Symptoms of Brain Tumors

By: Gregg Lowery, OMS-IV, Pacific Northwest University of Health Sciences, College of Osteopathic Medicine

Suppose someone randomly approached you and asked, “What are the symptoms of a heart attack and stroke?” Given the number of public ads informing you of the respective symptoms for both you’d likely be able to list most, if not all, of them. What if someone were to ask you the same question about brain tumors? Would you feel as confident answering this question?

Fortunately, brain tumors are not very common with an estimated occurrence of 30 out of every 100,000 people in the United States. With exposure to radiation being the only established risk factor, most primary tumors arise sporadically. This is especially true in tumors that develop in young adults. Once past the 30-40 age range, metastatic brain tumors unfortunately become more common. To clarify, a primary tumor describes a tumor that developed at the anatomical site it is located. A metastatic tumor describes a tumor that developed and spread from a different location of the body.

The type of lesion may influence how long it takes for an individual to detect or display symptoms. For malignant or metastatic tumors, symptoms may progress over a shorter period of days to weeks. In contrast, benign tumors may take weeks, months, or possibly even years before individuals become symptomatic. Some with benign brain tumors may even remain asymptomatic (no symptoms at all) with a mass being detected by imaging ordered for other reasons. So what exactly are some signs of a brain tumor?

Many would guess that headaches are a common sign of a developing tumor. While half of those with brain tumors report headache, headaches in general are usually not due to a tumor. Headaches that are associated with tumors tend to progress in severity over time. These headaches will also tend to present without a certain pattern, meaning they don’t routinely occur at specific times during the day nor do they seem to be aggravated by certain activities.

In contrast to headaches, seizures are one of the most common symptoms experienced in those with either a primary or metastatic tumor. These seizures tend to be focal meaning that the clinical signs expressed depend on the location of the tumor itself. For example, a tumor residing in the frontal lobe of the brain may produce stiffening and rhythmic jerking of a particular extremity. However, multiple consecutive seizures without a period of consciousness (called status epilepticus) can also be a clinical manifestation of brain tumors.

In addition to focal seizures, other focal signs may occur based on the location of the tumor. Muscle weakness of a particular extremity can be a subtle but common complaint. Sensory impairment such as changes in balance, coordination or vision can be a result of brain tumors. Difficulties with understanding speech and producing comprehensible language may develop.

So when your doctor asks you to push their hands away or squeeze their fingers realize they are not checking to see if you really have been going to the gym. If they ask you to open wide and move your tongue side to side, they really are checking cranial nerve function and not signs that you actually have been eating salads regularly. Thankfully brain tumors are not extremely common among the population. However, as with many medical conditions, earlier detection leads to earlier treatment and usually a better prognosis. Knowing the signs can be the first step in deciding whether to talk to your healthcare provider.

References:
Wong, ET and Wu JK. (2018) Overview of the clinical features and diagnosis of brain tumors. Eichler AF (Ed.) UpToDate. Retrieved March 22nd, 2019 from https://www-uptodate-com.proxy.pnwu.org/contents/overview-of-the-clinical-features-and-diagnosis-of-brain-tumors-in-adults


Living With a Brain Tumor

By: Carl Berkowitz, TCCC Volunteer

Kim Leary is an oncology RN clinical nurse, who lives with a rare type of brain tumor that affects the glia, or supportive tissue, of the brain. Given her extensive medical knowledge and first-person experience, one might ask why she is such a strong booster of the Tri-Cities Cancer Center’s Brain Tumor Support Group. Her answer to this question is straightforward. “Because learning about the experiences of others and being able to share my personal experiences are a huge benefit for all participants in our group.”

The TCCC Brain Tumor Support Group
Kim notes a number of the issues and concerns of brain tumor patients are not strictly medical and that many must learn to live with disabilities which are not obvious to friends and family. Skills previously taken for granted, such as hand coordination, finding the right word when speaking or the ability to recognize faces can be lost. And even learning how to respond to well-meaning observations such as ‘you look fine’ when in fact, the patient doesn’t feel fine, can be a challenge. Being with others who have dealt with these and other concerns is an important benefit of participation in the group.

While all cancers are unique, brain tumors, both malignant and benign, are special in that they can affect all parts of a patient’s life by interfering with basic cognitive skills. “My short term memory is not what it was before the glioma developed. Words and names frequently escape me, and I have to be more careful about not misplacing things.”

Kim and other support group participants bring together a variety of issues from a variety of caregivers. As a result, a multitude of concerns can be addressed, often with different approaches to common problems. Participants can contrast the location of their tumors with changes in their personality. Proposed treatments or the results from clinical studies are frequent topics of discussion. But less technical issues are also fair game, including (for example) the challenges of getting behind the wheel of a car after a 6 month hiatus, or the wisdom of ketogenic diets. Even ‘alternative’ medical procedures, such as acupuncture, have been discussed, with both advocates and skeptics having their say.

All of this is done under the guidance of TCCC Chaplain Margaret Ley, about whom Kim says “We all love Margaret; she knows exactly what to say, how to keep discussions going and is both empathetic and a good listener.” With the tone of meetings set by Margaret, all participants can relate to each other regardless of what kind of tumor they have or what stage they are at. “Margaret brings out the commonality of all participants.”

Kim’s advice to patients (and their friends!)
Family and friends were vital in helping Kim get through her medical exams, surgery, radiation therapy, and the many changes that come with a brain tumor. Having a special friend was also critical. Kim talks about how her companion and fellow dance enthusiast Mary Albin “…helped me more than I can say. She’d send me texts that made me smile or laugh all the time.” The lesson here for patients is to spend time with friends and keep up social interactions. And the lesson for the rest of us is to stay in contact with patients, if not in person, then with text messages, notes or phone calls.

A second message Kim likes to share with the support group is ‘Carpe diem’ … seize the day. “I don’t know what the future holds but I do know I have today to live it”, and this is exactly what Kim does. When not working as a nurse on clinical trials, she participates in a wide range of community activities including classes in Zumba, yoga/tai chi and Pilates (all of which help her coordination). Socializing with friends is also a big part of her life. But her main passion since the age of 5 is tap dancing, something she was not going to stop after her diagnosis; she’s now a 12-year participant in the Tri-City Tappers, having performed throughout our community for both public and private events.

“I know the statistics for my tumor and for others. But these are statistics and don’t apply to an individual. So you don’t really know what will happen. I think the best way to proceed is simply to enjoy today and the present moment. “

For more information…
To learn more about Kim and her amazing journey, come by the Brain Tumor Support Group on the third Thursday of each month at 10:00am at the Cancer Center. Call (509) 737-3427 for more information. Reservations are not necessary.


2018 Special Events

Cancer Crushing Fundraising Breakfast!
A record number of nearly 800 community members gathered at our annual “Cancer Crushing” Fundraising breakfast on March 29, 2018, generously sponsored by Mission Support Alliance. Our mission is to educate the community about the Tri-Cities Cancer Center and to raise funds in support of cancer patients and their families. Thank you to our community supporter in helping us raise more than $109,000!

Run for Ribbons
May 12, 2018 was a day to remember in which nearly 1,200 community members participated in the 10k, 5k, 1 mile Run for Ribbons walk-run event which raised nearly $60,000! With the help of over 60 volunteers, fun was had by all at Howard Amon Park and at our Ribbonfest Health Fair, our opportunity to provide education to the community. We thank the numerous supporters of the Tri-Cities Cancer Center and we are looking forward to continuing the tradition for the 9th annual event on Saturday, May 11, 2019!

HAPO Golf Classic
Thanks to our lifetime sponsor, HAPO Community Credit Union, over 160 participants enjoyed the greens, fun games, prizes, awesome tournament apparel and delicious margaritas at the Cancer Center Cantina! We are so grateful for the many businesses and individuals who have supported this tournament with raising over $75,000 to support the Tri-Cities Cancer Center mission. The HAPO Golf Classic this year will be on Friday, August 16th!

Autumn Affair
FIESTA! The 18th Annual Autumn Affair Benefit Auction was a “Havana Nights” theme and a huge successful FIESTA! Thank you to our Platinum Sponsor CH2M, individuals, and businesses in our region for another banner year which raised a record amount of over $273,000 for the Tri-Cities Cancer Center Foundation. Drumroll…………..The 2019 Autumn Affair will be held on Saturday, November 9th! And, we are moving to the Benton Franklin Fairgrounds event buildings 2&3 with a celebratory theme; Kentucky Derby! Join us at the best charity gala in the Tri-Cities!


TCCCF Annual Report

By: Elizabeth McLaughlin, TCCC Foundation Director

The Tri-Cities Cancer Center’s proud history of nearly 25 years is surpassed only by the over 25 year history of its Foundation. The birth of the Tri-Cities Cancer Center was a carefully coordinated effort of our three owner hospitals, an effort that was completely crafted through the incredible support and the incredible demand of our community. The strength of this community treasure has always, and will always lie within its people, whom we affectionately call our TCCC Family.

This Family is filled with our staff who are caring, compassionate and fiercely devoted professionals; our dedicated and loving volunteers whose efforts give over 12,000 hours of service to our patients, their families and our community each year; and our incredible members of both the Center and the Foundation’s boards, whose leadership, strategic planning and unwavering support of world class cancer care is a beacon of light during times of uncertainty, of success and of incredible growth and unprecedented change.

This incredible family includes YOU, our cherished and generous donors, whose investments in our Foundation have created remarkable change and have provided comfort, stability, and confidence for our patients who are in the midst of the fight of their lives.

YOU have created a level of world-class cancer care for our region that is truly second to none in complimentary services and cutting edge technology.

YOU have built a stunning campus that brings comfort, respects privacy and feels like home to our patients receiving treatment.

YOU have been the catalyst in kicking off our prevention efforts that are aimed at stopping cancer in its tracks. These efforts are critical in beginning to imagine a world without cancer.

And YOU have funded over 1000 no-cost screenings so far this year. . . Early detection is the key in the fight against cancer. And we can tell you, with all certainty, that your investment in our Foundation has saved lives.

The support YOU give to the Tri-Cities Cancer Center makes these achievements possible!

The great privilege of serving our community is something I know we, as your Tri-Cities Cancer Center staff and volunteers are all very proud of.

Because of YOU, we can ensure that no one in our community will fight cancer alone.

Warmest Regards,
Elizabeth McLaughlin, TCCC Foundation Director


Caring for Our Community

By: Chuck DeGooyer, TCCC CEO

There isn’t a day that goes by that I’m not reminded of the critical work and support that the Tri-Cities Cancer Center provides our community. As I reflect on 2018 and look forward to celebrating our 25th anniversary this year, there are so many important updates that I would like to share about your Tri-Cities Cancer Center.

In 2018, we continued the inaugural work of our Cancer Crushing Executives program, which promotes evidence-based practices to keep employees healthy by targeting the leading causes of cancer-related death. We have partnered with the University of Washington, the Washington State Department of Health, and the most senior leaders from the region’s largest employers to deliver this program. These leaders have made a commitment to improve the health and wellness of their employees, who collectively represent 30,000 employees and 100,000 lives when you take into consideration employee families.

In addition to our Cancer Crushing Executives program, we have and will continue to educate and provide services to our community focused on the prevention and early detection of cancer. With over 1,000 cancer screenings provided to members of our community in 2018, we have committed to increase our cancer screening efforts in 2019. We are specifically focused on the early detection of lung and colorectal cancer, which are two cancers often diagnosed in late stage within our community. Through our screening efforts, we hope to detect cancer at an earlier stage to improve patient outcomes. On the prevention front, we are partnering with the Benton Franklin Health District to improve HPV vaccination rates of 9 to 14 years olds within Benton and Franklin counties. The HPV vaccination is the best way to prevent HPV-related cancers later in life.

Due to our prevention and early detection education and awareness efforts, the Tri-Cities Cancer Center was a proud recipient of a national Innovation Award from the Association of Community Cancer Center’s (ACCC) in October 2018. This award means so much to our team who works hard to take care of our community.

What’s in store for 2019? This year promises to be one full of celebration and change.

Throughout the year, we will be celebrating our 25th anniversary by sharing personal stories about the impact the Cancer Center has had in our community. These stories will be shared through the lens of our patients, doctors, community members, volunteers, donors and our employees. We are excited to share these with a community who cares for each other so deeply. To find out more about our 25th anniversary stories and events, please visit tccancer.org/anniversary.

With steadfast focus, we will continue to ensure our community receives world-class treatment, survivorship, prevention and early detection programs delivered with excellence here at home. We look forward to the next 25 years of service as your Tri-Cities Cancer Center!


Fecal Immunochemical Test (FIT)

The Tri-Cities Cancer Center provides free Fecal Immunochemical Tests (FIT) that are FDA cleared to screen for colorectal cancer, colon polyps, diverticulitis, and colitis. FIT is a simple, self-administered test that provides quick results. Please contact the Tri-Cities Cancer Center at (509) 737-3432 and we can walk you through how to utilize this free screening.


Julia Hamrick

By: Carl Berkowitz, TCCC Volunteer

In 1993, the Tri-Cities Cancer Center (TCCC) Foundation was founded, followed in 1994 by the opening of the Cancer Center thanks to the hard work and dollars raised by many Tri-City individuals and organizations. There was a need in eastern Washington not only for a radiation oncology treatment center, but an organization that could provide ancillary support for patients and community educational programs. The tradition of giving that started the Center continues today through the work of the TCCC Foundation, a non-profit 501(c)3 organization that works to help provide these and other services at no cost to individuals and families who are affected by cancer.

Presiding over the TCCC Foundation Board this year is Julia Hamrick, who is both president of the Foundation and a volunteer at the Cancer Center. As a former project manager, Julia brings many skills to her responsibilities as a Board member and a volunteer.

Julia was introduced to the Cancer Center via Cindy Caldwell, with whom she was creating necklaces, earrings and other bead art sold at fund raisers for charitable organizations in our community. One event Cindy wanted her to participate in was the Cancer Center’s ‘Autumn Affair’ (note: this year’s Autumn Affair will be held November 9th). Of her introduction, Julia says “I immediately liked the people putting this event together, but didn’t see myself becoming more involved at first.” She later bumped into Cindy at Walmart, who then asked if she’d like to join the Foundation Board.

Julia just couldn’t say no, and she now says she’s glad she didn’t. “Being somewhat of an introvert, I was initially taken back by the fundraising aspect of the Foundation.” But she became increasingly supportive of this and other activities as she learned more about the services they support. Julia notes frankly that fundraising is not for everyone, but it’s critical to the success of the Foundation and many of the Cancer Center activities. She feels that fundraising has nothing to do with ‘me’ and that it’s all for the Cancer Center. And as long as she’s asking for something she believes in (the Cancer Center), she’s OK with it, saying that “fundraising has nothing to do with you and everything to do with what touches people’s hearts.”

Julia pointed out that there is more to Foundation activities than fundraising. Through the Foundation’s Guild and the Men’s Club, members provide physical support for many of the Cancer Center activities including manning booths, helping with parking or displays at public events and decorating the Center for holidays. There are also a number of ad hoc committees for special activities. A key role played by every Foundation member is serving as TCCC ambassadors to the rest of the community. Today, after several years of participating in Foundation activities, Julia feels the Foundation sets a gold standard for charitable organizations in the Tri-Cities, citing the integrity of the organization, how they operate, and the support the Foundation receives from the community.

One of Julia’s desires is to expand the area served by the Cancer Center. In particular, she’d like to see screening activities, educational programs and other resources offered to a larger geographic area than is now the case “While radiation treatment of course has to be done on the campus, many of our other activities might be expanded to individuals living further out.” And as a Board member, she’s always looking for future Foundation Board members who have needed skills in areas including finance, communications and who are just generally plugged into other community organizations that can support Foundation activities. While the officers define long term goals and strategies, Julia is quick to note that “We can’t have all ‘vision people’ or all ‘worker-bee’ people. We need a mix of both.”

Since retiring five years ago, Julia has found time to participate in a number of other non-presidential activities throughout the community. She still does hands-on work with the Cancer Center’s Autumn Affair Auction, is a Monday morning volunteer at the TCCC Resource Center, and helps at the Kennewick Food Bank. Asked during our February interview if any special non-presidential, non-volunteer, non-TCCC events are coming up in her own life, she shared the excitement of an upcoming trip to Israel and Jordan with husband Doug and fellow church members, after which she and Doug plan to explore warm, sunny Sicily.

To learn more about Foundation activities, contact Julia Hamrick, Foundation Board President by calling the TCCC Foundation office, (509) 737-3413, or foundation@tccancer.org


Eating for a Healthy Colon

By: Joan Stewart, RT(T), BA HCA Clinical Services Project Coordinator, TCCC

A healthy diet can help prevent against colon disorders. Risk factors for colon cancer include obesity, physical inactivity, heavy alcohol consumption, and a high intake of red and processed meats. The American Cancer Society reports that the links between diet, weight, exercise and colorectal cancer risk are some of the strongest for any type of cancer. In fact, an estimated 50 to 75 percent of colorectal cancer can be prevented through lifestyle changes according to the Colon Cancer Foundation. Colorectal cancer can be prevented, and here are the top six gut-healthy habits to get you started!

1. Limit red meat consumption to no more than two 4-oz portions each week, and limit processed meats to an occasional treat.

2. Decrease added sugars in your diet to less than 10% of total daily calories (around 25 g for women and 38 g for men per day) to help keep yourself at a healthy weight.

3. Increase your fiber intake to 25-35 g per day by increasing your intake of fiber-rich fruits and vegetables, whole grains, and legumes. Fiber aids colon health by preventing constipation. This can lower your risk of developing hemorrhoids and small pouches in your colon that can lead to diverticular disease.

4. Drink your milk! Studies show calcium and vitamin D may decrease risk of colon cancer. Other dietary sources of calcium include spinach, kale, and collard greens. Try to get between 1000-1200 mg calcium per day. Vitamin D can be found in fatty fish, cheese, and egg yolks as well as from the sun. Many foods like orange juice, cereal, bread, and some yogurt brands are also fortified with vitamin D.

5. Make at least half of your daily grains whole grains. Some readily available whole grains include barley, quinoa, whole wheat flour, wild and brown rice and oatmeal. These foods contain more vitamins, minerals, fiber, essential fatty acids, antioxidants and phytochemicals than refined white grains.

6. Limit alcohol consumption. Minimize alcohol intake to one drink per day or less.