THE COLUMBUS DISPATCH | Special Advertising Section | WEDNESDAY, OCTOBER 5, 2016
■
The Power of Pink
October Breast Cancer Awareness Month
Inside: DREAM Challenge
Advancing mammograms
A Survivor’s Story
Pregnant with breast cancer
Pelotonia Research
Treating depression in patients
F2
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 ■
Celebrate the power of pink in October: Breast Cancer Awareness month
BY DENISE BLOUGH DISPATCH MEDIA GROUP Love. Hope. Determination. These are the elements that form the foundation of Breast Cancer Awareness Month, which lasts through October. It is a time for organizations and individuals to honor those they have lost to breast cancer, and to celebrate those who have survived. Throughout the month, there are myriad opportunities to raise money and awareness for breast cancer around central Ohio and beyond. These events will help fund breast cancer research, education and care of patients — investments that continue to save lives each year. Though progress may seem slow, efforts throughout the last several decades have made a significant impact. According to the American Cancer Society, breast cancer mortality decreased 36 percent between 1989 and 2012 (the most recent available data), resulting in the avoidance of about 249,000 deaths. Breast cancer death rates remain on the decline. This would not have been possible without the time and money invested toward a cancer-free world.
THE POWER OF PINK Breast Cancer Awareness
Chief Revenue Officer Anna St. Charles Special Sections Editor Rebecca Walters Special Sections Writer Denise Blough
The Power of Pink is a publication of The Columbus Dispatch’s Advertising Department. For more information, call (614) 461-5000.
PHOTO COURTESY AMERICAN CANCER SOCIETY
Making Strides Against Breast Cancer Columbus will take place Oct. 23, in downtown Columbus. In 2016, there will be an estimated 9,390 new cases of breast cancer in Ohio, and 1,700 breast cancer-related deaths, according to statistics from the ACS. Here are some ways you can go pink this October: • Pink Out for Ohio State vs. Indiana football game, Oct. 8 — The annual breast cancer awareness Ohio State football game will be Oct. 8 at Ohio Stadium, where the Buckeyes will play against the Indiana Hoosiers. Since 2011, the student organization Pink Out at Ohio State has held an annual Pink Out during the Ohio State breast cancer awareness game, selling pink T-shirts to raise money for the Stefanie Spielman Fund for Breast Cancer Research. Students will be selling T-shirts on Oval Beach the week of Oct. 3, as well as on site before the game Oct. 8, said
IMAGE COURTESY ATHENS KOMEN RACE FOR THE CURE
The second annual Susan G. Komen Athens Race for the Cure will take place Oct. 23, in Athens.
Rachael Nagel, president of Pink Out at Ohio State, adding that the T-shirts will also be available online. “Last year we raised $15,788 for the Spielman fund,” Nagel said. “We’re ordering more shirts this year than we have in the past, so we’re hoping to break our goal by $5,000, if not more.” • Cleveland Browns, Oct. 9 — The Cleveland Browns breast cancer awareness game will be held Oct. 9 at the home game against the New England Patriots. The Browns will wear pink gear such as gloves and cleats, and 100 percent of the proceeds from the sale of pink-themed Browns gear and merchandise at the Browns Pro Shop and online will go to the American Cancer Society, said Rob McBurnett, communication coordinator for the Browns. • Aveda Institute Columbus Beauty for a Cure, Oct. 12 — For one day only on Wednesday, Oct. 12, Aveda Institute Columbus will provide complimentary haircuts, makeup applications, express facials, polish changes and neck and shoulder massages at both its Neil Avenue and High Street locations. A $10 donation is recommended for each service, with 100 percent of each donation going to the Breast Cancer Research Foundation, said Briana King, sales and marketing manager for Aveda Institute Columbus. Aveda will also accept donations for the BCRF instead of tips throughout the entire month of October. Both locations will be open from
9:30 a.m. to 8 p.m. for Beauty for a Cure. Appointments are limited and walk-ins will be accepted on a firstcome, first-served basis. Last year, the event raised $5,000 for the BCRF, and this year, the goal is $5,500, King said. • Hope’s Boutique Vendor Day, Oct. 19 — Hope’s Boutique, which offers unique services and products to breast-cancer patients at its location on the first floor of the Stefanie Spielman Comprehensive Breast Center, is hosting a Vendor Day from 9 a.m. to 5 p.m. on Wednesday, Oct. 19. Company representatives for everything from bras to wigs to makeup will be available, and makeup consultations will be offered free of charge, said Kathi Robbins, manager of Hope’s Boutique. Consultations for bras and wigs require an appointment. For more information, call 614-293-9393. • Making Strides Against Breast Cancer Columbus, Oct. 23 — The American Cancer Society’s Making Strides Against Breast Cancer of Columbus is a 5K fund-raising walk in honor of breast cancer patients and survivors, “Almost everyone has been touched by breast cancer in some way, and the walk unites communities to support each other,” said Denise Elsas, senior manager of community events for the American Cancer Society’s east central CONTINUED ON NEXT PAGE
■
CONTINUED FROM PAGE 2 division. “We honor those touched by the disease and raise awareness and funds to create a world free from the pain and suffering caused by breast cancer.” Making Strides of Columbus begins at 9:30 a.m. at Genoa Park and Amphitheater, located at 303 W. Broad St. Registration opens at 8:30 a.m., and parking is available at COSI. The money raised goes toward cancer research and programs provided by the American Cancer Society. Last year, the event raised $132,000. • Susan G. Komen Athens Race for the Cure, Oct. 23 — The sec-
THE COLUMBUS DISPATCH | Special Advertising Section | WEDNESDAY, OCTOBER 5, 2016
ond annual Susan G. Komen Athens Race for the Cure will take place Sunday, Oct. 23, at Ohio University. Registration opens at 10 a.m., and the 5K run and walk both begin at noon. The annual Columbus Race for the Cure, which happens in May, is the largest Race for the Cure in the nation. Komen Columbus started hosting one in Athens in the fall to address southeast Ohio’s lack of program funding for breast-cancer treatment and screening, said Nicolle Racey, director of communication and marketing for Komen Columbus. For each dollar raised, 83 cents
will go to the Komen Race for the Cure’s mission of investing in global breast cancer research and local breast health programs. Since 2000, Komen Columbus has invested $6 million in the 30 Ohio counties it oversees. In 2016, it has invested $1.46 million dollars to fund 21 community programs. Visit athensraceforthecure.org for more information. • Panera Bread Co. Pink Ribbon Bagels — During October, Panera Bread will be selling Pink Ribbon Bagels at all of its central Ohio locations, with a portion of each purchase going to the Stefanie Spielman Fund
F3
for Breast Cancer Research. Pink Ribbon Bagels are baked with cherry vanilla dough, cherry chips, dried cherries and cranberries, vanilla, honey and brown sugar, and are prepared fresh every morning at each Panera location. “The past six years, we have raised more than $600,000 for the Spielman Fund with bagel sales and other fundraising activities,” said Jessica Vogel, regional marketing manager for Covelli Enterprises, a central Ohio Panera franchise. “Last year, we sold 46,875 Pink Ribbon Bagels in central Ohio.”
F4
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 â–
� � � �  �  �  €
Pauline Russ was four months pregnant when she found out she had breast cancer. She underwent 12 weeks of chemotherapy without harming her unborn baby.
At four months pregnant, breast cancer was not on her radar BY DENISE BLOUGH DISPATCH MEDIA GROUP Breast cancer is diagnosed in roughly one pregnant woman in 3,000, according to the American Cancer Society. In 2009, Pauline Russ was one of them. Russ was 34 years old and four months pregnant when an ultrasound and biopsy confirmed that she had stage 2, triple-positive breast cancer. Before her diagnosis, Russ informed her doctor of a pain in her right breast at a routine pregnancy checkup. “Once my first trimester was over, she sent me to have an ultrasound just in case, although we both thought, ‘Oh I’m sure it’s milk ducts getting ready,’� she said. After the ultrasound, Russ was told nothing other than she needed to get a biopsy, but she could tell that something was wrong. “When I left that day, I opened up the piece of paper they gave me, and it said ‘category 5, highly suspicious of breast cancer,’� Russ recalled. “I remember being in my car just banging my
head against the steering wheel, thinking what am I going to do?� At first, she feared that she could not be treated while pregnant. Luckily, extensive research has proved that certain chemotherapy drugs, such as Adriamycin Cytoxan, are safe for both the mother and fetus during the second and third trimesters of pregnancy. Russ was told she would undergo chemotherapy for 12 weeks with no harm coming to her unborn child. “Once it got confirmed and once I had a plan, the anxiety levels went down so much,� she said. She said she felt well enough to continue her work as a physical therapist manager at OhioHealth throughout the treatment, but the safety of her baby still weighed heavily on her mind. “Every chemotherapy session, when I would watch the stuff drip in me, I was always scared that it was getting to him, too,� Russ said. After the first round of chemo and a threeweek break, Russ was induced into labor at 37 weeks pregnant. Just six See PREGNANT, next page
607144001 OHIO HEALTH SS General 4 x 13.3 Full Color   �
Â
‚ ƒ�„…† �‡ „ �ƒ …ˆ
â–
THE COLUMBUS DISPATCH | Special Advertising Section | WEDNESDAY, OCTOBER 5, 2016
PREGNANT, continued from previous page  Â?Â?Â? Â? Â? Â€ Â?Â?Â?ÂÂ?Â?‚Â
607144002
OHIO HEALTH SS General 4 x 13.3 Full Color
weeks. Just six hours later, on March 30, 2010, she gave birth to a healthy baby boy, Taxiarchi Michael Russ. “I was bald at that point, and it was the most reassuring thing that he had hair all over,� she said. “He really was okay during the treatments.� Russ underwent an additional round of chemotherapy, and after another small break had a successful one-sided mastectomy. She also began taking Herceptin, a targeted cancer drug. “This was not how I imagined spending my first years as a new mom, but I learned so much during that time — lessons that have stayed with me and have made me a better wife, mother, daughter, sister and friend,� Russ said, adding that she wouldn’t have been able to make it without the support from her husband, family, friends and fellow staff at OhioHealth, where she also was treated. One nurse told her that cancer is “like a big sandwich — you can only take one bite at a time,� which is what she tried to do by celebrating each step forward in her battle. She is now cancerfree. She transitioned from her role at OhioHealth as a physical
F5
therapist to the system director of surgical oncology, breast health and genetics at OhioHealth, which allows her to exercise her passion of helping those with cancer. Russ recently participated in Dancing with the Survivors, in which she and several other local breast-cancer survivors paired up with professional dancers in front of a live audience — similar to “Dancing with the Stars.� The event takes place in multiple U.S. cities each year, and donations and ticket sales benefit the Pink Fund, a public charity that offers financial assistance to breast-cancer patients. Russ raised about $2,000. Despite the countless bad parts, going through cancer gave Russ a new joy for life. “All the cliches — ‘enjoy every day,’ ‘don’t sweat the small stuff,’ — are so, so true,� she said. “Everything in life is worth celebrating. That’s the big lesson here.� And she doesn’t forget those who weren’t so lucky. “Those of us who have survived don’t forget about the ones who have passed,� Russ said. “When we raise money, when we make efforts to progress research and the treatment of cancer, it is in their honor.�
History of mammogram technology
(MS) — Mammography remains one of the most widely used diagnostic tools for breast cancer. An estimated 40 million mammograms are performed each year in the U.S. Mammography can be traced back to 1913, when German surgeon Albert Salomon attempted to visualize cancer of the breast through radiography. By the 1930s, the concept was gaining traction in the United States. Stafford L. Warren, an American physician and radiologist, began developing techniques of producing stereoscopic images of the breast with X-rays. Raul Leborgne, a radiologist from Uruguay, in 1949 introduced the compression technique, which is still used today. Advancements in
mammogram technology continued to improve through the 1950s and 1960s. Texas radiologist Robert Egan introduced a technique with a fine-grain intensifying screen and improved film to produce clearer images. In 1969, the first modern-day film mammogram was invented and put into widespread use. By 1976, the American Cancer Society began recommending mammography as a screening tool. Through the years, mammography became a great help to women looking to arm themselves against breast cancer. Thanks to improvements in early detection and treatment, breast cancer deaths are down from their peak and survival rates continue to climb.
F6
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 ■ COLUMBUS CANCER CLINIC
Clinic strives to raise awareness about importance of early detection
IMAGE COURTESY COLUMBUS CANCER CLINIC
The Columbus Cancer Clinic, founded in 1921, was the first free screening and detection facility in the United States, and it strives to educate the community about cancer prevention and the benefits of early detection. The Columbus Cancer Clinic is a Medicare-certified program that provides cancer-related examinations including risk assessments and screening tests for breast, cervix, colon, prostate and skin cancers, regardless of an individual’s ability to pay. The clinic also provides lowincome, underinsured or uninsured individuals living with active cancer with medical supplies, medical equipment, medication assistance, transportation to and from cancer-related medical appointments, pantry items, nutritional supplements and emergency financial assistance. The Clinic’s cancer-screening process provides education about cancer as well as a thorough examination. A certified nurse practitioner helps the client learn more about cancer screening and prevention. Before being examined, the client completes a risk-assessment form that allows the nurse practitioner to determine if any cancer predispositions exist.
Digital Mammography System
The Columbus Cancer Clinic has acquired a new digital mammography system. This system is similar to those found in digital cameras, and their efficiency enables better pictures with a lower radiation dose.
The images of the breast are transferred to a computer for review by the radiologist and long-term storage. The patient’s experience during a digital mammogram is similar to having a conventional film mammogram.
Mobile Mammography Unit
The Columbus Cancer Clinic also has a mobile mammography unit, which is transported to locations in and around central Ohio. If you are interested in scheduling a screening exam or having the mammography unit visit your church, business or community center, call 614-263-5006. Remember, early detection is key. The Columbus Cancer Clinic provides these services regardless of an individual’s ability to pay, and all major insurances are accepted. Screening examinations include: • Mammograms • Skin examinations • Colon cancer screening tests • PSA (Prostate Specific Antigen) test for prostate cancer screening • PAP tests and high risk HPV tests (for cervical cancer screening)
The Columbus Cancer Clinic Philosophy
The Columbus Cancer Clinic believes that individuals should have access to affordable cancer screening services and that everyone should be well-informed about methods to prevent cancer, as well as to detect cancer in its early stages. To learn more, call 614-263-5006 or visit lifecarealliance.org.
■
THE COLUMBUS DISPATCH | Special Advertising Section | Wednesday, October 5, 2016
Husband finds solace in remembering through journaling By Denise Blough Dispatch Media Group Amid a month of pink ribbons, feel-good stories and advertisements with smiling cancer patients, it’s easy to forget the millions of lives that are claimed by cancer each year. And among death’s sickening array of characters, cancer is one of the cruelest. Doug Alsdorf, professor at The Ohio State University, knows this reality all too well after losing his wife, Laura Alsdorf, to metastatic breast cancer in 2011. It’s hard to talk about death. Most people avoid talking about it in the public sphere because death can’t be dressed up — not even in pink ribbons. But Alsdorf will never forget or avoid discussing the bravery with which Laura — his soul mate and mother of his only child — faced death during her experience with breast cancer. “In the face of pretty much everyone’s No. 1 fear, Laura did not cower,” he said. “She never said ‘why me.’ She was courageous and resolute.” It was a long, painful process for Alsdorf to say goodbye to Laura and to accept that his life course has been altered. But he is moving ahead with new dreams, goals, hobbies and passions — such as joining the fight to end cancer. At the core of the fight against cancer is an unyielding drive powered by love, loss and hope — an arsenal that’s fortified by science and medicine. Alsdorf and Laura’s brother, Don Behrendt, are feeding that arsenal with the Laura J. Behrendt-Alsdorf Endowment Fund at The Ohio State
University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute. The fund has accumulated $120,000 thus far, and it benefits Dr. Sameek Rowchowdhury, who works on the genetic typing of cancer cells. Shortly after Laura died, Alsdorf started to find some small comfort in blogging his personal thoughts about Laura, their life together and how he’s been coping without her. “Do you know that electric feel when you first meet someone and you just glow together? That’s the feeling that Laura and I had for each other all throughout our dating and married life,” he wrote in one entry. His newfound love of writing is here to stay. Alsdorf is 50,000 words into a book he plans to publish about Laura and “life, love, death and dating,” the proceeds of which will benefit the fund at the James. He’s also working on another nonfiction book and a sci-fi novel. “Everyone should create. Be a painter, a sculptor; play music,” he said. “I can’t do any of those things very well. But writing I can do. Everybody can write. Everybody has a story.” He and Laura’s story began at Ohio State in Siebert Hall, where they were living as a resident advisor and graduate student, respectively. Ten years of friendship and romance later, they got married in 2001. Two years later, they welcomed their son, Garrett, into the world. “She was in love with me and I was in love with her,” Alsdorf said. “Together, we loved Garrett.” It was on May 17, 2011, that Laura’s story came to an end at 43 years old.
F7
Doug Alsdorf, and his late wife, Laura. She stood no chance in her six-year fight with breast cancer, but she won the battle in a different way — by living fully and passionately through it all. She earned a bachelor’s degree in business marketing from Ohio State and, with her husband’s encouragement, an MBA from USC. The height of her career was spent at Mattel, a major toy manufacturing company. Laura’s spunky personality and love of the toy industry and automotive racing made her the perfect person to help oversee toy lines within Hot Wheels, Alsdorf said. She was an avid diver, spoke French and had a great love for traveling. She made a point to keep exploring the
world through her final days — her last trip was to Turks and Caicos with her family and friends, just six weeks before she died. “She did all of that and so much more, all the while knowing that she was going to die young,” Alsdorf said. “She never let cancer define her, nor a single day of her life.” As it is inscribed on her tombstone, “cancer took Laura’s body, but it never touched her spirit.” Laura’s memory will always be alive in Alsdorf and Garrett — who’s now 13 — and her selfless love continues to inspire them. “I am so deeply grateful that Laura chose to love me,” Alsdorf said. “Her love now brings me peace.”
COVELLI ENTERPRISES
Panera Pink Ribbon Bagel proceeds benefit local breast cancer research
Panera Bread is once again hosting its Pink Ribbon Bagel campaign in participating Columbus bakery-cafes. Throughout October, a portion of the proceeds from Pink Ribbon Bagel sales will be donated to the Stefanie Spielman Fund for breast cancer research at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute. Last year, nearly 50,000 bagels were sold for the cause in the Columbus Panera Bread cafes, and during the past six years, Panera Bread has donated more than $600,000 to the Stefanie Spielman Fund as a result of these bagels sales and other fundraising efforts. One hundred percent of all donations made to the Stefanie Spielman Fund directly benefit life-saving research happening at The James. “We make this campaign a prior-
ity every year for a reason,” said Sam Covelli, owner/operator of Covelli Enterprises, the Ohio-based franchisee of Panera Bread. “The funds raised by the Pink Ribbon Bagels are helping to save the lives of local women with breast cancer. There’s no better feeling than knowing you can help make a difference.” Panera Bread is encouraging customers to take a photo with their Pink Ribbon Bagels to share their support for the cause on social media using #morethandough. The cafes are accepting pre-orders for bagels at covelli.com/gopink. Shaped in the form of the iconic pink ribbon, the Pink Ribbon Bagel features cherry chips, dried cherries and cranberries, vanilla, honey, and brown sugar, and is baked fresh every morning by Panera’s bakers at each bakery-cafe. In addition to the Pink Ribbon
Bagel sales, Panera Bread is also supporting the Stefanie Spielman Fund through donation canisters at the registers it Columbus-area cafes through October. The Pink Ribbon Bagel campaign is one facet of Panera Bread’s ongoing support for the Stefanie Spielman Fund and other OSU-affiliated charities like Pelotonia, which also raises funds for cancer research at The James. This year, Panera Bread introduced Receipts for Riders, a program to assist Pelotonia Riders in
their fundraising efforts. Panera Bread was also the presenting sponsor of Step Up for Stefanie’s Champions, a four-mile and one-mile walk/run that was held in April 2016 to benefit the same cause. The event was the newest evolution of Step Up for Stefanie, an event Covelli Enterprises/Panera Bread helped found in 2011. Covelli Enterprises believes charitable giving and community involvement is the backbone of its business. In 2015 alone, the company donated $26 million to local charities in the communities it serves. Covelli Enterprises also made the largest donation in history to The Ohio State University athletics department in 2010 with a $10 million commitment to build a new indoor sports arena on campus. For more information on Covelli Enterprises and Panera Bread, visit covelli.com.
F8
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 ■
THE OHIO STATE UNIVERSITY COMPREHENSIVE CANCER CENTER – ARTHUR G. JAMES CANCER HOSPITAL AND RICHARD J. SOLOVE RESEARCH INSTITUTE
Alternative breast-cancer treatments give patients more choices
IMAGES COURTESY OSUCCC – JAMES At left, breast radiation is delivered in a prone (face-down) position at the OSUCCC – James to keep radiation exposure outside the chest wall. Right, Julia White, MD, was instrumental in developing the prone breast radiation board as well as coming up with protocols used throughout the United States. Women with stage I breast cancer have the option to choose between breast-conserving surgery (lumpectomy) followed by radiation therapy or a full-breast removal (mastectomy). In the past, many patients struggled with the choice as they weighed the fear of recurrence against potential side effects of radiation therapy. But a growing body of recent scientific data suggests that a lumpectomy combined with radiation therapy is just as effective — if not more so — than a mastectomy, said Julia White, MD, director of breast radiation oncology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). Women with early-stage breast cancer are increasingly making the decision to keep their breasts. Nationwide, 70 percent of stage I breast cancer patients are choosing a lumpectomy followed by radiation. “Our challenge is to continue
improving the accuracy of radiation therapy to ensure our patients are receiving the most precise, optimal dosing for cancer control that also avoids overtreatment,” White said. Breast radiation therapy has changed dramatically in the past decade, resulting in sophisticated tools that allow radiation oncologists to carefully calculate treatment dosages and pinpoint treatment location to minimize damage to surrounding healthy tissues and organs. At the OSUCCC – James, breast radiation is delivered in a prone (face-down) position to keep radiation exposure outside the chest wall, avoiding collateral damage to the heart and lungs. White was instrumental in developing the prone breast radiation board and treatment protocols now used across the United States. “The challenge now is to improve the geometric accuracy of breast radiation therapy by using real-time imaging maps to specifically guide each
woman’s radiation treatment based on the specific location of her tumor within the breast,” White said.
Radiation before surgery in early-stage breast cancer
In collaboration with the OSUCCC – James breast cancer surgeon William Farrar, MD, White is leading a new clinical trial to evaluate the effectiveness of upfront partial breast irradiation in low-risk, early-stage breast cancer patients age 60 or older. In this phase II trial, women will receive accelerated, image-guided partial breast radiation prior to undergoing a lumpectomy. “We are not changing the elements of care in this trial — but we are changing the order in which a woman receives them with the goal of improving both treatment accuracy through real-time imaging guidance and post-treatment cosmetic outcomes,” explains White. Women over age 60 with stage I breast cancer who will be treated with
a lumpectomy and radiation may qualify for the trial. Prior to radiation treatment, each study participant will have two imaging tests that are then fused to create a 3-D map that will allow oncologists to deliver super-selective treatment based on the unique shape and location of the breast tumor. Participants will then receive image-guided radiation therapy two times a day for one week followed by a lumpectomy approximately three to four weeks later. “We believe this approach has the potential to improve radiation treatment accuracy because we can more precisely target the affected tissues when the tumor is still present. It could also reduce deformities of the breast that often occur when radiation is given after surgery.” To learn more about the OSUCCC – James breast cancer team, visit cancer. osu.edu/breastcancer or call 800-2935066.
Cancer’s effect on sexuality (MS) — Fatigue, nausea and emotional symptoms are common side effects of cancer treatments. Cancer can impact all areas of emotional and physical well-being, but few are aware that it can also affect sexuality. Although it is entirely possible for men and women undergoing cancer treatments to have healthy, intimate relationships, the Mayo Clinic noted that many people find that cancer causes a range of side effects that make sex more difficult. Erectile dysfunction is the most common sexual side effect of cancer treatments among men. Men experiencing pelvic cancers may experience more difficulty with sexual activity
both during and after cancer treatment than those who have other cancers. Erectile dysfunction for men or the inability to achieve intimacy for women are not the only sexual side effects of cancer treatment. Cancer’s effect on emotions and self-identity plays a large role in how people think about intimate behavior. Disappointment in the way one’s body looks, whether through weight loss/gain, hair loss, mastectomy or any other physical side effects of cancer treatment, can impact one’s sexual identity. The American Cancer Society also said that sexual desire and energy
levels change during treatment. Individuals may have less interest in sex because of the physical and emotional demands of cancer treatments. Furthermore, the treatment itself may lead to side effects that make it challenging to engage in intimate behaviors. Cancer and subsequent treatments also may have an effect on fertility, and this is something that both men and women need to be aware of. Menstrual cycles may become irregular, potentially making conception more challenging. Cancer patients should discuss their plans to have children with their physicians before choosing treat-
ment plans. After treatment, testing to assess fertility and if it is the right time to again try for children may be necessary, as a pregnancy during or just after chemotherapy can be complicated by birth defects. Treatment-related sexual changes can be long-term and permanent, or they may be transient. Patients should speak with their health-care team about concerns regarding their cancer’s affect on sexuality. While some men and women may be hesitant to discuss sexuality with their physicians, they should know that doctors have experience discussing sexuality and cancer treatments with their patients.
■
THE COLUMBUS DISPATCH | Special Advertising Section | WEDNESDAY, OCTOBER 5, 2016
Pelotonia funds in action BY DENISE BLOUGH DISPATCH MEDIA GROUP It’s no secret that research is what’s going to help save more lives from cancer. Since 2008, Pelotonia, Columbus’ annual cycling event and fundraiser for cancer research, has contributed more than $122 million to The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC–James). One hundred percent of the proceeds are used to advance research through a variety of initiatives, including Pelotonia Idea Grants and the Pelotonia Fellowship Program, both of which fund selected cancer studies. Two separate ongoing studies funded by Pelotonia at the OSUCCC – James are looking into the link between breastfeeding and breast cancer and figuring out how to alleviate depression in cancer patients.
Breastfeeding and TNBC
Pelotonia awarded a 2016 Idea Grant to Dr. Bhuvaneswari Ramaswamy, an oncologist at the OSUCCC– James, for a study exploring the link between breastfeeding and triple-negative breast cancer (TNBC) in AfricanAmerican women. Multiple studies have identified the protective effects of prolonged breastfeeding against developing breast cancer in general, but scientists have yet to fully understand the specifics of this link. More recent data has pointed to a possible association between a lack of breastfeeding and the development of TNBC, prompting the need for further studies, Ramaswamy said. TNBC is a subtype of breast cancer that’s particularly difficult to treat, as it lacks the three markers routinely used as therapeutic targets: estrogen receptors, progesterone receptors and human epidermal growth factor receptor-2 (HER2). Chemotherapy is the only treatment option. TNBC affects about 15 percent of breast cancer patients in the U.S., with younger black women being at a significantly higher risk. In fact, 39 percent of premenopausal African-American women with breast cancer have TNBC, compared with 16 percent of nonblack cancer patients of any age, according to a study in the Journal of the American Medical Association. African-Americans also have one of the lowest breastfeeding rates in the nation. “The data now shows that 40 to 50 percent of African-American women breastfeed their infants,” Ramaswamy said. “So if we can take that and increase the prevalence of breastfeeding, the hope is that we would reduce the risk of them developing TNBC.” So how does breastfeeding help prevent cancer? Ramaswamy and her research team think that the weaning process may have something to do with it. Whether a woman gradually lessens breastfeeding frequency over time (weaning) or does not breastfeed at
all, the breasts must stop producing milk — a process known as involution. For women who don’t breastfeed, this mechanism occurs much quicker. Ramaswamy’s research team is looking at a specific gene involved in the involution process called STAT3, which they believe is over-activated in women who don’t breastfeed. This would subsequently cause an inflammatory environment in the breast, leading to a higher risk of breast cancer. “Obviously it would be foolish to say that if we all breastfeed we can eradicate triple-negative breast cancer,” Ramaswamy said. “But if we can even reduce the risk and save a few lives from having to endure this devastating form of cancer, that would be critical.” Her team will test their hypothesis using several mouse models, and if their prediction holds true, they hope to repeat the study on human breast tissue. “I think knowing a little more about the biology of breastfeeding will strengthen the message that we can take to women and the community,” Ramaswamy said. “If, as a society, we provide the time and space for women — particularly working women — to breastfeed their children, can that help in preventing this type of cancer?” This is the second Pelotonia Idea Grant that Ramaswamy has received.
Combatting depression
Cancer research often is focused on developing new knowledge and therapeutics to fight the disease, but other areas of research can be just as beneficial, such as the work being done by Dr. Marlena Ryba, postdoctoral researcher and 2015 Pelotonia Fellow at OSUCCC–James. Ryba’s study seeks to alleviate depression in cancer patients, which is often overlooked or under-treated. Along with Dr. Barbara Andersen, a clinical psychologist and professor at Ohio State, Ryba is testing the ability of an online therapy in reducing symptoms of depression in cancer patients that have been diagnosed with Major Depressive Disorder (MDD). The study, called Beating the Blues, is based on cognitive-behavioral therapy, which attempts to reframe maladaptive thoughts and behaviors, which is the most effective treatment for depression, Ryba said. Beating the Blues yielded beneficial outcomes when tested in the general population, but the intervention has never been tailored to cancer patients, who are typically undergoing multiple life changes. The prevalence of depression in cancer patients ranges from 10 to 40 percent, depending on the type of cancer, Ryba said, adding that higher percentages are seen with breast cancer. “As you can imagine, cancer patients have many competing demands, so psychosocial care takes a back burner a lot of the time,” Ryba said. “The unique challenges that
cancer patients encounter warrant a different approach in treatment.” In addition to a busy schedule, patients may be reluctant to seek help, so the online nature of the therapy lends a way for people to receive treatment in the privacy of their own homes, and at their own convenience. The intervention was designed to be more interactive than other available therapies, allowing participants to build on previous sessions and choose specific issues they want to address, Ryba said. There are about 15 patients enrolled in the eight-week interven-
F9
tion, which started in August. After its completion, a wait-listed control group will begin the treatment. “Previous studies have shown the benefit of psychosocial care over and over again,” Ryba said. “This is just another way to deliver a treatment that has already shown to be effective to a population that really needs it.” Those interested in Beating the Blues can email beatingtheblues@osu. edu or call 614-292-6874.
F10
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 ■
MOUNT CARMEL
New therapies making breast surgery more efficient, effective at Mount Carmel
For most women who are diagnosed with breast cancer, their first and biggest concern is survival. Making the treatment process easier, shorter or less invasive are typically secondary. But not to the breast cancer experts at Mount Carmel. While returning breast cancer patients to full health is always the No. 1 priority, their team is working every day to make the process of treatment and survival as efficient as it is effective. And one of the primary ways they’re doing that is by investing in technologies that make treatment more precise and streamlined while also protecting healthy tissue. One such technology is called INTRABEAM® intraoperative radiation therapy, or IORT. It’s a singledose radiation therapy for patients with small, early-stage breast cancer. After performing a lumpectomy — a common breast-conserving surgical technique — the breast surgeon inserts an advanced, miniaturized linear accelerator right into the lumpectomy incision. The radiation oncologist then administers a 20- to 30-minute radiation treatment precisely to the tumor bed where the cancer was removed. And that’s important, because that’s where it’s most likely to recur. “Once the radiation is delivered intraoperatively, the device is removed
and the wound is closed to achieve the best cosmetic result,” said fellowship-trained Mount Carmel breast surgeon Dr. Shilpa Padia. “There are no stitches on the outside, and the patient goes home the same day.” Beyond the cosmetic and recovery benefits, though, IORT often eliminates or reduces the amount of postoperative therapy the patient needs. “Intraoperative radiation therapy allows patients to decrease their radiation time by providing a one-time dose during surgery compared to several weeks of daily treatment,” said Dr. Bridget O’Brien, another fellowshiptrained Mount Carmel breast surgeon. It also minimizes radiation exposure to surrounding healthy organs and tissue. “For women undergoing breast radiation, we take every measure to protect nearby tissue and organs, particularly the heart,” said Mount Carmel radiation oncologist Dr. Malolan Rajagopalan. “In addition to IORT, we can employ prone positioning or deep inspiratory breath hold with video goggles and biofeedback. These technologies improve our precision and make a meaningful impact in the lives of our patients.” Prone positioning allows some women to undergo breast radiation while lying face down. This allows the
During intraoperative radiation therapy, or IORT, a physician uses a miniaturized linear accelerator to deliver a precise single dose of radiation while a surgical procedure is in progress, reducing the need for additional radiation and minimizing exposure to healthy tissue and organs.
breast tissue to shift away from the chest wall and substantially decreases radiation to the heart and lungs. Breath hold, combined with videoconnected glasses that enable patients to see exactly how deeply they’re breathing, helps deliver radiation more accurately as well. Because of techniques and technologies like these, the average dose delivered to the heart for women undergoing breast radiation at Mount
Carmel is significantly lower than nationally acceptable limits. IORT is just the latest addition to the spectrum of technology Mount Carmel continues to add to make breast cancer treatment even more efficient and effective. To learn more about Mount Carmel’s comprehensive breast-cancer care program and the treatments and technologies available, visit mountcarmelhealth.com.
Hundreds of experts team up to improve early detection of breast cancer BY DENISE BLOUGH DISPATCH MEDIA GROUP As part of Vice President Joe Biden’s $1 billion Cancer Moonshot initiative, hundreds of scientists and coders are attempting to improve the ability of mammograms to detect breast cancer. About 100 out of every 1,000 women to get a mammogram will be recalled for further testing, but only five will be diagnosed with breast cancer, according to the American Cancer Society. This is largely due to issues in technology and image readability, especially as breast density increases. “The breast is a threedimensional structure, and standard mammograms take a two-dimensional picture of it,” said Dr. Jeff Hawley, breast radiologist at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). “Sometimes the tissue can overlap on the image, and that’s usually the cause
for us to recall patients who are actually cancer-free.” Yet hospitals have had trouble improving the mammogram recall rate, despite efforts to utilize computer-aided detection (CAD) software, he added. In theory, CAD software can draw radiologists’ attention to subtle cancer indications that they may not have otherwise noticed. But many radiologists, including Hawley, find the current versions to be of questionable value. So experts are teaming up in a large-scale, online competition to develop new computer algorithms in hopes of advancing mammogram readability. “I think in the era of computer learning, it’s certainly possible,” Hawley said. The competition, called the Digital Mammography DREAM Challenge, was launched in September by nonprofit research organizations DREAM (Dialogue for Reverse Engineering Assessments and Methods) and Sage Bionetworks.
The data-driven, opensource challenge lets participants train their computer models on 640,000 de-identified mammograms, said Dr. Thea Norman, director of strategic development at Sage Bionetworks and one of the competition’s organizers. “This is not to imagine that an algorithm could replace a human being’s set of eyes,” Norman said. “It’s about asking the question of whether an algorithm can be developed that can help a radiation oncologist understand the relative risk that a mammogram is showing a true positive cancer indication.” Research is conducted and data is recorded in a large online database, allowing scientists from around the world to collaborate across time and space. If an improved computer algorithm for mammogram screenings is found, a team of advisors that includes radiologists and breast cancer specialists will help move it forward to clinical trials in hopes of eventual widespread
use, Norman said. “We see this as the beginning of a research project, not the end,” she added. The mammography challenge is one about 40 DREAM challenges that have been hosted online since 2006. The challenges are a different approach to traditional academic research in that participants do not reap as many individual benefits. The common strategy in each challenge is to make large volumes of data accessible to large volumes of scientists in both medicine and computer science, so that biological patterns can be identified faster and more accurately. “I think we’re going to see a lot more of this, not only in radiology and breast imaging, but in all of medicine,” Hawley said, adding that no one from OSUCCC–James is participating in the challenge. Institutions involved in DREAM challenges have included Harvard University, MIT, Stanford University, Columbia University, the
European Bioinformatics Institute, IBM Research and many more. The Mammography Challenge winners will be announced in spring 2017. And the participants have more incentive than answering a key question in human medicine — their sights are on the $1.2 million in cash prizes, funded by the Laura and John Arnold Foundation, a private foundation in Texas that invests in various philanthropic initiatives. Beyond CAD software, another promising technology for breast cancer screening is 3-D mammography, in which multiple X-rays are reconstructed into a 3-D image of the breast, decreasing tissue overlap. “If we can reduce tissue overlap, most studies are showing that we can lessen false positive recalls by about 30 percent,” Hawley said, adding that the James offers 3-D mammography at the Stefanie Spielman Comprehensive Breast Center and has plans to expand it elsewhere.
F12
THE COLUMBUS DISPATCH | Special Advertising Section |WEDNESDAY, OCTOBER 5, 2016 â–