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Sunday, october 20, 2013
G2 • The Sentinel
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Sunday, October 20, 2013
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Sunday, October 20, 2013
The Sentinel • G3
Woman credits quick response in cancer recovery By Samantha Madison The Sentinel MT. HOLLY SPRINGS — When Kristy Bush called her doctor for the results of her biopsy, she immediately knew something was wrong; they didn’t usually put the radiologist on the phone. Bush had been through several breast cancer scares before, but all of the lumps found in her breasts had been benign. After her 40th birthday, Bush got another lump checked out. She was confident that the results of her biopsy were going to pose no threat to her life, she said. “I was absolutely shocked,” she said. “I was really expecting it to be nothing.” But the former oncology nurse knew what needed to be done to get on the road to
recovery as fast as possible. Bush had her MRI, and the doctors started scheduling things. However, she said they were taking too much time, so she took things into her own hands. “I started making the phone calls myself, for my own appointments,” Bush said. “I just wanted to get them done sooner. From the time of diagnosis to the time of my first chemo was two weeks, which is unheard of.” Bush was diagnosed with stage 1, triple-negative breast cancer, which tends to be found in younger patients and in people who carry a genetic predisposition for breast cancer. It is generally more aggressive than other forms, said Brynn Wolff, a breast surgeon at PinnacleHealth Breast Care Center in Harrisburg.
Knowing the form of cancer she had would not respond to hormone-based medications, Bush knew her options were limited to chemotherapy, radiation and surgery, she said. Using her resources in the oncology world, Bush set out to find a surgeon. Even though she scheduled appointments with two doctors, it only took one consultation for her to figure out who her surgeon would be. All signs pointed to Wolff. “Brynn Wolff ... is the one name I got (from my contacts),” Bush said. “I saw her, and I knew I was not going anywhere else.” From her days as an oncology nurse, Bush remembered seeing cancer return when women only had a lumpectomy or one mastectomy, so she opted for che-
Was the birth of my first son amazing?
motherapy and a bilateral mastectomy, which is the removal of both breasts. “I’m young, and my cancer was aggressive, so I wanted the best fighting chance, so I went in and told (Wolff) what I wanted to do,” she said. Wolff said Bush is an amazing person who kept a great sense of humor and was able to stay positive during the entire ordeal. “She was very matter of fact about what she wanted to do and just did it, without looking back,” Wolff said in an email. “She kept a positive attitude about everything and sailed right through her treatments, like it was just another day at work.” Wo l f f i s n ’ t t h e o n l y one who was impressed by Bush’s ability to stay
Yes.
grounded during a lifethreatening situation. Bush’s boyfriend, Wade Phillips, said she made it easy to stay positive. “It was almost as if, to the outsider, she was dealing with something as simple as a head cold,” he said. “She seemed to not run out of energy at any time (during the chemo). She was a real soldier.” Armed with her positive attitude and faith in God, Bush seemed to breeze right through the chemotherapy, not appearing to ever have a bad day, Phillips said. He said he hopes Bush is able to find a way to help other people going through the same type of situation. “I think anybody that she would talk to would find some comfort, if not a lot of encouragement, to get
through this,” he said. “I hope she can find a lot of people to help; she would definitely be an encouragement. I really look up to her. I really am proud to know her.” Bush’s daughter, Kassie, 16, said that it was scary to hear that her mother had cancer, but that she made it seem like it was not a big deal. “Initially it was scary, but then when we went through her going through treatment, it was kind of just something that was going on,” Kassie said. “She didn’t let it affect her whole life.” Kassie said going through something like this has made her family stronger and closer. When Bush started losing her hair, her children, Kassie and David, helped shave her head.
When Mindy Loftus had her first son, Drew, in August of 2010 at The Women’s Center at Carlisle Regional Medical Center, she got more than she expected—more expertise, attention and genuine concern for how she was feeling. “Being cared for by Dr. Schweitzer and a team who enjoys what they are doing gave me an amazing birth experience,” said Mindy. And when she and her husband were expecting their second son, Luke, they chose Pam Kozick, nurse midwife, and The Women’s Center, where they knew they could expect so much more.
Mindy Loftus and her family
Did we know exactly where we’d have our second son?
Absolutely.
For more information or to find a physician, please go to CarlisleRMC.com or call 1-855-249-CRMC.
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Body and More
G4 • The Sentinel
Sunday, October 20, 2013
Achieving personal harmony and balance during cancer Family Features What if after surviving your first cancer diagnosis at the age of 51, you were rediagnosed just 18 months later? Metastatic colorectal cancer patient Dave Johnson experienced that first-hand, and was initially reluctant and scared to tell his family, friends and co-workers. However, he soon learned two important lessons – that he had more support around him than he thought, and that he could control his lifestyle and personal harmony. Now at the age of 53, Johnson, a full-time banker, has discovered a new sense of inner well-being and, according to his physician, is again cancer free. Many people find achieving personal harmony and balance difficult – the de-
mands and stresses of everyday life often impede the ability to find inner peace. For those facing a cancer diagnosis, achieving that balance may feel impossible. And, yet, it is as important, if not more, for people living with cancer to find and maintain a sense of inner harmony. After being diagnosed with an advanced form of colorectal cancer, Johnson knew he had to fight the disease head on, from both a medical and mental perspective. Johnson worked with his physician to choose his treatment, and made the conscious decision to focus on areas of his life he felt he could control. “Setting goals and priorities, as well as staying active, became very important to me, and helped me
accept my diagnosis as my ‘new normal,’” said Johnson. “The ability to fulfill goals and keep both my mind and body busy helped me focus on the sweet spots in life that give me strength and joy.” Johnson also said expressing his emotions was important to regaining his balance. “There were many days when I could have said ‘why me’ and focused my energy on feelings of anger and resentment,” said Johnson. “I’d let myself experience those feelings but I made a point of expressing those emotions and then moving on, which helped me maintain mental clarity. Additionally, my faith helped me accept the challenges I was going through.” Tips to achieving personal harmony and balance dur-
ing cancer include: • Express your emotions: Make a point of expressing your emotions before they start to have a negative impact. • Set goals and priorities: Focus on the areas you can control and set out to fulfill the goals most important in your personal and work life. • Keep active: Find activities to keep both your body and mind busy that you also enjoy. • Enjoy the company of loved ones: Surround yourself with positive, supportive relationships, whether with your family, friends or co-workers. • Be open with your doctor: Don’t be afraid to discuss any cancer fears you have with your doctor or nurse. Johnson stressed the im-
portance of surrounding himself with positive, supportive relationships, including others who were also navigating a cancer journey. “I learned to celebrate the successes of other patients while supporting those experiencing setbacks – this in turn kept me self-motivated to fight my cancer with all the strength I had,” said Johnson. “It’s easy to feel overwhelmed after a cancer diagnosis.
For me, taking time to focus on myself and my inner being, and creating an environment that was as nurturing and calming as possible, helped me stay positive in combating my disease.” For more information on developing your own path in fighting colorectal cancer, visit the My Colon Cancer Coach website at www.mycoloncancercoach.org/, or talk with your healthcare provider.
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Sunday, October 20, 2013
Body and More
The Sentinel • G5
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G6 • The Sentinel
Sunday, October 20, 2013
Breast cancer in 2013: What you need to know Family Features Thirty years ago, a diagnosis of breast cancer was thought of as a virtual death sentence for many women, but since that time significant progress has been made in the fight against breast cancer. Reduced mortality, less invasive treatments, an increased number of survivors and other advancements have their roots in breast cancer research – more than $790 million of it funded by Susan G. Komen, the world’s largest breast cancer organization. However, the reality is that breast cancer is still a serious disease. National Breast Cancer Awareness Month, held each October, brings awareness to the disease and empowers women to take charge of their own breast health. This year, about 200,000 new cases of invasive breast cancer will be diagnosed among women in the U.S. and nearly 40,000 women will die from it. Globally, 1.6 million people will be diagnosed, and 400,000 will die. Despite the increased awareness of breast cancer, major myths still abound. Women must remain vigilant against this disease by learning the facts and understanding how they may be able to reduce their risk. The Myths and Facts on Breast Cancer Myth: I’m only 35. Breast cancer happens only in older women. Fact: While the risk increases with age, all women are at risk for getting breast cancer.
Myth: Only women with a family history of breast cancer get the disease. Fact: Most women who get breast cancer have no family history of the disease. However, a woman whose mother, sister or daughter had breast cancer has an increased risk. Myth: If I don’t have a mutated BRCA1 or BRCA2 gene, I won’t get breast cancer. Fact: You can still get breast cancer, even without a gene mutation. About 90 to 95 percent of women who get breast cancer do not have this mutation. Myth: Women with more than one known risk factor get breast cancer. Fact: Most women with breast cancer have no known risk factors except being a woman and getting older. All women are at risk. Myth: You can prevent breast cancer. Fact: Because the causes of breast cancer are not yet fully known, there is no way to prevent it. Actions to Reduce Your Risk Breast cancer can’t be prevented; however, research has shown that there are actions women can take to reduce their risk of developing breast cancer. • Maintain a Healthy Weight – Postmenopausal women who are overweight have a 30 to 60 percent higher breast cancer risk than those who are lean. • Add Exercise into Your Routine – Women who get regular physical activity may have a lower risk of breast cancer by about 10 to 20 percent, particularly
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in postmenopausal women. • Limit Alcohol Intake – Research has found that women who had two to three alcoholic drinks per day had a 20 percent higher risk of breast cancer. • Breastfeed, if you can – Re sea rc h h a s s h ow n that mothers who breastfed for a lifetime total of one year (combined duration of breastfeeding for all children) were slightly less likely to get breast cancer than those who never breastfed. For more information on the facts about breast cancer and what you need to reduce your risk, or to find resources in your community, visit Komen.org or call 1-877-GO-KOMEN.
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Sunday, October 20, 2013
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The Sentinel • G7
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A common complaint among women is their breasts are either too large or too small. Advanced plastic surgery procedures can address both problems. There are many aspects, which are similar and some are different. According to the American Society of Plastic and Reconstructive surgeons, the most popular surgical procedure in 2012 was breast augmentation with over 330,000 procedures performed. The majority of patients were between 19 and 50 years of age and 72% of patients chose silicon filled implants, and 28% saline filled implants. Breast reduction surgery was the 8th procedure on the list with over 112,000 procedures performed. Breast reduction patients usually have large, heavy pendulous or disproportional large breasts. Newer techniques for breast reduction involve repositioning the nipple areola on a pedicle of tissue and removing the excess tissue re-approximating the remaining breast tissue through a lollipop shaped incision. Breast reduction surgery with short scar techniques, result in better long-term shape, more fullness and less scars along the bra line. The long-term projection and shape of the breasts are improved and there is also a very high satisfaction rate among patients - over 90%. Regarding breast augmentation, there are new implants available, which are anatomically shaped and have a “gummy bear” fill to decrease the risk of implant rupture and other complications. Overall, breast augmentation has been found to have a 93% satisfaction rate. The breast augmentation procedure usually involves placing an implant through a short horizontal incision in the breast fold, placing the implant partially under the major chest muscle. There are differences in the procedures. Breast augmentation is considered a cosmetic procedure and not covered by insurance. Breast reduction is usually covered by insurance if symptoms exist such as back pain, shoulder grooving from bra straps, and skin irritation under the breast folds. National average fee was about $4,000.00 for breast augmentation and $5,000.00 for breast reduction, in addition to anesthesia and facility fees. Each person is unique and the procedures must be modified accordingly. Depending upon the patient’s age, screening for breast cancer may be indicated. However, the incidents of breast cancer are not increased by either procedure. Reference: Cosmetic surgery national data bank statistics 2012
Body and More
G8 • The Sentinel
Sunday, October 20, 2013
Life with advanced breast cancer: A daughter’s perspective Brandpoint Cate Edwards, daughter of Elizabeth Edwards, became part of the cancer community in 2004 when her mother was first diagnosed with early stage breast cancer. Shocked and defiant, Edwards and her mother assembled the best team of healthcare providers and confronted the cancer with grace, courage and perseverance. “I moved back in with my family to be with my mom through the early stages of her treatment,” said Edwards. “I was sure there was an end to cancer in sight and I wanted to see her through it.” Less than a year later, they were able to breathe a sigh of relief when Elizabeth’s scans came back clear and she appeared to be in remission. Unfortunately, the cancer was not gone for good. In 2007 the cancer returned. This time, it was metastatic breast cancer that had spread to the bone, which was treatable but incurable. Advanced breast cancer (ABC) is composed of metastatic breast cancer (stage IV) and locally advanced breast cancer (stage III), according to the American Cancer Society. Metastatic breast cancer occurs when the cancer has spread beyond the breast to other parts of the body, such as the brain, bones or liver. Locally advanced breast cancer means the cancer has spread to lymph nodes and/ or other tissue in the area of the breast, but not to distant sites in the body.
countries, conducted online by Harris Interactive on behalf of Novartis Oncology, showed that 70 percent of U.S. women living with ABC often feel isolated and left out of the broader breast cancer awareness movement. Additionally, 75 percent of women with ABC feel resources to help family and friends cope with and understand the disease would be especially helpful. To address the unique needs of the ABC community, the “Count Us, Know Us, Join Us” (Count Us) program was developed with guidance from 13 leading cancer advocacy groups. The Count Us program, which is available in English and Spanish at www.advancedbreastcancercommunity.org, provides education and support to patients, caregivers, loved ones and supporters.
In honor of her mother, who passed away in 2010, Edwards has joined Count Us as an ambassador to share her caregiver experience and to help amplify the voice of the ABC community. “Anyone impacted by this disease - whether a patient, daughter, husband, friend or colleague - is part of the community,” said Edwards. “Living with advanced breast cancer means living with uncertainty, but knowing first-hand the struggles this community faces, there is one thing that’s certain: no one should face it alone.” Rosalie Canosa, MSW, MPA, LCSW-R, Program Division Director, CancerCare, agrees more support is needed for the ABC community, which has different needs than the early stage breast cancer community,
especially when it comes to caregivers who need support as well. “ Seve n ty p e rc e n t o f women with advanced breast cancer have a caregiver, whether it’s a family member who attends every doctor appointment or a neighbor who brings a meal once a week,” said Canosa. “However, caregivers are often so focused on helping that they underestimate support theymay need over time. That’s why I am happy that Cate is joining the Count Us program, to raise awareness for everyone in the advanced breast cancer community.” For additional information on the Count Us program and resources for ABC support, as well as video messages from Cate Edwards, visit www.advancedbreastcancercommunity.org.
WE ARE HERE
The advanced breast cancer felt different. The focus turned from becoming a “survivor” to simply surviving, and Edwards and her mom sensed they were part of a new cancer community. “Before my mom was diagnosed with advanced breast cancer, I assumed breast cancer patients fell into two categories - those who were “survivors” and those who were not,” said Edwards. “When Mom’s cancer metastasized, I re-
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alized this wasn’t the case. There is a community of cancer patients who are challenged by an unpredictable, chronic disease that they could live with for weeks, months or years.” While there are many resources for early stage breast cancer, information specifically for the ABC community - which includes patients and those who care for them - has been limited. A 2012-2013 global survey of nearly 1,300 women in 12
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Sunday, October 20, 2013
Body and More
The Sentinel • G9
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(Rena Kass, M.D., J. Stanley Smith, M.D., Angela Soto-Hamlin, M.D., Anna Leung, M.D.; front: Annie Arguin, CRNP)
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Body and More
G10 • The Sentinel
Sunday, October 20, 2013
Tamoxifen therapy helps keep breast cancer in remission Brandpoint Julie Megee, a 41-year-old mother of two, was diagnosed with estrogen receptor-positive breast cancer earlier this year. Following a lumpectomy and radiation therapy, she discussed her long-term treatment plan with her oncologist to keep her in remission. Like many patients diagnosed with breast cancer, Julie was prescribed tamoxifen citrate, a drug used to block the effects of estrogen, which can cause cancer cells to grow. When Julie’s oncologist told her she would need to remain on tamoxifen for at least five years, her dislike of pills led her to discussing other options with her doctor. “I have always had difficulty taking any type of tablet medication, so I asked my oncologist if there was an alternative to the tamoxifen pill because I couldn’t imagine taking a tablet every day for at least five years,” she said. As a result, she was prescribed Soltamox® (tamoxifen citrate), the only oral liquid form of tamoxifen available. Soltamox® is the same medication as tamoxifen with the same approved uses, but it’s an oral liquid solution rather than a pill. With Soltamox®, Julie is now able to continue taking her medication each day, giving her the confidence to know she is doing everything she can to reduce the risk of her breast cancer returning. Julie owns and operates Perceptions Hair Studio in Norton, Mass., and leads a busy life as a small business owner while raising her two teenage children. With Soltamox®, taking her daily dose is easy, and since it is the same low monthly cost ($10) as generic tamoxifen tablets, it is well within her family’s budget.
While breast cancer treatment guidelines recommended tamoxifen be prescribed for up to five years to help prevent the recurrence of breast cancer for patients like Julie, there is new evidence to support additional benefit by extending treatment beyond this period for certain patients. “These studies now provide proof beyond reasonable doubt that continuing tamoxifen beyond five years reduces recurrence and death from breast cancer. The full survival benefits of extended treatment do not emerge until after the 10 years of treatment, so it is critical for patients to adhere to their treatment plan,” said Richard G. Gray, MA, MSc, professor of medical statistics at the University of Oxford, Oxford, United Kingdom, and lead author of the aTTom trial. Based upon the latest evidence, the US-based National Comprehensive Cancer Network (NCCN), a leading authority for breast cancer treatment, recently updated their treatment guidelines to support the long term benefits of tamoxifen. Tamoxifen is also effective in reducing the risk of breast cancer in women who are at high risk for the disease, including those who have a strong family history of breast cancer and other risk factors. The decision to extend tamoxifen therapy should be discussed between a patient and her physician, weighing the absolute benefit of tamoxifen therapy against the feasibility of a ten year regime, and its attendant side effects. Tamoxifen was first approved for use in the United States in 1977, and became widely used following studies published in 1998 definitively showing tamoxifen saved lives in early breast cancer. Despite strong clinical evidence of the benefits
strokes, pulmonary emboli, and uterine malignancies were fatal. Health care providers should discuss the potential benefits versus the potential risks of these serious events with women at high risk of breast cancer and women with DCIS considering tamoxifen to reduce their risk of developing breast cancer. The benefits of tamoxifen outweigh its risks in women already diagnosed with breast cancer.
Warning
of tamoxifen therapy, studies show between 30 and 70 percent of patients fail to complete their prescribed course of treatment, thereby diminishing its benefits in reducing the risk of breast cancer recurrence. Patients often cite side effects as reasons for not completing the prescribed course of tamoxifen therapy, although other factors can also play a role. While adhering to a tamoxifen treatment regimen of five years or more may not be easy for some women, giving women who prefer or need a -liquid instead of a pill may help improve long term compliance and the risk of breast cancer reoccurrence. After the shock of being diagnosed with breast cancer, Julie believes it is important every woman be offered the choice of a liquid or a pill to maintain her health.
Important Safety Information Serious and life-threatening events associated with tamoxifen medications such as Soltamox® (tamoxifen citrate) in the risk reduction setting (women at high risk
for cancer and women with DCIS) include uterine malignancies, stroke and pulmonary embolism. Some of the
In Women with Ductal Carcinoma in Situ (DCIS) and Women at High Risk for Breast Cancer Serious and life-threatening events were associated with tamoxifen in the risk reduction setting (women at high risk for cancer and
women with DCIS) include uterine malignancies, stroke and pulmonary embolism. (See CLINICAL PHARMACOLOGY, Clinical Studies, Reduction in Breast Cancer Incidence I n H i g h R i s k Wo m e n ) . H ea l t h c a re p rov i d e rs should discuss the potential benefits versus the potential risks of these serious events with women at high risk of breast cancer and women with DCIS considering tamoxifen to reduce their risk of developing breast cancer. The benefits of tamoxifen outweigh its risks in women already diagnosed with breast cancer. P l e a s e v i s i t w w w. soltamox.com for the full Prescribing Information and complete Black Box Warning.
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Sunday, October 20, 2013
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The Sentinel • G11
G12 • The Sentinel
Body and More
Sunday, October 20, 2013
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