Treating KCG

By: Carl Berkowitz, TCCC Volunteer
The tingling sensation in KC Garza’s left cheek was a mild irritant for many months. It hadn’t stopped her from going to her job, or from her love of singing with many local bands. But it was an annoyance as she planned for her wedding, sold one house while building a new one and continued with her travel for work and family activities. Worried that the discomfort in her face would keep her from a bachelorette party in Portland, she made an appointment with a neurologist who confirmed KC’s suspicion that it was trigeminal neuralgia (TN) and started her on a standard treatment of carbamazepine. But because of the potential for birth defects with this drug and her desire to start a family, this soon-to-be-bride decided against taking it.
KC made it through the bachelorette party drug free, with minimal discomfort. But while cooking dinner the next day, her face began to get very hot. She finished her cooking, sat down to eat and began nibbling at her food. And suddenly ”It felt like someone hit me in the side of my face with a baseball bat at the same time my cheek felt like it was on fire. It was like an electrical shock or lightning strike!” This unexpected and sudden flare up convinced her that she had to start the drug, despite its undesirable side effects. By this time, the nerve was so irritated and inflamed that anything would set it off, even drinking from a straw.
With her wedding less than a month away, KC was devastated. Although she got through the wedding with no shooting pains that day or the next, the discomfort came back. Her wedding would be the last time she was able to sing for many months. Shortly after, her neurologist upped her medication to the maximum amount. But the TN flare-ups continued, prompting her to continue looking for relief. A 3-D MRI done at the OHSU Facial Pain Clinic found that there was nothing impinging on the nerve, which is a common cause of TN. She continued her research which eventually led her to consider a surgical technique in which the inflamed nerve is rendered non-functional. But this invasive procedure was associated with a long recovery period and the possibility of additional neurological complications.
Although KC had been obsessive in her research on TN, with much time spent looking at peer reviewed clinical results, traditional folk medicines and cures posted on the internet, her road to recovery ironically started during a standard dermatology exam with Stacy Lameer.
On the day of KC’s exam, Stacy had gone to an early morning seminar on the services and capabilities of the Tri-Cities Cancer Center. Among the information she learned about was a specialized radiotherapy technique to treat TN, available at the Cancer Center.
Stacy passed this information on to KC, who made an appointment with TCCC radiation oncologist Dr. Guy Jones. Following a consultation visit, a custom mask was made for KC to assure that a tightly focused beam of radiation would hit only the specific nerve associated with her TN flare-ups. When the mask fitting was done, she came into the Cancer Center for the actual treatment. Then, as KC’s mother, Jodi Santillie describes it, “We were there for less than an hour, and it was done. The relief in KC was obvious.”
Not only was the radiation therapy effective, says KC but “Dr. Jones and the Cancer Center staff were awesome. They really cared, and knew that the pain was real, and life altering. When I told him what was happening, even though he knew what was happening, he was up front about what could and may not work. He reassured me that this was going to help.”
It’s been more than a year since KC’s last TN flare-up. While she still has some residual numbness and an occasional headache, the discomfort today is nothing like it was before. As a result, she’s getting back to her life ‘pre-TN’. She can sing again (“But I’ve got a lot of work to do to get my voice back”) and will be returning to her job with Freestone Environmental Services (“who let me work from home at my own schedule when I was too tired to come into the office”.)
But maybe the biggest and best step forward for KC, her husband Rufino and parents will be fussing over a brand new (7 weeks as of today!) happy, healthy little boy, Dominic Garza.
For more information on treatment of benign diseases, please visit us online at tccancer.org


Pink the Parkway

By: Kristina Lord, Warrior Sisterhood Board Member
Warrior Sisterhood’s annual and biggest fundraiser of the year will be in a new venue this year.
The fifth annual Pink the Parkway event moves this year from The Parkway to the nearby John Dam Plaza at 815 George Washington Way in Richland. This means the popular fashion show featuring cancer survivors will be on the HAPO Community Stage.
Pink the Parkway also features live music and other performances, food trucks, vendors and a kids zone with activities for children. The cost for admission includes drink, food and shopping deals at a variety of Parkway businesses. Tickets to the event are $15 per adult and $5 for kids. One child is admitted free with a paying adult.
“It’s always a great time and it’s for a great cause: helping women with cancer. Warrior Sisterhood provides a safe, nurturing group for cancer patients and survivors to connect and receive support from one another,” said Jen Ollero of Kennewick, a breast cancer survivor, who is Warrior Sisterhood’s president.
This year’s Pink the Parkway is from 11 a.m. to 4 p.m. Saturday, Oct. 13.
Misty Ovens of Richland, a breast cancer survivor, is one of Warrior Sisterhood’s founders. She’s been amazed at the community’s support for Pink the Parkway over the past four years.
“We’ve got a very generous community which really gets behind Warrior Sisterhood’s efforts to help cancer survivors and patients,” she said. “Pink the Parkway is a really fun event for the whole family.”
Warrior Sisterhood was founded in 2013 by four Tri-City women who wanted to create a safe, supportive place for other young women fighting cancer. Today, more than 100 women are members of the group that no one wants to join.
Warrior Sisterhood’s goal is to empower local women with cancer or a cancer-related diagnosis and survivors. There’s no age requirement to join, but many women in the group are trying to balance a job, family and busy life along with their endless medical appointments and fears about a recurrence.
The women meet monthly, rotating between the Tri-Cities Cancer Center and other venues in the community. Warrior Sisterhood offers emotional support during monthly group meetings, fun get-togethers and activities, group yoga classes and connection through a private Facebook group.
The group distributes chemotherapy gift bags to cancer patients stuffed with useful items and tips to make infusions more comfortable. The bags are typically delivered by a cancer survivor which provides the patient hope and strength to see other women on the other side of treatments. Warrior Sisterhood also provides nominal Visa gift cards to newly diagnosed women under 45; free yoga scholarships to patients going through treatment; an annual two-night retreat for cancer patients and survivors; and raises money and cancer awareness at community events to support its mission.
For more information about the group, visit https://tccancer.org/warrior-sisterhood; email tcwarriorsisterhood@gmail.com; or find the group on Facebook, Twitter or Instagram; or call the Tri-Cities Cancer Center at (509) 737-3413.


A Truly Insidious Cancer

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

As I begin making plans for September and the multiple cancer awareness events on the horizon, I took to the Internet for inspiration. There must be something out there new for Ovarian Cancer. Afterall, we have made much progress in melanoma, lung and kidney cancer; some of our deadliest just 10 years ago!

In my search I came across a blog from a Dr. Saul Rivkin, Swedish Cancer Institute Medical Oncologist, Founder and Chairman of the Rivkin Center. The Rivkin Center, based in Seattle, seeks to promote collaborative work and innovative research in early detection and treatment of ovarian cancer worldwide. The blog Dr. Rivkin had written called ovarian cancer ‘insidious’. That word jumped off the page; what a perfect descriptor!

Webster’s Dictionary defines insidious as it relates to disease as “developing so gradually as to be well established before becoming apparent”. As you may have heard numerous times, if we can find cancer early we have a much better chance of cure. There is no debating that fact. For ovarian cancer, women with Stage I or II disease can expect a 5 year survival. For women with Stage III or IV, the 5 year survival rate is a meager 28%. And unfortunately, 71-75% of all ovarian cancer patients are diagnosed in advanced stages – it was well established before becoming apparent!

There is no one test to diagnose ovarian cancer and the symptoms sound non-threatening, even routine:
• Abdominal fullness or bloating
• Pelvic or abdominal pain
• Difficulty eating or nausea
• Urinary frequency or urgency
• Constipation or diarrhea
• Vaginal bleeding

Most women experience one or more of these ‘signs’ each and every month. It is when more than one symptom or sign lingers more than a week and is unresponsive to the normal remedy that one should consider seeking medical attention.

I am sad to say my Internet search today found nothing new for early detection or innovative diagnostic testing for ovarian cancer. A visit to the National Cancer Institute’s clinical trials page and a search for any trial related to ovarian cancer resulted in 271 trials. A review of the first 20 listed finds 50% are trials not specific to ovarian cancer and nothing associated with early detection. Every late stage ovarian cancer patient hopes for the next breakthrough in treatment and we hope one or more of these trials will result in long-term disease free survival for the estimated 22,400 women that will be diagnosed with this disease every year.

An article published in a recent issue of Science magazine reported on the development of a test called CancerSEEK1 which, if successful, would detect several types of cancer at early stages; ovarian, liver, stomach, esophageal, pancreatic, colorectal, lung and breast. The test would look for gene mutations within the DNA found in blood that came from cancer cells and other biomarkers and proteins. The study shows promise, but much more work is needed to understand the effectiveness of this test for the detection of cancer. If the test resulted in a false positive (a misleading wrong answer), much unnecessary testing and mental anguish would be the only result for the patient.

The best recommendations we can make at this time for the early detection of ovarian cancer are for women to pay attention to their body and subtle changes, maintain a strong relationship with a primary care physician, and pursue a physical exam with a gynecologist annually. Though the US Preventative Services Task Force does not recommend routine screening for ovarian cancer, all healthcare agencies recommend an annual Well Woman Check for a physical exam, documenting health status and setting health goals. Remember, a PAP test is not an ovarian cancer test. Inform your doctor if you have a family history of breast and/or ovarian cancer as you may be at increased risk. Other factors that increase your risk of ovarian cancer include hormone replacement therapy, obesity or a history of endometriosis. If you have difficulty finding a healthcare provider or want more information, reach out to one the Tri-Cities Cancer Center’s Nurse Navigators at 783-9894.


TCCCF 25th Anniversary

By: Elizabeth McLaughlin, Tri-Cities Cancer Center Foundation Director

This August marks the 25th Anniversary of the initial formation of our Tri-Cities Cancer Center Foundation. On August 13, 1993, community members gathered at Cavanaugh’s Inn to formalize what was already an incredible grass roots effort to secure investments from community to build world-class cancer care right here, close to home.

At the time, the campaign to raise the $2.1 million dollars to fund the building of the Tri-Cities Cancer Center (TCCC) was about 90% complete, mostly due to the work of the same community members who gathered at the meeting.

On the table for discussion were many topics, including updates to the construction of TCCC and the strategic goals that this Foundation would pursue, in order to build and grow our Tri-Cities Cancer Center. Attendees discussed financial goals for an endowment and the need for staff and patient support programs, capital support and the establishment of a core group of volunteers.

The goals of the Tri-Cities Cancer Center Foundation also identified needs beyond fundraising. The group was tasked to lead the development of the regional identity of the Cancer Center. The group knew that the Foundation would need to serve as the community relations arm of the TCCC, looking for ways to build regional confidence in the care and service of our Cancer Center.

Board members were selected and officers were identified to begin the process of incorporation and strategic development of the TCCC Foundation. Joining the board in service in 1993 were:
• Hank McGuire, Chairman
• Gary McEachern, Vice Chairman
• Kris Kelley-Watkins, Secretary
• Sandra Gamble, Treasurer
• Bob Ashton
• Max Benitz, Jr.
• Jack Briggs
• Greg Carl, MD
• Jack Chapman
• Donald Cockeram
• Harold Cox
• Ron Hue
• Billie Jane Lampson
• Ed Ray
• Marilyn Robinson
• Joseph Spencer
• Donald Stancik
• Arlene Thompson
• Thomas C. Trotta, MD
• Sam Volpentest
• Sondra Wilson

These devoted Tri-Citians then worked to add additional members to the board, as well as discuss and monitor upcoming fundraising and community awareness activities. Joining these members were liaisons from our hospital owner foundations, who raised the needed support before the establishment of the Foundation to build the Tri-Cities Cancer Center:
• Mike McWhorter, KGH Foundation liaison
• Clayton Alford, Carondelet Foundation liaison
• Rollie Ehlers, Kadlec Foundation liaison

Support from a fundraising event honoring Billie Jane Lampson’s birthday, a raffle held by local Kiwanis chapters, participation in the annual Nike Golf Classic and the proceeds from the yearly Rotary Duck Race sales were among the first fundraisers that benefited the newly formed Foundation.

Additionally, the Okeefinokee Golf Tournament found a home with the TCCC Foundation, after several past tournaments were held by the Kennewick General Hospital Foundation on behalf of the Cancer Center. The tournament, now named the HAPO Golf Classic, has raised nearly $1.2 million dollars for cancer care in our community since becoming a part of the TCCC Foundation.

Volunteers hosted many other events as well. Bake sales, raffles, spaghetti feeds, chili cook-offs, volleyball tournaments and more, all created a base of support that still exists for the Foundation today. The establishment of our TCCC Guild and Men’s Club was a critical factor in creating the far reaching support for the Foundation. These volunteers also served as tour guides once the Cancer Center was open and created the base for our volunteer program, which added over 12,000 hours in service to the Cancer Center in 2017.

From its beginnings as a vacant lot at Vista Field, community support took the Tri-Cities Cancer Center from vision to reality and made a dramatic impact on the quality of healthcare in our region. The birth of the Tri Cities Cancer Center was a grassroots community project. The Tri-City Herald called it “a triumph for Tri-Citians who struggled into the thicket of conflict to bring a worthwhile project to conclusion (and)…gives the entire community a reason to be proud of its own dedication for contributing to the quality of health care available in the Tri-Cities.”

There have been many members of our community who have invested in world-class cancer care for our region since the Foundation began in 1993. Since this time, over $20 million dollars have been raised to create the level of care and service, grow the availability of world class technology and provide extensive outreach and support to our early detection and prevention efforts.

The true spirit of this Foundation is in the support from our community. The Tri-Cities Cancer Center began as a vision to bring the best in cancer care to the place we call home. The people, the stories and generous contributions from the community made the vision a reality.


Sugar: It Gets a Little Sticky

By: Kristin Koskinen, RDN, LD, CD, Eat Well, Live Well

68% of processed food and beverages sold in the US have added sugars. Nearly seventy percent! Sugar hasn’t made the hot-topic list in nutrition circles for a while, too often overshadowed by the likes of the sexier “macros” and “super foods.” However, evidence indicates that the sugar-laden Western diet has adverse effects on cardiometabolic health (think heart disease and diabetes) as well as cancer. Recent research at MD Anderson Cancer Center suggests excess dietary sugar, notably in the form of fructose, increases the risk of breast cancer and subsequent metastasis to the lungs*. Consumers are encouraged by health organizations, government agencies, and their healthcare providers to “read the labels” before making food purchases. It’s great advice, but not always so easy to follow. As part of my recent community education presentation at the TCCC, I covered some of the fundamentals of reading the label as it relates to added sugar. If you were there, here’s a review, if not, I hope to see you next time and here’s the low-down.

The Guidelines
So what exactly constitutes “excess sugar”? According to the World Health Organization and the American Heart Association it’s anything more than six (6) teaspoons of added sugar per day for children and women over the age of 18, nine (9) teaspoons for men 18 and older. This translates to a maximum recommended added sugar allowance of 24 grams of sugar for women and children, 36 grams for men. Most people underestimate the amount of sugar they eat or drink per day. As a reference point, a 12 oz. coke has 36 grams (9 teaspoons) of sugar in the form of high-fructose corn syrup. Added sugar is just what it sounds like: it’s added. It isn’t an integral part of the food. Added sugar doesn’t include the natural sugars found in whole fruits, vegetables, or milk, for example.

A New Label
The last iteration of the FDA Food Label rules lumped sugars together, making it difficult for consumers to distinguish naturally occurring sugars from those added. For example, a cup of plain yogurt may have 8g of sugar listed on the current label. That sugar comes from the milk used to make the yogurt and isn’t counted toward your daily added sugar tally. However, if your yogurt is flavored, it may have 16g or more of sugar, but the label didn’t make clear how much was added and how much was a natural component of the food. The additional sugar WOULD count toward your added sugar for the day. To clear up the confusion, beginning at the end of July 2018, the FDA rules will be updated to include an “Added Sugars” line to the label. Companies have until 2020 to comply, but you should see changes soon. Beyond the Nutrition Facts lies another bevy of potential confusion: the ingredients list. By law, manufacturers are required to post the ingredients of their products in descending order based on weight. To keep “sugar” from being the first listed ingredient on the label (because food shoppers are swift enough to recognize that’s usually not a healthy purchase) manufacturers will often use different forms of sugar so that they can be listed separately. Clever, huh?

A Rose by Any Other Name Would Smell as Sweet
Brilliant words from the great bard, William Shakespeare. And yet, he’s not the only crafter of words. Food manufacturers have more than sixty versions, and subsequently label names, for sugar at their disposal, which when presented in the legal minimum of a 6 point font (it looks like this: 6 point font), presents a decoding challenge for consumers. To keep things simple, look for these code words or parts of words which all translate to “sugar”:
– Syrup as any part of a word or phrase
– Words ending in –ose (glucose, fructose, sucrose, etc.)
– Sugar (organic, beet, cane, coconut or otherwise)
– Honey
– Nectar

Read beyond the first couple ingredients to get a good idea of how many versions of sugar you are eating, especially while we wait for the new labeling laws to take full effect. Oh, and if no one has mentioned it to you lately, you are sweet enough as you are, no extra sugar required. *Kimmons, R. https://www.mdanderson.org/newsroom/2015/12/sugar-in-western-diets.html

Kristin Koskinen, RDN, LD, CD
Kristin is a registered dietitian nutritionist based in the Tri-Cities. You can learn more about her and her practice, Eat Well, Live Well, at www.eatwellpros.com


Natural Supplements for Prostate

By: Lindsey Josephson, Naturopathic Physician, Tri-Cities Cancer Center

The use of natural therapies in cancer is an ever growing field and for good reason. Research from the Bastyr Integrative Oncology Research Center (BIORC) has recently shown that adding well-chosen natural therapies to your cancer treatment can may improve your outcomes for many types and stages of cancer! Caution is needed however since using natural therapies alone can cut your chances of survival in half (Yikes!). Fortunately, new research is coming out every day helping natural medicine practitioners to better understand how these medicines interact with conventional therapies. This will allow me and other natural practitioners to continue improving your cancer care experience.

In honor of upcoming prostate cancer awareness month, I will discuss a couple natural therapies that are popular among patients with prostate cancer. Please remember that all natural therapies can potentially interact either harmfully or beneficially with medications so never start any natural therapy without talking to myself or someone who is familiar with the activities of these substances.

1. Green Tea
Green tea is a popular beverage that is purported to have a wide variety of health benefits ranging from reducing cancer risk to weight loss. In the case of prostate cancer it’s true: green tea really does reduce the risk of getting prostate cancer. Not only can it reduce the risk of developing cancer but it can enhance the effectiveness of certain chemotherapeutics and block at least one mechanism by which prostate cancer can become resistant to certain treatments. There are however, other treatments that may be used for prostate or other cancers that can be made less effective or even completely inactive by green tea.

2. Quercitin
Quercitin is another natural extract that comes from various fruits and vegetables like apples, broccoli and onions. Quercitin works very well along with green tea to enhance the effectiveness of certain chemotherapeutic agents as well as to reduce the growth of prostate cancer cells. As a nice side effect quercetin can even reduce the severity of seasonal allergies. It can also change the way certain medications are metabolized in your body so again, talk to someone before you use it.

3. Resveratrol
Resveratrol is a compound that is found in many different plants in varying concentrations. It is most famously found in red wine but many other sources exist such as blueberries, peanuts, grapes and Japanese knotweed. Resveratrol is a substance of high interest for prevention of many cancers including prostate. However, the really interesting thing is that when resveratrol is consumed in food the amount needed to reduce cancer risk are much smaller than the amount that would need to be taken as a single agent in a supplement. Resveratrol is one of substances that clearly show the superiority of healthy diet and lifestyle over supplements for long term maintenance of health.

4. Turmeric
Turmeric is an exotic spice that is used commonly in Indian and middle-eastern cuisine. It is most known as the yellow colored spice in curries. The interest in turmeric as a cancer preventive agent originally began because of population research that showed those counties where turmeric was commonly eaten had lower rates of cancer than others. Further research into turmeric has shown a story very similar to that of green tea. Yes, turmeric can reduce your risk for cancers, including prostate. It can be used effectively with some cancer treatments to enhance potency and reduce side effects. It can also reduce the effectiveness of other treatments, so once your treatment is done, eat away on that curry but during treatment talk to me first.

For more information about our Naturopathic Clinic, please visit us at tccancer.org/naturopathic


Be Aware of Prostate Cancer

By: Juno Choe, MD, PhD, Radiation Oncologist, Tri-Cities Cancer Center

Let’s talk about prostate cancer. Prostate cancer is the second leading cause of cancer in men in the United States, and only skin cancers are diagnosed at a higher rate. Approximately 1 in 9 men will be diagnosed with prostate cancer at some point during their lives. It is estimated that over 164,000 men will be diagnosed with prostate cancer this year in the United States. Many prostate cancers progress slowly, and for most men with prostate cancer, they will not die from their disease. Despite this, it is estimated that there will be over 29,000 deaths this year due to prostate cancer.

In my practice, I am often asked by patients the reasons why they have developed prostate cancer. In the vast majority of cases, there is no specific cause that can be identified. Prostate cancer has a high incidence within our population and it affects a large number of men. However, there are well known factors that increase the risk for developing prostate cancer.

Age is a big risk factor. The risk of developing prostate cancer increases dramatically after age 50 and more than 60% of prostate cancers are diagnosed in men over the age of 65. African American men have a higher risk of developing prostate cancer compared with the general population. They are also more likely to develop prostate cancer at a younger age and their prostate cancers tend to be more aggressive. The reasons for these differences are unknown. Family history can be an important risk factor. Men with a first degree relative such as a father or brother with a history of prostate cancer will be twice as likely to develop prostate cancer. Having two close relatives with prostate cancer will increase the lifetime risk of developing prostate cancer five-fold. There are also families with genetic mutations including BRCA1 or BRCA2 and Lynch syndrome. Affected men in these families will be at a much higher risk for developing prostate cancer. Unfortunately, all of these risk factors are impossible to modify.

There are other risk factors that we may be able to change. There seems to be an association between prostate cancer and consuming red meat and high fat dairy products and not eating enough fruits and vegetables. There is also an association between obesity and an increased risk for developing prostate cancer, as well as many other cancers. Therefore, my recommendation is to adopt a healthier lifestyle, eat fewer calories, and exercise more. Minimize your intake of fat from red meat and dairy products. There may be a connection between eating a Mediterranean diet and many health benefits including reduced prostate cancer risk. Therefore, try to incorporate more olive oil into your diet. A diet rich in fish as well as fruits, vegetables, and legumes (such as beans) may reduce your prostate cancer risk. Tomatoes are high in lycopene and may be particularly helpful in preventing prostate cancer. If you smoke, it is important to quit smoking to reduce the risk of developing numerous types of cancers and worsening lung function as well as heart attacks and strokes. Cigarette smoking has also been associated with higher prostate cancer mortality. There may be an association between too much calcium supplementation and prostate cancer risk. While calcium taken in moderation may be reasonable, it is a good idea to avoid taking more than 1,500 mg of calcium supplements per day.

There is no way to completely eliminate your risk of prostate cancer. However, a prostate specific antigen (PSA) blood test can help diagnose prostate cancer. The current U.S. Preventative Services Task Force recommendation states that men between the ages of 55 and 69 can consider periodic PSA screening for prostate cancer. Some patients at higher risk may consider starting PSA screening at an earlier age. It is important to have a discussion with your primary care provider regarding the pros and cons of PSA screening.

As one of the leading cancers in men, I believe it is important to have an awareness of prostate cancer. Making smart lifestyle choices can help reduce your risk for prostate cancer and can help you to lead a longer and healthier life.