Pink Ribbon Facility Along with our radiologist, Dr. Kristy, we take pride in providing full-ďŹ eld digital mammograms for all breast tissue types. Our range of services include screening and diagnostic mammograms, breast ultrasounds, and breast biopsies. To schedule your mammogram call West River Health Services Radiology in Hettinger at 701-567-6060.
We’re right where you need us.
To the advertisers who helped us bring this publication to life,
Darcy, Shirl, Berna, Jolene & Charlotte,
we cannot take credit for this magazine, as you 5 make “Paint it Pink” what it is! Your willingness to share your stories is much appreciated! Without you, this would not have been possible! From the bottom of our hearts,
Thank you!
To the thousands who suffer from breast cancer every year; in your journeys,
Thank you!
we wish you the besT!
chris slone, Publisher
• TABLE
|
Kristi Heinrich, Graphic Designer
OF CONTENTS •
darcy mcgee . . . . . . . . . . . . . . . . . . . . 1-3
Ask a Pro .
Types & Stages .
Johnson Celebrates 14 Years of being Cancer Free
MRI of Hip Leads to Cancer Diagnosis
. . . . . . . . . . . . . . . . . . . . . . 4, 7
shirl hofland . . . . . . . . . . . . . . . . . 5, 6 Hofland Beats Breast Cancer
bernadette hendrickson. . . . . . . . 8-10 In God’s Hands
Perform routine self breast exam .
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jolene hendrickx. . . . . . . . . . . . . 12-14 Cancer Free for Four Years
. . . . . . . . . . . . . . . . . . . . . . . . . .
charlotte miller johnson . . . . . . . 19 Male Breast Cancer
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Answers to your frequently asked questions. Can I lower my risk? .
. . . . . . . . . . . . .
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What is the American Cancer Society doing about Breast Cancer . . . . . . . .
. . . . . .
Early detection is the best prevention! Our advanced technology allows us to provide quick, comfortable exams with fast results. DON’T WAIT, call us today at 701-523-5555 and schedule your mammogram now!
SOUTHWEST HEALTHCARE SERVICES Complete Healthcare Today, For a Better Tomorrow
24
25-28
for your mammogram?
AW ARENESS
20
21-23
Is It time ST CANC EA ER R B
17
DA R CY'S ST O RY 1
MRI of hip leads to breast-cancer diagnosis Chris Slone
reporternd@countrymedia.net T@cslone
It was a simple MRI for her hip. She needed one more for insurance purposes before having the necessary surgery. She was at the clinic in Hettinger, North Dakota, getting the scan. Afterward, the technician offered to perform a mammogram since the lady was overdue and since she had the time, so she agreed. The lady religiously scheduled her mammograms on time. However, with her lingering hip issues, she decided to put it off until she recovered from the hip surgery. After the mammogram, the technician came back into the room and wanted to redo the test. There was a spot that didn’t sit well with the medical staff. After the second test, the radiologist came in and the lady began feeling anxious as the radiologist had never entered the room prior to that day. There was a spot that concerned the radiologist. He suggested an immediate biopsy and 20 minutes later, the test was underway. However, the results wouldn’t be available for four days. The radiologist warned the lady. He was highly suspicious the prognosis would be cancer. After a long weekend, the call came in and the diagnoses followed. Darcy McGee had breast cancer. McGee’s daughter Bailey McGee, who works as a registered nurse in Hettinger, had Monday’s off and was there along with
her dad, Doug McGee, to receive the news. Darcy, who works at Dakota Western Bank in Bowman, North Dakota, went home on her lunch break to return the doctor’s call. “He gave me the final, ‘Yes, this is cancer and here’s what we’re going to do,’” Darcy said. The doctor was very optimistic about her options. He told McGee to stay positive. It was a treatable type of cancer and he told her she was going to be fine. “At the time, you’re in shock too. It just hits you,” McGee said. “I was gearing up this whole time to have this hip surgery done and then to have this thrown in a week before the hip surgery was scheduled.” McGee said the key is to stay positive and have a solid support system during these trying times. When she was told she had a spot and a biopsy was ordered, McGee was in total disbelief. She was alone. She thought, “this cannot be happening.” She went out to her car and cried. “I called my husband and said this is what they’re thinking,” McGee recalled. “He of course is always optimistic and said, ‘You don’t know that yet. Don’t jump to conclusions. You don’t know that yet.’” McGee also received a great deal of support at work as well. “I can’t even explain how good people are in the community,” McGee said. “My mailbox was full of cards every single day from people, which you don’t understand until you go through it, how much that means. “And I was always terrible
The ultimate fans of the game, honored by Gate City Bank and the NDSU Bison! L to R: Kruze Robinson and Bailey, Darcy, Doug and Kyle McGee
about saying, ‘I should get a card sent and not get it done.’ Now you know how much that truly means. When you’re doing it, you think it’s not that big a deal. But it helps you through a lot of rough days, that’s for sure.” McGee was diagnosed in April 2017. “Everything was just a whirlwind from that moment on,” McGee said. “We were at the doctors in Bismarck several times a week for tests.” Once they arrived to their first doctor’s appointment, Doug and Bailey accompanied Darcy. “I would recommend that to anyone that they have family with them,” Darcy said. “You, yourself can’t hear everything they’re saying.” The initial visit with the surgeon lasted an hour and a half. “They just throw so many things at you,” Darcy said. “They also give you different options. The decision of are you going to have a lumpectomy or are you going to have a mastectomy? They give you all the pros on each side and all the cons on each side. And then send you home and let you think about it. Bailey recorded the visit, so
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from page 1 they trio could go home and listen to it again at their own pace. “They’re just giving you so much information, you just need to go home and digest it all,” Darcy said. The original plan for McGee was to have surgery to remove the tumor, then chemotherapy and then complete the therapy with radiation. However, once she arrived in Bismarck, an MRI revealed the tumor was laying on her pectoral muscle. “We don’t want to try to remove it for fear we’re going to cut that muscle, which would basically take the use of my right arm,” McGee said. The plan to cure McGee was altered. She began chemotherapy immediately in hopes the tumor would shrink and pull away from the muscle. After that treatment, surgery would be next in line before contemplating radiation. McGee completed four rounds of chemotherapy, known as the “Red Devil.” She began her chemotherapy rounds May 19, 2017. “The color of the chemo coming into your IV is red and it is indescrib-
able of how awful it makes you feel,” McGee said. “You do one every two weeks because it took two weeks for your body to recover.” Afterward, she completed 12 weeks of chemotherapy using another drug, which wasn’t near as bad as far as nausea was concerned, according to McGee. “You could recover a lot quicker,” McGee said. “My whole issue those first eight weeks was dehydration.” McGee would have her chemotherapy session Thursday and by Monday, she would be in the clinic receiving IVs for dehydration. “It was like night and day,” McGee said. “Once I got those IVs, I knew how much better I’d feel.” Once she completed chemotherapy on Sept. 28, 2017, McGee’s body had to recover for six weeks before she was able to have surgery. Within those six weeks, she received another MRI. The tumor had shrunk far enough away from the muscle for surgery to become a viable option. However, during her six-week recovery period, McGee experienced a once in a lifetime moment. There was a contest through the
North Dakota State University Facebook page. They were looking for fans of the game to be celebrated at each Bison home game. McGee and her family are Bison fans, so Bailey entered an essay as part of the contest. Bailey wrote about Darcy and how she would be finishing chemotherapy. She talked about their
color
The of the chemo coming into your IV is and it is indescribable of how awful it makes you feel.
red
Darcy McGee
describing the Red Devil lack of a summer because Darcy had been ill from the treatments. Bailey’s essay was picked as a winner. Darcy finished her chemotherapy session Sept. 28 and the family traveled to Fargo for the Bison home game Sept. 30. “It was an amazing experience.
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They treated us amazing,” Darcy said. “They put us up in a very nice hotel for from page 2 two nights.” They received a tour of the locker rooms, the coaches’ rooms and the film room. The family had brunch in a private room before the game. Before the game, the McGee family walked through the tunnel and out onto the field. They were honored before the contest and Bailey’s essay was read as they were shown on the big screen. “It was quite an experience,” Darcy said. “It was a wonderful way to celebrate being done with chemo.” They finally made their way to their Gate City Suite — the sponsor of the contest. Once Darcy recovered from her chemotherapy treatments, it was time for surgery. “I chose to do a lumpectomy because it was just in my right breast,” McGee said. “They did a lumpectomy in November.” McGee had surgery Nov. 13, 2017. Once again, she needed ample time to let her body heal before proceeding to the next stage. Six weeks later, Dec. 11, McGee began radiation treatments, which occurred every day for five days a week. She lived in Bismarck for the duration. The cancer center in Bismarck owns full furnished houses, most of which were within walking distance to the facility. “For me that was a life saver,” McGee said. “It being wintertime and me being up their alone, I decided I needed to be able to walk to the cancer center if I was snowed in or couldn’t get my vehicle out.” Her rent was $15 a night. “That was a huge savings,” McGee said. “We couldn’t begin to rent an apartment. Many of the apartments won’t rent for two months.” Since her stay with the Bismarck Cancer Center, McGee has been a proponent of making donations to their foundation whenever she has an opportunity. “You just can’t imagine the people it helps,” McGee said. “The waiting room is constantly full, no matter what time you go. The same with the chemo room. It was rare to see all the chairs not taken, which is very sad that there’s that much cancer around. “And their foundation is amazing with the stuff they do.” After five long weeks of making Bismarck her home and undergoing radiation treatments, Jan. 17, finally arrived. McGee was declared cancer free. McGee still hasn’t had her hip surgery, which began this entire process. “I think I’ll leave with my hip pain for a while yet,” McGee said.
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Darcy and her brother Robb Narum on the morning of her last radiation treatment! Right before she rang the bell to signal she was finished with her treatments!
types and stages American Cancer Society What are the types of breast cancer?
In Situ There are two main types of in situ breast cancer: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS), also known as lobular neoplasia. Other in situ breast cancers have characteristics of both ductal and lobular carcinomas or have unknown origins. Ductal carcinoma in situ
DCIS (83% of in situ cases diagnosed during 2010-2014) refers to a condition in which abnormal cells replace the normal epithelial cells that line the breast ducts and may greatly expand the ducts and lobules. DCIS may or may not progress to invasive cancer; in fact, sometimes DCIS grows so slowly that even without treatment it would not affect
a woman’s health. Long-term studies of women whose DCIS was untreated because it was originally misclassified as benign found that 20%-53% were diagnosed with an invasive breast cancer over the course of 10 or more years.3-7
Lobular carcinoma in situ
LCIS (13% of in situ cases) refers to abnormal cells growing within and expanding some of the lobules of the breast. LCIS is generally not thought to be a precursor of invasive cancer, but is a strong risk factor for developing invasive cancer.
Invasive Most (80%) breast cancers are invasive, or infiltrating, which means they have broken through the walls of the glands or ducts where they originated and grown into surrounding breast tissue. Although breast cancer generally has been referred to as a single disease, there are up to 21 distinct histological
subtypes and at least four different molecular subtypes that differ in terms of risk factors, presentation, response to treatment, and outcomes.8-10 Gene expression profiling techniques have allowed better understanding of the molecular subtypes of breast cancers; however, this is a costly and complicated process and is not currently standard practice. Approximations of molecular subtypes have been identified using routinely evaluated biological markers, including the presence or absence of hormone (estrogen or progesterone) receptors (HR+/HR-) and excess levels of human epidermal growth factor receptor 2 (HER2, a growth-promoting protein) and/or extra copies of the HER2 gene (HER2+/HER2-).11 The four main molecular subtypes and their distribution are described here.
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SH IR L'S ST O RY
HOFLAND
BEATS BREAST CANCER Bacterial Meningitis
Chris Slone
reporternd@countrymedia.net T@cslone
so high because I was diagnosed with cancer and I was all stressed out. All I did was bawl and finally one day, I just started to pray. Then all of the sudden, I was at peace. I knew it was a battle. God doesn’t give you any more than you can handle. I can get through this. This is where I’m at and it worked. I started to calm down and took one day at a time.” Hofland had 2A triple negative breast cancer. “They diagnosed me and found the tumor,” Hofland said. “They actually went in and cut it out.” Hofland had a lumpectomy. “They say triple negative is a rare cancer, but there is more and more of it now,” Hofland said. “There is no cure for it. They use the chemo for it because the negative is responding to it for now. My stuff can come back anywhere, it can come back in my liver, my bone, my brain, my heart, my lungs — anywhere.” The first part of !
Shirl Hofland had her routine mammogram in June 2015. There was a lump, but it didn’t show up on the scan. It grew bigger in the subsequent months from July until November when the lump was rock hard. She ignored the lump, but in November, her family told her if she didn’t get it checked out, they were going to drag her into the doctor’s office. Early in November, her classmate Paul Mosbrucker died. One week after his funeral, Hofland was diagnosed with breast cancer. “I cried. I thought I was dying. I had kids in school. One was a junior. One was a freshman in high school. I thought I was going to die. I thought, where are the kids going to go when I’m dead,” Hofland said. Why me? Why does this have to I thought, where are the kids going happen to go when I’m dead. to me? What did I do to deserve this?” January, she had a port Hofland said she would have installed in her side, right dreams of people carrying her above her left breast. Jan. coffin. She kept wondering 17, 2017, she started chehow all of this foreign toxin had motherapy. entered her body? She had to have four “What could I have done rounds of chemotherapy different so I wouldn’t have gotwith a drug called, “The ten it? I cried a lot. I remember Red Devil.” thinking this was my last Christ“The first cycle I started mas. This is the last Thanksgiv- losing my hair, so I cut it ing I am ever going to have and short,” Hofland said. “The I tried to make it special,” Hosecond cycle they did, it fland said. “But the tension was started to fall out in hands
I thought I was going to die
full. It felt like a bunch of needles in the back of my head. It was like I had laid down on a set of nails. Then, they did two more cycles and I was bald.” Hofland was also exhausted from the treatment has her immune system was weakened. Hofland was also getting a shot that was attacking her bone marrow to speed up her white cells. After those four rounds of chemotherapy, she received two weeks off before starting a 12-week stretch of a drug called Taxol, which is another form of chemotherapy. “Every week, I would go in and they would do blood work the day before,” Hofland said. “If my platelets were up, then they would hit me with the Taxol.” Throughout those 12 weeks, with her immune system shot, Hofland never
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SHIRL HOFLAND
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one year after chemotherapy
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last day
of chemotherapy June 22, 2016
left her house. “I was stuck at home looking at four walls,” Hofland said. After she completed her Taxol treatments, Hofland went straight into 20 treatments of radiation — with only a threeday break to rest up. Although she’s cancer free, Hofland said she still has side
effects from the chemotherapy. She now has severe allergies. She doesn’t have much energy. “I have to push myself every day to do stuff,” Hofland said. “I’m good for about two hours and then I’m done. I gained about 30 pounds from the chemo that I’ve been trying to get off. Because the chemo goes inside your body and it’s a poison, it messes with everything. It messes with your thyroid and your metabolism. You can’t lose the weight like you normally would because I use to be really skinny.” In 2016, Hofland ended up with bacterial meningitis. “That one just about killed me,” Hofland said. It occurred Sept. 25. She had an ear infection for approximately five weeks that she had ignored. She was at a friend’s house and her eared had popped, and she got instantly sick. “My stomach was upset, I had a bad headache, my ear was killing me, my neck was sore,” Hofland said. After a visit to the doctor, she received some antibiotics, went
home and laid in a recliner. “I figured once I woke up, I would take my medicine but I never woke up,” Hofland said. She woke up five days later on a respirator. The doctors told her family that she wasn’t going to make it. The assumption was she had bacterial meningitis for over 14 days and the doctors weren’t aware of anyone pulling through in the Sanford Hospital, according to Hofland. “They were telling the family that I wasn’t going to make it that I was going to die,” Hofland said. She ended up pulling through, leaving the hospital and finishing her treatments at home as she recovered from the bacterial meningitis. The doctors didn’t think she’d be able to even swallow, yet she’s walking, talking and functioning normal. “It really is a miracle,” Hofland said. Hofland said having the breast cancer knocked her flat on her back and then have bacterial meningitis a year later, doctors have told her it would take three to four years for her to fully feel normal again and she may never get to that point energy wise.
325 Brown Ave • Mott, ND
701.824.2593 www.cbmott.com
111 S Main St Hettinger, ND
701.567.4331 Hours Monday . . . . . . . 10AM–4PM Tuesday . . . . . . . 10AM–4PM Wednesday . . . . 10AM–4PM Thursday . . . . . . 10AM–4PM Friday . . . . . . . . 10AM–4PM Saturday . . . . . . . . . . . Closed Sunday. . . . . . . . . . . . . Closed
6
types and stages continued ... Luminal A (HR+/HER2-) (71%).
These cancers tend to be slow-growing and less aggressive than other subtypes. Luminal A tumors are associated with the most favorable prognosis, particularly in the short term, in part because they are more responsive to anti-hormone therapy (see page 27).12, 13
Triple negative (HR-/HER2-)
(12%). So called because they are estrogen receptor (ER)-, progesterone receptor (PR)-, and HER2-, these cancers are twice as common in black women as white women in the US, and are also more common in premenopausal women and those with a BRCA1 gene mutation.14 The majority (about 75%) of triple negative breast cancers fall in to the basal-like subtype defined by gene expression profiling. Triple negative breast cancers have a poorer short-term prognosis than other subtypes, in part because there are currently no targeted therapies for these tumors.15
Luminal B
(HR+/HER2+) (12%).
Like luminal A cancers, luminal B cancers are ER+ and/or PR+ and are further defined by being highly positive for Ki67 (indicator of a large proportion of actively dividing cells) or HER2. Luminal B breast cancers tend to be higher grade and are associated with poorer survival than luminal A cancers.13
HER2-enriched (HR-/HER2+) (5%). HER2-enriched cancers tend to grow and spread more aggressively than other subtypes and are associated with poorer short-term prognosis compared to HR+ breast cancers.13 However, the recent widespread use of targeted therapies for HER2+ cancers has improved outcomes for these patients. how is breast cancer staged?
The prognosis of invasive breast cancer is strongly influenced by the
stage of the disease – that is, the extent or spread of the cancer when it is first diagnosed. There are two main staging systems for cancer. The TNM classification of tumors uses information on tumor size and how far it has spread within the breast and to adjacent tissues (T), the extent of spread to the nearby lymph nodes (N), and the presence or absence of distant metastases (spread to distant organs) (M).1 Once the T, N, and M are determined, a stage of 0, I, II, III, or IV is assigned, with stage 0 being in situ (abnormal cells have not penetrated the ducts or glands from which they originated), stage I being early-stage invasive cancer, and stage IV being the most advanced disease. The TNM staging system is commonly used in clinical settings. The latest revision (8th edition) to the TNM stage for breast cancer also incorporates biologic factors in order to further refine the breast cancer staging system and will be implemented by oncology programs in 2018.
207 Highway 12 W • Bowman, ND
701-523-4737
New England, ND 58647
7
Hendrickson beats breast cancer with
• faith
Chris Slone
reporternd@countrymedia.net T@cslone
Bernadette “Berna” Hendrickson had a scheduled mammogram and a routine six-month checkup at West River health care Center in Hettinger. However, there was nothing ordinary about either. That’s where Hendrickson’s cancer journey began — sitting alone in an exam room Dec. 5, 2014. The doctor sat down in front of Hendrickson and broke the news to her. “The mammogram showed a cluster of calcium and one spot was cancer,” Hendrickson said. The doctor proceeded to hand Hendrickson a tissue box. She took a tissue but never used it. Hendrickson explained to the doctor that she was fine and if it was God’s will, then everything was OK. The doctor recommended a biopsy, which Hendrickson wanted as soon as possible.
and family •
“The sooner the better because I have a garden to plant come spring,” Hendrickson recalled. Hendrickson left the exam room and called her husband, Jon Hendrickson. After breaking the news to her husband, she left the hospital and met other members of her family for lunch. One of Hendrickson’s daughters, Kari, asked how the appointment had went and Hendrickson finally broke the news to them. “Not too good,” Hendrickson said. Hendrickson told Kari the news. As the tears began to fall, Hendrickson assured Kari she would be fine. As she drove home, Hendrickson let her mind wonder as she finally began to process the situation. “I was thinking about this sickness and the seriousness of it,” Hendrickson said. “I want to live, but if I don’t, I do know that my kids and grandkids will be taken care of and Jon would be fine too because he has the support of our kids and
family.” When Hendrickson finally arrived home, she embraced her husband who assured her they would do whatever they had to do to get her healthy again. Hendrickson started slowly calling the rest of her children to tell them the news. As she began visiting with them, she knew she had the support system she needed to beat her illness. “I had a good support group with lots of prayers and love,” Hendrickson said. “I am blessed.” Hendrickson had her biopsy Dec. 17, 2014. The report stated she had a Grade I or II associated ductal carcinoma with an invasive in duct infiltrating ductal carcinoma. At this point, the facility in Hettinger was no longer able to treat Hendrickson, so she was referred to St. Alexius Medical Center in Bismarck. However, before she left, Hendrickson was given a bag filled with a fleece blanket, some gift cards for gas, an Applebee’s gift card and a knit stocking cap for when she began losing her hair. “I felt so cared for, even by strangers,” Hendrickson said. At the Jan. 6 appointment at St. Alexius Medical Center, Hendrickson decided to have a mastectomy, which was scheduled for Jan. 14. Hendrickson had cancer in
BE R NA'S ST O RY
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lymph nodes and had 31 of them removed. Hendrickson said her cancer was at Stage 2A. “I remember a nurse saying to me that with cancer a person has to be a fighter and she had me promise to do that, and I said I would,” Hendrickson said. Hendrickson also received a plaque from her daughter-in-law Maretta, which read “Good morning, this is God. I will be handling all of your problems today.” With the mementos and support, Hendrickson thought that whatever happens, she was going to remain upbeat. She knew she had great support through her journey and that’s all she needed. Another uplifting day for Hendrickson was Feb. 9, when three of her friends hosted a support party for her. Her church friends were there and she received a pink bag with caps, scarves, magazines, books, candy, crackers and other assorted items. That party helped Hendrickson as she had her port installed Feb. 16. A few days later, Feb. 25 —Jon’s birth-
day — she was scheduled to start her first chemotherapy treatment. While they were waiting in the reception room, a volunteer from the cancer society came to visit and make them feel comfortable. “This man was exactly what we needed to fill our time and calm our nerves,” Hendrickson said. They visited him several times during those waiting sessions and Hendrickson thought he was a terrific person to give up his days to help people. “I gave him a prayer card from my group at church that said, ‘Christ has nobody but yours, no hands, no feet on earth but yours. Yours are the eyes through which he looks with compassion on this world. Yours are the feet with which he walks to do good. Yours are the hands with which he blesses all the world.’ And I meant it. He is a very special person and gave me and Jon a peace that was a great comfort,” Hendrickson said. Hendrickson went through chemotherapy treatments every two weeks from Feb. 25 until April 8. During those hard times of not feeling well during her chemotherapy treatments, Hendrickson began looking for a quote in a book that would
help her cope. She found “the capital C = Christ.” “Christ can make cancer look mighty small,” Hendrickson
I want to live ... but if I don’t,
I do know that my kids and grandkids will be taken care of and Jon would be fine too because he has the support of our kids and family.
• Berna Hendrickson • said. “I hang on to that thought as I journey on this pilgrimage with Christ. Cancer is not something
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213 S Main St • Hettinger, ND | 605.641.8179 9
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from page 9 anyone would ask to have but if we put our lives in God’s hands, then we will be fine no matter how it turns out because we will be cared for.” The day Hendrickson dreaded for weeks finally occurred March 20. “I asked God why do you need to take my hair too,” Hendrickson said. “I had already lost parts of my body and didn’t wish to be bald, too.” Hendrickson thought about her selfishness of wanting to keep her hair. She said it’s humbling to wear a cap or hair cover. However, then she thought about Christ, and how he must have felt when they took his clothes and left him with just a bit of fabric around his waist. “I know Christ felt that same humbling as I was going through,” Hen-
drickson said. From April 22 to July 9, Hendrickson took Taxol Chemo therapy treatments through an IV. Through all her treatments, she never felt down. She never felt bad. She never felt defeated. “It’s a hard thing to have happen to you, but if you stay positive, your body reacts that same way,” Hendrickson said.
Since she completed her treatments, her reports have been good. She still has that lingering anxiety of getting her wellness checkup. “I have a fear of when you get close to that sixth month appointment, you just have that inner fear that you didn’t expect it the first time, so I don’t know how I would react the second time,” Hendrickson said. Since all of Hendrickson’s treatments, there’s been a cancer support group created in Bowman. “I was one of the founding people of that. It’s going well. We meet at the Methodist church on the second Tuesday of each month,” Hendrickson said. “When we talk, we all understand. When you talk cancer to a person who hasn’t had it, they have empathy for you but they don’t understand. This group, we understand. We understand each other’s stories because a lot of the stories are similar.”
15 S MAIN, BOWMAN
701-523-4949
We support breast cancer survivors
10
SW Auto Supply
Stuart Sather, Owner
PO Box 38 23 S Main Bowman, ND 58623
701-523-7540 Cell 701-440-5555 Fax 701-523-7542
email swautosupply1@ndsupernet.com
11
four years Chris Slone
reporternd@countrymedia.net T@cslone
Jolene Hendrickx had her yearly mammogram in October 2013. Nothing was abnormal on the scans. However, by January, she could feel a lump. “It just kept growing and I kept feeling it,” Hendrickx said. “It was one of those things. Do I need to take this seriously? Do I need to be concerned about it?” In February, Hendrickx became ill and went to the clinic for a checkup. She ended up mentioning the lump she had discovered. One ultra sound later, she was on her way to Bismarck for a biopsy. Hendrickx was in the common’s area at Bowman County School when she received the call. The results of the biopsy were back and she received the unwanted news. Hendrickx had breast cancer and had to return to Bismarck to formulate a game plan. “I went to my room and I cried for a longtime,” Hendrickx said. “I knew I had to get myself together because I was at lunch and I had the afternoon to teach. So, I washed my face and walked down the hallway and my co-workers knew what was up. So, then we cried again.” It was considered HER2-positive, which is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2), which promotes the growth of cancer cells. According to Hendrickx,
Hendrickx reflects on long battle
HER2-positive breast cancer tends to be more aggressive than other types of breast cancer. Luckily for Hendrickx, it was in the early stages and doctors had caught the breast cancer before last day it had spread. of chemotherapy “Once you’re diagnosed, it just Thursstarts rolling,” day, she would Hendrickx said. have her labs Hendrick’s schedule was indrawn, receive stantly filled with doctor’s appoint- treatments, have ments upon doctor’s appointher doctor visits ments. and then make “All you hear is you have canthe three-hour trek cer and you have to have cheback home that mo,” Hendrickx said. “With that, evening. thank goodness for my husband “Thank goodness (Jeff) because he was my ears. for my husband,” He wrote down everything and Hendrickx said. “I told me where I needed to be. slept all the way You’re just kind of in a fog of all home. He was my this.” support. I had so Hendrickx had to have the lump much support, it was removed surgically and then had incredible.” to have a chemo port installed, so Being a teacher, she could start chemotherapy. Hendrickx strugOnce she healed from surgery, gled not being in the she began her chemotherapy classroom. After her March 2013. Hendrickx went Thursday treatment, through eight rounds of chemoHendrickx would therapy. During her chemotherapy day in Bismarck, >> which was always on a
JOLENE
JO LE NE'S ST O RY
Cancer free for
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have to stay
d l an t or usb : :d aughter, Beth, h
home for an entire week. Then, she would be able to teach Monday, Tuesday and Wednesday before going back for another round of chemotherapy. “Every other week, I got to teach three days of school. That was probably the worst part for me,” Hendrickx said. “I never missed a day of school, hardly ever. The reason why I wasn’t able to go to school was because I was around so many kids and germs. My immune system was zero and there was just so many germs. Avoiding crowds and those sorts of things was just something you had to do when you were going through chemo.” Hendrickx said the chemotherapy was absolutely the hardest part. She said it was called the
,
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All you hear is YOU HAVE CANCER and you have to have CHEMO.
Red Devil. “It was so thick, they would have to push it in to you,” Hendrickx said. “It just makes you feel so rotten.” Hendrickx said she would often get nauseated, but her goal was
to never vomit and she accomplished her goal. Her other problem with the chemotherapy was exhaustion. “One time you would sleep all the time; the next time you couldn’t sleep,” Hendrickx said. “It just screws your whole system up.” Hendrickx said she had plans for what she wantfriends ed to accomplish when she was at home. However, most of her time was spent in a chair. “I had a friend that went through it and she said to make sure I get
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up, take
a shower and go for a walk every single day,” Hendrickx said. Before she had breast cancer, Hendrickx worked out every day. “I was probably at the top of my health as I could be,” Hendrickx said. Once she started receiving the “Red Devil,” she had a hard time exerting any energy. Hendrickx often set a goal of walking to her mailbox and back, which was two blocks away from the house. It was on a slight hill and toward the end of her treatments, she could reach the mailbox but she would have to sit down and rest because she couldn’t make it back up to the house. After she completed her chemotherapy treatments, she had a month to recover before the radiation began. Hendrickx had
a DRIVING FORCE
radiation for approximately 20 married. She wants to have minutes every day. grandkids. She had 31 treat“I look back and I think ments. man that wasn’t so horOnce she comrible was it,” Hendrickx pleted the radiasaid. “I really believe the tion treatments, reason I got it was to Hendrickx was deeducate people, to help clared cancer free. those people who don’t She’s been cancer quite get it and need help free for four years. to understand the chemoShe goes back therapy part of it or the every six months for radiation part of it.” a checkup. After five There is also a support years, she’ll go once group in Bowman. They a year for a checkup. meet on the second TuesHendrickx will also be on the Red Devil day of every month. chemo drug on medicine for 10 “My dream was to try years. and get a cancer support group Now, when Hendrickx reflects in our area just because there’s on the journey, she realizes it so many of us,” Hendrickx said. wasn’t great but it wasn’t a hor“Just because once you go rible ride. She kept a positive through chemotherapy and radiattitude throughout the entire ation, you have so many mixed ordeal. She knew she had to feelings after it’s all said and beat this bump in the road. She done. Those people understand still wants to see her children get what you’ve been through.”
It just makes you feel so rotten. JOLENE
in raising
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I am a 52-year-old woman who was recently diagnosed with breast cancer. I’m scared and would like to know what other choices do I have besides a mastectomy?
Dr. Cole Kreofsky I have a family history of breast cancer. Is there anything I can do to reduce my risk of getting the disease?
Dr. Robert Reynolds Radiation Oncologist Bismarck Cancer Center
If you’re concerned about breast cancer, there are steps you can take toward breast cancer prevention. Some risk factors, such as family history, can’t be changed. The following are lifestyle changes you can take to lower your risks: -Limit alcohol- limit yourself to less than one drink per day, as even small amounts increase risk -Don’t smoke- evidence shows a link between smoking and breast cancer -Control your weight- being obese or overweight increases the risk of breast cancer -Be physically active- physical activity can help you maintain a healthy weight, which in turn helps prevent breast cancer -Breast feed- the longer you breast feed, the greater the protective effect -Limit dose/duration of hormone therapy- hormone therapy for more than five years could increase the risk of breast cancer. -Avoid exposure to radiation and environmental pollution- reduce your exposure when possible Be vigilant about breast cancer detection. If you notice any changes in your breasts, consult your doctor. Also, ask your doctor when to begin mammograms and other screenings based on your history.
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Radiation Oncologist Bismarck Cancer Center
There are several approaches to the treatment of breast cancer, depending on the cancer’s type and stage. Many women with early-stage cancers can choose between a mastectomy or breast-conserving surgery (BCS), also known as a lumpectomy. The main advantage of BCS is that a woman keeps most of her breast. Generally, most women who choose a lumpectomy also receive radiotherapy treatments. After the cancerous tissue is removed, radiotherapy is used to help keep the cancer from coming back. The intent is to kill any cancer cells that may remain so that they can’t multiply. Radiotherapy can be given in two ways: treatment of the whole breast (3-4 weeks) or partial breast irradiation (only 1 week of treatment for those who have very favorable tumors). Long term studies have shown that for early-stage breast cancers, removing the cancerous tissue and a small rim of breast tissue surrounding it (lumpectomy), plus radiotherapy, gives women the same cancer control and survival outcomes as a total mastectomy. Moreover, with modern radiotherapy, side effects are minimized and long-term cosmetic outcomes are typically rated as good-to-excellent. Nowadays, many women will meet with a Radiation Oncologist prior to undergoing surgery for breast cancer to understand their treatment options better. Early stage breast cancer remains highly curable, and thus women should be comfortable with the treatment they receive.
I just finished up treatment for my breast cancer last month and I’m wondering when I’m considered a cancer survivor?
Dr. Cole Kreofsky Radiation Oncologist Bismarck Cancer Center
From the moment of diagnosis and for the balance of life, an individual diagnosed with cancer is a considered a survivor. Family members and caregivers affected by a person’s diagnosis are also considered cancer survivors. Cancer survivorship is the experience of living with, through, and beyond cancer. Today, more people than ever are surviving cancer because of better treatments, prevention, and early detection. As a result, much more attention is being placed on the long term adjustment of patients and their families to the physical, emotional, and practical impacts of a cancer diagnosis. Having cancer is often one of the most stressful experiences in a person’s life. In response to these needs, many clinical programs that attend to the needs of patients after they complete cancer treatment are called ‘survivorship’ programs. The Bismarck Cancer Center and the surrounding areas, offer multiple support groups for survivors and their loved ones to help you through your cancer journey. For a complete list of cancer support groups in your area, go to www. bismarckcancercenter.com or call (701)-222-6100.
BISMARCK CANCER CENTER 500 N 8th St • Bismarck, ND
701.222.6100
www.bismarckcancercenter.com
CH ARLOT T E'S ST O RY 19
Johnson
celebrates
14 years
of being cancer free “My late husband laid his was cancer free. She would go hand on my head late one back every six months for a routine reporternd@countrymedia.net morning and when he did, checkup but for the last 14 years, T@cslone I woke up. I felt a strange all of her checkups have produced sensation go through the top the same result — no trace of half of my body,” Johnson said. cancer. Charlotte Miller Johnson asked her husband, Johnson said her support groupJohnson was diagStanley Johnson, why he placed was tremendous during the entire nosed with breast his hand on her head. He told her ordeal. cancer Dec. 2003. he was praying for her. “My husband and boys were so She went in for a “God told him to put his hand on supportive,” Johnson said. “And biopsy, which was my head and pray for my healing. my sister and my sister-in-law, supposed to be I know God healed me because and this whole community. The benign. However, when I went in for surgery, they whole community of Bowman; I’ve once the unweldidn’t find any cancer,” Johnson always said sometimes you might comed news came said. “It was all gone.” not get along with everybody, but back, Johnson Johnson’s surgeon called her when you go through a crisis, it wasn’t wasting after the surgery and told her the doesn’t matter who you are, you’re time feeling sorry news — they didn’t find any canright there to help the next person. for herself. cer; despite the original biopsy It’s so true because I had people “My first reaction showing a different story. bringing food. I had people coming was OK, what do Regardless of the news, Johnand wanting to help me do house we do next,” Johnson still felt like she needed to go work. I was just overson said. “Then, I through the chemotherapy and whelmed.” was not afraid for radiation sessions. me. I was afraid for four my husband and my She started rounds of chemotwo boys. I guess it therapy, which must have been God began in protecting my mind. February. I wasn’t panicking or afraid, I just wanted to Afterwards, know what to do next. Johnson began a rigI wanted it over right orous round now. Let’s get this of radiation, done. Let’s get the which lastsurgery done. Let’s ed seven get the treatments weeks and done. Let’s get it behind me. That was my consisted of treatments first thought.” five days a She had surgery to week. remove the cancer After the Jan. 2004. However, treatments before she had the were said surgery, her husband 9 days after last treatment and done, prayed for her healing back row: my late husband Stan, son, Cory and son,Troy Johnson one morning. front row: Charolette and daughter-in-law, Kristi
Chris Slone
male breast cancer American Cancer Society Breast cancer in men is rare, accounting for less than 1% of breast cancer cases in the US. However, since 1975, the incidence rate has increased slightly, from 1.0 case per 100,000 men during 1975-1979 to 1.3 cases per 100,000 men during 2010-2014. Men are more likely than women to be diagnosed with advanced-stage breast cancer, which likely reflects decreased awareness and delayed
detection because screening mammography is not recommended for men due to the rarity of the disease.37 Similar to female breast cancer, the incidence of male breast cancer increases with age. The death rate for male breast cancer has decreased slightly from 0.4 (per 100,000) during 1975-1979 to 0.3 (per 100,000) during 20112015 due to improvements in treatment. Due to the infrequency of male breast cancer, much less is known about the disease than female breast cancer. Risk
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factors include radiation exposure, BRCA 1/2 gene mutations, Klinefelter syndrome, testicular disorders, family history of breast or ovarian cancer, diabetes, gynecomastia (enlarged breasts), and obesity.
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answers to frequently asked Breast cancer questions Lori Jepson
Nurse Practioner
What exactly is breast cancer? Cancer is a disease in certain cells of the body that cause them to grow out of control. When these abnormal cells are in the breast it is called breast cancer. As it grows it can change how the breast looks and feels. Different women have different warning signs, but some women have none at all.
• Taking hormones to replace missing estrogens and progesterone in menopause for more than five years. Taking oral contraceptives (birth control pills). • A personal history of breast cancer, dense breasts, or some other breast problem. • A family history of breast cancer (parent, sibling or child). • Getting radiation to the breast or chest as treatment for another type of cancer. • Being overweight, especially after menopause.
Causes:
Symptoms:
The main things that increase breast cancer risk are being a woman and getting older. Other factors that include increase risk are: • Changes in breast cancer related genes (BRCA1 or BRCA2) • Having your first menstrual period before age 12 and starting
Although some women have no symptoms, some warning signs of breast cancer are: • New lump in breast or under the arm. • Thickening or swelling of part of the breast. • Irritation or dimpling of the breast skin. • Redness of flaky skin in the nipple area or the breast. • Pulling in of the nipple or pain in the nipple area. • Nipple discharge other • at Coal Country Community Health • than breast mild, including took some time to answer questions blood. regarding breast cancer. Jepson gave a • Any change in size or brief description of breast cancer. She the shape of a breast. also spoke about causes, myths, symptoms • Pain in the breast.
Lori Jepson, family nurse practioner
and prevention.
menopause after age 55. • Never giving birth, or being older when your first child was born.
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Myths:
• Men cannot get breast cancer. Although nearly 2,000 men will be diagnosed with breast cancer each
year, it is 100 times more common in women. • Finding a lump in your breast means you have breast cancer. Eight out of 10 lumps are benign or not cancerous. If you discover a persistent lump in your breast it is important that you have it evaluated. • A mammogram can cause cancer to spread. The X-ray of the breast is called a mammogram and the x-ray and the pressure from the machine cannot cause the caner to spread. Base your decision on your provider’s recommendation and ask any questions you may have about the mammogram. • Breast cancer is a communicable disease. You cannot catch breast cancer or transfer it to someone else’s body. It is the result of uncontrolled abnormal cell growth in your own body. • Deodorant and antiperspirant cause breast cancer. Studies in both 2002 and 2006 found no correlation • Bra type increases cancer risk, underwire. It does not matter what type of bra or if you do not wear one at all, the risk is equal. • Breast size is directly related to cancer risk. The larger the breast the greater the risk for breast cancer. Not true, there is no correlation with size and frequency and with advanced imaging early detection is possible in larger breasts as well.
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Treatments?
Treatments are specific for the type and staging of the cancer. Treatments include, lumpectomy, mastectomy, lymph node removal, chemotherapy and radiation.
Prevention?
Knowing the risk factors for breast cancer may help you take preventative steps to reduce the likelihood of developing the disease. We are unable to do anything about age and gender, which are risk factors. Inherited factors – some inherited gene mutations may increase your breast cancer risk. Mutations in the BRCA1 and BRCA2 genes are the most common inherited causes. Gene testing can reveal the presence of potential genetic problems. Body and lifestyle Obesity after menopause as fat tissue contributes to increases in estrogen levels, and high estrogen may increase the risk of breast cancer. High breast density makes examination more of a challenge and the more glandular and fibrous tissue may be at a higher risk for developing breast cancer. Dense breasts make self-examinations harder so mammograms will often be the first indicator of an abnormality. Phys-
ical activity in the form of regular exercise 4-7 hours per week may help to reduce the risk and the use of alcohol is linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. Role of Breast Self-Exam (BSE). Several studies have shown that breast self-exams lack benefit and have shown a higher rate of breast biopsy that shows benign disease. We are educating women that Self-examination is an adjunct, not a substitute for mammography, and that when they note an abnormality it should be evaluated promptly. Many expert groups do not encourage self-breast exams, but they do encourage educating women about breast self-awareness, general breast health, benefits and limitations of BSE, as well as advising women to seek medical attention soon if they note an abnormality. The World Health Organization (WHO) recommends BSE as a way to empower women and to raise awareness among women at risk rather than a screening method. The best time to do a BSE is when your breasts are not tender or swollen, for example the day after your period ends. All women, including those who are pregnant, breast-feeding, or have breast implants, can do a BSE. If you choose to complete the examinations follow the attached recommendations. Clinical breast exam is indicated if you detect an abnormality.
A clinical breast exam is when a health care provider carefully looks for and feels for any changes in your breasts from the armpit to the breastbone. Further testing will be scheduled to fully evaluate the irregularity. A mammogram it is an x-ray of the breast. It can find cancer when it is very small and might not even be felt. What are mammograms and how do they detect breast cancer? A mammogram is an X-ray picture of the breast. They are the best way to find breast cancer early, before it is even large enough to feel. Early detection is key in optimizing treatments and outcomes. When breast cancer is found early, the five-year survival is 96 percent. What is the process of getting a mammogram? The provider will send and order to the radiology department for the test but to prevent barrier to care the patient can contact the radiology department and schedule their own mammograms. They just need to identify which provider they want the results sent to. If they have not used that facility before it is beneficial to provide access to the previous images for comparison. Prior to the exam it is helpful for the women to know that the compression of the breast is transient, but very important to improve image quality and reduce the amount of radiation required.
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Premenopausal women should not schedule their mammogram around the time of their menstrual period as the compression will be more painful and they will have lower quality films. Screening mammography is of greatest value for patients most likely to develop breast cancer and for whom early treatment is the most effective. The majority of women are of average risk (less than 15 percent life time risk) of developing breast cancer. In these women the most important decision is when to be screened. Breast cancer incidence rises with age. Breast cancer incidence is quite low under the age of 40, then begins to rise as women age. The sensitivity and specificity of mammography are also age dependent, being better in older women. When counselling women on screening we discuss potential benefits and harms – false positives and over treatments as a result of the test.
Under age 40: Suggest no
screening
Age 40-49: Encourage shared decision making with provider for average risk women. For women who decide to proceed, recommend screening every two years. Age 50-74: Suggest mammo-
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gram screening every two years unless previous screening identified finding that required shortterm follow up.
Age 75-older: offer screening only if life expectancy is at least 10 years. There is not a clear age limit and the incidence of cancer remains high into the 80s. They need to be allowed the option. Mammography is available in film and digital. Our facilities provide digital and offer 3-D as well. Digital mammography is preferred due to higher sensitivity especially for dense breast tissue. The cost of the exam can be prohibitive. Check with your insurance company to see what they cover. If you cannot afford to pay for a mammogram Women’s Way may provide a way to pay for your clinical breast exam and mammogram. Call 1-800-449-6636 or 701-328-2306 to see if you are eligible. This can be an option for women with high deductibles or no insurance.
Support
We no longer have a cancer center in Dickinson, but are fortunate to have a great facility in Bismarck, North Dakota. Once diagnosed, the patients are scheduled through the Cancer Center and are introduced to the team that will be with them through the journey. Programs include Breast Cancer
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Support for women of all ages. Face to Face for younger women. Counselling under the REACH program: Resources, Education, Advocacy, Caring and Hope. They provide these services even after discharge for both patient and family. There is a faith based cancer support group sponsored by Legacy United Methodist and Women of Strength Group at Sanford Oncology both in Bismarck. Multiple on line sites are available and some surrounding communities have groups of their own. Information is always available through the Cancer Center for location, dates and times. Pink It forward is a site that provides hope and empowerment by enriching the lives of those affected by breast cancer. All you have to do is enroll the person to receive information and items from that site. The Bismarck Cancer Care Foundation provides gas cards and lodging for those diagnosed.
Can I lower my risk ? Bismarck Cancer Center Breast cancer occurs when malignant (cancer) cells form in the breast tissue. The breast is made up of lobules, ducts, fatty connective tissue, blood vessels, and lymph vessels. The most common type of cancer begins in the lining of the ducts and is called ductal carcinoma. Lobular carcinoma occurs when the cancer begins in the lobules. Breast cancer occurs mostly in women, but men can get breast cancer as well. There is no sure way to prevent breast cancer. But, there are things you can do to lower your risk: Get to and stay at a healthy weight: Both increased weight gain as an adult are linked with a higher risk of breast cancer after menopause. The American Cancer Society recommends you stay
at a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity. Stay physically active: Many studies have shown that moderate to vigorous physical activity is linked with lower breast cancer risk, so it’s important to get regular physical activity. The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity every week. Limit or avoid alcohol: Alcohol also increases risk of breast cancer. Even low levels of alcohol intake have been linked with an increase risk. The American Cancer Society recommends that women who drink have no more than one alcoholic drink a day. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits (hard liquor). Other factors that might lower your risk: Women who choose
to breastfeed for at least several months may also get an added benefit of reducing their breast cancer risk. Using hormone therapy after menopause can increase your risk of breast cancer. To avoid this, talk to your healthcare provider about non-hormonal options to treat menopausal symptoms. Screening recommendations for women (for women at average risk for breast cancer) Women between 40-44 have the option to start screening with a mammogram every year. Women 45 to 54 should get a mammogram every year. Women 55 and older can switch to a mammogram every other year, or can choose to continue yearly mammograms. All women should do monthly self-breast exams. Be familiar with how your breasts normally look and feel and report any changes to a healthcare provider right away.
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What is the
american cancer society doing about
breast cancer?
As an organization of nearly 2 million strong, the American Cancer Society is committed to a world free from the pain and suffering of breast cancer – and all cancers.
Prevention, Early Detection and Treatment
The American Cancer Society is doing everything in our power to help prevent breast cancer – and all cancers. We promote healthy lifestyles by issuing cancer guidelines for prevention and early detection, helping people avoid tobacco, and reducing barriers to healthy eating and exercise. For those who are diagnosed, we’re there every minute of every day. Information, 24 hours a day, seven days a week The American Cancer Society is available 24 hours a day, seven days a week online at cancer.org and by calling us at
1-800-227-2345. Callers are connected with caring, trained American Cancer Society staff who can help them locate a hospital, understand breast cancer and treatment options, learn what to expect and how to plan, address insurance concerns, find financial resources, find a local support group, and more. We can also help people who speak languages other than English or Spanish find the assistance they need, offering services in more than 200 languages. People can visit cancer.org/breastcancer to find information on every aspect of the breast cancer experience, from prevention to survivorship. We also publish a wide variety of pamphlets and books that cover a multitude of topics, from patient education, quality-of-life and caregiving issues to healthy living. Visit cancer.org/bookstore for a complete list of books that are available for
order.
Help navigating the health care system
Learning how to navigate the cancer journey and the health care system can be overwhelming for anyone, but it is particularly difficult for those who are medically underserved, those who experience language or health literacy barriers, and those with limited resources. The American Cancer Society Patient Navigator Program reaches those most in need. The largest oncology-focused patient navigator program in the country, it has specially trained patient navigators at more than 120 sites across the nation. Patient navigators can help: find rides to and from cancer-related appointments; assist
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with medical financial issues, including insurance navigation; identify community resources; and provide information on a patient’s cancer diagnosis and treatment process. We collaborate with a variety of organizations, including the National Cancer Institute’s Center to Reduce Cancer Health Disparities, the Center for Medicare and Medicaid Services, and numerous cancer treatment centers to implement and evaluate this program.
Breast cancer support
Through the American Cancer Society Reach To Recovery® program, breast cancer patients are paired with trained volunteers who have had similar diagnoses and treatment plans to provide more personal, one-on-one support.
Finding hope and inspiration
Women with breast cancer and their loved ones do not have to face their experience alone. The American Cancer Society Cancer Survivors Network® provides a safe online connection where cancer patients can find others with similar experiences and interests. At csn.cancer.org, members can join chat rooms and build their own support network from among the members.
Transportation to treatment
The American Cancer Society Road To Recovery® program offers cancer patients free transportation to and from their cancer-related treatment. For those who cannot drive themselves or have no other means of getting to treatment, trained volunteers donate their spare time and the use of their personal vehicle to give cancer patients in their community a much-needed ride. Other transportation programs are also available in certain areas. Call us at 1-800227-2345 for more information.
Lodging during treatment
The American Cancer Society Hope Lodge® program provides a free home away from home for cancer patients and their caregivers. More than just a roof over their heads, it is a nurturing community where patients can share stories and offer each other emotional support. Through our Hotel Partners Program, we also partner with local hotels across the country to provide free or discounted lodging to patients and their caregivers in communities without a Hope Lodge facility.
Help with appearance-related side effects of treatment
The Look Good Feel Better® program teaches women how to cope with appearance-related side effects of cancer treatment. Group workshops are free and led by licensed volunteer beauty professionals (cosmetologists, estheticians, and nail technicians). Skin care, makeup, and hair loss solution techniques and tips are provided in a supportive environment. Information and materials are also available for men and teens. This program is a collaboration of the American Cancer Society, the Look Good Feel Better Foundation, and the Professional Beauty Association. To learn more, visit the Look Good Feel Better website at lookgoodfeelbetter. org or call 1-800-395-LOOK (1-800-3955665).
Hair-loss and mastectomy products
Some women wear wigs, hats, breast forms, and special bras to help cope with the effects of a mastectomy and hair loss. The American Cancer Society “tlc” Tender Loving Care® publication offers affordable hair loss and mastectomy products, as well as advice on how to use those products. The “tlc” TM
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products and catalogs may be ordered online at tlcdirect.org or by calling 1-800-850-9445. All proceeds from product sales go back into our survivorship programs and services.
Support after treatment
The end of breast cancer treatment does not mean the end of a cancer journey. Cancer survivors may experience long-term or late effects resulting from the disease or its treatment. The Life After Treatment: The Next Chapter in Your Survivorship Journey guide may help cancer survivors as they begin the next phase of their journey. Visit cancer. org/survivorshipguide to download a free copy of the guide. The American Cancer Society has also recently published a follow-up care guideline for breast cancer survivors that builds upon available evidence, surveillance guidelines, and standard clinical practice and is designed to facilitate the provision of high-quality, standardized, clinical care by primary care providers.252 The breast cancer guideline addresses the assessment and management of potential longterm and late effects, as well as recommendations for health promotion, surveillance for recurrence, screening for second primary cancers, and the
coordination of care between specialists and primary care clinicians.
Research
The American Cancer Society invests more in breast cancer research than any other cancer type. Our funded research has led to the development of potentially lifesaving breast cancer drugs such as tamoxifen and Herceptin, as well as improved understanding of genes linked to breast cancer. We are currently funding more than $59 million in breast cancer research through 159 research and training grants. These grants are awarded in multiple areas relevant to the disease, including genetics, etiology, diagnostics (imaging and biomarkers), drug development; and preclinical, clinical, and epidemiological studies in prevention, diagnosis, treatment, and quality of life. Specific examples of ongoing breast cancer research being conducted by American Cancer Society grantees include: Researching new ways of treating HER2+ breast cancer patients who do not respond to or become resistant to existing targeted therapies Evaluating psychosocial interventions aimed at supporting Latinas with breast cancer and their family partners to reduce distress and improve quality of life Exploring how a gene called amphiregulin may cause a woman with ER+ breast cancer to become resistant to engine repairs hormonal therapies Investigating ways to prevent breast cancer patients from developing brain metastases by studying proteins that may be involved in the spread of breast cancer to the brain Evaluating
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Mike Johnson
Owner
101 2nd St SW Hettinger, ND 58639 701.567.3524
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Advocacy
•
The American Cancer Society’s nonprofit, nonpartisan advocacy affiliate, the American Cancer Society Cancer Action NetworkSM (ACS CAN), advocates at the federal, state, and local levels to increase access to quality breast cancer screenings, diagnostic and treatment services, and care for all women; increase government funding for breast cancer research; and provide a voice for the concerns of breast cancer patients and survivors. Following are some of the efforts that ACS CAN has been in-
•
CANCER SOCIETY
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whether a non-invasive and inexpensive technique called auricular point acupressure can help women with breast cancer manage their pain at home Internally, the American Cancer Society also conducts epidemiologic studies of breast cancer and performs surveillance research to monitor racial and socioeconomic disparities in breast cancer screening, incidence, survival, and mortality. Using information collected from more than 600,000 women in Cancer Prevention Study-II (CPS-II), American Cancer Society epidemiologists study the influence of many risk factors, including alcohol consumption, diethylstilbestrol (DES), estrogen hormone use, family history of cancer, obesity, smoking, and spontaneous abortion on the risk of death from breast cancer. In order to continue to explore the effects of changing exposures and to provide greater opportunity to integrate biological and genetic factors into studies of other risk factors, more than 304,000 men and women were enrolled in the American Cancer Society Cancer Prevention Study-3 (CPS-3), and nearly all provided a blood sample at the time of enrollment. The blood specimens and questionnaire data collected from CPS-3 participants will provide unique opportunities for research in the US.
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volved with in the past few years to fight breast cancer – and all cancers: Improving Access to Affordable Care through Health Care Reform: The Affordable Care Act (ACA) was signed into law on March 23, 2010, giving cancer patients access to quality, affordable health care. All new health insurance plans, including those offered through state health insurance exchanges, are required to cover preventive services rated “A” or “B” by the US Preventive Services Task Force, including mammography screening, at no cost to patients. Additionally, the ACA removed cost sharing for any preventive services covered by Medicare. ACS CAN advocates for clear, comprehensive coverage of these preventive services, including breast cancer screening, and encourages states to broaden access to health care coverage for all low-income Americans through state Medicaid programs. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP): Protecting and increasing funding for the NBCCEDP is a high priority for ACS CAN at both the state and federal levels. Administered by the Centers for Disease Control and Prevention, this successful
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program provides community-based breast and cervical cancer screenings to low-income, uninsured, and underinsured women. More than 50% of the women screened are from racial/ethnic minority groups. Currently, only one in 10 eligible women can be served by the program due to federal funding cuts. ACS CAN is asking Congress to increase funding to ensure that more women have access to cancer screening. Protecting the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA): In 2000, Congress passed the BCCPTA, ensuring that low-income women diagnosed with cancer through the NBCCEDP were provided a pathway to treatment services through their state Medicaid program. In recent years, a number of states have considered proposals to eliminate the treatment program due to misconceptions around coverage needs following implementation of the ACA. The Breast Density and Mammography Reporting Act: Mammography sensitivity is lower for women with mammographically dense breasts because dense breast tissue makes it harder for doctors to see cancer on mammograms. The federal Breast Density and Mammography Reporting Act directs an evidence-based process to inform
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women about breast density and risk. Additionally, this legislation encourages new research to support the creation of clinical guidelines and best practices for screening of and reports to women with mammographically dense breasts. Patient Navigation: Patient navigation can improve quality of cancer care, particularly in vulnerable populations. ACS CAN supports the federal Patient Navigation Assistance Act, which would create a coverage solution that incentivizes providers to use patient navigators in order to improve care coordination for patients. The organization also is working with Congress and federal agencies to help increase funding for patient navigation programs. Funding for Cancer Research: ACS CAN continues to work to increase government funding for cancer research at the National Institutes of Health, including the National Cancer Institute and the National Center on Minority Health and Health Disparities. It is important to note that the preceding references to ACA provisions and other federal laws and guidance reflect current law as of July 18, 2017, and do not take into account potential changes to the ACA or other federal laws and guidance subsequently considered by Congress and the administration.
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Lori Jepson, FNP
Cassandra Altringer, DNP
Prevent Breast Cancer! Call your hometown clinic! Schedule your wellness screenings today!
Killdeer Clinic 220 4th Ave SW, Killdeer 701-764-5822 28