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A Breast Cancer Awareness Guide brought to you by

October 1, 2022 A special supplement to the


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CONTENT POTENTIAL WARNING SIGNS FOR BREAST CANCER

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Q&A WITH THE DOCTORS OF THE OWENSBORO HEALTH MITCHELL MEMORIAL CANCER CENTER MITCHELL MEMORIAL CANCER CENTER RENOVATIONS COMPLETE TREATMENT OPTIONS FOR BREAST CANCER PATIENTS LOCAL PROVIDERS

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BREAKING DOWN THE STAGES OF BREAST CANCER SUPPORT GROUPS EMPOWER CANCER PATIENTS

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Potential warning signs for breast cancer BY METRO CREATIVE

Breast cancer is the most commonly occurring cancer in women across the globe. According to the World Cancer Research Fund International, there more than 2.26 million new cases of breast cancer in women in 2020. Such figures are sobering, but it’s important to recognize that breast cancer survival rates have improved dramatically in recent decades, providing hope to the millions of women who may be diagnosed with the disease in the years to come. Various factors have helped to improve breast cancer survival rates, and education about the disease is certainly among them. Women are their own greatest allies against breast cancer, and learning to spot its signs and symptoms is a great first step in

the fight against this potentially deadly, yet treatable disease.

KNOWING YOUR BODY

The American Cancer Society urges women to take note of how their breasts normally look and feel. That knowledge is vital because it helps women recognize when something does not look or feel good to the touch with their breasts. Screening alone may not be sufficient, as the ACS notes that mammograms do not find every breast cancer.

SIGNS AND SYMPTOMS

When women are well acquainted with how their breasts look and feel, they’re in better position to recognize any abnormalities, which

may or may not be indicative of breast cancer. The ACS reports that the following are some potential warning signs of breast cancer. • A new lump or mass: The ACS indicates that this is the most common symptom

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of breast cancer. A lump or mass that is cancerous is often painless, but hard and has irregular edges. However, lumps caused by breast cancer also can be soft, round and tender. Some even cause pain. • Swelling: Some women

experience swelling of all or part of a breast even if they don’t detect a lump. • Dimpling: The skin on the breast may dimple. When this occurs, the skin on the breast sometimes mimics the look of an orange peel. • Pain: Pain on the breast or nipple could indicate breast cancer. • Retraction: Some women with breast cancer experience retraction, which occurs when the nipple turns inward. • Skin abnormalities: Breast cancer may cause the skin on the breast to redden, dry out, flake, or thicken. • Swollen lymph nodes: Some women with breast cancer experience swelling of the lymph nodes under the arm or near the collarbone.

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Q&A

FROM THE CANCER CARE TEAM OF THE OWENSBORO HEALTH MITCHELL MEMORIAL CANCER CENTER

How often should mammograms or screenings be performed?

A:

Women with average risk for breast cancer should receive a mammogram screening annually. Women should discuss their risk for breast cancer with their health care provider. If they are at high risk due to family history or genetic mutations, they may have other screenings in addition to mammogram, such as breast MRI.

Does age play a part in a woman’s likelihood of developing breast cancer?

A:

Yes. Most breast cancers are found in women age 55 and older.

At what age should a woman be seeking regular breast cancer screenings?

A:

Women of average risk for breast cancer may begin screening at age 40 with an annual mammogram.

What are some signs that women can watch for to indicate they may need to see a doctor?

A:

Women should be familiar with their breast tissue so that they can report any changes to their doctor. Report any new lump or mass, swelling of the breast, skin dimpling, breast pain, nipple retraction, redness of the breast, nipple discharge, or swollen lymph nodes under the arm or near the collar bone.

Are there risk factors associated with lifestyle (such as diet) or family history?

A:

Lifestyle-related risks include alcohol consumption, being overweight or obese, and lack of adequate exercise. Other risk factors include never having children, never breastfeeding, and use of some types of hormonal birth control. Family history plays a role in a person’s risk for breast cancer. Particularly — having a first degree relative (mother, sister or daughter) almost doubles a woman’s risk. It is possible to inherit a gene mutation that may increase your risk as well.


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Q&A

FROM THE CANCER CARE TEAM OF THE OWENSBORO HEALTH MITCHELL MEMORIAL CANCER CENTER

Are there precautions or steps that a healthy woman can take to reduce risk factors?

A:

Maintaining a healthy weight, avoiding alcohol and getting regular exercise (at least 150 minutes of moderate intensity exercise per week) are all things women can do to help reduce their risk of breast cancer.

What are the next steps after a diagnosis?

A:

After a breast cancer diagnosis has been confirmed, the patient will likely be seen by a team of specialists (breast surgeon, plastic surgeon, medical oncologist, radiation oncologist) to determine a treatment plan. This plan may include some of the following: further imaging, lab work, surgery, chemotherapy, endocrine therapy, immunotherapy, radiation therapy. Each individual case is different, based on details regarding each patient’s particular diagnosis.

What are the possible side effects of treatment?

A:

Side effects will vary from person to person and are based on which particular type of cancer treatment(s) a patient receives.

How does an oncologist determine the right treatment option for a patient?

A:

The oncologist will determine and arrange any further testing that may be needed after a diagnosis. They work closely with other disciplines such as surgery, radiology, pathology and radiation oncology to determine the best treatment plan for a patient. The stage of a patient’s cancer, along with pathology, genetic testing, patients age, and past medical history, among other factors, will help determine a patients treatment recommendations. The NCCN guidelines are comprised of current recommendations for cancer treatment developed by a multidisciplinary panel of experts in the field of cancer. Oncologists will often refer to the NCCN guidelines when making recommendations regarding a patient’s treatment.

What are the follow up steps after treatment?

A:

After breast cancer treatment, the patient will be followed closely by the oncology treatment team. This will include a physical exam 1-4 times as needed for the next 5 years and a mammogram every 12 months. Other imaging or lab work may be checked periodically as well based on patient’s particular case.

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Mitchell Memorial Cancer Center

RENOVATIONS COMPLETE BY OWENSBORO HEALTH REGIONAL HOSPITAL

The Owensboro Health Mitchell Memorial Cancer Center is much more than just a building. It’s part of our comprehensive approach to treating cancer. Through recent renovations, we’ve created an environment where we can offer national-quality cancer care, right here at home. Renovations at the Cancer Center go far beyond aesthetic updates like beautifully-designed lobby areas and a serene courtyard. Practical updates, such as touch-free doors, prevent the spread of germs — offering a safer environment for weakened immune systems. You’ll even notice updates you hear but don’t see, like the sound of white noise playing to muffle out the voices of others nearby, creating added privacy and peace of mind. And to create a seamless experience for patients, all departments of our cancer care team are now in one convenient location.

HEMATOLOGY & ONCOLOGY

Updated exam rooms are one of the renovation highlights in Hematology & Oncology. The rooms are equipped with specially-designed chairs, allowing the care team to weigh the patient while they’re seated and adjusting to allow easier examinations. The arms are made

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OUTPATIENT ONCOLOGY

The Outpatient Oncology department has been thoughtfully redesigned with the patient’s experience in mind. The beautiful art and glasswork in this area give it a sleek, modern feel. Window-filled private rooms offer beds or heated massage recliners to keep patients comfortable as they receive chemotherapy. Community areas are also available for patients who enjoy company during their treatment.

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MMCC also offers ser vices like a full-time genetic counselor that works with families to determine their risk of developing hereditar y cancer, and a patient financial advocate to help patients reduce the out-of-pocket cost of their treatment. For more information on cancer care, visit OwensboroHealth.org/ Cancer.

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Treatment options for breast cancer patients BY METRO CREATIVE

LOCAL PROVIDERS

Millions of women worldwide are diagnosed with breast cancer each year. Such a diagnosis is never welcome, but women should know that sur vival rates have improved dramatically in recent decades. In fact, the World Health Organization reports that, by the end of 2020, nearly eight million women were living despite having been diagnosed with breast cancer at some point in the previous half decade. One of the reasons for the improved sur vival rates is the efficacy of various treatments. The National Breast Cancer Foundation, Inc.® notes that doctors have various options to treat breast cancer, and they often devise treatment plans that include some combination of treatments. Though no one wants to imagine receiving a breast cancer diagnosis, understanding the potential treatments for the disease can help women and their families be more prepared should that day ever arrive. The following are three treatment options physicians may discuss with women as they begin devising ways to overcome the disease.

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1. CHEMOTHERAPY

Chemotherapy is used to treat various cancers, including breast cancer. Chemotherapy employs various drugs to destroy cancer cells or slow their growth. The drugs administered during chemotherapy are known as cytotoxic drugs and may be administered orally or intravenously. The NBCF notes that chemotherapy is offered to most patients, though doctors will consider a host of variables before deciding if chemotherapy is right for a given patient. Those variables include the type of tumor, its grade and its size.

2. RADIATION THERAPY

During radiation treatments, high energy rays are used to kill cancer cells. Only cells in the part of the body that is being treated with radiation are affected, so patients needn’t worr y that other parts of their body will be hit with radiation. The NBCF reports that

patients diagnosed with Stage 0 (DCIS) and most diagnosed with Stage 1 invasive cancer or higher can expect doctors to prescribe radiation therapy. Women who have had a lumpectomy also are likely to be prescribed radiation. Two main kinds of radiation are generally considered for breast cancer patients. External beam breast cancer radiation treatment delivers cancer-killing rays through a large machine. Internal breast cancer radiation is a newer treatment that injects radioactive cancer-killing treatments into the affected area.

3. TARGETED THERAPY

The NBCF reports that targeted therapy is commonly used in combination with traditional chemotherapy. Targeted therapy attacks specific breast cancer cells without harming normal cells, which is why it tends to produce less severe side effects than chemotherapy treatments. Targeted therapy employs drugs to block the growth of cancer cells in ver y specific ways. One example cited by the NBCF is the drug Trastuzumab, or Herceptin®, which is given to women whose breast tumors

have too much of the abnormal protein HER2. Though the side effects of targeted therapies tend to be less severe, women may still experience issues like fever and chills, nausea, headaches, and other symptoms after drugs have been administered. Expanding breast cancer treatments have done much to improve sur vival rates for patients. Women diagnosed with the disease are urged to play an active role in their treatments and ask any questions they might have before, during and after being treated.


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Breaking down the stages of breast cancer BY METRO CREATIVE

Once a person is diagnosed with cancer, his or her physician will try to determine how far the illness has progressed, including whether or not it has spread to other areas of the body. This effort is known as “staging.” Each cancer has its unique staging characteristics, and breast cancer is no different. The stage of the cancer ultimately refers to how much cancer is present in the body, indicates the American Cancer Society. Doctors treating breast cancer adhere to the TNM staging system, which is overseen by the American Joint Committee on Cancer. This staging uses both clinical and pathological (surgical) systems for breast cancer staging. Pathological staging may be more accurate because it examines tissues taken during surgery or a biopsy.

T CATEGORIES

T in the staging system refers to the tumor’s size and whether it

has spread to the skin or chest wall under the breast. Higher numbers refer to larger tumors and greater spread. TX: A primary tumor cannot be assessed. T0: No evidence of primary tumor. T1: Tumor is 2 centimeters (cm) or less across. T2: Tumor is more than 2 cm but not more than 5 cm across. T3: Tumor is more than 5 cm across. T4: Tumor is of any size growing into the chest wall or skin.

N CATEGORIES

N in the staging system identifies if the cancer has spread to the lymph nodes near the breast, and if so, how many. NX: Nearby lymph nodes cannot be assessed, which can happen if they were previously removed. N0: Cancer has not spread to

nearby lymph nodes. N1: Cancer has spread to one to three axillary (underarm) lymph node(s), and/or cancer is found in internal mammary lymph nodes (those near the breast bone) on a sentinel lymph node biopsy. N2: Cancer has spread to four to nine lymph nodes under the arm. One or more area of cancer spread is larger than 2 millimeters (mm). N3: Cancer has spread to any of the following: 10 or more axillary lymph nodes with area of cancer spread greater than 2 mm; to lymph nodes under the collarbone, with at least one area of cancer spread greater than 2 mm; cancer found in at least one axillary lymph node (with at least one area of cancer spread greater than 2 mm) and has enlarged the internal mammary lymph nodes; cancer in four or more axillary lymph nodes (with at least one area of cancer spread greater than 2 mm), and to the internal mammary lymph nodes on

a sentinel lymph node biopsy; to the lymph nodes above the collarbone on the same side of the cancer with at least one area of cancer spread greater than 2 mm.

M CATEGORIES

M indicates if the cancer has spread to distant organs. M0: No distant spread is present on X-rays or other imaging and physical tests. M1: Cancer has spread to other organs, notably the brain, bones, liver or lungs as determined by a biopsy or testing. Note that this staging system also uses sub-stages within each category, which further breaks down breast cancer staging into more characteristics and combinations. The ACS says there are so many possibilities that can go into staging that two women at the same breast cancer stage may have different experiences.

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Support groups empower cancer patients BY OWENSBORO HEALTH REGIONAL HOSPITAL

When a patient hears their physician say “you have cancer” ever ything changes — ever yday routines, the roles of family members and future plans. From the moments after a diagnosis through the treatment period, a strong support system is critically important to help patients cope and work toward a positive clinical outcome. But sometimes patients need more than family and friends as a support system—they need other people who are sharing the same experience. At Owensboro Health’s Mitchell Memorial Cancer Center, two kinds of support groups fill that need. The cancer center offers two professionally moderated topical support groups that are free and open to any individual diagnosed with cancer. Both groups meet monthly to focus on a topic relative to cancer care through guest speakers, activities and special events, but they’re each aimed at different audiences.

STRONGER TOGETHER

The Stronger Together group is an inclusive meeting for participants with a variety of diagnoses, stages and ages. Typically, this support group is attended by early-staged cancer patients. Because each month’s content is focused on a different topic, individuals can participate month-to-month as they choose.

WARRIORS: SUPPORTING EACH OTHER ONE DAY AT A TIME

The Warriors program is specifically for patients with advanced or metastatic cancer. There are multiple Warrior Groups, limited to 6 to 8 individuals, allowing for an intimate atmosphere. These cancer support groups exist to empower individuals as they navigate through the challenges of a cancer diagnosis. Research has shown that support groups improve the ability of patients to adjust and cope with their cancer diagnosis. Support groups are known to:

• Improve the patient’s quality of life • Build confidence • Offer educational support • Improve outcomes and treatment adherence • Allow individuals to receive support from other sur vivors The Stronger Together support group meets virtually (due to COVID-19) on the second Tuesday of each month at 6 p.m. Individuals who wish to attend can log onto OH.Webex.com/join/cbrey to join. Those interested in participating in the Warrior Support Group should contact the Mitchell Memorial Cancer Center to find the group that’s best suited for them. These support groups are focused on the patient diagnosed with cancer, but if an individual needs emotional or physical support

to attend, their caregivers are also welcome. Because Owensboro Health understands the need and importance of caregiver support, we hope to expand our support ser vices to include groups specifically for families and caregivers of cancer patients. Caregivers looking for a support group for themselves can contact the Mitchell Memorial Cancer Center for information about resources in the area. If you have questions about the support groups or resources available, contact Mitchell Memorial Cancer Center Outpatient Counselor Heather Gray at (270) 688-3675 or Heather.Gray@ OwensboroHealth.org, or Oncology Nurse Navigator Colleen Brey at (270) 688-3691 or Colleen.Brey@ OwensboroHealth.org.

“I have been very pleased with the cancer support group meetings offered through the Mitchell Memorial Cancer Center,” said one attendee. “The meetings have been very informative, beneficial and helpful for both myself and my wife through my cancer journey. The nurse navigator and counselor do a fantastic job of keeping the meetings fun and interesting.”


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Schedule Your Mammogram! Fighting Cancer Begins BEFORE Diagnosis Owensboro Locations Breckenridge Medical Building Ford Medical Building The Springs Health Centre

Healthplex Locations Henderson, Madisonville & Powderly Walk-ins accepted.

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Free spa headband during the month of October You must have a referral from your primary care provider. Mammograms for Life provides free screenings to women that qualify and need help paying for a mammogram.

Call 1-844-50-MAMMO to schedule an appointment or visit OwensboroHealth.org/Mammogram