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Cancer Awareness

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2018

Supporting Awareness for All Forms of Cancer

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Cancer Awareness

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October 28, 2018

Cancer Awareness is a special supplement to The Herald Republican, The News Sun, The Star, which are publications of KPC Media Group Inc. ©2018 All rights reserved

MEGAN KNOWLES

The Regional Cancer Center of Angola offers a linear accelerator, which can deliver very precise radiation to better target cancer cells.

Partnership benefits Steuben County cancer patients BY MEGAN KNOWLES

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RICK HENDERSON We miss you with all our heart and soul. Our love for you will never die.

BILLY HENDERSON 1945-2013 I know you are always with us now and always, goodbyes are only for those who love with their eyes because for those who love with their heart and soul there is no such thing as separation.

ANGOLA — For almost 20 years, a partnership between several medical entities has brought convenient cancer care to Steuben County. In 2000 Cameron Hospital, Radiation Oncology Associates and Parkview Health teamed up to create the Regional Cancer Center of Angola. “The vision was to be able to bring cancer services locally to Steuben County and southern Michigan,” Business Manager Nan Isenbarger said. Cameron had the available space, and Parkview and ROA purchased the equipment, she said. At one point, Fort Wayne Medical Oncology also came to the building, allowing the center to offer both radiology and chemotherapy services. “It made a nice cooperation between all the entities. We all work well together,” Isenbarger said, adding as an example that charts from the Cancer Center can easily be seen by Parkview doctors in Fort Wayne. In terms of service, the Cancer Center offers “probably 95 percent of the treatment” patients could find anywhere else, ROA co-founder Dr. John Crawford said. “We basically can do all of the modalities for radiation that the Fort Wayne offices (can do),” Isenbarger said. The Cancer Center offers all forms of radiation and the latest technology, including a linear radiation accelerator, Crawford said. “This technology delivers an external beam of radiation through the skin to the tumor. The high energy X-ray beams

produced by the accelerator kill cancer cells and shrink tumors,” according to the Cancer Center’s website. The technique is very precise and doesn’t hurt the skin as much as previous types of radiation, Crawford said. “It’s just the latest type of treatment for radiation: very high tech, very focused,” he said. In addition, the Cancer Center has a simulator that allows for better advanced planning of treatment so “specialists can deliver the appropriate dose of radiation, while sparing healthy tissue,” the center’s website states. “We spend a lot of time now that we didn’t before planning the treatment before the machine is every turned on,” Crawford said. When it’s time for the procedure, the center also utilizes image-guided radiation therapy to double-check that the machine is lined up correctly, allowing for a better cure rate and fewer complications, he said. Because chemotherapy can also be done in-house, patients can get both types of treatments, if needed, in the same place, rather than driving to different offices, Crawford said. Consultations and follow-up visits can all be performed at the Cancer Center, and there is always a doctor on call “for any emergency treatment or any questions or problems the patient might have at night,” Crawford said. “It’s really convenient for patients,” Isenbarger said, “it makes it so much easier to stay closer to home.”


October 28, 2018

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Cancer Awareness

Bile duct cancer, which is rare, has symptoms similar to other bile duct issues, like gallstones, and include jaundice; itching all over; light-colored or greasy stool; dark urine; pain, especially below the ribs on the right side; loss of appetite or weight loss; fever; nausea; and vomiting. Source: Harvard Health Publishing

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DeKalb Health offers state-of-the art imaging BY MEGAN KNOWLES

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AUBURN — From screenings and diagnosis to treatment, there’s not much in the way of cancer that DeKalb Health can’t do, members of the hospital’s team say. “(People) get the impression that there’s better equipment maybe (in a bigger city) and that’s just really not true,” Dr. Daniel Branam, a radiologist at Summit Radiology, said. “Anybody who needs diagnosis or their follow-up exam is probably going to get as good or better technology at DeKalb as anywhere in the state.” DeKalb Health finished its Imaging Center in 2011, which “was created to improve patient experience and outcomes and provide more privacy, comfort and state-of-the-art technology,” Terri Christensen, marketing director and public information officer for DeKalb Health, wrote in an email. Some of that technology includes wide-bore magnetic resonance imaging (MRI) scanners and 128-slice computed tomography (CT) scanners that also have artifact reduction, Branam said. Wide-bore MRIs combine stronger magnetic field strength with wider openings that are more comfortable for patients, he said. A 128-slice CT scan is “as good as it gets,” and artifact reduction provides a better picture when patients have metal hip replacements or fillings.

In addition, DeKalb Health offers the Women’s Diagnostic Suite, which offers a private waiting area and state-of-the-art technology in ultrasound, dual-energy X-ray absorptiometry and mammography, Christiensen wrote. DeKalb Health is also accredited by the American College of Radiation in CT, MRI, digital mammography, ultrasound and nuclear medicine, Christiensen wrote. “It is our goal to strengthen outcomes and provide the highest level of quality care. Being accredited displays we are certified as a credible and authentic entity, meeting and exceeding those benchmarks,” she wrote. “Patients have peace of mind knowing they are in good hands and DeKalb Health has proven itself as a legitimate establishment in their field and have performed well against a set of industry standards.” DeKalb Health also offers a set of screening questionnaires for those with higher risks for breast or lung cancer, DeKalb Health Director of Imaging Paula Amstutz said. “If you’re high risk you may have additional screenings” that can be done at DeKalb Health as well, Branam said. Imaging appointments are usually for 20-45 minutes, Amstutz said, though the actual imaging take a fraction of that. For diagnostic tests they try to have the results back quickly for patients as well, she said. From there, the hospital is equipped to do

DeKalb Health offers state-of-the-art 128-slice computed tomography (CT) scanners.

lab work, surgeries, infusions, nutrition and about anything except radiation, Christensen said. “There’s a tremendous amount of things we do as a hospital,” she said. Having such services available locally can save cancer patients from having to travel

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long distances for appointments, Christiensen said. “If you’re a cancer patient and you’re going to have a lot of labs and follow-ups, you’re going to be well treated here…you’ll have that personal attention here at DeKalb Health,” she said.

Noble, LaGrange hospitals benefit from connectivity BY MEGAN KNOWLES

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FORT WAYNE — Patients in Noble and LaGrange counties have the benefit of local convenience and regional expertise when it comes to cancer care, Parkview Cancer Institute President Dr. Neil Sharma said. “Parkview has made substantial capital investment to serve those communities and try to provide as much care locally as possible for the communities and their population,” he said. One of Parkview’s focuses is on offering services based on the needs of a local population, Sharma said. For example, Parkview LaGrange Hospital has two benign and malignant hematologists on staff, and is looking to add another, due to “an elevated number of benign blood disorders” in that community, Sharma said. Parkview Noble Hospital also has a general surgeon that works closely with

two Cancer Institute doctors to address breast cancer. Other local investments allow most of the “day-to-day care” of cancer treatment — lab work, imaging and diagnostics — to be performed at the LaGrange or Noble hospitals, Sharma said. Then, if complex surgical procedures, radiation or medical trials requiring both chemotherapy and minimally invasive surgical procedures are required, patients can get those done at Parkview Regional, with all of their records being shared from their local hospital. “We have complete access to all those records, those records don’t need to be moved back and forth so when the patient comes here it’s essentially a seamless process,” Sharma said. In addition to treating cancer, Sharma said there is an increased focus on preventing cancer, catching it early and helping patients and their family after remission, or what he calls “complete

cancer care.” “There’s a holistic approach we can take toward patients and their families that allows them to have better outcomes and go through the cancer care journey with a more positive experience and that includes emotional support, psychosocial support, financial support, transportation support but also surveillance for future recurrence of cancer and/or the prevention of other cancers through genetic counseling and specifically tailored surveillance survivorship programs,” he said. Many of these screening tests can be performed in LaGrange and Noble counties, he said, including pap smears, mammograms and colonoscopies. Parkview is also working with a breast cancer tumor site team that includes medical oncologists, radiation oncologists, radiologists, breast surgeons and geneticists to develop a program for women who are at a higher risk of developing breast cancer in order

to identify those risks earlier, develop new imaging techniques and give those patients access to high-quality screenings, Sharma said. “By having a unified health care network we’re able to implement these things at our satellite hospitals and not just do it only in Allen County,” he said. In fact, the Parkview Cancer Institute is striving to not only provide its expertise to northeast Indiana, but to the entire Midwest region, Sharma said. “The Parkview Cancer Institute is quickly evolving into a regional tertiary specialty hospital and is committed to providing a level of expertise not seen in the region previously, and that’s going to truly impact patients who are living in LaGrange and Noble and even into southern Michigan (and western Ohio),” he said. “We know we can partner with those communities to give them better access to greater expertise and cuttingedge cancer care.”


October 28, 2018

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Cancer Awareness

Avoiding tobacco and alcohol is one of the best ways of limiting your risk of esophageal cancer. Source: the American Cancer Society

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October 28, 2018

Screening for prostate cancer begins with a blood test called a prostate specific antigen (PSA) test. Because many factors can affect PSA levels, a doctor is the best person to interpret your PSA test results. Source: Centers for Disease Control and Prevention

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Cancer Awareness

Common leukemia symptoms include fever or chills, persistent fatigue, weakness, frequent or severe infections, losing weight without trying, swollen lymph nodes, enlarged liver or spleen, easy bleeding or bruising, recurrent nosebleeds, tiny red spots in the skin, excessive sweating (especially at night), and bone pain or tenderness. Source: the Mayo Clinic

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As of 2015, the cancer death rate for men and women combined had fallen 26 percent from its peak in 1991. This decline translates to nearly 2.4 million deaths averted during this time period. Source: American Cancer Society

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Cancer Awareness

To help prevent against skin cancer (melanoma), seek the shade, especially between 10 a.m. and 4 p.m.; don’t get sunburned; avoid tanning; never use UV tanning beds; use a broad spectrum (UVA/UVB) sunscreen and apply it properly; and examine skin once a month head to toe to look for changes. Source: Skin Cancer Foundation

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Factors that may increase a man’s risk of testicular cancer include an undescended testicle, abnormal testicle development, family history, age (particularly those between ages 15 and 35) and race (testicular cancer is more common in white men than in black men). Source: the Mayo Clinic

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October 28, 2018

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Cancer Awareness

When colorectal cancer is found at an early stage before it has spread, the five-year relative survival rate is about 90 percent. However, about 1 in 3 people in the U.S. who should get tested for colorectal cancer have never been screened. Source: the American Cancer Society

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Risk factors for pancreatic cancer include age (55 or older), gender (male), obesity, diabetes, chronic pancreatitis, cirrhosis of the liver, Helicobacter pylori (H. pylori) infection, smoking and certain genetic factors or syndromes. Source: Cancer Treatment Centers of America

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Cancer Awareness

Cirrhosis is scarring of the liver, and increases the risk of liver cancer. You can reduce your risk of cirrhosis if you drink alcohol in moderation, if at all; maintain a healthy weight; use caution with chemicals; get vaccinated against hepatitis C; and take measures to prevent hepatitis C. Source: the Mayo Clinic

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October 28, 2018

Women older than 50 should get a mammography every two years. Those ages 40-49 should discuss their breast cancer risks with their doctors to determine when and how often they should get mammograms. Source: the Office of Disease Prevention and Health Promotion

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October 28, 2018

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Cancer Awareness

There are six skin phototypes, going from light to dark. Individuals with skin types I and II face the highest risk of developing skin cancer, while types V and VI are at the lowest risk. That is because those with more pigmentation have more natural protection from the sun. However, people with darker skin can still get skin cancer. Source: Skin Cancer Foundation

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October 28, 2018

Thanks to better therapies, more than 80 percent of U.S. childhood cancer patients now become long-term survivors. Source: St. Jude Children’s Hospital

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October 28, 2018

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Cancer Awareness

Scientists believe that some risk factors, such as the use of tobacco or alcohol, may cause esophageal cancer by damaging the DNA in cells that line the inside of the esophagus. Long-term irritation of the lining of the esophagus, as happens with reflux and other conditions, may also lead to DNA damage. Source: the American Cancer Society

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October 28, 2018

The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) scans are being used more often. These tests may lead to the accidental discovery of more kidney cancers. Source: the Mayo Clinic

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Cancer Awareness

Signs and symptoms of stomach cancer may include fatigue; feeling bloated after eating; feeling full after eating small amounts of food; severe, persistent heartburn; severe indigestion that is always present; unexplained, persistent nausea; stomach pain; persistent vomiting; and unintentional weight loss. Source: the Mayo Clinic

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October 28, 2018

We support the owners of our beloved pets in their fight and victory over their cancer battle and want to bring awareness to the fact that pets also suffer from cancer. Early Warning Signs of Cancer*: • Abnormal swelling • A sore that does not heal • Weight loss • Loss of appetite • Bleeding or discharge from any opening on the body

• Unpleasant or unusual odor • Difficulty eating or swallowing • Loss of energy • Ongoing lameness or stiffness • Difficulty breathing, urinating or defecating

(*From National Canine Cancer Association)

Common Types of Cancer

Below is some information on clinical signs, tumor behavior, breed predisposition, and treatment options for the most common cancers seen in dogs. 1. Lymphoma or Lymphosarcoma Lymphoma is among the most common type of tumor seen in dogs, representing 20 percent of all canine cancers. Currently, dogs are 2-5 times more likely than people to develop lymphoma. Signs of lymphoma vary depending on the location of the disease: Peripheral Lymphoma or Lymphosarcoma The most common sign is enlargement of the peripheral (outside the body cavity) lymph nodes – particularly the nodes under the jaw, in front of the shoulders, and behind the knees. Internal Lymphoma or Lymphosarcoma Another form of lymphoma affects the internal lymph nodes or tissues that are made of similar lymphoid material such as the liver or spleen. Signs of internal lymphoma are often severe, consisting of vomiting, diarrhea, abdominal pain, or difficulty breathing. 2. Hemangiosarcoma Hemangiosarcoma is a tumor that develops from cells that line blood vessels (endothelial cells). This tumor most commonly affects middle-aged or older dogs of any breed. There is an increased frequency in golden retrievers and German shepherds. Hemangiosarcoma is described as indolent in onset, meaning it develops slowly over time and is not painful to the dog. Signs usually do not show up until late in the disease, when the dog suffers from internal bleeding due to the tumor rupturing.

3. Osteosarcoma Osteosarcoma is the most common type of primary bone tumor in the dog. It most frequently affects the long bones (front and rear limbs) of the dog, but it can be found in any bone including the skull or ribs. This tumor is usually associated with the giant dog breeds, with Great Danes being 200 times more likely than toy breeds to be affected. Most dogs are between 7 and 10 years of age at the time of diagnosis. 4. Mast Cell Tumor Mast cells are immune cells found throughout the body that play an important role in allergic reactions. Most mast cell tumors are found on the skin and may be detected by a sudden swelling or growth. The mast cells contain small granules that make them fairly easily to diagnose with a simple needle aspirate in your veterinary office. Boxers and bulldogs are more frequently diagnosed with mast cell tumors compared to other breeds. 5. Melanoma Melanoma or malignant melanoma is a tumor made of pigmented or dark skin cells that can be found anywhere on the dog’s body. Any dog can be affected, but dogs with dark skin or hair coats, such as the Scottish Terrier or Doberman Pinscher, are more frequently diagnosed. Melanomas behave differently depending on which part of the body they are affecting. 6. Squamous Cell Carcinoma Squamous cell carcinomas can develop on the skin and inside the mouths of dogs. Location of squamous cell carcinomas is strongly associated with survival times in the dog. Growths on the skin are often found early by owners and respond very well to surgery alone. Tumors within the mouth that affect structures like the tonsils or tongue are very

difficult to remove and can grow quite large prior to being detected. . 7. Mammary Carcinoma Tumors of the mammary glands are the most common tumor seen in unspayed female dogs. They can affect any of the mammary gland and may behave locally and respond well to surgery or more aggressively with ulceration or open wounds of the mammary gland and rapid tumor growth. 8. Apocrine Gland Carcinoma (Anal Sac Cancer) Apocrine gland carcinomas are also known as carcinomas of the anal sac in the dog. Approximately 50% of these tumors are diagnosed by your veterinarian during a routine rectal exam and show no apparent clinical signs. They can also be diagnosed if your dog exhibits increase in blood levels of calcium because the tumor secretes a hormone-like substance that causes hypercalcemia (elevated calcium). 9. Transitional Cell Carcinoma Transitional cell carcinoma is the most common tumor of the lower urinary system (bladder and urethra) in the dog. This tumor is considered locally invasive and is moderately to highly likely to metastasize to another area. Surgical options are dependent on the location, and often, these tumors cannot be completely removed. 10. Soft Tissue Sarcoma Soft tissue sarcomas are a group of several different types of tumors that share similar characteristics. These tumors are made of connective tissue and are located either within the skin or in tissues just below the skin. Owners often find these tumors when casually petting or grooming their dogs. Tumors that are included in this group are fibrosarcomas, hemangiopericytomas, liposarcomas, leiomyosarcomas, and nerve sheath tumors.

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