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thinkpink Breast Cancer Awareness Month

SUNDAY, OCTOBER 6, 2013

Survivors’ stories

Local breast cancer survivors share their stories of getting through the struggle of their lives, Page 8

MAKING STRIDES WALK | 2 ● KNOW YOUR RISK | 4 ● CALENDAR OF EVENTS | 6 MAN TELLS HIS STORY | 7 ● SUPPORT GROUPS | 13 ● PREGNANCY AND CANCER| 14

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INDEX Genetic testing a way to know your risk, Page 4 A calendar of area breast cancer awareness events, Page 6 Marion County man living life after extensive treatment, Page 7 Local residents tell about their stories of survival, Page 8 3-D biopsies offer hope in fight against breast cancer, Page 11 Pre-chemo options help women who want to get pregnant, Page 14 Contributing writers: Kristine Crane, Rick Allen, Andrea Carroz, Meghan Pryce Photographers: Erica Brough, Brad McClenney, Doug Finger, Bruce Ackerman, Cyndi Chambers Design/Layout: Sharon Sullivan Editors: Susan SmileyHeight and Lillian GuevaraCastro ON THE COVER: Oak Hall preschool teacher and breast cancer survivor, Kim Davis, enjoys teaching her students. Cover photo by Doug Finger/ Staff Photographer. Design by Rob Mack/Staff.

THE GAINESVILLE SUN | www.gainesville.com

Thousands plan to be Making Strides American Cancer Society fundraiser planned for Oct. 26 in downtown Gainesville By Andrea Carroz and Meghan Pryce and Kristine Crane Staff writers

aryn Wagner has walked the last nine years at the Gainesville Making Strides Against Breast Cancer walk in honor of her aunt, friends and her mother, who is a 37-year cancer survivor. “I think it’s a celebration, and hopefully one day we can find a cure,” she said. She said the more support there is, the more likely chance there is to find a cure. This year’s walk, which is a fundraiser for the American Cancer Society, will be Oct. 26 in downtown Gainesville. Registration opens at 7 a.m. and the walk is set to start at 9 a.m. at the Hippodrome Theatre, 25 SE Second Place. Dr. Jason Rosenberg, a breast cancer reconstructive surgeon in Gainesville, has consistently had a large walking team dubbed “Under Reconstruction.” Many of Rosenberg’s patients have undergone treatments for breast cancer, and are recovering by the time they reach him. “I tell them the year of going through breast cancer is going to be a bad memory and it usually is,” he said, adding that it’s rewarding to see patients transition from “the death sentence that cancer can be” to making them feel whole again. The ACS walks, held in 300 communities in the

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BAD MCCLENNY/STAFF PHOTOGRAPHER/FILE

Participants take part in the Making Strides Against Breast Cancer walk in Gainesville last October. This year’s walk will take place Oct. 26. U.S., raise about $60 million for the American Cancer Society, which celebrates its centennial anniversary this year. Funds raised are used for research, providing underprivileged women with access to mammograms, as well as free resources and support to newly diagnosed patients. The University of Florida Health is this year’s largest sponsor of the Gainesville walk. Last year, the walk raised $147,000 and had about 2,000 participants, said Tina Johnson,

co-chair organizer of the walk. This year, Johnson said she hopes the event raises $155,000 and has 165 teams participate in it. As of Friday, $15,491 had been raised. Also, there were 78 teams and 463 participants signed up. “The participants make the events successful,” Johnson said. This year’s Making Strides theme is “Making Strides Toward a World with More Birthdays,” Johnson said. Breast cancer is one of the leading causes of

cancer deaths in women, and the organization invests more in breast cancer research than any other cancer. It is also the Making Strides walk’s 10th anniversary, but Johnson said the Gainesville walk will not commemorate the birthdays. “It’s all about the survivors, and we honor them and honor their families,” she said. “We keep the focus on them.” Visit cancer.org/ stridesonline to donate to the American Cancer Society. For more infor-

If you go What: Gainesville Making Strides Against Breast Cancer walk Where: Downtown Gainesville When: Oct. 26. Registration at 7 a.m.; walk begins at 9 a.m. Information: makingstrides.acsevents.org mation about breast cancer, call the organization at 1-800-227-2345 or go to cancer.org.

www.gainesville.com | THE GAINESVILLE SUN

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SUNDAY, OCTOBER 6, 2013 |3

October is

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THE GAINESVILLE SUN | www.gainesville.com

Genetic testing makes mainstream what once was a ‘radical’ treatment By Kristine Crane Staff writer

hen Gerry Petrone of Archer was diagnosed with breast cancer at age 55, the Hospice nurse who had taken care of many dying breast cancer patients, took the news like a death sentence. Her doctor reassured her that it wasn’t; and indeed, a lumpectomy, chemotherapy and radiation would keep the cancer at bay — briefly. The cancer recurred six months later, so Petrone decided on a more aggressive treatment course: removal of her right breast. “Somewhere in there the doctor started talking about family history,” Petrone said. Her father had died of colon cancer, but no one else in the family had cancer, so it was unlikely that Petrone carried the BRCA genes, which are strongly linked to breast cancer risk. But her husband Frank’s family tree was filled with cancer: two of his sisters had had breast cancer, and one died of the disease at age 35. The other survived the disease — twice — and then got uterine cancer. Another sister died of lung cancer at age 45. His mother died of pancreatic cancer at age 46. His niece was diagnosed with breast cancer at age 30. “Dr. Carroll decided to test Frank for the BRCA gene, and he tested positive,” Gerry said. “We joked that you should know your partner’s genetic profile before you get married.”

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Breast cancer genes Cancer is in part a genetic disease, and

scientists have some of the strongest clues about why for breast cancer. Mutations in the BRCA genes — known as BRCA1 and BRCA2 — are linked to breast cancer, putting people who carry the gene at significantly higher risk for breast and ovarian cancer, and predisposing them to higher risk for other cancers as well. With the advent of BRCA testing nearly two decades ago, women with strong family histories of breast cancer have increasingly gotten tested for the genes. And what they are doing with that information also has evolved. Actress and film director Angelina Jolie’s decision to get a double mastectomy and reconstruction of her breasts last May put the spotlight on what was once considered a radical move but is now becoming a more mainstream decision for women who are at very high risk of the disease. According to the National Cancer Institute, 55 percent to 65 percent of women with the BRCA1 mutation develop breast cancer by age 70, compared to 12 percent in the general population. Having the mutation is rare: only between 1 in 400 and 1 in 800 (0.10 percent and 0.25 percent) of people in the general population do, so they have to meet certain criteria in order for insurance to cover the testing. In general, women or their first-degree relative (mother, sister) who are diagnosed before age 50 have a higher risk of being a gene carrier. “We encourage people to call up if the cancer is on the same side of the family,” said Lisa Brown, a genetic counselor at

BRAD MCCLENNY/STAFF PHOTOGRAPHER

Gerry Petrone and her daughter, Christia, at their home in Archer. Gerry was diagnosed with breast cancer at age 55, and Christia tested positive for the BRCA gene.

According to the National Cancer Institute, 55 percent to 65 percent of women with the BRCA1 mutation develop breast cancer by age 70, compared to 12 percent in the general population. University of Florida Health Shands Hospital. Brown added that families in which multiple members have cancer — such as Frank Petrone’s — are also indicative of the existence of the BRCA mutation.

Heartbreaking news For Frank Petrone, learning that he was a

BRCA mutation carrier, to some extent, clarified the reason behind all the cancer deaths in his large Italian-American family. “I had just thought that we were unlucky,” Petrone said, adding “I never thought that I would have to get mammograms and sonograms every year.” Carrying the mutation also puts Petrone himself at risk for developing breast cancer (and male

breast cancer is another sign that the BRCA mutation may run in the family). But male breast cancer is still very rare — 100 times less common than it is in women. So Petrone was less worried about his own risk and immediately concerned with his two daughters’ risk. The Petrones’ eldest, Ann Marie, 39 years old when her father was tested, was married and done with having children — and prepared to undergo a double mastectomy and reconstructive surgery if she tested positive for the gene. (BRCA mutation carriers often get prophylactic mastectomies to decrease their disease risk.) Her younger sister Christia, though, didn’t really want to know if she carried the gene or not. Thirty-one years old, unmarried and uninsured, she wasn’t prepared to lose her breasts. Ann Marie flew down from Virginia, and the two sisters got tested on the same day. The news, Gerry said, was “heartbreaking.” Ann Marie tested negative, and Christia, positive. “I had told Dr. Carroll that there is only one thing worse than having breast cancer, and that’s having a child with breast cancer,” she said. “I didn’t want her to go through what I went through.” Gerry pushed Christia toward surgery, but Christia opted for close surveillance for a couple of years. Every four months she underwent either an ultrasound or an MRI. “For me (not doing surgery right away) was being young and not

married and wondering how it was going to change me physically,” Christia said.

Breast reconstruction: a growing option Gerry herself had started toying with the idea of getting her right breast reconstructed. She had been wearing a breast prosthesis since her mastectomy, but sometimes it got in the way, and she wore baggy clothing in case it fell out. She attended a seminar on breast reconstruction at North Florida Regional Medical Center led by Dr. Jason Rosenberg, a nationally-renowned breast surgeon. She liked what she heard and did some follow-up research after the seminar before doing the surgery. “It was the best decision I ever made,” said Gerry, who sports a pink tank-top that reads “I love my little tatas.” She said that it’s great to be able to wear whatever she wants to now. Gerry’s decision inspired Christia to agree to surgery as well. In all, Christia underwent four surgeries to remove and reconstruct her breasts; she also had her ovaries and uterus removed. “I knew I was done having kids, so that didn’t bother me at all,” she said. Christia has one daughter, 15-year-old Lauren, who has not yet been tested for the BRCA mutation. By undergoing the surgeries, Christia’s risk of breast cancer went from 88 percent to 3 percent, which is lower than the 12 percent risk among the

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TESTING: Not all women are candidates for mastectomy Continued from 4 general population. She also lowered her risk of ovarian cancer, a rare but often deadly cancer that is also strongly associated with the BRCA mutation. “I look at it as a guarantee that she will see her daughter graduate from college,” said Frank Petrone, who convinced his brother to test for the BRCA mutations (and tested negative). Frank’s older sisters — now in their 70s — don’t want to get tested, even though the daughter of one sister was diagnosed with breast cancer. Christia said that recovering from her surgeries was intense, but she’s pleased with the result. Rosenberg performed the tissue-sparing reconstruction, for which he is renowned, in which tissue from a patient’s stomach is used to remake the patient’s breasts. “Dr. Rosenberg said that ‘if you don’t like it, at least you’ll get a tummy tuck,’” Christia said. Rosenberg said that the benefit of this is that the tissue grows into another part of the patient’s body, so the results last forever. And women are overwhelmingly pleased with their results, he said, pulling out his desk drawer filled with thank-you cards and even a song that a woman wrote for him in praise of his work. Rosenberg said that by the time women — with cancer, or those at very high risk of it — get to him, he’s like the light at the end of the tunnel. “We change peoples’ lives in a positive way,” he said.

Breast cancer risk factors Even though the option of breast reconstruction has grown as surgeons have become more skilled at doing them, not all women with breast cancer or at high risk of getting it are good candidates for mastectomy and reconstructive surgery. “Women have to be gene

LISA CRIGAR/CORRESPONDENT

Jerry and Wendy Blaznik enjoy a stunning sunset together at Carney Island Park on Lake Weir. Wendy Blaznik, whose grandmother and mother both had breast cancer, was diagnosed with it when she was just 36 years old. carriers or have some type of concerning hereditary condition for me to do a preventive mastectomy on them,” said Dr. Lisa Spiguel, assistant professor of surgery at the University of Florida College of Medicine. When those conditions are met, Spiguel said that younger women have increasingly opted for preventive mastectomies, especially if they have young children. Whenever possible, Spiguel encourages women to get through their childbearing and breastfeeding years before they consider removing their breasts. But some women remove their breasts even earlier if they’ve watched their mothers suffer

from the disease and want to avoid going through the same thing. Wendy Blaznik of Ocala, who had breast cancer, and has a strong family history of the disease, said that for her 23-yearold daughter Kristian, removing her breasts preventively is an option. “She’s very much ‘take care of business,’ said Blaznik, who works as the purchasing director of the Marion County Sheriff’s Office. Wendy Blaznik’s grandmother and mother both had breast cancer. Because Blaznik’s mother was diagnosed at age 45 — and breast cancer is generally both more aggressive and has a genetic component if it occurs

before age 50 — Blaznik knew she herself was at high risk. She was 27 when her mother died from the disease, and she considered having a preventive mastectomy. “But my doctors said that I was too young and that insurance wouldn’t cover it,” she said. Her doctors also discouraged her from getting genetic testing for the BRCA mutations, which were then just emerging. Back then, insurance companies didn’t cover cancer treatments for women testing positive for the mutations because they were considered pre-existing conditions. That was the early ‘90s, and about a decade later, at age 36, Blaznik was diagnosed with breast cancer and would have both of her breasts removed. “It moves very quickly when you are young. There was no talk of lumpectomy. There was no talk of mastectomy. It was a bilateral mastectomy all the way. There was really no choice because of my family history,” she said. Five years ago, Blaznik finally tested for the BRCA mutations. “My doctor recommended doing it. He said, ‘Let’s see where you stand because of your daughter,’” she said. The results of Blaznik’s test were inconclusive, and now they are waiting to see if insurance will cover testing for her daughter Kristian.

Boon of genetic testing Insurance companies no longer consider the BRCA mutation a pre-existing condition that would limit patients’ coverage, and the Women’s Health and Cancer Rights Act in 1998 opened the door for women undergoing mastectomies to be covered by insurance for reconstructive surgery as well. As a result, more high risk women are not hesitating to undergo genetic testing. Brown said, “I started the (hereditary breast cancer) program in 2001 and was

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Reducing Your Risk

Here are some steps you can take for breast cancer prevention and early detection based on your stage of life, according to Dr. Karen Daily, an assistant professor of medicine at the University of Florida and the founding director of the high-risk breast cancer clinic:

In your 20s & 30s: ■ Do

breast checks two weeks after your menstrual cycle. ■ Know your family history. ■ Breastfeed following pregnancy. ■ Get in the habit of regular exercise and good diet.

At age 35: ■ Consider taking

the Gail Model risk assessment, and chemoprevention, if you are done having children and have an above-average risk of breast cancer.

In your 40s: ■ Continue regular breast

checks and healthy habits. ■ Undergo annual

mammograms starting at age 40.

In your 50s: ■ Avoid Hormone

Replacement Therapy. ■ Continue to maintain a

healthy weight. ■ Undergo annual

mammograms and regular breast checks. ■ These practices can continue in the sixth, seventh and eighth decades of life.

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THE GAINESVILLE SUN | www.gainesville.com

AREA BREAST CANCER AWARENESS EVENTS

Gainesville events

Ongoing Roll Breast Cancer to the Curb: Gainesville residents can help support breast cancer awareness by ordering a pink garbage can for a $50 annual donation, which goes toward the Making Strides Against Breast Cancer annual walk. The program is a partnership between WCA Waste Corporation and the American Cancer Society. For more information, call the city of Gainesville Monday through Thursday at 334-2330.

ets: $20 per person. To purchase, contact Stacey Hayes at 367-5281 stacey.hayes@bbvacompass.com.

Saturday UF Health Pink Pumpkin Fest:

UF Health hosts the Pink Pumpkin Pedal-Off Charity Bike Ride at 8:15 a.m. The ride starts at Mowry Road and ends at the UF Health Cancer Genetics Research Complex on the corner of Archer Road and Gale Lemerand Drive. Participants can choose to ride a 20-, 40- or 55-mile route and are encouraged to wear pink ribbons. The registration fee includes a Dri-Fit shirt and lunch provided by Chuy’s Tex Mex. Proceeds benefit triple-negative breast Breast Cancer Fundraiser cancer research at the UF Health Luncheon: Making Strides Against Cancer Center. To register or to Breast Cancer hosts a luncheon to make a donation, call 273-5718. benefit the Jill Hayes Teston Breast ■ The UF Health Third Annual Pink Cancer Research Fund, 11:30 a.m.- Pumpkin Painting Party follows 2 p.m. at Carrabba’s Italian Grill, at 10 a.m., south lawn of the UF 3021 SW 32th St., Gainesville. Tick- Health Cancer Genetics Research

Tuesday

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Complex on the northwest corner of Gale Lemerand Drive. The family-friendly event provides free pumpkins for children to decorate in honor of friends and loved ones affected by breast cancer. To reserve a pumpkin, visit ufhealth. org/pinkpumpkinfest

Oct. 14 Look Good. Feel Better: The North Florida Regional Medical Center’s session will go from 10 a.m.-noon at the Cancer Center Campus of North Florida Regional Healthcare, 6420 Newberry Road. The session is devoted to helping cancer patients feel and look better. Call 1-800-227-2345 to register.

Oct. 21 Look Good, Feel Better: The American Cancer Society is hosting a “Look Good, Feel Better” event 1-2 p.m. at the Gainesville Hope Lodge, 2121 SW 16th St. The free program teaches beauty techniques to women cancer patients to help them combat the appearance-related side effects of cancer treatment. To register, call 376-6866 or 888-295-6787. For more information on the program, visit cancer.org.

Oct. 26 Gainesville Making Strides Against Breast Cancer: The 10th annual walk begins at 9 a.m. in downtown Gainesville. Visit makingstrides.acsevents.org to join a team or to donate.

Through Oct. 31 “Standing Up to Breast Cancer:” The North Florida Regional Medical Center displays 500 flamingos around its duck pond and a pink ribbon made of inner tubes in the duck pond. The exhibit honors the 500 women treated at the center for breast cancer over the past two years. The flamingos are sold in the hospital’s gift shop for $20 each. Proceeds go to the American Cancer Society. For more information, visit nfrmc.com.

Ocala events

Friday Second Annual “Making Strides Against Breast Cancer” Golf Tournament: The Nation Insurance Group and your local law enforcement officers and employees host the golf tournament at the Country Club at Silver

Springs Shores, 663 Silver Road, in Ocala. Registration and lunch begin at 11:30 a.m., and the shotgun start and four-man scramble begin at 1 p.m. Registration fee: $75 per golfer, which includes the greens fee, cart, range balls, lunch and beverages. Ale House and Papa John’s Pizza will serve food on the course. All proceeds benefit Making Strides Against Breast Cancer. For more information, contact Rochelle McAllister at rmcallister@ nationinsurance.com or 732-3881.

Oct. 17 Standing Up to Breast Cancer: The Ocala Regional Medical Center hosts an information session about breast cancer and women’s health, 10-11 a.m. at Senior Wellness Community Center, 9850 SW 84th Court, Ocala. The session will address how women can reduce their risk of getting breast cancer and what to expect after having a mammogram. Call 1-800-530-1188 to reserve your space for the session.

Oct. 19 Ocala Making Strides Against Breast Cancer: Registration for the Ocala event begins at 7 a.m., and the walk starts at 8:30 a.m. at the College of Central Florida, 3001 SW College Road in Ocala. Visit

makingstrides.acsevents.org to join a team or to donate.

Oct. 24 “Thursday Night Live:” The Ocala Royal Dames for Cancer Research host a musical event, 6-10 p.m. at Palm Grove at Oak Run, 6951 SW 115th St. Road, Ocala. Tickets cost $25 per person. Visit ocalaroyaldames.org to purchase a ticket.

Through Oct. 31 “Standing Up to Breast Cancer:” Ocala Health will decorate its lawn with pink flamingos to spread awareness of breast cancer screenings. The flamingos will be available to purchase for $12 at Ocala Regional Medical Center, West Marion Community Hospital, Ocala Health’s Senior Wellness Community Center, and at both Advanced Imaging Center locations. Funds raised will be donated to Michelle-O-Gram, a local organization that gives mammogram screenings to women with financial need. Advanced Imaging Centers also will offer digital mammograms for $179. To make an appointment or for more information, visit ocalahealthsystem.com.

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Reserve a free pumpkin to decorate in honor of friends and loved ones affected by breast cancer at UF Health’s Third Annual Pink Pumpkin Painting Party, which starts at 10 a.m. Oct. 12 on the south lawn of the UF Health Cancer Genetics Research Complex on the northwest corner of Gale Lemerand Drive. To reserve a pumpkin, visit ufhealth.org/pinkpumpkinfest.

www.gainesville.com | THE GAINESVILLE SUN

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Marion County man has new appreciation for life Breast cancer survivor Gene Kelly is enjoying every day after extensive treatment. By Rick Allen Staff writer

n the past year, Gene Kelly has taken a holiday cruise, secured a new job, traveled to Washington, D.C., with the Trinity Catholic High School band — and developed a new appreciation for life. This time last year, he was wrapping up chemotherapy treatments for breast cancer and was about to plunge into 26 days of radiation therapy. That’s right, he. “It’s a new year, a new start,” Kelly said. Kelly is a one-percenter in the sense that he is a male who was diagnosed with and survived breast cancer. One percent or fewer of new breast cancer diagnoses each year are men. This year, the American Cancer Society estimates that 2,240 men in the U.S. will be diagnosed with what is typically considered a women’s condition. Slightly more than 400 men will die from it. According to the National Cancer Institute, the survival rate for men is about the same as for women. It’s just that in men, breast cancer often is diagnosed at a later stage, thus decreasing the odds of survival. Kelly said he gets a lot of surprised reaction when other men find out he has had breast cancer. “They look at me, ‘You’re kidding, right? I heard of that. You’re the first one I’ve met,’” he said. And even some women aren’t aware that men are not immune, he added. “I was floored when my oncologist said men are as likely to get breast cancer as they are to get testicular cancer,” Kelly said.

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FILE/2012

ABOVE: Breast cancer survivor Gene Kelly talks about his cancer diagnosis in his Ocala home last year. LEFT: A year after wrapping up his treatments, he is back doing what he loves — volunteering with his son’s Trinity Catholic High School band.

CYNDI CHAMBERS/CORRESPONDENT

When he finished radiation at the end of last year, Kelly and his wife and son took a cruise for the New Year’s holiday. “It was good to get out and do some stuff,” he said. While at sea, he interviewed for a new job with Marion County, and got it. “I now manage the parts room for the county,” Kelly said. He oversees 1,500 pieces of equipment, from lawn mowers to the county’s fire trucks. He also finds time to help out with the Trinity Catholic band, as well as help run retreats for Blessed Trinity Catholic Church. As an involuntary member of a

very limited fraternity, Kelly has found he is in demand to talk about male breast cancer awareness, such as addressing a class of second-year medical students at the University of Florida. “Well, the class was set up auditorium style,” he said. “I was dressed nice and sat down in the front row. I could hear all the students talking among themselves, ‘I thought we were going to have a guest speaker about breast cancer. I guess not.’ “If you could have seen their faces when I was introduced and stood up, they were awestruck. They were more stunned by me

than by the fact that men can get breast cancer,” Kelly said. “I hope I opened their eyes some. That whatever specialty they go into, when somebody comes through the doors don’t minimize what it could be,” he added. Kelly said his doctor initially considered the lump in his left breast was “probably just a cyst or something” — but ordered a mammogram anyway. “I have a newfound respect for what women go through with them,” he quipped. In August, Kelly was a keynote speaker at the kickoff rally for the Making Strides Against Breast Cancer fundraising walk in Marion County later this month. “I was thrilled when Gene agreed to come and share his story at the MSABC kick-off event,” said Morgan Brantley, community representative for the American Cancer Society in Ocala. “I feel like we lose sight of the fact that cancer does not discriminate when it comes to gender, because breast cancer is publicized with all the pink and is directed at women,” Brantley

added. “Gene getting up and telling his story hopefully gives other men the confidence to come forward and share their stories as well.” Kelly said he was a bit embarrassed by the pink “survivor” sash he was asked to wear and that it might not have been so bad had it been a pink and blue sash. Blue is the symbol for male breast cancer awareness. But, Kelly said, he was more concerned other survivors might think he was making light of them. “No, I really am a breast cancer survivor,” he said. “I have nothing to hide. “I’ve been blessed,” Kelly continued. “If I hadn’t found that lump by accident, I might not be here now. But I’m living on restored time; I do have a future. I’m looking forward to my kids growing up, maybe grandkids someday. “If one person gets to realize they need to keep an eye out, that’s good,” he said. “I’ve done my job.” Rick Allen can be reached at rick.allen@starbanner.com or 867-4154

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Wearing the badge of a breast cancer survivor Membership to the suvivors’ club is going strong nationally thanks to early detection and treatment By Andrea Carroz and Meghan Pryce Correspondents

ore than 2.8 million people in the U.S. can claim the badge of having beat breast cancer. The four women who share their stories below lead different lives and come from different backgrounds. But they have at least two things in common: They are all mothers and breast cancer survivors. Krista Campbell, Sharon Jank, Kim Davis and Natalie Valdez all went through some form of surgery and treatment for the second most common cancer among American women. The most common is skin cancer, according to the American Cancer Society website.

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A Positive Mindset When Kim Davis walked into her doctor’s office on April 30, 2010, she was positive everything would be OK. That was the day she was diagnosed with breast cancer at the age of 36. She said she was shocked because she was so young at the time and had no history of cancer in her family. Davis was told she had cancer in her left breast and that tests had revealed two suspicious spots in her right breast. She was treated at the Florida Cancer Specialists and Research Institute in Gainesville and opted to have a bilateral mastectomy and immediate reconstruction. Seven months of chemotherapy followed. Complications from treatment forced Davis to temporarily leave her job teaching preschool at Oak Hall School only three weeks into the school year. She was able to go back in October once chemotherapy was complete. “It gave me a sense of normalcy,” she

DOUG FINGER/STAFF PHOTOGRAPHER

Kim Davis, a preschool teacher at Oak Hall, teaches 3-year-old students a song about fall during class last month. Davis was 36 when she was diagnosed with breast cancer. She had surgery and chemotherapy and has a 7 percent chance of it returning. said. “Going back to work was so important because it meant getting everything back to the way it should be.” Davis recalled spending eight nights in the hospital, which she said were the worst nights of her life. She said it was difficult to be away from her husband, Matt, and their two sons, Matthew and Andrew, who were only 11 and 9 at the time. “I think the harder part was not

“You have to have a positive outlook. I had no choice. I had a husband and two great kids at home.” KIM DAVIS, Oak Hall teacher and breast cancer survivor being able to be their mom as much as I needed to be,” she said. Her husband took care of all the schedules and appointments so she could concentrate on getting better. He said it made him feel useful and

helped him cope. “It is an incredibly trying experience, but I think it’s something that has brought us much closer together,” he said. Davis remembers the night she

decided to shave her hair with her family. She described it as the “night of tears.” Her husband and younger son helped while her older son only watched. She said she thought her boys worried she would blow away at any second. Davis now has a 7 percent chance the cancer will return, but she is still standing. She said her optimism is what got her through this journey. “You have to have a positive outlook,” she said. “I had no choice. I had a husband and two great kids at home.”

Still Fighting Sharon Jank doesn’t smoke, isn’t overweight and eats mainly organic and gluten-free foods. She wondered what she was doing wrong after she was diagnosed with breast cancer in April when she was 50 years old. “That’s the scariest word you can hear as a mom,” she said. “You just think the worst.” When Jank, of Ocala, first felt the

lump under her right breast, she thought it was scar tissue because her last mammogram hadn’t shown anything of concern. Jank received her diagnosis when she went to the doctor again after the lump grew. She said her doctor said the mammogram was too black and thick to see the cancer, but luckily, the cancer was caught early. Jank received chemotherapy, radiation and surgery at University of Florida Health in Gainesville. Although her margins were clear everywhere else, she still had cancerous cells near her chest wall. Now, Jank is receiving proton therapy at the UF Proton Therapy Institute in Jacksonville. Proton therapy is a relatively new form of radiation therapy that uses beams of protons to deliver more targeted, precise doses of radiation to the cancer. She said she feels the therapy is a better fit for her because it won’t cause damage to any underlying organs. The therapy minimizes the amount of scattered radiation going into her lungs. Jank, who has four children, said her eldest daughters immediately started playing the caregiver role when she was diagnosed and insist she eat healthy meals. One day, Jank posted a photo of chicken wings on Facebook and minutes later her phone was bombarded with scolding text messages from

“You can’t help but get scared and feel so alone. You have to constantly be reassured.” SHARON JANK, Marion County resident receiving proton therapy

her daughters. She said she sometimes has to hide food from her children. “That’s how bossy they are, and I love them for it,” she said. Jank said she is a very worried person, but the support she receives from her husband, children and the community help her stay calm. “You can’t help but get scared and feel so alone,” she said. “You have to constantly be reassured.”

A Doctor’s Fight Going through breast cancer, chemotherapy, raising a child on her own and working as an anesthesiologist was tough for Dr. Natalie Valdez. Valdez, who works at North Florida Regional Medical Center, was diagnosed with breast cancer in February 2009 at age 41. “Initially, it was devastating,” she said. She went three days without telling

BRUCE ACKERMAN/STAFF PHOTOGRAPHER

Marion County resident Sharon Jank listens as her son, Gerry, 20, a student at Santa Fe Community College, plays the piano at their home in The Country Club of Ocala. Jank was diagnosed with breast cancer in April, finished her chemotherapy at the end of June and had surgery in July. She is currently undergoing proton radiation treatments at the University of Florida Proton Therapy Institute in Jacksonville.

“My reason to get cancer was to meet people. That’s how I see it.” DR. NATALIE VALDEZ, anesthesiologist and breast cancer survivor anyone and afterward decided to have a bilateral mastectomy, a process where both breasts are removed. Her son, Eugene Brown, who was 13 at the time, was quiet and very protective of her once he found out. While going through chemotherapy, Valdez decided to keep working at the hospital to make the process easier instead of staying at home and feeling “like crap.” “At times, it was bad. But I had really good friends, and sometimes I wanted to quit chemo,” she said. Valdez said she experienced common symptoms such as fatigue and nosebleeds while going through her treatment. “I woke up in the morning and it took me a good 45 minutes to take a shower, and I had to catch my breath because I was tired,” she said. One thing that didn’t bother her from the chemotherapy was her hair loss. She admits that she actually misses being bald. Valdez is almost 5 years cancer-free, and at work she makes sure to tell others not to neglect this disease. She said she tells breast cancer patients stories of other survivors and lets them know it’s not the end of the world and that cancer is a very treatable disease. Valdez said she is the first woman in her family to have breast cancer, but she doesn’t worry anymore. “My reason to get cancer was to meet people. That’s how I see it,” she said.

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Breast cancer survivor Krista Campbell, 59, of Old Town, a karaoke singer and DJ at Chiefland Billiards, plays her guitar at the American Cancer Society’s WinnDixie Hope Lodge in Gainesville.

SURVIVOR: Found support, friends at Hope Lodge Continued from 9

“There were so many things that breast Against the Odds cancer robbed me of, but on the (other) Krista Campbell said she hand, the one thing that breast cancer laughed more than she gave me was an appreciation for the cried through her breast cancer journey. sickness.” Every weekend from May to June 2012 she and her husband watched reruns of the popular comedy show America’s Funniest Home Videos, which served as a comic relief for her. During the week, however, she lived in the American Cancer Society’s Winn-Dixie Hope Lodge, 2121 SW 16th St., a free housing facility for cancer patients who live far from their treatment center. While living at Hope Lodge, Campbell said she had daily radiation for seven weeks at the Cancer Center at North Florida Regional Medical Center. She found support from her neighbors at the Hope Lodge and developed a new family. It’s been two years since her diagnosis and Campbell is back home with her husband in Old Town. She is waiting to reach the

KRISTA CAMPBELL, Old Town resident and breast cancer survivor five-year mark of living without breast cancer. Over the past 300 years, every woman on her mother’s side of the family has died from some form of cancer, said Campbell, whose mother is 37 years cancer-free. Campbell said she was aware of her risks for cancer and had annual mammograms since she was in her 30s. In early February 2012, Campbell was diagnosed with breast cancer at age 58. That same year in March, Campbell had a partial mastectomy, where the bottom portion of her left breast was removed. “There were so many things that breast cancer robbed me of,” Campbell said, “but on the (other) hand, the one thing that breast cancer gave me was an appreciation for the

sickness.” Although she was often tired, Campbell said she tried to lead her life as normally as possible. On the weekends, she worked as a disc jockey at a club and worked out three times a week at the Gainesville Health and Fitness Center. “It was easy for me to stop at the gym, swim some laps, lift some weights to try to keep myself not just physically, but also mentally, fit,” she said. “I didn’t want to stop just because I had cancer,” she said. Today Campbell walks almost every day and rides her bicycle. She also continues to work as a DJ every Saturday at Chiefland Billiards in Chiefland.

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3-D biopsies offer new hope in fight against breast cancer By Marina Bolotnikova Pittsburgh Post-Gazette

ome women tested for breast cancer now have a faster screening option that eventually could supplant older screening techniques across the country. In June, Magee-Womens Hospital of University of Pittsburgh Medical Center in Pennsylvania became the first hospital in the country to perform a 3-D guided breast biopsy, a procedure that more quickly and accurately locates possible cancers and exposes patients to less radiation than older methods, said Dr. Jules Sumkin, chief of radiology at Magee. The idea to develop the technology came when Magee researchers worked with Hologic Inc., a company that manufactures mammography and breast biopsy equipment, to develop tomosynthesis, a 3-D mammography technique, in 2005. Radiologists found that tomosynthesis allowed them to find abnormalities in the breast that are difficult to see using conventional mammography. Tomosynthesis has allowed radiologists to identify about 30 percent more breast cancers than conventional mammography, Sumkin estimates. But it was difficult to reproduce the advanced images taken by tomosynthesis mammography with the imaging tools in existing biopsy technology. Magee researchers and Hologic addressed that issue by developing a 3-D

S

Tomosynthesis has allowed radiologists to identify about 30 percent more breast cancers than conventional mammography, Dr. Jules Sumkin, chief of radiology at Magee, estimates. guided breast biopsy technique. The technology improves biopsy technology in much the same way that tomosynthesis advanced mammography: Three-dimensional imaging creates a complete reconstruction of the breast to more accurately identify possible lesions and calculate their depth. In traditional guided biopsies — known as stereotactic biopsies — images are taken at two angles of the breast to calculate the depth of the possible lesion. The 3-D technique is able to measure lesion depth more accurately. Not all women require biopsies using mammography as a guide. But those who do, including women with especially hard-todetect cancers, will especially benefit from 3-D guided biopsy, Sumkin said. “If we can do a biopsy with ultrasound guidance, that’s preferable,” he said, “but there is a subset of patients where you can’t find it by ultrasound” because of body variations.” During a 3-D biopsy, a patient sits upright rather than lying on a table. This

benefits women who have difficulty lying down due to arthritis or other health complications, Sumkin said. Among other benefits to patients using this technology, procedure time is shorter and exposure to radiation is reduced. Because the stereotactic method requires that at least two images be taken, more X-ray doses are needed. Unlike stereotactic biopsies, which require expensive, standalone machines, 3-D biopsies are performed using a piece of equipment attached directly to tomosynthesis machines, which saves money, Sumkin said. Still, tomosynthesis is far less prevalent than two-dimensional mammography. Sumkin cited cost as the main barrier to hospitals’ adoption of the technology. “For a hospital to buy this equipment and not be reimbursed for it does not work in this day and age,” he said. Magee so far has performed 50 to 60 3-D guided breast biopsies, Sumkin estimates. Even though it’s a new procedure, some insurance plans have been covering its cost, but some, including Medicare, do not cover tomosynthetic mammograms, he said. Sumkin is optimistic that the benefits of tomosynthesis can save money in the long term. Tomosynthesis allows doctors to detect and treat deadly cancers early, which is much less costly than treatment at later stages.

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TESTING: Insurance companies

no longer consider the BRCA mutation a pre-existing condition Continued from 5

THE OAKS PINK PROMISE DISPLAY MAKE A “PROMISE” TO GET A MAMMOGRAM FOR EARLY DETECTION OCTOBER 7TH-12TH

knocking on doors. Now we have a waiting list,” Brown said. “Awareness is definitely there.” She added that Angelina Jolie’s announcement of her surgery didn’t cause an increase in “inappropriate referrals,” adding, “It did help women come out of the closet, so to speak.” Apart from family history, other breast cancer risk factors include early menarche and late menopause — in other words, a longer period of estrogen exposure. Spiguel said that all women, regardless of risk, need to know their bodies. “Everyone’s breasts are lumpy and bumpy, but if you notice change” consult

your doctor. “Screening mammograms are shown to increase survival, so don’t be scared,” Spiguel added. General guidelines are that women should start screening at age 40, but if you have a first-degree relative who was diagnosed with breast cancer, start screening a decade before their age at diagnosis. So if you’re mother was diagnosed at 52, start getting mammograms at 42. Dr. Karen Daily, the founding director of the high risk breast cancer clinic at UF, said there are other things that high-risk women can do to lower their risk. For example, taking chemoprevention drugs such as tamoxifen reduces breast density,

which in turn lowers breast cancer risk. “It’s frustrating because tamoxifen reduces breast density, but it’s a hugely underused technique. Only about 4 percent of people qualified to take it do take it. I’ve seen a lot of missed opportunities,” Daily said. Daily’s clinic focuses on prevention and early detection, and she encourages people to maintain a healthy weight and eat a low-fat diet. “Everyone forgets the common things, but it doesn’t get old to quit talking about them,” she said. Contact Kristine Crane at 338-3119, or kristine. crane@gvillesun.com

FAS HI O N E V E N T Oc to b e r 12 , 1p m -3 p m B e l k Cou r t Fa s h i on - F u n - Fre e b ie s

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Oncologist Karen C. Daily visits with patient Sara Tillmon of Tallahassee during an appointment at the Hematology and Oncology Shands Infusion Center at UF Health Shands Medical Plaza in Gainesville.

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Support services offer treatment, financial assistance Diagnostics/ Treatment ACORN, INC. MEDICAL CLINIC: Provides low-income women ages 50 to 65 with free breast cancer screenings during any office visit. Location: 23320 N. State Road 235, Brooker. Hours: 8:30 a.m.-5 p.m. Monday through Thursday; and 8:30 a.m. to 8 p.m. Tuesday. For more information, call 485-1133 or visit http://www. acornclinic.org/ UF HEALTH BREAST CENTER: Offers treatment options, including chemotherapy, radiation, hormone therapy and breast reconstruction, for benign and cancerous breast conditions. For directions and to schedule an appointment, call 2657070. UF HEALTH HIGH RISK BREAST CANCER CLINIC: Breast cancer prevention measures for women who are at high risk for cancer based on family history or prior breast biopsies. The clinic sees patients Monday mornings and provides individualized care. The program is led by UF medical oncologist Dr. Karen Daily. Visit shands. org/breastcenter or call 265-7070. NORTH FLORIDA REGIONAL MEDICAL CENTER BREAST HEALTH PROGRAM: Provides patients with mammograms, breast ultrasounds, minimally-invasive breast biopsies, treatment options and reconstruction. It is located at 6500 Newberry Rd. 1-800-6116913.

Support/Outreach CANCER RECOVERY PROGRAM:

Gainesville Health & Fitness and ReQuest Physical Therapy partner to provide a free four-week class taught year-round for cancer patients and survivors. To learn more, call Debbie Lee at Gainesville Health & Fitness at 377-4955 or the ReQuest Physical Therapy Center at 373-2116. PAT’S PERFECT FIT: The business sells mastectomy apparel and supplies, as well as orthopedic soft goods, wound care supplies and aids to daily living. Location: 3501 SW Second Ave. For more information, call 3776060. ESPECIALLY FOR WOMEN: The firm offers a full line of breast forms and mastectomy bras for every type of breast surgery, as well as hairpieces, swimwear, headwear and lymphedema sleeves. Location: 6781 W. Newberry Road, Oaks Mall Plaza. (332-9095) THE AMERICAN CANCER SOCIETY: The Alachua County Unit, 2119 SW 16th St., offers a number of programs, including: ■ Resource Center: Free bras, wigs, hats and more to all cancer patients who ask — no exceptions. ■ Look Good, Feel Better: Classes by professional cosmetologists to teach women hair, nail and makeup techniques to combat the side effects of treatment. ■ Road to Recovery: Rides to and from medical appointments to patients in need. ■ I Can Cope: A free educational program for people facing cancer – either personally or as a caregiver. This program provides participants with

reliable information, peer support and practical coping skills. ■ Reach to Recovery: Pairs a person recently diagnosed with breast cancer with a breast cancer survivor to help guide the patient through treatment and recovery. For details on all programs, call 1-800-2272345 or 376-6866 CATHOLIC CHARITIES OF GAINESVILLE: This outreach provides emergency assistance to people in need to help with food, utility bill, prescription assistance and more. Location: 1701 NE Ninth St. Visit http://catholiccharitiesgainesville.org/ or call 372-0294. THE AMERICAN CANCER SOCIETY: Th group offers free, comprehensive patient services and programs that help with emotional, physical and psychological needs associated with cancer. The organization has two Hope Lodges in Florida that offer free lodging and emotional support for cancer patients in Gainesville and Tampa. The Winn-Dixie Hope Lodge, 2121 SW 16th St. For more information call 352-338-0601. UF HEALTH SHANDS ART AND MEDICINE: Programs cater to hospitalized patients, such as bed-side crafts, creative writing, personal journaling, guided meditation and yoga. The program also provides a space away from the medical aspect of Shands through comfy chairs, an extensive library and computers. 1430 SW 13th St. To learn more, visit http://artsinmedicine.ufhealth.org/ or call 733-0880.

GAINESVILLE BREAST CANCER SUPPORT GROUP: The free monthly group welcomes breast cancer patients and survivors, and women with all forms of cancer. It meets every third Monday of the month at Trinity United Methodist Church, 4000 NW 53rd Ave. For more information, call Nancy Mackintosh at 386-418-3737 or Debbie Ryan at 386-418-0454. HEALING TOUCH CANCER SUPPORT GROUP: The spiritual group welcomes all cancer patients, survivors, family members and friends at 5:30 p.m. the third Thursday of every month at Trinity United Methodist Church, 4000 NW 53rd Ave. in the O. Dean Martin Prayer room. To learn more, call 331-2960.

ence room, 2121 SW 16th St. Meetings are open to patients, survivors, caregivers, family members and healthcare providers. The meetings educate patients and providers about resources in the area by bringing together people to network. Contact Barb Thomas at 377-4427 or bnbbarb@aol.com.

Holistic Options DRAGON RISES COLLEGE OF ORIENTAL MEDICINE: Offers a non-traditional approach to cancer treatment and recovery through the use of acupuncture, herbal medicine, lifestyle consultation and thera-

peutic massage. The college is at 1000 NE 16th Ave., Building F. For more information, call 371-2833 or http://www.dragonrises.edu/ QIGONG AND TAI CHI: Sifu Anthony Korahais teaches at his studio, Flowing Zen, which welcomes people of all athletic ability. Tai chi and qiqong can relieve the side effects associated with cancer treatment, including reduced pain, stress and nausea, according to the breastcancer.org website. The studio is at 5127 NW 39th Ave. For more information, call 327-4023 or visit http://flowingzen.com/

CANCER CONNECTIONS: Meets one Wednesday a month at the Hope Lodge confer-

Breast Cancer affects mothers, daughters and friends from all walks of life. Help in the ongoing fight against breast cancer by scheduling a mammogram for yourself today! Also, encourage others you know to do the same. Early detection does save lives. Sponsored by:

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Pre-chemo options may help women preserve fertility Emily Wax The Washington Post

hen Michele Foust received a diagnosis of Stage 2 breast cancer this spring, she typed out a list of questions about her treatment. At the top of the 26-yearold’s concerns was an unknown that haunts many young cancer patients: “If I survive, will I be able to have children?” Foust’s breast surgeon was unsure and told her she thought it was likely that chemotherapy would impair her chances by damaging healthy eggs as fast as it killed other rapidly dividing healthy cells such as hair follicles. Indeed, says Neelima Denduluri, a breast medical oncologist at

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Virginia Hospital Center, “chemo is a real risk to fertility.” Certain regimens, she says, “are more likely to cause infertility and decreasing of sperm count,” with up to 80 percent of patients affected, with exact rates depending on the type of cancer treatment and age at diagnosis. Despite this, medicine has come a long way recently toward helping cancer patients — women especially — preserve fertility prior to treatment. The most common and successful option for a woman with cancer is freezing an egg or embryo before undergoing chemotherapy or radiation. Once the patient decides she is ready to get pregnant, she is given

estrogen and progesterone to prepare the lining of the uterus. The embryo is then thawed (or the egg is inseminated) and transferred into the uterus. Success rates specifically for cancer patients have not yet been studied. But in vitro fertilization (IVF) rates are around 50 percent for women younger than 35. (For men with cancer, freezing sperm before treatment is far less invasive and less expensive.) There are also experimental options such as ovarian tissue freezing, in which all or part of an ovary is removed and the outer area, which contains the eggs, is frozen in strips for later use. The ovary can be reimplanted when

the patient is well. The procedure typically costs around $12,000; because it is experimental, research centers often provide funding, according to Teresa Woodruff, a professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University. Woodruff refers to such procedures as part of oncofertility, a new discipline that bridges oncology and reproductive medicine. “I really appreciated there were so many advances in cancer therapy, yet so many young survivors were ending up sterilized,” Woodruff said. “There was a real need for a focus specifically in this field.” ■■■

About 140,230 Americans younger than 45 will receive a cancer diagnosis this year, the American Cancer Society projects. The large majority of them are likely to survive for five years or more. But only recently has fertility been factored into a patient’s treatment plan, according to Mark Payson, a reproductive endocrinologist at Dominion Fertility, a practice based in Arlington, Va. When he speaks to breast cancer support groups, patients say that “only half of their oncologists talk to them about fertility options.” Last month, a study by researchers at the University of Sheffield in England found that only 40 percent of young female cancer patients were happy with the way their doctors discussed the options they had to preserve fertility. Most doctors are typically more concerned with saving the patient’s

THE WASHINGTON POST

Michele Foust, here with her husband, Andrew, plans to have her frozen eggs thawed when she is ready to become pregnant. life than with fertility options, Payson said. When Ilana Brunner’s breast cancer was discovered in 2009, she quickly embarked on fertility treatments in order to freeze some embryos before chemo began. But she was concerned others might not know to take the same steps. “When I started chemo, they hooked me up to the machine and made me watch a video about cancer and chemo. But the video never mentioned fertility for women,” though it mentioned it for men, said Brunner, a 40-year-old lawyer who lives in Silver Spring, Md. “I actually

complained. To me, it was a travesty.” Foust’s fate was different. A few days after her initial conversation, she and her husband got an urgent phone call with a new plan for her treatment. Her breast surgeon at Virginia Hospital Center had set up a conference call with Stephen Lincoln, a reproductive endrocrinologist with the Genetics & IVF Institute’s fertility preservation center for cancer patients: She would be able to try to freeze her eggs or embryos before her treatment.

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FERTILITY: Treatments rarely covered by insurance and drugs are costly Continued from 14 Genetics & IVF, along with other well-known fertility centers, is part of a nationwide effort to encourage oncologists and their staffs to talk to cancer patients about their increasing fertility options. “Everyone is recognizing now that talking about fertility is a part of dealing with cancer,” Lincoln said. “People aren’t just being rushed right into treatment anymore.” Denduluri concurs. “The awareness is just much higher now, whereas before many were concerned with finding the so-called cure and saving the patient’s life,” she said. “It’s more a balancing act now, and there are more strident feelings about the importance of bringing up fertility issues at the beginning of treatment.” ■■■

In late May, Foust went to the Genetics & IVF pharmacy near her home in Annandale, Va., and went home with a supply of vials of gonadotropins, hormones that stimulate the ovaries to produce eggs for retrieval. She would have to give herself injections every day for the next two weeks. Then Lincoln and his team would extract her eggs, a procedure done with light sedation. (The process is typically the same one used for any woman who would like to have her eggs frozen to preserve her ability to have children.) In breast cancer cases, doctors want to keep estrogen levels low because of concern that raising them might accelerate the growth of a tumor. Foust’s doctors combined a low dose of

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Ilana Brunner had her eggs frozen before her double mastectomy and again before chemotherapy. Neither step led to a pregnancy. But she later retrieved eggs that were fertilized with her husband’s sperm, resulting in the birth of twins Lyla, left, and Aryeh. gonadotropin and a medication that promotes ovarian stimulation while keeping estrogen levels low. “It was amazing that they could actually do this, safely. At the same time, you never think as a 26-year-old that the ability to bear children — something I was looking forward to — will be taken away from you,” said Foust, an emergency room nurse. She decided to freeze eggs instead of embryos because she was concerned about having embryos she might not use. There was also a chance that she could have children naturally, depending on how much harm chemotherapy caused to her fertility. “If I had children somewhere frozen, I would wonder what to do: Do you donate them? Do you send them to science?” she said. Just a few years ago, Foust wouldn’t have been

able to consider this problem. Back then, egg freezing had far lower success rates and was considered experimental by the American Society for Reproductive Medicine. That label was lifted in October, thanks to improved success rates with a new flash-freezing technology known as vitrification. “It’s been a massive leap forward,” said Frank Chang, a reproductive endocrinologist at Shady Grove Fertility Center, which has offices in Washington, Maryland, Pennsylvania and Virginia. A growing number of oncologists reject the traditional view that the hormones used to stimulate eggs for retrieval — as well as pregnancy itself — might increase the risk of developing certain cancers. Today many doctors see both the freezing process and pregnancy as safe after three to five years of

tamoxifen, a hormone drug used with breast cancer patients, according to Denduluri. And although large-scale data are still being collected about recurrence rates after pregnancy, tumor histories are also looked at on a case-bycase basis to see if carrying a baby is safe, according to Denduluri. There are also smaller studies showing that pregnancy after a breast cancer diagnosis does not carry a negative outcome as long as a patient waits two to three years after starting treatment with tamoxifen, Denduluri said. Treatments are viewed as elective and are rarely covered by insurance. Fertility drugs can cost $6,000 a round or more; egg retrieval and freezing can be another $5,500. For freezing embryos, the process can run $6,500 and more. ■■■

Many fertility centers

help cancer patients find help with funding their drugs. The Livestrong Foundation’s Fertile Hope program has helped close to 4,000 survivors since 2004, said Ashley Koenings, senior navigator for fertility services. Each month, the program helps about 80 people. Shady Grove works with Walgreens, which donates drugs to patients whose insurance does not cover them. Shady Grove also has financial assistance for egg retrieval, depending on a patient’s income level. But even with financial help, the emotional toll is often severe. “For once, could my body work with me instead of against me?” Brunner said of her efforts to retrieve her eggs. “During that time, a pregnant woman in a supermarket put me in tears.” Brunner froze her eggs twice — once before her double mastectomy and another time before chemotherapy. “Someone said, ’Are you sure you want to do this and start poking yourself with needles?’ And I said, ’This is nothing compared to what I have to do with cancer.’“ After two unsuccessful embryo transfers, including with a gestational carrier (a woman who volunteered to carry the pregnancy for Brunner), she tried again, post chemo. She was able to get one viable egg the first round and one more the second. Both were fertilized with her husband’s sperm using IVF and were implanted in a new gestational carrier. Her positive outcome in retrieving viable eggs after chemo is uncommon, doctors said. Today, she

has twins who are 9 months old. At a recent Shady Grove Fertility’s Family Day, her twins wore onesies that said, “Made with love . . . and science.” Meanwhile, Foust was able to freeze 15 eggs. When she is ready to become pregnant, the eggs can be thawed, fertilized and transferred to the uterus as embryos. She is currently going through eight rounds of chemotherapy. Knowing that her eggs are frozen brings her comfort. “I remember seeing a picture in my breast surgeon’s office that has a list of things that cancer cannot do,” she said. “And I wanted that to include that it couldn’t take a pregnancy away from us. Even if we never use the eggs or get pregnant on our own, it would be a blessing. I refer to my frozen eggs as my pocketful of sunshine.”

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