Supplement to the Tulsa World, Thursday, September 7, 2017
CANCER Survivors
Embracing life with
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Lung screening made a world of difference in Donna Coday’s life By Stefanie Forney, Special Sections Editor Lung screening made a big difference in Donna Coday’s life. With no symptoms to alert Donna Coday, 66, that her life was about to change last October, she went about her normal day-to-day activities, which often included being the person who family and friends came to share their problems with and lean on. Coday and her husband, Gary, live in Locust Grove. They have four daughters and eight grandchildren. “I didn’t have any symptoms, not even a cough,” recalls Coday. There was nothing that would have taken me to the doctor. I felt wonderful, but my sister, Barbara, was diagnosed with lung cancer last August. I was not familiar with cancer and didn’t know the dangers. I started going with her to her treatments at Oklahoma Cancer Specialists and Research Institute (OCSRI) and her doctor’s appointments, and we learned that although it’s scary, we could do it.” But when her husband’s primary care doctor was concerned about him being tired all the time, the doctor sent him to take a sleep apnea test at Hillcrest. The hospital was offering lung cancer screening tests so they decided to take the test together on their wedding anniversary in October then go to lunch. “They called and said the test showed something spotted on my lungs, and his test was clear,” Coday says. Her primary care physician sent Coday to a pulmonary doctor, who gave her two options: a needle biopsy or bronchoscopy. She chose the latter when she learned it was the most effective. “Everything started happening real fast,” she recalls. “I had the bronchoscopy, and a couple of days later I was told I had adenocarcinoma. It was 18 mm, and a couple of lymph nodes were involved.
anxiety. Fortunately, Coday is getting help for that. The whole experience has been quite an adjustment. “I went from being the caregiver of the family, where everybody came to me to talk about their problems and lean on me, to someone who needed care,” she says. “My caregiving had to stop, and it was hard for me. It’s also hard on those who lean on us. It’s a big adjustment for everyone. Patients aren’t the only ones touched by this. It affects the entire family, and everybody has to adjust.” Coday wants to encourage others and is very passionate about lung screening. Risk factors include smoking tobacco, living with secondhand smoke, if you are over 65, exposure to cancer-causing substances such as asbestos and radon, or if you have a family history of lung cancer. Early lung cancer does not cause symptoms. However, as it grows, the Tulsa World photo most common symptoms include: Donna Coday is passionate about lung screening and has plans to share • A cough that gets worse or does her experiences to encourage others going through this type of journey. not go away • Trouble breathing, such as short“There was no question where I very strong. I made it through two of ness of breath • Hoarse voice would go for treatment,” she says. those, and Dr. (Mary) Wasson decided • Frequent lung infections, such as “I went where my sister was being not to do the third one because my treated. We had matching reclinblood counts were falling too rapid- pneumonia • Feeling tired all of the time ers. I was no longer the caregiver; I ly,” Coday says. “In my opinion, radia• Weight loss with no known cause was now the patient. She was two tion does the curative, and chemo is • Constant chest pain months ahead of me in the program. kind of what you do to mop up any • Coughing up blood Having watched her go through cells that might have escaped.” radiation and chemo, I was mentally Coday says the doctors tell her she “I hope people will get the screenprepared.” is cancer free today, and her sister ing,” she says. “I also want them to From the very beginning, Coday is in remission. Both women have loved everyone at OCSRI who asfollow-up scans every three months. know that if they are going through something like this, they can do it! sisted in her treatment. “They are the Coday would tell anyone facing most compassionate, friendly, helpful cancer treatment to expect to expe- There are people who will take very good care of you as you go through people I’ve ever, ever been around,” rience fatigue. treatment.” she said. “I was in good hands.” One “Don’t push yourself. Go with it. It Coday is looking forward to volunof the radiation technicians was won’t last forever,” she says. “When even a close friend of one of Coday’s the last treatment knocked me off my teering with OCSRI. “There is nothing like talking to daughters. feet, Dr. Wasson told me, ‘This is not somebody who has been through it Coday went through 35 rounds your new normal. Your new normal of radiation and finished in January, will arrive later.’ Slowly, it did. I now go and knows what it’s like,” she says. and then she started chemo. “I was to an indoor track and walk the track “That gave me a lot of comfort while I was going through it, and that’s supposed to do three rounds at the to build my energy back up.” why I’m checking into volunteering.” very end that were very long and One thing she didn’t expect was
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Richard Smith advocates early prostate detection can save lives By Stefanie Forney, Special Sections Editor Other than skin cancer, prostate cancer is the most common cancer for American men. The American Cancer Society estimates that, by the end of this year, more than 160,000 new cases of prostate cancer will have been diagnosed in the United States. More than 26,000 deaths will result. In fact, about one in seven men will be diagnosed with prostate cancer in their lifetime. The good news is that although prostate cancer can be a serious disease, most men diagnosed with it will not die from it. Richard Smith, 62, who lives in Norman with his wife, Lisa, is an advocate for early detection. “You’ve heard the expression, ‘location, location, location.’ I am saying, ‘Early detection, early detection, early detection,’” says Smith. “Get your PSA (prostate-specific antigen) checked on a regular basis! Because of early detection and Cancer Treatment Centers of America (CTCA), my outcome has been excellent.” Smith says his PSA level started to creep up at his yearly physical exams. He wasn’t too concerned at first
Free PSA screenings The National Football League Alumni Association (NFLA), Cancer Treatment Centers of America (CTCA) and LabCorp are teaming up for the Prostate Pep Talk campaign. Beginning Sept. 1 through Oct. 15, 2,000 men, ages 40 and older, who meet eligibility requirements, may sign up to receive a free Prostate Specific Antigen (PSA) screening by LabCorp at most of its 1,750 locations throughout the U. S. After the first 2,000 free PSA screening spots are filled, eligible men may still schedule a screening at the discounted price of $25 throughout the sign-up period. Screenings must be performed within six months of the sign-up date. Eligible men may order their free or discounted PSA screening by visiting the Prostate Pep Talk website. Testing will be performed by LabCorp at most of LabCorp’s patient service center locations across the country. Men who have a PSA outside a normal range should consult with their physician to determine the next steps that best suit their needs. Elevated PSA levels do not always indicate prostate cancer. To sign up for a free or discounted screening, go to prostatepeptalk.com.
Courtesy photo
Richard Smith (second from left) with his wife, Lisa (right), and two of their children, Spencer and Morgan. because he knew the number could fluctuate a little. But it got to the point that his doctor urged him to visit a local urologist. “He told me about a test called a free PSA, which means unbound antigen,” Smith says. “He said your free PSA is a number between 3 and 25. So if I sent 25 storm troopers into battle and you only get 10 of them back, they aren’t an encampment. Fifteen of them have been killed off, and you have cancer. That made more sense; we aren’t just saying a number is elevated.” Smith had the PSA blood test, and his number came back at 14. “Oops, I definitely have cancer,” Smith says. “Next we did a biopsy to find out how much. My biopsy was last December. They do 12 tests in the prostate, and mine came back that six of the 12 were infected with cancer.” That meant that Smith needed to face treatment. He began educating himself about the total function of the prostate, and he learned that it was pretty important. “I decided that I wanted to keep my prostate,” says Smith, who contacted CTCA. “I was overwhelmed with what was available for treatment there — in a good
way! CTCA’s doctor used Cyberknife, which is a targeted radiation treatment. I’ve been very happy with the results.” Smith says that cancer definitely makes you realize that there can be bumps in the road, but the approach and attitude you have helps get over those bumps. “Because of early detection, my cancer diagnosis did not include chemotherapy. I consider myself blessed to not have gone through the sickness or other side effects chemo can cause.” Smith gives his wife 1,000 percent credit for her efforts as caregiver as they traveled this journey together. “Caregivers are vital to your treatment. Nobody asks how the caregiver is doing during the whole process, but it’s just as hard on them,” Smith says. “My life since treatment is different in the way that I spend more quality time with my family, and I enjoy the closeness that my wife and I have,” he adds. No case is typical. You should not expect experience these results.
Exercise can decrease the potentially harmful effects of obesity, which are linked to the development of insulin resistance. It’s becoming clear that insulin resistance is an important regulator of the development of cancer. Courtesy photo
Exercise plays vital role in reducing cancer risk (MS) — Cancer can strike without warning. Although there is no way to prevent cancer, there are certain measures people can take to help reduce their risk, and exercise is one of the more effective ways to do just that. The National Cancer Institute notes that there is substantial evidence to support the idea that higher levels of physical activity are linked to lower risks of several cancers, including colon cancer, endometrial cancer and breast cancer. In addition, a study published in the journal JAMA Internal Medicine found that leisure-time physical activity was associated with a significantly decreased risk of not only these three can-
cers, but also esophageal cancer, liver cancer, stomach cancer, kidney cancer and myeloid leukemia, among others. As many as one-third of cancer-related deaths can be linked to obesity and sedentary lifestyles, so it’s easy to see the relationship between exercise and a reduced cancer risk. One of the more important ways that exercise may lower cancer risk is through the reduction of estrogen and insulin levels in the body. Women with high estrogen levels in their blood have increased risk for breast cancer. Although estrogen is a reproductive hormone, it is also contained in fat cells. Exercise can help burn fat and lower the amount of blood estrogen in the
body, thereby lowering a woman’s risk of developing breast cancer. Exercise also can decrease the potentially harmful effects of obesity, which are linked to the development of insulin resistance. According to the study, “The Links Between Insulin Resistance, Diabetes, and Cancer” by Etan Orgel, MD, MS, and Steven D. Mittelman, MD, PhD, although the precise mechanisms and pathways are uncertain, it is becoming clear that hyperinsulinemia (insulin resistance), and possibly sustained hyperglycemia, are important regulators of the development of cancer and treatment outcome. Insulin resistance has been linked to the development of tumors in cases of breast and colon
cancers. The NCI states that exercise also can reduce cancer risk by: • reducing inflammation, • altering the metabolism of bile acids in the gastrointestinal tract, helping to decrease exposure of the body to suspected carcinogens, • improving immune system function, and • boosting mood and feelings of wellbeing. Additional research is needed to study the link between exercise and cancer risk. However, based on observational studies, existing studies support the notion that regular exercise can go a long way toward reducing cancer risk.
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Positive attitude central to Andy Firey’s journey By Stefanie Forney, Special Sections Editor It all began when Andy Firey noticed some lumps on his neck, which he thought might be swollen lymph nodes. His side was hurting, too. “I thought my side might be hurting because I kind of over did it at a water park with my family,” said Firey, 42, who lives in Mannford, Oklahoma. “On September 4, 2016, my side was hurting pretty bad so my wife took me to the ER.” He was sent to St. John Medical Center and then to Oklahoma Cancer Specialists and Research Institute, St. John’s partner in cancer care. They did a biopsy on his tonsil and found that it was small squamous cell carcinoma. After 35 radiation treatments on his tonsil, swallowing became very difficult for Firey, so he was put on a liquid diet through tube feedings before beginning swallowing therapy with St. John’s cancer rehabilitation program. Once his therapist determined that swallowing food and liquid was relatively safe, Firey received training on exercises to help maintain the mobility and strength of the muscles involved in swallowing. He is now able to eat nearly Andy Firey has enjoyed getting back to doing some of the things he loves, such as golfing and spending more time with family and friends. Courtesy photo
anything he chooses, and Firey and his therapist joke that he might be kicked out of a local “all you can eat” buffet restaurant. But Firey was to receive more news. “My right foot started hurting, and they found more cancer cells on a bone on the top of my right foot,” he said. He received surgery then radiation on his foot. “Then I noticed a lump on my left inner thigh,” Firey added. “They did a biopsy on that, and it was the squamous cell carcinoma so I did radiation on that. I’ve finished those treatments and have some IV treatments and follow-ups about once a week now.” Firey says his journey got pretty tough. “I couldn’t eat and, after the surgery on my foot, I couldn’t walk. I spent about three months on the couch. I was on crutches and then a cane for a while.” He received physical therapy for mobility challenges following surgery on his foot to remove a cancer tumor. After completing his therapy, he was given a complete home exercise program that he is continuing on his own. “Swallowing and walking are abilities that most people take for granted,” said Mary Wasson, PT, MS, therapist and rehabilitation coordinator at St. John. “Many cancer patients not only have to deal with the disease, but also the side effects of related treatments. Despite
Andy’s tremendous challenges, he was determined to get back his quality of life.” Firey manages a roofing company that he and his brother own. This requires him to meet the challenges of walking on uneven ground on work sites and climbing ladders. Thankfully, Firey has been able to return to work and is now able to climb on a roof and work alongside his team. “I’ve also gotten back to golfing a little,” he said. “Being able to get back out and do things with my family again has been the biggest blessing.” Firey’s cancer journey has been rocky, but he’ll be the first to tell you that you should maintain a positive outlook. “Don’t pay attention to statistics because every case is different. If there is a one-in-a-million chance to beat it, be that one.” Firey says you basically have two choices: “You can be positive or negative. I chose and continue to choose to be positive. Negativity doesn’t help anything. Also, just take it one day at a time. You can’t do anything about tomorrow until tomorrow. Just make it through today.” The cancer rehabilitation program at St. John offers physical and emotional therapy services specifically designed for people undergoing cancer treatment or living with its aftermath. Services are reimbursable by health insurance providers.
Understanding ways to help patients cope with cancer-related fatigue (MS) — Fatigue is one of the most common and frustrating side effects of cancer treatments. While fatigue is often a result of the cancer itself, cancer treatments can also increase feelings of fatigue. Learning how to manage fatigue can improve quality of life for the millions of people battling cancer ever day. Cancer-related fatigue (CRF) often is described as paralyzing. It can come on suddenly and without warning, and it’s not diminished by rest or sleep. Many of the therapies associated with cancer treatment are culprits in CRF. These include chemotherapy drugs, radiation therapy, bone marrow transplants and biologic therapies that include using cytokines to naturally attack cancer cells. The National Cancer Institute states that CRF can affect all areas of life by making patients reluctant or unable to partake in daily activities. Those who miss school, work or social occasions may start to experience depression. These occurrences can lessen quality of life and affect self-esteem.
Doctors may help those experiencing CRF find relief. By learning when fatigue occurs, doctors may be able to pinpoint what is causing the fatigue and then treat it accordingly. For example, if the cause is connected to a certain medication, alternative drug therapies may be suggested. CRF is sometimes linked to anemia. Medications that stimulate bone marrow to produce more red blood cells or blood transfusions may help with fatigue as well, according to The Mayo Clinic. When CRF is linked to depression, anxiety or lack of sleep, doctors may suggest self-help techniques, talk therapy and medications that can treat the underlying condition to improve the patient’s physical and mental well-being. In addition, modifications can be made around the home or office to help alleviate fatigue. Ergonomic changes, such as improving chairs, repositioning items so they are within reach or adjusting office furniture to reduce having to bend over or reach overhead, may help.
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Cancer survivor can’t say enough good things about Saint Francis oncology team According to cancer survivor Helen Campbell, R.N., it would be an impossible task to say enough good things about Warren Clinic Medical Oncology. And, foremost among her words of praise is, she doesn’t think she’d be around if it wasn’t for this special group of people. On October 17, 2012, Campbell was diagnosed with anaplastic large cell lymphoma, a rare type of non-Hodgkin lymphoma affecting only 1 to 2 percent of the adult population. Initial symptoms can include painless swelling of lymph nodes, rapid weight loss and fatigue. “Truly, when ‘Dr. Vicki’ (aka Vicki Baker, M.D.), oncologist on staff at Warren Clinic Medical Oncology, Dr. Joe Lynch, oncologist and director of the Saint Francis Bone and Marrow Transplant Program, and the rest of the Saint Francis Oncology staff took over my care and immediately zeroed in on the correct diagnosis, everything started to turn around dramatically,” Campbell says. “Prior to that, I had been through a series of missteps and inaccurate diagnoses. It was so frustrating because I knew something was very wrong.” Campbell, who has been a nurse in the Tulsa area for more than 45 years, found it ironic that during all those years, she’d never taken care of a patient with lymphoma. “When it was established that I had Stage IV lymphoma, (Stage IV being the most advanced), I was shocked. It seemed like a very gloomy picture,” Campbell says. “But, Dr. Baker is a real spitfire and got the wheels for my treatment rolling immediately. Her knowledge base, humility and compassion are truly exceptional. I can’t say enough good things about her either.” The history between Campbell and Dr. Baker goes way back. “Our paths initially crossed due to her career as a hospice nurse and mine as an oncologist,” Dr. Baker says. (Dr. Baker has practiced as an oncologist in the Tulsa community since 1990.) “Helen is an outstanding lady — so kind and compassionate. She has always taken such great care of her patients and their families. Even though I was very sorry her cancer brought us together this time, I was so grateful for the opportunity to give her the best possible care.”
commonly known as CHOP. CHOP is the acronym for a chemotherapy regimen used in treating non-Hodgkin lymphoma and consists of cyclophosphamide, an alkylating agent which damages DNA by binding to it and causing the formation of cross-links; hydroxydaunorubicin, an intercalating agent which damages DNA by inserting itself between DNA bases; oncovin, which prevents cells from duplicating by binding to the protein tubulin; and prednisone or prednisolone, which are corticosteroids. After a series of outpatient CHOP treatments, Campbell received a bone marrow transplant in early June 2013. “Following Helen’s first stage of treatment, our team agreed a bone marrow transplant was necessary to ensure we were doing all we could to get rid of the lymphoma,” Dr. Baker says. A bone marrow transplant is a procedure in which bone marrow that is diseased or damaged is replaced with healthy bone marrow. The bone marrow to be replaced may be deliberately destroyed by high doses of chemotherapy and/or radiation therapy.
Putting her treatment plan in action Campbell’s initial form of treatment was what is
Reprinted with permission from Saint Francis Health System’s magazine “Presence.”
Recovering and rebuilding Following the bone marrow transplant, Campbell recovered at home throughout with the help of a nurse aide. “A bone marrow transplant is an immensely powerful treatment for a serious disease, so of course, it knocks ‘the stuffing’ out of you for awhile,” Campbell says. “But, day by day, I began to feel a little bit stronger. “ Dr. Baker adds: “Every oncologist faces some cases that are sad, but there are so many others that are wondrous. Medical science keeps improving and when we are able to get great results and restore someone’s health and well-being, it is the most satisfying thing in the world. There are no words for it.” Now, more than ever, Campbell is enjoying life and appreciating every day to the fullest. “I’m so grateful for every single day and for the wonderful people in my life … and they certainly include the oncology team at Saint Francis. I love them all!” she says.
“From the handwritten notes, handmade quilts and kind gestures, I can honestly say I received outstanding and compassionate care from every single person in Saint Francis’ Oncology group. And, being a longtime nurse myself, I am pretty particular about that sort of thing.” Helen Campbell, cancer survivor
Foods that may help fight cancer (MS) — People concerned about their cancer risk may find that switching their diets can do a world of good. Certain foods may reduce cancer risk, according to various cancer experts, including the MD Anderson Cancer Center. In addition, some foods might increase a person’s risk of developing cancer. Knowing what to put on the table come breakfast, lunch and dinner can go a long way toward reducing one’s cancer risk. Some foods show cancerfighting
properties, although it is impossible to currently say one food or another can actually stop cancer from developing. Studies have shown that diets filled with colorful fruits and vegetables can reduce the risk of developing cancer, heart disease and diabetes. Cancer Research UK points out that some foods, such as red meat and salt-preserved foods, can increase a person’s risk of developing some cancers, while vegetables, fruits and foods high in fiber have the opposite effect. A comprehensive review of
thousands of studies on physical activity, diet and weight conducted for the World Cancer Research Fund and the American Institute for Cancer Research found that plant-based foods are the best at fighting cancer. Broccoli, berries and garlic showed some of the strongest tendencies to prevent cancer. According to research associates at Johns Hopkins University School of Medicine, a variety of chemicals from plants known as phytochemicals protect cells from harmful compounds in food and in the environment. Phytochemicals prevent cell damage and mutations. People who want to eat healthy and lower their cancer risk can include as many of these foods as possible. • Garlic: Studies suggest that garlic can reduce the incidence of stomach cancer by attacking bacteria associated with some ulcers and belly cancers. Sulfur compounds in the food may stimulate the immune
system’s natural defenses against cancer and could reduce inflammation and tumor growth. • Broccoli: Broccoli and other cruciferous vegetables like cauliflower, cabbage and kale contain glucosinolates. These are phytochemicals that produce protective enzymes that activate in the intestines. One compound, sulforaphane, is strongest and found in broccoli. Protective properties are highest in raw or steamed broccoli. • Blueberries: Blueberries
are loaded with antioxidants. Antioxidants neutralize the unstable compounds, called free radicals, that can damage cells and lead to cancer. • Tomatoes: The red, rich coloring of tomatoes comes from lycopene. In laboratory tests, lycopene has stopped cancer cells, including breast, lung, and endometrial cancers, from growing.
Which cancers are diagnosed most frequently? (MS) — Certain cancers are diagnosed far more frequently than others. But cancers that are diagnosed most often are not necessarily the most deadly cancers, nor are they always the most treatable. They simply represent those cancers with the highest prevalence. According to data from the American Cancer Society and the National Cancer Institute, excluding nonmelanoma skin cancers, the following cancers are those diagnosed with the greatest frequency. Breast cancer: Topping the list in the number of diagnoses is breast cancer. An estimated 254,000 new cases occur each year. However, breast cancer that is caught early tends to be highly treatable. Lung cancer: Lung cancer, including cancer of the bronchus, accounts for roughly 223,000 diagnoses each year.
The fatality rate for lung cancer is much higher than it is for breast cancer, with an estimated 156,000 deaths from lung cancer each year. Prostate cancer: Prostate cancer only affects men, making the number of cases even more striking. Prostate cancer diagnoses equal around 160,000 new cases annually. However, since prostate cancer grows slowly, treatment is often successful. Colorectal cancer: Estimates suggest new cases of colon cancer and rectal cancer will equal 135,000 in 2017, making cancers of the lower digestive system quite common. Melanoma: One of the deadliest forms of skin cancer, melanoma accounts for roughly 87,000 new cancer diagnoses each year.
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