breast cancer awareness 2014

NO REGRETSAt 33 years old, Toni Bieser learns she has an aggressive form of breast cancer.

Mediterranean Diet BenefitsIt’s Breast Cancer Friendly!

5 EXAM MUSTS

Working through diagnosis

Cancer Commandments

Coping with emotions

PLUS!+++

A BRAINERD DISPATCH PUBLICATION. OCTOBER, 2014

CancerAwarenessBreast

www.accracare.org

THERE’S NO PLACELIKE HOME.We’ll help you stay there.

Call Our Brainerd Office at 218-270-5905 or 1-866-935-3515

WE’RE A HOME CARE AGENCY PROVIDING:••

••

Skilled Nursing

Psychiatric Nursing

Consumer Directed Community Support Options (CDCS)

Personal Care Assistance (PCA) Services

Supporting Breast Cancer Awareness Month

Breast Cancer Awareness • October 2014 3

To our readers,

This Breast Cancer Awareness publication is especially dear to our This Breast Cancer Awareness publication is especially dear to our

hearts as our feature is a woman from right here in the lakes area, hearts as our feature is a woman from right here in the lakes area,

Toni Bieser. We are very grateful that she has shared her story. It reminds Toni Bieser. We are very grateful that she has shared her story. It reminds

us that even young women need to be aware and proactive when it comes us that even young women need to be aware and proactive when it comes

to early detection of breast cancer.to early detection of breast cancer.

We are also very pleased for the wonderful content contributions that We are also very pleased for the wonderful content contributions that

were gathered and submitted to us by our sponsors. Including: (in order of were gathered and submitted to us by our sponsors. Including: (in order of

appearance) Essentia Health, Unity Family Healthcare and Lakewood appearance) Essentia Health, Unity Family Healthcare and Lakewood

Health Care System. We really appreciate and their time and effort in putHealth Care System. We really appreciate and their time and effort in put-

ting these stories together and those that were featured.ting these stories together and those that were featured.

Contents Breast Cancer Awareness ‘14

Special TributesSpecial Tributes

Features:Mediterranean Diet ............. 6By Bev Bennett

No Regrets ............................. 12By Jodie Tweed

I Wish I Knew ......................... 20By Dawn Klingensmith

In this editionCopingAnxious Aftermath ....................... 4FoodSuper Vitamin D ........................... 7 Food Fight .................................... 8TreatmentWorking Through Diagnosis ........ 9PreventionExam Tips .................................... 16SurvivorsCancer Commandments ........ 18

From our sponsorsPink Ribbon Cupboard ............... 5By Essentia Health

Test of Strength ........................... 10By Essentia Health

Teaming Up ................................ 17 By Patrick RiouxA Reason To Shave My HeadBy Lakewood Health System

Breast Cancer Awareness is an annual publication of the Braienrd Dispatch. Questions or comments, please email [email protected]

Publisher: TIM BOGENSCHUTZAdvertising Manager: SUSIE ALTERS Marketing Coordinator: LEO MILLER

Art Director: LISA HENRY

“In Honor of Toni”

We support Breast Cancer Awareness

001141110r1

001142

365r1Pequot Lakes

218.568.4473Pequot Lakes

218.568.4473Pequot Lakes Crosslake

218.692.4472LakesStateBank.comMember FDIC

In Memory of Karen O’Brien

and Missy Netzeland Missy Netzel

Sincerely,

4 Breast Cancer Awareness • October 2014

AftermathAftermathanxiousCOPING

BY MATTHEW M. F. MILLERCTW Features

C ancer treatment is a full-time job, an all-encompassing experience that changancer treatment is a full-time job, an all-encompassing experience that chang-

es lives forever. And, since it is such a challenging event both emotionally and es lives forever. And, since it is such a challenging event both emotionally and

physically, it’s easy to assume that when cancer treatment ends for those who ysically, it’s easy to assume that when cancer treatment ends for those who

have had to endure it, the reaction immediately following the last treatment would be have had to endure it, the reaction immediately following the last treatment would be

immense relief. After all, to those of us who have watched someone we love experience immense relief. After all, to those of us who have watched someone we love experience

cancer, it’s a big relief when it’s “over.”cancer, it’s a big relief when it’s “over.”

The reality, however, is different. For cancer paThe reality, however, is different. For cancer pa-tients, it’s not over and, according to Dr. Lynne tients, it’s not over and, according to Dr. Lynne Wagner, director of the supportive oncology Wagner, director of the supportive oncology program at the Robert H. Lurie Comprehenprogram at the Robert H. Lurie Comprehen-sive Cancer Center at Northwestern Memorial sive Cancer Center at Northwestern Memorial Hospital in Chicago, finishing treatment can be a Hospital in Chicago, finishing treatment can be a relief tempered with anxiety but it can also cause relief tempered with anxiety but it can also cause some patients to be depressed. “It’s somewhat insome patients to be depressed. “It’s somewhat in-dividual, from a research perspective,” Dr. Wagdividual, from a research perspective,” Dr. Wag-ner says.

Christie Rigg, El Cerrito, Calif., a breast cancer Christie Rigg, El Cerrito, Calif., a breast cancer therapist and survivor herself, notes that when therapist and survivor herself, notes that when someone is diagnosed with cancer, “Life becomes someone is diagnosed with cancer, “Life becomes incredibly busy. It’s like your job is dealing with incredibly busy. It’s like your job is dealing with the cancer,” she says. “I said cancer should come the cancer,” she says. “I said cancer should come with a secretary—you’ve got appointments, surwith a secretary—you’ve got appointments, sur-geries, chemo, biopsies, bills – and everything else geries, chemo, biopsies, bills – and everything else needs to keep going.” As a result, she says, a lot of needs to keep going.” As a result, she says, a lot of the women she works with don’t begin to process the women she works with don’t begin to process their emotions until treatment ends and those their emotions until treatment ends and those feelings bubble up.

Additionally, with all those appointments Additionally, with all those appointments comes a built-in support system that cuts off cold comes a built-in support system that cuts off cold turkey, Dr. Wagner says. “You’re getting good supturkey, Dr. Wagner says. “You’re getting good sup-port from the medical team and coming in every port from the medical team and coming in every day,” she says. “Then you transition from regular day,” she says. “Then you transition from regular contact and a lot of patients are left out on their contact and a lot of patients are left out on their own.” Further, there’s the follow-up looming out own.” Further, there’s the follow-up looming out there and between treatment and that appointthere and between treatment and that appoint-ment there can be a sense of helplessness because ment there can be a sense of helplessness because

patients are no longer “actively” fighting cancer. Fear of the unknown results of all this treatment also compounds these other emotions.

Both Rigg and Dr. Wagner stress to the pa-tients they work with that feeling any of this and more is completely normal. Just as each cancer and treatment plan is individual, so is the range of emotions one may feel about finishing and at-tempting to resume “normal” life. Rigg finds that women who share their stories in groups realize quickly they are not alone in these feelings.

Reconnecting with social networks, exercise, and taking stock of priorities going forward can all help patients during this transition. Making healthy lifestyle choices can also empower pa-tients to feel more “in control” of their situations during this time. Dr. Wagner says advocacy work can also be helpful, whether fundraising, counsel-ing or volunteering with a cancer organization.

It’s important to realize that cancer is a life-changing event and because of that, patients are “really going through a grieving process,” Dr. Wagner says. “Part of that loss is that the view of themselves has changed—their view of a vibrant healthy person and they’re reminded of mortality. That’s quite a loss.” © CTW Features

After cancer treatments end, many patients experience a range of emotions – and not

all of them are happy

FREE book to help patients deal with the emotional trauma that follows cancer treatment. View it online at:www.cancer.gov/cancertopics/life-after-treatment

GET IT!


T here is a cupboard that

can ease troubled minds

and lift heavy hearts. Some-

times it even answers prayers.

And this cupboard is never

bare, thanks to the generos-

ity of local donors.

The Pink Ribbon Cupboard provides emergency financial assistance to people undergoing breast cancer treatment. The goal is to reduce some of the stress en-countered by families after a breast can-cer diagnosis, explains Kathy Buxton, a breast cancer survivor who created the cupboard.

When Kathy was diagnosed with breast cancer in 1996, she felt the amaz-

ing support of her husband, Bruce, her family and friends. “It really hit home to me: What if you didn’t have that sup-port?” she recalls. “I was too sick to care for myself. I was too sick to work, but for myself. I was too sick to work, but fthe bills would still come in.”

The Pink Ribbon Cupboard helps families with non-medical needs, such as gas vouchers for travel to treatment, rent and mortgage payments and help with grocery, telephone and utility bills. It has even replaced a furnace in the middle of winter. Nearly 250 families have been helped since the nonprofit project was launched in 2010, Kathy says.

“We relieve a financial stress so you can concentrate on getting better,” Kathy explains. “We let you know that someone cares.”

Getting a cancer diagnosis can be devastating, says Marian Foehrenbacher, a long-time cancer nurse who serves as

manager of the Essentia Health Cancer Center at St. Joseph’s Medical Center. A visit from a representative of the Pink Ribbon Cupboard offers help and un-derstanding, she says.

“We ask how they’re doing and ask how we can help,” explains Marian, who serves on the cupboard’s board of direc-tors with Buxton and Sue Beck, another breast cancer survivor.

Every dollar donated to the Pink Rib-bon Cupboard stays local and goes to local families, Kathy says. The cupboard serves all breast cancer patients in treat-ment in Cass, Crow Wing and Aitkin counties.

“We live in an incredible community and the support for the Pink Ribbon Cup-board has been unbelievable,” Kathy says.

For more information, call Kathy at 218.829.6205, Marian at 218.454.5850 or Sue at 218.829.7254.

Pink Ribbon Cupboard

From Left: Sue Beck, Kathy Buxton and Marian Foehrenbacher serve on the board of Pink Ribbon Cupboard, funded by United Way and Susan G. Komen Minnesota.

SPONSORED CONTENT

How you can help? Attend the annual Pink Tie Party. All proceedes benefit breast cancer patients.


DIRECTIONSLightly oil pizza crust on both sides using olive oil. Put chicken and vegetables on pizza dough as desired. Sprinkle generously with crumbled feta cheese. Drizzle with balsamic vinaigrette, and sprinkle chopped fresh basil over pizza to taste.Place it in the center of your barbecue’s cooking grids. Turn all burners to high and preheat grill to 400-600m F. Reduce temp. to medium/medium-high to maintain a temperature around 450m F.

Using a well-floured pizza peel, slide the un-cooked pizza onto the pizza stone.Check the pizza frequently -depending on thick-ness of crust, this will take between 8 and 20 minutes. Pizza is ready when cheese has melted and bottom is browned. Remove from pizza stone with the wooden pizza peel.Allow stone to cool completely before removing Allow stone to cool completely before removing from grill.

(MS) - Taken from the new edition of the Griller’s Handbook (by Broil King), this recipe provides an excellent base for grilled pizza, with options to change toppings for your flavor preference. More recipes and information can be found online at www.broilkingbbq.com.

INGREDIENTS• 1 pizza crust (thin homemade or pre-made)• 1 boneless chicken breast (pre-grilled)• 200 grams feta cheese• Kalamata olives - remove pits• Sun dried tomato• Red onion• Fresh basil• Balsamic Vinaigrette• 3 T. olive oil • 3 T. balsamic vinegar• Crushed chopped garlic to taste

Mediterranean Thin Crust Pizza

FOODW

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Dai

ly Poultry, Cheese, Eggs, Yogurt

Lim

ited

Meats and sugars

grids. Turn all burners to high and preheat grill to 400-600high to maintain a temperature around 450

Twic

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Wee

k + Fish, Seafood

Ever

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Fruits, Vegetables, Grains (mostly Whole), Olive Oil, Beans, Nuts, Legumes, Seeds, Herbs and Spices

MediterraneanDiet

Mediterranean Food Grid

MediterraneanMediterraneanMediterraneanMediterraneanMediterraneanMediterraneanMediterraneanMediterraneanMediterraneanMediterranean

BREA

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Following a healthy Mediterranean diet may improve your emotional state as well as your physical one.

The Mediterranean diet has long been linked to decreased risk of developing can-cer. Eating whole grains, vegetables, fruits and olive oil, with a moderate intake of fish may lessen the likelihood of developing clini-cal depression, a side effect often experi-enced by breast cancer patients and survi-vors.

Researchers looking at the dietary pat-terns of seniors for more than a decade, dis-covered that adhering to the Mediterranean diet was inversely related to developing de-pressive symptoms over time, according to a study published in The Journal of Nutrition, Health & Aging.

As with other studies, researchers looked

at food groups, not specifically ingredients grown in Mediterranean countries.

“It was a Midwestern version of the diet,” writes Kimberly A. Skarupski, Ph.D., lead au-thor on the study, in an email interview.

Her research suggests that the Mediterra-nean diet may be beneficial to mental health because it supplies B vitamins that play an important role in the synthesis of neurotrans-mitters that affect mood.

In addition, the antioxidant-rich diet may protect cells from oxidative damage.

Is it possible that the Mediterranean diet, which is as delicious as it is wholesome, pro-vides pleasure as an antidote to depression?

“We did not measure the ‘pleasure factor.’ I would think that taking the time to enjoy anything [food] would be good for depres-sion,” says Skarupski, assistant dean for fac-ulty development, Johns Hopkins University School of Medicine, Baltimore, Md.

By BEV BENNETTCTW Features

Antidote to Depression?

Researchers find that adhering to the

Mediterranean diet may stave off developing depression symptoms

over time.

Super Vitamin D“Vitamin D helps prevent tumors from growing.”

Women with breast cancer who have high levels of vitamin D in their blood have significantly higher survival rates than women with low levels, according to re-searchers who analyzed five studies with thousands of patients.

This recent study from the University of California San Diego is one of several showing an association between breast cancer protection and vitamin D, found in fatty fish, and which the body makes when the skin is exposed to sun. What’s the con-nection between cancer and vitamin D?

“Vitamin D helps prevent tumors from

growing,” says Dr. Cedric F. Garland, fel-low,

American College of Endocrinology (F.A.C.E.), professor, Department of Fam-ily and Preventive Medicine and Moores

UCSD Cancer Center, University of Cali-fornia San Diego, La Jolla, Calif.

Even so, any recommendation to con-sume more vitamin D for an anti-cancer benefit is controversial. There’s still a question of whether vitamin D is an active cancer fighter or an indication of some as-pect of a healthy lifestyle.


~ Dr. Cedric F. Garland

Breast Cancer Awareness October 2014 7

Get Your Vitamin D• 10 minutes in the sun, either an hour before or after noon, expos-ing 40 percent of your skin to sunshine, says Cedric F. Garland, Dr.P.H.• Eat foods rich in vitamin D. Salmon, tuna and mackerel are high in vitamin D. Fortified milk, soy milk, orange juice and breakfast ce-reals are also good bets. Dietary supplements are also an option.

Recommended AllowancesAge 71 or under - recommended allowance is 600 International Units (IU) of vitamin D daily. Age 71 or older - increase to 800 IU daily according to the Institute of Medicine, an arm of the National Academy of Sciences. (The IOM assumes people are getting a minimal amount of sunshine.) Garland recommends all women get 1,000 IU of vitamin D daily. But don’t overdo it. The safe upper limit for vitamin D is 4,000 IU a day, according to the IOM.

Testing Your Vitamin D Levels“If you’re a woman you should talk to your physician about get-ting your vitamin D levels checked. It should be the center of a well-woman visit,” Garland says, suggesting the end of winter, when you’ve been sun-deprived, as the best time for testing. © CTW Features

GET IT!


FOODFIGHT

FOOD

T he foods we eat contribute directly to our overall health. The foods we eat heavily influ-ence how healthy or unhealthy we become.

Some foods can even reduce our risk for cer-tain diseases, including cancer. According to the American Institute for Cancer Research, numer-ous studies have demonstrated that individual minerals, vitamins and phytochemicals have cer-tain anticancer properties that can protect men, women and children from this potentially deadly disease. The following are a handful of foods the AICR says could fight cancer and help improve overall health.

FOOD Walnuts Nuts are often cited in discussing foods with an-ticancer properties, but the AICR notes that wal-nuts are the most heavily researched. Despite research, the AICR remains hesitant to draw any conclusions with their potential link to lowering cancer risk. Several studies of mice found that consuming walnuts decreased the growth of breast and colon tumors among mice who ate walnuts as opposed to those who did not. Studies into the impact of the Mediterranean diet, which includes walnuts, have shown that such a diet can help people lose fat and lower their blood pressure and triglycerides. But the AICR still notes the need for more research into walnuts before they can be considered foods that fight cancer.77Excess body

fat increases a person’s risk

for seven types of cancer.

GrapefruitHalf of a medium pink, red or white grapefruit pro-vides at least 50 percent of an adults’ daily rec-ommended intake of vitamin C. Research into the potential anticancer properties of grapefruit for humans is ongoing, but studies of animals and cells show that grapefruit powder as well as limo-nin and naringenin, two phytochemicals found in grapefruit, decrease the growth and increase the self-destruction of breast, colon, lung, mouth, skin, and stomach cancers.

CherriesCherries are also great for fiber and vitamin C. Sweet and tart cherries also contain potassium. Cherries get their dark color from anthocyanins, antioxidants that protect cells from damage. Studies have shown that anthocyanins inhibit the growth of cancer cells and even stimulate their self-destruction while having no negative effects on healthy cells.

ApplesGreat source of vitamin C. One apple provides at least 10 percent of the recommended daily amount. Great source of fiber, which can help maintain a healthy weight. A major portion of apples’ dietary fiber is pectin, a polysaccharide that bacteria in the stomach uses to produce compounds that protect colon cells.

More information about the link between diet and cancer is avail-

able at www.aicr.org.


TREATMENT

Breast cancer statistics

paint a staggering

picture of a disease

that will impact the lives of

everyone. According to the

American Cancer Society,

235,030 Americans will be di-

agnosed with breast cancer

in 2014, and 40,430 will die

from the disease. What gets

lost in these raw numbers,

however, are the issues that

extend far beyond over-extend far beyond over-extend far beyond over

coming the disease itself.

A new study out of the University of Michigan, Ann Arbor, found that nearly one-third of breast cancer sur-vivors that were employed when they began cancer treatment were unem-ployed four years later. Women who received chemotherapy were the most likely not to be working.

The study surveyed 746 working

women at the time of early-stage breast cancer diagnosis, and then followed up four years later. Thirty percent of those women were no longer working at the time of the follow-up, 55 percent of those women said it was important for them to work and 39 percent were ac-tively seeking employment.

“Many doctors believe that even though patients may miss work dur-ing treatment, they will ‘bounce back’ in the longer term. The results of this study suggest otherwise,” says lead study author Dr. Reshma Jagsi, associ-ate professor of radiation oncology at the University of Michigan Medical School. “Loss of employment is a pos-sible long-term negative consequence of chemotherapy that may not have been fully appreciated to date.”

With higher numbers of chemother-

“Loss of employment is a possible long-term negative consequence of chemotherapy.”

apy patients reporting unemployment, researchers say it is possible that the need to take off time from work during the treatment could lead to long-term employment issues.

Aside from employment issues, many breast cancer survivors reported overall financial hardships, with 25 percent of women saying they are worse off finan-cially than the were pre-diagnosis.

“As oncologists, we are proud of the advances in our ability to cure an in-creasing proportion of patients diag-nosed with breast cancer. But as treat-ments improve, we must ensure that we do not leave these patients in financial ruin because of our efforts,” Jagsi says.

Race had a major impact on the findings, as Spanish-speaking Latinas were the most likely to be impacted, with debt more likely to be reported by

English-speaking Latinas and Blacks than by Whites.

According to the study, other impor-tant factors that made a woman more likely to experience these hardships include: age less than 65, household income less than $50,000, part-time work at diagnosis, reduced work hours after diagnosis, lack of substantial pre-scription drug coverage, breast cancer recurrence and undergoing chemo-therapy.

“These patients are particularly vul-nerable to financial distress,” Jagsi says. “We need to ensure appropriate communication between patients and their doctors regarding the financial implications of a cancer diagnosis and treatment decisions to help reduce this long-term burden.” © CTW Features

through diagnosisWorking

BY MATTHEW M. F. MILLERCTW Features

Besides employment issues, survivors reported overall financial hardships

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W hen she learned she had breast cancer, Tina Hauck’s first reaction was a common one.“My mind went blank,” she recalls. “You

hear about other people who have cancer. Then I realized it’s me we’re talking about.”

CANCER CENTER EARNS ACCREDITATIONS

The Essentia Health Cancer Center at St. Joseph’s Medical Center and its Breast Center have earned two national accredi-tations that recognize their high level of care.

The Cancer Center has been accredited as a Community Cancer Program by the Commission on Cancer, which is a pro-gram of the American College of Sur-geons. The designation gives local patients access to new treatments, medications and medical devices that are part of clinical trials. The work is part of the Essentia In-stitute for Rural Health’s commitment to cancer prevention and treatment research. The Brainerd center was first accredited in 2008.

The Breast Center has been accreditated by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. The designation recognizes Es-sentia Health’s commitment to providing the highest quality care for patients with breast disease and breast cancer by offer-ing state-of-the-art services and coordi-nation of treatment options by a multi-disciplinary team of specialists. The center was first accredited in 2011.

A leading consumer advocate for wom-en has also named the Breast Center as one of “America’s Best Breast Centers.” The Women’s Choice Award is based on the center meeting standards set by NAPBC as well as patient satisfaction measures collected by the federal Cen-ters for Medicare and Medicaid. Fewer than 300 breast centers across the nation made the cut. Women’s Certified Inc. es-tablished the Women’s Choice Award to help women identify where they can get the best care.

To learn more, call the Cancer Center at 218.828.3113

or go to: EssentiaHealth.org

When the words sunk in, Tina says her next thoughts were clear: “This is a test of my strength. We’ll just get to it.”

The 42-year-old Brainerd woman decided to deal with a cancer diagno-sis in the same way she took on serv-ing in the Air Force, getting a divorce, raising her son and earning a college degree while working. She’d bank on self-reliance to get through her latest life challenge.

“My parents taught us to be self-reli-ant and that we need to work for what we want,” explains Tina, one of five children of Don and Shirley Hauck of Brainerd. “This is just another test for me. I want to be here, and be here for my son.”

“Tina is very strong and determined,” says Dr. Aby Philip, her hematologist/oncologist at the Essentia Health Can-cer Center at St. Joseph’s Medical Cen-ter.

Tina discovered a lump in her right breast last October, shortly before her annual physical with Sue Hadland, a nurse practitioner at Essentia Health’s Baxter Specialty Clinic. Two mammo-grams and an ultrasound found two tumors, one about the size of quarter and another smaller one. A biopsy con-firmed cancer.

At the Essentia Health Cancer Cen-ter, Tina found Patient Navigator Mis-sy Laposky at her side during all the tests. “Missy was right there beside me the whole time,” Tina recalls. “She an-

swered my questions. Sometimes, she answered my questions before I even asked them because she’s been through this before.”

Tina says Dr. Philip and Nurse Prac-titioner Jessica Nybakken also have taken the time to answer her questions and explain her options. “Dr. Philip is very thorough,” she says. “And if I need anything, I can call Jessica.”

On Nov. 27, Dr. Ross Bengston per-formed a full mastectomy. Tina was re-leased on the morning of Thanksgiving.

Tina was diagnosed with Stage 3 in-vasive ductal carcinoma because cancer was found in nearby lymph nodes. She began the first of two rounds of che-motherapy in January and expects to finish in late June. Radiation therapy comes next.

As Tina began losing her hair, family, friends and co-workers began giving her hats. The hats kept her head warm and also warmed her heart. They came to symbolize the support Tina felt from those around her.

“Tina is an exceptional patient – she’s filled with kindness. She has a good heart and a gentle soul,” says Marian Foehrenbacher, the Cancer Center’s manager. “Tina continues to live her life as a mother and do normal things. She keeps that balance while having cancer. She’s an inspiration to our unit.”

Tina has continued to work as a se-nior tech support specialist at Ascen-sus, taking off the days she has chemo-

therapy. “My co-workers keep telling me how strong I am,” she says. Re-cently, Tina and a handful of employees whose lives have been affected by can-cer formed a a support group at work.

Tina is grateful that she has been able to receive care close to home. As the single parent of 16-year-old Tristan, she appreciates that she didn’t have to leave home to get treatment.

“It’s so helpful that everything is here in Brainerd. I can stay at home and stay at work,” Tina says. “I don’t have to take a day off to travel for chemo and I don’t have the travel expenses or hotel expenses.”

To help improve care for other breast cancer patients, Tina participated in a clinical trial. “She looks for the best outcome possible for herself and future breast cancer patients,” Foehrenbacher says. “Tina has gentle strength and a positive attitude.”

SPONSORED CONTENT

Test of Strength

Tina Hauck wearing one of the hats she received as encourage-

ment from family and friends and her son, Tristan.


Essentia Health’s cancer experts are here to make sure that the best care is available close to home, family and friends. For an appointment call 218.828.3113.

Dr. Laura Joque

Learn more at EssentiaHealth.org

EssentiaHealth.org

Essentia Health’s cancer experts are deeply committed to caring for cancer patients in the Brainerd Lakes Area. From participating in community events to raise awareness about the importance of cancer screenings to raising money that directly impacts the patients we care for, we are here with you in every way.

Our team consists of oncology and hematology providers, specialized surgeons, radiologists and pathologists, dieticians, specialized nurses and therapists, a nurse navigator, social worker, clinical research nurse, and so many more. We understand that patients want personalized care and we are here to make sure that the best care is available close to home and close to family and friends.

The Essentia Health Cancer Center team continues to demonstrate a commitment to delivering the highest level of cancer care to patients and families. Our Center is certified, accredited and recognized by the following:

When it’s cancer, we’re here with you every day. Close to home.

From left to right:Missy Laposky, RN, BA, OCN;Laura Joque, MD; Barb Morris, RN, BSN, OCN; Aby Z. Philip, MBBS andJessica Nybakken, AOCNP

“You hear about other people who have cancer. Then I realized it’s me we’re talking about.”

EssentiaHealth.org






– Tina Hauck, Brainerd

Tina discovered a lump in her right breast in October 2013. A biopsy confirmed cancer.

At the Essentia Health Cancer Center, Tina found Patient Navigator Missy Laposky at her side during all the tests and treatment. As Tina began losing her hair from the chemotherapy, family, friends and co-workers gave her hats. The hats kept her head warm and also warmed her heart.

Tina is grateful that she has been able to receive care close to home. As the parent of 16-year-old Tristan, she appreciates that she didn’t have to leave home to get treatment. “I want to be here, and be here for my son,” states Tina.

Dr. Anusha Madadi Dr. Aby Philip Missy Laposky, RN, BA, OCN

Jessica Nybakken, AOCNP

EssentiaHealth.org






EssentiaHealth.org







While nursing her second daughter, Sophia, who was born in September 2011, Toni Bieser noticed a strange, painless lump in her left breast.

Since she was breastfeeding, she figured it was probably a clogged milk duct. But when she stopped nursing a couple months later and the lump didn’t go away, she realized she should probably see her doctor.

Understandably, it took her a couple of months to make that doctor’s ap-pointment. She was a busy woman. She was living in Hopkins at the time and commuting a few days a week to her new job as an accountant at Hy-Tec Construction in Brainerd.

She and her husband, Jamie, were in the process of relocating to the Brainerd lakes area. They also had young daughters, Isabella and Sophia, born 18 months apart.

In early May she made an appointment with her obstetrician/gynecolo-gist, who also thought the lump could be related to breastfeeding. To find out, she was referred to the Jane Brattain Breast Center in St. Louis Park out, she was referred to the Jane Brattain Breast Center in St. Louis Park out,where she underwent tests, including a mammogram.

Toni was working in Brainerd when she received a call that no one, es-pecially a 33-year-old mother of an infant and toddler, would want to hear.

“They said it was cancer. I went outside to take the call and I just broke

Toni Bieser, a Brainerd wife and mother of two young girls, had much to lose

when she was diagnosed with an aggressive form of breast cancer at 33. But losing her breasts was a choice she made easily.

BY JODIE TWEEDFeature Writer

Toni Bieser and husband Jamie with their two daugh-

ters Isabella, 4 (left) and Sophia, 3.

Her husband accompanied her to her first appointment, and every appointment that

followed until her last.

PHO

TOS

BY K

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Y

NoRegrets


down,” Toni said. The breast cancer coordown,” Toni said. The breast cancer coor-dinator who broke the news to her was dinator who broke the news to her was kind and cokind and compassionate, telling her that they would get through this together. they would get through this together. The cancerous tumor was ductal carciThe cancerous tumor was ductal carci-noma in situ, or a type of breast cancer noma in situ, or a type of breast cancer found in the milk duct. ound in the milk duct. found in the milk duct. f

Toni then called her husband to break Toni then called her husband to break the news, and then went inside to talk to the news, and then went inside to talk to her mother, who is a co-owner at Hy-Tec her mother, who is a co-owner at Hy-Tec Construction. Her sister drove her down Construction. Her sister drove her down to the Twin Cities that night for her to the Twin Cities that night for her early morning appointment. Her husearly morning appointment. Her hus-band accompanied her to that first apband accompanied her to that first ap-pointment, and every appointment that pointment, and every appointment that followed until her last. ollowed until her last. followed until her last. f

The good news was that the aggressive The good news was that the aggressive form of breast cancer was contained to form of breast cancer was contained to the duct. Unfortunately, it was also large, the duct. Unfortunately, it was also large,

meaning that there was a possibility that sometime soon the tumor could break through the wall of the duct and spread.

Toni was given options of undergoing a lumpectomy or a mastectomy, but she had quickly made up her mind what she wanted to do. She wanted a double mas-tectomy to eliminate the chances that the breast cancer could develop in her healthy, right breast.

“I didn’t want to go through the pro-cess twice,” Toni said, of battling breast cancer. “Get rid of them. That’s all I could think about it. My breasts don’t define who I am, which is why I wasn’t scared to lose them.”

Two weeks later on May 21, 2012, Toni underwent a double mastectomy at Park Nicollet Methodist Hospital in St. Louis

”My breasts don’t define who I am, which is why I wasn’t scared to lose them.”

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Park. At the same time, her surgeon placed spacers in her chest to begin the process of breast recon-struction. The tumor found within her duct was 11 centimeters long when it was removed. When she was able to return home, her sister, Jolie Bray, a reg-istered nurse, stayed with her and helped care for her. She received a lot of support from family and friends, who also helped care for her young daugh-ters when she couldn’t hold or lift them herself.

Although she felt she had made the right decision Although she felt she had made the right decision Although she fto have both breasts removed, it still wasn’t easy to take off her bandages and be confronted with her wounds in the mirror. Over the course of several months, Toni underwent various processes and sur-gical procedures for her breast reconstruction so her surgeon could insert her breast implants.

“The first time the bandages came off, I cried,” Toni said. “I would cry every time the dressings were changed. But you’ve got to keep going. You can’t just curl up in a ball because life is going to go on. You have to move forward; there is no other option.”

She underwent genetic testing to find out if she had the BRCA gene mutation that increases a woman’s chances of developing breast cancer and/or ovarian cancer. She did not have the gene, and she didn’t have a history of breast cancer in her family.

Before she was diagnosed with breast cancer, Toni had participated in the Susan G. Komen Race for the Cure, a fundraising walk/run event that raises funds for breast cancer research, programs and to support women going through breast cancer. She and her family have walked in the Brainerd lakes area event every year since her diagnosis and sur-gery. Toni said she doesn’t walk to benefit herself, but to support the women who may be fighting this battle in the future and to help find a cure. She be-lieves that she is more than two years cancer-free because of the research, programs and awareness of breast cancer that has been the work of people who have walked this path before her.

“That’s how I’m alive,” she said. At 33, Toni was young to be diagnosed with

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The Susan G. Komen Foundation offers a breast cancer toll free hotline that offers free support services and help to find local support groups. That number is (877) 465-6636, or visit the website for additional resources and information at www.komen.org.

Breast cancers discovered in younger women are often more fast-growing and are a higher-grade and hormone receptor-negative. This means that the cancer is usually more aggressive.

Fewer than five percent of all breast cancers diagnosed in the United States are found in women under 40, according to the Susan G. Komen Foundation.

Younger women also struggle with worries about the impact of a diagnosis on their fertility and other factors.

LESS THAN

5%When a woman of any age is diagnosed with breast cancer, it can bring on a wave of emotions, from shock and fear, to denial, sadness and anger.

Breast Cancer in Young Women INFORMATION BY JODIE TWEED

thing, it would be that she would have gone to the doctor sooner.

“If you feel a lump or you’re nursing and you think it’s a clogged duct, get it checked out,” she said.

“Don’t wait like I did.”Her daughters, now 3 and 4, are too young to un-

derstand what their mom has been through, but the girls know that they participate in Race for the Cure to walk for “mommy’s boobies and other ladies’ boo-bies.”

“Race for the Cure, for me, is a celebration that I’m still cancer-free,” Toni said with a smile.

JODIE TWEED is a freelance writer who lives in Pequot Lakes with her

husband and three daughters. exercise

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PREVENTION

Don’t hold back because you think you’ll be judged. If you feel you can’t be honest, get another doctor,” Dr. Fitzgerald says.

3. Your expectationsDon’t be afraid to speak up. “You want

the physician to know what concerns you,” Dr. Sadovsky says. Being forthright helps physicians as well, he says.

4. Follow-through plansAsk your physician what your next steps

should be. These may include treatment for any conditions, screening tests according to your age and risk factors and a review of the test results.

5. Doorknob questionThis is what you bring up when you or

the physician are halfway out the door. “In my practice I would rather have a patient ask and take an extra minute than not,” Dr. Fitzgerald says. It’s easy to play Internet MD, looking up symp-toms for various conditions you’ve self-diagnosed. There are advantages and disadvantages to this, Dr. Fitzgerald says. You could use the informa-tion to take better care of yourself. But if you visit a site that’s not from a credible source, you could be misinformed. Your health professional is likely to commend you on your desire t o be up to date, but then recommend you not get too far ahead or read too much into the symptoms, Massey says.

For guidelines on the frequency of a physical exam and screening tests for your age and gender, visit the National Institutes of Health website at: http://1.usa.gov/PTHNDZ. © CTW Features


“Be clear to say why you’re here. The doctor will explore that.”

~Dr. Richard Sadovskya

TipsExam1. Reason

2. History

3. Expectations

4. Plans

5. Question1.Reason for an appointment

“You may say you’re here for a physical but you probably have an issue,” says Dr. Richard Sa-dovsky, associate professor of family medicine, SU-NY-Downstate Medical Center, Brooklyn, N.Y.

Have ready your list of concerns. It may take more than one visit to address all the concerns,” says Scott Massey, professor of physician assistant studies and program director, Misericordia Uni-versity, Dallas, Pa.

Prioritize – introduce the most urgent health matters first. If you’re unsure, think about any symptoms you experience. Ask yourself whether these are continuous and whether they’re getting worse, says Dr. Christopher Fitzgerald, internal medicine-pediatrics, Cedars-Sinai Health Systems, Cedars-Sinai Medical Group, Beverly Hills, Calif.

“If symptoms are getting worse we have to ad-dress them,” Dr. Fitzgerald says. Physicians will also encourage you to mention symptoms you consider trivial, especially if recurring and bother-some, such as intermittent heartburn.

“There may be a disease lurking under trivial symptoms,” Massey says.

2. Your health historyInclude your medical records, medica-

tions, family history going back to your grandpar-ents and your lifestyle habits, Massey says.

If you’re scheduling your first routine

physical, or first in years, you may antici-

pate a conversation similar to speed dat-

ing. You want your doctor to know as much

as possible about you, but you have a lim-

ited amount of time to share it. In addition,

you may wonder if, as in speed dating, you

should omit a few less appealing facts until

the patient-doctor relationship progresses.

Here are five things physicians want to hear

from you during that first visit.


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and their providers remain vigilant and thorough, in both the diagnosis and treatment of breast cancer. The St. Gabriel’s Hospital imaging department’s mammography program is certified through the Food and Drug Adminis-tration’s Mammography Quality Standards Act (MQSA). Congress enacted MQSA to ensure that all women have access to quality mammography for the detection of breast cancer in its earliest, most treatable stages. The certi-fication attests to the quality of both the equipment and the staff performing the exams. If additional imaging, such as ultrasound, or magnetic resonance imaging (MRI) is required, St. Gabriel’s Hospital has a full complement of quality diagnostics equipment and a patient archive and commuication system (PACS) to send the images to their providers or consulting specialists.

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Teaming UpBy Patrick RiouxUnity Family Health Writer

Do it for Her, and YOU.

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M elanie Young is a take-charge person. In her culinary

public relations role, Young was director of the influen-

tial James Beard Foundation Awards and worked with

major food clients.ajor food clients. When she was diagnosed with cancer in 2009,

she responded in her typical, practical way.she responded in her typical, practical way.

“I called a best friend who had breast cancer and wanted to talk. My second call was “I called a best friend who had breast cancer and wanted to talk. My second call was to my insurance agent,” says Young, author of the prize-winning book, “Getting Things to my insurance agent,” says Young, author of the prize-winning book, “Getting Things Off My Chest” (Cedar Fort, Inc., 2013).Off My Chest” (Cedar Fort, Inc., 2013).

And yes. She cried.And yes. She cried.“You do have a meltdown,” she says.“You do have a meltdown,” she says.But then she mustered her business skills to fight her disease on all fronts.But then she mustered her business skills to fight her disease on all fronts.Her book’s “five cancer commandments to follow” provide valuable health, financial, Her book’s “five cancer commandments to follow” provide valuable health, financial,

personal and professional guidance. She shares her insights in the following question-personal and professional guidance. She shares her insights in the following question-and-answer exchange.and-answer exchange.

COMMANDMENT 1: COMMANDMENT 1: Make a health management planQ: You recommend contacting all You recommend contacting all the health professionals you see, from the health professionals you see, from dentist to dermatologist before you start dentist to dermatologist before you start treatment. Why?treatment. Why?A: YoYou want to discuss best preparations and precautions. Once you start treatment and precautions. Once you start treatment you don’t want to have your teeth drilled. you don’t want to have your teeth drilled. You don’t want to look for a dentist when you You don’t want to look for a dentist when you have mouth sores [certain treatments can have mouth sores [certain treatments can cause painful mouth sores].cause painful mouth sores].Q: What if you don’t have a team of What if you don’t have a team of health professionals?health professionals?A: If you don’t have physicians lined up, If you don’t have physicians lined up,

you can find them. I added an eye doctor.

COMMANDMENT 2: Know how your health insurance coverage works and how you will pay for your treat-ment.Q: You’re faced with many treatment options, some of which may be very expensive but not covered by your insurance. How do you decide what’s appropriate? A: Learn to question everything. It comes back to the $4,000 shot. It’s a shot that

Commandmentsommandments

“You do have a meltdown.”

By BEV BENNETTBy BEV BENNETTCTW FeaturesCTW Features

Cancer SURVIVORS


boosts white blood cells. Some insur-ance doesn’t cover it. Ask why it’s necessary. In my case the $4,000 shot was covered.Q: Do you have any negotiating power for uncovered expenses?A: Get a cancer liaison [person] to help you. I refused treatment until I got it in writing that a $65,000 treatment would be covered. Most people will say and Most people will say and worry about money later. Ask.

COMMANDMENT 3: Organize your recordsQ: I thought electronic health records eliminated the need to have a paper trail. Why is this necessary? A: As someone whose computer lost everything twice, I have all my records electronic and on paper. Also, if my husband needs to access something, he can do so with the paper file.

COMMANDMENT 4: Establish a communications planQ: In this age of Facebook and Twit-ter, what should women consider when it comes to sharing news of their cancer with their social circle?A: This is a personal decision. Some

people share and want people to know. I’m not into oversharing. But it’s impor-tant to define this early on. You want to control the message. You don’t want people to say things about you. Q: What about people you work with?A: Your staff [or your employer] will know something is going on. You have to be honest. [Young closed her public relations business and opened Con-relations business and opened Con-nected Table, a consulting company.]

COMMANDMENT 5: Get informed and ask more questionsQ: You’re urging women to get at You’re urging women to get at Yleast two medical opinions before choosing a course of treatment. Does this include researching the hospital?A: That’s incredibly important. You’re not only getting the physician, you’re getting the hospital and the medical team. Q: What’s your motto on asking questions?A: Ask questions but make your own decisions. There are resources for everything. © CTW Features

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SURVIVORSSURVIVORS

Not every breast cancer patient goes through ot every breast cancer patient goes through

a “Why me?” period, but most reflect back at a “Why me?” period, but most reflect back at

some point and identify knowledge gaps – things some point and identify knowledge gaps – things

they wish they’d known at various stages, from pre-they wish they’d known at various stages, from pre-

diagnosis through treatment and recovery. Here, diagnosis through treatment and recovery. Here,

survivors share those things in hopes of helping survivors share those things in hopes of helping

others facing similar health challenges.others facing similar health challenges.

BY DAWN KLINGENSMITHCTW Features

Wish Knewi i

Dana Manciagli (left), 54, career coach and speaker, New York City

There may be more options out thereThere may be more options out thereMy identical twin, Tracy Frank, and I both survived breast

cancer twice. The third time took Tracy’s life on May 18, cancer twice. The third time took Tracy’s life on May 18, 2014. I’ll speak for Tracy on the things we wished we knew. 2014. I’ll speak for Tracy on the things we wished we knew. Since we had no known family history of cancer, we wished we had known that the BRCA gene (breast-ovarian cancer susceptibility gene) was highest in Ashkenazi Jewish her-itages. We would have gotten tested and known we were BRCA positive. We wish we knew sooner that there are labs that can take a biopsy and indicate the most effective chemo-therapies for a patient’s individual cancer. The tests (called Chemo-Sensitivity Testing or assays) aren’t widely used and you generally have to ask for them.

Bershan Shaw, 40, OWN “Love in the City” docudrama star, New York City (pictured above).Recovery means work – and relaxation

As soon as you get the diagnosis, that means a change needs to hap-pen. It’s a wakeup call. You can’t get sick and keep doing the same thing. We like to take a pill and not do the work. You have to do the work. For me, that involves diet, exercise and “me time” – meditat-ing, journaling or just sitting still with a cup of green tea. “Me time” is part of the work because it’s a productive and worthwhile in-vestment. I wish I’d put this knowledge into practice sooner because stress is so harmful to health.


Wendy Watkins, 47 corporate communications VP, Orchard Park, N.Y. Food need not be dull or agonizing

I wish I had known more about the impact of che-mo on my ability to eat during treatment. My mouth had severe sores and my energy level dropped drasti-cally which meant that proper nutrition was even more

important, but I was unable to eat many foods. Anything acidic or saltyburned my mouth. I had a constant metallic taste and a sore throat so it was difficult to swallow. I was limited to mashed-up, liquefied, bland foods. I have since learned there are other options through my involvement with the Cancer Nutrition Consortium, which offers resources and recipes for people in treatment.

RuPearl Sharpe, 57, account billing specialist, Sharpsburg, Ga. There are holistic treatment providers.Before I went to Cancer Treatment Cen-ters of America, my only option seemed

to be traditional medicine – just the drugs. At CTCA, they round it out with naturopathic care, nutrition, acupuncture, massage, and emotional and spiritual support – a mind-body-spirit approach, with different modes of treatment and everyone working together as a team. I know I needed the chemotherapy to rid my body of the cancer, but the natural remedies really helped with the side effects, and massage with the after effects.

Natalie Skinner, 37, eligibility specialist, Suffolk, Va. Support comes from unlikely places

I was so concerned about telling my kids, but it turns out my 19-year-old

daughter knew more about cancer in general than I did and was able to help me explain it to my son. In fact, it was my daughter who said, when we went in for shots, “Hey, Ma, you might as well say something about that little lump you found.” So she was a huge help from the very beginning. After my diagnosis, she helped me research my options and write down questions for my doctor. She even made it seem like losing my hair was the coolest thing in the world.

Bonnie Hirschhorn, 68, teacher and guidance counselor, Bayside, N.Y. Mammograms aren’t fail proof

I wish I’d known that a lump in my breast would not scrub away in the shower. That “We can see you in two weeks” was not an appointment I had to ac-cept. That “Nothing shows on the mammography” is not necessarily an indication of breast health.

Myra Taylor, 69, retired IT professional, Freeport, N.Y. Mammograms save livesI wish I’d known how important it is to get annual mammograms. I missed

two because I was “too busy” with work to take time off. By the time my cancer was diagnosed, I required surgery, chemo and radiation to treat it, and missed a lot more work than the couple of hours the exam would have taken. I’ve always wondered how different things might have been if I had gone for those two exams.


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“There was a moment after I’d been diagnosed when I thought, ‘Part of me wants to have cancer, and part of me doesn’t’; who thinks like that?! The part of me that didn’t want cancer is what most people can relate to, but the part that did was harder to understand. I want to be a testament to God, and show people how powerful faith can be.”

It’s that faith, in God, herself and the medical staff at Lakewood Health System, which has helped Ruby on the life-altering journey she started in January, 2014.

Ruby’s last mammogram was in December, 2010, and though she regrets her decision now, she repeat-edly ignored the yearly reminders to schedule an ap-pointment. Then in January, 2014, Ruby found a lump. “I’d been doing more exercise recently, and I thought it was just a by-product from that. Plus, I had no his-tory of breast cancer in my family, so I didn’t give it a second thought.” After mentioning the lump to her friends at Bible study in March, who told her to go in as soon as possible, Ruby scheduled a mammogram for the beginning of April.

A week after having both a mammogram and an ul-trasound, she had a biopsy, and on April 25th, Ruby’s

medical provider, Physician Assistant Amy Winkels, called to tell her she had breast cancer. “After hear-ing I had breast cancer, my daughter immediately told me I needed to go to the Mayo clinic, but I said no. I didn’t want the hassle and stress, and I had faith in everyone here [at Lakewood].”

Throughout her journey at Lakewood, Ruby worked with Amy, Dr. John Weitz, oncologist; Dr. Ronald Schnier, general surgeon; Kris Posner, RN, breast health navigator; infusion therapy nurses Deana Ny-pan and Joni Dailey and occupational therapist Audra Ragan. “Everyone I worked with was wonderful, and I couldn’t have asked for a better team of people.”

“You’re given so much information throughout the whole process that it’s hard to comprehend everything at once. Everyone should have someone like Kris, to help walk you through everything. And having Audra work with me and explain the ins and outs of therapy was so helpful, as well. Everyone else was always help-ful and understanding, which made the experience that much better.”

Cancer of any kind takes its toll on all aspects of a person’s life; it is mentally, emotionally and physically draining and often debilitating. During her journey,

Ruby has broken down only once. “I was bending over to pick up one of my grandchildren’s toys, and I started to cry. I didn’t like the idea of what this could do to them. But then I thought, ‘A lot of people go through life without grandparents’, so that changed my perspective. I have to stay strong for my family, and I thank God for everything because I don’t know how people have hope otherwise.”

“I could be down in the dumps, expecting everyone to pity me, but that’s not who I am. And if I can do anything to help anyone, whether that means listen-ing to their story, or telling them mine, or going with them to try on wigs after they’ve started their treat-ments, I’m more than happy to do so.”

“I also want to encourage women to get any lumps checked out, and get a yearly mammogram. After I finally went in, I had 32 lymph nodes removed, and three were cancerous. I kept putting off getting checked, and I don’t know if they would have caught it earlier had I gone in sooner or not, but if there’s a chance they might have, it’s worth it.” Check ups, ex-ams and screenings of any kind are worth it, not only for your sake, but also for the ones you love.

BY AMBER HOUSELOGLakewood Health System Writer

A Reason to shave my head“My hair was thinning on one side, so when I

was told I had breast cancer, it gave me

a good reason to shave my head,” said Ruby Hoyhtya,

of Wadena. It’s that kind of honest, positive thinking

that makes Ruby an inspiration to, not only those going

through breast cancer, but those of us who aren’t.

SPONSORED CONTENT

BY AMBER HOUSELOGLakewood Health System Writer

a good reason to shave my head,” said Ruby Hoyhtya,

of Wadena. It’s that kind of honest, positive thinking

that makes Ruby an inspiration to, not only those going

through breast cancer, but those of us who aren’t.

“I want to be a testament to God, and show people how powerful faith can be.” ~ Ruby Hoyhtya

Breast cancer survivor Ruby with Lakewood Breast cancer survivor Ruby with Lakewood Health System’s Breast Health Navigator Health System’s Breast Health Navigator Kris Posner, RN, BSN, MSN.Kris Posner, RN, BSN, MSN.


Y O U R H O M E F O R H E A L T H C A R E

NO EXCUSES. Lakewood Health System is a SAGE provider. SAGE offers free screenings and follow-up to uninsured/underinsured women. To see if you qualify call Julie at 218-894-8221.

Every day we have is a gift. We aren’t guaranteed to be healthy or cancer

free, but we do have the ability to take care of ourselves and those we love

by being proactive in our healthcare. That means taking the time for annual

checkups and screenings, like mammograms, to help us live a healthier life.

Changes in our body, no matter how small, can mean something and

make a big difference in our overall health. Don’t ignore your body.

Pay attention to any changes and get a mammogram today.

There is no substitute for early detection.

Life is precious.

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I encourage women to get a mammogram, even if you don’t have a family history of breast cancer. It’s so important. — Ruby with her grandkids ”

“

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BreastCancerPub_Ruby.indd 1 9/23/2014 12:02:50 PM

breast cancer awareness 2014

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