HoosierTimes Breast Cancer Awareness 2013

October is

Breast Cancer Awareness Month

“Raising Awareness Through Education”

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Gena Asher, now marking her 12th year as a breast cancer survivor, was honored in 2007 with the Melody Martin Awareness Saves Lives Award for development of a blog devoted to breast cancer education. Asher is shown here facing the camera as she receives the award and a hug from the daughter of the woman in whose memory the award was established.

Asher also is author of the story that begins on this page.

DAVID SNODGRESS| HERALD-TIMES

Month one of hope, spirit and fight in a war

By Gena Asher Special to the H-T

October brings fundraising walks and even more pink ribbons than usual, so it’s virtually impossible to ignore Breast Cancer Awareness Month. What draws the

big crowds to walks and fundraisers, however, is fear: Fear of receiving a breast cancer diagnosis yourself or in your family; fear that you’ll lose another person close to you to the disease; or fear that, if you are a survivor, the disease may recur.

One antidote is knowing that help is available should any of those fears come true. In 12 years as a breast cancer survivor, I’ve encountered health care professionals and survivors-turned-activists, all of whom have turned fear into life’s greatest motiva-

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tor by arming themselves and those in their care with information.

If you don’t already know the numbers, they are part of the October litany. According to the American Cancer Society, breast cancer is the second leading cause of cancer death in the United States (lung cancer is first) and the most frequently diagnosed cancer among U.S. females (excluding skin cancer). In 2011, more than 230,000 women were diagnosed with invasive breast cancer, and 39,520 died of

the disease. Breast cancer also occurs in about 2,000 U.S. men a year.

You’ve probably heard that one in eight women will develop breast cancer in her lifetime. Your risk increases as you get older: Your risk is one in 1,790 in your 20s, one in 229 in your 30s, one in 69 in your 40s, one in 42 in your 50s, one in 29 in your 60s and one in 27 in your 70s. So you can see that age is a risk factor: The older you get, the more your risk increases.

The good news is that there are more than

2.6 million breast cancer survivors in this country, and mortality rates have been on a slight downward trend since 2003.

Even if you do turn out to be one of those numbers, don’t panic. It’s natural to be rooted to the ground in fear when a medical professional tells you that you have breast cancer, but this is no time to be immobile. Doctors expect you to participate in the many decisions you face, and you’ll have to educate SEE FIGHT | PAGE F4

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Pink is the color for the fight against breast cancer as shown during the 2011 Making Strides Against Breast Cancer walk at Karst Farm Park.

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THE STRENGTH IT TAKES

A Powerful Partner in the Fight Against Cancer Imagine‌ A future with less cancer. A future that, because of advanced technologies and the skill and experience of dedicated healthcare professionals, offers better outcomes for survival. Indiana University Health gives those in South Central Indiana access to innovative cancer services. The IU Health Cancer Centers are more than one building in one location. We are a collection of facilities and multidisciplinary teams of specialists bringing patients a collaborative approach to the treatment of cancer. And, patients have access to research, clinical trials and alternative treatment options through the IU Health Melvin and Bren Simon Cancer Center as well as the Indiana University Health Proton Therapy Center.

When you need specialized breast care, we provide it.

Early Detection Saves Lives.

Schedule Your Mammogram Today.

Together, the IU Health Cancer Centers stand strong with you in the fight against cancer.

Meet Lisa Korff, MD

IU Health Morgan Hospital Cancer Center is proud to welcome Lisa R. Korff, MD, to our team. A fellowship-trained breast surgeon, Dr. Korff is recognized as an expert for her ability to provide specialized diagnostic and treatment options for patients with benign and malignant breast diseases. She has completed training in breast imaging, pathology, surgery and genetics.

Dr. Korff is available to consult with all patients with suspected breast disease or cancer.

To schedule an appointment with Dr. Korff, please call 765.349.6792.

IU Health Morgan Hospital 2209 John R Wooden Drive | Martinsville, IN

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FIGHT

Month one of hope CONTINUED FROM PAGE F2 yourself.

Medical facilities offer resources that range from patient navigators or guides to access to printed and Web-based materials to less structured programs and services. IU Health Bloomington’s Olcott Center for Cancer Education offers all three, starting with certified oncology nurses who also are patient guides.

“A woman who is diagnosed at SIRA (Southern Indiana Radiological Associates), for example, will see one of our patient guides within minutes of hearing she has breast cancer,” said Janice Ross, director of the Olcott Center. “The guide talks with her, shows her a booklet with a timeline and other information, and begins a relationship that goes on throughout treatment.”

An Olcott nurse will call within 48 hours to make sure the patient has sched-

MONTY HOWELL | HERALD-TIMES

Lily Roberts waits in a stroller with her family and walkers assembling for the Breast Cancer Awareness Walk at Showers Plaza in 2009.

uled appointments and to that time if they have quesanswer any questions, she tions or concerns. said. Sometimes, women Information also comes come to the center before in the form of second or third opinions. When you are panicked by a diagnosis, Join The Fight Against you naturally want to hurry toward fixing the problem, but take time to talk to other medical people. If all have the same analysis of your situation, you’ll feel confident. If they have varying opinions, you’ll need to weigh all the advice against your own information and feelings. As a consumer, I always get three estimates for any kinds of repair work, so why would I not get several opinions from professionals with whom I would entrust my life?

Regardless of who is on your team, your case probably will be part of a weekly discussion among cancer professionals in the area. In Bloomington, medical professionals involved in cancer treatment meet weekly

Breast Cancer

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Help support the many organizations in our community with their important cancer fighting missions

When you don’t have a guide by your side, take along a trusted friend to your appointments. When you are the patient, you may hear one or two scary words that highjack your ability to concentrate for a minute or two. The trusted friend provides an extra set of ears for moments like these. If you don’t have a friend to take along, take a recorder so you can listen later to all the details you may have missed.

You won’t be able to make all the decisions at once, anyway. In some cases, treatment decisions hinge on the tumor properties and other data not available until after biopsy or surgery. While it is a good idea to look ahead at the big picture, try not to anticipate the possible outcomes that might happen. You’ll have COURTESY PHOTO information overload, and Breast cancer survivor Gena Asher maintains her breast cancer some of those scenarios website at www.breastcancerfyi.org. may never occur, yet you’ve to discuss patients, ensuring coordination of each patient’s treatment. This way, by the time a patient moves to the next doctor for the next part of treatment, that doctor already has files and records. Even

12 years ago, this system was in place. Though I had already mapped out my own time line, I was reassured when a doctor called me to make sure I had an appointment to begin his part of the treatment.

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DAVID SNODGRESS | HERALD-TIMES COURTESY PHOTO

Hands joined in circle together hold a breast cancer struggle symbol. wasted time and energy worrying about them.

Most south-central Indiana communities have cancer support groups available, some specifically for breast cancer and some for people with any kind of cancer. No matter how many friends and relatives are helping you, you’ll find comfort in talking with people who have been through what you are facing. Initially, I figured support groups were for people who didn’t have anyone else in their lives, and I guessed that the whole scenario would be a Pity Party of the first order.

Instead, I found a set of instant friends, women who bluntly shared their advice and warnings about treatment and procedures as well as their emotional worries about their families and jobs. You are joining an exclusive club, and while no one wants to be a member, the support group experience can be enriching on many levels.

Some women find the group experience helps them evolve from fright-

ened cancer patients to comforting counselors for the next wave of newly diagnosed.

Ross said women in treatment and survivors attend the center’s twicemonthly breast cancer support groups. Churches, community groups and individuals in south central Indiana also host support groups for breast cancer.

You are likely to find one that suits your outlook by networking with Ross, medical practitioners or organizations such as the American Cancer Society, Komen Race for the Cure affiliates or Pink Ribbon Connection.

Not into the whole group thing? Talk to a patient guide, social worker or nurse one-on-one. Network to find someone whose expertise and outlook you value.

Or, tap into programs that aren’t support groups but are groups of people in similar situations. The YMCA co-sponsors the WISE program for cancer patients who wish to stay

More info For more on Bloomington’s Breast Cancer Awareness Walk, go to http://siraonline. com/walk.htm fit during and after treatment. Working out under supervision in a program tailor-made just for you is valuable to making a comeback from cancer; doing so with other patients and survivors provides an oasis in a storm.

Hopefully, you won’t ever join the ranks of the breast cancer patient population.

Ross reminds women that the best prevention is a healthy lifestyle and to know your body. When something feels wrong, get checked, she says.

In the meantime, lace up your shoes for October’s fundraisers.

The American Cancer Society’s Making Strides Against Breast Cancer is Oct. 12, and the Bloomington Breast Cancer Awareness Walk is Oct. 19.

In this picture from 2008, physician Bruce Monson explains new digital mammography equipment at Bloomington Hospital that provides a sharper, more clear view of the patient’s breast tissue. Both that hospital, now IU Health Bloomington Hospital, and Monroe Hospital have incorporated such new technology to assist in detecting breast cancer as early as possible, a critical factor in saving lives.

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Breast cancer a concern for young Metro Creative Connection

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At the age of 12 to 15, many young women are experiencing the body and life changes that accompany adolescence.

It can be difficult to imagine that breasts that are just beginning to develop may contain cancer. But such is the reality for some girls.

The majority of women who receive a breast cancer diagnosis are 40 or older. Experts at Monroe Carell Jr. Hospital at Vanderbilt University note that only 5 percent of breast cancer cases are found in women younger than 40. However, the hospital recently treated a 14-year-old girl who found a lump and learned she had a rare form of breast cancer called a phyllodes

tumor. Though such cases are rare, it behooves teenage and adolescent girls to familiarize themselves with the disease and be mindful of their breast health.

Some organizations have increased breast cancer messages for young girls and even conduct breast cancer workshops to educate young women about breast health. Dorothy Paterson of Texas, a former Girl Scout leader who was diagnosed with breast cancer herself, began conducting workshops for Girl Scouts in 2007. The idea isn’t to scare girls into believing they have the disease, but rather to increase their awareness of changes in their bodies that may or may not be normal.

Friend’s death inspires production of handbook on how to help out Special to the H-T

When a friend or relative is diagnosed with cancer, what do you say?

Ignore the elephant in the room and talk about anything but cancer? Ask what may be insensitive questions?

A book published earlier this year offers advice for those helping a friend or loved one navigate the cancer maze.

“When Cancer Strikes a Friend” was 10 years in the making, and aims to be a handbook for those who want to help in caring and meaningful ways the cancer patients in their lives. It

includes chapters on communication techniques; understanding cancer and the patient experience; gifts and sharing; “everyday, nitty-gritty help”; and spiritual care.

Author and former Bloomington resident Bonnie Draeger and her colleagues conceived the idea when her close friend died of breast cancer at 37.

Draeger is co-founder and director of the nonprofit In Marjolein’s Memory, also known as Friends & Cancer, a public charity dedicated to creating materials to prepare and encourage friends to help and support people with cancer.

Draeger and Friends & Cancer colleagues first surveyed focus groups around the country to determine if such a book was necessary and, if so, what format it should follow. Draeger drew on her experiences as a writer and as an ordained deacon

in the United Methodist Church.

She enlisted help from pros with expertise, including oncologists, plastic surgeons, counselors and therapists. But she also includes contributions from cartoonist Dave Coverly, a father-daughter cancer advocacy team and an ordained Zen Buddhist priest. The book features a glossary of cancer terms and several listings for suggested readings.

Four Bloomington people contributed chapters: Gena Asher of BreastCancerFYI.org, on using the Web responsibly and finding credible cancer information; Janice Ross of the Indiana University Bloomington Health Olcott Center for Cancer Education, on what to say at certain points in the friend’s cancer timeline; Catherine Sherwood-Laughlin, IU health sciences professor who has taught a popular course on cancer, on physical effects of cancer and its treatment; and Peg Stice, co-founder of Friends & Cancer and chairwoman of the board of directors, on becoming a cancer advocate.

The organization donated 2,000 copies to cancer centers and libraries when it was published in October 2012. It is available through most online book outlets as well as on the Friends & Cancer website, www. friendsandcancer.org.

H-T FILE

Pink bursts out all over the Indiana University campus as the Hoosiers Outrun Cancer Run and Walk, which raises money for local medical research and equipment, approaches every year.

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Olcott Center invaluable community resource

By Gena Asher Special to the H-T

If you are walking or running for breast cancer this fall, chances are you are supporting IU Bloomington Health’s Olcott Center for Cancer Education, a frequent recipient of the efforts of such events.

Hoosiers Outrun Cancer, held Sept. 28, is one of the main sources of funding, and other walks, such as Bloomington Breast Cancer Awareness Walk, often donate funds generated by sponsors or participants to the center or the center’s Girlfriend Fund.

Olcott director Janice Ross said such support means the center can expand and adapt its services to accommodate cancer patients’ needs.

“We are 100 percent funded through the Bloomington Hospital Foundation, through donations from community,” Ross said. “All of the money stays locally to take care of patients in our area.”

Those patients include about 800 newly diagnosed cancer patients each year, 100 of whom are breast cancer patients, as well as people who have been using the center’s services for several years, such as

those with chronic conditions or survivor issues.

Hoosiers Outrun Cancer raises about $180,000 per year. But smaller events, such as golf and euchre tournaments, and individual donations also generate funds to support programming.

The center has expanded that programming in the past two years. When Beautiful Creations, which had long supplied mastectomy supplies, went out of business, Olcott nurses trained to become certified fitters to bring the service to the center. Education programs on various topics, expanded support groups and a wig bank also take space at the center, housed in a First Street building south of the hospital.

Other services include outreach, taking cancer education on the road to fairs and events where Olcott nurses share prevention tips, and visiting schools to educate teens on cancer.

Ross said recent focus has been to identify barriers in the way of patients continuing treatment. The Girlfriend Fund, established a decade ago by a cancer survivor to fill gaps for patients who can’t afford

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IU Bloomington Health’s Olcott Center offers many services including helping fit women after they have a mastectomy.

DAVID SNODGRESS | HERALD-TIMES

Participants in the Breast Cancer Awareness Walk march down the sidewalk on Kirkwood Avenue in November 2010. The group walked past the courthouse to Sample Gates and back to Showers for the event. wigs or other incidentals, has become a safety net for many.

“The goal of the fund is to help people get through treatment, and we’re finding that this means gas cards in a lot of cases,” Ross said. “We don’t want transportation to be a barrier to treatment. This is a nationwide problem in cancer care.”

Other people may have needs not met by insurance, such as wigs or prostheses, and the center relies on the Girlfriend Fund for these.

On her wish list are an educational series that would bring guest speakers to talk about nutrition and sexuality, common concerns for patients, and programs that use art and music as therapy or avenues of self-expression for cancer patients.

“We have to value programs that may not bring in revenue but are the right things to do for patients,” Ross said.

To Our Community: Dr. Lisa Jerrells and Kathy Pafford LME would like to introduce our Women in Need program. Do you know a woman in your life who is battling cancer, or who is going through a divorce, or just a rough time in her life and needs some support? Have you ever experienced hard times yourself and appreciated support of your friends and family? Now, you can give back.

If you purchase a gift of $350 for a woman in need, she will receive expert care at the hands of Kathy Pafford, licensed medical aesthetician. The gift can be used toward epionce products, microdermabrasion, chemical peel, facial, and botox, as long as the client is not undergoing chemotherapy. A portion of proceeds will be donated to an appropriate charity that benefits women in need each year.

Please call us today to be a part of this program: (812) 334-2772.

Sincerely, Dr. Jerrells Kathy Pafford LME Carol Wellman, team member

Learn. Heal. Live.

Have a health question?

Ask a local health professional—join INstride’s monthly live chat and participate in the discussion. Visit myinstride.com/chat to submit your questions, follow the conversation, or read transcripts of past chats. Like INstride on Facebook to learn more.

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Screening, early detection can help to save your life American Cancer Society shares its guidelines

discuss their options with their physicians.

Metro Creative Connection

Men and women should begin screening for colorectal cancer and polyps beginning at age 50. Polyps are growths on the inner surface of the colon that are often noncancerous, but some can develop into cancer.

Some tests may be conducted to find both polyps and cancer, and these tests should be conducted at various intervals. Beginning at age 50, men and women should get a flexible sigmoidoscopy every five years, a colonoscopy every 10 years, a doublecontrast barium enema every five years, or a CT colonography, also known as a virtual colonoscopy, every five years. When tests other than a colonoscopy are positive, then a colonoscopy should be conducted as well.

Testing can also be conducted to detect colorectal cancer. Beginning at age 50, men and women should receive an annual fecal occult blood test or a yearly fecal immunochemical test. When results are positive, a colonoscopy should be conducted.

Early detection of cancer greatly increases a person’s odds of surviving this potentially deadly disease.

Screening can range from relatively simple self-examinations to more complicated procedures conducted by physicians.

The following are the widely accepted screening guidelines, courtesy of the American Cancer Society.

Breast cancer

Women should begin self-examinations of their breasts starting in their 20s. This helps women familiarize themselves with their breasts early on, which makes it easier to detect any abnormalities, including lumps, later in life.

In addition to breast self-exams, women should receive clinical breast exams, or CBEs, every three years while in their 20s and 30s, and then an annual CBE starting at age 40. The ACS also recommends women begin receiving annual mammograms starting at age 40. Some doctors may also recommend women with a family history of breast cancer or other significant risk factors receive an MRI in addition to a mammogram. These additional tests are rarely necessary, but women at a higher risk of breast cancer should

Colorectal cancer and polyps

Lung cancer

Despite the prevalence of lung cancer, the ACS advises against screenings for lung cancer in people whose risk for developing the disease is average. But the ACS does recommend screenings for those individuals who are at high risk for the disease. These

include men and women who meet all of the following criteria: 55 to 74 years of age; in fairly good health; have at least a 30 pack-year smoking history and are either still smoking or have quit smoking within the past 15 years.

More information about lung cancer screening is available at www.cancer. org.

Endometrial (uterine) cancer

According to the ACS, at the time of menopause all women should discuss the risks and symptoms of endometrial cancer, often A radiology technician examines a mammography image. referred to as uterine cancer.

Detection often begins with women themselves, who should report any bleeding or spotting to their physicians immediately upon detection.

Some women may be candidates for yearly endometrial biopsies. This includes women who have hereditary nonpolyposis colon cancer, or HNPCC, a condition also known as Lynch syndrome.

Women known to carry HNPCC-linked gene mutations are also candidates.

Women from families with a tendency to get colon cancer where genetic testing has not been done also are candidates for yearly endometrial biopsies. These yearly biopsies should begin at age 35, and women should discuss the risks, benefits and limitations of the tests with their physicians.

More information on cancer screenings is available at www.cancer.org.

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Breast cancer treatment light years beyond early days

By Brian Culp bculp@schurz.com

MARTINSVILLE — There was a time that the cure for breast cancer was simply barbaric, said Dr. Lisa Korff, a fellowship trained breast surgeon at Indiana University Health Morgan Hospital.

“Breast cancer treatment has come a long way,” Korff said. “There was a time when the treatment was a radical mastectomy.

That was disfiguring and morbid.”

Radical mastectomies were performed as a treatment for breast cancer as early as the late 19th century, according to the American Cancer Society’s website.

In such surgery, the sur-

geon removes the breast, chest muscle and underarm lymph nodes.

Radical mastectomies stopped being the standard of care in the 1940s with modified radical mastectomies that spared the muscles. The procedure continued to evolve with lumpectomies in the 1970s and varying degrees of radiation and chemotherapy.

The goal of these changes has been to increase the survival rates and decrease the recurrence rates for breast cancer, Korff said.

“We found that the more radical approach wasn’t always necessary, and we can do things that will be just as effective.”

Radiation increased survival rates as early

as the turn of the 20th century, according to the American Cancer Society’s website. Radiation was used to shrink cancerous tumors prior to removing them. Today, much more targeted radiation is still used.

Chemotherapy was introduced in the 1940s.

It decreased the size of tumors pre-surgery, but it was also used afterwards to prevent recurrence and treat cancer that had metastasized.

The evolution of breast cancer treatment has gotten more and more individualized, Korff said.

“The treatment for one person might be very different than for another; in fact, it likely will be different,” she said. “We take

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into account the biology of a tumor, where it has spread and many other factors.

“More and more can be done on a molecular level to address cancers these days.”

New therapies

Korff said selective estrogen receptor modifiers, aromatase inhibitors and targeted hormonal therapies also have dramatically changed breast cancer treatment and increased survival rates.

Selective estrogen receptor modifiers fight cancers that need estrogen to grow by limiting the ability of estrogen to enter the cancer cell, according to the American Cancer Society.

Aromatase inhibitors are for post-menopausal women and work by reducing the estrogen available to cancer cells. Targeted hormonal therapies use a drug that binds to a particular form of breast cancer that has too much of the HER2/neu protein on its surface. It destroys the cancer cells, but very little healthy tissue. Herceptin paired with chemotherapy cuts recurrence of HER2/ neu-positive breast cancer by 50 percent.

The most successful tool for helping women survive breast cancer, however, is earlier detection, Korff said.

“Screenings have helped us find breast cancers at an early stage,” Korff said. “We are seeing women who come to us in much earlier stages when treatments can be more effective.”

Some of that is because more people are getting SEE TREATMENT | PAGE F11

REPORTER-TIMES FILE PHOTO

Lisa Korff Q Physician and surgeon Lisa

Korff Q Joined Indiana University

Health in 2012.

Q Is fellowship-trained breast

surgeon with additional training in breast imagine pathology, surgery and genetics.

Q Provides specialized diag-

nostic and treatment options for patients with benign and malignant breast diseases.

Q Originally from the rural

Evansville area, Korff earned undergraduate and medical degrees from Indiana University Q Residency at Carl T. Hayden

VA Medical Center in Phoenix; following residency, worked there for three years.

Q One-year specialized breast

surgery fellowship at Grant Medical Center in Columbus, Ohio.

Q Goal: To help patients

beyond just curing their cancer.

“There’s a lot to go through, not just physically, but emotionally as well,” Korff said. “There are a lot of issues afterwards that deal with survivorship — such as, have they learned about diet or exercise as well as intimacy and sexual health.”

Research moving toward genetic links CONTINUED FROM PAGE F10 screened and are following guidelines set by the American Cancer Society, which is to get a mammogram every year after the age of 40. But some of that is also because of advances in mammography.

Since the 1950s, advances in mammography are credited with increasing the five-year survival rate for localized breast cancer from 80 percent to 98 percent the American Cancer Society reports. Standard mammograms became popular in 1967 with X-ray equipment made specifically for that purpose.

Digital mammography was introduced in the early 1990s and offers more detailed images and easier storage for future comparisons.

Three-D mammography is the newest technology. It produces clearer images and pinpoints more cancers and might someday lead to recommendation that the frequency of mammograms should be reduced by half, the American Cancer Society says on its website.

What’s to come

The future of breast cancer treatment really lies in the area of genetics and in studies that look at people who are being treated and have been treated and how they react to those treatments, Korff said.

“We have to give thanks to patients who participate in clinical trials,” Korff said.

“That’s how we learn how to improve breast cancer care. It wouldn’t happen if people weren’t willing to participate.”

Many of those trials look at individual cancers and the specific proteins they

Remembering Loved Ones

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TREATMENT

BREAST CANCER AWARENESS | HOOSIER TIMES | TUESDAY, OCTOBER 1, 2013 | F11 produce, Korff said.

Genetic testing also now allows doctors to pinpoint people who are more susceptible to developing breast cancer.

And some clinical trials are specifically looking at preventing and treating cancer on the celullar and genetic level.

According to an article by researcher Kathy Boltz in the Oncology Nurse Advisor, “Cellular therapy is a type of immunotherapy that uses T cells, the ‘foot soldiers’ of the immune system, which have been sensitized in the laboratory to kill breast cancer cells.

These sensitized T cells are injected into the parts of the brain to which cancer has spread. The research shows that the T cells can move through tissue and recognize and directly kill the tumor cells.

“With the gene therapy, genetically modified cancer cells are killed by a drug called 5-flurocytosine (5-FC). To get the gene COURTESY PHOTO into the cancer cells, the researchers first insert it The mammogram is a critical tool in early detection of breast cancer, which is most effectively treated early in its growth. into a virus that can infect the tumor cells. After the virus has infected the cells, LICENSED nontoxic 5-FC is given to MORTGAGE the patient. Tumor cells PROFESSIONALS infected by the virus convert the nontoxic drug to a toxic form that kills the cancer cells. Professor Noriyuki Kasahara in the department of medicine at the University of California Encouraging Awareness at Los Angeles developed Saluting Survivors the gene therapy method When you buy limited-edition hand relief™ with rosemary in his laboratory.” mint aroma, $4 U.S. of the purchase price will support crueltyBoth experimental therfree research through The Breast Cancer Research Foundation®, apies are being tested indi* and you’ll get 17% more than the regular size. That’s a positive vidually in ongoing clinical way to make a difference today! trials for primary malignant brain tumors; this pres*Maximum donation of $300,000 U.S. to The Breast Cancer Research Foundation® for research focusing on environmental and life style factors that possibly affect risk of breast cancer. No animal ents a unique opportunity NANCY KARAN MARK KATHY testing te testing. sting. Da Dates tes of pr promotion: omotion: 9/29/13 thr through ough 9/27/14.

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Think Pink Babsrvivor You are a su elf busy at the Beauty rs - Keeping you n Salo s power walk - Your dailyy friends and church - Your man ups e prayer gro g and we believe in th in ss le b a - Such yer. er. power of pra Love, with a pray ily m a F d Mother an In Honor of my Sister, Linda Connors She fought like a girl and won! Love you, JoEllen & The “Pinkettes”

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Eating lots of fruits and vegetables as part of a low-fat diet is something that has been found to help reduce the risk of developing cancer.

Fighting cancer with food Metro Creative Connection

Leah

In Memory Of Carolyn Mann We lost Carolyn to cancer after a very painful 4 months. Carolyn was a very kind and talented person.

We miss and love her so much.

Husband Jim, Children- Cathy, Tami, Cherie & Julie, Grandchildren, Sister-In-Law Cheryl, Aunt Jakie, and their cat and dogs that she & Jim adopted that she loved and was so kind to Carole Briles 23 years of Congratulations on You are a survivor! celebrating life. ious gift Each day is a prec ilities. wrapped in possibd live each day to an Continue to enjoy . st the fulle from your pals, Hugs and Love Minnie, Sandy, Sharon, and Marilyn

In Honor of Our Mommy, a Strong Survivor!

Tootie Skaggs doctors and nurses for I was sad for her and scared for her. I want to thank the ney ~Syd y! momm helping my mommy. I love my me being in preschool I want to thank the doctors who helped my mother. With teacher, Mrs. Heck, my and kindergarten, I want to also thank my elementary a million thank yous elementary principal, Mrs. Gearheart. I also want to send y when times were to the Morgan County Cancer Center for helping my famil ~ Spencer tough. I love you, Mom! my mom would die. I want to thank the afraid was and bad felt I , I was scared I love how she laughs doctors for helping my mommy get better. I love my mom! ie ~Sad me. and smiles! I love how she loves

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Tonya You have show n are answered us all how prayers Your faith an . d co inspiration to urage are an all of us.

We love you more tha words can sa n Jason, Britta y Jeff, and Rh ny, onda

Few, if any, families can say they have never had an experience with cancer.

While cancer can be treated effectively, there is no way for men and women to eliminate their risk of developing cancer.

Though cancer may strike even the healthiest of persons, there are ways men, women and even children can reduce their risk. One such way is to consume certain foods that researchers feel can reduce cancer risk.

Though precisely how these foods fight cancer remains a mystery, cancer researchers believe they can effectively lower an individual’s cancer risk when combined to form a healthy diet.

Q Beans: Beans boast numerous healthy attributes, and their potential to reduce cancer risk is one such attribute. Beans contain many phytochemicals that researchers believe protect the cells from the type of damage that can ultimately make a person susceptible to cancer. Beans also have

been shown to decelerate tumor growth and prevent tumors from releasing potentially harmful substances that can damage nearby cells.

Q Colorful fruits and vegetables: It may seem odd that a food’s color can have an impact on cancer risk, but colorful fruits and vegetables contain more cancer-fighting nutrients than fruits and vegetables that aren’t as flashy. Consuming such fruits and vegetables also helps men and women maintain a healthy body weight, an important benefit when considering extra weight or obesity can increase a person’s risk for multiple cancers.

Q Foods with folate: Folate is a B vitamin that can reduce a person’s risk of developing several cancers, including those of the colon, rectum and breast. Those who are fond of a healthy breakfast to begin their day may already be getting healthy doses of folate, which can be found in eggs, fortified breakfast cereals, orange juice and

strawberries, among other foods. If toast is your breakfast of choice, opt for whole wheat toast, as whole wheat products are a good source of folate.

Q Grapes: Studies have shown that resveratrol, a key ingredient in grapes, may prevent the type of damage that triggers the production of cancerous cells. Though scientists are not yet comfortable saying grapes, or beverages like grape juice and wine, can reduce cancer risk, they believe that the antioxidant and antiinflammatory properties of grapes make them a healthy option.

Q Water: Water may not qualify as a food, but it may protect people from bladder cancer. Potential cancer-causing agents in the bladder are diluted when drinking water. In addition, the more water you drink, the more frequently you’re likely to urinate, which means cancer-causing agents have less time to come into contact with the lining of your bladder.

BREAST CANCER AWARENESS | HOOSIER TIMES | TUESDAY, OCTOBER 1, 2013 | F13

Extra caution for black women Black women are being urged to be especially watchful for signs of breast cancer, with some researchers estimating as many as one in five black women may carry a genetic mutation that increases cancer risk. The mutation is the abnormality that convinced actress Angelina Jolie to undergo a preventive mastectomy. Researchers raised the alarm after realizing black women had been historically under-represented in tests for the mutation. Breast cancer is the most frequent cause of cancer death in black women aged 45-64.

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Radiation therapy is one of the standard treatments for breast cancer.

Doctors struggle over use of ‘c-word’ CLEARWATER, Fla. — Dr. Peter Blumencranz knows the scientific case against aggressively treating certain precancerous conditions.

But he also knows what can happen in an exam room.

He tells a patient with ductal carcinoma in situ (DCIS) — often called “stage-zero breast cancer” — that she shouldn’t panic. A few abnormal cells are lodged in a milk duct and may never grow into a dangerous cancer. He tells her she has options — but no guarantees. For some patients, that’s not enough.

“They’ll say, ‘This has tied me up so much. ... I just want my breasts off.

I don’t want to deal with it again,’” said Blumencranz, a surgical oncologist and medical director of the Morton Plant Mease Comprehensive Breast Program. “I try to talk them out of (mastectomy), but sometimes it’s hard.”

Such interactions between doctors and patients illustrate the complexity of the growing debate about how to deal with conditions that may — or may not — become a deadly cancer.

A group of prominent experts advising the National Cancer Institute concluded recently that screening for certain cancers — breast,

prostate, lung and thyroid — has detected many abnormalities that aren’t dangerous and don’t require treatment. In such cases, the chemotherapy, radiation and radical surgeries can be worse than the disease they are trying to prevent, the scientists wrote in an article published in the Journal of the American Medical Association.

Post mastectomy, women may face extensive reconstructive surgery or emotional anguish. Some can develop painful lymphedema.

All surgeries carry risks such as infections, reactions to anesthesia, even death.

During the past three decades, improved screening has increased the overall number of cancer detections. But for certain cancers, there haven’t been comparable reductions in cancer-related deaths, the authors noted. This fact suggests that in many cases, the cancers that have been found would not have been fatal. Meanwhile, deadlier cancers may crop up so rapidly, they evade annual screenings.

The researchers argue for renaming some conditions to exclude the word “cancer” so that patients will be less likely to push for treatment that could cause more harm than good.

That means, for instance, dropping the word “carcinoma” from “ductal carcinoma in situ.”

Such changes could be years in the making — and shouldn’t happen until scientists figure out how better to distinguish the harmless cases from the lethal ones, say some local doctors.

“I’m sure that we do overdiagnose and overtreat certain patients,” said Dr. Jack Steel, a Tampa Bay Radiation Oncology surgeon who treats many prostate-cancer patients. “The problem is, we don’t know which ones.”

Dr. Lodovico Balducci, a geriatric oncologist at Moffitt Cancer Center, pointed out that screening has reduced deaths from cervical and colon cancers. Yet he is convinced by numerous studies that too many men have had risky and painful treatment for prostate cancers that might not have ever spread.

“I think there’s a delicate balance that we need to exercise,” he said.

But he has seen enough complicated cases to know that it’s impossible to be definitive. Doctors say their conversations about cancer have evolved. Not only are there better treatment options, genetics can predict risk for a number of cancers.

Many patients realize a cancer diagnosis often is not a death sentence.

“Have things changed? I’ll say,” said Blumencranz. “If you look at breast cancers, stages one and two, most of those are cured these days.”

10

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F14 | TUESDAY, OCTOBER 1, 2013 | THE HOOSIER TIMES | BREAST CANCER AWARENESS

Warriors in the fight Perhaps because they are thrust into the spotlight so often, people believe that celebrity musicians, actors and sports figures are invincible. But many well-known women have battled breast cancer. Some have beaten the disease, while others succumbed. Each can help shed light on just how pervasive breast cancer can be and how no one is immune.

Anastacia, pop singer Christina Applegate, actress Q Brigitte Bardot, actress Q Merideth Baxter, actress Q Ingrid Bergman, actress Q Shirley Temple Black, actress Q Nancy Brinker, founder of Susan G. Komen for the Cure Q Agnes Chan, singer Q Sheryl Crow, singer ETHERIDGE Q Bette Davis, actress Q Barbara Ehrenreich, author Q Q

Melissa Etheridge, singer Edie Falco, actress Q Peggy Fleming, ice skater Q Jill Ireland, actress Q Kate Jackson, actress SIMON Q Betsey Johnson, clothing designer Q Susan Kadis, Canadian politician Q Hoda Kotb, TV host Q Linda McCartney, singer Q Kylie Minogue, singer Q Diana Moran, model Q Janet Napolitano, U.S. Secretary of Homeland Security Q Olivia Newton-John, singer Q Guliana Rancic, TV personality Q Nancy Reagan, former First Lady Q Lynn Redgrave, actress Q Robin Roberts, TV host Q Carly Simon, singer Q Jaclyn Smith, actress Q Dame Maggie Smith, actress Q Suzanne Somers, actress Q Dusty Springfield, singer Q Wanda Sykes, comedian Q Q

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Komen for the Cure founded in memory of a sister lost to cancer Metro Creative Connection

Few people who have waged war with breast cancer are better known than Susan Komen, a name many instantly associate with the organization Susan G. Komen for the Cure, the most widely known, largest and well-funded breast cancer organization in the United States.

Susan G. Komen was born Susan Goodman in 1943 in Peoria, Ill. According to her sister, Nancy, Susan was the high school homecoming queen and a college beauty queen.

After graduating from college, Goodman returned to her hometown and pursued modeling, eventually marrying her high school sweetheart, Stan.

Komen was diagnosed with breast cancer in 1977 after finding a lump that subsequent testing revealed was cancerous. Komen underwent a procedure called a subcutaneous mastectomy, in which the outside of the breast tissue was left intact, but the interior breast tissue was removed. The doctor who did the procedure assured Komen that she was cured. Her sister urged her to get a second opinion, but Komen was convinced she was safe. But within six months Komen found another lump under her arm, and, by this point, it was evident that the cancer had spread. Doctors at the Mayo Clinic soon determined the cancer had metastasized to her lung and under her arm.

Komen underwent several different treatments to slow the progression of the cancer, including radiation and intense chemotherapy.

However, the cancer continued to spread, and eventually her body developed a resistance to most of the medication. During treatment, Komen repeatedly spoke with her sister about her wish to make the entire breast cancer experience and treatments in the hospital more palatable for women, including improving the appearance of waiting rooms and treatment centers, and

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Nancy Brinker, founder and CEO of Susan G. Komen for the Cure, began the foundation in her sister’s memory in 1982. doing other things to help comfort those who would find themselves in similar situations in the future.

Komen lost her battle with breast cancer in 1980 at age 36. By the time of her death, Komen had undergone nine operations and three courses of chemotherapy and radiation.

Nancy Goodman Brinker then made it her mission to do everything she could to help end breast cancer and increase awareness of this potentially deadly disease. In 1982, Brinker established the Susan G. Komen Breast Cancer Foundation in her sister’s memory. Since its inception, the organization, now called Susan G. Komen for the Cure, has provided funding for basic, clinical and translational breast

cancer research projects. It also has become instrumental in breast health education and urging women to do self-screening while promoting annual mammograms. Through the years, the foundation has teamed up with many well-known businesses, brands and organizations as part of its fundraising efforts. To date, the organization has invested $750 million in breast cancer research, awarding many thousands of dollars in grants in countries around the world.

Through her struggle with breast cancer, Susan Goodman Komen unknowingly inspired an organization that has helped to save the lives of millions. Learn more at ww5. komen.org.

BREAST CANCER AWARENESS | HOOSIER TIMES | TUESDAY, OCTOBER 1, 2013 | F15

CHRIS HOWELL | HERALD-TIMES

Thousands participate annually in Hoosiers Outrun Cancer, a huge community event that attracts thousands. This picture is from the 2012 run and walk. This year’s event was held last Saturday.

You can take several steps to reduce your cancer risk Breast cancer is the second most common cancer among women, second only to lung cancer.

One in eight women is expected to develop breast cancer in her lifetime, and a recent survey by the Society for Women’s Health Research found that 22 percent of women named breast cancer as the disease they fear most.

The specter of breast cancer makes it no surprise that women are eager to seek various ways to reduce their risks of developing this potentially deadly disease.

Though cancer treatments continue to evolve, there remains no cure for breast cancer or any other types of cancer.

However, there are steps men and women can take to reduce their risks of developing breast cancer.

In fact, the National Cancer Institute says avoiding breast cancer risk factors is the best path to prevention.

Some of the actions to reduce the risk include: Q Avoid

exposure to radiation. Repeated exposure to radiation therapy used to treat illnesses such

as Hodgkin’s disease can increase a person’s risk of breast cancer, particularly if treatments begin at an early age.

Q Keep a healthy weight. Obesity increases the risk of breast cancer, particularly in postmenopausal women. Healthy eating and exercise can help women control their weight while reducing their risks of developing breast cancer and a number of other diseases.

Scientists at the Mayo Clinic believe there is a link between estrogen production in fatty breast tissue and breast cancer.

Q Get your exercise.

Exercising four or more hours a week can lower breast cancer risk. Exercise need not be heavy lifting at the gym. Any moderate physical activity, from cycling to walking, can be effective. Exercise decreases hormone levels in the body that can raise breast cancer risk. Some studies indicate simply walking briskly for one to three hours per week can reduce a woman’s breast cancer risk by 18 percent.

Q Eat a low-fat diet.

The Women’s Intervention Nutrition Study from the National Cancer Institute found that the high-

est rate of breast cancer reduction was among a group of women who ate a low-fat diet.

Q Reduce alcohol consumption. Various studies have indicated that women who drink alcoholic beverages may develop cancer at a higher rate.

Women who consume two to five drinks daily have a greater risk of developing breast cancer than those who abstain from alcohol.

Q Weigh the risks of hormone replacement

COURTESY PHOTO

Another action all women should take is to have periodic mammograms, such as can be taken with this mammography X-ray machine.

therapy. There are mixed reviews on hormone replacement therapy, or HRT, for postmenopausal women. There may be a link between long-term HRT and breast cancer, particularly when estrogen and progesterone are used in combination.

Some doctors advise estrogen-only hormone therapy for women who have had a hysterectomy.

Q Use of SER Ms and aromatase inhibitors. Selective estrogen receptor modulators, or SERMs, are drugs that act like estrogen on some bodily tissues but block the effect of estrogen on other tissues. Aromatase i n h i b i to rs de c rea s e the amount of estrogen made by the body.

Women with a high risk of breast cancer may benefit from taking a SERM or aromatase inhibitor.

Q Increase fruit and vegetable consumption.

Carotenoids are cancerprotective pigments found in a vast number of fruits and vegetables.

Researchers at New York University found women who had higher blood carotenoid levels had a significantly smaller risk of breast cancer

than women with lower levels.

Q Go sparingly on antibiotics. Only take antibiotics when they are truly needed. New evidence suggests that the more often a woman takes antibiotics, the higher her breast cancer risk. A study of more than 10,000 women found that women who took antibiotics for the equivalent of about 25 prescriptions over an average of 17 years were twice as likely to develop breast

cancer than women who never took the drugs.

Q Breastfeed your children. Lactation can suppress ovulation and the body’s production of estrogen, which has been linked to higher levels of breast cancer. Breastfeeding may drop a woman’s breast cancer risk by 4 percent.

Although there is no cure for cancer, there are a number of different ways women can reduce their risks for breast cancer.

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The Team of Choice Realty salutes all cancer survivors.

We encourage everyone to be healthy and maintain proactive health care, eat a healthy diet and be active with daily exercise. By improving our lives and the research for cancer, we can keep the memory alive of those who have lost their battles.

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