Cancer Care winter 2017

care

CANCER

for anyone touched by cancer

Living with brain cancer WINTER 2017

t

page 9

Stem cell transplant fights multiple myeloma page 4

Meet a nurse who faced cancer as a child page 8

Breast cancer What question: scientists Should discovered by chemotherapy dissecting or surgery kidney come first? tumors page 12 page 16

Preserving future fatherhood page 20

Brought to you by the

Upstate is the place to go for pancreatic cancer treatment

YOUR GUIDE

UPSTATE UNIVERSITY HOSPITAL is uniquely qualified to provide top-quality care for patients with pancreatic cancer and other diseases that affect the pancreas. e hospital earned a designation from the National Pancreas Foundation aer an extensive auditing process.

Upstate is one of four institutions in New York and the only one outside of New York City that the foundation allows to call itself an NPF Center for Care and Treatment of Pancreatic Disease.

It’s an important recognition that highlights Upstate’s multidisciplinary team approach of treating each patient individually to formulate comprehensive and compassionate care plans for the best possible outcomes. e audit made sure Upstate provides expertise in certain specialties, access to clinical trials, a variety of patientfocused programs, and more.

Dilip Kittur, MD, is proud of the designation. He’s the division chief of liver, pancreas and gallbladder surgery at Upstate. He points out the variety of state-of-the-art treatments for even advanced pancreatic cancer, including robotic pancreatic surgery, stereotactic radiation and advanced chemotherapy. ●

Did you know?

The scientist who discovered genetically inherited breast cancer visited Upstate IN 1990, her laboratory zeroed in on chromosome 17q21 to prove that breast cancer is genetically inherited in some families. e scientists working with Mary-Claire King, PhD, called this particular genetic mutation BRCA1. Soon aer, another mutation, called BRCA2, was identified.

Today the mutations are known not only for significantly increasing the risk of breast cancer in women but for putting men at risk for prostate and pancreatic cancer, too.

King spoke to a scientific crowd at Upstate’s Presidential

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Symposium last fall. She explained that determining who is at increased risk for breast cancer remains tricky.

About half of the people who are found to have a BRCA mutation are surprised, because they have no cases of breast cancer in their families.

Also, BRCA1 and BRCA2 are not the only genes involved in hereditary breast cancer. King said there are “breast cancer families” whose members have no BRCA mutations. ●

upstate.edu/cancer l winter 2017

INSIDE

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Inside this issue CARING FOR PATIENTS

SEARCHING FOR CURES

One man’s fight against multiple myleoma

page 4

Research on kidney tumors helps decipher proteins’ role

page 16

She cruises the coast after lung cancer treatment

page 5

Scientists explore genetic roots of rare blood cancer

page 17

Avoiding nerves preserves sexual function

page 6

Cancer patient as a child, now a cancer nurse Meet a teen living with brain cancer

IMPROVING LIFE Researching your diagnosis

page 19

page 8

Preserving future fatherhood

page 20

page 9

Calcium, fiber and calories: Fudge Pudding Cake recipe

page 21

SHARING EXPERTISE

MAKING A DIFFERENCE

Breaking apart breast cancer treatment options

page 12

Make-a-Wish provides Parker, age 11, with a man cave

5 things that happen after you find a lump

page 12

Upstate celebrates the annual Lung Cancer Vigil

A surgeon explains staging

page 15

back cover .

On the cover: Breonna Popluhar, 17, of Oneida is being treated for brain cancer at the Upstate Cancer Center.

See story, page 9.

PHOTO BY SUSAN KAHN

care

CANC ER

for anyone

touched

by cancer

Living with brain cancer WINTER

2017

M

care

CANCER

page 22

page 9

Stem cell transp lant fights

multip le myelom a page 4

Meet a nurse who faced cancer as a child page 8

Breast cancer questio What n: scienti Should chemo discove sts therap red or surger y dissect by ing y come first? kidney page 12 tumors page 16

Preser ving future fatherhood page 20

Brought

to you by

the

for anyone touched by cancer

WINTER 2017

CANCER CARE

UPSTATE CANCER CENTER

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

DIRECTOR (INTERIM) Jeffrey Bogart, MD

MANAGING EDITOR

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

WRITERS DESIGNER

Jim Howe, Susan Keeter, .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.

winter 2017 l upstate.edu/cancer

DEPUTY DIRECTOR (INTERIM) Gennady Bratslavsky, MD ASSOCIATE DIRECTOR FOR CLINICAL AFFAIRS Ajeet Gajra, MD ASSOCIATE DIRECTOR FOR CLINICAL RESEARCH Stephen Graziano, MD ASSOCIATE DIRECTOR FOR BASIC AND TRANSLATIONAL RESEARCH Leszek Kotula, MD, PhD ASSOCIATE DIRECTOR FOR COMMUNITY OUTREACH Leslie J. Kohman, MD

The Upstate Cancer Center is part of Upstate Medical University in Syracuse, N.Y., 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.

ASSOCIATE ADMINISTRATOR Richard J. Kilburg, MBA

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Outsmarting, outlasting

CARING FOR PATIENTS

Multiple myleoma is his opponent – and so far, he’s winning

BY SUSAN KEETER

JACK DURR SEES THE ONCOLOGY TEAM at the Upstate Cancer Center’s office in Oneida for most appointments. Having chemotherapy treatments, blood tests and checkups close to his home in Vernon is important to Durr, 72, who loves his job and dreads missing a day of work.

For 35 years, Durr has worked in a lab at the SUNY Polytechnic Institute in nearby Utica. He is enthralled by the scientific discoveries and technological advances that he has witnessed at the college over the years. “When I started, we didn’t have computers,” he explains. “Now we’re doing nanotechnology.” at love of scientific progress took on greater meaning when Durr was diagnosed with a cancer called multiple myeloma in 2009. Seven months aer diagnosis, Durr had an autologous stem cell transplant (see box) at the Upstate Cancer Center’s main site in Syracuse. e transplant put the disease in remission and likely saved Durr’s life.

Stem cell transplants are available in Central New York only at Upstate, says Upstate oncologist Teresa Gentile, MD, PhD. She points out that “we’re at the cutting edge of clinical trials, and Upstate has access to more recently approved immunotherapy drugs.”

In 2010, Durr was hospitalized for 17 days for the transplant. “Before the transplant, I had three trips to the hospital and was hooked up to a machine for 3-4 hours to harvest stem cells out of my blood. Aer they got my stem cells, the transplant started with a big blast of chemo to get rid of any cancer. en, they put my stem cells back into me, so I could make new, healthy blood,” he smiles. “When I was done, I was like a new, little baby. I had to get all my childhood vaccines again.”

When the transplanted stem cells were injected into Durr’s bloodstream, they moved into his bone marrow, where they proliferated and developed into healthy platelets, and red and white blood cells.

To further battle the multiple myeloma, Gentile recommended the immunotherapy drug Revlimid to strengthen Durr’s immune system and stop new cancer cells from developing. Durr’s cancer stayed in remission for six years.

“But, cancer figured it out again,” says Durr, who served in Army intelligence during the Vietnam War and stays

Jack Durr, 72, of Vernon.

PHOTO BY SUSAN KAHN

WHAT IS MULTIPLE MYELOMA?

Multiple myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.

-AMERICAN CANCER SOCIETY

WHAT IS A STEM CELL TRANSPLANT?

In a stem cell transplant, the patient gets high-dose chemotherapy (sometimes with radiation) to kill cells in the bone marrow. Then the patient receives new, healthy, blood-forming stem cells. Before the transplant, drug treatment is used to reduce the number of cancerous cells in the patient’s body. With an autologous transplant, the patient’s own stem cells are removed from his or her bone marrow or blood, stored and reinfused into the patient’s blood after treatment to kill cancer cells.

–AMERICAN CANCER SOCIETY

continued on page 11

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upstate.edu/cancer l winter 2017

With lung cancer at bay, she’s cruising Florida coast on her Harley

CARING FOR PATIENTS

BY SUSAN KEETER

AS A RETIRED POLICE OFFICER, Toni Lindgren knows how to deal with problems. So, when a physician at Fort Drum said, “I think it’s cancer,” Lindgren said, “I’m going to Upstate. I want the doctors who do cancer all day, every day.”

Last March, Lindgren, 58, of Carthage saw her primary care physician because she was concerned that her stuffy nose and occasionally bloody cough might be symptoms of an infection that her elderly mother could catch.

“Just to be on the safe side, let’s do a chest X-ray,” said Lindgren’s primary care doctor. She and her husband receive care though Fort Drum because of his military service. at evening, the doctor called her at home. He made sure she wasn’t alone. Her husband, Dale, was with her. “ere’s a large mass on the lower lobe of your right lung,” the doctor told them. “Don’t wait until Monday. Get a CT scan at Carthage Hospital now.” e CT scan confirmed a tumor in her lung, and Lindgren’s doctor gave her a referral to the Upstate Cancer Center.

At Upstate, Birendra Sah, MD, inserted a scope through her mouth, so he could view her lungs, trachea and surrounding area with the scope’s camera. at procedure, called a bronchoscopy, showed lung squamous cell carcinoma in a lymph node. It was followed by a PET scan, which illuminated the cancerous tumor and a number of continued on page 11 concerning spots near her trachea.

Toni Lindgren on the motorcycle she and her husband bought for her after her chemotherapy treatments for lung cancer. This winter, she is riding it along the eastern coast of Florida.

World traveler… and grateful lung cancer patient

PHOTO BY SUSAN KAHN

BY BETHANN KISTNER

NEARLY THREE YEARS AGO, Patricia Kranbuhl was diagnosed with stage IV lung cancer. Aer participating in a clinical trial at the Upstate Cancer Center, she is symptom free and is now back to doing the things she loves, including traveling the world.

In April 2014, Kranbuhl was excited to be taking her granddaughters on their first trip to New York City to see a Broadway show. “At that time, I had a nagging breathing issue, which I thought was probably asthma,” she said.

Her asthma concern turned out to be a diagnosis of stage IV lung cancer. Kranbuhl was immediately referred to

Upstate’s Ajeet Gajra, MD. Gajra explained to Kranbuhl that there was a malignant tumor on her lung, but as the cancer was also in her lymph nodes and blood, surgery was not an option. However, he noted that Upstate was conducting a clinical trial for which she would be a perfect candidate.

For the treatment, Kranbuhl had a port inserted into her chest wall. “Dr. Gajra asked if I wanted to start an IV infusion treatment that day, and I said yes. I wanted to stop the tumor from growing as soon as possible and do whatever I could to eliminate it,” Kranbuhl said. “It took two days to do the first treatment, one aernoon followed continued on page 10

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CARING FOR PATIENTS

Removing a hidden cancer

Surgeon avoided nerves when he removed prostate; patient – and wife – are thankful

BY AMBER SMITH

PROSTATE CANCER USUALLY GROWS SLOWLY. Unfortunately, Patrick Young’s cancer was aggressive, and furtive. It hid itself around the top side of his prostate, in the back, where a biopsy needle would be unlikely to reach.

Fortunately, Patrick Young’s wife, a research scientist, found an expert urologic oncologist just 90 minutes from their home in rural Chenango County. Young became a patient of Gennady Bratslavsky, MD, who chairs the department of urology at Upstate and who specializes in cancers of the kidney, bladder and prostate.

“My wife and I both love how passionate he is about what he does,” says Young, who grows organic vegetables and raises free-range hens in Guilford. He was 54 when he developed trouble keeping an erection.

His primary care provider began monitoring his level of prostate specific antigen, or PSA, an enzyme found in high concentrations in the blood of men who have prostate cancer. PSA levels can also be affected by inflammation or enlargement of the prostate. Young also underwent an biopsy before his wife, Rebecca Armstrong Young, PhD, sought an experienced urologist to take over his care.

Bratslavsky began closely monitoring Young’s PSA level.

When the level rose, Bratslavsky scheduled a magnetic resonance imaging scan and biopsy done with a powerful 3-tesla MRI system that uses technology similar to global positioning navigation to locate hard-to-find cancers of the prostate.

Upstate became the first provider in Central New York to offer the Phillips UroNav Fusion Biopsy System in October 2013. Since then, about 300 precision-guided fusion biopsies have been done with as many as 25 percent revealing aggressive cancers that otherwise would have been missed. Many of the men found to have continued on page 7

Patrick Young wears a necklace in memory of his mother who died at age 59 from lung cancer. She taught him to hunt. The necklace is made from antlers of the first deer Young shot, plus wooden and brass beads and a Buffalo nickel pendant carved by a master gunsmith.

PHOTO BY ROBERT MESCAVAGE

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CARING FOR PATIENTS

Removing a hidden cancer

continued from page 6

Urologist Gennady Bratslavsky, MD, meets with Patrick Young.

PHOTOS BY ROBERT MESCAVAGE

less-aggressive cancers were spared unnecessary treatment because the fusion biopsy provided reassurance that they were not harboring more aggressive cancers.

Young’s images and biopsy were done on Christmas Eve 2015. ey revealed cancer had corkscrewed out from the prostate and attached itself to his bladder. Surgery was Young’s only option, since he has ulcerative colitis. In order to give his body time to heal from the biopsy, surgery was scheduled for Feb. 29.

“I was scared, and I’m not normally a scared type of person,” Young admits. “Lung cancer killed my mother, and my baby brother had testicular cancer 12 years ago. ankfully, he has gotten through it.”

The painting above was made by Rebecca Young, PhD, about five months after her husband’s surgery. She took a photo of him when he came inside after working outdoors all morning. “I remember seeing him and thinking how grateful I was that he was well enough to be active again,” she explains. “To me, he was looking more alive than he had been in almost two years. I wanted to capture that moment.”

Above right: Rebecca and Patrick Young.

Bratslavsky’s plan was to remove Young’s prostate, delicately avoiding the nerves around the gland. at’s not always possible, Young knew, but he was hopeful. e surgery was a success.

E-cigarette dangers go beyond cancer

At a follow up appointment, Young kissed Bratslavsky on the cheek. “I love what you’ve done for Becky and me.”●

THE USE OF ELECTRONIC CIGARETTES is higher among high school students than adults, a trend that alarms U.S. Surgeon General Vivek Murthy, MD. E-cigarettes contain a concentrated and more potent dose of nicotine than tobacco cigarettes, which is particularly dangerous for teens.

Nicotine affects brain development, which continues to about age 25. ere may be no cancer-causing tobacco or tar in electronic cigarettes, but Murthy’s office points out that other harmful ingredients cause serious lung diseases.

In addition, the liquid nicotine used in e-cigarettes can be lethal. Just a quarter teaspoon is enough to kill a toddler, according to an article in the journal Clinical Toxicology written by doctors of pharmacy William Eggleston, Jeanna Marraffa and Christine Stork and Nicholas Nacca, MD. e four work together at the Upstate New York Poison Center in Syracuse. ey reported that the American Association of Poison Control Centers saw a 236 percent increase in calls related to e-liquid exposure in 2014, compared with the previous three years. “Nearly 60 percent of those exposures involved children less than 5 years of age,” the article says, before noting that any liquid nicotine product should be kept out of the reach of children. ●

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Cancer patient as a child, now a cancer nurse

CARING FOR PATIENTS

WHAT IS NON-HODGKIN LYMPHOMA?

Non-Hodgkin lymphoma is cancer that starts in cells called lymphocytes, part of the body’s immune system. This type of cancer accounts for about 5 percent of all childhood cancers, and about 500 children age 14 and younger are diagnosed with non-Hodgkin lymphoma in the United States each year. Its cause is unknown.

An array of imaging scans, blood tests and biopsy analyses may be used in diagnosing non-Hodgkin lymphoma.

Chemotherapy is the main treatment for children with this cancer. Surgery, radiation and stem cell transplants may also play a role in treatment.

SOURCE: AMERICAN CANCER SOCIETY

Nurse manager Nellie Diez

PHOTO BY KATHLEEN PAICE FROIO

BY AMBER SMITH

NELLIE DIEZ REMEMBERS being startled by her mother, whose first name she shares, as a 12-year-old in treatment for cancer.

For four weeks, mother and daughter had been at a children’s hospital two hours from their home in Puerto Rico. Diez was diagnosed on admission with non-Hodgkin lymphoma on Nov. 23, 1988. Now it was Christmas Eve, and Nellie Santiago was told to enjoy what would likely be her daughter’s last year of life.

Santiago gave terse instructions to Diez: “Get dressed.

We’re leaving.” ey were off to find more aggressive care, a move Diez today says saved her life.

Diez’s parents were divorced. Her father lived in New York City. He helped get her an appointment at Memorial Sloan Kettering Cancer Center, and she and her mother traveled to New York. Diez was a patient there for five months. She underwent 10 radiation treatments, plus chemotherapy.

“I had a lot of chemo. A lot,” she recalls. Her heart and lungs were affected by the cancer and its treatment.

She returned to Puerto Rico when she was discharged, coming back to the cancer center every two months for follow-up appointments. Her final treatment was in April 1991.

Her experience is a story she’s willing to share with patients of Upstate University Hospital, where Diez, 40, is a nursemanager of the 27-bed adult oncology unit. Some patients appreciate hearing from someone who has gone through what they face.

Diez began charting a future in nursing as a patient at Memorial Sloan Kettering. One of her physicians pointed

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her to Syracuse University, which at the time had a college of nursing. Diez wound up attending SU and doing her student nursing internship at the same cancer center where she had been a patient.

Today she works at Upstate, an academic medical center just blocks from where she attended college.

When she graduated with her bachelor’s degree, she intended to work in pediatric oncology — but there were no job openings. “So I convinced myself that we are all kids at heart” and applied for a position in adult oncology. at was 16 years ago.

She married in 2008. A few years later, she and her husband, José Diez, learned that because of her heart trouble, a pregnancy would be considered high risk — if she was even able to conceive. She got pregnant. And she felt her life come full circle when she learned her due date was Nov. 23, the same date of her cancer diagnosis 23 years before. Her son, Leonidas, was born by a scheduled Cesarean section Nov. 23. He’s 4½ now. Her daughter, Livia, is 18 months old. José Diez is a stay-at-home dad.

With the benefit of 30 years’ hindsight, and motherhood, Diez is able to appreciate that her mother was looking out for her when they made their abrupt departure from the hospital in Puerto Rico. It was the action of someone looking out for a loved one with cancer.

Diez gets it.

She’s on the other side of the bedside now, with a unique ability to relate to the fear and uncertainty that accompany cancer. As a nurse and cancer survivor caring for people with cancer, Diez sees her role as sacred. “I have the honor of taking care of people in very vulnerable conditions.” ●

upstate.edu/cancer l winter 2017

Oneida High School student learns to live with brain cancer

CARING FOR PATIENTS

BY JIM HOWE

A RUN OF SEVERE HEADACHES over a couple of weeks in 2015 led to an Oneida teen’s diagnosis of brain cancer.

“I would throw up a lot and couldn’t eat. It hurt really bad,” describes Breonna Popluhar, 17, a junior at Oneida High School.

A computerized tomography scan at an urgent care center led to an ambulance ride to Upstate, where further tests revealed a cancerous tumor that had likely been present since birth. It was causing headaches because it had no more room to grow, she said.

Surgery two days later revealed the growth to be oligodendroglioma (see box on page 10). Further surgeries followed in August and October 2015.

“Breonna has a type of infiltrating brain tumor that is not amenable to total surgical removal without causing significant deficits,” explains Zulma Tovar-Spinoza, MD, Upstate’s director of pediatric neurosurgery, who performed the surgery.

“While most of her tumor was successfully removed, surgery is Zulma Tovar-Spinoza, MD “only one part of the treatment,” Tovar-Spinoza notes. She and the other specialists on Popluhar’s multidisciplinary team at Upstate recommended chemotherapy as the next step to stop the tumor’s growth. Popluhar would take a monthly pill and be monitored every three months with a magnetic resonance imaging scan.

Chemotherapy le her tired, less motivated and oen nauseated. She got her first break from chemo in late 2016 and began to feel better in the weeks that followed.

“We want to wait and see right now what the tumor will do off of chemo,” Popluhar says.

She continues to attend school full time. Many of her fellow students are not aware she has cancer, “because my hair is OK, and I don’t talk about it a lot,” she says. She also works part-time washing dishes and takes weekly dance classes — although she can’t do upside-down moves at the moment and sometimes has to write down new dance steps because of poor short-term memory.

Breonna Popluhar PHOTO BY SUSAN KAHN PHOTO OF ZULMA TOVAR-SPINOZA, MD,

BY ROBERT MESCAVAGE

continued on page 10

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CARING FOR PATIENTS

Oneida high school student

continued from page 9

She knows the rest of her life will include medical appointments, and she knows she may face more surgery.

A CANCER WITH A LONG, STRANGE NAME

In the meantime, she and her family want to spread awareness of childhood brain cancer, a disease not always visible to others and that does not receive the attention some other cancers do.

The brain cancer called oligodendroglioma develops from oligodendrocytes, one of the types of cells that make up the supportive, or glial, tissue of the brain.

Her pediatric oncologist agrees. “e public should know that brain tumors are the second most common cancer in children (aer leukemia) and are now the No. 1 cause of cancer-related death in children,” says Melanie Comito, MD, chief of pediatric hematology and oncology.

“Despite this fact, the prognosis for brain cancer in children is, overall, good and very different from the prognosis for adults with brain cancer. is is due to the fact that the types of brain cancers in children are quite different that those found in adults,” Comito adds.

Popluhar’s mother, Dawn Heffron, describes the emotions the family has gone through, from initial shock to obsessively seeking information to maintaining optimism and patience while constantly awaiting test results.

Meanwhile, as Popluhar thinks about college options and her future, she doesn’t focus on brain cancer. ●

This cancer is relatively rare in adults and even rarer in children, and often is “silent” Melanie Comito, MD, and — growing slowly and Breonna Popluhar gradually, says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology.

Treatment generally involves surgical removal, if possible, along with radiation and/or chemotherapy, then monitoring for recurrence with MRI scans.

Comito notes that headaches are common in both children and adults and rarely mean a brain tumor. Headaches that persist and get more frequent and severe are a concern if associated with other complaints, such as seizures, changes in personality, vomiting, changes in walking or vision or decreased school performance.

Upstate offers cancer services for adults in Oneida, but children or teens like Popluhar are treated at the main Upstate campus in Syracuse.

World traveler

continued from page 5

by treatment the next morning.”

She credits the staff at the Upstate Cancer Center with helping her with the healing process. “ey stayed with me, as they do with all their patients, every step of the way. ey were compassionate beyond words. I could not be more grateful for the care that I continue to receive to this day,” she said.

When Kranbuhl received a letter from the Upstate Foundation as part of its annual Doctors’ Day celebration, she wrote a tribute and made a donation in honor of Dr. Gajra, and the research that she says extended her life.

While she continues maintenance treatment once a month, Kranbuhl’s love for travel is back on track. “I worked all my life. When I retired, I decided I would take a big trip every year to see the world.”

She enjoys meeting people, experiencing their cultures and learning their histories. Since her diagnosis, Kranbuhl has cruised the Mediterranean on a small boat and visited Cuba and India. Her favorite destination, however, remains her 2014 trip to Africa. “Waking up in the Serengeti was beyond spectacular,” she said.

Ajeet Gajra, MD, and Patricia Kranbuhl

Both Gajra and Kranbuhl say they are pleased with her progress. Her tumor is undetectable, and all tests are stable.

Kranbuhl adds: “I listen to Dr. Gajra because I trust him with my life, and I have a lot more traveling yet to do.” ●

To donate to Friends of Upstate Cancer Center, visit https://www.upstatefoundation.org or contact the Upstate Foundation at 315-464-4416.

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CARING FOR PATIENTS

Outsmarting, outlasting

continued from page 4

energized and upbeat by viewing cancer as an enemy he needs to outsmart.

Durr and Gentile put their heads together and discussed options for dealing with the cancer relapse. Rather than a second stem cell transplant, Durr chose new immunotherapy medication combined with chemotherapy.

He is in remission again, thanks to 32 weeks of chemotherapy treatments at the Oneida office, plus Pomalyst, a new immunotherapy drug.

Oncologist Teresa Gentile, MD, PhD, with Jack Durr, 72, at the Upstate Cancer Center office in Oneida. Upstate oncologists have been treating patients in Oneida for 25 years.

PHOTO BY SUSAN KAHN

What if cancer figures it out again? “Maybe I’ll have that second transplant,” Durr says with a grin. “Or, Dr. Gentile will tell me about new drugs we can try.” ● WHAT ARE STEM CELLS?

WHAT IS IMMUNOTHERAPY?

Stem cells differ from other kinds of cells in the body. All stem cells have three general properties: they are capable of dividing and renewing themselves for long periods; they are unspecialized (they could potentially become many different types of cells); and they can give rise to specialized cell types.

A type of biological therapy that uses substances to stimulate or suppress the body’s immune system to help fight cancer, infection and other diseases.

With lung cancer at bay

– NATIONAL CANCER INSTITUTE

– NATIONAL INSTITUTES OF HEALTH

continued from page 5

“I lit up like a Christmas tree,” described Lindgren, shaking her head.

Since the PET scan made it appear that cancer had spread from the lung to the lymph nodes, the initial plan was to treat Lindgren with chemotherapy and radiation.

Lindgren’s reaction was, “is thing’s growing every day.

I want surgery to get it out!” e multidisciplinary thoracic oncology team at Upstate met to discuss Lindgren’s case and, with her involvement, decided that a second biopsy, called a mediastinoscopy, was warranted to further examine the middle of her chest, between the lungs. e results were encouraging. Surgeons Jason Wallen, MD, and Robert Dunton, MD, biopsied multiple lymph nodes, and none were cancerous. Most of the areas illuminated by the PET scan were “false positives,” meaning noncancerous. Now, surgery was an option.

On May 3, Lindgren had minimally invasive surgery to remove the lower lobe of her right lung. She was released from the hospital four days later, on her husband’s 60th birthday. e final pathology report showed that only two lymph nodes were cancerous.

Oncologist Stephen Graziano, MD, recommended 12 weeks of chemotherapy. Between June and August, Lindgren and her husband rose at 5 a.m. to drive from Carthage to Syracuse for her treatments.

couple of bouts of nausea and never lost her hair. However, a few weeks into treatment, Lindgren faced another blow: While she was being treated at Upstate, her mother died in another hospital in another city.

“I couldn’t visit Mom because my resistance was low because of the chemo,” explained Lindgren. “But we were able to video chat. Mom told me she’d decided to stop her treatment for a lung condition. Now, she and my dad, who died six years ago, are angels in heaven making sure I’m OK.” One tough day at the hospital, Lindgren’s husband mentioned that they ought to look at a white HarleyDavidson motorcycle that was for sale in Utica.

For Lindgren, it was love at first sight. She had long dreamed of riding a Harley on Highway A1A in Florida with her husband.

With surgery and chemotherapy completed, Lindgren and her husband were ready to snowbird. Lindgren’s CT scan in September and chest X-ray in November were clear, paving the way for their extended trip. Shortly aer her birthday on Nov. 14, the couple le Carthage for St. Augustine, Fla. She will see doctors there, and then she has an appointment with Graziano in April at Upstate. e couple is grateful.

“When I got the news of lung cancer last spring,” admits Lindgren, “I didn’t think I’d live to see my birthday.”

Now, she’s in remission and enjoying warm weather and long motorcycle rides with her husband. ●

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Should chemotherapy or surgery come first?

SHARING EXPERTISE

Rethinking breast cancer treatment options

BY AMBER SMITH

MANY PEOPLE WITH A BREAST CANCER DIAGNOSIS will face surgery and chemotherapy as part of their treatment. A question more doctors and patients must answer is: In which order?

Chemotherapy is increasingly prescribed to help shrink breast tumors before surgery, similar to how it is used to treat some pancreatic, ovarian and bladder cancers. When it is used as a first step in treatment, chemotherapy is what doctors refer to as neoadjuvant therapy. “e concept of neoadjuvant chemotherapy has really taken hold because it holds so much promise,” Anees Chagpar, MD, told caregivers and researchers at Upstate in her delivery of an annual lecture paid for by the Carol M. Baldwin Breast Cancer Research Fund. Chagpar is director of e Breast Center at the Smilow Cancer Hospital at Yale-New Haven.

Chagpar says survival rates are the same, regardless of whether patients receive chemotherapy or surgery first. e National Comprehensive Cancer Network recommends considering chemotherapy before surgery in certain patients with breast cancer, and Chagpar said she agrees for several reasons: l An inoperable tumor may shrink enough aer

chemotherapy for a surgeon to consider removing it. l Women facing mastectomy, or complete removal of a

breast, may instead be able to have a breast-conserving operation if chemotherapy adequately reduces the size of the tumor. “For patients who want breast-conserving surgery, this is a way to get that,” she says. l Chemotherapy may wipe out cancer cells completely,

providing what doctors call a “pathological complete response.” Chagpar describes operations in which she removes tissue believed to contain the tumor, only to have a pathologist report there are no viable cancer cells. l Options are growing for clinical trials that involve

neoadjuvant therapy, giving patients access to cuttingedge treatment that would otherwise not be available. ●

Anees Chagpar, MD, illustrates a breast tumor with a chocolate chip cookie. Chemotherapy can either cause cancers to shrink concentrically, or may break apart, leaving cookie crumbs. That’s why surgery, and often radiation, is recommended as a follow-up to chemotherapy, and why it’s important to make sure patients have clear margins (or no crumbs at the edge of the tissue that is taken out).

Speaking at Upstate this fall, Chagpar explained the difficulty in predicting which patients will have tumors that will completely disappear with chemotherapy, which will fragment or shrink, and which may not respond at all.

SUPPORT GROUP MEETS WEDNESDAYS

Upstate Pink Champions is a breast-care support group that holds monthly meetings on the second Wednesday of the month from 5:30 to 7 p.m. in a conference room at the Upstate Cancer Center. The meetings focus on networking, support, education, advocacy and awareness. To learn more, email gopink@upstate.edu

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What happens after you find a breast lump

SHARING EXPERTISE

1. Primary care

3. Biopsy

Connect with your primary care provider, to have the lump investigated. e majority of self-palpated lesions turn out to be benign tumors or cysts, says Upstate medical oncologist Sam Benjamin, MD.

e laboratory at Upstate quickly turns around biopsy results, usually within 48 to 72 hours, Benjamin says.

Most breast biopsies do not find cancer.

“Unless we do imaging, and, sometimes, even a biopsy, we won’t know for a fact that it’s not cancerous,” he says.

4. Diagnosis Sam Benjamin, MD

2. Mammogram e U.S. Preventive Services Task Force recommends women age 50 and older be screened for breast cancer at least every two years, and more frequently if they have a family history of breast cancer.

If a mammogram reveals a lump that looks like a cyst, cells can be removed in a biopsy procedure called “fine needle aspiration.” If the lump appears solid, tissue can be removed in a “core biopsy.”

With Upstate’s multidisciplinary approach, women and men with a breast cancer diagnosis can be evaluated by a medical oncologist, surgical oncologist and radiation oncologist at the same time. “is gives the patient a much more comprehensive assessment of their condition,” he says.

5. Treatment plan Treatment recommendations have changed in the past couple of decades. Full mastectomy is not necessary for many patients, Benjamin says. ose with small tumors that have not spread may choose breast-conserving surgery, followed by radiation — and they may not require chemotherapy. ●

Covert operations Surgeons hide scars in new breast surgery technique A NEW SURGICAL TECHNIQUE means disfiguring surgical scars may be avoidable for women who face breast cancer surgery.

Kristine Keeney, MD, and Mary Ellen Greco, MD, are both certified in Hidden Scar Breast Care Surgery, an advanced approach in which surgeons remove cancerous tissue through a single incision made in an inconspicuous area.

“I’m proud to be able to offer this to our patients because it can potentially ease the emotional impact of breast cancer surgery,” says Keeney. “Our patients will be le with virtually no visual reminder of the surgery and will also have the opportunity for a more natural-looking breast reconstruction.”

It’s not appropriate for all patients. e tumor size and location, and the shape and size of the patient’s breast help determine eligibility. e technique can be used in a nipple-sparing mastectomy or a breast conserving procedure, also referred to as a lumpectomy.

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In a nipple-sparing mastectomy, the surgeon removes underlying breast tissue while preserving the nippleareolar complex and breast skin. e natural crease beneath the breast is the preferred incision location for this type of procedure.

A hidden-scar lumpectomy makes use of a single, discreet incision to preserve the majority of the breast, while removing the tumor and a small portion of healthy tissue around the margins. e incision for this type of surgery can be made in the crease beneath the breast, the areola border or the armpit.

Greco is pleased to offer the new approach because “it helps us confront our patients’ fears about how they will be changed aer surgery, while still offering the highest quality care.”

She and Keeney work together at the Upstate Breast Care Center, on the Community campus. ●

CANCER CARE

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Hunting for cancer

SHARING EXPERTISE

Doctors ‘stage’ cancer to create prognosis, treatment regimen; that means finding where it has spread

BY JIM HOWE

are needed to lessen the risk of cancer returning, known as adjuvant therapy, and what sort of monitoring, or surveillance, might be called for.

BEFORE A PATIENT STARTS TREATMENT at the Upstate Cancer Center, a medical team evaluates the cancer in a process called staging.

Staging determines the extent of cancer in the body, based on the tumor’s size and depth and whether it has spread to other areas, such as lymph nodes or organs.

Staging can be done surgically or with medical imaging.

“It allows us to plan treatment and determine whether the patient can be cured, using a standardized language to talk to other doctors,” explains Ajay Jain, MD, Upstate’s associate director of liver, pancreas and gallbladder surgery.

Under the system used in the United States and Europe, the higher the stage, the worse the prognosis. Generally speaking: l stages I and II mean the cancer has not spread to lymph nodes. l stage III means lymph nodes are involved.

l stage IV means the cancer has spread, or metastasized, widely, and the prognosis is poor.

Clinical and pathologic are the two main types of staging.

Clinical staging is done before treatment starts, to assess how far along a tumor is and where doctors and other health care providers can make a difference, Jain told an audience at the annual Upstate Cancer Symposium.

Clinical staging aims to predict whether a cure is possible and the likelihood of the cancer’s nearby or distant recurrence in the body. It also helps to plan a surgical strategy, which might include attempts to shrink the tumor before operating, known as neoadjuvant therapy.

Pathologic staging is done aer surgery by looking at the cancer cells under a microscope to give the true stage. is also helps determine whether radiation or chemotherapy

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“It’s a lot like hunting” Jain explains. “It’s based on how the beast behaves,” demanding intimate knowledge of the way various cancers grow and spread.

When staging tumors that arise in the bone or muscle, called sarcomas, doctors look at the lungs because that’s the most common site where sarcomas spread. For the skin cancer melanoma patients may require a full-body scan because melanomas are liable to spread anywhere.

Ajay Jain, MD

Certain cancers are likely to spread to bones. Health care providers use the first letters of the phrase “BLT with a kosher pickle” to recall those cancers, of the breast, lung, thyroid, kidney and prostate.

Staging criteria evolve as new information arises and as factors like the thickness and ulceration of the tumor are considered. As staging changes, so do treatments.

Jain stresses that staging is critical to cancer treatment and notes that it must be documented in the patient’s record before treatment starts. e National Comprehensive Cancer Network, an alliance of the world’s 27 leading cancer centers, provides the latest and best staging guidelines. Upstate and other cancer centers are audited by the American College of Surgeons’ Commission on Cancer to ensure that the guidelines are followed — so that patients receive the best available care. ●

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SEARCHING FOR CURES

Revealing research

Kidney tumor analysis helps decipher proteins’ role in cancer development

BY AMBER SMITH

SOME OF THE TUMORS Gennady Bratslavsky, MD, removes from patients’ kidneys are no bigger than olives.

Some are the size of watermelons. Since July 2014, many have ended up in the laboratory of Bratslavsky’s research partner, Mehdi Mollapour, PhD.

eir initial work was on cells from people with Birt-Hogg-Dube syndrome. at is a rare, inherited cancer syndrome caused by a mutation of the gene, FLCN, which predisposes people to form kidney tumors, pulmonary cysts and benign skin tumors.

Aer the surgeon removes the tumors, they are packaged on sterile ice in a cooler. A technician carefully transports the tissue from the operating room at Upstate University Hospital to the laboratory in adjacent Weiskotten Hall. ere, Mollapour and lab members Mark Woodford and Dianna Dunn dissect the tumors, extracting proteins from them for analysis.

Bratslavsky chairs the urology department at Upstate.

Mollapour, an assistant professor of urology, leads the renal cancer biology section in the urology department.

It’s a classic example of “bench-to-bedside” research that typically occurs at an academic medical center such as Upstate. Doctors at a patient’s bedside collaborate with scientists at a laboratory bench, sharing a focused mission to gain particular knowledge. In this case, what Bratslavsky, Mollapour and colleagues have learned about a specific type of kidney cancer applies to all kidney cancers — and likely many other cancers as well.

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eir team deciphered the complex relationship between FLCN and some crucial proteins, one called Hsp90 and a pair called FNIP 1 and FNIP 2 that watched over and exerted influence on Hsp90. e proteins’ interactions affect processes that take place within cancer cells that are forming, at a time so early in development that their existence cannot be detected through available testing.

“One of the biggest things that has been shown with this research is that control of Hsp90 is extremely precise,” Mollapour says. While their work on the tumors continues, the research team’s 15-page paper — which appears in the June issue of Nature Communications, a

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SEARCHING FOR CURES

Scientists explore genetic roots of rare blood cancer The June issue of the global scientific journal Nature Communications features work by (pictured, from left) graduate student Diana Dunn; research assistant Mark Woodford; biochemist/molecular biologist Mehdi Mollapour, PhD; urologist Gennady Bratslavsky, MD; and assistant professor Dimitra Bourboulia, PhD. The research team also includes professor Stewart Loh, PhD; graduate student Adam Blanden and librarian Wendi Ackerman.

PHOTO BY ROBERT MESCAVAGE

global scientific journal — details how Hsp90 is controlled. at’s particularly encouraging because Hsp90 is found in all cancer cells, not just kidney cancer cells. Learning how to manipulate this protein could lead to improved cancer treatment.

Consider someone with cancer who takes a drug but sees no effect. e drug may not work simply because it cannot gain entry to the cancer cells.

Or, consider someone who cannot tolerate a cancer drug because of debilitating side effects. It may be because too much of the drug is getting into healthy cells.

In both cases, regulation of the Hsp90 protein might help the drugs work better.

Drugs already in clinical trials are being tested for their ability to inhibit Hsp90, Bratslavsky says. And, it turns out, greater levels of the drugs accumulate in cancer cells when levels of the FNIP proteins are high.

It’s promising research, which only began because an Upstate surgeon decided to team up with a laboratory scientist to investigate a rare syndrome. ●

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SCIENTISTS AT UPSTATE have made progress in understanding the cause of a rare blood cancer called myelofibrosis, and they hope to learn how to block the disease’s progression.

Associate professor of pharmacology Golam Mohi, PhD, has been studying the life-threatening disorder, in which a defect in the bone marrow leads to overproduction or underproduction of various blood cells. Patients may suffer severe anemia, weakness and fatigue and get progressively worse. Some develop a more serious form of leukemia.

Golam Mohi, PhD

Mohi and graduate student Yue Yang and colleagues recently wrote about their laboratory research in the journal Blood. ey focused on a gene mutation (called JAK2V617F) that is linked to myelofibrosis and two similar blood cancers. ey found that loss of a particular gene (called EZH2) cooperates with the mutation in the development of myleofibrosis.

“It is imperative to better understand the cause of the disease, so that more targeted therapies can be developed to help manage the disease, and optimally, to prevent the disease from progressing,” Mohi says.

Work in his laboratory continues. ●

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IMPROVING LIVES

UPSTATE TREATS THE MOST STROKES IN THE REGION

From left, Hesham Masoud, MD, Amar Swarnkar, MD, and Grahame Gould, MD, in the bi-plane angiography operating room at Upstate University Hospital. Its location, in the new intraoperative MRI surgical suite, enables surgeons to obtain MRI scans during surgeries, improving patient outcomes.

In meeting the standards for a comprehensive stroke center, Upstate not only provides the expertise, resources and protocols for exemplary patient care but also is committed to the greater good health of our region. The Upstate Comprehensive Stroke Center has three goals: to provide the highest quality care, to reduce the stroke burden in Central New York and to support all health care providers. Visit us online to see our latest report and meet our entire team.

FOR MORE INFORMATION VISIT UPSTATE.EDU/STROKE CARING FOR PATIENTS. SEARCHING FOR CURES. SAVING LIVES.

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Useful information about cancer is a click away

IMPROVING LIVES

Where can you find reliable, up-todate information about cancer online?

Upstate Health Sciences Library library.upstate.edu e staff at the Upstate Health Sciences Library strives to connect the community with health information on cancer and many other medical topics. Visit the library website at upstate.edu/library and connect with a medical librarian by emailing library@upstate.edu, or by calling 315-464-7091. e library staff also recommends these for understandable, trustworthy cancer information: Upstate Cancer Center www.upstate.edu/cancer/types Information and links to resources for the types of cancer treated at the center and general patient information.

Choose from the alphabetical list of cancer types in the le menu for more information. If you have any questions about this site, you can call Upstate Connect at 855-964HOPE (4673) for help.

National Cancer Institute (NCI) www.cancer.gov Information on cancer from the National Cancer Institute, a component of the National Institutes of Health, includes information on treatments, clinical trials, relevant research, prevention, genetics, causes and articles available from the PubMed database (a free database of medical articles curated by the National Library of Medicine).

American Cancer Society www.cancer.org is nationwide nonprofit organization offers a wide range of information about cancer, including its prevention and treatment, healthy living, news and research.

National Comprehensive Cancer Network (NCCN) www.nccn.org/ A not-for-profit alliance of 25 of the world's leading cancer centers, the NCCN is dedicated to improving the quality, effectiveness and efficiency of care provided to patients with cancer. e site provides translations of the NCCN

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clinical guidelines, meant to help patients with cancer talk with their physicians about the best treatment options for their disease. Although some parts of the site require a sign-in, a large amount — marked as free or for patients — is free and open to the public.

MedlinePlus medlineplus.gov is is the National Institutes of Health’s website for patients and their families and friends, about cancer as well as other topics. e site is easy to search, and the search results are reviewed by medical librarians at the National Library of Medicine.

A note on other websites If you are looking for medical information at sites other than the ones listed here, Upstate’s medical librarians offer these tips, adapted from the Medical Library Association: l

l

l

l

l

Check to see if you can easily identify who is sponsoring the site, to help establish its dependability and credibility. e Web address can oen help identify the nature of the site: government agencies have .gov in the address; educational institutions have .edu; professional organizations such as scientific or research societies have .org; and commercial sites have .com (including some hospitals). e site should be updated frequently, as health information changes constantly, and be consistently available, with the dates of the latest revisions posted.

Factual information should be clearly presented and verifiable, with its source materials listed or linked to.

Opinions should be labeled as such and identified as coming from a qualified professional or organization. e site should clearly state whether the information is intended for the consumer or the health professional.

Many health information websites have two different areas, one for consumers, one for professionals.●

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IMPROVING LIVES

Kazim Chohan, PhD, leads Upstate’s Male Fertility Preservation Program, which came about through the efforts of Chohan and colleagues including pediatric oncologist Jody Sima, MD (also pictured); urologist JC Trussell, MD; oncologist Rahul Seth, DO; and pathology chair Robert Corona Jr., DO. PHOTO BY ROBERT MESCAVAGE

Preserving future fatherhood

TECHNIQUES AVAILABLE

Here’s what andrologist Kazim Chohan, PhD, and his staff offer at Upstate: l

This service helps boys and men with cancer maintain their ability to father children

BY JIM HOWE

SOME CANCERS, and some cancer treatments, can cause male reproductive damage.

But a variety of techniques available through Upstate’s Male Fertility Preservation Program can help men with a cancer diagnosis or temporary or permanent infertility issue.

l

“Survival is the first thing on their mind. Not fertility,” says Kazim Chohan, PhD, director of Upstate’s andrology department, where the program is housed. “at’s precisely why this should be offered.” He says physicians should tell their patients about fertility preservation as soon as a cancer diagnosis is made. Some health insurers will pay for the service.

Males of almost any age who hope to one day father a child may be candidates for fertility preservation. is includes boys who have not yet reached puberty, whose parents must make the decision for him. Weekend appointments are available for patients undergoing emergency chemotherapy or radiation therapy.

Chohan comes from a family that has made careers studying reproduction in both humans and animals. His father was an expert in artificial insemination of livestock in Pakistan, and one of Chohan’s sons is studying reproductive matters. Chohan himself has worked on aspects of reproduction in humans and in mammals ranging from mice to water buffalo.

Frozen sperm cells should remain viable for several decades, he says, noting there is no scientific consensus on the time limit, but a sample frozen in 1971 was used in 2011 and resulted in a healthy baby. Freezing techniques have progressed to the point where he does not see a limit on the length of time a sample could be kept frozen.

Success rates for frozen sperm samples are comparable to those of fresh samples, he says, and there are no known risks of birth defects from using frozen sperm. e samples are stored in sealed vials that prevent cross-contamination and can be shipped to fertility centers elsewhere, even overseas, in special canisters that stay cold for up to two weeks.

Using testicular tissue samples from young boys is a relatively new procedure that has so far only been used to produce animal offspring. Chohan believes the science is advancing rapidly enough that it will be a normal practice for humans within a decade. e testicular tissue, like the sperm samples, is frozen and stored in the andrology lab. ● For fertility preservation questions, contact the andrology department at 315-464-6550.

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l

Sperm banking: Collecting and freezing semen in liquid nitrogen (cryopreservation) for future use is the standard and least expensive procedure to preserve male fertility.

A basic semen analysis will evaluate the sperm to determine future options for assisted reproduction.

Generally, three to five samples are needed for the best chance of achieving pregnancy.

Testicular sperm extraction: Men with no sperm in their semen due to blockage or other conditions can have sperm extracted directly from their testicles with a brief surgical procedure. The sample is then frozen.

Testicular tissue freezing: Still an experimental process, this involves surgically removing and freezing tissue from the testicles of boys not yet old enough to produce sperm. The hope is that this tissue could be used in the future, once the boys have matured, to either restore fertility or produce sperm.

Fertility preservation for women, including egg and embryo freezing, is also offered by Upstate in partnership with Boston IVF. Call 315-703-3050 for more information.

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IMPROVING LIVES

Fudge Pudding Cake With Ice Cream

Dessert can be an important part of a meal for cancer patients because it oen provides plenty of calories per bite. If the patient feels too full to eat this dessert aer a meal, he or she can try eating it as a snack between meals. It’s a good source of calcium and fiber.

PEDIATRIC EMERGENCY DEPARTMENT:

Ingredients 1 cup all-purpose flour ¾ cup granulated sugar 2 tablespoons unsweetened (baking) cocoa 2 teaspoons baking powder ¼ teaspoon sat ½ cup milk 2 tablespoons vegetable oil

1 teaspoon vanilla extract 1 cup chopped nuts 1 cup packed brown sugar ¼ cup unsweetened (baking) cocoa 1¾ cups boiling water 4½ cups vanilla ice cream

Preparation 1. Heat oven to 350 degrees. In ungreased 9-inch square pan, mix flour, granulated sugar, 2 tablespoons cocoa, the baking powder and salt. Stir in milk, oil and vanilla extract with fork until smooth. Stir in nuts. Spread evenly in pan.

2. In small bowl, mix brown sugar and ¼ cup cocoa; sprinkle over batter. Pour boiling water over batter.

3. Bake 40 minutes. Let stand 15 minutes. Spoon cake and sauce into individual dishes.

Top each with ice cream.

HERE WHEN YOU NEED US Upstate University Hospital has the area’s only Pediatric Emergency Department, now in its own newly renovated and expanded space. Only at Upstate will

Microwave directions

you find physicians and

In 2-quart microwavable casserole, mix flour, granulated sugar, 2 tablespoons cocoa, the baking powder and salt. Stir in milk, oil and vanilla. Stir in nuts. Spread evenly in casserole.

In small bowl, mix brown sugar and ¼ cup cocoa; sprinkle over batter. Pour boiling water over batter. Microwave uncovered on medium (50 percent power) for 9 minutes. Rotate casserole a half turn; microwave uncovered on high 5 to 7 minutes longer or until top is almost dry.

nurses specially trained in pediatric emergency medicine 24/7/365.

Nutritional information This recipe makes nine servings. Each contains:

SOURCE: BETTY CROCKER LIVING WITH CANCER COOKBOOK

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490 calories 20 grams total fat (6 grams saturated fat; no trans fats) 20 milligrams cholesterol 240 milligrams sodium

310 milligrams potassium 71 grams carbohydrates 3 grams dietary fiber 7 grams protein

Pediatric Emergency Department

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Growing up, despite cancer

MAKING A DIFFERENCE

BY AMBER SMITH

Parker Hysick in his Pittsburgh Steelers-themed “man cave,” a gift from Make a Wish.

PHOTO BY SUSAN KAHN

What is leukemia?

Leukemias are blood cancers that start in the cells of the bone marrow and can, over time, crowd out or suppress the development of normal cells. Survival rates for childhood cancers have improved significantly over the past 50 years.

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CARING FOR PATIENTS THE HYSICKS OF BALDWINSVILLE got a puppy in November 2012, and their son Parker played with her constantly. So when Parker developed bruises, his mom and dad thought they were from roughhousing. When Parker began having nosebleeds, they attributed them to the temperature change.

But then Melissa Hysick noticed something about her 7-year-old son. “He doesn’t look right,” she said to her husband, Ron. ey made an appointment with the pediatrician. at was a Tuesday. Two days later, Sean O’Malley, MD, called. Parker had leukemia.

Hysick fell to her knees. She heard Parker say to his sister, Madi: “Mommy’s crying. I think someone died.” e next morning, Hysick met “a pair of angels,” as she describes Andrea Dvorak, MD, and nurse Yvonne Dolce, who lead Parker’s care at the Upstate Golisano Children’s Hospital.

“I’ve always felt like Dr. Andy and Yvonne were chosen specifically for us. ey’re so good with Parker. ey genuinely care about him,” Hysick says. She is an occupational therapist in the Syracuse City Schools. Ron Hysick is a physical education teacher in Baldwinsville.

Parker’s hospital stay was punctuated by moments Hysick will never forget. Her skinny son, with intravenous tubing attached to his body, stepped from the bathroom holding onto a hospital pole. e doctor had just told him about losing his hair. Now he was alone with his mom. “Mommy, why are you letting them do this to me?”

It broke her heart.

“Buddy, if I could take you away and hide you from this cancer, I would do that,” Hysick told him. “Right now, we are going to have to fight really hard and be really strong so that you can grow up.”

Parker was hospitalized until the day before anksgiving.

His parents were blown away by coworkers and family and neighbors who provided a anksgiving spread, and then meals continually while Parker was in treatment for the year, for acute lymphoblastic leukemia. at’s a cancer of the blood and bone marrow that usually gets worse quickly

Andrea Dvorak, MD, with Parker Hysick at the Upstate Cancer Center.

PHOTO BY SUSAN KAHN

if it’s not treated.

Every Friday Parker was at the Upstate Cancer Center for chemotherapy, sometimes for a few hours and sometimes all day. is March marks one year since Parker’s active treatment ended. His condition is monitored with monthly blood work now. It’s a scary time, Hysick explains, watching the results, wondering if the cancer is back.

She marvels at her son’s disposition. “He’s this awesome kid who never complains.”

When Make a Wish Central New York offered to grant Parker a wish, the youngster didn’t hesitate.

Martin Custom Homes delivered on his request by turning the Hysick basement into a Pittsburgh Steelers themed “man cave.”

Parker is now 11 and in fih grade. As his mother encouraged during his first hospital stay four years ago, Parker is growing up. ●

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Now airing on Sundays on WRVO AT 6 a.m. & 9 p.m.

Listen anytime: HEALTHLINKONAIR.ORG or ITUNES (search by topic)

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750 East Adams Street l Syracuse, NY 13210

Raising awareness

LIGHT-FILLED LUMINARIAS greeted visitors to the Upstate Cancer Center for the annual Lung Cancer Vigil on a crisp evening each November. Indoors, the Rev. Terry Culbertson asked visitors to set their cell phones to flashlight mode as she read from a poem: “Faith is the bird that feels the light and still sings when the dawn is dark.”

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Not counting skin cancer, lung cancer is the second most common cancer in women (behind breast cancer) and men (behind prostate cancer) but it is the deadliest. More than half of people with lung cancer die within one year of being diagnosed. e vigil at Upstate celebrates survivors and memorializes the departed, as illustrated by sentiments on the luminarias. “Keep the faith, Sis,” read one. Another said simply, “Hope. Peace. Love.” ●

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