Friday, April 29, 2011

Comfort for cancer patients

Breast cancer survivor Karen McLaren is giving back to the BC Cancer Agency’s Fraser Valley Centre with the help of her therapy dog Lara.

Boaz Joseph / The Leader
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Surrey & Area

By Boaz Joseph - Surrey North Delta Leader
Published: April 29, 2011 7:00 AM
Updated: April 29, 2011 9:35 AM

The word “horse” comes up twice in just five minutes – playfully – from people in a waiting area at the BC Cancer Agency’s Fraser Valley Centre.

A young girl playing with a toy dragon doesn’t know what to make of Lara, a 130-pound great Dane who introduces herself with a gentle sniff.

“She likes people,” handler Karen McLaren reassures the girl. “Not to eat – to play with.”

The conversation soon moves to a woman’s laid-back corgi-cross back at home; another man, petting Lara, describes his dog who retrieves the mail and newspaper.

Lara’s job is to lift spirits in a place full of somber news, confusion, pain, fear and occasional boredom.

The people Lara and McLaren meet are patients undergoing tests, chemotherapy, radiation and surgery, as well as their loved ones and caregivers.

While Lara is on the job in the red vest and white bandana of a certified therapy dog from St. John Ambulance, she’s also the pet of McLaren, a 36-year-old cancer survivor and former patient at the centre.

McLaren, diagnosed with breast cancer in December 2005, was treated over the next several months in the place she now visits with Lara each Wednesday morning.

At the time she underwent cancer treatment, there were few support resources available to patients, she says. There was no library, almost nothing to read and no comfort cart like there is now.

“You came here, you talked to your doctor, you got your treatment – it wasn’t the warm-and-fuzzies. There was no place if you were having a bad moment to walk away or for a caregiver to go away and just breathe.”

After McLaren finished her treatment, she heard about the need for therapy dogs – at a time when support services were ramping up at the BC Cancer Agency.

“I decided I had the perfect dog for it and I was the perfect fit for it because I’ve been here – I’ve walked in these shoes, so why not give back?”

Petting Lara gives the patients and caregivers a timeout from the present, a welcome moment of relaxation in the tense atmosphere.

“When the dog walks into the centre, it’s almost like there’s an audible sigh,” says Ellen Suarez, regional coordinator of Volunteer Services at the Fraser Valley Centre.

Even the staff is affected, adds Suarez.

McLaren, for her part, gives patients someone to talk to who isn’t their primary care provider or family.

They’re a two-person therapy team.

“I’m giving them hope because I’m a survivor, and I think my dog brings them maybe 30 seconds of not having to be in their head why they’re here.”

McLaren says it’s amazing to watch the reactions from patients.

“To be honest, having to be a patient here, it sucks. You’re dealing with life and death. It’s hard on the patient and the family, and if Lara and I can bring that smile, or that relief or that time in not-in-Cancerland, then I am so happy.”

McLaren tells the story of how Lara assertively approached a woman who was undergoing chemotherapy for breast cancer.

McLaren was fully prepared to pull Lara back if the patient was uncomfortable with the attention.

“Lara went right to the cancer spot and started nudging and the lady just grabbed on and said, ‘Help me, help me. Help me heal.’ “

McLaren and Lara met another woman undergoing chemotherapy.

“My poor children, my poor children, what are they going to do without a mother?” she cried.

When Lara sat in front of her, the woman suddenly grabbed the dog by the skin, brought her in, and took a deep breath.

“Yes, I can do this now,” she said.

McLaren, a former patient herself, is six months away from a five-year cancer-free status.

• Want to help support the Fraser Valley Centre and enjoy a little vino at the same time?

The Rotary Club of Surrey’s Wine and Food Celebration will be held on April 30 from 7-9:30 p.m. in the food court of Central City Shopping Centre, 10153 King George Blvd. Proceeds will go towards the construction of a planned quiet room and resource centre at the BC Cancer Agency’s Fraser Valley Centre.

The event will feature live music, a fashion show, wine tastings offered by 19 vintners and food from several local restaurants. The cost is $40. Tickets are available at the mall’s administration office or on the BC Cancer Foundation website at www.bccancerfoundation.com – click on Events.

For more information about volunteering with the BC Cancer Agency, visit www.bccancer.bc.ca

bjoseph@surreyleader.com

http://www.bclocalnews.com/surrey_area/surreyleader/community/120875459.html

Thursday, April 28, 2011

Screening can save your life

Colorectal cancer is the second leading cause of cancer death in Colorado. But it doesn't have to be.
We estimate that six of every 10 deaths from colon cancer could be prevented through screening. It is time for a statewide conversation that elevates the importance of regular colorectal cancer screening in the same way that breast cancer awareness has raised the importance of regular mammograms and, consequently, saved lives.
Several decades ago, with breast cancer rates rising, Colorado and the nation awakened to the need for more and better screening. Today, pink ribbons fly proudly, and thousands march in the streets to raise awareness and money for breast cancer research, screening and treatment. Mammo-grams have become a regular part of most women's health-care checkup.
Meanwhile, colorectal cancer remains largely under the radar, a silent killer. There are no symptoms in the early, treatable stages, and the main risk factor is simply advancing age.
More than 90 percent of colorectal cancer cases occur in men and women 50 years or older. Yet too many older Coloradans and their health-care providers are not having the crucial conversation about the need to screen for colorectal cancer.
We at the Colorado Department of Public Health and Environment urge Coloradans 50 years or older to talk to their doctors and begin regular screening for colorectal cancer. Screening is relatively painless and can be used to prevent colorectal cancer. And most insurance plans cover the screening.
One screening option is a simple lab test that helps detect blood in the stool and cancer at earlier stages. The more well-known colonoscopy is done while the patient is sedated, and the procedure can remove pre-cancerous polyps from the colon.
Colorado is one of 26 states and tribal organizations funded by the U.S. Centers for Disease Control and Prevention to increase colorectal cancer screening rates, public education and outreach. The department's new Colorectal Cancer Prevention program also aims to provide screening access, improve patient outcomes and prepare for health-care reform screening mandates.
We hope to break down the barriers to the colorectal conversation, to dispel the myths that colorectal cancer is rare, that it only affects men and that the screening procedure is painful or expensive. We will promote the importance, ease and effectiveness of colorectal cancer screening in an effort to make it as common as breast cancer screening. We have begun the conversation.
Screening saves lives.
Maybe yours.
Dr. Chris Urbina is executive director and chief medical officer of the Colorado Department of Public Health and Environment.
http://www.coloradoan.com/article/20110428/OPINION04/104280346/Screening-can-save-your-life?odyssey=mod|newswell|text|FRONTPAGE|s

Managing Chemoradiation Side Effects May Prolong Survival

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Brain cancer patients without treatment-related memory loss, fatigue gained 4 months, study finds

FRIDAY, April 22 (HealthDay News) -- Brain cancer patients live longer if neurological side effects from chemoradiation can be minimized, a new study says.

U.S. researchers analyzed the records of 2,761 patients with high-grade gliomas -- the most common primary brain tumor -- who were enrolled in 14 Radiation Therapy Oncology Group studies between 1983 and 2003.

Patients who didn't experience neurological side effects, such as fatigue and memory loss, during chemoradiation lived an average of four months longer than those who had such effects, said the team at the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia.

Chemoradiation involves giving patients chemotherapy and radiation treatments together.

Side effects were most likely to occur in patients who were older, frailer, had more symptoms and were receiving radiation twice a day.

The researchers said their findings suggest that damage to normal tissue during chemoradiation plays an important role in determining long-term survival and that minimizing side effects could benefit patients.

"Our results support the personalized approach to brain tumor management . . . and emphasize the importance of minimizing side effects," Yaacov Richard Lawrence, an assistant professor in the radiation oncology department at Thomas Jefferson University and director of the Center for Translational Research in Radiation Oncology at Sheba Medical Center in Israel, said in a university news release.

The study is published in the April issue of the British Journal of Cancer.

http://www.cancercompass.com/cancer-news/article/36577.htm?c=NL20110427

Tuesday, April 26, 2011

Federal Government Embraces an Anti-Cancer Diet

By Lorenzo Cohen Ph.D on April 25, 2011 9:49 AM | Comments (0)

By Alex De Alvarado and Lorenzo Cohen, Ph.D.

More than two-thirds of adults and one-third of children in the United States are obese or overweight. Mounting evidence links excess body weight with an increased risk for many types of cancer.

In fact, the American Institute for Cancer Research suggests that more than one-third of the most common cancers could be prevented if Americans maintained a healthy diet, increased their level of physical activity and stayed lean. The federal government recently released new dietary guidelines that echo the recommendations of many cancer experts, and may help to reduce this risk.

The U.S Department of Agriculture (U.S.D.A.) and the U.S. Department of Health and Human Services (D.H.H.S.) outline the guidelines in their latest edition of the Dietary Guidelines for Americans 2010. The guidelines are published every five years and are designed to help promote health, prevent chronic diseases and reduce the risk of becoming overweight or obese.

The new recommendations are seen as a major step by federal regulators to recognize the obesity crisis and provide more information on maintaining appropriate calorie balance, the importance of consuming nutrient-dense foods and increasing physical activity.

Key recommendations include:

Prevent and/or reduce obesity through improved eating and physical activity. For this population, this will mean consuming fewer calories from foods and beverages (estimated caloric intake: female, moderate activity, 51 and older - 1,800; male, moderate activity, 51 and older - 2,300).
Increase vegetable and fruit intake, especially dark-green, red and orange vegetables, beans and peas.
Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
Choose a variety of proteins, which include seafood, lean meat, poultry, eggs, beans and peas, soy products and unsalted nuts and seeds.
Use oils to replace solid fats where possible.
Choose foods that provide more potassium, dietary fiber, calcium and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.
Reduce daily sodium intake to less than 2,300 milligrams (mg) (1 teaspoon) and further reduce intake to 1,500 mg (1/3 teaspoon) among persons who are 51 and older and those of any age who are African-American or have hypertension, diabetes or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.
Reduce the intake of calories from solid fats and added sugars.
Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars and sodium.
Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
If alcohol is consumed, it should be consumed in moderation -- up to one drink per day for women and two drinks per day for men.

Following these guidelines will mean paying closer attention to what and how much we eat. This is challenging when eating in restaurants, which often serve single portions that could easily serve two people, or eating processed foods.

Whenever possible, cook fresh food at home with family and friends to achieve a healthy, balanced anti-cancer diet.

Please visit www.cnpp.usda.gov/Dietaryguidelines.htm for a more detailed breakdown of these new guidelines. You can also reference an online calendar to sign up for the Integrative Medicine Center class, Nutrition for Individuals Touched by Cancer, by calling 713-794-4700.

http://www2.mdanderson.org/cancerwise/2011/04/federal-government-embraces-an-anti-cancer-diet-1.html

6-year-old with cancer smiles with his scars

2:00 PM, Apr 26, 2011 | comments

Written by

Blair Shiff

Written by

Kathy Vitale

LOVELAND - Dominic Kenyon has something most 6-year-olds do not have: Two smiles. Dominic has a smile on his face, as well as one on his chest - formed by scars from surgery.

VIEW SLIDESHOW OF DOMINIC AND HIS FAMILY

Dominic was diagnosed with Wilms' tumor, a rare kidney cancer that primarily affects children. Dominic went through open-heart surgery and had one of his kidneys removed.

Dominic also had a close call. In December 2010, he went to the hospital to have his tumor removed when he experienced excruciating pain in his side. His mother, Kelly, says doctors told her that Dominic probably would not survive the surgery.

Dominic, though, proved them wrong.

"He is really our miracle child," Kelly Kenyon said. "He's defying all the rules."

After his surgeries, Dominic started undergoing chemotherapy. He will endure 25 weeks of on-and-off- treatment until the end of June. Kelly says Dominic seems to enjoy being bald and even wanted to paint an Avatar arrow on his head.

"I'm magical," exclaims Dominic.

Even though Dominic is doing better, the family's finances are struggling.

The Kenyon's owe more than $20,000 in medical bills. Luckily, the Kenyon family's four other children have rallied around Dominic and are trying to help with the hospital costs. Dominic's sisters Hailey, Taylor, Madison and his brother Logan helped make beaded bracelets to sell to help with the bills. The children's schools held penny drives. Monroe Elementary School in Loveland raised $1,500 alone. Conrad Ball Middle School in Loveland will start a drive in May.

Students who heard about Dominic in different states even pitched in to help. A school in Vermont collected $900, while another school will start a drive in May also.

Hopes Song, a cancer nonprofit organization, donated $2,000 to go towards the medical bills.

Kelly says she hates asking for help with their bills, but his illness has given her a special perspective. Instead of hiding her head in the sand, the family is fighting to keep bills paid and their child healthy.

The Kenyon family plans on holding a charity golf tournament on Aug. 13 at the Old Course in Loveland to help raise money. The entrance fee is $85. To sign up, contact Dondi Major at 970-203-5471.

To learn more about Dominic, the Kenyon family, or offer support, the Kenyons established a website on Caring Bridge, which provides free websites for loved ones of patients dealing with a serious health issue, http://www.caringbridge.org/visit/dominickenyon.

http://www.9news.com/news/article/195434/188/6-year-old-with-cancer-smiles-with-his-scars

POSITION STATEMENT OF THE
NATIONAL LYMPHEDEMA NETWORK
By: NLN Medical Advisory Committee Updated April 2011
Screening and Measurement for Early Detection of Breast Cancer
Related Lymphedema
Breast cancer treatment places individuals at lifelong risk for the development of
lymphedema. Early identification of lymphedema is believed to yield better patient
outcomes. Patient education regarding the signs and symptoms of developing
lymphedema and objective measurement of arms are needed to promote early
identification and to improve patient outcomes.

Patient education: Patients should be made aware of the need to contact a healthcare provider immediately if they begin to experience feelings of heaviness or tightness in at‐risk arms; if they notice swelling in the affected area; or if the arm and/or at risk chest or truncal areas becomes hot or red.

Objective measurement: Pre‐treatment baseline measurement of arms is essential, as this serves as the baseline data to which subsequent measurements can be compared. Regular measurements following treatment are indicated for the remainder of the patient’s life. Surgeons and medical oncologists who treat breast cancer and follow breast cancer patients/survivors should conduct these measurements at every patient visit. Such measurements should also be conducted in cases where primary care physicians or advanced practice nurses provide follow up care in lieu of the treating surgeons or oncologists. The following guidelines are suggested for all individuals, practices, or centers that treat breast cancer:
There is a written institutional policy and protocol addressing pre‐ and post‐treatment arm measurements.
All patients receive risk‐reduction guidelines prior to treatment. (1, 2)
All patients have their height and weight measured prior to treatment and their Body Mass Index (BMI) calculated, as an elevated BMI is associated with increased risk of developing lymphedema. (3, 4) Weight should be obtained and BMI calculated on every subsequent visit.

   - Overweight patients who have a BMI ≥ 25 should be referred to dietician for
   nutrition education. (5)
   - Obese patients who have a BMI ≥ 30 should be referred to a dietician for nutrition
   education and weight reduction. (5)

NLN , 116 New Montgomery Street, Suite 235, San Francisco, CA 94105
Tel: (415) 908‐3681, Fax: (415) 908‐3813 , Infoline: 1 (800) 541‐3259 , Email: nln@lymphnet.org , Online: www.lymphnet.orgNLN Position Paper: Screening and Measurement for Early Detection of Breast Cancer Related Lymphedema
Page 2 of 3
NLN  116 New Montgomery Street, Suite 235  San Francisco, CA 94105
Tel: (415) 908‐3681  Fax: (415) 908‐3813 
Infoline: 1 (800) 541‐3259  Email: nln@lymphnet.org  Online: www.lymphnet.org

All patients diagnosed with breast cancer have pre‐treatment measurements on both arms. They may be given a record of this information that can be shared by them with treatment providers.

All patients have post‐treatment measurements on both arms at each visit.
 All patients have post‐treatment symptom assessments for swelling, heaviness, and/or tightness in the affected arm/arms, and at‐risk chest and truncal areas.
Consistent measurement methods, as designated in the protocol, are used pre‐ and post‐¬treatment to facilitate measurement comparison, and are recorded in the patient medical records.
Circumferential tape measurements are acceptable when made with a flexible, non‐elastic Gulick II (or similar) tape measure. (6) At minimum, six measurements are recommended: circumference at the mid‐hand, wrist, elbow, upper arm just below the axilla, and at 10cm distal to and proximal to the lateral epicondyle on both arms. Bioelectrical spectroscopy (BIS) or infrared perometry are suggested as alternative or adjunct methods to circumferential measurement. Specific protocols describing standard positions and measurements for these procedures should be in place.
Medical records contain pre‐ and post‐treatment measurements in a format that is easily retrievable by the medical team.
 There is documentation that those performing such measurements have been trained and are capable of reliable measurement.
There are institutionally‐defined criteria for treatment referral based upon:

   - Objective measurements (e.g., an increase of 1 cm in any of the circumference
   measurements compared to the contralateral limb warrants a follow‐up visit in one
   month. A 2 cm change in any of the circumferential measurements or a 5% volume
   change in an at‐risk limb as calculated by a circumferential formula or perometry
   in the absence of such a change in the contralateral limb or a BIS reading outside
   normal limits for equipment being used (e.g., L‐Dex reading >10) warrant
   immediate referral for further evaluation by a professional trained in lymphedema
   assessment and management.
   - Objective evidence/visualization of swelling in the chest or trunk.
   - Subjective symptom reports (perceived swelling, tightness, tingling, or heaviness)
   in arm, chest, or trunk.

There is documentation that referrals for treatment have been made when indicated. Such referrals should be made to one of the following:

   - Certified Lymphedema Therapists who have met the minimum of 135 hours of
   lymphedema certification training as outlined by the Lymphology Association of
   North America (LANA®), or physician, advanced practice nurse, or physician’s
   assistant knowledgeable about lymphedema and lymphedema management. NLN
   Position Paper: Screening and Measurement for Early Detection of Breast Cancer
   Related Lymphedema
Page 3 of 3
NLN  116 New Montgomery Street, Suite 235  San Francisco, CA 94105
Tel: (415) 908‐3681  Fax: (415) 908‐3813 
Infoline: 1 (800) 541‐3259  Email: nln@lymphnet.org  Online: www.lymphnet.org
References
(1) NLN Position Paper (2011) Risk Reduction Practices (2011) Retrieved 4‐14‐11, from
http://www.lymphnet.org/pdfDocs/nlnriskreduction.pdf
(2) Fu, M.R., Chen, C., Haber, J., Guth, A. & Axelrod, D. (2010). The Effects of Providing
Information about Lymphedema on the Cognitive and Symptom Outcomes of Breast
Cancer Survivors. Annals of Surgical Oncology, 17(7), 1847‐53. Epub 2010 Feb
6.PMID: 20140528. DOI 10.1245/s10434‐010‐0941‐3
(3) Ridner, S., Dietrich, M., Stewart, B., & Armer, J. (2011). Body mass index and breast
cancer treatment‐related lymphedema. Supportive Care in Cancer, 1‐5.
(4) Helyer, L. K., Varnic, M., Le, L. W., Leong, W., & McCready, D. (2010). Obesity is a risk
factor for developing postoperative lymphedema in breast cancer patients. The
Breast Journal, 16(1), 48‐54.
(5) Centers for Disease Control. (2011). About BMI for adults. Retrieved 4‐14‐11, from
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
(6) Fu, M.R., Ridner, S.H., & Armer, J. (2009). Post‐Breast Cancer Lymphedema: (Parts 1
and 2). The American Journal of Nursing, 109(7):48‐54 (quiz 55) and 109(8):34‐41
(quiz 42). PMIDs 19546644 and 19641404.

Saturday, April 23, 2011

Waynesboro native Holly Bertone takes a humorous view of cancer

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Holly Bertone and her husband, Carter, were married 10 days after Bertone’s last treatment for breast cancer.

By Rachel Bryson

The Record Herald

Posted Apr 23, 2011 @ 09:32 AM

Alexandria, Va. —

This is the third in a series of articles to promote the 30th annual Waynesboro Area Gala Cancer Auction Saturday, April 30, in the Eagles Club Inc., 22 E. Main St., Waynesboro. The theme is “Make It a Grand Slam Year!” The silent auction starts at 4 p.m. and the oral bidding gets underway at 5:30 p.m. For more information, visit:
www.wagca.org

Eight words forever changed the life of Holly (Wolff) Jackson in August 2010.

On Aug. 18, the 39-year-old Waynesboro native, who now lives in Alexandria, Va., was told “You have breast cancer.”

Two days later, her boyfriend Carter Bertone asked, “Will you marry me?”

The only child of Bob and Bonnie Wolff of Waynesboro underwent surgery, radiation and chemotherapy, finishing her treatment on March 21.

Ten days later, she got married and is now Holly Bertone.

She used humor through much of her treatment, sending e-mails to friends, family and complete strangers with a humorous take on her treatment to keep her spirits up.

Holly’s story

Bertone found the lump in her breast and went to her primary doctor, who sent her for a mammogram and biopsy.

“You get a feeling in the pit of your stomach that you know it’s not good,” Bertone said.

She celebrated her 39th birthday on Aug. 17. The next day she was diagnosed with an invasive ductal carcinoma.

“I got the phone call from the doctor on my way home from work,” Bertone said. “I was on the metro train, it was a hot summer day and we were packed in the train like sardines.”

Bertone had no family history of cancer and was very healthy before her diagnosis.

Fortunately, Bertone’s type of cancer was slow growing. Without chemotherapy, she had a 12 percent chance of recurrence. With chemo, that dropped to 10 percent.

“I’m a 10 percent kind of girl,” Bertone said.

Her treatment

Bertone had a lumpectomy, which means that a small portion of her breast was removed.

She had four rounds of chemo, each three weeks apart, and then 34 days of radiation.

Bertone worked throughout her treatments, only taking a few days off from her job with the federal government and faithfully going to the gym.

“I just had my first follow-up checkup and I’m in good health,” Bertone said, adding she will have a mammogram and MRI in early August.

Something funny

Bertone never lost hope and had a unique way of looking at her treatment.

She started keeping a journal as a type of therapy, then started sending her thoughts and reflections to family and friends via e-mail. Soon she was e-mailing complete strangers.

Her list of contacts went from 10 people to 100.

“It was great therapy for me,” Bertone said. “I received very encouraging responses.”

Her e-mails all contained humor.

After the initial trauma wore off, Bertone said she had a choice: say “woe is me” or laugh through it.

“Cancer sucks,” Bertone said. “I tried to find the humor in it.”

Her e-mails covered topics like the positives of losing your hair, treatments with laser beams and her many “tattoos” — a black magic marker was used to indicate treatment sites on her body.

Bertone hopes to compile her list of e-mails into a book and have it published.

Redefining beauty also was a hurdle Bertone had to overcome.

“Breast cancer is a triple threat,” Bertone said. “It takes away your breast, hair and fertility. I had to really define what beauty meant.”

Who she is

Bertone graduated from Waynesboro Area Senior High School in 1989, received an undergraduate degree from Elizabethtown College and a master’s from Johns Hopkins.

When she married Carter Bertone on March 31, she become stepmother to his 8-year-old son Aidan.

http://www.therecordherald.com/features/x215602130/Waynesboro-native-Holly-Bertone-takes-a-humorous-view-of-cancer