Meet Chuck, Donna, Mark,and Tami,4 patients who share their emotional journeys with a rare, chronic blood cancer. The Purple Chair series explores their collective experiences, from diagnosis through WRWKHGLVFRYHU\RIDSDWKIRUZDUGZLWK-DND ® (ruxolitinib)—the UVW )'$DSSURYHGSUHVFULSWLRQPHGLFLQH for adults with certain types of P\HOR EURVLV 0) DQGWKH UVW)'$DSSURYHGSUHVFULSWLRQPHGLFLQH for adults with polycythemia vera (PV) who have already taken a medicine called hydroxyurea (HU) and it did not work well enough or they could not tolerate it.
Explore all 5 episodes to see how these patient journeys with 39DQG0)EHJDQȃDQGKRZWKH\GLVFRYHUHGWKHLULQGLYLGXDO SDWKVWRSRVVLEOHZLWK-DND
Chuck 7DNLQJ-DND IRU39 since 2020
Donna 7DNLQJ-DND IRU39 since 2020
Mark 7DNLQJ-DND IRULQWHUPHGLDWHULVN0) since 2017
-DND FDQFDXVHVHULRXVVLGH H HFWVLQFOXGLQJ
/RZEORRGFRXQWV -DND ® (ruxolitinib) may cause low platelet, red blood cell, and white blood cell counts. If you develop bleeding, stop taking -DND DQGFDOO\RXUKHDOWKFDUH provider. Your healthcare provider will do a blood test to check your EORRGFRXQWVEHIRUH\RXVWDUW-DND and regularly during your treatment. Your healthcare provider may change \RXUGRVHRI-DND RUVWRS\RXU treatment based on the results of your blood tests. Tell your healthcare provider right away if you develop or have worsening symptoms such as unusual bleeding, bruising, tiredness, shortness of breath, or a fever.
ΖQIHFWLRQ You may be at risk for developing a serious infection
GXULQJWUHDWPHQWZLWK-DND 7HOO your healthcare provider if you develop any of the following symptoms of infection: chills, nausea, vomiting, aches, weakness, fever, painful skin rash or blisters.
&DQFHU Some people have had certain types of non-melanoma skin cancers during treatment with -DND <RXUKHDOWKFDUHSURYLGHUZLOO regularly check your skin during \RXUWUHDWPHQWZLWK-DND 7HOO\RXU healthcare provider if you develop any new or changing skin lesions
GXULQJWUHDWPHQWZLWK-DND ΖQFUHDVHVLQFKROHVWHURO You may have changes in your blood cholesterol levels during treatment
ZLWK-DND <RXUKHDOWKFDUHSURYLGHU will do blood tests to check your cholesterol levels about every 8 to 12 weeks after you start taking -DND DQGDVQHHGHG
Increased risk of major FDUGLRYDVFXODUHYHQWVVXFKDV KHDUWDWWDFNVWURNHRUGHDWKLQ SHRSOHZKRKDYHFDUGLRYDVFXODU risk factors and who are current RUSDVWVPRNHUVZKLOHXVLQJ
another JAK inhibitor to treat UKHXPDWRLGDUWKULWLV Get emergency help right away if you have any symptoms of a heart DWWDFNRUVWURNHZKLOHWDNLQJ-DND including: discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back, severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw, pain or discomfort in your arms, back, neck, jaw, or stomach, shortness of breath with or without chest discomfort, breaking out in a cold sweat, nausea or vomiting, feeling lightheaded, weakness in one part or on one side of your body, slurred speech
ΖQFUHDVHGULVNRIEORRGFORWV
Blood clots in the veins of your legs (deep vein thrombosis, DVT) or lungs (pulmonary embolism, PE) have happened in people taking another JAK inhibitor for rheumatoid arthritis and may be life-threatening. Tell your healthcare provider right away if you have any signs and symptoms of blood clots during WUHDWPHQWZLWK-DND LQFOXGLQJ swelling, pain, or tenderness in one or both legs, sudden, unexplained chest or upper back pain, shortness
RIEUHDWKRUGLɝFXOW\EUHDWKLQJ
3RVVLEOHLQFUHDVHGULVNRIQHZ VHFRQGDU\ FDQFHUV People who take another JAK inhibitor for rheumatoid arthritis have an increased risk of new (secondary) cancers, including lymphoma and other cancers. People who smoke or who smoked in the past have an added risk of new cancers.
7KHPRVWFRPPRQVLGHH HFWV RI-DND LQFOXGH for certain W\SHVRIP\HOR EURVLV 0) DQG polycythemia vera (PV) – low platelet or red blood cell counts, bruising, dizziness, headache, and diarrhea; for acute GVHD – low platelet counts, low red or white
blood cell counts, infections, and swelling; and for chronic GVHD –low red blood cell or platelet counts and infections including viral infections.
These are not all the possible side H HFWVRI-DND $VN\RXUSKDUPDFLVW or healthcare provider for more information. Call your doctor for PHGLFDODGYLFHDERXWVLGHH HFWV %HIRUHWDNLQJ-DND WHOO\RXU KHDOWKFDUHSURYLGHUDERXW all the medications, vitamins, and herbal supplements you are taking and all your medical conditions, including if you have an infection, have or had low white or red blood cell counts, have or had tuberculosis (TB) or have been in close contact with someone who has TB, had shingles (herpes zoster), have or had hepatitis B, have or had liver or kidney problems, are on dialysis, have high cholesterol or triglycerides, had cancer, are a current or past smoker, had a blood clot, heart attack, other heart problems or stroke, or have any other medical FRQGLWLRQ7DNH-DND H[DFWO\DV your healthcare provider tells you. Do not change your dose or stop WDNLQJ-DND ZLWKRXW UVWWDONLQJ to your healthcare provider.
:RPHQVKRXOGQRWWDNH-DND ZKLOH pregnant or planning to become pregnant. Do not breastfeed during WUHDWPHQWZLWK-DND DQGIRUZHHNV DIWHUWKH QDOGRVH
3OHDVHVHHWKH3DWLHQW%ULHI 6XPPDU\RIWKH)XOO3UHVFULELQJ Information on the next page. You are encouraged to report QHJDWLYHVLGHH HFWVRI
SUHVFULSWLRQGUXJVWRWKH)'$ Visit www.fda.gov/medwatch , or call 1-800-FDA-1088 .
<RXPD\DOVRUHSRUWVLGHH HFWV WRΖQF\WH0HGLFDOΖQIRUPDWLRQDW 1-855-463-3463.
Incyte
ORJRDUHUHJLVWHUHGWUDGHPDUNVRIΖQF\WH kΖQF\WH0$7-$.
and the Incyte logo are registered trademarks of Incyte. -DND DQGWKH-DNDPlease read this summary carefully and then talk with your healthcare provider about Jaka (JAK-ah-fye). No advertisement can provide all the information needed to determine if a drug is right for you or take the place of careful discussions with your healthcare provider. Only your healthcare provider has the training to weigh the risks and bene ts of a prescription drug.
What is Jaka ?
Jaka is a prescription medicine used to treat:
• adults with certain types of myelo brosis (MF).
• adults with polycythemia vera (PV) who have already taken a medicine called hydroxyurea and it did not work well enough or they could not tolerate it.
• adults and children 12 years of age and older with acute graft-versus-host disease (aGVHD) who have taken corticosteroids and they did not work well enough.
• adults and children 12 years of age and older with chronic graft-versus-host disease (cGVHD) who have taken one or two types of treatments and they did not work well enough.
It is not known if Jaka is safe or effective in children for treatment of myelo brosis or polycythemia vera.
Before taking Jaka , tell your healthcare provider about all of your medical conditions, including if you:
• have an infection
• have or have had low white or red blood cell counts
• have or had tuberculosis (TB), or have been in close contact with someone who has TB
• have had shingles (herpes zoster)
• have or had hepatitis B
• have or have had liver problems
• have or have had kidney problems or are on dialysis. If you are on dialysis, Jaka should be taken after your dialysis
• have a high level of fat in your blood (high blood cholesterol or triglycerides)
• have had cancer in the past
• are a current or past smoker
• have had a blood clot, heart attack, other heart problems or stroke
• are pregnant or plan to become pregnant. It is not known if Jaka will harm your unborn baby
• are breastfeeding or plan to breastfeed. It is not known if Jaka passes into your breast milk. Do not breastfeed during treatment with Jaka and for 2 weeks after the nal dose
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking Jaka with certain other medicines may affect how Jaka works. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. How should I take Jaka ?
• Take Jaka exactly as your healthcare provider tells you.
• Do not change your dose or stop taking Jaka without rst talking to your healthcare provider.
• You can take Jaka with or without food.
• Jaka may also be given through certain nasogastric tubes.
ż Tell your healthcare provider if you cannot take Jaka by mouth. Your healthcare provider will decide if you can take Jaka through a nasogastric tube.
ż Ask your healthcare provider to give you speci c instruction on how to properly take Jaka through a nasogastric tube.
• If you miss a dose of Jaka , take your next dose at your regular time. Do not take 2 doses at the same time.
• If you take too much Jaka call your healthcare provider or go to the nearest hospital emergency room right away.
• You will have regular blood tests during your treatment with Jaka . Your healthcare provider may change your dose of Jaka or stop your treatment based on the results of your blood tests.
What are the possible side effects of Jaka ? Jaka can cause serious side effects including:
Low blood cell counts. Jaka may cause low platelet counts (thrombocytopenia), low red blood cell counts (anemia), and low white blood cell counts (neutropenia). If you develop bleeding, stop Jaka and call your healthcare provider. Your healthcare provider will do a blood test to check your blood cell counts before you start Jaka and regularly during your treatment with Jaka . Tell your healthcare provider right away if you develop or have worsening of any of these symptoms:
• unusual bleeding
• bruising
• tiredness
• shortness of breath
• fever
Infection. You may be at risk for developing a serious infection during treatment with Jaka . Tell your healthcare provider if you develop any of the following symptoms of infection:
• chills
• aches
• fever
• nausea
• vomiting
• weakness
• painful skin rash or blisters
Cancer. Some people have had certain types of non-melanoma skin cancers during treatment with Jaka . Your healthcare provider will regularly check your skin during your treatment with Jaka . Tell your healthcare provider if you develop any new or changing skin lesions during treatment with Jaka . Cholesterol increases. You may have changes in your blood cholesterol levels during treatment with Jaka . Your healthcare provider will do blood tests to check your cholesterol levels about every 8 to 12 weeks after you start taking Jaka , and as needed. Increased risk of major cardiovascular events such as heart attack, stroke or death in people who have cardiovascular risk factors and who are current or past smokers while using another JAK inhibitor to treat rheumatoid arthritis.
Get emergency help right away if you have any symptoms of a heart attack or stroke while taking Jaka , including:
• discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back
• severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
• pain or discomfort in your arms, back, neck, jaw, or stomach
• shortness of breath with or without chest discomfort
• breaking out in a cold sweat
• nausea or vomiting
• feeling lightheaded
• weakness in one part or one side of your body
• slurred speech
Increased risk of blood clots. Blood clots in the veins of your legs (deep vein thrombosis, DVT) or lungs (pulmonary embolism, PE) have happened in people taking another JAK inhibitor for rheumatoid arthritis and may be life-threatening.
• Tell your healthcare provider right away if you have any signs and symptoms of blood clots during treatment with Jaka , including:
ż swelling, pain or tenderness in one or both legs
ż sudden, unexplained chest or upper back pain
ż shortness of breath or dif culty breathing
Possible increased risk of new (secondary) cancers. People who take another JAK inhibitor for rheumatoid arthritis have an increased risk of new (secondary) cancers, including lymphoma and other cancers. People who smoke or who smoked in the past have an added risk of new cancers.
The most common side effects of Jaka in adults with certain types of MF and PV include:
• low platelet counts
• low red blood cell counts
• bruising
• dizziness
• headache
• diarrhea
The most common side effects of Jaka in people with aGVHD include:
• low red blood cell counts
• low platelet counts
• low white blood cell counts
• infections
• swelling
The most common side effects of Jaka in people with cGVHD include:
• low red blood cell counts
• low platelet counts
• infections, including viral infections
These are not all of the possible side effects of Jaka . Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Incyte Corporation at 1-855-463-3463.
The risk information provided here is not comprehensive. To learn more, talk about Jaka with your healthcare provider or pharmacist. The FDA-approved product labeling can be found at www.jaka .com.
Manufactured for:
Incyte Corporation, 1801 Augustine Cut-off, Wilmington, DE 19803
Revised: September 2021 PLR-JAK-00055
Jaka is a registered trademark of Incyte. All rights reserved.
U.S. Patent Nos. 7598257; 8415362; 8722693; 8822481; 8829013; 9079912; 9814722; 10016429
© 2011-2021 Incyte Corporation.
For more information call 1-855-463-3463 or go to www.jaka .com.
E xclusively on Can cer Health.com
Cancer Health Stories
5HDGWKHƓUVW person stories of people who are living with cancer, including personal diaries and honest, moving essays. cancerhealth.com/stories
Whether you’re newly diagnosed or a long-term survivor, check out our Basics section on cancer treatment, how to manage side effects and more. cancerhealth.com/basics
Learn about the latest treatment and prevention advances, cure research and conference news. cancerhealth.com/science-news
Scan the QR code (left) with your smartphone to check out the digital issue of Cancer Health online, or go to cancerhealth.com/digital to read past issues and the entire Smart + Strong digital library.
16 LESSONS FROM THE FRONT LINES
As a family physician and a breast cancer patient, Cheryl Law shares how she navigates her treatment. BY JENNIFER COOK
20 CANCER HEALTH 25: CHAMPIONS OF HEALTH EQUITY
These individuals work to ensure fair opportunities to prevent, treat and survive cancer. BY THE CANCER HEALTH STAFF
4 From the Editor Yes, You Can!
6 News
Start mammograms at 40 instead of 50? | celebrity news | chemo drug shortage | does aspartame cause cancer? | the “staggering numbers” of Medicaid unwinding | good news about cancer mortality
8 Care & Treatment
Improving sexual health for women with breast cancer | mRNA vaccines as treatment | weight loss drugs to ƓJKWFDQFHU"| duration of lung cancer immunotherapy | Kisqali reduces breast cancer recurrence
10 Basics Seasonal vaccine alert
12 Voices
A liberating lesson from Adam Hayden, who has brain cancer
14 A Lung Cancer Diary
How Hank Baskett got unexpected help from Hugh Hefner
26 Can Heal
A triathlete and horse rescuer, Siri Lindley gives you tools to triumph.
28 Your Team
Tinka Duran, MPH, is the senior director at the Great Plains Tribal Epidemiology Center.
29 Solutions
Say no to nausea and vomiting.
30 Resources
Information on bladder cancer
32 Good Stuff
Products to promote healing
33 Reader Survey
Share your thoughts about health and well-being.
declaration is right there in the title of this magazine: Cancer Heal th. We aim to empower people living with cancer by providing information, research, resources, community and inspiring real-life stories.
We’re excited to introduce a new column: Can Heal provides a space for cancer survivors to share their advice for getting to the other side of treatment. For our Can Heal debut, on page 26, we profile Siri Lindley, a champion triathlete, coach, horse rescuer and LGBTQ advocate. After a diagnosis of acute myeloid leukemia followed by treatment with chemo, radiation and a bone marrow transplant, she is now cancer-free. In her new self-help book, Finding a Way: Taking the Impossible and Making It Possible, she uses her own experiences as examples to teach you how to do exactly that.
Cheryl Law, MD, featured on our cover, also imparts wisdom gleaned from her own life. A family physician in Alabama and mother of three whose breast cancer has spread to her brain, Law shares how she navigates treatment. For her insights, turn to page 16. And for more about breast cancer, see Care & Treatment on page 8 for details about two recent studies.
Another inspiring thriver is Hank Baskett. After learning that he had Stage IV non-small-cell lung cancer in 2011, he received pivotal support from his son—Hank III, a former NFL player and costar of Kendra on Top and Hugh Hefner. Read his Lung Cancer Diary on page 14.
Don’t miss Adam Hayden’s Voices column on page 12. Hayden, who is
living with brain cancer, offers a liberating lesson about fear. And meet Tinka Duran, an epidemiologist and member of the Rosebud Sioux Tribe, on page 28.
<RXōOOƓQGPXFKPRUHLQRXUIDOO issue. A major highlight is our fourth annual Cancer Health 25 on page 20. This year, we shine a much-deserved spotlight on Champions of Health Equity—individuals who work to ensure we all enjoy fair opportunities to prevent, treat and survive cancer. Thanks to their efforts, more of us can heal.
EDITOR-IN-CHIEF
Trent Straube
MANAGING EDITOR
Jennifer Morton
SCIENCE EDITOR
Liz Highleyman
EDITOR-AT-LARGE
Bob Barnett
NEWS WRITERS
Sukanya Charuchandra; Laura Schmidt
COPY CHIEF
Joe Mejía
ART DIRECTOR
Doriot Kim
ART PRODUCTION MANAGER
Michael Halliday
ADVISORY BOARD
Dena Battle; Jamie Ennis Boyd; Catherine Guthrie; Timothy Henrich, MD; Carl June, MD; Leigh Leibel, MSc; Yung Lie, PhD; Gilberto Lopes, MD; Jennifer L. McQuade, MD; Amelie Ramirez, DPH; Hope Rugo, MD; Kelly Shanahan, MD; Carla Tardif
FEEDBACK
Email: info@cancerhealth.com
SMART + STRONG
PRESIDENT AND COO
Ian E. Anderson
EDITORIAL DIRECTOR
Oriol R. Gutierrez Jr.
CHIEF TECHNOLOGY OFFICER
Christian Evans
VICE PRESIDENT, INTEGRATED SALES
Diane Anderson
INTEGRATED ADVERTISING
MANAGER
Jonathan Gaskell
INTEGRATED ADVERTISING
COORDINATOR
Sarah Pursell
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. 23. Copyright © 2023 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, photo copying, recording or otherwise without the written permission of the publisher. Smart + Strong® and Cancer Health™ are registered trademarks of CDM Publishing, LLC. Cancer Health is BPA audited.
Editor-in-Chief
trents@cancerhealth.com
Twitter: @trentonstraube
If you smoked, you may still be at risk, but early detection could save your life.
Women at average risk for breast cancer should begin mammogram screenings at age 40 instead of 50, recommends a draft statement from the U.S. Preventive Services Task Force, whose previous guidelines on the matter were issued in 2016. The new proposal follows a review by the group’s members of more recent and inclusive science about breast cancer in people under 50, notably data regarding racial inequities. The updated recommendations “will save more lives among all women,” Wanda Nicholson, MD, MPH, the task force’s vice chair, told CNN. “This is particularly important for Black women, who are 40% more likely to die from breast cancer.” Nicholson cautioned, however, that screenings aren’t enough to address disparities.
The National Comprehensive Cancer Network already recommends annual mammograms for all women 40 and older at average risk, and the American Cancer Society offers similar guidance. But the task force holds particular weight. The Affordable Care Act (Obamacare) mandates that health insurance cover preventive services that receive a grade A or B from the task force. (The previous mammogram recommendations scored a B.) This summer, the task force accepted public comments on its proposed guidance. A
By sharing their cancer journeys, these celebrities raise awareness, combat stigma and help educate the public. Actress Shannen Doherty posts updates on Instragram about breast cancer spreading to her brain. Sarah Ferguson, Duchess of York, discussed her breast cancer story via the podcast Tea Talks with the Duchess and Sarah. YouTuber and novelist Hank Green tweets about his Hodgkin lymphoma treatment. And ESPN sportscaster Dick Vitale, who has vocal cord cancer—his third cancer diagnosis—also shares his experiences on social media.
The nationwide drug shortage is increasingly endangering people with cancer. Chemotherapy meds are among the WRSƓYHGUXJVDIIHFWHGE\WKH VKRUWDJHQRWDEO\FDUERSODWLQ and cisplatin, two platinumEDVHGWKHUDSLHVRIWHQXVHG WRJHWKHUIRUEUHDVWOXQJDQG prostate cancers as well as for EORRGFDQFHUVVXFKDVOHXNHPLD and lymphoma. In fact, these two meds are used in treat-
ments for as many as 500,000 new cancer patients each year, according to the National &RPSUHKHQVLYH&DQFHU Network (NCCN).
The NCCN also reported that the drug shortage has LPSDFWHG RIVXUYH\HG cancer centers. And news outlets across the nation reported that local doctors are VFUDPEOLQJWRƓQGPHGVHYHQ resorting to administering
lower or fewer doses.
0DQ\IDFWRUVFRQWULEute to the shortage, including supply chain interruptions affecting, for example, ingredients made in China as well as quality control issues at factories that manufacture generics.
0HGLFDOH[SHUWVDQGDGYRFDWHV are urging the White House and Congress to address the drug shortage.
“This is particularly important for Black women.”
This summer, a research arm of the World Health 2UJDQL]DWLRQ :+2 FODVVLƓHGWKHDUWLƓFLDOVZHHWener aspartame as “a possible carcinogen to KXPDQVŐƓQGLQJŏOLPLWHGHYLGHQFHŐWKDWLWPD\ FDXVHOLYHUFDQFHU%XWDQRWKHU:+2UHSRUWIRXQG WKDWDVSDUWDPHLVJHQHUDOO\VDIHLQW\SLFDOTXDQWLWLHV WKH:+2ōVDFFHSWDEOHLQWDNHLVWKHHTXLYDOHQWRID
150-pound person drinking nine to 14 cans of diet
VRGDDGD\ 7KH)RRGDQG'UXJ$GPLQLVWUDWLRQ
(FDA) responded that “FDA VFLHQWLVWVGRQRWKDYHVDIHW\ FRQFHUQVZKHQDVSDUWDPHLV
XVHGXQGHUWKHDSSURYHG conditions.” The American &DQFHU6RFLHW\DOVRZHLJKHG LQŏ7KHVFLHQFHLVVWLOOHYROYLQJŐVDLG William Dahut, MD, the group’s chief VFLHQWLƓFRIƓFHUŏ%XWZHUHFRP PHQGSHRSOHřUHYLHZWKHLURYHUDOO GLHWDU\LQWDNHLQFOXGLQJSURFHVVHG PHDWDQGDOFRKRONQRZQFDUFLQR JHQVDVVRFLDWHGZLWKLQFUHDVHGULVN of cancer.”
The artificial sweetener is found in diet drinks and low-calorie foods.
During the COVID-19 pandemic, the Families First Coronavirus Response Act required states to keep people enrolled in Medicaid, the health insurance program for low-income and disabled Americans, even if they no longer met the requirements. Beginning April 1, in what’s called the Medicaid unwinding, states started returning to regular operations, meaning no more mandatory continuous enrollments.
KFF, formerly the Kaiser Family Foundation, estimates that between 8 million and 24 million people will lose coverage over the next year. A KFF report from May found that most people were dropped because of missing paperwork and other procedural errors, not because they didn’t qualify. In Indiana, for example, 53,000 IRONVORVWFRYHUDJHWKHƓUVWPRQWK RIWKHP due to technicalities—“staggering numbers,” as Ed Clere, a Republican lawmaker from the state, described it. Lawmakers, advocates and the Biden White House are urging states to slow the disenrollments.
Mortality rates for most cancers are declining globally, reports a study by the American Cancer Society and Brookdale University Hospital Medical Center. Researchers looked at eight major cancers— female breast, lung, colon and rectum, prostate, stomach, liver, cervix and esophagus—in 47 countries. Mortality rates decreased in most cases, except for lung cancer in women (mostly in Europe) and liver cancer in men. Liver cancer deaths were linked to hepatitis C, obesity and other factors. To reduce cancer risk, researchers suggest vaccinations, tobacco control, regular screenings and healthful lifestyles.
Coverage varies from state to state. Most states expanded Medicaid under the Affordable Care Act (Obamacare). The 10 holdouts are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming, exacerbating health disparities in the South.
The unwinding takes place as new reports show that Medicaid expansion improved treatment and survival for young women with breast cancer, decreased mortality and racial disparities among people with gastrointestinal cancers and increased palliative care for people with advanced cancer. Lisa Lacasse, president of the American Cancer Society Cancer Action Network, summed it up thus: “Research continues to underscore the impact increasing access to comprehensive, affordable health insurance through Medicaid has on cancer patient survival.”
“Staggering numbers” of Americans are losing coverage.
$GG\L ŴLEDQVHULQ DGUXJWKDW KHOSVEDODQFHFKHPLFDOPHVVHQJHUVLQWKHEUDLQOHGWRLPSURYHPHQWVLQVH[XDOGHVLUH OLELGR
DQGEHWWHUKHDOWKUHODWHGTXDOLW\ RIOLIHIRUSUHPHQRSDXVDOZRPHQ XVLQJKRUPRQHWKHUDS\IRU EUHDVWFDQFHUDFFRUGLQJWR UHVHDUFKSUHVHQWHGDWWKH American Society of Clinical 2QFRORJ\$QQXDO0HHWLQJ
7KHVWXG\HQUROOHGZRPHQ ZLWK6WDJHWR6WDJH,,,EUHDVW FDQFHUZKRKDGEHHQRQKRUPRQHWKHUDS\IRUDWOHDVWWKUHH PRQWKVDQGZHUHH[SHULHQFLQJ
ORZOLELGR7KH\WRRN$GG\L RQFHGDLO\DWEHGWLPHIRUVL[ PRQWKVDQGZHUHIROORZHGIRU DERXWD\HDU7KHGUXJZRUNVE\ DOWHULQJOHYHOVRIWKHQHXURWUDQVPLWWHUVVHURWRQLQGRSDPLQH and norepinephrine.
7KHSDUWLFLSDQWVVDZVLJQLƓFDQWLPSURYHPHQWVLQVH[XDO GHVLUHDURXVDOOXEULFDWLRQ RUJDVPDQGVDWLVIDFWLRQ:KDWōV PRUHWKH\UHSRUWHGOHVVSDLQ DQGGLVWUHVVGXULQJVH[DQGDQ LQFUHDVHGQXPEHURIVH[XDOO\ VDWLVI\LQJHYHQWVDVZHOODVLPSURYHGVOHHSŏ'HFUHDVHGOLELGR
A customized vaccine using the same messenger RNA (mRNA) technology as COVID-19 vaccines may help people ƓJKWFDQFHU7RFUHDWHSHUVRQDOL]HG vaccines, scientists sequence a sample from a patient’s tumor and identify neoantigens (abnormal proteins) that are most likely to elicit DQLPPXQHUHVSRQVH
In a Phase II trial, people with advanced melanoma who received Moderna’s experimental cancer vaccine V940 (mRNA-4157) plus Merck’s checkpoint inhibitor Keytruda (pembrolizumab) after surgery had a 44% lower likelihood of disease recurrence or death and a 65% lower risk of metastasis or death than WKRVHZKRWRRN.H\WUXGDDORQH,Q-XO\WKH companies announced the start of a Phase III trial that will enroll more than 1,000 people ZLWKKLJKULVNPHODQRPD
LVDQH[WUHPHO\SUHYDOHQW
XQGHUWUHDWHGDQGGLVWUHVVLQJ V\PSWRPLQZRPHQZLWKEUHDVW FDQFHURQHQGRFULQHWKHUDS\Ő VDLG6KDUL*ROGIDUE0'RI 0HPRULDO6ORDQ.HWWHULQJ&DQFHU &HQWHUŏ+DYLQJDPHGLFDWLRQ WRWUHDWWKLVRIWHQXQDGGUHVVHG LVVXHZLOOLPSURYHWKHTXDOLW\ RIOLIHDQGVH[XDOIXQFWLRQ RIPLOOLRQVRIZRPHQZLWK EUHDVWFDQFHUŐ
%LR17HFK3Ɠ]HUōV&29,'YDFFLQH partner, is also working on cancer
YDFFLQHV,QD3KDVH,WULDOSHRSOH received Roche’s checkpoint inKLELWRU7HFHQWULT DWH]ROL]XPDE a vaccine dubbed autogene
FHYXPHUDQ %17 DQGFKHPRtherapy after surgery for pancreatic
FDQFHU+DOIKDGVWURQJ7FHOOLPPXQH responses against tumor neoantigens, and these responders showed no signs of cancer recurrence during 18 months of follow-
XS$UDQGRPL]HG3KDVH,,VWXG\LVQRZXQGHUZD\ DFFRUGLQJWRWKHFRPSDQLHV
“It’s exciting to see that a personalized YDFFLQHFRXOGHQOLVWWKHLPPXQHV\VWHPWRƓJKW pancreatic cancer—which urgently needs better treatments,” said senior investigator Vinod Balachandran, MD, of Memorial Sloan Kettering &DQFHU&HQWHU
Popular weight loss drugs boost natural killer (NK) cells, which may improve their ability to combat cancer. Glucagon-like peptide-1 (GLP-1) analogs, such as semaglutide (Ozempic and Wegovy), originally developed for diabetes, are also used to treat obesity, which is linked to at least 13 types of cancer. Losing weight can help reduce cancer risk, but GLP-1 analogs may have a more direct effect.
Twenty study participants with obesity and defective NK cell function received semaglutide once weekly for six months. While the number of circulating NK cells did not change, their function improved. In laboratory experiments, NK cells from treated patients were better able to kill cancer. Even people who GLGQōWORVHZHLJKWVDZDEHQHƓW ŏ7KHFXUUHQWƓQGLQJVUHSUHsent very positive news for people living with obesity on GLP-1 therapy and suggest the EHQHƓWVRIWKLVIDPLO\RIWUHDWments may extend to a reduction in cancer risk,” said Donal O’Shea, MD, of University College Dublin.
3HRSOHZKRUHVSRQGZHOOWRƓ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ƓQLWHO\KDGVLPLODUVXUYLYDOUDWHVDIWHUWZRPRUH\HDUV RIIROORZXS DQGUHVSHFWLYHO\
ŏ:HKRSHWKLVGDWDSURYLGHVUHDVVXUDQFHWKDWVWRSSLQJWUHDW PHQWDWWZR\HDUVLVDYDOLGWUHDWPHQWVWUDWHJ\WKDWGRHVQRW VHHPWRFRPSURPLVHRYHUDOOVXUYLYDOŐ6XQVDLG
$GGLQJWKH&'.LQKLELWRU.LVTDOL ULERFLFOLE WRKRUPRQH WKHUDS\DIWHUVXUJHU\UHGXFHGWKHULVNIRUUHFXUUHQFHE\IRU SHRSOHZLWKHDUO\WRPLGVWDJHEUHDVWFDQFHU
7KH3KDVH,,,1$7$/((WULDOLQFOXGHGSUHPHQRSDXVDORU SRVWPHQRSDXVDOZRPHQDQGDIHZPHQZLWK6WDJH,,RU,,, KRUPRQHUHFHSWRUSRVLWLYH+(5QHJDWLYHEUHDVWFDQFHUWKDW ZDVFRQVLGHUHGDWULVNIRUUHFXUUHQFH$IWHUVXUJHU\WKH\ZHUH UDQGRPO\DVVLJQHGWRUHFHLYHDGMXYDQWKRUPRQHWKHUDS\ZLWK RUZLWKRXW.LVTDOL7KRVHZKRDGGHGWKHWDUJHWHGWKHUDS\VDZ DVLJQLƓFDQWLPSURYHPHQWLQLQYDVLYHGLVHDVHIUHHVXUYLYDO PHDQLQJWKHLUFDQFHUGLGQRWUHODSVHDQGVSUHDG
ŏ7KHVHODQGPDUNUHVXOWVZLOOIXQGDPHQWDOO\FKDQJHKRZZH WUHDWSDWLHQWVZLWK6WDJH,,DQG,,,+5SRVLWLYH+(5QHJDWLYH HDUO\EUHDVWFDQFHUZKRDUHLQQHHGRIQHZZHOOWROHUDWHGRSWLRQV WKDWSUHYHQWWKHLUFDQFHUIURP
FRPLQJEDFNŐVDLGOHDG
LQYHVWLJDWRU'HQQLV6ODPRQ 0'3K'RI8&/$
People with cancer are advised to get COVID-19, flu and maybe RSV vaccines this fall.
FALL HAS ARRIVED, WHICH means respiratory illness season is around the corner. While COVID-19 hasn’t yet settled into a predictable seasonal pattern, respiratory pathogens tend to circulate in the fall and winter.
Respiratory illnesses are caused by germs that enter the nose or mouth and establish infection in the respiratory tract. These include the SARS-CoV-2 virus that causes COVID, other coronaviruses and rhinoviruses
WKDWFDXVHFRPPRQFROGVLQŴXenza viruses, respiratory syncytial virus (RSV) and Streptococcus pneumoniae bacteria that cause pneumococcal pneumonia.
Respiratory illnesses share some common symptoms, including nasal congestion, coughing and a sore throat. Some people have fever, headaches and body aches. But many experience only mild or asymptomatic illness. Testing is the only way to know what you have.
Common colds usually resolve on their own with supportive FDUH&29,'ŴXDQG569DOVR usually resolve, but they can lead to severe, even life-threatening, complications. Seniors, young children and immunocompromised people are more likely to develop severe illness.
People with cancer, especially those with lung cancer or blood cancers and those receiving treatment that impairs immune function, are more prone to
severe respiratory illnesses, and they may need to take precautions, such as wearing a wellƓWWHGPDVNDQGDYRLGLQJLQGRRU gatherings. While many have thrown away their masks, you can still take steps to protect yourself and vulnerable loved ones.
Vaccines work by stimulating antibody production and triggering longer-lasting memory B-cell and T-cell responses. They can lower the risk for serious illness, hospitalization and death even if they don’t always prevent infection itself.
The Centers for Disease Control and Prevention (CDC) recommends that adults should UHFHLYHDQDQQXDOŴXYDFFLQHLQ the fall. Each year, scientists design new ones based on the current circulating strains.
For COVID, adults and children should get recommended primary vaccine doses and appropriate boosters. This fall, the CDC recommends new boosters IURP0RGHUQD3Ɠ]HU%LR17HFK DQG1RYDYD[WKDWWDUJHWWKH predominant omicron XBB.1.5
variant. Some cancer patients may be eligible for extra doses.
RSV vaccines are being of-
IHUHGIRUWKHƓUVWWLPHWKLV\HDU The CDC advises that adults ages 60 and older should discuss with their provider whether to get the single-dose GSK or 3Ɠ]HU569YDFFLQH7KHDJHQF\ recommends a one-time pneumococcal vaccine for adults ages 65 and older.
It takes around two weeks after vaccination to reach maximum antibody levels, so get vaccinated early enough to gain full protection before a winter wave. While RSV vaccines offer protection for a year or more, 6$56&R9DQGŴXDQWLERGLHV typically wane after a few months, so don’t get these vaccines too soon.
Vaccines are generally safe and well tolerated. Some people experience temporary injection site reactions, which may be DFFRPSDQLHGE\ŴXOLNHV\PStoms. More severe side effects are possible but rare.
People with respiratory illnesses can often manage their symptoms with supportive care at home. Seek medical care if you develop a high fever, have GLIƓFXOW\EUHDWKLQJRUH[SHULence other concerning symptoms. Whatever bug you have, stay home from work or school while ill, cover coughs and sneezes, and wear a mask to prevent transmission. Q
Free, Online Conference
Learn about topics impacting the AYA cancer community:
•Dealing with side effects during & after treatment
•Taking time off & paying for it
•Disability insurance
•Health insurance
•Sharing your diagnosis
•And much more!
More FREE Help
Free one-on-one help
Register: TriageCancer.org/Conferences
Legal & Financial Navigation Program
Speak with a trained professional for practical tips on navigating work & cancer, disability insurance, & more.
Get help: TriageCancer.org/GetHelp
Practical Guide to Cancer Rights for Young Adults
Young adults with cancer face unique challenges – so we created a guide just for you.
Learn tips for navigating work and cancer.
Download your free copy: TriageCancer.org/CancerRightsGuides
“Do you fear something awful might happen?” asks Adam Hayden, 40, a writer and speaker with brain cancer who lives with his wife and three sons in Indianapolis.
THE PALLIATIVE CARE OFFICE at Eskenazi Hospital is tucked QHDWO\EHWZHHQ6HQLRU&DUH DQG2SWRPHWU\RQWKHVL[WKŴRRU Checking in at the front desk, I DPDVNHGŏ2SWRPHWU\"Őŏ3DOOLDWLYH&DUHŐ,UHSO\,DPKDQGHGD clipboard and directed to door
D. I glance while I walk to see
“Senior Care” in narrow sans serif font mounted in sharp black text on the clean, white walls. I was diagnosed with brain cancer at \HDUVROG PHDQZKLOHWKH median age of diagnosis is 64. I can’t help but grin, sitting in the Senior Care waiting area.
$IHZTXHVWLRQVLQWRDQDQ[LHW\ questionnaire I’m given to complete, I snort with laughter. 7KH*$'DVNVWKHVXUYH\ respondent to circle the answer,
ranging from “Not at all” to ŏ1HDUO\HYHU\GD\ŐFRUUHVSRQGing to the prompt: “Feeling afraid as if something awful might happen.”
Something awful might happen? Something awful did happen! I have terminal cancer!
“Most people with cancer feel like something awful might happen, so we take that into DFFRXQWZKHQVFRULQJŐP\ mental health professional reported while I took at least half RIRXUƓUVWVHVVLRQWRSURYLGH WKHGLUHFWRUōVFXWFRPPHQWDU\ WRP\DQ[LHW\DQGGHSUHVVLRQ questionnaire.
Afraid that something awful might happen is the lens through ZKLFKPDQ\RIXVFDQFHUSDWLHQWV SUREDEO\VHHWKHZRUOG,WōVQRW IHDUH[DFWO\PRUHOLNHDQ HYROXWLRQDU\DGDSWDWLRQ Fitness for survival when surviving cancer is “hope for the best and plan for the rest.”
What’s the big deal about throwing up a quick Facebook post, and we can all move on with our lives?
7KHGLIƓFXOW\ZLWKPHVKDULQJ WKHQHZVRIP\VWDEOHVFDQOLHV in what I’ve just said: “We can all move on with our lives.” The harshest (but most liberating) lesson that each cancer patient must learn—bigger than that, the lesson taught to all when ZHKDYHWKHJRRGVHQVHWRSD\ FORVHDWWHQWLRQWRRXUPRUWDOLW\ŋ is that brutal and freeing truth: Life moves on.
The liberation comes through acceptance that our friends, IDPLO\MREVVRFFHUFOXEVDQG microbreweries don’t depend on us for their survival—even for WKHLUVXFFHVVDQGMR\7KDWDOODUH sad in our passing is expected. The liberation comes when we choose to be passionate and powerful in the present moment because, with or without us, life moves on. When we accept that, DQG,PHDQWUXO\JHWLWGHHSLQ our bones, we don’t just share the good news, we sing it.
Adam Hayden before his appointment at Eskenazi Hospital in Indianapolis
Things started to make sense for me following a recent stable MRI scan. It took me a while to share WKDWQHZVZLWKDQ\ERG\ RXWVLGHP\FORVHFLUFOH And don’t get me wrong, it’s good news! So ZK\ZDVLW so tough for me to let it out?
See, the fear that something awful might happen is the future XQFHUWDLQW\ZHPXVWFRQWHQG with. The what-could-be has robbed us of the what-is. The possible is a thief of the present. This has all been hard to see, EXWWKDQNIXOO\,ōPQHDWO\WXFNHG in between Senior Care and 2SWRPHWU\ Q
To read more of Adam Hayden’s blog posts, go to cancerhealth.com/hayden
Hank Baskett, 79, lives with his wife, Judy, in Clovis, New Mexico. He was diagnosed with Stage IV ALK+ non-small-cell lung cancer in 2011.
I GREW UP IN SOUTH CAROLINA, WITH EIGHT brothers and sisters. You could say we were poor, but we didn’t know it because of the love we shared. I joined the Air Force in 1961, out of high school, and served in Vietnam from 1967 to ’68 and again from 1969 to ’70. We would sit outside and watch the planes spray that black and red fog from Agent 2UDQJHZKLFKLVQRZLGHQWLƓHGE\WKHIHGHUDO government as a presumptive cause of lung cancer.
I started medical treatment for respiratory problems in the ’70s—they were written off as allergies, EURQFKLWLVŴX;UD\VGLGQōWVKRZDQ\FDQFHU although I didn’t have MRIs or CT scans until 2011.
I retired as a chief master sergeant in 1991, got my college degree in sociology and in 1994 became executive director of the Oasis Children’s Advocacy Center, which investigates child abuse. I retired again in January 2016. I have two daughWHUVIURPP\ƓUVWPDUULDJHDQG-XG\DQG,JRW married in 1980. We have two sons.
My friend Bill—he was in one of my troops; we served together in Egypt and at Cannon Air Force Base in New Mexico—was going to the nearest Veteran’s Affairs Medical Center in Amarillo, so I said I’d go with him. While I was there, I decided to go to the emergency room about my persistent hackLQJFRXJK$Q;UD\VKRZHGVRPHWKLQJRQP\ lungs, so they ordered a CT scan. The doctor came back and said, “It’s cancer, and it’s bad.” He said a nurse would be calling me about treatment.
I thought, This is like a death sentence—how am I gonna go home and tell Judy? I took a walk alone. I said to myself, “I’m going to try and not worry about this.” I gave it to my Heavenly Father. I just asked Him to take it and guide me through it.
When Judy came home, she looked and me and said, “What’s wrong?” She just knew from my face. I told her it was cancer and it was bad. Everything changed. I also spoke with our youngest son, Hank III, that night. The next day, I called my other son and daughters, my sisters and brothers and then Judy’s family.
Hank III was an NFL wide receiver and costar with his wife, Kendra, on the TV show Kendra on Top. She was a former Playboy Bunny, and they were both close to Hugh Hefner. That Sunday, they took our 18-month-old grandson, Hank IV, to the annual Easter egg hunt at the Playboy Mansion in Los Angeles, and when they told Hef about me, he asked his assistant, Mary, to set up appointments
IRUPHWRVHHKLVGRFWRUV6RDIHZGD\VODWHU,ŴHZ to LA and saw a primary care doctor, an oncologist, a pulmonologist and a cardiologist. They did a ELRSV\,ŴHZEDFNKRPHDQGDFRXSOHRIGD\V later, the oncologist called me and told me I had Stage IV non-small-cell lung cancer. He wanted to start chemotherapy right away. I’m thinking, Stage IV, that’s the last stage out.
Approximately two weeks later, I started chemotherapy treatment at Cedars-Sinai hospital in LA. I ŴHZRXWWKHUHHYHU\WKUHHZHHNVIRUD\HDU,OHDUQHG a long time ago that you can only control what you can control. In the meantime, you just got to live, to enjoy all the beautiful things in the world.
The chemo wasn’t working, so they started me on a different chemo regimen.
May 2012
I had my last chemo injection. It wasn’t working. I had lost my hair and had swelling in my legs, although I still played golf. They told me there was nothing else they could do. But the Heavenly Father had already set things in motion for me.
Because of me, my son Hank sponsored a golf WRXUQDPHQWWREHQHƓWWKH%RQQLH-$GGDULR/XQJ Cancer Foundation, [which merged with the Lung Cancer Alliance in 2019 to become the GO2 for Lung Cancer foundation]. I went. Bonnie was there. I’m a hugger, and so is she. She looked at me and told me my pallor wasn’t good, maybe I wasn’t getting the right treatment. She set me up with D. Ross Camidge, MD, PhD, at the University of Colorado Cancer Center in Aurora. I will never forget how [Bonnie] made me feel. Somebody cares.
June–December 2012
I started on a different chemotherapy combination. But they also did new tests. At Cedars-Sinai, I had been tested to see if my cancer had an ALK [anaplastic lymphoma kinase] mutation. That test showed only 13% of the cells in a tumor biopsy were positive for ALK, but the threshold for treatment was 15%. Dr. Camidge thought it was pretty close, so he retested me and found it was 16% or 17%. So I was now a candidate for a targeted therapy for ALK-positive lung cancer.
January 2013
I started taking a targeted therapy. After a few years, I developed resistance, so I was switched to an experimental ALK inhibitor. It’s a pill I still take every day. I’m so thankful for my doctor, the nurses, the people who parked my car at the hospital. They’re all part of my therapy.
March 2014
0\VRQ+DQNEHFDPHDQRIƓFLDOVSRNHVSHUVRQIRU WKH%RQQLH-$GGDULR/XQJ&DQFHU)RXQGDWLRQDQG together, we did a public service announcement
)RUPRUHƓUVWSHUVRQHVVD\VJRWR cancerhealth.com/stories
for TV to raise awareness about lung cancer. It was called “The Big Hug.”
January 2016
I retired from the child abuse center. I did fundraisers for this too. These children are so precious.
2014–2020
I continued to work with the GO2 for Lung Cancer foundation, giving speeches at cancer walks, fundraisers and events. A Hank Baskett Sr. Spirit Award has been given at each golf tournament. We’ve participated in events in Philadelphia, Phoenix, DC, San Francisco. They even put me on a billboard in the Denver area. If it’s gonna help someone, I’m gonna do it. COVID shut down the awards program, but if it starts up again, I’ll get involved again!
July 2020
$Q05,UHYHDOHGDWXPRULQP\EUDLQDƓUVW,MRNHG with the doctor. I said, “I can’t have a tumor on the brain because my momma always told me I didn’t have a brain.” You got to keep your sense of humor.
August 2020
,UHFHLYHGƓYHERXWVRIUDGLDWLRQWUHDWPHQWWRWKH EUDLQRYHUƓYHGD\V2QP\QH[WYLVLWWKH\WROGPH that everything was looking good.
March 2022
I was prescribed a second pill, another targeted therapy that works against a different mutation.
April–May 2023
An MRI revealed a new tumor on the brain. A radiologist located two tumors instead of one. I received radiation treatments for both tumors.
August 2023
People with cancer call me all the time, from all over the world, and I tell them, “Don’t claim the cancer.” I don’t have cancer. I was diagnosed with cancer, but that’s not me. Don’t let cancer control you. You control the cancer. Surround yourself with people who say, “We’re gonna beat it.” Look at yourself in the mirror every day, and say, “Hey, good lookin’, we’re gonna have a great day.”
FROM THE AGE OF 4, CHERYL LAW, MD, 41, KNEW THAT SHE WANTED TO BE a doctor. Her parents, the rst in their families to complete college, had moved from rural Alabama to pursue careers near Birmingham, where they raised Law and her brother. She often was the only Black girl or Black kid in the classroom, an isolating and lonely experience. But her drive and determination helped her realize her childhood dream: After attending Alabama State University, a historically Black university, she earned her medical degree in 2008 from the University of South Alabama College of Medicine and became the rst doctor in her extended family—and one of the very few (2.8%) Black female physicians in the United States.
In 2014, Law married Rodney Bey, and they settled outside Birmingham, near her hometown. She joined two doctors in a Hueytown practice, taking over for a third retiring physician. Law entered the practice, her rst job after family medicine residency, “with all of these dreams and hopes of how life would be, now that I was done with my training,” she says. “My parents had stayed in the same profession and worked for the same companies for 20-plus
years. So I thought that’s how life would be for me—you get your job, you work there forever, you retire from there.”
In short order, she and Bey had three kids—Josie, 8; Rodney, 6; and Joy, 5. “We were pregnant about a month after being married, so marriage, pregnancy and kids were all wrapped up in one,” she says. To make things work with Law’s busy doctoring schedule, Bey stayed home with the kids.
As a family medicine physician and a breast cancer patient, Cheryl Law shares how she navigates her own treatment.
Cheryl Law had a mastectomy on Juneteenth. The cancer later spread to her brain.
In the spring of 2018, at a postpartum exam six weeks after the birth of Joy, Law told her doctor that her left breast was in amed and painful—due to an infection from breastfeeding, she gured. But an ultrasound, mammogram and biopsy said otherwise: e diagnosis was triple negative breast cancer, a rare breast cancer subtype. Law had just turned 35. She and Bey were silent with shock when they received the news while driving the family car. “How could this really be us?
Not in the prime of our lives, not when we’re having these babies, not when we’re talking about family trips and our future,” she recalls thinking. With no previous major health problems, “I just never would have considered that breast cancer would be my introduction to having health issues.”
Triple negative breast cancer is so named because this subtype’s cancer cells have no estrogen or progesterone receptors and make little if any HER2, a protein that spurs tumor growth. It’s more common in women under age 40; it grows and spreads faster than other breast cancers; there are fewer treatments; and Black women have nearly triple the risk of other women. Given these realities and concern over some of Law’s lab scores, she and her oncologist discussed the option of her joining a drug trial. Law was hopeful that she would get into the experimental arm of the I-SPY 2 trial, which tests new treatments aimed at shrinking locally advanced breast cancer, but “I ended up getting standard of care,” she says. at regimen was AC-T, which consists of Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) and Taxol (paclitaxel).
Law started chemotherapy presurgery to try to shrink the tumor, all the while continuing to see patients—taking a day o on Mondays for infusions and heading to work the next day. “I did fairly well with A and C, but the T was really tough. at’s when the hair loss started, the extreme fatigue,” she says. “But it was not working for my cancer. at was even more terrifying.”
She stopped chemo early, and on Juneteenth—June 19, the day in 1865 that enslaved Blacks in Texas were freed by executive decree, two years after the Emancipation
Proclamation—she had a mastectomy to remove her left breast. “ at being the day of freedom, I thought, I’m being released from having this breast cancer on that date.”
Law’s demanding workload and parenting—the “good distractions” in her life—took over once more as she recovered from surgery, started on an oral chemotherapy regimen and hoped to put breast cancer in the rearview mirror. “I wanted to be strong and move through [the cancer experience]. So I had the perspective of, ‘You can get through cancer and it’s done.’”
Bey and Law celebrated their fth wedding anniversary (which also coincided with Law’s birthday) at the end of April 2019. Soon after, Law began having pain around her cheekbones and one eye. She sometimes had seasonal allergies, so she treated herself for a sinus infection. But a good friend from medical school who happened to be an oncologist suggested that Law get a brain scan “just to be certain there isn’t something going on in your head.”
But there was—an MRI revealed that Law had metastatic breast cancer (MBC) that had spread to her brain.
e devastating diagnosis coincided with the departure of her rst oncologist, “a male physician who always exuded hope and optimism, who would put his hands on me and smile.” Now a new, female physician was telling her, “You need to stop working, go home and spend as much quality time as you can with your family.” e bleak message resonated with Law. “ is was di erent,” she says. “I was fully aware that this is a lifelong issue, and now my life may be shortened because of this diagnosis.”
Brain surgery was scheduled on another special date: June 6, Law’s parents’ wedding anniversary. Part of her left frontal lobe had to be removed in order to extract the tumor during a surgery that took just four hours instead of the predicted six to eight hours—“a miracle,” Law says. A small stroke she had during the operation left the right side of her body weak, including her right leg. But one of the things she’s grateful for is that the surgeon didn’t have to mess with her hair. “Hair is something
I’M TRYING TO JUST IMPART KNOWLEDGE AND WISDOM.
that’s important to Black women—and all women, I would say.”
Since the surgery, Law has been on an anti-seizure medication and an oral chemotherapy agent. She has brain MRIs and lab work every three or four months, chest and pelvic CT scans once or twice yearly, a yearly mammogram and other tests that her physician team recommends.
ere have been ups and downs, but recently, she has been doing well.
After the MBC diagnosis in 2019, Law took her oncologist’s advice and left her medical practice to spend more time with family. In retrospect, she saw that her heroic attempts to balance a demanding workload with a new marriage, three children in quick succession and parenting had been far from optimal. “I was on such a journey to think about healing others that I didn’t even think about the fact that I needed to help myself,” she says.
She realized that she needed to acknowledge that her emotional well-being was important, that her sleep was important. “You’re telling everyone else they need to eat well and sleep well. What about you?... You don’t need to rush to everyone’s aid. You don’t have to say yes to everything. You don’t have to—you can’t.”
e past few years have been a time of exploration, “ nding that I still have worth and that I’m still able to use my medical knowledge and my experience as a patient without feeling overwhelmed,” she says. She has also looked at her daily regimen and now eats more veggies and fruit, drinks more water and walks more. And “there’s a lot of thoughtfulness about the plans for the kids, like what’s next in terms of their schooling. I’m trying to just impart knowledge and wisdom with them as I can.” She takes time to explain science, which she wants them to like “the way mommy does—or at least have an understanding about it.”
Law has gone on a couple of retreats that have been “amazing—the connections are helpful and healing for me. I feel less isolated after meeting others with MBC.” She was asked to join the board of Cancer Culture, an organization founded by people with breast cancer who want to bring awareness to breast cancer issues, especially ones that are overlooked, like MBC research. She’s also on the Cancer Patient Family Advisory Council at the O’Neal Comprehensive Cancer Center of UAB Medicine, where she consults on hospital initiatives that help patients access services at the hospital, and is a young advocate for Living Beyond Breast Cancer, a nonpro t that connects people to information and support. Law helped organize LBBC’s annual conference this year.
She nds it tough when people ask how she’s doing because there are so many ways she could respond. “I could focus on all the things that are going wrong,” Law says. “ e aches and pains and the weakness and the memory loss and things like that. But I’m here. ere’s so much to be grateful for. I’ve got these kids I’m surrounded by. And I’ve got so many parts of my body that are still functioning better than many would expect. I have a spiritual belief and faith that I know is keeping me around. And I’ve got love and hope; let’s leave it at that.” Q
/LIHDIƓUPLQJDGYLFHIURPD PHWDVWDWLFEUHDVWFDQFHUVXUYLYRU
1. You have to have hope. “I really have gathered a lot of hope from my grandmothers, who both lived to be over 100.”
2. Draw strength from others. “I had a 90-plus-year-old patient who’d had cancer, and it recurred. She still had a hope and faith and a strength that was amazing. It didn’t seem like cancer ruled her life.
“Relationships are so important. I needed the medical knowledge of someone else [her oncologist friend] to help me recognize when I needed a brain scan.”
3. Speak up for yourself. “Speak on your concerns and issues, including ƓQDQFLDORQHV<RXUSK\VLFLDQVKRXOG be documenting what your issues are—documentation is important as it relates to change and improving health equity.”
2UƓQGVRPHRQHHOVHWREH your voice. “In my practice, I had little old ladies who needed their granddaughters to come with them and explain what was going on in real-talk ways.”
5. Accept help. “Some of my Sigma Alpha Iota sisters [a music sorority] from college helped me clean up my house. I was embarrassed, but they said, ‘We’re here to care for you.’”
)LQG\RXUFRPPXQLW\ “Find folks who appreciate you. That can change with different stages in your experience. Some people liked Cheryl better without cancer; some like Cheryl with cancer. It’s so easy being comfortable in the MBC comPXQLW\:HKDYHOHVVRIDƓOWHU<RX put things out there, and they get it.”
7. Trust that there is more support than you’re aware of. “There are folks in hidden places that have been taking care of me, praying for me and loving on me. It’s not always who you see that’s there for you.”
BY THE CANCER HEALTH STAFF
Many communities and minority populations experience health disparities, ranging from unequal access to cancer screenings and increased barriers to care to higher rates of late diagnoses and a reduced quality of life. For instance, in the United States, the cancer mortality rate is 19% higher for African-American men than for white men. Health equity advocates aim to address such imbalances, whether they are a result of race and ethnicity, gender, socioeconomic status, sexuality, geography (living in rural areas), education, language or some other factor.
“Health equity means everyone has a fair and just opportunity to prevent, nd, treat and survive cancer,” explains the American Cancer Society Cancer Action Network, adding a caveat: “Equity is not the same as equality. Equality is providing everyone with the same tools and resources. Equity is providing tools and resources based on needs that allow everyone the opportunity to be as healthy as possible.” For instance, does health information need to be presented in Korean or in a manner that’s
culturally sensitive? Do some clients require transportation or internet access? Do patients see themselves re ected in their health care sta ?
Our fourth annual Cancer Health 25 honors individuals working tirelessly to de ne and address such disparities. ey include doctors, nurses, researchers, volunteers, patient navigators, grassroots advocates and a world leader. is year, some entries even include more than one person. All are champions of health equity.
Maura Abbott
Amy McElroy
Kristin O’ Meara
New York, New York
ColumbiaDoctors and the Columbia School of Nursing
launched a clinical outreach program in 2022 to provide cancer screenings and other essential health services to residents of Washington Heights and neighboring New York City communities, many of whom are underserved minorities. e outreach program, which includes on-site events and school health days, is led by Maura Abbott, PhD, an oncology nurse practitioner and the assistant dean of clinical a airs at the Columbia School of Nursing; Amy McElroy, MPH, RN, ColumbiaDoctors’ director of population health; and Kristin O’Meara, ColumbiaDoctors’ director of strategic communications. What began as a series of skin screenings and educational events for the communities has evolved into a multidisciplinary array of o erings, including eye exams, u shots, mammograms, prostate cancer screenings and more.
Karlie Allen
Nathan Begaye
Liliana Mulato
Salt Lake City, Utah
e Intermountain West region— Utah, Idaho, Montana, Nevada and Wyoming—spans a vast area and includes disparate communities, such as American Indian, Latino and rural
populations, whose unique needs are met by the patient navigators at the University of Utah’s Huntsman Cancer Institute. ese include program leaders Nathan Begaye and Liliana Mulato and adolescent and young adult patient navigator Karlie Allen as well as recently added navigators Amelia elin, Mariela Sanchez and Naomi Guerrero Reyes. Together, they break down barriers their clients face—for example, by speaking Spanish. ey also expand clients’ access to clinical trials and the latest cancer treatments.
Washington, DC
As vice president in 2016, Joe Biden launched the federal Cancer Moonshot initiative. As president, he supercharged the program that aims “to cut the cancer death rate in half in the next 25 years [and] end cancer as we know it.” In support of the initiative, the National Cancer Institute unveiled a National Cancer Plan that sets eight goals, one of which is to “eliminate disparities in cancer risk factors, incidence, treatment side e ects and mortality.” Biden lost a son to brain cancer: Major Beau Biden was stationed overseas where he was exposed to hazardous burn pit emissions, known to be carcinogenic. Last year, Biden championed and signed the PACT Act, legislation that
improves health care and bene ts for veterans—many from minority and underprivileged communities—who were exposed to toxic and cancercausing substances.
Collins, Colorado
A deep commitment to the elimination of cancer disparities affecting underserved communities motivates Evelinn Borrayo, PhD, a professor at the Colorado School of Public Health and the associate director of its Latino Research and Policy Center. She applies behavioral science to address disparities in cancer prevention, control and survivorship among racial and ethnic minorities and other medically underserved populations. Past research has examined the psychological, cultural and social factors a ecting the prevention and treatment of lung and head and neck cancers among Latinas and Latinos. She works in Colorado communities with poor cancer outcomes to identify barriers and help remove them person by person.
Portland, Oregon
Yee Won Chong and Brooks Nelson are transmasculine friends and housemates who were diagnosed with breast and ovarian cancer, respectively, within days of each other. In 2018, they made
the short lm Trans Dudes With Lady Cancer to raise awareness, educate providers and support others like themselves. Trans people need cancer screenings based on the organs they possess, but many lack regular access to health care or nd existing services unwelcoming. Nelson, an experienced lmmaker, also made a documentary exploring how gender transition affects trans people’s loved ones and communities. Chong, an immigrant from Malaysia, provides transgender inclusion trainings to colleges and workplaces and developed the “Say is Not at” technology platform to promote inclusive language.
In 2012, Cora Connor’s brother Herman discovered he had renal medullary carcinoma (RMC), a rare form of kidney cancer that primarily a ects young AfricanAmerican men who carry the sickle cell trait. Seeing the limited treatment options available to Herman, Connor founded R.M.C. Inc. to advocate for her brother, educate the public and health care professionals and enhance the lives of others a ected by RMC. She has lobbied for health care legislation in South Carolina to educate young people about the cancer risks associated with sickle cell disease, and she urges young Black people with sickle cell disease to get tested for RMC.
scientist, Julie HT Dang, PhD, MPH, works to ensure that diverse and underserved populations have access to cancer prevention and intervention tailored to their culture and community. She’s an assistant professor and executive director for the O ce of Community Outreach and Engagement at the University of California, Davis Comprehensive Cancer Center, where her research and programs boost AsianAmerican participation in cancer research and clinical trials and promote testing for hepatitis B, which can lead to liver cancer. Her work also encourages more young people and those in rural areas to get vaccinated against human papillomavirus (HPV), another cause of cancer. Her other areas of expertise include breast and colorectal screenings for Black, Latino and Native American communities.
Craig Dee
Seattle, Washington
Seattle Children’s Cancer Consortium. He centers relationality, an Indigenous value, in his work to build research capacity and cultivate partnerships with tribes, the Indian Health Service and Urban Indian Organizations. “Indigenous people,” he says, “have always been involved in public health. We look out for the community.”
Loretta ErhunmwunseeTerrance Mayes
Duarte, California
Stanford, California
Sacramento, California
A cancer health disparities behavioral
American Indian and Alaska Native populations experience higher mortality and incidence rates for lung, breast, colorectal, kidney and liver cancers compared with non-Hispanic white populations. ese disparities result, in part, from limited access to screening and prevention services. Craig Dee, an MPH candidate and member of the Navajo Nation (Diné), aims to change that. Dee leads the Indigenous Cancer Health Equity Initiative within the O ce of Community Outreach & Engagement at the Fred Hutch/University of Washington/
When the National Com prehensive Cancer Network launched the Diversity, Equity, & Inclusion Directors Forum last year, it tapped Terrance Mayes, EdD, the executive director and associate dean of strategic initiatives at the Stanford School of Medicine, to chair the forum and Loretta Erhunmwunsee, MD, of City of Hope National Medical Center, to serve as vice chair. With over 20 expert members, the forum meets to share challenges and best practices to improve the diversity of clinical sta . A thoracic surgeon with a focus on lung and esophageal cancer, Erhunmwunsee is also a health equity researcher who explores how social determinants and structural inequities impact cancer biology and outcomes. “In order to achieve cancer health equity,” she says, “cancer centers must identify and eliminate structural barriers and practices that undermine workforce diversity, equity and inclusion.”
David Ford
Los Angeles, California
Two-time cancer survivor David Ford is passionate about cancer screenings. Ignoring his doctor’s advice to get a colonoscopy in 2014 landed him in the hospital three months later with a ruptured intestine because of colon cancer. Surgery saved his life. ree years later, prompt attention to his doctor’s advice after an elevated PSA test led to a diagnosis of early-stage prostate cancer that was treated successfully with radiation. As a member of the board of directors for the American Cancer Society’s Cancer Advocacy Network, Ford works tirelessly to expand awareness and access to cancer screenings, especially in communities of color.
Gill says, “is to positively impact the cancer landscape for underrepresented communities so that everyone receives equitable care and treatment.”
mize health and reduce disability before and after a cancer diagnosis. He’s also active with ZERO Prostate Cancer Run/Walk events. Earlier this year, the American Cancer Society honored him with the Fredda Bryan National Diversity, Equity, and Inclusion Award.
Project is an awareness and educational campaign that was launched earlier this year by Total Health, which provides free oncology continuing medical education. Helping lead this new e ort is breast cancer survivor Sharon Gill, the head of partnerships and advocacy Programs at Total Health. e Cancer Equity Project has already launched the EBONY-B001 clinical trial for young Black women with high-risk breast cancer, and it established the SEEK Color Certi cate Program to encourage cancer care teams to further their education in order to better serve patients of color. “My goal,”
Patricia Goldsmith says her passion for patient advocacy stems from when she was 19 and lost her only sibling, who was 22, to a brain tumor. Founded in 1944, CancerCare o ers free information and services—including support groups for African Americans, young people, LGBTQ folks and more—to help manage the emotional, practical and nancial challenges of cancer. CancerCare ’s tool kit for employers helps remove barriers to insurance coverage for cancer treatment, including biomarker testing. Goldsmith, who describes herself as an “avid animal rescuer,” started CancerCare ’s Pet Assistance and Wellness Program, which helps cancer patients keep and care for their pets.
Charlie W. Hill
Hampton, Virginia
Known as a prostate cancer warrior (who also battled follicular lymphoma) and a tireless volunteer, Charlie W. Hill cofounded the Hampton Roads Prostate Health Forum in 2007, a nonpro t that raises awareness and provides education to communities in his region of Virginia, with a special focus on men of African descent and what he calls “pre-hab”—activities that opti-
Chris Lathan
Boston, Massachusetts
An oncologist and the chief clinical access and equity o cer at the Dana-Farber Cancer Institute,
Chris Lathan, MD, MPH, researches the e ects of race— including racial disparities in lung cancer treatment—class and access to care on cancer outcomes. Lathan is a founding director of the Cancer Care Equity Program at Dana-Farber, an outreach program that provides cancer diagnostic services directly to underserved Black communities. e program, which has been operating for 12 years, has reduced the time it takes to diagnose cancer from an average of 32 days to just 12 days.
Kathy Levy
Birmingham, Alabama
With 30 years of experience in health care and community relations, Kathy Levy works to ensure that all people have equitable access to lung cancer care. As project manager of Alabama Lung Cancer Awareness, Screening and Education (ALCASE) through GO2 for Lung Cancer, Levy helps educate people with lung cancer in
seven counties in Alabama. For her activism focused on increasing access to lung cancer screening, Levy was a nalist for the prestigious C2 Catalyst for Equity award, which recognizes people who work to overcome racial and ethnic disparities in cancer care.
In December 2018, while dressing for a holiday party, Keneene Lewis, MEd., found a lump on her breast; it turned out to be Stage III ductal carcinoma, an aggressive type of breast cancer. As a Black woman, she witnessed racial bias rsthand when, believing that Black women don’t feel pain the same as other women, a radiation technician withheld pain-numbing cream. As a single mom, she experienced nancial distress. Now, Lewis is giving back. An active blogger, she is an administrator for Living Beyond Breast Cancer, managing grants so women undergoing treatment can pay for vital expenses, such as rent. She is currently in remission.
“I am a family doctor but also a cancer researcher,” explains Li Li, MD, PhD, MPH, who chairs the Department of Family Medicine at the University of Virginia’s School of Medicine. “My research really tries to understand the disparities between Black and white [population groups] in terms of risk
and survival of colon cancer.” Specically, he explores “how our environment works together with the genome to drive the colon cancer carcinogenesis.” Li has received grants from the Damon Runyon Cancer Research Foundation and others and serves on numerous organizations that focus on cancer prevention and population health, including the U.S. Preventive Services Task Force.
Javier Macias
Laura Ortiz-Ravick
Chicago, Illinois
White Plains, New York
Serving Spanishspeaking families impacted by blood cancers, Javier Macias and Laura Ortiz-Ravick provide educational opportunities and resources that help Spanish speakers make informed decisions about care and treatment. Working alongside the Leukemia & Lymphoma Society (LLS) team, Ortiz-Ravick and Macias have educated over 600 Promotores de Salud (health promoters) and other Spanish-speaking community health workers nationally about blood cancers and have reached over 200,000 Latino individuals in the last two years through grassroots community outreach e orts. ey also partner with national and local stakeholders to enhance trust between LLS and vulnerable segments of this population. In addition, OrtizRavick works with LLS’s Myeloma Link initiative to help raise awareness of this cancer’s prevalence in the African-American community.
Los Angeles, California
In her May Laboratory at UCLA, Folasade (Fola) May, MD, PhD, a gastroenterologist and associate professor of medicine at the David Ge en School of Medicine, seeks to eliminate health disparities in colorectal cancer screening and care among Black and other underserved populations. With funding from the National Institutes of Health, the American Cancer Society, Stand Up To Cancer (SU2C) and others, she has designed and executed multiple studies to examine the impact of patient, provider and system factors on colorectal cancer, obesity, chronic liver disease and liver cancer. She raises public awareness about preventive health as she advocates for policies to improve health care delivery and health equity.
Joanna Fawzy Morales
Park Ridge, Illinois Cancer rights attorney Joanna Fawzy Morales, Esq., has spent nearly 30 years advocating for people with cancer and their caregivers.
e cofounder and CEO of Triage Center, a national nonpro t that provides free education on cancerrelated legal and practical matters, Morales has led nearly 1,000 seminars on these issues as well as legislative advocacy. She has also won several awards, including the 2009 Susan G. Komen for the Cure
Public Policy Advocate of the Year. She has taught law and coauthored Cancer Rights Law: An Interdisciplinary Approach for the American Bar Association.
Roberto Novoa
Palo Alto, California
One day soon, smartphones and telehealth programs, using arti cial intelligence to scan image datasets, may help dermatologists and primary care doctors identify melanoma and other skin cancers. But datasets based on light-colored skin miss some malignancies in people of color. Dermatologist and dermatopathologist Roberto Novoa, MD, an associate professor at the Stanford School of Medicine, is working to change that. He is part of a team of researchers funded by L’Oréal Dermatological Beauty Brands and the Melanoma Research Alliance that created the rst publicly available dataset that includes biopsyproven malignancies in people of color, which should improve diagnosis of skin cancer in diverse populations.
Edith A. Perez, MD, the chief medical o cer of Bolt Biotherapeutics and a professor emeritus at the Mayo Clinic, has spearheaded numerous e orts to improve representation in clinical trials and access to the latest treatments. An internationally recognized translational researcher and breast
cancer guru, Perez is the chair of the Stand Up To Cancer (SU2C) Health Equity Committee, vice chairperson of the SU2C Scienti c Advisory Committee and a cofounder of the DONNA Marathon, a fundraiser for breast cancer research and support for patients and families in need ofnancial and health care navigation assistance. You may recognize her from SU2C’s recent public service announcements promoting the importance of funding groundbreaking cancer research.
Kim F. RhoadsSan Francisco, California
A former surgeon, Kim F. Rhoads, MD, MPH, is an associate professor of epidemiology and biostatistics at the University of California, San Francisco (UCSF) and the associate director of community outreach and engagement at the UCSF Cancer Center. Her research covers the cancer spectrum while addressing disparities and amplifying community voices. To further boost those e orts, she founded the community health nonpro t Umoja Health. “I am passionate about advancing health equity and working at the intersection between health care and public health,” says Rhoads, who also has a background in community organizing.
Kathleen Schmeler
Houston, Texas
Cervical cancer screening saves lives. To that end, Kathleen Schmeler, MD, a professor of gynecologic oncology and reproductive medicine at MD
Anderson Cancer Center, developed programs that offer free Pap and HPV tests to women in underserved communities—the Rio Grande Valley in Texas, and Mozambique—as well as care for those with abnormal results. At MD Anderson, she works with collaborative international e orts to reduce the burden of women’s cancers, including cervical and breast cancer, and is executive director of the Global Oncology Program, which aims to reduce the global cancer burden in low- and middle-income countries, including a model initiative in Indonesia.
Robin Yabroff
Baltimore, Maryland
Cancer survivors frequently experience medical nancial hardship, which is associated with increased mortality. So concludes one of the 250 papers coauthored by Robin Yabro , PhD, MBA, scienti c vice president for health services research at the American Cancer Society. She leads a research team examining ways to lessen this burden, including reducing the cost of drugs and improving access to transportation and insurance. She aims to identify factors at every level of care that can be modi ed to improve access to a ordable prevention, screening, treatment, survivorship and end-of-life care to achieve equity in cancer outcomes. Q
In her book Finding a Way, champion triathlete, horse rescuer and leukemia thriver Siri Lindley gives you tools to triumph.
“SIRI, YOU HAVE ACUTE MYELOID LEUKEMIA WITH A GENETIC mutation that is going to make this very complicated to treat.” Thus, Siri Lindley, 53, learned she had cancer in 2019 when blood work for a hip replacement surgery led to the unexpected diagnosis. What hapSHQHGQH[WLVH[WUDRUGLQDU\6KHŴLSSHGWKHVFULSWRQWKLVOLIHWKUHDWHQLQJ disease. Her treatment regimen included chemotherapy, radiation and a bone marrow transplant as part of two clinical trials (much of it during the COVID-19 pandemic), but she viewed the challenge as an RSSRUWXQLW\IRUJURZWK7RRXUJUHDWEHQHƓWVKHGRFXPHQWHGLWDOOLQKHUVHOIKHOSERRNFinding a Way: Taking the Impossible and Making It Possible
“All the tools I used to get me through the darkest times in my life, I am now going to give to you,” she writes in the introduction. Part memoir, part workbook—it includes questionnaires and assignments—the book teaches you how to recognize the stories you tell yourself that hold you back, causing pain, suffering and fear.
Lindley knows about overcoming obstacles and motivating others. She’s a world-champion triathlete and coach who has also battled anxiety, obsessive-compulsive disorder (OCD) and the closet (she’s a proud gay woman and LGBTQ advocate today but initially faced challenges coming out to herself and family).
With her wife, Rebekah Keat, Lindley founded and runs Believe Ranch and Rescue, a horse rescue program in Colorado. Horses are key to Lindley’s healing process, as she explains in this interview, which has been edited for clarity and length. Our discussion marks the debut of the column Can +HDOŋWKDWOLIHDIƓUPLQJGHFODUDWLRQLVULJKWWKHUH in the title of this magazine, Cancer Heal th—and we hope the column will help you do just that.
You advise people to be aware of negative selftalk and to craft more helpful narratives. How did you apply this, for example, to cancer treatment? I kept thinking, This chemotherapy is part of what’s
going to save my life. If I went in hating it and thinking it was poison, that didn’t feel healing to me.
Siri Lindley’s book is part memoir, part self-help.
I also had a massive phobia about vomiting. It was debilitating. If I saw someone vomit, it would put me into a panic attack for hours. And then I get this cancer, and I’m vomiting like 70 times a day. I had a friend, Tony Robbins’s wife, who said, “Siri, it’s all about reframing. What if every time you throw up, you know your body is releasing something that shouldn’t be inside, that you’re getting one step closer to surviving.” That simple reframe didn’t make it easier, but it allowed it to not completely devastate me.
In the hospital, when things were so bad, as soon as I started thinking of things I could appreciate—I have a roof over my head; I have health insurance; my mom is sleeping there on the couch—I felt a little bit better. And these are things you can do when lying in bed and so sick.
When I was given this diagnosis, my wife’s reaction and my doctor’s tone of voice were like, “This is the end.” But if I gave it that meaning, then how was I going to show up?
I remember the statement “What if what you’re going through now is preparing you for what you asked for?” What if, in the process of me taking on WKLVGLVHDVHDQGƓQGLQJDZD\WRVXUYLYHLW,OHDUQ
things about me and about life, and I develop different skills, and that allows me to live my mission and purpose?
What is your purpose in life?
Before I got sick, I had found my freedom from anxiety and the freedom to be authentically me. I found the love of my life, and I had my father back. I found my freedom after all the suffering, and I ZDQWHGWRKHOSRWKHUVƓQGWKHZD\WREHIUHHRIWKH stuff that holds them back. And then I get sick.
Did other mental tricks help you through?
The biggest thing I did every single day, just lying in that hospital bed, was create [an empowering vision]. The vision was me running up my favorite mountain trail, strong and healthy. And using all ƓYHVHQVHVŋEHFDXVHWKLV LVZKDWPDNHVLWVRSRZHUIXOŋ
I’d imagine feeling the sun and warmth on my cheeks and the cool breeze in my hair. I’d hear my wife cheering me on. I’d smell the ZLOGŴRZHUVDQG,ōGJHWWR WKHWRSŋ,ōPFDQFHUIUHH$QG in those moments, no matter how sick I was, I felt healthy and strong and alive. Your mind doesn’t know if you are imagining this or if it’s for-real happening. But I felt that, if I could see that YLVLRQHYHU\VLQJOHGD\WKHQ,ZDVPDQLIHVWLQJWKLVŋ this is where I’m heading.
And a year to the date of my bone marrow transSODQW,UDQWKDWWUDLOŋWKLVLVJRLQJWRPDNHPH [ pauses@FU\ŋ,UDQWKDWIDYRULWHPRXQWDLQWUDLODQG I’m telling you it was exactly as I had seen it in my mind. Every part. I remember crying tears of gratitude at the top and thinking, This is the stuff I need to share. This is the stuff people need to be doing.
You have a chapter titled “The Power of the Unexpected Teacher,” and your example is Savannah, your horse. How did she help you heal?
When I got back from the hospital, I was 25 pounds lighter than today, and I was still really sick. They allowed me to come home because it was during
)RUPRUHLQVSLULQJSURƓOHVJRWR cancerhealth.com/stories
COVID, and I was getting depressed. Typically, when I would ride Savannah, before I even get my feet in the stirrups and balance myself, she takes off. But this time, I get on top of her, and she takes these tiny little steps, like two inches. She has never done that before. She was saying, “You’re still vulnerable and weak, so this is what we’re going to do today.” Each week, I’d ride her a little bit. About six to eight months after my transplant, I get on her this one day, and before I have my feet in the stirUXSVVKHWDNHVRIIDQG,ōPOLNHŏ:KRDŐDOOWHUULƓHG And then as we calmed down, I get a phone call saying I’m cancer-free. It was her way of saying you are no longer weak. That’s one of the hardest parts once you get cancer-free: living with the fear of it coming back, needing to protect yourself. I was very much in that space, and this was her way of saying, “It’s time to start living again.” That was like a wake-up call. I can’t live the rest of my life worrying about this happening again.
In summary, what’s your top-line advice for someone diagnosed with cancer?
No. 1: Give this an empowering meaning that will not make you feel like a victim or weak or unlucky. And think about other lessons: Are you going to learn how to receive help?
When I got sick, I felt this strong message to release anything inside that causes dis-ease [meaning ŏODFNRIHDVHŐ@ŋZKHWKHUWKDWZDVDQJHURUUHVHQWment toward someone who hurt me. So it’s taking a personal inventory. What’s some of the stuff you PXVWOHWJRRI"7KHUHZDVDORWRIIRUJLYHQHVVŋIRU myself and others. I wanted to sweep out my soul to make room for the healing to move through me.
The message on the other side of this is: I’m going to positively believe each person is going to make it, and there is an extraordinary gift that will reveal itself and will impact your life for the better, so keep your eyes open for that. You’ll realize how much people love you, and, even though you complained about it, you’ll realize how much you love your life. Q
What is the Great Plains Tribal Epidemiology Center?
We work to address the health disparities, including cancer disparities, of the Great Plains Tribes in North Dakota, South Dakota, Nebraska and Iowa. Our goal is to report timely, accurate and useful data. We do that by measuring and monitoring the health status of our population. We advocate for their healthrelated concerns at a regional, state and national level.
How are cancer rates and outcomes different among American Indians than other groups?
American Indians have higher UDWHVRIVSHFLƓFFDQFHUV,QWKH Great Plains region, for example, we have higher rates of colorectal, breast and lung cancer. Lung cancer is one of the larger ones because we have high smoking rates in our tribal communities. We also work to provide increased education on the EHQHƓWVRIQRWVPRNLQJ2XU cancer outcomes are worse. We have barriers to prevention, screening and treatment. We live in a very rural area, and our relatives may have to drive many miles to get to treatment. Delays can cause progression to Stage II cancer or even to Stage III or IV, which we know is harder to treat.
Also, there are very few palliative care services in our tribal
communities. We have partnered with other organizations, like community health workers, to assess and implement palliative care to help our relatives. But again, living so far out from larger cities, it’s hard to get those resources to our tribal communities.
I hear you using the word relatives. Does this mean you refer to community members as relatives?
We do. Many times when we get together and we do a prayer, we end with Mitakuye Oyasin, which means that we are all related.
How do you use data to help improve cancer rates and health outcomes?
Being able to study the trends and patterns of cancer in our tribal communities helps us develop outreach, education and evidence-based interventions to increase screening, early detection and prevention.
What programs are you involved with to help address some of these issues?
We have a Comprehensive Cancer Control Program funded by the Centers for Disease Control and Prevention. It’s a collaborative approach used by communities and their partners to combine, share and coordinate resources to reduce the cancer burden.
Through the program, we work with stakeholders on a national, regional, state and tribal level to use data to inform and educate our coalition members, partners and policymakers. They lead the implementation of strategies to increase cancer prevention, screening and support for cancer survivors, families, caregivers, health providers and our relatives.
What inspires you in your work?
I’m from the community, Sicangu Lakota, an enrolled member of the Rosebud Sioux Tribe. Helping my people, which is all people, because we’re all related— that’s where my passion comes from. It comes from the community. Q
Here’s why it’s important to promptly address nausea and vomiting— and how you can navigate these common conditions during treatment.
It’s a common side effect of chemotherapy, radiation and some other cancer treatments and meds as well as a symptom of cancer itself, especially tumors in the brain, liver and gastrointestinal tract. Don’t delay treating nausea and vomiting. Not only can these conditions disrupt your ability to stick to a treatment regimen, but they can also lead to malnutrition and dehydration—which is why you should sip liquids throughout the day. These tips can help you navigate nausea on your way to recovery.
Avoid spicy, greasy and fried foods as well as fragrant, strong odors (open a window when cooking). Start with broths, smoothies, bread and oatmeal to see what you can tolerate.
Danielle Penick, RD, of the blog Survivors’ Table, advises skipping your favorite foods so you won’t associate them with illness. Instead, save them for posttreatment. For more help, seek an oncology dietitian.
What soothes one cancer patient might sicken another, so pay attention to your routine and diet and note what works for you. Does taking a short walk after eating help, or is it better to rest? When do you prefer to eat? Can you sleep or relax with your upper body elevated? Does salt or lemon juice make foods more or less tolerable? These tactics help some folks but not others. You do you.
An Asian root herb, ginger calms the stomach and aids in digestion. Add slices of ginger to your teas and smoothies, shred some into your meals, indulge in crystalized candied ginger or take a supplement. Mint, especially peppermint, is also versatile and healthful. It can be added to drinks and enjoyed as hard candies. Used as essential oils and aromatherapy, mint can also calm and relax.
Emetic describes something that causes vomiting. Doctors often prescribe cancer patients antiemetic drugs— up to a combo of four. Antianxiety meds may also help, as can over-the-counter options like
Dramamine and Bonine. What about marijuana for nausea? The American Society of Clinical Oncology experts advise that “doctors do not yet have enough evidence to recommend it as a treatment.”
Acupuncture and acupressure have been shown to help with nausea. Try this: With your palm facing up, apply pressure on your inner arm slightly below the wrist. Or try acupuncture bracelets, such as SeaBands. Other complementary therapies include relaxation methods (such as breathing exercises) and distraction techniques like counting backward, playing video games and singing.
7+(%/$''(5,6$+2//2:25*$17+$76725(685,1(7+$7ō6 made by the kidneys and then expelled through the urethra. The most common bladder cancer is urothelial carcinoma (also called transitional cell carcinoma). It starts in cells of the innermost lining of the bladder, called the urothelium. As tumors grow, they may spread into the surrounding muscle wall and to other parts of the body. The following websites offer education, support and more for people with bladder cancer.
$ƦƞƫƢƜƚƧ%ƥƚƝƝƞƫ &ƚƧƜƞƫ6ƨƜƢƞƭƲ bladdercancersupport.org
Raising awareness, supporting bladder cancer survivors and advocating for research and early diagnosis are just a few of this organization’s goals. The website offers basic facts about this cancer, an active forum, links to clinical trials and more.
$ƦƞƫƢƜƚƧ&ƚƧƜƞƫ6ƨƜƢƞƭƲ cancer.org
<RXōOOƓQGLQIRUPDWLRQDERXW bladder cancer before, during and after treatment, including resources and downloadable PDFs to help patients cope with their diagnosis, understand treatment options and stay well beyond treatment.
$ƦƞƫƢƜƚƧ6ƨƜƢƞƭƲƨƟ &ƥƢƧƢƜƚƥ2ƧƜƨƥƨƠƲ cancer.net
This patient information website, run by the world’s largest cancer organization, features expert-written articles about bladder cancer treatments by stage, survivorship, follow-up care and more. Stay up to date on the latest research, statistics and clinical trial results.
%ƥƚƝƝƞƫ&ƚƧƜƞƫ$ƝƯƨƜƚƜƲ 1ƞƭưƨƫƤ bcan.org
Boosted by an online support community of over 43,000 members, the Bladder Cancer Advocacy Network offers patients, caregivers, survivors, advocates and research professionals numerous resources, including virtual and in-person support groups by state as well as a psychological support call center (833-ASK-4-BCA) led by professional oncology social workers.
&ƚƧƜƞƫ &ƚƫƞ cancercare.org
Formed by professional oncology social workers, Cancer Care provides specialized services and resources, such as guidance for caregivers and questions to ask your doctor after a bladder cancer diagnosis. Learn to cope with your illness by connecting with an oncology social worker for support and advice on treatment via the free Hopeline at 800-813-HOPE (4673).
&ƚƧƜƞƫ1ƞƭưƨƫƤ cancernetwork.com
The Cancer Network features
consistently updated practical clinical information by cancer research experts. Search “Bladder Cancer” to browse hundreds of videos with experts discussing aspects of bladder cancer, such as “Diagnosing Bladder Cancer: Best Practices in Workup and Staging” and “Best Supportive Care for Patients With Bladder Cancer.” 1ƚƭƢƨƧƚƥ&ƚƧƜƞƫ,ƧƬƭƢƭƮƭƞ cancer.gov
This site offers fact sheets, statistics, treatments, ongoing research and more, including pages devoted to bladder cancer. Browse causes and risk factors, symptoms, survival rates by stage and screening options.
3ƚƭƢƞƧƭ&ƨƚƥƢƭƢƨƧ worldbladdercancer.org
This patient organization advocates for bladder cancer patients across the globe. Its website offers a variety of resources on all stages of the cancer— from prevention through survivorship. Fact sheets and tool kits are readily available in Spanish, French, Arabic and other languages.
The Luckiest Unlucky Person I
Know: A Practical Memoir (available on Kindle, $.99) chronicles one woman’s journey with metastatic breast cancer and provides helpful exercises to guide others toward attaining balance and clarity in the face of life’s obstacles. Author Kristin Smith Westbrook , the founder of Calm City, a mobile meditation studio, was diagnosed with breast cancer 12 years ago and has had four subsequent recurrences. “Life with cancer is often characterized as a battle, but I don’t want to see P\OLIHDVDƓJKWŐVKHZULWHV7KH memoir pairs personal storytelling with simple breathing techniques and mantras to cultivate calmness.
Prosperity Candle sells inspiring candles handmade by female artisans and refugees seeking a brighter future in the United States. The Courage Collection ($27 per candle; on sale at press time for $18)DYDLODEOHLQŏ7KULYHŐ ŏ5LVHŐDQGŏ'DUHŐUHPLQGV women and girls of their strength as they battle breast cancer. Each candle includes a special card telling the story of the woman who crafted it, and 10% of sales from every candle is donated to the Breast Cancer Research Foundation. Free of dyes and enhancers, the candles are made with coconut soy blend wax that burns up to 45 hours, natural wicks and premium scents, including apple and black tea, amber and bergamot, and palo santo and sandalwood. Plus, the ceramic containers can be reused or repurposed.
Two-time breast cancer survivor Fran Dunaway and her wife, Naomi Gonzalez, founded TomboyX, a gender-neutral, size-inclusive clothing brand. After undergoing a bilateral mastectomy, Dunaway struggled WRƓQGDEDVLFQRQODF\EUDIRUWKRVHZKRKDYHKDGPDVWHFWRPLHV6KH and her team created the Holdster bra ($40), a one-sided bra that can be worn over either breast, has an adjustable band WKDWVLWVEHORZVFDUOLQHVDQGƓWVVL]HV;6WR;:KDWōVPRUH LWVVPRRWKŴDWORFNVHDPVZRQōWLUULWDWHWHQGHUDUHDV$YDLOable in black, silver or cream, the Holdster provides light support with no stiff underwire or thick padding.
Need to calm your mind and lift your spirits? Crocheting can serve as a therapeutic and soothing distraction. The Woobles , a beginnerfriendly crochet company, offers delightful crochet kits for all ages. Each kit has everything needed to begin, including pre-started yarn and step-by-step video tutorials. Join the more than 250,000 people who have tried The Woobles and start your crochet collection using the Penguin Crochet Kit ($30) or Easy Peasy Beginner Bundle ($100) , which includes a penguin, bunny, fox and chick. Choose from a wide selection of fun kits!
Perfect for postmastectomy recovery, AWD Medical Silicone Tape ($17.99)
helps soften and smooth scars. Its silicone is medical-grade, breathable, ŴH[LEOHDQGJHQWOH7KH tape mimics the natural skin barrier to promote skin tissue formation and repair collagen. It also reduces itching, redness and discomfort and can be reused.
Find more products to make life easier: cancerhealth.com/good-stuff
Wellness encompasses various aspects of your health and well-being. This includes your physical, mental, emotional, social, spiritual, occupational and intellectual health. Cancer Health wants to know how you maintain wellness in your life while living with cancer.
How long have you been living with cancer?
T Less than a yearT 5–10 years
T 1–5 years T More than 10 years
T I am now cancer-free.
How would you rate your overall wellness since your cancer diagnosis?
T Excellent T Fair
T Good T Poor
To what extent has cancer impacted your physical well-being?
T Extremely T Slightly
T Moderately T Not at all
Have you made any lifestyle changes to improve your physical health since your diagnosis?
T Yes T No
To what extent has cancer impacted your emotional well-being?
T Extremely T Slightly
T Moderately T Not at all
Are you able to discuss your emotional concerns with your health care team?
T Yes T No
Do you have a good support network?
T Yes T No
'R\RXƓQGKHDOWK\ZD\VWRPDQDJH\RXUVWUHVV"
T Yes T No
Does spirituality or faith play a role in your wellness journey?
T Yes T No
Do you maintain a healthy work-life balance?
T Yes T No
'R\RXUHJXODUO\ƓQGZD\VWRVWLPXODWHDQG challenge yourself mentally?
T Yes T No
Do you regularly take time to unwind and relax?
T Yes T No
What year were you born?
What is your gender?
T Male T Female T Transgender T Other
What is your current level of education?
T Some high school T High school graduate
T Some college T Bachelor’s degree or higher
What is your annual income?
T Less than $15,000 T $15,000–$34,999
T $35,000–$49,999 T $50,000–$74,999
T $75,000–$99,999 T $100,000 or more
What is your ethnicity? (Check all that apply.)
T American Indian/Alaska Native
T Arab/Middle Eastern T Asian
T Black/African American T Hispanic/Latino
T 1DWLYH+DZDLLDQ3DFLƓF,VODQGHUT White
T Other ___________________________
What is your ZIP code?
Scan this QR code with your smartphone to take this survey at cancerhealth.com/surveys.
Or email a photo of your completed survey to website@cancerhealth.com.
For 75 years, Damon Runyon has provided funding to scientists who bet their careers on high-risk, high-reward hypotheses, concepts, and strategies. In this time, Damon Runyon scientists have advanced cancer research exponentially – because each one builds upon the achievements of those who came before.
As we celebrate this milestone of scientific achievement, we honor the scientists who have contributed to this legacy and continue to carry it forward. With them, we look to the future.
To learn more, visit damonrunyon.org
Gordon J. Freeman, PhD Damon Runyon Fellow ’79–’81 Alexandra-Chloé Villani, PhD Current Damon RunyonRachleff Innovator