Celebrating fighters
Pink is stronger than you think Sunday, October 8, 2017
Resources available for all patients BY KAYLA ELDER
kelder@gainesvilletimes.com
After hearing the dreaded news of a breast cancer diagnosis, one of the first thoughts for many patients is, “how am I going to pay for treatments?” Insured or uninsured, American Cancer Society patient navigator Jennifer Roberts said there are resources for everyone. Roberts, who works at Northeast Georgia Medical Center, said she also needed assistance after being diagnosed with breast cancer. “I actually am two years out of my chemo and radiation for breast cancer, and I experienced some assistance through the Patient Advocate Network, which is a national foundation,” Roberts said. She underwent her breast cancer treatment at the medical center while
Inside
A resource list includes local organizations and support groups that address breast cancer.
she continued to work as a patient navigator, connecting patients with financial resources. “I have federal Blue Cross Blue Shield for instance, so every time I would have chemo they were expecting that I pay $1,500 every chemo. That was times six because I needed six treatments,” Roberts said. “They helped because I had a bigger copay. Before that would kick in, Patient Advocate Network actually helped pay up to $5,000 for my chemotherapy. That really helped me a lot. Who has $1,500 to fork out every 21 days?” Roberts said they work ■■Please see Financial, 9
Causes, treatments researched heavily, local doctor says BY JOSHUA SILAVENT For The Times
Cancer has been around since time immemorial. “The ancient Egyptians had cancers, and they actually tried to treat them,” said Dr. Charles Nash, a medical oncologist with The Longstreet Clinic in Gainesville and medical director of cancer services at the Northeast Georgia Medical Center. Nash has even visited the Museum of Egyptian Antiquities in Cairo where old surgical instruments used to address forms of brain cancer are on display. “Those were smart dudes,” Nash said. “(Although) I’m sure they lost a Nash few more people.” Advancements in early detection have saved the lives of countless women with a breast cancer diagnosis over the past few decades. And as treatments evolve, breast cancer is no longer a death sentence. But recommendations for screenings and prevention continue to fluctuate as new research emerges. The result can leave women confused as they strain to keep up with changes. “I don’t think it’s a onesize fits all recommendation,” Nash said. “There is a lot of disagreement (in the medical community).” Nash said there are typically multiple factors at play when it comes to determining risk. These include everything from diet to use of hormone therapy to the age at which women first give birth, which makes for an especially compelling risk factor among women of the millennial generation. Nash said genetic predis-
‘It’s a God thing’
positions remain a major contributing factor and that women with mothers who have been diagnosed with breast cancer need to begin screenings as early as possible. About one in eight women in the United States, or 12 percent, will develop invasive breast cancer over the course of her life, according to breastcancer. org, a nonprofit organization. That’s more than 250,000 new cases each year, plus 63,410 new cases of noninvasive breast cancer. “It’s time well spent, I think,” Nash said. Nash said that breast cancer is one of the top four cancers treated at The Longstreet Clinic, accounting for at least 25 percent of all cases, followed by lung cancer, prostate cancer and gastrointestinal cancers. However, Nash added that thyroid cancers are becoming more prevalent. With demand for cancer services as high as ever, Nash said new nurse practitioners and doctors are being hired. Nash said they are expanding research programs and clinical trials and are adding technology to support cancer treatments. It’s one more element in the growing number of partnerships that have placed NGMC in the top 9 percent of all cancer programs nationally, as ranked by CareChex, an independent health care ratings organization. Or as Nash prefers to put it, NGMC is better than 91 percent of programs across the country. “That’s iron sharpening iron,” Nash said. “We are cutting edge.”
SCOTT ROGERS | The Times
Natalie Kytle Donatelli with husband Vincent and twin boys Michael, left, and John, both 9, and daughter Ava, 5. Natalie was recently diagnosed with cancer and is going through chemotherapy.
Newly diagnosed patient juggles treatment, family Online
BY JOSHUA SILAVENT For The Times
It can be said that the spirit rises in times of crisis. That’s especially true for Natalie Kytle Donatelli. “I believe in God. I believe in miracles,” she said. Diagnosed in July with Stage 3 breast cancer, the disease has since spread to her spine and doctors now consider it Stage 4. That means a cure is not possible, only remission. “So that was a little tough to hear,” Donatelli, 36, said. “If I didn’t have my faith, I don’t think I would be where I’m at in this journey.” She’s also leaning on her family, which she describes as a “rock.” Her husband attends school but remains engaged on every level, Donatelli said.
Join The Times for a live discussion with Natalie Kytle Donatelli and other women affected by breast cancer. Go to facebook.com/gainesvilletimes at noon Oct. 18.
“This has made us grow closer together,” she added. She knows her parents are there to take care of her, too. And her three elementary-age children, two boys and a girl, remain involved in football and gymnastics, but are also constant companions and reminders of her inner strength. “Cancer has picked the wrong person,” Donatelli said her family told her when she was first diagnosed. “I think having children and having other things like working, has been a
good distraction.” Donatelli has continued to keep her schedule as a home hospice nurse, often working on-call. Serving others in her own time of need has proved rewarding and healthy. She said it helps to keep her from dwelling negatively on her own condition. She also keeps an eye out for opportunities to serve others in need, like when she was at a restaurant and overheard a family from Florida who had evacuated as Hurricane Irma approached last month. She paid for their meal. Donatelli has also discovered just how much she enjoys her alone time. It’s a chance for self-reflection that she may have previously taken for granted. ■■Please see Natalie, 10
Fellow patients provide support BY KAYLA ELDER
kelder@gainesvilletimes.com Opening up to others, especially those who understand the situation, can be vital for breast cancer patients. Robyn Chambers of Flowery Branch needed the encouragement and listening ear when she was diagnosed at 47 years old in 2013. “The reason I wanted to go to a group for support was because I felt lost,” Chambers said. “I needed someone who was going through what I was going through. I have had friends who have gone through breast cancer, but I needed to talk to someone who was going through it right then.” Chambers said her journey began the summer of 2012, when she went for a mammogram and checkup. Though “everything was fine” at the time, in December 2012 she found a lump. “I went straight to the doctor, and the doctor didn’t seem to be worried. Then in
January, I went to the surgeon and she did not seem to be worried either, but we did the biopsy,” Chambers said. “That was on a Wednesday, and two days later I went back and she told me it was cancer.” Since Chambers’s cancer was “fed from estrogen,” she decided to have a bilateral mastectomy with reconstruction. “I got started with that process in January, and my lymph nodes and margins were clean. I had my surgery March 4, and then I started the reconstruction process,” Chambers said. “I went to see my oncologist, and he told me that if I had four rounds of chemo that that would lower my rate for recurrence, so I did that. I started that in April, and I still proceeded with reconstruction. My four rounds of chemo — I lost my hair. He finished my reconstruction in July, and I went back to work in August.” Chambers said being
■■Please see support, 9
Courtesy of Robyn Chambers
Robyn Chambers, 51, was diagnosed with breast cancer in 2013.
CMYK 2
Sunday, October 8, 2017
think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Researchers look for clues to causes of breast cancer Diet, nighttime light may be factors By Richard G. “Bugs” Stevens
University of Connecticut
(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.) For most of the common cancers, a major cause has been identified: smoking causes 90 percent of lung cancer worldwide, hepatitis viruses cause most liver cancer, H pylori bacteria causes stomach cancer, human papillomavirus causes almost all cases of cervical cancer, colon cancer is largely explained by physical activity, diet and family history. But for breast cancer, there is no smoking gun. It is almost unique among the common cancers of the world in that there is not a known major cause; there is no consensus among experts that proof of a major cause has been identified. Yet, breast cancer is the most common form of cancer in women worldwide. The risk is not equally distributed around the globe, though. Women in North America and Northern Europe have long had five times the risk of women in Africa and Asia, though recently risk has been increasing fast in Africa and Asia for unknown reasons.
Is diet to blame? Up until about 20 years ago, we thought it was all about diet. As people abandon their local food sources and begin to eat highly processed foods with lots of fats, the hypothesis went, breast cancer was thought to be more likely to develop. This hypothesis was logical because when researchers analyzed countries’ per capita fat consumption and breast cancer mortality rates, they found a strong correlation. In addition, rats fed a high-fat diet are more prone to breast tumors. By studying Japanese migrants to California, researchers found that the first generation had low risk like their parents in Japan, but then by the second and third generation, risk was as high as white American women. So, the genetics of race did not account for the stark differences in the breast cancer risk between Asia and America. This was also consistent with the idea that the change in food from the lean Asian diet to the high-fat American diet causes cancer. So it all made sense. Until it didn’t.
Diet studies find that fat is not the answer Starting in the mid-1980s, large, well-done prospective studies of diet and breast cancer began to be reported, and they were uniformly negative. Fat in the diet of adult women had no impact on breast cancer risk at all. This was very surprising — and very disappointing. The evidence for other aspects of diet, like fruits and vegetables, has been mixed, though alcohol consumption does increase risk modestly. It is also clear that heavier women are at higher risk after menopause, which might implicate the total amount of calories consumed if not the composition of the diet. There is a chance that early life dietary fat exposure, even in utero, may be important, but it’s difficult to study in humans, so we don’t know much about how it might relate to breast cancer risk later in life. If diet is not the major cause of breast cancer, then what else about modernization might be the culprit?
what we can modify, and what WE CAN’t The factors shown to affect a woman’s risk for developing breast cancer fall into two categories. First, those that cannot be easily modified: age at menarche, age at birth of first child, family history, genes like BRCA1. And second, those that are modifiable: exercise, body weight, alcohol intake, night-work jobs. The role of environmental pollution is controversial and also difficult to study. The concern about chemicals, particularly endocrine disruptors, started after the realization that such chemicals could affect cancer risk in rodent models. But in human studies the evidence is mixed. Because child bearing at
Whatever is going on, it’s important to find answers because breast cancer has become a scourge that now afflicts women all over the world in very large numbers, at almost 2 million new cases this year alone. a young age and breast feeding reduce risk, the incidence throughout Africa, where birth rates tend to be higher, and where women start their families at younger ages, has been lower. Death rates, however, from breast cancer in sub-Saharan Africa are now almost as high as in the developed world despite the incidence still being much lower. This is because in Africa, women are diagnosed at a later stage of disease and also because there are far fewer treatment options. The question is whether the known risk factors differ enough between the high-risk modern societies and the low-risk developing societies to account for the large differences in risk. The answer: probably not. Experts think that less than half the high risk in America is explained by the known risk factors, and that these factors explain very little of the difference in risk with Asia. A related question is whether the high risk in America and Northern Europe is due to a combination of many known exposures, each of which affects risk a little bit, or mostly due to a major cause that has so far eluded detection. And maybe some of the known risk factors have a common cause that we don’t yet understand.
Are we just finding more cancer? Since the 1980s, screening by mammography has accounted for some of the increase in incidence in the modern world compared to the developing world, but not nearly enough to explain the entire difference. About 20 percent of the cancers found by mammography are now believed to be of a type that would never have progressed beyond the very small early stage that mammography can detect. But the problem is that we can’t tell which are the benign ones and which are not.
What about electric light? Electric light is a hallmark of modern life. So, maybe the introduction and increasing use of electricity to light the night accounts for a portion of the worldwide breast cancer burden. This might be because our circadian rhythm is disrupted, which affects hormones that influence breast cancer development. For example, electric light at night can trick the body into daytime physiology in which the hormone melatonin is suppressed; and melatonin has been shown to have a strong inhibitory effect on human breast tumors growing in rats. The theory is easy to state but difficult to test in a rigorous manner. Studies have shown that night-working women are at higher risk than day-working women, which was the first prediction of the theory. Other predictions are that blind women would be at lower risk, short sleepers would be at higher risk, and more highly lighted communities at night would have higher breast cancer incidence. Each of these has some modest support though none are conclusive. What we do know is that electric light in the evening or at night can disrupt our circadian rhythms, and whether this harms our long term health, including risk of breast cancer, is not yet clear. Whatever is going on, it’s important to find answers because breast cancer has become a scourge that now afflicts women all over the world in very large numbers, at almost 2 million new cases this year alone.
Photos courtesy of Dallas Sage
Dallas and Chad Sage attend a Braves game Aug. 27 with their daughter, Madelyn. Dallas Sage was diagnosed with breast cancer shortly after Madelyn was born.
F ghting for the future
Dallas Sage keeps family in focus as she continues battle with cancer BY JOSHUA SILAVENT For The Times
“Cancer has always been a terrifying word with me,” said Dallas Sage. With that in mind, Sage tries to provide a sense of normalcy to her young daughter, Madelyn, who was born last year shortly before Sage was diagnosed with Stage 4 breast cancer. But the treatment and travel schedule Sage and her family have endured in the past 12 months has served as a constant threat to this carefully constructed normalcy. “I hope that my daughter never has to know what we’ve gone through,” Sage, 29, said. “I hope her life has been impacted the least.” While Sage tries to shield her daughter from the worst that cancer brings, including frequent visits to a medical facility in Houston for treatment, family and friends step up to make sure little Madelyn remains her happy, joyful self. “Leaving her behind has been really difficult,” Sage said. “But she’s in good care. I would never want her day to be spent in the hospital.” And at the end of her most trying days, Sage looks to her daughter for the hope and inspiration she needs to carry on the battle against inflammatory breast cancer, which includes multiple rounds of chemotherapy. “I want to see her grow up,” Sage said. “I want to see her future. It’s what gets me through all this.” Since first telling her story in The Times last year, Sage said she has pushed through the ups and downs that often accompany a cancer diagnosis and corresponding treatment. For example, complications delayed radiation and surgery and compelled Sage and her doctors to take a “more unconventional approach” in her treatment schedule. Inflammatory breast cancer is a rare and aggressive type. The cancer cells block lymph vessels in the skin of the breast and can spread rapidly. According to the National Cancer Institute, inflammatory breast cancer accounts for just 1 percent to 5 percent of all breast cancers in the United States. Tweaking her chemotherapy has proved beneficial, with Sage receiving three clear scans now, allowing her to proceed with needed surgery and five weeks of radiation. “Just because of how quick and how much area is affected, people don’t typically get to surgery,” Sage said. Diagnosed before she turned 30 years old, Sage described the last year as a “very humbling experience.” But the support of her church, the Hall County community, friends and family, and doctors and strangers has been uplifting, if also a little overwhelming. “Probably the most surprising thing was the outpouring of support,” Sage said. “It’s more than I could ever ask for.” And Sage credits her husband, Chad, who she met while attending Chestatee High School and married four years ago, with being the rock in her family. He helps determine treatment decisions and navigates the logistical challenges of receiving treatment in Houston, as well as at the Northeast Georgia Diagnostic Clinic in Gainesville. It’s not been easy for Sage to tell her story, but she’s finding meaning in the journey, too. “I’m generally a very private person,” she said. “But as hard as that was for me, it was also a blessing.” Sage said she has come to find purpose in her medical journey beyond what she ever expected to face. This includes raising awareness about inflammatory breast cancer and serving to give other women facing this disease hope for a better tomorrow. “I knew when I was diagnosed with this that God had a purpose,” Sage said.
Dallas Sage cuddles with her daughter, Madelyn, in August 2016. Sage was diagnosed with breast cancer in June of that year.
Dallas Sage holds her daughter, Madelyn, on Christmas Day.
‘I hope that my daughter never has to know what we’ve gone through. I hope her life has been impacted the least.’ Dallas Sage
CMYK think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
From nurse to patient
3
‘I can truly put myself in their shoes’
SCOTT ROGERS | The Times
BY JOSHUA SILAVENT
According to the Mayo Clinic, this form of breast cancer begins in the milk-producing glands, or lobules, and can spread to the hat happens when the nurse lymph nodes. becomes the patient? “Then we started talking treatment That’s a question Melissa plans,” Summerlin said. Summerlin wasn’t ready to answer when she That comment says a lot about the resiwas diagnosed with breast cancer this past dent of Dahlonega, a wife and mother of two November. In fact, she was on the verge of adult children with a granddaughter to boot. starting a new phase in her life and career. Summerlin, by her own admission, is not Disease was the last thing on her mind. exactly equipped with patience. She likes to “I think I was in shock,” Summerlin, 50, determine her fate and push ahead no matsaid. “I was like, ‘Whoa, now what?’” ter the obstacle. The biopsy that revealed her cancer was “I don’t want to drag this out,” she told her given on the last day of her job as a hospice doctors. and palliative care nurse with the NorthBut patience is exactly what she had to east Georgia Health System in Gainesville. learn during the course of her treatment. And that test only took place after she was “One thing I learned through all this is that told to do so during an educational confer- no one has the same treatment plan,” Sumence a week or so prior, a conference that merlin said. aimed to teach women just how to perform Hers has included four cycles of chemoself-examinations. therapy, with the pain and nausea worsening The revelation that she faced Stage 3 inva- with each cycle, plus 28 radiation treatments the left breast, which sive lobular carcinoma quickly settled in, to JEMC_Community_BraseltonCentennial_2_JEMC 10/4/16 4:02 PM Page 1 must be carefully administered because of potential complihowever, if only because of its severity.
W
For The Times
cations on the heart. Summerlin also chose to have a double mastectomy because of the high chances of the cancer recurring. But she also learned a lot along the way that she wants to advise other women about. “Even though I thought I was making good decisions and informed decisions, still at the end of the day those decisions were being made with emotion,” Summerlin said. For example, she jumped at the opportunity to start plastic surgery reconstruction as soon as possible, something she would come to later regret. “I don’t know that all my decisions would be the same,” Summerlin added. Summerlin’s cancer is now in remission and her prognosis or survival rate over five years is above 90 percent, she said. “They don’t say cure,” she added. “If it had been caught earlier, they would have talked cure.” She returned to work and a new job in September in the oncology field in Gainesville, and working again with patients has been
Proudly Supporting
exciting, if also a bit of a change of pace. “I had not gotten up early in almost a year,” she said, laughing. “It’s what I feel like I was put on this earth to do.” Summerlin said she doesn’t talk about her cancer diagnosis with her patients. But she feels she has a newfound sense of empathy. “I can truly put myself in their shoes,” she said. “Many times we take much better care of our patients than we do ourselves.” For example, Summerlin said she can relate to the many symptoms of the disease and corresponding side effects of treatment, or the burden cancer places on family members. Summerlin said she hopes she can dispel some misconceptions that she herself may have harbored, such as breast cancer being an obvious solid lump that is easily detected. She encourages women to be very proactive in getting regular mammograms and performing self-exams. “There’s got to be something good that comes out of this,” Summerlin said.
Breast Cancer Awareness Month
Your Power. Your Community.
jacksonemc.com
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Sunday, October 8, 2017
Finding beauty through the fight
Photos by SCOTT ROGERS | The Times
Mary Smith gets set to display a wig inside the All About You shop inside Longstreet Cancer Center. The shop specializes in post mastectomy products, compression garments, wigs and other related accessories.
A popular item for sale at All About You inside Longstreet Cancer Center is the Dammit Doll for stress relief.
‘We are here and ready to help.’ Mary Smith, All About You manager
think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
All About You at Longstreet Cancer Center offers specialty products for those with or without special healthrelated needs. The shop employs a Certified Fitter specially trained to fit bras, breast forms and wigs, as well as compression therapy products including sleeves, stockings and gloves.
All About You helps patients feel a little more like themselves BY KAYLA ELDER
kelder@gainesvilletimes.com During the chaos of a diagnosis, doctor’s appointments and treatments, feeling good is often lost. All About You steps in to help those affected by breast cancer. “This provides them with wigs, bras and prosthetics to bring them back to some sense of normalcy so that they feel more comfortable in their clothing and around others,” said Mary Smith, manager of All About You. The shop, located at the Longstreet Cancer Center in Gainesville, sells a variety of products and is open to the community. “We are here and ready to help,” Smith said. “Whether they are getting treatment here or elsewhere, and regardless of where they travel, we serve all Northeast Georgia counties, not just Hall County and not just Longstreet patients.” The wigs for sale are not custom made but are high quality synthetic wigs, Smith said. The shop also has turbans, scarves, wraps and hairpieces, swimwear and swim forms, nonmetallic deodorant, oncology shampoo and skin care products and compression therapy products such as sleeves, gloves and stockings. “We also have compression garments that are used for various reasons; lymphedema being one, which is the swelling in the arms that ladies sometimes have after they have had breast sur-
All About You
When: 8 a.m. to 5 p.m. Monday, Wednesday and Friday, noon to 5 p.m. Tuesday and Thursday Where: 725 Jesse Jewell Parkway SE, Gainesville More info: 770-297-5633
gery and have lymph nodes removed,” Smith said. All About You employs a certified fitter by the American Board for Certification in Orthotics, Prosthetics and Perodorthics specially trained to fit bras, breast forms and wigs, as well as compression therapy products. “We can schedule appointments if they require a fitting, or they can come in; everything is totally private. We do our fittings here in the shop,” Smith said. “If the garments, or whatever the patient chooses or needs at the time, are here then they can take them that day, if not we can get them ordered, and we usually get them in a week.” She encourages patients to make an appointment. All About You files insurance, according to Smith, who said “if those insurance benefits are not available, then there are other options for them, and we will explain those to them if they have that need.’ To schedule a private consultation or inquire further about products and services available at All About You, 725 Jesse Jewell Parkway SE, call Smith at 770-297-5633.
All About You inside Longstreet Cancer Center employs a certified fitter trained to fit bras, breast forms and wigs, as well as compression therapy products including sleeves, stockings and gloves.
CMYK think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
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5
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Sunday, October 8, 2017
THINK PINK
The Times, Gainesville, Georgia | gainesvilletimes.com
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FOR OVER 25 YEARS
OAKWOOD PACKAGE STORE IS A PROUD SPONSOR OF
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Thursday, October 26 from 4PM – 6PM
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CMYK think pink
Photo sessions celebrate women BY AMBER TYNER
atyner@gainesvilletimes.com Jenn Hyman, owner and photographer for Mirrored Images Boudoir in Gainesville, wants to “bring a different light to breast cancer” through her Sparkle and Celebrate Pink event on Oct. 18. Hyman, along with Cotton Rouge & Co., Cotton Rouge Photo and makeup artist Staci Gibbs, will be offering a photo session with professional makeup and hair for those fighting the disease and those who have survived it. “I think it’s seen as being an ugly disease, which it is, but this is just a different view on it,” she said. Participants of this free event will have three wardrobe options: mesh body suit with rhinestones, pasties with rhinestones or body paint and glitter with rhinestones. “We are both actually boudoir photographers, but these aren’t going to be boudoir style pictures,” Hyman said about herself and Katie Cotton of Cotton Rouge & Co. “They’re more inspirational pictures so that they can have them for themselves (and) that they can share them with their families.” She said they already have five women who have signed up for the event, and they would like to have a total somewhere between 15 to 20. “They’re super excited,” she said about the women. “...they’ve all chosen just to do the straight body paint and glitter and rhinestones straight on them. They’re very willing to participate and celebrate it and get the full experience out of it that they can.” Hyman’s mother was a breast cancer survivor. “So it’s kind of closer for me,” she said. “And I also work full time as a nurse, and the hospital that I’m at is a cancer facility, so we come across that a lot.” To make this event happen, Hyman shared the idea with her friends, who quickly jumped on board. Hyman said the event will be held at Cotton Rouge & Co. Studio in Taylors, S.C. because it will provide a bigger space. “We’re able to offer it to more women (there) than what I would be able to here,” she said. The session will include group and individual shots. “We’re also going to share their story,” Hyman said. “Everybody has got a unique story on their survival.”
Sparkle and Celebrate Pink
When: 10 a.m. Oct. 18 Where: Cotton Rouge & Co Studio, 250 Mill St., Taylors, S.C. How much: Free More info: www.mirroredimages.net
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
7
Help along the way Patient navigators help manage ups, downs of cancer diagnosis, treatment BY JOSHUA SILAVENT For The Times
For women with breast cancer, having a support network can be essential in their long-term prognosis. As a patient navigator at the Northeast Georgia Medical Center, Lisa Bridges stands on the precipice of what comes next for women with a new cancer diagnosis. Bridges, a registered nurse who helped launch the program nearly 10 years ago, said navigators assist from the moment of diagnosis all the way through treatment to survivorship by engaging families in decision making, removing logistical and financial barriers to care and providing needed education on what women can expect in their medical journey. It’s about personalizing services. “The navigation really adds that extra dimension,” Bridges said. “You’re not the breast cancer patient in room four. You are more than your diagnosis.” Helping patients navigate all the what ifs that accompany cancer treatment begins, in many ways, with helping them manage fear. “It is difficult,” Bridges said. “But as nurses we kind of do that anyway.” Shouldering the burden of cancer with patients is made more difficult the younger and older they are, Bridges said, particularly if families and friends are not present and financial constraints enter the picture. “Those are real needs,” she added. “They have difficulties that give them a hard time to be treated.” “It’s not just the diagnosis that impacts them, but what was going on in their life beforehand,” Bridges said, adding that it could be work complications or prior illnesses in the family. During treatment, Bridges said patients can be overwhelmed and unsettled by the level and intensity of care they receive. “I don’t think they realize how many people are going to be involved in taking care of them,” she added. And the challenges often continue for patients even when they reach remission. By that time, they’ve become “accustomed to being watched very carefully,” Bridges said. With so much mental, physical, emotional
SCOTT ROGERS | The Times
Lisa Bridges is a breast cancer patient navigator at the Northeast Georgia Medical Center. The program provides a continuous presence from diagnosis to completion of treatments.
and spiritual energy directed at the challenge of surviving cancer, sometimes the grace shown to them by friends and strangers alike can wane. Bridges said it’s important for navigators to remain with patients into survivorship with continued counseling and stress management. “It’s like you withstood the bomb blast but you’re still picking out the shrapnel,” she added. There’s also the lingering fear of if and when cancer might return. “They’re looking over their shoulder,” Bridges said. Over the next three to five years, Bridges said she expects demand for services at the medical center and The Longstreet Clinic to grow. Meeting this demand will likely require the addition of new patient navigators and an increase in provisions to care for survivors.
While Bridges specializes in breast cancer, other navigators are dedicated to supporting patients with head, neck and lung cancers, gastrointestinal diseases like colon cancer, and then gynecological diseases and prostate cancer. The American Cancer Society also supports navigation services. Like many working in the health care or social service fields, Bridges has found that her patients have taught her perhaps as much or more than she has taught them. For example, she said, waiting in line at the grocery counter or other minor inconveniences are nothing to get frustrated about. It’s as if Bridges has learned to find the beautiful in being annoyed. It’s all about gratefulness. “When you deal with people who have a life-threatening illness, you feel a lot more gratitude for the small things in life,” Bridges said. “Things don’t bother you as much.”
CMYK 8
think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
The importance of checkups Local survivor advocates for being proactive, health conscious BY KAYLA ELDER
kelder@gainesvilletimes.com Gail Barksdale seemed to have a clean bill of health. She followed a healthy routine doing yearly mammogram screenings and working out with a personal trainer. Her mammogram results continued to come back normal even after she found a knot under her arm in the summer of 2004. She assumed everything was OK because she had no history of cancer in her family. “I have always been health conscious,” Barksdale said. “I was, at the time, going for regular checkups with my gynecologist and having the mammograms. There is no history of cancer in my family, so it was not on my radar. But when you go for your mammogram, you assume everything is going to go great.” In July, she went to the doctor for another reason and happened to mention the knot. That’s when things changed. After making another appointment, this time having a diagnostic mammogram and ultrasound, she was directed to see a surgeon. “They did it all in one day,” Barksdale recalled. “When the surgeon wanted to see me in the Women’s Center, I knew it was not looking good.” Barksdale was given the option of having a lumpectomy with radiation or a mastectomy. “My little knot was very tiny so I didn’t think it would be a big deal,” Barksdale said. “The chances of it returning are a little higher if you do a lumpectomy, but I had read it was a real trauma to your body to have a mastectomy. For a moment, I couldn’t decide. It was all new. It was hitting me in the face, and I hadn’t had a lot of time to think.” She decided on a lumpectomy, resulting in clean margins. But her post-operation visit came with bad news, Barksdale said. “It had metastasized. There were cancer cells growing in what was sent off. There was no sure way to know if they had gotten all of the cancer,” Barksdale said. “Then I had to make a decision of whether he should go back in and take more tissue or have
DAVID BARNES | The Times
Gail Barksdale found a knot under her arm in 2004 that was later diagnosed as breast cancer. She has now been cancer free for 12 years.
cancer treatment.” Barksdale chose the cancer treatment, adding that “when someone tells you that you have cancer, you want to take care of it right then.” The following months she began chemotherapy and radiation. “Everything is black and white for me; I make a decision and move forward. I think in my mind, the reason everything was OK, no matter what happens with the treatment, I felt like I was doing something for the next generation,” Barksdale said. “The next person that has breast cancer, maybe they will learn. When you
go into the oncology office, you answered questions on an iPad about how you felt, what was going on, and before you start your treatment you meet with a psychologist and support team. They are very sensitive to all of your needs.” She said there are “things in life that change you,” cancer being the turning point for her. “It is a real marker to view your life and see those people around you, some aren’t going to make it,” Barksdale said. “It makes you think through your life and what you want it to look like. Right now I want to be busy and a part of life. ... That was the beauty of how every-
thing evolved.” Barksdale, 62, stayed busy in her position as a first time advocate at Georgia Southwestern State University in Americus, then as the assistant director of learning support at the University of North Georgia’s Gainesville campus. “My doctor said my job was a turning point for me. It gave me hope; I was around young people full of life,” Barksdale said. “Really, what you do with your next step is critical. As you see people living, you want to be a part of that and value it more.” Barksdale has now been cancer free for 12 years. She continues to
have checkups with her oncologist and has blood work done every six months. “If anything is wrong or not ticking right, you know they are going to jump on it. Follow-ups are critical,” she said. “You need to know your body. When it comes to breast cancer, it is important you do your own examinations. If something doesn’t feel or look right and it keeps coming to your mind, go see what it is. Don’t be afraid. You will get support as you go along.” Barksdale said that “before big things happen you have to think about what you would do before the battle.”
OcTOber 18 Join The Times’ Facebook Live event to hear breast cancer survivors share their stories. Go to Facebook.com/gainesvilletimes
at NOON on October 18
to hear from them, ask questions and share your own stories. Courtesy of Christine Holcomb
iLash Studio 42 is the sponsor of this event.
Christine Holcomb, left, and Lynn Kearns lead a HealingStrong support group.
There’s no one-size-fits-all solution to helping those experiencing breast cancer BY KAYLA ELDER
kelder@gainesvilletimes.com Most have been touched by cancer. Whether it be a personal diagnosis, a family member, a friend or even an acquaintance, most have had an encounter with the disease. For some patients, those who just encounter the disease and don’t have the diagnosis themselves can add stress. “You need support to give you encouragement,” said Christine Holcomb, treasurer of the local chapter of HealingStrong, a cancer support organization. “Just try to live and enjoy life. The way you think affects every cell, so being supportive and having happier people around you is really important.” Holcomb said loved ones can help during a breast cancer diagnosis by simply being there. “Be there as a friend and say, ‘what can I do for you?,’ instead of getting information for them. Sometimes a good book helps, but just being there, being a friend and not trying to control their treatment is best,” Holcomb said. “It is so overwhelming already when you are in the throes of it. Most people are capable of doing their own research unless they are very sick.” Diagnosed in 2011 with breast cancer, Holcomb decided against chemotherapy and instead chose to support her immune system with raw foods, supplementation and detoxification. In 2013, she attended the first
HealingStrong conference and realized the importance of in-person support. This led to the first HealingStrong group in Gainesville. HealingStrong is a cancer resource organization educating, connecting and encouraging those seeking comprehensive, natural strategies to heal and stay strong. “The importance of groups is enormous. Just being there listening to all the stories is exciting. It is powerful,” Holcomb said. “This is a group that is not down. We don’t say ‘I have stage 2’ or ‘I was diagnosed” — we don’t talk about that. “We talk about how to build our immune systems, how to get healthy and how to stay strong.” Linda Conover has been going to the HealingStrong support group for three years, before and after her cancer diagnosis. She, however, said the most important thing people can share when loved ones are going through their cancer journey is their knowledge. “I’ve studied health my whole life, and I thought I knew everything until I came to this group. Knowledge is power,” Conover said. “Listen to doctors, as well as those around you going through it.” She said learning from others is the way to “getting healthy, being healthy and staying healthy.” “It is important to talk to others to learn from them and share experiences of what works and what doesn’t work,” she said.
OcTOber 26 Silent Auction
for Bras for a Cause with Wine & Hors d’Oeuvres To raise funds for breast cancer awareness, The Times is hosting a silent auction on
Thursday, October 26, 2017 from 4 p.m. to 6 p.m. at Quinlan Arts Center. Local artisans have created art pieces using bras, donated by Belk. Oakwood Package Store is the sponsor of this event.
Quinlan Arts Center 514 Green Street, Gainesville, 30501 For more information, contact Leah Nelson at 770-535-6330
Proceeds to benefit For Her Glory Honestly Local
iLash Studio 42
CMYK think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
9
How to know whether to forgo chemo Valerie Malyvanh Jansen and Ingrid Mayer Vanderbilt University
(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.) THE CONVERSATION — There has been substantial publicity about the MINDACT trial, which could lead to changes in breast cancer treatment. The study’s results suggest that women with a certain genetic profile would have a good chance of survival and cure regardless of chemotherapy. While the results are encouraging, breast cancer treatment decisions are complex, and this study does not necessarily provide a clear yes or no answer about the need for chemotherapy. As oncologists, we see this latest scientific development as yet another powerful tool in assessing a patient’s risk of developing cancer recurrence. However, the study results cannot be used as a sole tool to help guide treatment decision making. It does not tell you that if a patient has a genetic profile associated with high risk of recurrence, taking chemotherapy would change that risk. In essence, this trial is one more tool to inform patients and physicians about a tumor’s biologic behavior (more or less aggressive, more or less chance of development of a cancer recurrence). But the takehome message is that these results still do not help physicians and patients decide if chemotherapy can be skipped or not.
A treatment mainstay For years, surgery was usually the first step to remove a breast cancer tumor from the body. Both surgery and radiation (needed in certain cases) are helpful in promoting “local control” of the breast cancer. Treatments such as chemotherapy and/or hormone-blocker pills are considered as additional or adjuvant treatments, to help “sterilize” the rest of the body (“systemic control”) from potential microscopic cancer cells that can break off from the original tumor in the breast, and ultimately may be responsible for the so-called distant recurrence of the breast cancer. The decision of whether
a breast cancer patient will receive chemotherapy and/or hormone-blockers is based on many factors, including tumor size, grade, lymph node status, and presence or absence of hormone receptors or HER2 receptors. In years past, chemotherapy was given to most women. It often brings unpleasant side effects, including nausea, hair loss and fatigue. Some of the toxic drugs used in chemotherapy can sometimes cause health issues years down the road, such as thinking or memory problems called chemo brain. In addition, chemotherapy requires a great deal of time. It is also expensive, often costing tens of thousands of dollars. The decision of whether to have chemotherapy or not is, thus, a very important choice for hundreds of thousands of women receiving treatment for breast cancer. It is understandable that many women prefer not to have chemotherapy. The good news is that many women with early stage disease are now potentially cured, sometimes without chemotherapy given after surgery.
understanding a complex disease Breast cancer is the most common cancer diagnosis and the second leading cause of cancer-related deaths in American women. Only lung cancer kills more women. Not all breast cancers are alike. In fact, we are finding that many are much more aggressive than others. Many respond well to new therapies. In a new era of personalized medicine, we, as oncologists who specialize in breast cancer, have much more information than ever to guide us in helping our patients. Research has found that more than 75 percent cases of breast cancer express what we call hormonereceptors, which are proteins in the cancer cell that are “fed” by the hormone estrogen. This “fuel”, in turn, causes the cells to grow and divide. These cancers are called estrogen-receptor positive, or ER+. Treatment of early stage ER+ breast cancer consists of surgery, sometimes radiation, and hormone-blocker (endocrine) therapy with or without chemotherapy. After a woman’s tumor is
support ■■ Continued from 1 diagnosed with breast cancer made her “feel sad and very emotional.” “It has changed my life,” she said. “It was by the grace of God and so many prayer warriors that I was able to get up every morning, and of course the love of my husband and children. It is devastating and hard.” During that time, Chambers reached out to a support group. “The ladies that I found, they were wonderful women who told me their stories and supported me with what I was going through, but they had just lost so many members,” Chambers said. “I went, I met friends, but it wasn’t what I needed.” The women had been through the process, but Chambers felt she needed to hear from
financial ■■ Continued from 1 with different foundations to connect people with resources such as the American Cancer Society, The Cancer Foundation and Glory, Hope & Life. “One of the biggest barriers that we do see is transportation, and there are a couple different avenues that we can assist our patients with,” Roberts said. “If our patient needs physical transportation to get to and from treatments, we help arrange Road to Recovery, which is volunteers through the American Cancer Society to help our patients get back and forth.” Glory, Hope & Life, “a great resource to have in this area,” helps by giving funds to patients for gas, food and utilities, Roberts said. “The Cancer Foundation covers several counties around us — they help with similar things, but they also
‘... many (breast cancers) are much more aggressive than others.’
examined in a biopsy, some of the recently developed profiling tools can be used to help assess risk of recurrence and death in a more precise way. First, there is Adjuvant! Online. This software provides an estimation of chemotherapy effectiveness when added to endocrine therapy, based on clinicalpathologic features, or what we see in a patient upon exam, or what we learn through laboratory tests. Second, there is Oncotype DX, a 21-gene test, that actually has the ability to predict chemotherapy benefit and the likelihood of distant breast cancer recurrence, or metastasis. More recently, a third tool called MammaPrint was developed. This 70-gene signature examines 70 genes involved in breast cancer growth and survival, and was the one tested in the MINDACT trial. Unlike Oncotype DX, it only provides risk assessment (low risk or high risk) for distant recurrence, or metastasis, but it does not predict chemotherapy benefit. The purpose of the MINDACT (Microarray in NodeNegative and 1 to 3 Positive Lymph Node Disease May Avoid Chemotherapy) trial, an international, prospective, randomized phase 3 study, was to determine the clinical utility of the addition of the 70-gene signature (MammaPrint) to standard criteria in selecting patients for chemotherapy. The analysis focused on patients with discordant risk results. These included those with cancers that showed high clinical risk but low genomic risk. High clinical risk would include a woman who had a larger tumor size and more lymph node involvement. Low genomic risk refers to those cancers lacking the genes that signify aggressive growth. The women were randomly selected, based on high or low clinical risk, or on high or low genomic risk. The women that had both low clinical and genomic risk did not receive chemotherapy and were not evaluated in the trial. The women with both high clinical and genomic risk all received chemotherapy in addition to endocrine therapy, and were also not evaluated in the trial. The women with discordant risk (i.e. high
someone in the same place as she was. Chambers said she needed “to hear from someone who had a bilateral mastectomy.” “I have several friends who had gone through that, but if I had a woman who was going through it at the same time I was, that would have been a wealth of information for me,” she said. “That is what I was looking for so we could go through it together.” She found that woman, and a core support group of friends, at an Amy Grant music video filming. “The whole video consists of breast cancer survivors. I had met someone who had gone through the same thing as me, and we became very close friends,” Chambers said. “I needed someone who understood how I was feeling at the time, because I was broken and I needed someone to talk to — someone to say things out loud to.” Chambers said she “would encourage anyone going through breast cancer to reach out and look for someone who has been through it or is going through, and talk to them.”
help with durable medical equipment, pharmacy expenses and sometimes copays,” Roberts said. Roberts said there is a variety of resources depending on the need. “I typically help patients connect with Look Good Feel Better, a local cosmetologist who volunteers her time through the American Cancer Society and teaches women how to deal with adverse side effects to chemotherapy and radiation,” Roberts said. Through the American Cancer Society, Roberts is also able to provide all her patients with a personal health manager, which is “a really nice organizer for our patients to keep track of things, because sometimes it can be really overwhelming with all the doctors, chemo and radiation appointments,” as well as one free wig. “We do also have a hospital charity through Northeast Georgia Medical Center. What I would suggest to patients that are unin-
sured or underinsured is to definitely apply to our hospital charity,” Roberts said. “We do give chemotherapy and radiation at the hospital, so if a patient is approved at 100 percent, then their bill would be taken care of.” Roberts said there are a variety of local resources that have helped patients “get to their treatment or continue on with their treatments.” “There are definitely resources out there,” Roberts said. “I had good insurance and still I needed assistance, so there is also help for patients that still do have insurance that maybe need some assistance as well.” For more information and resource help, contact Roberts at Jennifer.Roberts@ nghs.com. “I think the biggest thing is contacting either myself or Lisa Bridges, the nurse navigator, if they are feeling like they are overwhelmed or need some help,” Roberts said. “... I think that is the best way to help them.”
genomic risk but low clinical risk, or low genomic risk and high clinical risk) were all treated with endocrine therapy, but were randomized to either receive chemotherapy or to not receive chemotherapy. In the group of women with high clinical risk but low genomic risk who were treated with chemotherapy, there was only a 1.5 percent increase in the five-year survival rate, without the cancer spreading to another organ in the body, the authors reported. (95.9 percent in the chemotherapy group vs. 94.4 percent in the no chemotherapy group). Since the five-year survival is very similar in both groups, it is still unclear who are the women that actually can truly be spared of chemotherapy. Similar results were seen in the group of women with low clinical risk but high genomic risk (i.e. the fiveyear survival rate was very similar between the patients randomized to chemotherapy or not).
Bringing together information So what does this mean for our patients in the clinic? Let us consider two hypothetical clinical scenarios. Patient 1 is a 55-year-old woman with a 1.5 centimeter tumor that is ER+, lowgrade, low proliferative rate with 0 of 3 sentinel lymph nodes, or nodes to which the tumor is most likely to have spread. Proliferative rate refers to the rate of growth of cells within the tumor; less than six percent is low, and greater than 10 percent is high. Based on these clinicalpathologic features of her tumor, she is considered to have low clinical risk. According to results from the MINDACT trial, her clinical risk would trump her genomic risk, therefore, getting a MammaPrint test would be a waste of time and
money. Patient 2 is a 55-year-old woman with a 3.0 cm tumor that is ER+, high-grade, intermediate proliferative rate, with 2 to 5 positive sentinel lymph nodes. The patient is adamant about not receiving chemotherapy. Based on the clinicalpathologic features of her tumor, she is considered to have high clinical risk, and chemotherapy followed by endocrine therapy would be the standard of care recommendation. If her MammaPrint test returns as low genomic risk, we could counsel the patient about her risk of distant metastasis without chemotherapy and breathe a sigh of relief if she had low genomic risk. She would certainly benefit from endocrine therapy, a daily, oral medication, for five to 10 years to reduce her risk of distant recurrence, or cancer that has spread, or metastasized. It is not clear, however, whether she would be in the 1.5 percent of patients who might have benefited from chemotherapy but did not receive it, or in the group of patients who were spared the toxicity of chemotherapy based on the MINDACT trial. These cases illustrate the complexity of clinical decision making in an era when we have a growing amount of data about the biology of each patient’s cancer. The MammaPrint test as used in the MINDACT trial suggests but does not predict a patient’s benefit from chemotherapy. It is merely a prognostic tool that tells us that the biology of the tumor matters. We already knew this. For this reason, we believe the MammaPrint test is another tool which may help patients understand their risk of recurrence better. It is important that patients continue to have active discussions with their physicians about treatment options based on these gene panel tests in an effort to achieve personalized care.
NICK BOWMAN | The Times
A Christmas kitty-themed bra will be available.
Local artists decorate bras for a cause Bras decorated by local artists will be available during a silent auction event later this month to benefit For Her Glory, a local charity that provides wigs to women who have lost their hair due to battling cancer. The Times is putting on Bras for a Cause 4-6 p.m. Oct. 26 at the Quinlan Visual Arts Center in Gainesville. “We’ve got 10 bras donated by Belk, and artists have decorated them,” said Leah Nelson, advertising director for The Times. Among the artists participating are Linda Tilden, Anne Brodie Hill, Denise Wellborn, Jessica Deese, Melissa Howard and Jessica Drexler. “It’s just whatever their interpretation is,” Nelson said about the designs. “I’ve received a couple that are holiday themed.” Admission to the event is free, and guests will be able to enjoy wine and snacks as they view the pieces. Nelson said The Times hopes to continue this event in the future. “We hope it gets bigger and bigger and (we) have more artists involved,” she said. “We just hope it grows and grows.” Amber Tyner
Bras for a cause
When: 4-6 p.m. Oct. 26 Where: Quinlan Visual Arts Center, 514 Green St. NE, Gainesville How much: Free admission
Join us at Hulsey Environmental Services, Inc. nt Hu
ing for a Cur e
Save a Rack!
WE SUPPORT YOU! Many individuals, in this little part of Georgia that we call ‘home’, have been affected by Breast Cancer. One in every eight will be diagnosed with this disease this year. Each one of us has the opportunity in spreading awareness to our Community about Research and Early Detection. Show your commitment in finding a cure! Together we can end Breast Cancer!
Hulsey Environmental Services, Inc. 1430 Calvary Church Road, Gainesville, GA (770) 536-1161
CMYK 10
natalie ■■ Continued from 1
SCOTT ROGERS | The Times
Natalie Kytle Donatelli was recently diagnosed with breast cancer at age 36. She is currently going through chemotherapy and may have radiation later this year.
Resources for patients The Longstreet Clinic Cancer Support Group
What: Support group for all cancer patients, caregivers and survivors When: 6:30 p.m. the last Tuesday of every month Where:Longstreet Cancer Center waiting area, 725 Jesse Jewell Parkway, Gainesville
Breast Cancer Faith-Based Support Group
What: Support group for breast cancer patients, caregivers and survivors. When: 2 p.m. the fourth Saturday of every month Where: Flat Creek Baptist Church, 5504 Flat Creek Road, Oakwood More info: Call Robyn Chambers at 770-401-4893 to attend
Northeast Georgia Health System Oncology Patient Navigators
What: Provides cancer patients with guidance and support throughout their cancer journey, including helping to navigate the health care system and any challenges that may impede treatment. When: Navigators can be
think pink
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
She said she recently attended a “dueling pianos” live music show at 37 Main in downtown Gainesville all by herself. “I really kind of enjoy that,” she said. “I normally would not do that by myself.” The community has stepped up, too, and in return Donatelli hopes sharing her story can benefit other women in some way. “It’s been an opportunity to share the strength that I’ve gained from this journey,” she said. So despite the side effects of chemotherapy, such as mouth sores, fatigue and decreased appetite, Donatelli remains hopeful. “I have a peace about it,” she said. “I’m pretty
reached from 8 a.m. to 4 p.m. Monday through Friday. More info: Registered nurse Lisa Bridges assists patients with breast cancer. Call 770-2195857 or email Lisa.Bridges@ nghs.com
American Cancer Society local assistance
Jennifer Roberts, patient navigator with American Cancer Society, provides access to programs and services. Call 770-219-5812 or email Jennifer. Roberts@nghs.com.
Natalie Kytle Donatelli Breast cancer patient
stubborn.” The doctors have given her great advice, too. “Your journey is your own journey,” Donatelli said she was told. So while a “textbook” prognosis might give her two to five years to live, Donatelli said, “Who knows?” “Live each day and make each day special,” she added. “That’s probably the best piece of advice (the doctor) gave me.” There are tough days, for sure. It’s more emotional than physical, Donatelli said. And it’s hard for her being on the other side
More info: 770-219-8820, www. nghs.com/clinical-trials
Northeast Georgia Medical Center’s Financial Assistance
What: Helps patients apply for public health coverage programs, discounts, payment plans or free care to eligible uninsured or underinsured patients for medically necessary care. More info: 770-219-1898, www. nghs.com/financial-assistance
Cancer State Aid
Cancer Rehabilitation
What: Northeast Georgia Medical Center’s cancer rehabilitation services treat the side effects of chemotherapy, radiation and other common treatments of cancer. Patients can consult with the staff to verify insurance benefits for specific plans. More info: 770-219-8200, www. nghs.com/cancer-rehabilitation
Clinical trials
‘I realize I have the strength, and I’m going to keep fighting and nothing is going to get me down. Honestly, I feel like it’s a God thing.’
Northeast Georgia Medical Center partners with many national oncology groups to provide patients the opportunity to participate in nationwide clinical trials sponsored by National Cancer Institute and other established cancer institutions.
What: Provides financial assistance for cancer-related diagnostic testing, evaluations and treatment planning support, as well as cancer treatment support for patients whose prognosis and planned treatment are medically eligible for program funding. More info: Contact Lisa Hunsbusher at 770-219-1734 for eligibility requirements or visit dph.georgia.gov/cancerstate-aid-2.
Cancer Foundation
What: Assists patients in Northeast Georgia with rent/ mortgage, prescriptions not covered by insurance, utility bills, nutritional assistance, durable medical equipment and
when she’s so used to caring for the ill. First getting the diagnosis made her a little frustrated that she hadn’t been more proactive. “I kind of beat myself up,” she said, adding that she hadn’t been regularly performing self-examinations. But with no family history of breast cancer, Donatelli could be forgiven for thinking she wasn’t a likely candidate. She said she has to be careful and mindful to set limits on her activities and commitments, but she wants to remain engaged in
gas cards ($500 cap per patient each year). More info: 706-353-4354, www. cancerfoundationofnega.org.
Glory, Hope and Life
What: Assists cancer patients, caregivers and families with a variety of financial, physical and emotional support services through resources, programs and activities. More info: 770-533-4705, www. gloryhopelife.org
Salvation Army Project SHARE
What: Provides utility assistance for people affected by illness, job loss or other unfortunate circumstances. More info: 770-534-7589, projectshareinfo.com/where-toapply
Chaplain services
What: Northeast Georgia Health System offers chaplain visits, contact with personal pastors, devotional literature and Sunday chapel services. When: Chapels are available 24 hours a day, seven day a week. Office hours are 9 a.m. to 4 p.m. Monday through Friday. Where: NGMC Braselton and NGMC Gainesville More info: Gainesville office: 770-
her children’s lives and her own work. Donatelli will conclude the first rounds of an aggressive form of chemotherapy in December. Then her bones will be rescanned to check progress. No changes and no new lesions would be a good sign. Radiation would come next. And she’ll keep planning her future without hesitation in the meantime. “I realize I have the strength, and I’m going to keep fighting and nothing is going to get me down,” she said. “Honestly, I feel like it’s a God thing.”
219-5077, after-hours 770-2191873; Braselton office: 770-8484928, after-hours 770-848-0735
Hospice of Northeast Georgia Medical Center
What: Provides inpatient and outpatient hospice services More info: 770-219-8888, www. nghs.com/hospice
HealingStrong
What: Support group focused on natural strategies to heal and stay strong. When: First Tuesdays of the month Where: Natural Juice Cafe, 2480 Limestone Parkway, Gainesville More info: www.healingstrong. com, christine@healingstrong. com
Look Good Feel Better
What: American Cancer Society program that teaches beauty techniques to help women cope with some of the physical changes they may experience. More info: lookgoodfeelbetter. org, 800-395-5665
Team Maggie for a Cure
What: Helps women fund fertility treatments and egg retrievals. More info: www. teammaggieforacure.org
Willa, we admire the courage you have shown for more than a dozen years following a double mastectomy, and other cancer.
So She Did
bravery
I never knew what was until I saw it in my Nana/ Mama! for choosing to fight 21 years ago!
Thank you
Love Mario, Ches, Madison, and Jordan
She Believed She Could
Martha T. Mays
love and blessings from sisters, linda and Helen
Kicked Cancers Butt in 1996!!
Love Asberry Turner and Vickie Turner
Pink is Pretty Pink is Bright My Nana/ Mama made the decision to...
Live and Fight!!! Congratulations on 21 years of being
a Survivor!!
Love Jade and Carmen
Diva
Cancer picked the wrong & got its ugly butt kicked!!! Love Coop
CMYK THINK PINK
The Times, Gainesville, Georgia | gainesvilletimes.com
Sunday, October 8, 2017
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770-831-0155 • email: pthcleaning@aol.com website: www.personaltouchcleaning.com
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We Support Breast Cancer Research
My Sister's Resale Boutique A high-end thrift store selling home decor, clothing for men & women, shoes, purses & jewelry.
100% of the proceeds benefit the homeless women and children of the My Sister's Place shelter. Monday-Friday 10 a.m. - 6 p.m. | Saturday 10 a.m. - 3 p.m. 130 John Morrow Parkway, Suite A, Gainesville, GA 30501
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3210 Poplar Springs Road Gainesville, Ga
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CMYK 12
Sunday, October 8, 2017
The Times, Gainesville, Georgia | gainesvilletimes.com
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