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It can happen to anyone by Kat Gore and Angela Garcia-Cook
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ancer doesn’t discriminate. Cancer doesn’t care about your age, gender, ethnicity or socioeconomic status. Breast cancer is the most common cancer diagnosed in American women. According to the North Bay Cancer Alliance, the highest rate of breast cancer in the United States is in the San Francisco Bay Area. Looking at statistics over the past few years, nearly 400 Sonoma County women are diagnosed with breast cancer annually and around 85 Sonoma County women die from breast cancer a year. Angela Garcia-Cook was 41 when she was diagnosed with breast cancer. She was at the top of her game before the diagnosis. “I felt like I was in the best physical condition I’d ever been in, running 28 miles a week,” she said. Garcia-Cook was in the process of buying Healdsburg Physical Therapy and had two young children, a husband and her mother to care for. She said that the diagnosis happened at a terrible time. “Prior to my cancer diagnosis, I would have said, ‘No way, I couldn’t get cancer.’ I exercise regularly; I eat a healthy diet, low in saturated fats and carbohydrates and I have no family history of breast cancer. I even nursed my babies, which is also supposed to be protective,” GarciaCook said. On the day that Garcia-Cook discovered her cancer, she was driving in the car with her sister,
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talking about how she should probably get a mammogram – she had carried the slip for a
mammogram in her purse for a year, but hadn’t gone in for the test. Later that day, she went for a run, took a
shower and discovered a lump in her left armpit. Medical experts recommend selfbreast exams monthly. The American Cancer Society recommends that women age 40 and older have an annual mammogram. Women in their 20s and 30s should have a clinical breast exam included in their regular health exam every three years. At first, Garcia-Cook wanted to ignore the lump she had discovered in the shower, then decided to investigate further. “I knew it was cancer by the time I turned off the water. I still call it divine intervention. I went in to see the doctor the next day, who sent me for a mammogram, then a breast ultrasound, which led to a biopsy that day. The diagnosis was confirmed two days later,” she said.
See Not Me page 9
Inside Page 3: Local Health Centers Page 4: Battling Breast Cancer Page 5: 5 Prevention Tips Page 7: 15 years of Barb’s Race Page 8: Benefit wine events Page 10: Survivor Walk Oct. 10 Photo by Kat Gore NOT ME — Angela Garcia-Cook felt in her top physical condition when she was diagnosed with her first bout of cancer at age 41..
The Healdsburg Tribune
The Windsor Times
Access changes everything Diagnostic testing is now free for all under new federal laws by Ray Holley Amid the still-simmering conflict over the Affordable Care Act (often called Obamacare) is a provision wellknown to medical providers and less understood by the general public; all insurance policies are now required to cover diagnostic testing, including screening and testing for breast cancer. “These tests are not subject to copays or deductibles,” says Mary Szecsey, executive director of West County Health Centers, which serves western Sonoma County through a network of clinics. “This has made a difference to patients who, in the past, may not have accessed that care because they couldn’t afford it.” Dr. Jose Chibras agrees. Chibras is the medical director for Alliance Medical Center, which, along with Alexander Valley Healthcare, serves northern Sonoma County. “We had a woman come in with a breast mass and she was able to be
Community health centers and many private practice medical providers are using a “care team” model for health care.
FIND A HOME— Reforms under the federal Affordable Care Act (Obamacare) allow for free annual exams and certain diagnostic tests. For women and others without a primary doctor, local community health centers provide these services. Clinics are located in Cloverdale, Healdsburg, Guerneville, Sebastopol, Occidental and Forestville, as well as Santa Rosa and elsewhere. tested and treated, and she can now live a full life and be a happy grandmother,” Chibras said. “If she had waited two or three years, her life would have been very different. She might have had to undergo a radical mastectomy, go through chemo, radiation, and she might have died. We focus on preventive testing because we know it changes lives, it
Think Pink is published by SONOMA WEST PUBLISHERS, INC. as a supplement to the Oct. 1, 2015 issues of The Healdsburg Tribune, The Windsor Times, Sonoma West Times & News and the Cloverdale Reveille. PUBLISHER Rollie Atkinson
BUSINESS MANAGER Anna Harsh
CIRCULATION
saves lives.” Chibras emphasizes how different the health care landscape is now with access to preventive diagnostic testing. “Before 2010 if one of my patients wanted diagnostic testing she would have had to make up a reason to see a doctor,” he said. “She would have had to say that she had a cold or a fever. Now, we can see her
SALES MANAGER Paula Wise
when she’s well and we can keep her well.” Community health centers – and many private practice medical providers – are using a “care team” model for health care, which is especially good for women who need See page 6
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ADVERTISING SALES Cherie Kelsay, Steve Pedersen, Carol Rands, Beth Henry
ADVERTISING DESIGN & PRODUCTION Deneé Rebotarro, Jim Schaefer
EDITORIAL Rollie Atkinson, Kat Gore, Ray Holley,
WEBSITE MANAGEMENT Eileen Mateo
Think Pink Magazine Advertising and Editorial offices are located at 230 Center Street, Healdsburg, CA. 95448 or P. O. Box 518, Healdsburg, CA. 95448 Phone: (707) 433-4451 (707) 823-7845 (707) 894-3339 www.sonomawest.com Additional copies available for free at our local newspaper offices in Healdsburg, Cloverdale and Sebastopol.
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The fight against breast cancer Can breast cancer be found early? Screening refers to tests and exams used to find a disease, like cancer, in people who do not have any symptoms. The goal of screening exams, such as mammograms, is to find cancers before they start to cause symptoms. Breast cancers that are found because they can be felt tend to be larger and are more likely to have already spread beyond the breast. But screening exams can often find breast cancers when they are small and still confined to the breast. The mammogram is the main test recommended by the American
Cancer Society to find breast cancer early. The American Cancer Society also recommends breast MRI for women who are at high risk of breast cancer because of certain factors.
Can breast cancer be prevented? There is no sure way to prevent breast cancer. But there are things you can do that might lower your risk., such as changing risk factors that are under your control. (See the section "What are the risk factors for breast cancer?") For example, body weight, physical activity, and diet have all been linked to breast cancer, so these might be
areas where you can take action. Taking a drug to lower your breast cancer risk may also be an option. If you have a strong family history of breast cancer, you can talk to your doctor about genetic testing for mutations in genes that increase the risk of breast cancer, such as the BRCA genes. If you have such as mutation or come from a family with a mutation but haven’t been tested, you could consider surgery to lower your risk of cancer.
Five ways to reduce your breast cancer risk While you can’t change some breast cancer risk factors—family history and aging, for example—there are some risk factors that you can control. And while there is no sure way to prevent breast cancer, there are things you can do that may lower your risk. Here are 5 ways to help protect your breast health. 1. Watch your weight. Being overweight or obese increases breast
cancer risk. This is especially true after menopause and for women who gain weight as adults. After menopause, most of your estrogen comes from fat tissue. Having more fat tissue can increase your chance of getting breast cancer by raising estrogen levels. Also, women who are overweight tend to have higher levels of insulin, another hormone. Higher insulin levels have also been linked to some cancers, including breast cancer. If you’re already at a healthy weight, stay there. If you’re carrying extra pounds, try to lose some. There’s some evidence that losing weight may lower breast cancer risk. Losing even a small amount of weight – for example, half a pound a week – can also have other health benefits and is a good place to start. 2. Exercise regularly. Many studies have found that exercise is a breast-healthy habit. The difference in risk between the most active and the least active women is typically Continued on page 5
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Early detection, lifestyle changes can reduce risks replacement therapy (HRT) was used more often in the past to help control night sweats, hot flashes, and other troublesome symptoms of menopause. But researchers now know that postmenopausal women who take a combination of estrogen and progestin may be more likely to develop breast cancer. Breast cancer risk appears to return to normal within 5 years after stopping the combination of hormones. Talk with your doctor about all the options to control your menopause symptoms, and the risks and benefits of each. If you do decide to try HRT, it is best to use it at the lowest dose that works for you and for as short a time as possible.
From page 4 around 25%. In one study from the Women's Health Initiative, as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18%. Walking 10 hours a week reduced the risk a little more. The American Cancer Society recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week. (Or a combination of both.) And don’t cram it all into a single workout – spread it out over the week. 3. Limit time spent sitting. Evidence is growing that sitting time, no matter how much exercise you get when you aren’t sitting, increases the likelihood of developing cancer, especially for women. In an American Cancer Society study, women who spent 6 hours or more a day sitting outside of work had a 10% greater risk for invasive breast cancer compared with women who sat less than 3 hours a day, and an increased
risk for other cancer types as well. 4. Limit alcohol. Research has shown that women who have 2 to 5 alcoholic drinks daily have a higher risk of breast cancer than women who drink only 1 drink a day or not at all. Studies have found evidence
that links even lower levels of drinking alcohol to an increase in breast cancer risk. As little as 3 to 6 glasses of wine a week has been shown to slightly
This information is provided by the American Cancer Society, the primary organization for October’s Breast Cancer Awareness Month campaign. For much more information visit the ACS website at www.cancer.org/cancer/breastcancer.
5. Avoid or limit hormone replacement therapy. Hormone
Paula Wise
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From page 3 testing and follow up care. According to Szecsey, “Every patient is assigned to a care team, which includes a provider, a nurse, a medical assistant, a scheduler and support staff. They make sure that patients get to their appointments
and that we get their test results. We follow them and support them through the process.� What is the process? Health centers and doctors’ offices are not equipped for mammograms, ultrasounds and lumpectomies, so the care team helps the patient schedule those outside services. “We help them
What happens after treatment for breast cancer? For many women with breast cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. (When cancer comes back after treatment, it is called recurrence.) This is a very common concern in people who have had cancer. It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. For other people, the cancer may never go away completely. These people may get regular treatments with chemotherapy, radiation therapy or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have. If you are taking Tamoxifen or Toremifene, you should have pelvic exams every year because these drugs can increase your risk of uterine cancer. If you are taking an aromatase inhibitor for early stage breast cancer, your doctor will want to monitor your bone health and may consider testing your bone density. If symptoms, exams, or tests suggest a recurrence, imaging tests such as an x-ray, CT scan, PET scan, MRI scan, bone scan and/or a biopsy may be done. Your doctor may also look for circulating tumor cells in the blood. The blood levels of tumor markers go up in some women if their cancer has spread to bones or
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other organs such as the liver. They are not elevated in all women with recurrence, so they aren’t always helpful. If cancer does recur, your treatment will depend on the location of the cancer and what treatments you've had before. It may mean surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or some combination of these. It is also important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
with barriers as well,� said Szecsey. “If there are language or transportation issues, we help them with that.� Once the test results are received, a care team member will help the patient decide if treatment is needed and follow up afterwards to make sure the patient is getting treatment, taking medications properly, even help with lifestyle changes if that’s what it takes to keep the patient on the road to health. But, not everyone has insurance,
even in the world of better access. Citizenship or other issues may play a role in a woman’s ability to get coverage. There is help for everyone, said Szecsey. “There are programs for low income and uninsured. We’re very well aware of these programs and we’re able to help women get the care they need.� Adds Chibras, “The important thing is to make an appointment and get in to see a doctor. Let us help you live a healthy life.�
Our Boutique... provides women who have or had breast cancer with the space and time to understand the alternatives available while achieving wellness and balance in their lives, including: Breast Prosthetics Mastectomy Bras and Swimsuits Lymphedema Garments Hats and Wigs
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— Information provided by the American Cancer Society
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I’ve Had My Mammogram...
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15 years of Barb’s Race raises nearly $1 million Triathlon race named for cancer survivor by Greg Clementi Billed as the only all-women’s half triathlon distance contested in the world, Barb’s Race begins just after dawn at Johnson’s Beach in Guerneville with a 1.2-mile swim, continuing with a 56-mile bike ride In photo above, this year’s Barb’s Race top finishers were (l-r) Liza Rachetto, Lisa Heisinger and Anna Guzman.
7th Annual
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Proudly supporting Breast Cancer Awareness Month Graton Ridge Cellars will donate a portion of wine sales to the Sutter North Bay Women’s Health Center!
through Sonoma County and ending with a 13.1-mile half-marathon, finishing up at Windsor High School. The race is named for Healdsburg resident and longtime Vineman volunteer and organizer Barbara Recchia. “I couldn’t have asked for a better day for our 15th anniversary celebration of Barb’s Race,” said Recchia, a two-time cancer survivor. “I got to hang a medal on and hug a lot of happy finishers. I'm always very moved and inspired by the survivors who participate and thrive in this event. We do this for them and for all of our friends and family members who have been touched by cancer,” she added. Forty-two-year-old Liza Rachetto of Los Altos continued her dominance of the event, winning her fourth straight Barb’s Race title with a time of 4:51:07. Santa Rosa resident and 2011 champion Lisa Heisinger crossed the finish line in second place in 4:59:21. Rounding out the top five were: Anna Guzman (5:07:06), Jessi England (5:14:31) and Krista Shultz (5:37:57). This year’s race had raised nearly $90,000 for local cancer charities, with a projected total of $970,000 when all funds have been collected. Most funds from Barb’s Race are contributed to local organizations which provide support services for people with a cancer diagnosis. Roughly two-thirds of the funds have been donated to Sutter’s Institute for Health and Healing (previously Integrative Health & Healing Services) that offers physical, emotional and spiritual care and comfort for cancer patients to relieve the effects of their treatment. Those wishing to make a donation to local cancer charities can do so at www.active.com/donate/vineman15.
Supporting Breast Cancer Awareness Sandy Mays
Katherine Phillips (707) 974-6244
Breast Cancer Survivor
Key Properties, 4908 Sonoma Hwy., Santa Rosa www.keyprops@pacbell.net • www.keyprops.net • (707) 538-5115 7
707-486-5748
Katherine Phillips Remember to do monthly self exams & regular mammograms
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For Our Children & Grandchildren
Graton Ridge hosting Pink Party Graton Ridge Cellars is hosting its seventh annual Pink Party celebrating Breast Cancer Awareness Month. The party will be held from 11 a.m. to 4 p.m. on Saturday, Oct. 17 at the Graton Ridge tasting room, located at 3561 Gravenstein Hwy. North between Sebastopol and Forestville. The party features wine tasting and appetizers for $10 per person, which is donated directly to the
Sutter North Bay Women’s Health Center. Pink boas will be given to everyone who purchases wine. Sue Bonzell, family member and Graton Ridge Cellars Director of Marketing stated, “Our family has been affected by breast cancer and we feel strongly about giving back to a cause that is so important to us.” Graton Ridge Cellars has partnered with Sutter North Bay Women’s Health Center in Santa Rosa to donate a portion of their wine sales from this event. To date, Graton Ridge Cellars has donated more than
We Support Breast Cancer Awareness Month
“Never, never, never give up. If you’re going through hell, keep going. Success is not final, failure is not fatal; It is the courage to continue that counts.” — Sir Winston Churchill Dori & Bill Coleman Our beautiful granddaughter Leila Biagi
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$8,000 to the Santa Rosa breast care facility. Whether people can attend are not, they are encouraged to send in the name and/or photos of loved ones affected by breast cancer for the ‘Pretty in Pink’ Line of Honor.
Thumbprint Cellars raising awareness, funds all month Stop by the Thumbprint Cellars tasting room at 102 Matheson Street on the Healdsburg Plaza and donate to the fight against breast cancer by purchasing a “Save Second Base” bracelet. Proceeds will go directly to the Avon Foundation for Women. October is also the start of Thumbprint Cellars’ “Leave Your Mark” campaign to raise awareness and funds for women’s and men’s health issues and the Redwood Empire Food Bank. Guests are invited to place their colorful thumbprints on a special canvas in the tasting room. For information, call 707-433-2393.
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A full-line distribution yard featuring a wholesale lumber, milling and priming operation. Locations in Healdsburg and Cloverdale.
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Not Me .... From page 1 Garcia-Cook had a triple positive breast cancer. It was termed a grade III invasive ductal carcinoma, stage 2a. Treatment was daunting. GarciaCook worried about how she was going to go through treatment and continue to care for her family and business. Her treatment consisted of six sessions of chemotherapy spread
three weeks apart, a weekly infusion of Herceptin, a bilateral mastectomy with skin expanders followed by reconstruction, radiation and Tamoxifen. “Chemo was hard, but I managed to work through the whole thing with just taking a few days off. The first dose was the worst, which caused horribly painful mouth sores and, of course, the loss of my hair. Surgery was hard too; drains, pain pump, limited activity and no work,” Garcia-
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We Support Breast Cancer Awareness! MindStream Company helps individuals and organizations cope with stress, anxiety and the dis-ease of the body. As seen on 60 Minutes and Oprah; taught at Google, the military, and schools nationwide. Now in our town of Healdsburg, you can learn the official Mindfulness Based Stress Reduction (MBSR) meditation skills that can measurably help you not just survive, but thrive!
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Go to: MindStreamCompany.com for more information and to watch the 60 Minutes video or call the instructor directly at 415-272-4160 Gina, the instructor is offering 25% off the MBSR/mindful schools course; just mention the ad when inquiring. In addition, 10% off class proceeds will go to cancer research in honor of Mikki McGee, Gina’s mother, who is a breast cancer survivor.
Angela Garcia-Cook (second from left) sings with local band, the Fitch Mtn’ eers. Cook said. Garcia-Cook said that the one bonus to having breast cancer was getting breasts that fit her body. So, she had a “Bye-bye booby party.” Garcia-Cook said that she didn’t have a second thought about losing her other breast as well. “As far as I was concerned, having cancer in one breast was the biggest risk factor for having it in the other,” she said. Garcia-Cook explained that radiation therapy was “pretty much a breeze,” but is deceivingly damaging. The treatment gave her fibrosis in her left upper lung. Following treatment, Garcia-Cook focused on being as healthy as possible. She switched to a vegan diet. She researched more holistic avenues to improve her health. Garcia-Cook even started singing with a local band called the Fitch Mtn’eers this year. You can catch them playing at Stark Wine Company monthly. After finishing treatment for breast cancer, Garcia-Cook learned that her cancer had metastasized to her lung. It was the last thing she expected. It started with pain in her upper back in November 2014. “I thought I just needed to stretch,” she said. Her coworkers tried to help, and she went to a chiropractor and acupuncturist. She saw her oncologist, who ran several tests. The pain progressed to her right side. For about a week, she woke up at night with a tearing pain in her right lower lung. Garcia-Cook tried heat, Lidocaine patches and pain pills. “I finally saw a lung specialist when I
could barely make it across my office parking lot without being short of breath,” she said. Garcia Cook’s husband, who works for a medical oxygen supplier, did a six-minute walk test on his wife. Normal oxygen saturation is above 90 with a heart rate below 100. GarciaCook’s easily dropped into the 70s. “Now we knew something was really wrong, but it didn’t present like cancer,” she said. Garcia-Cook’s rheumatologist thought she had autoimmune disease. The physician put GarciaCook on two weeks of high doses of prednisone. Garcia-Cook seemed a little better, but still couldn’t do much. “I finally elected to have a lung biopsy with a minimally invasive technique. I expected to be back at work in a few days,” she said. “I awoke the next day with my husband getting that awful phone call and stepping out of the room.” Garcia-Cook spent two weeks in the hospital, then two weeks at home. She has had chemo three times and says she can breathe much better. She’s been told that she has a good prognosis. She lost her hair, she’s skinny and she has to give herself injections because the two main veins to her liver were completely blocked. “Anyone can get cancer, so do your best to take care of yourself by eating right, exercising, keeping a positive attitude and finding a fulfilling hobby to keep the stress away,” Garcia-Cook said. “I’m trying to keep a positive attitude, to stay strong for my family and me.
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Windsor Knights team up with Pink Divas Again this year the Windsor Knights youth football program has joined forces with the Pink Divas for the “Fight like a Knight� fundraiser. Pink Diva Stephanie Phillips and parent volunteers are selling fundraiser spirit packs for $20. These packs will have pink socks, t-shirts and shoelaces that our players are authorized to wear with
their game uniforms during the month of October. Pink mouth guards and towels also will be available for purchase.
Survivor walk at Sonoma Mountain Village on Oct. 10 Making Strides Against Breast Cancer of Sonoma County is a 5k walk around the Sonoma Mountain Village complex in Rohnert Park on Saturday, Oct. 10. Registration/check-in, the Survivor
recognition area, the ‘selfie’ booth and the Strides Store, on the soccer field, open at 8 a.m. The festivities begin at 9 a.m. with inspirational speakers and some warm up and stretching. The walk will begin with breast cancer survivors leading everyone in a lap around the soccer field before heading out on the course. Water and sunscreen will be available along the course. This is a pet friendly event – there’s a prize for the best dressed dog. Wear your pink, bring your family, friends, neighbors and co-workers out for a fantastically fun day doing your part to put an end
to breast cancer. How can you be a part of the solution to end breast cancer? Form a team, register and participate in the Making Strides event on October 10, 2015; sign up and participate as an individual; donate to a team or participant; “like� the Making Strides Sonoma County page on Facebook; volunteer to help out at the event or with the other volunteer opportunities with the American Cancer Society; call the American Cancer Society at (800) 227-2345 or go online (cancer.org/stridesonline) to get more information.
We Support Breas st Cancer Awaarreness Month Great Rates For: Newspapers, Flyers, Programs, Newsletters, Brochures & Posters
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What’s the difference between a screening mammogram and a diagnostic mammogram? Screening mammograms are x-ray exams of the breasts that are used for women who have no breast symptoms or signs of breast cancer (such as a previous abnormal mammogram). The goal of a screening mammogram is to find breast cancer when it’s too small to be felt by a woman or her doctor. Finding breast cancers early (before they have grown and spread) greatly improves a woman’s chance for successful treatment. Diagnostic mammograms investigate possible problems. A woman with a breast problem (for instance, a lump or nipple discharge) or an abnormal area found in a screening mammogram typically gets a diagnostic mammogram. Sometimes diagnostic mammograms are done for screening in women without breast problems who were previously treated for breast cancer. During a diagnostic mammogram, the images are reviewed by the radiologist while you are there so that more pictures can be taken if needed.
A diagnostic mammogram is usually interpreted in one of three ways: It may reveal that an area that looked abnormal on a screening mammogram is actually normal. When this happens, the woman goes back to routine yearly screening. It could show that an area of concern probably is not cancer, but the radiologist may want to watch the area closely. When this happens it’s common to ask the woman to return to be re-checked, usually in 4 to 6 months.
The results could also suggest that a biopsy is needed to find out if the abnormal area is cancer. If your doctor recommends a biopsy, it does not mean that you have cancer. If a biopsy is needed, you should discuss the different types of biopsy with your doctor to decide which type is best for you.
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In honor of the Think Pink campaign, when you choose us as your Realtors and mention this ad, we will donate 5% of our net commission after close of escrow to a local charity of your choice. Call for details.
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Brad Drexler, M.D. Obstetrics, Gynecology & Infertility Comprehensive Women’s Healthcare in Healdsburg for more than 20 years
e are dedicated to providing exceptional patient care in a comfortable environment, and believe in the power of patient education and prevention to promote good health. Dr. Drexler will take the time to listen to your concerns and involve you in your care decisions.
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