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HOPE

October 2013


HARLINGEN MEDICAL CENTER S UPPORTS E ARLY D ETECTION

Mother, Daughter, Friend, or Wife‌ Make early detection a Habit for Life! D I G I TA L M A M M O G R A M

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$ 5501 S. Expressway 77 Harlingen, TX www.harlingenmedicalcenter.com

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* This reduced rate is available to the general public during the month of October 2013. Special cash price only, no supplemental claims, and radiologist interpretation fee is included.


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FALL 2013

CONTENTS 6

Living on Faith

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Riding, Walking, Running to Cancer Survivorship

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Hope in Difficult Times

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Advanced Treatment & Compassionate Care

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My Breast Cancer Journey

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Cancer Biggest Killer of Hispanic Texans

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Strong, Brave, Resolute

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Future of Cancer Treatment

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Going Beyond the Science

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Never Give Up

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Always Looking to Tomorrow

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From Pain & Isolation to Hope & Healing

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7 Reasons You Might Not Need a Will

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M. Espinoza Publisher

A. Gardner

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Editor in Chief

J. Espinoza

Community Relations

Contributors 19

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Alvaro Restrepo, M.D. Nurul Wahid, M.D. Janice Workman, CNM Kelli Davis, M.A.O.M., L.Ac. Gregory E. Turley, Esq. Michelle Beltran Dora Lomas Molly Hinojosa Reverend Rick Reyes

MAE News Group LLC

Never Giving Up Hope My mother and my aunt are both cancer survivors. I personally have not experienced the shock of being told I have cancer. I have never had to tell my family that I have cancer and that I might not survive. I did not have to undergo painful, but potentially lifesaving treatments and surgeries. I have not had to live every day knowing that remission did not mean I was cured and I thank God that I haven’t had to cry the tears of losing a child. When we began the Never Giving Up Hope Magazine, I wondered if words could truly help one person to look forward to another day. After speaking with survivors and listening to their stories, I know that they do. That sometimes a burden feels lifted just by sharing experiences together. To that end, this publication and its website were created to help our readers by providing a forum where cancer patients and their families, friends, and our community, can come together in fellowship for those individuals whose bravery, determination and greatness of heart we can admire, respect and emulate. I pray that one day soon a cure will be found for this horrid disease.

anne@nguh.net

Marketing Graphic Design Website Management

Rick Reyes Jr.

Associate Graphic Design

4121 N. 10th St. #157 McAllen, TX. 78504 1 (888) 649-0639 PH (956) 264-9498 FAX (512) 233-2272 info@NGUH.net www.NGUH.net The information contained in this publication is intended to provide health information and news to the general public. It is made available with the understanding that, Never Giving Up HOPE Magazine (HOPE), Texas Medical Observer (“TXMO”), MAE News Group LLC, contributors and guest columnists are not engaged in rendering medical, health, psychological, or any other kind of personal professional services. The information/news should not be used in place of a call or visit to a medical, health or other competent professional. HOPE, TXMO, ISW and MAE News Group, LLC specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, from the use and application of any of the content featured on Never Giving Up HOPE Magazine. HOPE magazine and its contributors accept no responsibility for inaccuracies, and the advertiser is solely responsible for ad content and holds publisher harmless from any error. All contents are protected by copyright and may not be reproduced without written consent from the publisher.

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grow. Miraculously, three days came and went.

By Molly Hinojosa

My name is Molly Hinojosa and on June 9, 1999 I was diagnosed with acute promyelecytic leukemia, two days later on a Friday I was sent to MD Anderson Cancer Center in Houston, TX. All of this happened so quickly, I never completely understood what was happening or the seriousness of my illness. I decided to dismiss the situation, thinking I would be back at home by the end of the weekend. I had been going through a divorce during this time and it had just been finalized. My father was my primary and only caregiver. He rode in an ambulance with me and helped make medical treatment decisions. My mother had just undergone surgery herself and wasn’t able to travel. My illness was so advanced they didn’t know if chemotherapy would work. They told my father the worst case scenario; I had 3 days to live with no hope of recovery. When I heard this, I turned to God. I wanted to live, I wanted to take care of my children and see them

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I stayed in Houston for four months during the first year. After a while I forgot about the cancer and found myself focusing on how I would end up paying for all of this. I had gone from two incomes, then one, to being hospitalized and not able to work at all. Luckily I had some insurance through my employer and was able to get assistance through social workers at MD Anderson. I went through nine months of chemotherapy, three times a week. At the time only an investigational drug was an option. After nine months of treatment I was told I had a “clean bill of health.” I was thrilled and relieved, but only for one month. Then I relapsed and was once again devastated. I found myself back in Houston with a doctor insisting I try a new chemotherapy treatment, one called arsenic trioxide. After arguing with the doctor for a while thinking if the cancer itself didn’t kill me, the treatment would. I was asked to sign off on the new protocol as the treatments would need to begin immediately. I was blessed to have a nurse who prayed for me when the chemo was induced. I truly believe it was her prayer that made me realize I needed to trust in my faith. Fortunately, the new therapy worked and I was quickly back in remission;

however, I would still need a bone marrow transplant. I was very hesitant, I had done my research on my illness and felt confident in my knowledge, but I knew nothing of this and felt afraid of the unknown possibilities. My siblings were tested by doctors and it was discovered that my older brother would be a match. At this point and after everything I had gone though I wanted to make sure this time that I had everything covered. I asked my doctor for some time as I wanted to make sure my affairs were in order. I needed to know that my children would be taken care of in the case that something went wrong. On October 23, 2000 I flew back to Houston for my final round of chemo. After seven days and seven nights with one day of rest I had the transplant implemented. What was intended to be a 90 day recovery actually turned out to be a year; I developed encephalitis which affected my walking and I was in need of a wheelchair for the next three years. Throughout this entire experience I felt as though I had seen God’s work in my life. What I thought to be the most negative things that could have happened to me have really been a blessing in disguise. Through my experience, I am now able to help and give hope to other cancer patients and let them know that cancer doesn’t have to be a death sentence, regardless of what you’re told.


The fight against cancer in the Rio Grande Valley is a team effort. That team includes physicians, nurses, medical specialists, and, of course, patients, along with their loved ones and caregivers. But the team isn’t limited to those directly on the front lines of the fight. Defeating cancer is a broad-based community effort here in the Valley. And that committed team of patients, caregivers, family, and friends comes together in McAllen each October for the annual Texas Oncology Breast Cancer Awareness Bike/Walk/Run. This year’s event, the sixth annual, takes place on Saturday, Oct. 26. The daylong event includes a 20, 40, or 60 mile bike ride; a 2.5 mile or 4.5 mile walk, and a 5K run. Funds raised by participants in the Bike/Walk/Run have previously benefited Comfort House Services, Inc., Food Bank of the Rio Grande Valley, American Cancer Society, and Life Beyond Cancer Foundation. In addition, the funds allocated to the Texas Oncology foundation will be used to provide support to patient education, assistance, and survivorship programs. Dr. Alvaro Restrepo’s guiding vision for the event includes raising awareness of the importance of community education and the role that healthy living can play in cancer prevention. “We often advise our patients to be active, exercise, eat nutritious foods – to live a healthy lifestyle. We’re bringing that to life in a powerful way, as hundreds of people demonstrate a

TXO Walk Run Ride 2012

Riding, Walking, Running to Cancer Survivorship

healthy activity by choosing to ride a bike, walk, or run in our event,” said Dr. Restrepo. “But here we also have the special responsibility of helping raise funds that address immediate needs in our patients and community-at-large.” The event also is a reflection of Texas Oncology’s communitybased approach to cancer treatment, which emphasizes providing advanced care to patients, located near their families and other important support. “Our physicians, nurses, and staff members can all attest to the difference it makes when patients can undergo weeks or months of treatment – but still are able to stay at home and sometimes a job, or don’t have to miss a child’s soccer game or church service,” said Restrepo. “We believe that reducing patient anxiety with compassionate care here at our treatment center, plus the critical support from family and friends nearby, makes for an overall better patient experience.” The Bike/Walk/Run event brings that community of support together each year in a memorable, purposeful event, with benefits that help people in the Valley throughout the year. “Our purpose is quite serious, to spotlight cancer patients’ needs, but the event is a fun and exciting day, and we are thrilled with the overwhelming support from the people of the Valley,” said Restrepo. www.txowalkrunride.com

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In loving memory of my mom.. By Rev. Rick Reyes We all have times when we feel hopeless. We are not exempt from the difficult times. Difficult times will test our peace, our joy, our stability and yes, even our hope. We live in an imperfect world. For the most part we face these difficult times, with hope for better days, with the support of our family, friends and our faith. We manage and move on.

Adelita Gonzalez Who will always inspire others to fight cancer through relentless positive energy and the true spirit of a fighter.

There are others, however, that are affected by difficult times in such a way that their mind, body and spirit become so disrupted that they enter into a state of hopelessness. When a person enters into a state of hopelessness they have an overwhelming feeling of being oppressed, uninspired, forsaken, limited, powerless, captive, bound or helpless. If one or more of these traits describe you on most days, it’s probably safe to say that you are in need of hope. If you are in need of hope there is good news! “There are three things that will last forever – Faith, HOPE and Love.” ~ The Apostle Paul Yes, that’s true; hope is always within your reach. Hope is looking at your difficult times and deciding that in the midst of your storm, you are going to lower your anchor, batten down the hatches and wait for the storm to blow over. The problem or crisis you are facing today will not be the same tomorrow. Everything changes day by day. Some things will change and get better quicker than others. Whatever you do, do not lose hope. “When we have lost everything, including hope, life

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becomes a disgrace, and death a duty. ~ W. C. Fields Listen to the counsel that these great men offer: “Hope is like a star – not to be seen in the sunshine of prosperity, but only to be discovered in the night of adversity.” ~ Charles Spurgeon “To hope is to cherish a desire with anticipation.” ~ Webster “We must accept finite disappointment, but we must never lose infinite hope.” ~ Martin Luther King Jr. “Blessed is the man who trusts in the LORD, whose confidence is in him. He will be like a tree planted by the water that sends out its roots by the stream. It does not fear when heat comes; its leaves are always green. It has no worries in a year of drought and never fails to bear fruit.” ~ The Prophet Jeremiah It is easy to have hope when things are going along smoothly for you. The reality is that things will happen that will test your hope. Always remember, hope will last forever and it is within your reach. Hope has the power to pull you through the difficult times. Although we live in an imperfect world and your hope will be tested, hope is like a ray of sunshine; a break in the clouds or the light at the end of a dark tunnel. Hold on to HOPE.


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Advanced Treatment and Compassionate Care Texas Oncology Helps Valley Patients Fight Cancer

With the rapid pace of advancements in medicines and technology, cancer treatment has changed. But it’s not just the progress of medical science that is making a difference. How and where treatment is delivered also matters. Today, more than 65 percent of all cancer care is administered at the community level, on an outpatient basis in your oncology doctor’s office setting. That means the critical support of friends and family is more important than ever in helping cancer patients navigate the ups and downs of treatment. In the Rio Grande Valley, patients have advanced comprehensive treatment available from local physicians at the communitybased clinics of Texas Oncology. In addition to offering high-quality chemotherapy and radiation treatment, Texas Oncology teams deliver care with personal compassion and commitment in four Valley locations. “Our patients tell us that the warm, caring atmosphere and personal experiences with staff at Texas Oncology makes a big difference in meeting the challenges of cancer treatment,” said Dr. Billie Marek, medical oncologist and medical director of Texas Oncology, South Texas region. “We are inspired by our patient’s personal strength and courage. Everyone on our team strives to reflect that spirit of inspiration in every encounter with our patients.” Since 1986, Texas Oncology has expanded to meet growing need for more treatment locations that are convenient to patients, resulting in less disruption to their lives. Texas Oncology’s current team of 15 oncologists includes specialists in medical oncology, radiation oncology, hematology, and urology, providing care from practices in McAllen, Weslaco, Harlingen and Brownsville. In addition, Texas Urology Specialists–Brownsville offers specialty care with a medical team that works collaboratively

with oncologists to provide high quality urological services and treatment. Texas Oncology provides treatment for all types of cancer, from the most recognized forms such as breast cancer, prostate cancer, skin cancer, and lung cancer to any of the more than 200 forms of cancer identified by the medical community. Patients have access to advanced technologies, treatments, and services, including diagnostic imaging, radiation therapy, chemotherapy, laboratory services, and an on-site pharmacy. Texas Oncology also offers genetic screening and consultation through its Genetic Risk Evaluation and Testing Program. Texas Oncology–McAllen also provides its patients opportunities to participate in innovative research programs, including clinical trials that evaluate new cancer prevention and treatment options. Through its affiliation with US Oncology Research, Texas Oncology has played a role in developing 46 cancer-fighting therapies approved by the Food and Drug Administration. Texas Oncology patients also benefit from the collective experience and expertise of more than 350 Texas Oncology physicians statewide, as well as a broad range of leading-edge treatment options. For example, the Texas Center for Proton Therapy, currently under construction in the Dallas area (opening in 2016) will offer new hope for patients with tumors that are best suited for the extraordinary precision that proton therapy offers – including children with cancer. With more than 25 years of service, Texas Oncology provides innovative, advanced treatment options, compassionate care, and hope to Rio Grande Valley patients and their loved ones in the fight against cancer. For more information please visit www.texasoncology.com Fall 2013

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My Breast Cancer Journey:

Facts, Fallacies and Fiction advanced imaging are diagnostic tools; they can help with early detection, but they do not prevent the disease. “I don’t have to worry, there’s no breast cancer in my family.” Only five percent of breast cancers are genetic. One in eight women will develop breast cancer in their life time. Genetic considerations are a reality and should not be ignored by those who have familial risks.

By Janice Workman, CNM

After submitting to the poking and prodding of my annual exam, a peasized lump was discovered in my left breast. I had previously experienced fibrocystic changes and had a biopsy performed, so the recommendation of an ultrasound-guided biopsy didn’t faze me. My Doctor’s call did. “Jan, you have cancer.” I hung up, shocked and shaking, while “Well, now I’m going to die.” careened through my brain. As I went through surgery, chemotherapy and radiation, I discovered this was not the only misconception about breast cancer I would encounter. “How could you get cancer? You’re a nurse.” Breast cancer is not a respecter of education, profession, socio-economic class or gender. We’ve seen, politicians, their wives, movie stars, rock singers, athletes, moms, dads, sisters, brothers, and friends, fall victim. Every three minutes someone is diagnosed with breast cancer. “Didn’t you get your mammogram e v e r y   y e a r ? ”   M a m m o g ra m   a n d 12

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“But you’re only 44 years old! That’s too young.” The idea a woman is too young has caused misdiagnoses and delay in treatment with devastating results. A few years ago, breast cancer was identified in a 16 year old. “If you get a mastectomy, you won’t have to have radiation and chemo.” There are different types and stages of breast cancer. Treatment I received was based on the tumor’s response to hormones, speed of growth, size and affect on the rest of my body. Lumpectomy or mastectomy were my options. I was given the information needed to make an informed decision. “You must have worn underwire bras….used antiperspirant…taken birth control pills…smoked….ate too much meat….lived under a power line….” There are factors which have been proven to increase the risk of breast cancer and many more that allege to, but there is no one cause. “I know a lady who drank this tea, and she was cured….My mom’s friend takes shark cartilage, it says on the bottle ‘sharks don’t get cancer’…Worm wood capsules kill the parasite that causes

cancer…” Well-meaning people who want to help? Snake-oil salesmen after a quick buck? There is no miracle cure or easy answer to breast cancer. Ultimately people make their own decisions about what treatment path they will follow. My strongest recommendation is to gather information. The internet, with all its’ opinions is available at our fingertips. Be cautious. “I should have visited you, but… I didn’t want to bother you… I didn’t want to wake you… I didn’t want to catch it… I figured you were busy with treatments…” I heard all these comments and more. I will say this once: Cancer is not catching! I realize people were working from their level of comfort. So, let me increase comfort levels out there. My days were filled with cancer: cancer treatment, online support groups, dressing changes, doctor visits, exhaustion, vomiting, and loneliness. It was hard to reach out. Some people reached in. A friend drove me to the store for groceries. Another sent a funny card every week. I had offers of transportation to appointments when my husband couldn’t take me. Going bald was a side effect that didn’t bother me much, but I appreciated caps, hats, scarves and the creative way a co-worker turned them into attractive head covers. For others, wigs or a makeover can raise spirits. Can you provide a meal or two? Is childcare needed? Maybe house cleaning, laundry or lawn care? Yes, I was busy, sometimes sleeping, but friends calling or stopping by were never a bother as long as they were there to help and not be entertained.


“ Yo u   f i n i s h e d   y o u r treatment. Now you can get on with your life and put all this behind you.” After hair grows back, scars fade and energy returns, it is easy to forget what someone has gone through. Every mammogram and oncology follow-up exam reminds me. Aches and pains most folks wouldn’t think twice about bring fear of recurrence. Side effects flare, demanding attention. There are times I need to laugh, cry and talk about my journey. Breast cancer was and is a part of my life. I longed to return to “normal” and “wanted my life back.” Then I realized I had my life back and needed to embrace a “new normal”. “I’ve got cancer, now I’m going to die.” Yes, people die from breast cancer every day. My initial response to my diagnosis, however, was the result of old information. The face of breast cancer changes frequently. Innovative technologies allow earlier identification and decreased treatment sideeffects. New therapies aid those with extensive disease to have a longer quality of life. I am thankful to people who thrust breast cancer to the forefront of public attention, removing taboo associated with discussing it and offering sensitive education over erroneous thinking.

Cancer Biggest Killer of Hispanic Texans UTMB HEALTH - More Hispanic Texans die from cancer than any other cause, according to a new report by the Comparative Effectiveness Research on Cancer in Texas research group. The report documents cancer as the leading cause of death among Hispanic Texans under the age of 76. Only three percent of Hispanic Texans are older than 75. Texas’s Hispanic population has more than doubled since 1990. Texans of Hispanic ethnicity now comprise 38 percent of the state’s population. Based on data from the Texas Cancer Registry, Medicare claims records and state vital statistics; researchers compared rates and trends for cancer in Hispanics to those for non-Hispanic whites in Texas. Key findings include: • Hispanic Texans are less likely to be screened for breast or colon cancer. • Hispanics have lower rates of new cancer diagnoses for breast, colon and lung cancer. • Of the cancers diagnosed in Hispanics, fewer were in the earliest, most treatable stages – those typically detected through screening. Breast cancer at the most advanced stage was diagnosed at a 12 percent higher rate. • Cancers more common among Hispanics were stomach and liver cancer in men and stomach, liver and cervical cancer in women. Such cancers can arise from untreated infections. • Overall mortality from all cancer was lower among Hispanics with the exception of stomach and liver cancer. • Survival after a diagnosis of cancer is

superior for Hispanics compared to nonHispanic whites. These findings were based on 10 years of data about the diagnoses of new cancer cases and 21 years of data about cancer deaths. The CERCIT researchers noted one puzzling contradiction. Even though cancers tend to be more advanced when diagnosed in Hispanics, death rates were lower than in the white population. This phenomenon, known as the Hispanic Paradox, has been noted before by other researchers looking at disease and survival rates across the spectrum. Hispanic Americans tend to survive illness and live longer than white Americans with the same diseases even though the Hispanics have less education, income and access to health care. Foreign-born Hispanics had lower mortality rates than those born in the United States, according to analyses of regional differences within the state. The multidisciplinary consortium of CERCIT investigators works on issues related to cancer screening, cancer treatment, posttreatment surveillance and supportive care for cancer patients and survivors. CERCIT is funded by the Cancer Prevention and Research Institute of Texas. The CERCIT project is led by principal investigator Dr. James S. Goodwin of University of Texas Medical Branch at Galveston and co-principal investigator Dr. Linda S. Elting of the University of Texas MD Anderson Cancer Center. Other project and core lead investigators include Drs. Catherine D. Cooksley, Anthony DiNuzzo, Karl Eschbach, Jean Freeman and Taylor S. Riall of UTMB; Dr. Sharon H. Giordano of MDA; Dr. Vivian Ho of Rice University and Dr. Melanie Williams of the Texas Cancer Registry.

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a z r a G a d n o Rh

e t u l o s e R , e v a r B , g n o tr

S

By Michelle Beltran

According to the American Cancer Society, yearly mammograms are recommended beginning at age 40. At the time of diagnosis Rhonda was 37, too young to have annual mammograms and without any history of cancer in her family, she was not encouraged to undergo any early cancer detection exams. Rhonda Garza’s journey began after feeling a lump on her left breast. Although abnormal, a mammogram declared the lump “benign.” A year later, the lump had grown significantly and a second mammogram and biopsy confirmed the long thumb shaped mass to be cancerous; she was diagnosed with Stage IIIC breast cancer. Three because of the size and tumor grade, and C because it had spread to the adjacent lymph nodes. Rhonda admits that she did not know how much trouble she was in or what a struggle fighting cancer would be. Her cancer treatments lasted just over a year, and included chemotherapy, surgeries, more chemotherapy and finally 37 days of radiation. A difficult process she could not have successfully completed without the support of her family and friends, “My inspiration was my husband and my two young boys, then age 7 and 10. In my heart I knew I had no choice but to be brave for them.” She received some chemotherapy treatment at Texas Oncology in Weslaco, but also traveled to M.D. Anderson Cancer Center in Houston. Because of her treatments, Rhonda experienced nerve damage which requires her to use hearing aids. Another possible side effect of chemotherapy is weakening of bones, which contributed to her suffering a broken leg in 2008, only a year after completing radiation. However, Rhonda now recalls how cancer research saved her life. With advances in 14

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Rhonda Garza at Relay for Life of the Mid Valley in 2006 while undergoing chemotherapy. Posed with her sister, Rebecca Scheuerman.

modern medicine, treatments are now designed to help people on a more individual basis. With more personalized cancer treatments, patients like Rhonda have a better chance of completing the treatment process; “We don’t have a one shot cure for all cancer, but every day we are getting closer and closer. Don’t even bother looking at your odds; those statistics are from others who did not have the same treatment opportunities that we have today. People are living longer and better lives with cancer than ever before,” she says.

Rhonda encourages everyone to follow the standard guidelines for cancer screening in order to increase their chances of early cancer detection and to consult a doctor if any abnormalities are found. She insists that persistent symptoms cannot go unnoticed and must be checked by a medical professional. Follow ups are also important because it gives doctors the opportunity to monitor progress and designate alternative treatments when necessary. “Seek out other people that have gone through it,” Rhonda says, “and don’t be afraid to ask questions.”

“Everyone has bad days, but you must persevere. You need to keep moving when you feel sad,” she says. Acknowledging some days are easier than others when fighting cancer, Rhonda encourages fighters to keep their chin up, listen to their doctor’s suggestions and stay current with reliable medical literature. Rhonda’s cancer is c u r re nt l y   d o r m a nt ; she continues to live an active lifestyle and receives yearly checkups.

Relay for Life 2013 From left; Rhonda Garza, Marianne Seal, Heather Marks and Sam Magee.


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Patients & Texas Oncology Partner in the Future of Cancer Treatment Until the fight against cancer is won, researchers will never stop looking for more and better ways to treat, detect, and prevent cancer. Texas Oncology physicians, staff, and patients take part in the fight against cancer by bringing some of the most promising clinical trials in the nation to Texans in their communities. Creating tomorrow’s breakthroughs in cancer treatment requires forward-thinking physicians and patients. Texas Oncology harnesses the power of a network of more than 350 physicians at more than 120 sites of service, enabling physicians to collaborate and share best practices with each other, so that each physician can stay focused on what they do best – caring for patients. As a pioneer of community-based cancer treatment, Texas Oncology also delivers the opportunity for patients to participate in important clinical trials and research that can result in new treatment options to almost every corner of Texas – including McAllen. Clinical trials evaluate new cancer prevention and treatment options as part of a comprehensive research process that often takes years. Clinical trials test the safety and effectiveness of new or modified treatments using new drugs, unique approaches to surgery and radiation therapy, or various combinations of cancer treatments. “Patients who participate in research, such as a clinical trial of new medicines, are helping themselves and others,” said Katia Moreno, research nurse at Texas Oncology–McAllen. “Patients who join clinical trials are directly and personally joining with physicians, researchers, and scientists in the fight against all types of cancer.” Since 1994, Texas Oncology–McAllen patients have participated in more than 90 research studies. Currently, 14 studies are underway exploring treatments for breast cancer, lung cancer, bladder cancer, lymphoma, and leukemia. Visit www.TexasOncology.com/ClinicalTrials.aspx for more information.

Understanding Your Cancer Future – Genetic Testing Cancer research is not only about treating cancer, but also preventing it and detecting it early. Advancements in genetic science can help patients identify specific individual risks. Only 5 to 10 percent of cancer cases are related to genes, but when a certain kind of cancer “runs in the family,” it can be helpful to know if there is a hereditary link. Texas Oncology’s Genetic Risk Evaluation and Testing Program is a comprehensive approach that starts with a detailed personal and family medical history to determine whether more indepth testing is needed. A genetic test (a simple blood sample) can then identify an increased risk for certain types of cancer such as Colon and Endometrial Cancer Syndrome (HNPCC) and Breast and Ovarian Cancer Syndrome (BRCA 1/2). Texas Oncology physicians, nurses, and trained genetic counselors work with patients to discuss family history, explain test results, and explore potential preventative treatment options. Decisions based on genetic testing results are extremely personal. That’s why it is important to know risk factors, including information about genes and family history, in order to make informed decisions. Through research and programs such as genetic testing, Texas Oncology stays on the leading-edge in finding innovative ways to deliver high-quality cancer care to communities from the Panhandle to the Valley. With the support of a statewide network, tomorrow’s breakthroughs are built on research happening in communities today. Fall 2013

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GOING BEYOND THE SCIENCE

To Provide a Community of Care By Janice Workman

When the mushroom cloud dissipated and the ash settled in Japan, it was obvious we now had weapons of mass destruction. Thankfully, Dr. Robert Wilson, a physicist, was able to look beyond the devastation, to realize that healing could also come out of this energy. In 1946, he proposed a medical use for protons in cancer treatment. Cancer cell destruction was still the goal; however, by using proton therapy to deliver precisely targeted radiation to tumors, thus minimizing side effects and damage to surrounding healthy tissue. His vision is now a reality and has helped to save the lives of thousands of people worldwide. Today, proton therapy is being used to treat hard to reach tumors, pediatric cancers and disease in sensitive areas near the brain, eyes, heart, lungs, and spinal cord. This technology is now closer to home for those in need of the alternatives that proton therapy offers. The “Texas Center for Proton Therapy” is the name of a multimillion dollar, 63,000 square foot, state-of-the art facility currently under construction in Irving, Texas. The Center with its second-generation technology capable of serving more than 100 patients a day is expected to be up and running in early 2016. Recently named executive director of this leading-edge institution is Gary Barlow, BSRT, (R), (T). Mr. Barlow brings with him a solid background: technical director of the highly recognized University of Florida Proton Therapy Institute; more than 28 years in the field of radiation oncology; and a passion for proton therapy and the hope it brings to cancer patients. “This center is another tool in our arsenal to treat cancer while maintaining quality of life. So many dedicated professionals, pulling together experience, knowledge, skills – all to treat, to cure, to help, one day, eradicate cancer.” “For myself, I am enthusiastic about this opportunity to be involved in this project

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Gary Barlow

from the ground floor, to be able to look back and realize I was part of a dedicated team, building something exceptional...” For him, the ‘something exceptional’ he is a part of, extends way beyond the physical structure and advanced technology to include a strong patient-focused approach emphasizing community based support. A term most often used to define specialized hotel assistance; ‘concierge service’ has been adopted to reflect the patient-centered emphasis which is so much a part of what the Texas Center for Proton Therapy has to offer. This way of thinking and caring for patients developed from the belief that cancer treatment involves more than the patient and the disease. Mind, body, spirit, and family are all included in this normative approach. Patients of the Texas Center for Proton Therapy will end up in a “community of care” where support groups, seminars, gatherings, lifestyle sessions, family focused events and assistance with lodging, restaurants, places to worship and recreational facilities are just as much a part of the treatment as the proton therapy. If the consequences leading to need for this care weren’t so dire, it could almost sound like a vacation. Ironically enough, that is the term some patients may use to describe proton therapy: a radiation vacation. To understand why, one would simply look

at the difference in side effects between conventional radiation and proton therapy. On one hand are the possible side effects of traditional treatment, which are felt after treatment is given: Nausea, fatigue, and skin irritation (similar to sunburn) at the tumor site can start soon after treatment begins. Effects are usually temporary, but can last for the duration. Long-term ramifications, which may start after treatment begins or not show up until years later, may impact the heart, lungs and organs in the area targeted for treatment due to development of permanent scar tissue or inflammation.

The ceremony included a seven foot wall inscribed with words of encouragement from city leaders, members of the health care community, patients and survivors which is to be installed in the community room.


On the other hand, secondgeneration proton therapy has been shown to reduce the development of a secondary cancer, and has been reported to have minimal negative side effects to date.   P ro t o n   t h e ra p y ’s   “ p i n - p o i n t accuracy” minimizes side effects and helps reduce damage to normal, healthy tissue. Sounds like a no brainer, right? Unfortunately, as with most things in life, it cannot be that easy. Proton therapy is not the answer for all cancers. It cannot replace conventional radiation in every circumstance. While both types of treatment offer benefits, depending on the tumor’s size, type and location as well as other patient-and diseasespecific factors, proton therapy will be most beneficial to patients with tumors in sensitive areas near the spinal cord or eyes and in some brain, head and neck, lung and prostate cases, as well as for children with solid tumors, as the new treatment is preferred due to the absence of extraneous radiation that can affect the child’s rapidly growing organs, also, in some cases, proton therapy can be used in combination with chemotherapy, traditional radiation and surgery as their physician deems necessary. T h e   Te xa s   C e n t e r   fo r   P r o t o n Therapy’s commitment to honor current and future survivors and to continue the battle to eradicate cancer was apparent at the dedication and groundbreaking ceremonies for the Center where a seven foot wall inscribed with words of encouragement from city leaders, members of the health care community, patients and survivors was unveiled. As the center construction progresses, others have and will be invited to add their artwork and inspiration to the wall which will later be installed in the center’s community room. It sets the theme for the soon to be opened Texas Center for Proton Therapy – Hope.

“Never Give Up”

By Kelli Davis, M.A.O.M., L.Ac.

On one of my visits home from college, my father, Jim Davis, gave me a ring. His wedding ring - the one he’d worn during his marriage to my mother. They’d divorced when I was two, but he’d kept it all these years to give as a blessing for my own wedding which was now right around the corner.

slip off. But I wear it every day. It draws people’s attention and I love sharing its meaning. Inside is inscribed “Never Give Up” - the phrase my dad kept plastered in multiple places around his house to serve as a reminder when his motivation waned, as it does at times for everyone. Now, it keeps me motivated.

A few weeks later, my dad passed away, seventeen days before his 51st birthday and five weeks before my wedding. He’d lived two years beyond the six months his doctors had expected at his diagnosis. His use of nutrition and alternative treatments had kept the chemotherapy side effects to a tolerable minimum and helped him sustain the energy and determination to keep fighting.

My father was infuriatingly stubborn. When he died, he died knowing that he had made every effort and had taken control of his life and his mind. He lived his last days how I believe he wished he’d lived his entire life - jovial, motivated and optimistic. That was enough for him. And if he could find his strength and inspiration, couldn’t I? Couldn’t anyone?

Over a thousand people attended his memorial services. Friends, family, coworkers, even his regular waiters from his favorite restaurants filed in to show their support. I was awed. My dad had touched lives everywhere. He was a hardworking, self-made man, a mentor and friend to many, and very generous to those in need. But he also struggled with deep depression, obesity, an indulgent alcohol habit, and many strained family relationships. He used cancer as a way to prove to himself that he could - and would - fight for himself, be his own advocate, and work to heal not only his body, but his life.

His inspiration led me to pursue a fouryear graduate degree in acupuncture and oriental medicine. It is my hope that through my training, I may help as many patients and families as possible who are facing cancer to “Never Give Up.” This column is a part of that effort. In each issue, I’ll be sharing the unique perspective I adopted from Chinese Medicine, other complementary treatments that may be of help, and stories from people dealing with some of the same challenges you might be facing.

Support is the key to an experience with cancer. Support leaves patients stronger and wiser after their diagnosis than before. It is my hope, through my The ring he gave me is unique - it’s father’s memory, to provide some of that square, three colors of gold, and too large support. for my petite fingers. I often fear it will

Kelli Davis is licensed by the Texas Medical Board to practice acupuncture and oriental medicine in Texas, where she holds private practice in Houston and The Woodlands at The Axelrad Clinic. Her dream is to help relieve the suffering of cancer patients through supportive, strengthening, integrative treatments.

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Always Looking to Tomorrow By Michelle Beltran

In our busy day to day lives, we tend to ignore that which we don’t want to see, many times at the cost of our own health. Thankfully, that is when loved ones step up and do the caring for us. Such is the case with Mr. Raul de la Rosa. After noticing the abnormal size of his left testicle, Raul shrugged it off as a hernia and went on with his day. Thankfully, Raul’s wife was more concerned and cross referenced a medical book, matching up his symptoms, and finally convinced her stubborn, too busy husband to see a doctor. Raul got a Wellness Screening done at Rio Grande Regional Hospital. Six hours later, Raul gets a call from his sister, an employee of the hospital, telling him to return immediately. Blood exams confirmed what his doctor suspected; Raul is thought to have testicular cancer. He is then referred to Dr. Marek, whose specialty includes medical oncology and hematology. Dr. Marek diagnosed Raul with Stage III prostate cancer as the disease had quickly spread to his kidneys, liver, lungs and lymph nodes. After receiving the news of his diagnosis, Raul clearly remembers that while his wife and sister became distraught, he stayed calm, “I never doubted that I’d

Raul & Adriana De La Rosa and Grandson Joshua Alaniz

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get through it, because tomorrow was always too important to me,” he says. As part of his treatment, Raul had surgery to remove the testicle affected with cancerous cells. He also had a porta-cath implanted in his chest to make it easier to withdraw blood and for drugs to be infused without repeated injections. Raul’s aggressive weekly treatment included twelve hour cycles, Monday through Friday. He started with chemotherapy; then the rest of the week’s treatments varied between injections and blood work to determine when the body would be strong enough to handle another cycle of chemotherapy. This treatment generally lasts six months, five of which revolve around chemotherapy. While the treatment caused Raul to lose all of his hair, he fortunately did not experience any of the other potential side effects except for occasional fatigue. He admits that by the second cycle of chemotherapy, he felt depressed, but he was able to change his attitude, “I didn’t let it keep me down.” In fact, he remembers a time when he finished chemotherapy treatment on a Thursday and the very next day he was with his family in Fredericksburg, Texas competing in a cook off placing 2nd for his famous chili recipe. “I didn’t let it stop me...I was out there with my grandkids one day after chemo,” he says. His support system included his family and an organization based in Donna called Angels of the Reservation. He is very thankful to this organization for their donations and support. It was of great help since he had to use his savings to begin treatments before his insurance began coverage. The organization often held community fundraisers to assist cancer fighters and survivors. Because of his treatment, Raul was without work for

six months and his wife had to become the head of household as well as his primary caregiver, “without her, it would have been a lot harder.” Although Raul is not out of the woods yet, he says he is excited to see his grandchildren grow up. He wants to attend their graduations and his son’s wedding later this year. After everything he has been through, he says he looks at life differently, “It’s easy to take things for granted and having cancer makes you think about what is truly important.” Raul’s encouragement to other cancer fighters is to stay mentally positive, be as active as you can, not dwell on the disease and to follow their doctor’s advice. “I work hard and enjoy life to the fullest,” he says, and he never let the disease take over who he was or let it interfere with what he loved to do — spend time with his family and join in cooking competitions. Doctors have told Raul that the possibilities of the cancer returning are high, to which he responds by saying “if it comes back, I will stay positive and move forward to another day.”


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From Pain and Isolation to Hope and Healing who entered my room had to be covered head-to-toe in order to keep my room as sterile as possible. I didn’t like that it was called “isolation.”

By Dora Lomas

My name is Dora Lomas and I have been cancer-free for just over five years. My son Xander was four when I went away for ten months to be treated at M.D. Anderson. My little one, Christopher was only eight months old. When I was diagnosed at a local hospital, I was told that I probably would not survive but at M.D. Anderson I was never given up on. My sarcoma was large, advanced and very aggressive. Dr. Robert Benjamin treated it just as aggressively. From July to November in 2007 I had several rounds of a combination of two of the strongest chemotherapies. I was actually sedated for over two weeks because I’d been intubated and on a breathing machine, so I could undergo this chemotherapy. I was in I.C.U. for more than forty days. During this time I had many hallucinations and what I believe to be a vision. I spoke with God and He told me I was going to live and that I had something very important to do. Still, for a long time it just didn’t look good. I had many blood transfusions. I was nourished through a feeding tube directly into my stomach. I had a tracheostomy, so I couldn’t talk for months. I endured many infections. Anyone

I finally got moved from I.C.U. It was a good sign. But I was so weak and still had this sarcoma in my lung. I communicated by writing on a Magna Doodle that belonged to my kids. My husband slept on a recliner every night. My family and friends visited often. I had to learn to walk again. When I was able to stand up for the first time, I caught a frightening glimpse of myself in the mirror. I was smaller. My legs were scrawny. I was bald. I was really dark. My head hung because my neck was weak. My mouth was agape because it stayed that way after they took me off the breathing machine. But the chemo was working. It shrunk my tumor from the size of a small watermelon to the size of a lemon. It was contained in the bottom lobe of my lung and Dr. David Rice, who was the thoracic surgeon who’d previously wanted to remove my entire lung, thought that he could successfully remove only the bottom lobe now along with the tumor. I was allowed to come home for a few days since they’d stopped administering chemo so I could get strong enough to have surgery. I finally got to see my boys. It was bitter-sweet because I knew I’d be leaving soon and I knew the surgery would be dangerous. They had to remove one of my ribs to get to the tumor. The surgery was a success but there were compli-

cations while I was in post-op. It looked like a scene from a movie. The running. The confusion. The shouting. While I struggled to breathe I felt like I was slipping away. I looked at my husband while they “bagged” me and pumped air into me. I shook my head to tell him it was all over. Then another vision… more like a feeling. I could feel my sons standing over me on my right. I don’t know why but they were older. Each had their hand on my arm. Suddenly, the team that was working on me walked out of the room. They were all gone and it was so quiet. I thought I’d died. Then one nurse, who’d been standing behind me, loudly said, “You’re okay. You’re breathing on your own now.” From November to March I felt like I was racing back to the boys. We stayed with my sisterin-law in Liberty while I was an out-patient. We drove back and forth for chemo and fluids. I carried it around in a little backpack. Several times, though, I was hospitalized because of low white blood cell counts. There were more transfusions. I had physical therapy. I tried to walk as much as I could. I was eating on my own and my tracheostomy was removed. We called the boys every day and we’d send presents by mail. Then came the moment we’d been waiting for. The cancer was gone. All gone. We finally came home. It was a bit of a struggle. My husband hadn’t worked in almost a year and was having a hard time finding work. My little Christopher didn’t recognize me any-

more. I was still so weak and I couldn’t carry him or play on the floor. I had to give him time and it broke my heart. I also lost a dear friend to cancer. Roy had been diagnosed before I was and he saw me through my illness. I thought we were drawing strength from each other only I didn’t do enough. Sometimes I even felt guilty for surviving. I tried as much as possible to get our lives back to normal. We lived. We worked. We did our best for Xander and Christopher. I’d go back to Houston often for check-ups and Dr. Benjamin slowly led on to how bad things were. I’m a miracle. So I’m here now and things are amazing. We’re happy and healthy. My boys are brilliant. Still, I know I’ve been through a lot. I know I’ve put my family through a lot. I know I go through life smiling as if nothing happened and I know that I’m always scared the cancer will come back. As for Group H.O.P.E., I love this support group because everyone in the room with me understands. It’s helped release anger and fears, and it’s helped me let go of some of the guilt. It has allowed me to feel things I always just wanted to put away. And it’s done through art. I have fun. The time I spend with this group gives me time to focus on myself and where my head is. The exercises are always light but a little challenging. I always learn something about myself. I feel powerful afterward. It’s become very important to my well-being. It’s the best thing I do for myself.

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7 Reasons You Might Not Need a Will By Gregory E. Turley, Esq.

There’s a local lawyer who is a prominent advertiser. You’ll see his billboard picture on your drive to work or you’ll see him on the outside of yellow pages. If you’re home, you’ll see him on television. One thing he advertises is “Simple Wills for $149.” Which raises the question, why don’t more people have a will? Let us assume it is not the cost. You can’t buy many TV commercials at $149 a pop. So it must be a question of need, or rather, lack of need. What are some reasons that you might not need a will? Here are seven. 1. You own no property of substance. Since the main purpose of a will is to transfer property at death, if you have no property to speak of, then you probably don’t need a will to transfer the property you don’t have. Examples are: if you rent an apartment, you have no car and walk everywhere or get rides, and you prefer to pay for everything in cash if you have it. What will happen to the little property that you have at death? Chances are it will be picked over and thrown out, garage sale-style. 2. You’re single and free of attachments.

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With no wife, no kids and no pet, you can go where you want to go, do what you want to do. And when you don’t have anyone that you have any legal obligations to support, there’s no need to make any plans for anyone else. This includes any surviving parents and/or siblings. 3. You have an account with a co-owner or a benefit designation. These are called Non-Probate Assets, assets that pass outside of probate according to contract. Even if you have a will, the assets will transfer according to the designation previously made. Examples include life insurance policies, jointly owned bank accounts and pay on death accounts. 4. You don’t believe your death will affect anyone else. In fact, you probably don’t like to think of death at all, so why would you want to take any action that would cause you to think about death now? 5. You think making a will would be too expensive. With our price example above, that lawyer is not getting rich doing wills. The good news is that once you have a will done, it will usually last a long time because family and financial circumstances change slowly

over a period of years. 6. You believe all of your property will simply go to your wife or husband. This does solve problem number 1, which avoids the garage sale situation. And for practical purposes, this will cover the personal property that is owned by both. But it does create a potential problem if the survivor wants to sell or borrow against the family home. 7. You plan on giving away or selling any valuable things during your lifetime. A program of giving can be a good one. It allows for flexibility over the years, but assumes that you actually do it and don’t run out of time by surprise as with an accident or sudden illness. As you can see, a will can’t do it all. These are seven reasons why not having a will is not bad. But a will does have the unique advantages of covering a wide array of property in a general manner. You don’t have to itemize everything in a will because it is designed to last a long time. It can be changed as needed. You can name guardians, executors and trustees. And those are the Seven Good Reason for HAVING a will. The choice is yours.


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