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Sunday, September 30, 2018 | 1

Pink

October is National Breast Cancer Awareness Month

Pink Ribbon Run Coalition fights breast cancer, supports survivors ANDREW WIND

andrew.wind@wcfcourier.com

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CEDAR FALLS — Those diagnosed with breast cancer in the Cedar Valley can find a lot of help to get through the difficult times. Groups meet regularly, offering a network of support. Grants are available to help ensure those receiving treatment can stay afloat financially. And volunteer advocates are present at community events to raise awareness. All of this is done through the Beyond Pink TEAM, a Cedar Valley breast cancer coalition. TEAM is an acronym describing how the group strives to help those diagnosed with breast cancer: Take action, Educate, Advocate, Make a difference. That support is perhaps most

evident to the public during the annual Pink Ribbon Run, which will take place Oct. 6. The route of the five kilometer run/walk goes through downtown and many participants wear pink. This will be its 12th year. A $30 registration fee is paid for the 5K race and all funds raised go to the Beyond Pink TEAM to help local families facing a breast cancer diagnosis. The event is presented by Oakridge Realtors and University of Iowa Community Credit Union. “Because we have such great sponsorships, we are able to cover all of our expenses through sponsorships and every race dollar goes back into the community,” said Gabbi DeWitt, who is on the Pink Ribbon Run committee. Another sponsor, Community Auto Group, covers the registration fee for any breast cancer survivor who participates in the run. The number of people participating in the 5K has grown from

700 three years ago to 975 last year. “If we could hit that 1,000 mark we’d love it,” said DeWitt. “It’s a big number with this size of race. We’re just a tiny volunteer committee that does this.” She has some ideas about why participation has grown. “I think it’s two-fold. I think it’s very difficult to find someone who doesn’t know someone who’s impacted by breast cancer,” said DeWitt. “A lot of time people are responding to that. “The other thing that I think makes people come to our race is that the money stays local. They know the people who are benefiting from the registration dollars.” To register or for more information, go online to beyondpinkteam.org or search Pink Ribbon Run on Facebook. The committee has raised more than $315,000 since the race’s inception, including $57,000 last year. That allowed the Beyond

SUBMITTED PHOTO

Adel Kessler of Cedar Falls reaches the finish line of the Pink Ribbon Run. Pink TEAM to make grants totaling $66,345 to 78 women in seven counties. Funds can be used for any essential living expenses such as rent, electrical bills, gift cards for gas or groceries, and many other purposes. One of those beneficiaries is

Angie Rinnels of Cedar Falls, who was diagnosed with breast cancer last year. “I was devastated,” she said, after hearing the diagnosis. “You never think it will happen to you.” Please see RUN, Page 2


BREAST CANCER AWARENESS MONTH

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Breast density: Know your score for earlier detection META HEMENWAY-FORBES

meta.hemenway-forbes@ wcfcourier.com

‌ ridge Pargulski “was the B gal who had a mammogram every year without fail.” Yet, in February 2012, she was diagnosed with Stage 3 breast cancer that had spread to seven lymph nodes. “My chance of survival had just plummeted,” she said. Seeking treatment and answers, the Johnston woman stumbled upon a TED Talk by Dr. Deborah Rhodes of the Mayo Clinic in Rochester, Minn. Rhodes’ talk was on how dense breast tissue can mask cancer on mammograms. Pargulski made an appointment with Rhodes, who explained that Pargulski had dense breasts and, “judging by the size of the tumors, the cancer had likely been there for five years. I could not believe it had taken getting in to an oncologist’s office for someone to tell me that,” Pargulski said. On her way out the door from Rhodes’ office that day in 2012, the doctor noted legislation in several states that requires health care providers to notify women of their breast density score on mammogram reports. “The light went on and I knew what I was going to do,” Pargulski said. “I was going to go back to Iowa and try to get this done.” It took an army, an Iowa Army of Pink, in fact, to get it done. Pargulski, who’s now cancer-free, founded the Army of Pink advocacy organization that took the issue to the Iowa legislature. Iowa’s Breast Density Inform law was signed in 2017, requiring information on a patient’s breast density to be included in mammogram result letters. Every woman getting a mammogram will be informed of her density category: A. Fatty B. Scattered fibroglandular density C. Heterogeneously dense D. Extremely dense Every woman categorized as C or D will receive additional information noting that having dense breast tissue puts one at an increased risk for breast cancer, and that dense breast tissue masks cancer on a mammogram making it difficult to detect. “Early detection is so critical. Why not know your score?” said Diane Dodds of Marion, who’s breast cancer was undetected by Please see DENSITY, Page 4

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Rinnels completed chemotherapy and surgery this year. She received a grant for travel costs to her appointments in Iowa City. “It was such a sigh of relief to be able to get help and not worry about the extra costs of going back and forth for treatments,” she said. The fund began with a $1,000 donation in 2006, predating the 5K event, and grants have been given since 2008. The advocacy coalition had more modest aims when it started in 1988, 30 years ago. At that point, it was called the Cedar Valley Committee for Breast Cancer Awareness. “Their goal was to increase the use of mammography, start a breast cancer support group and start a $40 coupon campaign,” said Dee Hughes, who has worked with the group since it began. The coupons, intended to make mammograms more affordable, were first offered in April 1989. “And over the years, it

An intro to dense breast tissue „„ Approximately 50 percent of women in Iowa have

dense breast tissue.

„„ Dense breast tissue cannot be felt by you or your phy-

sician. It can only be determined by visualization on mammogram. „„ In women with extremely dense tissue, cancer is 4-6 times more likely than in women with fatty breasts. „„ Dense tissue shows up white on a mammogram, and so does cancer, making it difficult to detect. In dense breasts, mammograms will miss 50 percent of cancers present, delaying diagnosis. You may be more likely to have dense breasts if you: „„ Are younger. Your breast tissue tends to become less dense as you age, though some women may have dense breast tissue at any age. „„ Have a lower body mass index. Women with less body fat are more likely to have more dense breast tissue compared with women who are obese. „„ Take hormone therapy for menopause. Women who take combination hormone therapy to relieve signs and symptoms of menopause are more likely to have dense breasts. Source: www.iowabreastdensity.com, Mayo Clinic

Breast density categories Levels of density are described using a results reporting system called Breast Imaging Reporting and Data System. The levels of density are: A: Almost entirely fatty indicates that the breasts are almost entirely composed of fat. About 1 in 10 women has this result. B: Scattered areas of fibroglandular density indicates there are some scattered areas of density, but the majority of the breast tissue is nondense. About 4 in 10 women have this result. C: Heterogeneously dense indicates that there are some areas of nondense tissue, but that the majority of the breast tissue is dense. About 4 in 10 women have this result. D: Extremely dense indicates that nearly all of the breast tissue is dense. About 1 in 10 women has this result. Source: Mayo Clinic

What you can do If you have dense breasts, discuss these supplemental breast cancer screenings with your doctor: 3-D mammogram (breast tomosynthesis) Tomosynthesis uses X-rays to collect multiple images of the breast from several angles. The images are synthesized by a computer to form a 3-D image of the breast. Many mammogram centers are transitioning to incorporate 3-D mammograms as part of the standard mammogram technology.

Breast cancer signs & symptoms AMERICAN CANCER SOCIETY

‌ K nowing how your breasts normally look and feel is an important part of breast health. Finding breast cancer as early as possible gives you a better chance of successful treatment. But knowing what to look for does not take the place of having regular mammograms and other screening tests. Screening tests can help find breast cancer in its early stages, before any symptoms appear. The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancer, but breast cancers can be tender, soft, or rounded. They can even be

painful. For this reason, it is important to have any new breast mass, lump, or breast change checked by a health care professional experienced in diagnosing breast diseases. Other possible symptoms of breast cancer include: „„ Swelling of all or part of a breast (even if no distinct lump is felt) „„ Skin irritation or dimpling (sometimes looking like an orange peel) „„ Breast or nipple pain „„ Nipple retraction (turning inward) „„ Redness, scaliness, or thickening of the nipple or breast skin „„ Nipple discharge (other than breast milk) Sometimes a breast can-

cer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt. Swollen lymph nodes should also be checked by a health care provider. Although any of these symptoms can be caused by things other than breast cancer, if you have them, they should be reported to a health care professional so that the cause can be found. Because mammograms do not find every breast cancer, it is important for you to be aware of changes in your breasts and to know the signs and symptoms of breast cancer.

Breast cancer facts in the U.S. NATIONAL BREAST CANCER FOUNDATION

‌One in eight women in the United States will be diagnosed with breast cancer in her lifetime. Other facts include: „„ Breast cancer is the most commonly diagnosed cancer in women. „„ Breast cancer is the second leading cause of cancer death among women. „„ Each year it is estimated that over 252,710 women in the United States will be diagnosed with breast cancer and more than 40,500 will die. „„ Although breast cancer in men is rare, an estimated 2,470 men will be diagnosed with breast cancer and approximately 460 will die each year. „„ On average, every 2 minutes a woman is diagnosed with breast cancer and 1 woman will die of breast cancer every 13 minutes. „„ Over 3.3 million breast

SHUTTERSTOCK ILLUSTRATION‌

cancer survivors are alive in the United States today. According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization. In recent years, perhaps coinciding with the decline in prescriptive hor-

mone replacement therapy after menopause, we have seen a gradual reduction in female breast cancer incidence rates among women aged 50 and older. Death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness and continually improving treatment options.

Breast MRI MRI uses magnets to create images of the breast. MRI doesn’t use radiation. Breast MRI is recommended for women with a very high risk of breast cancer, such as those with genetic mutations that increase the risk of cancer. Breast ultrasound Ultrasound uses sound waves to analyze tissue. A diagnostic ultrasound is commonly used to investigate areas of concern discovered on a mammogram. Molecular breast imaging (MBI) MBI, also known as breast-specific gamma imaging, uses a special camera (gamma camera) that records the activity of a radioactive tracer. The tracer is injected into a vein in your arm. Normal tissue and cancerous tissue react differently to the tracer, which can be seen in the images produced by the gamma camera. Source: Mayo Clinic

kind of just expanded,” Hughes noted. “We added a newsletter in 1996, a free newsletter. We got the breast and cervical cancer program to the Cedar Valley.” Black Hawk was one of the first counties to have the program, which is focused on early detection of cancer. It allows for free doctor visits to receive mammograms and paps smears at no cost. After the two main organizers from Covenant and Allen hospitals left the group’s leadership, Hughes said it floundered for a number of years. That changed when the committee received the $5,000 Iowa Health Prize in 1997. The group got involved with advocacy at the national level, talking to Iowa’s Sen. Charles Grassley about supporting the Breast and Cervical Cancer Act. He did, and it was approved by Congress and signed into law in 2000. That allowed women who were diagnosed with one of the cancers to receive Medicaid, ensuring they can get treatment. The name was changed to

the Beyond Pink TEAM in 2006. That same year, the first Young Cancer Survivors meeting was held, adding another option to its monthly Touch of Courage support group. Young Cancer Survivors holds quarterly meetings that are open to people who have had any type of cancer. Efforts of the group have continued, both locally and nationally. The Beyond Pink TEAM was accepted as a board member on the National Breast Cancer Coalition in 2012. Christine Carpenter and alternate Lori Seawel represent the group at meetings in Washington, D.C., that involve working with members of Congress. In the Cedar Valley, Beyond Pink held the first Ignite the Cancer Conversation in 2016 — an annual event that has included a conference and a book club. The all-volunteer organization has branched out over the decades, but Hughes noted it has kept a singular focus throughout that time. “We’re fighting to end the disease,” she said.

Free Mammo Night Hosted by

Covenant Comprehensive Breast Center with support from the Care For Yourself program, Covenant Foundation and Check the Girls Foundation. Who: Women ages 40 and older who have cost-barriers to receiving their yearly mammogram What: Free mammograms When: Thursday, November 15 5:00 p.m. to 8:00 p.m. Where: Covenant Medical Center 4th floor of Outpatient and Women’s Center Transportation provided upon request. Appointments are required and there are a limited number available. Call 319.292.2225 to schedule today!

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BREAST CANCER AWARENESS MONTH



Sunday, September 30, 2018 | 3

Pink isn’t just a color anymore JODIE MULLER

Reprinted from Beyond Pink TEAM Touch of Courage Connection ‌

‌One morning during the summer of 2016, I rolled over in my bed, my hand brushed across my right breast, and I felt a lump. I had just turned 52. In that one second, my life changed forever. I tried not to panic and hoped that the lump was due to my monthly cycle and would go away. Deep down, I already knew what it was, but I waited a couple of months anyway, which wasn’t really smart. In October, I went to the doctor, had a mammogram and was barely back at work when the doctor called to say my mammogram was “suspicious for cancer.” The very next day I had a biopsy. I waited five long days for my results. My husband and I were just trying to get through the weekend and trying to distract ourselves with television, but it was October and October is breast cancer awareness month. Reminders were every place I turned, and pink was everywhere;

even the football players had pink shoes and gloves. Pink …. pink … pink! I know it is dumb, but I was to the point where I hated when friends gave me anything pink. I was Stage 2 ER+ and HER2-, and subsequently scheduled for a lumpectomy, followed by the placement of a port a couple weeks later. About 10 days after the port was placed, I developed a DVT in my upper arm, which landed me in the hospital for five days, getting out on Christmas Day. There were a lot of discussions about what to do, but ultimately the port was replaced with a PICC line, and I had to give myself daily blood thinner injections for two months. I might mention that getting off the couch to stab yourself in the stomach is something that someone going through chemo doesn’t want to deal with. I endured 16 chemotherapy treatments, followed by 30 radiation treatments and am currently taking Tamoxifen, which besides some stellar hot flashes, is going okay. I feel like I managed to get

BRANDON POLLOCK, COURIER STAFF PHOTOGRAPHER‌

Jodie Muller through the treatments fairly well and was able to work most of the time. Of course, after work, I had no more energy for anything else. My mom, husband, my work family and friends were key to keeping me going. We ignored a lot of housework and discovered the joy of online grocery shopping. When you are going through

something so tough, you just sort of plug away and get through the day. When I was first diagnosed, it was terrifying, to say the least. You know, at least intellectually, that people survive. But even if I didn’t say it out loud, I was considering the very real possibility that maybe I won’t be around

to see what kind of people our grandchildren will grow up to be. You think, will I even be here in a year. But now it is 20 months later, and I am feeling better (not 100 percent, but better), and I am beginning to feel more hopeful for the future. I am looking forward to learning how to LIVE past my cancer diagnosis, which I am still figuring out. I am appreciating the simple things that we take for granted and want to get healthy and stronger and hope that I am around to be at my grandchildren’s graduations and weddings. I have never tried to ask God “Why me?” Instead, I think “why not me?” I ask for strength and ability to EMBRACE HOPE and maybe have FAITH and TRUST that things will be okay. I think the most important thing that someone newly diagnosed needs to do is reach out to someone for support and ask for help when you need it. I have met so many lovely, generous women since this journey began who are willing to listen and offer support.

Sue and Dean Witwer’s Free mammography event planned at legacy lives on in Covenant Comprehensive Breast Center trained advocates MELODY PARKER

melody.parker@wcfcourier.com ‌

‌CEDAR FALLS – Susan Witwer is remembered as a determined but graceful advocate for breast cancer prevention, education and support. She was a team leader for the National Breast Cancer Coalition and assisted with the Iowa delegation during NBCC’s annual Lobby Day on Capitol Hill in Washington, D.C. Witwer died in 2010. After her death, her husband Dean and their children generously began funding the Beyond Pink TEAM’s Susan Witwer Memorial Scholarship. Over the years, the fund has helped send eight new advocates to the annual National Breast Cancer Coalition Leadership Summit in D.C. Dean Witwer died April 24, leaving behind a legacy of trained breast cancer advocates to represent the Cedar Valley and surrounding area at the national level. Susan was a breast cancer survivor and always interested in politics, says her friend Christine Carpenter, Beyond Pink TEAM advocacy council chairperson and NBCC board member. “She used to tell me that sometimes she’d watch the news and end up throwing her shoe at the TV,” Carpenter says. In 2003, Carpenter invited her to attend the National Breast Cancer Coalition Annual Advocacy Conference, that included a day spent lobbying Congress. She learned about the research that was taking place to find a cure for breast cancer, the importance of advocacy and learning about the making of

legislative process. “The experience empowered her. She was a survivor who was doing something positive, that could have an impact. At home she wrote letters and thank-yous and followed up to keep breast cancer in the forefront for specific legislation we wanted passed. She didn’t have to throw her shoe at the TV anymore,” says Carpenter. In 2004, Witwer became an NBCC team leader. She also studied NBCC’s legislative priorities and politely but with persistence presented its position to Iowa’s Congressional senators and representatives. She was named an honored member of Beyond Pink TEAM in 2006, nominated by Carpenter. In two years, NBCC will reach its Breast Cancer Deadline 2020. The deadline for a strategic action plan was set in 2010 as a commitment to know how to end breast cancer. Through the Artemis Project, NBCC is working with researchers and patient advocates to develop a preventive breast cancer vaccine. Another aspect of the Artemis Project is understanding how to prevent breast cancer metastasis, including why some to breast cancers go dormant for years and then remerge having spread to other organs. Donations can be made to the Susan Witwer Scholarship Fund at www.beyondpinkteam.org. For more information on NBCC’s Breast Cancer Deadline 2020, visit www.breastcancerdeadline2020.org.

in honor of

‌WATERLOO – Covenant Comprehensive Breast Center, with support from the Care for Yourself program through the Black Hawk County Health Department, Covenant Foundation and Check the Girls Foundation, is hosting a free mammography event in an effort to meet the needs of the community. The event will take place on Nov. 15 at the Covenant

Comprehensive Breast Center at Covenant Medical Center. The event is for women ages 40 and older who have cost-barriers to receiving their yearly mammogram. Appointments for free mam-

mograms will be available from 5 to 8 p.m. with day-time appointments available as needed. Transportation and interpretation services available upon request. “We know many women avoid scheduling a mammogram because of the cost of the

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test, or the cost of care if something is found,” says Kelly Flaucher, mammography supervisor for Wheaton Franciscan Healthcare-Iowa. “Far too often women spend so much time taking care of everyone else in their family that they forget to take care of themselves.” Appointments are limited and required. Call Gabbi DeWitt at 292-2225.

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BREAST CANCER AWARENESS MONTH

Advice from a 13-year breast cancer survivor

SHUTTERSTOCK PHOTO‌

PATTY WANDSCHNEIDER

Reprinted from Beyond Pink TEAM Touch of Courage Connection ‌

Distress, emotional struggles part of breast cancer battle groups, religious or spiritual groups, online support communities, or oneon-one counselors. What’s best for you depends on your situation and personality. Some people feel safe in peer-support groups or education groups. Others would rather talk in an informal setting, such as church. Others may feel more at ease talking oneon-one with a trusted friend or counselor. Whatever your source of strength or comfort, make sure you have a place to go with your concerns. There are many support groups available, such as the American Cancer Society Reach To Recovery program. This program matches you with a local volunteer who has had breast cancer. As someone who’s been through the experience, your Reach To Recovery volunteer can answer many of your questions. The cancer journey can feel very lonely. You shouldn’t feel the need to try to deal with everything on your own, and your friends and family may feel shut out if you don’t include them. Let them in, and let in anyone else who you feel may help. If you aren’t sure who can help, call your American Cancer Society at 1-800Special issues 227-2345 and we can put women face you in touch with a group Many women with breast or resource that may work cancer face additional for you. stressful issues. For example, your appearance might have changed as a result of breast cancer surgery. You may also have concerns about sexuality after breast cancer. For younger breast cancer survivors, changes in appearance and sexuality might be even more stressful. Some women 2515 Falls Ave., might still be thinking Waterloo, IA 50701 about starting a family or 319-235-6085 having more children, and might worry about how the cancer and its treatment might affect this. Others might have already started families and might worry about how this could affect them. For some women, chemotherapy can cause early menopause, which can be very distressing on its own. Regardless of the changes you experience, it’s important to know that there is advice and support out there to help you cope. AMERICAN CANCER SOCIETY

‌ uring your treatment, D you may find yourself overwhelmed by many different emotions. This happens to a lot of women. Some amount of depression, anxiety, and fear is normal when breast cancer is a part of your life. A certain amount of distress is normal as well. Some women are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Emotional issues can arise after treatment as well. For example, you’ll probably be concerned that the cancer might come back. Maybe you’re more aware of the effects the cancer has had on your family, friends, and career. You may take a new look at your relationships with those around you. Unexpected issues might also cause concern. For instance, you might be stressed by financial concerns resulting from your treatment. You might also see your health care team less often after treatment and have more time on your hands. Any of these things might make you anxious.

‌I was diagnosed with stage 2 breast cancer 13 years ago. I was 38 weeks pregnant with my third child. We were watching a lump I had felt we e k s prior that wasn’t g o i n g Wandschneider away. My doctor recommended we have it biopsied, “just in case.” The day after the biopsy, we were told it was cancerous and the following day I had our third son. A few weeks after his birth, I had surgery and was recovering when my mom unexpectedly passed away. A couple weeks after her funeral, I started chemo followed by radiation. My husband was having his own struggles since he had gone through ovarian cancer with his mom 15 years earlier and had already lost his dad. Needless to say, it was a very difficult time in our lives, but we made it through. My mom’s twin sister, who was like a second mom, helped us out tremendously. I also had a sister-in-law close by that helped watch the boys if I needed help. A grandmotherly neighbor loved to come to our home and rock our baby and feed him when I needed to rest. I couldn’t have done it without the help of family and friends. Having a

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mammogram because of dense breast tissue. She was diagnosed in 2012, and became part of the Pink Army campaign, writing letters to state legislators. “I was so angry when I heard my risk was so much higher and Iowa did not have a law,” she said.

newborn was actually very therapeutic, emotionally and physically. I think my arm that had the lymph nodes taken out of it gradually strengthened by carrying him around. What a blessing it was to have him. I tried to focus on getting better so that I could care for my three boys. I had grown up going to church every Sunday, but found I became closer to God on a daily basis. He was truly by my side the whole way through. My attitude about life has definitely improved since my cancer. There were times I struggled with seasonal depression and times when I was more negative than I liked to be. Today, I try to always look for the good in everyone and in every situation. I try to practice being grateful even for the little things in life! I like to write down things that I am grateful for, or think about them before I fall asleep at night. This may be helpful for anyone going through or after a cancer diagnosis. One of my biggest obstacles was preparing meals while going through treatment. It was especially

hard to prepare meat. I couldn’t stand the smell of cooking meat. I don’t really care for it still today, but I do it for my growing boys! I’ve always loved fruits and vegetables, so that’s good since they boost our immune system. It’s always been challenging for me to want to exercise. I know that it’s an important part of staying healthy, so I try to walk, garden, or do some yoga exercises. I wish I had tried to walk during the time of chemo and radiation. I had it in my mind that I needed to rest and save my energy. Now I know that it can help with overall well-being and our perspectives on life. I’ve also learned how to use diaphragmatic, also called belly breathing, to help relax if I start to feel anxious about anything and for overall health. This has helped me tremendously with shoulder and neck pain, too, since that’s where I’ve always carried any stress that I feel. The Beyond Pink TEAM wasn’t around and doing all the wonderful things they do today. I’ve recently

joined the group, however, now that I have more time in my schedule. I recently resigned from 20 years of teaching reading to become a health advocate and beauty consultant. I have combined my passion for teaching and my desire to be healthy to educate others about steps they can take to have optimal health. I view difficult times, including my cancer, as something I can learn and grow from. For 13 years, I have felt like God has something more for me to do besides raising a family, even though I know that’s important, too. I feel blessed to be able to do what I’m so passionate about. I think it’s important for people to find time to do the things that make them happy, whether it be for work or as a hobby. I know if you’re going through cancer now, or if you recently have that it feels like you’ll never get better. My advice is to take one day at a time and to find at least one thing each day to feel grateful for, even when life seems so hard. Please know that you are loved and that there is help out there if you need it. Don’t be afraid to ask! There are resources available, and you most likely have a family member, friend, church or community member that would love to feel needed.

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