care
CANCER
for anyone touched by cancer WINTER
IN THIS ISSUE
7 things your radiation oncologist wants you to know page 12
What dogs teach us about lymphoma page 14
Fixes for depression page 17
Advice for eating when you aren’t hungry page 19
Does losing weight prevent recurrence of breast cancer?page 16
How to sleep well page 20
Brought to you by the
2019
YOUR guide
5 reasons your child needs
H P V
the
1 2 3 4 5
vaccine
Cancer screening tests will not protect your child from most cancers related to the human papilloma virus, or HPV. There is no treatment for HPV infection. More than 90 percent of HPV-related cancers are prevented by vaccination. The vaccine works better when given at the recommended ages of 11 to 12 years and before infection with the virus. The vaccine can safely be given with the tetanus and meningitis shots.
educators, this curriculum teaches about head and neck cancer YOUR STUDENTS ARE AT A GREATER RISK FOR DEVELOPING HEAD AND NECK CANCER THAN ANY OTHER DEMOGRAPHIC.
Physicians, researchers and caregivers created a self-guided education and advocacy program focused on head and neck cancer. e materials cover causes, prevention and how to minimize risk factors through smart lifestyle choices, including vaccination against the human papilloma virus, or HPV.
use, excessive and the Tobacco drinking HPV virus significantly increase their risk — but education will reduce their risk.
PRESENTED BY
We’ve created content free digital
for educators that is easy to understand YOUR and deliver, including: teacher guide (curriculum, script STUDENTS and talking points) instructor-guided online presentation ARE AT A (power point) GREATER RISK beneath the surFACE documentary link supplemental materials: student FOR DEVELOPING activities, additional resources and follow up materials HEAD AND NECK To review the materials, visit: CANCER THAN www.upstate.edu/surface ANY OTHER DEMOGRAPHIC.
beneath the surFACE is a self-guided education and advocacy program for secondary school students that has been developed by the physicians, researchers and caregivers at the Upstate Cancer Center. The curriculum covers head and neck cancer causes, prevention and ways to minimize risk factors through smart lifestyle choices.
G
G G G
For more information, contact: Matthew Capogreco capogrem@upstate.edu 315-464-3605
18.33711181.85mumusk
e Upstate Cancer Center offers a cancer prevention educational curriculum for people who teach secondary school students.
PRESENTED BY
with a polymer mesh mask that conforms to their head and neck during treatment. ey can keep the masks aer treatment is complete, but many patients decline.
e curriculum includes a script paired with a digital presentation, HPV fact sheet, worksheets and an awardwinning documentary, “beneath the surFACE.” e documentary focuses on an art project in which students in seven school districts transformed patients’ radiation therapy masks into art.
Matt Capogreco, program and events coordinator at the cancer center, connected with high school art teachers who have their students decorate the leover radiation masks as a school project.
Patients with head and neck cancers are typically treated with a combination of radiation therapy, chemotherapy and surgery. To receive radiation therapy, patients are fitted
e cancer prevention curriculum is available on the upstate.edu/cancer website, and more information is available from Capogreco at 315-464-3605. ● Learn more about radiation therapy on page 12.
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CANCER CARE
upstate.edu/cancer l winter 2019
inside
4
6
12
10
7
Inside this issue caring for patients
living with cancer
5 reasons your child should get the HPV vaccine
page 2
He chose radiation to treat his prostate cancer
page 4
What cancer taught one mom
page 6
How working together streamlines care
page 7
What to do about depression
page 17
A comforting winter treat: gingerbread
page 18
Advice for eating when you aren’t hungry
page 19
How to get proper sleep
page 20
making a difference
Survivors share stories in breast cancer exhibit
page 8
Up Close: A peek inside the lab
back cover
‘Can Man’ closing in on his goal
page 21
How social workers help patients
page 22
sharing expertise What your radiation oncologist wants you to know How dogs are teaching us about lymphoma Should weight loss be part of breast cancer treatment?
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page 12 page 14 page 16
On the cover: Mijung Lee, MD, is involved in research that examines whether weight loss can reduce breast cancer recurrence. See story, page 16.
care
CANC ER
for anyone
IN THIS
Does preventlosing weight recurrenc of breas t cancer? e page 16
touched
WINTER
by cancer 2019
ISSUE
7 radiati things your on oncolo wants you to gist know page 12 What dogs about lympho teach us ma page 14 depres sion page 17 Advice you aren’tfor eating when hungry page 19 How to sleep well page 20
Fixes for
Brought
to you by
the
PHOTO BY SUSAN KAHN
care
CANCER
for anyone touched by cancer
WINTER 2019 CANCER CARE
UPSTATE CANCER CENTER
EXECUTIVE EDITOR Leah Caldwell Assistant Vice President, Marketing & University Communications
DIRECTOR (INTERIM) Jeffrey Bogart, MD
MANAGING EDITOR
Amber Smith 315-464-4822 or smithamb@upstate.edu
WRITERS
DESIGNER
Jim Howe Susan Keeter Charles McChesney Amber Smith Susan Keeter
DEPUTY DIRECTOR (INTERIM) Gennady Bratslavsky, MD ASSOCIATE DIRECTOR FOR CLINICAL RESEARCH Stephen Graziano, MD ASSOCIATE DIRECTOR FOR BASIC AND TRANSLATIONAL RESEARCH Leszek Kotula, MD, PhD ASSOCIATE DIRECTOR FOR COMMUNITY OUTREACH Leslie J. Kohman, MD ASSOCIATE ADMINISTRATOR Richard J. Kilburg, MBA
winter 2019 l upstate.edu/cancer
The Upstate Cancer Center provides the quarterly magazine Cancer Care for anyone touched by cancer. Send subscription requests and suggestions to magazine@upstate.edu and request additional copies by calling 315-464-4836. Cancer Care offices are located at 250 Harrison St., Syracuse, NY 13202.
The Upstate Cancer Center is part of Upstate Medical University in Syracuse, N.Y., one of 64 institutions that make up the State University of New York, the largest comprehensive university system in the United States. Upstate Medical University is an academic medical center with four colleges, a robust biomedical research enterprise and an extensive clinical health care system that includes Upstate University Hospital’s downtown and Community campuses, the Upstate Golisano Children’s Hospital and many outpatient facilities throughout Central New York — in addition to the Upstate Cancer Center, which is located at 750 E. Adams St., Syracuse, NY 13210.
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CARING FOR patients
Jan Roberts, left, with radiation oncologist Jeffrey Bogart, MD. Roberts wears a cap that honors those, like him, who served in Vietnam, especially those who didn’t come back. PHOTO BY RICHARD WHELSKY
he chose radiation treatment to treat his prostate cancer BY JIM HOWE
JAN ROBERTS WASN’T SURE WHAT TO EXPECT when he received radiation treatments for prostate cancer at the Upstate Cancer Center.
disorder. He is retired from his family business of selling highway equipment, such as sanders and snowplows.
A disabled Vietnam veteran, he receives primary care at the Syracuse VA Medical Center, where he was diagnosed aer an elevated test result for his PSA, or prostate-specific antigen. It would have been a lengthy drive from his home in Cazenovia to Albany, the nearest VA offering treatment. e Veterans Choice Program, however, allowed him to receive treatment at Upstate.
His treatments were given on the state-of-the-art Vero radiation system. Instead of traditional radiation treatments, which can take up to 45 daily sessions over nine weeks, the precision and accuracy of the imageguided radiation technology allowed treatment to be completed over 28 sessions in fewer than six weeks. He finished his treatments at the beginning of November 2018.
Offered the choice of surgical removal of the prostate or radiation treatment, Roberts chose a non-invasive approach with focused radiotherapy. He became a patient of Jeffrey Bogart, MD, the head of radiation oncology.
“I usually had the same staff every day. ey made me feel wonderful, as though I was the only person in the hospital. ey were all very kind, very good, and what could have been an unpleasant experience was pleasant,” Roberts says.
“I went for radiation, and I was a little apprehensive, but once I got into the hospital, what I thought was going to be an unpleasant scenario turned out to be a very good scenario, all things considered,” says Roberts, 73, who also deals with the effects of wartime wounds, exposure to the herbicide Agent Orange and post-traumatic stress
His routine involved stripping from the waist down, lying on a table with a custom body mold, his hands on two grips over his head. e machine, guided by daily integrated imaging of the precise location of the prostate, would revolve around him as it focused radiation on the cancer cells. continued on page 5
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CARING FOR patients
Vero offers latest in radiation technology BY AMBER SMITH
When doctors recommend radiation therapy for a tumor in the lungs, the chest or another spot in the body, they must figure out how to target that tumor while minimizing damage to healthy tissue around it. ey also consider that even if the patient lies still during treatment, his or her digestion, heartbeats and breathing will cause the tumor to move.
he chose radiation
continued from page 4
“It’s not a very long process. You’re in the room maybe 15 to 20 minutes.” He didn’t feel anything during the procedure, but he would aerward. “I got very fatigued as the treatment went on,” he says. He drove himself to the treatments every weekday, and he found himself sleeping more. He also had some bladder and bowel troubles that were cleared up with medication. He noted the camaraderie that developed among fellow patients awaiting treatment. “We all talked about our different problems as we were being radiated,” he recalls. Aer his course of radiation, he had a follow-up visit with Bogart, and his PSA levels will be monitored to see if they return to a lower number. e fatigue is wearing off, and he pushes himself to keep busy each day. His activities include working with veterans at the Syracuse VA Medical Center as well as the group Combat Veterans Anonymous, where he helps fellow vets cope with the many aspects of PTSD. “I have nothing but good things to say about Upstate, and not just the people radiating me,” Roberts says. “As soon as I walked in the front door, they said, ‘Good morning,’ and they always had a smile, and I never had to wait for anything.
One solution is a powerful stereotactic radiotherapy system called Vero, a 9-ton circular machine that was anchored into the ground floor of the Upstate Cancer Center when it opened. Vero is designed to deliver concentrated and precise doses of high-power X-ray beams from almost any angle, and amid the normal anatomical movements of the body. Vero has unique capabilities in being able to both image and treat complex tumors, unlike other radiotherapy technology. at is because Vero can move around the patient, using a first-of-its-kind robotic O-ring gantry pivot (see photo). Vero “integrates several state-of-the-art capabilities and technologies into one machine,” explains Jeffrey Bogart, MD, who leads Upstate’s department of radiation oncology and is also the interim director of the cancer center. “is includes the ability to deliver radiation treatment at unique angles that may better protect surrounding structures, such as minimizing radiation to the rectum and bladder in the case of prostate cancer. Vero also has a unique tracking feature that facilitates treatment of moving tumors, such as those in the lung, liver, and other tumors.” e enhanced precision means patients may undergo more intense treatments in a fewer number of visits. Such customized care provides hope for greater cure rates — and fewer side effects.
“You got the feeling that only person who counted was you, and they made everybody feel that way,” Roberts said.●
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What cancer taught one mom:
CARING FOR patients
Keep things as normal as possible BY SUSAN KEETER
LEVI HADDAD WAS ABOUT TO TURN 4 when he went with his mother to her doctor’s appointment in November 2017. e youngster was tugging on his ears. e doctor felt a line of bumps where Levi’s neck met his shoulders, prescribed antibiotics and scheduled a followup appointment in two weeks. Laurin Haddad remembers that her son had been increasingly tired and congested, symptoms that mimicked allergies. Four days aer the doctor’s appointment, Levi was so exhausted that he lay on the floor during his birthday party. At night, his snores turned into gasps for breath. e next morning, Haddad called the doctor to ask for blood tests and took Levi to an urgent care center. Aer the blood work was done, mother and son tried to enjoy a pancake breakfast at e Gem Diner on Spencer Street in Syracuse. Before noon, their family doctor called with the results from the laboratory. She told them to immediately go to the emergency department at Upstate. Levi was admitted to the Upstate Golisano Children’s Hospital. e next morning, he received his first treatment for T-cell acute lymphoblastic leukemia, under the care of pediatric hematologist/oncologist Philip Monteleone, MD, in Upstate’s Waters Center for Children’s Cancer and Blood Disorders.
what is t-cell acute lymphoblastic leukemia? Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, found in approximately one-third of all newly diagnosed pediatric cancer patients. ALL is a blood cancer in which too many lymphoblasts (immature white blood cells) are found in the bone marrow and blood. e T-cell type is fast-growing and found in 10 to 25 percent of pediatric ALL cases. Children with T-cell ALL typically receive more and higher doses of anticancer drugs than children with the more common early B-cell subtype. Symptoms of ALL include fever; easy bruising or bleeding; loss of appetite; pale pallor; tiredness and weakness; bone or joint pain; pain or feeling of fullness below the ribs; painless lumps in the neck, underarms, stomach or groin; and petechiae, which are flat, pinpoint dark red spots beneath the skin caused by bleeding. SOURCES: NATIONAL CANCER INSTITUTE AND ATLAS OF GENETICS AND CYTOGENETICS IN ONCOLOGY AND HAEMOTOLOGY
continued on next page
Levi Haddad, 4, with his mother, Laurin Haddad. Adopted at 1 day old, Levi was diagnosed with leukemia on his fourth birthday. PHOTO BY ROBERT MESCAVAGE
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CARING FOR patients
What cancer taught
continued from page 6
For the first six months of treatment, Levi and his mother alternated between hospital stays and time at home, in relative isolation. Haddad wanted to protect her son from exposure to infections while his immune system was depressed by chemotherapy. She kept family and friends updated through a free website called CaringBridge.org
Syracuse. His mother went back to her law practice, part time, and worked around Levi’s weekly chemotherapy treatments and hospitalizations. In August, the JCC hosted a blood drive and a bone marrow donor drive in Levi’s honor. At that time, his treatments followed a 10-day cycle: chemotherapy and an appointment at the Upstate Cancer Center, then home for 10 days. Philip Monteleone, MD
Levi received a variety of cancer medications, in liquid and pill form, and through intravenous lines. He submitted to lumbar punctures — needle sticks in his lower back — and had to take steroids. Laurin Haddad acknowledges difficulty, especially when Levi’s “steroid monster” appears. at’s her description of the medication’s side effects: lethargy, salt cravings, physical pain and anger. But many times Levi is still her kind-hearted son with the sweet smile. Haddad remembers one visit at the Upstate Cancer Center. Levi saw a little girl crying because she had to get a lumbar puncture. “It’ll be OK,” Levi told her as he put his arm around her. “It’s not that bad.”
Now, Levi is receiving maintenance chemotherapy. He has monthly intravenous treatments at Upstate and takes steroids for a week each month. Twice in three months, he has a lumbar puncture to inject chemotherapy into his spinal fluid. He takes a pill once a day, plus an additional pill once a week. is treatment is scheduled to continue until April 2020. roughout it all, Levi has been busy at his pre-kindergarten class, working to make up for the six months of school he missed. Haddad says she has learned a lot in the year since her son’s diagnosis. “When your child has cancer, you see his life as more precious. “You are terrified,” she admits. “But you can’t interfere with your child’s happiness. So you paint a smile on your face and figure out how to get your lives back to normal as much as possible.” ●
Teaming up Care teams share workspace In April 2018, with Monteleone’s approval, Levi returned to pre-kindergarten at the Jewish Community Center in
COMMUNICATION IS EASIER, care is more efficient, and medical providers develop stronger bonds through the new layout at the Upstate Cancer Center. at’s because the members of a patients’ care team share the same work space.
Doctors, nurses, nurse practitioners, medical assistants and others including nutritionists, social workers or palliative care experts work in the same “pod,” situated near four or five rooms where patients are examined or receive treatment. “Everyone that a patient will need to see during their visit is right there,” explains Adham Jurdi, MD, the medical director of adult hematology/oncology at Upstate. Such a design “gives the treating physicians the resources needed at our disposal to address the patients’ needs much faster.” is style of team-based medical care has become common at cancer centers throughout the United States, so interior designs built around group work space have become popular ways to ease the way for patients who are fatigued and stressed. e journal Healthcare Design described the trend in November 2017 this way: “What were once disjointed patient journeys that le many traversing from building to building for lab work, exams, procedures, specialist consultations, pharmacy pickups, and lab work again are being replaced with thoughtful solutions that put all of those stops under one roof.” In 2018, when the cancer center expanded onto the fourth floor of its building, space devoted to outpatient care for adult cancer patients nearly doubled. Now there are 35 exam rooms and 44 infusion chairs for adults. And, the fih floor now houses Upstate’s clinical pathology lab. Jurdi says, “the goal is to have a more rapid turnaround time for certain lab work.” ● winter 2019 l upstate.edu/cancer
Adham Jurdi, MD PHOTO BY SUSAN KAHN
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CARING FOR patients
LOOK NOW
Breast cancer survivors share their stories for artistic project
BY SUSAN KEETER
BREAST CANCER led Tula Goenka to reevaluate her life. “I realized I could use my experience, and my body, to say something about breast cancer. All of us can use our experiences to advocate for others,” she explains. Goenka, a professor at Syracuse University, organized a photography and video exhibition showcasing breast cancer survivors this past fall at the Point of Contact Gallery in Syracuse. Prints made by photographer and breast cancer survivor Cindy Bell featured 42 women and two men, 25 of whom were shown in clothed portraits accompanied by photos of their bare breasts altered by surgery. e remaining 19 chose anonymity, posing only for photos of their chests. Tula Goenka, center, with her daughter, Ranya Shannon, who was 9 when Goenka was diagnosed with breast
Inspiration for the project came from cancer, standing next to Cindy Bell’s portrait of Goenka at the “Look Now” exhibition. a poster Goenka saw at SU’s Newhouse School in 2009, three years THE LONG VIEW aer she was diagnosed with breast cancer. e poster Lois Schaffer, diagnosed in 1972 advertised a talk by Playboy’s former CEO Christie Hefner, who spoke about transforming the domestic publishing“It was the 1970s, and a paternalistic environment,” based business into a global multimedia and lifestyle explains Lois Schaffer, who had lymph nodes removed company. Goenka wondered whether the magazine known along with her mastectomy. “I was annoyed with male for photos of naked women would ever put on its pages a surgeons who just didn’t get what breast cancer patients woman aer breast cancer surgery. were going through.” Goenka, whose treatment included two lumpectomies, chemotherapy, a double mastectomy and reconstructive surgery, thought it was time for a project championing breast cancer survivors. She met with colleagues and cancer survivors to discuss cultural ideals of beauty, breasts as sources of nourishment and symbols of femininity, and the significance of breasts bearing the battle scars of cancer treatment. e result was a project that included not just the photography exhibit and documentary video, but a website (looknowproject.org) and theater performance, now in process. It’s called “Look Now: Facing Breast Cancer.” Here are stories from five participants.
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en Schaffer met Patricia Numann, MD, surgeon and founder of Upstate’s Breast Care Center, which is named in her honor. “Dr. Numann helped me put what I was feeling into words. I adore her.” rough Numann, Schaffer got involved with Reach to Recovery and Cancersurmount, programs in which survivors provide support to others with cancer. Schaffer remained Numann’s patient for many years. Schaffer has nothing but praise for two male physicians she encountered in the 1970s: radiologist Robert continued on page 9
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CARING FOR patients
LOOK NOW
continued from page 8
How does Muller look back at breast cancer? “I was given a pink gi bag at my first appointment. I was busy thinking, ‘I don’t want to be part of the breast cancer club,’ so I never looked in the bag until much later,” she remembers. “It was filled with useful information and health care products that I needed. I could have saved myself a lot of work if I’d just opened the bag.”
Lois Shaffer
Sagerman, MD, who insisted she have radiation treatments, and Howard Weinberger, MD, who ran a program in which Schaffer and other survivors taught Upstate medical students about their experiences with cancer. Looking back 45 years, how did breast cancer affect Schaffer? “I became active in the women’s movement. I got a master’s degree in adult education. I ran a program for displaced homemakers,” says Schaffer. ”I wouldn’t wish cancer on anyone, but it gave me strength.”
ANGELS AND A LITTLE PINK BAG
Patti Muller
Patti Muller, diagnosed in 2007 Patti Muller had just moved to Central New York when she was diagnosed with breast cancer shortly aer anksgiving. Alone in a new area with a new job and two young children, Muller was introduced to Carol and Beth Baldwin, founders of the breast cancer research fund that bears their name. “Carol and Beth stayed with me throughout my surgery and first chemotherapy treatment,” remembers Muller. “Beth was by my side dozens of times throughout treatment.” Under the direction of oncologist Sheila Lemke, MD, Muller had surgery, chemotherapy and radiation treatments at Upstate. And — as a woman of Ashkenazi Jewish descent, which is a risk factor — Muller had genetic testing at Upstate to see if she carries a breast cancer gene. She does not.
HERE FOR HER DAUGHTERS Stephanie Fay, diagnosed in 2014 Stephanie Fay, 47, describes her breast cancer as “sneaky.” ree years ago, aer a day teaching preschoolers, Fay was unconcerned as she drove to her annual mammogram appointment. A 3-D mammogram looked clean. But because Fay’s breast tissue is dense, doctors ordered a follow-up ultrasound. It identified something. Upstate surgeon Mary Ellen Greco, MD, performed three biopsies. Fay soon learned that she had invasive lobular carcinoma in her right breast and several lymph nodes. Upstate oncologist Mijung Lee, MD, recommended chemotherapy before surgery. continued on page 10
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CARING FOR patients
LOOK NOW
continued from page 9
Fay describes the first 12 weeks of chemotherapy as the toughest part of treatment. She lost her hair, had little energy and felt sick much of the time. She had to take a leave from teaching because chemotherapy depressed her immune system, and close contact with children and childhood diseases would have been dangerous. “Choosing to have a bilateral mastectomy was easy,” Fay explains. “I wanted to do whatever I needed to get better.” e second round of chemotherapy was much easier, and Fay was able to return to teaching part time. Now, she has appointments with Greco and Lee twice a year and is back teaching full time. How has breast cancer affected Fay? “Cancer reminds me to be grateful. Because of all the care I got, I’ll see my daughters, Evelyn and Julia, graduate from high school,” says Fay. “I’m watching them develop into powerful women. I’m so glad to be here.” Fay was one of the 19 participants who chose to have only an unidentified photo of her bare chest in the exhibition.
Anju Varshney with her husband, Pramod Varshney
APPRECIATIVE OF A NEW LIFE Anju Varshney, diagnosed in 2006 Anju Varshney had just had a mammogram that was “fine” when she woke up and found a quarter-sized lump in her le breast. She shrieked and called her husband, Pramod. Varshney met with surgeon Mary Ellen Greco, MD, on a ursday and had a lumpectomy the following day. On Tuesday, Varshney learned the tumor was malignant and aggressive. e next day she met with Upstate oncologist Sheila Lemke, MD, who started chemotherapy immediately. Greco performed a bilateral mastectomy and removed lymph nodes, some of which proved cancerous. Varshney continues to have annual appointments with Greco at Upstate’s Community campus. “I trusted the people right here,” says Varshney. “Staying in Syracuse for treatment was the best decision I could have made.” What does Varshney remember about breast cancer? “Tula (Goenka, creator of “Look Now”) and I went through treatment together. We sat near each other and chatted while we had chemotherapy infusions at Upstate.” How has breast cancer changed Varshney? “Cancer has given me a new life. I have faith in the doctors, in the people around me, and in God. My motto is, ‘Life happens. Keep smiling.’” Stephanie Fay continued on page 11
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CARING FOR patients
LOOK NOW
continued from page 10
SURPRISED BY PINK RIBBONS Jeanine Capone, diagnosed in 2002 Jeanine Capone was 38 when she stood in front of a mirror and saw that her le nipple looked strange. A mammogram didn’t show anything worrisome, but a sonogram found a lump that was thought to be a cyst. A needle biopsy was inconclusive. It took a core biopsy to identify cancer. Capone had the lump removed surgically, and she had to find an oncologist. She remembers walking into Upstate’s outpatient oncology center (which today is the Upstate Cancer Center.) “I’ve got breast cancer, and I don’t know what to do,” she remembers saying to a nurse. e nurse showed her around and talked with her at length. Capone worried about what to say to her sons, who were 8 and 9 at the time. “You tell them the truth,” she remembers the nurse telling her, “and you answer their questions.” Two days later, Capone received a gi from that Upstate nurse: two books on how to talk with children about cancer. Capone was referred to Upstate oncologist Jonathan Wright, MD, and together they planned her post-surgery treatment: chemotherapy and radiation, followed by 10 years of estrogen-suppressant medication. Growing up, Capone’s sons, Bradley and Bryan, did multiple school projects on breast cancer. In high school, they surprised her by asking to see her surgical scars. When they turned 18, Bradley and Bryan got pink ribbon tattoos on their chests, in the same location as their mother’s scars from breast cancer surgery. Photos of their tattoos are part of the “Look Now” exhibition at looknowproject.org. ●
Jeanine Capone PHOTOS ON PGS. 8-11 FROM THE OPENING OF THE EXHIBIT BY SUSAN KAHN. “LOOK NOW” EXHIBITION PORTRAITS BY CINDY BELL
SHARE YOUR CANCER STORY Cancer Care magazine showcases Central New Yorkers who are living with cancer. To share your story, contact managing editor Amber Smith at SmithAmb@Upstate.edu
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SHARING expertise
SEVEN THINGS YOUR RADIATION ONCOLOGIST WANTS YOU TO KNOW BY AMBER SMITH
Linda Schicker, MD, an assistant professor of radiation oncology at Upstate, tells what to expect when you face radiation therapy. She sees many patients at the Upstate Cancer Center’s radiation oncology office in Oneida, at 605 Seneca St.
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Our goal is to kill the bad cells and spare the good cells.
“Radiation is composed of little packets of energy called photons. When those photons interact with matter like the human body, they can either directly or indirectly damage the DNA strands. ey don’t just damage the DNA strands of normal cancer cells. ey can also damage the DNA strands of your normal cells. “Cancer cells lose their repairability. Sometimes they’re killed immediately. More oen, they will have breaks to that DNA strand, and they can’t fix it, and aer several breaks the cell eventually dies. Depending on where the cell is in the cell cycle, it can be more sensitive to that. Chemotherapy can also make it more sensitive to that kind of damage. “Regular cells are also damaged that way. But, if we give a minimum of six hours between hits of radiation therapy, normal cells can repair that damage, up to a point. “So, we can’t give too much at once, and we can’t give the treatments too close together, or we would kill the normal cells too.” 12
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The ionizing radiation we use is the same that is used for chest X-rays, just stronger.
“Radiation only affects what it hits. If you have a cancer cell on the end of your nose, and I’m treating your breast, it won’t do anything for the cancer cell on the end of your nose. “e radiation travels through you, in a straight line. It doesn’t stay in you. It doesn’t circulate in your body like chemotherapy does. “External beam radiation is just like getting a chest X-ray. You can’t feel it, see it or touch the radiation. You won’t know anything has happened.”
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Treatment may also come through radioactive decay.
“Another type of radiation therapy is called brachytherapy. It’s something you either put inside the body permanently, or that you can put in temporarily with an applicator. “When we do a radioactive seed implant in a patient with prostate cancer, we put in 80 to 100 very tiny radioactive seeds, smaller than a piece of rice. ose are implanted into the prostate. ey stay there permanently. As the seeds are sitting there, they give off radiation by radioactive decay, and eventually they lose their radioactivity. upstate.edu/cancer l winter 2019
SHARING expertise
“For patients who have cervical cancer, we have an applicator that goes into the patient like a hollow tube. en we have a machine that has a high-dose rate source, such as cesium, that’s attached to a guidewire that slides into that applicator, where it dwells for a few minutes and then it is removed.”
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You probably will not lose your hair, and you definitely will not glow.
“Radiation passes through people. It doesn’t stay in you. So you won’t be radioactive, and you won’t glow in the dark. “Many patients’ first thought is that they’re going to lose their hair and they’re going to be sick to their stomach. at generally doesn’t happen. If I radiate your head, yes, your hair will fall out. If I radiate your stomach, yes, you will feel nauseated – although we have great medicines now that can help prevent that. Most of the sites that we’re treating are not the head or the stomach. So you don’t get the nausea, and you don’t get the hair falling out. “Sometimes we see a minimal skin change. It can turn pink, or a little bit tan, or get a little bit of a peel. Oen we don’t see any skin change at all. “Treatment side effects are site specific. If I treat your throat, you may get a little bit of a sore throat. If I treat your bladder area, your bladder may get a little bit irritable. ese tend to be temporary things.”
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Treatments are usually fast.
“It only takes a few minutes to do treatments. You’re usually in and out of the office on a treatment day in about 15 minutes.”
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You likely will have some decisions to make about your treatment.
“ere are oen several treatment options, and it’s important that you be able to understand what they are, so you can make an educated decision. ere are short-term and long-term effects to be considered. “e short-term effects are that generally aer about two weeks, sometimes a little sooner, people will notice that they get some fatigue. It won’t really stop you from doing something you want to go, but you will notice that you’re a little bit more tired. And, just as it takes a few weeks for that to come on, at the end of treatment it takes a few weeks for that to go away. But it does go away, and you will return to your normal energy level. “e long-term effects are very important, and we always have to talk about that because it can alter somebody’s treatment decision. If I tell you ‘if I do this, you may always have a little bit less lung capacity,’ that’s an important thing for you to know. Radiation does do damage, and some of that damage is permanent. And sometimes it doesn’t show up immediately. Sometimes the damage shows up later. So you have to have that conversation.”
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You can help me help you by eating healthily, exercising and resting.
“Radiation does damage, and your body will fix that damage, but it needs the building blocks to do it. People who maintain a normal, healthy diet and get enough protein tend to do better. ey tend to tolerate treatment better. ey tend to heal faster aerward. “Radiation does make people a little bit tired, but people who get a little bit of exercise every day tend to feel less fatigued. Getting rest is also important. Your body has a job to do. It’s trying to repair the damage that we do with radiation. Rest helps you do that.” ●
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SHARING expertise
what can we learn from dogs? canine cancer treatment for lymphoma serves as model for humans BY JIM HOWE
TREATING CANCER IN DOGS aims for a twofold benefit, says a Cornell University scientist: Help the sick animal and possibly find new ways to treat cancer in people. And no, she doesn’t have a secret lab where she implants cancers into dogs, a question she is oen asked. “ere is no colony of dogs with lymphoma. ese are people’s pets that come into the vet school, and we are studying them in a very similar way to the way we study humans,” says Kristy Richards, PhD, MD, an associate professor in the department of biomedical sciences in the Cornell College of Veterinary Medicine in Ithaca and in the hematology/medical oncology division of Weill Cornell Medicine in New York City. “e ‘comparative oncology’ strategy is still a bit of a foreign concept to most doctors, but veterinarians learn it from Day One,” she said in a talk at the Upstate Cancer Center, noting the idea of comparing animal and human diseases has been around since the 19th century. Dogs can get lymphoma (see page 15), and it is remarkably similar to the human variety, even under the microscope. Chemotherapy is the current standard of treatment for dogs, and Richards and her colleagues are hoping through drug trials to find alternatives to the harshness of chemo and, in the process, find better treatments for humans. Of special interest is immunotherapy, or using the body’s immune system to fight cancer. Testing combinations of immunotherapy drugs in humans takes years because the drugs must be tested one at a time and must be proven in people who are not cured with chemotherapy before they can be tried with newly diagnosed patients. With their lifespans of just 10 to 15 years, however, dogs can yield quicker results than humans, and there are fewer restrictions on combining drugs in trials. Richards hopes her work can help speed up the tremendous cost in time and money that it takes to bring a new drug from the idea 14
CANCER CARE
Upstate Cancer Center Interim Director Jeffrey Bogart, MD, and Cornell University researcher Kristy Richards, PhD, MD. Richards spoke at the cancer center about lymphoma in dogs and its implications for lymphoma in humans. PHOTO BY JIM HOWE
stage to the market, which can easily reach 14 years and $2 billion, according to the National Institutes of Health. “We set out to use the canine model in two ways,” said Richards: l l
“One is to figure out what was molecularly similar and different between the human and canine lymphoma. “e other was to use the canine model in clinical trials to speed up that drug testing process in ways that are faster than human versions.”
She focuses on a subtype of non-Hodgkin lymphoma that is most common in both dogs and people: DLBCL, or diffuse large B-cell lymphoma. In dogs, this lymphoma has only a 10 percent cure rate aer the standard treatment of four-drug chemotherapy and a monoclonal antibody drug. e human cure rate tends to be much higher — around 60 to 70 percent, depending on when the disease is detected and other factors. Among the drugs to be investigated in these canine trials will be an immunotherapy that was used in 2015 to halt the melanoma, a skin cancer, that had spread to former President Jimmy Carter’s brain. While the body can find and remove some cancer cells before they take hold, upstate.edu/cancer l winter 2019
SHARING expertise
canine cancer
continued from page12
tumors can sometimes hide from this. e treatment used on Carter, called a PD1 inhibitor, blocks cancer’s ability to hide, but it is only about 20 percent effective. Richards will investigate whether combinations of PD1 inhibitors and other targeted therapies may increase the effectiveness of cancer treatment in dogs. Richards is also studying lymphoma using lab mice, but implanting cancer cells into an inbred mouse in a sterile laboratory lacks the real-world value of a pet dog whose owner brings it in for treatment. “We have a spontaneous tumor in its natural environment, not implanted or lab style.” e dogs are also readily available for the frequent biopsies the trials need. Cornell is part of a consortium of several research universities taking part in developing canine drug trials. ey hope to study a range of possible treatments, from immunotherapy drugs to natural products such as cranberry extract (to which some lymphoma cells are sensitive), as well as combinations of treatments. Research trials on pet dogs, as well as cats, around the world include cancers of the brain, breast, lung and prostate, as well as for arthritis and seizures, according to the journal Science. Researchers hope that drugs proven to work on household pets, rather than lab mice, will provide pharmaceutical companies with a better idea of where to put their resources for developing human cancer drugs. And while Richards says she hopes to alleviate the dogs’ suffering, her overarching goal will remain the same: “I am a human oncologist, so my main goal is to study human disease. If the dogs can help, it's a win-win situation for both species.”●
if your dog has lymphoma Owners of a dog with lymphoma can speak to their veterinarian, who should have information on the drug trials being offered by Cornell’s College of Veterinary Medicine in Ithaca, or call 607-253-3060. Several trials are planned to start within the next several months.
about canine lymphoma l
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Lymphoma is a group of cancers that stem from lymphocytes, a type of white blood cell that helps the immune system fight infection. It affects the lymph, or lymphatic, system, which is part of the immune system, the body’s means of fighting infections and certain diseases. Lymphoma is one of the most common cancers in dogs. It is similar to non-Hodgkin lymphoma in people, with similar chemotherapy treatments for both dogs and people. In humans, non-Hodgkin lymphoma is the seventh most common cancer, representing about 4 percent of all cancers in the United States. Lymphoma is estimated to make up between 6 percent and 25 percent of all canine cancers. Dogs get cancer at about the same overall rate as humans, and close to half of dogs older than 10 will develop cancer. Canine lymphoma can affect any body organ but tends to be found in organs that play a role in the immune system, like the lymph nodes, spleen and bone marrow. Chemotherapy, which can be expensive, can slow the cancer’s progress in dogs but is unlikely to cure it. Remissions are possible, which means periods of time with no signs of the disease before it returns. Chemo rarely causes dogs to lose their hair, and it does not tend to make dogs as sick as it does people. e animals can suffer side effects, though, such as mild vomiting and diarrhea, decreased appetite and activity and increased drinking and urination. Dogs get chemo in much lower doses than humans, to avoid too much suppression of the immune system and vulnerability to infection; you can’t tell a dog to avoid germs by washing its paws. ●
SOURCES: AMERICAN VETERINARY MEDICAL ASSOCIATION, CORNELL UNIVERSITY, AMERICAN KENNEL CLUB
e cost of having a dog treated for lymphoma in a clinical trial at Cornell is usually just for the standard treatment, and Cornell pays for the additional biopsies and blood tests needed for the study. If the dog is enrolled in a clinical trial, the pet will be seen by the oncology service at Cornell University Hospital for Animals. It will be seen by a board-certified veterinary oncologist, who will tell the owner about the trials available. e trials are oen done with pills, which the owners can give the dog at home, so the owners just need to bring their dog back for rechecks every so oen. ● Veterinary oncologists Kelly Hume, left, and Vincent Baldanza examine Sophie, a dog with lymphoma, at the Cornell University Hospital for Animals. Lymphoma in dogs is remarkably similar to lymphoma in humans, and researchers hope that studies of the canine cancer can help humans with the disease. Hume is a Cornell faculty member, and Baldanza, a resident veterinarian at the time, is now a veterinary oncologist in California. (PHOTO COURTESY OF CORNELL UNIVERSITY HOSPITAL FOR ANIMALS) winter 2019 l upstate.edu/cancer
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Should weight loss be part of breast cancer treatment?
SHARING expertise
BY AMBER SMITH
AN OBESE WOMAN WITH BREAST CANCER is at increased risk for recurrence, compared with healthy-weight patients. Researchers want to know whether she can reduce her risk of recurrence by losing weight. Central New Yorkers can help find the answer. e Upstate Cancer Center is one Mijung Lee, MD of several sites in the United States where women can enroll in a study that will examine the effectiveness of weight loss programs aer breast cancer diagnosis. Women are eligible to participate if they have invasive breast cancer that has not spread. Participants receive encouragement via telephone, a subscription to a health magazine and various supportive mailings designed to help them lose weight. Oncologist Mijung Lee, MD, says the study is important. “Right now, we can tell patients to lose weight. But how much is really therapeutic?” Losing what percentage of body weight will make a difference? Lee says having clear data would help doctors give patients clear goals. Most women who are diagnosed with breast cancer want to focus on treatment, Lee says. It can be a stressful time, which is perhaps not an ideal time to launch a weight-loss program. Still, if researchers can prove that losing weight improves a woman’s outcome, that may provide incentive for her to succeed at weight loss. ●
advice from major cancer groups
Five major cancer organizations agree on the importance of achieving and maintaining a healthy weight for breast cancer survivors. Among suggestions for how to do that: l l l
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Pay attention to calories consumed and calories expended. Avoid high-calorie foods and beverages. Limit alcoholic drinks.
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Limit red meat and avoid processed meat. Follow a diet high in vegetables, fruits, whole grains and legumes. Eat foods that are low in sugar and saturated fats. Include foods containing carotenoids or high in calcium.
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Engage in physical activity or exercise daily, ideally more than 150 minutes of moderate or 75 minutes of vigorous activity each week. Include strength training with aerobics. Avoid prolonged sedentary behavior.
SOURCES: AMERICAN CANCER SOCIETY, AMERICAN INSTITUTE FOR CANCER RESEARCH, AMERICAN SOCIETY OF CLINICAL ONCOLOGY, NATIONAL COMPREHENSIVE CANCER NETWORK AND WORLD CANCER RESEARCH FUND INTERNATIONAL.
upstate.edu/cancer l winter 2019
LIVING WITH cancer
WHAT TO DO ABOUT DEPRESSION
p slee les b u o tr
angry outbursts
e best buffer? Open, direct communication and problem solving. “It’s important not just to be talking about the facts of a diagnosis and what they heard from the doctors, but also how they’re feeling about all that. ey may be feeling scared, perhaps. Or sad. Or even angry about the circumstances. “For them to be able to openly communicate about those things can prevent that from turning into a depression or turning into anxiety, or isolating family members from one another. And it can also really empower them to work together to problem solve.” Schweitzer says depression is generally treated the same, whether the person has cancer or not. However, some anti-depressants may not be prescribed if they would interfere with medications the person is taking to treat his or her cancer. He says it’s important that depression is identified and treated. People who are depressed typically lose interest in activities they used to enjoy. eir quality of life may seem to deteriorate, and they could lose motivation to follow their prescribed treatment. ey may develop anxiety, too, which amplifies their fears and worries. All of this can have an impact on how well cancer treatment works. Schweitzer mentions studies comparing groups of cancer patients who have depression with groups that are not depressed; the group with depression has a poorer survival rate.
winter 2019 l upstate.edu/cancer
on dwe fa l l i ilu ng re s
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A cancer diagnosis affects the whole family. In fact, Schweitzer says, studies looking at female partners of men diagnosed with prostate cancer showed the women experience more distress. In some cases, women experienced depression or anxiety at twice the rate of men.
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“e majority of people do get through this really stressful and emotionally laden experience without becoming depressed,” says Upstate Cancer Center psychologist Jeffrey Schweitzer, PhD. at said, people with a cancer diagnosis are at higher risk for depression — and he wants them to know help is available.
tho of s ughts uic ide
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ALONG WITH A DIAGNOSIS OF CANCER, people commonly experience bouts of sadness. Two or three out of 10 may develop depression. Others may experience a grief reaction with symptoms like those of depression but that come and go.
th slow in e ki d ng
BY AMBER SMITH
in cra creas v e wei ings a d ght n g ai d n
decreased appetite and weight loss
you may have a major depressive disorder if, for most of the day, you experience five or more of these symptoms during most days over a period of at least two weeks. Easing depression in patients or caregivers “all starts with your support network,” he says. at includes family members, friends, neighbors and your team of medical providers. It’s unclear exactly how these connections help, but Schweitzer says they do. “At best, cancer is tremendously stressful, not just for you but for your family and loved ones,” he says. “At worst, it can be life-threatening, life-altering, traumatic.” Schweitzer encourages people to be open with their medical providers. “Talk with them about any emotional symptoms or psychological symptoms and how you’re experiencing the diagnosis. If you’re feeling it’s too overwhelming, it’s too much — if you’re engaging in that open, emotional communications with family, friends and community, and you’re actively problem solving with them and your doctors — and you’re still feeling down, it might be time to talk to a professional.” ●
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LIVING WITH cancer
IN THE KNOw
UPSTATE’S
HealthLink on Air Radio Show Podcast On Demand
89.9 & 90.3 FM WRVO.ORG Produced by Upstate Medical University, HealthLink on Air explores health and medical issues of interest to Central New Yorkers.
Now airing on Sundays on WRVO at 6 a.m. & 9 p.m.
Listen anytime: HEALTHLINKONAIR.ORG or iTunes (search podcasts for “HealthLink”)
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CANCER CARE
Gingerbread: a comforting winter treat
Nutrition experts, chefs and “foodies” collaborated on recipes —including this gingerbread — for “e New American Plate Cookbook,” published by the American Institute for Cancer Research.
is recipe uses whole-wheat pastry flour instead of white flour, which adds fiber, vitamins and phytochemicals and makes for a lighter version of traditional gingerbread. It’s moist and flavorful, thanks to naturally sweet molasses and aromatic spices, and it goes well with fresh fruit or a cup of tea. Prep time is an hour, and baking time is 35 minutes. is makes 9 servings.
ingredients
preparation
2 cups canola oil spray 1¾ cups whole wheat pastry flour ¼ cup packed light brown sugar 1½ tablespoons ground ginger ¼ teaspoon ground cinnamon ¼ teaspoon ground nutmeg ¼ teaspoon ground cloves 1½ teaspoons baking soda ½ teaspoon salt ½ cup dark unsulfured molasses ½ cup unsweetened applesauce 6 tablespoons canola oil 1 large egg ½ cup boiling water
1. Preheat oven to 350 degrees. Lightly coat 9-inch square pan with canola oil spray. In medium bowl, si together flour, sugar, spices, baking soda and salt. 2. In separate, large bowl, whisk together molasses, applesauce, canola oil and egg until well blended. Add dry ingredients and stir until well combined. Whisk in boiling water and pour batter into prepared baking pan. 3. Bake for about 35 minutes, until the cake begins to pull away from the pan and a wooden toothpick inserted near the center comes out clean. Cool in pan on wire rack for 30 minutes. Invert cake onto platter and cool for about 15 minutes before serving. 4. Cut into 9 squares and serve warm. For storage, wrap tightly in foil and keep in fridge for up to 3 days.
nutritional information per serving: 245 calories 10 grams total fat (1 gram saturated) 37 grams carbohydrate
3 grams fiber 357 milligrams sodium 4 grams protein
SOURCE: AICR.ORG/HEALTH-E-RECIPES
upstate.edu/cancer l winter 2019
LIVING WITH cancer
Advice for eating when you don’t feel hungry
Nutrition is an important part of staying healthy, especially during cancer treatment. But eating when you have no appetite or feel full all the time can present a challenge. Eight tricks to try, from Upstate Cancer Center registered dietitian nutritionist Maria Erdman:
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Small, frequent meals may be easier to stomach than three full sit-down meals.
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Choose foods high in calories and protein. (See list.)
What sounds good?
Plan to eat on a schedule, rather than just when you feel hungry. Set an alarm to go off every couple of hours and have a few bites of something.
Drink liquids 30 minutes before or aer meals, and limit yourself to sips as needed while you are eating.
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Here are Erdman’s high protein/high calorie suggestions: Eggs
Yogurt (Greek has more protein; plain with fresh fruit has less sugar; add granola or muesli with nuts if tolerated.) Milkshakes (made with Ensure or Carnation Instant Breakfast, with or without creamy peanut butter cocoa powder and banana – use frozen chunks for thicker texture.)
Milk or chocolate milk (add 2 tablespoons powdered milk to 1 cup milk to make it “fortified.”)
winter 2019 l upstate.edu/cancer
Cottage cheese with fruit and/or seeds (chia, ground flax, sunflower), if tolerated
Peanut butter and jelly sandwich, or peanut butter on crackers, or spread on toast with fruit
Macaroni and cheese cooked with fortified milk (stir in so-cooked vegetables for nutrition boost.)
Cheese with crackers, melted on veggies or grilled in a sandwich
Baked turkey, chicken or fish
Hummus with vegetables to dip (stir in olive oil for added calories.)
Hot cereal cooked in fortified milk
Cheese or vegetable pizza Mashed potatoes with fortified milk
Tuna/chicken/egg salad sandwich
Beans and lentils (dry or from can, rinsed to remove excess sodium.)
Baked beans, refried beans, multi-bean salad with olive-oil based dressing
Prevent becoming full too quickly by chewing slowly and thoroughly. Focus on foods that have enticing smells and look good. If certain food smells turn you off, try eating the food cold or at room temperature. Avoid foods that make you gassy or bloated; they can leave you feeling full. Exercise to help stimulate your appetite. ●
Nuts – almonds, walnuts, pistachios, peanuts or pecans Guacamole (avocado mashed with salsa, lime juice, plain Greek yogurt, as a dip or on top of scrambled eggs or beans.) Coconut milk (from a can, add 1 to 2 tablespoons to smoothies and cereals for added nondairy calories.) Tofu (add to smoothies, cook into stir-fry, or use to make chocolate pudding.)
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LIVING WITH cancer IN THE KNOw
Getting proper sleep BY AMBER SMITH
THE SPECTER OF CANCER, the intricacies of treatment and the side effects can create enormous stress — which can lead to nights spent tossing and turning instead of sleeping. If that describes you, or someone you love, proper management may help, says Antonio Culebras, MD, a neurologist and medical neurology director of the Upstate Sleep Center. Your doctor may be willing to prescribe hypnotic medicines, or sleeping pills, but that is the last resort. “You have to sleep,” Culebras emphasizes. “Once you have slept, then you can deal with other problems, but first of all you have to sleep.” Sleep quality is measured by duration, continuity and depth. If your sleep is disrupted by nightmares, loud snoring or anxiety, it may be too fragmented to be good quality. Poor sleep can impact physical, mental and emotional capabilities the next day.
How much sleep do you need in 24 hours? Giraffes: 5 to 30 minutes Horses: 2½ hours Humans: 7 to 9 hours Sloth: 10 to 15 hours Tigers: 18 hours Koalas: 14½ to 22 hours SOURCES: ANTONIO CULEBRAS, MD, NEUROLOGIST AND MEDICAL NEUROLOGY DIRECTOR OF THE UPSTATE SLEEP CENTER BBC.COM/EARTH
Culebras says it’s important to be disciplined about sleep. e World Sleep Society gives this advice:
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Establish a regular bedtime and waking time.
If you are in the habit of napping, do not exceed 45 minutes of daytime sleep.
Avoid excessive alcohol ingestion four hours before bedtime and do not smoke. Avoid caffeine six hours before bedtime. is includes coffee, tea and many sodas, as well as chocolate.
Avoid heavy, spicy or sugary foods four hours before bedtime. A light snack before bed is acceptable. Exercise regularly, but not right before bed.
Use comfortable, inviting bedding.
Find a comfortable sleep temperature setting and keep the bedroom well ventilated.
Block out all distracting noise and eliminate as much light as possible.
Reserve your bed for sleep and sex, avoiding its use for work or general recreation. ●
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upstate.edu/cancer l winter 2019
‘Can Man’closing in on his goal
MAKING A difference
BY JIM HOWE
A LOCAL FUNDRAISING EFFORT is close to reaching its 2018 goal of cashing in a million returnable bottles and cans to fight cancer in Central New York. With participating redemption centers offering 6 cents per container for the Cans for Cancer campaign, that comes to $60,000. Laurence Segal of DeWitt and other volunteers held a Cans for Cancer drive to collect empty deposit containers recently near Destiny USA mall in Syracuse. Segal is a tireless advocate of Cans for Cancer and spends most of his time retrieving the returnables around the Syracuse area, wheeling pink collection bins or toting large plastic bags to redemption centers. His bottles and cans come from sources including the New York State Fair and concerts at the nearby amphitheater, among other events, as well as from individual Laurence Segal and volunteers at a can collection drive at Destiny USA PHOTO BY SUSAN KAHN donations. e effort raised $50,000 in 20162017 for the Carol M. Baldwin Breast Cancer “My mother always said that Laurence is her fih son,” she Research Fund of CNY, which pays for cancer research says of Segal, whom she called the face of the fundraising efforts at Upstate. e proceeds in the latest effort are to be effort. She noted a longstanding friendship between the split evenly between the Baldwin fund and the Upstate Baldwin and Segal families, both of which have been Cancer Center, which will give a portion to the American touched by breast cancer. Segal’s mother, grandmother Cancer Society’s Real Men Wear Pink, a breast-cancer and great aunt were all affected by breast cancer, as was awareness campaign aimed at men. a former male colleague. “Laurence is the most passionate cancer advocate I have “It’s not the dollar amount that matters to me, as long as ever met. To give so selflessly on a program that requires so no man, woman or child with cancer feels alone or that much work, and take nothing in return, speaks to the research is underfunded,” Segal says. person he is,” says Matthew Capogreco, program and events coordinator for the cancer center. And despite his being identified with collecting thousands of containers, “I want the focus to be on research and Beth Baldwin, executive director of the charity that bears scientists at the hospital, not the bottles and cans,” he adds. ● her mother’s name, notes that all the money raised stays in Central New York to fight cancer.
Three ways to donate Bring returnable bottles and cans to these businesses, which offer 6 cents for returns that go to Cans for Cancer: l l l
Mail a check — with a memo directing it to Cans for Cancer — to either: l
Bottle’s End, 101 Montrose Ave., Solvay; Express Bottle Return, 2312 Erie Blvd. E., Syracuse; E-Z Bottle & Can Return Center, 644 Bleecker St., Utica.
winter 2019 l upstate.edu/cancer
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e Upstate Foundation Inc., 750 E. Adams St., CAB 326, Syracuse, NY 13210 or the Carol M. Baldwin Breast Cancer Research Fund of CNY, PO Box 187, Warners, NY 13164.
Donate online by visiting the above charities’ websites: l
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www.upstatefoundation.org (e fund is listed as Laurence Segal Cans for Cancer) www.findacurecny.org (Cans for Cancer can be noted with the “write a note” option on the donation page).
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MAKING A difference IN THE KNOw
Patients grateful for social workers BY JIM HOWE
PATIENTS OFTEN NEED MORE than just medical treatment as they face the challenges of dealing with cancer. Finding ways to address emotional, financial and other problems is the job of the social workers at the Upstate Cancer Center. ey help to ensure that patients are able to receive their medical care and deal with its effects on their daily life. People diagnosed with cancer who feel overwhelmed or depressed, for example, might be directed to counseling with the center’s oncological psychologist. Social workers can help those with financial hardships check to see whether money is available to defray the costs of driving to treatment from far away, of prescription drugs or of basic needs if their budget is stretched. e Upstate Foundation offers various funds, such as the Maureen T. O’Hara Teal ere’s A Cure, Donald J. Roller Jr. Cancer
Funds created in memory of Maureen T. O’Hara and Donald J. Roller Jr. help cancer patients.
Patient Assistance and Hope for Heather funds, to name a few. Financial help can also come from government programs as well as other private sources, such as the St. Agatha Foundation, which helps breast cancer patients in Central New York. If needed, a social worker can direct patients to programs that can help them apply for Medicaid, the government health plan for people with a lower income, or for other public insurance, such as through the Affordable Care Act.
Social worker Chevelle Jones-Moore
“For our breast cancer patients, we have a support group, the Pink Champions, and support groups for certain other types of cancer,” says Chevelle Jones-Moore, a social worker at the cancer center. In addition, Jones-Moore or fellow social worker Amy Williams can contact CancerConnects, a local nonprofit organization that helps people with cancer find support groups, therapy sessions and other resources as they battle cancer. e social worker can help “establish a connection” between the patient and the source of support, such as by arranging a phone call or an appointment to get the support process started. “For our patients with children who want additional support, I will ask them if they would like to receive the services of a child life specialist,” Jones-Moore says. Sarah Buck, the child life specialist at the cancer center, can work directly with a child or help an adult to explain things to a child. Typically, patients will be told on their first appointment at the cancer center that social workers are available, and they can oen meet the social worker that same day or soon aer. Visiting a social worker is voluntary; patients are always free to refuse a social worker’s help. For patients who must travel a great distance for treatment, Jones-Moore might be able to secure a gasoline card or help them find low-cost or free lodging, if they need to stay in Syracuse for a series of daily treatments. continued on page 23
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upstate.edu/cancer l winter 2019
MAKING A difference
Patients grateful
continued from page 22
Volunteers are sometimes available to drive patients to and from treatment, such as the American Cancer Society’s Road to Recovery program. “We also screen for any psychosocial needs patients may have, to help them adjust to their illness,” Jones-Moore says, and that might involve arranging for a therapist or some other form of help. One patient who received help from a cancer center social worker is Nancy Akerhielm, 60, of Syracuse, a single, semi-retired business professional who has worked in computer systems management. Her breast cancer had spread to her lymph nodes by the time she was diagnosed. She underwent a mastectomy, chemotherapy and radiation treatments. During chemo, an emergency expense came up. “It was an added stress to my household, and I was just feeling like I was up against a wall,” Akerhielm explains. Jones-Moore put her in touch with the St. Agatha Foundation, which helped her to pay some bills and handle the emergency. “It was a great help, and it freed me up to deal with other stuff,” Akerhielm says.
Social worker Amy williams PHOTOS BY SUSAN KAHN
e house needed a furnace and proper sealing against the weather, at the same time Wattam faced various operations, including a tracheotomy to help him breathe, blood transfusions, chemotherapy and radiation treatments. Jones-Moore connected Wattam, who formerly ran an auto body shop, with a government program that provided money to winter-proof and heat the home.
“A cancer diagnosis kind of throws some people, to put it mildly,” she says, and temporary aid “gets you over the hump.” Mark Wattam, 54, of Weedsport is another patient who was helped. Wattam recently died, four years aer becoming sick with multiple myeloma, a cancer that arises in the blood. His family was in the midst of building and moving to a smaller home when he was diagnosed.
to donate to patient assistance programs at the upstate cancer center, visit www.upstatefoundation.org or contact the upstate foundation at 315-464-4416.
NEW ARRIVAL The Upstate Family Birth Center offers a safe, comfortable place to welcome your baby into the world. We work with you and your doctor to provide the birth experience you seek, and further support you with physicians, neonatal and family nurse practitioners, specialty trained nurses, and access to anesthesia on site, around the clock. Our newly updated unit adds to that experience, with comfortable, private, suites. Each suite is a family-friendly space with a pullout couch, so loved ones can stay close by.
TO LEARN MORE, GO TO UPSTATE.EDU/BIRTHCENTER winter 2019 l upstate.edu/cancer
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750 East Adams Street l Syracuse, NY 13210
UPClose
A peek at laboratory analysis
Pneumatic tubes whisk blood samples to the new Core Laboratory on the fih floor of the Upstate Cancer Center, where two Roche cobas 8000 analyzers stand, whirring quietly. e machines test hundreds of blood samples each day for signs of illness and disorders.
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Small samples of blood — as little as a single drop — are decanted to small containers called cuvettes and glide automatically to the correct module of the yards-long machines, where an automated arm drops down to add a reagent — a chemical that will coax a test result. e swiness of the machines allows caregivers to quickly assess situations. Sped from the operating room to the lab, a sample from a patient undergoing surgery for cancer of the parathyroid can be collected and delivered, and within 20 minutes — while the patient remains on the operating table — the analyzer can show whether all the cancer was successfully removed.
Roy Philpot, chemistry coordinator, pathology, Upstate Cancer Center PHOTOS BY WILLIAM MUELLER
