Banner MD Anderson Creating Hope

creating hope MARCH 2012

Imaging is everything Enhancing early detection through an innovative diagnostic imaging technique

BY JAKE POINIER

DENNY COLLINS

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ith a family history that includes a father with prostate cancer, a mother who had breast cancer, and a brother who died of colon cancer — not to mention her own bout with breast cancer 24 years ago — Nancy Morton wasn’t taking any chances. “When I learned I had a very high calcium blood count, my family history told me to get checked right away,” she says. “If there was even a one percent chance of cancer, I wanted it out of there.”

Morton’s quick action, with the aid of an advanced diagnostic technique at Banner MD Anderson Cancer Center, saved her life. “When Nancy came to see me, she had high calcium levels, and some vague complaints such as tiredness, weakness and weight gain,” says Rob Schuster, M.D., chief of surgery at Banner Gateway Medical Center. “The most common cause for that is a problem with the parathyroid, right around the thyroid gland, abnormally making calcium, but she had some previous tests that said the area was normal.”

Schuster examined her and ordered a type of diagnostic imaging that’s only available at Banner MD Anderson Cancer Center and its parent facility, The University of Texas MD Anderson Cancer Center in Houston.

“A hypersecreting parathyroid can be very difficult to find radiologically,”

Don Schomer, M.D. diagnostic imaging section chief at Banner MD Anderson Cancer Center, uses highly sophisticated techniques including three-dimensional imaging to achieve the most precise diagnosis.

INSIDE 2 Focused on early detection

6 ‘Flavor profiling’ helps in chemo treatment

4 Expressions of hope

8 Events and classes

3 Ask the expert

7 Steps of Hope Garden Project

Focused on

DENNY COLLINS

early detection

An innovative diagnostic imaging study only available at Banner MD Anderson Cancer Center and The University of Texas MD Anderson Cancer Center in Houston provided Nancy Morton’s physicians the information they needed to diagnose and treat her thyroid cancer. says Don Schomer, M.D., diagnostic “It showed that the parathyroid gland imaging section chief at Banner MD was in a completely different location Anderson Cancer Center. “With MRI than we thought, near her spine. It also and CT scans, they blend into other showed a large mass on her thyroid, tissue, while nuclear medicine shows which no one knew about.” you their activity, but without very A biopsy revealed the mass to be precise imagery.” cancerous. But To overcome the diagnostic Not only can we that, MD Andertest proved to be son is pioneering detect the tumors early, it a double blessing, an innovative because armed helps us make surgeries with highly actechnique called biologic imagcurate information, as safe as possible and ing — which Schuster was able combines nuclear help patients get back to to perform both medicine, a rotatthe thyroid cancer normal life sooner. ing camera that and parathyroid – Dr. Rob Schuster, M.D. operations at once provides tomographic data, a through a minimal CT scan, and a incision. “From a multiphase post-contrast study. surgical standpoint, we rely on these In layman’s terms, when you put very advanced radiological tests to tell those high-tech tools together, it’s an us where to go,” Schuster says. “Not all-star team: They produce an incredonly can we detect the tumors early, ibly precise 3-D image. it helps us make surgeries as safe as “In Nancy’s case, the images were possible and help patients get back to absolutely remarkable,” Schuster says. normal life sooner.”

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Most patients who come to Banner MD Anderson Cancer Center already have a diagnosis of cancer. But sometimes a person may have radiological or lab abnormalities, or even symptoms that raise suspicion, and they’re not sure where to go.

Banner MD Anderson’s new Suspicion of Cancer Clinic is targeted at precisely this type of early detection. “Our goal is to expedite the workup and get them to the right physician, because oncologists are very specialized,” says David Edwards, M.D., section chief of internal medicine at the Banner MD Anderson Cancer Center and a part-time clinician working in the program.

The staff includes two general internists and one pulmonologist. The process operates on a similar principle to triage in an emergency room, starting with a conversation between the patient and a nurse clinical navigator. “If a patient already knows he has cancer, they’ll talk about how was it diagnosed, and what type of cancer it is,” said Edwards. “If someone has a spot on her lung, but hasn’t had a workup, the navigator will direct her to the appropriate physician. We even talk to ER physicians with a patient who they believe has cancer, but don’t have an official diagnosis.”

Patients can access the Suspicion of Cancer Clinic through their primary care physician or by calling Banner MD Anderson directly at 480-256-6444.

Which is exactly the path Morton hopes to be taking. With the operation successfully completed, she recently received a radiation treatment that would remove any remaining cancer cells in her bloodstream, and was hoping to receive a clean bill of health. “The doctors at Banner MD Anderson were fantastic and the technology was great,” she said.

“The way I look at it is that a few hours of treatment can buy a lot more years.”

askthe expert Q:

How can I reduce my risk of colon cancer?

A:

The risk of developing colon cancer is influenced by key factors that include genetic predisposition, some preexisting medical conditions and lifestyle.

STEP ONE: Ask your physician to evaluate your risk based on your family history of colon cancer and any preexisting conditions you have that would increase your likelihood of developing the disease. For example, if a family member developed colon cancer before age 50, or you have an inflammatory bowel disease, such as ulcerative colitis, you have a higher risk of developing colon cancer.

STEP TWO: Get screened. If your risk is low, start your colon cancer screenings at age 50 and repeat every five to 10 years. If your screening reveals something that may be precancerous, your doctor will specify more frequent screenings. If your initial risk is medium or high, your physician will recommend that you start your screenings at a younger age and with higher frequency.

Q:

BY ANDREA MARKOWITZ

If you’re already 50 or older and have never been screened, start now.

STEP THREE: Talk to your physician about taking certain supplements. Many vitamins and medications have been investigated for their ability to prevent colon cancer. While, for many, the jury is still out, you may consider taking 1,000 to 1,500 mg of calcium and one baby aspirin, which is 81 mg, daily. It is important to first consult with your physician, because certain supplements may cause some harmful side effects in some people.

STEP FOUR: Commit to a healthy lifestyle.

Eat a diet rich in fruits, vegetables, vegetable oils and fiber. Avoid red meat, processed foods and sugar, and fatty foods.

Maintain a low body mass index and stay physically fit.

Don’t expect to lower your risk by following a healthy lifestyle for just a few months. You really have to commit to these lifestyle changes.

What is the most important thing I should know about colon cancer?

A:

Colorectal cancer can be cured with laparoscopic or conventional surgery when it’s discovered early. Catching it later may require additional therapy such as chemotherapy and radiation, and the potential for being cured may be

reduced. It takes about 10 years to develop colon cancer, so if you begin your screenings at the appropriate age for your risk level, your doctor has a better chance of finding and removing potential precancerous lesions, or polyps, when they’re still benign.

for more info:

For more information about colon cancer visit bannermdanderson.com.

Meet Dr. Tomislav Dragovich Tomislav (Tom) Dragovich, M.D., Ph.D. is chief of the section of hematology and medical oncology at Banner MD Anderson Cancer Center in Gilbert, Arizona.

His specialties are digestive tract cancers including colorectal, esophageal, stomach, pancreatic and hepatobiliary.

WORK EXPERIENCE: Prior to joining Banner MD Anderson Cancer Center, Dr. Dragovich served as director of the clinical gastrointestinal cancer program, and associate professor of medicine in the Section of Hematology/ Oncology at the University of Arizona College of Medicine.

MEDICAL SCHOOL: University of Belgrade School of Medicine, Serbia.

INTERNSHIP AND RESIDENCY: University of Chicago Medical Center/ Weiss Memorial Hospital.

POST-GRADUATE TRAINING: Ph.D. in Pharmacology, University of Illinois, Chicago.

FELLOWSHIP TRAINING: Hematology and Oncology, University of Chicago Pritzker School of Medicine BOARD CERTIFICATION: American Board of Internal Medicine, Medical Oncology and Hematology.

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Expressions of

Hope

F

rom the Tree of Hope in the main lobby to the Lantern of Hope that lights up the night sky, symbols of hope abound at Banner MD Anderson Cancer Center.

But hope is more than a word at the cancer center. It is a symbol of the empowerment patients have to participate in

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their care. To our staff, HOPE stands for Helping Oncology Patients to be Empowered. Our staff and physicians provide patients and their loved ones with information, education and support to help them find their own symbols of hope throughout their cancer journey.

DENNY COLLINS

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1. The Tree of Hope was donated by the Cancer Center’s first CEO Pam Nenaber as a symbol of hope and compassion.

2. Patients and visitors are encouraged to tie colored ribbons to

the Tree of Hope in recognition of those touched by cancer.

3. The Lantern of Hope lights up the night sky as a symbol of hope for those touched by cancer.

MARK SKALNY BANNER MD ANDERSON CANCER CENTER

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4. A visitor ties a ribbon on the Walk of Hope at Desert Botanical Gardens to honor someone touched by cancer.

5. Thousands of guests wrote messages of hope on brightly

colored ribbons along the Walk of Hope sponsored by Banner MD Anderson Cancer Center at Desert Botanical Gardens.

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‘Flavor profiling’

helps in chemo treatment

Executive chef tailors’ meals to patients’ taste, nutritional needs

BY GREMLYN BRADLEY-WADDELL

C

hemotherapy is a wonderful tool in the war against cancer, but as most folks know, it has some less than wonderful side effects like hair loss, fatigue and nausea.

And an overwhelming majority of patients also suffer from “taste acuity,” says Heather Metell, executive chef at Banner MD Anderson Cancer Center and Banner Gateway Medical Center in Gilbert.

“Food doesn’t taste like it’s supposed to,” she says, explaining that taste buds – like cancer cells – are a type of cell that grows quickly. Just the type that an anti-cancer treatment such as chemo is created to destroy.

As a result, Metell says, patients often find their food tastes odd: metalliclike, too salty, too sweet or just plain tasteless. And taste can vary from day to day; one day, foods taste sweet; the next, they don’t. But because maintaining one’s weight and strength is vital to be able to continue and finish chemo treatments, it’s that much more important to make sure one is getting enough sustenance, adds registered dietitian Monika Baxter, who also works at the cancer center.

All of this got Metell to thinking.

And one of her first thoughts was instead of sending food up to a patient’s room and finding out later that the food tasted wrong, why don’t we go up to their room first and ask what they can taste? Then, a meal can be tailored to their specific needs. So, that’s what Metell’s staff began doing. Armed with samples of vanilla pudding, peanut butter and lemon yogurt – foods that

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typically register to most folks as sweet, savory and sour – they meet one-on-one with patients, often before chemotherapy treatments have begun, to determine what they can taste and how it tastes. Then, if a patient can detect sourness, for example, Metell might whip up a lemon crème sauce to put atop halibut. If another patient can taste sweetness, a protein-packed Chocolate Diablo smoothie may be added to the menu.

Metell calls the process ‘flavor profiling’ and believes she and her staff are the only ones in the country doing this kind of thing in a hospital setting.

Metell calls the process “flavor profiling,” and believes she and her staff may be the only ones in the country doing this kind of thing in a hospital setting. They began this “very motherly approach,” as she calls it, after the cancer center opened in September 2011 and have worked with about 25 people thus far. Metell is also collecting data and trying to improve upon the method every day.

“So far, it’s been working out pretty well,” Metell says. “It’s challenging but pretty rewarding when you get someone nourished.”

Profile: Executive Chef Heather Metell Heather Metell has always felt at home in the kitchen, whether it was the one in her childhood home or a more commercial variety.

“I was washing dishes at a little inn at 12 years old,” says the executive chef, who now oversees a staff of about 50, including dietitians, cooks and dishwashers, at Banner MD Anderson Cancer Center and Banner Gateway Medical Center in Gilbert.

Originally from Massachusetts, Metell made her living for years in the kitchens of some of the finest East Coast resorts.

And while she ditched the country-club atmosphere and its stressful demands when she moved to Arizona – she yearned for a more relaxed lifestyle, one in which she didn’t have to put in “90 hours a week” – the elegant and refined approach to food she had mastered during her years on the resort scene is evident in the menu offerings she now serves up for patients.

“It’s been a bit of a challenge to make the food taste good without salt or fat,” says Metell, whose culinary passion is making sauces. “But we’re probably one of the only hospitals that makes its own veal demi-glacé.”

Steps of Hope

Become a Lasting Part of the Healing Courtyard

T

he healing courtyard outside the main lobby of Banner MD Anderson Cancer Center symbolizes the journey patients and their families often travel.

Leave your legacy at Banner MD Anderson Cancer Center by purchasing a personalized tile or plaque for the healing courtyard. Engraved tiles, or Steps of Hope, will surround the “Togetherness” sculpture on the west side of the garden, and individual plaques can be placed on or near sponsored trees or benches throughout the garden.

Contact Banner Health Foundation at 602-747-GIVE (4483) to learn more.

Banner Health Foundation secures and stewards charitable gifts to help Banner Health achieve its nonprofit mission of making a difference in people’s lives through excellent patient care.

The Foundation is seeking charitable contributions for a wide range of programs designed to support patients and their families. Contact us to learn more about ways you can support Banner MD Anderson, or to get involved in the Foundation’s Cancer Has Met Its Match fundraising campaign.

STEPPING THROUGH THE HEALING COURTYARD The Healing Courtyard was designed to represent the cancer journey through desert landscaping and artistic elements. Three separate areas offer quiet places for reflection.

WATER GARDEN This area includes three low decorative water walls that gently trickle water along stone fountains to create a tranquil environment to symbolize the beginning of the cancer journey.

ZEN GARDEN This area, located in the middle of the courtyard, features benches for relaxation and stepping stones through a seasonal garden of wildflowers that

form the “Journey of Hope.” This path is a symbol of the cancer journey, with the stepping stones and large boulders resembling challenges patients and their families may face along the way.

TOGETHERNESS GARDEN This area, located in the back of the courtyard, is designed for patients and their families to gather and reflect on their journey as they look upon the Togetherness Sculpture. You enter this garden through a narrow doorway which symbolizes hope and victory at the conclusion of treatment. The Togetherness Sculpture features three stones that symbolize those who made the journey. The tallest piece represents the survivor; the next, family, and the last, friends.

for more info: BANNER MD ANDERSON CANCER CENTER On the campus of Banner Gateway Medical Center U.S. 60 and Higley Road in Gilbert Schedule an appointment: (480) 256-6444

Follow us on Facebook: Facebook.com/bannermdanderson Check out our website bannermdanderson.com

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PRESORT STD U.S. POSTAGE PAID LONG BEACH, CA PERMIT NO.1677

Events and Classes Special Events A Multi-Disciplinary Approach to Breast Cancer TUESDAY, APRIL 17, 6 P.M.

Hear from Banner MD Anderson’s breast cancer experts in the specialties of mammography, medical oncology, surgery and radiation oncology. These physicians will discuss the latest innovations in the prevention, screening and treatment of breast cancer.

Banner Gateway Medical Center, 1900 N. Higley Road RSVP: 602-230-2273

Mindfulness-Based Stress Reduction 6-WEEK COURSE

Develop tools to begin or enhance your mindfulness practice. Class benefits include relaxation, stress reduction, and mind/body awareness. Open to all current cancer patients and cancer survivors.

Dates: Tuesday afternoons beginning May 1st and ending June 5th 2012.

Time: 4-5pm Register: Call 602-230-CARE to register.

There is no cost for this program but weekly attendance is required.

Preventing Skin Cancer & Melanoma in the Valley of the Sun THURSDAY, MAY 3, 6 P.M.

Featuring two of Banner MD Anderson’s melanoma experts: Dr. Mark Gimbel, surgical oncologist and Dr. Jade Homsi, medical oncologist. Learn how to protect your skin, signs and symptoms of skin cancer, latest treatments for melanoma.

Banner Gateway Medical Center, 1900 N. Higley Road RSVP: 602-230-2273

Wellness classes

Dates: Friday mornings starting on April 20th and ending May 25th 2012.

Time: 8-9:30am Register: Call 602-230-CARE to register.

There is no cost for this course but weekly attendance is required.

Banner MD Anderson Cancer Center offers a variety of classes and support groups to assist cancer patients, survivors and their support teams. These classes are free and open to the public. Classes are held at Banner MD Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ, 85234.

Weight Management Strategies for the Breast Cancer Survivor

Cancer Survivorship Support Group

6-WEEK PROGRAM

A weight management program for the breast cancer survivor that provides strategies for weight loss/maintenance, physical activity and stress reduction. Will stress the importance of lifestyle on cancer reoccurrence. This class is not open to patients currently undergoing treatment for cancer.

Journey to Wellness Group

4 P.M., THIRD WEDNESDAY OF EACH MONTH

A wellness education group led by a registered dietitian and exercise physiologist that promotes healthy lifestyles. A different topic is discussed every month. Please check our website for topic updates at www.bannermdanderson.com.

Monday Morning Meditations 9 A.M. EVERY MONDAY MORNING

Take a moment to relax and breathe with us. In the Healing Garden or in the Learning Center.

Chair Yoga

10 A.M. EVERY MONDAY MORNING

A calming yoga that stretches our bodies safely while relaxing our minds. Yoga is done sitting in the chair or standing behind the chair for assistance.

Gentle Yoga

4 P.M. ON EVERY THURSDAY

Yoga aimed at releasing the tension in your muscles and mind.

For questions, contact the Health and Wellness Coordinator at Banner MD Anderson Cancer Center at 480-256-4141.

4 P.M., SECOND TUESDAY OF EACH MONTH

A therapeutic support group led by licensed social workers to encourage hope and healing for all cancer survivors. Support is welcome to attend but please no children under 16 years of age.

To schedule an appointment, call 480-256-6444