MDA Prevention Summer 2015

prevention power of

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

SUMMER 2015

Protect your skin with

sunscreen

How to make the best selection and reduce sun exposure

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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

s temperatures begin to soar, many families will take part in a variety of outdoor activities like swimming, boating and hiking. If you plan on spending more than 10 minutes in the sun, it is recommended that you apply sunscreen to protect your skin from harmful ultraviolet (UV) radiation.

While making your summer plans, be sure to include a sunscreen that not only fits your lifestyle but also protects your skin from the damaging effects of the sun.

CHOOSE THE RIGHT ONE

With so many sunscreens on the market now, it can be overwhelming to know how to make the best selection. Without an expiration date, sunscreen can last no more than three years, according to Centers for Disease Control and Prevention. However, that timeframe can be shorter if the sunscreen has been exposed to high temperatures.

E X E R C I S E | 2 →

INSIDE

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Cancer takes patient through unexpected — and inspiring — journey

Share a message of hope

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Survivors look to give back to Banner MD Anderson

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→ FROM THE COVER

Mark Gimbel, MD, a surgical oncologist at Banner MD Anderson Cancer Center in Gilbert, advises:

“Look for a product containing broad-spectrum protection that blocks both types of UV radiation, UVA and UVB. A good sunblock is one that gives 100 percent protection and includes an active ingredient such as titanium dioxide.”

Differentiating between the effectiveness of sun protection factor, also known as SPF, determines the amount of time the sunscreen has to prevent UVB from damaging the skin.

“I recommend a sunscreen with SPF 30 for the sun-exposed areas of the body,” Gimbel said, “especially the neck, face and ears.”

However, the higher the SPF doesn’t necessarily mean more protection.

“An SPF 15 blocks 93 percent of the harmful UVB radiation while an SPF 30 blocks 97 percent, Gimbel added. “The added benefit of SPF 30 to SPF 50 is only 1 percent.”

Sunscreens come in a variety of sprays and lotions that are water resistant, kid-friendly and formulated for dry or sensitive skin. Experts suggest using caution when applying sunscreen on children — especially infants, who should wear sunscreen after the age of 6 months.

“Spray sunscreen on your hands first before rubbing on children to avoid the eyes and mouth,” Gimbel said.

KNOW WHEN TO REAPPLY

It is suggested that one ounce of sunscreen should be applied 30 minutes before sun exposure to allow ingredients to fully bind and absorb into the skin, according to The Skin Cancer Foundation.

Sunscreen significantly diminishes after an extended period of time outdoors especially after swimming or excessive sweating.

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SIGNS AND SYMPTOMS OF SKIN CANCER Skin cancer is the most common form of cancer in the U.S. with more than 3.5 million Americans diagnosed each year, according to the American Cancer Society. The good news is that with early detection through regular self-exams and annual screenings, skin cancer is curable.

NON-MELANOMA SKIN CANCERS Growths or lesions on the skin can be a sign of non-melanoma skin cancer.

“Basal cell carcinoma and squamous cell carcinoma are non-melanoma skin cancers that are a direct result of sun exposure, typically seen in adults over age 50,” said Gimbel. “These can look like a growth, scaly patch or a wound on the skin that won’t go away or continues to grow.”

Symptoms of non-melanoma skin cancer include flaking or itching and noticeable changes in appearance. They can look like sores, bumps or scars.

Those at risk for non-melanoma skin cancer are people with fair skin, light eyes and blonde or red hair. Excessive unprotected sun exposure and family history are also thought to be contributing factors.

MELANOMA SKIN CANCER Melanoma is considered the most dangerous form of skin cancer. To identify melanoma, experts recommend following the ABCDEs of skin cancer: Asymmetry, Border, Color, Diameter, and Evolving.

“If a mole or pigmented spot has indistinct borders, gets darker, starts to grow in size, shape or elevation, or change colors, it’s important to have it evaluated by a dermatologist for possible biopsy,” Gimbel said. “If melanoma is present, a patient should be referred to a surgeon for treatment.”

“Reapply every few hours,” said Gimbel.

“Even water resistant sunscreen needs to be reapplied because it usually gets wiped off with a towel.”

Don’t be fooled by hazy or overcast days.

“Approximately 40 percent of UV radiation can still make it through the clouds,” Gimbel added. “You still should wear sunscreen even on days when the sun isn’t out if you plan to be outside for any length of time.”

BE PREPARED

The sun is considered to be the strongest and most dangerous between 10 a.m. and 4 p.m. Chose an indoor activity or seek shade under a tree or umbrella.

There are other unexpected ways the sun can cause harm.

“Be sure to wear sunscreen during activities like water skiing to avoid reflective radiation from the sun,” said Gimbel.

Polarized sunglasses can protect the eyes and decrease chances for developing cataracts later in life. Brimmed hats,

long sleeves and pants made from tightly woven materials and swim shirts are also suggested.

“Today there are plenty of lip balms and other cosmetics that contain SPF,” Gimbel added.

AVOID LONG-TERM DAMAGE

The effects of sun exposure like wrinkling, freckling and brown spots are cumulative and not immediately noticeable. Sun damage occurs over an extended period of time, with the majority taking place during adolescence and early adulthood.

However, there are ways to make a positive impact on skin at any age.

Use sunscreen on a daily basis. Steer clear of indoor tanning which can increase chances for skin cancer. Seek other ways to obtain vitamin D through food sources.

“Even if someone starts using sunscreen regularly later in life, it still has beneficial effects,” Gimbel said. • pp

Finding Inspiration

Cancer takes patient down an unexpected — and inspiring — journey

BY KRISTINE BURNETT

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ife sometimes has a way of making us take pause and refocus on what is truly important. For Kellie Williams of Gilbert, that moment came in the wake of a cancer diagnosis that tested her faith and her fortitude.

A single mother of five who recently lost her second-oldest child, 47-year-old Williams began her cancer journey and the road to self-discovery in September 2013.

After more than a year of profuse bleeding, doctors at a Phoenix area hospital determined that a hysterectomy was necessary.

However, a pre-op appointment revealed more than they expected: a mass the size of a fist that appeared to be in her cervix.

Following a biopsy, doctors dealt Williams a diagnosis of cervical cancer.

Just hours after learning that she would soon be fighting cancer, Williams was in need of emergency medical attention.

Hemorrhaging, she turned to the Emergency department at Banner Gateway Medical Center. Due to her recent diagnosis, emergency physicians brought in their cancer care colleagues at Banner MD Anderson Cancer Center, located on the Banner Gateway campus, to stabilize Williams. This was the start of her relationship with cancer care experts such as Matthew Schlumbrecht, MD, a gynecologic oncologist at Banner MD Anderson.

UNEXPECTED RESULTS

During a stay at Banner Gateway she got to know Dr. Schlumbrecht and elected to have him take over her treatment. But when he performed another biopsy to confirm the diagnosis and determine a treatment strategy, Williams received yet another surprise.

“After he did the biopsy and testing, we discovered that I didn’t actually have cervical cancer,” Williams explained.

“I had uterine endometrial sarcoma.”

A rare form of cancer in the muscles or tissues of the uterus, the disease required a different treatment approach than originally expected.

Kellie Williams says her cancer diagnosis and treatment made her grateful.

Today, she sees the experience as a blessing that strengthened her faith.

“Dr. Schlumbrecht brought in me, my family and close friends to explain everything — he even drew diagrams on a whiteboard to help us understand,” Williams said.

Dr. Schlumbrecht and his colleagues determined that the mass, which had grown significantly over the course of three weeks, needed to be removed. Two weeks later, Williams underwent surgery, which included a radical hysterectomy and removal of her uterus, ovaries, lymph nodes and even her appendix.

REMARKABLE TREATMENT

Once healed from surgery, she began 32 rounds of radiation.

Though doctors prepared her for such side effects as fatigue, nausea and even a burning sensation, she didn’t present any symptoms. Five rounds of weekly outpatient chemotherapy were added to her treatment regimen. Doctors again prepared Williams for the side effects of treatment, and, again, she had none.

“To be honest, having cancer was one

of the best times of my life,” she said.

“It was a blessing.”

Convinced that her lack of side effects was somewhat of a fluke, doctors did their best to warn Williams that she wouldn’t be as lucky during inpatient chemotherapy. A higher dose of medication that requires inpatient hospital care, she began a 16-week routine of spending one week in the hospital for treatment followed by two weeks at home to recover. Despite near certainty that Williams would suffer the side effects of chemotherapy, she was never sick.

“I didn’t have any fatigue or nausea or any of the side effects they expected,” she said. “I called treatment my vacation. I had permission from my doctors to walk around, so I went all over that hospital.”

Williams rode an exercise bike for 30 minutes each morning, never lost her appetite and got to know staff and volunteers throughout Banner Gateway where she received inpatient care and Banner MD Anderson.

FINDING GRATITUDE

“Getting sick was a blessing that made me realize how wonderful life is,” she said. “It was truly a miracle that strengthened my faith. It was something that I needed to go through in my life to get where I’m going.”

Williams completed cancer treatment in May 2014, and is now labeled “NED,” No Evidence of Disease.

“I actually miss my treatments,” she said with a chuckle.

While her cancer fight may be over, her journey is far from finished.

In addition to visiting Banner MD Anderson almost every week, Williams has formed a fundraising team that will help fund cancer research at Banner MD Anderson.

Williams faces a high chance of cancer recurrence. Aware of the uncertainty that lies ahead, she remains positive and forever grateful for her journey.

“Every misfortune is a blessing in disguise,” she said. “I truly believe that now.” • pp BannerMDAnderson.com 3

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t Banner MD Anderson Cancer Center, WE ARE ALL IN for the fight against cancer — with world-class medicine, unique clinical trials, and a team of experts dedicated to developing a customized treat4 P OWE R O F PR E V E N T I O N S U MMER 2 0 1 5

ment plan for each person. We believe in the healing power of a supportive community.

And there’s nothing more powerful than knowing we have community behind us, especially during our darkest hours.

That’s where you come in!

Share a message of hope, like the ones included on these pages, and let a patient who is facing cancer know you are all in! Use the attached postcard to send in your words of support or upload them at

WeAreAllIn.com!

These messages will be shared with patients at Banner MD Anderson Cancer Center in Gilbert, as well as our radiation oncology programs at Banner Desert in Mesa and Banner Thunderbird in Glendale.

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FOUNDATION

Cancer survivors find hope Now they look to give back to Banner MD Anderson

BY BRIAN SODOMA

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ennis and Kathy Desmond know the statistics all too well: cancer will affect one in two men and one in three women, according to the National Cancer Institute. The Arizona couple was on the wrong side of those numbers, but fortunately on the right side of survival rates.

Both credit Banner MD Anderson Cancer Center in Gilbert and The University of Texas MD Anderson in Houston for their positive outcomes and now, through a fundraising effort titled “Brokers For Hope,” the Desmonds want to help support others on their own cancer journeys.

“When this impacts you or your family, there is no mountain you wouldn’t move to find the best possible care, and the very best care is right here at Banner MD Anderson,” Dennis says.

positive. MD Anderson had been testing a drug named Rituxan, which was successfully starving cancer cells of blood flow with little to no damage to healthy cells.

The treatment worked, and Dennis has been cancer free ever since. “That proved to be the silver bullet for me,” he adds.

THE POWER OF A SINGLE WORD

Twenty years ago, a routine physical revealed elevated blood calcium levels for Dennis.

Further tests eventually found tumors in his abdomen and non-Hodgkins lymphoma.

At 47, Dennis felt there was still a lot more life ahead of him, but two oncologist visits were less encouraging. Both physicians said his disease was treatable but he should expect it to come back. The conversation changed at MD Anderson Cancer Center in Houston.

“That was the first time anyone had ever used the word ‘cure’ with us,” Dennis remembers. “The team in Houston said, ‘We have a 55 percent chance of curing you.’ That really got my attention.”

The team at MD Anderson helped Dennis beat cancer, but it returned three years later.

This time, the outlook was even more 6 P OWE R O F PR E V E N T I O N S U MMER 2 0 1 5

2013, colorectal cancer was detected.

“If I could give any advice, if you’re in this situation, you should still get checked every three years, even if you have to pay for it yourself,” she offers.

Kathy also sought treatment from MD Anderson in Houston. But in the 20 years since her husband’s battle, she learned of the center’s growing presence in the Valley through its partnership with Banner Health and decided to go to Banner MD Anderson. “We were surprised to hear the Houston doctor say, ‘You have all this (world-class treatment) in your own backyard now,’ ” Kathy recalls.

In particular, Kathy was grateful for the quiet confidence and calming presence of her oncologist Tom Dragovich, MD. “I remember around Christmas-time (in 2013) I was at home in the depths of my side effects from chemotherapy and the phone would ring and he would ask how I was doing,” she says. “I can’t tell you what that means to a patient.”

BROKERS FOR HOPE

Both cancer survivors, Dennis and Kathy Desmond have started Brokers for Hope to support patient care at Banner MD Anderson.

KATHY’S JOURNEY, A PREVENTION TIP

At 51, Kathy had her first colonoscopy.

That procedure, and one more three years later, revealed non-cancerous polyps. But when a third colonoscopy several years later didn’t reveal polyps, her insurance recommended waiting five years for her next procedure. After five years, in March

Leveraging Dennis’ 30-plus years of commercial real estate experience, the couple recently launched Brokers for Hope along with Banner Health Foundation board member and Chairman of Ryan Companies Southwest, John Strittmatter. They host events for local commercial real estate brokers where they share their story and also solicit financial support for patient care at Banner MD Anderson.

After exceeding a goal of $20,000 through March, they are confident $100,000 can be raised by the end of the year. “The name for the program really came about pretty naturally. We really do see Banner MD Anderson as a house of hope,” Dennis adds. • pp

PREVENTION

Strike a Pose

7 healing benefits of yoga that will have you eager to master the mat

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hose who regularly do yoga know the physical and mental health benefits of this ancient art, and modern scientific research backs the practice, too.

So, dust off that yoga mat and check out these seven health benefits of yoga.

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FLEXIBILITY: Yoga is a well-known way to increase flexibility, and the benefits go far beyond just showing off.

“Increased flexibility leads to fewer aches and pains. For example, tight hips can strain knee joints,” says Laurie Trigilio, a holistic instructor at Banner MD Anderson Cancer Center in Gilbert, where she teaches chair and mat yoga for cancer patients and survivors. “The whole body is positively affected when you start to lengthen the connective tissue in a safe way for greater elasticity.”

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STRENGTH: Yoga helps build strength in the leg muscles, core and back. Strong, lean muscles look good, yes, but they also support overall health.

“Weight-bearing exercises are good for the bones and preventing osteoporosis,” Trigilio notes.

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BALANCE: Yoga typically includes moves designed to enhance balance.

Good balance becomes especially important as we age, Trigilio says, because it can help prevent falls.

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STRESS RELIEF: With deep cleansing breaths and mindful awareness among its key components, yoga helps engage the parasympathetic nervous system, which helps calm the body — reducing stress hormones like cortisol and adrenaline, lowering blood pressure and improving blood flow.

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IMPROVED POSTURE: Sitting up straight is about more than looking good. “Poor posture can lead to other back, neck and joint problems, which in turn inhibits full deep breaths,” Trigilio says. So, when you improve your posture through yoga, you also affect the way you breathe, which ultimately triggers the relaxation response.

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IMMUNITY: Yoga’s postures help the lymphatic system fight infection.

A small study out of Norway in 2013 showed that yoga may be better than traditional exercise at boosting immunity — actually affecting immune cells at the genetic level.

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A LONGER LIFE: A yoga session ends with a few minutes of stillness and meditation. For you busy, Type As out there, this is where you might roll up your mat and head for the door to save time. But stick it out.

Savasana (or “Corpse Pose”), Trigilio says, is the most important posture of all.

“Many believe that is why we do yoga — to find that peace. The physical part of yoga is to support that meditative peace,” she says. “Meditation actually increases the length of the telomeres (the parts that affect aging) at the end of our chromosomes which helps us live longer and healthier lives.” • pp

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NUTRITION

From the ground up

already processed), consider adding one half-cup serving a day or even one a week to start. Simple recipes, such as the one here, can get you started. Ultimately, your goal should be to consistently add whole grains into your meal plan every day.

Plant-based eating can keep you healthy

BY DEBRA GELBART

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e’ve all heard of vegans, vegetarians and carnivores.

But might some people be “flexitarians” and not know it?

A flexitarian diet differs from a Mediterranean diet, though there are some similarities, explained Christi Kirk, RD, CSO, a registered dietitian and board-certified specialist in oncology nutrition at Banner MD Anderson Cancer Center in Gilbert.

A flexitarian eater is one whose diet is primarily plant-based, with an emphasis on vegetables, fruit, raw whole grains, beans and legumes. “But flexitarians will consume poultry and fish in moderation,” Kirk said. A Mediterranean diet emphasizes fish and other seafood, unsaturated fats such as olives and olive oil, vegetables, whole grains and red wine, she said.

EVERYDAY BASICS

CHRISTI KIRK proteins and healthy fats almost as condiments, Kirk said.

She encourages not contemplating sweeping changes in your diet all at once, because the prospect can be overwhelming. “Small changes really add up to better health,” she said. “If you typically eat one or two servings of fruit or veggies a day, try upping the number to three a day at first, with the goal to get to five servings a day.”

If you’ve never tried cooking a whole grain, such as brown rice or quinoa when it’s in its original form (rather than

MEDITERRANEAN TABBOULEH

SMALL CHANGES CAN MAKE A BIG IMPACT

But you don’t need to choose a specifically named food lifestyle to be healthy, Kirk said, as long as your diet is primarily plant-based. When you strive to make healthy choices every day, you’ll enjoy living in your own skin more than if you eat mindlessly and without any planning. The American Institute for Cancer Research recommends eating mainly plant foods and turning to animal

In addition to whole grains, Kirk said, it’s a good idea to try to add four other types of food every day whenever possible. These are: beans or legumes, such as lentils and chickpeas; orange or leafy green vegetables; healthy fats, such as avocado or nuts or seeds; and fish that might include wild salmon, albacore tuna, sardines or mackerel. “All of these foods can help prevent cancer and other diseases,” she said.

She also advises seasoning these ideal foods with any of the following herbs and spices: turmeric, fennel, red chili pepper, cloves, ginger, basil, rosemary, chives and cilantro. “All of these play a role in preventing chronic disease,” Kirk said. • pp

Combine all ingredien

• 2 cups cooked and cooled farro (grains of cer tain wheat species sold dried at specialty grocers) • 1 cup chopped fresh basil • ½ cup chopped fre sh mint • ¼ cup finely chopp ed red onion • 3 T balsamic vinega r • 2 T chopped oil-pac ked sundried tomatoes • 1 T oil from sundrie d tomatoes • 2 T chopped Kalam ata olives • 1 yellow bell pepper , cored and diced • ¼ cup crumbled feta cheese • Salt and ground bla ck pepper, to taste

ts in a bowl. Toss well,

then season with salt

and pepper.