Journeys Spring 2016

Journeys SPRI N G 201 6

The healing power of art

When cancer hits home

Strands of strength

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Accreditations The Community Cancer Center and its partners meet the highest accreditation standards for cancer care.

2 Journeys | Spring 2016

Quality Cancer Care: Recognizing Excellence

Journeys Contents 4 The healing power of art 6 The right treatment, right here 8 Leading the way 10 When cancer hits home 12 Relaxation therapy 14 Reaching out for skin cancer awareness 16 Strands of strength 18 Early detection is vital with head and neck cancer 19 Ask the expert

Leading the Way As the Helen G. Nassif Community Cancer Center enters its fourth year of serving patients in our community, we’re excited about the many opportunities that await us in 2016. We look forward to working with the community, our patients, their families, and local providers, including our new partner, St. Luke’s Albert G. and Helen Nassif Radiation Center.

The Nassif Radiation Center represents the final piece in the complete care continuum. Patients can now come to one place to see their doctor, receive treatment, and get the support they need as they move from diagnosis to cancer survivorship. The Community Cancer Center helps make the process seamless by collaborating with our community partners to enhance and improve care coordination.

We are proud of our role as the leader in cancer care in our community. And we will continue to expand our programs and services to complement rapidly growing advances in diagnosis and treatment.

We invite you to find out more by visiting our new website at communitycancercenter.org.

Kimberly Ivester, MS, BSN, RN, OCN

Administrative Director, Nassif Community Cancer Center Director, Cancer Care, UnityPoint Health – St. Luke’s Hospital

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Molly and Brian Scott are proud to support the Photo Art Gallery Project.

The healing power

of art

Photo Art Gallery Project helps patients in multiple ways “Cancer runs in my family,” says Brian Scott. “It’s all over the place.”

That personal experience was instrumental in Scott’s decision to serve on the board of directors for the Community Cancer Center. “I was really interested in helping the center get off to a good start,” explains Scott. “We’re trying to deliver a level of coordinated care that wasn’t available before.”

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Scott says the goal of the Community Cancer Center is to surround patients and their loved ones with support, from diagnosis through treatment and beyond. He adds, “I wish this had been available when I was going through cancer with my family.”

Now Brian Scott and his wife, Molly E. Scott, have found a way to help others while honoring the memory of loved ones lost to the disease.

The Photo Art Gallery Project harnesses the healing power of artwork for the benefit of everyone impacted by cancer.

Research shows artwork can improve the patient experience by promoting healing, easing pain and stress, and increasing overall well-being. Through the Photo Gallery Art Project, donors can sponsor the placement of timeless images throughout the Community Cancer Center and St. Luke’s Radiation Center.

Brian and Molly Scott chose to sponsor three single-panel photos, each one memorializing different loved ones. In particular a photo of the Grant Wood Studio has special meaning to Molly Scott, whose family were longtime patrons of Wood.

The generosity of Lumir and Norma Newmeister and their sons made this project possible.

Proceeds support cancer center services such as nutrition consultations and integrative therapies that are not reimbursed by insurance.

Norma Newmeister, a dedicated volunteer and friend to St. Luke’s Hospital, Foundation and Auxiliary for over 40 years, had long wanted to donate art to the Community Cancer Center.

She, her husband Lumir Newmeister, and their sons made the Photo Gallery Art Project possible by providing the seed money to get it started. They also donated two four-panel photographs— one placed at the Community Cancer Center and the other at St. Luke’s Radiation Center.

For more information or to

“We saw this as an opportunity to help cancer patients and their families by providing a more healing environment,” explains Norma Newmeister. Adds Lumir, “It’s rewarding to be able to donate to something you can see.”

Donors can choose from more than 100 beautiful images, from local landmarks to pastoral landscapes, by local photographers Ed and Molly Kempf (Impact Photography/Joe Photo) and Andrea Shriver. Each 16 x 24 panel is $1,000 and can be used to honor a loved one, celebrate a survivor or make a lasting gift for the benefit of cancer patients.

sponsor a photo, call (319) 369-8100.

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Lee Overton received great care, close to home.

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The right treatment, right here St. Luke’s Nassif Radiation Center makes high quality advanced cancer treatment more convenient, at a lower-cost.

Lee Overton admits he might not have agreed to radiation treatment for his prostate cancer if it weren’t for the new St. Luke’s Nassif Radiation Center. But once he began treatment shortly after the center opened, Overton says, “I actually looked forward to going every day!”

Medical Pavilion, which is already home to the Community Cancer Center, puts all the care a patient with cancer needs in one convenient location. She adds, “Our patients now stay with one care team from diagnosis through treatment and beyond.”

Overton, 77, of Hiawatha, had been monitored for elevated PSA levels—the test that detects prostate cancer—for several years. When his PSA number rose in early 2014, Overton’s urologist, with Physicians’ Clinic of Iowa, Thomas Richardson, performed a biopsy that confirmed early stage prostate cancer. After discussing treatment options with Dr. Richardson, Overton elected to take a wait-and-see approach known as active surveillance.

In 2015, his PSA jumped again and Dr. Richardson suggested Overton begin radiation treatment.

Another benefit of the Radiation Center: It saves the patient money. Ivester explains when services are considered freestanding instead of hospital-based there is a lower cost to the patient and their insurance company. Treatment at the Radiation Center can lower out-of-pocket costs for patients by 20 to 50 percent.

Notes Ivester, “That’s something we see as critical in delivering lower cost, higher quality cancer care. Patients need to play an active role in their health care decisions, that includes what the cost of their care will be.”

“I decided radiation therapy was a good thing to do,” says Overton. “It was low risk, with fewer side effects, and the new radiation center made it convenient. I just had to go down the hall.”

Lee Overton is pleased his treatment with the TrueBeam™ Linear Accelerator, which offers pinpoint accuracy to minimize damage to healthy tissue, resulted in few side effects. In fact, Overton says the entire experience couldn’t have been better. “My nurse, Stephanie, was very professional and so much fun! And the follow-through was wonderful. From the welcoming greeting at the door to the way they were always on time, I’ve never been to a doctor’s office so well run!”

Overton was one of the Radiation Center’s first patients when he began treatment in November 2015. “The whole thing was great,” he raves. “It was so handy, starting with the parking being so close.”

St. Luke’s Nassif Radiation Center allows patients to receive treatment locally as part of the coordinated care offered by the Community Cancer Center. Kimberly Ivester, director at the Community Cancer Center, says housing the Radiation Center inside the PCI

For more information about St. Luke’s

Radiation Center go to unitypoint.org/radiation.

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Leading the way Community Cancer Center at the forefront of breast cancer research Dr. Francis Collins, director of the National Institutes of Health, has called this a “remarkable moment” in cancer research. Scientists are more knowledgeable than ever about how cancer starts, how it spreads and how to combat it.

The Community Cancer Center works collaboratively with Physicians’ Clinic of Iowa (PCI) Hematology and Oncology to bring research studies to cancer patients in our community. Clinical trials, like those available right here in our community, are helping scientists develop new and better ways to prevent, diagnose and treat cancer.

One local patient recently became the first in North America to participate in a clinical trial aimed at improving treatment for metastatic breast cancer that has spread to the bones. The trial involves the use of Radium 223, or Xofigo®. In 2013, the FDA approved the use of Radium 223 to treat prostate cancer that has spread to bones and is resistant to medical or surgical treatments that lower testosterone. Now Radium 223’s use in breast cancer treatment is being investigated.

In this trial, patients are randomly assigned to receive either Radium 223 or a placebo—an inactive substance that looks like the drug. Because it is a “double-blind” study, neither the patient nor the doctor will know which substance the patient receives. PCI Oncologists William Fusselman, MD, Rasa Buntinas, MD, and Bharat Jengiri, MD, are the principal cooperators in the study. Dr. Buntinas will closely monitor the patient’s health and well-being throughout the therapy.

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“To participate in a clinical trial, the patient has to meet specific guidelines for eligibility,” explains Kristin Sperfslage, study coordinator for the Community Cancer Center. “In this case, the patient did not respond to standard breast cancer therapies and she met the other requirements.” More than 200 patients world-wide are expected to participate in the study, which is estimated to be completed in May 2017.

“One benefit of clinical trials is patients may get access to treatments before they are available to the general public,” says Dr. Buntinas. In addition, patients can help others by adding to our knowledge about cancer care. That’s one reason why the local patient decided to participate in the Radium 223 trial. “We’ve made a lot of progress in fighting cancer,” she says, “but we need more. I’m hoping if this trial doesn’t help me, it will help someone else.”

On average, the Community Cancer Center has 15 different clinical trials available at any given time.

That number has recently grown as clinical trials are now available at St. Luke’s Nassif Radiation Center. Trials may offer new investigational drugs, compare the benefits of one drug over another, or focus on improving quality of life for cancer patients by decreasing treatment-related side effects.

Participation in a clinical trial is always voluntary and patients may leave at any time.

For more information on clinical trial options, talk to your doctor or call the Community Cancer Center at (319) 558-4876 and ask to speak to a research coordinator.

Rasa Buntinas, MD, an oncologist with Physicians’ Clinic of Iowa (PCI), monitors patients throughout the study

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Oncology nurses Dorothy, Watkinson and Hays gain new perspective from personal experience

home When cancer hits

Oncology nurses diagnosed with cancer share bond with their patients

Cancer knows no barriers. It can strike male and female, young and old, all races and occupations. That point was driven home for the Community Cancer Center family in 2015 when three oncology nurses affiliated with the center were diagnosed with cancer.

As clinic coordinator for Physicians’ Clinic of Iowa (PCI) Hematology and Oncology, Marci Hays, RN, often assured patients she understood what they were going through. But today Hays admits, “I really didn’t understand until I went through it myself.”

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Last summer Hays was diagnosed with breast cancer at age 41. Suddenly the healthcare professional who explained treatment options to patients had to choose treatment for herself…and found it overwhelming.

“I thought I knew everything about cancer,” explains Hays, “but I couldn’t make a decision. It was so hard to absorb it all.”

Hays says she asked a lot of questions and found support from a colleague. Brenda Dorothy, RN, office nurse for James Renz, MD, PCI Surgical Specialists, was diagnosed

with breast cancer in August. The cancer was discovered as a result of her annual mammogram. “I had no symptoms, I felt awesome,” recalls Dorothy, who was 47. “Then suddenly your whole world changes.”

Andrea Watkinson, RN, knows the feeling. Clinical services manager for the Community Cancer Center, Watkinson was just 29 when she was diagnosed with myxofibrosarcoma in July 2015. “I developed a lump above my left elbow, but I thought it was just a lipoma, a harmless fatty tumor,” says Watkinson. “For someone my age, this type of cancer is really unexpected.”

All three women underwent treatment locally. For Hays and Dorothy, that included surgery at St. Luke’s Hospital and chemotherapy that resulted in hair loss. “I used to tell patients to expect that,” says Dorothy. “But to actually see your hair coming out in clumps is a very traumatic thing.”

Brenda Dorothy, RN

Watkinson’s cancer did not call for chemo, but she had two surgeries followed by radiation therapy at St. Luke’s Nassif Radiation Center.

She says, “I couldn’t have asked for anything better. It was so convenient. And best of all, I was treated by people who were my friends—my family, almost. It was very comforting.”

The mission of the Community Cancer Center is to coordinate care for a seamless patient experience. “That’s my goal as clinical services manager and it’s what I experienced as a patient,” notes Watkinson.

Hays agrees. “We spend a lot of time planning what we do with patients and it worked exactly right. This is what cancer care should be.”

The three nurses also agree their cancer experience has given them a greater empathy for their patients. “I know what it’s like to feel terrible from chemo, but still feel like you have to go to work,” says Dorothy.

Adds Hays, “Now I can tell my patients I’ve gone through the same thing, and it’s going to be OK.”

Andrea Watkinson, RN

For Andrea Watkinson, the experience has really driven home the benefits of the Community Cancer Center’s approach. “I saw firsthand why we do the things we do,” she says. “It wasn’t just special for me. It’s what we do for all our patients.”

Put the Community Cancer Center on your side in the fight against cancer. Find out more

about our patient and family-centered approach at communitycancercenter.org.

Marci Hays, RN Spring 2016

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Relaxation Therapy Reiki and Reflexology are soothing complements to traditional treatment

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“This is the first time in a long time I haven’t been in pain.”

The woman who spoke those words had just finished her first combined Reiki and Reflexology session at the Community Cancer Center. She had been battling cancer for years, recalls Jana C. Crane, certified registered reflexologist and reiki master.

“When she came in, I sensed what she needed most at that moment was just to be calm.” With her soothing relaxation techniques, Crane was able to ease the woman’s stress level, as well as her pain.

Reiki therapy (pronounced ray-kee) is often called the “healing touch.” This Japanese healing art uses a light touch—or no touch at all—to promote relaxation and a sense of well-being. During a session, Crane places her hands gently on, or just above, the client’s body. “Reiki is a lot like a prayer, sending good energy to the person,” notes Crane, “It’s very spiritual.”

Holistic therapies Reiki and Reflexology reduce stress and promote healing.

Crane likes to combine Reiki with another complementary therapy, Reflexology. It’s the application of pressure to the feet, hands and ears. “People don’t realize how relaxing it is to get your hands and feet rubbed,” explains Crane. “We focus on those areas, but it benefits the whole body.”

Studies indicate Reflexology may reduce pain, anxiety and depression while enhancing sleep and relaxation. Crane’s clients often find it helps reduce the “toxic” feeling of cancer drugs in their system. Other benefits can include improved circulation and easing of side effects like neuropathy. “After a session,” says Crane, “my clients will tell me I ‘worked my magic’ again.”

Crane adds Reflexology and Reiki are great alternatives to massage for individuals who can’t lie flat or on their stomach. She says, “You can be sitting in a chair. It doesn’t tickle and it doesn’t hurt.”

Reiki and Reflexology are both part of the Community Cancer Center’s Integrative Wellness services that focuses on the whole person rather than on just treating the disease.

Other holistic therapies available at the Community Cancer Center include acupuncture, massage therapy, yoga, meditation and Tai Chi. The services are designed to complement an individual’s treatment plan. Members of the patient’s support team—their family and friends—are also encouraged to use the center’s holistic services.

“Cancer is a scary thing for patients and their loved ones,” says Crane. “I enjoy helping them escape from their worries for that hour. I tell my clients this is all for you, just relax and enjoy.”

For more information or to schedule an appointment, call the Community Cancer Center at (319) 558-4876.

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Reaching out for skin cancer awareness Outreach program targets rising melanoma rates

Melanoma, the most deadly form of skin cancer, is also one of the fastest-growing cancers in Iowa. In fact, the American Cancer Society reports the number of new melanoma cases in the state is up 284 percent since the 1970s. And among young people age 15 to 29, melanoma is now the second most common form of cancer.

John Vander Zee, MD, medical director for Melanoma and Advanced Skin Cancer Care notes, “We’ve seen a significant increase in the young adult population coming to our melanoma clinic.” The Melanoma and Advanced Skin Cancer Care Clinic at the Community Cancer Center specializes in invasive and non-invasive melanoma and other forms of skin cancer in patients of all ages.

Dr. Vander Zee, says one possible reason for the increase in melanoma is the popularity of tanning beds. Indoor tanning is potentially more harmful than sun exposure because of the greater intensity of its ultraviolet radiation. In a 2010 study, people who first used a tanning bed before age 35 increased their risk of melanoma by 75 percent.

Kimberly Ivester, Administrative Director, Nassif Community Cancer Center and Director, Cancer Care, UnityPoint Health – St. Luke’s Hospital, says the goal of the Community Cancer Center’s outreach program is to raise awareness of the risk factors for melanoma. “It is so important for youth to know tanning habits they may have now have lasting consequences.”

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The Community Cancer Center works closely with local schools to spread the word about indoor tanning and skin cancer. Our team talks to classes and hand out educational materials in school cafeterias. We also use a Dermascan—a machine that highlights skin damage not visible to the naked eye. Other outreach activities include meeting with lifeguards and distributing sunscreen at swimming pools and ballparks.

Two years ago, the Community Cancer Center was the first in the community to launch a “Ban the Tan” campaign for local high schools. The Community Cancer Center provided posters and educational materials to assist student leaders and health classes at the schools with educating their peers on the dangers of tanning and encourage students to sign a pledge not to indoor tan.

Joe Martin, physical education teacher at Springville High School, says 92 percent of their students took the pledge to not indoor tan. “The kids themselves got involved in promoting it,” says Martin. “We do a lot of activities here to raise cancer awareness. It seems everyone knows someone who’s been affected by cancer of some type.”

The Community Cancer Center is holding the “Ban the Tan” contest again this year. In addition, we are reaching out to school PTO groups to educate parents. This is essential as parents need to understand the health risks to their children when they use tanning beds.

“We also work with companies like MidAmerican Energy and Alliant Energy, which have a high percentage of outdoor workers,” adds Ivester. “We want them to know their risk and also to understand how their kids may be at risk.”

For more information on the outreach program and the Advanced Melanoma and Skin Cancer Clinic, call (319) 588-4876.

John Vander Zee, MD, Medical Director, Melanoma and Advanced Skin Cancer Clinic

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Nicole Gerdin and Nancy Hagensick team up to improve patients’ lives.

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Strength Strands of

Empowering women in their fight against cancer

Fighting cancer is a daily battle. Sometimes the challenge is just to try to look and feel like yourself.

Community Cancer Center, says, “We’re always looking for innovative services we can bring to our patients.”

Deb Pulver of Des Moines understands. In 2002, Pulver was diagnosed with breast cancer at age 45.

Shortly after, chemotherapy caused her hair to fall out. Suddenly the face in the mirror did not look like Deb—it was the face of a cancer patient.

SOS agreed to expand to the Cedar Rapids area.

Today, the organization has an Eastern Iowa coordinator, Nicole Gerdin, and has established relationships with two Cedar Rapids salons— Advanced Hair Technologies and Jeffrey Scott Salon.

Salons are chosen for their expertise with wigs as well as experience working with cancer patients. Women are encouraged to visit the salon before they lose their hair so the professionals can match the wig to their current hairstyle.

“I didn’t want people to know I was sick,” recalls Pulver.

“I didn’t want sympathetic looks. I wanted to be normal.”

Fortunately for Pulver, she could afford to purchase a quality wig that looked like her natural hair. When a woman at church complimented her hair and asked where she got it cut, Pulver realized she could choose whom she shared her illness with. The wig helped her regain a sense of control over her own life.

After her recovery, Deb Pulver was determined to help other women feel confident in the face of cancer. In 2011, she founded Strands of Strength (SOS), a nonprofit organization whose mission is to provide wigs free of charge to women suffering hair loss due to cancer treatment that could not otherwise afford to get a wig.

“We’re trying to help women feel empowered,” says Pulver. “Our goal is to give them the personal strength they need so they can successfully fight their disease.”

In 2015, the Community Cancer Center reached out to Pulver’s organization after seeing an article about Strands of Strength’s success in Des Moines. Nancy Hagensick, psychosocial services coordinator at the

Hagensick says SOS works, in part, because it is so simple for the patient. “If a woman is going to have chemotherapy that will lead to hair loss, we talk to her before treatment begins,” explains Hagensick. “We let her know what to expect and what her options are.

If she is interested in a wig but can’t afford it, we give her a voucher from SOS. She takes the voucher to one of the participating salons and receives a free wig.”

Pulver credits community support for the success of Strands of Strength. “It’s incredible what people will do when it’s something they care about,” she says. A fundraising luncheon will be held at the Cedar Rapids Country Club on Wednesday, Oct. 19 to support SOS in eastern Iowa.

For more information, contact Nicole Gerdin at (319) 331-4080 or nicole@strandsofstrength.com.

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Early detection vital with head and neck cancer Free screenings in April

This year, an estimated 60,000 people in the U.S. will be diagnosed with head and neck cancer. The survival rate is 80 percent when detected early. Yet most people are not familiar with it or even know if they are at risk.

That’s why each April is designated as Head and Neck Cancer awareness month. Jeffrey Krivit MD, a board-certified otolaryngologist with Physicians’ Clinic of Iowa Ear, Nose & Throat (PCI ENT), says PCI and the Community Cancer Center will offer free screenings during Oral, Head and Neck Cancer Awareness Week, April 10-16.

Head and neck cancer is a broad term that covers several different cancers that begin in the cells lining moist surfaces such as the mouth, nose and throat. More rarely it can also begin in the salivary glands.

Dr. Krivit says approximately 85 percent of head and neck cancer is related to the use of tobacco, including cigarettes, cigars or pipes, chewing tobacco and snuff.

Frequent and heavy alcohol consumption is another significant risk factor and alcohol and tobacco together increase the risk even more. “Alcohol is toxic to the upper digestive tract,” explains Dr. Krivit. “When it’s combined with tobacco use, the effect is increased.” He adds, “When you quit smoking, your risk begins to drop.”

Infection with cancer-causing types of the human papillomavirus (HPV) is also a risk factor, particularly for cancers that involve the tonsils or base of the tongue.

Dr. Krivit urges anyone who has been hoarse for more than two weeks to see a doctor, particularly if they are 18 Journeys | Spring 2016

at high risk. Other warning signs can include a lump in the neck; nasal or mouth bleeding; or mouth pain that radiates to the arm.

Treatment depends on the location of the tumor, the stage of the cancer, and the patient’s age and general health. “With stage one or two, treatment typically involves surgery and radiation therapy,” says Dr. Krivit.

The new St. Luke’s Nassif Radiation Center located in the PCI Medical Pavilion has been a plus for patients, adds Dr. Krivit. He explains, “They really like coming to one location. They can see all their physicians on the same day and get their tests and radiation therapy in one place. It means better, more coordinated care. And the outpatient pricing also makes it less expensive.”

The physicians at PCI ENT are the only head and neck cancer specialists in Cedar Rapids. Says Dr. Krivit, “We treat everything between the brain and the lungs— everything in the middle is us.” In addition to head and neck cancers, the group also diagnoses and treats thyroid and parathyroid cancers. Bottom line, says Dr. Krivit: “You don’t have to leave the area to get the expertise you need.”

For more information on head and neck cancer screening, contact the Community Cancer Center at (319) 558-4876.

Ask the Expert Answers to questions about thyroid cancer How common is thyroid cancer?

We typically have fewer than 100 cases per year in our community. However, the incidence has been increasing, largely because technology has enhanced our ability to detect thyroid nodules.

Are there different types of thyroid cancer?

Yes. Papillary thyroid carcinoma and follicular thyroid carcinoma account for about 90 percent of cases.

Fortunately, these types of cancers can be treated relatively simply with good outcomes.

Who is at risk for thyroid cancer?

It’s more common in women, and most cases we see are adults in their 40s or 50s. A very small number of cases occur in children and teens.

Ryan Dempewolf, MD, is a board-certified otolaryngologist with Physicians’ Clinic of Iowa Ear, Nose & Throat. He provides medical and surgical treatment for disorders of the ear, nose and throat including thyroid and head and neck cancers.

How is it treated?

Most people have surgery to remove their thyroid gland, followed by treatment with radioactive iodine.

Unlike radiation therapy, the patient simply swallows the iodine in a capsule or liquid form. Long-term they’ll also need to take replacement thyroid hormone.

We are always watching for updated or new guidelines on how we treat any cancer. Sometimes a more conservative approach can be taken. Many factors can play into a patient’s diagnosis including genetics and health behavior choices. There is a lot to consider when deciding on a patient’s treatment plan and long-term surveillance.

What is the outlook for someone with thyroid cancer?

The outcome for well-differentiated papillary or follicular cancer (the most common types) is very good. After treatment, thyroid cancer patients are usually very healthy. I encourage them to play a role at the Community Cancer Center by encouraging and mentoring other cancer patients.

For more information about thyroid cancer or available support services, contact the Community Cancer Center at (319) 558-4876.

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202 10 th Street SE, Suite 285 | Cedar Rapids, IA 52403 communitycancercenter.org

a

community of care focused on you, your family and your future

Like a community, we come together

• t o support cancer patients and their loved ones • t o bring together the very best physicians and support team • t o offer high quality care that’s more affordable

It’s a different kind of cancer care, right here at home.

Call (319) 558-4876 or visit communitycancercenter.org