers is increasing annually and is currently about 15-20 percent. The amount of guilt and pressure this puts on current/former smokers is significant.” Lung cancers usually are grouped into two main types called small cell and nonsmall cell (including adenocarcinoma and squamous cell carcinoma). These types of lung cancer grow differently and are treated differently. “Typically, non-small cell lung cancer is slightly less aggressive than small-cell lung cancer and is treated with surgery at early stages while SCLC is usually not treated with surgery (chemotherapy and radiation),” explained Laki Rousou, M.D., Chief of Thoracic Surgery, Chief of
Robotic Surgery, and Medical Director of the Lung Cancer Screening Program, at Mercy Medical Center. SCLC also tends to grow near the center of the chest and often affects the lymph nodes. Donna M. Cheria, 62, of Ludlow, was diagnosed with lung cancer in 2018 after suffering with a mild cough and being sent to Mercy Medical Center for a chest X-ray. “The diagnosis changed my life because I started smoking very young, at 16,” she said. “Dr. Rousou was amazing with me and my family. I had great trust in him, and I understood everything that was going on.” She has followed up faithfully with appointments and X-rays every year for four
• Are between 50 and 80 years old
chemotherapy/immunotherapy all in the Sister Caritas Cancer Center,” Rousou said. • Are currently a smoker or About 200 patients are have quit within the past treated there each year. No lung transplants are 15 years done there. “No one deserves lung • Smoked an average of cancer. What I try to explain one pack of cigarettes to patients is that while having a day for 20 years a history of tobacco abuse is indisputably a risk factor, it Studies have shown that is only that — something in such lung screening can lower their history that increases the risk of death from lung the possibility that they may cancer by 20 percent in peodevelop lung cancer,” LeBlanc ple who are at high risk. said. “This does not guarantee a definitive diagnosis. We Trinity Health Of New England and Mercy Medical screen patients who grew up Center offer cutting edge, on a tobacco farm, have been smoking for as long as they comprehensive and multidisciplinary lung cancer care. can remember and have a “We have a robust screening pack year total that exceeds
diagnosed with lung cancer.” Lung cancer usually does not have any symptoms, especially in early stage disease, explained Rousou, who earned a medical degree at Boston University School of Medicine. “Symptoms that one might have are either very nonspecific (fatigue, cough, fever) or an indication of late-stage disease (chest-wall pain, unintentional weight loss, coughing up blood). The absence of specific symptoms especially for early-stage lung cancer is precisely what makes lung cancer screening so essential because early-stage lung cancer has a relatively high cure rate.” Smoking cessation is the best way to reduce risk of
lung cancer incidence and should be the mainstay of public health initiatives,” Rousou said, adding that there is no evidence that any one type of food increases the risk of lung cancer. “There is some evidence that a diet rich in fruits and vegetables can decrease your risk of developing lung cancer, but more research needs to be done. In general, I recommend eating a healthy diet rich in fruits and vegetables and low in processed sugars to reduce overall cancer risk and maintain a healthy lifestyle/weight.” The risk of developing lung cancer increases with age regardless of smoking. “That rate of increase in risk increases much faster in smokers than nonsmokers. Stopping smoking slows that rate of rise in risk. This is just one of the many benefits of smoking cessation,” the doctor said. There are many new tools for the diagnosis, staging, localization, risk stratification and treatment of lung cancer that are being used now at Mercy Medical Center. “New targeted therapies (immunotherapy) are being used now, and new drugs are being developed seemingly by the month,” Rousou explained. “These drugs target specific ‘markers’ that can be identified on the tumors. Until recently, they were used in stage 4 disease, but now these are often used as an adjunct or replacement for our current therapies.” The doctor recalled a patient from about six years Left: Laki Rousou, M.D., Chief of Thoracic Surgery, Chief of Robotic Surgery, and Medical Director of the Lung Cancer Screening ago who was diagnosed with Program, with the da Vinci Surgical System at Mercy Medical Center. Stage 4 lung cancer. “TestRight: Ashley LeBlanc, RN, Nurse Practice Manager for Thoracic Surgery and Nursing Director of the Lung Cancer Screening ing the tumors for ‘markers,’ Program (right), and Johanna Orsolino, Program Coordinator (left), review a patient file at Mercy Medical Center. there was a match to a specific (PHOTOS COURTESY OF MERCY MEDICAL CENTER) treatment for that cancer (immunotherapy). He is still alive today, working and functionyears and appreciates the care program, technology for the 100 whose screenings do developing lung cancer. accurate diagnosis and stagshe has received. not come back suspicious for Radon testing and abatement, ing at a high level with this treatment. On surveillance Persons may qualify for a if necessary, can also reduce ing of lung cancer (Illumisite lung cancer. We also screen – Navigational Bronchoscopy patients who meet the minilow-dose CT lung screening risk of developing lung cancer. imaging tests, there is very and Endobronchial Ultraminimal tumor burden if any. at the Sister Caritas Cancer mum recommendations for “Primary prevention (stopCenter at Mercy Medical Cen- sound), robotic surgical rescreening, having quit smok- ping young people from start- A story like that was unheard ter if they meet the following section, stereotactic radiation ing 14 years ago and only have ing smoking in the first place) of 10 years ago,” Rousou said. criteria: and radiation treatments and a 20-pack year total who are remains crucial to decreasing
%%SATFOL-%%3MONTH%%2DATE
D2 | SUNDAY, MAY 22, 2022
THE REPUBLICAN | MASSLIVE.COM
UV Exposure is not the only cause of melanoma
The relationship between
Stress and Cancer
Melanoma is the deadliest type of skin cancer. Melanoma occurs when melanocytes, the cells that produce pigment in the skin, become damaged, mutate and start growing unchecked.
as neither UV exposure nor family history seem to play a role in its development. The American Cancer Society says gene changes related to melanoma are typically acquired during a person’s lifetime, and in some instances seem to happen randomly within a cell. Melanomas that do not result from UV exposure show changes in the C-KIT genes. There’s also the chance that those who develop melanoma inherited gene changes from a parent. While sunlight or UV expo- These melanomas often sure are typically considered result from changes in tumor suppressor genes, rather than risk factors for the developgenes that help cells grow, ment of melanoma, the fact divide and stay alive, known that melanoma can occur anywhere on the body - even as oncogenes. Tumor supon patches of skin that never pressor genes are supposed see the light of day - indicates to control cell growth. When UV radiation exposure is not cells don’t work correctly due to inherited changes or other the only reason melanoma damage, they grow out of occurs. control, potentially leading to Mucosal melanoma is a melanoma. rare form of melanoma, The Mayo Clinic says there accounting for roughly 1 may be additional environpercent of all cases. Everymental factors that damage day Health says mucosal the DNA in skin cells and melanoma can develop in cause melanoma, but the the sinuses, nasal passages, cause of cell damage isn’t vagina, anus, oral cavity, and other internal areas that always clear. However, the following risk factors should likely are not exposed to the be on the minds of all people, sun or other UV radiation. and serve as the motivation Researchers have not been behind routine skin checks able to identify any risk factors for mucosal melanoma, and health care visits.
S
tress is a complicated subject that can leave many people scratching their heads. Many professionals insist they work best under pressure, and that impression is not without merit. A study from researchers at the University of California, Berkeley found that significant but brief stressful events led to the proliferation of new nerve cells in the brains of rats that ultimately improved their mental performance. But one of the key takeaways from that finding is that the stress experienced by the rats was acute. Numerous other studies have found that prolonged
· Having fair skin and a history of sunburn.
· Excessive UV
light exposure.
· Living closer to the equator or at a higher elevation.
· Having more than
50 ordinary moles on the body.
· A family history
stress adversely affects the body by weakening the immune system, straining the heart and damaging memory cells in the brain. Another variable that can cause confusion is that no two people are the same. So stress that’s acute, and potentially beneficial, to some might be overwhelming and harmful to others. The complicated dynamic between human beings and stress becomes even more complex when considering the potential relationship between stress and cancer, one of the leading causes of death across the globe. Because stress is so often linked to negative health outcomes like heart disease and stroke, it seems natural to assume it’s also connected to cancer. However, it’s not that simple.
Does stress cause cancer?
of melanoma.
· The presence of a
weakened immune system from disease or medication.
The National Cancer Insti Institute reports that the evidence that stress can cause cancer is weak. In addition, the results of various studies into the potenpoten betial relationship be tween stress and cancer have differed, making it unlikely that medical professionals will definitively declare that stress causes cancer any time soon. The NCI notes that some studies have linked various psychological factors with an increased
Individuals concerned about melanoma can get to know their skin and learn about their family history so they’re more aware of any abnormalities and risk factors.
Better Conversations Start with Better Hearing!
Mental Health | Addiction | Crisis
May is Better Hearing & Speech Month!
Get Well. We Can Help. Call today: 413-BHN-WORK (413-246-9675) 24-Hour Crisis Line: 413-733-6661 Visit bhninc.org for more information
The Finest Hearing Care by Doctors of Audiology —— SINCE 1984 ——
Enjoy a rewarding career with great benefits and professional growth opportunities at BHN! View all openings and apply at bhnworks.org
200 North Main St. North Building, Suite 103 East Longmeadow, MA 3166849-01
Susan Bankoski Chunyk, Au.D. Doctor of Audiology
413-525-7979 hampdenhearing.com info@hampdenhearing.com
Jennifer Lundgren Garcia, Au.D. Doctor of Audiology
risk for cancer, while other studies have denied that link.
So are stress and cancer unrelated? When examining the relationship between stress and cancer, perhaps it’s best to avoid absolutes. For instance, the NCI notes that stress can lead some people to engage in unhealthy behaviors, such as excessive alcohol consumption, that have long been identified as increasing a person’s risk for cancer. This doesn’t mean stress causes cancer, but rather that an individual’s response to stress could very likely lead to cancer. In such instances, avoiding unhealthy responses to stress, such as drinking, smoking or overeating, could help people avoid cancer. That’s especially likely if they replace these unhealthy responses to stress with more beneficial alternatives, such as exercise, a healthy diet and activities that allow people to escape the source of their stress.
What about stress and current cancer patients? The NCI notes that individuals who respond to a cancer diagnosis and subsequent treatment by engaging in risky behaviors such as smoking and drinking alcohol may have a poorer quality of life after treatment. In addition, the NCI reports that experimental studies have found that mice bearing human tumors that were exposed to stressful situations, such as confinement and isolation, were more likely to have those tumors metastasize than mice that were not exposed to such stressors. This highlights not only the link between stress and cancer, but also the importance of a strong support network for cancer patients. Stress is a complex condition, so it’s no surprise that the relationship between stress and cancer is complex as well. Individuals concerned about their stress levels can consult with their physicians about healthy ways to manage and reduce stress.
SUNDAY, MAY 22, 2022 | D3
%%SATFOL-%%3MONTH%%2DATE
THE REPUBLICAN | MASSLIVE.COM
Nick’s
Inspiring Story: Two tumors, two cancers, and the specialized teamwork that saved his life. Above: Nick Pignatelli and his wife Maryellen are grateful for the care their family received at Baystate Health. (PHOTO COURTESY OF BAYSTATE HEALTH)
Nick Pignatelli, 66, was enjoying his active lifestyle in Lenox, playing tennis every day alongside his painting contracting business. BY PAT GAGNON
Special To The Republican
The change in his health was sudden. He told his wife Maryellen that he was feeling extremely ill, and they went to Berkshire Medical Center in Pittsfield. Tests showed that Pignatelli had two large tumors, one in his small intestine and the other in his colon. He was bleeding in his gastrointestinal (digestive) tract. His doctors sent him to receive life-saving care at Baystate Medical Center. “When Nick was admitted he needed immediate surgery,” said Dr. Nicolas Jabbour, chair of the Department of Surgery at Baystate Medical Center. “His case was complex because there were two tumors representing two separate cancers, in two different areas, and they were bleeding.” Doctors needed a plan to surgically treat both tumors – that plan was a Whipple procedure involving two doctors. Dr. Jabbour would remove the tumor from the small intestine and reconnect organs to allow Pignatelli to digest food normally, and colorectal surgeon Dr. Ziad Kutayli would perform bowel surgery to remove the tumor from the colon and complete a colon resection with a temporary ileostomy, which is a surgical opening in the abdominal wall to release stool. “We did both of these major surgeries at the same time,”
Dr. Kutayli said. Due to the bleeding, Pignatelli was experiencing prior to surgery and the complexity of the operation, caregivers needed to prepare for every contingency and critical team members needed to be mobilized. Baystate Medical Center has specialists in-house who were able to orchestrate Pignatelli’s complex care, including specialists in cancer surgery, colon and rectal surgery, gastroenterology, pathology to study the tumors, radiology to provide a map of all the major blood vessels around the tumors, and anesthesia to safely manage his breathing and heart rate during his nine-hour surgery. After surgery, Pignatelli relied on specialized nurses to care for his ileostomy. Dedicated enterostomal therapy nurses, an RN with specialized training in treating patients with ostomies, were there to teach him how to care for the ileostomy. Pignatelli was able to start his chemotherapy quickly after the operation, allowing for the best outcome. He received chemotherapy and care under the direction of medical oncologist Dr. Armen Asik from the Baystate Regional Cancer Program at the D’Amour Center for Cancer Care, in order to increase his chances of a cure. After his course of treatment, he returned to Baystate Medical Center for his final procedure to close the ileostomy. “Because of the number of tumors and where they were located, we asked Nick about his family history of cancer,” Dr. Kutayli said. Genetic tests conducted in the hospital’s Pathology Department confirmed that Pignatelli had Lynch syndrome, a genetic predisposition causing a higher risk of certain types of cancer. “With this identified, his family can now have genetic testing to find out
if they have Lynch syndrome and need proactive, preventive testing to catch and treat cancers at their earliest stage,” Dr. Kutayli said. Pignatelli will continue to follow-up with his doctors for screening of Lynch related cancers. His surgery was successful. Doctors determined that there were no cancer cells in the margins, which meant no cancer cells at the outer edge of the tissue removed. They expect him to return to the quality of life he once enjoyed before his illness, and he will continue to receive preventative testing. As for the care he received at Baystate Medical Center, Pignatelli said, “I couldn’t have gotten better care. They saved my life. Dr. Jabbour, Dr. Kutayli, Dr. Asik, the nurses, everyone – they are true experts and they showed such compassion.” Pignatelli said of Dr. Jabbour, “I think he is a genius. When I came to Baystate for treatment with another provider, he would make sure he saw me when I was here. He calmed me with his demeanor. He told me step by step what was going to happen and how I was going to feel and that was reassuring.” “Our care of Nick highlights our expertise in handling complex medical cases,” Dr. Kutayli said. “One of our strengths at Baystate is the comprehensive multidisciplinary care we provide. We have a whole system in place for communication among surgeons, pathologists, oncologists, and radiologists, and we are able to deliver this high level of care every day to people who need it in our community.” Surgeons at Baystate use the latest minimally invasive procedures and robot-assisted techniques, and offer a wide range of both general and specialty surgical care.
Learn More At: BaystateHealth.org/ Services/Surgery
“
HEARING YOU HAVE TWO CANCERS IS OVERWHELMING,
THEY GAVE ME CONFIDENCE
”
Nick,
Cancer Survivor from Lenox, MA
When his physicians discovered Nick was bleeding internally from two separate tumors in his colon and small intestine, they referred him to Baystate Medical Center for emergency surgery. “When I was in the ambulance on my way to Baystate, what was going through my mind was scary as heck,” he recalls.
orchestrated a plan to surgically treat both tumors at the same time. Not long after the complex procedure, he received chemotherapy to allow for the best outcome. “I couldn’t have gotten better care. They saved my life,” he says.
To watch Nick’s amazing story, go Identifying the need to take im- to BaystateHealth.org/Nick mediate action, Nick’s care team
D4 | SUNDAY, MAY 22, 2022
%%SATFOL-%%3MONTH%%2DATE
THE REPUBLICAN | MASSLIVE.COM
SUNDAY, AUGUST 28, 2022 10 AM to 4 PM
ONE MGM WAY, SPRINGFIELD, MA MGM ARIA BALLROOM - 2ND FLOOR
SENIORS ARE MORE ACTIVE THAN EVER BEFORE! BE A PART OF THIS FREE COMMUNITY EVENT FOR ACTIVE ADULTS, CAREGIVERS AND THEIR FAMILIES. THIS EXPO PROVIDES ACCESS TO THE FASTEST GROWING DEMOGRAPHIC IN WESTERN MASS!
TO RESERVE YOUR BOOTH OR TO DISCUSS SPONSORSHIP OPPORTUNITIES, CONTACT
STEVE FOX: SFOX@REPUB.COM OR 413.426.8625
Visit
PRIMELIFEEXPO.COM FOR MORE INFORMATION