Healthy Living October 2010

l l a F

2010

Healthy Living

October is

month

Inside:

Services at Skagit County hospitals Look Good ... Feel Better Breast cancer facts Eat to prevent cancer Cancer support groups A supplement to the Skagit Valley Herald and Anacortes American

Healthy Living

04 Editor Bev Crichfield | bcrichfield@skagitpublishing.com Advertising Director Mark Dobie | mdobie@skagitpublishing.com Display Advertising Manager Deb Bundy | dbundy@skagitpublishing.com Advertising Operations Manager Sarah Hickman | shickman@skagitpublishing.com

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12

fall 2010

Table

Skagit County hospitals cancer services........................... 04 Look Good ... Feel Better program.................................... 06 Practicing breast self-awareness....................................... 08 Breast cancer facts........................................................... 09 Reduce your risk................................................................ 10 Eat to prevent cancer........................................................ 12 Factors that increase risk.................................................. 13 Cancer support groups...................................................... 14

Advertising Consultants Jared Hanson | jhanson@skagitpublishing.com Stephanie Harper | sharper@skagitpublishing.com Leah Hines | lhines@skagitpublishing.com Marcus McCoy | mmccoy@skagitpublishing.com Michelle O’Donnell | modonnell@skagitpublishing.com Kathy Schultz | kschultz@skagitpublishing.com Katie Sundermeyer | ksundermeyer@skagitpublishing.com Paul Tinnon | ptinnon@skagitpublishing.com

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of Contents

Graphic Designers Ashley Crerar Jody Hendrix Christina Poisal Patricia Stowell Cover Design & Page Layout Patricia Stowell

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hen it comes to fighting, treating and supporting breast cancer patients and survivors, all three Skagit County hospitals have you covered: ISLAND HOSPITAL Anacortes For information: 360-299-4200 or ppedersen@islandhospital.org Island Hopsital’s accredited Cancer Care Center provides a wide variety of options to help detect and fight breast cancer. The center is part of the North Puget Oncology Cancer Care Centers, and along with other services includes a Cancer Resource Center to provide information for patients, survivors and their families.

• Screening mammography: This is an X-ray exam of the breast on any woman who has no symptoms. The goal is to find cancer when it’s still too small to be felt by a woman or her doctor. The mammogram takes two X-ray pictures of each breast.

• Diagnostic mammography: This is an X-ray exam of the breast in a woman who either has a breast problem (a breast lump, nipple discharge, etc.) or has had a change

Fall Healthy Living | october 2010

of her breasts detected through a screening mammogram. During the diagnostic mammogram, more pictures are taken to study the area of concern.

• Breast ultrasound: Ultrasound imaging produces a picture of the internal structures of the breast. The sonographer or physician performing the test may use Doppler techniques to evaluate blood flow or lack of flow in any breast mass.

• Breast MRI: This is not a replacement for mammography or ultrasound imaging, but is a supplemental tool for detecting and staging breast cancer and other breast abnormalities.

• Breast wire localization: This procedure guides a surgical breast biopsy of a small mass that may be hard for the surgeon to find. A hollow needle is placed in the breast, and X-rays are used to guide the needle to the suspicious area. A thin wire is put through the center of the needle.

• Ultrasound breast biopsy: Ultrasound can be used so the doctor can see the needle on a screen as it moves toward and into the mass. The cell tissue is removed and examined under a microscope.

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• Breast surgery: In this type of biopsy, the surgeon makes an incision in the skin of the breast and takes out all the abnormal area together with a narrow area surrounding normal tissue.

• Breast cancer chemotherapy: Drugs are are used to kill or slow the growth of rapidly multiplying cells, like cancerous cells. For breast cancer, chemotherapy drugs are given intravenously or orally. Once the drugs enter the bloodstream, they travel to all parts of the body to reach cancer cells that may have spread beyond the breast.

Chemotherapy is given in cycles of treatment followed by a recovery period. It involves a combination of drugs.

• Clinical breast exam: This is a physical examination of the brest done by a health professional and used to pick up any problems.

SKAGIT VALLEY HOSPITAL Mount Vernon 360-424-4111 or ContactUs@skagitvalleyhospital.org The Skagit Valley Hospital Regional Cancer Care Center provides services to breast cancer patients and survivors through its Breast Institute, which opened in late 2009. It offers a group of physicians, oncolowww.goskagit.com

gists, radiologists, pathologists and surgeons who provide a multitude of diagnosis, treatment, education and recovery options. Skagit Valley Hospital, Skagit Regional Clinics and the hospital’s joint venture with the Breast Care Center offer screening and digital mammography, and breast MRI, biopsy and breast surgery, including reconstruction.

• Radiation therapy • Chemotherapy • Acupuncture • Massage • Patient navigator: The navigator serves as a resource to each patient, from diagnosis and treatment to survivorship.

UNITED GENERAL HOSPITAL Sedro-Woolley 360-856-7244 or www.unitedgeneral.org United General Hospital in Sedro-Woolley offers a variety of diagnostic and treatment options at

“When you need orthopedic rehab, make Life Care Center Mount Vernon your first choice.”

its North Puget Cancer Center and its Breast Care Suite: • RapidArc IMRT: Advanced radiation therapy, using the “RapidArc,” a new technology that allows for high-intensity radiation to be safely delivered to the precise place it’s needed.

• 3-D Conformal Radiation Therapy: Radiation therapy commonly used to treat breast cancer.

• Chemotherapy: The general term for treatment involving the use of chemicals to stop cancer cells from growing. United’s chemotherapy unit includes wide screen televisions and headsets for music.

• Hormonal therapy, anti-estrogen therapies and biologic therapies.

• Digital mammography: a faster, more accurate method of screening for breast cancer using digital

instead of film images.

• Soft touch mammography: a new product that drastically eases the discomfort of a typical mammogram.

It uses a foam cushion to create a softer, warmer and more comfortable mammogram experience.

• Prevention information In addition, United offers plenty of support for cancer patients and resources, including: • Nutritional counseling • Lymphedema specialist • Chemo brain therapy • Social worker • Financial counseling • Genetic counseling • Appearance center • Wig fittings • Look Good ... Feel Better classes • Medical fitness center • Gentle exercise classes • Support groups

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American Cancer Society Aims To Help Patients

Look Good ... Feel Better

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By BEVERLY CRICHFIELD, Editor

osmetologist Velda Blair remembers how her daughter dreaded the cancer treatments she suffered through.

The pain. The illness. And, of course, what the treatments did to her once-youthful appearance.

So when Blair and her daughter found out about the American Cancer Society’s Look Good ... Feel Better program, they decided to check it out.

During the classes offered through the program, Blair and her daughter were able to find a suitable wig to cover her daughter’s balding head and learned how to take care of her dry skin and draw on eyebrows that looked natural.

“It’s so good for them,” Blair, of Mount Vernon said about the cancer patients in the classes. “They get to meet with other people in the same boat that they are in.

It’s visiting and sharing — it’s therapy.”

Blair’s daughter died three years ago from breast cancer. But the impact of those classes stayed with Blair.

So a year-and-a-half ago, she started the Appearance Center at United General Hospital, and six months ago, became involved as a cosmetologist and instructor for the Look Good ... Feel Better program.

“I knew from experience how traumatic it was when she (her daughter) knew she would lose her hair and eyebrows,” Blair said. “I had the skills.”

The Look Good ... Feel Better program was developed in 1989 by a charitable organization supported by the cosmetology industry in partnership with the American Cancer Society and the Professional Beauty Association/National Cosmetology Association.

The program aims to provide beauty and health services to women like Blair’s daughter, who not only have to face a life-threatening illness but struggle with the changes in their appearance, said Chrystal Campbell, a quality of life manager for the American Cancer Society.

“There are a lot of hair changes and skin changes, and these things lead to a loss of femininity and self-esteem,” Campbell explained.

The organization coordinates the program with all three hospitals in Skagit County, Campbell said.

The classes are taught by volunteers who have been trained by the organization to help with the special beauty needs of cancer patients — everything from the importance of moisturizing the skin and finding the right wig to using the proper concealer over discolorations of the skin caused by radiation or chemotherapy treat

Fall Healthy Living | october 2010

ments.

Eight cosmetologists have been trained to help out in Skagit County, including Blair.

Most of the classes range from three to five patients, Campbell said. And while the women may find support there, the classes aren’t set up as support groups, she said.

“It’s a fun place for women to get together to try on makeup, and learn how to color their eyebrows,” Campbell said. “It’s an amazing opportunity for them to make an impact on their treatment by making them feel better.”

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The women are given a free cosmetic kit in four shades to enhance any complexion, Cambell said.

A similar batch of classes had been set up for men suffering with cancer, but those classes weren’t successful, Campbell said.

Instead, men like to receive help on a one-on-one basis or over the phone, she said.

Blair said between three and four patients usually attend her classes at the Appearance Center that’s stocked with a variety of wigs, scarves and hats. She’ll shave a head or cut hair for cancer patients there, if asked.

During those classes, she spends

about two hours instructing women on the importance of hygiene — chemotherapy weakens the immune system and women need to be especially careful to keep clean and avoid infection — the importance of sunscreen and moisturizer and the many secrets of hiding hair loss.

It may not seem like rocket science, but Blair said she hopes the skills she’s teaching the women help brighten their perspective. “This is something important to help a woman cope with the way she looks,� Blair said. “That’s the way society is — it’s important.�

To find out more about the Look Good ... Feel Better program, call 425-322-1100 for dates and to register. Classes are offered at Island Hospital in Anacortes, Skagit Valley Hospital in Mount Vernon and United General Hospital in Sedro-Woolley. Times and dates can vary.

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Practicing Breast Self-Awareness

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arly detection of breast cancer is the single-most effective way to beat the disease. That is why it is essential for women to conduct their own breast exams to discover any potential anomalies early on.

While doctors stress the importance of self-examination, many women still

show up for routine wellness visits admitting they don’t do examinations because they simply don’t know how- perhaps because the practice was given the formal name “breast self-exam.” Today, however, doctors tell women to have “breast self-awareness.” That means women don’t have to follow a set protocol regarding checking for breast changes, and simply being aware of how the breasts look and feel is key.

Breast self-awareness can help women notice changes in the breasts and alert a doctor promptly.

Why the change in the formalities?

Doctors have determined that most women notice a lump in their breasts

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• Breasts are best checked for changes directly after a menstrual period. At this time the breast tissue will be softer and less tender due to diminishing hormone levels.

• Look at the breasts every day and notice their appearance and shape.

Recognizing subtle differences can help alert a doctor if something is amiss.

Be conscious of these changes: • changes in breast size, shape, skin texture, or color • dimpling or puckering of the breast • discharge from the nipples • scaliness of the skin • nipple pulling to one side • lump or mass in the breast • enlarged lymph node under the arm

• Women should know their risk for breast cancer. While there isn’t a definitive genetic correlation, the high rate of breast cancer in one family may mean a particular woman is more at risk.

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To demystify the process even further, follow these guidelines:

Any changes or questions about breast condition should be promptly brought up with a doctor.

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while doing routine activities, such as bathing or dressing. They also figured out that a formal method of examining the breasts was not necessary. Lumps can be found simply by touching the breasts in any pattern, as long as the entire breast is checked.

• Get routine screenings at a doctor’s office. Women over the age of 40 should get a mammogram every year.

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Here are some facts and figures about breast cancer: • About 1 in 8 women in the United States (between 12 and 13 percent) will develop invasive breast cancer over the course of their lifetime.

• About 39,840 women are expected to die in 2010 from breast cancer.

• More than 1 in 4 cancers are breast cancer.

• As of 2010, there are more than 2.5 million breast cancer survivors in the U.S. • A woman’s risk of breast cancer doubles if her mother, sister or daughter has been diagnosed with breast cancer.

• About 20-30 percent of women diagnosed with breast cancer have a family history of breast cancer.

• The most significant risk factors for breast cancer are gender (being a woman) and age (growing older).

• White women 40 years and older have a higher rate of breast cancer than African-American women under the age of 40. However, African-American women under the age of 40 have a higher breast cancer rate than white women under the age of 40.

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• Breast cancer is the second leading cause of cancer death in women.

• Only 5 to 10 percent of breast cancers occur in women with a clearly defined genetic predisposition for the disease. Most are “sporadic,” meaning there is no direct family history of the disease.

• An estimated 1,970 new cases of male breast cancer will be diagnosed in 2010 in the U.S. • Most breast cancer diagnosis and deaths occur in women 50 years and older.

Courtesy of the American Cancer Society

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Cancer: You Can Reduce Your Risk

T

here was a time when “cancer” was a word that was only whispered in polite society. It was the devastating, insidious illness that almost nothing could be done about. Death from cancer was ugly, unavoidable and best not thought about until you absolutely had to.

Preventing it was thought to be, in most cases, out of the realm of possibility.

Today, we know a great deal more about cancer and have made advances in its treatment. Yet many of us are still in denial, reluctant to engage the topic in our daily lives.

In fact, there are a number of common-sense ways to reduce your risk of getting certain kinds of cancer. No guarantees, but there are steps you can take now to improve your odds.

And guess what? They’re the same things you do to avoid getting heart disease. That’s right: Watching your weight, avoiding junk food and getting exercise - which you already knew will would help to fend off a heart attack - also greatly reduce your chances of getting cancer.

According to the American Cancer Society, about a third of the 550,000 American cancer deaths each year are linked to obesity, poor diet and inactivity. Another third are due to smoking.

In other words, one of the biggest contributors to cancer risk is lifestyle - and that’s something over which you have control.

The numbers behind this statement? “Forty percent of breast cancer cases in the U.S. - about 70,000 cases a year - could be prevented” by changes in behavior, says Susan 10

Fall Healthy Living | october 2010

By ranit mishori Special to The Washington Post Higginbotham, director of research for the American Institute of Cancer Research (AICR).

A German study published last year in the Archives of Internal Medicine showed a 36 percent reduction in cancer risk overall among people who changed to more-healthful habits. A Harvard School of Public Health study described 44 percent of cancer deaths as avoidable in a report that appeared in BMJ, a British medical journal.

None of this is easy, but bad habits can be changed, and it’s good to know which ones count when it comes to reducing your risk of cancer. So here they are:

Obesity

More than 100,000 cancer cases each year - cancers of the uterus, esophagus, pancreas, kidney, gallbladder, breast and colon - are linked to being overweight, according to the AICR. Scientists believe it partly has something to do with estrogen stored in and produced by our fat cells.

In women, “fat cells are a major source of estrogen after menopause,” says Michael Thun, vice president emeritus of epidemiology and surveillance at the American Cancer Society. That estrogen, he notes, “promotes the development of uterine and breast cancer.”

Fat also increases the concentration of a substance called insulin-like growth factor, which has also been linked to cancer. Furthermore, recent studies have looked at chronic inflammation - to which obesity contributes - and its role in various cancers, including those of the Skagit Publishing

liver, esophagus and gallbladder. “It is a combination of the effects of hormones, mechanical and chemical inflammation,” Thun says.

Here’s the catch, though. There’s little evidence that losing excess weight will improve your odds of avoiding cancer. The key, says Thun, is to avoid weight gain in the first place.

Recommendation: Maintain a healthy body weight, beginning in childhood.

Physical Inactivity

“The sedentary lifestyle is a big contributor to cancer, we now think,” says Higginbotham - and not just because it leads to weight gain.

Research is suggesting there’s something risky about inactivity itself.

The strongest evidence involves colon cancer. One review found that just getting exercise reduced colon cancer risk by 50 percent, regardless of the intensity of the workout.

Even moderate exercise, such as brisk walking for three to four hours per week, was shown in one study to lower colon cancer risk. Thun believes exercise may speed up your digestive processes, so that food moves faster through your system.

The quicker the transit times of food through the colon, the lower the risk of cancer.

With breast cancer, a 2003 study in the Journal of the American Medical Association reported that as little as 30 minutes a day of walking could mean a 20 percent reduction in risk. The effects were strongest among women in the normal weight range, where the study showed a 37 percent risk reduction. The National www.goskagit.com

Cancer Institute has linked lack of physical activity to other cancers as well, including cancers of the esophagus, kidneys and uterus.

Recommendation: Exercise regularly. If possible, aim for at least 30 minutes every day.

Drinking Past Moderation

“Heavy drinking increases the risk of about five cancers in your upper airway and digestive tract,” says Thun. The organs affected are the mouth, esophagus, pharynx, larynx and liver.

Even moderate amounts of alcohol have recently been linked to an increased risk for breast cancer in women who are in menopause. The mechanisms for this observed association are still unclear: Researchers are looking into a possible effect of estrogen levels and into genetic

differences among individuals in an enzyme that breaks down alcohol.

Recommendation: No more than two drinks a day for men and one for women.

Smoking

This should be old news. Smoking is by far the most researched and proven cause of cancer, a true slam dunk, going back to the 1964 Surgeon General’s report. According to the National Cancer Institute, more than 180,000 Americans die every year from cancer related to tobacco: smoking, chewing or breathing in somebody else’s smoke. Thun notes that smoking has been linked to 15 types of cancer, including mouth, throat, esophagus and lung, liver, stomach, colon, kidney, bladder and even cervix. It is no surprise, he says, because cigarette smoke has “40 different known carcinogens.” If you’re

OM RO D E

Mishori is a family physician and faculty member in the Department of Family Medicine at Georgetown University School of Medicine.

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a smoker, the younger you quit, the better your odds.

Recommendation: Obvious.

Let’s be clear. These are guidelines, not a promise you’ll never get cancer if you follow this advice.

Genetics count. So do things in the environment over which you have no control.

Cancer also afflicts nonsmoking slim people who eat well and work out often. But many of these lifestyle changes come with so many other benefits, beyond helping prevent cancer - weight loss to feel good, sunscreen for less-wrinkled skin - that it makes sense to adopt them anyway.

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Eat

to

Prevent Cancer

A

typical brown bag lunch, such as a ham sandwich, salted chips and a soft drink could put you at greater risk for cancer, according to a recent scientific report looking at food, nutrition, lifestyle and cancer prevention.

Processed meats, including lunchmeats, bacon and sausage, are linked to colorectal cancer. If you add a bag of salted chips, you’re getting sodium, which is associated with stomach cancer. Caloric soft drinks can pack on the pounds, another red flag in the cancer war.

No wonder the American Institute for Cancer Research and the World Cancer Research Fund recommend you change your menu.

But if your lunchmaking skills haven’t evolved from tucking a couple of slices of bologna between bread, you may be at a loss for fast and healthy alternatives.

The good news is that you have a wide variety of options, including deli fare, if you select meat products that are free of preservatives and added sodium, according to Dee Sandquist, MS, registered dietitian.

However, you can also improve on your usual menu.

“For most Americans who are eating a lot of convenience foods, creating a home deli will help a 12

Fall Healthy Living | october 2010

By Bev Bennett CTW Features

lot,” Sandquist, spokesperson for the American Dietetic Association, Washington D.C., says.

“Roast a turkey breast, slice and freeze in single portions,” she says.

On a positive note, eating more fruits, vegetables and beans may be beneficial. You’ll get the dietary fiber and antioxidant vitamins in plant foods and you’ll probably be consuming fewer calories.

How about hummus instead of meat in a sandwich? Spread the bean paste on whole wheat bread or a whole-grain tortilla.

“If you’re ready to abandon the Skagit Publishing

sandwich, it’s easy to pack a soup. You can experiment with different kinds of soup, lentil or black bean, for example,” says Sandquist, a dietitian in Vancouver, Wash.

Don’t forget to add fruits and vegetables to the lunch bag. Pack an apple or orange or a carton of salsa for dipping with raw cauliflower or mushrooms.

To reduce your likelihood of developing cancer, the American Institute for Cancer Research, Washington D.C., recommends taking these steps: • Get rid of excess weight. Stay as lean as possible within a body mass index (a ratio of height to weight) of 18.5 to 24.9. To calculate your BMI check the web site of the National Institutes of Health at http://nhlbisupport. com/bmi/ • Get at least 30 minutes or physical activity daily.

• Limit foods and sugary drinks high in fat and/or calories but low in nutrients.

• Limit red meat and avoid processed meat except for special occasions.

• Eat mostly foods of plant origin.

• Limit your intake of alcoholic beverages.

• Limit salt consumption.

See lunch menus on next page. www.goskagit.com

Although any woman is at risk of developing breast cancer, several factors have been shown to increase that risk: • Increasing age (especially after age 50) • A personal history of breast cancer • Family history of breast cancer in a mother, sister or daughter • High breast tissue density • High-dose radiation to the chest • Never giving birth or having a child after age 30 • An especially long menstrual history • Long-term use of hormone replacement therapy • Recent use of oral contraceptives • Obesity • Low physical activity • High alcohol consumption Courtesy of the American Cancer Society

Here are three healthy and easy lunch menus.

1. Hummus wrap: Spread 1/4 cup hummus on a multi-grain tortilla.

Cover hummus with baby spinach leaves. Thinly slice 1 plum tomato and arrange over spinach. Roll up and wrap in plastic wrap. Add three fresh or dried figs and a small bag of baby carrots. Add tea or water for a beverage.

2. Chicken pockets: Buy or cook skinless, boneless chicken breast. Cut into strips. Pack into two or three mini whole-wheat pita breads. Add a small carton of tomato salsa and top the chicken pockets just before eating. Add a bunch of grapes.

3. Tuna lunch: Buy a small bag of baked, unsalted pita chips. Pack with a small pouch of tuna fish or salmon and a small bag filled with grape tomatoes. Add a small carton of low-fat plain yogurt for dipping. www.goskagit.com

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october 2010 | fall Healthy Living

13

The American Cancer Society offers a variety of support groups and services for those fighting and recovering from breast cancer (or, in some cases, other cancers, as well). For more information on these programs and services, call 800-227-2345 or visit www.cancer.org.

• Reach for Recovery — free service offers information and support to those facing breast cancer through one-on-one contact with American Cancer Society volunteers. Information 24 hours a day, seven days a week.

• Patient Lodging Program — a partnership between the American Cancer Society and some hotels to provide free or substantially reduced lodging for patients and caregivers who must travel long distances for outpatient treatment. Restrictions and qualifications apply.

• Road to Recovery — American Cancer Society recruits, screens and trains volunteer drivers to help take cancer patients to treatment.

• American Cancer Society Cancer Survivors’ Network — a

virtual community that provides support for cancer survivors for other survivors and their families. Available 24 hours a day, seven days a week at www. cancer.org.

• American Cancer Society “tlc”: magazine supports women dealing with hair loss and other physical effects of cancer treatment. It offers a variety of affordable products, such as wigs, hats, turbans and prostheses that can be requested through home delivery. For information: www.tlccatalog.org.

Other support groups and services: Breast cancer Advocates: Survivors with the Angel Care Breast Cancer Foundation will attend consultations, chemotherapy and radiation appointments with newly diagnosed

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Fall Healthy Living | october 2010

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breast cancer patients. 877417-3484, angelcare@angelcarefoundation.org or www. angelcarefoundation.org.

CANCER SUPPORT GROUP: meets from 1 to 2 p.m. the second Wednesday of the month at the Stanwood Community and Senior Center, 7430 276th St. NW. 360-629-7403, ext. 110.

WOMEN’S CANCER SUPPORT: meets from 5 to 6:30 p.m. the second Wednesday of each month in the Skagit Valley Hospital Safeway Room, 1415 E. Kincaid St., Mount Vernon.

360-814-8255.

COUPLES WITH CANCER: meets from 1 to 2 p.m. the third Wednesday of the month in Skagit Valley Hospital San Juan Room A, 1415 E. Kincaid St., Mount Vernon. 360-428-8236.

CANCER SURVIVORS/ POST-TREATMENT SUPPORT: meets from 5 to 7 p.m. the first Wednesday of the month in the Skagit Valley Hospital Shuksan Room, 1415 E. Kincaid St., Mount Vernon. 360-428-8236.

MEN’S CANCER CLUB: meets from 6 to 8 p.m. the second Thursday of the month at United General Hospital Room 503, 2000 Hospital Drive, Sedro-Woolley. 360-856-7245. www.goskagit.com