Pink Purpose: The Battle Against Breast Cancer

Pink Friday, October 15, 2010

PURPOSE 2nd-leading

female cancer claims 40K annually Self-checks, mammograms considered key survival tools

BY CHRISSY ALSPAUGH z calspaugh@therepublic.com

T

HIS year, more than 260,000 new cases of breast cancer will be diagnosed in women across America, according to American Cancer Society.

Another nearly 2,000 American men will be diagnosed with the disease.

Combined, breast cancer is expected to claim the lives of an estimated 40,000 this year.

Medical officials insist early detection through monthly self-checks and annual mammograms, when appropriate, gives patients the best chance for survival.

Advancements with digital mammography, less invasive biopsy methods, new surgery options and more effective chemotherapy drugs are also helping fight the battle against breast cancer.

Breast cancer begins

the e l t t ba t s n i a g a t s a bre r e c can

Breast cancer is the most common cancer among American women after skin cancers, according to American Cancer Society.

The chance of developing invasive breast cancer at some point in a woman’s life is slightly less than one in eight, or about 12 percent, according to the society.

Cancer begins as one damaged, or mutated, cell.

That one cell has the potential to grow into an invasive tumor that can leave the area in which it began and travel to other parts of the body.

Deana Tuell, manager of Breast Health Center at Columbus Regional Hospital, said researchers have identified 15 different types of breast cancers, depending on the type of tissue in which the tumor begins its growth.

Breast cancers are named according to the part of the breast in which they develop.

For example, cancers beginning in the ducts are called ductal carcinomas, which comprise the largest number of cancers in women; cancers beginning in the lobules are called lobule carcinomas and account for a small percentage of cases.

Over time, the cancerous cells multiply and fill the duct or lobule.

In its earliest stage, breast cancer is confined to the layer of cells in which it began, called in situ carcinoma. This stage is called noninvasive, or preinvasive, according to American Cancer Society.

“That’s the kind of breast cancer you want, if you’re going to get it,” Tuell said.

The alternative is invasive, or infiltrating, carcinoma

that has grown beyond the layer of cells where it started.

Tuell said invasive breast cancer leaves the breast and most commonly enters the lymph nodes under the arm, allowing the cells to spread throughout the lymphatic or blood systems.

The more lymph nodes infiltrated by breast cancer cells, the more likely it is that the cancer might be found in other organs as well, according to American Cancer Society.

Watching the signs While the causes of breast cancer are not fully known, Tuell said, aging is the most significant factor that increases a woman’s risk.

For example, a 20-year-old woman has a one in 1,760 chance of developing breast cancer, but a 70year-old’s chances are one in 27, according to Susan G. Komen for the Cure.

Tuell said at CRH less than a fourth of women who are diagnosed are younger than 50. However, 46 percent of the center’s diagnoses are among women ages 60 to 70, she said.

Having a first-degree relative — mother, daughter or sister — who has had breast cancer is another important risk factor, Tuell said.

Women who are overweight are also at a higher risk of getting breast cancer.

According to Susan G. Komen for the Cure, some other risk factors include being exposed to large amounts of radiation, starting menopause after age 55, having the first child after age 35, postmenopausal hormone use and current or recent use of birth control pills.

American Cancer Society encourages women at age 20 with an average risk of developing breast cancer to begin monthly self-exams, a systematic, step-by-step approach to examining the look and feel of the breasts.

“Just make sure there’s nothing new,” Tuell said. “If you keep in touch with your body, you know when something is new, and you go to the doctor and see what it is.”

Tuell said men are taught to perform monthly exams for testicular cancer, and they also should include a monthly breast self-exam.

Women in their 20s and 30s also are urged to have a clinical breast exam by a professional as part of a regular health exam at least every three years, according

See CANCER on Page C12

Awareness month October is Breast Cancer Awareness Month, a time when the disease comes to the forefront through stories and events nationally.

For good reason.

Breast cancer is the most common cancer among women after skin cancer.

The Republic and sister papers Johnson County Daily Journal and Brown County Democrat partnered on a project to shed light on breast cancer for our readers.

For months, the newspapers have interviewed doctors, nurses and survivors to learn more about the disease, how it impacts people, how it is being fought and what the battle was like for survivors.

Within this special section is information gathered by the three papers that we hope you will find useful and inspirational.

Kirk Johannesen Special Projects Editor The Republic

z Women have about 12 percent chance of getting this disease z

OFFERING STABILITY In patients’ worst hours nurses offer help and hope See, C10

SURVIVORS’ STORIES Donna Hill, C3 Janie Gordon, C4 Joyce Adkins, C6 Lisa Klosterman, C7 Larry Shepherd, D1 Sherry Lucas, D5

Mary Taulman, D7 Bev Wilson, D8 Mary Speer, D8 Cheryl Fox, D9 Kim Fields, D10 Carolyn Purvis, D11

RESOURCES Doctor/Patients, C9 Hospitals, D3 Insurance, C8 Mammograms, D2 Nurses, C10 Purdue Research, C9 Self-Examination, D4 Support Groups D7 Surgeons, C11

WALKING FOR FUNDS North student raises $2,400 for Susan G. Komen Foundation See, D9

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PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

innovation fights breast cancer... period.

At Columbus Regional Hospital, we have a unique position on our breast cancer team. She’s called a Breast Health Navigator and she understands the physical and emotional roller coaster that breast cancer can be. She’s here every day helping her patients through those tough times, the good times, and actually through all the times.

Her personal approach along with our commitment to advanced technology like all digital mammography and breast MRI, plus national accreditation in breast ultrasound and mammography, gives patients at Columbus Regional Hospital’s Breast Health Center unmatched power in the fight against breast cancer.

The Breast Health Navigator once just an idea, now a living, breathing, helping innovation.

In support of Breast Cancer Awareness month, Columbus Regional Hospital has turned our Web site pink for a limited time. Check it out and learn more of what Innovation is up to at crh.org.

All women age 40 and older should have an annual screening mammogram - have you had yours this year?

Contact our Breast Health Center at 812-376-5064 to schedule - it’s critical in the fight against breast cancer.

© Columbus Regional Hospital

PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

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SURVIVOR STORY: Donna Hill

Just to see the snow

Diagnosis leads woman to approach journey with humor, hope

BY CHRIS SCHILLING cschilling@therepublic.com

D

ONNA Hill wanted to see the snow.

It was spring 1993, and she had just been diagnosed with breast cancer.

A suspicious lump had been growing in her right breast, driving her to get a mammogram. She knew something was wrong. A biopsy confirmed her suspicions.

Cancer brings with it a host of questions and decisions.

Hill, a Columbus resident who works as a systems analyst at Columbus Regional Hospital’s Tech Center, contemplated whether to have a total mastectomy, researched her options and spoke with friends in the medical field about what to do.

And among the thoughts of how to battle the cancerous growth, Hill contemplated her mortality.

She thought about her children and whether she would see her grandchildren grow up.

She wondered if she would live until Christmas.

“I remember that one of the things I was thinking about at that time, back in March and April when all this started, was, ‘Will I be here to see the snow?’” Hill said.

Positive attitude The thoughts felt extra heavy for Hill. She had seen her sister die in 1989 from breast cancer at age 49 after a three-year fight.

Biography AGE: 58 RESIDES: Columbus OCCUPATION: Systems analyst at Columbus Regional Hospital’s Tech Center.

DIAGNOSED: Late 1992.

IN REMISSION: Since December 1993.

FAMILY: Husband of 26 years, Randy Hill; daughter, Amy Abrell of North Vernon; two stepsons; six grandchildren.

Hill, who was 41 when diagnosed, learned from her sister’s experience that humor helped, especially those around her.

When her sister was smiling and laughing, so were her family members.

Hill approached her fight with cancer the same way.

Her daughter, Amy Abrell, of North Vernon, was 21 when her mother was diagnosed. The news upset her and made her scared. But her mom’s attitude helped.

“She always had the mentality that it wasn’t going to get her down, and she was going to beat it and be here for a long, long, long time to come,” Abrell said.

The death of her sister led Hill to detect her own cancer.

She became more self-aware, and she found the suspicious lump on her right side.

“

I remember that one of the things I was thinking about at that time, back in March and April when all this started, was, ‘Will I be here to see the snow?’

”

— Donna Hill

of her right breast, performed in March 1993. Six months of chemotherapy followed.

It was a difficult six months.

Hill relied on her Christian faith, and she relied on her family.

Faith, friends, family

ANDREW LAKER | THE REPUBLIC

Donna Hill, breast cancer survivor, opted for a total mastectomy in 1993.

A surgeon whom her family doctor referred her to said the lump didn’t feel unusual and suggested Hill wait six months before another mammogram.

Within a week, she was back for more tests. A biopsy came

back positive for cancer.

“You’re just so shocked at that point. Just the ‘C’ word gives you a shock,” she said.

“Your head is kind of spinning,” she said.

After researching her

options, she contacted the surgeon the next day and said she wanted a bone scan and a chest X-ray to make sure the cancer had not spread elsewhere.

After all the tests, she opted for a total mastectomy

The cancer had forced her to put everything in perspective, and determination pulled her through the months of chemotherapy.

Little things began to bother her. She has small veins, making it difficult to put IVs into her arm. Even the smell of the oncologist’s office began to irk her.

“Everything becomes an awareness for you,” Hill said.

She remembers sitting on the porch one day with her husband, Randy, about an hour before she was supposed to go to a chemotherapy session. She was crying and didn’t want to go.

Her husband told her she didn’t have to go and left her alone to think it through. After praying and looking for answers, Hill went and found her husband and asked him to take her to the treatment.

Randy was her rock. He was there “every step of the way” and never wavered, she said.

Family members can become more upset in the fight against cancer than the patients, Hill said.

“They don’t want to lose you any more than you want to lose

See HILL on Page C8

Breast cancer incidence and death rates generally increase with age

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SURVIVOR STORY: Janie Gordon Gordon enjoying life after cancer

BY PAUL MINNIS pminnis@therepublic.com

J

ANIE Gordon never will be “normal” again, as she once understood the word before she was stricken with breast cancer.

She has a harder time concentrating. Her long, dark hair — once her pride and joy — grew back in a salt-andpepper shade. Chemotherapy rushed her body into menopause.

There also have been good changes: She doesn’t sweat the small stuff anymore. She is a better wife, mother, friend and Christian.

“Cancer is one of the best things that ever happened to me,” Gordon said, although she prays that it never comes back.

Diagnosis Gordon, choir director at Columbus North High School, was diagnosed with breast cancer in June 2009, when doctors discovered a mass during routine mammography.

She was baking cookies when she received a phone call with news that the mass was malignant.

“Your whole world changes with one phone call,” she said.

“I don’t remember anything else said.”

Gordon said she hugged her son, who was in the room with her, and called her husband, who stood by her side and kept her positive.

She had the cancerous mass removed in July and has undergone chemotherapy and radiation and remains on medication.

Biography Age: 51 Resides: Grandview Lake Occupation: Choir director at Columbus North High School.

Diagnosed: June 2009 Tumor removed: July 2009 Family: Husband, Mark (married 26 years); adult children, Amy and Chris.

Chemotherapy was a wake-up call. Gordon said she figured it might make her sick enough to miss an occasional day of school, but she would be back the next day stronger than ever.

Instead, she was hospitalized three times after just the first chemotherapy session. It caused rashes and a fever, and doctors never found the cause.

“I took a 12-week leave of absence (from school),” she said.

Gordon still is humbled by the outpouring of affection from students, friends, her church and many others who helped her on the hard road to recovery.

During chemotherapy, people delivered meals to her home, though Gordon sometimes was too sick to eat.

Many acquaintances called her, especially after they saw in The Republic that she was sick. Though she appreciated the calls, Gordon said she had too much going on personally to update everyone.

That’s when she created a

blog at caringbridge.org that enabled her to update her condition for all of her friends to see.

Since then she has printed the site’s journal and guest book, which together are about the thickness of a dictionary.

Its size serves as a reminder to Gordon about how much the people in her life care about her condition and now her recovery.

Scary times Breast cancer created some tough nights. Gordon, who is married, said she often had a hard time sleeping. After falling asleep, she would wake up and think for a moment that everything was OK. Then she would remember the cancer.

“There’s this weight that comes over you when that happens,” she said. “You don’t believe it.”

Gordon said she and her husband have been enjoying life since she became cancer-free.

Two weeks after her surgery, they went on a cruise to the Caribbean, where they snorkeled, among other things. She said they now are planning a trip to New York City, where they will see Broadway shows.

On Oct. 9, she modeled two outfits for a pink-ribbon fashion show at the Marriott in Indianapolis.

It’s all about enjoying life now, at least when she’s not responding to the bell between classes at Columbus North and teaching choir classes.

Right: Columbus North choir director Janie Gordon conducts the singing of the national anthem before kickoff of the varsity homecoming football game.

“Before, I was a detail-oriented planner, a perfectionist and a control freak,” she said, adding she would “stress out” if things didn’t go just as she wanted. Now, life is different.

She doesn’t book every hour anymore, which leaves time to accept friends’ spurof-the-moment invitations to dinner, for example.

“I just want to be in the moment,” Gordon said. “Tomorrow is a new day.”

ANDREW LAKER | THE REPUBLIC

Breast cancer is the most common cancer among women after skin cancers

PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

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SURVIVOR STORY: Joyce Adkins

Cancer strengthens sisters’ bonds

BY BRENDA SHOWALTER

J

bshowalter@therepublic.com

OYCE Adkins had plenty of family support when she was diagnosed with breast cancer in December 2008. Four of her sisters and an aunt also went through the same battle.

The Columbus resident grew up in Jenkins, Ky., with her large family that included nine sisters and six brothers. Their father worked in the coal mines, and their mother stayed home to care for the children.

Cancer has been an unwelcome intrusion on the close family, who shared each other’s grief when diagnosed, were there during treatments and rejoiced when the cancer was declared in remission.

Adkins, 69, remembers when her hair started falling out due to chemotherapy treatments, and she sat in her garage crying while her daughter, Regina Henson, shaved her head.

“I cried the whole time,” she said. “That was worse than losing my breast.”

The women, who share a close bond that stretches beyond sisterhood, also can laugh about some of the trials of surviving breast cancer.

“My head was as slick as that table,” Adkins said, grinning at the memory.

The sisters sometimes wonder if the small Kentucky town where they were born and grew up had anything to do with the unusually high incidence of cancer in their family. They think about their father’s many years working in the coal mines and if that somehow was connected.

They also consider that cancer might simply be in the family genes. Other family members have had cancer, including a nephew who had colon cancer and a brother who had skin cancer.

are the best people you’ll ever meet — every one of them. And they’re the stron“They gest family I’ve ever seen. ”

— Regina Henson

Family strength Four of the 10 sisters gathered in Columbus this spring at Adkins’ house, where they talked about the support they provide each other and how cancer taught them they are stronger than they ever imagined.

They laughed and enjoyed each other’s company, got caught up on family happenings and enjoyed a big breakfast with homemade sausage gravy, biscuits and jelly.

“They are the best people you’ll ever meet — every one of them,” said Henson. “And they’re the strongest family I’ve ever seen.”

Adkins had one of her breasts removed, as did sisters Lavada Wright, Dorothy Hall, Louise Vance and Belva Mullins.

“The doctor called me on the phone on a Friday and told me it was cancer,” Adkins remembered. “He wanted to take my breast off the next Thursday.”

At first, Adkins was numb by the diagnosis and hasty schedule, but after the gravity of the situation sunk in, she was ready for the mastectomy.

“I waited three weeks. If it has to come off, I wanted it out,” Adkins said. “I didn’t want it to stay in there growing.”

Mullins, 59, who lives in Jenkins, had the most difficult and extensive cancer treatment of the sisters.

“I had 26 radiation treatments, eight of the

ANDREW LAKER | THE REPUBLIC

Sisters Joyce Adkins, left, Lavada Wright, Alice Lockwood and Belva Mullins pose for a photo outside Adkins’ home in Columbus this spring.

Lockwood is the only one of the group who has not had breast cancer. Two more sisters also have battled the disease. bad chemo and 38 more chemo treatments,” Mullins said. “They took out 12 lymph nodes, and cancer was in eight of them.”

Mullins is thankful that she feels good today and survived the ordeal, which sent her on emotional highs and lows.

When she was diagnosed, she did not have health insurance, and she discovered that one of the medications she needed to take would cost more than $400 a month.

“I went into a fit,” she said, smiling. “That’s the one time I really cried.”

Mullins is thankful, however, that the doctor gave her medicine samples, and she found an advertisement from pharmaceutical company AstraZenica that stated it would offer help to people who couldn’t afford their medicine.

“It’s true,” Mullins said about the company’s commercials she has seen numerous times on TV. “I never had to pay a dime for those pills.”

With gratitude The sisters are thankful they have come through the dark days of cancer, even though

they know the risk exists that the disease could return.

Mullins said doctors tell her she has about an 80 percent chance of remaining cancer-free.

“You can’t give up,” she said. “You can never give up.”

Wright said the family’s experience also taught them to be strong advocates of mammograms. They especially make sure the women in their family keep up to date on the diagnostic test.

One of the sisters, Alice Lockwood, once had a scare when a mammogram showed a lump, but it turned out to be benign.

Adkins said she always wondered how she would handle cancer if it ever happened to her.

Having a strong family support system, including her husband, Ervin, made a big difference, but Adkins said having faith that God would take care of her was equally important.

She said she was frightened at first, but after attending her church, Divine Vision, in Columbus one evening, she felt better after fellow church members offered their support and prayers.

“I had the most peaceful feeling after that,” Adkins said.

“We could have cried and screamed and throwed fits and turned our backs on the Lord, but I wouldn’t have done that for the world. We need him now worse than we ever did.”

Adkins believes God was with her through her ordeal and remains at her side, giving her strength.

“I feel like he healed me,” she said.

Biography AGE: 69.

HOMETOWN: Jenkins, Ky. Current residence, Columbus.

HUSBAND: Ervin.

PASSIONS: Spending time with her family and singing at her church, Divine Vision.

FUNDRAISER: Adkins made a CD of inspirational songs that she sells to raise money for breast cancer research.

Pink idea began in early ’90s: N

BY BRENDA SHOWALTER bshowalter@therepublic.com

e h t tle t st a b ain t ag reas er b nc ca

Regina Henson has worn her pink breast cancer awareness bracelet so much that she laughs that it’s nearly worn out.

Henson bought the bracelet when her mother, Joyce Adkins of Columbus, was undergoing treatment for breast cancer in 2009.

She found comfort in wearing the bracelet while she and her mother went through the difficult time.

The Seymour resident also has shirts, necklaces, a purse, socks and other items that are pink or are decorated with pink ribbons. She even writes with a pinkcolored pen.

“It just makes me feel good, and it makes me think of my mom and my aunts,” Henson said.

Breast cancer has struck several members of Henson’s family, including four aunts, who grew up together in a small, coal-mining town in Kentucky.

While pink has become Henson’s color of choice, she also prefers when a portion of the sales price goes to breast cancer research and awareness efforts.

“I pay attention to that,” she said. “If I’m going to buy the pink things, I would rather the money go to research.”

Pink beginnings Pink ribbons have been used to promote breast cancer awareness since the early 1990s.

Susan G. Komen Foundation handed them out during a race in New York City for breast cancer survivors, and Self magazine used them as part of its October Breast Cancer Awareness issue.

However, various Web sites, including Thinkbeforeyoupink.org, and American Cancer Society, state that the evolution of the pink ribbon had a bit of a rocky start.

Self and the Estee Lauder cosmetics company used

pink ribbons as p ter they were not a woman using peac awareness.

The woman, C business executive the ideas was too c Haley wanted t the money donated vention.

Ribbons of vario became very popu yellow ribbon to w and soldiers return Over time, pink come internationa and their use explo cer Awareness Mo People can buy and luggage to yog

Consumer caut

Those who wan should pay attenti said Karen Vando American Cancer “We encourage cause to make sur cancer research,” informed and dilig Vandoski sugge Bureau about com make donations.

Wendy Noe, gra Indianapolis affili said Yoplait yogur send in Yoplait lid Komen.

ATTLE

AGAINST BREAST CANCER

T H E R E P U B L I C , C O L U M B U S , I N D ., F R I D A Y , O C T O B E R 15, 2010

SURVIVOR STORY: Lisa Klosterman

Support, busy schedule, faith best medicine for Klosterman

S

BY BRENDA SHOWALTER bshowalter@therepublic.com

EYMOUR — Lisa Klosterman sees the world from a different perspective after being diagnosed with breast cancer and undergoing a double mastectomy.

She appreciates her life, her family, friends, co-workers and church — all the things that helped her get through the ordeal that began with her diagnosis in May 2009.

Klosterman, a Seymour resident, continued in her job as a staff accountant at Blue & Co. in Columbus.

She also spent evenings as a cheerleading coach at Trinity Lutheran High School — even during spring tax season, her busiest time of year.

“When you’ve got something like this going on, the more you can keep your mind occupied on fun, positive things, the better you feel,” she said. “So that’s what I tried to do.”

Klosterman became very appreciative of everyone who provided support. She was inspired to see the good in so many people.

“It’s amazing how people came to my aid, whether it was a phone call, a card, a small gift or just inquiring about me,” she said.

Knowing people were keeping her in their thoughts and prayers meant the world to her.

“It was probably the most eye-opening part of this whole experience for me — to see the care and concern that’s out there,” she said. “It was an amazing thing.”

‘Inevitable’ In the back of her mind, Klosterman, 49, thought she would develop cancer someday because of a strong family history of cancer, which included leukemia and cancer of the liver, lungs and ovaries.

“It wasn’t if, it was when it would hit me,” she said. “I just didn’t know it would be breast cancer.”

Once she received her diagnosis, her first reaction was anger.

“I was livid,” she recalled. “I had gone for a mammogram every year, from the time I was 40.”

She missed her mammogram in 2008, but when she had one in 2009, the doctors found a mass.

“They told me it had been there five or six years. The screening mammogram did not pick it up,” she said.

Klosterman advises women having mammograms to make sure they get a digital test. And if women are told they have extremely dense breast tissue, she said, they might inquire about other types of tests, such as ultrasounds or MRIs. Klosterman said different women have different types of breast tissue, and she believes they should not have the same types of tests.

“I would just hope as things continue to

JOEL PHILIPPSEN | THE REPUBLIC

Lisa Klosterman instructs cheerleaders as they practice a routine at Trinity Lutheran High School. change,” she said, “that insurance companies would be more receptive to allow women, who have a certain criteria, to have the tests that are more suited to them as an individual.”

Staying positive Klosterman’s husband, Mark, said watching his wife go through such a difficult time was tough, but he was impressed with her strength and called her “one tough gal.”

“You don’t realize what something like this is like until it hits home,” he said.

He was appreciative of all the support provided to his wife, including from Trinity Lutheran students and staff and the couple’s church, St. John Sauers.

People pitched in to prepare meals, offer encouragement and be there for Klosterman when she was going through treatments.

“We have been blessed,” Mark said.

Klosterman said having the support of her husband and children — Kyle, 21; Kraig, 19; and Kyra, 16 — was important to her and helped her get through the most difficult days.

One of her biggest supporters was her

twin sister, Laurie Barber.

“Laurie was there for me every step of the way, taking me to doctor visits, treatments, surgeries, etc.,” Klosterman said.

She also learned how important it was for her to try to stay positive.

“Your mind plays such a big part in how you function each day,” she said.

“If you’re not careful and you let it get away from you, it can make for a real miserable time. That’s when having your support people around helps.”

Klosterman said she had a few “poor me days,” but she realized she couldn’t have too many in a row. She also feels fortunate that, overall, she came through her cancer treatments well.

Klosterman said she was never overly sick, although she had some fatigue, headaches and joint pain.

“I am an extremely lucky person,” she said. “They have come so far in how they treat breast cancer. Nothing really kept me down.”

Klosterman took two weeks off for her surgery but was able to schedule her radiation treatments in the mornings so she could

go to work in the afternoons.

She learned many life lessons from having cancer, including that she has an inner strength — perhaps more than she realized.

But she also discovered she couldn’t do it on her own, and she offers this advice to others going through a similar circumstance: “Surround yourself with positive people.

When you are feeling down, they’re there to pick you up and tell you that it’s OK, and it’s going to be all right.”

She also counted on her faith.

“God didn’t do this to me,” she said. “He helped me through this.”

Biography AGE: 49.

HOMETOWN: Seymour.

FAMILY: Husband, Mark; children, Kyle, 21; Kraig, 19; and Kyra, 16; five sisters: two brothers.

EMPLOYMENT: Staff accountant at Blue & Co. in Columbus.

Now concept an international symbol

part of their marketing, but only afable to come to an agreement with a ch-colored ribbons for breast cancer

Charlotte Haley, reportedly told the es that she thought their plan to merge commercial. to make the point that not enough of d was being budgeted for cancer pre-

ous colors promoting different causes ular during the 1990s, including the welcome home hostages held in Iran ning from tours of duty. k ribbons and the color pink have bel symbols of breast cancer awareness, odes each October during Breast Canonth. all types of pink items from blenders gurt, pens, M&Ms and cans of soup.

tion

nt to support breast cancer research ion to information on pink products, oski, media relations specialist for Society in Indiana. e donors who want to donate to the re their donations are going to breast she said. “We encourage people to be gent on where their money is going.” ests checking with Better Business mpanies selling pink items claiming to

ant and education coordinator of the ate of Susan G. Komen Foundation, rt has a program where people who ds are helping provide a donation to

Pink ribbon history z 1979 — Penney Laingen, wife of a hostage who

had been taken in Iran, was inspired by a song to tie yellow ribbons around the trees in her front yard. z Early 1990s — A woman named Charlotte Haley began making peach-colored ribbons and attaching them to cards to raise awareness for her daughter, grandmother and sister, who all had been diagnosed with breast cancer. z 1991 — Evelyn Lauder of Estee Lauder Corp. and Alexandra Penney of Self magazine were putting together a special insert for the magazine to recognize Breast Cancer Awareness Month and wanted to use Haley’s ribbon idea. Without her consent to use the peach ribbons, they chose pink ribbons instead. z Mid-1990s — American Cancer Society adopted the pink ribbon as its symbol for breast cancer. It was officially used across the board in 2002-2003.

Source: American Cancer Society “That money definitely goes back to Komen,” she said.

Noe also believes that just having pink as a symbol of breast cancer awareness is good.

“It’s a wonderful way to keep up awareness and to realize we are still fighting,” she said. “Every person has been touched by breast cancer in some way.”

Noe figures if someone is going to buy a product anyway, why not buy one that provides a donation to the cause.

People who want to make a direct donation to Komen or American Cancer Society can do that, Noe said, but small, everyday donations — such as the ones yogurt lids provide — also are important.

JOE HARPRING | THE REPUBLIC

Far Left: Regina Henson, left, and her mother, Joyce Adkins are not above collecting most anything pink in battling breast cancer and educating the public. Thinking pink is personal for both of them: Adkins has battled breast cancer, as have four of her sisters.

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Chances of cancer locally same as statewide

BY KIRK JOHANNESEN johannesen@therepublic.com Breast cancer rates for Bartholomew County’s population are essentially the same as each of the state’s other 91 counties, according to Indiana State Department of Health officials.

The county had 106.4 breast cancer cases per 100,000 women from 2003 to 2007, the most recent year of data available.

And the county had 26.4 deaths per 100,000 women.

Statewide, there were 115.1 cases and 24.7 deaths per 100,000.

“There’s nothing to suggest differences between counties in Indiana with breast cancer. They’re pretty much the same,” said Pramod Dwivedi, ISDH’s chronic diseases immunology director.

ISDH looks at county level data, but sometimes there are too few cases in a county to make a good judgment if a significant difference exists, said Dr. Meenakshi Garg, medical director for the division of chronic disease and prevention control.

Decatur (94.1) and Jennings (89.1) counties had the lowest incidence rates in the area, but also didn’t have enough cases to determine whether the rates were stable.

More male cases According to Indiana State Cancer Registry, Bartholomew County had 490 breast cancer cases from 1998 to 2007, seven

of which were men.

The county also had 115 deaths related to breast cancer in that period, all women.

The incidence and mortality rates for Bartholomew County were similar to the state figures and those of Decatur, Jackson and Jennings counties.

However, the cancer registry showed Bartholomew County had a higher incidence rate of male breast cancer than the state or neighboring counties from 1998 to 2007.

Bartholomew County averaged 1.45 male breast cancer cases for every 100 females, while the state average was 0.75. Decatur County averaged 0.67, Jackson County 0.35 and Jennings County had zero male breast cancer cases compared to 153 female.

However, ISDH’s Epidemiology Resource Center said the small number of male breast cancer cases in and around Bartholomew County makes the rates unstable and doesn’t allow for definitive conclusions to be drawn.

The Epidemiology Resource Center said no statistically significant difference exists between Bartholomew County and the rest of the counties in the state, and there appears to be no increased risk of breast cancer in males due to living in Bartholomew County.

The most common age for breast cancer in Bartholomew County women from 1998 to 2007 was age 55 to 59, with 69

Insurance coverage

amount of deductible, limits on amounts paid for surgery, chemo, radiation therapy and Insurance professionals and breast cancer reconstructive surgery. experts said that though coverage for breast z Premiums should be kept current. Do not cancer varies depending on one’s plan, generally allow insurance to lapse due to lack of payment. plans cover at least: z Family Medical Leave Act requires insurance MAMMOGRAM: One between ages 36 and 40. coverage be offered to cancer patients or those One annually after 40. with a history of cancer on the same terms as TREATMENT: Could include chemotherapy, other employees. State laws also protect cancer radiation, surgery. Medicare, for example, covers patients. Seek help if you believe you are facing everything that is medically necessary. discrimination due to your medical issues.

COVERAGE: Typically 80-20, but plans can vary. z Patients who consider experimental/ TIPS: research medications should check regarding z Patients should inform their insurance cost coverage. Most insurance companies do not company of their condition and ask for cover experimental drugs. Patients also should guidelines for filing claims or making payments ensure that their drug has been approved for on claims. their type of cancer — otherwise a check for “off z Patients should ask regarding the need label” use should be done to ensure coverage. and procedure for pre-approval of hospital — Sources: Columbus Regional Hospital admissions, guidelines for second opinions, Breast Health Center, Medicare

Incidence and mortality rates Breast cancer incidence and mortality rates per 100,000 people for 2003-2007: Incidence rate Mortality rate Bartholomew County 106.4 26.4 Decatur County 94.1 23.6* Jackson County 112.5 23.7 Jennings County 89.1 16.9*

ana,” Garg said.

National rates might be higher than state rates, so the goal is to reduce Indiana’s rates.

Early detection is among the areas of focus of Indiana Cancer Consortium. Its strategic plan, called Indiana Cancer Control Plan, focuses on all cancers.

The plan suggests for primary prevention: z Tobacco cessation and prevention. z Eating healthier foods. z More physical activity. zMaintaining healthy weight or losing weight. z Sun safety. z Encouragement of breastfeeding, which has been found to reduce risk of cancer for

Source: Indiana State Department of Health The Republic graphic by Hollie Tekulve

ISDH collects cancer statistics from hospitals, ambulatory clinics and outpatient clinics, said Bridget Strong, director of the cancer registry.

The state monitors trends, Garg said.

There have been no state-

wide trends for increases or decreases in breast cancer incidence rates from 1995 to 2007.

However, there is a decreasing trend of breast cancer-related deaths from 1995 to 2007.

The mortality rate was 29 per 100,000 women from 1995 to 1999 but fell to 24.7 per 100,000 women from 2003 to 2007.

Early detection efforts, such as screenings, have factored into improved outcomes for breast cancer cases, Garg said. When reviewing incidence and mortality rates and setting goals and policies, he said, the state’s goal is not simply to be lower than the median rate.

“Our goal is to do whatever we can … to try not to add to the burden of cancer in Indi-

chemotherapy treatments, a woman approached her and asked if she was OK. Hill told the woman she was fine but that she had cancer. The woman said she would pray for her.

Her doctors, nurses and medical staff became more than just people providing a

service. They were healers and became friends.

After her last appointment with her oncologist, Hill felt as if she had cleared a major hurdle. She feels God put her through the experience for a reason, to help others understand how to go through the process of dealing with breast

cancer.

Hill has become an advocate for breast cancer awareness, offering advice and guidance to those who call on her.

Hill has been cancer-free since the end of 1993.

Reflecting in her living room 17 years later, she recalls the early days in her

fight and how just making it to Christmas felt so important to her.

“That’s kind of an unusual thing to think about, but that is one of the things I thought about: I want to see it snow this year,” she said.

“And that year it did. It was an awesome thing.”

women diagnosed. Age 70 to 74 was second with 61. The bulk of the cases — 71 percent — were between ages 45 and 74.

The number of breast cancer-related deaths among Bartholomew County women generally increased with age: 16 from ages 40 to 49, 19 from 50 to 59, 25 from 60 to 69, 20 from 70 to 79 and 33 age 80 and older.

Mortality rates falling

Johnson County 113.5 25.3 Indiana 115.1 24.7 * Unstable due to the small number of breast cancerassociated deaths that occurred.

mother and baby. z Immunizations. z Healthy sexual behavior.

An early detection goal in the plan is to increase the percentage of women age 40 and older who receive annual breast cancer screenings, from 62 percent to 67 percent by 2014.

HILL

Continued from Page C3 them,” she said. “You have things that you have to do to keep going; they have to watch you go through it. That’s hard.”

Randy said he felt like “someone dipped me in hot oil” when he found out his wife was diagnosed with cancer. He felt devastated inside but had

to stay strong for her.

Hill realized the love of God and the love of her family and friends. It strengthened her faith.

Awareness advocate While walking through the grocery store one day after losing her hair from the

e for breast canc er in Bartholomew Co. women from 1998-2007 was 55 to 59

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Medicine of compassion

C9

Oncology specialists say sensitivity key to patient care

BY BRIAN BLAIR bblair@therepublic.com When Dr. Rahul Dewan began practicing radiation oncology 22 years ago, breast cancer patients sometimes were treated more like mere medical cases than people who were hurting by some physicians, as he recalls.

“It was like, ‘You need this removed; then, let’s move on.’ It was practical and expedient.

RAHUL DEWAN And women often suffered in silence.”

Thank goodness times have changed, according to Col u m b u s Regional MICHAEL MAK Hospital’s D ewa n .

He figures the compassion he brings to each patient is as important as his technical knowledge and skill.

“The breast has emotional attachment, unlike, for instance, an appendix or a lens

tell people to prepare for changes, because science keeps “ We coming up with new answers. We tell people not to feel bad if they hear something contradictory from multiple sources. ” — Dr. Michael Mak

A growing number of chemotherapy treatment options keeps patients and doctors on their toes.

“We tell people to prepare for changes,” said Mak, “because science keeps coming up with new answers. We tell people not to feel bad if they hear something contradictory from

multiple sources.”

Mak said his initial talks with patients must be spread over two visits, sometimes an hour each because of the sheer volume of information to review.

“I think that, at first, sometimes people expect a cut-anddried recipe,” he said.

A patient’s emotional support system can become as important as any treatment, according to Mak. “When people first come in, one of the best prognostic signs is that they don’t come here alone,” he said. “Even for younger women, if there’s not someone like a partner around, they can be at a great disadvantage.

“I often will try to gently inquire if there is someone around to help them.”

He is bothered by sensationalistic breast cancer data online that confuses many patients. For example, he said a multitude of patient advocate groups have their own agendas.

Plus, he said pharmaceutical companies will often help

develop awareness campaigns to push regulators to accelerate approvals for new drugs.

Desperate, well-meaning, individuals will start blogs when they develop strong opinions.

“All this makes the Internet medium buzz with lots of loose and poorly vetted data,” said Mak. “It helps to raise funds, obviously, and it helps to keep awareness going, but it does not help actual sick people.”

Mak regularly offers a simple suggestion to patients who might be confused by dozens of studies and even more treatment possibilities.

“If you don’t yet want to ask me what to do, you can ask me where to look (for reliable, impartial information),” he said.

One positive element of breast cancer treatment is that patients generally have time to consider and research their choices without feeling there is an emergency.

“I know that cancer is a scary word, but there is no need for rushed, poorly-informed decisions. Patients need to be comfortable with their choices.”

Dr. Michael Mak pages through patient charts inside the CRH Cancer Center.

looking at is how the disease and prevention are related to women’s heritage and environment,” said Sophie Lelièvre, associate professor of basic medical sciences, who also is leader of Breast Cancer Discovery Group at Purdue Center for Cancer Research.

“Better understanding how these factors affect the disease’s gene expression, also known as epigenetics, will put us closer to understanding why breast cancer cases are rising at different rates throughout the world. Of particular concern is the rapid rise in low- and middle-income

countries where aggressive forms of the disease are seen in young women.”

The International Breast Cancer and Nutrition Project, which is partnering with World Health Organization and International Agency for Research on Cancer, will begin by focusing on the

United States, France, Japan, Ghana, Uruguay, Lebanon and Canada.

Developing countries also are reporting more breast cancer cases than ever, Lelièvre said.

“We believe these increases are sincere and not solely the result of improved screening

(of the eye), both for the individual and their significant other,” said Dewan. “And because of that, it has to be approached with a mind-set that will handle the person’s emotional and physiological state.”

Radiation treatment for breast cancer patients generally lasts six to seven weeks, said Dewan.

“We understand that’s no small deal,” he said.

Dewan and Dr. Michael Mak, a medical oncologist who administers chemotherapy, say the Internet often feeds patients as many questions as answers.

“The field has become so convoluted that you cannot just sit down and answer ‘yes’ and ‘no’ to questions,” said Dewan.

‘Prepare for changes’

JOEL PHILIPPSEN | THE REPUBLIC

Team launches international breast cancer project WIRE REPORTS WEST LAFAYETTE — A team led by Purdue University researchers is kicking off a 20year, multi-nation study to learn more about the role diet plays in women developing breast cancer.

“What we are specifically

and detection, or even a country’s improved ability to report such statistics,” Lelièvre said.

“Experts believe we are on the verge of an international breast cancer epidemic, and the World Health Organization labeled cancer prevention an urgent priority.”

National Cancer Information Center, division of American Cancer Society, 800-227-2345

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In patients’ worst hours ...

BY BORIS LADWIG bladwig@therepublic.com When patients get one of the worst kinds of news — “You have cancer” — nurses Tammy Creech, Beth Staker and Deana Tuell help them cope.

They provide information, a hand to hold, a shoulder to catch the patients’ tears.

And they offer hope.

Their hope stems from the knowledge that most breast cancer patients have a good survival chance if the cancer is caught early.

The three nurse navigators at Columbus Regional Hospital’s Breast Health Center urge all women to get an annual mammogram at age 40.

The nurses frequently answer questions from women who are getting mammograms, but they primarily deal with patients whose mammograms have raised concerns.

If a mammogram shows a lump, patients require a biopsy to determine whether the lump is cancerous. The nurses accompany the patient for consultations to answer questions and provide an extra set of ears so that they can repeat information when patients think of questions later.

Early start Creech, Staker and Tuell knew at an early age that they wanted to work in the medical field.

Staker, who has worked at CRH for more than eight years, said she developed an interest in medicine in high school.

Creech, who has worked at CRH for 32 years, said that when she was 9, her brother, Dennis Ramey, died in an auto accident at age 20. That incident prompted her to pursue a medical career.

Tuell, who has worked at CRH for 29 years, said she decided while at Columbus North High School to become a nurse.

Tuell’s mother, Roberta Wiseman, was diagnosed with breast cancer at 44 and died at 48.

Tuell said her mother had to go to Indianapolis for treatment. She remembered her mother vomiting on the way back.

Her experience with the way patients were treated back then has instilled in her thankfulness for how Breast Health Center is helping women today.

Tough news The nurses often spend time with patients at their most vulnerable: when they get the diagnosis.

“Those words, ‘You have breast cancer,’ that’s always the hardest,” Creech said.

The news typically floods the

patient’s brain with thoughts of mortality, pain, insurance and worries about finances and families.

In that situation, patients sometimes struggle to absorb critical information about their illness and the multitude of treatment options.

The nurses said some patients remain outwardly calm, while others have observable reactions.

“It’s pretty overwhelming when you first find out,” said Staker.

Creech said, “Sometimes I have tears streaming down my face right along with them.”

Though the nurses’ empathy remains, their focus soon switches to teaching patients to persevere and to provide whatever they need, confident that their experience and expertise will help patients in their struggle.

“Trying to stay positive is very important,” Creech said.

Tuell said, “My job is to make it as easy (for the patients) as possible. I find great satisfaction in that.”

She said she knows that patients appreciate the assistance: She would have appreciated it when her mother was ill.

Creech said, “I know that I’m helping them. It’s still rewarding for me.”

And Staker said, “I feel good that I’m able to help them (through that) shock and fear.”

nurses offer hope, help

ANDREW LAKER | THE REPUBLIC

Above: The radiologist reading room at Breast Health Center is where nurse navigators Deana Tuell, left, Tammy Creech and Beth Staker often meet with patients to discuss mammogram results. Below: Sharon Bronnenberg, the nurse navigator at Community Breast Care Tuell said keeping a clear in Greenwood, listens to a presentation on yoga and practices yoga during a breast cancer support group.

Benefits for all

head provides her with the opportunity to excel at helping the patients.

To help keep a clear head, she balances her job by spending time with family, reading and praying.

“My faith is the most important thing in my life,” she said.

And though sometimes she wonders why such an illness had to strike someone, particularly someone in an already difficult situation, Tuell said she cannot let those thoughts linger.

“Because then you don’t do your job well,” she said.

Creech relaxes by spending time with her children — Jennifer, Jessica and Josh — in the gym or at Volunteers in Medicine.

The nurses hold patients’ hands, help them break bad news to frightened children and give them hugs in time of need. Yet, the nurses said, the patients reciprocate in spades.

“I get back far more from my patients than I ever give out,” Tuell said.

And Staker said, “I gain a lot. I feel very honored to do the work I do.”

Navigators help patients cope with questions

My job is to be a stable person in their “lives, someone they know they can call if they’re having a bad day, and they know I’ll be by their side. ” Bronnenberg — Sharon

BY RYAN TRARES For The Republic Within moments of being diagnosed with breast cancer, Kim Siebenmorgen felt like she was drowning.

Medical jargon such as “ductal carcinoma,” “metastasized” and “tumor markers” were overwhelming her. She needed a guide, someone to slow everything down and talk her through the challenge she would face.

That person was right next to her, in her nurse navigator Sharon Bronnenberg.

“When you’re tossed into a diagnosis like this, you’re bombarded from so many sides with different things, and not all of it is necessary information you need to make decisions,” Siebenmorgen said.

“She was right with me to give me immediate support.”

For women suffering from cancer and their families, these specialists give guidance for the overwhelming questions and concerns that arise during treatment. As a nurse navigator, Bronnenberg is equal parts medical resource and emotional counselor.

“My job is to be a stable person in their lives, someone they know they can call if

they’re having a bad day, and they know I’ll be by their side,” said Bronnenberg, who works for the Greenwood-based Community Breast Care.

As the patient is moving from physician to oncologist to surgeon, with a different doctor each time, the navigator can provide some continuity in the process, said Cassie Carnie, the breast health navigator at St. Francis.

Siebenmorgen met Bronnenberg right as oncologists were informing her she had Stage 4 cancer, which has spread to her spine and was in her blood.

Bronnenberg held Siebenmorgen’s hand while she sobbed and then answered questions once she was ready.

Bronnenberg can relate to her patients. She was diagnosed with a 5.5-centimeter tumor in her right breast in 1998.

The Stage 3 cancer required six months of chemotherapy and a mastectomy.

She’s been cancer-free for the past 12 years.

“What I try to do is give them hope. They know I’m a sister, and survivors are never far away, lending an ear, a hand and a shoulder to cry on,” she said. “It makes this journey easier.”

SCOTT ROBERSON | FOR THE REPUBLIC

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C11

Balancing professionalism with human touch

BY PAUL MINNIS pminnis@therepublic.com After years as breast surgeons, Drs. Frederick Shedd and David Thompson have seen the full range of patient emotions.

The tears. The determination. The happy endings and the sad.

But Shedd, who works with Thompson at Columbus Regional Hospital’s Breast Health Center, never was so personally touched than when his sister was diagnosed four years ago with breast cancer.

“It is very emotional for me,” said Shedd, who remembers how he felt before she had a successful mastectomy.

Thompson said — and Shedd agreed — that surgeons must hold their emotions in check.

Patients and families need them to be objective pillars who keep the focus on the task at hand: beating the disease.

The Breast Health Center has a team of nurse navigators who tend to the patients’ emotional, personal and even spiritual needs.

Doctors still must be cognizant of what patients are going through, even while leveling with them about the prognosis and letting them and their families know what they are up against.

Emotional topic Shedd said he never sees more of an emotional response from women than those times when he must share with them that they have breast cancer.

Other cancers, though serious, generally do not alter the way a woman looks.

In the case of breast cancer, women face the possibility of losing one or both breasts, in addition to the hair loss that comes with chemotherapy treatment.

THE REPUBLIC FILE PHOTOS

Above: Dr. David Thompson makes his patient rounds at Columbus Regional Hospital. Right: After surgery, Thompson does paperwork before moving on to patient visits.

Still, doctors must be honest. That’s why they ask family members to accompany the diagnosed patients, so that when the patients hear “cancer,” lose focus and tune out everything else, the families can listen to what still needs to be said.

Shedd said patients often build friendships with their surgeons that last years after the patients have gone into remission.

“I see patients at least twice a year the first two years (for follow-ups) and maybe once a year after that,” Shedd said.

But he added that many patients start falling out of touch five to seven years later, perhaps because they feel more confident that the cancer will not return.

Breast restoration Dr. Tom Jackson is a plastic surgeon who has no qualms about investing emotionally in patients. But he said it’s up to the doctor and what makes him comfortable.

“How we interact with pa-

tients has to be an outgrowth of your personality,” he said. “I know I would have a hard time if I couldn’t be myself.”

Jackson said his job is different than that of cancer surgeons, who must deal with patients at their most vulnerable times.

By the time patients get to him, they are breast cancer survivors who are excited about the prospect of physical restoration.

“I’d say it’s six months to a yearlong process before we get people fully reconstructed,” he said. “We do develop long-term relationships.”

Jackson said his job is most rewarding when people come through plastic surgery looking better than they did before their mastectomies or other surgeries. He has seen the positive emotion that comes from a job well done.

“Those are the really rewarding times,” Jackson said.

“It’s not always that way, but it means a lot when a person can see light at the end of the tunnel.”

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CANCER

Continued from Page C1 to American Cancer Society.

After age 40, clinical breast exams are recommended annually.

Also at age 40, women should have a screening mammogram each year, according to American Cancer Society.

Tuell said health care providers have made huge ad-

vancements with diagnosis in the last decade, thanks to the switch from analog to digital mammography.

“The images are so much clearer, crisper now. We can see things that are much smaller,” she said.

Women at higher risk of developing breast cancer might

Dorenbusch of Southern Indiana Surgery.

He said biopsy methods have advanced drastically in recent years.

“Before, the patient had to go to the operating room for a piece of tissue to be taken out, to be biopsied,” Dorenbusch said. “Now, most are done

need to be screened earlier and more frequently, according to Susan G. Komen for the Cure.

Biopsy and surgery No matter whether breast cancer was found by exam or mammography, the next step is a biopsy, said Dr. Michael

Who gets breast cancer?

Sex Excluding cancers of the skin, breast cancer is the most common cancer among women, accounting for nearly 1 in 4 cancers diagnosed in U.S. women.

Age Breast cancer incidence and death rates generally increase with age.

Race/Ethnicity White women have a higher incidence of breast cancer than African-American women beginning at age 45. In contrast, African-American women have a higher incidence rate before age 45.

Incidence and mortality rates by age and race U.S. 2002 - 2006: Age specific probabilities of developing invasive female breast cancer: If the current age is ...

Incidence: African-American

The probability of developing breast cancer in the next 10 years is:

Or 1 in:

20 30 40 50 60 70

0.06% 0.44% 1.44% 2.39% 3.40% 3.73%

1,760 229 69 42 29 27

Lifetime risk

12.08%

8

Source: American Cancer Society

Incidence: White

Mortality: African-American Mortality: White

Mortality trends The death rate for breast cancer has decreased since 1990.

Between 1975 to 1990, the death rate for all races increased by 0.4% annually.

Between 1990 and 1995, the rate decreased by 1.8%.

Between 1995 and 1998, the rate decreased by 3.3%.

Between 1998 and 2006, the rate decreased by 1.9% The Republic graphic by Amber Pulley

by the radiologist with just a needle.”

Breast cancer is diagnosed in four stages that describe the extent of cancer in the body.

The stages are based on whether the cancer is invasive or non-invasive, the size of the tumor, the number of lymph nodes involved and if it has spread to other parts of the body, according to American Cancer Society.

Stage 1 breast cancer describes a tumor that’s smaller than about an inch and hasn’t spread to lymph nodes; on the opposite end of the disease, Stage 4 means the cancer has spread to another organ or organs.

Stage 1 cancer has a greater than 90 percent long-term survival rate.

“Compared to 10 or 15 years ago, we tend to see more early stage breast cancers, Stage 1 and 2 breast cancers, because women are more cognizant of the need for mammography,” he said. “We tend to find breast cancers much earlier than we used to.”

However, by the time breast cancer advances to Stage 4, “we know that’s a cancer we can’t cure,” Dorenbusch said.

“Those are the women that the goal is simply to try to control things, to keep the cancer from spreading to other places.”

Dorenbusch said surgery is part of nearly 100 percent of breast cancer treatments.

He said most patients with breast cancer have the choice between two options that work equally well, in terms of controlling the cancer and survival rate.

Mastectomy, a procedure that’s been in place for decades, is the surgical removal of one or both breasts.

The alternative is lumpectomy, a newer operation in which just the portion of breast tissue containing the tumor and some surrounding

healthy tissue is removed to preserve the breast.

He said most surgeries are now outpatient procedures.

Finishing treatment Dorenbusch said patients are seen a few days after surgery to review the pathology report, which details the type and size of cancer, makeup of the tumor and whether the cancer has spread beyond the breast.

He said almost all patients who opt for a lumpectomy need radiation to ensure any cancerous cells left behind don’t spread.

While radiation therapy historically has been a six-week process, Dorenbusch said the full treatment now can be administered twice a day over a five-day period.

He said patients with relatively small tumors and lymph nodes that are cancer-free might require no additional treatment.

For women whose breast cancer is related to hormones in the body, he said several years of anti-estrogen treatment may be prescribed.

About a third of patients with more advanced breast cancers undergo chemotherapy after surgery, Dorenbusch said.

He added that advancements have made modern chemotherapy drugs more effective at preventing recurrence, have improved survival rates and have led to fewer physical side-effects.

Tuell said the bottom line is catching breast cancer early.

“Everything depends on how early you find it,” she said. “The earlier you find breast cancer, the smaller the tumor, the easier it is to cure and the less chance it will go somewhere else.

“Until we’re able to cure every kind of breast cancer there is, we’re stuck with trying to be as aware as we can to find it early.”

ore then, but I’ve had my ey f e b r “I knew m e c n a c t s es opened.” — Larry Shepherd en could get brea

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D1

SURVIVOR STORY: Larry Shepherd Spreading word on male breast cancer

ANDREW LAKER | THE REPUBLIC

Larry and Jonna Shepherd attended the Hope Relay for Life event in June. Larry is a survivor of male breast cancer.

H

BY KIRK JOHANNESEN johannesen@therepublic.com

OPE — Larry Shepherd says that because he’s been a man of strong religious faith for many years, he believes his bout with breast cancer has a purpose.

The reason is to spread awareness.

“I knew men could get breast cancer before then, but I’ve had my eyes opened to the fact,” Shepherd said.

“I’ve told guys about having breast cancer and had them tell me they didn’t know men could get it.”

Male breast cancer is rare, but Shepherd is living proof it can happen.

Shocking news On Aug. 11, 2009, Shepherd went to his family physician, Dr. Philippa Shedd. The appointment had been planned because he was dealing with a cyst on his thyroid, but it provided an opportunity to discuss another issue.

He had noticed a lump under his right nipple, which seemed to be growing bigger and worse.

Certain ways his shirt rubbed against the lump caused a painful sensation. And the nipple began to invert.

Shedd expressed concern about the mass and ordered a mammogram. He also was referred to Dr. Frederick Shedd, a general surgeon and Philippa Shedd’s husband.

He performed a needle biopsy Aug. 14 and took about five tissue samples from the mass.

Frederick Shedd called Larry at work Aug.

Biography AGE: 49 RESIDES: Hope OCCUPATION: Toolmaker/engineer at Quality Machine & Toolworks in Columbus.

DIAGNOSED: Aug. 17, 2009 IN REMISSION: Since Dec. 23 FAMILY: Wife, Jonna; children, Ashley Gearheart, 24, Josh Shepherd, 22, Jason Gearhart, 21, Caleb Shepherd, 21, Ashton Shepherd, 19.

17 with bad news. Larry had Stage 4 breast cancer. The tumor was 2 inches in diameter.

“It kicks the wheels out from under you,” he said.

Frederick Shedd told him male breast cancer was uncommon. While one woman in eight is likely to develop breast cancer, only one man in 200 is. However, Shedd told him male breast cancer is more aggressive.

“In the era I grew up, a lot of times cancer was a death sentence,” Larry said.

But with advances in medicine and treatments, he knew that’s not always the case nowadays.

Larry had a consultation Aug. 18 with Frederick Shedd about the next steps.

The first was a mastectomy on Aug. 26 to remove the cancerous tumor. The same day he also had the cyst removed from his thyroid.

Before surgery, he was injected with radioactive dye to show where the cancer was. It

revealed it had also reached one lymph node.

“When they told me it had gone to the lymph nodes, I knew it was the one thing he wouldn’t want to hear,” said Jonna Shepherd, Larry’s wife.

Surgery left Larry with no nipple on his right breast, just a large scar.

Shedd removed 20 lymph nodes, but only the one was cancerous.

Rocky recovery Larry returned home Aug. 27. The next day he gave Jonna a scare when he passed out while washing and shaving. Jonna found him on the floor with his eyes open, but unresponsive.

“I thought he was dying on me,” she said. “I was crying. I went off the deep end.”

In September, Larry had a PET scan with Dr. David Gray to check on the cancer.

The scan revealed cancer had spread to his collarbone and liver. Jonna was heartbroken.

“I thought we were going to get on with life, and this was another kick in the stomach,” she said.

“We’ve been married seven years. I was a single mom for 14 years. I finally thought I had found Mr. Wonderful, so it was scary to think he would not be around and not have a life with him.”

Larry said he tried to remain positive by accepting the news as a lesson from God and something he’d just have to deal with. He said Gray thought the cancer was treatable and controllable, and he’d have many years of life.

He started chemotherapy treatments

Sept. 30. Larry received four chemotherapy treatments, which lasted three to four hours one day every three weeks, from September through December.

He worked all through treatments. The only time he took off was afternoons the day of treatments.

He never got sick to his stomach or had diarrhea. He felt tired, though; the steroids prescribed made him gain 50 pounds, and he lost all his body hair.

Larry had another PET scan Dec. 23, and good news followed as Gray said the cancer was in remission.

Doctors wanted to be safe and proceeded with radiation treatments to burn any residual cancer cells.

Radiation treatments consisted of lying on what looks like an X-ray machine for 10 to 15 minutes daily, Monday through Friday, for six weeks.

After 25 treatments, he had blisters on his skin, which cracked and bled. The pain caused him to take two weeks off work after the final radiation treatments. They concluded Feb. 22, his birthday.

Larry still has regular checkups, particularly to keep tabs on his tumor markers, which in July got close to exceeding the normal range.

He takes Aredia and osteoporosis medication, because the cancer entered his collarbone.

And he takes an anti-hormone pill daily, Tamoxifen, because hormones cause breast cancer.

“I wouldn’t wish it on nobody, but I don’t consider it to be the end of the road for anybody anymore,” Larry said.

Male breast cancer rare but still serious matter

BY KIRK JOHANNESEN johannesen@therepublic.com The rarity and lack of awareness of male breast cancer make early detection difficult, said a Columbus doctor.

Dr. Frederick Shedd, a general surgeon here for 19 years, said the fact that breast cancer is considered only a disease of women is why it’s usually diagnosed at a later stage in men.

Breast exams in men are not taught and rarely are mentioned by health providers as something for men to be aware of, Shedd said.

And breast exams are only addressed when a man becomes aware of a mass.

It’s understandable why the disease is connected with women. The local incidence of male breast cancer is on par with national averages of 1 percent of all diagnosed breast cancers, Shedd said.

“I have treated three male breast cancers over the past 19 years here in Columbus and saw no cases as a medical student, intern or resident,” he said.

Shedd thinks the low incidence rate and strong focus on breast cancer in women lulls

His mother’s twin sister died of breast cancer in the 1960s, and a cousin had a double mastectomy in 2005. Larry worries that his daughter z The ratio of female to male breast cancer in the U.S. is 100 to 1. might be more at risk. z About 1,910 men will be diagnosed in a year, and about 440 will die from the disease.

Most men react with disbelief when told they z The overall incidence rate of breast cancer is 1.3 men per 100,000 but 123 women per 100,000. have breast cancer, Shedd said. z Common symptoms of male breast cancer are: a lump or hard knot in the chest area, skin He prepared Shepherd for the possibility of dimpling or puckering, redness of the breast, itchy or scaly sore or rash on the nipple, nipple breast cancer during a biopsy last year. Still, discharge. the news was difficult for him to accept.

“It’s not the most macho thing a guy can go z Because the male breast is smaller than the female breast, it is more likely the disease will through,” Shepherd said. spread to the chest wall.

A mastectomy is required for most males, z Factors that increase the risk of breast cancer in men include: genetic conditions, family history, who usually are not candidates for a lumpecchronic liver disorders, alcoholism, obesity, older age. tomy due to the size of the breast. The chemoz Most breast cancer in men occurs in ages 65 to 67. therapy used is similar to women. z A mastectomy, a surgical procedure to remove the breast, is the main treatment for male Most males have estrogen positive cancers breast cancer. and therefore are good candidates for hormonal — Sources: American Cancer Society, Susan G. Komen for the Cure therapy, a separate treatment from the standard chemotherapy, Shedd said. men into a false sense of protection from the of breast cancer and the presence of mutated Although Shepherd’s breast cancer has been disease. tumor suppressor genes, BRCA 1 or BRCA 2, in remission about a year, Shedd said his battle Men should be more aware, because the in- should be educated about their risk, Shedd continues. cidence for male breast cancer nationally is said.

“Larry does have a strong risk that his canslowly rising, he added.

Larry Shepherd, a male breast cancer survicer will recur,” Shedd said. “His markers may About 40 percent of male breast cancers vor who lives in Hope, thinks family genes condetect recurrence, but not always.” are genetic. Males with a strong family history tributed to his illness.

Fast facts

000 , 0 Overall incidence rate of breast cancer is 1.3 men per 100,000 but 123 0 1 women per

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Experts still urge mammograms at 40

BY BRIAN BLAIR bblair@therepublic.com An hour out of her day 10 years ago gave Norma Adams the rest of her life.

“Fortunately,” said Adams, “they found this early, at Stage 1.”

She refers to the breast cancer that a routine mammogram uncovered. She never would dream of skipping the annual exam that most doctors still recommend.

“So much can happen in 12 months,” said Adams, who had no history of cancer in her family. She recovered and has been healthy ever since.

Deana Tuell, manager of Columbus Regional Hospital’s Breast Health Center, preaches the gospel of mammograms as passionately as anyone for a simple reason.

“The whole goal of mammographies,” said Tuell, “is to find things when they’re very small and very treatable.”

Digital mammographies and magnetic resonance imaging of breasts — breast MRIs — have boosted detection exponentially, according to experts.

“We can see so much more than ever before,” Tuell said.

Guidelines dispute Like many other professionals in the field, she was bothered about a U.S. Preventive Ser-

JOE HARPRING | THE REPUBLIC

Despite a schedule filled with volunteer work and a demanding fitness regimen, Norma Adams always has found time to get her mammogram. That diligence led to an early diagnosis of breast cancer. vices Task Force survey released in November and research published in the New England Journal of Medicine Sept. 23.

The task force guidelines recommended that women with a normal risk for breast cancer begin screening and mammograms at age 50, rather than age 40. The survey said the change was meant to reduce harm from overtreatment and patient anxiety.

The task force also recommended against

teaching breast self-examination and said women ages 50 through 74 should undergo lessfrequent mammograms.

Twenty-five percent of women diagnosed with breast cancer at Columbus Regional Hospital are 50 and younger, according to Tuell. The study in the New England Journal of Medicine stated that mammograms don’t help women over 50 as much as some previously thought.

“We know mammograms aren’t a magic bullet,” said Tuell, “but we think it’s the best we’ve got — and it’s still fairly cheap to do.”

She said experts know mammograms miss up to 10 percent of problems.

“But, if I’m a woman, I still want to take the chance that having one will help me,” said Tuell.

American Cancer Society, National Cancer Institute and the national Consortium of Breast Centers all recommend annual screenings at 40.

Assistance programs Tuell said the complaint of no insurance is no reason to avoid proper care.

“In this community,” said Tuell, “that’s not a good excuse.”

An assistance program has been in place for a decade to cover the cost of procedures for the uninsured, said Tuell. These patients pay only $5 themselves.

See MAMMOGRAMS on Page D10

Technology allows better test inspection

BY SARAH MICHALOS For The Republic FRANKLIN — Radiologists at a Franklin hospital no longer have to use magnifying glasses to see irregular spots on a mammogram X-ray.

Johnson Memorial Hospital’s Breast Center has two new digital mammogram machines that allow workers to zoom in on a computer screen for a closer look and detect and flag problem spots using special software.

Most other Indianapolis-area hospitals already have been using the digital machines for up to five years.

Columbus Regional Hospital, Schneck Medical Center and Decatur County Memorial Hospital also use digital mammography.

The machines capture a digital image

that allows radiologists to more easily pinpoint a calcification or tumor, Johnson Memorial Hospital mammography technologist Stacy Winget said.

Radiologists also can adjust the brightness or contrast to make certain areas easier to see.

Previously, radiologists took an X-ray photo to a darkroom and scrutinized it against a lighted screen to find abnormalities.

Digital mammography is more accurate in finding cancer in women younger than 50 years old and women who have dense breast tissue, according to a study conducted by The National Cancer Institute.

The new machines also will allow more patients to be seen the same day because radiologists don’t have to wait for the Xrays to print, Winget said.

SCOTT ROBERSON | FOR THE REPUBLIC

Johnson Memorial Hospital has upgraded its mammography to all digital technology.

About the guidelines Here’s a look at the U.S. Preventive Services Task Force recommendation on screening for breast cancer, released in November 2009.

Screening mammography z Ages 40 to 49: The task force recommends against routine screening mammography. z Ages 50 to 74: Screening every two years is recommended. z Ages 75 and older: Insufficient evidence to determine additional benefits and harm of clinical breast examination.

The task force found that screening for breast cancer between the ages of 50 and 60 produced a projected 17 percent reduction in mortality. Starting at age 40 added 3 percentage points to that number.

Self-examination The task force recommends against clinicians teaching women how to perform breast self-examination, because evidence shows those exams don’t reduce breast cancer mortality.

Harm of detection and early intervention Harm includes psychological trauma, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening. Because of false-positive test results, over-diagnosis and unnecessary earlier treatments are problems for all age groups. They are more common for women 40 to 49.

Other agency recommendations z American Cancer Society, American Medical Association and National Comprehensive Cancer Network: Recommends annual mammography beginning at age 40 z American College of Physicians: Recommends that mammography for women 40 to 49 be based on individualized risk assessment, with physicians informing patients of the possible benefits and harm of screening. z American College of Obstetrics and Gynecology: Women 40 to 49 should have mammograms every one or two years. Women 50 and older should have the tests annually.

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Breast cancer services Columbus Regional

40 who have no clinical signs of breast disease, no serious ADDRESS: 2400 E. 17th St. family history of breast KEY DEPARTMENT: Breast disease or no personal past Health Center history of breast disease.

PHONE: CRH main, 379z Diagnostic mammograms 4441 or 800-841-4938; Breast — Performed to resolve a Health Center, 376-5064 particular question related SERVICES OFFERED: to the breast. Uses digital z Digital mammography technology, but also includes — This is like using a digital extra mammographic X-ray camera to take a picture instead of a camera that uses images. z Breast MRI film. Image is captured by a — A supplement to special X-ray detector, which mammography, magnetic converts the image into a digital picture for immediate resonance imaging is an advanced imaging tool that review on the computer provides more detail about a monitor. Digital image provides a bit more contrast. possible abnormality. Useful in determining a course of z Screening mammograms treatment.

— These look for the early z Breast Health Navigator warning signs of breast Program — A navigator nurse cancer. They are performed routinely on women over age serves as a resource and familiar face while assisting

Decatur Memorial ADDRESS: 720 N. Lincoln St., Greensburg.

KEY DEPARTMENT: Radiology - Breast Health Center.

PHONE: 812-663-1156 SERVICES OFFERED: z Digital Mammography z Screening Mammography z Diagnostic Mammography z Computer Aided Detection (CAD) z Breast Ultrasound z Breast Ductograms z Breast Needle Localizations

a patient through treatment and recovery, so the patient can focus on health and recovery. z Mammography assistance program — For people who need a mammogram but can’t afford one. Those who qualify for assistance can get a mammogram for $5.

To qualify, participants must be at least 40 years old, have not had a mammogram in the last year, cannot be pregnant or breast-feeding, have no history of breast cancer or breast problems, be referred by a doctor, have a household income at or below 200 percent of poverty level and live in Bartholomew, Brown, Decatur, Jackson, Jennings, Johnson or Shelby counties.

Call Breast Health Center to

z Breast imaging guidance biopsies and cyst aspirations z Assistance programs: Komen Grant; Indiana Breast Cancer Awareness Trust Fund. These programs are for people who meet financial guidelines and are eligible for screening and diagnostic mammograms, and imaging-guided biopsies at no cost. z Special Screening Programs for Industry z ACR (American College of Radiology) accredited z MQSA (Mammography Quality

Schneck Medical ADDRESS: 411 W. Tipton St., Seymour.

KEY DEPARTMENTS: Cancer Center and Diagnostic Imaging Women’s Center.

PHONE: Main, 522-2349; Cancer Center, 522-0480; Diagnostic Imaging Women’s Center, 523-4874.

SERVICES OFFERED: z Dedicated women’s center z Digital mammography z Breast ultra sound z Breast MRI z Same-day biopsies z Stereotactic breast biopsy z Utrasound-guided biopsy z Self-referrals for screenings z Flexible scheduling for mammograms — Source: Schneck Medical Center

apply. z Diagnostic breast ultrasound — Sound waves used to detect solid or cystic lesions in the breast. z Ultrasound guided core needle biopsy — Small pieces of breast tissue removed under ultrasound guidance and examined for cancer cells. z Stereotactic guided breast biopsy — Tiny pieces of breast tissue removed with computer guidance and examined for cancer cells. z MammoSite — An advanced technology for targeted radiation therapy. z Breast Cancer support services z Same-day testing results and 24-hour pathology results — Source: crh.org

Standards Act) certified z All technologists are registered in mammography z All breast-ultrasound technologists are registered by ARDMS z Radiologist Dr. Barbara Taylor was selected by ACR to be a Fellow of the American College of Radiology. She was also given a Hoosier Hero Award recorded in the state congressional record for her efforts to provide mammography services to rural Indiana.

— Source: Decatur County Memorial Hospital

St. Vincent Jennings ADDRESS: 301 Henry St., North Vernon.

PHONE: 352-4200.

SERVICES OFFERED: z Breast cancer screenings. z Mammography. z Reduced rate mammograms three months a year. z Scholarships available to those who cannot afford a mammogram.

— Source: St. Vincent Jennings Hospital

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Atterbury works with area hospitals for cancer services

BY KIRK JOHANNESEN johannesen@therepublic.com EDINBURGH — Breast cancer among soldiers at Camp Atterbury is rare, but those who need treatment are referred to hospitals in neighboring communities.

Medical personnel at Atterbury have seen few cases of breast cancer because most soldiers stay in the National Guard for limited periods of time, said 1st Lt. Jessica Halladay, public information officer.

“There are those who make the 20-plus-year career in which there may be a few cases,” Halladay said. “I would say the fitness and health that come from the military may contribute to the number being low.”

Also, soldiers are pre-screened at their home posts or by their private physicians before coming to Atterbury, said Maj. Leanna Brown, officer in charge of the troop medical clinic. The prescreenings reduce the number of soldiers with breast cancer seen by Atterbury’s medical personnel.

Female soldiers are encouraged to perform self-exams, and Atterbury’s doctors can perform basic examinations.

“Mammograms are encouraged by all over 40, and it is something Army doctors look for to be completed annually,” Halladay said.

But if soldiers need breast cancer services not available at Atterbury, such as a mammogram or magnetic resonance imaging, they are referred to hospitals in communities such as Columbus, Franklin and Greenwood, Brown said.

Some soldiers see private doctors for regular examinations, such as dental or female reproductive health. They must provide those results to the Army, so the soldier’s physical health assessment is current.

If Atterbury doctors refer soldiers to specialists, the doctors receive the results so they can determine the course of care for the soldiers, Brown said.

Most soldiers on active duty receive Tricare, the military health insurance, which they can use to set an appointment if it’s needed before going overseas or in the U.S. What happens to a soldier’s status if he or she has breast cancer depends on the stage of the cancer and the soldier’s situation, Halladay said.

Soldiers would remain in the Guard and perform duties as their superior officers saw fit. However, they would not mobilize overseas and could be discharged for medical reasons if their condition worsens, and they could no longer perform their duties.

“There is a long medical process they would go through to make sure they are getting care and to make sure they receive the benefits they are entitled to before discharge occurs,” Halladay said.

are those who make the 20“ There plus-year career in which there may be a few cases. I would say the fitness and health that come from the military may contribute to the number being low.

”

— 1st. Lt. Jessica Halladay

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The walk raises important funds for care and research. Both walk in honor of Debbie Brown, Dave’s wife and Michelle’s aunt who is a breast cancer survivor.

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PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

T H E R E P U B L I C , C O L U M B U S , I N D ., F R I D A Y , O C T O B E R 15, 2010

Finding breast cancer early is important. Here is what the American Cancer Society recommends : Have a mammogram every year starting at age 40.

Get a breast exam by a doctor or nurse every three years if you are in your 20s and 30s.

Know how your breasts look and feel. Tell your doctor or nurse right away if there is any change in your breasts.

How to check your breasts: Sometimes, you can feel the underarm area better this way.

In front of a mirror While standing in front of a mirror, look at your breasts with your arms by your side, then raise them over your head, then press your hands on your hips and tighten your chest muscles.

Look for any changes in your breasts.

Look for a change in size, shape, contour, dimpling, rash, redness or scaliness of the nipple or breast skin.

While lying down

Sitting or standing

Lie down on your back, put a pillow under your right shoulder and place your right arm behind your head.

While sitting up or standing and with your arm slightly raised, feel the area under your arm.

Use the finger pads, not the finger tips of the three middle fingers on your left hand to feel for lumps in the right breast.

When you first begin checking your breasts, it is hard to know what you are feeling. With practice, you will become familiar with your breasts. You might ask your nurse or doctor to help you by letting you feel your breasts as they do your breast exam.

Use an up and down pattern, starting at your underarm and moving across the breast to the middle of the chest bone.

Repeat the exam on the left breast, using the finger pads of the right hand.

Source: American Cancer Society

The Republic graphic by Amber Pulley

Blood, tissue samples helping speed research

BY SARAH MICHALOS For The Republic INDIANAPOLIS — Blood and slivers of breast tissue from Hoosier women who have never had breast cancer are helping researchers find out why the disease develops and how to cure it.

Indianapolis’ Susan G. Komen for the Cure Tissue Bank was started five years ago by a Hoosier cancer survivor who learned that research had been halted because researchers didn’t have access to healthy breast tissue to compare with cancer-infected tissue.

The bank is the only facility of its kind in the world.

“My mantra has always been, we’re going to change the world,” said tissue bank founder Connie Rufenbarger, who was diagnosed with breast cancer in the 1970s at age 34.

“If this is the number one obstacle and we’re going to address that, then certainly we’re going to change the world.”

How bank works Women sign up to donate either blood or breast tissue during one of the bank’s annual donation events.

Donating tissue is an hour-long out-

patient surgery that involves a doctor numbing the side of the breast and using an automated tool to carve out a sample about 1½ inches long.

Since the center opened, about 1,100 women have donated breast tissue.

Researchers from as far as England and Australia have shipped tissue and blood samples cataloged at the bank.

They write proposals, which are kept secret until a detailed report with findings is published. The reports generated using the first round of tissue samples likely will be published in the next year.

Many researchers are just now learning about the bank, which started accepting proposals from researchers in January 2009.

Last year, about 15 proposals were received during two application periods. Only a few are chosen, depending on the number of samples they need and what’s available.

That’s why it’s important for women to keep donating, so that researchers can continue using their samples to find a cure, Susan Clare, one of the bank’s two doctors, said. The center can only collect so many samples each year because of the work it takes to catalog them and the storage space available at the center.

Meeting the need The bank gets nearly all of its funding from Susan G. Komen for the Cure.

The nonprofit agency gave $1 million to expand the bank in 2007 and has been the main funding source ever since. Details about the funding are not released.

The concept of opening a tissue bank was discussed first in the 1990s during a National Cancer Institute conference Rufenbarger attended.

At the time, she was working for a doctor, help ing explain treatment options for breast cancer patients.

Researchers at the conference agreed that one thing was stopping the progression of their research — a lack of access to blood and healthy breast tissue samples. Individual researchers were responsible for finding donors and collecting enough samples to do their study, Rufenbarger said.

She talked to some of her patients and colleagues to see if people would be interested in donating.

“The women said, ‘What do you need?’” Rufenbarger said. “The consensus was, ‘If you need blood, tell us where to be, and we’ll be there.”

About the bank What: Susan G. Komen for the Cure Tissue Bank, which is the only healthy breast tissue bank in the world.

Where: Indiana University Simon Cancer Center in Indianapolis.

How it works: Women donate their blood and breast tissue so researchers from around the world can use it to study breast cancer. Donating breast tissue takes about an hour and is done by a surgeon. A piece of healthy breast tissue is surgically removed, cataloged and frozen until a researcher needs it.

Who: Women with healthy breast tissue are asked to donate. The tissue bank also solicits donations from women of varying racial and religious backgrounds. Donors must be at least 18, not allergic to local anesthetic, not be taking a blood thinner and not have breast implants or have had a breast reduction.

Background: The tissue bank was started in 2005 by Connie Rufenbarger, a cancer survivor and breast cancer consumer advocate who learned that breast cancer researchers didn’t have access to healthy breast tissue.

Funding: Susan G. Komen for the Cure began funding the tissue bank in 2007 and will provide the majority of funding until at least spring 2013. Donations also help support the bank.

Employees: Five full-time, plus two doctors who oversee the bank 1,083: Number of tissue samples collected since the bank opened 6,959: Number of blood samples collected since the bank opened INFORMATION: komentissuebank.iu.edu

Monthly breast cancer support group, started by survivor Bonnie Nolting, 579-6655

PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

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SURVIVOR STORY: Sherry Lucas

Too tough to give up Woman living with cancer after 6 bouts with disease

BY BRIAN SANDERS bsanders@therepublic.com

S

EYMOUR — Cancer is a dreaded disease for anyone to face even once in a lifetime.

Sherry Lucas of Seymour has endured six bouts with five different cancers, including breast cancer.

Through faith, love, humor and a good bit of stubbornness, Sherry is alive today.

The 69-year-old is coping with bone cancer and the early stages of Alzheimer’s disease but shows no signs of surrender.

“I’m not dying with cancer, I’m living with it,” she proclaimed one August afternoon while sitting on her patio watching the birds with her husband, Sonny Lucas.

The pair married 45 years ago.

“One thing led to another, and her mother was standing behind me with a shotgun, and we got married,” Sonny, 73, joked.

“You’re rotten,” his wife replied, with a chuckle.

That humor is part of what has seen the couple through some trying times.

Breast cancer battles In 1999, Sherry got news that was becoming all too familiar.

She had cancer … again. This time cancer was found in her left breast.

Having already endured two bouts with cancer, Sherry took the breast cancer diagnosis in stride.

“I’m not like most people, I don’t break down and bawl,” she said.

“You’ve just got to deal with it.”

JOE HARPRING | THE REPUBLIC

She refused her doctors’ recommendation of a mastectomy because she didn’t want to lose a breast.

Comforting the comforter, Sherry Lucas runs her fingers through her daughter’s hair. Though end-of-shift tired, Kristy Smith spends a few minutes with her mother on a recent morning in Seymour. Since 1983, Lucas has battled cancers of the heart, lung, brain, bone and breast (twice). She has endured long enough to now face Alzheimer’s disease.

She also passed on chemotherapy, believing it would do more harm than good.

Sherry’s had no breast cancer-related issues in some time.

the couple enjoyed two good years before cancer again reared its head.

Instead, she opted to undergo radiation treatment alone.

Her blood still is tested regularly for signs of the breast cancer’s return.

In 2005, doctors found cancer in Sherry’s right breast. Again, she was told a mastectomy and chemotherapy were necessary, but she again opted for radiation treatment.

Compared to what she had already been through, Sonny said the breast cancer fights were not that bad.

While celebrating their September birthdays, Sonny noticed that Sherry looked pale and didn’t feel well.

While not officially in remission,

Biography Age: 69 Resides: Seymour Occupation: Retired from Cummins Diagnosed: 1999 and 2005 Family: Husband, Irwin “Sonny” Lucas; children, Tim, Tom and Shawn Lucas and Kristy Smith; eight grandchildren

History of cancer Sherry’s first bout with cancer began in 1983.

Originally misdiagnosed as arthritis, the pain actually was the result of heart and lung cancer.

“Neither one of us had any thoughts of cancer,” Sonny said.

Despite the doctor offering little hope of survival, Sherry opted for a five-and-a-half-hour surgery that removed numerous cancerous lymph nodes, her left lung and heart sac.

Released from the hospital five days later, she recovered quickly, and

“It’s time to go again, isn’t it?” he asked her.

Sherry agreed.

This time doctors found cancer in her brain and gave her no more than nine months to live.

Sonny recalled his devastation.

“I was so mad, I felt like I could tear that hospital down,” Sonny said.

The anger soon gave way to disbelief and laughter.

“Well, hon, we’ve got time to go home and make another baby,” Sonny said, recalling Sherry’s response to the bad news.

“I believe that’s the reason she’s beat it all this time,” he said, referring to her sense of humor.

“I don’t take anything serious,” she agreed.

Over the course of 33 intense radiation treatments, Sherry lost her appetite and much of her hair.

“That was the only time I cried,” she said of losing her hair.

Making matters worse, Sonny was laid off from his job.

After six months of struggles, the couple began a routine of praying together every morning, asking God for a cure for Sherry’s cancer, a job for Sonny and patience for both of them.

The following spring, Sherry regained some of her strength and appetite and Sonny soon got a new job in St. Louis.

“Things just fell into place for us,” Sonny said.

‘Not giving up’ Today, Sherry is fighting bone

cancer in six places throughout her body.

She takes 18 pills a day, makes monthly hospital visits and gets frequent bone-building injections, but Sherry is living with cancer.

“I’m not giving up. If the Lord calls me home, that’s fine, but I’m going to stay in there and fight, and he’s going to fight with me,” she said, nodding to her husband.

“He’s a good person; I couldn’t make it without him.”

Sherry and Sonny say fighting cancer has brought their family closer together and given them a deeper faith.

When battling cancer, a little stubbornness and just the will to keep on living can go a long way.

“If I would have given up when I first got cancer, I’d be dead by now, but not me,” Sherry said. “I’m a fighter, and he’s a pusher. He pushes me, and I fight.”

“I’m not dying with cancer, I’m living with it.” — Sherry Lucas

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PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

T H E R E P U B L I C , C O L U M B U S , I N D ., F R I D A Y , O C T O B E R 15, 2010

Radical treatment

Women opt for mastectomies when tests reveal high risk for cancer At a glance

BY SARAH MICHALOS For The Republic FRANKLIN — Darci Wertz knew it could come. She thought she would get breast cancer.

She felt it, and the odds were against her. The test results said her chances of developing the disease were nearly 90 percent.

But the Franklin resident didn’t wait for the diagnosis, which could have come the next day or 15 years in the future.

Wertz didn’t want to face her 4-year-old daughter, Halle, and tell her that her mom had a chance of preventing breast cancer but didn’t.

Instead, Wertz had both her breasts removed as part of the most radical treatment available for women with breast cancer, even though she didn’t have a trace of the disease.

Wertz, like other local women with a deep family history, decided to get special testing that would reveal if she carried a gene mutation that makes her more likely to develop breast cancer.

Her results came back positive, and her doctor said she had an 87 percent chance of developing breast cancer before she reached menopause.

Wertz’s mother was diagnosed with breast cancer at age 31, when Wertz was 5. Her paternal grandmother also had breast cancer, so she already knew her risk was high.

“I felt like a walking time bomb,” she said.

Similar situation Positive tests results were enough to convince Franklin resident Kari Findley, 33, and her two sisters that they needed to get their breasts removed. Their mother also had tested positive for the gene, after her grandmother and aunt died of the disease.

Findley’s doctor told her she could take medication to reduce her chances of getting cancer and could come in for frequent exams and mammograms to see if any tumors

What: Breast cancer gene test, commonly called BRCA gene How it works: People have their blood tested for a certain gene mutation that causes irregular cell growth. People with the gene mutation have a higher chance of developing breast or ovarian cancer. The gene test does not test for cancer.

Two types: People can test positive for two different gene mutations, which are separated into BRCA1 and BRCA2. Women who test positive for BRCA1 also have an increased risk of developing cervical, uterine, pancreatic and colon cancer.

Women who test positive for BRCA2 have an increased risk of developing pancreatic, stomach, gallbladder, bile duct and skin cancer. Men who test positive for BRCA2 have a stronger chance of developing testicular and prostate cancer than if they test positive for the BRCA1 gene.

Who gets tested: People with a family history of ovarian or breast cancer on either side can get tested. Doctors only recommend testing for people with a strong family history, meaning multiple people on one or both sides who have had cancer.

At a higher risk: People who have an immediate family member with breast or ovarian cancer, which includes parents, siblings and children. People also are at a higher risk if they have at least two family members on one side with breast or ovarian cancer, such as an aunt and a cousin. Jewish women whose ancestors came from Eastern Europe also have a higher risk.

SCOTT ROBERSON | FOR THE REPUBLIC

Darci Wertz had a double mastectomy after testing positive for the BRCA gene. Wertz is shown with husband, Ryan, and children, Andrew, 1, and Halle, 4, at their Franklin home.

had developed.

“To me, that would be agony, the waiting,” Findley said. “Each day, in the back of my mind, I would be saying, ‘Will I find a lump today?’”

Choice of life Both women also wanted to set an example for their young daughters to put your health, not appearance, first.

Living a long, healthy life is more important than having your natural breasts, Wertz said. And unlike other women, the idea of being without breasts didn’t shock her.

Her mother had one of her

breasts removed during her battle with cancer, which eventually claimed her life when Wertz was a teenager. Her mother slipped a prosthetic breast into her bra and also wore a specially designed bathing suit in the summer.

“It was really nothing unusual for me,” Wertz said. “I just never thought of it as odd.”

Having the mastectomy gave her and her family assurance that she did everything possible to keep cancer away, Wertz said.

She was given two other options — get mammograms and other special tests every six months

that could catch cancer, or take a medication that blocks estrogen and lowers the risk for the disease.

But those options didn’t cut her chances of getting cancer as much as a mastectomy, Wertz said. Nine months after her first surgery, she has never regretted her decision.

Wertz often pauses when she’s around the dinner table with her husband, their daughter and their son, admiring the family she helped create.

“You look at it differently when you have kids,” Wertz said. “Why would I have ever made a decision other than to save my life?”

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PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

T H E R E P U B L I C , C O L U M B U S , I N D ., F R I D A Y , O C T O B E R 15, 2010

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Survivor inspired to start support group

BY KIRK JOHANNESEN johannesen@therepublic.com Bonnie Nolting remembers how she felt upon receiving the news that she had breast cancer.

“Cancer took me down. It knocked the wind out of me,” said Nolting, who was diagnosed Dec. 2, 2005.

She searched for a support group but couldn’t find one. Fortunately, her sisters, husband, children and parents gave her the support she needed.

She called sister Julie Phillips every day for a month.

“She’d give me the tough love talk,” Nolting said.

After a month, she was in the frame of mind that she was ready to beat breast cancer.

She did, and now Nolting is making sure others with breast cancer have the same kind of support she received.

Nolting started a breast cancer support group in January. It has 16 members and meets monthly, usually at her home or at a restaurant.

“I felt this need to give back and help people,” she said. “I thought there’s probably a lot of people out there that need support that don’t have family (support).”

Emotional support Sometimes the meeting involves reading inspirational stories.

Support group info WHAT: Breast cancer support group, started by breast cancer survivor Bonnie Nolting.

WHEN: Meets monthly; times and locations vary.

WHY: To provide information and support to people who are being treated for breast cancer or are survivors.

INFORMATION: Bonnie Nolting, 579-6655.

BONNIE NOLTING

Other times they don’t focus on breast cancer but how group members are feeling or what is happening in their lives.

Members offer comfort and advice, and talk, laugh and eat.

“It’s more emotional support and letting people know they are not alone, because you can feel really alone when you are going through something like this,” Nolting said.

Around Easter, group members made baskets and put notes of encouragement inside plastic eggs, and gave the baskets to Breast Health Center at Columbus Regional Hospital. They were a hit.

New members receive a pink book with the names and contact information of the other members, to help them stay connected.

The group has members at various stages of breast cancer.

Some are recently diagnosed, some have just started chemotherapy and others are multiyear survivors.

Nolting underwent a lumpectomy, radiation and chemotherapy.

She finished treatments in June 2006 and has been cancerfree since.

Breast cancer has touched other members of her family. Her mother, JoAnn Chasteen, and aunt, Erma Loesch, are survivors.

An aunt, Patty Rust, died from it in 1991.

Members of the support group with similar stages of breast cancer often gravitate toward each other, Nolting said.

“Friendships have developed from the support group, which is great,” she said.

Phillips said she’s not surprised her sister started the support group.

“She’s just a doer, all her life,” Phillips said.

Nolting played multiple sports and was a cheerleader.

“That competitive nature got me through this, and is what inspired me to help others,” Nolting said.

SURVIVOR STORY: Mary Taulman

‘I wanted to get it over with’ Edinburgh resident recalls treatments 37 years apart

BY BRIAN BLAIR bblair@therepublic.com

E

DINBURGH — The bottom-line resoluteness that has shaped Mary Taulman’s lifelong work ethic — the one that still keeps her up until the wee hours of the morning with cleaning and more — shaped her approach to breast cancer.

Tears? She recalls none. Pity? Get real.

“I wanted to get it over with,” she said, “and move on.”

As best and businesslike as she could, she did that in 1970 with a radical mastectomy. And again on the other breast after the same diagnosis in 2007.

“Who would think it — breast cancer with the same person 37 years apart?” she asked.

While she reminisced about her experiences, the 88-year-old Edinburgh native stopped to talk with her husband, Marshall, 91, on their front porch.

Then she chuckled with the mail carrier.

“You’re bringing me a check for $1,000, aren’t you?” asked Taulman.

Her brightness and Marshall’s humor seemed infectious.

Three neighbors waved heartily as they pulled up in nearby driveways.

Though technology and social climates changed radically between each of Taulman’s diagnoses, she can recall little difference between the two — except, perhaps, that her recovery the second time was faster.

The former Cummins Inc. secretary still takes Arimidex to lower her risk of a recurrence.

She is grateful that medical staffers have become much more sensitive to women’s plight during treatment.

“The people at the (Columbus Regional) Hospital were wonderful,” she said, adding that the nurses were kind and surgeon Dr. David Thompson was very patient with her.

“But I’ve never had much trouble dealing with people,” she said.

She knows many women face grief over the removal of a breast and feels compassion for them. But her situations were different.

“You’ve lost something, and you know it’s never coming back. But I never had much to begin with,” she said, breaking into a wide grin before looking away.

She wears a mastectomy bra during the winter to give her

ANDREW LAKER | THE REPUBLIC

Marshall and Mary Taulman relax at their home in Edinburgh. Mary had breast cancer in 1970 and again in 2007. shape. However, she ditches it during summer.

“It’s too hot,” she said, “and gets uncomfortable.”

She looked puzzled when asked if she ever felt a fear of death. Marshall intervened to interpret that look.

“She has a little theory,” he said, sitting calmly with hands clasped and legs crossed. “And that theory is this: When your heart stops beating, you’re dead.”

And not before then.

She broke into laughter at his explanation but acknowledged she sacrifices no time to substantial worry of nearly any kind.

Not even while Marshall prepares for radiation to recover from a cancerous tumor recently removed from his face.

“Basically,” said Marshall, “the Lord has walked through life with us. And we sure appreciate it.”

Biography AGE: 88.

RESIDES: Edinburgh.

FAMILY: Married to husband Marshall 70 years; son Larry Taulman of Edinburgh.

WORK: Retired from Cummins Inc. DIAGNOSED: 1970 and 2007 with a radical mastectomy both times as treatment.

ADVICE TO OTHERS: “Don’t be scared.”

trics and Gynecol grams every 1 or 2 yea American College of Obste rs ogy advises women 40 to 49 have mammo

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SURVIVOR STORY: Mary Speer

Woman seeks alternative path

BY BRIAN SANDERS bsanders@therepublic.com

N

ORTH VERNON — Faith and a combination of modern and alternative medicine have afforded Mary Evelyn Speer eight more years with her ever-growing family.

In 2002, after a routine mammogram, doctors found a lump in Speer’s breast. For the Jennings County woman, there was no doubt the lump was cancer.

“I knew it when I’d seen it,” she said.

While waiting for a scheduled biopsy, Speer, 71, consulted Solomon Wickey in Jefferson County, an Amish herbalist and iridologist.

Iridology is an alternative medicine technique in which diagnoses are made by observing the patterns, colors and other features of a patient’s eyes, specifically their irises.

Wickey agreed that the lump was cancerous.

Speer and her husband had been seeing Wickey for years with positive results.

Wickey is the subject of June Naugle’s book “Solomon’s Touch: The Life and Work of Solomon J. Wickey.”

Biography Age: 71 Resides: Jennings County Diagnosed: April 2002 Family: Husband, Walter Speer; six children; 22 grandchildren; 22 great-grandchildren.

“He said that he would help me, and I believed that he could,” she said.

Non-traditional route Wickey prescribed a strict four-month detoxification diet that prohibited Speer from eating sugar, salt, dairy products and meat.

Speer dined on fresh fruits, vegetables and little else and drank a pint of fresh carrot and celery juice every morning.

“I started on the diet right away. … I didn’t cheat once, and it was very hard,” she said.

Resisting the temptation to eat a bowl of cereal with milk

See SPEER on Page D11

ANDREW LAKER | THE REPUBLIC

Mary Evelyn Speer pets her golden retriever puppy Bailey on the back porch of her home in Jennings County.

SURVIVOR STORY: Bev Wilson Survivor discourages rushing chemo “All I could think of was getting my life back.”

— Bev Wilson

BY CHRISSY ALSPAUGH calspaugh@therepublic.com

B

EV Wilson said it’s unlikely that she could have avoided the side effects of the chemotherapy that helped her beat breast cancer.

But now with symptoms that probably are permanent, she wishes she would have tried.

Doctors discovered an aggressive, fast-growing tumor in Wilson’s right breast when she went in for her annual mammogram in 2009.

She was diagnosed with advanced Stage 2 breast cancer, and treatment began with a lumpectomy of the tumor.

Further tests showed she needed a complete mastectomy and removal of 10 lymph nodes in her right arm.

ANDREW LAKER | THE REPUBLIC

Bev Wilson pauses during an interview at her home.

Wilson said she’d watched her sister-in-law fight the disease, so she expected to undergo chemotherapy.

Biography AGE: 67 RESIDES: Columbus DIAGNOSED: Feb. 13, 2009.

FAMILY HISTORY WITH BREAST CANCER: None.

IN REMISSION: One year.

FAMILY: Husband, Gene; son, Glen Wilson; daughter, Kelly Wilson; granddaughters, Lacey, Lydia and Lindsey.

wakes up with you and goes to bed with you. I remember sitting in the dark because it hurt too much to go turn on a light.”

About halfway through her chemotherapy, Wilson said, she began experiencing numbness and tingling in her hips and feet.

She said nurses mentioned that if she developed numbness, they could suspend treatments to give her body time to recover.

But unlike her sister-inlaw’s six rounds of the drugs, Wilson ultimately needed 16 treatments.

“All I could think about was getting my life back, where I could go for walks again and play with my grandkids again,” Wilson said.

Rough ordeal

“Now, I feel like I rushed it.

But hindsight’s always 20/20.”

She said nothing could have prepared her for the mouth sores, extreme tooth sensitivity and chest pains and bladder infections that prompted her to go to the ER. “I thought about stopping (chemo),” she said. “I just remember that tiredness that

Lingering effects A year into remission, she still experiences numbness in her hips, feet and hands — a condition called neuropathy, which can be caused by some

See WILSON on Page D10

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PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

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North student walks for breast cancer

BY ANDREA ZEEK azeek@therepublic.com

A

S a member of Columbus North High School’s girls cross country team, running 35 miles a week is commonplace for senior Abbie Todd. But one of her more memorable journeys was the 60 miles she walked in three days for breast cancer.

Abbie, 17, raised money for and participated in the Aug. 6 to 8 Susan G. Komen 3-Day for the Cure in Chicago this year, as part of her high school senior project. “(The project was) a lot of responsibility,” she said.

“Some students might build a doghouse or make blankets.

Fundraising, I think, is great because you’re not just helping Columbus, you’re helping all over the world.”

To be eligible to walk, Abbie had to come up with $2,300 for the charity. She spent the summer organizing yard sales, a car wash, a bake sale, a donation table at Kroger and an Applebee’s dinner event from which she received 15 percent of the bill.

She also set up donation cans around the city and made and sold T-shirts that said, “Together we can make a difference.”

“I spent most of my summer worrying about how to get my money raised,” she said.

Biography AGE: 17 RESIDES: Columbus OCCUPATION: Columbus North High School senior SENIOR PROJECT: Raised $2,456.23 for Susan G. Komen Foundation, which is dedicated to fighting breast cancer; participated in a Walk for the Cure event in Chicago.

FAMILY: Sister, Alexis; stepsister, Makayla; mother, Cindy Todd; father, Steve Todd; stepmother, Gwen Todd.

“Instead of relaxing and going on vacation like everyone else, I asked for donations every week, checked up on cans, called businesses asking for money.”

But her hard work paid off, because by the end of the summer, she had surpassed her goal by raising more than $2,400 for Susan G. Komen Foundation.

Family motivation Dana Curish, executive director of Susan G. Komen’s central Indiana affiliate, said Abbie is part of an increasing number of young participants.

There were 3,413 walkers ages

See TODD on Page D11

ANDREW LAKER | THE REPUBLIC

Columbus North senior Abbie Todd displays one of the posters she made for her fundraising effort to benefit the Susan G. Komen Foundation and 3-Day for the Cure. Todd raised $2,400.

SURVIVOR STORY: Cheryl Fox Breast cancer turns woman into fighter N

“No one doctor knows everything, and ultimately you have to be your own best advocate. Had I gone (the other doctor’s) way, I would have had things done that weren’t necessary, in my eyes,” she said.

Fox underwent a mastectomy in March, followed by breast reconstruction surgery. She spent three days in the ICU so doctors could make sure the tissue transfer was working.

“My poor husband,” Fox said. “He said, ‘You look more beautiful than I’ve ever seen you.’ He was just happy to see me alive.”

While undergoing her treatment, Fox agreed to participate in several research tests.

“Anything I could do to help the girls in my class, or my two nieces, so hopefully at some point we can find a cure, and nobody has to go through this. Or so it doesn’t go from one in eight women to one in six,” she said.

BY TOM LOTSHAW Brown County Democrat

ASHVILLE — The only time Cheryl Fox cried was in her car after leaving the doctor’s office.

That’s when she started thinking about her 4-yearold son, Cameron.

“I waited long enough to have him, and I didn’t want to have me die,” she said.

It was January 2008. Fox, a math teacher at Brown County High School, was 46 years old and just learned she had breast cancer.

A routine mammogram in early December showed “some suspicious spots,” according to a letter Fox got several days later.

The letter had said to call right away, but when she did, the doctor’s office said it wouldn’t be able to get her in for a followup appointment until January because of the holidays.

“I went over by myself on a teacher workday that first Monday in January, because I didn’t think it was going to be anything,” Fox said. “I remember sitting in the consultation room by myself, with the doctor saying, ‘These are tumors, these are malignant.’”

The three tumors were small, but they were in different quadrants of her breast and would eventually require a mastectomy.

Fox cried that first day in January, but she also decided to be a fighter. She returned to school the next day and told her students she had breast cancer.

Positive attitude “So many of them related to it because of their mom or their grandmother. One in eight women has breast cancer,” she said.

Fox tried to maintain a positive attitude. And nearly three years later, a banner to that effect still hangs in her classroom.

The banner, helping herself as much as her students, reads:

“Don’t g

Does what she can TOM LOTSHAW | FOR THE REPUBLIC

Breast cancer survivor Cheryl Fox with her son, Cameron Fox, who was her inspiration for getting through the disease.

“Attitude is a little thing that can make a big difference.”

A week after receiving her diagnosis, she met with a doctor at Indiana University Medical Center to talk about treatment options. “(The doctor) said this is not something we have to rush at, but I couldn’t wait until school was out,” Fox said.

She began trying to educate herself about treatments and got a second opinion from another doctor, something she encourages anyone diagnosed with breast cancer to do.

The second doctor had a radically different view of her treatment options and suggested radiation, something Fox ultimately never had to undergo.

This past May, she participated in Brown County Relay for Life.

After walking an opening lap for survivors around the high school track, Fox spoke at the event and walked another 20 miles. Cameron, now 7, walked more than 12 miles.

“I don’t help Relay as much as I would like. I give what I can. If somebody’s got questions, I will do what I can to help and make time for them,” Fox said.

Such support helped in her fight against breast cancer.

Friends and family and cancer survivors can offer all kinds of support, from help with dinner and work around the house to critical emotional support and valuable feedback on treatment options, Fox said.

“Don’t go it alone,” she said. “You really need to search out women who have been through it. Seek a support system, the bigger the better. Don’t be afraid to ask for help.”

Fox continues to see a general practitioner every six months for a checkup. She is cancer-free to the best of her knowledge.

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SURVIVOR STORY: Kim Fields Family helps smooth ‘rough road’

BY CAREY SHEA editorial@therepublic.com

Biography

T

HE morning of Sept. 10, 2008, started out much like any other for Kim Fields. She got her two daughters off to school, said goodbye to her husband and went to work.

Even though everything seemed normal, she felt anxious. Two weeks before, doctors told her she had a mass in her left breast and they needed to perform some tests.

The odds were in her favor, they said, as most masses turn out to be benign.

“They called me while I was at work and told me I had breast cancer over the phone,” Fields said. “I was in a room with my co-workers, not my family, not my husband.”

The rest of the day went by in a blur. Fields became a spectator to her own life. She said it felt like witnessing her own funeral.

Friends and family came over, but she never felt present. Even with their support, Kim and her husband, Scott Fields, felt alone.

“Family comes over and friends come over when you’re first diagnosed, and everybody hates it and everybody feels for you, but people go home and go back to life,” Kim said.

“We lay down every night knowing that we had to wake up the next morning and do it all over again.”

This happened two weeks before their 10th wedding anniversary.

Critical decisions Kim and Scott recalled the months after the diagnosis and the journey that followed.

“I did things then I probably couldn’t do again,” said Scott, “but

AGE: 35 RESIDES: Columbus OCCUPATION: Distribution supervisor for Enkei America DIAGNOSED: Sept. 10, 2008, with invasive ductal carcinoma IN REMISSION: Two years FAMILY: Husband, Scott; daughters, Sidney, 10, Lillian, 7. you have to step up and do that.”

By October, Kim would start chemotherapy, which meant September was fraught with critical decisions.

“When I was diagnosed, I had options and choices: Did I want to go and see a surgeon and get it taken out; did I want to meet with the oncologist first?” said Kim. At the advice of her doctor, she went to Center for Women’s Health in Greenwood and decided to get chemotherapy before removing the tumor.

“They wanted to leave the tumor in to make sure that they knew the chemotherapy was working, and I am glad that we did. I had four rounds of chemo, and they did a mammogram; the tumor was half of its original size,” she said.

The effects on Kim set in quickly. She lost all of her hair first. Then she could hardly move without feeling pain the week following each round of chemotherapy. She remembers trying to explain to her children, Sidney and Lillian, then 8 and 5 years old, what was happening.

“We told them there was something inside of me that was trying to make me sick, and unfortunately there were medicines out there that would make me sicker to make me better,” said Kim.

The road was hard, she said. By January, after four more rounds of chemo, the tumor disappeared. She had beaten the cancer but learned her chances of getting it again were significant.

Still at risk Kim discovered that she had inherited the breast cancer gene, which gave her an 80 percent chance of getting breast cancer from birth and an increased chance of getting it again.

“Because of the breast cancer gene, it was recommended that I have a complete, bilateral mastectomy. I had a hysterectomy, and they took out my ovaries as well, because I had a 50 percent chance of getting ovarian cancer,” Kim said.

Scott said that through the chemotherapy and the following surgeries, the physical and emotional stress could have easily led to depression.

“Depression can beat anybody if you let it get to you,” said Scott, “but when you have the two little ones running around you can’t let it get to you.”

As a carrier for the breast cancer gene, Kim worries about her children.

With a 50 percent chance of inheriting it, Kim said, they will need to be tested early, but her illness has given them the information and the warning they need to be vigilant.

Kim still gets tested every three months and said the fear that the cancer might return never really goes away, it only becomes more manageable.

She and family, friends, and co-workers walked in March for a Cure in Indianapolis in April and remarked at how many survivors there were, of all ages.

“There’s hope,” said Kim. “It’s a rough road; you have to think positive and hang on to family and friends.

They will get you through it.”

JOEL PHILIPPSEN | THE REPUBLIC

Kim Fields gets tested every three months for cancer and said while the fear that it might return never really goes away, it does get more manageable.

WILSON

Continued from Page D8 chemotherapy drugs.

Wilson said medicine helps with the constant tingling, but the condition likely will never go away.

She said since chemotherapy, her taste buds also have changed.

caused by a blockage in the lymphatic system.

Wilson tries to limit use of her right arm and uses a special compression pump nightly to reduce the symptoms.

“I am grateful that chemo helped me, and now I’m in remission, but you just know there are side effects you’re going to live with,” she said.

She said most of the cost of the equipment was paid

by Medicare and encouraged others with the condition to research whether a compression pump might be an option.

The removal of 10 of her lymph nodes also caused a condition called lymphedema, a condition of localized fluid retention and tissue swelling

Wilson recently went to the doctor to talk about reconstructive surgery, and said she’s considering a second mastectomy — to pre-

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Bev Wilson uses a compression pump on her arm to treat lymphedema — a condition stemming from her breast and lymph node cancer treatment.

vent a recurrence of breast cancer and to prevent the possibility of more chemotherapy.

“I always say that if I got cancer again, I would never go through chemo again,” she said. “But then again, I’m only 67, so who knows?

“I would tell others to not get so impatient with their treatment that they do more than what you should. I think I did. I think I rushed my treatment so much, when I should’ve gotten more delay in between to maybe prevent some of the things that happened to me.”

ANDREW LAKER | THE REPUBLIC

MAMMOGRAMS Continued from Page D2

She mentioned that she’s heard some women 75 and older wonder why they should undergo breast screenings. But figures show that advancing age increases the risk of such cancer.

The number of mammograms has increased gradually each of the last several years at Seymour’s Schneck Medical Center, according to Rita Baker, the hospital’s director of diagnostic imaging.

The hospital did 4,814 breast

screenings and diagnostic procedures in 2008, and 5,125 in 2009, according to Baker. She expects this year to finish in the 5,000 range.

Sally Acton, Schneck’s director of cancer services, said she was glad that U.S. Health and Human Services Secretary Kathleen Sebelius in November encouraged women “to do what they’ve always done” after an uproar over the task force survey.

“I never stopped encourag-

ing women to keep doing that (precaution),” said Acton, an oncology nurse since 1986. “I know that a lot of women have found their own lumps. You have to know your own breasts to know when things are abnormal.”

Schneck launched free clinical exams this year handled by nurse practitioners. A surgeon follows up if any abnormalities are found, according to Acton.

The hospital foundation has funded extra steps such as

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mammograms and ultrasounds when necessary.

That was especially important, since many of the women coming in either had just lost a job or had no health coverage on their job.

At Columbus Regional, Tuell said that even with extensive education programs about the need for regular screening, she cannot rest.

“Until we see 100 percent compliance,” she said, “we won’t be happy.”

PINK PURPOSE — THE BATTLE AGAINST BREAST CANCER

T H E R E P U B L I C , C O L U M B U S , I N D ., F R I D A Y , O C T O B E R 15, 2010

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SURVIVOR STORY: Carolyn Purvis Keeping the faith Religion brings comfort

C

JOEL PHILIPPSEN | THE REPUBLIC

Carolyn Purvis reads the Bible in her living room at her home near Ogilville as paintings of Jesus hang on the wall above her. Purvis, who has had breast cancer, says that she found comfort in reading the Bible and the support of her family and friends.

BY ANDREA ZEEK azeek@therepublic.com

AROLYN Purvis always will remember the day she was diagnosed with breast cancer in January 2005.

After a routine medical checkup in June 2004 at Columbus Regional Hospital, Purvis had been asked to return to the doctor’s office in six months.

“That had never happened before,” she recalled as she sat in an armchair — her late husband’s favorite — in her tidy living room.

During her follow-up visit, Columbus Regional Hospital doctors found she had breast cancer. They sent her to another building for a biopsy.

Her short walk across the parking lot was the first chance she got to process the information. At the time, Purvis’ husband, Ed, was suffering from Alzheimer’s disease, and they were taking care of their young, adopted son.

“By the time I got to the hospital, I broke down because I didn’t see how I was going to get through it,” she said. “When you hear of cancer, you don’t hear of most people living.”

Purvis said she called a friend who had cancer to help her deal with the new emotions. She also researched her cancer on the Internet, but said that wasn’t doing her much good.

“The more I read about it, the more scared I became,” she said.

So Purvis changed her tactics.

“I just decided to do what the doctor said and leave it in the Lord’s hands.”

Doctors recommended Purvis undergo radiation treatment instead of chemotherapy. So after getting a second opinion at a Greenwood

Biography AGE: 70 RESIDES: Columbus OCCUPATION: Retired Cummins “jack-ofall-trades” FAMILY: Children: Patty Jo, Leon, Rickey Dean; stepchildren: Mike, Greg, Debbie, Robin, Vicky; adopted children: Mark, Lisa, Rick. Husband: Ed (deceased).

cancer center, she started treatments — five weeks’ worth in one week. That meant two X-rays and radiation every morning and night.

Purvis described the experience as tiring.

As her husband’s Alzheimer’s worsened, she juggled caring for him, their son and herself.

She said she took comfort in her religion and especially from Bible verses about healing.

“Most people, when they get sick, they look for that higher power,” she said.

No matter what, she made sure to read two chapters of the Bible when she woke up and before she went to sleep.

“I promised the Lord that I would put him first in the morning and at night,” she said.

Sadly, Ed lost his battle with Alzheimer’s in May. But Rick, now 14, is in school, and come January, Purvis will have something to celebrate: Her doctors will declare her cancer officially in remission.

Although this doesn’t mean it can’t come back, she has faith.

“I’m a firm believer that God healed me,” she said. “He took (the cancer) away.”

SPEER

Continued from Page D8 over her prescribed diet of fruits and vegetables was not always easy.

“If it’s your life; you can do it,” she said.

Speer returned to the hospital for the biopsy and instead instructed her doctors to remove every trace of growth.

Rather than undergo chemotherapy or radiation treatments, Speer put her faith in God and Wickey’s diet. A Christian all her life, she felt led by God to trust the Amish man’s judgment.

The fact that Speer is allergic to many medications also

factored into her decision for alternative treatment.

Speer’s six children were split on how they felt about their mother’s cancer-fighting strategy. Some felt she should go the traditional medical route, while others believed the diet could work, but each supported their mother.

“I’ve got enough faith in her faith that it’s going to be OK,” said her daughter, Kristina Johnson, recalling her feelings at the time.

Today, Speer is cancer-free and grateful for the added time she has to spend with her

family, particularly her grandchildren and great-grandchildren.

“I’m very blessed and thankful that I’m here. … I’ve had eight years I might not have had,” she said.

She is quick to credit prayers from friends and family with her recovery.

Throughout the experience, Speer says she never felt the terror or fear she thought would come with breast cancer.

“I knew that God led me exactly the way I went. I never had the fear that I hear you have.”

“Before actually doing the walk and seeing all of those survivors and how it’s changed their lives, before my coach (North girls assistant basketball coach Martha Kalb) died and the friend of my family died, I never really thought that much about (breast cancer), because it never really affected me,” she said. “Getting involved in it changed my view, because now I see how important it is to find a cure.”

her better.

“I thought it would be easy, thought it would be a piece of cake,” she said. “Actually, it was tough; I got tons of blisters, and I was really sore.”

But she said the whole experience, especially the supporters who cheered on walkers, made the challenge well worth it.

“It was great,” she said.

“I’m so glad that I did it.”

Abbie’s father, Steve Todd, said he is pleased with his daughter’s hard work as well.

“Senior projects, you hear a lot of different stories; some are very involved, some are not,” he said. “I think (Abbie) went above and beyond what she needed to do. As a parent, anytime your child does something above and beyond, that makes you very proud.”

TODD

Continued from Page D9 10 to 19 at the most recent 3Day for the Cure, she said.

“It’s really kind of exploded in the last couple of years,” Curish said. “We’re absolutely just thrilled, because it’s never too early to understand and be aware of breast cancer, not only for yourself, but for other family members. … I think it speaks so well of the younger generation that they’re getting involved and not only raising money, but raising awareness.”

Abbie said she got the idea to do the walk from her stepmother, Gwen Todd, who told Abbie of her plans to walk in memory of her aunt and grandmother. Abbie said she learned a lot from the event, including that men and women can get breast cancer, and that they’re getting the disease at younger ages.

Eye-opening event The joyous atmosphere of the walk — the excitement, the singing, people dressed in goofy hats, men unashamedly wearing pink — also surprised her. As for the physical aspect of the walk, Abbie said she thought her cross country experience would have prepared

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if any long-term studies into the cancer-combating effects of diets such as Speer’s or the use of herbs.

On the other hand, radiation and chemotherapy treatments have years of studies from which to draw, according to Thompson.

“We know they work,” he said.

In some cases, no further treatment is needed after a tumor is removed.

“Sometimes we don’t recommend additional chemotherapy or radiation,” he said.

Speer has nothing against modern medicine.

Up until a few years ago, she frequently consulted with an oncologist, and she regularly

A doctor’s perspective Dr. David Thompson with Southern Indiana Surgery knows patients who have done well with follow-up treatments similar to Speer’s.

He also knows a patient whose colon cancer worsened after following a similar regimen over traditional treatment methods.

While he doesn’t have a problem with patients choosing non-traditional cancer treatment options, he doesn’t recommend them.

“As a physician, I’m just here to give them their options,” he said. “We try and recommend things that are going to be based in scientific research.”

At this point, there are few

visits a traditional doctor in Columbus.

Wickey now lives near Fort Wayne, but Speer still visits him a few times each year.

Overcoming breast cancer has been a humbling experience and one that served to strengthen her faith and discipline.

Speer pointed out that while the diet worked for her, it is not for everyone. “(Others) have to feel right about what they do. I felt right about what I did, and that’s why I did it.”

Her best advice to others diagnosed with breast cancer is don’t despair.

“You don’t ever, ever give up. … As long as you’re breathing, you’ve got hope.”

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