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prevention power of

PR E V EN TION • R ESE A RCH • INNOVAT ION

SUMMER 2014

Healthy choices for at-risk patients Cancer Prevention Program services include education, wellness and community outreach

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B Y M E G H A N N F I N N S E P U LV E D A

ducation may be the key to prevent cancer. The team of experts at Banner MD Anderson Cancer Center in Gilbert’s Cancer Prevention Program encourages lifestyle strategies by offering nutritional counseling and stress reducing techniques, in combination with genetic testing and recommendations for people with low to high risk of developing cancer. The American Cancer Society reports that nearly half of all cancer deaths could be prevented by making healthy choices that include not smoking, staying at a healthy weight, eating right, keeping active, and getting recommended screening tests. SCREENING EVALUATIONS

The first step in the fight to prevent cancer? Determine the risk. “We try to evaluate patients who are considered at high risk for cancer based on genetics,” says Santosh Rao, M.D., medical and integrative oncologist, Banner MD Anderson. Patients of the Cancer Prevention Program are also evaluated by a team of medical professionals consisting of an exercise physiologist, registered dietitian, integrative social worker and psychologist. The program is funded, in part, through philanthropic donations and grants. PREVENTION | 2 

INSIDE

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Cancer prevention starts with what you eat

Cox founder leaves legacy of public service, giving back

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‘Miracle’ patient beats the odds

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COVER FEATURE

 FROM THE COVER

COMPLEMENTARY WELLNESS

A series of classes, held in the Wellness Center, such as restorative and chair yoga, healing movement and breath, and meditation are available for patients designed to reduce stress by caring for the mind and body. “Research tells us that physical activity is good,” Rao says. “Yoga can relieve stress and is gentle on the body. Meditation helps with mental clarity by focusing on breathing techniques.” For newly diagnosed patients to survivors, the program has something for individuals at all stages. “I had support services that helped me get on my feet, stabilized and prepared me for my journey after treatment,” says Phyllis Gagnier, 73, of Gold Canyon. “I have benefited from every resource available and have been successful in restorative healing of my mind, body and spirit.” Quarterly cooking classes feature recipes that include cancer fighting ingredients, and are taught by the hospital’s head chef. The team is also developing a smoking cessation program to reduce lung cancer. “These services have greatly helped me reprogram my brain so I can listen to and appreciate my body,” Gagnier says. “I’m living my life more mindfully.” Gagnier, a two-time cancer survivor, has started writing again and works out to build strength and flexibility. She is hopeful others can benefit from these healing techniques. “I transformed fear into healing and I know I have the support whenever I need it.” Individual consultations and group support classes are also available for survivors and their support teams.

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“We try to evaluate patients who are considered at high risk for cancer based on genetics.” — DR. SANTOSH RAO, MEDICAL AND INTEGRATIVE ONCOLOGIST, BANNER MD ANDERSON

COMMUNITY EDUCATION, OUTREACH

Several community outreach programs are in place to educate and support children and adults. A current school-based initiative includes a partnership with a local Phoenix elementary school that focuses on cancer prevention and the importance of wellness. Physicians from Banner MD Anderson provide lectures to students in their classroom on topics such as the dangers of smoking, skin cancer prevention and maintaining a healthy lifestyle. An exercise physiologist and registered dietitian conduct classes surrounding physical activity, nutrition, relaxation, gardening, tai chi and mindfulness. “We planted a vegetable and herb garden with the students,” says Kristine Salmon, senior manager, The James M. Cox Foundation Center for Cancer Prevention and Integrative Oncology at Banner MD Anderson. “Following the 16-week class, we measure our success with two assessments.” A lecture series is held regularly where people can learn about the latest research results regarding lifestyle practices that can modify cancer-causing factors and reduce chances of developing cancer. Additional initiatives include education and outreach to the Hispanic population, who are considered at high risk for developing ovarian and breast cancer. “We realize there is a great need to provide support, including literature and educational materials to the underserved community,” Salmon said. • pp

CANCER PREVENTION CONSULTATION OPPORTUNITIES Currently, consultations are available at Banner MD Anderson Cancer Prevention Program for high risk patients, or those receiving genetic counseling. Patients can meet with an exercise physiologist, registered dietitian, integrative social worker or psychologist. An exercise physiologist will develop a comprehensive plan that meets the American Cancer Society’s guidelines for cancer prevention which involves 150 minutes of aerobic exercise per week. The physiologist will provide tips and work closely with each patient to determine the best approach, which may include yoga, walking, swimming or chair exercises. At the consultation, a registered dietitian will create a comprehensive nutritional plan that will incorporate a whole food, plantbased diet. Research from the American Cancer Society shows that cancer patients benefit from reducing or eliminating processed and refined grains and meats from their diets. Nutrition series and lectures are also available for the community. The integrative social worker can assist with stress reduction and provide tools for mind and body relaxation, and tips for pain management. A psychologist is available to counsel patients on a variety of mental health concerns, including providing coping mechanisms and ways to address and reduce anxiety.

To make an appointment with the cancer prevention program, please call (480) 256-6444.


SUPPORT

Wellness classes and support for cancer patients and survivors No-cost community outreach focuses on physical and mental health B Y M E G H A N N F I N N S E P U LV E D A

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variety of classes are offered regularly at Banner MD Anderson Cancer Center in Gilbert, geared towards patients who are newly diagnosed with cancer, those currently undergoing treatment, survivors, support teams and the public. All classes are free to cancer patients and the community. WELLNESS PROGRAMS

Restorative yoga is a mat-based class that supports the body while allowing the mind to decompress. Chair yoga is practiced while sitting or standing behind a chair for support. A healing movement and breath class incorporates yoga with movement meditation. Accupunture is available and Banner MD Anderson programs include Look Good Feel Better, restorative yoga and support groups.

MEET THE TEAM A group of highly specialized medical professionals at Banner MD Anderson work together and share their expertise and best practices. These complementary and alternative medicine techniques positively support healing, encourage selfempowerment and create a better quality of life, in a supportive and caring environment. The team consists of: • Diljeet Singh, M.D., DrPH, integrative oncologist and gynecologic oncologist • Santosh Rao, M.D., medical and integrative oncologist • Josh Wludyga, exercise physiologist • Lynn Schuster, nurse practitioner • Samuel Chates, integrative social worker • Christi Kirk, Registered Dietitian • Ranay Yarian, community outreach coordinator • Kristine Salmon, senior manager • Beverly Yoches, psychologist

helps to manage symptoms and stress. Wellness series are also offered that focus on overall well-being topics. Cooking for wellness classes are led by the hospital’s head chef and incorporate cancer fighting ingredients. SUPPORT GROUPS

A special caregiver support group provides educational and emotional support to encourage hope and tips on self-care. The survivorship group meets bimonthly and is available to those who have completed treatment. Monthly specialized support groups focus on various topics including raising children, intimacy, and being without a caregiver while living with cancer. A group for individuals newly diagnosed addresses questions and provides education. It also is an opportunity for patients to connect with others who are on a similar journey. SPECIAL EVENTS

Look Good Feel Better is a program dedicated to building self-esteem and improved quality of life for patients undergoing cancer treatment. This class features cosmetology professionals who answer questions and provide suggestions and tips on skin changes and hair loss — often experienced after chemotherapy and radiation treatment — caring for wigs and scarves, and alleviating dry skin. Cancer prevention series lectures are given monthly by various physicians who share and discuss the latest in research findings and treatment options. • pp Check back regularly for monthly and special classes, lectures and events by calling 480-256-6444 or by visiting bannermdanderson.com.

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PREVENTION

Cancer prevention starts with what you ea Foods that can help you avoid cancer are delicious, easy to find BY DEBRA GELBART

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he American Institute for Cancer Research estimates that almost 375,000 cancer cases could be prevented with nutrition, activity and maintaining a healthy weight. “Their recommendations include eating a variety of plant-based foods, decreasing sodium intake and sugary drinks, decreasing red meat, restricting processed meats and limiting alcohol intake to a moderate amount,” says Christi Kirk, RD, CSO, a registered dietitian and board-certified specialist in oncology nutrition at Banner MD Anderson Cancer Center in Gilbert. IMPORTANCE OF FRUITS, VEGGIES

“When looking at fruits and vegetables, we want to encourage eating different kinds.” These include cruciferous — cabbage, Brussels sprouts, cauliflower, bok choy, kale, watercress, turnips, arugula, radishes and wasabi — as well as citrus and those that are deep orange, dark green leafy and red, she says. “Many of these fruits and vegetables have similar nutrient profiles, so if you aren’t a fan of broccoli, try cauliflower or bok choy. If you don’t like tomatoes, try red peppers.” Since each phytonutrient does something different in the body, it’s important to get a wide variety for optimal health, she added. “The name of the game when looking at these different colors and types of produce is to experiment to fit them into your diet and enjoy their flavor,” Kirk says. “There are two ways to accomplish this; try different recipes at home or if you see something on the menu while eating out, try it.”

Fruits and vegetables contain what are known as “phytonutrients.” According to the U.S. Department of Agriculture, these components are thought to promote human health. Fruits, vegetables, grains, legumes, nuts and teas are rich sources of phytonutrients. BY THE NUMBERS Variety in foods is key when talking Kirk says an ideal cancer-prevention diet about a cancer preventative diet, Kirk says. should include these quantities every day:

• 5 servings of fruits and vegetables, based on a variety of types and colors. • 3 servings of whole grains (either ½ cup grain, 1 slice of whole-grain bread or 3 cups air-popped corn) • 1 serving of plant proteins, such as beans, nuts and seeds. One serving of beans is typically ½ cup; one serving of nuts and seeds is typically ¼ cup. “These contain phytochemicals and beneficial oils,” Kirk said. • 1 5-6 ounce serving of lean protein such as fish or chicken. Kirk cautions that phytonutrients encapsulated or available in dried powders likely don’t work like they do in whole foods. “While the use of vitamin, mineral or herbal supplements can sometimes be appropriate when recommended by a medical professional, these items should not be counted on for cancer prevention, which is why we encourage the ‘Food First’ concept,” she says. “According to research, there is no substitute for a varied, plant-based diet when looking for a cancer prevention diet.” • pp

TWO RECIPES TO PROMOTE CANCER PREVENTION SPICED LENTILS

BREAKFAST “SQUARE-MEAL” SQUARES | From the American Institute of Cancer Re

• Chicken Broth (low sodium is best) • Dried Lentils • Cumin • Salt and Pepper • Any other seasoning flavor you like

• Canola oil spray • 1 Tbsp. canola oil, divided • 1 small carrot, shredded • ¼ cup finely chopped onion • 1 whole scallion, chopped • ¼ tsp. ground turmeric • 4 oz. firm tofu, cut into 4 pieces • 1 large egg white • 1 tsp. reduced sodium soy sauce (optional) • ½ tsp. salt • 5 ounces (½ package) frozen chopped spinach, defrosted • 1 cup cooked brown rice

Liquid to lentils will be about 3:1 so if you use ½ cup of lentils, you’ll need about a cup and a half of liquid. Bring liquid to a boil and season.

Err on the side of strong seasoning as when you add the lentils, they will dilute the seasoning. Once at a rolling boil, reduce heat to low. Pour in lentils and stir a couple of times. Cover and simmer for 15-20 minutes. Open and fluff. The lentils should be tender. If they aren’t, have them sit for a little longer. If not all of the liquid is absorbed, you can wait for the liquid to cook off, stirring often.

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Preheat the oven to 325 degrees. Coat a loaf-shaped baking pan with cooking spray. Set aside. Heat 2 teaspoons of the oil in a small skillet over mediumhigh heat. Sauté the carrot, onion, scallion and turmeric until the carrot is soft, about 5 minutes. Turn the mixture into a mixing bowl. Squeeze each piece of tofu to eliminate excess water. When it resembles cottage cheese, place it in a food processor or

blender. Add the remaining oil, so using) and salt. P smooth. Transfer with the cooked Stir in the spinac With a rubber sp until well combin the mixture in an in the prepared b

Bake 30 to 45 mi until firm to the to center. Cool com pan. Turn out on board and cut in


ASK THE EXPERT

JOSH WLUDYGA

Exercise physiologist, Banner MD Anderson Cancer Center

Q: How does exercise

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contribute to cancer prevention?

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e egg white, oy sauce (if Purée until r to the bowl vegetables. ch and rice. patula, mix ned. Spread n even layer baking pan.

inutes or ouch in the mpletely in the nto a cutting nto 4 squares.

Wrap pieces individually, then place in a zip-lock plastic bag and store in the refrigerator up to 3 days or in the freezer for two weeks. Eat at room temperature or after being gently warmed in a microwave. Makes 4 servings. Per serving: 129 calories, 5 g. total fat (less than 1 g. saturated fat), 16 g. carbohydrate, 6 g. protein, 3 g. dietary fiber, 353 mg. sodium.

There’s evidence that physical activity can help reduce the risk of several types of cancer, with the evidence usually being stronger in cases of breast, colon or colorectal cancers. There is, however, also evidence for prostate cancer, and perhaps even lung cancer, and there is growing evidence for some of the other cancers that are not as well researched. In general, evidence shows that people who are more physically active may see a greater reduction in developing cancer than those who are sedentary. We’ve seen studies that show a 15 to 25 percent reduction in developing cancer, just from exercise alone. For colorectal cancer, I’ve seen studies showing numbers as high as a 27 percent reduction. Q: Why does exercise appear to help? A: While we don’t know the definite reason exercise seems to help prevent cancer, some theories relate to hormones and how physical activity helps regulate them. In an active person, hormone levels tend to be more properly regulated, even when sitting at rest, as compared with someone who is sedentary. Physical activity has been shown to keep hormone levels of estrogen, insulin and growth factor hormone at more normal levels, or in a state of homeostasis, which means your body is in state of balance. Q: What kind of exercise do you suggest? A: You can choose something as simple as walking. You want to walk at a moderate, brisk pace, though, not just stop-and-go walking with your dog. I also suggest using a pool, especially when it gets warmer. The pool’s especially good for people who have joint issues; they’re usually able to do low-impact exercises and aerobics and the buoyancy of the water makes it easier on their joints. You could also choose hiking or biking, and I’ve even suggested Zumba classes. Sometimes, the biggest motivator is finding something you enjoy doing. Then it’s something you look forward to.

Q: How frequently do I need to work out? A: We always recommend a minimum of 150 minutes of activity per week. Most people break that into 30 minutes a day for five days a week. But if you’re sedentary and have other conditions such as high blood pressure or diabetes, try starting with 15 minutes at a time and work toward that 30-minute goal to accumulate that 150 minutes per week. Q: How do I get started? A: Start slowly. That 150 minutes is the number we look toward, but that can be a lofty goal in the beginning, especially for someone who’s been sedentary, so start slowly and work toward the goal. If you have any current health concerns, especially a pre-existing heart condition or a joint-related condition, you should speak first with your physician before starting an exercise regimen. If you want to see a significant change in how your body looks and feels, give it about two months. There’s always the potential to see a difference in as little as two weeks, but the body does take it time when making these changes. If you’re consistent and you give it about two months, there’s a very good chance you’ll see a difference in how you look and feel. • pp

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GIVING

Cox founder leaves legacy of public service, giving back $5 million gift funds center for cancer prevention, integrative oncology

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id you know that the founder of your local cable company once ran for president of the United States … and that the foundation named in his honor is helping provide cancer prevention and care services for residents of Arizona and beyond? James M. Cox was a former schoolteacher and news reporter in Ohio when he founded Cox Enterprises in 1898. His ambition was to own a newspaper, so at age 28, he borrowed $26,000 from friends and family and purchased the Dayton (Ohio) Evening News. His success with the newspaper led him into public service, and Cox eventually became Ohio’s first three-term governor. In 1920, he was the Democratic nominee for president of the United States. After losing the election to Warren Harding, Cox turned his attention to growing his media business.

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TRADITION OF CARING

Today, that business is a leading communications, media and automotive services company with revenues of nearly $16 billion and more than 50,000 employees across the United States. Gov. Cox died in 1957, but the company he founded is still family-owned and continues to operate in accordance with his values. “Ask yourself one question, ‘Is it right?’ Then do what you believe is best for your town, your state and your country,” was Cox’s motto. Through the James M. Cox Foundation, Cox Enterprises fulfills its founder’s vision by providing philanthropic support to the communities in which it operates. The foundation’s $5 million grant to Banner Health helped fund The James M. Cox Foundation Center for Cancer Prevention

and Integrative Oncology at Banner MD Anderson Cancer Center. As a nonprofit health system, Banner relies on the generosity of individuals, corporations and foundations, such as the Cox Foundation, to help fulfill its mission of making a difference in people’s lives through excellent patient care. These benefactors and partners in wellness make the difference between a good healthcare system and an outstanding one. COMMUNITY INVOLVEMENT

“The Cox Foundation is particularly excited about this gift to Banner,” says Alex Taylor, executive vice president of Cox Enterprises and great-grandson of the company’s founder. “Our family has always believed in getting involved in


PROFILE

‘Miracle’ patient beats the odds Philippe Garnier overcomes Stage 3 melanoma, gains respect for sun BY BRIAN SODOMA

PLAYING IT SMART

any people at Banner MD Anderson Cancer Center in Gilbert refer to him as “The Miracle Patient.” Philippe Garnier, 44, has certainly earned such a title. Garnier has endured an intense, five-year cancer battle that, by all accounts, he probably should have lost. The experience has re-shaped many of the daily choices he makes and his overall philosophy on life.

Garnier still loves the sun. He vacationed almost every month in 2013, visiting beaches and other sunny spots. But now he plays it smart, and he’s not too concerned about his tan. “I usually go to the beach in the mornings, from about nine to 11, then I leave,” he said. “I wear a hat. I use SPF 60 sunscreen. If I go into the water, I always have a shirt on. I used to think

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SUN SPOTS

Presidential candidate James M. Cox (left) and vice-presidential candidate Franklin D. Roosevelt campaign in 1920. the communities where we do business. Through this gift, thousands of our customers, employees and others will receive world-class health care, and that’s worth more than I could ever say.” J. Stephen Rizley, senior vice president and general manager of Cox Communications in the Southwest region, was a leader of the campaign to raise philanthropic support for Banner MD Anderson and helped secure the grant from the James M. Cox Foundation. He considers it part of his job to be a custodian of the Cox legacy in Arizona. “Cox wishes to associate its name with efforts that will bless lives, build communities and foster economic development,” Rizley says. “I believe that is attainable here at Banner MD Anderson Cancer Center.” • pp

Growing up in Montreal, the French Canadian saw plenty of long winters, and sunny beach escapes were on his mind. So, when the opportunity to live in the Caribbean islands came, he took it. For six years, he enjoyed the sun, and one of his favorite activities, snorkeling. But Garnier also admits to being a bit careless when it came to sun protection. “I didn’t like the [sunscreen] creams,” he says. Even in his teen years, while still living in Canada, he ventured into tanning booths. “I thought I needed to have a tan.” Stage 3 melanoma was found on his back in 2008, many years after his Caribbean experiences. The melanoma later traveled to his underarms and spine, requiring multiple surgeries and aggressive cancer treatments. The experience even crippled him at one point. He relied heavily on Banner MD Anderson physical therapist, Leona Sharman, for regaining the use of his right arm. “She helped me so much,” Garnier adds. “I lost about 90 percent mobility of my arm and have gotten most of it back.”

“I usually go to the beach in the mornings, from about nine to 11, then I leave. I wear a hat. I use SPF 60 sunscreen. If I go into the water, I always have a shirt on. I used to think I wanted a tan … I’m OK with my skin being white now.” — PHILIPPE GARNIER

I wanted a tan…I’m OK with my skin being white now.” Garnier has remained cancer-free throughout 2013. He now eats more of a plant-based diet with minimal processed foods, avoids sugars, fats and stress as much as possible, elements that literally “feed” cancer, he has learned. Garnier’s cancer journey has also framed a fresh perspective on life. He has created a website chronicling his “miracle” journey, and he’s also learned the power of the many friends and family he has around the world. “I have people praying for me around the planet. It really helps.” • pp

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EVENTS AND CLASSES

Promising New Targeted Drugs for Cancer Treatment

June

11

Recent clinical trials using novel targeted agents suggest they may also prove to be effective for the prevention of some cancers. Join us to hear Dr. Klaus Wagner discuss the latest advanced research findings and learn about new treatments and recommendations.

Transitioning from Cancer Patient to Cancer Survivor

July

9

Ask the Expert: Cancer Survivorship Series | Cancer survivors struggle with life after cancer and redefining themselves in relationships at work and with family and friends. Join Psychologist Dr. Beverly Yoches in addressing these issues and learn ways to cope with this transition to improve quality of life.

Survivorship Support and Symptom Management

Aug

13

Many cancer survivors deal with health problems related to cancer treatment. Commonly cited problems are pain and fatigue. Join Dr. Rebecca Armendariz, Pain/Palliative Medicine and Rehabilitation Physician, to learn how to manage symptoms and improve daily life.

The Gynecologic Cancer Survivor: Addressing Concerns & Moving Forward

Sept

10

FOR ALL CLASSES Time: 6-7:30 p.m. Location: Grand Canyon Conference Rooms, Banner Gateway Medical Center To RSVP: Call 602-230-2273 (CARE) To learn more about these events or to register, please visit www.Banner MDAnderson.com

What can be done to help women with gynecologic cancers? A lot! Join Dr. Matthew Schlumbrecht, to learn ways to deal with post-treatment related side effects and concerns related to gynecologic cancer.

FOR MORE INFORMATION

On the campus of Banner Gateway Medical Center, U.S. 60 and Higley Road in Gilbert Banner MD Anderson Radiation Therapy also available at: Banner Thunderbird Medical Center, 55th Avenue and Thunderbird in Glendale, 602-865-5445 Banner Desert Medical Center, Dobson and US 60 in Mesa, 480-412-3808

To schedule an appointment, call 480-256-6444

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Banner MD Anderson Power of Prevention - Summer 2014