Cancer Health Summer 2020

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A Leukemia Diary

COVID-19: Stay Protected Bringing Wellness Home

SONGS OF SURVIVAL

Save Your Fertility

Six months to live? That was 14 years ago.

Curtis Salgado

APPROVED USE YESCARTA is a treatment for your non-Hodgkin lymphoma. It is used when you have failed at least two other kinds of treatment. YESCARTA is different than other cancer medicines because it is made from your own white blood cells, which have been modified to recognize and attack your lymphoma cells.

Before getting YESCARTA, tell your healthcare provider about all your medical problems, including if you have or have had: • Neurologic problems (such as • Liver problems seizures, stroke, or memory loss) • Kidney problems • Lung or breathing problems • A recent or active infection • Heart problems IMPORTANT SAFETY INFORMATION Tell your healthcare provider about all the medications you take, What is the most important information I should know about YESCARTA? including prescription and over-the-counter medicines, vitamins, and YESCARTA may cause side effects that are life-threatening and can lead herbal supplements. to death. Call or see your healthcare provider or get emergency help How will I receive YESCARTA? right away if you get any of the following: • Since YESCARTA is made from your own white blood cells, your blood will be collected by a process called “leukapheresis” (loo-kah-fur-ee-sis), • Fever (100.4°F/38°C or higher) • Dizziness or lightheadedness which will concentrate your white blood cells.

• Difficulty breathing • Severe nausea, vomiting, • Your blood cells will be sent to a manufacturing center to make or diarrhea • Chills or shaking chills your YESCARTA. • Fast or irregular heartbeat • Confusion • Before you get YESCARTA, you will get 3 days of chemotherapy to • Severe fatigue or weakness prepare your body.

It is important to tell your healthcare provider that you received YESCARTA • When your YESCARTA is ready, your healthcare provider will give and to show them your YESCARTA Patient Wallet Card. Your healthcare it to you through a catheter placed into your vein (intravenous provider may give you other medicines to treat your side effects. infusion). The infusion usually takes less than 30 minutes.

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THIS IS MORE THAN HOPE.

THIS IS REMISSION.

™

YESCARTA® is the first CAR T-cell therapy approved for adults with certain types of non-Hodgkin lymphoma. YESCARTA empowers your immune system to recognize and destroy cancer cells, making complete remission possible when other treatments fail.

In a clinical study of 101 patients with non-Hodgkin lymphoma who had experienced other treatment failures, YESCARTA helped 51% [52 out of 101] of patients achieve complete remission and 21% [21 out of 101] of patients achieve partial remission. Not all patients in the clinical study who achieved a complete remission remain in remission.

Complete Remission: The disappearance of all signs of cancer in response to treatment.

This does not necessarily mean the cancer has been cured.

Partial Remission: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment.

Learn more at YESCARTA.com

• You will be monitored where you received your treatment daily for at least 7 days after the infusion.

• You should plan to stay close to the location where you received your treatment for at least 4 weeks after getting YESCARTA. Your healthcare provider will help you with any side effects that may occur.

• You may be hospitalized for side effects and your healthcare provider will discharge you if your side effects are under control, and it is safe for you to leave the hospital.

• Your healthcare provider will want to do blood tests to follow your progress. It is important that you do have your blood tested. If you miss an appointment, call your healthcare provider as soon as possible to reschedule.

What should I avoid after receiving YESCARTA? • Do not drive, operate heavy machinery, or do other dangerous things for 8 weeks after you get YESCARTA because the treatment can cause sleepiness, confusion, weakness, temporary memory and coordination problems.

• Do not donate blood, organs, tissues, and cells for transplantation.

What are the possible or reasonably likely side effects of YESCARTA? The most common side effects of YESCARTA include: • Fever (100.4°F/38°C or higher) • Low white blood cells (can occur with a fever) • Low red blood cells • Low blood pressure (dizziness or lightheadedness, headache, feeling tired, short of breath)

• Fast heartbeat • Confusion • Difficulty speaking or slurred speech • Nausea • Diarrhea

These are not all the possible side effects of YESCARTA. Call your healthcare provider about any side effects that concern you. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Important Facts about YESCARTA, including important warnings, on the following page.

YESCARTA, the YESCARTA logo, THIS IS MORE THAN HOPE. THIS IS REMISSION., KITE, and the KITE logo are trademarks of Kite Pharma, Inc. GILEAD is a trademark of Gilead Sciences, Inc. © 2020 Kite Pharma, Inc. All rights reserved. YESC0154 Version date: 05/2020

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IMPORTANT FACTS

This is only a brief summary of important information about YESCARTA and does not replace talking to your healthcare provider about your condition and your treatment.

(yes-kar-ta) THE MOST IMPORTANT INFORMATION TO KNOW ABOUT YESCARTA® YESCARTA may cause side effects that are life-threatening and can lead to death. Call or see your healthcare provider or get emergency help right away if you get any of the following: • Fever (100.4°F/38°C or higher) • Difficulty breathing • Chills or shaking chills • Confusion • Dizziness or lightheadedness • Severe nausea, vomiting, or diarrhea • Fast or irregular heartbeat • Severe fatigue or weakness It is important to tell your healthcare provider that you received YESCARTA and to show them your YESCARTA Patient Wallet Card. Your healthcare provider may give you other medicines to treat your side effects.

ABOUT YESCARTA YESCARTA is a treatment for your non-Hodgkin lymphoma.

It is used when you have failed at least two other kinds of treatment. YESCARTA is different than other cancer medicines because it is made from your own white blood cells, which have been modified to recognize and attack your lymphoma cells.

BEFORE RECEIVING YESCARTA, TELL YOUR HEALTHCARE PROVIDER ALL ABOUT YOUR MEDICAL PROBLEMS, INCLUDING IF YOU HAVE OR HAVE HAD: • Neurologic problems (such as seizures, stroke, or memory loss) • Lung or breathing problems • Heart problems • Liver problems • Kidney problems • A recent or active infection Tell your healthcare provider about all the medications you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

HOW YOU WILL RECEIVE YESCARTA • Since YESCARTA is made from your own white blood cells, your blood will be collected by a process called “leukapheresis” (loo-kah-fur-ee-sis), which will concentrate your white blood cells.

• Your blood cells will be sent to a manufacturing center to make your YESCARTA.

(continued)

• Before you get YESCARTA, you will get 3 days of chemotherapy to prepare your body.

• When your YESCARTA is ready, your healthcare provider will give it to you through a catheter placed into your vein (intravenous infusion). The infusion usually takes less than 30 minutes.

• You will be monitored where you received your treatment daily for at least 7 days after the infusion.

• You should plan to stay close to the location where you received your treatment for at least 4 weeks after getting YESCARTA. Your healthcare provider will help you with any side effects that may occur.

• You may be hospitalized for side effects and your healthcare provider will discharge you if your side effects are under control, and it is safe for you to leave the hospital.

• Your healthcare provider will want to do blood tests to follow your progress. It is important that you do have your blood tested. If you miss an appointment, call your healthcare provider as soon as possible to reschedule.

WHAT TO AVOID AFTER RECEIVING YESCARTA • Do not drive, operate heavy machinery, or do other dangerous things for 8 weeks after you get YESCARTA because the treatment can cause sleepiness, confusion, weakness, temporary memory and coordination problems.

• Do not donate blood, organs, tissues, and cells for transplantation.

THE POSSIBLE OR REASONABLY LIKELY SIDE EFFECTS OF YESCARTA The most common side effects of YESCARTA include: • Fever (100.4°F/38°C or higher) • Low white blood cells (can occur with a fever) • Low red blood cells • Low blood pressure (dizziness or lightheadedness, headache, feeling tired, short of breath) • Fast heartbeat • Confusion • Difficulty speaking or slurred speech • Nausea • Diarrhea These are not all the possible side effects of YESCARTA. Call your healthcare provider about any side effects that concern you. You may report side effects to the FDA at 1-800-FDA-1088.

GET MORE INFORMATION • This is only a brief summary of important information about YESCARTA. Talk to your healthcare provider to learn more.

• Visit www.YESCARTA.com or call 1-844-454-KITE (5483).

YESCARTA, the YESCARTA logo, KITE, and the KITE logo are trademarks of Kite Pharma, Inc. GILEAD is a trademark of Gilead Sciences, Inc. © 2020 Kite Pharma, Inc. All rights reserved. YESC0154 Version date: 05/2020

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CONTENTS

E xclusively on

Curtis Salgado looks at life in a whole new way.

Cancer Health.com Cancer Health Stories Read the firstperson stories of people who are living with cancer, including personal diaries and honest, moving essays. cancerhealth.com/stories

Basics

Whether you’re newly diagnosed or a long-term survivor, check out our fact sheets on cancer treatment, managing side effects and more. cancerhealth.com/basics

Treatment News

COVER AND THIS PAGE: (SALGADO) JAY FRAM; (HEART SPEECH BUBBLE, IV TREATMENT, TYPEWRITER) ISTOCK

Learn about the latest treatment advances and conference news. cancerhealth.com/treatment

Blogs

Check out our selection of blogs by people living with cancer, advocates, experts and the Cancer Health editors. cancerhealth.com/blogs

Cancer Health Digital Go to cancerhealth.com to view the current issue and the entire Smart + Strong digital library.

14 STILL SINGING Bluesman Curtis Salgado has survived liver cancer, lung cancer and a heart attack. He’s doing just fine. BY CHRIS AZZOPARDI 18 THE CANCER HEALTH 25: CHANGE MAKERS Each of these 25 individuals has done something extraordinary to help people living with cancer. BY THE CANCER HEALTH STAFF 4 From the Editor Change Makers 6 Care & Treatment COVID-19 changes cancer care | FDA new drug approvals | enhancing natural killer cells | prostate cancer progress 8 News Bringing wellness home | financial lifelines | the beauty of broccoli | COVID-19 survey | pandemic lessons cancer survivors know 10 Basics COVID-19 and cancer 13 Voices A breast cancer survivor wants to save others from infertility grief.

24 Diary How one man lives his best life with chronic lymphocytic leukemia 28 Your Team Rehabilitation is restorative.

29 Resources Coping with the new coronavirus 30 How To Manage your medications.

31 Good Stuff A soothing summer basket 32 Life With Cancer Becoming a master gardener 33 Reader Survey Tell us which topics matter to you.

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SUMMER 2020

CancerHealth 3

FROM THE EDITOR

Cancer Health TM

Change Makers

4 CancerHealth SUMMER 2020 cancerhealth.com

CE

HEALTH 25: ChangeRM akers

cancer care (Care & Treatment, page 6).

You can also get help through financial lifelines and stay-at-home wellness programs (News, page 8) as well as other tools to help cope with the coronavirus (Resources, page 29).

Don’t be afraid to give help—or accept it. Specialists are available wherever you are being treated to help you recover better and faster (“Cancer Rehabilitation,” page 28).

Please help us, too, by letting us know topics you’d like us to cover in the future (Reader Survey, page 33).

As you undergo your own cancer journey, remember that kind words and deeds, given or received, make a difference. Each of us has a chance to become a Change Maker.

SMART + STRONG PRESIDENT AND COO Ian E. Anderson EDITORIAL DIRECTOR Oriol R. Gutierrez Jr. EXECUTIVE EDITOR Bob Barnett CHIEF TECHNOLOGY OFFICER Christian Evans VICE PRESIDENT, INTEGRATED SALES Diane Anderson INTEGRATED ADVERTISING MANAGER Jonathan Gaskell INTEGRATED ADVERTISING COORDINATOR Ivy Peterson SALES OFFICE 212-938-2051 sales@cancerhealth.com BULK SUBSCRIPTIONS order.cancerhealth.com or subs@cancerhealth.com CDM PUBLISHING, LLC CHIEF EXECUTIVE OFFICER Jeremy Grayzel CONTROLLER Joel Kaplan Cancer Health (ISSN 2688-6200) Issue No. 9. Copyright © 2020 CDM Publishing, LLC. All rights reserved.

No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise without the written permission of the publisher. Smart + Strong® and Cancer Health™ are registered trademarks of CDM Publishing, LLC.

BOB BARNETT Editor-in-Chief bobb@cancerhealth.com Twitter: @BobCancerHealth

Cancer Health is BPA audited.

(BARNETT) MICHAEL HALLIDAY

PEOPLE LIVING WITH CANCER help other people living with cancer.

It happens every day, in ways large and small.

Sometimes helping becomes your life’s work. In this issue, we’re celebrating the Cancer Health 25: Change Makers (page 18)—individuals whose experience with cancer has motivated them to find new ways to give back. Their personal stories and public service elevate the spirit.

Words of support can reverberate for years. Blues musician Curtis Salgado, who has survived both liver and lung cancer, will always remember the help that lifted him up when he was at a low ebb, which came from a woman who had survived colon cancer, a story he recounts in “Still Singing” (page 14).

Breast cancer survivor MeganClaire Chase’s experience has made her a passionate advocate for better outreach to women about their fertility options before treatment (“Fertility Grief,” page 13). With the help of a fellow cancer survivor, Jeff Neurman (“A Leukemia Diary,” page 27) started the podcast Guys With Cancer to help other men with cancer overcome the social pressure to be stoic. Multiple myeloma survivor O. David Dye is grateful for blessings from doctors, nurses, church members, friends and family, but his most unexpected blessing was being given “An Enduring Gift of Gardening” (page 32).

In these days of pandemic distress, we could all use a little more help.

You can learn to protect yourself from the new coronavirus by reading up on the Basics (page 10), and find out how to navigate the ways it is changing

THE CAN

EDITOR-IN-CHIEF Bob Barnett MANAGING EDITOR Jennifer Morton SCIENCE EDITOR Liz Highleyman DEPUTY EDITOR Trent Straube SENIOR EDITORS Kate Ferguson, Meave Gallagher COPY CHIEF Joe Mejía ASSISTANT EDITOR Alicia Green ART DIRECTOR Doriot Kim ART PRODUCTION MANAGER Michael Halliday ADVISORY BOARD Timothy Henrich, MD; Carl June, MD; Gaby Kressly; Yung S. Lie, PhD; Gilberto Lopes, MD; Peter Pitts; Hope Rugo, MD FEEDBACK Email: info@cancerhealth.com

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CARE & TREATMENT

BY LIZ HIGHLEYMAN

New CARs Genetically engineered natural killer cells could be the next breakthrough in immunotherapy. Like CAR-T cells, CAR-NK cells are reprogrammed with artificial receptors to recognize and attack cancer.

CAR-T therapy involves removing a sample of a patient’s white blood cells, inserting the new receptors into T cells, multiplying them in a lab and reinfusing them back into the body. CAR-NK cells, in contrast, don’t have to be custom-made for each patient and could potentially be manufactured as off-the-shelf products.

In a recent small study, CAR-NK therapy led to complete remission in seven out of 11 people with lymphoma or leukemia. What’s

Now Approved more, the CAR-NK cells didn’t cause immune-mediated side effects as CAR-T cells often do.

Coming down the pipeline: CAR macrophages (CAR-M), immune system first responders that eat abnormal cells. If T cells are like a game of Space Invaders, macrophages are more like Pac-Man. Researchers at the University of Pennsylvania recently reported that genetically engineered macrophages could kick-start an attack against solid tumors, which are resistant to current CAR-T therapy.

In a mouse study, CAR-Ms shrank tumors and prolonged survival.

PROSTATE CANCER PROGRESS The androgen-blocker Zytiga (abiraterone acetate) improved quality of life compared with chemotherapy for men with prostate cancer, researchers reported at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium in February.

The STAMPEDE trial is evaluating treatments for men with locally advanced or metastatic prostate cancer and those considered at high risk for disease progression. The study previously showed that both Zytiga and the chemotherapy drug docetaxel delayed progression and improved survival when added to standard hormone therapy, leaving open the question of which is a better option.

Now, the study has shown that over two years, men who took Zytiga had higher overall quality of life scores than those on chemotherapy. A similar pattern was seen when looking specifically at physical functioning, role functioning and social functioning. The chemo group, however, reported less fatigue. The pain score was higher in the docetaxel group, possibly due to its side effect of peripheral neuropathy.

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The COVID-19 pandemic hasn’t slowed down the Food and Drug Administration’s approval of new cancer treatments. Here are the latest arrivals: Jelmyto (mitomycin) for upper urinary tract cancer Koselugo (selumetinib) for pediatric neurofibromatosis (nerve tumors) Pemazyre (pemigatinib) for cholangiocarcinoma (bile duct cancer) Retevmo (selpercatinib) for non-smallcell lung cancer and thyroid cancers Sarclisa (isatuximab) for multiple myeloma Tabrecta (capmatinib) for non-small-cell lung cancer Trodelvy (sacituzumab govitecan) for metastatic triple-negative breast cancer Tukysa (tucatinib) for advanced or metastatic HER2-positive breast cancer.

Coronavirus Changes Cancer Care The coronavirus pandemic has led to dramatic changes for people living with cancer. Many are over 60, and chemotherapy and radiation can cause immune suppression, both of which are linked to poorer COVID-19 outcomes.

The American Cancer Society reports that nearly one in four cancer patients have delayed care, including nonurgent surgery. People with new cancer symptoms are avoiding care—Flatiron Health reports that visits from new patients decreased by nearly 40% from early February to late April—and screenings for breast, colon and cervical cancer have dropped by around 90%.

What’s more, some clinical trials have been suspended, and even when they’re not, many people are reluctant to enroll. “Trial interruptions are devastating news for thousands of patients,” says American Society of Clinical Oncology president Skip Burris, MD. “In many cases, clinical trials are the best, or the only, appropriate option for care.”

Cancer experts have modified treatment guidelines to adapt to the pandemic. Many centers are shifting from in-person appointments to telemedicine and home care. The National Comprehensive Cancer Network advises using oral drugs, if feasible,

instead of those given by IV infusion. Some doctors favor therapies that cause less immune suppression or are less likely to cause side effects that could require hospitalization, even if they’re slightly less effective. Some people may be able to start medications or radiation therapy while awaiting surgery, and those with low-risk cancer could opt for active surveillance. In some cases, radiation can be administered on schedules with fewer visits.

Monitoring scans sometimes can be done less often or replaced with blood tests. But in other cases, the risk of delaying or modifying treatment outweighs the risk of COVID-19.

Questions about whether it’s safe to put off treatment are causing anxiety for both patients and providers. “These postponements can be wrenching and frustrating for doctors and have forced patients into a battle on two fronts, against their disease and against the coronavirus,” says Daniel Boffa, MD, of Yale School of Medicine.

For now, the best approach is to keep in touch with your care team and develop an individualized plan tailored to your specific type of cancer and its stage.

ALL IMAGES: ISTOCK (MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY)

COVID-19 OUTCOMES People with cancer are at greater risk for severe COVID-19, but this depends on their specific cancer type, disease stage and mode of treatment, researchers reported at the American Association for Cancer Research virtual annual meeting in April and in the AACR journal Cancer Discovery.

A study in China compared 105 COVID-19 patients with cancer and 536 people without.

Overall, those with cancer were nearly three times more likely to have severe illness, be admitted For more care and treatment news: cancerhealth.com/treatment

to an intensive care unit or be put on a ventilator. What’s more, they were about twice as likely to die (11% versus 5%). But people with certain cancer types fared worse: Two thirds of those with blood cancers and half of those with lung cancer had severe events. Patients with metastatic cancer had about a sixfold higher risk of severe illness or death, but those whose cancer had not yet spread had about the same risk as people without cancer.

In another study, researchers

identified 218 COVID-19 patients with cancer at Montefiore Health System in the Bronx.

Over a quarter (28%) died—two to three times the rate of people without cancer. This, too, varied by cancer type. While 55% of those with lung cancer, 38% of those with colon cancer and 37% of those with blood cancers died, people with prostate cancer (20%) or breast cancer (14%) had relatively lower mortality.

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NEWS

BY BOB BARNETT

Bringing Wellness Home Wellspring Global is a new website that brings stress management and wellness into your home for free.

It does so via evidence-based programs and events created by health care professionals from academic medical centers and tailored to the needs of people with cancer.

“There is fabulous science that demonstrates that non-pharmacological but evidenced-based interventions—including exercise, meditation, breathing practices, stress reduction techniques and qi gong—are capable of helping individuals with cancer control anxiety, depression, fear, fatigue, nausea and pain,” says oncologist Gregory Mears, MD, a professor of medicine at Columbia University Irving Medical Center and medical director of Wellspring Global.

He teamed up with journalist and yoga expert Leigh Leibel, MsC, clinical director of Yoga Therapy for Cancer at Irving, and other colleagues to “build a website to deliver these therapies at a distance.”

“Everyone who is contributing is from an academic medical center or hospital,” says Leibel. “They work every day with cancer patients and are highly trained in how to present these practices in a safe way.” For example, people with cancer that has metastasized to their bones need to avoid certain

yoga postures, she notes.

The collaborative project launched with 47 clinicians from 15 medical centers in the United States and Canada, including Columbia University Medical Center, MD Anderson Cancer Center (Houston), Roswell Park Cancer Center (Buffalo), University of Maryland School of Medicine (Baltimore), University of Cincinnati Health, Children’s Hospital of Philadelphia, the University of North Carolina at Chapel Hill and others.

At launch, the site featured podcasts, Zoom events and recorded video classes, scheduled phone call-ins and other offerings on yoga, acupressure, qi gong, sleep, nutrition, exercise and breathing. There’s a podcast on happiness, a live Zoom event on how to lead an anticancer lifestyle, mindfulness meditation sessions, interactive healing circles led by an oncology nurse and a sound bath led by a licensed music therapist. The site is in English and Spanish.

“People ask me, ‘Where do I even start? Where can I begin? I want something that is simple and accessible,’” says Leibel. “Now I can tell them, ‘Start here.’” Visit wellspring.global.

The Beauty of Broccoli The pungent smell of broccoli— whether it’s the supermarket variety, Italian broccoli rabe, Chinese broccoli or broccolini— is produced by small molecules known as glucosinates. These molecules, also found in other cruciferous vegetables (including cabbage, cauliflower and watercress), may protect against certain cancers.

Now a team led by Stanford University’s Elizabeth S. Sattely, PhD, and funded by the Damon

Runyon Cancer Research Foundation has begun to unlock how this happens. It was already known that when gut microbes metabolize glucosinates, they generate compounds called isothiocyanates, which block tumor development in mice.

Sattely and colleagues pinpointed genes that enable a specific gut microbe to produce these isothiocyanates. The work builds on pioneering chemoprevention research on broccoli from the

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early ’90s by the late Damon Runyon Fellow Paul Talalay, MD, of Johns Hopkins University.

In the future, scientists may be able to engineer gut microbes to produce these beneficial compounds. In the meantime, the new research reinforces the importance of something that parents have been saying to their kids for a long time: “Eat your broccoli!”

FINANCIAL LIFELINES Family Reach, a national nonprofit organization based in Boston, has been helping people with cancer pay their bills for 25 years. Its staffers normally work through a network of oncology social workers and patient navigators at 440 hospitals across the country.

“They tell us about a family in trouble and let us know how we can help,” says Family Reach CEO Carla Tardif. That assistance may mean arranging for free access to a certified financial planner, providing financial education and paying direct grants to vendors to cover bills such as rent, mortgage and car loans. Amid the COVID-19 pandemic, however, many of these hospital workers were overwhelmed, so Family Reach pivoted. Among the changes: Direct access. Anyone can now go directly to the website and fill out an application (https://familyreach.org/family-eligibility). “We don’t have funds for everyone,” admits Tardif, “but we can help. We can do the research that our cancer patients may not be able to do.”

Lodging. Family Reach already had a small program with the Hilton corporation to provide lodging for people in treatment, and now it’s been expanded.

Expanded financial navigation services. Through its network of pro bono certified financial planners, Family Reach can help individuals deal with their financial stress more effectively. That planning can help people not only financially but emotionally, says Tardif.

“All the financial and other fears that people with cancer have are magnified by this pandemic,” she says. “We can help you find resources. It might be a financial plan, a way to manage debt and credit cards. We’ll help you understand what is in your control and what you can do.” Her advice: “Speak up. Don’t be ashamed. You did not fail your family; the system failed you. Reach out early so we can give you all the tools you need. You are not alone.”

CANCER LESSONS FOR THE PANDEMIC “A surprisingly large number of cancer survivors come out the other end of the experience seeing it as beneficial.

Not something they would wish anyone but revelatory.

They emerge from the months of anxiety, suffering and uncertainty feeling a greater sense of purpose and a newfound appreciation for life…. They do not sweat the little things. They appreciate family time a lot more. They step away from the hamster wheel of work, or slow down.

They bask in the second chance. Imagine if, collectively, we embraced this global pandemic as an opportunity for that sort of transformation.”

—Canadian health columnist and author André Picard

(ANXIETY GRAPHIC) COURTESY OF KCCURE; (ALL OTHER IMAGES) ISTOCK

THE STAT: FEAR What do people with cancer fear most, catching COVID-19 or cancer progression? Both equally, according to a new survey of 530 people with kidney cancer conducted by the nonprofit Kidney Cancer Cure.

The group’s president, Dena Battle, notes that a 7 on the survey’s scale reflects a high level of psychological distress—one usually associated with a need for professional psychological support. “Patients are really suffering, and it’s a story that’s not being told,” says Battle.

“I know that hospital systems are struggling and doing heroic things, but we need to find long-term solutions to make sure patients have access to the therapies that they need.”

Get more cancer news: cancerhealth.com/news

7

On a scale of 1 to 10, rate your level of anxiety about:

CANCER

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7

COVID-19

CancerHealth 9

BASICS

BY LIZ HIGHLEYMAN

COVID-19 and Cancer THE NOVEL CORONAVIRUS that emerged in late 2019 (officially known as SARS-CoV-2) raises new concerns for people living with cancer, ranging from worry about whether you’re at higher risk to the prospect of delayed cancer treatment.

COVID-19, the respiratory disease caused by the new coronavirus, is mild to moderate in about 80% of cases. Symptoms may include fever, cough, shortness of breath, chills, muscle pain, headache, sore throat and new loss of taste or smell. However, some people have no symptoms at all. About one in five people will develop severe disease that may progress to pneumonia and respiratory failure.

While anyone can contract the coronavirus, certain individuals are at greater risk for severe disease, namely people over age 60, those with compromised immune systems and people with underlying health conditions, such as chronic lung disease, heart disease, diabetes or high blood pressure. Some studies have found that people living with cancer may be more likely to become seriously ill.

Some chemotherapy drugs can cause a low white blood cell count (neutropenia), a temporary immune suppression that makes you more susceptible to infections. People who receive

bone marrow transplants or CAR-T therapy are especially susceptible. Hormone therapy and checkpoint inhibitors, however, do not appear to increase the risk.

The pandemic may affect your treatment because hospitals are short on staff and supplies, and infection risk is higher in medical settings. Some care providers are relying more on telemedicine.

If you have scheduled surgery, infusions or scans, you may experience delays, depending on the stage of your cancer. In some cases, it may be possible to receive treatment at home. If you are in a clinical trial, follow the guidance of the research staff. Most people at average risk for cancer can safely delay routine screenings, such as mammograms.

Maintain good communication with your care team to discuss the best options. If you do need to receive treatment or scans at a medical facility, the staff may employ extra safety measures.

Everyone should take precautions to prevent COVID-19, but these are especially important for people at higher risk. A new type of test can show who has developed antibodies, but it is not yet clear whether these offer protection against the coronavirus, or, if so, how long such immunity might last. Prevention measures include staying away

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from people who are sick—and avoiding others if you are ill— washing your hands thoroughly, using hand sanitizer, wearing a face mask and not touching your mouth, nose or eyes. Get your annual flu shot, and ask about a vaccine to prevent pneumonia.

Social distancing will remain important even after local stay-athome orders have been relaxed.

Avoid crowds, work from home if you can and stay at least six feet away from people you don’t live with.

If you have mild symptoms, you can often manage them at home by drinking plenty of fluids and using over-the-counter fever, cough and pain medications. But check with your care team to see whether these might interfere with your cancer treatment. Get further care if you have trouble breathing. Call ahead before you go to a clinic or hospital.

Currently, no medications are approved for the treatment of COVID-19, but hundreds of studies are underway. Be cautious about rumors and overly optimistic information about treatments that have not been tested in randomized clinical trials.

Many coronavirus vaccine trials are also ongoing. Experts predict a vaccine could be available by the end of 2021. ■ Learn more about COVID-19: cancerhealth.com/coronavirus

ISTOCK

Stay in touch with your cancer care team about how the new pandemic will affect you and your treatment.

BY MEGAN-CLAIRE CHASE

VOICES

Infertility Grief

COURTESY OF MEGAN-CLAIRE CHASE

Cancer Health blogger and breast cancer survivor Megan-Claire Chase lives in Atlanta.

MANY PEOPLE WITH CANCER grieve for a piece of themselves that’s been lost to this horrible disease. It may be the loss of a body part or the body you used to know. When treatments make you infertile while you’re still of childbearing age, that’s another level of palpable grief.

As a young adult breast cancer survivor—Stage IIA invasive lobular at 39 years old—I continue to be shocked and dismayed by the lack of conversation, support and resources about fertility preservation and infertility offered at oncology centers.

My oncologist told me I needed four rounds of two chemotherapy agents plus 12 rounds of a different chemo drug and asked whether I wanted to freeze my eggs all in the same breath.

All I heard her say was, “You need 16 rounds of chemo, which needs to start as soon as possible.” I couldn’t focus on anything else. Do I want to live, or do I want to die? It doesn’t seem like a fair choice. I felt pressured to begin chemo immediately.

What I didn’t know is that for many cancer diagnoses, a short delay of a couple of weeks for fertility treatments won’t affect your chances of treatment success. But it may preserve your future ability to have children.

Why aren’t we assigned an oncology nurse navigator or social worker immediately after that initial appointment to help For Chase’s blog: cancerhealth.com/megsie

us process the possibility of infertility and consider whether we want to freeze our eggs first? I believe that every such patient should receive a mandatory consultation with a fertility specialist to hear the options before treatment begins.

It’s our right.

One of the hardest paths I’ve had to travel on my cancer journey was when my choice of having a child was taken away. Since I was intolerant of the medications to help prevent recurrence for premenopausal women, I had to be medically induced into menopause in 2017 so I could try the medications for postmenopausal women. My only thought was to do what was needed so I wouldn’t have to go through this cancer insanity again or die.

I never realized how lonely and isolating survivorship can be. Not one person on my medical team mentioned counseling or even acknowledged my mental health, not even after my hysterectomy and oophorectomy (removal of both ovaries).

Support groups are filled with women who are married and/or already have children. There is

Chase blogs about being a young cancer survivor on Warrior Megsie.

no place for a single, youngish, infertile woman. None of them could relate to my experience.

I wasn’t prepared to handle this type of grief or loneliness.

It’s like once the cancer is gone and you’ve entered the realm of NED (no evidence of disease) or are on a maintenance treatment, you’re a tiny and fragile fish thrown out to sea into the middle of circling great white sharks. Our oncology providers and centers must do better at preparing us for the emotional turmoil that stems from infertility. See us as people.

For me, infertility is one grief that will never go away. ■

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Veteran bluesman Curtis Salgado was told his liver cancer would kill him in six months. That was 14 years ago.

BY CHRIS AZZOPARDI PHOTOGRAPHY BY JAY FRAM

B

Y THE TIME CURTIS SALGADO was wailing a four-letter expletive on his friend’s floor, he knew his health had taken a hit. For years, he’d had hepatitis C, which had led to early-stage cirrhosis and, now, gallstones. It was 2006—before his first terminal cancer diagnosis and his quadruple bypass.

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“After cancer,” says Salgado, “life turns into a whole new thing.”

Salgado, who is a selfemployed musician, had no health insurance. He wound up in the hospital for nearly a week but feared receiving a bill he couldn’t afford. So he ignored the signs that his health was suffering and left, hoping for the best because “that’s the kind of knucklehead I am,” he says.

Then the doctor called. A biopsy had detected a cancerous tumor the size of a clementine (5.5 centimeters, about 2.2 inches) on his liver.

Even as he was on the phone, his overburdened body collapsed to the floor as he yowled the f-word. “From that point on,” he says, “it was a roller coaster ride.”

In the years since, the soul singer-songwriter has had many reasons to sing the blues.

The good news? He’s still singing the blues.

A sense of humor keeps Salgado steady.

cured with new medications in 2016.)

By 2006, liver damage from hepatitis C had led to liver cancer. Radiation shrank the tumor somewhat, but his doctor told him that if he didn’t get a liver transplant soon, the cancer would be terminal, and he’d have only six months to live. “All you can do is just think about it, and just one day at a time,” he says about the grim prognosis. “You’re just thinking, How am I gonna get out of this? I was on a journey that was just—you had 10 different paths in front of you, and, basically, you picked the wrong one, and it could be you’re doomed.”

The tumor was so large that all but one transplant center refused him treatment. But after six months, he underwent successful liver transplant surgery at the Nebraska Medical Center in Omaha. He still lacked health insurance, but a benefit concert in Salgado’s hometown of Portland, Oregon, paid for the transplant. While he recovered in the hospital, Bonnie Raitt, with whom he had toured, covered his rent. Once he returned home, he took it easy for a year. Everything considered, he calls it “a wonderful miracle.”

Three weeks later, however, a biopsy of his old diseased liver detected a microscopic invasion of a small blood vessel.

Eight months later, the cancer had metastasized. (If it had been found before the transplant, he wouldn’t have qualified for a new liver.) In early 2008, a routine checkup turned up a marble-sized cancerous mass on the lower left lobe of his left lung. He had no symptoms.

Surgery removed the tumor, but in 2012, it came back in the same spot; this time, his surgeon removed the entire lower lobe of his left lung.

Then came the heart attack. It was spring 2017. His band was leaving Vermont for a gig in upstate New York.

As he loaded gear onto the tour van, he felt uncharacteristically winded; a dull ache radiated through his shoulder

FOR ME, MUSIC AND LIFE GO HAND IN HAND.

“I Told Myself I’d Never Get Cancer” Salgado’s liver cancer diagnosis didn’t come out of nowhere— not when he considers his history. The 66-year-old musician was in his early 20s when he became the leader of the blues band The Nighthawks and, a few years later, co-leader of the Robert Cray Band. Drugs were everywhere. “I did it all,” he says. “I shot up drugs, I smoked drugs, drank a lot, partied. Then I just went, ‘I’ve had enough.’”

He saw the devastating effects lung cancer had on his mother, a chain-smoker—it killed her. “It wasn’t pretty, and I told myself I’d never get cancer,” he says. Shaken by her death, he was galvanized to take better care of himself.

So at 35, Salgado entered a treatment facility and beat his addictions. He started working out, lost weight, focused on music again, played bigger venues and in 1991 released his first solo album, Curtis Salgado & the Stilettos.

But the damage to his body, particularly to his liver, had been done. Just before the album’s release, he learned he had hepatitis C. He skipped most of the treatments, which at the time were costly, caused flu-like symptoms and were not very effective. (He was eventually treated and

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blades. Shortly thereafter, his mouth filled with saliva. “I didn’t even know it was a heart attack,” he says.

Next stop: a quadruple bypass. Back home in Portland, he took heart health classes at the local hospital, started eating smaller, healthier meals, walked more, went to physical therapy and ran on a treadmill to James Brown music.

Three months after undergoing the bypass, Salgado returned to the stage on July 4, 2017, performing at the Waterfront Blues Festival in Portland. Remarkably, his voice was unaffected, still high and loud and hard.

A Blues Brotherhood Salgado and his mother, an amateur pianist who played for the family, made his first guitar together. He was 11. It was a cardboard toy modeled after a Fender Stratocaster.

The next year, he got a real guitar. He played it at talent festivals near his childhood home in Eugene, Oregon.

“Life and music, for me, go hand in hand,” says Salgado.

“It’s the thing that powers me, the thing that excites me.”

As a kid, he devoured his parent’s jazz records, including Count Basie and Fats Waller; later, his two older siblings introduced him to the music of ’60s blues icons Skip James and Paul Butterfield. Salgado started playing gigs in high school and a few years later played bars in Eugene with The Nighthawks.

He became co-leader of the Robert Cray Band. One day, in 1977, John Belushi, in town to film Animal House, came to see Salgado play. Salgado had never heard of him, but they bonded over the blues—Belushi mentioned that Ray Charles, one of Salgado’s heroes, was an upcoming guest on Saturday Night Live—and became fast friends.

Salgado would later inspire Belushi’s role in the 1980 film The Blues Brothers. “Curtis opened the door to a new and more exciting area of music for me,” wrote Belushi in a letter of recommendation for his mentor. He dedicated his Blues Brothers album to Salgado.

From 1984 through 1986, Salgado fronted Roomful of Blues, and in 1991, he released the first of 10 solo albums.

In 2013, at that year’s Blues Music Awards, he received the coveted B.B. King Entertainer of the Year award.

Pick Yourself Up, and Move Down the Line “How do I take all this stuff?” he says reflecting on being surrounded by death—many of his friends have died— and having his own brushes with it. “It is what it is. You pick yourself up, and you move down the line. Life is finite.” Salgado contemplates death with pathos and wry For more survivor profiles: cancerhealth.com/magazines

humor on his intimate and improvisational acoustic soul-blues-Americana 2018 album, Rough Cut, a collaboration with guitarist Alan Hager. While it ruminates on the inevitabilities of aging, he says, “it’s not songs for old people.” It includes “Hell in a Handbasket,” a song he wrote while recovering from his second lung cancer surgery in 2012. The lyrics go: “Now I’ve been told by some, for all the sins I’ve done, any chance of seeing Heaven, they say it’s next to none. I supposed that’s true, if you take into consideration, everything I’ve done, I never did in moderation.” Says Salgado, with a chuckle, “it’s a fun little death ditty.” On another, “So Near to Nowhere,” he sings: “In a fever dream, drippin’ boulders of sweat, I’m asking God why I ain’t dead yet.

He says, ‘I warned you boy, but you never listen, the Devil don’t want the competition.’”

That time after his second surgery was marked by prolific songwriting, and some of the songs he wrote then ended up on his new album, Damage Control, which will be released as soon as the pandemic allows. The personal and self-reflective album is about overcoming adversity, and Salgado cowrote 12 of its 13 songs—the most he’s ever written for a release.

How’s his health these days? “You can say I’m doing great. I’m doing fine.” These days, “fine” includes taking an immunosuppressant medication so that his body won’t reject his liver transplant. That makes him susceptible to pesky colds and other infections, including COVID-19.

He went into quarantine in March; he definitely falls into an at-risk group for the virus.

As for cancer, he’s in remission and goes for checkups every four to six months. “After cancer,” he says, “life turns into a whole other thing.” He now focuses on what’s worth his time and energy. That includes dancing with his life partner of seven years, Suzanne, an artist—sometimes to R&B grooves, other times Louisiana zydeco. One way he stays active is by blowing into his harmonica and performing onstage, a workout on its own. “It’s something to sing 30 songs every night,” he says.

During the worst of it, Salgado drew strength from the words of Suzanne Lindley, a colon cancer survivor he met in Chicago while speaking about his harrowing experiences at the 2008 symposium for the liver cancer support group Say YES to HOPE. He hopes others find the same encouragement that helped him keep fighting even when the odds were stacked against him. “You don’t die of cancer,” she told him. “You live with cancer.” ■

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These remarkable individuals make a difference every day.

BY THE CANCER HEALTH STAFF

LET US CELEBRATE THESE CHANGE MAKERS. THEY HAVE each experienced cancer, either personally or through someone they love.

And it has changed them, made them want to give back and given them a mission to make a difference for others living with cancer.

Change makers, we honor you.

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Change Makers Melinda Bachini Billings, MT In 2009, Melinda Bachini was working as a paramedic when she was diagnosed with cholangiocarcinoma, a rare cancer of the bile ducts, which soon spread to her lungs. Two years later, she decided that chemotherapy was too detrimental to her quality of life, but she remained determined to see her six children grow up. Melinda, 51, joined a clinical trial of adoptive cell therapy at the National Cancer Institute and experienced a remarkable response. Though not cured, her cancer remains at bay.

Today, she is a public speaker, legislative advocate and advocacy coordinator for the Cholangiocarcinoma Foundation.

(BOYER) COURTESY OF ANNE BOYER/CASSANDRA GILLIG; (ALL OTHERS) COURTESY OF SUBJECTS

Amy Berman New York, NY How do you live well with serious illness?

Amy Berman, RN, 60, offers two words of advice: palliative care. Since being diagnosed with Stage IV inflammatory breast cancer nearly a decade ago (she’s still living with cancer), Amy enlisted palliative specialists to manage pain and symptoms. Judging by her adventures in world traveling, reindeer sledding and camel riding, which she chronicled in the Winter 2020 issue of Cancer Health, it works. She promotes palliative care through lectures, social media, blogs and her work as senior program officer at The John A. Hartford Foundation, which invests in better care for older adults. In 2015, the online platform Disruptive Women in Healthcare named her one of “15 Disruptive Women to Watch.” She recently testified before the Senate Committee on Aging.

Justin Birckbichler Fredericksburg, VA The founder of the award-winning blog ABallsySenseofTumor.com (ABSOT), Justin Birckbichler, 28, became a men’s health activist shortly after being diagnosed with Stage II testicular cancer in 2016. His goal is to use humor to help men overcome their fear of opening up and thus help promote discussions about testicular cancer. A prolific and passionate advocate, Justin has written more

than 160 articles for online and print magazines. In 2019, he was named one of “40 Under 40 in Cancer” by a team of global health care advisers. A highlight of his advocacy includes giving a TEDx Talk on men’s testicular health in November 2019.

Jamie Ennis Bloyd Lexington, KY When Jamie Ennis Bloyd’s 5-year-old son was diagnosed with Stage IV Burkitt’s lymphoma in 2014, she used her years of public policy, political and advocacy experience to get Kentucky’s first-ever pediatric cancer legislation passed. The governor then appointed her to the board of the state’s Pediatric Cancer Research Trust Fund. Jamie, 39, is currently director of government affairs and external relations at the American Childhood Cancer Organization, the nation’s oldest and largest grassroots organization dedicated to childhood cancer. In 2017, she secured corporate support from Amazon to launch a historical campaign to raise awareness of childhood cancer, and in 2019, the Foundation for a Healthy Kentucky named Jamie a “Healthy Kentucky Policy Champion.”

Anne Boyer Kansas City, MO Sometimes, the tools society hands people with cancer don’t really help, and it takes an artist to show us why.

“We are expected to keep our unhappiness to ourselves but donate our courage to everyone,” wrote poet and essayist Anne Boyer, 46, about her harrowing experience with triple-negative breast cancer in her 2019 memoir, The Undying. She rebelled against the pink ribbon world of breast cancer awareness, which often asks women to stay “positive.” Instead, she demonstrated that openness and honesty about uncertainty, fear and pain can be liberating.

Mike Dubron Los Angeles, CA Los Angeles County firefighterparamedic Mike Dubron, 57, was 39

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Robert Ginyard Baltimore, MD After entrepreneur Robert Ginyard, 58, was treated for prostate cancer in 2010, his life’s mission changed. He now educates men and their partners about intimacy, sharing his own experience to help them tackle major issues such as sex, love and life after prostate cancer. As an African-American man, he is particularly engaged in raising awareness in the Black community, where prostate cancer rates are alarmingly high. Robert, who lives with his wife and two children, is now chair of the board for ZERO—The End of Prostate Cancer.

Dan Engel Los Angeles, CA As a melanoma survivor, Dan Engel, 58, has overcome a lot to finally be able to say he is cured. His cancer recurred five times following his initial diagnosis 22 years ago. Dan underwent 10 operations and participated in six clinical trials to get where he is today. “You don’t get six chances at life unless it’s for a good reason,” he told Cancer Health in the Summer 2019 feature about his life. Now Dan is dedicated to helping others with cancer. Two years ago, he started PatientTrueTalk.com, a free online platform that connects people living with cancer as well as survivors based on their cancer type and treatment plans.

Jamie Troil Goldfarb Takoma Park, MD Jamie Troil Goldfarb, 42, was diagnosed with Stage II melanoma in 2007. She and her husband happened to work in clinical trial recruitment, and after the cancer spread to her liver and pancreas, she joined a study of tumor-infiltrating lymphocytes, a new type of immunotherapy, at the National Cancer Institute (NCI). She credits the trial with saving her life. She now helps drug companies find study participants and is a research advocate for the NCI. She works with the Melanoma Research Alliance, the Melanoma Research Foundation, the Melanoma International Foundation, the Alliance for Regenerative Medicine, the Center for Information and Study on Clinical Research Participation and Imerman Angels, a one-on-one cancer support community.

Janet Freeman-Daily Seattle, WA Janet Freeman-Daily, 63, a retired aerospace engineer, was diagnosed with advanced non-small-cell lung cancer in 2001. She cofounded a global group of over 300 lung cancer patients who share the same uncommon genetic mutation, the ROS1ders. She says she is alive today thanks to clinical trials of treatments that target ROS1.

Janet is a blogger (GrayConnections.net), public speaker and consultant advocating for patient-led research. She is a cofounder and moderator for #LCSM (Lung Cancer Social Media) chat, a social media forum for lung cancer survivors and researchers, and she participates in lung cancer communities on Inspire.com, SmartPatients.com and CancerGRACE.com.

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Patricia J. Goldsmith New York, NY Since 2014, Patricia Goldsmith, a colorectal cancer survivor, has served as CEO of CancerCare, a national organization that provides free and professional support services for people living with cancer.

She oversees the vision and direction of the organization, bringing more than 20 years of nonprofit, management and strategic planning experience to her role. Patricia has held senior-level positions at the Moffitt Cancer Center and the National Comprehensive Cancer Network, where she oversaw operations with the goal of improving the

(ENGEL) ARI MICHELSON; (GOLDSMITH) COURTESY OF CANCERCARE

when he was diagnosed with Stage IV colorectal cancer.

He found other firefighters with cancer to lean on during his nine-month battle. After discovering the horrors cancer wreaks among firefighters, Mike founded the Firefighter Cancer Support Network (FCSN), which assists newly diagnosed firefighters and connects them with fellow firefighters who have survived cancer. The nationally recognized organization also educates members of fire services about the health hazards associated with fighting fires and advocates for improved equipment, tactics and wellness exams. FCSN (FirefighterCancerSupport.org) leads the charge to proactively fight cancer in fire services around the world.

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Change Makers quality and effectiveness of care for cancer patients.

Most recently, she started CancerCare’s Pet Assistance and Wellness Program, which addresses the unique needs of people with cancer who share their home with a cat or dog.

(KURTTILA) ALANNA HALE; (PAINTER) COURTESY OF THE BROAD INSTITUTE; (ALL OTHERS) COURTESY OF SUBJECTS

Adam Hayden, MA Greenwood, IN Since his 2016 diagnosis with the brain cancer glioblastoma, Adam Hayden, 38, has used his academic training as a philosopher, writer and speaker to engage audiences through articles, speaking engagements and his blog, Glioblastology. His focus on living and dying well with cancer has resonated with many audiences, including the End Well Symposium in San Francisco. Recently, Adam tackled COVID-19 in an online article about how those with serious illnesses could help the public more readily accept mitigation guidelines and personal responsibility. “My wife is a health care worker,” he says. “I’m so proud of her and thankful for other health care workers during this public health crisis.”

Karen Hoyt Tulsa, OK A former public school teacher and adjunct professor, Karen Hoyt, 63, was diagnosed with liver cancer in June 2014. She had been living with hepatitis C for years after initially being misdiagnosed. After undergoing chemotherapy and a liver transplant in April 2015, the inveterate educator transitioned into life as an author, blogger, yoga teacher and mindful meditation guide. She serves on several boards and committees that advocate for transplant candidates. Karen shares her experiences and insights about living her best life, including building good relationships with herself and others and “honoring the extra days and hours I’ve been given,” she says.

Florence Kurttila Citrus Heights, CA Florence Kurttila, diagnosed with colon cancer in 2001, is a longtime patient

advocate. As profi led in Cancer Health (Spring 2019), she was successfully treated with surgery and chemotherapy but lost her husband to cancer five years later.

She then began sharing her experiences and supporting others living with the disease. Since retiring from her human resources career in 2018, Florence, now 67, has become even more active, speaking at conferences, lobbying legislators and reviewing research grants from a patient’s perspective. She works with the American Cancer Society, the American Society of Clinical Oncology, the Colorectal Cancer Coalition, Fight Colorectal Cancer and the SWOG Cancer Research Network.

Corrie Painter, PhD Cambridge, MA Corrie Painter was diagnosed with angiosarcoma in 2010 while studying for her doctoral degree in biochemistry.

She cofounded Angiosarcoma Awareness, which raises money to study the rare malignancy.

Corrie, 46, is associate director of operations and scientific outreach for the Cancer Program of the Broad Institute of MIT and Harvard. She is also associate director of Count Me In, a nonprofit that enables patients to participate as partners in cancer research by making their genetic and clinical data freely available. Current initiatives include the Metastatic Breast Cancer Project, the Metastatic Prostate Cancer Project, the Angiosarcoma Project, the Brain Cancer Project and the Osteosarcoma Project. Corrie is also on the steering committee of the new COVID-19 & Cancer Consortium.

Daniel G. Petereit, MD Rapid City, SD When radiation oncologist Daniel G. Petereit, 57, was growing up, he loved fishing for walleyed pike on South Dakota’s Missouri River with his physician dad. His own medical career took him to the Midwest, but in 1999, he decided to move back West to raise his family and work at a community cancer center in Pine Ridge. It primarily serves Northern Plains American Indians, who have the highest cancer rates and lowest life expectancy of any ethnic group in the country. In 2002, with a National Cancer Institute grant, he started

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Amelie Ramirez, DPH San Antonio, TX Amelie Ramirez has worked for over 30 years to investigate the causes of cancer disparities among Latinos— and to find solutions. She was influential in proving that patient navigation improves the quality of life for Latino cancer patients and survivors. She directs the University of Texas Health Science Center at San Antonio’s Institute for Health Promotion and Research as well as Salud America!, a national Latino-focused organization that promotes health equity. Amelie hosts the annual Advancing the Science of Cancer in Latinos conference, which unites health professionals in tackling cancer among Latinos. She also leads the Éxito! Latino Cancer Research Leadership Training program, which supports Latinos who want to earn doctoral degrees and pursue careers in cancer research.

Steve Schwarze Missoula, MT As Steve Schwarze puts it, he’s a dad, mountain biker, hockey player, professor of communication studies and the director of climate change studies at the University of Montana—and for the last four years, he’s been doing it all with Stage IV colorectal cancer. He also serves as interim mayor for Colontown, a Facebook community of colorectal cancer survivors and caregivers, where he helps lead 10 “neighborhoods” focused on clinical trials. Steve, 49, describes his job on the sites as helping “patients learn about clinical trials and navigate the process of making decisions and enrolling in those trials.” After his own diagnosis, Steve found community and solace online. Now he’s giving back. You could say it’s the neighborly thing to do.

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Mary “Dicey” Jackson Scroggins Washington, DC Dicey Jackson Scroggins, 70, is a 23year ovarian cancer survivor, health activist and writer. She is the cofounder of In My Sister’s Care, an organization focused on eliminating health disparities and improving gynecologic cancer awareness and care for medically underserved women. As director of global outreach and engagement at the International Gynecologic Cancer Society, Dicey is responsible for establishing and maintaining relationships with gynecologic cancer advocacy communities globally on the society’s behalf. She and her daughter are founding partners of the writing and film production firm Pinkie Hugs, which specializes in documentaries about social justice, such as the short film People Will Carry Your Story, coproduced with the documentary production company Spark Media, about raising awareness of gynecologic cancers among the Navajo people.

Kelly Shanahan, MD South Lake Tahoe, CA Kelly Shanahan, 60, had a successful practice as an obstetrician-gynecologist when she was diagnosed with Stage II breast cancer in 2008. She underwent surgery and chemotherapy, but five years later, she was diagnosed with metastatic cancer. After treatment side effects forced her to give up her career as a surgeon, she devoted herself to advocacy. She is a board member of METAvivor, which is dedicated to the fight against metastatic breast cancer in women and men, and a member of the Metastatic Breast Cancer Alliance and the Advanced Breast Cancer Global Alliance. She speaks at conferences, is an active advocate on social media and has participated in legislative advocacy for more research funding for metastatic cancer—but she says her most important job is being a mom.

Aki Smith Los Angeles, CA “Inspire hope.” The phrase greets visitors on the Hope for Stomach Cancer website. And inspire hope is exactly

(RAMIREZ) COURTESY OF THE UT HEALTH SCIENCE CENTER AT SAN ANTONIO

the Walking Forward program. Building trust took time, as did overcoming a sense of fatalism about cancer in the community. The program has helped more than 4,500 American Indians through patient navigation, community education and access to clinical trials. As a result, those with screening-detectable cancers (breast, cervix, prostate, colorectal, lung) now get treated at earlier stages and experience higher cure rates.

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Change Makers

(TAYLOR) ARI MICHELSON; (UNDERWOOD) LUKE COPPING; (WILSON) COURTESY OF THE AMERICAN LUNG ASSOCIATION; (ALL OTHERS) COURTESY OF SUBJECTS

what the nonprofit’s cofounder, Aki Smith, excels at. After her father, Shigeo Tsuroka, was diagnosed with advancedstage stomach cancer in 2013, Aki helped him navigate the daunting cancer landscape—medical decisions, health care staff, paperwork, insurance, financial help, all of it.

Her dad had a gastrectomy (removal of the stomach) and recovered but still deals with permanent toxicity from his treatment. Today, Aki, 39, and the nonprofit provide support, guidance and resources for others on similar journeys; she also collaborates with many other organizations. Whether on social media, at a podium or behind the scenes, Aki is raising awareness, working for a cure and, yes, inspiring hope.

Jeff Taylor Palm Springs, CA After contracting HIV in the 1980s— long before effective treatment was available—Jeff Taylor, now 58, relied on clinical trials and advocacy to keep himself alive. A decade later, those lessons of selfempowerment served him well when he was diagnosed with anal cancer. His doctor said the labs, which regularly handled Pap smears for women, wouldn’t even process anal Pap smears for men. Plus, doctors believed his cancer would progress very slowly, so they wouldn’t operate, which led Jeff to fi nd a more proactive surgeon. Then he got to work changing the standard of care for anal cancer prevention to, among other things, include Pap smears so insurance would cover them.

Clinical trials are currently underway. As the executive director of HIV+Aging Research Project—Palm Springs, he’s devoted to working with HIV providers, researchers and long-term HIV survivors, a population at higher risk for some cancers, to promote living well with chronic disease.

Willie Underwood III, MD, MSc, MPH Buffalo, NY Urologist Willie Underwood, 55, a prostate cancer survivor first diagnosed in 2012, has studied racial disparities in prostate cancer his entire professional life. Black men diagnosed with more aggressive cancer are the least likely to

get treatment, his studies show. But when Black men get equal care, including early detection, appropriate treatment and access to quality insurance, most outcome disparities disappear. Willie’s own cancer experience, profi led in Cancer Health (Winter 2020), has also changed the way he practices medicine, prompting him to share his story with patients, loved ones and the public to help men overcome both the emotional and medical challenges of prostate cancer.

Milli Wilson Albuquerque, NM A singer with a beautiful voice, Milli Wilson, 62, never thought she would get lung cancer, despite her family history and being a smoker for 45 years. But one day, an American Lung Association (ALA) commercial about risk and early detection prompted her to get screened for the disease. That screening saved Milli’s life. She was diagnosed with Stage II non-small-cell lung cancer. She got treated for her cancer, quit smoking and became an ALA advocate, promoting lung cancer screening. Although she was afraid her cancer would hurt her singing voice— her favorite song is “At Last” by Etta James—Milli says it actually gave her a new sound. And everyone in her extended family who had been a smoker has quit.

Matthew Zachary New York, NY While a college senior, Matthew Zachary, a concert pianist and composer, was diagnosed with pediatric brain cancer. Today, 25 years later, Matthew, now 46, has turned that experience and his health care advocacy into a digital media empire. From 2007 to 2018, he hosted and produced the wildly popular podcast The Stupid Cancer Show. In 2020, he launched not just a new podcast—Out of Patients with Matthew Zachary— but an entire podcast production company, Off scrip Media. Its mission? “Th rough raw, unapologetic podcasts about advocacy, heroism and the audacity of health,” he promises, “we’re going to build community, end isolation, amplify voices and improve quality of life for patients and caregivers around the world.” You know we’re tuning in! ■

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DIARY

AS TOLD TO MEAVE GALLAGHER

A Leukemia Diary

Six years after his diagnosis with chronic lymphocytic leukemia, Jeff Neurman blogs and cohosts a podcast for men with cancer. He lives with his family on Long Island, New York.

July 2013 I saw the oncologist every three months. I had no sense of whether things were getting worse or staying stable; everything was determined by what the phlebotomist sucked out of my veins.

CLL is generally an older person’s cancer, so to be diagnosed at a young age is problematic. You don’t know how rapidly the illness will progress.

So I was watching and waiting for about four and a half years.

November 2017 My white blood cell count started going up pretty rapidly. But the only manifestation of the disease I noticed was that the lymph nodes in my neck were pronounced and the lymph nodes in my throat were enlarged and causing difficulty swallowing.

The oncologist gave me three options: one, do nothing, which he did not advise; two, traditional chemotherapy; three, a clinical trial. When Melissa and I started asking questions, he interrupted, saying, “You have all the information you need.

Go home and think about it, and let me know what you want to do.”

We were stunned that he would just cut us off

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when this was A toast to life: Jeff obviously a huge Neurman with his decision. That’s when we wife, Melissa decided we needed to get somebody else. My current oncologist is a CLL expert and just fantastic. She presented me with the same options and recommended chemo because two thirds of the people with my markers who go through this regimen do not need further treatment.

May 2018 We delayed chemo to get past cold and flu season.

It was six rounds of treatment, so I would have treatment one week and be off for three weeks.

The first day, I would be at the infusion center all day, then that night I would feel OK. By the end of the second day, I would start feeling run-down. By the end of the third day, I would be pretty nauseous, and that would last until the sixth day, when I would start to feel more normal for the next couple of weeks. Then the cycle would repeat.

I’m lucky because I have a terrific wife and a terrific family and great friends. My parents, who don’t live locally, came a couple of times, and my in-laws live nearby, so they would help out. I didn’t tell too many people I had cancer, and, as a practicing attorney, I definitely wasn’t advertising it to my clients.

October 2018 After I finished chemo, I was told that my white cell count was down to around where they wanted it, but it would be two years before we’d know how effective treatment has been. This means for the next couple of years, I still have to go in for testing every three months, just like before.

I was devastated, and I was very angry. I was so

(PAPER) ISTOCK; (THE NEURMANS) COURTESY OF JEFF NEURMAN

May 2013 I had turned 40, and I figured it was a good time to get a physical. They did routine blood work, and when it came back, my doctor said my white blood cell count was high. At the time, my wife, Melissa, and I had two sons, a 3-month-old and a 3-year-old, so somebody was always sick with something. I figured it was just a bug.

But they reran the blood work, and the numbers did not improve. They tested more blood and concluded that I had chronic lymphocytic leukemia (CLL), and my life changed forever.

eager to have a life that didn’t revolve around having cancer. But once you have cancer, it never really goes away. CLL is not curable—even if you’re in remission, like me, you’re always living with the specter of cancer.

(PAPER) ISTOCK; (THE NEURMANS) COURTESY OF JEFF NEURMAN

February 2019 When I was going through chemo, I took my laptop for work, but, really, I was writing about everything that was happening, and I started producing a blog. It was a really good outlet. It has also allowed me to connect with others who are going through similar experiences.

September 2019 I started a podcast, Guys With Cancer, with my friend Rudy Fischmann, who has brain cancer.

When you’re a guy with cancer, there’s societal pressure—real or perceived—to be stoic about it, which is totally unhelpful. We want there to be a place for men and people with men in their lives who have cancer to understand what they’re going through.

January–February 2020 In these first three months, my health has been stable. As a result, my oncology checkups have mercifully been spaced a bit farther apart. Around Thanksgiving of last year, I was quite ill with some unknown virus. Ultimately, I emerged seemingly unscathed, and the hyper-concern about my wellbeing that I experienced during that acute period For more first-person stories: cancerhealth.com/stories

apparently has caused me to involuntarily worry less about my health.

Left: Jeff and his sons, Andrew and Will; right: Jeff, Will, Andrew and Melissa Neurman

March 2020 Of course, while “enjoying” this span of relatively ignorant bliss (is ignorance a prerequisite to bliss?

I think likely so), I then became distracted further by that which has preoccupied nearly all of us, a new health disaster making a play to become the new C-word. Naturally, as someone with an already faulty immune system, I was far from complacent about the novel coronavirus. But again, bizarrely, in some ways, I was better suited for it than most of my friends and neighbors because I was already accustomed to taking many of the precautions that so many others are now struggling to adopt.

A TYPE OF BLOOD CANCER Chronic lymphocytic leukemia, the most common type of leukemia in adults, occurs when immature white blood cells in the bone marrow grow out of control. It affects cells that carry out immune responses, usually antibody-producing B cells. These abnormal blood cells can crowd out healthy ones, leading to complications, including increased susceptibility to infections.

cancerhealth.com

SUMMER 2020

CancerHealth 27

YOUR TEAM

BY KURT ULLMAN

Cancer Rehabilitation

Julie Silver, MD, author of Before and After Cancer Treatment, is director of cancer rehabilitation at Spaulding Rehabilitation Hospital in Boston.

What is cancer rehabilitation?

Oncology patients go through therapies such as surgery, chemotherapy and radiation, which may damage healthy cells in addition to those that are malignant. This can lead to physical and mental problems, such as muscle weakness, swallowing or speech problems, lymphedema, physical disability and cognitive issues.

Cancer rehabilitation helps you recover from both the cancer and the treatment.

For instance, after surgery for head and neck cancer you may have trouble turning your head, which can make it hard to drive, among other things. Rehabilitation helps you retain as much range of motion as possible.

Feeling better physically is also tied to improved psychological well-being, which can improve your ability to function and return to work or other activities.

One known toxicity of cancer therapy is bankruptcy, so helping you continue to get a paycheck is important to recovery too.

What kinds of care do you provide to oncology patients?

We use many different rehabili-

Rehab helps people recover from both cancer and its treatment.

tation interventions to help you function better and have less pain.

These may include consultations with specialists, such as a rehabilitation physician (physiatrist) or a physical, occupational or speech therapist. Mental health professionals, dietitians, exercise physiologists and other health care professionals also provide valuable services.

Is cancer rehabilitation useful before treatment begins?

Yes, in many cases. “Prehabilitation” consists of interventions that help you to be as strong as possible for the upcoming treatment. It’s similar to physical therapy to strengthen your muscles before knee surgery.

Getting you stronger before

28 CancerHealth SUMMER 2020 cancerhealth.com

How can I get rehabilitation?

Most cancer centers have these services available. However, you may have to ask, as rehabilitation may not be routinely offered.

Having a conversation with your oncology team is the first step. You do not need to know all the options or become an expert. Ask your doctor about whether cancer rehabilitation might help with your ability to function as optimally as possible before, during and after treatment. Ask if you might benefit from the rehabilitation program and what needs to be done for a referral.

This is an important conversation that should happen more than once over the course of treatment. One of the best things about cancer prehab and rehab is that they empower people to do something that is really positive for their health during a time when they are facing a serious health crisis. ■ Who’s on your team? cancerhealth.com/team

COURTESY OF SPAULDING REHABILITATION HOSPITAL

major cancer surgery may entail a multifactorial approach that includes, for example, exercise, nutrition and stress reduction (e.g., meditation, yoga). Studies done on patients with colon cancer have found that they do better after surgery if they prepare for the operation ahead of time. For example, they may have a shorter hospital stay and be able to walk farther and faster.

THIS TEAM APPROACH HELPS you recover from cancer as well as the side effects of treatment.

The goal is to improve both your ability to function and your quality of life.

BY MEAVE GALLAGHER

RESOURCES

Coping With Coronavirus COVID-19 HAS DISRUPTED CARE AND RAISED TREATMENT safety concerns for many. These trustworthy sources can help you stay up to date on how to get care and stay safe.

AMERICAN CANCER SOCIETY cancer.org ACS has resources specific to how COVID-19 can affect people with cancer, including answers from experts, questions for you to ask your health care team and tips on staying active and eating healthy while selfisolating. You can also contact ACS with questions on its 24-hour help line at 800-227-2345 or via live chat.

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CANCER.NET cancer.net/blog/tags/coronavirus Regularly updated in both English and Spanish, Cancer.net’s resources include a guide to protecting yourself during the COVID-19 pandemic and making decisions about the continuation of your health care during uncertain times.

CANCERCARE cancercare.org Though CancerCare’s patient support groups now meet remotely, the organization still has many telephone and online support groups in addition to online Connect Education Workshops. CancerCare is also still accepting applications for financial assistance.

Discover more resources: cancerhealth.com/resources

CANCER SUPPORT COMMUNITY cancersupportcommunity.org In addition to its specific resources about COVID-19, the Cancer Support Community has extended the hours of its Cancer Support Helpline during the pandemic. Call 888-793-9355, or visit the site to chat in English or Spanish with counselors and resource specialists.

NATIONAL CANCER INSTITUTE supportorgs.cancer.gov NCI offers a searchable database of organizations offering many different types of services for people living with cancer, including financial aid, counseling and support groups. Also, check out NCI’s information about what people with cancer should know about COVID-19.

CENTERS FOR DISEASE CONTROL AND PREVENTION cdc.gov/coronavirus/2019-ncov The CDC website, which is updated daily with information about the spread of COVID-19 in the United States, has guidance for people at higher risk for severe illness and tips on what to do if you are sick or caring for someone at home who is unwell.

NATIONAL COALITION FOR CANCER SURVIVORSHIP canceradvocacy.org NCCS’s blog is constantly updated with news related to cancer survivors’ concerns about the COVID-19 pandemic and its potential to affect their lives.

NCCS is working with the American Society of Clinical Oncologists to bring readers the best, most up-to-date information.

FEDERAL EMERGENCY MANAGEMENT AGENCY fema.gov/coronavirus-rumorcontrol See something fishy on Facebook? FEMA’s Coronavirus Rumor Control page is regularly updated to debunk myths and misrepresentations about the government’s response to the COVID-19 pandemic. Also, find links to trusted sources here.

NATIONAL COMPREHENSIVE CANCER NETWORK nccn.org/covid-19 NCCN has scientifically reviewed, regularly updated info about COVID-19, including visitor policies, a fact sheet for people with cancer and a self-care guide for oncology health care professionals, who also need to stay safe and healthy.

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SUMMER 2020

CancerHealth 29

BY MEAVE GALLAGHER

Manage Your Meds CANCER TREATMENT CAN MEAN HAVING TO TAKE many different medications, including oral therapies and drugs to help with side effects. Here’s how to keep track of all your meds so you always take the right dose at the right time.

Start by storing information about each of your prescriptions, over-the-counter medications and supplements in one place.

Include each drug’s generic and brand name, descriptive details like size and shape, why you’re taking the med, who prescribed it and when, how it’s taken and any side effects it causes. Ask your treatment center for a form to fill out, or use a template like the American Cancer Society’s “My Medicines Form.” Prefer using a smartphone? Download a free app that tracks medications. Input all your prescription information, including your doctor’s specific instructions, set refill alerts and learn about potential side effects and drug interactions.

Next, organize your pills, capsules, tablets and other medications in an inexpensive pill organizer, available at most drugstores. If you’re taking many medications, ask your pharmacy to presort them into multidose packages. Medications that you take at the same time will be packaged together and labeled with the date and time to take them. (However, it’s still a good idea to track them yourself so you can discuss issues with your medical care team.)

Traveling? Always pack your meds in your carry-on luggage.

Keep liquid medications in their original packaging with the prescription label to avoid problems with airport security. If it’s inconvenient to carry pills in their original containers, take photos of the labels with you, along with your doctor’s and pharmacy’s contact information. In addition, don’t forget to account for time zone changes! Finally, pack a few extra days’ worth of medication in case of unexpected delays. ■

30 CancerHealth SUMMER 2020 cancerhealth.com

9 MEDICATION MANAGEMENT TIPS

1

Talk to your prescribing doctor about all your medications, side effects and interactions.

2

Tell your medical care team about any over-the-counter medicines and supplements you’re using.

3

Track your meds and supplements with a spreadsheet or an app. Update regularly.

4

Track your side effects and discuss them with your doctor.

5

Fill all your prescriptions at the same pharmacy.

6

If you have only a few prescriptions, use a pill organizer to sort your doses.

7

If you have many meds, ask your pharmacy for presorted multidose packaging.

8

When traveling, pack your meds and prescription info in your carry-on bag.

9

Stay on top of refills—set alarms, and request automatic refills.

Get more info on managing your meds: cancerhealth.com/medication

ISTOCK

HOW TO

BY MEAVE GALLAGHER

GOOD STUFF

A SUMMER BASKET

Head into the hot season with cool, nourishing, soothing products—and a good book.

Heal scars and protect them from the sun with Kelo-Cote Scar Gel UV With SPF 30 (.53 oz., $34.50), based on the clinically proven Kelo-Cote Scar Gel but with added protection for when you want to spend time in the sun. All Kelo-Cote products are also waterproof. The dermatologist-recommended, silicone-based formula relieves itching from burns and scars that can result from radiation treatment and is gentle enough for use on children and others with sensitive skin.

Ease night sweats from treatment side effects, or just cool off during hot weather, with the Chillow Cooling Pillow ($50.99). Just fill the inner lining with cool water, slip it into its extra-soft, washable cover and place it over your regular pillow, or use it alone to cool off comfortably during the day or night. Studies show the Chillow helps people fall asleep faster and spend more time in restorative, rejuvenating REM sleep.

People in treatment for cancer often experience lower levels of iron. A safe, easy way to increase your iron intake without hard-todigest supplements is to cook with a Lucky Iron Fish ($35). Add to a broth or sauce that includes a few drops of an acid such as lemon juice or vinegar (it works especially well with tomato-based sauces).

After 10 minutes, the fish will have released 6 to 8 milligrams of easily absorbable iron. (The adult requirement for people 51 and over is 8 mg daily.)

Lucky Iron Fish (which also comes in a leaf design) has been clinically tested and is reusable daily for up to five years.

Find more products to make life easier: cancerhealth.com/good-stuff

Give relief when it’s really needed with a Soothing Chemotherapy Gift Set ($65) from Choose Hope. Packed with gentle skin care products, warm slipper socks, and tea and drops to combat nausea and dry mouth, this box comes wrapped and ready to give or send to whoever needs it. For a bolder statement, customize a Chemotherapy Gift Tote (from $20) with inspirational— and useful!—accessories available in the ribbon color of your choice.

In Better Off Bald: A Life in 147 Days (Build Your BLISSS, $14.99), Andrea Wilson Woods writes movingly about life with her 15-year-old sister, Adrienne, who was diagnosed with Stage IV hepatocellular carcinoma. Woods chronicles the fear, anxiety and seeming absurdity of a teenager receiving such a serious diagnosis as well as the joy she and Adrienne find amid the pain.

Woods’s work didn’t stop after Adrienne’s death; in 2002, she formed Blue Faery, a foundation whose goal is to “prevent, treat and cure primary liver cancer… through research, education and advocacy.”

cancerhealth.com

SUMMER 2020

CancerHealth 31

LIFE WITH CANCER

BY O. DAVID DYE

An Enduring Gift of Gardening IF THERE IS A SILVER LINING to my experience with cancer, it’s Harvest for Health. Who knew growing turnip greens and okra would be so healing?

I was diagnosed in 2014. I was 71. One morning, I noticed a scaly rash on my chest; that day, I experienced extreme fatigue.

Blood work and a biopsy led to an unsettling diagnosis full of dread, fear and uncertainty: multiple myeloma, a treatable but not curable disease.

Treatment was grueling— months of chemotherapy, then a bone marrow transplant.

When I returned home, I could walk only a fraction of a mile without rest. Remission lasted a while, but soon the myeloma returned. So I started on a clinical trial of two oral drugs and an infusion that took place over 18 four-week cycles. I was released with a “deep” remission.

Like so many families affected by cancer, my wife and I were the recipients of many blessings— from doctors, nurses, church members, friends, family. But one blessing was unexpected.

The University of Alabama at Birmingham invited me to participate in Harvest for Health, an “at-home gardening intervention for cancer survivors over 65” funded by the National Cancer Institute to determine whether gardening could boost exercise and nutrition.

Dye and his mentor, Nell Haigh, with raised-bed butter beans, okra

Participants received $500 worth of gardening supplies.

I was all in. When I was a kid, I watched my grandmother and aunts on the front porch of their farmhouse, shelling butter beans, snapping string beans and peeling apples for canning.

Years later, my wife and I planted corn behind our first house, and when our kids were little, we dabbled with growing squash, tomatoes and okra. But 30 years had passed.

I left the orientation session with a soaker hose, gardening tools, a watering can, plant food, garden gloves, three bags of seeds and insect-killing soap.

Soon a raised garden bed form and soil were delivered. I met

32 CancerHealth SUMMER 2020 cancerhealth.com

my mentor, a volunteer who is a certified master gardener.

I learned to mix the soil “like you’re baking a cake and not lasagna,” fight deer with a fence and deter flea beetles and cutworms with neem oil and diatomaceous earth. My first crop included broccoli, spring onions, sugar snap peas, cabbage and a variety of greens. My wife cooked turnip greens in chicken broth and prepared corn bread muffins and cabbage slaw. “This is so good you’ll have to continue planting greens,” she told me.

Now I’m also growing okra, butter beans, rattlesnake pole beans and squash.

Gardening gave me exercise and fresh air, but also purpose, the satisfaction of developing new skills and producing something valuable. I enjoyed the partnership with my mentor and the sense of community. I felt great pleasure participating in a project that could benefit other cancer survivors. There were more benefits than I could have ever imagined.

I enjoyed the gardening project so much that I didn’t want it to end. And in a sense, it hasn’t.

After I expressed interest in continuing to learn and garden, Harvest for Health offered me a a partial scholarship to enroll in a local master gardeners class.

Gardening is a gift that truly keeps on giving. ■ For more first-person stories: cancerhealth.com/stories

COURTESY OF O. DAVID DYE/JUDY DYE

O. David Dye, 77, a multiple myeloma survivor who lives in Troy, Alabama, was intrigued by an offer to be part of a Harvest for Health study. Now he’s training to be a master gardener.

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Chemotherapy may destroy your cancer, but it doesn’t have to destroy your hair. “ It was a powerful experience to look healthy throughout chemotherapy and be treated as a healthy person by others. I identified as someone who was healing instead of someone who was sick.”

- Deborah Cohan, MD, San Francisco, CA

PRO 20191031-01 EN

DigniCap is FDA cleared to minimize hair loss in patients with solid tumors undergoing chemotherapy.

Learn more at dignicap.com

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