BREASTCANCERAWARENESS

SURVIVORS’ STORIESRESEARCH

NEW TREATMENTSPREVENTIVE MEASURES Friday, OctOber 17, 2014

An alarm went off on myiPhone yesterday: Time toschedule my mammogram.

I made that annual Octobercalendar entry three years

ago when we began this effort to promoteBreast Cancer Awareness throughout theNorth Shore and Merrimack Valley. Likemany women who spend so much timetaking care of kids and work and home,we sometimes need that little reminderto take care of ourselves, too.

I am proud to present this specialreport on Breast Cancer Awareness withhopes that this will be a resource — anda reminder — that prevention is possible.On these pages, you’ll read stories ofinspiration, stories of medical advances,and stories of practical matters.

Early detection is key to survivingbreast cancer. That means along withmammograms, monthly self-exams are amust. The National Breast Cancer Foun-dation tells us that when breast canceris detected early, at the “localized stage,”

the five-year survival rate is 98 percent.Still, other facts are alarming:

1 in 8 women will be diagnosed withbreast cancer in their lifetime. And lastyear alone, there were 232,000 new inva-sive cases diagnosed, and 39,620 deaths.

A sincere thank you to the dozens ofcommunity and business leaders whohave made this guide possible throughtheir sponsorships. You’ll see theirmessages not only in these pages, butalso throughout our newspaper andwebsite during the month of October.They are spreading the ‘power of pink’throughout our region.

When you see a pink ribbon this month,I hope you are reminded of the impor-tance of early detection, and this pledgeto be a survivor:I PLEDGE TO:� Schedule my mammogram� Perform a monthly self-exam� Exercise regularly� Follow a healthy, low-fat diet� Quit smokingCopies of this special report are avail-

able at the front lobby of the Daily News.

Please stop by our office on Liberty Streetin Newburyport if you’d like a few extrasto pass along to those you love. Andplease thank the sponsors whose generos-ity has made this effort possible.

Welcome to ourBreast Cancer Awareness special report

Karen Andreas

KAREN ANDREASPublisherThe Daily News of Newburyportand North of Boston Media Group

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SupportingBreast Cancer

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Join us in our fight against BreastCancer by purchasing some of yourfavorite professional salon brandsin their seasonal pink packaging!

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When it comes to fightingcancer, it helps to know everyavailable option. Fortunatelyfor patients of the GerrishBreast Care Center at AnnaJaques Hospital, a closeaffiliation with Beth IsraelDeaconess Medical Center(BIDMC) brings even moreadvanced clinical expertise towomen in our community.

Every Thursday morning,Dr. Peter Hartmann, medi-cal director of the GerrishBreast Care Center, andmembers of a multidisci-plinary team discuss currentcases with a medical oncol-ogy expert at BIDMC viahigh tech videoconference.The collaboration, whichbegan last year, allows theteam to discuss screening,diagnosis and treatmentwhile providing patientswith additional expertise andparticipation by BIDMC intheir treatment planning.

Patients benefit fromthese weekly videoconfer-ences in several ways:

Breadth of expertiseThe more resources dedi-

cated to planning treatmentfor a patient, the better.Cancer care is changing rap-idly, and academic medicalcenters such as BIDMC havetheir fingers on the pulse ofthe latest research and treat-ment. Yet many women pre-fer to be treated in their owncommunities. The collabora-tion gives patients the bestof both worlds — access tocutting-edge advances with-out traveling far from home.

Specialty care, close to homeVideoconferencing allevi-

ates the need for the patientto seek additional counselby traveling to a specialistin Boston. The videocon-ferencing is also anotheravenue for the team to learnabout clinical trials that mayoffer potential treatmentfor patients at the GerrishBreast Care Center. Some tri-als may require the patientto have a certain componentof the care in Boston, butoften treatment is adminis-tered at Anna Jaques.

TimelinessWaiting can add additional

stress for patients who havebeen diagnosed with cancer.Sharing ideas in real-timevia videoconferencing meansless delay for the patient. Asan example, a woman canhave a mammogram on Mon-day, a biopsy on Tuesday andhave her case discussed onThursday, meaning there isa treatment plan within daysof the diagnosis.

During the weekly video-conferences, both new andongoing cases are discussed,ensuring that all patientshave access to Anna Jaques’network of experts.

Videoconferencing brings care close to home

Courtesy photosAbove, doctors at AnnaJaques discuss current caseswith a medical oncologyexpert at BIDMC via hightech videoconference everyThursday. The collaborationbetween doctors at AnnaJaques and doctors at BethIsrael Deaconess MedicalCenter gives patients access tocutting-edge advances withouttraveling far from home, saysDr. Peter Hartmann, at right.

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Supporting Breast CancerAwareness Month

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Breast health screeningsare much more personalizedthese days, which meansthat when you go for yourannual checkup, you won’tnecessarily receive thesame battery of tests as thewoman next to you. 

We know that earlierdetection leads to betteroutcomes, but we also don’twant to expose women tothe anxiety of additionaltesting if it isn’t warranted. 

New screening mod-els, like the ones used atthe Gerrish Breast CareCenter, affiliated withBeth Israel DeaconessMedical Center, allow us to

determine which women areat a greater risk for develop-ing breast cancer.

In addition to assessinga woman’s current healthand past mammograms, ourscreening models take intoaccount a detailed familyhistory of various cancersto determine her lifetimerisk for developing breastcancer. 

We look at multiple gen-erations on both maternaland paternal sides – thepatient’s parents (and auntsand uncles), grandparentsand great-grandparents. 

We also want to know if aperson’s children have hadcancer. For this reason, Iencourage patients to learnas much as possible about

their family medical history.Breast cancer may run

in the family if first-degreerelatives, such as a motheror sister, or many close rela-tives (aunts, grandmothers,cousins) have been diag-nosed with breast cancer orovarian cancer, especiallybefore age 50. 

In general, the risk fordeveloping cancer beginsa decade earlier in sub-sequent generations. Forexample, if your motherdeveloped breast cancerat age 40, you are at anincreased risk beginning atage 30. 

For that reason, it’simportant to have these con-versations about family his-tory with your primary carephysician sooner ratherthan later.

While breast cancer is theprimary concern, we alsoneed to know about a his-tory of all other cancers inthe family, especially colon,pancreatic, prostate, mela-noma and ovarian cancer.These cancers may beassociated with inheritablegenetic syndromes. 

However, not everycase with a strong family

history will test positivefor a genetic syndrome. Forthis reason, researchers areinvestigating other genesin families that have a his-tory of cancer. 

While we have come along way in our understand-ing of breast cancer, moreresearch is needed to under-stand exactly how the genesaffect risk and which othergenes also play a role.

When there is a familyhistory of cancer, we oftenrecommend that womenspeak with a genetic coun-selor to determine if addi-tional tests and screeningsshould be done to check forpossible genetic mutations. 

If a genetic mutation ispresent, there are additionalsteps that a woman cantake to lower her risk ofcancer, such as having herfirst breast cancer screen-ing at a younger age, havingmore frequent screeningsor being screened for othercancers. 

Risk is a product of manythings. You can’t chooseyour relatives, but thatdoesn’t mean we shouldbe passive about ourhealth as it relates to our

family history. I encour-age everyone — menincluded — to know hisor her family history andproactively address anyconcerns that might affect aperson’s health.

¢ ¢ ¢

Dr. Peter Hartmann ismedical director of the Ger-rish Breast Care Center atAnna Jaques Hospital, affili-ated with Beth Israel Dea-coness Medical Center.

What does your family tree have todo with breast cancer screening?

Dr. Peter Hartmann

Courtesy photoDr. Peter Hartmann is the medical director of the GerrishBreast Care Center at Anna Jaques Hospital.

Breast cancer may run in the family if first-degree relatives, such as a mother or sister, or many close relatives (aunts,grandmothers, cousins) have been diagnosed with breast cancer or ovarian cancer, especially before age 50.

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Besides skin cancer,breast cancer is the most

commonlydiagnosedcanceramongAmericanwomen.

Justunder 30percent ofcancers inwomen arebreast can-

cers. Over a woman’s life,the risk of breast cancerincreases from 1 in 227 atage 30 to 1 in 26 by age 70.

Around 230,000 newcases of invasive breast

cancer are diagnosed peryear, with about 57,000new cases of noninvasive(in-situ) breast cancer.Although about 40,000women a year will die frombreast cancer, the deathrate from breast cancer hasbeen decreasing since 1990.

These decreases in thedeath rate from breastcancer are thought to bethe result of treatmentadvances, earlier detec-tion, thorough screeningand increased awareness.

Primarily, women mustbe aware of the risks ofbreast cancer and aware ofthe resources available inthe community to screen,diagnose and treat.

One very effective strat-egy being employed todayis the team approach.It brings together a

multidisciplinary group ofkey medical professionals— radiologists, breast sur-geons, medical oncologists,radiation oncologists andplastic surgeons.

This team then workstogether to help womendetermine their risk ofbreast cancer, promoteappropriate screening, makean accurate diagnosis if a

breast lump is found andthen tailor a specific treat-ment plan for each patient.

When the team approachis implemented from thetime of diagnosis throughtreatment and recovery, itcan result in significantlyimproved patient outcomesand quality of life.

Many women willrequire less extensive

procedures, such as alumpectomy, to treat theirbreast cancer, while asmall portion may requiremastectomy to fully treatthe cancer.

The prospect of a mas-tectomy is daunting and alife-changing event.

Understanding thatbreast reconstructioncan be an integral part ofbreast cancer treatmenthas a positive effect onwomen diagnosed withbreast cancer. Breastreconstruction has shownagain and again to havea positive effect on thequality of life, self-esteemand body image forwomen who undergo amastectomy.

The American Society ofPlastic Surgeons has estab-lished Oct. 15 as Breast

Reconstruction AwarenessDay (BRA Day).

It is the belief of oursociety that all women whoare candidates for breastreconstruction should bemade aware of the optionsavailable to them. Allwomen who are candidatesfor breast reconstructionshould be offered treatmentin a safe and timely manner.

Breast reconstructioncan be done at the time ofmastectomy or months toyears after, depending onthe needs and wishes ofthe patient.

Never say never when itcomes to reconstruction.

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Facts about breast cancerDr. Michele SasmorRiverSong Plastic

Surgery

Never say never when it comes to reconstructive surgery post breast cancerUnderstanding that breast reconstructioncan be an integral part of breast cancertreatment has a positive effect on womendiagnosed with breast cancer. Breast

reconstruction has shown again and againto have a positive effect on the qualityof life, self-esteem and body image forwomen who undergo a mastectomy.

Dr. MicheleSasmor

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PATIENT NAVIGATORSCHART A PATH THROUGH

APPOINTMENTS, TERMINOLOGY

Hearing the words “you havecancer” can stop even the stron-gest person — and their fami-lies — in their tracks. 

Although not the medical cri-sis it once was due to treatmentadvancements, the diagnosis of apotentially life-threatening illnessleads to additional testing, appoint-ments and treatment. 

It is one of the most stressfulevents in a person’s life, as shefaces uncertainty and difficultdecisions. 

As the Patient Navigator of theGerrish Breast Care Center, affili-ated with Beth Israel DeaconessMedical Center, I help patientsobtain the health care they need,give them the resources to makedecisions and advocate on theirbehalf. My goal is to lessen theiranxiety while making sure theyhave timely access to care.

Patient navigation began in thelate 1980s in Harlem, N.Y. Dr. Har-old Freeman felt that women oftenneeded assistance and advocacyafter being diagnosed with breastcancer. 

Later, research showed thatpatient navigators indeed helpedwomen better plan and imple-ment appropriate care while fewerwomen “fell through the cracks.”Since that time, patient navigationhas become more commonplace inhealth care, especially for patientswith cancer.

At the Gerrish Breast Care Cen-ter, every woman has access to myservices. In fact, the radiologist

will contact me each time a womanhas a “suspicious” finding duringher mammogram. 

My first goal is to quickly sched-ule a biopsy so that the patient hasas short of a wait as possible untila diagnosis is made.

Although 75 to 80 percent of sus-picious breast findings are nega-tive, the stress between this findingand a concrete diagnosis, (benignor malignant) is a very frighteningand stressful time to patients andtheir families. Fortunately I canoften schedule the biopsy the nextday and a follow-up appointmentwithin 48 hours of that.

As a specialty trained regis-tered nurse, I tailor my work toan individual’s needs, which mayinclude explaining new terminol-ogy, scheduling appointments,identifying barriers to care, con-necting the patient to hospital andcommunity services and providingemotional support to the patientand family. I also stay on top ofresearch and new trends in breasthealth which may benefit ourpatients.

Every patient and family is dif-ferent, which keeps my role inter-esting as I serve as the conduitbetween all of the different health

care providers. Giving womena single point of contact in thispotentially overwhelming situationmakes sure that access to timely,specialized care is possible for allpatients.

It is an honor and a privilege towalk next to the patients as theyprogress on their cancer journey.I have had the lovely opportunityto meet many wonderful womenand their family and friends whohave taught me the meaning ofstrength.

To find out more about the Ger-rish Breast Care Center visit www.ajh.org/breastcare.

Kathy Porter,RN, OCN,

Patient Navigator

Kathy Porter, RN, OCN, is the patient navigator at the Gerrish Breast Care Center at Anna Jaques Hospital.

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Every picture tells a story,especially when it comes tobreast imaging results. 

As Mammography Super-visor at Anna Jaques Hos-pital, I’ve seen the samesituation many times. Awoman comes to us for amammogram, and althoughshe’s had previous screen-ings, she doesn’t bring anyof the past images with her. 

If the current mammogramshows any abnormalities,she’ll need more imagingand a possible biopsy to fur-ther investigate.

 If she had images fromprior screenings, we couldcompare the pictures to seeif the abnormalities hadgrown. If the abnormalitieshadn’t grown or changed, thepatient could have avoidedall the additional tests. 

Ideally, you will have allof your screenings doneat the same center, butthat isn’t realistic over thecourse of your life. You arestill able to obtain access topast screenings, even if youhave moved on to anotherfacility. 

All you need to do is con-tact the center where youhad them done or give yourprovider the permission tocontact them, and they’llsend the images. 

For that reason, it is impor-tant that you keep a noteof where you’ve had pastmammograms. 

Facilities used to keepmammography results forten years, but now thatscreenings are digital, theycan be kept for much longer.

In most cases, your pri-mary care physician would

have received a writtenreport after your screening,but we much prefer to seethe images. 

Reports may allude toabnormalities in previousimages, but we need tocheck actual size and loca-tion — details that are notalways specific in writtenreports. A history of mam-mogram images lets us seethe full picture over time.

Having a complete pic-ture of your breast healthcan mean less additionaltesting and less worry.When it comes to gettingyour mammogram, themore information we have,the better your chancesof receiving the care youneed. Knowing your pastcan save you a lot of worryin the present.

TIP: Bring past mammogramswith you if go to a new facility

Lisa MooreMammographySupervisor, AnnaJaques Hospital

LISA MOOREMammography Supervisor, Anna Jaques Hospital

All you need to do is contact the centerwhere you had them done or give yourprovider the permission to contactthem, and they’ ll send the images.

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Esther Reid was 47 yearsold when she was firstdiagnosed with coloncancer in 1999. 

“It hit me hard,” shesaid. “I took good care of myself.Walked six miles a day, don’tdrink, don’t smoke.”

Her family has a history of can-cer, which informed her approachto her health all her life. Reid’smother died of breast cancer whenReid was 17 years old. Reid wasone of nine children, and three ofthem died of cancer —her broth-ers Michael, Joe and Johnny.She also had a niece who died ofleukemia.

Still, she wasn’t expecting tohear a cancer diagnosis as a resultof the tests run at her annualcheckup — nor would she expectbreast cancer more than a decadelater.

“I had complained about blood,”said Reid, who lives in HamptonFalls, N.H. But “nothing was show-ing up until they did a colonos-copy. At that point (it had) spreadto the liver.”

Her doctors at Lahey MedicalCenter couldn’t remove the tumoron Reid’s liver because of the dam-age it would have caused to theorgan. 

She spent two years on chemo-therapy and went on a clinicaltrial for a new drug for more thansix months to attack the tumor.

“It seemed to shrink,” she said.After that, surgeons were able toremove the tumor.

“I had no grandchildren at thetime. My daughter had just gottenengaged. I picked myself up and Isaid, Hey, I have a lot to live for. Nograndchildren yet.” 

Reid has three daughters and,

now, five grandchildren.Reid’s final surgery for colon

cancer, when doctors removedthe ports they had used for che-motherapy, was in 2002, and it wasalmost a decade before she hadany sign of cancer again.

“I would go for my mammogramfaithfully every year, because ofmy mother,” Reid said. “In 2011,they found something in the rightbreast, (and) did a biopsy.”

At that time, it was benign, butdoctors increased the frequencyof her mammograms to every sixmonths.

“A couple years go by, 2013,December, (they found) somethingon the left,” Reid said. “They dida biopsy. It’s cancerous. I decidedthat day to have them removed.... Both breasts. Never regretted it.”

She said “I really didn’t knowuntil that day in the doctor’soffice.”

Reid said that her breast cancerwas caught early on. Because ofthat, and because she decidedon an immediate mastectomy,she never had to undergo othertreatment. 

“Not even a pill. No radiation oranything, because I went for thatmammogram,” she said.

She almost didn’t go, though.Her husband, Robert, at the timehad been recently diagnosed withprostate cancer. 

“He got sick maybe two yearsago,” she said. “I almost didn’t gofor that mammogram, becausehow can I put that on him?”

On the other hand, not goingwouldn’t actually change the stateof her health. She thought betterof it, and went for the check up.

“If I had put it off one moreyear,” she said, “God knows whatthe outcome would have been.”

Robert is 65 years old; they’vebeen married for 43 years.

Altogether, Reid views her expe-riences with cancer as positive. 

“I would meet the nicest peo-ple,” she said. “It was a good expe-rience for me. I wish people couldfeel like I did — it wasn’t the endof the world.”

Not that it wasn’t a struggle. “I had tough times, of course

I did. I had almost given up (atone point) and my husband said,‘Don’t you dare,’” she remembers.

There’s a difference that sheillustrated between being optimis-tic and being unprepared for whatcan happen. 

“I got my head sized for the wig,(but) I never lost my hair,” shesaid.

And, she said, “when the grand-children came, that was a wholedifferent ball game. I live forthem.”

Reid said it was importantto “put it all in order, don’t lookat the whole picture. ... You can’tlook at the whole picture. It’s toomuch, too overwhelming. And lis-ten to no one.”

She added, addressing peoplewho might know someone who’sgoing through cancer: “They don’tneed to know all the details of so-and-so down the street. Becausethey’re on alert. I was on alert.”

She said, “I would hear thingspeople would tell me, I wouldnever say that to someone.(Things like) ‘You know, cancercan come back.’”

She said that when it began, shewas getting by minute-to-minute.Then after a while it was hour-to-hour, day-to-day. 

Now she’s back out to a muchmore expansive view of life, livingyear-to-year. 

“I’m 62, going on 63. Five grand-children. Five. That I didn’t thinkI was going to see, at first,” shesaid. 

By Thomas shamma

STAFF WRITER

ESTHER’SSTORY

After losing loved ones, shewas determined to live

The link between diet and can-cer is real. The foods that peopleconsume affect their bodies inmany tangible — though notalways obvious — ways.

Some foods have been linkeddirectly with cancer preven-tion. Several specific vitamins,minerals and phytochemicalshave demonstrated anti-cancerproperties. 

And there is powerful evidencethat suggests that it is the effectof those compounds workingin concert in the context of aperson’s total diet that creates acancer protection “environment”in the body.

Some foods and substancesnoted for cancer prevention attri-butes include:

� Berries (Blueberries, raspber-ries, cranberries and others),

� Green tea,

� Garlic,� Cruciferous vegetables (broc-

coli, cabbage, brussels sprouts),� Onions and leeks,� Tomatoes,� Resveratrol (in red wine).Other foods, as part of healthy

diet, contribute to overall health,and thereby build a body that isless likely to be affected by can-cer. Maintaining a healthy weightand lifestyle has been linked tocancer prevention.

These include:� Whole grains,� Beans and legumes.The human body is a com-

plex organism and new studiesand research are adding to ourunderstanding of it every day.

 Cancer prevention and treat-ment is advancing every day aswell, and knowledge about howthe food we consume affects can-cers risk is a crucial weapon inthe fight against all forms of thisdisease.

Eat foods thatprotect and heal

By KaThy marshall, rNaNNa Jaques

Kathy Marshall

NEWBURYPORT — This October, local hair salons and spas offering fundraisers to helpsupport the Gerrish Breast Cancer Center at Anna Jaques.Here are a list of salons and dates. Call the for further details and to make anappointment.� Beautique, Oct. 18-25, 978-255-2774� Eclipx Salon, Oct. 19, 978-255-4483� Essencia Salon and Spa, Oct. 19-20, 978-388-4772� Hair Spray Salon and Spa, Oct 18-25, 978-358-7839� Interlocks, Oct. 24, 978-465-3010� Jon Val Hair and Skin Salon, Oct. 18-25, 978-373-1180� Linda’s Alpha-Omega Salon, Oct. 19, 978-463-4211� Mirror Mirror Salon, Oct. 18-25, 978-255-2284� Salon Avie, Oct. 21-24, 978-948-3555� SKYY Salon and Spa, Oct. 18-21, 978-462-2300� Transformations, Your Salon and Day Spa, Oct. 18, 978-346-0660

HELP SUPPORT ANNA JAQUES’ GERRISH BREASTCANCER CENTER

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GEORGETOWN — No youaren’t seeing things, and therewas no laundry mishap. 

Georgetown firefighters havebeen sporting pink duty shirtsin October, to support breastcancer awareness.

“The awareness and earlydetection of breast cancer issomething everyone shouldbe conscious about,” said FireChief Albert B. Beardsley.“Georgetown firefighters areproud to wear pink this monthto raise awareness about adisease that affects so manypeople in our lives.”

Georgetownfirefighterswear pinkduty shirtsin October

CLOCKWISE FROM ABOVE: Georgetown firefighter/EMTs in their pink T-shirts forbreast cancer awareness month; Georgetown firefighters pose with their new pinkT-shirts in honor of breast cancer awareness month; a detailed look at the T-shirt.

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We’re here if you need us.And so are we.Peter Hartmann, MD, FACS

Medical Director/Breast SurgeonAnna Jaques HospitalGerrish Breast Care Center Nadine Tung, MD

Breast Medical Oncology andGenetics and Prevention, DirectorBeth Israel Deaconess Medical Center

C O M P R E H E N S I V E B R E A S T C A R E a t A N N A J A Q U E S H O S P I T A L

At the Gerrish Breast Care Center at Anna Jaques Hospital, we firmlybelieve that patients benefit most when cared for by a team. Our affiliationwith Beth Israel Deaconess Medical Center brings together skilledphysicians, like breast surgeon Dr. Peter Hartmann of AJH and breastoncology specialist Dr. Nadine Tung of BIDMC, to provide collaborative,

individualized care. Together, the care team provides a fast, accuratediagnosis and develops a highly personalized treatment plan. Patientshave easy access to advanced clinical services, including genetic testing,and a dedicated Patient Navigator to provide the medical and emotionalsupport they need. At the Gerrish Breast Care Center, compassionateworld-class care starts and ends close to home.

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S c h e d u l e a m a m m o g r a m : 9 7 8 - 8 3 4 - 8 2 1 0 w w w . a j h . o r g / b r e a s t c a r e