Cancer Care, spring 2016

care CARING FOR PATIENTS

CANCER

for anyone touched by cancer SPRING 2016

t

Her message: Read your medical records page 6

Do you need an oncologist? page 14 The value of plantbased diets page 18

When to test for lung cancer page 8

How a bone marrow transplant saved a life page 4 Trying to outsmart a gene page 16

Brought to you by the

spring 2016 l upstate.edu/cancer

upstate.edu/cancer

guide YOurGUIDE YOUR

How to use this website resource CARE In addition to cancer diagnosis and treatment, patients may also seek emotional counseling, genetic counseling, nutritional counseling, pain management, palliative care, rehabilitation, social work or spiritual care.

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PREVENTION Find out about our cancer screening options to protect against breast, cervical, colorectal, lung and prostate cancers.

Information is also available about smoking cessation options.

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CLINICAL TRIALS Explore options for volunteering to evaluate new drugs, devices or procedures.

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EVENTS Stay updated on events that support the Upstate Cancer Center at upstate.edu/cancer.

From the “about” tab, click on the calendar of events.

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APPOINTMENTS Make an appointment online or by phone (315-464-4673) and read about what to expect at your first visit.

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INFORMATION Learn about various cancers and blood disorders.

LET’S BE FACEBOOK FRIENDS

Follow the Upstate Cancer Center on Facebook.

Our page includes posts about events and activities taking place at Upstate and donations from various community groups. Sometimes we include something unexpected, such as a video clip of the lobby piano playing on a rainy day, or a cra project that turned socks into snowmen.

Visitors are welcome to write on our wall about their experiences. “I wouldn’t be alive without the help I received from this place,” one man wrote in January. ●

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CANCER CARE

upstate.edu/cancer l spring 2016

INSIDE

6

7

16

12

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Inside this issue CARING FOR PATIENTS

SEARCHING FOR CURES

A lifesaving bone marrow transplant

page 4

Using a ‘knife’ to shrink a brain tumor page 5 She shares a lesson from her endometrial cancer journey

page 6

Looking at lung cancers

page 7

When to seek screening

page 10

Nurses who guide you through cancer care

page 11

When cancer spreads to the liver

page 12

5 things to know about prostate cancer

page 13

Do you need an oncologist?

page 14

care CARING

CANC

On the cover: dorette Thompson.

See story, page 6.

FOR PATIEN TS

ER

for anyo ne

touc hed

SPRING

M

How bone marrowa transp lant saved a life page 4 Trying to outsmart a gene page 16

G

upstate.edu/ca ncer

Brought

to you by

the

care ER

for anyone touched by cancer

SPRING 2016

EXECUTIVE EDITOR Leah Caldwell Assistant Vice President, Marketing & University Communications MANAGING EDITOR

Amber Smith 315-464-4822 or smithamb@upstate.edu

WRITERS DESIGNER

Jim Howe, Jim McKeever, Amber Smith Susan Keeter

The Upstate Cancer Center provides the quarterly magazine, Cancer Care, for anyone touched by cancer. Send subscription requests and suggestions to magazine@upstate.edu and request additional copies by calling 315-464-4836.

Cancer Care offices are located at 250 Harrison St., Syracuse, NY 13202.

UPSTATE CANCER CENTER INTERIM DIRECTOR Jeffrey Bogart, MD MEDICAL DIRECTOR Leslie J. Kohman, MD ASSOCIATE ADMINISTRATOR Richard J. Kilburg, MBA

spring 2016 l upstate.edu/cancer

page 16

How a protein acts as a cancer accomplice

page 17

The value of a plant-based diet

page 18

Relaxing with reiki

page 20

‘Beads of Courage’ help kids with cancer

back cover

MAKING A DIFFERENCE 20 years of survival celebrations

page 21

Giving back, 17 years after treatment

page 21

Sarah’s Guest House is a home away from home

page 22

2016

The value of plantbased diets page 18 When to test for lung cancer page 8

spring 2016

PUBLISHER Wanda Thompson, PhD Senior Vice President for Operations

Pain treatment strategies of Chinese-American immigrants

by canc er

Her messag e: Read your medica l record s page 6 Do you an oncoloneed gist? page 13

PHOTO BY WILLIAM MUELLER

CANCER CARE

page 16

LIVING WITH CANCER

SHARING EXPERTISE

CAN

Learning how to influence prostate cancer cells

Events

Learn about events that support the upstate Cancer Center at upstate.edu/cancer The upstate Cancer Center is part of upstate Medical university in Syracuse, NY, one of 64 institutions that make up the State university of New York, the largest comprehensive university system in the united States. upstate Medical university is an academic medical center with four colleges, a robust biomedical research enterprise and an extensive clinical health care system that includes upstate university Hospital’s downtown and community campuses, the upstate golisano Children’s Hospital and many outpatient facilities throughout Central New York — in addition to the upstate Cancer Center.

The Cancer Center is located at 750 e. Adams St., Syracuse, NY 13210.

CANCER CARE

3

She’s his lifesaver

CARING FOR PATIENTS

Her bone marrow cured his leukemia GREG SIWINSKI AND HIS FAMILY looked forward to hosting a woman from Hildesheim, Germany, last October at their home in Syracuse. He had never met her, but the two had a special connection. Bone marrow from her body provided Siwinski with healthy stem cells to replace those that were destroyed by leukemia.

“Basically, I owe my life to this person,” says Siwinski, 60, an industrial hygienist who works in the Occupational Health Clinical Center at Upstate. Andrea Chroston, in her early 40s, and her two daughters stayed with the Siwinski family for two weeks. e trip was the first time Chroston had been on an airplane.

Siwinski treated his donor and her daughters to the highlights of New York state, including trips to New York City and Niagara Falls.

It was almost nine years ago that Siwinski was diagnosed with acute myeloid leukemia, a fast-growing form of cancer of the blood and bone marrow that he believes he developed from exposures to workplace chemicals more than 20 years ago. is type of leukemia is oen treated with chemotherapy, radiation and/or stem cell transplant.

Siwinski’s initial treatment did not work, and a transplant became his hope for increasing his long-term survival.

BY AMBER SMITH

people to attend a bone marrow drive. “I urge you all to sign up and swab your cheek to see if you are the ‘right stuff ’ for someone in need,” he wrote.

Siwinski and his donor had to wait two years aer the transplant to connect. ey communicated by email and telephone over the years, until they met in person in October. eir meeting was sealed with a thank-you kiss at Hope Lodge in New York City, where Siwinski spent his initial recovery aer the transplant. ●

donor Andrea Chroston gets a thank-you kiss from marrow recipient greg Siwinski.

e bone marrow registry is international in scope, and the best match for Siwinski turned out to be in Germany. Aer Siwinski was matched with his donor, FedEx transported her bone marrow to Memorial Sloan Kettering Cancer Center in New York City, where he went for the transplant.

“I’m glad to report I seem to be cured,” he wrote in January in a note to the Upstate Medical University campus asking HOW YOU CAN JOIN THE REGISTRY Younger donors provide the greatest chance for transplant success, so the National Marrow Donor Program seeks donors between the ages of 18 and 44. Patients are most likely to match with someone of their own race or ethnicity, so the program seeks to recruit registry members of diverse ancestry.

A list of medical and weight guidelines for potential donors is available at BeTheMatch.org A blood sample or a cheek swab is used to add a person to the registry. If they become a match for someone, donors are asked to make a time commitment of 20 to 30 hours over a four- to six-week time period to attend appointments and donate.

Donor stems cells can be removed in a couple of ways. A bone marrow harvest is a minor surgical procedure in which marrow is removed from the back of both hipbones. A procedure called leukapheresis is similar to a regular blood donation, except that donors receive several days of shots to help stem cells move from the bone marrow into the blood. When the blood is removed, the stem cells are separated, and the remaining red blood cells are returned to the donor.

Find a donor registry drive by visiting the program at BeTheMatch.org SOURCES: BETHEMATCH.ORG, US NATIONAL LIBRARY OF MEDICINE

Hear more at healthlinkonair.org. Search “bone marrow transplant.”

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upstate.edu/cancer l spring 2016

‘It’s treatable’

CARING FOR PATIENTS

Lung cancer responds to gamma knife, chemotherapy

BY AMBER SMITH

CYNTHIA SPRINGSTEAD OF AUBURN gathered her brother and three sisters soon aer she received her cancer diagnosis. It was time to let the rest of the family know what her husband and two grown sons already knew.

“I have to tell you something,” she told the four people she grew up with, “and once I tell you, I want you all to get your crying done now.”

She told her siblings about the pain in her chest that brought her to Upstate University Hospital on Oct. 1. She told them about the test that revealed lung cancer and the subsequent tests that showed it had spread to her adrenal glands and lymph nodes and, later, to her brain.

“It’s bad news,” Springstead conceded, quickly adding, “Here’s the good news: It’s treatable. It’s treatable, and I’m coming along very nicely. Don’t give me the sad looks.” ere were tears, but then her family honored her wishes. Springstead, 64, says her family has been the best support team.

Stephen Graziano, MD, is her oncologist. Her first round of chemotherapy was Nov. 1. She had gamma knife treatment Nov. 18 with neurosurgeon Walter Hall, MD, and radiation oncologist Michael Lacombe, MD. She resumed chemotherapy Dec. 1. e family found out in March that the gamma knife treatment succeeded in reducing the size of the lesion in her brain by half.

Springstead said she prays to St. Peregrine, the patron saint of cancer patients, and tries to maintain a positive outlook; she has grandchildren she wants to see graduate. ●

interior view of the gamma knife.

ABOUT THE GAMMA KNIFE The radiation therapy device called the gamma knife does not cut.

Rather, it is designed to target a high dose of radiation to a hardto-reach or critical area of the brain, causing little or no radiation damage to surrounding tissues. This radiosurgery treatment is often recommended for patients whose cancer has spread to the brain, but it is also used for brain tumors, abnormal blood vessel formations, epilepsy and a variety of neurological conditions. Here’s how the procedure is done: 1. A lightweight frame is attached to the patient’s scalp to keep the head steady during treatment. A local anesthetic helps minimize discomfort.

2. Imaging scans are done to show the exact location and size of the area to be treated.

3. The patient rests while the treatment team (including a neurosurgeon, radiation oncologist and physicist) creates a treatment plan.

4. The head frame is attached to a special helmet with dozens of holes, through which the energy beams will be directed.

5. The patient is positioned on a couch that moves into the machine, and treatment begins.

6. When treatment is complete, the couch moves out of the machine, the frame and helmet are removed, and the patient can resume normal activities within 12 to 24 hours.

exterior view of the gamma knife.

spring 2016 l upstate.edu/cancer

CANCER CARE

5

Read your medical records

CARING FOR PATIENTS

She tells everyone:

BY AMBER SMITH

AS THE WORLD MARKED the turn of the millennium on Dec. 31, 1999, Dorette ompson and her husband, David, were in New Jersey for a black-tie celebration. ompson, in her late 50s, awoke that morning to unusual spotting.

at was the beginning of her ongoing endometrial cancer journey.

She had abnormal tissue removed from her uterus. In the spring of 2000 she underwent a hysterectomy and therapy that she believed le her cancer free.

Four years later an imaging scan showed a tiny uterine tumor, and ompson sought treatment in Rochester.

It was 2005 when her leg began to swell, revealing an enlarged lymph node in her pelvis. She was referred to radiation oncologist Seung Shin Hahn, MD, at Upstate.

Seung Shin Hahn, Md, talks with his patient, dorette Thompson.

PHOTO BY WILLIAM MUELLER

“He was the first person who was honest with me,” says ompson, who lives in the village of McGraw in Cortland County. Hahn told her the tumor she had was large and inoperable. It was pressing on her intestines and the main artery leading to her leg, and the physician was surprised that ompson’s leg wasn’t hurting because of it.

Until then, ompson believed the tumor to be tiny. She had not read her medical records, which clearly listed the tumor’s size and location. at’s the lesson she now shares with anyone facing cancer: Read all of your medical records.

Hahn’s plan was to weaken the tumor with a special type of radiation therapy then available at MedStar Georgetown University Hospital in Washington, D.C. ompson went there. “I came back home, and a month or two later, they checked – and the tumor had disappeared.”

In 2012, she learned her endometrial cancer had spread.

Again, she was treated with radiation, this time at Upstate.

She takes a hormone pill daily to reduce the risk of a new cancer developing.

“I feel fine,” insists ompson, now 76. “I owe my life to Dr. Hahn.” She says the last 16 years have been positive.

She accepted her cancer diagnosis, found a doctor and a plan of action she fully believed in, and always has something she is looking forward to do or accomplish. ●

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ABOUT ENDOMETRIAL CANCER l

The average age of women diagnosed is 60; it is uncommon among pre-menopausal women.

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Pregnancy, use of birth control pills and the use of an intrauterine device are linked to a lower risk.

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Overweight women are twice as likely to develop endometrial cancer, compared with women who maintain a healthy weight, because fat tissue can increase a woman’s estrogen level, which increases risk.

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It is up to four times more common in women with diabetes.

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Women who have had breast or ovarian cancer may have an increased risk, as may women who have undergone pelvic radiation therapy.

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Abnormal vaginal bleeding is the most common symptom and should be evaluated right away.

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In addition to a physical exam, tests for endometrial cancer may include ultrasound, a biopsy of the uterine lining and blood tests, with additional tests if the doctor suspects the cancer is advanced.

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Surgery is the main treatment, but in some cases radiation therapy, hormonal therapy and/or chemotherapy may be recommended.

SOURCE: AMERICAN CANCER SOCIETY

upstate.edu/cancer l spring 2016

CARING FOR PATIENTS

a TOP priority

Jason Wallen, Md, (right) is medical director of upstate’s Thoracic Oncology Program. Members of the team meet each week to review cases.

PHOTOS BY SUSAN KAHN

Medical providers gather to discuss patient care

BY AMBER SMITH

JUST BEFORE 2 P.M. every Wednesday, 18 men and women, most wearing white coats, take seats around a conference table in the Upstate Cancer Center.

Some carry water bottles. Others tote laptop computers. ere’s no chitchat or daydreaming. is is a meeting with an important purpose. is is where Upstate’s medical experts gather to discuss patients with the most confounding cancers of the lungs, chest or esophagus.

It’s called the TOP Multidisciplinary Care meeting.

TOP stands for oracic Oncology Program, and multidisciplinary means that doctors, nurses and other medical professionals are involved from a variety of specialties, including medical imaging, medical oncology, pathology, pulmonology, radiation oncology and surgery.

It is one of several multidisciplinary teams whose members meet to bring their expert focus to patients facing different types of cancer.

Santiago Miro, Md, discusses a case with the team.

“e group focuses together on one case at a time, tapping our collective experience to benefit each patient,” explains Jason Wallen, MD, an assistant professor of surgery and medical director of the program.

Here’s the computerized tomography scan of a 66-year-old woman who underwent lung cancer screening. She has a tumor measuring almost 8 centimeters, which is huge.

Next for her, everyone agrees, is a positron emission tomography (PET) scan, which will help determine if the tumor is cancerous. ey also talk about what to do if it is.

A large screen on one wall is a showcase for imaging scans.

A smaller screen shows other pertinent patient records.

Each week’s discussion includes a half dozen new patients who are suspected of having cancer, along with a half

dozen established patients who have new test results or a significant change requiring group input.

At the center of the table sits Wallen. At a nearby podium stands Santiago Miro, MD, an assistant professor of radiology. As Wallen introduces each case, Miro projects the corresponding images.

e next patient is a 57-year-old woman with a tumor in the lower lobe of one lung. Her doctor tells the group, continued on page 8

spring 2016 l upstate.edu/cancer

CANCER CARE

7

Sharing expertise a TOP priority

CARING FOR PATIENTS

continued from page 7

“She’s very interested in surgery” and that she quit smoking three days ago. Miro shows scans of her lungs on the big screen: Cysts are visible throughout both lungs. e group discusses what stage of cancer the woman may have, whether it’s cancer, and what other problems may account for the cysts, if it’s not. e meeting is filled with instruction, questions asked and answered, and cordial discussion. For each patient’s case, his or her doctor provides a synopsis of the situation. Miro displays the most recent imaging scans, sometimes with previous scans for comparison. “is is obviously growing like crazy,” Miro says, pointing to a tumor affecting a 77-year-old woman. It has not invaded her lungs, but it’s close to her spinal column. He explains how her imaging scans make him wonder if she has an infection or an immune disorder, rather than cancer. e group decides the best course of action is to examine a sample of her lung tissue and a sample of the fluid from her chest cavity.

For another patient, they discuss the merits of radiation or chemotherapy. And for another, they concede that he could have two unrelated cancers at the same time or, perhaps, cancer plus a fungal infection in his lungs.

More than an hour later the meeting is over. In that time, each patient’s case receives undivided attention — and the patient will receive a personal plan for his or her next course of action. ●

The upstate Cancer Center was designed to accommodate a model of multidisciplinary care. Thoracic Oncology was the first multidisciplinary program at upstate, beginning in 1999. Specialists in other types of cancer at upstate also offer this team approach.

Pictured, front row, from left: nurse Patricia Bravo; Linda Veit, MPH; Manju Paul, Md; ernest Scalzetti, Md. Second row: Jeffrey Bogart, Md; Ajeet gajra, Md; Leslie Kohman, Md; Jason Wallen, Md; robert F. dunton, Md. Third row: Birendra Sah, Md; Santiago Miro, Md. Fourth row: Christopher Curtiss, Md; Stephen graziano, Md; rolf grage, Md. PHOTO BY SUSAN KAHN

A look at lung cancers Lung cancer is the second most common cancer in men and women, but it is the deadliest of cancers. Each year more people die of lung cancer than of colon, breast and prostate cancers combined, reports the American Cancer Society. Tobacco smoking is by far the leading cause of lung cancer, responsible for at least 80 percent of lung cancer deaths. Most lung cancers are either small cell or non-small cell.

NON-SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER

Percent of cases: 85.

Percent of cases: 10 to 15.

Types: Squamous cell carcinoma, adenocarcinoma and large cell carcinoma are all non-small cell lung cancers.

Note: Small cell lung cancer is rare in someone who has never smoked.

Signs and symptoms: Persistent cough, chest pain, hoarseness, shortness of breath and recurrent chest infections are among the common signs of non-small cell lung cancer.

Treatments: Surgery, radiation including stereotactic body radiation therapy, radiosurgery, chemotherapy, targeted therapies and/or immunotherapy may be recommended.

Survival: Almost half of patients survive at least five years if the cancer is found before it spreads.

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CANCER CARE

Signs and symptoms: Because this type spreads quickly, it is usually discovered after it has spread and before the emergence of signs or symptoms, which are the same as those for non-small cell lung cancer.

Treatments: Chemotherapy, radiation therapy and/or surgery may be recommended.

Survival: Almost a third of patients survive at least five years if the cancer is found before it spreads.

SOURCE: AMERICAN CANCER SOCIETY

upstate.edu/cancer l spring 2016

CARE FOR SENIORS

UNIVERSITY GERIATRICIANS

GEMCARE

SerViceS iNclude: • geriatric & memory assessments • Physical & medication review • Primary care for frail elders

Need emergeNcy or urgeNt care?

Visit gem care, the only emergency room designed for seniors age 65+.

upstate Specialty Services, 550 Harrison St., Syracuse

upstate university Hospital, community campus 4900 Broad road, Syracuse

Patients, doctors or family members may request appointments: 315.464.5166

(the former community general Hospital)

call upstate connect: 800.464.8668

UPSTATE.EDU

spring 2016 l upstate.edu/cancer

CANCER CARE

9

Without symptoms

CARING FOR PATIENTS

How a CT scan found a hidden lung cancer

BY AMBER SMITH

glen Wells of Central Square volunteers at upstate university Hospital one day a week.

GLEN WELLS WAS A smoker most of his life, and cancer runs in his family.

So in 2013 when his family doctor, David Page, MD, suggested he be screened annually for lung cancer, Wells followed the advice — not realizing then that it would ultimately save his life.

Medical insurance did not cover the cost of the screening at that time. Wells paid $235 out of his own pocket. e computerized tomography scan revealed nothing unusual in his lungs. He returned in 2014, and again the scan was clear.

By the third year, his insurance plan was paying for the screening. is time, the scan showed a troubling spot.

Wells, 67, who lives in Central Square, had no cough.

He was never out of breath. Nothing was a chore for him.

“I had absolutely no symptoms whatsoever,” he says.

A biopsy revealed cancer. It was a small cancer in the early stages, confined to the upper lobe of his right lung. Lung cancers that are discovered at such an early stage have a good chance for cure.

Within a month, he underwent surgery to have that lobe removed. at was it. He required no chemotherapy and no radiation.

His treatment was over before the diagnosis really sank in.

Today, almost a year aer the surgery, he’s healthy, and he’s grateful for the screening. “Without that screening, I never would have known.”

PHOTO BY RICHARD WHELSKY

HOW YOU CAN GET SCREENED

Most insurance plans now pay for annual screening for lung cancer for smokers and those who have quit within the last 15 years if they are between ages 55 and 80 and have no symptoms of lung cancer. Low-dose computerized tomography (CT) scans are designed for people with a history of “30 pack year” smoking. (See box below.)

Studies have shown more than 80 percent of the lung cancers detected in screening are stage 1, meaning they are treatable or curable, says Santiago Miro, MD, who leads Upstate’s lung cancer screening program.

He says lung cancer deaths drop by about 20 percent in smokers and former smokers who undergo annual screening. Death rates also drop from other causes, since the CT scan sometimes discovers other potentially life-threatening problems that can be treated.

Patients have to understand nodules that are harmless may appear similar to nodules that are cancerous, so additional testing may be required.

While the U.S. Preventive Task Force recommends annual screenings for people between ages 55 and 80, the Centers for Medicare and Medicaid Services reimburses for people age 55 to 77. Miro said most insurance companies cover people from ages 55 through 79.

Schedule a screening by calling 315-464-8668. ●

WHAT’S A PACK YEAR?

Multiply the number of packs of cigarettes smoked per day by the number of years smoked. irty pack years is equal to smoking one pack a day for 30 years, or two packs a day for 15 years, and so on.

Hear an interview at healthlinkonair.org. Search “lung cancer screening.”

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upstate.edu/cancer l spring 2016

A trusted guide

CARING FOR PATIENTS

through cancer treatment

BY JIM HOWE

care,” says Rose Valentino, the nursing director at the Upstate Cancer Center. is might involve solving problems with transportation, family or insurance, for example, and the navigator keeps busy behind the scenes — monitoring patients as they move from, say, surgery to radiation treatments.

“In addition to smoothing the patient's experience, navigators have been shown to improve outcomes and efficiency for health care providers,” Valentino adds.

CANCER PATIENTS CAN FEEL overwhelmed as they face not just their disease, but a bewildering array of appointments, treatments and insurance forms.

Many are looking for one person who can explain the next procedure, remind them of an appointment and help them deal with an insurance company. at person is the nurse navigator.

One of the Upstate Cancer Center’s nurse navigators, Holly Briere of Baldwinsville, explains the role as “the central point of contact for the patient. We’re the person they can come to if they have any questions or concerns. We put it all together for the patient.”

Briere works with liver, gallbladder and pancreas patients. e center also has nurse navigators devoted to other cancer teams: thoracic/lung, bone marrow transplant and head and neck, plus it plans to fill a vacant breast cancer and survivorship position soon.

“We’re kind of the face of the program we represent, that person the patient can always come to and rely on us and know that we are making sure that things are getting done on their behalf,” Briere says.

“Navigation brings together all the best parts of nursing.

It’s that personal interaction, but it’s also quality, making sure that our program is as efficient as it can be.” e need to improve access and guide patients through the complexities of the medical system became apparent to a surgical oncologist in Harlem by the late 1980s. Harold Freeman, MD, founded a navigation program in 1990 that evolved into the nonprofit Harold P. Freeman Patient Navigation Institute. Other groups have also formed to support the concept of navigation.

Navigator roles are still evolving and take different forms depending on the institution and the diseases involved, but “their primary role is to identify and remove barriers to

Experience counts in a job like this. Briere, for example, draws on her 17 years as an oncology nurse to help educate and support her patients.

One of those patients, Mark Vamvakias, 50, of North Syracuse, refers to Briere as a godsend.

“I cannot stress enough the help and assistance that Holly provides to me and my family as we cope with my condition and all the endless paperwork and scheduling demands required to monitor, treat and recover from my condition,” says Vamvakias, who met Briere a month before his April 2015 surgery for neuroendocrine tumors.

He has kept in touch during subsequent chemotherapy.

“Holly is only a phone call away to answer any question we have, no matter how insignificant we may think it is, or to just talk and give us some sense of reassurance. … To be honest, I really don’t think we could have done any of this without her.” ●

What is a nurse navigator?

“Patient navigator” is the general term for people who work to identify and overcome barriers to patients’ medical treatment and move them through the health care system efficiently.

Some institutions use lay people as navigators, particularly for nonmedical issues, such as scheduling or transportation.

The Upstate Cancer Center requires its navigators to be registered nurses, so they are not just patient navigators but “nurse navigators.”

The center also recommends at least three years of nursing experience, at least a bachelor’s degree in nursing or a related field and oncology or case management experience.

Currently, no state or national certification is required for nurse navigators, but efforts are underway to develop certification through the Academy of Oncology Nurse and Patient Navigators, says Rose Valentino, the nursing director at the Upstate Cancer Center.

(For specifics, go to www.aonnonline.org/career-center/ aonn-navigation-certification/)

CANCER CARE

11

‘Secondary’ cancer

SHARING EXPERTISE

See a surgeon before starting chemotherapy for ‘liver mets’

BY AMBER SMITH

dilip Kittur, Md, and Ajay Jain, Md

MEDICAL PROGRESS in the last decade or so has improved the survival chances for people whose colorectal cancer has spread to the liver. Today, surgery may provide a cure – depending on the steps a patient takes aer diagnosis.

Blood that leaves the colon circulates through the liver via the portal vein. It is through this large blood vessel that colorectal cancer cells can spread to the liver. Up to 70 percent of patients with cancers of the colon or rectum will also develop tumors in their liver.

When that happens, the patient is said to have colorectal cancer liver metastases, also known as secondary liver cancer or liver mets. e diagnosis may sound dire, and oentimes, patients with liver metastases are offered only palliative chemotherapy with the goal of prolonging survival. But a growing body of evidence shows that some patients can survive for long periods of time or be cured by having their colorectal liver mets surgically removed.

Such surgery can be challenging, which is why patients need to find experienced doctors who frequently operate on the liver. Dilip Kittur, MD, and Ajay Jain, MD, hepatobiliary and pancreatic surgeons at Upstate, perform

up to 40 liver surgeries per year, making Upstate a “high volume” center. e timing of surgery in relation to other treatment is critical.

“Someone who has liver mets should be seen by a surgeon before they start chemotherapy, to see whether surgery is an option now or maybe in the future,” Jain says.

“Preoperative consultation allows the surgeon and medical oncologist to plan how much chemotherapy should be given and when.”

Kittur says that “too oen, patients receive too much chemotherapy in advance, leaving their livers congested and in no condition for surgery. at ruins the patient’s best chances for a cure.”

Cancer experts say surgery provides up to 40 percent of patients with five or more years of survival. Radiation therapy or chemotherapy are treatment options, too, but their success rates are lower.

Ideally, a patient’s oncologist would collaborate with a surgeon early on, says Jain. He and Kittur work closely with oncologists throughout Central New York to develop individual treatment plans for each patient.●

Screening catches colon polyps 13 More than 2,500 colon cancer screening kits were distributed in the first two years that Upstate Medical University partnered with Kinney Drugs to provide the kits for free during March, Colon Cancer Awareness Month. Of the 103 people whose results indicated they should undergo a colonoscopy, 13 were found to have polyps that were removed. Colonoscopy is a procedure that allows a doctor to inspect the inside of the intestinal tract and remove any polyps, which can turn cancerous. ●

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upstate.edu/cancer l spring 2016

Every man’s at risk

SHARING EXPERTISE

Expert gives overview of prostate cancer

rakesh Khanna, Md

prostate cancer. Unfortunately, by the time a nodule could be felt on the prostate, the patient’s cancer was inevitably advanced and difficult to treat.

Who is at risk?

“If you’re a man and you live long enough, you will develop prostate cancer,” says Rakesh Khanna, MD, an assistant professor of urology at Upstate. It’s the most common cancer in American men, other than skin cancer, “and many men are going to have very small prostate cancers that are asymptomatic.”

e PSA test is not perfect. A man can have prostate cancer and have a normal PSA. He can have an elevated PSA and not have cancer.

“But the PSA is the best screening test we have right now,” Khanna says.

Age is the primary risk factor. e average age at diagnosis is 66, according to the American Cancer Society.

“Nowadays, because we are screening, we are trying to find the prostate cancers before they become symptomatic. If they are localized and they’re smaller when we treat them, a patient will have a better outcome.”

Some men whose family history includes early-onset prostate cancer are at greater risk for developing prostate cancer early. e disease occurs more oen in African-American men and less oen in Asian-American and Hispanic men than in non-Hispanic whites. No one knows why.

What causes it?

While the exact cause remains a mystery, a variety of genetic abnormalities are known to lead to prostate cancer.

Research today focuses on “trying to identify, at the molecular level, which gene abnormalities are responsible for taking prostate cancer from a confined stage to a metastatic stage, where it spreads outside the prostate,” Khanna says.

How is it diagnosed? e blood test that measures levels of a protein called prostate-specific antigen can help detect early prostate cancer, but the PSA test does not diagnose the disease.

Prostate cancer is diagnosed through a biopsy of the prostate. A tissue sample is removed and evaluated by a pathologist to determine if cancer is present and how aggressive it is.

Before the PSA screening became available in the 1990s, doctors relied on a physical examination to diagnose

does prevention help?

It’s not conclusive, but some data suggests that physical activity and a healthy diet may help prevent prostate cancer from developing. One thing is definite: Physical activity and a healthy diet will not increase your risk.

What happens after diagnosis?

While not all patients require them, a variety of surgical and radiation therapy options exist, some of which have significant side effects.

Many prostate cancers that are discovered early will cause no symptoms and have no impact on a man’s lifespan.

Based on their patients’ PSA level, age and treatment preferences, doctors may recommend: l

l

“Watchful waiting,” in which no additional testing or treatment is required unless symptoms emerge; or “Active surveillance,” which involves repeated blood tests, physical exams and/or biopsies for signs of cancer progression. ●

Reach Upstate’s Department of Urology by calling 315-464-1500.

Hear an interview at healthlinkonair.org. Search “prostate cancer.”

spring 2016 l upstate.edu/cancer

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13

SHARING EXPERTISE

Ajeet gajra, Md PHOTO BY SUSAN KAHN

Should you see an oncologist?

If you have a cancer diagnosis, the answer is probably yes

BY AMBER SMITH

IN MODERN AMERICAN HEALTH care, it’s your primary care doctor who oversees your medical care. He or she keeps track of your health, fielding your questions and concerns, referring you to specialists when appropriate.

Your primary care doctor is someone to keep in your life if you face a cancer diagnosis, because you may still have health needs that are not related to cancer.

A medical oncologist is someone to add to your health care team if you receive a cancer diagnosis. ey specialize in the diagnosis and treatment of cancer, but their role goes beyond prescribing medication.

“A medical oncologist is not just a chemo doctor. ey play many roles,” says Ajeet Gajra, MD, an associate professor of medicine specializing in hematology and oncology at Upstate. “ey can be the doctor who creates a treatment plan for the patient, or the scientist who provides prognostic information. A big part of the job is to help patients come up with a cancer care plan.”

Gajra believes anyone with a cancer diagnosis can improve their understanding of their disease by seeing a medical oncologist. He could think of one exception: non-melanoma skin cancers, which are typically removed in simple surgeries by dermatologists or surgeons. e medical oncologist may provide treatment, insight into what treatment is necessary, or other related referrals.

Someone with tongue cancer, for instance, may have the cancer removed and then require speech pathology or help learning to swallow. Someone who faces surgery for cancer may want to see an oncologist to learn of options beyond surgery or to go over the pathology report aerward.

Having a team approach to cancer is a key to the care at the Upstate Cancer Center. Gajra recalls a patient who found his way to Upstate aer having a small lung cancer 14

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removed. e patient, whose treatment had been surgical, had not understood that cancer was also found in a lymph node — meaning it had spread from his lung and would require additional treatment. e surgeon, focused on performing a good operation, had not paid full attention to the finer points of the pathology report.

Focusing on those details is a strength of a good medical oncologist and one example of the benefit of the team approach. “e patient needs to be sure that somebody sits down and reads through the pathology report," Gajra said. "at will help determine if any additional treatments are needed.” e risk of developing cancer is much higher among cancer survivors than the general population. Smokers who develop lung cancer and are treated successfully still may develop a second lung cancer. Also, radiation and chemotherapy that are used to treat cancers can prompt other cancers to develop later.

A medical oncologist can help insure proper surveillance so that these issues are recognized as early as possible.● WHAT IS A CANCER CARE PLAN? Your cancer care plan may include: 1. A treatment plan, including options and possible side effects.

2. A treatment summary, for when active treatment concludes.

This communicates the care you received, any ongoing issues that need to be addressed and a list of medications you are taking.

3. Survivorship, telling the follow-up care you will require for the rest of your life.

For examples, visit the American Society of Clinical Oncology at cancer.net or the National Coalition for Cancer Survivorship at canceradvocacy.org

upstate.edu/cancer l spring 2016

One of the best

SHARING EXPERTISE

Upstate oncology program makes list of top 100 UPSTATE UNIVERSITY HOSPITAL has a great oncology program. at’s according to Becker’s Hospital Review, a health industry publication that creates an annual list of 100 hospital and health systems with great oncology programs. e list is not ranked, and hospitals cannot pay to be included. Rather, hospitals are chosen based on a number of factors, including recognitions received, accreditations earned and cancer-oriented group memberships held.

“We are committed to the fight against cancer,” says hospital Chief Executive Officer John McCabe, MD. “From our biomedical research and training of future health professionals, to the state-of-the-art care offered in both the Upstate Cancer Center and our inpatient settings, we are on the front lines of that fight every day.”

Upstate offers the most advanced diagnostic and treatment technologies for adults and children and has more than 90 physicians who specialize in cancer care. e American College of Surgeons Commission on Cancer accredits the Upstate Cancer Center, and the hospital received the program’s Outstanding Achievement Award in 2015. e cancer center has also earned accreditation from the American College of Radiology and the American College of Surgeons National Accreditation Program for Breast Cancers. ●

TrueBeam™ linear accelerator is one of the radiation treatments available in the the upstate Cancer Center.

GET TO KNOW OUR EXPERTS our multidisciplinary team offers: •

the most advanced breast imaging technologies

•

high-risk evaluation, genetic counseling and consultation for breast cancer prevention

•

personalized cancer treatment plans including surgical oncology, medical oncology and radiation oncology

C A R I N G F O R PAT I E N T S

spring 2016 l upstate.edu/cancer

l

SEARCHING FOR CURES

Breast Cancer Program l

S AV I N G L I V E S

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15

SEARCHING SeArCHiNg FOr FOR CureSCURES

Can she outsmart a gene?

Young scientist strives to influence prostate cancer cells ONCE PROSTATE CANCER SPREADS, treatment usually includes hormones in what is known as androgen deprivation therapy. “is shuts down testosterone production, which is effective for a while but associated with big quality-of-life costs,” explains Rebecca Sager, a fourth-year MD/PhD student at Upstate who recently received a Young Investigator Award from Rockland Inc., a Pennsylvania biotechnology company.

Men taking hormones for metastatic prostate cancer report declines in general health, sex drive and overall physical function, increased body fat and erectile dysfunction.

Improving survival is important, but so is learning how to minimize the side effects of treatment.

Prostate cancer is the most common cancer in men, with one in seven men likely to be diagnosed in their lifetime, according to the American Cancer Society. It’s the second leading cause of cancer death in men, behind lung cancer.

Hormone therapy is usually prescribed for men with metastatic prostate cancer that cannot be cured with surgery or radiation.

into molecular changes associated with this type of prostate cancer.

She has worked for two years in the laboratory of Leszek Kotula, MD, PhD, an associate professor of urology and biochemistry and molecular biology at Upstate.

In the Kotula laboratory, Sager examines the role of genetic alterations in the WAVE protein complex in prostate cancers that rebecca Sager progresses despite hormone therapy. e WAVE complex, which includes tumor suppressor gene ABI1, is important for cell adhesion, shape and migration.

Sager’s goal is to help design and purify an antibody against ABI1 that works better than others that are already available for use in her research. She wants to understand what causes hormone therapy to fail in some patients.

Ultimately she would like to find biomarkers that could identify the men with the highest-risk disease — so they could receive the most aggressive treatment. ●

Does culture influence pain control?

Sager’s $4,000 prize will go toward furthering her research

WHAT SORTS OF THERAPIES are Chinese-Americans likely to use for pain control when they undergo cancer treatment?

at’s a question raised in a paper published this year in the Journal of Pain and Symptom Management. One of the authors is Alice Chu, a medical student at Upstate.

She and her co-authors surveyed 170 Chinese immigrants receiving cancer care at a community-based oncology practice. eir primary language was Mandarin or Cantonese, and all of the patients had persistent pain for at least three months prior.

Traditional Chinese medicine techniques are distinctive in their emphasis on energy theory, with pain believed to result from disharmonies and imbalances in the body. erefore, the researchers reasoned, an ethnic Chinese patient may be likely to seek help repairing the imbalance through use of Chinese medicine approaches. e majority of the patients in the survey, or 77, reported using only pain medications. Seventeen said they used only herbal medicine, massage, acupuncture or other complementary or alternative medicine approaches.

Eighteen said they made use of both approaches.

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Of the 35 patients who used complementary or alternative approaches either alone or in combination with pain medications, 19 favored herbal medications, 13 used acupuncture, and eight underwent Chinese massage, called tui na. Others said they used energy healing or Reiki, qigong, tai chi and meditation. ● Alice Chu

WHO SEEKS ALTERNATIVES? Four characteristics of the Chinese-Americans in this study who were most likely to use complementary or alternative medicine for pain control: l

high school education or higher

l

higher pain intensity and interference

l

greater psychological distress

l

younger in age

SOURCE: THE JOURNAL OF PAIN AND SYMPTOM MANAGEMENT

upstate.edu/cancer l spring 2016

Cancer’s accomplice

SEARCHING FORFOr CURES SeArCHiNg CureS

Targeting a protein to treat kidney cancer

BY AMBER SMITH

A PROTEIN CALLED HSP90 chaperones cancer cells, allowing them to grow and thrive.

Scientists around the world have been working with measured enthusiasm on how to disrupt Hsp90. is involves figuring out the mechanics of Hsp90, how best to get to the protein and which medication can restrain Hsp90’s ability to assist cancer.

Scientists at Upstate — using tissue samples from patients who underwent kidney surgery at Upstate University Hospital — have helped answer some of the questions.

Renal cell carcinomas are the most common type of kidney cancer, a disease that affects mostly older men and women. Unfortunately, these cancers are resistant to chemotherapy, explains Mehdi Mollapour, PhD, an assistant professor of urology and biochemistry and molecular biology. at’s why researchers are focused on finding other strategies to halt the growth of and kill kidney cancer cells.

What they learn can also inform how other types of cancer cells are killed.

Previous research has shown that keeping the Hsp90 protein away from another protein chaperone called Aha1 helps sensitize cancer cells to drugs that can inhibit Hsp90. e question was how to accomplish that reliably.

Mollapour’s team of scientists found a way, using specific compounds to kill a hyperactive enzyme called c-Abl, which regulates Aha1. With Aha1 successfully separated from Hsp90, the Upstate scientists were able to show that Hsp90 drugs can be used more effectively to inhibit kidney cancer cell growth.

Building on that research project, the team used tissue samples granted by patients who underwent partial or total kidney removal at Upstate in recent years. Working with an investigational medication designed to inhibit Hsp90, the scientists showed that with Aha1 separated from Hsp90, the drug accumulates in the tumor cells, but not in healthy kidney cells.

spring 2016 l upstate.edu/cancer

The research team from upstate includes, from left, Mehdi Mollapour, Phd, an assistant professor of urology and biochemistry and molecular biology; diana dunn, a graduate student; Mark Woodford, a research assistant; dimitra Bourboulia, Phd, an assistant professor; and gennady Bratslavsky, Md, professor and chair of urology.

PHOTO BY DEBORAH REXINE

“is was a big finding,” Mollapour says. “Fundamentally we finally managed to find the answer to why this drug accumulates in the tumors and not the normal cells.” e drug modifies the tumor cells, which affects their ability to function. eir work appears in the February issue of the journal Cell Reports. “is type of study brings Hsp90 drugs closer to a clinical trial in kidney cancer patients,” Mollapour says. Such drugs have already been tested successfully in clinical trials ● of patients with different types of breast cancers, lung cancer, leukemia and stomach cancer. ●

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17

Quality nutrition

IMPROVING LIFE

comes from plant-based recipes

EATING A PLANT-BASED DIET can be an easy and delicious way for cancer patients to get the varied nutrients they need, but many people only know how to prepare vegetables as a side dish or a simple salad, says a registered dietitian nutritionist at the Upstate Cancer Center.

“Nutrition is extremely important for cancer patients, but I’ve found in my practice that people aren’t really familiar with plant-based foods,” says Maria Erdman, who is also a certified specialist in oncology nutrition.

Upstate students benefit from nationally recognized professors, excellent job placement and SUNY tuition.

Open houses are held each fall and spring.

DEGREE PROGRAMS Biomedical Sciences (MS, Phd) Cardiovascular Perfusion (BS) Medical Biotechnology (BS) Medical Imaging (BS, BPS) Medical Technology (BS, MS) Medicine (Md, Md/Phd, Md/MPH) Nursing (BS, MS, dNP, post-master’s certificate) Public Health (MPH) Physician Assistant (MS) Physical Therapy (dPT) Radiation Therapy (BS, BPS) Respiratory Therapy (BS)

Education • Healthcare • Research

www.upstate.edu/students

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“It’s important to eat plant-based foods because they’ve not only been shown in multiple studies to reduce the risk of cancer in the first place, but they’re also a wonderful way for people going through treatment to get all the nutrients they need,” she says.

BY JIM HOWE

their appetite, the students designed some “energy-dense” recipes to allow patients to get a lot of calories in a small amount of food.

As well as offering good nutrition, “eating plant-based foods also happens to reduce the risk of diabetes and heart disease,” Erdman says, and offer phytonutrients, such as lycopene and resveratrol, which help the body to work better and reduce the risk of chronic diseases. e recipes are all easily adapted, so patients can add or subtract as needed, including adding fish, meat, eggs and dairy products as well as changing the seasonings.

Several cancer-related cookbooks are available online for recipes and other information in the Family Resource Center at the Cancer Center. ●

Oen, cancer patients must avoid highdose vitamin pills or other supplements because they can interfere with some treatments, but the lower-dose nutrients naturally occurring in foods don’t pose that problem, she notes.

Erdman recently helped a class of nutrition science and dietetics students at her alma mater, Syracuse University, to develop several plant-based recipes (see page 19) for cancer patients — including fruits and vegetables as well as nuts, seeds and whole grains. e students kept in mind that some cancer patients might have mouth sores, for example, so they might offer a smoothie or puree and avoid possible irritants like lemon juice or black pepper. Likewise, since some patients might have lost registered dietitian nutritionist Maria erdman speaking at a cooking demonstration at Syracuse university.

PHOTO BY STEVE SARTORI/SYRACUSE UNIVERSITY

upstate.edu/cancer l spring 2016

IMPROVING LIFE LiViNg WiTH CANCer

White Bean and Roasted Vegetable Salad Ingredients 1 each red and yellow bell pepper, seeded and chopped into ¾-inch pieces (may substitute 3 sliced carrots and 3 cut Roma tomatoes) ½ large red onion, peeled and chopped into ¾-inch pieces 3 large garlic cloves, peeled and smashed 2 tablespoons good-quality olive oil, divided 2 (15.5-ounce) cans cannellini beans (white kidney beans), drained and rinsed 3 tablespoons good-quality red wine vinegar 1 tablespoons freshly squeezed lemon juice Kosher salt and freshly ground black pepper, to taste

Preparation

Preheat oven to 425 degrees.

Toss bell peppers, onion and garlic cloves with 1 tablespoon of the olive oil; season with salt and pepper to taste. Roast vegetables for 20 to 25 minutes, stirring occasionally, until soened and beginning to caramelize.

Toss still-warm vegetables with cannellini beans, red wine vinegar, lemon juice and salt and pepper to taste.

Allow salad to sit at room temperature, stirring occasionally, for at least 1 hour to allow flavors to marry. Discard garlic cloves. Stir in chopped parsley; taste and adjust seasoning, if desired. Makes 4 servings.

Based on the nutrition information, this recipe is an excellent source of protein, fiber, calcium, potassium, iron, magnesium, phosphorus, zinc, vitamin B-6, vitamin C, vitamin E, folate, thiamin, choline and a good source of vitamin A. It contains a very low amount of saturated fat and no cholesterol.

Nutritional information per serving 417 calories 23 grams protein

Finely chopped fresh parsley, to taste

67 grams carbohydrates 16 grams dietary fiber

7 grams total sugar 8 grams total fat zero cholesterol 165 milligrams sodium

ADAPTED FROM THE KITCHN.COM

Chocolate Avocado Mousse Preparation

Place avocado pieces into food processor or blender and puree.

Ingredients 1 ripe avocado, peeled, chopped, pit removed

Add honey, cocoa powder, vanilla extract and kosher salt and process until well combined. Scrape sides of food processor to ensure cocoa powder is incorporated.

Gradually add 1 tablespoon of water at a time to achieve a creamy consistency.

Adjust seasoning with lemon juice to taste.

Refrigerate for at least 1 hour.

¼ cup honey (see note)

Garnish with raspberries when serving.

¼ cup unsweetened cocoa powder

Makes 2 servings.

2 teaspoons vanilla extract ¼ teaspoon kosher salt ¼ cup water Lemon juice, to taste Raspberries, to garnish

Note: In case of a compromised immune system, check with your dietitian or health care provider to see whether honey may be safely consumed; in many cases, it’s fine as long as the honey is pasteurized, not raw.

ADAPTED FROM CREATIVESIMPLELIFE.COM

Nutritional information per serving 409 calories 5 grams protein 55 grams carbohydrates

37 grams total sugars 24 grams total fat zero cholesterol 15 milligrams sodium

14 grams dietary fiber spring 2016 l upstate.edu/cancer

CANCER CARE

19

Hands-on relief

IMPROVING LIFE LiViNg WiTH CANCer

Reiki can prompt relaxation along the road to recovery

BY JIM HOWE

AMONG THE WAYS cancer patients at Upstate cope with the stress and pain of their disease and treatment is Reiki, a touch therapy that can promote relaxation and a sense of well-being. e service is offered free by appointment at the Cancer Center by spiritual care volunteers and Reiki masters Bob Crandall of Baldwinsville and Gary Kassel of Syracuse. ey are among the many Reiki practitioners who have offered the service at Upstate University Hospital for about the past 13 years, says the Rev. Terry Culbertson, manager of the spiritual care department.

Culbertson says Reiki is one of the many ways her staff meets the spiritual and emotional needs of a broad array of patients, family members and staff. “A spiritual practice is the laying on of hands, so I see it as an outgrowth of many faith traditions, done in a way that gives dignity and respect to people,” she says.

Crandall and Kassel describe Reiki as helping to “settle” a patient who may be agitated, nervous or in pain. “Some patients have found relief from the side effects of chemotherapy and/or radiation treatments,” Crandall says.

Bob Crandall provides reiki for Bailey Colvin.

PHOTOS BY DEBBIE REXINE

e patient will usually lie fully clothed on a table in the Cancer Center’s Integrative erapy Room, with low light and soothing music. e Reiki master will place his hands over the patient or on the patient in a series of positions for 20 to 30 minutes. Sometimes he may work with patients in the center’s infusion area.

“When I’ve worked with Bob and Gary, I experience a great sense of calm,” describes Bailey Colvin, a brain cancer patient who has undergone radiation treatments. “Aerward, I’d feel much more balanced … and I leave with such a positive outlook, that everything is going to be all right.”

Crandall says Reiki complements medical treatments. “It does not take the place of evidencebased medicine,” he says. “Reiki is a spiritual practice, but it will work for any denomination, for any belief system or nonbeliever. It will even work for a person who doesn’t believe in it.

It will not work for someone who doesn’t want it.”

When the Cancer Center was in the planning stages, a survey showed a high demand for Reiki, says Linda Veit, the special projects manager at the center. Eventually, she hopes to offer more services, such as massage and stress management techniques. ● WHAT IS REIKI? Reiki (pronounced RAY-kee) is an Asian system of touching with the hands based on the belief that such touching by an experienced practitioner strengthens and normalizes certain vital energy fields held to exist within the body.

Reiki, whose Japanese name means “universal life energy,” claims to provide many of the benefits of more traditional massage therapy, such as reducing stress, relieving pain and promoting healing, leaving one with feelings of warmth, relaxation and well-being.

Schedule a Reiki session by contacting Upstate Connect at 315-464-8668. gary Kassel demonstrates reiki.

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upstate.edu/cancer l spring 2016

17 years later...

MAKING A DIFFERENCE MAKiNg A diFFereNCe

a grateful patient gives back

BY BETHANN KISTNER

AS A 13-YEAR-OLD boy, Colin LaReaux enjoyed sports, video games and movies. However, aer feeling tired and finding a lump that did not respond to antibiotics, testing determined that LaReaux had Hodgkin disease. His parents researched the best health care institutions for treatment and found Irene Cherrick, MD, at Upstate University Hospital.

Every weekend from Friday through Sunday, for four months, LaReaux came to Upstate for chemotherapy, followed by two months of radiation. “I would watch a lot of movies, was given SU basketball tickets and utilized anything the hospital had available for entertainment while I was in treatment. During the week, it was back to school and playing soccer. I was bald and weaker than normal, but I was lucky that I could do much of what I always did,” he says.

At age 20, LaReaux was deemed cancer free; he was only required to get yearly blood work.

Since his diagnosis, LaReaux has graduated from high school, college and law school. On a wintery day in 2014, he decided he wanted to do something to give back for the care he received and for the good health he now enjoys.

“It was 20 degrees outside with several feet of snow on the ground, and I started to think about what I could do to give back in a positive way,” LaReaux explains. “I emailed my high school friend Brooke Hoffman, who is a fellow Hodgkin disease survivor. She was diagnosed in college and told me that my journey helped her get through treatment.”

Hoffman had been cancer free for 10 years, and she, too, was grateful for the care and compassion from her Upstate doctors. Hoffman emailed him back 20 minutes later, replying, “When do we start, and what do we do?”

LaReaux and Hoffman agreed they wanted to raise money to purchase items to entertain children going through cancer treatments. “We understand how important it is to have something fun to do to take your mind off your

Colin Lareaux (left), Shawn Kruger (middle), Brooke Hoffman (right) and supporters deliver a $7,200 check to the upstate golisano Children’s Hospital.

treatment, so we raise money to purchase items that will help pass the time, such as PlayStations, videos, books, iPads and so on.”

While they both come from large families who were willing to help them raise money, most of their fundraising has been a grassroots social media effort.

“First, we sold T-shirts and held a couple of fundraisers at the CrossFit gym I belong to, but we wanted to grow,” LaReaux says. “I met a group who hold local events with the purpose to make the world 10 percent better every day.

We connected and started to hold random meet-ups, which were advertised on social media.”

LaReaux and Hoffman call their group “315K” which represents their telephone area code, as well as “15K” standing for the Utica Boilermaker, a race in which they participate. “We hold events, primarily at the Celtic Harp in Utica because owner Tom Powers has been amazing to our group. He contributes financially to our fundraising, by providing a venue. Our biggest event so far has been our second annual ‘Half-way to St. Patrick’s Day’ fundraiser, in which we quadrupled what we raised the past year.”

To date, LaReaux and Hoffman have raised more than $16,000. ● ARE YOU GRATEFUL? There are many ways to make donations to the Upstate Cancer Center and the Upstate Golisano Children’s Hospital. For details, contact the Upstate Foundation at 315-464-4416 or www.FoundationForUpstate.org

Upstate marks 20 years of celebrating cancer survivors

National Cancer Survivors Day takes place the first Sunday in June, a celebration of life for people of all ages that is held in Syracuse and hundreds of other communities nationwide.

Upstate sponsors the Syracuse event, which was first held 20 years ago in its Campus Activities Building. Aer the event outgrew that space, it was held for many years at the Holiday Inn Electronics Parkway. is year the event takes place at the Burnet Park Zoo, with up to 650 people expected to attend.

With cancer death rates declining, the number of Americans living with a history of cancer is growing. National Cancer Survivors Day is designed to “show the world that life aer a cancer diagnosis can be fruitful, rewarding and even inspiring,” says the National Cancer Survivors Day Foundation.

Learn more at www.upstate.edu/cancer/about/events.php or by calling 800-464-8668. spring 2016 l upstate.edu/cancer

CANCER CARE

21

Almost home

CARING FOR PATIENTS MAKiNg A diFFereNCe

Guest house welcomes patients, families BY JIM HOWE

CANCER PATIENTS AND THEIR families who travel to Syracuse for treatment face the question of where to stay and how to get around.

10 –

minutes drive to the Upstate Cancer Center

20 or 35 – dollars per day for single or double occupancy (although no one is turned away for inability to pay)

Spending days or weeks away from home can get expensive if the patient, and oen a relative or friend along for support, stay in a hotel and eat in restaurants. It can feel cold and impersonal as well.

30 –

Sarah’s Guest House offers a warm alternative. It’s a comfortable, homelike residence that provides a low-cost place to stay with free meals, a laundry room, lounges, parking, Wi-Fi and rides to and from the hospital.

percent of guests who stay because a relative has cancer; 30 percent stay for heart patients, and 30 percent stay for surgical or orthopedic patients

12 –

guests per day is average; 20 is a full house

3–

days is the average length of stay for guests

It’s designed for adult patients and their families, in contrast to the Ronald McDonald House, which serves families of sick children.

In operation since 1994, Sarah’s Guest House was inspired by a leukemia patient who wanted to bring the “home away from home” concept of adult hospitality houses to Syracuse. His aunt, Mary Keough, founded the nonprofit residence and ran it for many years. Although it has no religious affiliation, the house takes its name from the biblical Sarah, Abraham’s wife, who was known for her hospitality and kindness to wayfarers.

Most of the patients who stay in Sarah’s Guest House are receiving outpatient cancer treatment at the Upstate Cancer Center, and many go home on weekends. But the house hosts patients for any medical issue and from any Syracuse hospital, as well as the patient’s family members or friends. “ey were just so nice to me,” says Kassandra Holmes, 66, of Utica, who stayed from March to July 2015 while she was undergoing chemotherapy and radiation treatments for small cell lung cancer. “It was very comfortable, and they make you feel just like you’re one of their own, a family member. You don’t have to do anything but go to your appointment and rest.” Holmes plans to stay at the house again when she returns for follow-up procedures. e house’s executive director, Jen Coman, says many of the cancer patients get close to the volunteers. “ey might have a 15-minute treatment and then are here with us the rest of the day. “ese people have to leave their families, pets and neighbors and stay in a strange city,” she says, noting that

22

SARAH’S GUEST HOUSE BY THE NUMBERS

CANCER CARE

40 to 53 – percent of guests from the North County (Lewis, St. Lawrence and Jefferson counties), depending on the year

she felt lucky to live close by when she underwent breast cancer surgery herself two years ago. e residence occupies the renovated convent of Most Holy Rosary Church, at the edge of Syracuse’s Strathmore neighborhood, about two miles west of the Cancer Center.

Eleven rooms are divided into suites with single or double beds, each with a sink and a shared bathroom. Guests need a referral from a health care provider, medical social worker or pastoral care worker. anks to volunteers, meals are available every day, as well as rides to the hospitals, and someone is always around to offer a friendly ear or a cup of coffee. Bedding and towels are provided, and toiletries are available if anyone forgets a toothbrush.

More than half of the funding for the operation comes from individuals, and the rest from organizations including the St. Agatha Foundation, William G. Pomeroy Foundation and Jim and Juli Boeheim Foundation, as well as fundraisers including an annual gala and golf tournament. “e budget is still under $250,000 a year, which is low for a place like this,” says Coman, who is assisted by three part-time employees. e house keeps a tight budget and gets a lot of donations of goods and services from a small army of volunteers. ●

upstate.edu/cancer l spring 2016

UPSTATE CARES ABOUT OLDER ADULT PATIENTS

upstate university Hospital is the first in the region to achieve NiCHe exemplar status. Only five other hospitals in New York state have this designation.

This national status — from Nurses improving Care for Healthsystem elders — is awarded to both upstate university Hospital locations.

NI

CHE

NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS

downtown l community

upstate.edu

spring 2016 l upstate.edu/cancer

CANCER CARE

23

750 East Adams Street l Syracuse, NY 13210

UPClose

16.152 0516 39.6M ELsk

Beads of Courage supports children and families who are coping with serious illness, including cancer. e beads, which are collected on chains or necklaces, are meant to inspire resilience, each representing bravery and a milestone along the child’s treatment path. Beads of Courage also offers a sibling program, designed to help alleviate the stress and anxiety of brothers and sisters.

PHOTOS BY WILLIAM MUELLER