Sounds of Good Health with Genesis Podcast
Abstract
Sounds of Good Health with Genesis is the official podcast of Genesis HealthCare System and covers topics on maintaining good health and improving body, mind and spirit.
Tailored Cancer Care
Enables Working Mom to Stay Close to Home
One Sunday evening, Kristie Prati applied lotion to her body and detected a lump in her breast. She instantly felt compelled to act. “I had that sinking feeling,” Kristie remembered. “I just knew this was something I couldn’t waste time on. I had to make the call.”
The next morning, Kristie phoned the Genesis Cancer Care Center. It seemed like the natural place to call, because she frequently heard patients praise the center in her professional role as counselor at Genesis Rehabilitation Services.
“Co-workers and friends had previously shared the wonderful experiences they had from the Genesis Cancer Care team. I chose to stay around the area for treatment due to keeping my family life as stable/normal as possible,” Kristie said. “I was pleased that I got in quickly to see Dr. Hanley.”
During Kristie’s initial appointment, she received an ultrasound and a physical exam to gather more information.
“Kristie had a mass in her left breast that was smooth and round. The shape and imaging seemed consistent with something benign,” said Shannon Hanley, M.D., fellowship-trained breast surgeon, Genesis Breast Care Center. “Typically, I biopsy tissue and send it to the lab before surgery, but Kristie wanted the lump taken out right away. We did, and surprisingly the pathology revealed malignancy – it was cancer.”
Dr. Hanley explained to Kristie the diagnosis and what her options were for the journey ahead.
“That was a total shock,” Kristie said. “When I was given the diagnosis, my kids were the first thing that popped into my head. I wanted to do everything in my power to stop the cancer from spreading or returning.”
Customized Cancer Care
Kristie is the mother of twin 9-year-old girls, Gabriella and Ava. With them in the forefront of her mind, she chose to undergo chemotherapy and a bilateral mastectomy with immediate reconstruction.
“I let my patients know that long-term survival is the same whether they choose a lumpectomy (surgical removal of part of the breast) or a mastectomy (surgical removal of the entire breast) and then I leave it up to them,” Dr. Hanley said. “There isn’t a cookie-cutter plan for patients. We always consider genetics, density of tissue, type and cancer location and several other factors. Every plan of care is tailored to that patient.”
To customize each patient’s care, members of the Genesis Cancer Care Center collaborate closely. They gather weekly to discuss newly diagnosed breast cancer patients and design the best comprehensive plans.
“It’s something special we have here,” Dr. Hanley said. “The care team is close knit, and the right hand knows what the left hand is doing. We talk and tailor plans for each patient. Some need chemotherapy before surgery, some need surgery first and then chemotherapy, and some don’t need chemo at all.”
One Surgery, Two Purposes
Kristie successfully underwent six rounds of chemotherapy before her mastectomy with immediate reconstructive surgery.
“I had fairly minimal side effects and continued working throughout chemo. When it came time for surgery, Dr. Hanley and Dr. Tiwari were able to do the mastectomy and start reconstruction at the same time. (Pankaj Tiwari, M.D., is a plastic surgeon who specializes in breast reconstruction.) “This was important to me because I wanted my life to remain as normal as possible for my husband and children. I did not want them to miss out on any practices or events,” Kristie said.
The collaboration and coordination between breast and plastic surgeons during immediate reconstruction allows patients to eliminate an extra surgery and recover quicker. During the procedure, the breast surgeon removes the tissue, then the plastic surgeon constructs the new breast.
“I find that women undergoing mastectomies have greater satisfaction when these surgeries are performed simultaneously,” Dr. Hanley said.
Familiar Faces, Family Vibes
With Kristie’s reconstruction and chemotherapy recently completed, she’s looking back with gratitude for the ability to have excellent cancer care close to home.
“The Genesis Cancer Care Center is only 10 minutes from my house. Since we’re part of a small community, I saw several familiar faces there. I kept thinking, ‘This is how it’s meant to be – they’re part of my treatment team.’ By the end, they had become like family.”
The cancer care team consists of medical oncologists, radiation oncologists, surgeons, radiation therapists, pathologists, radiologists, nurse navigators and nurse practitioners. Together, they provide leading-edge, compassionate cancer care to community members.
“We’re personally invested in each of our patients. We offer everything a big city cancer center would, yet because of all the familiar faces you’ll see here, our support system can be much stronger than a larger center,” Dr. Hanley said. “I’m proud of the quality of care here.”
One Sunday evening, Kristie Prati applied lotion to her body and detected a lump in her breast. She instantly felt compelled to act.
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Pathology Screening After Hysterectomy Saves Mom
Cervical cancer treated with radiation and chemotherapy
It’s often said that mothers hold their families together … but what if Mom gets cancer?
Stacey Scott, 42, from Lewisville, Ohio, finds great joy caring for her family, but she found herself needing extra care last year when she was unexpectedly diagnosed with cervical cancer.
“My whole world stopped,” Stacey said. “I remember thinking, ‘What? This can’t happen to me. I can’t get cancer. My son is graduating from high school; my daughter needs me. How am I going to do this?’ It was just plain scary and overwhelming.”
Dealing with symptoms for two years
Stacey had sought out her gynecologist because of numerous symptoms including lengthy menstrual cycles, severe cramping, unusual discharge, constant nausea and fatigue. She suffered with those symptoms for two years before finally undergoing procedures, including a hysterectomy, which led to her cancer diagnosis.
“Every time a cervix and uterus are removed during a simple hysterectomy for presumed benign conditions, they undergo certain testing,” explained Eugene Hong, M.D., radiation oncologist at the Genesis Cancer Care Center. “Results from that pathology identify unexpected cancers between two and five percent of the time. When that happens, the cancer is labeled as an incidental or occult finding, and it obviously comes as quite a surprise.”
Stacey’s hysterectomy pathology results showed she had stage 1b cervical cancer, meaning the disease was contained in the cervix. Genesis’ expert team of pathologists – Ejaz Ahmad, M.D., Irena Sheyn, M.D., and Jonathan Tongson, M.D., were involved in diagnosing and confirming Stacey’s cancer from her Pap test and tissue examination. The Genesis pathology department ensures cancer diagnoses, including 100 percent of all new malignant diagnoses, are reviewed by least two pathologists.
Warning signs of cervical cancer can be tricky
Stacey was surprised and shocked. Typically, abnormal Pap tests lead the way to finding cervical cancer, as early cervical cancers usually have no symptoms. Once cervical cancer grows invasive into nearby tissue, symptoms can include:
- Abnormal vaginal bleeding
- Unusual vaginal discharge
- Painful intercourse
Because cervical cancer is an aggressive cancer, early detection leads to the best cure rates. In fact, early detection of cervical cancer provides cure rates between 90 and 95 percent.
Stacey received a referral to a gynecological oncologist at a Columbus hospital, who recommended treatment at the Genesis Cancer Care Center. Her team of cancer specialists crafted a personalized package of treatment involving external beam radiation therapy, chemotherapy and an internal high-dose radiation therapy called brachytherapy.
“I ended up having five rounds of chemotherapy, 25 doses of radiation therapy and two doses of internal radiation. I went five days a week for five weeks in a row – and I did not miss a single appointment,” Stacey said.
Fighting to stay in treatment
Stacey’s perfect attendance to her treatment appointments did not come easily – she fought to make it through each day of travel and treatment, and she even considered giving up at one point. Living in Lewisville meant a one hour and 20-minute drive each day, each way. With a busy working family, Stacey determined to make the drive by herself, except for Mondays when she had both radiation and chemotherapy and leaned on family and friends to drive her. The drive became more difficult as the accumulative effects of treatment grew heavier.
“The first week, I started feeling drained, sweaty and constantly hot,” Stacey said. “The second week got worse. By the third week, nausea, fatigue and sickness were horrible. I was so weak, I could barely shower. I also got thrush from the chemo. My mouth was full of sores and I couldn’t eat real food. The fourth week, my muscles and intestines couldn’t hold things in any longer. The drive to Genesis felt so long, and I’d have to stop at every restroom along the way. It was awful. Every muscle hurt. I wanted to give up. In fact, I went to my cancer nurse navigator and told her, ‘I just can’t do it anymore. I’m done.’”
Annette Barr, BSN, RN, CGRN, OCN, cancer nurse navigator at Genesis, remembers that conversation well. “Treatment is not simple, and people often want to quit when they’re feeling overpowered by the side effects,” Barr said. “When that happens, I help them remember why they started treatment in the first place. There’s obviously a reason for choosing to fight the disease – and if the reason is still there, there’s still reason to fight.”
Making accommodations so patients are comfortable
Barr’s pep talk gave Stacey a boost of motivation to continue treatment. Next, Barr connected Stacey with tactics to lighten the load of cancer treatment.
“I encouraged Stacey to take opportunities for additional support (like receiving extra IV fluids toward the end of the week) and to approach her battle one day at a time,” Barr said. “Plus, we talked with physicians and they modified medications to help with side effects. Like many of our patients, Stacey is independent, strong and resilient, but it’s important to realize there are times to allow others on the journey with you.”
Barr also collaborated with the American Cancer Society and Cancer Concern Coalition of Morgan, Muskingum and Perry Counties to gift Stacey with hotel accommodations at the Hampton Inn for the last few nights of her treatment. This enabled Stacey to avoid the long drive at her most exhausted state. Not only did this surprise make her last days of treatment much more pleasant, Stacey felt like they made completion of treatment possible.
“Our best outcomes happen when therapy is completed as scheduled, and I didn’t want her to look back and regret not finishing,” said Barr. “And she did it! She showed power and strength and courage to finish every day. She’s an amazing role model for her daughter and son.”
Treatment involves medicine and compassion
Likewise, Stacey praises the Genesis cancer team.
“I know I just met them when I started treatments, but in five weeks it felt like they were family. The doctors, nurses and radiation folks are absolutely wonderful. I could call any time and they’d talk me through what I was feeling, and the doctors would call me personally to check in,” Stacey said.
Checking out of the Hampton Inn and Genesis Cancer Care Center’s treatments, Stacey celebrated her treatment completion – and that fact that she was cancer-free!
Today, Stacey continues serving her family. Her son recently walked in his high school graduation, and her daughter moved out of the house. Family remains central and the “To Do” lists remain long, but now Stacey has advice for other busy moms out there who may brush aside their own health concerns.
“You can’t take life for granted,” said Stacey. “As soon as you have a symptom, get it checked out. Your life depends on it.”
Stacey Scott, 42, found herself needing extra care from Genesis when she was unexpectedly diagnosed with cervical cancer.
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Mother of Two Survives Stage II Breast Cancer
Patient attributes recovery to compassionate surgeons and nurses
Ashley Tamasovich had a nagging, gut feeling that she needed to schedule a routine well-check with her primary care physician, but she had brushed it off. She’s always been a healthy person, and not one to run to the doctor. But one night, as she rolled into a comfortable position in bed, her hand felt something peculiar in her underarm – something round and hard, about the size of a quarter.
“I thought to myself, ‘Well, that’s different. That shouldn’t be there.’ And it gave me the push to finally go in and be seen,” Ashley said. “I knew something wasn’t right, and this wasn’t just a cyst.”
That initial doctor visit led to an ultrasound, which revealed several abnormally large lymph nodes. The next step was a biopsy.
The diagnosis was breast cancer.
Research helps choose the right facility for cancer treatment
Ashley works in the medical field as a physician assistant for a local dermatologist. When it came time to decide where to receive her cancer treatment, Ashley used her medical experience to study her options.
“I did my research,” Ashley said. “I found that cancer centers follow specific guidelines and standards set by national organizations, so I’d receive the same breast cancer treatment at the Genesis Cancer Care Center as in bigger, further-away institutions.
“I did my research on doctors as well, and Genesis has very knowledgeable physicians. I’m glad I chose to have my treatment at Genesis. They know you by name at the cancer center and ask how you’re doing. My chemo nurses and I have conversations and then pick them up right where we left off during the next treatment. It’s all very personalized.”
Scott Wegner, M.D., a founding medical oncologist of the Genesis Cancer Care Center, says that receiving quality, personalized cancer care is both purposeful and powerful.
“The medical process for cancer treatment is extremely standardized. We follow the exact pathways and guidelines and administer the same drugs and treatment schedules. So really, it’s not about that – it’s about the care you receive from the people giving the treatment. The care at Genesis is extremely passionate, genuine and patient-focused. There’s no better team,” Dr. Wegner said.
With cutting-edge equipment and technology, three medical oncologists, two radiation therapists, two board-certified palliative medicine physicians, four nurse navigators and a team of specialized nurses and staff members, the Cancer Care Center offers first-class cancer care close to home.
“It’s all about the patients, not us, so if there’s something we need help from an academic institution, we’ll do that every time. But for breast cancer specifically, there is nothing we can’t do here, in the comfort of our center,” Dr. Wegner said.
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Fighting aggressive breast cancer
Approximately 20 percent of breast cancer diagnoses fall into the high-risk category. Ashley received a diagnosis of stage two, HER2-positive breast cancer – a high-risk and aggressive form of the disease.
“HER2 has one of the highest risks of relapse and death without treatment, so surgery alone is very unlikely to cure the disease, but we do have effective chemotherapies for it,” explained Dr. Wegner.
A specialized nurse navigator at the Cancer Care Center, Wendy Long, BSN, RN, OCN, CBHN, coordinated Ashley’s treatment schedule so her treatments could begin right away. She also became Ashley’s go-to contact and got things moving quickly.
“We always want to start therapy for cancer in a timely manner, but when patients are young like Ashley, who is 36 years old and have a fairly aggressive cancer, we get them started on their journey even quicker,” explained Long. “As a nurse navigator, I get to be there for patients, answering questions, aligning appointments and guiding them through their entire experience – from abnormal imaging, through diagnosis, treatment and survivorship. It’s our job to make things go as smoothly as possible, so patients can focus their energy on healing.”
Being considerate even during cancer treatment
Ashley underwent chemotherapy every three weeks for six treatment sessions. She experienced fatigue, nausea, loss of appetite, muscle aches and hair loss. But she still managed to think of others.
After her husband shaved her head, Ashley donated her 12 inches of beautiful blonde hair to Wigs for Kids, an organization dedicated to helping children look like themselves again after traumatic medical issues.
“I just wanted to help someone else out,” Ashley humbly said.
Dr. Wegner wasn’t surprised about Ashley’s generosity.
“A cancer diagnosis can bring out the best in people,” Dr. Wegner said. “The humanity, the kindness, grace, forgiveness – I’ve seen it over and over again. Ashley is kind, stoic, logical and has been an amazingly strong person through this whole thing.”
Breast reconstruction at Genesis after chemotherapy
Ashley finished her six treatment sessions that contained a mix of four chemotherapy drugs. Now, she’ll continue one of those four chemo drugs as a “maintenance” routine for one year. She underwent a bilateral, nipple-sparing mastectomy by Shannon Hanley, M.D., Genesis breast surgeon, with immediate reconstruction by a plastic surgeon at Genesis. This is a new option for breast cancer patients who fit the medical qualifications – they no longer need to travel to Columbus and have a second surgery for reconstruction. It’s all done at Genesis Hospital.
Following recovery from surgery, Ashley plans to undergo radiation treatment at Genesis Cancer Center. Regardless of where she is in her cancer journey, her family and her Genesis family, will be supporting and cheering her on.
Make an appointment today
Call Genesis Central Scheduling at (740) 454-4242 to schedule a mammogram. To make an appointment with a provider at the Genesis Breast Care Center, call (740) 454-5221.
Patient attributes survival and recovery of Stage II breast cancer to the compassionate surgeons and nurses at Genesis.
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Mom of Two Wins Hard-fought Battle Over Breast Cancer
Therapist learns valuable lessons through her own diagnosis
Megan Rollins, 36, works with cancer patients at Genesis as their physical therapist assistant. She’s encouraged and strengthened them for 11 years. So when she discovered her own lump while getting dressed for her husband’s Christmas party, she surprised even herself by not feeling too concerned.
“I told myself it was probably benign, and I’d get it checked out later. My husband was the one who actually pressured me to see the doctor sooner,” Megan recalled.
On Christmas Eve, while her then 8- and 5-year-old children daydreamed about Christmas, Megan underwent a mammogram and ultrasound. A few days later she had a biopsy. The screening and testing process moved rapidly – and that’s a good thing.
“Megan had clinical, Stage 2, triple negative breast cancer – it’s very high risk,” explained Scott Wegner, M.D., Megan’s medical hematologist/oncologist and medical director of Genesis Cancer Services. “This cancer is more likely to spread and cause death due to malignancy. With aggressive cancer, it’s important to act swiftly.
Different opinions not needed
Megan chose to receive treatment at the Genesis Cancer Care Center. Although she had never worked directly with Dr. Wegner during her professional time at Genesis, she says the thought of going somewhere else or seeking different opinions never crossed her mind. Instead, she said she trusted herself to the strangers at Genesis, who quickly became family.
“I walked in with a life-threatening disease saying, ‘I’m here. Help me!’ It’s one of the most vulnerable places a person could ever be in,” said Megan. “But these people changed quickly from a group of strangers into a group of family who were helping me fight this.”
It didn’t take long to develop relationships or to begin her 16 chemotherapy treatments rounds.
“I was diagnosed on Tuesday, my appointment with Dr. Wegner was Wednesday, and my first chemotherapy was Monday. That’s just five days after my appointment with him. I think those numbers are pretty impressive,” Megan said.
As a breast cancer navigator at the Genesis Cancer Care Center, Wendy Long, B.S.N., R.N., OCN, CBHN, guides patients from diagnosis through treatment and then throughout survivorship. Having a specialized, assigned cancer navigator helps patients focus on healing.
“There’s so much to absorb with a new diagnosis, so I answer questions and make sure everything’s scheduled and moving in a timely manner,” Long said. “Patients often feel like the waiting and not knowing what to expect before starting treatment is the worst, so I do what I can to get everything aligned and help things flow easier for them.”
Long immediately helped Megan organize her treatment regimen. “During my first meeting with Dr. Wegner, Wendy gave me a planner and wrote in my appointments and cycles for chemotherapy, then she numbered them – and I needed that, said Megan. “It was so much to take in.”
Caring for Megan … and her family
Megan says chemotherapy was “rough,” and she experienced too many side effects to count. She spent days in bed, lost her hair and eyebrows, and weakness and nausea raged. Her family supported her through treatments, and her family received extra support in unexpected ways too.
Sister Bernadette Selinsky, Genesis Spiritual Care, talked with Megan every time she received chemo. “She’d not only ask how I was, but she’d ask about my kids. She knew they were having a hard time too, and she was praying for them too. That was a big deal for me,” Megan recalls.
In addition, Megan noticed that her husband Jesse also received support and attention from the Genesis family.
“Not only did I receive superb care, but they did the exact same thing for my husband. Every warm blanket, food or kindness they gave me, they gave him, too. They took care of him because he was there to take care of me. Knowing they were taking care of him was huge for me,” Megan said.
As Dr. Wegner met with Megan frequently, he noticed her positive support team and Megan’s personal strength and determination.
“Megan has a fabulous, young family, she works part-time, and she determined nothing would stop her,” Dr. Wegner said. “I don’t think about cancer as a battle. People are dealt this disease, and it’s not whether they’re a fighter or not. Patients experience it the way their bodies and cancer allow them to. That said, Megan has been incredibly strong through her experience.”
Mastectomy versus lumpectomy – making the tough choice
After much thought, conversation and prayer, Megan chose to have a lumpectomy after chemotherapy. She said deciding whether to have a mastectomy or lumpectomy was the hardest decision she’s ever made in her life, but that she’s at peace that this was the right choice for her.
The surgery left Megan with arm pain from agitated nerves and scar tissue. She couldn’t hold her arm out to put away dishes, let alone lift another person, which she needed strength for to return to work. With her physical therapy background, Megan knew to visit Genesis Rehabilitation Services for outpatient physical therapy. She received a treatment that broke up scar tissue in her arm and helped her regain mobility.
“If people didn’t know about the abilities of physical therapy, they might suffer through things like that. Now I’m fully functioning and getting better daily,” Megan said.
She’s been changed … in a good way
With treatment and surgery complete and successful, Megan’s latest results show no evidence of breast cancer. Instead, Megan continues finding evidence of healing. She recently returned to her work at Genesis and helps other patients during their cancer journey.
“I am a completely different person and a completely different therapist,” Megan said. “I’ve seen so much good come out of this. I’m more empathetic and can feel what patients feel. I can also read how a person is doing so much more accurately now. It’s carried over into my family too. Little problems don’t matter now. All that matters is that we are happy and healthy. So really, this has changed me for the better. There are blessings in hard things.”
Genesis therapist learns valuable lessons through her own diagnosis and made a tough decision between lumpectomy versus mastectomy.
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Early Colonoscopy Diagnoses Police Officer With Stage III Colon Cancer
Don't ignore changes in bowel habits or energy levels
Marcus Ramsey is a career law enforcement officer who risks his own life to help others every day. That is, until he learned his life was to be in someone else’s hands for a while.
Marcus felt tired and lethargic, which was unusual because the 45-year-old was normally physically active. He also noticed disturbing changes in his gastrointestinal habits. After weeks of dealing with the symptoms, Marcus made an appointment with his family doctor, and a colonoscopy was scheduled immediately. The colonoscopy revealed stage 3 sigmoid colon cancer.
Although Marcus’ life suddenly changed, the first responder maintained his bravery. “I thought from the beginning, ‘We’d get through this,’” said the Roseville resident.
Before-50 colonoscopy saved his life
The expert team of surgeons and cancer specialists at Genesis were with Marcus to help him through the diagnosis and treatment. First, Marcus had surgery performed by Thomas Diehl, M.D., a general surgeon at the Genesis Center of Surgical Excellence, to remove part of the colon and lymph nodes.
Dr. Diehl applauded Marcus’ decision to make an appointment with the family doctor and follow up with a colonoscopy. “While a colonoscopy is recommended beginning at age 50, if you see a change in bowel habits, get the colonoscopy even if you’re younger than 50,” said Dr. Diehl. Discovering the cancer under age 50 worked in Marcus’ favor. “Someone in their 40s will recover faster, particularly with a positive attitude,” Dr. Diehl said.
Marcus underwent about six months of chemotherapy at the Genesis Cancer Care Center and kept his spirits up throughout the treatments. “He tolerated his treatment well and is a very optimistic guy,” said Phu Tran, M.D., hematologist and oncologist, Genesis Cancer Services. “I believe his positive personality and his family support helped him significantly,” Dr. Tran said.
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Choosing your cancer team for colon cancer treatment
“A cancer diagnosis is a life-changing experience for most patients. We have a strong team committed to our patients, and we support them every step of the way through the cancer treatment,” Dr. Tran said. Marcus appreciated the support throughout his cancer treatment. The Genesis staff made his hospital stay and treatments a positive experience. “I had excellent care throughout,” said Marcus. “My wife stayed with me, and as a caregiver, she was treated well, too. The medical staff here is absolutely fantastic.”
Marcus appreciated the team’s constant compassion. “The staff always let me know what was going to happen next and was beside me every step of the way,” Marcus said. “I’ve had really great care, which made my job of healing much easier.”
Marcus was grateful for the high-quality care close to home. “While I was having treatments, all the responsibility for continuing life at home was put on the family,” he said. “My wife and children didn’t get to check out when I got cancer.”
A cancer diagnosis is life-changing for most people
In law enforcement, Marcus faces adrenaline-charged circumstances every day. He now views the fast-paced life a little differently. “Every day is a gift. My perspective on life has changed considerably. I tend to focus on my family a lot more,” he said. Marcus also thinks about how important it is to slow down and enjoy one’s surroundings, particularly from the road. An avid Harley-Davidson® motorcyclist, he was thrilled to return to his favorite hobby.
Marcus is now cancer-free. “Of course, I’m not avoiding doctor’s visits anymore,” Marcus admitted. He will continue to return to the Genesis Cancer Care Center every several months for check-ups.
Today, thanks to the Genesis Cancer Care team’s support, Marcus is back on the beat, protecting and serving the rest of us.
Police officer, Marcus Ramsey, saved his own life by scheduling a colonoscopy early.
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College Student Wins Fight Against Hodgkin's Lymphoma
Advanced ‘breath-hold’ treatment limits radiation exposure
As a college student, Becky Downing, 21, radiated with enthusiasm for the future. She excelled at Hope College in Michigan, and during her senior year, she lined up an interview for a coveted internship at Walt Disney World Resort. Everything seemed perfect.
But one day before her internship interview, she woke with a curious, itchy rash. Topical cream from an urgent care didn’t help although Becky completed her interviews.
Weeks later, another physical change appeared—a small lump on the left side of Becky’s neck. Her school’s health center referred her to a specialist. An initial needle biopsy of the lump was inconclusive. A surgical biopsy that Becky underwent during finals week produced a diagnosis of Hodgkin’s lymphoma.
Symptoms of Hodgkin’s lymphoma
• Lump in the neck, underarm or groin
• Itchy skin
• Drenching night sweats
• Fever
• Unexplained weight loss
Coming home to Zanesville for cancer treatment
Determined to graduate on time, Becky decided to complete her last semester online, while receiving chemotherapy and radiation treatment in her hometown of Zanesville at the Genesis Cancer Care Center.
Registered nurse and oncology specialist Annette Barr was Becky’s cancer navigator. “Navigation is about developing a relationship with a patient. It’s important to identify the care recommendations along with a patient's goals,” said Barr. “Becky was amazing during treatment. It was immediately obvious that Becky had developed her life plan, and this cancer was not about to slow her down. She was always upbeat. She was also surrounded by a supportive and cohesive network of family and friends who were there for her during her good days and her not-so-good days.”
Under the care of hematologist/oncologist Scott Wegner, M.D., Genesis Cancer Services’ medical director, Becky initially received chemotherapy infusions every other week for two months. Other than losing her hair, she said this part of her journey was the easiest. Next came radiation treatment.
Treating Hodgkin’s lymphoma in younger patients
The good news: Hodgkin’s lymphoma cure rates stand between 80 and 90 percent. The bad news: When patients receive radiation for Hodgkin’s lymphoma at a young age, treatment-related health problems can arise later in life. Today’s advanced technology and techniques aim to change that.
“We know patients receiving treatment for Hodgkin’s lymphoma in their 20s often experience side effects decades after treatment,” said Eugene Hong, MD, a Genesis radiation oncologist. “For example, people treated in the 1960s developed health issues more problematic than the original cancer itself such as heart disease and secondary cancers. That’s why today’s treatments for young patients strive to minimize potential long-term side effects while maintaining cure rates. With that in mind, we chose the deep-inspiration breathing technique for Becky.”
Limiting radiation exposure for healthy organs and tissue
The Deep-Inspiration Breath Hold (DIBH) technique dramatically reduces radiation exposure to the heart, breast tissue and lungs. Here’s how it works:
Physicians use advanced 4-dimensional (4-D) imaging technology to plan treatment. The technology captures images in real time, displaying the rise and fall of the chest, and the movement of organs and tumors within as patients breathe.
Radiation specialists use the 4-D images to map a path for the radiation beam that targets tumors and avoids exposure to surrounding areas. The technology calculates exactly how much radiation exposure tissue and organs receive.
During treatment, the patient holds a deep breath for 30- to 40- second intervals, keeping internal organs in a constant, precise position while radiation is administered.
Long-term effects of chest radiation
It sounds simple, but inhaling a precise amount of air repetitively takes practice and patience.
“It often requires multiple tries to align everything within the strict parameters,” Dr. Hong said. “Our computer records a surface map of the body and shows when the body, belly and lungs are perfectly placed for the radiation.”
Although DIBH requires more time and effort than conventional radiation therapy, the added accuracy pays off.
“With traditional radiation techniques, Becky’s heart would’ve been exposed to the full radiation dose and her long-term heart disease risk would’ve increased significantly,” Dr. Hong said. “Using DIBH, Becky’s heart received a tiny fraction of the radiation.”
Radiation therapy and heart disease
One risk associated with chest radiation therapy is heart and cardiovascular problems years after treatment. For Hodgkin’s lymphoma patients, studies show many patients who have received radiation therapy eventually require cardiac treatment or cardiac surgery for heart disease.
Long-term effects of radiation therapy can include:
• Valve disease
• Coronary artery disease
• Aorta disease
• Valvular disease
• Pericardial disease
• Myocardial disease
Treating Hodgkin’s lymphoma with radiation is necessary to save a patient’s life. DIBH and other radiation therapy techniques are reducing the damaging effects of chest radiation for cancer patients. According to the American Cancer Society, the 5-year relative survival rate for all cancers diagnosed between 2002 and 2008 is 68 percent, and that’s a marked increase from the 49 percent documented between 1975 and 1977.
Although heart disease may not develop for 10 or more years after radiation therapy, it’s important to let your doctor or cardiologist know about your treatment history. DIBH also can benefit certain patients with lung cancer, breast cancer and non-Hodgkin lymphoma. While the capabilities of using DIBH at Genesis are limited now, the Cancer Services team is considering purchasing the equipment to enable more qualified patients to be able to use this innovative technique.
Cancer-free … and a bright future
After completing treatment at the Genesis Cancer Care Center, Becky returned to Hope College in May – cancer-free and in time to graduate with her class. While her classmates cheered her recovery, Becky says Genesis’ cancer team also deserve a round of applause.
“The doctors and nurses are amazing. They put confetti on my chair on my birthday, brought me crackers and drinks, and took great care of me,” she said. “It’s obvious they know what they’re doing and they genuinely care. Cancer, no matter how you slice it, is awful and hard, but I had an overall good experience … a lot better than I expected.”
“Becky was so outgoing during her treatments,” said Barr. “She met and developed a friendship with another cancer patient in her age group who was on a different journey, yet had similar challenges. That’s one of the advantages of our chemotherapy area. It allows the opportunity for networking between cancer survivors as well as many other benefits.”
Today, Becky is a cancer-free college grad, armed with a plan for survivorship that the Genesis cancer team developed for her. She is moving forward to her much-anticipated internship with Disney, and her future feels bright again.
Deep-Inspiration Breath Hold (DIBH) radiation treatment for Hodgkin's lymphoma at Genesis saves college student.
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Avid traveler receives treatment for two cancers in same breast
DIEP flap reconstruction after surgery and chemotherapy
“I never thought, ‘Will I get cancer?’ I thought, ‘When will I get cancer?’” said Vanessa Brosie, a 61-year-old Zanesville resident. Vanessa’s intuition stems from a family history peppered with a variety of cancer diagnoses including her father, who died of colorectal cancer, and her brother, who died of melanoma. So when she felt a solid, marble-sized lump on her breast, she took quick action.
“I used MyChart and sent a message to my family doctor that Sunday,” Vanessa said. “On Monday he told me I had appointments scheduled for a 3D mammogram, an ultrasound and to meet Dr. Hanley at the Genesis Breast Care Center. I was happy and appreciative about that! There was no delay.”
Shannon Hanley, M.D., breast surgeon, Genesis Breast Care Center, saw Vanessa’s abnormal mammogram and biopsied her lump – but felt a need to gather even more information.
“What I felt in the physical exam just didn’t match up on the imaging, so I ordered an MRI – and that’s how we found another area in her breast that looked suspicious. That second area turned out to be a completely different type of cancer,” Dr. Hanley said.
Two types of breast cancer in one breast is uncommon – but it does happen.
“Everyone is really different,” Dr. Hanley said. “There’s not a cookie-cutter response to each patient. We individualize care based on pathology and the patient’s wishes. Vanessa had two separate cancers in one breast, and we had to treat each differently.”
Types of breast cancer cells
Several types of breast cancer exist, and different types respond to different treatments. Physicians determine which treatments to recommend by testing breast cells for certain receptors that attach to hormones.
• ER Positive: Breast cancers that contain estrogen receptors
• PR Positive: Breast cancers that contain progesterone receptors
• HER2 Positive: Breast cancers that contain higher than normal levels of a growth-promoting protein
• HER2 Triple Positive: Breast cancers that contain higher than normal levels of a growth-promoting protein, and contain estrogen and progesterone receptors
• HER2 Negative: Breast cancers that don’t have higher than normal levels of the HER2 growth-promoting protein.
• HER2 Triple Negative: Breast cancers that don’t have receptors for estrogen or progesterone, and don’t have higher than normal levels of the HER2 growth-promoting protein.
Vanessa’s test results identified one of her cancerous areas as triple negative (not sensitive to estrogen, progesterone or targeted HER2 treatment) and the other as sensitive to estrogen and progesterone (ER and PR positive). Knowing the cancer cells’ sensitivities allowed Vanessa’s collaborative team of breast cancer physicians at Genesis to develop a customized treatment plan.
The treatment: A multistep plan with close-to-home care
First, Vanessa underwent eight rounds of chemotherapy over a 16-week period in order to weaken and destroy the cancerous cells. The chemotherapy came with expected side effects for Vanessa – like hair loss and energy depletion – yet she felt determined to continue working. She said having close-to-home care made all the difference during the physical exhaustion.
“I’m so glad I was in Zanesville to have my treatment,” Vanessa said. “My cancer team knew what side effects I’d likely have, and then scheduled my treatments with timing to help me accomplish my goal of working. My husband could come to every doctor’s appointment and to all my chemo treatments. Being close made it much easier on him, too.”
Choosing the right surgery and breast reconstruction option
Next, Vanessa planned for surgery. Because she had different cancers and locations, Dr. Hanley recommended a mastectomy. During a mastectomy, the surgeon removes the entire breast (versus a lumpectomy, where just the lump and surrounding tissue is removed).
Vanessa chose to have a bilateral mastectomy followed by breast reconstruction. Dr. Hanley and Vanessa discussed two main reconstruction choices: traditional implant reconstruction and DIEP flap reconstruction.
DIEP (Deep Inferior Epigastric Perforators) flap reconstruction involves surgically removing a portion of excess skin, fat and tissue (no muscle) from the lower half the belly, and then moving and forming it into a new breast. To keep the removed tissue alive, highly trained plastic surgeons connect the tiny blood vessels from the removed tissue with the blood vessels in the chest.
“After I perform the mastectomy, plastic surgeons from Midwest Breast & Aesthetic Surgery come in and do the reconstruction – and if the patients are qualifying candidates, they can have the reconstructive surgery on the very same day,” Dr. Hanley said. “There are only a few surgeons within the Columbus area who perform these microvascular surgeries. It’s a tenuous surgery. I think it’s a special, unique thing to be offered here.”
When Vanessa learned that she qualified for the DIEP flap reconstruction option, she immediately felt confident that was the best choice for her.
“I would much rather have my own tissue than a foreign body implant,” Vanessa said. “The surgery itself went smoothly. Now I kid around and say that I went in with breasts and came out with breasts – since they did reconstruction the same day. I am amazed they could do that!”
Her amazement spilled over into other areas of care too – like the quality, compassionate care she received.
“I’m impressed with all the doctors. It’s so important to trust your doctors and to feel comfortable asking all the questions you have, and I could not have asked for a better team with this treatment. Their patience, knowledge and skills – I’m just super happy about everything. I wouldn’t want anyone to have to go through this, but for what it was, it was a pleasant surprise,” Vanessa said.
Life after cancer: Traveling and adventure
Today, Vanessa lives a vibrant, cancer-free life. She says she strives to make the most of her time on Earth by living with faith, humor and purpose. For example, Vanessa and her husband set a goal to visit all 88 counties in Ohio. They’re thoroughly enjoying their travels and adventures together. Vanessa also finds herself talking openly with other women about breast cancer and encouraging routine mammograms and preventative care.
“Preventative care is priceless,” Vanessa said. “Be vigilant. Catch it early – it’s the best thing you can do. The only way to do that is through mammograms and self-exams. You cannot put a price on the few minutes it takes out of the day … and the little bit of discomfort does not compare to what you might have to go through if you didn’t take preventative action.”
Make an appointment today
Call Genesis Central Scheduling at (740) 454-4242 to schedule a mammogram. To make an appointment with a provider at the Genesis Breast Care Center, call (740) 454-5221.
Vanessa’s test results identified one of her cancerous areas as triple negative and the other as sensitive to estrogen and progesterone.
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Quality Oncology Practice Initiative (QOPI)
Quality Oncology Practice Initiative (QOPI)
Assuring oncology practice quality for patients
The Quality Oncology Practice Initiative (QOPI) is a voluntary self-assessment and improvement program launched by the American Society of Clinical Oncology (ASCO) in 2006 to help hematology-oncology and medical oncology practices assess the quality of the care the practices provide to patients. Through the QOPI program, practices abstract data from patients’ records up to twice per year and enter this information into a secure database. QOPI conducts and on-site survey to verify quality standards are met every 3 years. More than 900 oncology practices have registered for the QOPI program. The Genesis Cancer Care Center is a certified QOPI program, ensuring our patients receive the highest level of quality care.
Evidence-based quality measures
QOPI-certified practices demonstrate a commitment to more than 190 evidence-based quality measures involving patient safety, education of staff and patients, standards of care, chemotherapy preparation and delivery, management of side effects, and follow-up of patients.
Quality improvement initiatives lead to better care
To be a QOPI-certified practice, the Genesis Cancer Care Center is required to have policies and procedures in place to meet all standards. We use performance data to identify, develop and implement quality improvement initiatives leading to better care and better outcomes for our patients. Practice and patient case data must be submitted twice a year for review. On-site surveys are conducted every three years.
Taking the extra steps for our patients
By becoming QOPI-certified, the Genesis Cancer Care Center took an additional step towards providing the best in oncology care for our patients and community. While the Commission on Cancer accreditation looks at the overall program, QOPI looks at specific measures of quality oncology practice.
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National Accreditation Program for Breast Centers (NAPBC)
National Accreditation Program for Breast Centers (NAPBC)
Highest quality breast care services for patients
Accreditation through the National Accreditation Program for Breast Centers (NAPBC) demonstrates a commitment to the highest standards of care for patients with breast diseases including cancer. The NAPBC works with other professional organizations to provide the most efficient and contemporary breast care using scientific evidence about what works best for patients. The NAPBC monitors compliance for standards at each breast center. The Genesis Breast Care Center maintains the highest quality of care by participating in the NAPBC.
Comprehensive program with a team approach
Breast centers with a NAPBC accreditation like the Genesis Breast Care Center develop a comprehensive program that includes a continuing spectrum of care from education, screening, prevention, diagnosis and treatment to survival. As part of the accreditation, Genesis has a multidisciplinary group such as physicians, nurse navigators, certified nurse practitioners and others that form the NAPBC Breast Program Leadership Committee and Breast Team. This group is committed to patients and our community and ensures coordination of all breast care services to remain the highest quality.
Qualified staff and coordinated care
NAPBC accreditation requires a qualified staff, facility, procedures, imaging and supportive care. Each center must meet regularly for review of patient cases, provide required services, conduct quality review, provide education, submit data, and pass a site survey. Surveys occur every three years.
Genesis Breast Care Center offers high-quality care
Genesis is committed to offering you high-quality breast care close to home. Being accredited by the National Accreditation Program for Breast Centers shows our dedication to provide you with the highest quality of breast care is our priority.
Make an appointment
Call today to schedule an appointment at the Genesis Breast Care Center.
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