Assisting uninsured women in receiving early diagnosis of, treatment for breast, cervical cancer

 

Dr. Robert Burack

By Robert Burack, M.D., MPH, physician manager of the Breast and Cervical Cancer Control Program and professor of Internal Medicine at Karmanos Cancer Center and Wayne State University School of Medicine.

The Breast and Cervical Cancer Control Program (BCCCP) is the No. 1 safety net for uninsured women in Michigan. Karmanos Cancer Institute is the local contracting agency in Wayne County for BCCCP, which is one of 21 state-wide programs operated by the Michigan Department of Community Health.

Through this program, low-income women, ages 40-64, have access to life-saving cancer screening services, and women who have breast and cervical cancer are identified at earlier stages of these diseases, when the survival rate is far more favorable and treatment is less expensive.

Early detection is an extremely effective tool in fighting breast cancer. When breast cancer is found and diagnosed while still confined to the breast, the 5-year relative survival rate soars to 98 percent. What’s more, timely mammograms could prevent 15 to 30 percent of all deaths from breast cancer in woman over age 40. And, as much as $20,000 is saved in initial treatment cost for each breast cancer case that is detected early.

Sadly, low-income women have lower screening rates; are 41 percent more likely to be diagnosed with late-stage breast cancer; and are three times more likely to die from breast cancer. Uninsured women are more likely to receive a late-stage breast cancer diagnosis and are 20 to 50 percent more likely to die from the disease than women with insurance. And because of gaps in our health care system, a breast cancer diagnosis is much deadlier for racial and ethnic minorities, the poor, and those with little or no health insurance. We must close the gaps that exist between need and access, fear and understanding, and breast cancer and its cures.

Since 1992, when the BCCCP program was established in Wayne County, it has grown substantially from an initial enrollment of 358 to more than 8,000 women in 2011. Over this time nearly 900 women have been diagnosed and treated for breast cancer and 300 for cervical cancer.  Most importantly, in the absence of the earlier detection provided by their participation in the BCCCP, most if not all of these women would have remained undiagnosed until their disease had progressed beyond the stage at which it remained curable.

The Wayne County Breast and Cervical Cancer Control Program (BCCCP) today has an opportunity to reach a new milestone – providing potentially life-saving cancer screenings for 10,000 women in a single year. 

The work of the BCCCP would not be possible without the support it receives from MDCH and its community partners. Recognizing the still-unmet need in Wayne County, MDCH recently increased its funding of the Wayne County BCCCP to allow the enrollment of an additional 1,200 women.  This will bring this year’s enrollment total to over 10,000. 

The program’s work also would not be possible without the additional support it receives from its community partners including the Komen Detroit Race for the Cure, the Links organization, and other groups.  This additional support has been critical in expanding the program’s enrollment (by at least 20 percent) and assuring timely diagnosis and treatment for all who need it. 

With the Wayne County BCCCP’s mission in eliminating the preventable burden of breast and cervical cancer in our community, reaching 10,000 women this year is a critical step towards accomplishing that goal.

To reach the BCCCP at Karmanos Cancer Institute, please call 1-800-KARMANOS (1-800-527-6266), e-mail info@karmanos.org or visit www.karmanos.org.

How Karmanos Helped Me Achieve My Goals

Corinne Duluk

By Corinne Duluk, Web Manager at the Barbara Ann Karmanos Cancer Institute

When I sit back and think about where I was 17 years ago and where I hoped to be when I became an “adult,” I am proud to say I have accomplished my goals.

Seventeen years ago I lost my mom to adrenal cancer. It was devastating to watch someone die in such a painful way. There was very little known about this type of cancer back in 1995, so the prognosis was bleak from the day she was diagnosed.

I watched my mom go through surgery, chemotherapy and radiation, only to see her get weaker and weaker with every passing day. This once vibrant woman, so full of life and love, became a living skeleton. But, to be honest, to this day I have never seen someone fight a losing battle with the energy and determination that she exuded.  

During the year or so that she fought her cancer, it was an amazing thing to witness an entire family come together in support and love for her. Every day a member of the family stayed with her, made dinner for me, my sister and dad, and dropped everything just to help. Throughout the whole journey we had unwavering support and dedication. I look back now and realize that without their help, that period of my life could have been much more difficult.

When she passed away I knew I had a couple of options for how to deal with the situation. I could feel sorry for myself and go down a path of self-destruction or I could dedicate my life to accomplishing my goals with the same energy and determination as my mom did through her cancer battle. Drawing on the inspiration from my mother and family, I decide that I would dedicate my life to my goals, with the central goal of helping others.

Nursing: it’s not just about caring for the patient’s physical ailments

Jamie DeSnyder

By Karmanos Staff Nurse Jamie DeSnyder

I have learned that as a nurse, the basic life-saving techniques are not the only things that you need to know with this profession.  A nurse has to be patient, respectful and ready for anything.

This story about Ms. B. would test anyone’s patience.  I met Ms. B at approximately 9 p.m. when she came up from the Emergency Room for a blood transfusion reaction.  She had been stabilized and transferred up to the floor.  I was prepared to keep a close eye on her for any signs or symptoms of anaphylaxis.  What I wasn’t prepared for was the emotional roller coaster ride she was going to go on that night.

When Ms. B arrived to my floor, she was very irritable, barking out orders to turn her, take her socks on and off, and put the head of the bed down.  Of course, I was compliant with her wishes, thinking, ‘Let her yell at you. She’s had a rough day.’ 

She fell asleep and slept quietly for about three hours when she woke up in a fury.  As I was filling out patient charts, I heard her scream “NUUUUURSEEEE!” I ran over to see what she needed. “I’m cold!” was her loud statement.  So I went to get her a warm blanket and turned the heat up. 

Finding life-saving doctors, right in your own back yard

By Tom Kalas

Karmanos patient Tom Kalas will speak at the 30th Annual Dinner to benefit the Barbara Ann Karmanos Cancer Institute. For more information about Annual Dinner, held Saturday, April 28 at the General Motors Vehicle Engineering Center in Warren, click http://www.karmanos.org/app.asp?id=1124

In November 2007, I was diagnosed with Acute Myelogenous Leukemia, also known as AML. It is a very aggressive and deadly form of cancer. I was 44 at the time, with a business, a wife and three young kids.

When diagnosed, my world shattered. I definitely was not ready to die, but I was also very fearful of what the immediate future would be like. To complicate things even further, three months prior, my father was diagnosed with liver cancer and given one year to live. 

I truly was at an extreme low, but vowed to seek treatment at what is considered the very best (or so I thought) leukemia treatment center in the country.  My path took me to an out-of-state comprehensive cancer center within two days after my diagnosis for a second opinion and to find hope that my condition was misdiagnosed and a better outcome would result. What I didn’t realize at the time — but later would discover — was that the best center for treatment of my illness was right here at the Barbara Ann Karmanos Cancer Center.

Bringing the best in cancer care, expertise to the suburbs

Dr. Jordan Maier

By Jordan Maier, M.D., medical director of Karmanos’ Weisberg Cancer Treatment Center in Farmington Hills

Over the past few years I have had several family members and friends diagnosed with different types of cancer. While I have devoted my life to taking care of cancer patients, the shock, anxiety and fear of hearing a loved one has cancer never diminishes. 

Fortunately, because I work with the best oncology physicians, researchers, nurses and staff at Karmanos, I don’t have to think twice about where to send patients for their care.  And because all of our physicians specialize in specific areas of oncology, the expertise they provide allows me an unparalleled level of comfort when asking one of them to see a family member. 

Those who live in the suburbs may find it more convenient to be seen at our satellite treatment center in Farmington Hills. This center, also known as the Weisberg Cancer Treatment Center, provides the same high level of medical attention as our main location in midtown Detroit, just closer to home. 

Caring for the menopausal woman during cancer treatment

Dr. Lisa Chism

By Lisa Chism, DNP, nurse practitioner at the High Risk Breast Clinic at the Alexander J. Walt Breast Center at Barbara Ann Karmanos Cancer  Center

As a nurse practitioner, I take care of new patients and evaluate new breast problems, patients at elevated risk for breast cancer, and breast cancer survivors. Recently, I began developing a clinic to take care of the menopausal symptoms of women with cancer, those who cannot go on hormonal replacement therapy or are at high risk for breast cancer. Those symptoms may include hot flashes or flushing, night and day sweats, urogenital symptoms such as incontinence, and weight gain, among other symptoms.

It’s estimated that 230,480 women would be diagnosed with breast cancer in 2011, according to the American Cancer Society, and that more than 50 percent of these women were ages 35-51, according to 2011 Surveillance, Epidemiology and End Results data. That means that many women who were diagnosed with breast cancer were premenopausal.

As a result of their cancer treatments, many of these women will experience an induced menopause, which is much more abrupt than a natural menopause and associated with more symptoms, such as the ones mentioned above. For many women, the impact of breast cancer treatment-induced menopause through chemotherapy, surgery, radiation therapy and hormone treatments greatly impacts their quality of life.

Congratulations to our Dream Team Co-Leader!

Dr. Gerold Bepler

By Gerold Bepler, M.D., Ph.D., president and CEO of the Barbara Ann Karmanos Cancer Institute

It’s been a very exciting week for us at the Barbara Ann Karmanos Cancer Center! One of our finest and most beloved doctors, Patricia LoRusso, D.O., director of our Phase I Clinical Trials and the Eisenberg Center for Experimental Therapeutics, has been selected to co-lead the prestigious Stand Up To Cancer (SU2C) – Melanoma Research Alliance (MRA) Dream Team. With this honor, she becomes the first woman to serve in a Dream Team leadership role since SU2C began funding the teams in 2009.

I also would like to recognize her colleague and Dream Team Leader Jeffrey M. Trent, Ph.D., president and research director of the Van Andel Institute in Grand Rapids, and the Translational Genomics Research Institute in Phoenix, for this tremendous distinction.

Dr. Patricia LoRusso

Drs. Trent and LoRusso will direct a Dream Team made up of some of the nation’s leading cancer experts to find more effective treatments for an aggressive form of skin cancer. Dr. LoRusso is a world-renowned expert in clinical and translational research, and Dr. Trent is an internationally recognized expert in molecular-based approaches to cancer. The purpose of the team is to identify patients with BRAF Wild-Type (BRAFwt) metastatic melanoma, do extensive genomic profiling on their tumor, and identify a personalized therapeutic intervention based on the patient’s genomic makeup.

Dr. LoRusso is an incredible leader and a pioneer in the area of testing novel therapeutics to advance personalized cancer care, developing the next standard of care that will be used around the world. This appointment is a testimony to the dedication of Dr. LoRusso and Dr. Trent and their relentless commitment to eradicate cancer. We congratulate them and their entire Dream Team on this outstanding recognition.

Battling a challenging cancer

Dr. Philip A. Philip

By Philip A. Philip, M.D., Ph.D., FRCP,  leader of the Gastrointestinal Oncology Multidisciplinary Team and professor of medicine and oncology at the Karmanos Cancer Center and Wayne State University School of Medicine

Pancreatic cancer presents a challenge to the oncologists whose patients are diagnosed with the disease.  The pancreas is a six-inch long organ that sits across the back of the abdomen, behind the stomach. The pancreas uses digestive and intestinal juices to break down proteins, carbohydrates and fats. It also secretes hormones that affect blood sugar levels.

Because the pancreas is located in the center of the abdomen, deep inside the body, pancreatic cancer is difficult to diagnose at an early stage. Initial disease symptoms—like jaundice, back pain and digestive problems—are often attributed to other ailments. In many cases, by the time a physician makes a correct diagnosis, the cancer has spread to other organs, significantly reducing the chance for a cure.

More than 44,000 new cases of pancreatic cancer will be diagnosed this year and more than 37,000 patients will die from the disease, according to the National Cancer Institute. Pancreatic cancer mortality rates have changed little in the past three decades. The five-year patient survival rate is less than 5 percent.

It’s not clear why some people get pancreatic cancer while others don’t. But researchers have identified certain risk factors.

Studies show that cigarette smoking, a diet high in fat and animal protein, and diabetes increase the chance of getting pancreatic cancer. We also know that people with a family history of pancreatic cancer are more likely to get the disease.

Treatment options include surgery, chemotherapy, radiation therapy and targeted therapies using cancer-fighting drugs. Karmanos researchers continue to explore methods of early detection and disease prevention.

Pancreatic cancer is the fourth-leading cause of cancer death. It’s critical that we identify genetic and other risk factors that lead to the disease and develop new therapies for relief of cancer associated symptoms.

For more information about pancreatic and other cancers or to schedule an appointment with a Karmanos doctor, please call 1-800-KARMANOS (1-800-527-6266), e-mail info@karmanos.org or visit www.karmanos.org.

Cigarettes aren’t the only cause of lung cancer

Dr. Shirish Gadgeel

By Shirish Gadgeel, leader of the Thoracic Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute and associate professor of oncology at Wayne State University School of Medicine

In the early 1900s, lung cancer was a relatively rare disease, with barely a mention in major medical textbooks. This year, there will be an estimated 221,000 new lung cancer diagnoses in the United States and nearly 157,000 deaths from the disease, according to the American Cancer Society.

Many people presume a direct link between lung cancer and smoking. But that assumption isn’t always accurate.

About 85 to 90 percent of lung cancer cases occur in current or former smokers. But only about 20 percent of long-term smokers go on to develop lung cancer. Ten to 15 percent of lung cancer patients are people who have never smoked.

So what accounts for lung cancer cases in patients who quit smoking many years ago or never took up the habit?

The risk for developing lung cancer persists even after smoking cessation. Other risks include exposure to asbestos, radon and second-hand cigarette smoke. There is also increasing evidence that small particulate matter in air pollution may cause lung cancer.

At Karmanos, cancer researchers are actively seeking better ways of detecting the disease at an early stage. They’re also investigating other lung cancer risk factors such as genetics, as well as developing better treatments and cancer-fighting drugs.

If we can reduce our nation’s smoking habits, we will make a major impact on lung cancer mortality. That won’t eliminate lung cancer entirely, but it can be substantially reduced.

If you’re interested in receiving information about smoking cessation, call 1-800-KARMANOS (1-800-527-6266) and ask for the Patient/Community Education Department or send an e-mail to communityed@karmanos.org.

Quit Tips

Here are some ideas to help smokers break the habit:

Change your daily routine. Because smoking becomes such an ingrained habit, sometimes a small change in your daily routine – like driving a new route to work – can break the cycle.

Drink lots of water. People who quit smoking sometimes feel tired. Drinking water can help flush out fatigue-causing toxins that have built up in your body.

Become more physically active. Engage in a light exercise program instead of smoking. This will improve your health – a tangible benefit of quitting!

Clean house. The day before you quit, wash all your clothes and thoroughly clean your house and car. This eliminates smoke odors that can trigger a relapse.

Coping with stress during the holidays

Kathleen Reynolds

By Kathleen Reynolds, MSN, RN, CS, clinical nurse specialist with Karmanos’ Supportive Service Department and Counseling Service

Once summer is over, it seems as if the holidays come one right after another – almost as if they are rolling over us like a bulldozer!  Store promotions for Halloween take place right after Labor Day, and before we know it, Thanksgiving is here, and then the huge push towards the winter holidays of Hanukkah, Kwanzaa, and Christmas. It all ends in a mad rush as we plan our New Year’s Eve festivities.

Many cancer patients struggle getting through one day to the next while going through cancer treatment. The onslaught of these wonderful social and family events during the holiday season can become almost like an albatross around your neck.  You may feel guilt over your inability to keep the fast and furious pace you normally keep and you may feel exhausted by your cancer treatments. It can all send you into a tailspin!

As you ponder how you might make this a better year for yourself, keep in mind that to benefit from treatment, you need to minimize your stress levels and nurture your body so that you can keep yourself in a healing environment.