A REKINDLED FRIENDSHIP
THROUGH GENETIC COUNSELING:
PATIENT SENDS CHILDREN TO SAME GENETIC COUNSELOR
MORE THAN TWO DECADES LATER P. 10
DEAR PATIENTS, FAMILIES AND COMMUNITY MEMBERS,
I hope you are looking forward to the warmer days ahead as we witness the changing of seasons, where our days are longer, and our flowers begin to bloom.
I am delighted to introduce our Spring 2024 Hope Magazine, focusing on the incredible stories of cancer survivors within our community. This edition is dedicated to celebrating the resilience, strength and triumph of those who have battled cancer, illuminating their inspiring journeys and highlighting the support networks that have lifted them through every challenge.
One of those stories is about Jennifer. She illustrated how her genetic counselor helped her make tough decisions for her health. Jennifer expressed her gratitude for the care she received and why she recommended Karmanos for her daughter’s testing (Page 10). In another story, Paul described his fresh start after successful Gamma Knife radiosurgery treatment for metastasized cancer in his brain (Page 12). I sincerely hope the stories featured in this magazine will serve as a beacon of hope and illustrate the light at the end of the tunnel for those currently navigating their own cancer journeys.
In addition to celebrating the individuals featured in this magazine, I would like to share that since I joined the Barbara Ann Karmanos Cancer Institute in August of 2023, I have been in awe of this institution’s impact in Detroit and nationally. We are at the forefront of pioneering breakthrough treatments and cancer research. Our dedicated team members continue to push the boundaries of science, striving to improve cancer patients’ outcomes and quality of life through
innovative therapies and personalized approaches. The advancements in recent years offer renewed hope for those affected by cancer due to our transformative and collaborative research and clinical practice. Karmanos is a true Michigan and national gem, and I look forward to the breakthrough discoveries we will continue to accomplish throughout the rest of 2024.
Karmanos continues to enhance accessibility and quality and provide the best cancer care in Michigan and beyond. We are excited to share that we have expanded our cancer services in Roseville. Soon, we look forward to sharing details about a new clinic that will bring renowned expertise and premier cancer treatments to more communities. The new location is slated to open in metro Detroit by the end of 2024.
The stories of the many cancer survivors at Karmanos reflect a theme of hope despite a cancer diagnosis. Help me celebrate the accomplishments of our patients as they embark on a new beginning. We’re thankful for your continued trust and confidence in Karmanos’ mission. We hope you pass this magazine along to a neighbor, friend or family member to help spread the news about the best cancer care in the state.
Warm regards,
Boris C. Pasche, M.D., Ph.D., FACP President & CEO
Barbara Ann Karmanos Cancer Institute
Bruce (left), Kim’s husband, her daughter Ashley (center) and Kim (right) celebrating Ashley’s graduation. Page 4.
FAMILY CHEERLEADER TURNED FIGHTER DEFEATED MDS
A family steps up, supports its matriarch after cancer diagnosis
Sitting on the bleachers, cheering on her children and grandchildren on the court and in the field – this was Kim Harrison’s life. She is a wife, a mother of six, and a grandmother of 14. Harrison is committed to being at every event, big or small. She had no idea that shortly after her daughter’s wedding in 2013, her family would become her cheerleaders as she faced the curveball of her life — cancer.
Months after the wedding, Harrison received a call from her doctor while at work. From a routine checkup, her primary care provider noticed her body’s white blood cell count was dangerously low.
She was advised to quit her job and not travel. Even a trip to the grocery store could be dangerous – her doctor explained that if she were in a car accident, she would bleed out.
The diagnosis that started the fight
She was diagnosed with myelodysplastic syndrome (MDS), a rare type of blood cancer that causes blood-forming cells in the bone marrow to become damaged, abnormal, or defective, leaving patients without enough normal blood cells to function.
“I had never heard of this disease. Even working as a hospital transporter, I had never run into someone with this disease until that patient was me,” Harrison said.
MDS usually does not present symptoms until the disease progresses. It can be detected in blood work before the patient experiences symptoms. Once MDS progresses, patients may experience shortness of breath, fatigue, frequent infections, bleeding, pale skin, weight loss, loss of appetite, bone pain, and fever.
Harrison went from sitting in the bleachers to sitting in a chair receiving chemotherapy infusions. After three months without improvement, a neighbor recommended she get a second opinion at Karmanos Cancer Center
in Detroit. Harrison was greeted with a warm welcome from Lois Ayash, M.D., hematologist, medical oncologist, and Bone Marrow and Stem Cell Transplant (BMT) Multidisciplinary Team member.
Kim’s bone marrow transplant
The chemotherapy provided more time for Harrison, but she needed a bone marrow transplant. Karmanos’ BMT team performs around 200 transplants each year. In the progressed stages of MDS, a bone marrow transplant is the recommended course of action if the patient is healthy enough to withstand the potential rigors of the therapy and graft-versus-host disease.
“Without a transplant, the bone marrow will completely fail, or the disease will transform into acute leukemia. There is a better chance of curing the patient with a transplant,” Dr. Ayash explained.
Harrison’s brother volunteered first, but family member after family member, no one was a match. Finally, after four months, Harrison received the phone call – Karmanos found several matches.
March 27, 2014, was a long-anticipated day for the Harrison family. On the 10th floor of Karmanos Cancer Hospital, with two vital bags of plasma in hand, Harrison’s care team reviewed all the details.
“What I loved about the staff at Karmanos was their dedication to detail and understanding. They would go over everything with me to ensure I understood what to expect on my road to healing,” reflected Harrison.
“The patient interaction is the best part of the job. I love taking care of them in person as they go through
Lois Ayash, M.D.
Kim poses with her new Team Karmanos T-shirt.
a transplant,” said Dr. Ayash. “I know it’s a scary time for them, but I love getting them through the chemotherapy, the transplant and other tough parts of the care process.”
After the transplant, Harrison began her recovery at the hospital. With a goal of completing 16 laps around the transplant floor, she would pass by the symbolic bell that would one day signify the end of her cancer treatment.
“My life depended on my white blood cell count. It wasn’t about how I was feeling; it was solely based on my numbers each week,” said Harrison.
By her side each day, her husband Bruce would remind her how proud he was. Her husband’s words kept her going, even when she wanted to quit. And, instead of grandma showing up for their sports games, her grandchildren showed up with flowers to brighten her day.
“I assumed my grandma was fearful of the unknown, but I never saw it in her,” Harrison’s granddaughter Claire shared. “She was the walking lap queen. When she took laps around the hospital [floor], she beat all the other patients by so many laps, which showed her drive to always persevere.”
After 30 days, she was finally able to go home. However, returning to Karmanos for her follow-up bloodwork brought many emotions. Week after week, she began to get discouraged at the lack of improvement in her white blood count. However, Dr. Ayash said this was her new normal range. The bone marrow transplant was successful. Harrison has been cancer-free for almost a decade.
“I did not know if I would be able to make it to see my daughter’s graduation or the birth of my grandsons, but I made it because of the experience and expertise at Karmanos,” Harrison said.
Since her transplant, Harrison has enjoyed taking vacations with her husband, and she continues cheering on her biggest fans and cheerleaders — her family. She even returned to the stands in time to watch her daughter Ashley finish her softball season.
“I always knew my mom would watch my game however she could. Whether it was in the stands, in the car, or on a screen at home,” said Ashley.
“From the clerks at check-in to the lab technicians, to the nurses, I am so impressed with the quality of care and dedication that the Karmanos staff gives our patients,” said Dr. Ayash. “It is normal for patients to be anxious, but I know the staff will do everything possible to make this a positive experience for them.”
Data released by the Center for International Blood and Marrow Transplant Registry shows that Karmanos’ BMT Program is one of only a select group nationwide reporting some of the best survival outcomes for related and unrelated stem cell transplantation.
If you are in need of a bone marrow or stem cell transplant, it is important to be evaluated by the experts in this field before beginning treatment. Call 1-800-KARMANOS or visit karmanos.org/BMT for more information.
Kim (left) with Dr. Lois Ayash (right) at Karmanos.
Kim shows off the back of her new Team Karmanos T-shirt.
Kim’s husband Bruce (left) and Kim (center) attend one of her daughter Ashley’s (right) softball games.
WATCH THE WARNING SIGNS.
I DID, AND “I'M BETTER THAN GOOD”
Michael enjoyed watching batting practice at the 2023 Prostate Cancer Awareness Night with the Detroit Tigers.
At first glance, you might not think Michael Dudley is someone who ever faced a disease like cancer.
After all, he’s a former collegiate track athlete who competes in triathlons. He swims, bikes and runs regularly. He watches his diet closely, and he doesn’t drink or smoke.
Yet, Dudley has beaten cancer not once but twice: first, when he faced colon cancer in 2017, and in 2021, when he underwent successful treatment for prostate cancer at the Karmanos Cancer Center.
Dudley advised that the key to defeating the disease is being attentive to early warning signs and being aware of your family health history.
“Your health is your wealth,” says Dudley, 67, a Southfield resident who is a business consultant for the McDonald’s Corporation and an ordained minister. “Without health, you’ll have a substandard quality of life. That’s why regular physicals and specialized health screenings like prostate exams and colonoscopies are so important.”
Along with that, be aware of your personal health risks. As an African American with a family history of cancer, Dudley knew he had an increased risk of developing colorectal cancer.
“My father died of cancer, and we lost two of his sisters and one of his brothers to the disease,” Dudley shared. “My mom is 89 and the eldest of nine siblings, and she’s outlived them all. Two of them died from cancer-related matters.”
So, when Dudley first noticed blood in his stool in 2017, it was a wake-up call.
“I saw my doctor, who scheduled a colonoscopy,” Dudley explained. “The evidence of cancer was clear. Further testing showed I was at stage II.
“The diagnosis was a little surprising to me. I was preparing for a triathlon at the time and felt I was on top of my game. With the support of my wife, I became determined not to let cancer beat me. I competed in that triathlon that same week.”
Dudley had a colon resection to remove the disease surgically. He recovered quickly and resumed his active lifestyle.
Going to battle once more
Four years later, Dudley noticed he began urinating more often than usual.
“I thought it was because I had been working out a lot and drinking lots of fluids,” he said. “I wanted to check with my doctor to see if this issue might be connected with something else.”
Frequent urination is among the early signs of prostate cancer, but it could also indicate an enlarged prostate. Generally, the first step when screening for the disease is to have a prostate-specific antigen (PSA) test. Blood is drawn and analyzed in a lab for antigens that can indicate the presence of cancer.
In Dudley’s case, his PSA levels were normal. But for extra peace of mind, he consulted with Isaac Powell, M.D., urologic oncologist, member of the Genitourinary Oncology Multidisciplinary Team, and the Population Studies and Disparities Research Program at Karmanos.
Dr. Powell performed a rectal exam and then ordered an MRI scan and a biopsy. The results: Dudley had an early but very aggressive form of prostate cancer.
Isaac Powell, M.D.
“My mindset after being diagnosed a second time was simply to overcome a new trial,” he recalled. “Of course, there were moments of fear and reflection. I went through a range of emotions. But I relied on my faith and family. I was going to battle through the naysayers, through my family history, through that second diagnosis. I was determined to rise above.”
Early detection leads to better outcomes
Dr. Powell believes Dudley’s quick and decisive action to get a second opinion despite his good PSA results was critical.
“Patients who suspect prostate cancer also need a rectal exam,” Dr. Powell explained. “Given Michael’s personal and family history of cancer, it made sense to seek another opinion. He had an aggressive lesion, which didn’t present much PSA.
“We felt Michael’s cancer was confined to the prostate. Usually, patients who have had their prostate removed surgically have good outcomes. Michael opted for surgery.”
For decades, Dr. Powell has researched the health disparities between African American and Caucasian cancer patients. The data shows that African Americans—particularly those of West African descent—are at 60%-70% higher risk of prostate cancer, and the death rate for African Americans is two to three times higher than Caucasians.
“A genetic component contributes to this disparity,” said Dr. Powell. “We encourage White men to get their initial PSA exam at age 50. But for African Americans, I recommend age 40.”
According to Dr. Powell, many African Americans are reluctant to discuss cancer symptoms and treatment openly. So, he fosters open, trusting doctor-patient relationships to break down those barriers.
“I encourage patients to ask their doctors many questions,” he suggested. “I also tell patients that when detected early, cancer is curable. I had prostate cancer 20-some years ago, and I’m still living and working and very happy with my life. People often associate a cancer diagnosis with death. But the five-year survival rate for prostate cancer patients with local, non-metastasized disease is 98%.”
Living his best life
After the removal of his prostate, Dudley was cancer-free again. He slowly resumed exercising and continued his healthy diet. He continues to see Dr. Powell for checkups and his internist for regular lab work.
“I’m better than good,” Dudley says. “I’ve got a great future ahead of me with a heavy dose of the good life.”
He adds that he shares his story with family, friends and community members to encourage men to schedule regular medical exams.
“I know there aren’t many African American men who want to go public with their cancer story. But I tell people the diagnosis didn’t define me—it redefined me,” expressed Dudley. “I’ll have an opportunity to share my story with many people, and if sharing can help save just one person’s life, it will be very worthwhile. Cancer is a diagnosis—not a death sentence. I’m living proof.”
The most important thing you can say to your friends and family members with a prostate is to schedule an appointment and talk to their primary care provider about the benefits and risks of a prostate cancer screening. For more information, visit karmanos.org/prostatefacts .
Michael after finishing the Motor City Triathlon.
Michael (left) with Dr. Isaac Powell (right).
Karmanos Cancer Institute
Offers More Cancer Services and Specialists at Roseville Medical Oncology Clinic
The southern Macomb County cancer center that opened in December 2022 now provides infusion treatments, pharmacy and more clinic space
The Barbara Ann Karmanos Cancer Institute has expanded its offerings for patients at the Karmanos Cancer Institute – Roseville, located at 30550 Utica Road. After a year of expansion and renovations at the new cancer center, patients may now receive chemotherapy infusion services. More clinic space has been added to the facility, allowing three physicians to provide thoracic, head and neck, breast, sarcoma, and gynecologic cancer treatment in the community. The clinic also offers on-site lab draws and a compounding pharmacy will open soon at Karmanos’ 16th location.
“Our new Roseville facility is an extension of our plan to grow our ambulatory network. Karmanos now has 16 network sites in Michigan and northwest Ohio. Our strategic objective is to provide a broad array of best-in-class cancer services to our patients in the communities in which they live,” said Brian Gamble, president of Karmanos Cancer Hospital in Detroit and the Karmanos Cancer Network.
Renovations to the 6,000-square-foot facility consisted of the addition of eight infusion bays, which include a negative pressure room, and a new compounding pharmacy, allowing the pharmacy team to mix the medications needed for each patient receiving chemotherapy on the day of treatment. The facility housed six clinic rooms when it opened in December 2022, having formerly housed primary care services for the community.
Tarik Hadid, M.D., MPH, MS, FACP, hematologist and medical oncologist, member of the Head and Neck Oncology, Phase 1 Clinical Trials, and Thoracic Oncology Multidisciplinary Teams (MDTs), began practicing in Roseville when the facility opened. He is now joined by Jailan Elayoubi, M.D., and John Wallbillich, M.D. Dr. Elayoubi is a medical oncologist and member of the Breast Cancer, Phase 1 Clinical Trials, and Sarcoma Oncology MDTs. She specializes in breast cancer and sarcoma (soft tissue cancer). Dr. Wallbillich is a gynecologic oncologist and member of the Gynecologic Oncology MDT. He provides evidence-based treatment
for cervical, fallopian tube, gestational trophoblastic disease, ovarian cancer, uterine (endometrial cancer), vaginal, and vulvar cancers.
“Our mission is to provide our patients with their best chance and to treat them with dignity, respect and compassion. We accomplish this by providing access to our top-rated physicians and a staff dedicated to the mission and continually recognized for their high patient satisfaction scores. When patients walk in the door at Roseville, they can expect the same level of service as our patients in our other 15 locations across Michigan and northwest Ohio and our main campus facility in Detroit,” Gamble added.
To learn more and schedule an appointment at Karmanos Cancer Institute – Roseville, visit karmanos.org/roseville or call 1-800-KARMANOS
Karmanos Cancer Institute - Roseville now has eight infusion bays, like the one pictured here, allowing patients to receive chemotherapy and other infusion therapies in the clinic.
Tarik Hadid, M.D., MPH, MS, FACP
Jailan Elayoubi, M.D.
John Wallbillich, M.D.
THE DESIGNATION THAT MAKES A DIFFERENCE
Karmanos Cancer Institute is the only National Cancer Institute (NCI)-Designated Comprehensive Cancer Center in metro Detroit and one of just 57 centers of its kind in the United States. To receive this designation, a hospital must demonstrate expertise in laboratory, clinical and population-based research. Hospitals must also provide early-phase clinical trials and conduct community outreach and educational activities. This means patients can access treatments exclusive to Karmanos, cancer prevention programs, and multidisciplinary teams of cancer specialists — a comprehensive approach you cannot find at a community hospital.
LASTING BOND AND EXCEPTIONAL CARE
THROUGH GENETIC COUNSELING LEADS TO REKINDLED FRIENDSHIP DECADES LATER
Patient sends children to same genetic counselor over 20 years later
"...I am 100 percent confident that I would not even be here today, or in as good health as I am, had it not been for the information that I got from genetic counseling."
-Jennifer Traub
As Nancie Petrucelli, MS, LCGC, reviewed her upcoming patient schedule, she recognized an all-too-familiar last name. She checked the new patient’s chart and found that the patient’s mother was also her former patient more than two decades ago.
“There was even a letter in the chart that I’d written to the mother back in 1998,” said Petrucelli, the director and senior genetic counselor with Karmanos Cancer Institute’s Cancer Genetic Counseling Service.
That letter was to Jennifer Traub, who sought Petrucelli to provide genetic counseling to her now-adult daughter. A young wife and mom of two, Traub has a significant family history of breast and ovarian cancer, going back to her great-grandmother. Her physician referred her for genetic counseling. That’s where she met Petrucelli, who just started her career.
“My mom, her two sisters, my maternal grandmother, maternal great-grandmother, and one of my sisters all had breast or ovarian cancer,” Traub explained. “Except for my sister and one of my aunts, they all lost their lives to the disease.”
Traub’s genetic testing revealed that she is positive for the BRCA1 gene mutation, which increases her risk of developing cancer. BRCA1 stands for breast
cancer gene 1, which everyone has two copies of, just like the BRCA2 gene. When a person tests positive for a gene mutation in one of the BRCA genes, they tend to have a much higher risk of developing breast and ovarian cancer. Other cancers associated with the BRCA genes include melanoma, pancreatic, prostate, and male breast cancer.
Traub credits the guidance, information, and resources Petrucelli provided with helping her make the tough decision to undergo a complete hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) in 1999. In 2000, Traub had a prophylactic bilateral mastectomy. A prophylactic bilateral mastectomy can be a total mastectomy, where both breasts are removed, including the nipples, or a nipple-sparing mastectomy, where surgeons remove as much breast tissue as possible, leaving the nipples.
What is genetic counseling and testing?
Doctors refer patients for genetic counseling because of a personal or family history of cancer. Cancer development is connected to genes about 5%-10% of the time.
“People who have hereditary cancer are at a significantly higher risk to develop certain types of
cancer in their lifetime because of the genetic mutation they inherited,” Petrucelli said. “Patients are referred to a genetic counselor who evaluates the family history and determines if the cancer in the family could be genetic. We are looking for certain clues or red flags of hereditary cancer.”
Petrucelli adds that the genetic counselor discusses the patient’s family history with them to determine if testing is appropriate. If testing is indicated, the genetic counselor facilitates blood or saliva sample collection and sends the sample to a laboratory for genetic analysis.
“Cancer genes play a vital function in our bodies when working properly, to protect us from developing certain cancers. The testing is to ensure there is no mutation within the gene that would cause the gene not to work,” she concluded.
A profound experience comes full circle
“Given my risk of developing breast and ovarian cancer and the prevalence of both cancers in my family, I am 100% confident that I would not even be here today, or in as good health as I am, had it not been for the information that I got from genetic counseling,” Traub expressed.
After recovering from her surgeries, Traub returned to college, and in 2006, she earned her Bachelor of Science in Dietetics. She began a career as a registered dietician nutritionist (RDN), specializing in cancer prevention and reducing the risk of developing cancer through nutrition.
Even though they lost touch after Traub’s testing and surgeries, she and Petrucelli never forgot each other.
“I remembered her because when I had to tell her she was positive for the BRCA1 gene mutation, it was just very emotional. We were about the same age, and we connected. That session just stuck with me,” recalled Petrucelli.
Traub remembers Petrucelli “going above and beyond” in helping and supporting her as she decided to have her surgeries, one of the most challenging decisions of her life. When Traub’s adult daughter and son needed genetic counseling, she knew she wanted Petrucelli to handle their cases.
“I’m just grateful that I had the experience of getting tested and being able to do something about it. I’m grateful that I could use my experience in a career that helps others and even guide my daughter (who is also positive for BRCA1) through her research and making her decision,” Traub said.
Though genetic testing does not require a physician referral, some insurance companies may require that a provider refer you. Most insurance companies cover genetic testing. Should you proceed with a genetic test, the outside testing laboratory will investigate your insurance coverage and notify you of any out-of-pocket expenses.
Consider genetic counseling if you have:
• Several relatives with the same or related cancers (i.e., multiple relatives with breast cancer or colon and uterine cancers on the same side of the family);
• A personal or family history of a rare or unusual cancer, such as male breast cancer, ovarian cancer, or pancreatic cancer;
• A relative with more than one type of cancer;
• Or a personal or family history of cancer, or both, under the age of 50.
Karmanos offers genetic counseling and testing throughout the Karmanos Cancer Network within McLaren Health Care. To learn more about genetic counseling and testing, visit karmanos.org/genetics
The Genetic Information Nondiscrimination Act of 2008 is a federal law that protects people from discrimination based on genetic information when it comes to health insurance and employment. There are also state laws that do the same.
A genetic counselor can address any concerns regarding genetic discrimination during a genetic counseling appointment.
Nancie Petrucelli, MS, LCGC
A PRECISE BEAM OF HOPE: GAMMA KNIFE
PROCEDURE GIVES PATIENT NEW LEASE ON LIFE
Paul Poole never expected his life would change in the blink of an eye. At 69 years old, he was enjoying his life in Redford with his wife of 32 years, Carol, and playing rounds of golf on his local course. But in May 2022, that’s exactly what happened. It all started with a seizure.
Poole was driving home from his brother’s house when his wife noticed he was acting strange.
“I kept looking out of the sideview mirror as I was driving. I was shaking my head, jerking it, and my wife kept thinking something was wrong,” Poole explained.
He didn’t believe anything was wrong, so he kept driving. But when he got home and sat in his chair, it was apparent he was having a seizure.
“Next thing I know, my legs were going crazy, my arms were going crazy. My arm was beating on the wall, and I couldn’t stand on my leg. It felt like paralysis,” said Poole. “She [Carol] called 911, and they took me to the hospital.”
An MRI revealed that Poole had a large mass in the right frontal lobe of his brain. This news shook his and his wife’s life.
“I have a heart condition and COPD due to smoking for many years, but I have been able to manage those. Learning of the tumor on my brain was shocking,” Poole expressed. “There are just all these things I manage, plus the seizure and brain tumor; I just think sometimes, ‘I shouldn’t even be here right now.’”
Physicians eventually confirmed the tumor was cancerous and had likely metastasized from another primary site.
When he heard his diagnosis, “I quit smoking and drinking that very same day, and I haven’t touched any of it since. I was a heavy smoker and drinker for years – I was abusing myself.”
The first step in Poole’s treatment was surgery to resect the tumor on his brain on May 16, 2022.
“The tumor was located in an area where if they had to cut a hair more either way, Paul could have had altered speech, been paralyzed, or he could have lost his motor skills,” Carol explained.
Paul visted Karmanos Cancer Institute at Lawrence and Idell Weisberg Cancer Center in Farmington Hills, which houses the only Gamma Knife in the country that is not located in a hospital.
“After the resection, the tumor was looked at under a microscope. It was most consistent with metastatic poorly differentiated neuroendocrine tumor,” explained Michael Dominello, D.O., radiation oncologist at the Barbara Ann Karmanos Cancer Institute, to whom Poole’s surgeon referred him for further treatment options. “While these tumors often originate in the lung, due to Paul’s recent pneumonia, the PET scan was challenging to interpret. At that time, outside of the lungs, his PET did not show an obvious alternate primary site for the cancer.”
“Everything that has happened since my diagnosis is a miracle,” Poole added.
Dr. Dominello is the medical director of Gamma Knife Radiosurgery and the leader of the Neuro-Oncology Multidisciplinary Team (MDT) at Karmanos. He recommended Gamma Knife radiosurgery to the area where the tumor was removed on Poole’s brain to prevent reoccurrence of the disease.
Michael Dominello, D.O.
“Gamma Knife was the best option for delivering the radiation since this machine is specialized for targets in the brain and is more precise than linear accelerator-based techniques,” Dr. Dominello explained.
Gamma Knife radiosurgery in one dose
Gamma Knife treatment is a focused form of radiation therapy that precisely aims a high dose of radiation on a tumor or target inside the brain to eliminate cancer cells and spare healthy brain and body tissue. Preserving tissue helps maintain normal function that can impact a patient’s quality of life. Although “knife” is in the name, it is non-invasive, and there’s no cutting involved.
“Patients with cancerous or non-cancerous diagnoses related to the brain are possible candidates for this type of treatment. This can include brain metastasis, when cancer spreads to the brain, meningiomas or acoustic neuromas, which are non-cancerous tumors in the brain, or even non-tumor related problems, like trigeminal neuralgia,” explained Dr. Dominello.
There are many extra steps taken with Gamma Knife Radiosurgery compared to alternative high-dose radiation treatments for the brain.
“One of the most important steps includes a same-day, high-resolution MRI of the brain to get the most accurate images of the area to be treated and to evaluate for additional areas possibly requiring treatment. Secondly, we have a team comprised of a neurosurgeon, a radiation oncologist, a neuroradiologist, and a physicist present on the day of the procedure, which is unique and often can make the difference.”
Karmanos has offered Gamma Knife radiosurgery to patients for over two decades with promising results. Since the installation of the new Leksell Gamma Knife® Icon at the Lawrence and Idell Weisberg Cancer Center in Farmington Hills in 2019, Karmanos has treated over 500 patients with this precise stereotactic radiosurgery, averaging around 100 patients a year.
Poole gets treated
Poole’s Gamma Knife radiosurgery was completed on June 9. He felt anxious as he laid on the treatment table, but he was determined to face his fears. It also helped him and his wife to know the treatment would be delivered in a single dose. Gamma Knife treatment only requires a single fraction, using stereotactic radiosurgery, and is completed in one appointment.
“I feel blessed to have been cared for by such a wonderful group of doctors and nurses who were so
comforting,” explained Poole. “They treated not only myself but also my wife with such kindness because they knew how concerned we both were.”
Then… the lung and the thyroid
Poole’s brain metastasis was at first a case of unknown primary cancer, according to Dr. Dominello.
“The metastasis appeared in his brain without any evidence of the primary site where the cancer would have originated from within his body, likely because the changes in his lung from his recent pneumonia made the PET scan less sensitive.” Dr. Dominello explained. “Many months after his brain surgery and Gamma Knife, the changes from the pneumonia in his lung cleared. On his subsequent PET scan, we could see a nodule in the upper lobe of his right lung. Understanding that this may be where the cancer had originated and seeing no other disease throughout the body or in the lymph nodes of the chest, we offered a five-treatment course of SBRT (stereotactic body radiotherapy) to his right lung lesion. SBRT is a high-dose radiation for tumors in the lung or other locations within the body.
“Meanwhile, his repeat brain scans showed no signs of recurrence and are suggestive of a favorable response to treatment,” he added.
Dr. Dominello worked closely with Hirva Mamdani, M.D., a medical oncologist, lung cancer specialist, and leader of the Thoracic Oncology MDT, and George Yoo, M.D., FACS, otolaryngologist (ear, nose and throat specialist), surgical oncologist, and member of the Head and Neck Oncology MDT, who are also part of Poole’s cancer care team. With Poole’s brain tumor, the nodule in his right lung, and now another nodule found on Poole’s thyroid, all three physicians bring their expertise to these
Paul (right) and his wife Carol (leftt) in the newly renovated and expanded Weisberg Cancer Center.
specific tumor sites. They communicate and consult with each other for Poole’s personalized treatment plan, and with all of them practicing at the same location, they minimize the number of times Poole needs to visit for appointments.
“They’re [the doctors] just outstanding people, and they’re really caring,” Poole said as he reflected on the collaboration of his Karmanos physicians and what he’s been through. “I just have a different faith now, and these doctors have given me that.”
“Prayers got us through this, and God gave the doctors the gift to care for Paul,” said Carol, holding back tears. “I am so grateful that they’ve given him more time to live his life and do all the things in life he’s always wanted to do but didn’t at the time, like being able to take trips with me to visit our kids.”
Today, no signs of brain cancer
When Poole was first diagnosed, he made a life-changing decision that same day – to quit smoking and drinking. He has turned to a healthier lifestyle and enjoying time with his family.
“Since my diagnosis, the family gets together more often. I see my sisters and talk with my brother by phone more. They pray for me daily and have been a blessing.
“During Christmas, our kids got a cabin in Tennessee and paid for the entire vacation for us to stay and be with the grandkids and just enjoy each other. I even got to walk my daughter down the aisle when she got married in January. She brought a tear to my eye.”
All three doctors are monitoring Poole’s health, and he’s doing well. When it comes to his brain metastasis, he cannot say enough about the expertise of Dr. Dominello and Karmanos. He is also so grateful to his wife for her strength and unwavering love during a difficult time. His most recent MRI from January 2024 shows no signs of cancer.
“I would recommend this treatment to anyone who is a candidate for it,” added Poole. “Cancer is scary. It doesn’t affect you until it happens to you or a loved one, and where you get care is the most important part of the journey.”
If you or a loved one is diagnosed with cancer of the brain or upper spinal cord or has a non-cancerous tumor in those areas, they may be a candidate for Gamma Knife radiosurgery. Call 1-800-KARMANOS or visit karmanos.org to request an appointment with a Neuro-Oncology MDT specialist.
You may be eligible for the Lung Cancer Screening Program at Karmanos if you are a current or former smoker. Receiving annual lung cancer screenings can help reduce the risk of dying from lung cancer by monitoring the lungs to find the disease early.
Visit karmanos.org/lungcancerscreening to learn more about the program, or call us.
Paul (left) and Dr. Michael Dominello (right) in the newly renovated and expanded Weisberg Cancer Center.
Women ages 40+
Women should begin having annual mammograms at age 40 or earlier if you have a family history of cancer.
Are you a smoker?
If you are a current or former smoker age 50-80 with at least 20-pack/year smoking history, you should consider screening.
People ages 21-65
Certain risk factors increase the risk of getting cervical cancer like family history, smoking, medical history and long-term use of contraceptives.
People ages 45+
Begin screening at age 45 and continue every 10 years. Those at an increased risk should screen sooner and more often.
The Cancer Genetic Counseling Service helps determine cancer risk. This service is helpful to anyone who has anxiety and/or concern about their risk of cancer due to several relatives with the same or related cancers, a personal/family history of a rare or unusual cancer, a relative with more than one type of cancer or a personal/family history of cancer under the age of 50.
A participant at the Screening Saves Lives: Cancer Screening and Educational Event engages with the inflatable lung display.
PROVIDING MORE THAN CANCER SCREENINGS, MEETING
THE COMMUNITY’S NEEDS
Hundreds more attend Karmanos’ screening saves lives event than year before
Over 300 people received a cancer screening during the Screening Saves Lives: Cancer Screening and Educational Event on Saturday, Oct. 7, 2023.
The Barbara Ann Karmanos Cancer Institute in Detroit provided colon pre-screening consultations, head and neck examinations, mammograms, and lung and skin cancer screenings. This was the second time Karmanos offered these screenings during a Saturday event, and it was bigger than the first with the goal of providing multiple essential needs to the community at one time and in one place.
“We are amazed by how many people walked through our doors. On top of the 304 people who received cancer screenings, there were over 400 people who came just to get information, food, resources, and to participate in some of the mental health and self-care activities,” said April Brown, director of Concierge Services and Screening and Prevention at Karmanos.
The day was packed with activities. Karmanos provided education on cancer, screenings, genetic counseling, and treatment. Eastern Market gave away about 475 pounds of fruits and vegetables. Wayne State Mobile Health Unit provided wellness checks, while the Detroit Health Department’s iDecide Health Clinic offered flu shots. Jazz Pharmaceuticals blew up a MEGA lung for people to walk through and learn about specific lung health conditions. Nearly 130 people participated in a self-care activity, whether it was a massage from Irene’s Myomassology Institute or chair yoga with Sara Ruhland Yoga. Karmanos would also like to thank Shannon Renee, a five-year breast cancer survivor and co-host of 105.1 The Bounce’s The Morning Bounce, The Bounce Crew, the Michigan Breast and Cervical Cancer Control Program (BCCCP), Be the Match and Midigitel.
“It was a day to think about yourself – do what you need to do to take care of yourself physically and mentally, for free,” Brown continued. “We are so thankful for our partners who offered these services to our community and shared our mission of ensuring everyone’s health needs are met, from food to physical health checks and mental health.”
Though screening rates have improved since the pandemic, Karmanos encourages the community to schedule cancer screenings they may be putting off. Resources like the BCCCP are available to receive cancer screenings at no
additional cost. The BCCCP helps females receive free breast and cervical cancer screenings if they fit the following criteria: earn an income of 250% under the federal poverty level, are uninsured or underinsured, are age 21-39, and are referred to the program with an abnormal Pap test or clinical breast exam which requires a diagnostic service; or are age 40-64 and in need of a breast, cervical, diagnostic, or treatment service.
The next Screening Saves Lives event is Saturday, June 8. Learn more about cancer screenings at karmanos.org/screeningandprevention or call 1-800-KARMANOS.
Upcoming Karmanos Events
June 8
Pink Out the Park with the Detroit Tigers
Location: Comerica Park Visit tigers.com/tickets
Screening Saves Lives Event
Location: Farmington Hills Register at karmanos.org/screeningsaves
July 8
Prostate Cancer Awareness Night with the Detroit Tigers
Location: Comerica Park Visit tigers.com/tickets
The list above does not include all planned events. Please visit karmanos.org/karmanosevents for updates.
Looking for ways to cope with cancer? Karmanos offers general and specific cancer support groups (for patients, survivors, their family, friends and caregivers), art and music therapy sessions, yoga, tai chi, meditation sessions, and more! Visit karmanos.org to view the patient and support services available.
Karmanos is looking forward to upcoming events, including Pink Out the Park and the Prostate Cancer Awareness Night with the Detroit Tigers.
In October of 2022, Tammy Jugovich felt something suspicious during a breast self-exam: a lump about the size of the tip of her pinky finger. Within four months, that lump in her right breast was the length and width of her thumb.
MCLAREN PROTON THERAPY CENTER TREATS 1,000th PATIENT
Refusing to wait any longer may have saved breast cancer patient’s life
Jugovich didn’t hesitate. She immediately went to her gynecologist’s office.
“I demanded to have a mammogram and an ultrasound either that day or the next,” Jugovich said. “They got me in that afternoon.”
The next day, she went in for a biopsy that revealed she had invasive ductal breast cancer. It was a frightening diagnosis, but Jugovich was so glad she did not wait to have a mammogram.
“I really believe my days would have been shortened if I had not insisted on getting that appointment,” she said.
After surgery to remove what turned out to be four tumors, Jugovich had chemotherapy. Her care team recommended radiation for the next part of her treatment plan, so she went to see Christian Hyde, M.D., DABR, radiation oncologist at the Karmanos Cancer Institute at McLaren Greater Lansing.
Christian Hyde, M.D., DABR
“I appreciate that Dr. Hyde took the time to research my case and talk it over with his team. It made me feel safe about being under his care,” Jugovich said.
The cancer was in her right breast, but it was also possibly in lymph nodes located close to her heart. So, instead of traditional radiation, using X-rays, Dr. Hyde recommended proton therapy.
“We tried to see if an X-ray plan would be able to adequately spare the heart from radiation damage, but it turned out that X-rays would not have been safe,” Dr. Hyde explained. “Because we can control where the protons stop, we can better avoid damage to the heart and other vital organs than traditional X-rays, which travel more extensively in the body.”
With fewer associated risks, proton therapy is often recommended for women with left-sided breast cancer because of the proximity to the heart.
“We know that radiation exposure can lead to heart issues even many years after treatment, which is why we want to reduce it as much as reasonably achievable,” said Dr. Hyde.
Convinced Dr. Hyde’s recommendation was her best option, Jugovich became the McLaren Proton Therapy Center’s 1,000 th patient.
Jugovich lives in Lansing. With the McLaren Proton Therapy Center located in Flint, she was initially concerned about traveling to treatments for six weeks. Those worries were put to rest when she found out she could stay at the Hospitality House at McLaren, located next to the McLaren Proton Therapy Center. The Hospitality House provides low-to-no-cost accommodations for patients and their caregivers.
“I am so grateful and thankful for the Hospitality House. It is a beautiful place and takes 80% of the stress out of this experience,” said Jugovich.
The McLaren Proton Therapy Center is part of the Karmanos Cancer Network. To learn more about proton therapy, visit karmanos.org/KCIproton.
Tammy stands in one of the many relaxing areas for patients and their families to enjoy at the Hospitality House at McLaren in Flint.
SUPPORTING BREAKTHROUGH CANCER TREATMENT DISCOVERIES AT KARMANOS THROUGH YOUR IRA
The Barbara Ann Karmanos Cancer Institute thanks our supporters for keeping the very best cancer care available to patients in Michigan. Together, we make a big difference in the fight against cancer. Philanthropic support allows the Karmanos Cancer Institute to offer patients specialized expertise and access to leading therapeutic options, superior diagnostic technology and hundreds of clinical trials. To continue with our efforts, you may consider making a tax-wise gift to Karmanos. Making a gift through your individual retirement account (IRA) benefits both you and us.
The IRA charitable rollover, also known as the qualified charitable distribution (QCD), is a popular gift option. You can give any amount (up to a maximum of $105,000) annually from your IRA directly to a qualified charity such as Karmanos Cancer Institute without having to pay income taxes on the money. This option helps donors feel good knowing that they are making a difference at Karmanos.
Sample Request from Plan Owner to Administrator for Charitable Distribution from IRA
Dear Sir or Madam:
Why consider making a gift through your IRA?
• Your gift will be put to use today, allowing you to see the difference your donation is making.
• When you turn 73, you can use your gift to satisfy all or part of your required minimum distribution (RMD).
• You will not pay income taxes on your gift. The transfer generates neither taxable income nor a tax deduction, so you benefit even if you do not itemize your deductions.
• Since the gift doesn’t count as income, it can reduce your annual income level. This may help lower your Medicare premiums and decrease the amount of Social Security that is subject to tax.
Thank you for considering a tax-wise gift to the Barbara Ann Karmanos Cancer Institute. Karmanos does not render legal or tax advice, so please consult your tax advisor regarding any charitable giving.
Please accept this letter as my request to make a direct charitable distribution from my Individual Retirement Account number _____________.
Please issue a check in the amount of $____________ payable to Karmanos Cancer Institute at the address below:
Barbara Ann Karmanos Cancer Institute
4100 John R
Mailcode LA04DS
Detroit, MI 48201
Karmanos Cancer Institute’s Tax ID number is 38-1613280.
In your transmittal to the Karmanos Cancer Institute, please include my name and address as the donor of record in connection with this transfer. Please copy me on your transmittal.
It is my intention to have this transfer qualify for exclusion during the 2024 tax year. Therefore, it is imperative this distribution be postmarked no later than December 31, 2024.
For additional information about making a qualified charitable distribution, you may contact us through any of the methods listed below:
• Call (248) 226-2163
• Email giving@karmanos.org
• Visit karmanos.org/irarollover
Our mailing address is:
Karmanos Cancer Institute 4100 John R
Mailcode LA04DS Detroit, MI 48201
Tax ID: 38-1613280
THE RIGHT CARE AT THE RIGHT TIME
Choosing the proper care helps save time and money while conserving valuable resources. McLaren has the right care for you.
McLaren Medical Group Primary Care mclaren.org/welcomeback
McLaren Now
Virtual visits anytime, anywhere on your smartphone, tablet or computer with a webcam. mclaren.org/mclarennow
McLaren Now+Clinic
For minor illnesses, injuries and conditions at select Walgreens. mclaren.org/nowclinic
McLaren Walk-In Clinics
For more urgent conditions such as accidents, falls, minor burns, or injuries, moderate backaches and sprains, etc. mclaren.org/walkinclinics
McLaren Emergency Care
If your condition is emergent, call 9-1-1 or seek care at a dedicated McLaren Emergency Room. mclaren.org/ER
Karmanos Cancer Network
McLaren Health Care Headquarters
McLaren Medical Group
McLaren Proton Therapy Center
McLaren Physician Partners
McLaren Health Plan
MDwise
McLaren Now+Clinic at Walgreens
4100 John R St. Detroit, MI 48201
1-800-KARMANOS (1-800-527-6266) or visit karmanos.org
Karmanos Cancer Institute is a 501(3) tax-exempt organization. Visit karmanos.org/give for donation information.
WORLD-CLASS CANCER CARE CLOSE TO HOME
Our cancer doctors, whether they’re based in Detroit, Northern Ohio or any of our network locations, have met rigorous criteria to become certified as Karmanos providers. This assures patients and their families that they will receive the very best care from Karmanos treatment facilities located at:
Karmanos Cancer Center at Karmanos Cancer Institute
AXE 2. Karmanos Cancer Institute at McLaren Thumb Region
CITY 3. Karmanos Cancer Institute at McLaren Bay Region
4. Karmanos Cancer Institute at McLaren Clarkston
5. Karmanos Cancer Institute — Dearborn
HILLS 6. Karmanos Cancer Institute at Lawrence and Idell Weisberg Cancer Treatment Center
7. Karmanos Cancer Institute at McLaren Flint, McLaren Proton Therapy Center
8. Karmanos Cancer Institute at McLaren Northern Michigan
9. Karmanos Cancer Institute at McLaren Greater Lansing
10. Karmanos Cancer Institute at McLaren Lapeer Region
MAUMEE, OH
11. Karmanos Cancer Institute at The Toledo Clinic Cancer Center MOUNT CLEMENS
12. Karmanos Cancer Institute at McLaren Macomb, Ted B. Wahby Cancer Center MOUNT PLEASANT
13. Karmanos Cancer Institute at McLaren Central Michigan, Morey Cancer Center
14. Karmanos Cancer Institute at McLaren Northern Michigan PONTIAC
15. Karmanos Cancer Institute at McLaren Oakland PORT HURON
16. Karmanos Cancer Institute at McLaren Port Huron
17. Karmanos Cancer Institute — Roseville