Journeys Fall 2015

FALL 2015

BRINGING BODY, MIND & SPIRIT TOGETHER Yoga benefits patients from diagnosis through survivorship

Page 6 THE POWER TO DECIDE Assessment provides education, genetic testing and support

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Journeys

CONTENTS

COMMUNITY PARTNERS OPEN DOORS TO MORE SERVICES The Community Cancer Center partners with other local organizations to form a community of care that surrounds patients and loved ones with the services and support they need.

“We have great partners,” says Emi Chapman, development manager, Cancer Services for UnityPoint Health® St. Luke’s Foundation. “Instead of duplicating programs, we work together, which helps everyone’s dollars go further.”

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WORKING TOGETHER FOR WELLNESS

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BRINGING BODY, MIND & SPIRIT TOGETHER

Support team helps cancer survivor adopt a healthier lifestyle

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Yoga benefits patients from diagnosis through survivorship

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LUNG CHECK CAN BE A LIFESAVER

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Quick, painless scan catches cancer at its earliest stage

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THE POWER TO DECIDE Cancer Risk Assessment provides education, genetic testing and support

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CAREGIVERS’ RETREAT FOCUSES ON QUALITY OF LIFE Because cancer impacts loved ones as well as patients

A LEGACY OF HELPING OTHERS

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

Partners include Gems of Hope, a Cedar Rapidsbased organization inspired by a nine-year-old girl’s daily notes of encouragement to her mother who was battling cancer. Today, Gems of Hope helps other cancer patients and their loved ones with a wide range of services, from gifts of handcrafted jewelry mounted on inspirational cards to support groups for children and teens impacted by cancer.

Palliative Care helps patients live the best life possible

Other partners include the Iowa Cancer Consortium (ICC), American Cancer Society and Aiming for a Cure Foundation. “Each one offers different services that help fill in gaps,” explains Chapman.

For example, an American Cancer Society program, Look Good Feel Better, offers women undergoing cancer treatment tips for makeup, skin and nail care and hair loss. And Aiming for a Cure does everything they can to keep things normal for a child with cancer. Says Chapman, “Sometimes it’s the little things you don’t think about that can really make a difference.”

ADVANCED OPTIONS, CLOSE TO HOME

Chapman adds each partner plays a vital role in improving the lives of cancer patients. “Through these partnerships, we open more doors for our patients by making sure they know all the resources available to them locally.”

Clinical trials offer new possibilities for patients

For more information on how your organization can become a community partner, call (319) 369-8100.

Cook family honors “amazing person” through support of wellness program

RELIEVING SYMPTOMS, PROVIDING SUPPORT

JOURNEYS | 3

WORKING TOGETHER FOR

wellness

Support team helps survivor adopt a healthier lifestyle

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ike many of us, Jo Moore of Marion, Iowa, has struggled with weight control over the years. While not a big eater, Moore observed “the weight just likes me” and she couldn’t seem to shed those pesky excess pounds.

Then came her 2012 diagnosis of stage 1 colon cancer. Fortunately, her cancer was discovered early. After surgery in April 2012, she has remained in good health and is cancer-free.

But Moore knew she had multiple risk factors, including age and family history, which put her at risk for a recurrence of the disease. She soon learned her weight and diet added to her risk.

both love fruits and vegetables, so adding more of those to their diet was the easy part. In addition, the couple replaced regular milk with almond milk (“it tastes very good and has fewer calories!”), switched from canned vegetables that are high in sodium to healthier frozen versions, and use very little salt.

“I’ve lost about 30 pounds working with Beth,” says Moore. Beckett shares recipes with Moore and taught her the importance of reading labels.

She also introduced Moore to MyFitnessPal, an online calorie-tracking tool, and they meet once a week to review Moore’s progress and challenges.

“Cancer risk increases with weight gain,” explains Beth Beckett, RD, CSO, LD, dietitian with the Helen G. Nassif Community Cancer Center.

“Colon cancer in particular is affected by weight and food choices—not just how much you eat, but what you eat.”

“We’re not focused on the sheer amount of weight loss,” explains Beckett. “What’s great about Jo is she’s so positive and has been able to sustain her lifestyle change.” Beckett stresses adopting a better diet is not about depriving yourself of the things you like, but about striking a healthy balance.

In the fall of 2012, Moore’s oncologist at Physicians’ Clinic of Iowa Hematology & Oncology, referred her to the Wellness Program at the Community Cancer Center. Moore began working closely with Beckett as well as with Cancer Exercise Specialist Matt Schmitz. Beckett says the team individualizes its approach for each patient and makes sure they feel supported. “This is a partnership,” explains Beckett. “Matt and I work together to help Jo meet her goals.”

In addition to the nutrition support Moore receives, she works out in the Community Cancer Center gym and takes a weekly Tai Chi class. “ It’s a simple-looking exercise,” says Moore, “but so relaxing!”

That includes helping Moore make healthier food choices. Moore says she and her husband Jay 4 | JOURNEYS

As Jo Moore looks forward to her 80th birthday, she continues to be monitored for colon cancer and continues to work with her support team at the Community Cancer Center.

“I tell Beth she’s my inspiration,” says Moore, “And I’m doing great!”

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Colon cancer in particular is AFFECTED BY WEIGHT AND FOOD CHOICES— not just how much you eat, but what you eat.

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Beth Beckett, RD, CSO, LD, dietitian

Exercise is helping Jo Moore move beyond cancer.

For more information on the Wellness Program, please visit communitycancercenter.org.

Bringing

body, mind & spirit together

Yoga benefits patients from diagnosis through survivorship

Instructor Lisa Hanigan helps her class reach for wellness.

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ractitioners of the ancient Indian discipline of yoga have long touted its many benefits, including increased flexibility, improved muscle strength and better balance and posture. But increasingly, research is confirming yoga can do much more for an individual’s body, mind and spirit.

Lois Penkos knows that well. The 65-year-old Cedar Rapids woman first started taking yoga several years ago. Then in January 2009, she was diagnosed with breast cancer. Instead of giving up her yoga practice, Penkos found she needed it more than ever.

“Here I was turning 60 and suddenly I learned I had breast cancer,” says Penkos. “The yoga class at the Community Cancer Center helped me find myself and showed me a way to move forward.”

Breast cancer survivor Ann Kleman feels the same way. Twelve years after her initial diagnosis, Kleman takes anusara yoga once a week at the Community Cancer Center. She says, “Yoga requires concentration. You learn to focus on it instead of being preoccupied with your disease or your treatment. It’s energizing and relaxing at the same time.”

Instructor Lisa Hanigan says her goal is to help participants become stronger and more flexible, not only in their physical bodies but in the rest of their life as well. She describes yoga as an “innercise,” rather than exercise, and thinks that aspect is especially important to those who have faced cancer.

“They’ve learned to look at life in a different way.

They’re ready to explore their spiritual side. And by concentrating on yoga, they learn to relax, face their fears and start enjoying every minute.”

Research shows there are health benefits as well.

A 2007 study by Duke University showed on the day after breast cancer patients practiced yoga, they experienced significantly lower levels of pain and fatigue and higher levels of relaxation and invigoration. Other studies have suggested the gentle guided movements of yoga can help expand range of motion, improve circulation, lower blood pressure and relax muscle tension—all of which can help speed the recovery process. Exercise, including yoga, also causes the body to release endorphins, which are proven to improve mood.

The Community Cancer Center class is open to all ages and skill levels. Some, like Penkos and Kleman, have been doing yoga for years, while others are new to the practice. But they share a common bond. “In a way, it’s like a support group,” says instructor Hanigan. “Everyone in the room has gone through a cancer experience and that camaraderie is very important to them.”

Penkos agrees. “The friends I made in class played a big part in helping me get through this. I’ve gotten to know some really wonderful people here.”

For more information on wellness classes, visit communitycancercenter.org.

Quick, painless scan identifies cancer at its earliest stage

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amela Hoffman of Marion started smoking when she was a teenager and continued to smoke for almost 30 years. Then at the age of 43, she kicked the habit for good. But Hoffman knew better than most all those years of smoking could eventually catch up with her.

“I lost two brothers and one sister to lung cancer,” says Hoffman. “When you have a family history like that, it’s a little frightening.”

In 2013, Hoffman’s daughter spotted a flyer about a new service at UnityPoint Health St. Luke’s Hospital. St. Luke’s Lung Check is a non-invasive test that uses a low-dose CT scan to provide detailed, three-dimensional images of the lungs.

A 2011 study by the National Cancer Institute found screening could reduce lung cancer deaths by 20 percent.

Hoffman says, “My daughter asked me what I thought about it and I said it sounds great—sign me up!”

Lung Check can be a LIFESAVER

Lung cancer survivor Pamela Hoffman says early detection saved her life.

At the time Hoffman had the test, the lung screening was not covered by insurance so she paid the $175 fee. Today Medicare and most insurance providers cover the test for individuals who meet specific criteria. Andrea Watkinson, clinical services supervisor at the Community Cancer Center, says the criteria include being between the ages of 55 and 77, a current smoker or one that has quit within the last 15 years, and having at least a 30-pack-year history. Because Hoffman had quit smoking more than 15 years ago, she was considered lower risk, but her extensive family history of lung cancer offset that.

Hoffman’s first scan revealed a small nodule in her left lung. She was referred to J. David Cowden, MD, a pulmonologist, or lung specialist, with Respiratory and Critical Care Associates. Over the next two years, Dr. Cowden monitored the nodule through regular CT scans and a PET scan. Then a scan in March 2013 indicated the nodule had increased in size.

“Dr. Cowden suggested I have it removed,” recalls Hoffman. Because of the nodule’s location, it wasn’t possible to do a standard biopsy. Fortunately, Hoffman’s health made her a good candidate for surgery. James Levett, MD, a surgeon with Physicians’ Clinic of Iowa, removed the top lobe of Hoffman’s lung. Testing showed the nodule was indeed adenocarcinoma—the most common kind of lung cancer.

“Pamela’s cancer was discovered as early as you can find it,” says Watkinson. Because it was caught at such an early stage, Hoffman did not have to undergo additional treatment, such as radiation or chemotherapy. Dr. Cowden, pulmonologist,and Dr. Bharat Jenigiri, medical oncologist with Physicians’ Clinic of Iowa, will continue to monitor Hoffman closely through the Lung Care Clinic.

“If I hadn’t had the lung scan, we wouldn’t have known about the nodule,” says Hoffman, “and I probably wouldn’t have found out I had lung cancer until it had spread.”

Today, Hoffman has recovered from her surgery and says “all the doctors gave me rave reviews.” She encourages long-time smokers, especially those with a family history like hers, to consider getting the Lung Check.

Lung Check is offered by the Community Cancer Center together with St. Luke’s Hospital, a Screening Center of Excellence, and is the area’s only American College of Radiology accredited lung screening CT program. For more information, call (319) 558-4876.

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The POWER to decide

Cancer Risk Assessment provides education, genetic testing and support

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fter watching her mother battle breast cancer, Lenchen Raeside knew her family history put her at an increased risk, so she was vigilant about mammograms. That vigilance paid off when Raeside, 55, was diagnosed with breast cancer in 2014 and learned the tumor had been caught at its earliest, most treatable stage.

“They found it early enough I didn’t need chemotherapy or other followup treatment,” says Raeside.

Then her oncologist, Rasa L. Buntinas, MD, Physicians’ Clinic of Iowa Hematology & Oncology, suggested Raeside consider genetic testing through the Cancer Risk Assessment and Genetics Clinic at the Community Cancer Center.

Raeside agreed because she thought it might give her daughter, a young mother, insight for her own health.

Raeside met with Genetic Nurse Practitioner Shana Coker at the Community Cancer Center. Coker talked to Raeside about her family history and personal risk factors.

She also explained the benefits, risks and potential outcomes of genetic testing. “We make sure people understand how results might Lenchen Raeside chose genetic testing for her daughter and granddaughter’s sake.

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impact them,” says Coker. “We want them to know what their risk reduction options are if they have positive results.”

Raeside chose to get tested and was surprised to learn she has a CHEK2 gene mutation associated with an increased risk of breast cancer, particularly for women with a family history. The mutation is less common than BRCA1 or BRCA2, the so-called “breast cancer genes.”

Raeside says the results supported her decision to get a bilateral mastectomy (removal of both breasts).

Coker cautions genetic testing is not appropriate for everyone.

“We do a thorough screening and education so individuals can make an informed decision.”

But for Lenchen Raeside, the knowledge she gained was significant, not only for her daughter but for Raeside’s brothers as well.

“My particular mutation may increase the risk for colon cancer,” explains Raeside. “It means I need to get a colonoscopy more frequently and my brothers need to be more vigilant, too. Getting tested has proved very positive for my family.”

For more information on Cancer Risk Assessment services, call (319) 558-4876.

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Annual Caregivers’ Retreat focuses on quality of life Because cancer impacts loved ones as well as patients

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aking care of a loved one can be extremely rewarding. It can also be stressful. Too often, family caregivers are so focused on the patient’s needs they ignore their own.

The Community Cancer Center makes supporting family caregivers a priority. Caregivers can use our support services, from the fitness center to classes like yoga and Tai Chi. And once a year, the Community Cancer Center hosts the Caregivers’ Quality of Life Retreat.

This free event, first held in 2013, celebrates the role of caregivers while also giving them tools to help take care of themselves. “From the start, our hope was not just to have our caregivers feel good for a day, but to help them make lasting changes,” explains Psychosocial Services Coordinator Nancy Hagensick. With that in mind, the retreat includes activities to enhance quality of life along with helpful information presented specifically for caregivers.

“We’ve introduced people to yoga, meditation, music therapy and mind-body skills,” says Hagensick. “Plus we talk about things like how to use humor as a way to cope, and the benefits of increasing physical activity. We also allow time for journaling or walking the beautiful trails at Prairiewoods Retreat Center.”

Jim Kovarik attended one of the first retreats. The caregiver for his wife Janet, Kovarik recalls the retreat as a good place to learn techniques to deal with the stress of caregiving, as well as to remind you to take care of yourself. Says Kovarik, “It was 12 | JOURNEYS

an opportunity to get outside yourself and see you’re not alone in going through these things.”

At the start of the retreat, attendees are asked to indicate their level of distress and identify problems they’re experiencing, such as being torn between work and family responsibilities. Patients and caregivers are encouraged to work together on an action plan to improve their quality of life.

Hagensick follows up by phone 30 days after the retreat to measure improvement. “The average distress score at the start of the retreat was a six on a scale of zero to ten,” says Hagensick. “A month later, the average distress level dropped to two.”

Kovarik says his wife was very conscientious about taking care of herself and making the most of the time she had left. The two of them had started getting massage therapy even before her diagnosis and increased the frequency after she became ill.

Janet Kovarik passed away in January 2014, but Jim Kovarik continues to come to the Community Cancer Center for massage therapy. He says, “The people there have been very welcoming to me and the retreat has helped me make lasting changes.”

In addition to the annual retreat, the Community Cancer Center offers evening “mini retreats” throughout the year. “Caring for yourself is part of caring for your loved one,” says Hagensick. “It can actually allow you to be a better caregiver.”

The 2015 Caregiver’s Retreat is October 21, 10:30 a.m. - 4:30 p.m. at Prairiewoods Retreat Center. For more information, call Nancy Hagensick at (319) 558-4876.

“

It was an opportunity TO GET OUTSIDE YOURSELF and see YOU’RE NOT ALONE in going through these things.

”

Jim Kovarik, caregiver

A legacy of helping OTHERS Cook family honors “amazing person” through support of wellness program

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ane Borg Cook was a successful business executive, civic leader and loving wife, mother and friend. “My wife was an amazing person,” says Rob Cook. “She still is.”

When Jane died in August 2008 after a long battle with breast cancer, her family looked for an appropriate way to honor her memory. Rob Cook says he and his children were determined to carry on what Jane would have done.

Wellness immediately came to mind. “Mom always believed the best medicine was to be active physically, mentally and emotionally,” says daughter Jennifer Davis. “Regular exercise and proper nutrition helped maintain her quality of life for 9 ½ years after her cancer diagnosis.”

Rob Cook approached Community Cancer Center Director Kimberly Ivester, who was developing a wellness program to help cancer patients cope with physical, social and emotional challenges. Exercise classes, nutrition guidance and holistic therapies would be available to patients at a minimal cost. “I asked what it would take to offer them at no cost,” recalls Cook. “That’s how it started.”

Cook, together with daughters Jennifer and Katy and son Robbie, made the initial donation. Other family members and close friends eventually tripled that amount. The Cook Cancer Wellness Program opened at

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St. Luke’s Hospital in August 2009 and moved to the Community Cancer Center in 2012.

The Cancer Wellness Program, includes the ability to work one-on-one with a professional such as a dietitian, social worker or cancer exercise specialist as well as participate in group classes such as yoga, Pilates and Tai Chi, and cooking demonstrations. “One thing I’m most proud of,” says Rob Cook, “is the Center will take any cancer patient as long as they are under a doctor’s care. It doesn’t matter where they receive treatment or where they live.”

Today the Cancer Wellness Program is so popular Rob Cook says it is bursting at the seams. His next goal is to ensure enough money is available to sustain the program well into the future. “There’s an ongoing need for programs such as these,” explains Cook. “Everybody I talk to knows someone who has had cancer and would benefit from this extra support.”

Mary Klinger, president of UnityPoint Health St. Luke’s Foundation, says your donation to the Cancer Wellness Program will help improve and enhance the quality of life for those affected by cancer. Adds Rob Cook, “We all agree Jane would love the concept of providing a place where all cancer survivors could go to be safe, comfortable and loved.”

Through the Cancer Wellness Program, Jane Borg Cook’s legacy continues to inspire other cancer patients and help them thrive.

Top: Mary Klinger, St. Luke’s Foundation president Bottom: Emi Chapman, Cancer Services development manager

For information on how you can help, call St. Luke’s Foundation at (319) 369-7716.

JOURNEYS | 15

W

hen it comes to coping with the challenge of a serious cancer diagnosis, Julie Shaw tells her patients, “You are the captain of this ship.”

Shaw, a nurse practitioner with St. Luke’s Palliative Care team, wants patients to know Palliative Care is all about them. “We’re the experts at what we do,” explains Shaw, “but you’re the expert on your life. What matters to us is what matters to you.”

Palliative Care specializes in the relief of the pain, symptoms and stress of serious illness such as cancer. A team of doctors, nurse practitioners, social workers and chaplains work together to improve the patient’s physical, emotional and spiritual health. Palliative Care can be provided at any stage of illness and can be given along with cancer-fighting treatment.

“We are not Hospice,” explains Shaw.

“We are not about stopping aggressive therapy. In fact, while we eventually refer some patients to Hospice, we discharge others from Palliative Care because they are doing well.”

Relieving symptoms, providing support Palliative Care helps cancer patients live the best life possible 16 | JOURNEYS

As a nurse practitioner, Shaw’s focus is on managing symptoms, either from the illness itself or as a side effect of treatment. “Especially early on, patients are anxious about chemotherapy or radiation. They worry how it will affect them. I let them know we will be very aggressive about managing their symptoms and relieving pain.”

Shaw also works with patients, their family and doctors to create a plan of care. “We don’t take over the care,” adds

Shaw. “We are an extra layer of support for you and your loved ones.” That includes making sure patients understand their condition and choices for medical care, as well as helping them develop advance directives to make their wishes known.

The Palliative Care team also includes oncology-certified social workers like Kim Roberts, who provides counseling and support. She answers questions and offers guidance with difficult decisions throughout the disease process. Roberts says, “My goal is to help you and your family cope with issues related to your illness and its impact on your lives.”

Laura McClure, 48, has benefited from St. Luke’s Palliative Care in both a hospital setting and at home. McClure completed treatment for breast cancer in January 2014, only to be diagnosed with an unrelated, advanced stage of pancreatic cancer a few months later. Side effects from the aggressive treatment she received impacted McClure’s quality of life. She’s glad the Palliative Care team was there for her and her husband.

“They were very thorough in explaining things,” says McClure. “They helped with the side effects of my chemo and checked in with me to see how I was feeling. I always knew I could go to them if I had any questions.”

McClure says she’s feeling pretty good now, but it’s reassuring to know St. Luke’s Palliative Care team will be there if she needs them. With Palliative Care, patients like Laura McClure get the help they need to live the best life possible.

For more information on Palliative Care, call (319) 369-7909.

◄ Julie Shaw, nurse practitioner, and Kim Roberts, social worker.

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Advanced treatment options, close to home Research at the Community Cancer Center is made available in collaboration with Physicians’ Clinics of Iowa (PCI). William Fusselman, MD, PCI Hematology & Oncology, serves as principal investigator. Through the Iowa Wide Oncology Research Coalition (I-WORC), PCI and the Community Cancer Center have access to federally funded trials. They also participate in trials conducted by industry and pharmaceutical companies.

William Fusselman, MD, clinical trials principal investigator

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ancer treatments studied today could become the standard of care tomorrow. That’s just one reason why patients consider participating in a clinical trial, says Kimberly Ivester, director at the Helen G. Nassif Community Cancer Center.

“Clinical trials give our patients more options,” explains Ivester. “In most cases, the patient receives one more component, such as a new cancer-fighting drug, in addition to the current standard of care.

It’s a way for them to get access to innovative new treatments.”

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Participation is always voluntary, stresses Dr. Fusselman, and a patient who wants to withdraw from a trial can do so at any time.

But those who participate may find it gives them more options, as well as benefiting future patients and generations.

“Patients often say, ‘If there’s something I can do to help other patients, I want to be a part of that,’” says Ivester.

On average, the Community Cancer Center has 15 different clinical trials available at any given time. They can be used for evaluating a new treatment or medication, improving quality of life by reducing side effects, or improving diagnosis or prevention.

From the new St. Luke’s Albert G. and Helen Nassif Radiation Center, local cancer patients will

ASK THE EXPERT:

Clinical trials offer new possibilities

Massage therapy

gain increased access to radiation therapy trials or trials that offer a combination of radiation and chemotherapy treatment.

Laura Riniker is a licensed massage therapist trained in massage for cancer patients, lymphatic massage, orthopedic massage and Table Thai massage.

“We’re excited about the opportunity to expand the clinical trials for patients in our community, by taking part in trials that look at advances in radiation therapy,” says Ivester.

Why is massage therapy beneficial for cancer patients and survivors?

Anxiety is a huge issue with cancer patients. Massage can help you relax and feel more positive about your body. But the benefits go beyond stress relief. After surgery, massage can help break down scar tissue. For those with mild swelling from lymphedema, we can gently redirect fluid to other areas.

Ivester adds some patients think a clinical trial is a last resort after all other treatment has failed. But clinical trials are often a good way to start treatment and give patients more options to discuss with their provider. Clinical trials are not available for every type of cancer, but are a good option to consider when they are available.

“Some patients consider a clinical trial their best option,” says Ivester.

“And the best part is, they can have access to these trials while receiving treatment right in Cedar Rapids.”

Cancer patients are urged to talk to their doctor about their treatment options, including clinical trials. By learning about available studies and what’s involved, patients can make the decision that’s right for them.

For more information on clinical trials, call the Community Cancer Center at (319) 558-4876 and ask to speak to a Care Coordinator.

Is massage safe for cancer patients?

Yes. A light, relaxing massage is safe for people at all stages of cancer. An experienced therapist knows how to modify pressure, position and technique to accommodate recent surgeries or treatment-related side effects.

Why choose a therapist experienced with cancer patients?

Everything we do is with health in mind. Breast cancer survivor Robin Crow says, “I appreciate that the massage therapists know what I’m going through so I don’t have to explain.”

“

It’s so rewarding to see patients come through cancer and know we were there for them.

Laura Riniker, licensed massage therapist

”

Can anyone get a massage at the Community Cancer Center?

Yes, but cancer patients receive a special reduced rate. It reflects the Center’s holistic approach of focusing on the whole person and not just the disease. We meet regularly with the nurses, exercise therapist and nutritionists to make sure we’re working together, doing what’s best for each patient.

How often should I get a massage?

Most people come on a regular basis. Mindy Jellison, who was diagnosed with thyroid cancer in 2010, calls massage therapy at the Community Cancer Center her reward for good behavior, adding, “I’m a firm believer everyone should do it. It improves your mental well-being.”

For more information about massage therapy at the Community Cancer Center, call (319) 369-8161.

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Discover the future of CANCER CARE

St. Luke’s Albert G. and Helen Nassif Radiation Center

GRAND OPENING

Monday, September 21 | 4:30 - 6 p.m.

Ribbon cutting • Tours • Refreshments

Discover the future of cancer treatment in eastern Iowa. St. Luke’s Albert G. and Helen Nassif Radiation Center completes the full spectrum of coordinated cancer care for St. Luke’s and the Community Cancer Center. Featuring the most advanced cancer-fighting technology available—external beam radiation therapy— plus brachytherapy for targeted treatment of prostate, breast and other cancers.

Find out more at communitycancercenter.org.