Living Well Jan/Feb 2016

cancer awareness

progress in the fight

JAN/FEB 2016

A Publication of the

ways to support a friend resiliency afterward January/February 2016 ~ living well

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living well ~ January/February 2016

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A publication of the

publisher Mark Heintzelman

missoulian.com

editor Matt Bunk

People in Missoula and western Montana want to feel good, look good and live well. Available at more than 150 newsstand locations throughout the area, Western Montana Living Well is well suited to more than 30,000 readers monthly who want health tips on fitness, nutrition, family, financial advice, wellness, therapy and beauty.

graphic design Krista Ness Bob Jacobson

advertising sales Rachel Crisp Philips 406-523-5223 contributors Brandpoint Jennifer Feenstra Macy Hyvonen Tim Nielsen

The opinions, beliefs and viewpoints expressed by the various authors and forum participants in this publication do not necessarily reflect the opinions, beliefs and viewpoints of the Missoulian or Lee Enterprises. The author of each article published in this publication owns his or her own words.

No part of the publication may be reprinted without permission. ©2016 Lee Enterprises, all rights reserved. Printed in the USA.

WESTERN MONTANA CLINIC DERMATOLOGY DEPARTMENT

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living well ~ January/February 2016

January/February 2016 VOL. 33

in this issue

HPV can cause oral cancer pg.6

prevent cancer pg. 8

cancer awareness lung cancer 101 pg. 12 surviving pancreatic cancer pg. 16

also inside resiliency after cancer pg 28 support your friend pg 32

advances in research pg. 20

breast reconstruction pg. 24

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HPV can cause oral cancer

By Macy Hyvonen

I

t’s a common misconception that going to the dentist is just about preventing cavities and gum disease. Many people don’t realize that your dentist is also looking for other forms of disease that might first appear in your mouth. These include diabetes, eating disorders and oral cancer.

According to the Academy of General Dentistry, oral cancer is one of the most common cancers, with approximately 35,000 new cases reported annually in the United States (www.oralcancerfoundation.org/hpv/). Dentists are trained to look for signs of oral cancer every time they examine a patient.

At Family Dental Group, we are concerned that many of our patients who were traditionally considered low-risk for oral cancer may be much more vulnerable than the medical and dental community has realized. Until recently, we were taught that, in general, patients who use tobacco products or consume excessive amounts of alcohol had a higher risk for oral cancer. In the past, most oral cancer cases were older patients with one or more of these well-known risk factors.

Men were more likely to develop the disease than women. In general, it was usually older men who smoked and consumed alcohol on a regular basis who were at the highest risk for developing oral cancer. It was very rare to see a young, healthy adult develop oral cancer.

But these statistics are changing. Now dentists across the country are seeing more young patients with oral cancer, as well as an increased risk for women. More and more, these traditionally low-risk groups are developing this serious, life-

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living well ~ January/February 2016

The HPV family contains nearly 200 strains, and is one of the most common viruses in the United States. changing disease. What has changed? What is causing young people with healthy lifestyles to suddenly see an increase in their risk of oral cancer? The culprit appears to be human papillomavirus (HPV).

Did you know ...

HPV is a virus that infects epithelial cells of skin and mucosa on any portion of the body, in this case, the mouth, throat, tongue and tonsils. Transmission of the virus occurs when these areas come into contact with the virus, allowing it to transfer between cells (www.oralcancerfoundation.org/ hpv/).

The HPV family contains nearly 200 strains, and is one of the most common viruses in the United States. Of these nearly 200 strains, only nine are associated with cancer. And of those nine potentially cancer-causing strains, only one, HPV16, is associated with oropharyngeal cancer (cancer of the middle portion of the throat, including the base of the tongue, soft palate, tonsils and walls of the pharynx). Typically, HPV infections in the mouth and throat do not produce any symptoms, and only a very small percentage of these infections develop into cancer. Studies show that in most cases, a healthy immune system will be likely to clear, or suppress, HPV eventually (www. oralcancerfoundation.org/hpv/).

According to the American Dental Association Council on Scientific Affairs, approximately 11,000 cases, or 63 percent, of oropharyngeal cancers are associated with HPV infection. Since HPV has been identified as a risk factor for oral cancer, it could explain why younger, healthier people are now more frequently being diagnosed with the disease. It is not just people who use tobacco products anymore. Any of us can be at risk for oral cancer.

Because HPV infections do not typically produce any symptoms, having an oral cancer screening every six months increases the likelihood of an early diagnosis. If you notice any unusual appearance of the soft tissue in your mouth or throat, or experience a persistent sore throat, difficulty swallowing, hoarseness, ear pain or enlarged lymph nodes, you should schedule an exam with your dentist. As with all cancers, the earlier the diagnosis, the better the chance of successful treatment.

Dr. Macy Hyvonen is a general dentist practicing at Family Dental Group in Missoula. Originally from Charlo, Hyvonen graduated from the Arizona School of Dentistry and Oral Health. Her practice includes patients of all ages and treatment needs.

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Cancer prevention 101

By Jennifer Feenstra, DPT

I

n 2014, about 1.6 million people were diagnosed with cancer in the U.S. Cancer is not a single disease but a group of related diseases. At its most basic level, cancer is caused by a mutation, or change, in the cells in our body and then those cells replicate and take over space in the surrounding tissues or spread throughout the body in fluid, such as blood.

In most cases, masses of cells are produced and become what are known as tumors. In other cases, such as leukemia, the cancer cells are dispersed throughout the fluids in our body, in this instance the blood. There are more than 100 different forms of cancer, most named for the body part where it originated such as lung cancer, or by the type of cell that it originated from like squamous cell carcinoma. Approximately 39.6 percent of men and women will be diagnosed with some form of cancer at some point during their lifetimes. Because of this overwhelming statistic, the question becomes, “what can be done to prevent cancer?�

Cancer prevention can be broken down into two categories: Factors that increase the risk of cancer and factors that may affect the risk of cancer. Many things in our genes, our lifestyle and the environment around us may increase or

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living well ~ January/February 2016

decrease our risk of getting cancer. That includes diet, physical activity, smoking and age. Several of these factors are things that we are unable to change, such as our age, but others can be easily modified to decrease our risk of getting cancer.

Factors that are known to increase the risk of cancer

Tobacco use is strongly linked to an increased risk for many kinds of cancer. Smoking cigarettes or chewing tobacco are the leading causes of several types of cancer including cancer of the lung, oral cavity, stomach, kidney, pancreas, bladder and acute myelogenous leukemia (AML).

Using any type of tobacco puts you at much greater risk of getting cancer. Even if you don’t use tobacco, exposure to secondhand smoke might increase your risk of lung cancer. There are several options available to help with quitting smoking, so talk to your doctor about your options.

Certain viruses and bacteria are able to cause cancer. Examples of cancer-causing viruses and bacteria include: Human papillomavirus (HPV) which is the leading cause of cervical cancer, and Hepatitis B and C viruses increases the risk for liver cancer. Both HPV and Hepatitis B are

The key to a healthy lifestyle

January/February 2016 ~ living well

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preventable through the use of vaccines, although there is not currently a vaccine for Hepatitis C. Being exposed to radiation is a known cause of cancer.

There are two main types of radiation linked with an increased risk of cancer: ultraviolet radiation from the sun and ionizing radiation from medical tests such as x-rays and CT scans, as well as radon gas in our homes. Excessive exposure to sunlight has been found to be the primary cause of non-melanoma skin cancers, whereas ionizing radiation is known to cause leukemia, breast cancer and thyroid cancer.

To avoid increased risk of skin cancer caused by ultraviolet radiation, avoid tanning beds, stay in the shade when possible and use plenty of sunscreen when you are in the sun. Remember that your skin is still absorbing UV rays even on a cloudy day, so always wear sunscreen when outdoors.

Immunosuppressive medicines are linked to an increased risk of cancer. These medicines lower the body’s ability to stop cancer from forming. An example of immunosuppressive medications include those to keep a patient from rejecting an organ transplant.

Factors That May Affect the Risk of Cancer

The foods that you eat on a regular basis can place you at higher or lower chances of getting cancer. Some studies show that fruits and vegetables may protect against cancers of the mouth, esophagus and stomach. Fruits may also protect against lung cancer. On the other side of that coin, some studies suggest that a diet high in fat, proteins, calories, red meat and processed meats can increase the risk of cancer. Although making healthy selections at the grocery store and at mealtime can’t guarantee cancer prevention, it might help reduce your risk. Some studies have also shown that alcohol may place you at higher risk for cancers such as oral, esophageal, breast and colorectal.

Studies show that people who are physically active have a lower risk of certain cancers than those who are not.

Studies show a strong link between physical activity and a lower risk of colon cancer, breast cancer and endometrial cancer.

Staying physical active may not only help reduce your risk for certain types of cancer but, along with a proper diet, it will also help you lose weight. Maintaining a healthy weight might lower the risk of various types of cancer.

Studies suggest that obesity is linked to higher risk for

Studies show that people who are physically active have a lower risk of certain cancers than those who are not.

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living well ~ January/February 2016

cancer of the kidney, pancreas, esophagus, endometrial lining, colon and breast.

Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic physical activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.

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Although there is still so much that we don’t know about cancer, there is one thing that we are certain of: Living a healthy lifestyle is not only good for a happy and healthy present, but has the benefit of helping to ensure a fulfilled and longer life.

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Misconceptions Brandpoint

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living well ~ January/February 2016

about lung cancer

W

hat is the deadliest type of cancer in America? If you answered colon, breast, pancreatic or prostate cancer, you are incorrect. In fact, the correct answer claims the lives of more than all four of these cancers combined: lung cancer.

More than 220,000 people are diagnosed with lung cancer annually, according to the National Cancer Institute, and yet there are many common misconceptions about this widespread disease.

The 2014 Any One Any Lung survey uncovered not only a significant lack of understanding about the impact of lung cancer, but also a critical absence of knowledge about the role of genetic changes in the development of the disease. The survey, sponsored by Novartis Oncology and conducted online by Harris Poll, found an astounding 84 percent of the general public feel they know little or nothing about lung cancer, which means education needs to be a priority.

“It’s really important that people realize lung cancer can affect anyone,” says lung cancer survivor Richard Heimler. His diagnosis came as a shock not only because he was only 44 years old at the time, but also because he had never smoked.

“I hope in the years ahead we can change the perception of lung cancer and elevate it as a public health priority. As an 11-year survivor, I believe my story can give inspiration to my fellow patients and their families,” he says.

Lung cancer is more complex than most people think.

Get the facts about three of the most common myths and misconceptions about lung cancer diagnosis and treatment.

Myth: Smoking is the cause of lung cancer.

Fact: Smoking is a risk factor, but not the only one.

This misconception is common - nearly 75 percent of Americans immediately think smoking is the cause when they hear someone has lung cancer. The truth: Nearly 15 percent of people with lung cancer have never smoked.

Many factors contribute to a lung cancer diagnosis, including the environment, family history and genetic makeup.

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Myth: Genetics has nothing to do with lung cancer.

Fact: Genetics plays an important role in lung cancer development.

Just 28 percent of Americans recognize changes in genetic makeup as a cause of lung cancer, according to the survey. But genetic mutations are closely linked to the most common form of lung cancer, known as non-small cell lung cancer (NSCLC). Approximately 60 percent of patients with NSCLC have been found to be linked to certain mutations. The scientific community has identified 12 genetic targets that drive NSCLC, including EGFR and ALK.

Myth: All lung cancer treatments are similar.

Fact: Because all lung cancers are different, today’s treatments vary greatly.

New technologies that look at a patient’s tumor cell on the molecular level help doctors develop individualized treatment plans, otherwise known as precision oncology.

This approach provides patients with the best treatments for their type of lung cancer while avoiding treatments that won’t be effective based on their genetic makeup. In fact, leading medical organizations recommend that lung cancer patients undergo molecular testing for these reasons.

“My advice for someone who is just being diagnosed with lung cancer is to take it one day at a time and be

hopeful,” says Heimler. “Everyone’s medical journey is different, so it’s important to be educated and informed about developments in diagnostic testing and personalized medicine. There are also patient advocacy organizations that offer tremendous resources and support for lung cancer patients and caregivers.”

More people need to know the facts about lung cancer.

In order for patients with lung cancer to get the best care, treatment and support, increased public awareness and education are needed. Learn more at www.anyoneanylung. com or visit www.novartisoncology.com/us.

Sources: * American Cancer Society. Cancer Facts and Figures, 2014. Available at http:// www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2014/. * National Cancer Institute. Common Cancer Types. Available at http://www. cancer.gov/cancertopics/types/commoncancers. Accessed March 5, 2015. * Any One Any Lung Survey, Harris Poll, sponsored by Novartis Oncology (2014). * Centers for Disease Control and Prevention. Cigarette Smoking Among Adults – United States, 2006. * * Morbidity and Mortality Weekly Report, 2007; 56(44):1157-1161. * Samet JM. Lung cancer in never smokers: clinical epidemiology and environmental risk factors. Clin Cancer Res. 2009; 15(18):5626-45. * Pao W, Girard N. New driver mutations in non-small-cell-cell lung cancer.

Lancet Oncol. 2011;12:175-180. * Lindeman NI, Cagle PT, et al. Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitors. Arch Pathol Lab Med. 2013; 137: 828-1174.

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living well ~ January/February 2016

January/February 2016 ~ living well

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Pancreatic cancer survival on the rise Brandpoint

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living well ~ January/February 2016

F

or Diane Borrison, it started with her eyes.

They had suddenly taken on a yellowish hue. It didn’t take her long to realize her skin had followed suit. Borrison knew right away there must be something wrong, and she scheduled an appointment with her doctor immediately.

The diagnosis was worse than she feared pancreatic cancer.

Being told you have cancer is terrifying in any instance, but few diagnoses drive fear like pancreatic cancer. The five-year survival rate is just 7 percent.

Borrison says she was shocked upon hearing the diagnosis. “How and why has this deadly cancer attacked me?” she remembers asking.

“I had always considered myself to be very healthy,” she later wrote, recounting her experiences.

“I’ve always been physically active. I never smoked nor had been overweight. I had recently lost a little weight, but who wouldn’t welcome that?”

Fortunately for Borrison, the same tests and scans that showed she had cancer also showed she was a candidate for the Whipple surgery, an intense operation to remove part of the pancreas. “My Whipple was performed at a high-volume pancreatic cancer hospital,” she says, adding that after the surgery she underwent six months of chemotherapy.

During this time, she had loved ones by her side. “My family and friends were a source of great comfort and support.”

The surgery and chemotherapy were a success, and now, nine years later, Borrison is a member of that seven percent survival statistic. She has continued to follow-up with blood tests and scans to monitor her disease, and the results, thankfully, have been negative. “Right now, I am cancer free,” she says.

Moving forward

“Cancer free.” These are the words every cancer patient wants to hear, and when Borrison heard them, she knew she had just been given the opportunity to do more.

As she underwent her own battle with cancer she learned more about the poor prognosis pancreatic cancer patients face, and she vowed to do everything she could to change those statistics. She started volunteering with the Pancreatic Cancer Action Network, the national organization dedicated to advancing research, supporting patients and creating

hope for those affected by pancreatic cancer.

Her support has grown, and today Borrison has made improving the lives of pancreatic cancer patients her main goal. “We need reliable, effective treatments for this disease, not just luck,” she said.

Finding effective treatments

Today, with the support of volunteers like Borrison, the Pancreatic Cancer Action Network is continuing the fight against this deadly disease and is aiming to double survival by 2020.

The organization was founded in 1999. Since 2003, it has awarded 123 research grants totaling more than $28 million to scientists at 51 institutions worldwide. The organization has also helped increase federal funding for pancreatic cancer research from $17 million in 1999 to more than $101 million in 2013.

Further, its Patient Central one-to-one service connects patients and their caregivers to valuable information about the disease, clinical trials, treatment options and support resources - all free of charge.

Patient Central serves more patients annually than any other single institution in the world - it has provided information, resources and hope to some 100,000 contacts since the program started in 2002.

Now the Pancreatic Cancer Action Network is aiming to raise $200 million by 2020 to significantly increase its investment in research and clinical initiatives and to redefine the future of pancreatic cancer.

One example of this is that funds raised to support the $200 million goal will allow the Pancreatic Cancer Action Network to expand the reach of its personalized medicine service, which provides eligible pancreatic cancer patients and their oncologists with information about the biology of their tumor. Information that is gathered through this service can help shape future clinical trials that drive progress for patients.

This funding goal is clearly in-line with the organization’s commitment to double pancreatic cancer survival by 2020 and improve outcomes for people like Borrison.

While there will always be fear surrounding a pancreatic cancer diagnosis, there should also be hope.

To learn more about the Pancreatic Cancer Action Network, please visit www.pancan.org.

January/February 2016 ~ living well

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Progress in the fight against cancer Brandpoint

W

hen you consider that more than 1.65 million new cases of cancer will occur in the U.S. this year, and that more than half a million people will die from the disease, it can be difficult to imagine there’s any good news about cancer.

But a new progress report and survey on cancer released by the American Association for Cancer Research (AACR) indicates that there is plenty of positive news, including that the majority of American voters (85 percent) recognize that progress is being made against cancer and 74 percent favor increasing federal funding for cancer research.

“We have made spectacular progress against cancer, which has saved the lives of millions of individuals in the United States and around the world,” says Dr. Margaret Foti,

chief executive officer of the AACR. “However, without increased funding for cancer research, we will not be able to realize the promise of recent discoveries and technological advances.”

In the AACR Cancer Progress Report 2015, the AACR asks Congress and the administration to commit to robust, sustained and predictable increases in funding for the National Institutes of Health, the National Cancer Institute and the U.S. Food and Drug Administration. The AACR is a professional organization focused on advancing cancer research.

“Our national survey shows that this issue is a priority for most American voters,” Foti says, “and the AACR is committed to advocating for the lifesaving research that brings hope to cancer patients everywhere.”

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In the mid-1970s, fewer than half of all cancer patients survived their disease for five or more years. The most recent calculation puts the five-year survival rate at nearly 70 percent, according to the progress report.

Between Aug. 1, 2014, and July 31, 2015, the FDA approved nine new anticancer drugs and therapies; new uses for six previously approved anticancer treatments; a new use for a previously approved imaging agent; a new vaccine to prevent cancer; and a new cancer screening test, the report notes.

Findings

The AACR survey showed American voters are largely aware of the importance of cancer research, and know researchers have made strides in fighting the disease. Conducted by Hart Research Associates and Public Opinion Strategies, the poll showed: • More than five out of every six voters (85 percent) agree progress is being made against cancer.

• More than eight out of 10 voters (81 percent) favor using taxpayer dollars to fund medical research.

• Nearly three out of four voters (74 percent) favor increasing federal funding for cancer research, and nearly half (49 percent) strongly favor the idea.

• By a five-to-one margin, registered voters in the AACR survey said they would be more likely to vote for a presidential candidate who supports making the fight against cancer a national priority by providing sustained increases in federal funding for cancer research.

To learn more about cancer research, visit www.aacr.org. To get involved or to make a donation, visit the AACR Foundation’s website at www. aacrfoundation.org.

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living well ~ January/February 2016

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living well ~ January/February 2016

Breast reconstruction after mastectomy More than an option

E

Brandpoint

motional distress, a sense of disconnection from one’s body and a decreased sense of femininity - these are all emotions breast cancer patients may feel following a mastectomy. However, there’s hope.

Breast reconstruction, a type of surgery that rebuilds the breasts of women who have had all or part of a breast removed, can improve psychological wellbeing and quality of life for women who have undergone a mastectomy. In addition, research shows breast reconstruction often results in improved body image and self-esteem. However, many women facing a mastectomy are not actually offered breast reconstruction as an option.

“Addressing the tumor is only part of the course of treatment when dealing with breast cancer - breast reconstruction is an option every woman deserves, whether she is considering a mastectomy following a breast cancer diagnosis or as a preventative measure,” says Dr. Allen Gabriel, board-certified plastic surgeon at PeaceHealth Medical Group Plastic Surgery in Vancouver, Washington. “Breast reconstruction should be an early part of the discussion as women evaluate their treatment plans. The surgical decisions that are made early during breast cancer treatment will follow the patient a lifetime, and this is why every patient should have the opportunity to discuss her options with a plastic surgeon. Not every patient will choose to have reconstruction, or even be a reconstructive candidate, but every patient deserves to have the information at hand.”

January/February 2016 ~ living well

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research shows breast reconstruction often results in improved body image and self-esteem

Mastectomies are on the rise for breast cancer, according to recent studies, including a 2014 study published in JAMA Surgery that found the percentage of women with breast cancer who opted for a mastectomy (removing the entire breast) over a lumpectomy (removing the breast cancer) increased to 38 percent in 2011.

Additionally, the Susan G. Komen Foundation reported there has been an increased rate of double mastectomies, which rose by about 17 percent per year during a 10-year period, due to an increased effort to prevent breast cancer in high-risk women.

Knowledge is power

Because of this, it’s more important than ever to educate and empower women to have the confidence to discuss their breast-reconstruction options with their oncologists and surgeons, especially as there have been significant advancements to the surgical techniques, tools and the materials used in breast reconstruction in the past two decades. This means women who have breast cancer today have more choices and better outcomes than even just a few years ago.

“When you first find out you have breast cancer, your doctors talk about your diagnosis, your prognosis, your treatment; however, some doctors don’t take the discussion further. The patient also wants and has a right to know what happens after the mastectomy,” says Sherry Stose, a retired registered nurse and breast cancer survivor who was diagnosed in 2011.

On Jan. 18, 2012, Stose had a bilateral mastectomy with the start of her breast cancer reconstruction process.

“I’m very happy with the choice I made to undergo breast reconstruction. For me it was when I felt truly healed,” Stose says. “Because I had my breasts reconstructed, the fact I had breast cancer is not thrown in my face every day. I don’t see it every time I get out of the shower. In fact, many days, I feel so normal and complete that I forget I even had cancer.”

Options to consider

The goal of breast reconstruction is to recreate the breast, and there are many options to do that. The reconstructive plan is individualized for each patient and dependent upon her situation. It’s important for women to

discuss the advantages and disadvantages of each breast reconstruction option with their plastic surgeons in order to determine their best path forward.

One innovative technology is AlloDerm(R) Regenerative Tissue Matrix from Acelity. AlloDerm Tissue Matrix is an acellular dermal matrix (ADM) that, when sutured into the breast pocket, readily incorporates with a patient’s own tissue. This allows for rapid and healthy revascularization, as well as minimal inflammation and scarring. The gentle processing of AlloDerm Tissue Matrix offers surgeons a solution for soft tissue support where weakness exists.

Tools such as ADMs, as well as fat grafting, allow surgeons in certain cases to reconstruct the breast on top of the patient’s pectoral muscle immediately following mastectomy. Pre-pectoral (over the muscle) breast reconstruction is achieved by using both the ADMs and fat grafting, as this allows surgeons to supplement the thin mastectomy skin.

“Innovations and advances in breast reconstruction ... have really changed breast reconstruction. We are utilizing these tools to replace the missing components that mastectomy has removed, which are fat and breast tissue. These technologies have provided more options and allowed surgeons to optimize outcomes for patients with breast cancer who have to or choose to undergo mastectomy,” says Dr. Gabriel.

“Companies like Acelity are putting a strong emphasis on further advancing breast-reconstruction approaches, working with plastic surgeons to understand new techniques and incorporate new technologies to help make breast reconstruction a less burdensome process for women.”

“Since my diagnosis, I’ve become a mentor to other women with breast cancer, and the best advice I can give is to do everything you can to learn about your breast reconstruction options. Ask your doctors about your options. Ask your family. Ask your friends. Talk to another breast cancer patient,” says Stose. “Just get all of the knowledge you can. Because ultimately, it’s your choice, and you need to make the decision about what is best for you.”

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January/February 2016 ~ living well

27

Resiliency after cancer

By Tim Nielsen, PT 28

living well ~ January/February 2016

C

ancer treatment is generally quite taxing on the body, but rehabilitation services can help cancer victims.

Every cancer survivor can benefit from physical therapy.

That’s a bold statement. But if you analyze the conditions which can occur after cancer diagnosis and treatment, many of those conditions are readily treatable. These may include balance loss, low endurance, stiff joints, muscle weakness, difficulty walking, pain, sensation loss in hands and feet, scar-tissue restrictions, postural changes, reduction in motor skills, loss of function and lymphedema effects.

Obviously, physical therapy is predicated on provider orders, type of cancer and treatment, as well as the patient’s tolerance to the established program. When services are started depends on the above factors. They may start as “prehabilitation” strengthening after cancer diagnosis but before treatment in order to build up strength ahead of time.

Physical therapy during cancer treatment likely will be determined by cancer treatment days and after-effects. This may involve pain management, relaxation and strengthening exercises as tolerated. After cancer treatment is finished, more physical theraphy may be helpful for latent problems to regain strength, endurance and mobility. As an example, treatment for lymphedema may occur over a long period of time with manual and exercise techniques to alleviate long-term extremity swelling and improved range of motion.

Exercises for aerobic fitness and muscle strengthening can be helpful to improve tolerance to restarting desired ADLs, work and recreation. Recommended cardiovascular exercises would be gradually increased to five times per week, up to 30 minutes in each session. A strengthening program done three times per week would focus on major muscle groups in the arms, legs and core trunk.

Initial strengthening exercises could be done in an aquatic setting for progression in a less weighted, more comfortable and safe environment. Balance training related to weight-bearing activities could also be started. Flexibility and relaxation exercises would be accomplished with techniques including stretching, yoga and stress-relieving techniques. Beginning exercising with a structured program during cancer recovery may also help sleep restfulness which would improve energy and healing for desired daily activities. The cancer survivor would learn a follow-up exercise and self-care program to be accomplished at home as well.

In a follow-up study with patients after colorectal cancer, several parameters were surveyed. Cancer survivors were asked about the quality of their current health, following health recommendations, and receiving support after cancer diagnosis.

Of those surveyed, 84 percent described their overall health as good, very good or excellent. However, only 35 percent were maintaining a healthy body weight and only 19 percent were exercising as recommended (i.e. 2.5 hours of cardiovascular exercises per week). Interestingly, 71 percent of family members and friends did encourage the survivors to exercise on a regular basis. Following up with physical therapy may help motivate patients to be more compliant with long-term exercising.

Cancer survival, especially for certain types, has significantly improved longevity and quality of life. Physical therapy can facilitate that quality of life with appropriately ordered care during different stages after cancer diagnosis and chosen treatment. Survivors can take advantage of this to learn proper exercise type, frequency, duration, intensity, equipment use and progression to fight the sometimes overwhelming challenge of cancer and subsequent treatment.

January/February 2016 ~ living well

29

LivingWell Acupuncture

Acupuncture Clinic of Missoula Safe, gentle and effective healthcare.

Rebecca Sobin, D.A.O.M. L.Ac. Tonia Janzen, M.Ac.O.M., L.Ac. Dallas Seaber, M.Ac.O.M., L.Ac.

Assisted Living

Hillside Place

Why shouldn’t you still live in a house in a neighborhood? ALL of the services and amenities of assisted living in the home-like environment you are used to.

Call for a personal tour.

Blue Mountain Clinic provides patientcentered, family practice services to the local community from a choice-based perspective. We believe that choices in any health care decision should be met with dignity in a supportive environment. Our services include: pediatrics, mental health, general wellness, travel medicine, transgender health and reproductive care for women and men.

3031 S Russell St • 728-1600 acupunctureclinicofmissoula.com

4720 23rd Ave • 251-5100

610 N California St, Missoula, Mt 59802 (406) 721-1646

Alzheimer’s Care

Assisted Living

Independent Living

Pearls of Life Memory Care Pearls of Life Memory Care is a signature program designed to provide an environment that meets the varied needs of a person with memory loss.

Secure areas, life enrichment, and health services are all part of the program.

Call for a personal tour: HiLLside HeaLtH Care

251-5100

tHe ViLLage HeaLtH Care Center

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Affordable Independent living for persons 62 or older

Assisted Living We recognize each person is unique So you’ll find just the right level of care and support to enjoy your individual freedom. Pop by and see how Life is Just a Little Easier Here.

3710 American Way, Missoula

363-1144

(406) 273-0101

Alzheimer’s Care

Assisted Living

Footsteps Memory Care ®

We walk through the journey of memory loss with you providing genuine care and increasing support as the journey changes. Every day we embrace moments of success 3710 American Way, Missoula

(406) 273-0101 30

Family Practice

living well ~ January/February 2016

SENIOR RESIDENCE

Spacious studio, 1 and 2 bedroom apartments with meal plans, linen service and housekeeping included. Assistance with bathing, dressing, monitoring medications, and other daily living needs. Call or stop by for a personal tour.

2815 Old Fort Rd • 549-1300

3 meals a day • Housekeeping Centrally Located • Convenience Store Beauty Salon • Service Coordinator Non-Denominational Chapel

Missoula Manor Homes 909 W. Central Missoula, MT 59801 728-3210 or visit www.missoulamanor.com TTY Relay 711

Independent Living

Independent Living

Your well-being is our priority. Enjoy life to the fullest, doing the things you want to do rather than what you have to do. Pop by and see how Life is Just a Little Easier Here.

3710 American Way, Missoula

(406) 273-0101

H e a l t H Pharmacy

D i r e c t o r y

Skilled Nursing

Skilled Nursing Hillside Health Care Center Caring for Our Community

New Missoula Location on South Avenue near Community Medical Center • Drive-thru on South Avenue • Locally owned • Same prices as big box stores • Locations also in Frenchtown & Philipsburg • Flu shots $15 (walk-in) 2230 27th Ave (406) 926-2940 www.granitepharmacy.com

Psychiatric Services

Variety of Services • Mental Health Treatment • Medication Management • Therapy • Migraine Treatment • Weight Loss • Draw Site For Lab Corp • Genetic Testing • Transcranial Magnetic Stimulation Treatment • Nutraceuticals • Adolescents - Adults

406-721-2537 Tmsmontana.com • Alephmt.com 2685 Palmer St. Suite A Missoula

Psychiatric Services

Hillside Health Care

A skilled nursing facility offering: 24-hour RN care; state of the art Sub-acute Rehabilitation unit designed to address the needs of the medically complex patient. Long Term Care, Pearls of Life Memory Care, Overnight at the Village, and Serenity Palliative Care.

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Skilled Nursing

Skilled Nursing

Valley View Estates

A skilled nursing facility in Hamilton providing 24 hour care, full rehabilitation services and a light care wing for those with minor health issues.

The only limited memory program with a secured unit offered in the Bitterroot Valley. Complete with Pearls of Life Signature Memory Care Program.

225 N 8th • Hamilton • 363-1144

SENIOR RESIDENCE

Spacious studio, 1 and 2 bedroom apartments with meal plans, linen service and housekeeping included. Assistance with bathing, dressing, monitoring medications, and other daily living needs. Call or stop by for a personal tour.

2815 Old Fort Rd • 549-1300

Skilled Nursing

Now Accepting New Clients

• Case Management • Adult Group Homes • Community Based Rehab & Support Staff • Recovery Mall • Health and Wellness Programs • Group Home Living • Payee Services y • Children's Mental Health Services (406) 721-2038 2685 Palmer St., Suite C Wocmt.com Same Day or Next Day Appointments

In addition to Long Term Care, Riverside’s signature Transitions Sub-acute Care program is your bridge from hospital to home – providing short term rehabilitation services for Physical, Speech and Occupational therapy.

721-0680

1301 E. Broadway, Missoula

January/February 2016 ~ living well

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32

living well ~ January/February 2016

5 ways to support a friend diagnosed with cancer Brandpoint

L

earning a good friend or family member has been diagnosed with cancer can be shocking news. You want to do anything you can to help and offer support, but it’s difficult to know what to say and do.

Cancer patients with strong emotional support tend to have a

more positive outlook and adjust better to the changes cancer treatment brings to their lives, according to cancer.org. You have the opportunity to be a part of that emotional support group and help bring about a better quality of life for your friend or family member.

January/February 2016 ~ living well

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Here are some ideas for what you can do right now:

Give the gift of a clean home.

One of the most beneficial things you can do to help are everyday tasks that get forgotten like grocery shopping or cleaning the house.

Sometimes it’s the unexpected that makes the biggest impact. Cleaning for a Reason is an organization that partners with professional residential maid services to provide free house cleanings to women battling cancer. With more than 1,200 local maid services in all 50 states, this organization helps women focus their energy on fighting cancer.

Make plans.

Spend time with your friend just like you did before the cancer diagnosis. Short, regular visits are always better than long, infrequent ones. Always be sure to call ahead before your visit. Be flexible and understanding if your friend suddenly isn’t feeling up to a visit.

Encourage other family members.

People tend to focus solely on the cancer patient, which puts their caregivers and family members on the back burner. These caregivers are under a lot of stress trying to cover both their existing roles and the new responsibilities of caring for someone who is sick. Offer to babysit the kids for a night or drive them to their after-school activities. Don’t forget to take time to ask how the rest of the family is doing.

Be careful with gifts of food.

While cooking a meal or bringing over baked goods may seem like a good idea, your friend may have diet restrictions during treatment. Cancer patients often have symptoms of nausea and vomiting, so always ask before you bring over a dish to share.

Maintain your support.

Cancer patients need steady support during the entire process. It’s easy to be there during the initial diagnosis, but it’s the people who stick around that truly make a difference.

Make an agreement with your friend group, church group or other organization to take turns offering support. Even if your friend turns down help, ask again every week or two, so it’s clear you are always willing to be there.

Learn more about supporting a friend with cancer by visiting cleaningforareason.org.

34

living well ~ January/February 2016

Heal at your own pace.

If it weren’t for the care and expertise that I received from the therapists at The Village Health Care, I would not be walking today!

Pat Swanson

My occupational and physical therapists were instrumental in getting me back on my feet after my hip surgery. I can’t say enough good things about them.

Celia Linsted

Do you need a post-hospital rehabilitation stay?

One of our communities can help.

Surgeries or illness often require more recovery time than is anticipated.

We offer post-hospital supportive services nearby for your recovery.

• Evolutions Therapeutic Recovery Center

• Transitions Sub-Acute Care

• Sub-Acute Rehabilitation Unit

• Physical, Occupational, and Speech Therapy

• Physical, Occupational, and Speech Therapy

• Physical, Occupational, and Speech Therapy • Care for MedicallyComplex Cases

• Private Rooms

www.hillsidesenior.com 406-251-5100 4720 23rd Avenue, Missoula A Platinum Service® network of providers

www.riversidesenior.com 406-721-0680 1301 East Broadway, Missoula

www.villagehealthcare.com 406-728-9162 2651 South Ave. West, Missoula

Call for a tour today!

January/February 2016 ~ living well

35

Amber Jackson

Breast Cancer Survivor

My superpower is

attitude.

Stronger than her initial uncertainty, more powerful than her diagnosis, Amber’s ‘can-do-anything’ attitude helped her to kick cancer’s butt.

It’s this same attitude that gives her the power to embrace a new life.

Embrace your inner superhero to do great things.

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living well ~ January/February 2016

communitymed.org