Couple face lung cancer together

TrasksHelping our community right here in Tucson get and stay healthy and keep on dancing is what Tucson Medical Center is all about. We’re showing off some of our fabulous community members in our latest commercials and you get to find out a little more about them here on our blog. Meet TMC dancers, Jeff and Viki Trask.

The Trasks came together to meet a challenge when Jeff hired Viki as his new director of sales to help him open a hotel in Tucson.

The owners indicated if they achieved a 70 percent occupancy in the first full year – rare in the business – they would give them a trip to Hawaii, all expenses paid. At year end, the hotel’s occupancy was 71.2 percent.

The Hawaii trip turned out to be their honeymoon.

The two are braving a new challenge now.

It started when doctors found cancer in Jeff’s left lung. His physician recommended cardiothoracic surgeon Douglas Lowell. Five days in the hospital passed quickly after the operation and he returned to his life.

Two years later, it would be the right lung, with Dr. Lowell summoned to help again. Another surgery, another five days in the hospital.

Two years later, Viki had the diagnosis: lung cancer. They turned to Dr. Lowell again.

“TMC was great. If you needed something, they were there,” Viki said. “We were even more impressed after we learned TMC is a nonprofit. That’s remarkable!”

Jeff and Viki stated, “We’re extremely grateful to our team of doctors and healthcare providers. They’re all fantastic and we want to thank our nurse navigator, Kim Kastel, who came up with the moniker: Team Trask.”

Jeff has since been diagnosed with his third bout. They both have had rounds of chemotherapy or immunotherapy in addition to their surgeries.

“We’re living with cancer,” Viki said. “Yes, it can be devastating to learn of the diagnosis, but we are determined to stay positive and understand we are living with cancer. We’re on the five-year plan and we just go from there.”

Jeff said one of his doctors recently asked how he’s feeling. “Do you get tired? I do, but only after I work on the oleanders for three hours. I still ride my bicycle during the week. It’s wonderful to be alive.”

Long-time smokers and ex-smokers breathe easier with a lung screening.

Make an appointment today. Call (520) 389-5390

Worries getting in the way of making that call to get a lung screening? You’re not alone. Nurse navigator, Kim Kastel addresses some common barriers people face in this blog post.

Smokers, Kim is here to help you breathe easier

Kim Kastel, Thoracic Nurse Navigator

Kim Kastel, Thoracic Nurse Navigator

The risks of being a long-time smoker can weigh heavily on your mind, especially when considering the threat of lung cancer. Early detection is vital for surviving lung cancer, but the symptoms often present themselves until the cancer is already advanced and a cure is elusive. The CT scanning technology that Tucson Medical Center uses during lung health screening can find the tiniest of nodules, allowing doctors to see suspicious lesions when the tumors are small and can be removed. This screening can literally save lives.

Many people who have a high risk of lung cancer feel unable to take that first step of getting a screening. Kim Kastel, the nurse navigator for the lung cancer program, addresses some of the emotional barriers she’s heard to help people overcome the struggle to get testing:

Am I going to be judged for smoking?

Absolutely not! This is a non-judgement zone. We’re pleased you’re taking this first step to protecting your health and the earlier we can catch lesions the better the outcomes. We work actively against that stigma and increasingly the general public is recognizing that while smoking puts you at increased risk for lung cancer, lung cancer affects non-smokers too.

Am I going to be pressured to stop smoking?

Or am I going to be told off for smoking? I don’t want to be shamed.

While we will encourage you to stop smoking, we know this is a difficult process and we’re not going to pressure you to stop. We can direct you to resources to help stop smoking if you’re ready to take that step.

(ASHLine is a local resource that can help if you’re ready to stop smoking and want support. You can call them at 1-800-556-6222)

What if they find cancer? I don’t want to have cancer.

No one wants cancer, but if we find a suspicious lesion during a lung health screening, you will have support from a nurse navigator throughout the process. The earlier we find any lesion the easier and quicker it will be to get you to being able to say you don’t have cancer.

If I have cancer, it’s already too late. What’s the point?

With early intervention it is possible in some cases to literally cut the cancer out and be done with it — no chemo, no radiation, no medications. If a lesion is found that requires treatment beyond surgical removal, know that in the past 10 years cancer treatments have made huge bounds forward in targeted therapy and are continuing to advance.

I stopped smoking five years ago, so I don’t need to worry with a lung screening, right?

Well done! You’ve lowered your risk. But if you smoked for a long time you will still want to be checked.

Who should get checked?

We offer lung CT screenings to individuals at high risk for developing lung cancer. You may be eligible for a screening if you are:

  • between the ages of 55 and 77 (some insurance companies will cover up to 80 years of age)
  • have smoked an average if one pack of cigarettes a day for the past 30 years
  • if not currently smoking, then quit smoking in the last 15 years.

Will insurance cover the screening?

Most insurance will cover the screening for those at high risk (see above). Medicare Part B covers a lung cancer screening with Low Dose Computed Tomography (LDCT) once per year for those who meet all of these conditions:

  • Aged 55 to 77
  • Asymptomatic, i.e., no current signs or symptoms of lung cancer
  • A current smoker or one who has quit within the last 15 years
  • A history of tobacco smoking for at least 30 “pack years” (an average of one pack a day for 30 years)
  • A written order from a doctor

Find out more about lung health screening by calling Kim, our nurse navigator

at (520) 389-5390

Breast cancer survivor spreading a message of body positivity

BethAnne King LobmillerBreastless and beautiful

When breast cancer survivor and advocate BethAnne King-Lobmiller was just 10 or 11 years old, she recalls accidentally barging in on her grandmother as she was changing her blouse. “I must have gasped or looked shocked … but she just smiled and invited me to come in and close the door. Then she explained to me why she didn’t have breasts.”

“She had a bilateral mastectomy in the 1970s, back when cancer surgery was radical and went deep, and as a result, she was completely flat.” King-Lobmiller recalls with a smile. “I had never noticed that she wore fake boobs – she even wore smaller ones in the summer to stay cooler – and none when she was in her pajamas.”

Possibly in part as a result of her grandmother’s unapologetic honesty and generosity in sharing her experience, King-Lobmiller dedicates herself to advocating for body-positivity after breast cancer. Breastless and Beautiful, the advocacy group she started, boasts more than 300 members and exists for women who have chosen not to undergo reconstruction after a mastectomy. Says King-Lobmiller, “I didn’t choose flat, it chose me … as corny as that sounds.”

But the journey to her current state of body-positivity took time, reflecting back on her own diagnosis, she says, “When I first heard that I was going to have a mastectomy, I was beside myself, I couldn’t’ accept it.”

“One of the things I noticed about myself as I attended support groups was that I was really more freaked out about it than anyone I knew. But I was just processing it and grieving the finality of the loss. I wasn’t soothing myself with the idea of the breasts I would have afterward, so it felt very raw and real.”

Choices post mastectomy include going flat

Not willing to go through additional surgery beyond her mastectomy, King-Lobmiller found there was an assumption among everyone from medical professionals to support groups that reconstruction would be the obvious choice. Going flat wasn’t an overt part of the mix.

“I’m not advocating for flatness, I’m asking for there to be a conversation about the option.”

Her philosophy is that, like most things, the more people see healthy, beautiful survivors who have chosen flat and the more the community knows about it, the more comfortable women will become with making the choice that is best for them.

“Honestly, hardly anyone notices. When they do, I think to myself, “Please say something to me” because I always want the opportunity to educate someone and help them to understand,” said King-Lobmiller.

“The idea that I’m not a feminine and beautiful woman because I don’t have breasts is ridiculous,” she said.

TMC’s dedicated Oncology Nurse Navigators are here to help with resources for patients and their families and information about support groups. And don’t forget to schedule your annual mammogram today.

Recent breast cancer diagnosis? Advice from breast cancer survivors

Vanessa H-B.jpg

Now what? Once you move beyond your initial reaction to a breast cancer diagnosis, whether it is disbelief, fear, anger or uncertainty, what should you do? We asked three breast cancer survivors for words of wisdom to the recently diagnosed.

1. Bring a trusted friend or family member as an advocate to your doctor’s appointments

When faced with a cancer diagnosis the options can seem daunting and the information overwhelming. It can be invaluable to have an advocate in the room to be a second set of ears. A person who is confident enough to ask questions, able to take notes and willing to process the information afterward with you. Advocates should understand their role prior to going to your appointment so they can be prepared.

2. Write down your questions

Create a written list of specific questions prior to your appointments to discuss with your doctor. Let your doctor know that you have questions at the beginning of your appointment.

3. Beware of Dr. Google

Dr. Michelle Boyce Ley, board-certified breast oncology surgeon, medical director of TMC’s Breast Health Program and a breast cancer survivor herself said, “Don’t google outcomes. I’ve seen what’s out there and they don’t look like my own patients.” Tess X, a patient of Dr. Boyce Ley’s, said “I didn’t do much reading outside the basics because you can really get into the weeds and pseudo-science. I looked up my particular variant of BRCA2 and did some calculations on risk over 10 years and lifetime, but I have a biology background. Then I talked with Dr. Boyce Ley to discuss my risks and treatment options.”

4. Talk to your doctor about risk and benefits

“Don’t assume the risks and benefits are the same as a friend’s with the same form of cancer,” Tess X said. Two people can have the same form of cancer, but the treatment plan might be quite different dependent on stage, location and the individual’s aversion to risk.

5. Ask about all the options including if there are options in treatment that they don’t offer.

“It makes me so sad when I give a talk and someone comes up afterward and says, ‘Why didn’t they offer me that?’” said Dr. Michelle Boyce Ley, . It’s important that your physician be willing to discuss all options with you, so you can participate in shared decision-making. “You can’t make a good decision unless you have the information.”

6. Don’t be afraid to share your diagnosis with others

“I met many survivors that way,” said Vanessa Hough Buck. “They have been an encouragement to me. Find a support group of survivors.”

7. Don’t avoid being in photographs while you’re going through treatment

“Even when you don’t feel your best, be in the picture. When I look back now, those are my favorite photos,” Buck said.

8. Let people know what you need from them

“Your friends and family have good intentions but don’t always know what to do. It’s alright to ask for specific help. And it’s OK to say ‘no’ to visitors,” Buck said.

 

Are you a breast cancer survivor? What advice would you give to the recently diagnosed?

TMC for Women has a high risk breast clinic that provides education, treatment options, and coordination to best help high risk patients choose their next steps.

 

 

Hidden Scar technology allows surgeons to minimize scarring without compromising breast cancer treatment

Hidden Scar breast cancer surgery centerBreast cancer surgery can save a woman’s life. And with new advances, surgery doesn’t necessarily mean leaving scars behind that serve as a visible reminder of cancer.

Tucson Medical Center is a Hidden Scar Center, with demonstrated expertise in surgical techniques that minimize scarring while retaining effective oncologic results.

Through Hidden Scar, surgeons make incisions in a location that’s harder to see so the scar is less visible. Advanced tools and technology make it easier for surgeons to make small incisions and reduce the risk of complications, all while keeping as much healthy breast tissue as possible.

“It’s important to me to individualize the care my patients receive,” said breast surgical oncologist Michele Boyce Ley. “For many women, scars do matter.  They can impact clothing choices, self-confidence, self-esteem, intimacy, and other important factors of daily life. Through Hidden Scar techniques, women can have surgical treatment that not only offers the best clinical outcomes, but provides the best aesthetic outcome as well.”

One option to consider is whether a nipple sparing mastectomy might be appropriate. “This technology facilitates preservation of the nipple for a more natural appearance after mastectomy,” said Boyce Ley, a fellow-ship trained surgeon.

Because every cancer is different, it’s important to discuss options with your physician and surgeon, based on the size and location of the tumor.

“Sometimes, we need a creative solution; I take a lot of pride in finding the solution that best matches the needs of each patient,” said Boyce Ley.

 

Technology puts Tucson Medical Center at the center of complex cancer care

image3Cancer is often anything but a textbook disease.

Thoughtful deliberations go into each case: Is surgery an option? Should radiation and/or chemotherapy be considered? If so, in which order and for what duration?

When a case isn’t straightforward, it helps to bring a multidisciplinary team of experts together to review images and discuss the best treatment options.

And thanks to technology, physicians practicing here at Tucson Medical Center are now a part of the discussion with Mayo Clinic physicians through eTumor Boards via something akin to a WebEx on steroids.

Tucson Medical Center’s position as a member of the Mayo Clinic Care Network provides physicians with the ability to consult with Mayo Clinic specialists, as well as participate in multidisciplinary discussions regarding complex cancer cases.

And now, working with experts across the country, physicians have a dedicated room where they can share slides on an 80-inch screen with enough detail and definition to determine the best approach for each unique patient – all while having face-to-face conversations on a another screen.

The space, which accommodates 15 participants, also features high-definition screens at each individual station that allow the user to toggle back and forth between a speaker and the slides.

Scott Marshall, a manager of information services at TMC, thanked Mayo Clinic for its work with TMC on the eight month project. “Building a room like this is extremely intricate. We must have robust audio and video capabilities, while ensuring the information is encrypted and secure. The Mayo technicians were instrumental in guiding us through this project as we worked together to provide a mechanism for stronger collaboration that will improve outcomes for patients.”

Stephanie Boreale, the senior director of ambulatory services at TMC, said the facility supports best practices, since tumor boards are associated with improved clinical outcomes and patient satisfaction. “The ability to conduct video conferencing will facilitate the engagement of providers in discussions of cases, improving coordination and strengthening patient care.”

Breast cancer – what men need to know

shutterstock_325524227October is awesome! The baseball and football seasons are both thumpin’. The NFL just got into gear, and MLB is ramping up for the World Series. We’re talking Heath Miller, Deangelo Williams, Matt Kemp, Drew Brees, Richard Sherman, Anthony Rizzo and more! OK, where’s the remote and the chips?!

October is also awesome because it is Breast Health Awareness Month, and the athletes mentioned above are all taking part in supporting it. Guys, this should remind us all that men have a part in supporting breast health awareness.

“Hold up! I don’t have to worry about breast cancer; I’m a dude.” If that is your attitude, then you are wrong in two ways.

One: Men can get breast cancer. More than 2500 men are diagnosed with breast cancer every year. Two:  Breast cancer doesn’t affect just one person, it affects everyone around her. Whether it’s your mom, sister, friend, cousin, wife or daughter, their health and wellbeing are a part of your life. How serious could this be? Breast cancer is the most common cancer among women and a leading cause of cancer-related deaths in women.

“Got it; I’ll get out my pink t-shirt and pull on a pink bracelet. Done.” That’s great bro, but we can take the support up a notch.

No need to research for weeks or try to mansplain every detail. Knowing the basics and being able to thoughtfully answer some questions will help support her in making decisions about her own health. And it shows we care – because we do.

Here are a few things guys should know about breast cancer:

  • Early detection can save lives. Getting a regular mammogram is the best way to detect cancer early. At what age, and how often should a woman get a mammogram? Every woman is unique and should assess her risk and discuss preventative measures with her doctor.
  • Mammogram: OK, everybody has probably heard this term, but what it is exactly? It is an x-ray of the breast. There have been a lot of advancements in mammography. Digital and 3D mammography create clearer images for better detection. Just so ya’ know fellas, the breast has to be compressed and it isn’t fun.
  • Symptoms: Breast cancer has many symptoms other than a lump. Itching, redness, swelling, dimpling, clear or bloody discharge can all be symptoms of breast cancer. If a woman is experiencing these symptoms, she should consult her doctor.
  • There is more than one type. There are many forms of breast cancer, and there are varied treatments depending on the type of cancer and the age of the patient.
  • There is hope: There has been a dramatic increase in breast cancer survivability rates in the past 40 years. New tests, targeted drugs and early detection are making a difference. While one in eight women will be diagnosed with breast cancer, the five-year breast cancer survival rate is 90 percent, up from 75 percent in 1975.

Men are becoming more knowledgeable and involved in breast cancer awareness – and that rocks! We care and we want to be supportive.

The information is out there and easy to access. So guys, let’s browse these links and get the information that will help us be supportive this month, and the whole year-round.

Additional resources:

Susan G. Komen

Susan G. Komen Arizona

National Breast Cancer Foundation, Inc.

Breastcancer.org

Breast Cancer Research Foundation

American Breast Cancer Foundation

Foundation for Women’s Cancer

American Cancer Society

Centers for Disease Control and Prevention

If you have any concerns or questions, please feel free to contact the TMC Breast Center at (520) 324-1286 or email breast.navigator@tmcaz.com.

breast-center

 

Medical insurance covers annual mammography screening as a preventative service, and grant funds allow TMC to offer mammograms for uninsured women age 40 and over. To make an appointment, call (520) 324-2075.

New non-invasive colon cancer screen hits the market; is it better than a colonoscopy?

colon cancer awareness true or falseA new home-based screening test for colon cancer has recently hit the scenes. Cologuard or stool DNA testing was approved by the U.S. Food and Drug Administration this past August and is covered by Medicare.

The test looks for cancer-related DNA and red blood cells in a person’s stool. On the one hand, it doesn’t require the unpleasant preparation that is needed for a colonoscopy. But on the other hand, the $600 cost, which is not yet covered by private insurers, is much greater than the $25 it costs for a more basic fecal occult blood test, also called a FIT test.

colon cancer awareness ribbom“It’s a good test. It’s better than the stool occult blood test. Cologuard detected 92 percent of colorectal cancers and 42 percent of advanced adenomas, or polyps, in the study population, while the FIT screening test detected 74 percent of cancer and 24 percent of advanced adenomas. But it’s a very new test,” said Fadi Deeb, M.D., a local gastroenterologists, who also serves as TMC’s section chief for gastroenterology, “and we don’t know how often we should do it, every two years, every three years, or every five years? Intervals have not been tested, so we just don’t know.”

Given its $600 cost, which is equal to 24 FIT tests, it would be interesting to see a study comparing one Cologuard to 20-24 consecutive FIT tests over a period of one to three years, in detecting colon cancer and advanced adenomas. Dr. Deeb said.

It is not currently recommended as a method to screen for colorectal cancer by the United States Preventive Services Task Force. The USPSTF recommends adults age 50 to 75 who are at average risk for colon cancer to be screened using fecal occult blood every year, a sigmoidoscopy every five years plus stool occult blood every three years, or colonoscopy every 10 years.

Dr. Deeb said the new test had its limitations. “You can’t use it if you have a personal history of colon polyp, colon cancer, a family history of colon cancer, ulcerative colitis, Crohn’s disease, familial adenomatous polyposis or bleeding hemorrhoids.”

Cologuard was not test directly against colonoscopy for screening. “Colonoscopy is the gold standard” and is more effective in detecting precancerous polyps, which can be removed during the same procedure. Regular screening for and removal of these polyps with a colonoscopy can reduce a person’s risk of developing colorectal cancer by up to 90 percent.

This new test has a false-positive rate of about 13 percent, meaning those people will likely need to undergo a colonoscopy to rule out cancer.

“The test is an option for certain patients who don’t like invasive procedures or for those who can afford it,” he said.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461