Breast Cancer Awareness 2014

Breast Cancer

Awareness

5 EXAM MUSTS Mediterranean Diet Benefits

It’s Breast Cancer Friendly!

NO

REGRETS

At 33 years old, Toni Bieser learns she has an aggressive form of breast cancer.

PLUS!

+ Working through diagnosis + Cancer Commandments + Coping with emotions A BRAINERD DISPATCH PUBLICATION. OCTOBER, 2014

THERE’S NO PLACE LIKE HOME. We’ll help you stay there.

WE’RE A HOME CARE AGENCY PROVIDING:

• Skilled Nursing • Consumer Directed Community Support Options (CDCS) • Psychiatric Nursing • Personal Care Assistance (PCA) Services Supporting Breast Cancer Awareness Month

www.accracare.org

Call Our Brainerd Office at 218-270-5905 or 1-866-935-3515

Contents

Breast Cancer Awareness ‘14

Features:

Mediterranean Diet ............. 6

By Bev Bennett

No Regrets ............................. 12

By Jodie Tweed

To our readers, This Breast Cancer Awareness publication is especially dear to our hearts as our feature is a woman from right here in the lakes area, Toni Bieser. We are very grateful that she has shared her story. It reminds us that even young women need to be aware and proactive when it comes to early detection of breast cancer.

I Wish I Knew ......................... 20

By Dawn Klingensmith

In this edition

Coping Anxious Aftermath....................... 4 Food Super Vitamin D ........................... 7 Food Fight .................................... 8 Treatment Working Through Diagnosis ........ 9 Prevention Exam Tips .................................... 16 Survivors Cancer Commandments ........ 18

From our sponsors

Pink Ribbon Cupboard ............... 5

By Essentia Health

Test of Strength ........................... 10

We are also very pleased for the wonderful content contributions that were gathered and submitted to us by our sponsors. Including: (in order of appearance) Essentia Health, Unity Family Healthcare and Lakewood Health Care System. We really appreciate and their time and effort in putput ting these stories together and those that were featured.

Sincerely,

Special Tributes

By Essentia Health

Teaming Up ................................ 17

By Patrick Rioux

Breast Cancer Awareness is an annual publication of the Braienrd Dispatch.

Questions or comments, please email Leo.Miller@BrainerdDispatch.com Publisher: TIM BOGENSCHUTZ Advertising Manager: SUSIE ALTERS Marketing Coordinator: LEO MILLER Art Director: LISA HENRY

“In Honor of Toni” We support Breast Cancer Awareness

In Memory of Karen O’Brien and Missy Netzel Pequot Lakes

Member FDIC

218.568.4473

Crosslake

218.692.4472

LakesStateBank.com

001142365r1

By Lakewood Health System

001141110r1

A Reason To Shave My Head

Breast Cancer Awareness • October 2014

3

anxious

COPING

Aftermath

BY MATTHEW M. F. MILLER CTW Features

C

ancer treatment is a full-time job, an all-encompassing experience that changchang es lives forever. And, since it is such a challenging event both emotionally and physically, ysically, it’s easy to assume that when cancer treatment ends for those who

have had to endure it, the reaction immediately following the last treatment would be immense relief. After all, to those of us who have watched someone we love experience cancer, it’s a big relief when it’s “over.”

After cancer treatments end, many patients experience a range of emotions – and not all of them are happy

GET IT! FREE book to help patients deal with the emotional trauma that follows cancer treatment.

View it online at: www.cancer.gov/ cancertopics/life-aftertreatment

4

Breast Cancer Awareness • October 2014

The reality, however, is different. For cancer papa tients, it’s not over and, according to Dr. Lynne Wagner, director of the supportive oncology program at the Robert H. Lurie ComprehenComprehen sive Cancer Center at Northwestern Memorial Hospital in Chicago, finishing treatment can be a relief tempered with anxiety but it can also cause some patients to be depressed. “It’s somewhat inin dividual, from a research perspective,” Dr. WagWag ner says.

Christie Rigg, El Cerrito, Calif., a breast cancer therapist and survivor herself, notes that when someone is diagnosed with cancer, “Life becomes incredibly busy. It’s like your job is dealing with the cancer,” she says. “I said cancer should come with a secretary—you’ve got appointments, sursur geries, chemo, biopsies, bills – and everything else needs to keep going.” As a result, she says, a lot of the women she works with don’t begin to process their emotions until treatment ends and those feelings bubble up.

Additionally, with all those appointments comes a built-in support system that cuts off cold turkey, Dr. Wagner says. “You’re getting good supsup port from the medical team and coming in every day,” she says. “Then you transition from regular contact and a lot of patients are left out on their own.” Further, there’s the follow-up looming out there and between treatment and that appointappoint ment there can be a sense of helplessness because

patients are no longer “actively” fighting cancer.

Fear of the unknown results of all this treatment also compounds these other emotions.

Both Rigg and Dr. Wagner stress to the patients they work with that feeling any of this and more is completely normal. Just as each cancer and treatment plan is individual, so is the range of emotions one may feel about finishing and attempting to resume “normal” life. Rigg finds that women who share their stories in groups realize quickly they are not alone in these feelings.

Reconnecting with social networks, exercise, and taking stock of priorities going forward can all help patients during this transition. Making healthy lifestyle choices can also empower patients to feel more “in control” of their situations during this time. Dr. Wagner says advocacy work can also be helpful, whether fundraising, counseling or volunteering with a cancer organization.

It’s important to realize that cancer is a lifechanging event and because of that, patients are “really going through a grieving process,” Dr. Wagner says. “Part of that loss is that the view of themselves has changed—their view of a vibrant healthy person and they’re reminded of mortality.

That’s quite a loss.” © CTW Features

SPONSORED CONTENT

Pink Ribbon Cupboard T

here is a cupboard that can ease troubled minds

and lift heavy hearts. Sometimes it even answers prayers.

And this cupboard is never bare, thanks to the generosity of local donors.

The Pink Ribbon Cupboard provides emergency financial assistance to people undergoing breast cancer treatment. The goal is to reduce some of the stress encountered by families after a breast cancer diagnosis, explains Kathy Buxton, a breast cancer survivor who created the cupboard.

When Kathy was diagnosed with breast cancer in 1996, she felt the amaz-

ing support of her husband, Bruce, her family and friends. “It really hit home to me: What if you didn’t have that support?” she recalls. “I was too sick to care ffor myself. I was too sick to work, but the bills would still come in.”

The Pink Ribbon Cupboard helps families with non-medical needs, such as gas vouchers for travel to treatment, rent and mortgage payments and help with grocery, telephone and utility bills. It has even replaced a furnace in the middle of winter. Nearly 250 families have been helped since the nonprofit project was launched in 2010, Kathy says.

“We relieve a financial stress so you can concentrate on getting better,” Kathy explains. “We let you know that someone cares.”

Getting a cancer diagnosis can be devastating, says Marian Foehrenbacher, a long-time cancer nurse who serves as

manager of the Essentia Health Cancer Center at St. Joseph’s Medical Center.

A visit from a representative of the Pink Ribbon Cupboard offers help and understanding, she says.

“We ask how they’re doing and ask how we can help,” explains Marian, who serves on the cupboard’s board of directors with Buxton and Sue Beck, another breast cancer survivor.

Every dollar donated to the Pink Ribbon Cupboard stays local and goes to local families, Kathy says. The cupboard serves all breast cancer patients in treatment in Cass, Crow Wing and Aitkin counties.

“We live in an incredible community and the support for the Pink Ribbon Cupboard has been unbelievable,” Kathy says.

For more information, call Kathy at 218.829.6205, Marian at 218.454.5850 or Sue at 218.829.7254.

From Left: Sue Beck, Kathy Buxton and Marian Foehrenbacher serve on the board of Pink Ribbon Cupboard, funded by United Way and Susan G. Komen Minnesota.

How you can help? Attend the annual Pink Tie Party. All proceedes benefit breast cancer patients.

Breast Cancer Awareness • October 2014

5

FOOD

C ST

ANCER-F

n

Diet BREA

LY END ! Me RI

Mediterranean Diet e rr a n e a dit

Meats and sugars

Mediterranean Food Grid

Poultry, Cheese, Eggs, Yogurt

Every Meal

Twice A Week +

Weekly to Daily

Limited

Mediterranean Thin Crust Pizza

6

Breast Cancer Awareness • October 2014

INGREDIENTS

• 1 pizza crust (thin homemade or pre-made) • 1 boneless chicken breast (pre-grilled) • 200 grams feta cheese • Kalamata olives - remove pits • Sun dried tomato • Red onion • Fresh basil • Balsamic Vinaigrette • 3 T. olive oil • 3 T. balsamic vinegar • Crushed chopped garlic to taste

DIRECTIONS

Fish, Seafood

(MS) - Taken from the new edition of the Griller’s Handbook (by Broil King), this recipe provides an excellent base for grilled pizza, with options to change toppings for your flavor preference. More recipes and information can be found online at www.broilkingbbq.com.

Lightly oil pizza crust on both sides using olive oil. Put chicken and vegetables on pizza dough as desired. Sprinkle generously with crumbled feta cheese. Drizzle with balsamic vinaigrette, and sprinkle chopped fresh basil over pizza to taste.

Place it in the center of your barbecue’s cooking grids. Turn all burners to high and preheat grill to 400-600m F. Reduce temp. to medium/mediumhigh to maintain a temperature around 450m F.

Using a well-floured pizza peel, slide the uncooked pizza onto the pizza stone.

Check the pizza frequently -depending on thickness of crust, this will take between 8 and 20 minutes. Pizza is ready when cheese has melted and bottom is browned. Remove from pizza stone with the wooden pizza peel.

Allow stone to cool completely before removing from grill.

Fruits, Vegetables, Grains (mostly Whole), Olive Oil, Beans, Nuts, Legumes, Seeds, Herbs and Spices

Antidote to Depression?

By BEV BENNETT CTW Features

Following a healthy Mediterranean diet may improve your emotional state as well as your physical one.

Researchers find that adhering to the Mediterranean diet may stave off developing depression symptoms over time.

The Mediterranean diet has long been linked to decreased risk of developing cancer. Eating whole grains, vegetables, fruits and olive oil, with a moderate intake of fish may lessen the likelihood of developing clinical depression, a side effect often experienced by breast cancer patients and survivors.

Researchers looking at the dietary patterns of seniors for more than a decade, discovered that adhering to the Mediterranean diet was inversely related to developing depressive symptoms over time, according to a study published in The Journal of Nutrition, Health & Aging.

As with other studies, researchers looked

Super Vitamin D “Vitamin D helps prevent tumors from growing.”

By BEV BENNETT

~ Dr. Cedric F. Garland

CTW Features

Women with breast cancer who have high levels of vitamin D in their blood have significantly higher survival rates than women with low levels, according to researchers who analyzed five studies with thousands of patients.

This recent study from the University of California San Diego is one of several showing an association between breast cancer protection and vitamin D, found in fatty fish, and which the body makes when the skin is exposed to sun. What’s the connection between cancer and vitamin D? “Vitamin D helps prevent tumors from

growing,” says Dr. Cedric F. Garland, fellow, American College of Endocrinology (F.A.C.E.), professor, Department of Family and Preventive Medicine and Moores UCSD Cancer Center, University of California San Diego, La Jolla, Calif.

Even so, any recommendation to consume more vitamin D for an anti-cancer benefit is controversial. There’s still a question of whether vitamin D is an active cancer fighter or an indication of some aspect of a healthy lifestyle.

at food groups, not specifically ingredients grown in Mediterranean countries.

“It was a Midwestern version of the diet,” writes Kimberly A. Skarupski, Ph.D., lead author on the study, in an email interview.

Her research suggests that the Mediterranean diet may be beneficial to mental health because it supplies B vitamins that play an important role in the synthesis of neurotransmitters that affect mood.

In addition, the antioxidant-rich diet may protect cells from oxidative damage.

Is it possible that the Mediterranean diet, which is as delicious as it is wholesome, provides pleasure as an antidote to depression?

“We did not measure the ‘pleasure factor.’

I would think that taking the time to enjoy anything [food] would be good for depression,” says Skarupski, assistant dean for faculty development, Johns Hopkins University School of Medicine, Baltimore, Md.

Get Your Vitamin D

GET IT!

• 10 minutes in the sun, either an hour before or after noon, exposing 40 percent of your skin to sunshine, says Cedric F. Garland, Dr.P.H. • Eat foods rich in vitamin D. Salmon, tuna and mackerel are high in vitamin D. Fortified milk, soy milk, orange juice and breakfast cereals are also good bets. Dietary supplements are also an option.

Recommended Allowances

Age 71 or under - recommended allowance is 600 International Units (IU) of vitamin D daily. Age 71 or older - increase to 800 IU daily according to the Institute of Medicine, an arm of the National Academy of Sciences. (The IOM assumes people are getting a minimal amount of sunshine.) Garland recommends all women get 1,000 IU of vitamin D daily. But don’t overdo it. The safe upper limit for vitamin D is 4,000 IU a day, according to the IOM.

Testing Your Vitamin D Levels

“If you’re a woman you should talk to your physician about getting your vitamin D levels checked. It should be the center of a well-woman visit,” Garland says, suggesting the end of winter, when you’ve been sun-deprived, as the best time for testing. © CTW Features

Breast Cancer Awareness • October 2014

7

FOOD

FOOD FIGHT T

7

he foods we eat contribute directly to our overall health. The foods we eat heavily influence how healthy or unhealthy we become.

Some foods can even reduce our risk for certain diseases, including cancer. According to the American Institute for Cancer Research, numerous studies have demonstrated that individual minerals, vitamins and phytochemicals have certain anticancer properties that can protect men, women and children from this potentially deadly disease. The following are a handful of foods the AICR says could fight cancer and help improve overall health.

Grapefruit

Half of a medium pink, red or white grapefruit provides at least 50 percent of an adults’ daily recommended intake of vitamin C. Research into the potential anticancer properties of grapefruit for humans is ongoing, but studies of animals and cells show that grapefruit powder as well as limonin and naringenin, two phytochemicals found in grapefruit, decrease the growth and increase the self-destruction of breast, colon, lung, mouth, skin, and stomach cancers.

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Breast Cancer Awareness • October 2014

Excess body fat increases a person’s risk for seven types of cancer.

More information about the link between diet and cancer is available at www.aicr.org.

Walnuts Nuts are often cited in discussing foods with anticancer properties, but the AICR notes that walnuts are the most heavily researched. Despite research, the AICR remains hesitant to draw any conclusions with their potential link to lowering cancer risk. Several studies of mice found that consuming walnuts decreased the growth of breast and colon tumors among mice who ate walnuts as opposed to those who did not. Studies into the impact of the Mediterranean diet, which includes walnuts, have shown that such a diet can help people lose fat and lower their blood pressure and triglycerides. But the AICR still notes the need for more research into walnuts before they can be considered foods that fight cancer.

Cherries Cherries are also great for fiber and vitamin C. Sweet and tart cherries also contain potassium.

Cherries get their dark color from anthocyanins, antioxidants that protect cells from damage.

Studies have shown that anthocyanins inhibit the growth of cancer cells and even stimulate their self-destruction while having no negative effects on healthy cells.

Apples Great source of vitamin C. One apple provides at least 10 percent of the recommended daily amount. Great source of fiber, which can help maintain a healthy weight. A major portion of apples’ dietary fiber is pectin, a polysaccharide that bacteria in the stomach uses to produce compounds that protect colon cells.

Working through diagnosis

BY MATTHEW M. F. MILLER CTW Features

B

reast cancer statistics paint a staggering picture of a disease

that will impact the lives of everyone. According to the American Cancer Society, 235,030 Americans will be diagnosed with breast cancer

“Loss of employment is a possible long-term negative consequence of chemotherapy.”

women at the time of early-stage breast in 2014, and 40,430 will die cancer diagnosis, and then followed up four years later. Thirty percent of those from the disease. What gets women were no longer working at the time of the follow-up, 55 percent of lost in these raw numbers, those women said it was important for however, are the issues that them to work and 39 percent were actively seeking employment. extend far beyond over over“Many doctors believe that even though patients may miss work durcoming the disease itself. ing treatment, they will ‘bounce back’ in the longer term. The results of this A new study out of the University study suggest otherwise,” says lead of Michigan, Ann Arbor, found that study author Dr. Reshma Jagsi, associnearly one-third of breast cancer sur- ate professor of radiation oncology at vivors that were employed when they the University of Michigan Medical began cancer treatment were unem- School. “Loss of employment is a posployed four years later. Women who sible long-term negative consequence received chemotherapy were the most of chemotherapy that may not have been fully appreciated to date.” likely not to be working.

With higher numbers of chemotherThe study surveyed 746 working

Besides employment issues, survivors reported overall financial hardships apy patients reporting unemployment, researchers say it is possible that the need to take off time from work during the treatment could lead to long-term employment issues.

Aside from employment issues, many breast cancer survivors reported overall financial hardships, with 25 percent of women saying they are worse off financially than the were pre-diagnosis.

“As oncologists, we are proud of the advances in our ability to cure an increasing proportion of patients diagnosed with breast cancer. But as treatments improve, we must ensure that we do not leave these patients in financial ruin because of our efforts,” Jagsi says.

Race had a major impact on the findings, as Spanish-speaking Latinas were the most likely to be impacted, with debt more likely to be reported by

English-speaking Latinas and Blacks than by Whites.

According to the study, other important factors that made a woman more likely to experience these hardships include: age less than 65, household income less than $50,000, part-time work at diagnosis, reduced work hours after diagnosis, lack of substantial prescription drug coverage, breast cancer recurrence and undergoing chemotherapy.

“These patients are particularly vulnerable to financial distress,” Jagsi says. “We need to ensure appropriate communication between patients and their doctors regarding the financial implications of a cancer diagnosis and treatment decisions to help reduce this long-term burden.” © CTW Features

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Breast Cancer Awareness • October 2014

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TREATMENT

9

SPONSORED CONTENT

Test of Strength W

hen she learned she had breast cancer, Tina Hauck’s first reaction was a common one.“My mind went blank,” she recalls.“You hear about other people who have cancer. Then I realized it’s me we’re talking about.”

When the words sunk in, Tina says her next thoughts were clear: “This is a test of my strength. We’ll just get to it.”

The 42-year-old Brainerd woman decided to deal with a cancer diagnosis in the same way she took on serving in the Air Force, getting a divorce, raising her son and earning a college degree while working. She’d bank on self-reliance to get through her latest life challenge.

“My parents taught us to be self-reliant and that we need to work for what we want,” explains Tina, one of five children of Don and Shirley Hauck of Brainerd. “This is just another test for me. I want to be here, and be here for my son.”

“Tina is very strong and determined,” says Dr. Aby Philip, her hematologist/ oncologist at the Essentia Health Cancer Center at St. Joseph’s Medical Center.

Tina discovered a lump in her right breast last October, shortly before her annual physical with Sue Hadland, a nurse practitioner at Essentia Health’s Baxter Specialty Clinic. Two mammograms and an ultrasound found two tumors, one about the size of quarter and another smaller one. A biopsy confirmed cancer.

At the Essentia Health Cancer Center, Tina found Patient Navigator Missy Laposky at her side during all the tests. “Missy was right there beside me the whole time,” Tina recalls. “She an-

10

swered my questions. Sometimes, she answered my questions before I even asked them because she’s been through this before.”

Tina says Dr. Philip and Nurse Practitioner Jessica Nybakken also have taken the time to answer her questions and explain her options. “Dr. Philip is very thorough,” she says. “And if I need anything, I can call Jessica.”

On Nov. 27, Dr. Ross Bengston performed a full mastectomy. Tina was released on the morning of Thanksgiving.

Tina was diagnosed with Stage 3 invasive ductal carcinoma because cancer was found in nearby lymph nodes. She began the first of two rounds of chemotherapy in January and expects to finish in late June. Radiation therapy comes next.

As Tina began losing her hair, family, friends and co-workers began giving her hats. The hats kept her head warm and also warmed her heart. They came to symbolize the support Tina felt from those around her.

“Tina is an exceptional patient – she’s filled with kindness. She has a good heart and a gentle soul,” says Marian Foehrenbacher, the Cancer Center’s manager. “Tina continues to live her life as a mother and do normal things.

She keeps that balance while having cancer. She’s an inspiration to our unit.”

Tina has continued to work as a senior tech support specialist at Ascensus, taking off the days she has chemo-

Breast Cancer Awareness • October 2014

Tina Hauck wearing one of the hats she received as encouragement from family and friends and her son, Tristan.

therapy. “My co-workers keep telling me how strong I am,” she says. Recently, Tina and a handful of employees whose lives have been affected by cancer formed a a support group at work.

Tina is grateful that she has been able to receive care close to home. As the single parent of 16-year-old Tristan, she appreciates that she didn’t have to leave home to get treatment.

“It’s so helpful that everything is here in Brainerd. I can stay at home and stay at work,” Tina says. “I don’t have to take a day off to travel for chemo and I don’t have the travel expenses or hotel expenses.”

To help improve care for other breast cancer patients, Tina participated in a clinical trial. “She looks for the best outcome possible for herself and future breast cancer patients,” Foehrenbacher says. “Tina has gentle strength and a positive attitude.”

CANCER CENTER EARNS ACCREDITATIONS The Essentia Health Cancer Center at St. Joseph’s Medical Center and its Breast Center have earned two national accreditations that recognize their high level of care.

The Cancer Center has been accredited as a Community Cancer Program by the Commission on Cancer, which is a program of the American College of Surgeons. The designation gives local patients access to new treatments, medications and medical devices that are part of clinical trials. The work is part of the Essentia Institute for Rural Health’s commitment to cancer prevention and treatment research.

The Brainerd center was first accredited in 2008.

The Breast Center has been accreditated by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. The designation recognizes Essentia Health’s commitment to providing the highest quality care for patients with breast disease and breast cancer by offering state-of-the-art services and coordination of treatment options by a multidisciplinary team of specialists. The center was first accredited in 2011.

A leading consumer advocate for women has also named the Breast Center as one of “America’s Best Breast Centers.”

The Women’s Choice Award is based on the center meeting standards set by NAPBC as well as patient satisfaction measures collected by the federal Centers for Medicare and Medicaid. Fewer than 300 breast centers across the nation made the cut. Women’s Certified Inc. established the Women’s Choice Award to help women identify where they can get the best care.

To learn more, call the Cancer Center at 218.828.3113 or go to: EssentiaHealth.org

“You hear about other people who have cancer.

Then I realized it’s me we’re talking about.”

– Tina Hauck, Brainerd

hen it’s 2013. A biopsy confirmed cancer.

When it’scancer, cancer, e’re here At the Essentia Health Cancer Center, Tina found we’re herewith with Patient Navigator Missy Laposky at her side during u er, all the tests and treatment. As Tina began losing her ouevery everyday. day. hair from the chemotherapy, family, friends and coh ose to home. workers gave her hats. The hats kept her head warm Close to home.

Tina discovered a lump in her right breast in October

Essentia Health’s cancer experts are here to make sure that the best care is available close to home, family and friends. For an appointment call 218.828.3113.

From left to right: From left toRN, right: Missy Laposky, BA, OCN; Missy Laposky, Laura Joque, MD; RN, BA, OCN; Laura Joque, MD; Barb Morris, RN, BSN, OCN; Morris, RN,and BSN, OCN; Aby Barb Z. Philip, MBBS AbyNybakken, Z. Philip, MBBS and Jessica AOCNP Jessica Nybakken, AOCNP

From left left to to right: right: From and also RN, warmed Missy Laposky, RN, BA, OCN; OCN; her heart.

Missy Laposky, BA, tia Health’s cancer experts areJoque, deeply committed The Essentia Health Cancer Center team Laura Joque, MD; Laura MD; sentia Health’s cancer experts are deeply committed The Essentia Health Cancer Center team continues to demonstrate a commitment Barb Morris, RN, BSN, BSN, OCN; OCN; ng for cancer patients inBarb theMorris, Brainerd Lakes RN, Tina is grateful that she has been able to receive continues to highest demonstrate a commitment caring for cancer patients in the Brainerd Lakes Aby Z. Philip, MBBS and to delivering the level of cancer Aby Z. Philip, MBBSto andraise From participating in community events to the families. highest level cancer ea. From participating inJessica community events to raise As the Jessica Nybakken, AOCNP care todelivering patients Our of Center AOCNP careNybakken, close to home. parent ofand 16-year-old

ness about the importance of cancer screenings care to accredited patients and families.

Our Center is certified, and recognized by wareness about the importance of cancer screenings ing money that directly impacts the patients we Tristan, she appreciates that didn’t have to leave isshe certified, accredited and recognized by the following: raising money that directly impacts the patients we eply plywe committed or, are here with you The in every way.

The Essentia Health Cancer Center team team the following: Essentia Health Center home to get Cancer treatment.

“I want to be here, and be re for, we are here with you in every way. continues to to demonstrate demonstrate aa commitment commitment nerd continues erd Lakes eam consists of oncologyto hematology here forthe my son,” states Tina. toand delivering the highest level of cancer cancer delivering highest level of vents to raise ur team consists of oncology and hematology care to patients patients and and families. families. Our Our Center Center ers, specialized surgeons, radiologists care to cer screenings oviders, specialized surgeons, radiologists and is certified, certified, accredited and recognized recognized by by is accredited and ogists, dieticians, specialized nurses and he e patients we thologists, dieticians, specialized nurses and the following: the following: pists, a nurse navigator, social worker, clinical way. erapists, a nurse navigator, social worker, clinical ch nurse, and so many more. We understand search and so many more. We understand atologynurse, atients want personalized care and we are here at patients want personalized care and we are here gists istssure andthat the best care is available close to ke make sure that the best care is available close to es and and close to family and friends. me clinical and close to family and friends. ker, er, tiaHealth.org understand sentiaHealth.org d we are here ble close to

Dr. Laura Joque

Dr. Anusha Madadi

Dr. Aby Philip

Jessica Nybakken, AOCNP

Missy Laposky, RN, BA, OCN

Learn more at EssentiaHealth.org

Breast Cancer Awareness • October 2014

11

Her husband accompanied her to her first appointment, and every appointment that followed until her last.

No Regrets

BY JODIE TWEED Feature Writer

T

PHOTOS BY KELLY HUMPHREY

oni Bieser, a Brainerd wife and mother of two young girls, had much to lose when she was diagnosed with an aggressive form of breast cancer at 33.

But losing her breasts was a choice she made easily.

12

Toni Bieser and husband Jamie with their two daughters Isabella, 4 (left) and Sophia, 3.

Breast Cancer Awareness • October 2014

While nursing her second daughter, Sophia, who was born in September 2011, Toni Bieser noticed a strange, painless lump in her left breast.

Since she was breastfeeding, she figured it was probably a clogged milk duct. But when she stopped nursing a couple months later and the lump didn’t go away, she realized she should probably see her doctor.

Understandably, it took her a couple of months to make that doctor’s appointment. She was a busy woman. She was living in Hopkins at the time and commuting a few days a week to her new job as an accountant at HyTec Construction in Brainerd.

She and her husband, Jamie, were in the process of relocating to the Brainerd lakes area. They also had young daughters, Isabella and Sophia, born 18 months apart.

In early May she made an appointment with her obstetrician/gynecologist, who also thought the lump could be related to breastfeeding. To find out, she was referred to the Jane Brattain Breast Center in St. Louis Park where she underwent tests, including a mammogram.

Toni was working in Brainerd when she received a call that no one, especially a 33-year-old mother of an infant and toddler, would want to hear.

“They said it was cancer. I went outside to take the call and I just broke

My breasts don’t define who I am, � which is why I wasn’t scared to lose them. down,� Toni said. The breast cancer coorcoor dinator who broke the news to her was kind and compassionate, co telling her that they would get through this together.

The cancerous tumor was ductal carcicarci noma in situ, or a type of breast cancer ffound ound in the milk duct.

Toni then called her husband to break the news, and then went inside to talk to her mother, who is a co-owner at Hy-Tec Construction. Her sister drove her down to the Twin Cities that night for her early morning appointment. Her hushus band accompanied her to that first apap pointment, and every appointment that ffollowed ollowed until her last.

The good news was that the aggressive form of breast cancer was contained to the duct. Unfortunately, it was also large,

�

meaning that there was a possibility that sometime soon the tumor could break through the wall of the duct and spread.

Toni was given options of undergoing a lumpectomy or a mastectomy, but she had quickly made up her mind what she wanted to do. She wanted a double mastectomy to eliminate the chances that the breast cancer could develop in her healthy, right breast. “I didn’t want to go through the process twice,� Toni said, of battling breast cancer. “Get rid of them. That’s all I could think about it. My breasts don’t define who I am, which is why I wasn’t scared to lose them.�

Two weeks later on May 21, 2012, Toni underwent a double mastectomy at Park Nicollet Methodist Hospital in St. Louis

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Breast Cancer Awareness • October 2014

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PHOTOS BY KELLY HUMPHREY

Park. At the same time, her surgeon placed spacers in her chest to begin the process of breast reconstruction. The tumor found within her duct was 11 centimeters long when it was removed. When she was able to return home, her sister, Jolie Bray, a registered nurse, stayed with her and helped care for her. She received a lot of support from family and friends, who also helped care for her young daughters when she couldn’t hold or lift them herself.

Although she ffelt she had made the right decision to have both breasts removed, it still wasn’t easy to take off her bandages and be confronted with her wounds in the mirror. Over the course of several months, Toni underwent various processes and surgical procedures for her breast reconstruction so her surgeon could insert her breast implants.

“The first time the bandages came off, I cried,” Toni said. “I would cry every time the dressings were changed. But you’ve got to keep going. You can’t just curl up in a ball because life is going to go on. You have to move forward; there is no other option.”

She underwent genetic testing to find out if she had the BRCA gene mutation that increases a woman’s chances of developing breast cancer and/or ovarian cancer. She did not have the gene, and she didn’t have a history of breast cancer in her family.

Before she was diagnosed with breast cancer, Toni had participated in the Susan G. Komen Race for the Cure, a fundraising walk/run event that raises funds for breast cancer research, programs and to support women going through breast cancer. She and her family have walked in the Brainerd lakes area event every year since her diagnosis and surgery. Toni said she doesn’t walk to benefit herself, but to support the women who may be fighting this battle in the future and to help find a cure. She believes that she is more than two years cancer-free because of the research, programs and awareness of breast cancer that has been the work of people who have walked this path before her.

“That’s how I’m alive,” she said.

At 33, Toni was young to be diagnosed with breast cancer. She said if she could change one

Building Awareness

About Breast Cancer Do yourself and those you love a favor, make an appointment for your mammagram today.

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Breast Cancer Awareness • October 2014

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Breast Cancer in Young Women thing, it would be that she would have gone to the doctor sooner.

“If you feel a lump or you’re nursing and you think it’s a clogged duct, get it checked out,” she said.

“Don’t wait like I did.”

Her daughters, now 3 and 4, are too young to understand what their mom has been through, but the girls know that they participate in Race for the Cure to walk for “mommy’s boobies and other ladies’ boobies.”

“Race for the Cure, for me, is a celebration that I’m still cancer-free,” Toni said with a smile.

LESS THAN

5%

JODIE TWEED is a freelance writer who lives in Pequot Lakes with her husband and three daughters. exercise

INFORMATION BY JODIE TWEED

Fewer than five percent of all breast cancers diagnosed in the United States are found in women under 40, according to the Susan G. Komen Foundation.

Younger women also struggle with worries about the impact of a diagnosis on their fertility and other factors.

Breast cancers discovered in younger women are often more fast-growing and are a higher-grade and hormone receptor-negative. This means that the cancer is usually more aggressive.

When a woman of any age is diagnosed with breast cancer, it can bring on a wave of emotions, from shock and fear, to denial, sadness and anger.

The Susan G. Komen Foundation offers a breast cancer toll free hotline that offers free support services and help to find local support groups. That number is (877) 465-6636, or visit the website for additional resources and information at www.komen.org.

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PREVENTION

Exam Tips “Be clear to say why you’re here.

The doctor will explore that.”

1. Reason

~Dr. Richard Sadovskya

2. History

Don’t hold back because you think you’ll be judged. If you feel you can’t be honest, get another doctor,” Dr. Fitzgerald says.

ions

at 3. Expect 4. Plans

n 5. Questio

By BEV BENNETT CTW Features

If

you’re scheduling your first routine physical, or first in years, you may antici-

pate a conversation similar to speed dating. You want your doctor to know as much as possible about you, but you have a limited amount of time to share it. In addition, you may wonder if, as in speed dating, you should omit a few less appealing facts until the patient-doctor relationship progresses.

Here are five things physicians want to hear from you during that first visit.

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Breast Cancer Awareness • October 2014

3.

Your expectations

1.

Reason for an appointment

“You may say you’re here for a physical but you probably have an issue,” says Dr. Richard Sadovsky, associate professor of family medicine, SUNY-Downstate Medical Center, Brooklyn, N.Y. Have ready your list of concerns. It may take more than one visit to address all the concerns,” says Scott Massey, professor of physician assistant studies and program director, Misericordia University, Dallas, Pa. Prioritize – introduce the most urgent health matters first. If you’re unsure, think about any symptoms you experience. Ask yourself whether these are continuous and whether they’re getting worse, says Dr. Christopher Fitzgerald, internal medicine-pediatrics, Cedars-Sinai Health Systems, Cedars-Sinai Medical Group, Beverly Hills, Calif.

“If symptoms are getting worse we have to address them,” Dr. Fitzgerald says. Physicians will also encourage you to mention symptoms you consider trivial, especially if recurring and bothersome, such as intermittent heartburn.

“There may be a disease lurking under trivial symptoms,” Massey says.

2.

Your health history

Include your medical records, medications, family history going back to your grandparents and your lifestyle habits, Massey says.

Don’t be afraid to speak up. “You want the physician to know what concerns you,” Dr. Sadovsky says. Being forthright helps physicians as well, he says.

4.

Follow-through plans

Ask your physician what your next steps should be. These may include treatment for any conditions, screening tests according to your age and risk factors and a review of the test results.

5.

Doorknob question

This is what you bring up when you or the physician are halfway out the door. “In my practice I would rather have a patient ask and take an extra minute than not,” Dr. Fitzgerald says.

It’s easy to play Internet MD, looking up symptoms for various conditions you’ve self-diagnosed.

There are advantages and disadvantages to this, Dr. Fitzgerald says. You could use the information to take better care of yourself. But if you visit a site that’s not from a credible source, you could be misinformed. Your health professional is likely to commend you on your desire t o be up to date, but then recommend you not get too far ahead or read too much into the symptoms, Massey says.

For guidelines on the frequency of a physical exam and screening tests for your age and gender, visit the National Institutes of Health website at: http://1.usa.gov/PTHNDZ. © CTW Features

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By Patrick Rioux Unity Family Health Writer

Quality Imaging

Women’s health invariably leads to the topic of breast cancer. Patients and their providers remain vigilant and thorough, in both the diagnosis and treatment of breast cancer. The St. Gabriel’s Hospital imaging department’s mammography program is certified through the Food and Drug Administration’s Mammography Quality Standards Act (MQSA). Congress enacted MQSA to ensure that all women have access to quality mammography for the detection of breast cancer in its earliest, most treatable stages. The certification attests to the quality of both the equipment and the staff performing the exams. If additional imaging, such as ultrasound, or magnetic resonance imaging (MRI) is required, St. Gabriel’s Hospital has a full complement of quality diagnostics equipment and a patient archive and commuication system (PACS) to send the images to their providers or consulting specialists.

Saung Park, MD, is certified by the American Board of Surgery and is a Fellow in the American College of Surgeons. He completed a comprehensive, five-year general surgery residency at the Mayo Clinic in Rochester after earning his medical degree from Tufts University School of Medicine, Boston, MA. He is adept at breast surgery and the treatment options for women with a breast cancer diagnosis.

For more information about how St. Gabriel’s Hospital and its CHI St. Gabriel’s Health affiliate Family Medical Center are leading the way in the diagnosis and treatment of breast cancer, call 320-632-5441.

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SURVIVORS

Cancer

Commandments

By BEV BENNETT

M

CTW Features

elanie Young is a take-charge person. In her culinary public relations role, Young was director of the influential James Beard Foundation Awards and worked with

major ajor food clients. When she was diagnosed with cancer in 2009,

she responded in her typical, practical way.

“I called a best friend who had breast cancer and wanted to talk. My second call was to my insurance agent,” says Young, author of the prize-winning book, “Getting Things Off My Chest” (Cedar Fort, Inc., 2013).

And yes. She cried.

“You do have a meltdown,” she says.

But then she mustered her business skills to fight her disease on all fronts.

Her book’s “five cancer commandments to follow” provide valuable health, financial, personal and professional guidance. She shares her insights in the following questionand-answer exchange.

COMMANDMENT 1: Make a health management plan

“You do have a meltdown.”

Q: You recommend contacting all the health professionals you see, from dentist to dermatologist before you start treatment. Why?

A: Yo You want to discuss best preparations and precautions. Once you start treatment you don’t want to have your teeth drilled.

You don’t want to look for a dentist when you have mouth sores [certain treatments can cause painful mouth sores].

Q: What if you don’t have a team of health professionals?

A: If you don’t have physicians lined up,

18

Breast Cancer Awareness • October 2014

you can find them. I added an eye doctor.

COMMANDMENT 2: Know how your health insurance coverage works and how you will pay for your treatment.

Q: You’re faced with many treatment options, some of which may be very expensive but not covered by your insurance. How do you decide what’s appropriate?

A: Learn to question everything. It comes back to the $4,000 shot. It’s a shot that

boosts white blood cells. Some insurance doesn’t cover it. Ask why it’s necessary. In my case the $4,000 shot was covered.

Q: Do you have any negotiating power for uncovered expenses?

A: Get a cancer liaison [person] to help you. I refused treatment until I got it in writing that a $65,000 treatment would be covered. Most people will say and worry about money later. Ask. COMMANDMENT 3: Organize your records Q: I thought electronic health records eliminated the need to have a paper trail. Why is this necessary?

A: As someone whose computer lost everything twice, I have all my records electronic and on paper. Also, if my husband needs to access something, he can do so with the paper file.

COMMANDMENT 4: Establish a communications plan Q: In this age of Facebook and Twitter, what should women consider when it comes to sharing news of their cancer with their social circle?

A: This is a personal decision. Some

PINK FROSTING a sweet night out benefiting

people share and want people to know.

I’m not into oversharing. But it’s important to define this early on. You want to control the message. You don’t want people to say things about you.

Q: What about people you work with?

A: Your staff [or your employer] will know something is going on. You have to be honest. [Young closed her public relations business and opened Connected Table, a consulting company.]

breast cancer patients

COMMANDMENT 5: Get informed and ask more questions You’re urging women to get at Q: Y least two medical opinions before choosing a course of treatment. Does this include researching the hospital?

Tuesday, October 28th

A: That’s incredibly important. You’re not only getting the physician, you’re getting the hospital and the medical team.

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Q: What’s your motto on asking questions?

A: Ask questions but make your own decisions. There are resources for everything.

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SURVIVORS

Wish Knew i i

BY DAWN KLINGENSMITH CTW Features

N

ot every breast cancer patient goes through a “Why me?” period, but most reflect back at

some point and identify knowledge gaps – things they wish they’d known at various stages, from prediagnosis through treatment and recovery. Here, survivors share those things in hopes of helping others facing similar health challenges.

Dana Manciagli (left), 54, career coach and speaker, New York City

Bershan Shaw, 40, OWN “Love in the City” docudrama star, New York City (pictured above).

Recovery means work – and relaxation As soon as you get the diagnosis, that means a change needs to happen. It’s a wakeup call. You can’t get sick and keep doing the same thing. We like to take a pill and not do the work. You have to do the work. For me, that involves diet, exercise and “me time” – meditating, journaling or just sitting still with a cup of green tea. “Me time” is part of the work because it’s a productive and worthwhile investment. I wish I’d put this knowledge into practice sooner because stress is so harmful to health.

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Breast Cancer Awareness • October 2014

There may be more options out there My identical twin, Tracy Frank, and I both survived breast cancer twice. The third time took Tracy’s life on May 18, 2014. I’ll speak for Tracy on the things we wished we knew.

Since we had no known family history of cancer, we wished we had known that the BRCA gene (breast-ovarian cancer susceptibility gene) was highest in Ashkenazi Jewish heritages. We would have gotten tested and known we were BRCA positive. We wish we knew sooner that there are labs that can take a biopsy and indicate the most effective chemotherapies for a patient’s individual cancer. The tests (called Chemo-Sensitivity Testing or assays) aren’t widely used and you generally have to ask for them.

Natalie Skinner, 37, eligibility specialist, Suffolk, Va. Support comes from unlikely places I was so concerned about telling my kids, but it turns out my 19-year-old daughter knew more about cancer in general than I did and was able to help me explain it to my son. In fact, it was my daughter who said, when we went in for shots, “Hey, Ma, you might as well say something about that little lump you found.” So she was a huge help from the very beginning.

After my diagnosis, she helped me research my options and write down questions for my doctor. She even made it seem like losing my hair was the coolest thing in the world.

Wendy Watkins, 47 corporate communications VP, Orchard Park, N.Y. Food need not be dull or agonizing I wish I had known more about the impact of chemo on my ability to eat during treatment. My mouth had severe sores and my energy level dropped drastically which meant that proper nutrition was even more important, but I was unable to eat many foods. Anything acidic or salty burned my mouth. I had a constant metallic taste and a sore throat so it was difficult to swallow. I was limited to mashed-up, liquefied, bland foods. I have since learned there are other options through my involvement with the Cancer Nutrition Consortium, which offers resources and recipes for people in treatment.

Bonnie Hirschhorn, 68, teacher and guidance counselor, Bayside, N.Y. Mammograms aren’t fail proof I wish I’d known that a lump in my breast would not scrub away in the shower. That “We can see you in two weeks” was not an appointment I had to accept. That “Nothing shows on the mammography” is not necessarily an indication of breast health.

Myra Taylor, 69, retired IT professional, Freeport, N.Y. Mammograms save lives I wish I’d known how important it is to get annual mammograms. I missed two because I was “too busy” with work to take time off. By the time my cancer was diagnosed, I required surgery, chemo and radiation to treat it, and missed a lot more work than the couple of hours the exam would have taken. I’ve always wondered how different things might have been if I had gone for those two exams.

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Before I went to Cancer Treatment Centers of America, my only option seemed to be traditional medicine – just the drugs. At CTCA, they round it out with naturopathic care, nutrition, acupuncture, massage, and emotional and spiritual support – a mind-bodyspirit approach, with different modes of treatment and everyone working together as a team. I know I needed the chemotherapy to rid my body of the cancer, but the natural remedies really helped with the side effects, and massage with the after effects.

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Breast Cancer Awareness • October 2014

21

SPONSORED CONTENT

A Reason to shave my head

BY AMBER HOUSELOG

Lakewood Health System Writer

“My

hair was thinning on one side, so when I was told I had breast cancer, it gave me

a good reason to shave my head,” said Ruby Hoyhtya, of Wadena. It’s that kind of honest, positive thinking that makes Ruby an inspiration to, not only those going through breast cancer, but those of us who aren’t.

Breast cancer survivor Ruby with Lakewood Health System’s Breast Health Navigator Kris Posner, RN, BSN, MSN.

“I want to be a testament to God, and show people how powerful faith can be.” ~ Ruby Hoyhtya “There was a moment after I’d been diagnosed when I thought, ‘Part of me wants to have cancer, and part of me doesn’t’; who thinks like that?! The part of me that didn’t want cancer is what most people can relate to, but the part that did was harder to understand. I want to be a testament to God, and show people how powerful faith can be.”

It’s that faith, in God, herself and the medical staff at Lakewood Health System, which has helped Ruby on the life-altering journey she started in January, 2014.

Ruby’s last mammogram was in December, 2010, and though she regrets her decision now, she repeatedly ignored the yearly reminders to schedule an appointment. Then in January, 2014, Ruby found a lump.

“I’d been doing more exercise recently, and I thought it was just a by-product from that. Plus, I had no history of breast cancer in my family, so I didn’t give it a second thought.” After mentioning the lump to her friends at Bible study in March, who told her to go in as soon as possible, Ruby scheduled a mammogram for the beginning of April.

A week after having both a mammogram and an ultrasound, she had a biopsy, and on April 25th, Ruby’s

22

Breast Cancer Awareness • October 2014

medical provider, Physician Assistant Amy Winkels, called to tell her she had breast cancer. “After hearing I had breast cancer, my daughter immediately told me I needed to go to the Mayo clinic, but I said no.

I didn’t want the hassle and stress, and I had faith in everyone here [at Lakewood].”

Throughout her journey at Lakewood, Ruby worked with Amy, Dr. John Weitz, oncologist; Dr. Ronald Schnier, general surgeon; Kris Posner, RN, breast health navigator; infusion therapy nurses Deana Nypan and Joni Dailey and occupational therapist Audra Ragan. “Everyone I worked with was wonderful, and I couldn’t have asked for a better team of people.”

“You’re given so much information throughout the whole process that it’s hard to comprehend everything at once. Everyone should have someone like Kris, to help walk you through everything. And having Audra work with me and explain the ins and outs of therapy was so helpful, as well. Everyone else was always helpful and understanding, which made the experience that much better.”

Cancer of any kind takes its toll on all aspects of a person’s life; it is mentally, emotionally and physically draining and often debilitating. During her journey,

Ruby has broken down only once. “I was bending over to pick up one of my grandchildren’s toys, and I started to cry. I didn’t like the idea of what this could do to them. But then I thought, ‘A lot of people go through life without grandparents’, so that changed my perspective. I have to stay strong for my family, and I thank God for everything because I don’t know how people have hope otherwise.”

“I could be down in the dumps, expecting everyone to pity me, but that’s not who I am. And if I can do anything to help anyone, whether that means listening to their story, or telling them mine, or going with them to try on wigs after they’ve started their treatments, I’m more than happy to do so.”

“I also want to encourage women to get any lumps checked out, and get a yearly mammogram. After I finally went in, I had 32 lymph nodes removed, and three were cancerous. I kept putting off getting checked, and I don’t know if they would have caught it earlier had I gone in sooner or not, but if there’s a chance they might have, it’s worth it.” Check ups, exams and screenings of any kind are worth it, not only for your sake, but also for the ones you love.

“

I encourage women to get a mammogram, even if you don’t have a family history of breast cancer.

It’s so important.

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— Ruby with her grandkids

DIAGNOSTIC TESTING SURGERY AND CHEMOTHERAPY

”

Life is precious.

CARE COORDINATION SAGE PARTICIPANT

Every day we have is a gift. We aren’t guaranteed to be healthy or cancer free, but we do have the ability to take care of ourselves and those we love by being proactive in our healthcare. That means taking the time for annual checkups and screenings, like mammograms, to help us live a healthier life.

Changes in our body, no matter how small, can mean something and make a big difference in our overall health. Don’t ignore your body.

Pay attention to any changes and get a mammogram today.

There is no substitute for early detection.

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9/23/2014 12:02:50 PM

Breast Cancer Awareness • October 2014

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