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Summer 2013 | Vol. 1, No. 3

Your Connection to Healthy Living

Navigating unfamiliar waters

Men facing prostate cancer need to weigh many factors when choosing treatment.

Jon Sorenson is back building ships after choosing robotic surgery at Porter Adventist Hospital to treat his prostate cancer. Read his story on Page 4. 

Inside this Issue

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 3 out of 10 Colon Cancers Hereditary  Easing Arthritis With Exercise  FREE Women’s Health Expo

porterhospitallorg :: Spring 2013

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Photo by Ellen Jaskol


colon Cancerhas genetic link Little-known syndrome causes high risk Although many people now know that breast cancer can be caused by a genetic trait, few know that there is a genetic trait that causes just as much colon cancer in both men and women. The Porter Lynch syndrome, also known as hereditary Adventist Hospital nonpolyposis colorectal cancer (HNPCC), causes Cancer Care three in every 100 cases of colon cancer. That’s about the same number caused by the breast cancer Center is part genetic mutation known as BRCA1 and BRCA2. of the Centura Health Cancer One in 500 people has Lynch syndrome, which Network, delivering gives a person a 50 to 80 percent chance of integrated, developing colon cancer. (An average person with no known risk factors has about a 5 percent chance advanced cancer of developing colon cancer.) care across Colorado. “Few people know about this syndrome, but it’s the most common form of inherited colon cancer,” says Melissa Gilstrap, MS, CGC, certified genetic counselor at the Porter Adventist Hospital Cancer Care Center.

Signs of Lynch syndrome:  Three relatives with cancers associated with Lynch syndrome  Two or more cancers associated with Lynch syndrome in one relative  Ten or more polyps of any sort found at one time

In addition to causing colon cancer, Lynch syndrome also increases the risk of ovarian, uterine, renal, stomach, and pancreatic cancers. Lynch syndrome is so common yet so unknown that Porter Adventist Hospital screens all patients with colon and rectal cancers for markers of the genetic mutation. If a patient shows markers of Lynch syndrome, the patient is referred to Gilstrap for genetic counseling and possible genetic testing. You can learn more about Lynch syndrome online at porterhospital.org/genetic-counseling.

A Nice Nap Colonoscopies aren’t so bad … really! Colon cancer, the second most deadly type of cancer, is one of the few cancers that can actually be prevented. But it takes a colonoscopy to do that, and most people loathe having this procedure. A colonoscopy entails having a physician, typically a gastroenterologist, run a scope with a camera through your rectum and colon. If the physician finds a suspicious lesion or polyp, it will be removed and biopsied. All colon cancers start as a polyp, so removing the polyp prevents the cancer from developing, says Wesley Kasen, MD, a gastroenterologist at Porter Adventist Hospital.

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VIBRANT :: Porter Adventist Hospital

A 20-minute test Although a colonoscopy sounds uncomfortable, the actual procedure — thanks to anesthesia — is not unpleasant and takes only about 20 minutes (although you will be in the doctor’s office about two to three hours total). Most patients will be given propofol, an anesthesia that puts them to sleep within 15 seconds. “Almost everyone says it’s the most amazing nap they’ve ever had and ask for a doggie bag to take one home,” Kasen says. No cost to patient People with no known risk factors should get their first colonoscopy at age 50 (45 if you are African-

American). If you have health Dr. Wesley Kasen insurance or Medicare, screening colonoscopies should be covered with no cost to you. However, if a polyp is discovered, the procedure may be reclassified as therapeutic and copays can apply.

Learn More Join Dr. Kasen on Oct. 2 to learn more about colorectal cancer prevention. See back cover for details. 


Troubled Joints Extra weight causing two types of arthritis

It’s well understood by now that extra pounds exacerbate osteoarthritis, a type of arthritis caused by wear and tear on the joints. But doctors are now seeing a link between obesity and rheumatoid arthritis, a different form of arthritis that is believed to be caused by genetics and environment. “We don’t fully understand the link with obesity,” says Todd Miner, MD, an orthopedic surgeon and joint replacement specialist at Colorado Joint Replacement in Denver. “But we do know that if a person has the genetic markers for either type of arthritis, being overweight will result in greater joint destruction at an earlier age and more severe symptoms.” Osteoarthritis develops when the cushioning cartilage between joint bones erodes, leaving bone scraping against Dr. Todd Miner bone. This type of arthritis generally occurs through trauma or through wear and tear. Being overweight puts more pressure on the joints, leading to faster erosion. Contrary to popular belief, high-impact sports such as running and basketball do not cause osteoarthritis, Miner says. “Genetics predispose a person to arthritis,” he says. “We’ve seen runners with very high mileage go their whole lives without any problems, and other people who have never run a mile develop arthritis.” However, if a person is predisposed to arthritis or starts to develop it, it is best to avoid high-impact sports to help preserve the joint as long as possible, Miner adds. Unlike osteoarthritis, rheumatoid arthritis can develop as early as adolescence or throughout life. With this type of arthritis, the body’s immune system causes erosion of bone and loss of cartilage with multiple joints typically affected. Also, the synovial fluid in the joint becomes inflamed, leading to destruction of soft tissue in the joints. Rheumatoid arthritis is the most common form of inflammatory arthritis and occurs more often in women. The correlation between obesity and rheumatoid arthritis is not fully understood. One theory is that obesity, which causes inflammation throughout the body, also causes inflammation in the joints and leads to deterioration of cartilage in the joints. Even without knowing the dynamics, however, it is clear that the more weight a person carries, the greater the likelihood of arthritis, Miner says.

Photo: EXERCISE ©iStockphoto.com/aabejon

Schedule your mammogram by text Have you been meaning to schedule your annual mammogram, but the only time you remember is in the middle of the night? The Porter Breast Center has started a new program just for you. You can now text your name to 303-872-7469, and one of our schedulers will call you within two business days during business hours to schedule a time that is convenient for you. We’ll also retrieve past results from other facilities, if needed. Early morning appointments beginning at 7 a.m. are available.

Exercise

Eases Arthritis For people with arthritis, regular physical activity aids joint flexibility, improves balance, and helps achieve lasting relief from chronic pain. Yet in a study published earlier this year, 42 percent of participants with rheumatoid arthritis did not engage in even 10 minutes of sustained physical activity once per week. The top reasons for not exercising? Surprisingly, participants cited lack of motivation and disbelief in the benefits of exercise — not pain — as the reason for not exercising.

Arthritis Day Learn more about arthritis and exercise, new treatments for arthritis, and joint replacement — including the new anterior hip replacement surgery — at Arthritis Education Day on Sept. 21. See back cover for details. 

Porter Adventist Hospital is a regional medical center that provides care for complex health issues. We specialize in general and robotic surgery, cardiovascular care, spine care, joint replacement, liver and kidney transplants, and cancer care. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or to substitute for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email us at vibrant@centura.org.

2525 South Downing Street Denver, CO 80210 303-778-1955 porterhospital.org :: Summer 2013

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Charting a successful course for prostate cancer treatment B

efore you embark on any journey, you want to make sure you have the best information and guidance. The journey from a cancer diagnosis to treatment is no different.

At 70, Jon Sorensen has always been healthy, and he has longevity on his side — many of the men in his family have lived into their 90s. So, when Sorensen was diagnosed with prostate cancer, it was a bit disorienting. But with doctors from Porter Adventist Hospital who sat with him for an hour and experts providing him with information, he felt empowered to navigate his treatment options. Having information from multiple sources gave Sorensen the confidence to make his treatment choice. “Everybody was trying to assist me,” he says.

Charting a Course Ultimately, he had a choice to make: Choose to treat the cancer, or wait and see. His doctors suggested he could take an “active surveillance” approach. Some refer to this approach as “watchful waiting,” but

says Stephen Ruyle, MD, a urologist at Porter Adventist Hospital, it’s not just about waiting. “You do repeat biopsies to make sure the cancer is not growing,” he explains. “The patient is followed intensely.” Sorensen, who is retired from the U.S. Navy and the Jefferson County Sheriff’s Office, is a take-charge person. He wanted to treat the cancer before it had a chance to grow. When deciding on a course for treatment, men and their doctors need to consider a few factors, Ruyle says. First, it’s important to consider the man’s age (and how many years of life he has yet to live) and his overall health, as well as how big and how aggressive the cancer is. With the da Vinci® Surgical System, a surgical robot commonly used for prostate surgery available at Porter Robotics Institute, men experience shorter recovery times, smaller incisions, less blood loss during surgery, and fewer side effects (such as urinary incontinence) than with traditional prostate surgery. Sorensen’s decision to have surgery turned out to be a wise one. “There was a second tumor,” he says.

Treatment options Not all men opt for immediate treatment. Some choose “active surveillance,” which involves monitoring the cancer with biopsies to make sure it’s not growing. For men who are older or have a serious health condition, this might be the best option.

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For those who choose treatment, the options are:

Surgery. A prostatectomy is the removal of the prostate gland as well as some surrounding tissue. Nearly 80 percent of prostatectomies are now performed with robotic surgery; Porter Robotics Institute performs the most robotic prostatectomies annually in the metro area. Possible side effects of surgery include urinary incontinence and erectile dysfunction. External beam radiation. Typically done five days a week for several weeks, this type of targeted radiation treatment involves directing highpowered X-rays at the cancer.

Brachytherapy. This kind of radiation treatment involves implanting tiny radioactive seeds into the prostate tissue. The seeds then deliver a low dose of radiation over a period of time.

VIBRANT :: Porter Adventist Hospital

Porter Robotics Institute is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado.


Finding His Way One of the first people to reach out to Sorensen once he made his decision was Annie Hetterle, MA, NCC, LPC-C, a clinical therapist and the robotics experience coordinator at Porter Robotics Institute. “Annie called me and wanted to give me a tour of the hospital,” Sorensen recalls. “It seemed like everyone involved wanted me to be at ease.” That’s exactly what Hetterle hopes to hear. “As the experience coordinator, my goal is to ensure patients and their families feel supported and cared for throughout their stay,” she explains. “As a therapist, I also want to empower patients through information and resources.”

She is with the patient in pre-op and is a resource to the family during the surgery, working to ensure open communication between the family and the operating room team.

Jon Sorenson, of Broomfield, weighed his options carefully before choosing robotic prostatectomy.

Hetterle also visits patients daily throughout their stays. Having an experience coordinator on a patient’s care team provides an additional layer of care, she says. “When you come to the hospital, you’re vulnerable, and it can be overwhelming,” she says. “My hope is to provide support and help empower patients. They feel more calm — and reassured.” It worked for Sorensen, who today is still cancer-free. “I had had good health my whole life, and this was a whole new thing,” he says. “It was good to have everyone supporting me like they did.”

Photo by Ellen Jaskol

Once a person chooses surgery, Hetterle jumps into action. She contacts the patient and asks him to complete a survey about his hobbies, preferences, and interests to get to know him personally, and then she offers to show him around the hospital while they begin discussing his care plan. She listens to his past experiences and hopes for the surgery, and works with him and his family as they plan for the procedure.

Online Prostate Assessment If you are experiencing urination problems, it could be a sign of prostate trouble. Go online to porterhospital.org/prostate to check your symptoms and find out if you should seek care.

SHOULD I GET SCREENED? When a man has prostate cancer, it triggers the release of prostatespecific antigen (PSA) into the blood. That’s why the PSA screening, which is done with a simple blood test, is used to check for signs of prostate cancer. Other things can cause an elevated PSA level and depending on your age and the results of a PSA test, your doctor will advise you on whether it makes sense to wait a few months and screen again or if a biopsy to check for cancerous cells is warranted. The U.S. Preventive Services Task Force recently determined that the risks of potential side effects of treatment outweighed the benefits and recommended against routine PSA screenings for men at normal risk. Nonetheless, many physicians still recommend the screening. Stephen Ruyle, MD, a urologist at Porter Adventist Hospital, says he suggests men who expect to live at least 15 years start screening between the ages of 40 and 70. Ruyle, who is 54, started his own screenings at 40. Men who’ve had a brother, father, or grandfather diagnosed with prostate cancer, as well as African-American men, are at higher risk.

Run to raise awareness Join The Urology Center of Colorado (TUCC) Foundation for the fourth annual Blue Shoe Run for Prostate Cancer on Sept. 15 to raise money for prostate cancer screenings, community education, and research. Learn more and register at theblueshoerun.com.

“Those patients, I tell for sure to get screened,” he says. Photos: OCEAN ©iStockphoto.com/Turnervisual; HAND ©iStockphoto.com/haveseen; SHOES ©iStockphoto.com/chictype

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LivingVIBRANTLY Your key to a better, healthier life

A Women’s Wellness Expo, hosted by Castle Rock, Littleton, Parker, and Porter Adventist Hospitals Nancy Sharp, Keynote Speaker

Join us for a day to celebrate women, their courage and their zest for life. This FREE event will be filled with tips for maintaining good health — giving you tools to live, love, and play at your best! The day will get a laughter-filled start with keynote speaker Nancy Sharp. Sharp, author, Huffington Post blogger, and nationally known speaker, draws from her own Exclusive giveaways and drawings transformative story of courage and renewal to inspire women around the country to harness Health advice from leading experts their courage and live boldly.

FREE chair massages

“Courage enables us to keep showing up and push beyond our limitations, even in the face of loss, disappointment, and change,” says Sharp.

Spa-la-la! Win a FREE spa gift certificate! Register by Aug. 31 to be entered in a drawing for a day at the spa. Call 303-777-6877 or visit southdenverhealth.org/ expo-registration.

Women’s Wellness DATE | Sat, Sep 7 TIME | 9 a.m.-2 p.m. LOCATION | The University of Denver, Newman Center for the Performing Arts, 2344 E. Iliff Ave. COST | FREE (free parking available in the garage)

Reserve your space today for this special event online at southdenverhealth.org/womens-expo.

expo schedule 9 a.m. Doors open 10 a.m.  Kick off the day with Keynote Speaker

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University of Denver New man Center

Nancy Sharp who will present: Living Vibrantly— Your Key to a Healthier, Better Life

9 a.m.- 2 p.m. Visit with experts throughout the day to learn about sleeping better, stress relief, bone and joint health, and much more! Then pick from these talks:  ormones: What You Need to Know to Stay Balanced; 11 a.m. H Dr. Vandna Jerath, OB/GYN 11:30 a.m. Top Tips to Keep Your Heart Healthy; Dr. Cinthia Bateman, cardiologist

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VIBRANT :: Porter Adventist Hospital

Noon  Gurgles, Grumbles, and Growls —What Is Your Stomach Trying to Tell You?; Dr. Pat Michaletz-Onody, gastroenterologist

1 p.m. Lose Your Belly Fat and Help Your Heart — Cooking Demonstration; Dr. Richard E. Collins, The Cooking Cardiologist

1 p.m. Yoga — Learn How to Strengthen Your Mind, Body, and Spirit

PhotoS: NANCY SHARP by ELLEN JASKoL; FLOWER ©iStockphoto.com/felinda; SPOON ©iStockphoto.com/alphacat


Cancer doctor brings balance to his life and to his patients Todd Capizzi, MD, a medical oncologist and hematologist at the Porter Adventist Hospital Cancer Care Center, wasn’t born in Colorado, but it didn’t take him long to become a Colorado runner. Capizzi, who grew up in Massachusetts and moved to Colorado in 2010, is an ultra-marathoner who routinely runs in races upward of 30 miles. His favorite runs are on mountain trails, and he has completed the Pikes Peak Ascent, a half marathon up the mountain. “I work hard and take care of very difficult and challenging cases, so it’s important to have work-life balance or I can’t give all of myself to my patients,” says Capizzi, who also brings balance to his life through family, including spending as much time as possible with his 5-year-old daughter. Capizzi brings that same sense of balance to his patients, weighing their physical and emotional needs when making treatment recommendations. He joined the Porter Cancer Care Center because it provides complete cancer care from diagnosis through recovery in one location with excellent outcomes. But he also is not hesitant to refer his patients elsewhere if it’s in their best interest.

Name: Todd Capizzi, MD Specialty: Medical Oncology and Hematology Practice: Cypress Hematology and Oncology, operated by Centura Health Physician Group Family: Engaged with one daughter, lives in Castle Rock, and sees patients at Porter and Parker Adventist Hospitals Training: Medical school at New York Medical College; residency in internal medicine and fellowship in hematology and oncology at Baystate Medical Center in Massachusetts

“If someone has a very rare type of disease, then it may be best to send them to a referral center with a lot of those cases,” Capizzi says. “Or patients may want to receive care closer to home.” Capizzi also encourages his patients to get second opinions. “It can be very comforting to hear someone else give the same advice,” he says. Capizzi specializes in treating patients with head, neck, and lung cancers most often related to tobacco use, as well as cancers of the urinary and genital track, and blood-borne cancers, including leukemia.

Life After Cancer

Cancer survivors can help reduce risk of recurrence With continuing advancements in cancer treatment, more and more patients are not only surviving cancer but living long lives following treatment. Those improved survival rates, however, mean that patients have a greater likelihood of facing a recurrence.

Photo by Michael Richmond

“Far fewer people now die from cancer, but longevity gives more time for cancer to recur,” says Todd Capizzi, MD, an oncologist at the Porter Adventist Hospital Cancer Care Center. “We now think of cancer as a chronic condition.” This isn’t meant to worry patients, Capizzi says, but to empower them. “It’s a change in mindset,” he says. “It used to be that a cancer diagnosis meant dying. Now it’s not that way, but it means that you need to make sure you’re taking all the steps you can to remain cancer-free.”

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To make an appointment with Dr. Capizzi, call 303-715-7030.

A few of the things cancer survivors need to be aware of include:  Maintaining recommended che ckups and follow-up screenings. “It’s easy once you’re five or 10 years out to start thinking you don’t need to be screened, but that’s not the case .”  Maintaining — or implementing —a healthy lifestyle. A healthy diet, limit ed alcohol consumption, and definitely not smo king play an even bigger role once you’ve been diagnosed with cancer. Excess weight also increases the chance of recurrence of some cancers, such as breast.  Taking your medications. Patie nts may be prescribed cancer-fighting medicati ons, such as tamoxifen, for years but often will stop taking them early due to a false sense of secu rity, financial stress, or side effects. Talk with your doctor about your concerns, as mos t issues can be addressed, and don’t stop taking your medications without consulting your physician.


Portercare Adventist Health System

Non-Profit Organization U.S. Postage

Grocery Store

Paid

Walk

Denver, CO Permit No. 4773

2525 South Downing Street

~and ~

Denver, CO 80210

Talks Porter Adventist Hospital and King Soopers are sponsoring a series of Walk-and-Talk events where you can meet a registered dietitian to learn more about healthy shopping. Programs will be held at the grocery store listed; please arrive 10 minutes early and meet the dietitian in the produce section. See Walk-and-Talk events below.

Porter Adventist Hospital is part of Centura Health, Colorado’s largest health care network. Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura Health, 2013.

Re porte gister onli ne at rhosp ital.o rg/ev ents

Upcoming Events

Join the health experts at Porter Adventist Hospital to learn ways to stay healthy as well as new treatments for health problems. All programs are FREE. For programs held at the Porter Adventist Hospital Conference Center, free valet parking at the hospital’s main entrance or plentiful free parking in the Porter Adventist Hospital parking garage is available. Registration is required for all events; register online at porterhospital.org/events or call 303-777-6877.

Living Vibrantly — Women’s Wellness Expo

PhotoS: BAG ©iStockphoto.com/ansonsaw; WOMAN FACIAL ©iStockphoto.com/targovcom; WOMAN GROCERY ©iStockphoto.com/gpointstudio

An event hosted by Porter, Littleton, Parker, and Castle Rock Adventist Hospitals A day dedicated to healthy living. It will include lectures, a cooking demonstration, chair massages, and one-on-one sessions with health experts discussing topics from skin health to hormones and everything in between. FREE parking in Newman Center parking structure. For full details, see Page 6.  Date: Sat, Sep 7  Time: 9 a.m.-2 p.m. L  OCATIoN: The University of Denver, Newman Center for the Performing Arts, 2344 E. Iliff Ave.

Become a Grocery Guru This Grocery Store Walk-andTalk is for individuals who do not have any specific health issues but want to learn more about

nutrition. Registered dietitians will walk through the aisles and discuss how to make healthy food choices in each major food category. This event will be held twice at different locations:  Date: Mon, Sep 16  Time: 6-7 p.m. L  OCATIoN: Kent Place/Fresh Fare King Soopers, 3495 S. University Blvd.  Date: Tue, Sep 17  Time: 2-3 p.m. L  OCATIoN: University Hills

King Soopers, 2750 S. Colorado Blvd.

Arthritis Education Day Learn the latest research and treatment for osteoarthritis. Experts specializing in knee and hip arthritis, along with professionals who focus on pain management, rehabilitation, and exercise, will be on hand. Join us for this unique opportunity to talk to the doctors and to get your questions answered.  Date: Sat, Sep 21  Time: 1-5 p.m.  REGISTRATION: 720-644-4403 L  OCATIoN: Porter Adventist Hospital Conference Center

Blood Sugar Blunders This Grocery Store Walk-and-Talk addresses wise food choices to prevent and control diabetes.

cholesterol and blood pressure. You also will find out how to read nutrition labels to become skilled at choosing foods that promote heart health and avoid foods that contribute to heart disease.  Date: Tue, Sep 24  Time: 6-7 p.m. L  OCATIoN: University Hills King Soopers, 2750 S. Colorado Blvd.

Colon Cancer Prevention Registered dietitians will take you through the aisles to help you find diabetic-friendly foods, and give you meal and snack suggestions. They also will teach you how to carb count to make it easy to enjoy food while controlling your blood sugar.  Date: Mon, Sep 23  Time: 2-3 p.m.  LOCATIoN: Kent Place/ Fresh Fare King Soopers, 3495 S. University Blvd.

Shop for a Healthy Heart During this Grocery Store Walkand-Talk, you will learn which foods are best for lowering

Colon cancer affects one in 20 people, making it relevant to us all. A colonoscopy is one of the top five tests for men and women, beginning at age 50. It examines the colon to identify and remove polyps before they become cancer. Dr. Wesley Kasen, a board-certified gastroenterologist, will discuss colon cancer and this lifesaving procedure. He will be available to answer questions about this vital aspect for maintaining your health.  Date: Wed, Oct 2  Time: 6-7 p.m. L  OCATIoN: Porter Adventist Hospital Conference Center

Vibrant summer 2013  

Read about the latest treatment options for prostate cancer, the link between colon cancer and Lynch syndrome, how extra weight is now thoug...

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