User: sburris
Time: 10-01-2013 10:04 Product: INIBrd
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-Cov
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
Color: C K Y M
WEDNESDAY, OCTOBER 2, 2013 •
A custom advertising publication of The Indianapolis Star ✱ Wednesday, Oct. 2, 2013
INDY’S in the
PINK
Breast cancer awareness month: LIVING BEYOND THE DIAGNOSIS
Babies and breast cancer
E
Whatever it takes By Angela Parker For Custom Publications
Megan Rosbottom was 33 years old and 29 weeks pregnant with her second child when she felt a lump in her armpit. Because swollen mammary glands aren’t unusual during pregnancy and typically subside after the birth, she and her doctor logically decided to wait and see. Rosbottom’s daughter, Fiona, was born Dec. 28, 2012. In the excitement that followed, she forgot about the lump until mid-January, when she felt something on the side of her breast. Her husband, Lucas, confirmed that it felt abnormal. By the time she saw her doctor and had both a mammogram and an ultrasound, another month had passed. Test results confirmed a cancerous lump and a second suspicious area, this one behind the nipple. “They were more concerned with that area than the lump,” Rosbottom said. “But [Dr. Erin Zusan, breast surgical oncologist, Community Breast
Megan and Lucas Rosbottom with their daughters, Fiona and Reese
Care South] wasn’t comfortable saying the lump was just a cyst. She wanted to biopsy it that day.” The procedure indicated cancer was present. Based on the tumor’s size and the lymph nodes involved, Rosbottom’s diagnosis was Stage 3 cancer. “Then the treatment began rapid-fire,” she said. Within the next week she had an MRI, an echocardiogram and surgery to place a chemotherapy port. A PET scan revealed that the cancer was located in the right breast only but had spread to the lymph nodes. “It was an aggressive cancer, and I was so young that they wanted to hit it hard. They wanted to do everything they could to get rid of it,” Rosbottom said. She began chemotherapy on March 1, 2013, and finished in June. In July she had a double mastectomy. Of 20 lymph nodes removed, eight were determined to be cancerous. Rosbottom also tested positive for the BRCA1 gene, an indicator for breast and ovarian cancer, so she had her ovaries
Pregnancy and cancer: The connection Is there a link between pregnancy and breast cancer? “Yes, there is,” said Stanley Givens, MD, medical director and radiation oncologist with the Hendricks Regional Health Cancer Center. “When a woman is pregnant, the cycle of estrogen and progesterone is different than in the nonpregnant state. This may make breast cancers behave much more aggressively and be somewhat less responsive to therapy in a pregnant female than one who is not pregnant.” The risk ranges from 1-in-1,000 to 1-in-10,000 pregnant women who develop breast cancer. According to Givens, either set of odds is relatively small. “Cancer in a pregnant woman is uncommon, but in that uncommon event, breast cancer is the most common to see,” he said. “The younger a woman is when she develops breast cancer, the greater the likelihood of a genetic link to that development.” Breast cancer in pregnant women typically is more aggressive Givens and more likely to be detected at a later stage, however. One reason, Givens said, is that some warning signs can mimic normal pregnancy changes. The breasts become fuller, more tender and lumpier, which makes it more difficult to identify abnormalities. Abundant estrogen also makes younger women’s breast tissue more dense, which can reduce the effectiveness of mammography. Some women don’t pursue a diagnosis for fear of harming the baby. “Treatment can be a challenge, balancing the needs of the mother with the developing fetus,” Givens said. “It’s got to be difficult. They’ve just gone through this tremendous process and given life to their child and all the joy that comes with that, but they’re immediately confronted with a very challenging health issue — all while trying to take care of a brand-new baby.” ✱
and fallopian tubes removed as well. Rosbottom was scheduled to begin radiation treatments last month. But before the first appointment arrived, she discovered another lump. Another biopsy — and yet another cancer diagnosis — quickly followed. Her doctors don’t expect the new tumor to require surgery — radiation therapy should take care of it — but a PET scan will help make sure. She’ll also have regular Herceptin therapy for the next year to prevent any recurrence. “It’s been a whirlwind at our house this whole year,” Rosbottom said. “My stepmom and my mother-in-law have been wonderful. One if not both of them have stayed with us since Valentine’s Day. I’ve just recently gone at it on my own. “And Lucas, my husband, is fantastic. He’ll say, ‘We have two girls, so whatever (the doctors) tell us to do, we’re going to do.’ Any time I get down, he reminds me of that. I have those three to live for. I’m not ready to say goodbye, so we’re going to do whatever it takes.” ✱
From zero to 10 to zero O
By Angela Parker For Custom Publications
n Feb. 3, 2013, Levi Rosenfeld came into the world a bit earlier than expected. After being cared for at Riley Hospital for Children at IU Health, his family thought the worst of their worries was over. But just as life settled down, Levi’s mother, 28-year-old Brittanny Seybold, found a lump in her right breast. Her obstetrician, Ian Johnston, MD, sent her to the Hendricks Regional Health Women’s Center for a biopsy and ultrasound. The next day, March 22, Johnston called with the news: Seybold had breast cancer. “It was a shock because nobody in my family has had breast cancer, and we don’t really have a strong history of cancer at all,” she said. She even tested negative for the BRCA gene, an indicator of breast and ovarian cancers. Her doctor believes the cancer was present before the pregnancy, and the surge of hormones spurred rapid growth. ❯ See ZERO TO 10, on Page 2
PHOTO: SUBMITTED
very woman knows her body will change during pregnancy. But what if something changes in a negative way? How can she tell if her new normal is anything but normal? For these women, the joy of pregnancy was accompanied by a dreaded disease: cancer.
P1
User: sburris
P2
Time: 10-01-2013 10:05 Product: INIBrd
• WEDNESDAY, OCTOBER 2, 2013
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-A
Color: C K Y M
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
INDY’S IN THE PINK
Every survivor has a story E
very woman who has experienced breast cancer has a unique story to tell. Among them all, the common denominators are courage, resiliency and a fierce determination to live life to the fullest.
Jill’s story Jill Golightly discovered a lump in her breast in November 2010, when she was in New York City to watch the University of Notre Dame play football at Yankee Stadium. She chalked it up as a benign cyst; cancer wasn’t on her radar. She had no family Golightly history of the disease and had seen her doctor for an exam in June. “I didn’t let it ruin my vacation,” she said. “I wasn’t that concerned.” Golightly saw her doctor the following Monday and scheduled an ultrasound for several weeks later, on her day off. After that
test, her doctor ordered a biopsy for the next day. At this point, she became concerned. The biopsy confirmed a diagnosis of noninvasive ductal breast cancer. Golightly subsequently tested positive for the BRCA1 gene. Within a week, she began a fourmonth chemotherapy regimen, followed by a single mastectomy, lymph-node removal and 32 radiation treatments, then preventive mastectomy on the left side, “Both work reconstruction and keeping and a as much hysterectomy. “I did it all,” normality Golightly said. as possible Chemotherapy helped me get was the “hardest through it.” part,” she said, and she remains thankful for family and friends who offered support during that difficult time. “Now that I am involved with a lot of survivors, I realize that although my journey was very difficult, I went through it well,” she said. “I didn’t have the complications many women get.”
A step at a time By Shari Held For Custom Publications
K
im DeMasie, 50, was diagnosed with triple positive invasive ductal carcinoma in the left breast in July 2011. Follow-up tests revealed two “satellite” areas on her right breast. Though a nurse at Riverview Hospital,
DeMasie was in no way prepared for what lay ahead. Throughout her journey with cancer, she kept a journal on CaringBridge.org, a health-focused social networking site. Parts of her journal are excerpted below.
August 2011 When I found out I had to have chemo ... I was heartbroken. Yesterday when I woke up my scalp was sore. Then when I washed my hair, it started coming out in handfuls. It was a weird feeling just watching it fall. But I have to think if the chemo is doing this on the outside to good cells, (hopefully) it’s doing worse on the inside to bad cells. So we drudge forward into the next phase of this crazy walk.
Golightly, now 38, has discovered a reserve of strength she didn’t know she had. She focuses on being a good mom, attending school events and soccer games with her two daughters, ages 11 and 7. She continues to work hard, taking time off only when necessary. “Both work and keeping as much normality for the girls as possible helped me get through it as well as I did,” she said. With cancer behind her, Golightly is getting back to the activities she enjoys. In May she participated in the 500 Festival Mini-Marathon and is training for a second race. “In some ways it feels like it was just yesterday,” she said. “In other days, it feels like it was eons ago.”
struggled to get through eight rounds of chemotherapy. A regimen of the Taxol drug made her feel as though every bone in her body were breaking. She was weak and dizzy, suffered severe migraines and had no feeling in her hands and feet. “I couldn’t function,” said Hollis, the mother of two, ages 13 and 16. That treatment was suspended and replaced with 33 rounds of radiation, which were easy in comparison. Hollis, 39, wasn’t a good candidate for hormone treatment to suppress her body’s estrogen production. After seven months, she was bedridden and nonfunctional. She also developed lymphedema — swelling in the arms — and wrapped up three months of physical therapy last Julie’s story July. This month, In February 2012, she’ll undergo Julie Hollis felt a lump reconstructive in her right breast. surgery. She didn’t have any Despite many reason to believe it was challenges, Hollis, serious. owner of Julie’s “I was in great shape Flowers of Geist, and wonderful spirits,” provided floral she said. “I had never arrangements for 20 felt better in my life.” weddings, with help Still, she went to see from friends and her doctor the next family. She even got day. And two weeks married in June. after being diagnosed Hollis and her husband at their June wedding. “I decided it was with Stage 3 invasive time to move on ductal cancer, Hollis with life and start had a mastectomy. In the next chapter,” she said. “My husband has a second surgery, performed in March, 20 been phenomenal, never leaving my side lymph nodes were removed — and three through all this and taking care of my kids were found to be cancerous. Her doctor when I couldn’t.” reported that the cancer had metastasized. Hollis has decided to forgo additional “The cancer was so extensive and treatments and rely instead on frequent aggressive, my chance of recurrence was checkups. 86 percent,” said Hollis, a 2013 Komen “It was just too toxic,” she said. Ambassador who is helping to advocate for And now that the side-effects of health and wellness in central Indiana. “I treatment are gone, she worries less. was young and healthy, so they needed to “If you’re always worrying about what throw everything at me.” will happen, you’re not actually living life,” But her body had other ideas. Hollis Hollis said. ✱ PHOTO: RICH MILLER
By Shari Held For Custom Publications
❯ ZERO TO 10 continued from Page 1
September 2011 Even though it’s been two months, it still feels like some kind of dream. I took our dog Zoe out the other day and saw my reflection in the patio door without my hat. I thought, ‘Who is that bald girl?’
November 2011 The last chemo was Friday, and I’m definitely feeling it. My brain knows it’s over but my body hasn’t heard the news yet. Everything hurts. I feel like my body went through one of those old washing machines.
PHOTO: SUBMITTED
After four months of chemotherapy, in December 2011 DeMasie had a partial mastectomy on her left breast and a biopsy of her right breast. In January her lymph nodes were surgically removed, along with additional tissue around the tumor site. When the tissue margins weren’t cancer-free, she had a third surgery in February. Each time she was supported by her family, including her husband, Jeff.
February 2012 The past three surgeries weren’t good enough. I feel like I’ve been able to stay strong and just ‘go along’ with the plan, but I lost it and couldn’t stop crying. I want to have a mastectomy and be done with this. I just can’t put my family through another failed surgery. After much consideration I’ve decided to have a bilateral mastectomy. DeMasie’s fourth surgery was completed in March.
April 2012 It started to hit me what this cancer has cost me. I cried hard and loud and just let it out. It felt good to finally just scream at cancer and how much hurt it causes people.
April 21, 2012 I got the ALL CLEAR! Hooray! I told Jeff I felt like a cloud was lifted when we finally got all of the cancer out and we can get on with life. Hopefully this is the last entry in this journal. Thank you for all of your well wishes. ✱
DID YOU KNOW? ❯ Scientific evidence does not support a link between wearing underwire bras and increased risk of breast cancer. ❯ More than 40,000 women will die from breast cancer in the United States this year. It will kill about 440 men. ❯ Breast cancer is the most frequently diagnosed cancer among U.S. women. ❯ In the United States, a woman is diagnosed with breast cancer every three minutes. And every 13 minutes, one woman dies of the disease.
Brittanny Seybold, her fiance, Stephen Rosenfeld, and their sons, Devlin and Levi
Seybold immediately underwent tests to determine the disease’s progression, and she learned it already had spread. In addition to the breast tumor, 10 more growths were found on her liver. “My first oncologist basically said there was not a whole lot he could do because it was Stage 4,” she said. “I was like, ‘Oh, great. I have an 8 year old and a baby at home.’ It was devastating.” Seybold decided not to accept that prognosis. She met with Ruemu Birhiray, MD, an oncologist with St. Vincent Health. And though the specialist acknowledged the difficulty of the situation, he also offered hope. “He said, ‘We’ll do everything we can. There’s no reason to plan a funeral,’” Seybold said. They went to battle in April. After the second high-dose chemotherapy session, the breast tumor no longer was “It was a hard palpable. decision, but to “Dr. Birhiray was really excited,” she said. “Only about 30 potentially save percent of patients respond that quickly. Since it was reacting my life and keep so well in my breast, he said there was no reason to believe it me here longer wasn’t reacting as well in my liver.” After six more rounds of chemotherapy, Seybold had a CT for my kids, I scan last July. That test showed breast tissue clear of cancer and have to do it.” a single 1-centimeter spot on the liver. A week later, that single spot was not visible on an MRI. For her part, Seybold did everything possible to boost her odds. She decided to keep a positive outlook, change her lifestyle and switch to a plantbased diet, which she says helped her tolerate rigorous chemotherapy. In early September, surgeons removed Seybold’s right breast and one lymph node, which proved to be disease-free. Thought the left breast was unaffected by cancer, it will be removed in about six months. “It was a hard decision,” she said. “But to potentially save my life and keep me here longer for my kids, I have to do it.” ✱
❯ African Americans have the highest death rate from breast cancer of any racial/ethnic group in the United States. ❯ There are more than 2 million breast cancer survivors in the U.S. today. —Komen Central Indiana
CREDITS
❯ The five-year survival rate for women with breast cancer that has not spread to lymph nodes or other sites increased from 74 percent in 1982 to 98 percent in 2009. This is a product of Custom Publications, a division of Star Media. This feature and others can be found at indystar.com/custompubs. ADVERTISING CREATIVE ADVERTISING SALES Associate manager: Elaine Benken Account manager: Christine Sipos Creative coordinator: Beth Winchell christine.sipos@indystar.com (317) 444-7183
User: sburris
Time: 10-01-2013 10:05 Product: INIBrd
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
IS-0000000457
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-B
1S T
Color: C K Y M
WEDNESDAY, OCTOBER 2, 2013 •
P3
User: sburris
P4
Time: 10-01-2013 10:05 Product: INIBrd
• WEDNESDAY, OCTOBER 2, 2013
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-C
Color: C K Y M
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
INDY’S IN THE PINK
By Julie Young For Custom Publications
T
he news can weaken a husband faster and more decisively than Kryptonite subdues Superman. Though they attend appointments, gather information and vow to be strong for the women they love, men say that breast cancer makes them feel less like a superhero and more like a hapless sidekick. “Men, by their very nature, are problem solvers. They like to fix things, but there is Stephan nothing they can do to fix cancer. That realization can be quite a blow,” said Lee Stephan, a mental health professional for Community Health Network. Stephan’s own wife passed away from breast cancer in 2010.
Staying strong Despite feeling helpless, men tend to act quickly to protect the women who mean the world to them. They juggle personal and professional responsibilities, and they strive to create a normal home environment at the very moment their universe is shifting. Fortunately, men can find emotional support in a number of outlets. When Mike Petraits learned that his wife, Donna, had breast cancer, he immediately reached out to the St. Vincent Center for
Women’s Health helpline, (317) 338-4437. By calling that “You simply have number, he was able to gather information that helped him to jump in and do stay strong and keep smiling whateer it takes to when his wife needed him help your wife.” most. The woman on the other end —Mike Petraits, whose of the phone described many wife Donna (right) is a options and positive scenarios, breast cancer survivor and and though the cancer was 2013 Komen Ambassador serious, Petraits was able to remain upbeat when the situation got tougher. “Sometimes you hear things you don’t want to hear express his frustrations and soothe his heart. and you get information you don’t want “When something like this happens, it to know about,” he said. “But you simply is really transformative,” he said. “It sets have to jump in and do whatever it takes to priorities where they need to be, and you help your wife climb out of this hole. We realize that you have to man up and do what celebrated every victory. We cried when needs to be done.” we needed to, and we stayed in control of When men have to face the worst-case a situation that seemed to have a life of its scenario, they may need to connect with own at times.” others who’ve been through a similar situation. Relying on others When Stephan lost his wife, he discovered a real shortage of local support groups Rich Dawson was 32 when his wife, geared toward men. Though they may not Heather, was told that the lump in her breast want to admit they need help or support, was cancerous. With two young children, men should have the opportunity to share he had to face the possibility of raising them concerns and ask questions. alone. “I’m really committed to growing this The couple did their best to keep home group and getting the word out to let men life normal for the kids, but Dawson felt know that whatever feelings they have, it’s fears and doubts creep in during quiet normal — and above all, they are not alone,” moments. When that happened, he would he said. ✱ turn to his family, friends and pastor to
DID YOU KNOW? ❯ In the U.S., more than 250,000 women under age 40 are living with breast cancer. Many were in their 20s when it was discovered.
❯ It’s OK for people with cancer or a history of cancer to get a flu shot, but those with cancer should not receive the nasal spray vaccine. That’s because the virus in the shot is dead; the virus in the nasal spray is living. ❯ 90 percent to 95 percent of breast cancer occurs in women with no immediate family history. ❯ Radiation is measured in rads. A woman who has an annual mammogram for 50 years receives about 20 to 40 rads. Breast cancer patients who are treated with radiation receive several thousand rads.
mammo
❯ It can take up to 10 years for a mass to grow large enough to detect on your own. ❯ Some studies have found that larger breast size increases risk, while others have found no link. ❯ Cancer is 5 percent more likely to occur in the left breast than in the right. ❯ Studies have found that for each alcoholic drink consumed per day, the relative risk of breast cancer increases by about 7 percent. Women who had two to three alcoholic drinks per day had a 20 percent higher risk than nondrinkers.
101
❯ The three largest studies to date on caffeine and breast cancer found no link between drinking coffee or tea and the risk of breast cancer. ❯ Many studies have found that women over 5’3” have a slightly higher risk for breast cancer. One reason might be growth spurts caused by higher hormone levels. ❯ Research does not support a link between breast cancer and the use of deodorant or antiperspirants. ❯ Before menopause, being overweight appears to decrease a woman’s risk of breast cancer. After menopause, it increases her risk by 30 percent to 60 percent.
When she has breast cancer
Resources for male caregivers
Men who endure breast cancer alongside their wives may benefit from peer support, but their needs often are overlooked. A number of local facilities offer information, hope and help as men work through their questions and frustrations. Community Health Network men’s support group Community Hospital North 8040 Clearvista Pkwy., Suite 290 First Tuesday of each month, 6 - 7:30 p.m. (317) 621-4323 Franciscan St. Francis Health patient and caregiver support Indianapolis and Mooresville Mondays, 6 - 8 p.m. (317) 257-1505 Hendricks Regional Health cancer support group (317) 718-4360 St. Vincent Center for Women’s Health helpline (317) 338-4437 Available 24 hours St. Vincent Health’s Our Fight Against Cancer program (317) 338-4968 www.ourfightagainstcancer.com Riverview Hospital Cancer Center support group 395 Westfield Road, Noblesville First and third Tuesday of each month (317) 776-7179
—Komen Central Indiana
What to expect: 1 You will remove clothing and deodorant, jewelry or other objects from the waist up, and will be given a gown to wear.
2 The technologist will discuss with you any lumps or other breast changes you have noticed. Areas of concern are noted.
As a Breast Imaging Center of Excellence, Hendricks Regional Health uses all-digital mammography, which provides electronic images of the breast that can be enhanced by computer technology. Using computer-aided detection systems, mammogram images are analyzed for abnormalities that may indicate the presence of cancer.
PHOTO: KOMEN CENTRAL INDIANA
To support their wives, men become breast cancer heroes
3 You will stand in front of the machine and the technologist will position your breasts, one at a time, on the x-ray plate. 4 A separate plate will be placed on top of the breast to compress it against the x-ray plate. Compression of the breast is required to ensure optimal images of the breast tissue. 5 Two pictures will be taken of each breast.
Types of mammograms The American Cancer Society recommends that women age 40 and older have a screening mammogram every year. Screening mammograms take about 15 minutes. A doctor’s order is not required. If you are experiencing breast pain, a lump or skin thickening, nipple discharge or a change in the size or shape of your breast, contact your doctor to be referred for a diagnostic mammogram or other tests. A diagnostic mammogram takes about 30 minutes, with results available before the patient goes home.
Screening mammograms are done at our Danville and Plainfield campuses. Convenient early and evening hours are available. Diagnostic mammography is performed in Danville.
Don’t forget to get your mammogram. Go to hendricks.org/mammo or call (317) 745-3404. IS-0000000246
User: sburris
Time: 10-01-2013 10:05 Product: INIBrd
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-D
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
Raspberry Lemon Parfaits
Ingredients
Ingredients
¼ c canola oil 1 t vanilla extract ½ c milk ½ c pomegranate juice
Directions Preheat oven to 425 degrees. Combine dry ingredients and blueberries in a bowl. Combine liquid ingredients in another bowl. Add the liquids to the dry ingredients and stir until just combined. Fill muffin cups 2/3 full and bake 12-15 minutes until golden brown. Optional streusel topping: Combine 2T brown sugar, 2T flour and 1T butter; sprinkle 1T on each muffin before baking. Yield: 12 muffins, 135 calories/muffin (without the topping) IS-0000000377
WEDNESDAY, OCTOBER 2, 2013 •
Blueberry Pomegranate Muffins 2 c flour ½ c sugar 1 T baking powder 1 c blueberries (fresh or frozen) 1 egg
2 (6 ounce) packages fresh raspberries 2T sugar 2 (6 ounce) cartons lemon meringue light yogurt
Color: C K Y M
1 ½ cups (4 ounces) frozen fat free whipped topping, thawed 3 cups (1 inch) cubed angel food cake Raspberries for garnish (optional)
Directions Combine raspberries and sugar in a medium bowl. Let stand 5 minutes, stirring occasionally. Place yogurt in another bowl; gently fold in whipped topping until combined. Layer about 1/3 cup each angel food cake, raspberry mixture, and yogurt mixture in each of 4 tall glasses. Repeat procedure once. Garnish with additional raspberries, if desired. Serve immediately, or chill until ready to serve. Yield: 4 servings
P5
User: sburris
P6
Time: 10-01-2013 10:06 Product: INIBrd
• WEDNESDAY, OCTOBER 2, 2013
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-E
Color: C K Y M
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
INDY’S IN THE PINK
Family history, genes and breast cancer By Jen Bingham For Custom Publications
A
re you at risk of being diagnosed with breast cancer? To get a better idea, take a look at your family history and genetics, both of which are key risk factors.
Understand your risk “Most women don’t know their risk,” said Debbie Saslow, PhD, director of breast and gynecologic cancer for the American Cancer Society. “They either think it’s greater than it is or smaller than it is.” Women tend to overestimate their own risk when any family member has had the Saslow disease, she said. “The closer someone is to you on your family tree and the younger their age when diagnosed, the more danger you’re in,” Saslow said. “On the one hand, everyone’s at risk. On the other, some women are afraid they’re at high risk when they’re not.” Talk to your health care provider about your family history, but don’t be overly anxious if one relative has had breast cancer. Rebekah Krukenberg, MS, CGC, LGC, a genetic counselor with Krukenberg
Community Health Network, said cancer comes in three types: sporadic, familial and hereditary. “Sporadic cancer accounts for greater than 60 percent of cancers and is based on environmental or unknown factors. In familial cancer, a family looks like they have more cancer than normal but don’t have a genetic component you can find,” she said. The third type, hereditary cancer, is passed down through generations and can be pinpointed genetically. Krukenberg said it accounts for 7 percent to 10 percent of diagnosed cancers.
Working with a pro Genetic testing for cancer is one way to determine your risk level. But Saslow emphasizes that many doctors aren’t equipped to recommend genetic testing for breast cancer and aren’t able to interpret results. “If you have a worrisome history, ask for a referral to someone who knows how to take the information and transfer it into clinical recommendations,” she said. “Go to a genetic counselor or a doctor or nurse trained in cancer genetics. A trained pro can take your cancer info and use a complex model that will help you decide whether to have genetic testing.” Helping patients determine whether to pursue testing is one task Krukenberg handles daily. “When patients come in to see whether
Sooner is better B
By Holly Wheeler For Custom Publications
reast cancer specialists emphasize regular mammograms and self-exams as two important ways to detect and treat tumors early on, giving patients the best chance of survival.
Conflicting consensus
When and how often should a woman get a mammogram? The American Cancer Society recommends that females should begin getting an annual mammogram at age 40. The U.S. Preventive Services Task Force says women should have the test done at age 50 and every other year after that. For each woman, the actual timing should depend on her physician’s advice and her understanding of her own health. “The source of confusion is that there’s never been a perfect research study for screening for breast cancer,” said Erika Rager, MD, MPH, a breast surgeon for Franciscan St. Francis Health Indianapolis. “Some started at 40, some started at 50, some did screenings every year, every two or maybe two-and-a-half years.” The ACS recommendation takes into account the benefits of mammograms, Rager said, but it doesn’t consider the risks. “That’s where the (American Academy of Family Physicians) and the U.S. Preventive Services Task Force came out with their recommendations,” she said. Rager With earlier mammograms, women are more likely to get a false positive. About 10 percent undergo additional testing, which can be stressful and costly and cause patients to miss work unnecessarily. A small percentage of these women are advised to have a biopsy. “We argue about the details, and that’s fine, but we don’t want to lose sight of the forest for the trees,” Rager said. “The bottom line is that women who have regular screenings for breast cancer have a 15 percent to 20 percent lower risk of dying from breast cancer.”
Know your genes In determining a woman’s risk for breast cancer, family history is big factor. Genetics and certain other conditions can help an individual understand her risks and spur her toward regular care and, when recommended, genetic testing. Genetic counselors are health professionals who help patients with multiple risk factors and educate them about genetic disorders. Based on test results, a counselor can describe the available options and recommend certain treatments. “There are several things that we look for, such as younger ages of onset, cases of cancer that fit known hereditary patterns, bilateral cancers – these are cancers affecting both organs. These red flags suggest there could be a hereditary cancer condition,” said Morgan Dally, MS, CGC, a genetic counselor with Franciscan St. Francis Health Indianapolis. “Just one case in the family does not warrant genetic Dally counseling. It’s when we see multiple cases for a physician to refer.” If a genetic mutation is present, Dally noted, the woman has an 87 percent chance of developing breast cancer. “For these women we suggest routine surveillance or preventive surgery,” she said. “Increased surveillance can mean earlier mammograms, while preventive surgery could be a mastectomy.” ✱
Imaging’s new offering Breast cancer detection is making new strides as the latest development in imaging is helping patients detect tumors earlier. Tomosynthesis, called 3D mammography by some, might detect earlier “Mammograms stages of breast cancer when used in conjunction with can detect traditional mammography. “Mammograms can detect tumors as small as three tumors as small to four millimeters in many cases,” said Jack Drew, as three to four MD, a radiologist who practices at Riverview Hospital. millimeters in “Tomosynthesis doesn’t detect smaller tumors, but it many cases.” increases the sensitivity by taking multiple images of the breast from many angles, which can lead to better detection rates. It can also be less painful because it requires less pressure on the breast when compared to a traditional mammogram.” Tomosynthesis was approved by the FDA in 2011, but has not yet been widely adopted as physicians evaluate its effectiveness. ✱
FACTS ❯ Tomosynthesis increases the sensitivity of screening for breast cancer to 76%. Mammography has on overall sensitivity of 66% ❯ Tomosynthesis increases the specificity of screening for breast cancer to 89% from 81% from mammography. ❯ Tomosynthesis decreases the recall rate for additional imaging by 43%.
they’re a candidate for testing, we talk about their medical and family history,” she said. “We draw it out on a board so they can see it on one page. We also talk to them about cancer and genetics and how they’re related, and give the details on genetic testing and what it can and can’t do.”
You may have a higher risk of breast cancer if … ❯ A male relative has been diagnosed with breast cancer. ❯ A number of close blood relatives on one side of the family have had breast cancer. ❯ Any relative has had cancer in both breasts. ❯ You have relatives with other glandular cancers, such as pancreatic. ❯ A relative has had ovarian cancer at any age. ❯ A relative was diagnosed with breast cancer at a young age. ❯ Any relative has had cancer of the breast and ovary. ❯ You have a personal history of ovarian cancer.
Genetic testing isn’t for everyone, Krukenberg said. Generally, it’s recommended only for individuals whose family history places them at high risk for breast cancer. Even then, test results should be taken with a grain of salt. “Having negative results doesn’t mean you’re never going to get breast cancer; you’re at the same risk as everyone else,” Saslow said. “And if you’re positive, it doesn’t mean you will get cancer.”
If the risk is high What should you do if you have a genetic factor that increases your risk? The common recommendations are to increase the frequency of self-exams at home and to get annual mammograms and MRIs, with the two imaging tests spaced six months apart. Other courses of action include preventive medication and prophylactic mastectomies, along with routine well care, such as exercising, eating well, maintaining a healthy weight and avoiding tobacco smoke. “Increased screening does reduce risk most of the time,” Krukenberg said, noting that genetic counselors guide patients through testing and help them understand their present and future options. When a strong familial risk is present, she said, some patients are advised to seek increased screenings and take preventive measures, even if they test negatively for a genetic factor. ✱
Indy’s turning pink in October A
By John Adams For Custom Publications
s summer turns to autumn, Midwesterners anticipate nature’s smooth transition from every shade of green to red, orange, brown and brilliant gold. This October, Indianapolis is bucking the typical color trend by turning bright pink instead. The shift is a visible sign of the city’s support for National Breast Cancer Awareness Month, an annual effort to promote understanding of the disease. Items from clothing and jewelry to food and drinks are turning pink to spread the word that breast cancer can be prevented and treated through early detection. “There’s never too much pink,” said Dana Curish, executive director of Susan G. Komen Central Indiana. “We’re still losing women to breast cancer, and all of these events going on are raising money to help low-income women access early screening and detection services, in addition to funding research to help save future generations.” Curish Just 60 percent of women who have health insurance today choose to get an annual mammogram, Curish said. The ultimate goal this month is to create mass awareness through these and other local events: Power of Pink bracelets ❯ Throughout October Brighton Collectibles, located inside The Fashion Mall at Keystone, is offering unique Power of Pink bracelets for $60. Each bracelet sold benefits Susan G. Komen Central Indiana and the Indiana Women in Need Foundation. Visit the store soon to get your oneof-kind bracelet. Break (pink) bread ❯ Throughout October Since Panera Bread began offering Pink Ribbon Bagels 12 years ago, the eatery has helped raise more than $2 million for breast cancer charities nationwide. Central Indiana locations are offering this tasty favorite and donating proceeds to Susan G. Komen. Premium pink ❯ Throughout October When you’re in a shopping mood and up for a short road trip, head down I-65 to Edinburgh Premium Outlets. Donate $10 to Susan G. Komen and you’ll receive 25 percent off the cost of your favorite item at a number of retailers. The mall is planning to kick the action up a notch on October 26 and 27, serving up light eats and live music. Pink pottery party ❯ Thursday, Oct. 10 Stop in at the Ceramic Dreams studio at 1134 E. 54th St. from 5 to 8 p.m. You’ll receive a 20 percent discount on all pottery you paint. Ceramic ribbons and lots of pink paint will be available for patrons. Wear your brightest pink painting clothes! Cancer Sucks party ❯ Saturday, Oct. 19 Sara’s Soldiers is a group of friends and family who’ve come together after the breastcancer death of Sara Moyer Carpenter last September. Sara, just 30 years old at the time, left behind a husband and 18-month-old daughter. The team is hosting a Cancer Sucks party from 7 to 10 p.m. at the Stonegate Meeting House on 6653 Westminster Drive in Zionsville. Bring cash for the silent auction and you’ll help raise money for Susan G. Komen Central Indiana while keeping Sara’s memory alive. Celebration of Life ❯ Thursday, Oct. 17 Riverview Hospital is sponsoring this special event to share cancer survivors’ stories, including their struggles and challenges. WTHR-Channel 13’s Julia Moffitt will host the event, held at the Mill Top Banquet and Conference Center, 802 Mulberry St. in Noblesville, from 6 to 8 p.m. Register at www.riverview.org. Someone to lean on ❯ Monthly throughout the year Hendricks Regional Health in Danville hosts a free support group for breast cancer survivors, patients and family members. The group originated with women who beat the disease and continues on today to encourage others through the journey. Meetings are the third Thursday of each month from 6 to 7:30 p.m. Call (317) 250-3057 for details. To learn more and join the effort to end breast cancer, visit www.komenindy.org. ✱
User: sburris
Time: 10-01-2013 10:06 Product: INIBrd
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-F
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
Beauty and the breast-cancer beast
Good nutrition can help women beat breast cancer
T
here is a link between a woman’s diet and her risk of breast cancer, but it’s not as direct as using sunscreen to avoid melanoma. The American Institute of Cancer Research, which funds research and develops recommendations, reports two main risk factors: family history and age. Gael Wasserman, RD, CD, an oncology nutrition specialist for Community Health Network, adds two more. “Good nutrition and maintaining a healthy weight play a role in breast cancer prevention,” she said. That’s good news, because choosing the right foods and maintaining an appropriate weight are modifiable risk factors — ones women can control.
yet clear, but a diet that includes foods and supplements containing this vitamin are shown to moderately decrease the risk in premenopausal women. Antioxidants like vitamins C and E are found in densely colored fruits and vegetables. And while regular intake of fruits and veggies isn’t known to prevent breast cancer, these fiber-rich foods are low in calories, which can help you maintain a healthy weight and therefore help reduce the risk for cancer. The ACS urges adults to eat at least five servings of fruits and vegetables every day.
11 for prevention To further reduce the risk of cancer, the ACS recommends these 11 steps to better health. ❯ Consume food and drinks in
moderate amounts so you can maintain a healthy weight.
Calories, alcohol and soy A recent Women’s Health Initiative study of the link between dietary fat and breast cancer shows no definite evidence that low-fat foods help prevent the disease. But a diet high in calories often leads to obesity, which is clearly linked to breast cancer. The American Cancer Society urges women to limit their consumption of alcohol, high-fat meats and foods high in saturated fats. Regarding alcoholic beverages, the ACS says women should limit themselves to one daily drink, which equates to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of spirits. The ACS also recommends that women diagnosed with breast cancer eat only small amounts of soy products and avoid supplements containing large amounts of isoflavones, an estrogen-like plant chemical that could increase the risk of estrogenresponsive cancers.
Increase the green, bump up the D A potentially potent cancer-fighting ingredient is vitamin D. Research also points to the positive benefits of consuming calcium-rich foods. The connection between vitamin D and breast cancer is not
❯ Eat only small portions of high-
calorie foods.
❯ Choose vegetables,
whole fruit and other low-calorie options over French fries, chips, ice cream and donuts.
❯ Limit your intake of sugar-
sweetened beverages.
❯ Reduce the amount of
processed and red meat you eat. When you do eat red meat, choose lean cuts in small portions.
❯ Limit your intake of processed meats,
including bacon, sausage, lunch meat and hot dogs.
❯ Choose fish, poultry or beans over red
meat.
❯ Eat five or more servings of vegetables and
fruits daily.
❯ Choose whole grains instead of refined-
grain products.
❯ Limit your carbohydrates by turning
away pastries, candy and sugary breakfast cereals.
❯ Drink no more than one alcoholic beverage
a day if you’re a woman; two drinks for men. ✱
WEDNESDAY, OCTOBER 2, 2013 •
By Holly Wheeler For Custom Publications
A
nyone who’s been through cancer treatment knows that the disease affects the whole person. For women, breast cancer can have a profound impact on outward appearance. To support breast cancer patients and survivors, the medical community increasingly offers new resources. Hair loss perhaps is the most noticeable physical change a woman experiences during chemotherapy. Ann Maier, CMT, LC, educates patients and helps prepare them for this and other changes. She also coordinates Debbie’s Make You Smile Fund, part of IU Simon Cancer Center’s CompleteLife program, which provides support and care for patients, families and caregivers. “I tell them what can happen — I feel like I’m giving them more bad news — but it’s better if they know ahead of time than have more surprises,” Maier said. “Every patient reacts to treatment differently.” Because intense cancer treatments can make skin appear sallow, Maier recommends women wear makeup when possible. She also advises patients to cut their hair short before it begins to fall out. As to other beauty treatments, she urges patients to steer clear of manicures and pedicures for the time being, as both can increase the risk of infection. A better way
to accessorize is to choose fun, trendy or colorful scarves and hats. “I try to get the body and mind to work together,” she said. “On the days you feel good, take the time to put on your wig and your makeup. When you do that, it makes you feel good and your family, too.” Hospitals and treatment centers increasingly are introducing products and services to help patients manage the physical changes of cancer. Doing so can improve an individual’s self-image and state of mind. “The Oasis is an appearance center, a place where all of our patients can go and leave feeling better about themselves,” said Kimberly Williams, RT(R)(T), manager of radiation oncology at Franciscan St. Francis Health Indianapolis. She also manages The Oasis store, which stocks wigs, turbans, scarves, breast prostheses, swimsuit tops and lingerie, as well as skin creams, synthetic eyelashes and UV-protective clothing — all reasonably priced. “I once had a patient with breast cancer who wore a different wig everyday,” Williams said. “One day she’d have short blond hair, the next long red hair. I want our prices to be affordable so a patient can have more than one wig, so they can have a little fun. The more fun you have with it, the better you feel.” ✱
Innovations in surgery Cancer patients today have the advantage of highly advanced medical procedures and treatments. Where the previous generous of women might have to undergo a deforming mastectomy, they now can choose from a variety of surgical options. “One of the things we always take into consideration is body image,” said Kandice Ludwig, MD, a breast surgeon with IU Health. “Oncoplastic surgery is a cancer surgery using plastic surgery techniques. (The surgeries) are done in conjunction with a plastic surgeon, and oftentimes the patient will get a breast reduction. That allows me as a cancer surgeon to remove what I need to remove, and then the plastic surgeon comes in to rearrange the tissue and make the other side match.” Patients facing a mastectomy can work with a surgeon to determine the ideal treatment, which could include reconstructive surgery, implants or prostheses. “A technique that’s gained popular attention is the subcutaneous mastectomy, or ‘nipple sparing’ mastectomy, as popularized by Angelina Jolie,” said Robert Goulet, MD, FACS, medical director of the Community Health Network breast program. “You do the mastectomy through an incision, which is hidden underneath the fold of the breast, but save the envelope of skin, including the nipple, and remove the breast tissue.” ✱
YOU ARE
QUIRKY, LOVING,
STRONG, FUNNY, SMART. And Breast Cancer Shouldn’t Change That. Your family and friends treasure who you are. And so do we. At the Franciscan St. Francis Health Breast Clinic, you’ll benefit from leading-edge treatments and research. You can see all of your specialists in one visit, and in one location, without spending hours in waiting rooms or traveling to appointments. Because we know you have a life to live. To schedule an appointment, or for a second opinion, call (317) 528-1420.
Erika Rager, M.D.
Breast Cancer Specialist
Inspiring Health INDIANAPOLIS • MOORESVILLE • CARMEL
FranciscanStFrancis.org/cancer IS-0000000458
P7
INDY’S IN THE PINK
Food fight! By Shauna Nosler For Custom Publications
Color: C K Y M
User: sburris
P8
Time: 10-01-2013 10:06 Product: INIBrd
• WEDNESDAY, OCTOBER 2, 2013
PubDate: 10-02-2013 Zone: Special
Edition: 1 Page: OfAdvFolio-G
Color: C K Y M
AN ADVERTISING SUPPLEMENT OF THE INDIANAPOLIS STAR
1S T
PULLING NO
PUNCHES IN THE FIGHT AGAINST CANCER.
ON BEHALF OF OUR CUSTOMERS AND ASSOCIATES, WE ARE PROUD TO JOIN THE FIGHT AGAINST BREAST CANCER AND SUPPORT THE IMPORTANT WORK OF THE AMERICAN CANCER SOCIETY.
5K WALK EVENT
Saturday, October 26, 2013
Celebration Plaza in White River State Park, Downtown Indianapolis Registration starts at 7:30 a.m.; walk begins at 9:00 a.m. To learn more or to sign up for the event, visit www.MakingStridesWalk.org/IndianapolisIN Purchase a Making Strides donation “card of hope” at any Central Indiana Kroger in the month of October.
IS-0000000389