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Lymphland International Lymphedema Online
April 4, 2011 - Cure Swelling On The Body With Lymphedema Massage Treatment - UK News Reporter
– Posted By Naomi Farley –
Any obstruction in the lymphatic vessels will prevent the smooth flow of the fluids in the body and lead to a
pooling effect. This is the cause for lymphedema or swelling, particularly in the extremities of the body.
Lymphedema massage is conducted to stimulate the obstructed lymph flow and direct it to the bloodstream.
Excess fluid is eliminated from the body along with waste material in the elimination process.
Cellulitis is commonly seen among lymphedema patients and is a major complication that requires
hospitalization for intravenous administration of antibiotics. Bacteria attack the skin on the affected limb and
may travel to the tissues and consequently into the blood stream. Protein-rich fluids that have accumulated in
the limb form a rich medium for the bacteria to grow and spread through the body. The visible symptoms of
an infection are red blotchy skin which feels warm to the touch, swelling and increasing pain. Flu-like
symptoms may also be present with fever and chills. In some cases, as the lymph nodes fight against
infection they may enlarge.
Extreme care should be taken while performing manual lymph drainage. Too much pressure on the skin may
inadvertently increase the blood flow, leading to accumulation of water in the tissues which is not a good
sign. It may lead to unnecessary complications for a lymphedema patient. It is therefore advisable to visit a
trained massage therapist who has the knowledge of the techniques of manual lymph drainage and is also
aware of the contraindications.
A lymphedema massage done rightly can prove to be extremely useful to the patient. But the effectiveness of
the massage lies in the skill of the therapist to direct the flow of lymph correctly. Therefore, training is
essential for manual lymph drainage. The patient may himself learn the technique -it is the ideal way to keep
lymphedema in check. Another essential factor is to keep note of the progress or the decline of the condition
after beginning the lymphedema massage treatment. If the condition worsens, you may have to reassess your
options and make the changes accordingly.
Whether a massage can prevent lymphedema is a matter of debate. However, the fact remains that a
massage therapy can have a very soothing effect which, in many instances, helps to alleviate the pain and
swelling, post surgery. It helps a patient relax and deal better with the trauma and stress that is the result of
the painful condition. The body can heal itself much faster due to the therapeutic effect of the lymphedema
massage. Nevertheless, it is advisable to use the services of a massage therapist, especially trained to deal
with lymphedema patients. Patients who are at high risk of contracting lymphedema must remain alert to the
earliest signs of the disease and opt for preventive measures to keep the problem at bay.
For the best Lymphedema Treatment, visit Mary Walters’s site on how to choose the best Lymphedema
management for your needs.
April 6, 2011 - Survivors put dragon boats to work - Northern Rivers Echo – by Liina Flynn –
As I made my way to Lake Ainsworth at Lennox Head to find out just what dragon boat racing is, a Viking
fantasy of what a dragon boat would look like formed in my mind: a long boat with curved prow, dragon
head and shields attached to the sides (although perhaps without the sword-wielding Viking warriors). When
I arrived at the recreation facility, I was little disappointed to see there was no dragon head on the dragon
boat. However I soon learnt from Rainbow Region Dragon Boat Club president Veda Dorrough that there
is indeed a crimson dragon head! (It’s just that it’s only attached to the boat when the team is competing in a
regatta.)
Dragon boat racing is actually a Chinese tradition that has developed into a worldwide water sport and is
fast growing in popularity in Australia. Instead of the Rainbow Region Dragon Boat being propelled by
Viking warriors wielding swords, I find the crew is a group of women and men wielding paddles. It takes a
maximum of 22 people to propel a boat from start to finish (20 paddlers plus a sweep and a drummer) and
right now, the paddling crew has started their warm up, jumping around and stretching outside the Lake
Ainsworth Recreation Facility boat shed.
Some of them have brought their own paddles along and have gloves to get a better grip on the paddle. I’ll
be borrowing one of the club’s paddles today, along with the other newbies in the crew. I’ve already gained
kudos with the team because I called it a paddle, not an oar; a basic distinction that all dragon boat paddlers
seem to know. The crew is formed into pairs in two lines by team captain John Turner and he goes through
the basics of how to paddle with the new recruits.
It’s almost sunset on Lake Ainsworth. The sun is hanging low in the blue sky, and as the crew pulls the boat
out of the shed and slides it into the water, it makes slow reflective ripples of clouds and sunlight on the lake.
Two of the paddlers hold the boat still while I grab my paddle and make my way onto the boat, carefully
balancing as I slip down to the middle and take my place next to Veda.
As I sit in my seat, Veda tells me I need to turn my body in, back to the water, hip against the boat, with my
outside foot forward and my inside foot under the seat. I seem to have it. Now, with arms outside the boat, I
need to hold the paddle with one hand on top, one on the bottom, then dip it into the water in an A shape.
There’s lots of water splashing, everyone is laughing and the more experienced crew are giving the first-
timers tips on how to improve their paddling. I have a breakthrough moment when I’m shown how to do the
dragon boat rock. It involves rocking forward and back while paddling, feeling the ‘heartbeat’ of the boat,
created by the paddlers’ rhythm. It’s good to know that if I need a break from paddling, all I need to do is
rock ‘n’ roll, still helping to keep the boat’s momentum and smooth motion of gliding through the water. This
really is team-work and, during a regatta, when the team is competing in races, a drummer would also sit on
the boat, keeping everyone in time.
“It’s a precise sport; timing is everything,” Veda says. “As you paddle, try not to touch the boat or the
person in front with your paddle.”
Veda is from Lismore, and she is survivor of breast cancer and one of the founding members of the original
club, Rainbow Dragons Abreast. Six years ago, Veda was involved in a breast cancer survivors’ exercise
group when she heard about a dragon boating group that had started in Darwin for survivors of breast
cancer. The paddling phenomenon was becoming a popular form of exercise for women who had
experienced lymphedema, after having the lymph nodes under the arms removed, and a doctor had
recommended dragon boat paddling as a trial form of exercise for them. The paddling helped the women to
build up their arm and upper body muscles again and the women who had initially trialled it loved it so much
they didn’t want to stop.
Veda formed a local club and committee and after six months of organising and training in the pool to get fit,
the committee had gathered enough sponsorship so they could rent a dragon boat to practise in. A year
later, the Lions Club Trust gave them money to buy their own boat. It wasn’t until about 14 months ago,
after the numbers of women involved in Rainbow Dragons Abreast began to decline, that the group opened
up the club to the wider community. Now there are two clubs, one where the women paddle for fun and
exercise, and the other (now including eight men) that trains for competition in regattas.
“Anyone over 18 is welcome to come along and give it a try,” Veda said. “You don’t have to be a super
athlete and it will increase your fitness. It’s good that the team has a few men in it now. It makes a difference
when you are paddling in a mixed-sex race against some strong Maoris at a regatta.”
Laura, one of the ex-club presidents and a breast cancer survivor, loves the positive feeling in the club, the
joking and the friendliness.
“It doesn’t matter if you make a mistake, everyone is so supportive,” Laura said. “For new people just off
their treatments, it’s a positive experience that helps them get through the emotional and physical hardships.
We laugh and have fun and don’t talk about breast cancer. You might start off being down, but then you feel
great.”
Laura’s partner John Turner joined the club 14 months ago and has now taken over the important role of
team captain and coach.
Today, John is the sweep and stands on the back of the boat, steering with the rudder and calling out “one,
two” with the timing of the strokes, and watching to see if we are all keeping time. He tells us to watch the
leading pair of paddlers (called the strokes); they set the pace and rhythm of paddling for all the crew. I
need to watch the stroke sitting diagonally opposite to me and synchronise with her. Jane, one of the
coaches, explains that when a paddler gets out of time with the others, it starts a ripple through the group
and the water gets disturbed. Every now and then I can feel the boat slow as a paddler loses her rhythm,
then it leaps forward as the paddlers get into time again.
“Let her run,” John calls and we all pull our paddles out of the water and onto the side of the boat in a
position called 10 and 2 (like the clock positions). I’m learning. Everyone is keen to give me tips on my
paddle-holding form and I’m told that the club’s motto is ‘It doesn’t matter if you lose or win, as long as you
look good in the boat’.
We practise swapping our sitting positions. In pairs, one person slides across, then the other steps over
them. The boat rocks lightly, but we are still upright. Lucky I brought my sense of balance with me today.
Veda says the boat has only overturned once when the crew were doing a series of exercises they has never
done before, and they don’t do them anymore.
“Once a dragon boat starts to tip, there’s no bringing it back!” Veda laughed, and stressed to me that it is
actually a very safe sport.
Out on the lake, we practise a fast paddle. I really have to reach forward and pull the paddle through the
water harder than ever before. We move through four levels of intensity, paddling harder, faster, lunging
forward more and rocking back as we pull the paddle through the water. Now it’s more important than ever
to keep time, or I could end up bumping into someone else’s paddle. John calls out for only the front half of
the boat to paddle, while the paddlers at the back pull their paddles in and rock back and forward in time
with the strokes. Before we pull back into shore, John gets us to practise stopping the boat; he has over-
steered us into a wall of lily pads and we are all laughing as the back paddlers start paddling to reverse us
out.
“Good paddling, bad steering,” John says. “It’s hard to turn the boat sometimes.”
Deborah Gibson and Mary Davis from Richmond Hill have been paddling with the club for the past year,
since it was opened to the general community, and now they are both hooked on paddling. Mary loved the
club’s inclusiveness and Deborah has now started training to be a sweep.
“John told me you need to be fit and have good balance to be sweep,” Deborah said. “And you need to
have a loud voice so that when you shout, the people at the front of the boat can hear you.”
The club is in training for the next regatta and travels to different locations for races throughout the year. The
biggest regatta is on during Chinese New Year celebrations, in Sydney on Darling Harbour, where teams
from all across Australia come together to race. The club usually races in 250-metre distance events, so
some fast paddling is called for. It takes the team about one minute and 10 seconds to travel the distance,
but it can take longer depending on the wind, rain and tidal currents. The club has a few trophies and last
year placed third in the final race at Darling Harbour.
“Every time we are lining up to start a race, I think ‘I wish we’d practised harder’,” Veda laughed. “Then
the adrenalin kicks in.”
The crew not only seems to love the fitness regime, but also the companionship and camaraderie. A group
of women have started going to a boxing class together because they met in the club and became inspired to
get fitter. Cathy, one of the crew members, is a weekend regular who used to play soccer but can’t now
because of an injury. She finds that dragon boat paddling is a good low impact sport that people with knee
or leg injuries can get into, and I’m told the oldest paddler on the team is 70.
If you like to get up early and see the sun rise over the lake while having lot of fun in a boat, you can go
along to the NSW Sport and Recreational Facility at Lake Ainsworth and try dragon boat paddling on
Saturdays at 7am or Sundays at 8am. If you like to hang out on the lake before sunset, you can take a ride
with the mystical dragon boat paddlers in the gloaming on Tuesdays and Thursdays at 5pm.
April 7, 2011 - Turner Syndrome Foundation participates in the NJ Marathon Festival - Asbury Park Press
– Written by Donna Villavicencio Reader Submitted –
Turner Syndrome Foundation participates in the NJ Marathon Festival for second year and holds kick off
Treats & Sweets for TS
Turner Syndrome Foundation (TSF) will be participating in the 15th Annual New Jersey Marathon Festival
(NJMF) at the Shore in Long Branch the weekend of April 30 - May 1. This is TSFs second year as a
charity and their first as a beneficiary at the NJMF and they are off to a good start. TSF has already
recruited over 90 participants and hopes to surpass their goal of 100 plus participants and to raise over
$25,000 at this event.
Turner Syndrome (TS) is the leading chromosomal abnormality affecting women and girls and occurs in 1 in
2000 live female births. TS occurs when all or part of the second X chromosome is missing. Girls with TS
only have a small chance of making it to a live birth. Most will miscarry. Of those that do make it, most will
go undiagnosed until their teen years missing valuable and necessary treatments to give them the best
possible life. No two girls with TS are exactly alike but the most common indications of TS are short stature
and delayed puberty. Many of these girls and women also have heart defects, kidney defects, ear issues,
hearing loss, lymphedema, learning disabilities and the list goes on and on. Ask almost anyone and they have
never heard of Turner Syndrome unless it directly affects their life which is why the Turner Syndrome
Foundation was created.
Turner Syndrome Foundation is a 501c3 nonprofit organization whose goal is to support research initiatives,
facilitate educational programs to increase professional awareness and enhance medical care of those
affected by TS. Laura Fasciano, founder and president of TSF and a Holmdel NJ resident, started the
foundation shortly after her daughter was diagnosed with TS at age seven. She sensed their was a difference
but her daughter went undiagnosed for years like many of those affected by TS.
In addition to participating in the NJMF for the second year, TSF will also launch their newest fundraising
campaign, a bake sale called Treats & Sweets for Turner Syndrome, during the Sunday events. This is no
ordinary bake sale. Treats & Sweets for TS is a nationwide effort by those affected by TS to raise
awareness about the relatively unknown syndrome and funds for TSF so they can continue their important
work. 100% of proceeds will go directly into foundation programs to facilitate education, resources and to
provide support
The New Jersey Marathon Festival at the Shore is in its 15th year and expects over 10,000 total
participants and over 30,000 spectators. This is a family friendly weekend with a 3 mile fun run/walk, a 1.2
mile kids marathon, kids races, carnival games, a FunBus and more on Saturday, April 30 and a marathon,
half marathon and half marathon relay on Sunday, May 1. The CareGirlz, a nonprofit organization of talented
6 to 13 year old girls, will also be performing at this years Saturday events in honor of TSF. People come
from all over the country to participate in these events. TSF alone has participants from NJ, NY, PA, CT,
AZ, NE and CA.
If you are interested in helping the Turner Syndrome Foundation by participating as part of Team TSF at this
years New Jersey Marathon Festival at the Shore, by volunteering at the event, or by simply making a
donation, go to www.tsfusa.org. For more information on the New Jersey Marathon Festival at the Shore,
go to www. njmarathon.org.
TSF is also in need of baked good donations from bakeries, restaurants and supermarkets for their Treats &
Sweets bake sale. Please contact coach@teamtsf.org if you able to help.
Turner Syndrome Foundation, PO Box 726, Holmdel NJ 07733. 800-594-4585. EIN#27-1409942
April 7, 2011 - (4/2011) Free Your Feet! - Basil & Spice – by Arthur Rosenfeld –
In 1980, I was traveling in Kenya’s Aberdare mountain range with my father, Dr. Isadore Rosenfeld—
renowned cardiologist and host of Fox News Sunday Housecall—when a runner burst into camp, having
run 26 miles to deliver an urgent medical message. Upon receiving my father’s reply he took a sip of water
and ran back to deliver it.
Being surrounded by the creatures of the African highlands, and having recently left the plains, I managed an
evolutionary perspective on the fact that a man could run a double marathon through the forest—outrunning
lions and all that—but barefoot? How could his ankles, knees and hips take the pounding, never mind his
feet? The deed was unimaginable to someone who wore leather loafers to work and soft sneakers to the
gym.
At that time, I could never have imagined that more than 30 years later there would be a quiet revolution in
the way we see running. In the wake of Christopher McDougall’s bestselling Born to Run—a chronicle of
the exploits of the barefoot running of Tarahumara Indians of Mexico’s Copper Canyon—and perhaps
coincident with a grass-roots re-evaluation of the role of the foot in life, if not love, athletes around the
country are shedding their highly-constructed, heavily cushioned running shoes in favor of high-tech,
minimalist shoes.
This change has been a long time coming. In 1997, Chinese scholar warrior Jwing-Ming Yang discoursed on
the evils of soft shoes at a martial arts symposium I attended in Virginia. Drawing on Traditional Chinese
Medicine several thousand years old, he explained that from the standpoint of Chinese medicine there is a
“heart” in the foot, one that functions like a fireplace bellows to aid in the circulation of fluid that would
otherwise be trapped in the legs, causing it to pool around the ankles because we are, after all, bags of
water with a few stiff sticks thrown in. Wearing a shoe with too much padding on the bottom eliminates this
effect—the sole of the shoe is compressed rather than the sole of the foot—and, to press the analogy, the
heart of the foot does not beat.
Western medicine recognizes the importance of muscular action in circulation of two of the body’s critical
fluids, lymph and blood. Lymph resembles blood plasma and is vital to the immune system. Its relies on a
complex system of tiny valves, and is slowly propelled through the small spaces between tissues and organs
by the action of both smooth and skeletal muscle. Patients whose lymphatic system is obstructed (a
condition called lymphedema that may result from parasites or from radiation treatment for cancer) often
exhibit swelling in the extremities, the result of pooling lymph. One treatment is to wrap the legs with
compression bandages to help accomplish precisely the circulatory “squeezing” to which Master Yang
referred. Blood is moved by muscle too. Arteries have muscular walls that contract to help them carry
oxygen-rich blood to needy tissues, while veins, like lymph, rely on a combination of valves and the pumping
action of skeletal muscles (including those in the hands, arms, legs and feet) to return deoxygenated blood to
the heart.
Everyone knows that high heels are bad for the low back, joints, intervertebral discs and overall posture, but
it turns out that even the raised heel on most athletic shoes is less than ideal as well. Thickly padded, laterally
stabilized athletic shoes were initially conceived to protect ankles, knees, hips and spine from the repetitive
torsional and shocking forces found in running. The idea had merit—and still does for some people—but the
competition of the consumer marketplace led the idea to run amok. Aggressive marketing these days has
most of us, even kids, wearing shoes that in many cases over-protect the foot. The result is that foot muscles
never develop properly, leading not only to effects on circulation, but frequently to problems with tendons,
toes, and nails.
The feet also play a role in the circulation of energy. Acupuncturists, massage therapists, and reflexologists
will tell you that some of the most important “points” are in the foot, including the sole. Barefoot running or
walking, particularly over uneven terrain, stimulates these important points, yielding benefits well known to
Eastern medicine.
In our aboriginal days, we experienced the world through the digits and muscles and skin of our feet just as
much as we do through our hands. Most of us have lost that interface with the world, but we can begin to
get it back by engaging a mind/body practice that uses our whole body and increases our awareness. Tai chi
is especially well suited to this task, as it deliberately concentrates our attention on balance, footwork, and
stability.
It may also help to choose a shoe that allows the foot to function the way it was intended to while at the
same time providing a level of protection from hazards on the roadway or, better, on the trail. Many athletes
have a favorite brand, but for my money a good first step in the awakening of the foot is Nike’s “Free” line,
available as both runners and cross-trainers. These shoes still have a raised heel and look and fit like regular
athletic shoes, but have minimal padding and a hyper-flexible sole. A good next step might be the “Barefoot”
shoes from Merrell or the New Balance Minimus line. At the extreme end of the spectrum is Vibram’s
FiveFinger offerings, shoes that are like gloves for your feet, toes and all.
Transition slowly to one of the less constructed athletic shoes if you want to reap the benefits, though,
because years of relying on cushion, padding, and ankle support weaken the feet and it takes time to
strengthen them again. Many minimal workout shoes will cause foot pain if worn too often and for too long
at the beginning. Specific medical/structural issues aside, the change may cure existing or incipient problems,
but if you rush it, you’re going to be uncomfortable and may even hurt yourself. Try a half an hour here or
there, then an hour, then more, all over the course of a few weeks. Walk barefoot more often, too. Your
feet will love you for it.
April 10, 2011 - Toms River woman finds exercise changes lives - Asbury Park Press – by
LISA COHAN ARONOW –
I came into the fitness business after 22 years in professional services supporting computer consultants. I
liked my work, but hated the commute, the hours, the stress and the feeling that working to support a
lifestyle, although necessary, was wholly unfulfilling.
When the literal and metaphorical smoke of 9/11 cleared, I decided that I had to change my life. I didn't
know what I wanted to do, so I started spending hours at my gym, hanging out from dawn until dusk
working out, talking to the trainers, chatting up new clients and probably being something of a pain. The
owner of the gym said that he'd hire me if I'd become a personal trainer, so I did.
I went to work for the gym, discovering something along the way — many women in their middle years
joined gyms at the advice (or threat) of their doctor. They didn't want to be there, and had preconceived
notions about what their experience was going to be, often resulting in a short, expensive and unsatisfying
relationship. I thought maybe I could do something to help these women achieve their goals in a way that
was comfortable for them.
I established Women's Wellness LLC in 2004 as a fitness company dedicated to working with women over
the age of 50. The company was founded to offer an alternative way of exercising for women who otherwise
would not have a positive experience by joining a gym. The business evolved in the last four years to include
men. My personal training clientele are living with diagnoses of chronic illnesses: diabetes, cardio/pulmonary
disease, Parkinson's, obesity, rheumatoid arthritis, osteoporosis, cancer, to name a few.
Soon after I started the company, I convinced a 57-year-old woman who was obese, had Type II diabetes
and was a breast cancer survivor to take a chance on working with me. I told her that if we worked hard
enough, she could shed the weight, and in doing so maybe reverse the diabetes, or at least positively impact
her tri-glyceride and glucose numbers.
About a year after we started working together, she called me from her doctor's office and told me that we
had done it! He had taken her off all but one of the diabetes and blood pressure medicines, and one of her
cholesterol medicines.
I sat in my car and cried like a baby. She had put her life in my hands, and together we changed it for the
better. From that moment on, it became a personal mission to work with people to ameliorate or obliterate
the vast amounts of medication they were prescribed.
My breast cancer survivor clients are dearest to my heart because the road they travel is hard. Lymphedema
(localized fluid retention) is their greatest concern, but I have proven to them all that by carefully building
their strength and flexibility, they can do what everyone else does.
This is the hardest work I've ever done, and without a doubt the most rewarding.
Lisa Cohan Aronow of Toms River owns Women's Wellness LLC (732-299-7676).
Getting Ahead runs Sundays. If you are a businesswoman interested in writing about your career, please
send your story to Business Editor Dennis P. Carmody at dcarmody@njpressmedia.com
April 11, 2011 - Still not enough awareness of lymphedema - Bizjournals.com – by Athena Merritt -
For breast cancer survivors, like my mom, once the radiation treatment ends another battle begins —
lymphedema.
Which is why my mom has to slip every so often into a back room of Advanced Lymphedema Therapy
Services in Langhorne to see physical therapist Kim Koschineg, who owns the business. When your first
contact with a new patient goes something along the lines of “Hi, nice to meet you, now take off your clothes
I’m going to massage you,” close bonds are formed early, Koschineg joked before a crowded room at the
Sheraton Bucks County Hotel on Saturday.
“It’s very close-up close and personal and we share a lot in our treatment,” Koschineg said. “Many feel
lymphedema is worse than breast cancer treatment. It can strike at anytime.”
Patients, like my mom, and their loved ones, like me, gathered to celebrate Koschineg’s five years in
business, an anniversary she marked with a banquet that also recognized National Lymphedema Day.
“You’re the reason why we like to get up and come to work,” said a very pregnant Koschineg. She is due in
five weeks, and is planning to work right up until her due date, just like with her first child, which comes as
no surprise to her many patients.
Free lunches, free T-shirts and plenty of information on lymphedema flowed out in those three hours, both
from the speakers and from the conversations of those at the tables.
Far too many with lymphedema, a condition that brings fluid retention and a swelling of the tissues, still battle
ignorance when they meet with health practitioners. Drawing blood or taking blood pressure readings from
the arm of someone suffering lymphedema is a no-no, yet women at the table, like my mom, who wear
medical bracelets warning of their condition have still had to stop nurses from doing it. A woman two seats
away from my mom, who has the problem in both arms, said she’s had to explain over and over again that
her blood pressure must be taken from her leg. For others, the frustration stems from not being correctly
diagnosed with the problem.
Like Barbara, whose health deteriorated over 25 years before she Googled “swelling legs” online and
learned about lymphedema herself and became a patient of Koschineg.
“In all those years no one, not one doctor, mentioned the word lymphedema to me,” she told the audience.
Guenter Klose, who trained Koschineg and has been practicing lymphedema treatment for over 26 years,
flew in for the day to serve as the keynote speaker. Progress is being made on many fronts, including patient
advocacy, research and legislative efforts, said Klose, who is the founder of Klose Training & Consulting
LLC in Colorado http://www.klosetraining.com/Home.asp .
“There are more people now than ever working on the problem of lymphedema,” Klose said.
The Lymphatic Research Foundation promotes research. And the American Lymphedema Framework
Project promotes understanding of current treatment and a standard of care, he said. Advocates hope to see
the re-introduction of the Lymphedema Treatment Act this spring, which would bring a change in Medicare
law, he said. But, said Klose, who urged patients and others to pass along what they’ve learned, “It is still
the case that people need this understanding of lymphedema.”
The National Lymphedema Network’s website.
April 12, 2011 - Lymphedema Research Study - Wire Service Canada – by akennedy –
Patients in Ontario living with lymphedema will be involved in University of Pittsburgh Research Study on
Foot Problems.
April 12, 2011 - Toronto, Ontario, Canada
The Lymphedema Association of Ontario is proud of its role in supporting a unique research study that
targets people living in Ontario with lymphedema and the foot problems they experience.
The University of Pittsburgh is conducting a research study of foot characteristics and foot problems of
people with lymphedema of the lower limbs, including the usability and availability of existing footwear. This
study is a collaborative effort of the University of Pittsburgh, Bauerfeind USA, the Lymphedema Association
of Ontario, and the International Lymphoedema Framework.
The ultimate goal of the research study is to improve the availability of clinically appropriate footwear for
persons with lymphedema. Including lymphatic filariasis, acquired lymphedema is the second leading cause
of disability worldwide. One of the key preventative interventions is the provision of footwear, especially
low-cost footwear. Research is needed to objectively measure the foot problems and to report user
satisfaction with current footwear.
Lymphedema is a chronic swelling of a body part, most frequently an arm or leg but can also affect the
trunk, head or neck. Lymphedema is the result of a malfunctioning lymphatic system or as a result of damage
to the lymphatic pathways. Cancer treatment is the leading cause of lymphedema in Canada, as people
acquire the condition as a result of their cancer treatment following surgery or radiation therapy. An
estimated 63,000 persons in the province of Ontario are living with this debilitating condition that remains an
under recognized and untreated health problem.
Adults living with lymphedema in their leg and attending a Lymphedema Patient Conference in Toronto on
June 18, 2011 have the opportunity to participate in the research study that will ultimately improve their
quality of life by addressing the practicalities of footwear in swollen feet for these patients. The Patient
Conference is being held in conjunction with the 3rd International Lymphoedema Framework Conference,
which will attract researchers, clinicians and educators from over 25 countries gathering to further global
implementation of best practice.
Study participants will undergo a series of tests to get objective measures of their feet and legs:
The Bodytronic 300 (Bauerfeind USA) 3D-Scan uses video imaging to create a 3D model of the
participants’ feet and legs and then automatically calculates the following measurements: foot length, width,
arch length, shoe size, foot and leg volume and the pressure that their feet exert on the floor when standing.
A Lymphedema therapist will inspect participant’s feet and legs for skin changes, calluses, blisters, wounds,
and foot deformities with digital images of the feet taken from various angles.
A footwear specialist (pedorthist) will inspect the footwear and document the pattern of wear and tear.
Lastly, participants will be required to complete a series of questionnaires about their experiences with
compression garments and appropriate footwear.
The University of Pittsburgh researchers hope to develop a useful tool for evaluating the use and usefulness
of footwear for a variety of disabling diseases/conditions including lymphedema.
For more information about lymphedema, the work of the Lymphedema Association of Ontario, the 3rd
International Lymphoedema Framework Conference and the University of Pittsburgh Foot Research Study,
please visit www.lymphontario.ca
April 13, 2011 - Devon Medical Products Receives FDA 510(k) Clearance for ArterioFlow(TM) Pump
that Treats Diabetic Foot, Peripheral Arterial Disorders –
Devon Medical Products Receives FDA 510(k) Clearance for ArterioFlow(TM) Pump that Treats Diabetic
Foot, Peripheral Arterial Disorders
Apr. 13, 2011 (Business Wire) — Devon Medical Products, a manufacturer and distributor of creative,
safe, and cost-effective medical devices, today announced it received U.S. Food and Drug Administration
(FDA) 510(k) clearance to market its ArterioFlow™ 7500 arterial pump that treats diabetic foot ulcers,
peripheral arterial disease, and other chronic disorders of the lower extremities caused by reduced blood
supply or ischemia. Devon Medical Products will feature the ArterioFlow 7500 and its line of CircuFlow™
compression pumps that treat lymphedema at the Medtrade Spring Conference at the Sands Expo and
Convention Center in Las Vegas on April 13-14.
According to the 2011 National Diabetes Fact Sheet released by the American Diabetes Association
(ADA) earlier this year, approximately 25.8 million people – 8.3% of the U.S. population – have diabetes.
Various studies show that about 15% of diabetics develop diabetic foot ulcers, or open sores or wounds
that develop as a result of poor circulation, trauma, and vascular complications. Six percent of people who
develop foot ulcers are hospitalized annually due to infection, and 14-24 percent of people with diabetes
who develop a foot ulcer have an amputation.
“Diabetic foot ulcers have proven to be the most common lower extremity injuries leading to amputation,
and the compression therapy provided by the ArterioFlow increases blood flow to promote faster healing
and prevent infection and amputation,” says Dr. John A. Bennett, CEO of Devon Medical Products. “While
prevention of ulcers is ideal, immediate treatment of ulcers that do form is vital. Our goal with the
ArterioFlow and all of our compression devices is to make therapy easy and convenient so that patients will
comply more and in turn avoid terrible health consequences.”
The ArterioFlow applies compression to the foot and calf sequentially through compression sleeves to empty
the veins in the lower extremities. In return, the arterial blood is more easily and readily delivered to the feet
and blood-deprived tissues. The device can also be used to treat peripheral arterial disease, intermittent
claudication, and other chronic disorders of the lower extremities caused by reduced blood supply or
ischemia.
Devon Medical Products’ engineers and product developers designed the ArterioFlow. The company
works with various distributors across the United States and abroad.
Visit Devon Medical Products in booth #1958 at the Medtrade conference for more information.
About Devon Medical Products
Devon Medical Products (www.devonmedicalproducts.com) is an international medical device manufacturer
and distributor that provides the medical community with creative, safe, and cost-effective medical products.
The company has cultivated an exclusive line of innovative medical devices designed to advance healthcare
treatments and maximize safety for healthcare workers and patients worldwide. The company is
headquartered in King of Prussia, Pennsylvania, and has international offices staffed with bilingual engineers,
product developers, and FDA-regulatory experts.
Devon Medical Products
Darren M. Behuniak
Director, Marketing
& Communications
610-755-4958
MED NEWS DOCS:
April 11, 2011
Less Invasive Lymph-Node Biopsy Could Prevent Unnecessary Surgery For Patients With Early Stage
Endometrial Cancer
Sentinel-lymph-node (SLN) biopsy can accurately diagnose lymph node status in patients with early stage
endometrial cancer and provide vital information on the most effective adjuvant (additional) treatment
without the need for complete lymphadenectomy (removal of all the pelvic lymph nodes), thereby reducing
the risk of surgical complications. These findings published Online First in The Lancet Oncology, suggest that
this minimally invasive procedure is a safe and effective alternative to more extensive lymph node removal.
Accurately determining how far cancer has spread, a process known as staging, is used to plan the most
effective treatment for patients. Traditional surgery (lymphadenectomy), involving the removal of all the
pelvic lymph nodes, is associated with an increased risk of complications including lymphocysts and
lymphoedema (swelling caused by excess fluid build-up), and has shown little benefit in patients with early
stage endometrial cancer.
A few small retrospective studies have suggested that doctors could evaluate endometrial cancer using SLN
biopsy, a less invasive procedure involving the excision of just a few nodes instead of all regional lymph
nodes*.
The SENTI-ENDO trial was designed to investigate the performance of SLN biopsy at predicting lymph
node status in patients with early stage endometrial cancer. Between July, 2007, and August, 2009, 133
patients with early stage endometrial cancer from nine centres across France underwent SLN biopsy
followed by complete lymphadenectomy.
SLN was successful in 77% of cases in the right hemipelvis and 76% in the left hemipelvis, with an overall
detection rate of 98%.
No false negative cases were recorded in 100% of hemipelvises, so all healthy lymph nodes were correctly
identified. Using the patient as the unit of analysis, the less invasive technique produced a negative predictive
value (probability that patients who test negative result are correctly diagnosed) of 97% and sensitivity (rate
of true positives) of 84%.
No complications were reported during SLN biopsy.
The authors say: "The SLN procedure provides data to tailor adjuvant therapy without increasing the risk of
intraoperative and early postoperative complications. Therefore, the SLN procedure alone could be
recommended for low-risk and intermediate-risk endometrial cancer."
They conclude: "Further studies are needed to evaluate the cost-effectiveness of systemic lymphadenectomy
compared with lymphoscintigraphy and the SLN procedure, and the effect of the SLN procedure on
adjuvant therapies and quality of life."
In a Comment, Henry Kitchener from The University of Manchester, Manchester, UK suggests that SLN
biopsy can now be considered standard care: "The procedure seems feasible (almost 90% of women had
detectable SLNs), and it seems reliable in terms of negative predictive value and sensitivity when ultrastaging
of SLNs is implemented."
Notes
*During the SLN biopsy, a radioactive colloid and/or blue dye are injected pericervically and follow the
path that tumour cells are most likely to take from the tumour to the lymph nodes. The first(s) node(s) to
absorb the dye and/or radiocolloid, the sentinel node(s), is removed and biopsied.
April 15, 2011
Breakthrough Breast Cancer Report Finds Lymphoedema Services Are Not Meeting Breast Cancer
Patients' Needs –
Breakthrough Breast Cancer today published a report claiming more needs to be done across the NHS to
meet the needs of breast cancer patients who develop lymphoedema after their treatment. The
recommendations, which form part of Breakthrough's 'Constant Reminder? Living with Lymphoedema'
report, aim to ensure everyone who develops lymphoedema after breast cancer has access to services that
can give them the best possible quality of life.
Lymphoedema can occur following some forms of breast cancer treatment and is caused by a build up of
excess fluid in the tissues. This can cause long term swelling in the arm, hand or upper parts of the torso.
Although the physical effects are clear to see, it is often the psychological and social effects that have the
greatest impact and can lead to low self esteem and depression. Although breast cancer treatment is not the
only cause of the condition, it is estimated that at least one in five patients who undergo surgery for the
disease will go on to develop lymphoedema in their arm.
Breakthrough surveyed 200 people who had experienced lymphoedema after breast cancer treatment and
found that in some parts of England, patients are not getting access to vital care for the condition due to
inequalities in services provided. This means that in some cases people have to travel long distances, wait for
treatment, or even go without the services they need. The report suggests, amongst other things, that
monitoring of lymphoedema patients, education and training for healthcare professionals and local referral
guidelines all need to undergo change to improve patient experience.
Maggie Alexander, Director of Policy, Education and Influencing at Breakthrough Breast Cancer, says,
"This condition can have a real impact on everyday life -some people find it difficult to work, wear normal
clothes, or undertake everyday tasks such as gardening or playing with children and grandchildren.
With more people surviving breast cancer, we need to make sure that people who develop lymphoedema
after breast cancer treatment have the care they need to live their lives with the best possible quality of life.
Unfortunately we have found that some patients simply aren't being given the access to services they need to
help them live with their lymphoedema.
We hope our Constant Reminder report will spur people on to push local commissioners and healthcare
professionals to implement a series of changes, that will allow for an improved quality of life for all
lymphoedema patients."
About the report
-- The National Cancer Action Team (NCAT), in early 2010, published a care pathway for the treatment of
patients with or at risk of lymphoedema. This guidance sets out the care that all cancer patients at risk of
lymphoedema, including those treated for breast cancer, should receive. Many of the recommendations in
Breakthrough's report draw upon the detailed recommendations included in the NCAT pathway.
- Breakthrough has also produced a standalone campaigner's toolkit, Your guide to taking action locally -
England, for people who are interested in driving forward changes on this issue in their area.
Key recommendations in the report include:
-- The number of patients diagnosed with and treated for the condition should be recorded to improve
estimates of the number of cases of lymphoedema in their area
-- A range of appropriate lymphoedema services should be commissioned through primary, cancer and
specialist lymphoedema services and appropriate treatments should be provided. These should be available
to all patients who need them in the area. The appropriate setting for care should be considered based on
patients' needs (e.g. community care and secondary care)
-- Education and training should be given to all healthcare professionals (including primary care, cancer,
palliative, and allied healthcare professionals) regarding lymphoedema signs and symptoms and best practice
for risk reduction and management
- Local referral guidelines and systems should be developed to enable relevant primary, cancer and palliative
healthcare professionals to refer directly to local lymphoedema services.
Breast cancer in the UK
- Nearly 48,000 women are diagnosed with breast cancer each year in the UK.
- Breast cancer is the most commonly diagnosed cancer in the UK.
- 1 in 8 women in the UK will develop breast cancer at some point in their lifetime.
- Around 1,000 women die of breast cancer every month in the UK.
- Around 300 men are diagnosed with breast cancer every year in the UK.
- More women than ever in the UK are surviving breast cancer thanks to better awareness, better screening
and better treatments.
Source:
Breakthrough Breast Cancer
April 13, 2011 - FDA approves Devon Medical pump for diabetic ulcers - Bizjournals.com – by John
George –
The American Diabetes Association estimates 25.8 million people in the United States, or 8.3 percent of the
population, have diabetes.
About 15 percent of diabetics develop diabetic foot ulcers, which are open sores or wounds that develop as
a result of poor circulation, trauma, and vascular complications.
From that group, 6 percent end up in the hospital because of an infection and 14 percent to 24 percent
require an amputation.
A King of Prussia medical-device company has a new device aimed at helping improve some of those
statistics.
Devon Medical Products has received Food and Drug Administration marketing clearance for the company’
s ArterioFlow 7500 arterial pump, which was developed to treat diabetic foot ulcers, peripheral arterial
disease, and other chronic disorders of the lower extremities caused by reduced or restricted blood supply.
The ArterioFlow 7500, and its line of CircuFlow compression pumps that treat lymphedema (swelling in the
legs and other body parts), will be on display by Devon Medical at the Medtrade Spring Conference in Las
Vegas Wednesday and Thursday.
“Diabetic foot ulcers have proven to be the most common lower extremity injuries leading to amputation,
and the compression therapy provided by the ArterioFlow increases blood flow to promote faster healing
and prevent infection and amputation,” said Dr. John A. Bennett, Devon’s CEO. “While prevention of ulcers
is ideal, immediate treatment of ulcers that do form is vital.”
April 19, 2011 - A new way to zap cancer – WPTV – by Amanda Kahan –
George Pittman is back in class and back in the saddle.
He's a volunteer math and science tutor and he just loves watching little minds grow. Also growing in this
prostate cancer survivor: malignant melanoma like these in his left leg. Doctors cut out four in less than a year.
Mercy Medical Center's Vadim Gushchin treated him with an intense, isolated blast of chemotherapy. Using
small catheters like this one, surgeons infused a massive dose of chemo into George's leg alone.
The procedure took just 30 minutes.
In a third of cases though all nodules disappear. The old method meant larger incisions and catheters. This is
minimally invasive all-around.
Good news for George who got back to class as fast as he could.
Getting back up to speed shouldn't be a problem.
BACKGROUND: Chemo Blast is a surgical procedure to allow you to get high doses of chemotherapy
only in one limb (an arm or leg). The benefit of method is that you do not get effects of the anticancer
treatment in other areas of your body. After years of advancements, Isolated Limb Infusion -- or ILI -- is a
minimally invasive technique that uses the same principles of regional high-dose chemotherapy but through
smaller catheters. These specific catheters allow are similarly used by cardiologists to study vessels of the
heart. For many people, ILI is the only option to avoid amputation. (Source: Mercy Medical Center)
WHAT TO EXPECT IN THE OR: You will be admitted to the hospital and should expect to stay for four
to five days. This procedure is done in the surgery area. You will receive general anesthesia. The limb to be
treated will be warmed to help the chemotherapy have the most effect. A type of tourniquet is used to stop
the flow of blood in and out of the limb being treated. This also prevents the chemotherapy from spreading
throughout your body. The chemotherapy will be given through an incision into a major artery and vein in the
limb to be treated. After surgery you will have a bandage (dressing) over the surgical site. If you had any
lymph nodes removed during the surgery you will likely have a drain in place to prevent fluid build-up. You
may spend the first night in the Surgical Intensive Care Unit where you will have frequent attention. The
pulse, color, sensation and movement will be checked often on the affected limb. You will be given
medication to help control pain.
Before discharge you and your caregivers will be instructed about all your care needs. After you go home
you will still need to care for your wound, for a drain, to manage swelling. (Source: The Ohio State
University Medical Center)
POSSIBLE SIDE EFFECTS: Wound infection/separation: You will be told how to care for the surgery site
after you leave the hospital.
Nerve damage: You may have damage to nerves in the limb treated with chemotherapy or from swelling that
may occur after the procedure.
Pain: You will be checked and treated for pain while in the hospital. Pain medication will be used to help
control pain after your discharge as well.
Swelling or Lymphedema: The treated limb will have a tendency to swell. You will be given instruction how
you can help manage swelling. This may include patient education handouts to help you care for this
condition.
Skin changes: The skin on the treated limb will be discolored and may peel. Gentle skin lotions with no
alcohol may be used. The lotion should not be used near the incision or wound.
Blood clots or vein inflammation: These are more rare complications. It is possible but not likely that blood
clots may develop in the artery or vein of the treated limb.
FOR MORE INFORMATION, PLEASE CONTACT:
Stacey Sherman
Institute for Cancer Care at Mercy Medical Center
(410) 332-9349
(Information provided by Ivanhoe)
April 19, 2011 - CCH expands breast health and oncology support services - Sauk Prairie Eagle –
Columbus Community Hospital recently expanded breast health and oncology support services with the
addition of a Breast Health Patient Navigator Program under the direction of Cathy Butterbrodt-Oines,
RNC, breast health specialist.
"As a breast health patient navigator, I support patients following their mammogram and diagnosis by guiding
them through the various services involved and connect them with appropriate resources and support," said
Butterbrodt-Oines.
"The program is complimentary for the patients of CCH," added Butterbrodt-Oines, who emphasizes the
program as a team approach involving the physician, the breast health specialist, the medical imaging
department, the laboratory, the surgeon, the dietician and a lymphedema specialist.
"Breast health begins with receiving regular mammograms," stated Butterbrodt-Oines.
CCH's medical imaging department offers digital mammography by appointment by calling 623-1210.
For more information regarding the breast health program at CCH call 623-6434.
April 20, 2011 - CHS in Florence now offers a Lymphedema program – SCNow – By Nicole Boone –
Carolinas Outpatient Rehabilitation Centeris proud to announce the addition of the Lymphedema Program.
Janice Spicer recently completed the lymphedema certification course and is now a certified lymphedema
therapist.
Lymphedema is the chronic accumulation of protein rich fluid in the interstitial space and can develop into
elephantitis of the limb if not treated. Treatment may consist of manual lymph drainage (MLD) followed be
compression bandaging using short stretch bandages for management of volume reduction, as well as, to
provide low resting pressure and high working pressure for further volume reduction. Once the limb is
decongested, the patient can be measured for compression garments that will replace bandages during the
day.
For more information on the Lymphedema Program, please contact Janice Spicer at Carolinas Outpatient
Rehabilitation Center at 661-4360.
April 21, 2011 - A 'Pioneer' in Breast Cancer Survivors' Quality of Life Delivers Komen Distinguished
Lecture at UM School of Nursing - UMB News –
Patricia Ganz, MD, a medical oncologist who has studied the late effects of cancer treatment, delivered the
2011 Komen Distinguished Lecture at the University of Maryland School of Nursing (UMSON),
emphasizing that greater attention should be paid to the consequences associated with the improved rate of
survival for women with breast cancer.
She spoke on April 14 in the UMSON auditorium, and her remarks were simulcast with the support of the
Maryland Affiliate of Susan G. Komen for the Cure for viewing by UMSON nursing students at the
Universities at Shady Grove in Rockville, Md., and by nursing students at Bowie State University in Bowie,
Md., and Coppin State University in Baltimore.
The decline in breast cancer mortality means that for many women "cancer is now a chronic disease," said
Ganz, director of cancer prevention and control research at the , Jonsson Comprehensive Cancer Center,
University of California, Los Angeles. For cases of early-stage breast cancer, the five-year survival rate
exceeds 90 percent, and continued improvement is expected. "But there is a cost to women and their
families in the form of time, money, and human, interpersonal, and existential costs," Ganz said.
The lecture was made possible by a grant to UMSON from the Komen Maryland Affiliate to advance
education and practice in the treatment of breast cancer. Principal investigator of the grant is Sandra
McLeskey, PhD, RN, a professor at UMSON and co-director of the Komen Maryland Affiliate Nursing
Partnership along with Deborah McGuire, PhD, RN, FAAN.
McLeskey, left, is shown in the photo with Ganz, center, and McGuire, a professor at UMSON who will be
the next principal investigator. McGuire introduced Ganz as "a pioneer" in studying quality of life of cancer
patients and survivors.
Breast cancer treatment now includes use of combined modality therapy and prolonged adjuvant and/or
maintenance therapies, such as endocrine therapies that are given for about 10 years to many women, Ganz
said. The risk of second malignancies is greatly reduced. However, benefits may need to be weighed against
harm, Ganz said, as she and other researchers attempt to learn why some women appear susceptible to
certain late effects after treatment.
Breast cancer survivors report premature menopause, infertility concerns, body image changes, and
lymphedema, which is swelling in the arm on the side of their breast cancer surgeries. These findings came
from a study in which Ganz and colleagues interviewed 1,100 women in the Washington, D.C., and Los
Angeles areas about their experiences as breast cancer survivors.
Along with early detection, advances in drug therapies have increased longevity. Yet these treatments are
often linked to long-term physical effects, including symptoms of persistent fatigue. Ganz said post-treatment
fatigue remains under-reported and under-treated in breast cancer survivors despite its severity.
In a follow-up of the women in their study five years after diagnosis and treatment, researchers found that
one-third reported persistent fatigue. Many also were experiencing pain, sleep disturbances, mood
disruptions, menopausal symptoms, and cognitive dysfunction that may have been related to early
menopause. Associated medical conditions included anemia, cardiovascular disease, and cardio-respiratory
disease.
"It [the fatigue] is like being wiped out by a bad flu," and so pervasive that women "don't have energy to do
any kind of leisure activity," said Ganz. She said it is unlike an ordinary feeling of being tired and may be
linked to biologic characteristics of the patient, or to the treatment.
"In terms of its impact on quality of life, this is one of the most distressing symptoms that patients report,
behind only pain and nausea, and can interfere with the ability to work, to care for their families, and their
concerns about fighting the cancer," she added.
"Attention to symptom management means there can still be a good life after cancer," Ganz told an audience
made up primarily of nursing students, educators, and health care practitioners. She suggested that breast
cancer survivors must be questioned about symptoms and treated proactively. Despite what she called
"substantial disruptions in their quality of life," women may not expect relief once the cancer is under control.
"If we don't ask, they may not bring it up," Ganz said.
Strategies to cope with these late effects include recommending moderate exercise, suggesting that those
with cognitive issues avoid distraction, and treating when appropriate for anxiety, insomnia, and depression,
among other conditions. Women of childbearing age may want their eggs to be harvested prior to therapy in
the event they become infertile after treatment.
McLeskey announced that the Komen Maryland Affiliate has awarded the School a sixth year of funding to
advance education and practice. This additional support of $204,738 will continue a multi-pronged initiative
that includes the two partner institutions and will expand to a third - Salisbury University - in June.
The Komen Maryland Affiliate Nursing Partnership has previously grown to include the School of Social
Work and the School of Pharmacy. Starting in June, new partners will include the University of Maryland
Marlene and Stewart Greenebaum Cancer Center and the University of Maryland Medical Center.
April 22, 2011 - Cancer prevention, treatment topics at Jefferson Healthcare symposium - Peninsula Daily –
PORT TOWNSEND — Jefferson Healthcare hospital will host a free cancer symposium at Fort Worden
State Park on Saturday.
Specialists will tell about the latest in cancer prevention and treatment from 9 a.m. to 3 p.m. in the Fort
Worden Commons and No. 204 buildings.
Among the presenters will be Dr. John Choe, director of the Cancer Prevention Clinic at the Seattle Cancer
Care Alliance, and Dr. Paul Stehr-Green.
Choe will present a keynote address at 9 a.m. on the latest information about cancer prevention, and Stehr-
Green will present “Cancer Clusters: Is There More Cancer in Your Neighborhood? Exploring the Myths
and Realities.”
Other presenters include a variety of oncologists and physicians who diagnose and treat cancer in all its
forms and will present information on specific ones such as skin, prostate, lung and breast cancers.
The topics of the other seminars and workshops are “The Prostate Cancer Dilemma,” “Cancer Screening:
What Works and What Doesn’t,” “Integrative Oncology,” “Saving Your Skin,” “Breast Cancer Update,”
“Lung Cancer Update,” “Eating for Survival,” “Lymphedema, Prevention and Treatment,” “Coping with
Cancer: Balancing Your Inner Life While Juggling Life With Cancer,” “Chemotherapy Basics” and “Cervical
Cancer and HPV.”
Local resources will be shared for those who are facing cancer now.
Community education
Local Jefferson Healthcare physicians identified cancer as a focus for community education in 2011 because
of its far-reaching effects and because many cancers can be prevented or detected early if people can
identify their risk factors and modify certain behaviors and lifestyle practices.
The majority of the seminars and workshops will be presented twice — both in the morning and the
afternoon — so that the maximum number of guests will be accommodated.
The keynote address, however, will be presented one time only.
Throughout the day, attendees will be encouraged to ask questions of the experts after each presentation.
Lunch will be available through the Bon Appetite Servery, in the Commons.
A limited number of lunch tickets will be available for purchase in the lobby of the Commons for $10 on a
first-come, first-served basis
Prize drawings will take place throughout the day.
A detailed program for the symposium is at www.jeffersonhealthcare.org.
For more information, phone 360-385-0610.
April 22, 2011 - Next in line for competitive bidding: Vents and manual wheelchairs? - HME News - By Liz
Beaulieu –
BALTIMORE – Because CMS thinks Round 1 is going so well, industry stakeholders wouldn’t be
surprised if the agency expands more than the number of competitive bidding areas in Round 2.
“The fear is that they see such incredible success that they’ll take the product categories in Round 1 and add
to them in Round 2,” said Cara Bachenheimer, senior vice president of government relations for Invacare.
Earlier this month, CMS officials shared with members of the Program Advisory and Oversight Committee
(PAOC) a list of the 20 product categories under consideration for Round 2. The list contains the nine
product categories in Round 1 plus infusion pumps and related drugs; manual wheelchairs; off-the-shelf
orthotics; negative pressure wound therapy devices; nebulizers; ventilators, TENS devices; commode chairs;
patient lifts and seat lifts; blood glucose monitors; and lymphedema pumps.
The product category on the list that’s particularly worrisome to industry stakeholders: ventilators.
“I don’t know how you would competitively bid vents, because it’s such a clinically and service intensive
product,” said Wayne Grau, vice president of supplier relations and government affairs for The MED Group.
A product category that industry stakeholders are fairly certain CMS will try to slip into Round 2: manual
wheelchairs.
“CMS plans to improve coding for manual wheelchairs, but they put that on hold, so that’s a pretty good
indication that they’ll be in,” Bachenheimer said. “The question is whether they will exclude some of the
higher-end chairs. The expenditures there aren’t significant, so CMS may be receptive to excluding those.”
Industry stakeholders were able to get complex power wheelchairs (Group 3) excluded from Round 1, but
it took an act of Congress.
A product category that raised eyebrows: patient lifts and seat lifts. Providers often consider these products
cash items.
Unfortunately, at the end of the day, money, not quality of care, will drive CMS’s decision, industry
stakeholders say.
“CMS is charged with targeting the product categories with the highest price tag or those where the
beneficiary co-pay is the most,” said Walt Gorski, vice president of government affairs for AAHomecare
April 23, 2011
Massage therapy licensing adds credibility to industry - PennLive.com –
When Denise Nickey developed chronic neck and shoulder pain from long hours hunched over a drafting
table, she went to a massage therapist for relief.
The former commercial art designer was so impressed with the results that she decided to become a
massage therapist herself.
“I love it. Being able to help people feel better is a wonderful feeling. It brings a lot of purpose to what I do,”
said Nickey, 42, who has been a certified massage therapist for almost 15 years. “Many of my clients have
chronic conditions. To be able to give them hope and lift them up a little bit is very rewarding.”
The Wellsville resident trained at a massage therapy clinic and started out working for a chiropractor. She
now contracts with Papillion Skin Transformation Center in Lemoyne and Journey to Wellness in Dillsburg.
She currently specializes in lymphatic massage, which is gentler than deep penetrating massage and aimed at
recharging the body’s lymph system and improving immunity.
“It’s not digging out a trigger point or a knot in a muscle. It’s more subtle energy type work,” explained
Nickey, who said lymphatic massage is as in demand as deep massage.
For a person who has lymphedema — a blockage in the lymphatic system that prevents lymph fluid from
draining well — or another condition where excess fluid is stored, lymphatic massage can help offload the
body of extra fluid, Nickey said. It can also clear out toxins such as lactic acid, heavy metals or chemicals in
the body, she said. She uses a vibrational machine to help stimulate the lymph flow.
Some of her patients come for relief of lymphedema caused by a mastectomy that included removal of
lymph nodes in the arm. Others come to find relief from symptoms of Lyme disease, fibromyalgia or side
effects of chemotherapy. Others come simply for routine “maintenance” — to keep their immune system
functioning well.
“People are changing their focus as far as what the body needs to maintain good health,” she said. “This is
very cleansing, rejuvenating and anti-aging. It eliminates the lactic acid and free radicals that cause premature
aging.”
Though more and more people are realizing the therapeutic benefits of massage, therapists say the
profession recently got a boost to its credibility with a licensure requirement to practice in Pennsylvania.
“It really is raising the standard for the profession,” said Brenda Schuck, president of the American Massage
Therapy Association Pennsylvania Chapter. “You’re going to have more skilled therapists rather than
someone who just massages someone’s shoulders and calls themselves a massage therapist.”
Sharon Crane, a certified massage therapist with Shaffer Chiropractic in Mechanicsburg, said licensure will
bring a new level of respect and integrity to the profession.
“It will also separate the trained professionals from the pornographic massage parlors, the extreme of which
is sex trade,” she said.
The law prohibits anyone without a license from advertising themselves using terminology associated with
massage therapists, including even the word “massage.”
“Massage therapists have been licensed in Alabama, where I come from, for years, and we don’t have that
type of connotation anymore. I think licensure in Pennsylvania will help change the mindset here,” said
Georgeanne Pritchett, who recently completed a Master Bodyworker program with the Utah College of
Massage Therapy and is nationally certified. She is in the process of applying for her Pennsylvania license.
“Massage has such great benefits for body, mind and spirit,” said Pritchett, who practices at the Family
Wellness Center in Lower Paxton Twp. “I think the standards that therapists have to meet for licensing will
bring us more clients who will benefit from that.”
Perhaps now, more doctor and chiropractic offices and hospice clinics will offer massage as an alternative
therapy, Schuck said.
Licensure might also open the door for insurance companies to consider covering massage therapy services,
therapists said.
Nickey, who doesn’t offer insurance billing for her services, said she has seen a slight drop in business due
to the slow economy, but overall “people who see the value of it and the results continue to come.”
She charges between $65 and $75 an hour and sees many of her clients on a monthly basis.
Nickey received her Pennsylvania license at the end of February after completing the requirements and
paperwork. She had to take an updated CPR class for health providers and get proof from the Associated
Bodywork and Massage Professionals, a professional organization, that she is a member, among other
things.
Licensure brings a sense of accomplishment, she said.
“I still do the same thing, but I have a piece of paper that says I’m licensed and now I’m recognized like any
other licensed professional,” she said. “We are a legitimate profession with highly qualified and skilled
professionals, and we should be treated as such.”
About the law
Anyone who practices massage therapy in Pennsylvania is required to be licensed by the Pennsylvania
Department of State.
Since it began issuing licenses in January, the State Department has assigned more than 800 licenses and
receives 25 to 45 applications daily, according to Kevin Murphy, director of public relations for the
department.
The license, which costs $65, must be renewed every two years. Continuing education is required for
renewal. The law also provides for standards of professional conduct and includes requirements for
treatment areas and equipment.
Different licenses are offered depending on a massage therapist’s education level and training. Temporary
practice permits, good for six months after completion of their education, are issued to those who need to
take a licensure exam.
Here are some examples of requirements, which may vary according to each license:
Proof of graduation from high school or the equivalent
Certification of good moral character form, filled out by two people not related to you
Criminal background check
CPR certification
Letter of good standing if you are licensed in another state
Proof that you have been in active, continuous practice between Oct. 9, 2005, and Oct. 9, 2010 (for
example, tax returns or proof of membership as a practitioner from a board-approved professional
association)
Exam scores from a national certification examination board
Proof that you completed a massage therapy program of at least 500 hours
For more information about which license to apply for and what is required for each, visit the Department of
State website at www.dos.state.pa.us/massagetherapy
April 25, 2011
Backus plans annual Pink Fair for May 5 - TheDay.com –
Sorry Tina this was an announcement for an activity that has now passed May 5th
Cancer Survivor? Getting Massage? Here's What You Should Know - Opposing Views - by Cinco Vidas –
Last month, I attended an extensive training taught by Morag Currin, author of Oncology Esthetics, A
Practitioner’s Guide. I wanted to learn more about which spa treatments are safe during cancer treatments,
and which may be ill-advised.
Morag, founder of Touch for Cancer, is a wealth of knowledge, and I learned so much from her. The main
thing I want to tell my readers is this: It’s important to feel good during and after cancer, and I believe that
spa treatments—particularly massage—can help reduce side effects and produce pain-killing endorphins. It
is equally important, however, to educate yourself, and find an esthetician or massage therapist that knows
what he/she is doing. Particularly if you’ve had lymph nodes removed, be very cautious in your selection. A
therapist who doesn’t know any better may perform the wrong technique or massage too close and increase
your risk of lymphedema, a long-term condition that can create chronic and painful swelling.
“Studies of massage for cancer patients suggest massage can decrease stress, anxiety, depression, fatigue
and pain,” Morag says. “A physical connection through touch is really important for any person when not
feeling well, and with any health challenges as it provides comfort.”
She goes on to warn, however, that regular spa treatments and pressure may trigger lymphedema, or
exacerbate an existing case of it. Other things that may put you at risk of injury include a recent surgery,
fragile skin (that may tear), pain, neuropathy, wounds, or radiation burns.
The main thing to remember is to be gentle, gentle, gentle, and follow these tips:
1. Avoid all aggressive therapies during cancer treatments, including deep tissue massage, hot stone
therapy, Swedish massage, Shiatsu, sports massage, and anything that feels too rough.
2. Call before you go to the spa. Ask about licenses and certifications. Check the website. And ask if
anyone on staff has experience working with not only cancer patients, but you’re particular condition. Check
Morag’s website for a list of certified oncology estheticians in your area.
3. Observe when you go for your appointment. Does your esthetician ask questions? At the very least,
he/she should have you fill out an extensive form detailing your medical treatments including surgery,
chemotherapy, radiation, lymph node removal, ports, incision locations, white blood cell count, etc.
Someone who doesn’t take the time to know this about you isn’t educated—go to someone else.
4. Ask about the type of products they’re planning to use. Ask to see the bottle and the ingredient list.
Allow them to use only safe and nurturing formulas that are fragrance-free and made without sulfates,
phthalates, and other potentially harmful ingredients. (Take our ingredients to avoid card with you.)
5. Stop anything that feels uncomfortable. If anything hurts or feels uncomfortable to you, tell the esthetician
to stop. He/she should be more than willing to listen to you and make adjustments. If not, care enough about
your health to leave.
April 27, 2011
Komen awards community grants - LubbockOnline.com –
The Lubbock Area affiliate of Susan G. Komen for the Cure, one of more than 125 affiliates nationwide
dedicated to bringing an end to breast cancer, recently awarded eight community grant programs with
awards totaling more than $318,000 to support local breast health education and breast cancer screening
and treatment programs.
This year’s recipients include:
■ The American Cancer Society, Reach to Recovery, $13,110
The American Cancer Society’s Reach to Recovery program provides vital education and support to many
breast cancer survivors by women who are themselves breast cancer survivors. Reach to Recovery
volunteers educate women undergoing breast cancer treatment and provide newly diagnosed patients with
post-surgical accessories related to breast surgery and/or lymphedema.
■ Covenant Health System. Mobile Mammography, $75,810.30
Covenant Health System’s Mobile Mammography program provides screening mammography to women in
rural and underserved communities. The program provides one-on-one education for patients about how to
detect a lump or abnormality in their breast, mammography screening for early detection and diagnostic
follow-up care. It also allows for screening and diagnostic services through Arrington Comprehensive Breast
Center.
■ Covenant Health System, Breast Cancer Survivorship, $6,623
Arrington Comprehensive Breast Center will provide a breast cancer survivorship program to women
across the South Plains and will target women who have been diagnosed with breast cancer and their
caregivers. The program will offer support through diagnosis, treatment, grief and survivorship.
■ Joe Arrington Cancer Center, Chorus of Angels, $28,700
The Chorus of Angels financial assistance program is designed to alleviate expenses that create barriers to
essential treatment for financially vulnerable breast cancer patients of the Joe Arrington Cancer Center.
Expenses for basic needs such as transportation and lodging are almost never covered by insurance and
Chorus of Angels can help alleviate many of these out-of-pocket expenses. ■ Texas AgriLife Extension
Service, Friend to Friend, $7,826.56
Texas AgriLife Extension Service’s Friend to Friend program will work to educate rural women within the
Lubbock Area Affiliate’s service area about breast health and preventative breast cancer screenings. The
Friend to Friend program will target women in seven of the affiliate’s 16 counties.
■ UMC Foundation, Breast Cancer Prevention, Diagnosis & Treatment, $70,268
University Medical Center and the Southwest Cancer Treatment & Research Center provide
comprehensive breast health services including prevention, diagnosis and treatment for the communities of
West Texas. The Breast Cancer Prevention, Diagnosis and Treatment program will promote breast cancer
prevention through targeted education, screening mammography, diagnostic services, and treatment options
for women who do not have adequate health care coverage.
■ UMC Foundation, Celebrate Today, $8,386
The Celebrate Today program will provide supplies, assistance and specialized services to breast cancer
patients in the Lubbock Area Affiliate’s service area. Supplies will include lymphedema sleeves,
lymphedema compression garments, wigs, transportation and housing assistance to those with financial
barriers.
■ The YWCA of Lubbock, Breast and Cervical Health Initiative, $107,818
The YWCA of Lubbock’s Breast and Cervical Health Initiative is devoted to educating women about
breast cancer and the importance of early detection through breast self-exams, clinical breast exams and
screening mammography. In addition, the program offers free breast health and breast cancer education,
screening and diagnostic services to medically underserved women in the Lubbock Area Affiliate’s 16
county service area.
Trinity Rehabilitation Services achieves three-year accreditation - Quad-Cities Online –
Press release submitted by Trinity Regional Health System
Trinity Medical Center's inpatient rehabilitation program has been re-accredited for a period of three years
by CARF, the Commission on Accreditation of Rehabilitation Facilities, an international accrediting body
that helps organizations measure and improve the quality of their programs and services. This is the 12th
consecutive three-year accreditation awarded to Trinity Rehabilitation Services since 1978.
Trinity received the three-year accreditation, the highest honor possible, after a rigorous peer review process
testing each standard the program upholds. The accreditation demonstrates Trinity's ability to continuously
improve efficiency and service delivery, establishing quality care that is measurable and accountable. CARF
surveyors specifically noted areas of excellence to be effective communication among staff and the patient as
well as the high degree to which the patient is involved in the rehabilitation process.
Trinity's rehabilitation team coordinates care by meeting together weekly to discuss programs and goals.
Members of this team include physiatrists, (physicians specializing in rehabilitation medicine), rehabilitation
nurses, physical therapists, occupational therapists, speech pathologists, social workers, program managers,
case managers, nutrition services, psychologists/rehabilitation counselors, recreation therapists and pastoral
care staff.
Trinity's Rehabilitation Services offers a variety of individually tailored programs. In addition to the
comprehensive integrated inpatient rehabilitation program, Trinity provides comprehensive outpatient
physical, occupational and speech/language therapy, rehabilitation counseling and pediatric rehabilitation
services;; aquatic therapy; pain management; hand therapy; sensory integration; vestibular and balance
rehabilitation; lymphedema management therapy; women's pelvic health therapy; stroke care and support
group; as well as specialty services for patients with Muscular Dystrophy and related neuromuscular
disorders, for amputees and for those who need neurodevelopmental and early intervention treatment.
Trinity Rehabilitation Services was created in 1970, the first program of its kind in the Quad-City area.
Since 1978, it has maintained maximum accreditation in comprehensive inpatient rehabilitation by CARF.
CARF is an independent, not-for-profit accrediting body promoting quality, value and optimal outcomes of
services through a consultative accreditation process that centers on enhancing the lives of the persons
served. Since 1966, CARF has established consumer-focused standards to help organizations measure and
improve the quality of their programs and services.
For information, contact Jodi Dykema, director of Trinity's Rehabilitation Services, (309) 779-3131.
Cancer could not shake woman's faith - Eastern Arizona Courier - By Diane Saunders –
When Sandra Villa was stricken with breast cancer in 2008, she lost her hair from chemotherapy and her
breasts in a double mastectomy, but she did not lose her faith in God or her sense of humor.
“I thank God. He was there with me the whole time,” Villa said in a recent interview.
She and her sister, Sally Martinez, are both Duncan residents who plan to participate in the annual Relay for
Life on May 6 and 7 at the Graham County Fairgrounds. The event begins at 6 p.m. May 6 and ends at 9 a.
m. May 7.
Relay for Life is an annual event that recognizes cancer survivors and honors the memory of those who died
from this dreaded disease.
Villa recalled the dark days after her breast cancer diagnoses.
“I did not accept it. I said ‘I do not have cancer,’” she said.
Reality did not set in until the chemotherapy ports were placed in her body. Her aggressive cancer was
attacked on several fronts, including four chemotherapy treatments, a month of daily radiation treatments and
another round of six chemotherapy treatments in addition to the double mastectomy.
She received chemotherapy at the cancer center at Mt. Graham Regional Medical Center and radiation at a
facility in Tucson.
Martinez said she was given a prescription for nausea medication to pick up at a local pharmacy while Villa
underwent her first session of chemo. To her surprise, Villa did not need the medicine after the initial
treatment or after subsequent treatments.
“When I was done with my chemo, I went and had my hamburger and my fries and my soda,” Villa said.
She lost her hair, though, as most chemotherapy patients do.
“I cried about my hair falling out,” she said.
Villa‘s unusual reactions to medical procedures continued after she had her mastectomy. She did not need to
take pain medication after the procedure. She also healed faster than expected.
“Everybody was amazed at her recovery,” Martinez said. “I never saw her cry. I never saw her complain.”
Before her bout with cancer, Villa performed home services for the handicapped. Because her cancer
surgery included removal of lymph nodes she has lymphedema — swelling caused by having fewer lymph
nodes — in her left arm. This has limited her ability to lift or move heavy objects.
Villa said she believes God has a plan for her. Part of that plan includes sharing her faith.
Susan G. Komen for the Cure of Southwest Florida gives out more than $1 million in grants - The News-
Press - by CHRISTINA CEPERO
Susan G. Komen for the Cure of Southwest Florida gave $1,015,235 in grants Wednesday, surpassing $1
million for the first time.
Thirteen nonprofits that serve Lee, Collier, Charlotte, Glades and Hendry counties received 14 grants, the
most the Komen affiliate has given. The grants will go toward education, screening, diagnosis and treatment
in the fight against breast cancer.
NCH Healthcare System received more than $42,400. Breast health navigator Lynn Hurley, who has
guided more than 250 women diagnosed in the past year through treatment, said she feels like NCH got $1
million.
“Because every program that Komen gives money to, I’m able to tap into that,” Hurley said.
Lee Memorial Health System received $199,000.
“When they find out there’s something there (a grant), even though they’ve been diagnosed with cancer, the
burden’s lifted,” said Lee’s breast health navigator, Dara Leichter.
The Komen affiliate received $1.55 million in requests from the 13 organizations.
“The grant requests and needs in the community have exceeded the amount that we’ve had to disburse, but
the amount that we’re giving to the community is bigger than ever,” said grants committee member Carol
Flegel. Each grant application was reviewed five times.
Most of the money was raised by 12,000 participants at the March 12 race at Coconut Point Mall in Estero.
The awards were presented at a luncheon of about 125 Komen board members, sponsors and grant
recipients at Bayfront Bistro on Fort Myers Beach.
“It’s amazing to me how we passed the $1 million mark with this economy,” said Monica Young, Komen’s
education committee chairwoman. “People trust us and I think people understand what our mission is. We
really do want to see a world without breast cancer.”
Young lost her 25-year-old daughter to breast cancer 15 years ago.
“This is really a proud day because we get to recognize the people that are on the frontlines,” she said.
“They are out there in the community; they are facing the people who are in need at a really desperate time.”
April 28, 2011
Grant to aid local breast cancer patients, survivors - Glens Falls Post-Star – by Lydia Wheeler –
Glens Falls Hospital wants to highlight its breast cancer patients in Washington County.
The hospital recently received a $29,790 grant from the Northeastern New York Affiliate of Susan G,
Komen for the Cure, which is working to better the lives of people who have had or are currently facing
breast cancer.
Because Washington County is considered an under-served population in the region, Vickie Yattaw, an
oncology resource nurse at Glens Falls Hospital, said the money will be used to offer more services to
Washington County residents in more convenient locations within the county.
Of the approximately 150 newly diagnosed cancer patients who come through the cancer treatment center
at Glens Falls Hospital each year, roughly 60 are from Washington County, Yattaw said.
She said the hospital is looking for a place hold exercise classes. One such class is currently held in
Greenwich, close the hospital's Greenwich Medical Center.
Part of the Komen grant money will also cover copays for Washington County breast cancer patients
receiving rehabilitation treatment through the STAR (Survivorship Training and Rehabilitation) Program.
"For anyone that has gone through cancer treatment, whether it be surgery, chemotherapy or radiation, they
usually have some long-term side effects from those treatments," Yattaw said. "We hook patients up with a
physical therapist to help get them back to the way they were before their treatment."
And because insurance typically does not cover lymphedema products, the grant will be used to purchase
lymphedema sleeves and a pump.
The devices are needed because, sometimes in surgery or in radiation, lymph nodes in the breast can be
damaged or removed, Yattaw said. That can disrupt the flow of lymphatic fluid, causing the arm to swell.
If left untreated, the arm can remain swollen, so Yattaw said lymphedema sleeves act as a compressing
garment to keep the swelling under control.
The grant money will also help fund a free breast cancer survivors retreat that's held the first weekend of
December each year. Breast cancer survivors interested in attending should contact Yattaw at 926-6639.
This is the second year Glens Falls Hospital has received funding from the Northeastern New York Affiliate
of Susan G. Komen for the Cure organization to dedicate specifically to Washington County.
A total of $277,860 was distributed to 13 local organizations involved in the fight against breast cancer in
New York. The money was raised through the 16th annual Susan G. Komen Northeastern New York Race
for the Cure held last October in Albany and through other fundraising efforts and funds received from the
Susan G. Komen for the Cure national organization.
Komen Foundation gives grants in excess of $1 million - Cape Coral Daily Breeze – by By BOB PETCHER
The Southwest Florida Susan G. Komen for the Cure awarded a record-setting dollar amount of grants to
13 nonprofit organizations in five counties at its annual grants luncheon at Bayfront Bistro on Fort Myers
Beach Wednesday.
The local affiliate, which raises much of its funding through its annual Race for the Cure event, gave
$1,015,235 from its 2011-12 grant cycle to provide education, screening, diagnosis and treatment in the
fight against breast cancer. This is the first time the Komen Foundation has exceeded $1 million, an increase
of 23 percent over last year's grant totals.
The grant recipients were Cancer Alliance of Naples, Virginia B. Andes Volunteer Community Clinic,
LIGHT of Southwest Florida, Family Health Centers of Southwest Florida, NCH Healthcare System,
Collier Health Services, Partners for Breast Cancer Care, Senior Friendship Centers, Gulfcoast South Area
Health Education Center, Manatee County Health Department, Lymphedema Resources Inc.,
Neighborhood Health Clinic and Lee Memorial Health System, which was presented nearly $200,000 from
Snook Bight Marina and Bayfront Bistro resident owner Joe Yerkes.
"It was obvious to me that we had to give something back to the community. What impressed us most
(about the Southwest Florida Susan B. Komen Foundation) was the percentage of the money that goes right
to the community in Lee and Collier counties," said Yerkes. Over the past two years, the "All-Aboard Fest,"
featuring a fund-raising wine dinner and live auction at Yerkes' businesses, has resulted in donations of more
than $140,000.
The Komen affiliate has dished out more than $4.7 million to local nonprofits since 2002. Seventy-five
percent of the money raised stays in the local communities to create life-saving education programs and
funding for breast health.
Executive Director Miriam Ross attributes distribution success to advocates, sponsors, event participants
and any other donation contributor. She thanked her board members for their help in the reviewing and
selection operations.
"It's a pretty long process, but it's an important process," she said.
Roughly 75-100 people attended the luncheon, emceed by NBC2 meteorologist Robert Van Winkle.
"Back in 1982, the survival rate for breast cancer was only about 74 percent. Now, here we are in 2011,
and I'm proud to say that the survival rate is close to 98 percent right now," he said. "Komen was just given
a 4-star rating from Charity Navigator (a watch dog agency) for the fifth year in a row."
Breast cancer survival begins at home. Many of the grant presenters and awardees echoed the sentiment
that women - mostly mothers - neglect their own health to care for the children.
Cape Coral's Susan Murphy was not one of them. She found a lump in her breast, had a physical done and
scheduled appointments with a radiologist. In May 2010, she was diagnosed with a very aggressive form of
breast cancer at the age of 44. She said that since she found the lump early, they were able to remove
everything.
Since she could not afford the necessary insurance, Murphy was referred to Dara Leichter with Lee
Memorial Health System to apply for a grant that helped her cover the cost of having surgery, chemotherapy
and radiation.
"Within one day I got the grant from Susan G. Komen," she said. Murphy was named the 2011 Honorary
Team New Balance Member for the Race of the Cure.
"The other thing that this affiliate is doing, besides the money it raises, is the education," said Leichter, breast
health navigator for the health system's Regional Cancer Center. "I'm starting to see women coming to my
office now that are in an earlier stage, because they know that there is somebody out there.
- Meghan McCoy contributed to this report
April 30, 2011
Q&A with Peoria breast surgeon Lynne Jalovec - Peoria Journal Star - By JENNIFER DAVIS –
Imagine a day in the not-too-distant future when your family doctor runs genetic tests on you - specific
screenings based on your family medical history.
And then imagine if your particular cancer cells could be compared with other cancer patients worldwide to
determine a tailor-made treatment program proven to work.
These are just a couple of the exciting advancements that Dr. Lynne Jalovec, a Peoria breast cancer
surgeon, sees on the horizon.
"I envision, and I know someone is going to say it sounds far-fetched, but my guess is that it will be a routine
thing for doctors to run genetic tests on you," Jalovec says. "They'll look at your family history and say, 'We
should run this as a wellness check.'"
We talked with Jalovec, who has been practicing for more than 20 years. Always exploring the cutting edge
of breast cancer research, Jalovec was No. 1 in the country for including patients in a national clinical trial of
sentinel lymph node biopsies that is fast becoming standard care.
Below is an edited version of our interview.
Q: What is happening on the frontlines of breast cancer?
A: A couple of things. In surgery, there's big news. When a patient comes in with breast cancer, most
patients, if the cancer was caught early, have a choice to keep their breasts rather than remove their breasts.
But the choices are there. If they want their breasts removed, fine. But they have a choice of keeping their
breasts.
About 10 years ago, we started investigating and very rapidly adopted a new way of looking at lymph
nodes. Lymph nodes are checked on cancer patients to see if their cancer has spread. So, we started
looking at and rapidly adopted a technique called sentinel lymph node biopsy.
We use a tracer to find the lymph nodes that drain the breast first. And we take those out and test them in
surgery. If there's no cancer in those lymph nodes, then the woman gets to keep her other lymph nodes.
Now, why is that important? Well, the other lymph nodes, when you take all of them, you increase a
woman's risk for a condition called lymphedema of the arm.
Well, this trial was very innovative and very scary for women. What it did was, women who had a sentinel
node positive were randomized into having all the lymph nodes taken or no more taken. And then you were
put into a group by computer randomization. Some of them went back to surgery and had all the lymph
nodes taken, and some of them did not. I will tell you that they had difficulty finishing the trial, and that's one
problem with this article. Women had a hard time volunteering for this. It might screw you up.
In fact, Peoria, with Dr. (Denise) Mammolito and myself, we were in the top 10 accruers in that trial. So, we
were instrumental in getting that trial accomplished. So, I ended up, I was actually No. 1 in the country. So,
people know Peoria. And not just because of me, please don't get that impression. It's because of the
cooperative nature of our breast cancer management here in a small community. You don't usually get this in
a place like Peoria. You get this in Chicago, at a place like Northwestern.
Now, we don't start our own research here too much in breast cancer. We're not, necessarily, developing
the trials, but we're participating in the major trials as much as we can to give our patients what's new out
there. So, we could offer our patients sentinel node biopsies because we were right on the cutting edge of it.
Right when it started, we were there.
Q: So, this is now the standard of care?
A: At six years, this is an early trial, but it is giving us data to, again, move ahead in breast cancer surgery to
do less so we can cause less harm. It took a long time for surgeons to accept lumpectomies as an alternative
to mastectomies. In their heads, with all their training, theoretically, more is better. They didn't have
chemotherapy like we do today. They didn't have the hormonal therapy we have today, the anti-cancer
hormonal therapy.
So, we have better systemic treatment then we had 20 years ago, and that is impacting and allowing us to do
less surgery and have fewer side effects of our surgery.
This is, for women who know what lymphedema is like, they all wish we had known this before, but they
look at it as, 'This is great because if my daughter gets breast cancer she may not have to go through what I
went through.'
Lymphedema is not as horrible as they make it out to be. Most women have mild to moderate (symptoms.)
It's not horrible.
Q: So, this is great, but it also seems there is a rise in women choosing double mastectomies, particularly
when you have stars like Christina Applegate choosing that route. Is that a trend you see here?
A: We have seen an increased rate of prophylactic (preventive) mastectomy. The reconstruction is better -
no ifs, ands or buts - and women know that. The reconstructive surgeons are out there talking about it. You
hear people talking about how much nicer they are.
The other thing is, women are talking to each other more. They're going on the Internet more. You're right.
People like Christina Applegate, stuff like that, is influencing women to say, 'Look, I think I'm just going to
have both of them off.'
What we try to explain to women is that prophylactic mastectomies are appropriate for some women. If you
have a high risk for breast cancer. If you're known to be genetically positive for the BRCA 1 or 2, then,
certainly, it's a very good option. Now, there is another time that I see women choosing it that I think is not
wrong. If you need to have a mastectomy because you have multiple cancers in your breast or a very large
breast. If you need a total mastectomy on one side, many times you're going to have something done on the
other side to match.
If she's 35 or 40 years old, she's got a lot of years ahead of her to maybe get another cancer. So sometimes
they'll ask, 'What about my other breast? Can I have my other breast removed?' So, we'll explore it. We
talk about it. It's not going to affect survival. In those women, it's not going to make their survival better. Not
the women who already have cancer. Their survival is impacted by the cancer they already have. That
cancer is going to leave them with a risk of dying, if they had invasive cancer. They'll always have some risk
that it's going to come back and take their life. The chance of getting a second breast cancer in the opposite
breast is only 7 percent in 10 years. And if you're taking the pill therapy, the anti-estrogen pill, it's half of
that: 3 percent. And we're following them.
A prophylactic mastectomy may be beneficial for symmetry or for psychological benefit more than anything.
And then for the people who are genetically at risk, there is a benefit for them because their risk for breast
cancer is much higher.
When you talk about lumpectomy and a quick sentinel node (removed), they're back at work in two weeks
like nothing ever happened. When you talk mastectomies and reconstruction, it's eight weeks off work
typically and a lot longer than that before you feel normal again.
Q: Is there anything else new that you are excited to see coming?
A: Another new area for breast cancer is Oncotype DX. This is revolutionary.
A simple way to describe it would be to say we're doing gene profiling of a person's cancer. We're not
doing BRCA testing. We're not looking at their genes to see if they have a higher risk for cancer. We're
looking at someone's genetic makeup of their cancer, their particular cancer, and we're comparing it to the
genetic makeup of what I call banked tissue on previous cancer patients that an organization called the
National Surgical Adjuvant Breast and Bowel Project (NSABP) has. This is a clinical trial organization that
does a lot of breast cancer research. That group was ingenious 20 years ago because what they did was
when patients participated in trials, they signed a paper that said they could collect tissue and bank it, freeze
it. So, they have all these women's cancers on file. And they have results from clinical trials in which patients
had hormonal therapy versus hormonal therapy with chemotherapy. And they know the genetic makeup of
the people and they looked to see how did they do. Could you predict how they were going to do? And the
answer is, yes, we can. That's very exciting.
Now, a result of this is, women who used to get chemotherapy routinely are not all getting it. So the side
effects of chemotherapy are being able to be avoided. So, there's a cost benefit to society because we're
talking $50,000 to $60,000 for chemotherapy. It's expensive, more if you do certain chemotherapies with
newer drugs. And the side effects of chemotherapy can be long-term. Some women have neuropothies,
where they get tingling in their hands and feet that are long-term. Some women will go on to develop
leukemias later on, 10 to 15 years later. So, it's a low risk, but if you didn't need the chemo to begin with,
why have the risk?
So, again, you see that everything is geared towards we want to individualize the treatment of breast cancer
so that if you need chemotherapy, fine. If you need it, you assume the risks. But if you don't need it, let's not
give you the side effects. Let's not make you take something you don't need.
This is big. It was adopted around the country in the matter of a year. It was unbelievable how quickly it got
adopted by the medical oncologists.
This is a test that is already commercially marketed. They were able to use the tissue they had banked to
actually run the test and see if they could make some predictions. They could, is what they found. They
could stratify people into risks, and they could predict what someone was going to do in certain categories
of treatment. It is routinely used nowadays.
There's a new thing in radiation called partial breast irradiation. They abbreviate it PBI. Done with multiple
techniques, it can be delivered to the patient, for lumpectomy patients.
The standard radiation right now is six weeks. Daily treatment, six weeks. There's a Canadian regime that is
15 treatments, which would be about half that. This one is five days, twice a day. Pretty nice. The long-term
results are still pending. But lots of women are being offered this, and we offer this in Peoria.
Q: It's been over a year since the controversial study came out that suggested women not start getting
mammograms until age 50, and then get them every other year. Have you seen any effects from that report?
A: Nothing changed. I had a fear of that. We have not really seen (any change.)
I think there was immediate media attention to it. The American Cancer Society came out strong, saying
we're not changing our guidelines. The American College of Surgeons came out strongly. Probably the only
organization that kind of supported (it) were the gynecological organizations, but even they kind of hushed
up after the people who really deal with breast cancer, the surgeons and oncologists, came out strongly.
You start mammography at age 40, and it's every year after 40. We recommend women consider starting
earlier if their mother had breast cancer at a young age, so 10 years earlier than your mother. And if
anybody is genetically positive or they have strong family histories, their doctors help them determine when
to start.
But that scared me to death because I thought, 'Oh, my God, we're taking a step backwards.'
We've made all these strides to improve breast cancer survival. The breast cancer mortality rate since 2000
has dropped by 2 percent per year. So, in the last 10 years, we made a 20 percent improvement in survival.
That's not just drugs, that's early detection.
I will tell you that mammography is not perfect. There have been articles about breast self-exam, slamming it.
What I would say is this: The data is lacking on whether breast self-examination improves survival. What we
do know is that early detection helps with survival. That would suggest that if we can find it, especially in a
young woman who is not mammograming yet, if we can find it earlier, we may impact survival. For the
woman who feels, breast self examination makes her nuts - I'm so scared I can't do it - the lack of data
would say, 'Relax, you're probably not going to hurt yourself by not doing it.'
But all doctors tell their patients, 'Know your body.'
If you're having a change in the way you're body is acting, you're supposed to go see a doctor. A change in
your normal physical health is supposed to be noted because it could be an indicator of a medical problem.
Examining your breasts is just an extension of that. It's not perfect either. But, it doesn't cost anything to do it.
Q: What else can we do to guard against breast cancer?
A: That's where we're struggling because exactly what to tell women is tough. We know some things that
can lower your risk for cancer in general and breast cancer. One of the things is maintaining normal body
weight.
So, being overweight is a risk factor for breast cancer. It appears that high fat diets may be a risk for breast
cancer. So, doing exactly what they say we should do for good health, which is maintaining our weight.
Don't eat high fat diets. You want to eat more protein and vegetable and fruit diets, more natural,
unprocessed food. Things like that. Those all seem to impact on breast cancer risk, but to a small degree.
One of the things we did learn in the last 10 years with the woman's health initiative study, and I believe the
publication was in 2002. This was the one that showed combination hormones, which is estrogen and
progesterone hormones, after menopause do slightly increase your risk for breast cancer if taken beyond
four years. So, at about the four-year mark, you start to see a slight rise in risk. So, what happened after
that article was published? A lot of women threw out their hormones. And do you know what happened to
the incidence of breast cancer? It dropped significantly.
So, we do know some things. We know that taking combination hormones when you go into menopause is
probably not the best idea unless you really, really, really need to do it. It doesn't mean you can't do it, but
the idea is we don't need hormones the rest of our lives. We were meant to go into menopause. It's OK to
go into menopause, whether we like it or not. There are things that women can use to help with menopause
symptoms.
The problem is, that is only going to reduce cancer a small amount. We need to understand better what is it
in our environment that is putting us at risk, beginning when we're this big.
Because, if you notice, breast cancer, like all cancers, increases with age. Cancer is a disease of genetic
changes in our DNA in our cells that is no longer being repaired. As we get older, our repair mechanisms
aren't working as well. So, the DNA in our cells are mutated by outside influences, what a lot of people call
carcinogens. Carcinogens in the air we breathe, the foods we eat, the water we drink.
But even just the lack of the ozone layer is giving us more exposure to radiation from space and such. All of
that influences or affects the DNA in our cells over years, and as we get older, our repair mechanisms aren't
working so it's cumulative, and we start to see more cancer as we age.
So, if we improve our repair mechanisms in our cells or if we can get rid of more of the carcinogens in our
environment - and I'm wondering if some of this drop in cancer incidence is due to, you know, there's more
people trying to eat organic. There's more encouraging of having people check for radon in their homes,
especially in places like Illinois. You get the radon out of the homes, these kids aren't exposed to it anymore,
and you may be dropping cancer incidences as they get older.
Q: Anything else we should know?
A: One of the things I tell my patients is, if a patient wants to go out of town for a referral, we gladly send
them. But I also make sure the patients understand that I would not leave Peoria to go get breast cancer
treatment. Now, if I had something that was so way out there that no one has ever seen - but that's pretty
unusual for us because we've seen just about everything. And it's not wrong to seek an outside opinion,
never wrong.
But, I have another breast surgeon, Dr. Mammolito, to go to. I would have her do my breast surgery. I
would stay here and have my chemotherapy, and I know all the main breast surgeons in the country. I know
them by first name
Bob Main selected as 2011 Chattanooga Area Manager of the Year - Chattanooga Times Free Press - by
Mike Pare
When Bob Main started his job 23 years ago, he was the first, and only, employee of Siskin Hospital for
Physical Rehabilitation.
“I was given the chance of a lifetime to be able to design and build and staff a hospital,” said Main, who
oversees the only freestanding, not-for-profit rehabilitation hospital in Tennessee that now employs nearly
400 people.
Main has been tapped as the 2011 Chattanooga Area Manager of the Year. The award, in its 24th year, is
made annually by area business groups, including the Chattanooga Area Chamber of Commerce, which pick
a manager deemed to have made a significant contribution to the area.
Main, the 67-year-old president and chief executive of the Chattanooga hospital, said he has had
opportunities to leave the city but stayed.
“I’ve got a lot of blood, sweat and tears in this place,” he said about the 109-bed facility that marked its
20th year in 2010. “We’ve got a team that really cares about people.”
The Buffalo, N.Y., native said Siskin is “providing services to the community that were never there before.”
“In rehab circles, if you ask anybody and say Siskin Hospital, they’ll say Chattanooga, Tennessee. We’ve
got a national reputation,” Main said.
Dr. John Boxell, who chairs the Siskin Hospital board, called Main “a compassionate person, committed, an
extremely hard worker.”
“He’s constantly looking for ways to enhance care for the patients he serves,” Boxell said.
At Siskin, its staff deals with not just patients but their entire families, Main said.
“Their whole life has been altered,” he said. “We’ve got a chance to rebuild that lifestyle. It’s amazing what
the human spirit can do.”
Siskin provides a lot of free care, the hospital CEO said, and it doesn’t have an endowment or foundation to
speak of from which it can draw.
“That comes out of the hospital operation, but we’re doing well,” he said.
In 2009, the most recent year for which the hospital’s financial records are available, Siskin reported a net
gain in income of more than $2.5 million on revenues of nearly $32.5 million.
According to the selection committee that picked Main for the award, the Chattanooga area has benefited
from Main’s vision of providing specialized programs such as a brain injury unit and lymphedema, balance
and dizziness, and driving evaluation programs.
Main worked with his staff to develop the Fitness Center at Siskin Hospital, which provides a place where
disabled and able-bodied people, whether former patients or not, can exercise side-by-side with the benefit
of using specially designed equipment developed for their needs.
Main said the biggest change in his job over the years is that it has “gotten tougher because no one wants to
pay for service anymore.”
When Siskin opened, its average patient stay was 33 days, he said. Today, it’s 15 or 16 days, Main said.
“We have to fight to get patients certified for care,” he said.
In Tennessee, for example, TennCare won’t pay for inpatient rehabilitation, which Main said is highly
unusual.
“People don’t think about rehab until they need it,” he said.
Looking ahead, Siskin officials are continuing to eye the area’s needs and to fill them, Main said, including
preparing for health care reform. That includes looking at getting into an accountable care organization, one
of the provisions in the reform bill in which service providers work together to offer a seamless continuum,
he said.
“We’re monitoring very closely what’s happening in Washington,” Main said.
Boxell said Main is well-deserving of the recognition.
“Siskin is one of the leading rehabilitation hospitals in the country,” he said. “What he has demonstrated in
leadership, longevity and commitment and compassion has paid dividends for our region.”
– Posted By Naomi Farley –
Any obstruction in the lymphatic vessels will prevent the smooth flow of the fluids in the body and lead to a
pooling effect. This is the cause for lymphedema or swelling, particularly in the extremities of the body.
Lymphedema massage is conducted to stimulate the obstructed lymph flow and direct it to the bloodstream.
Excess fluid is eliminated from the body along with waste material in the elimination process.
Cellulitis is commonly seen among lymphedema patients and is a major complication that requires
hospitalization for intravenous administration of antibiotics. Bacteria attack the skin on the affected limb and
may travel to the tissues and consequently into the blood stream. Protein-rich fluids that have accumulated in
the limb form a rich medium for the bacteria to grow and spread through the body. The visible symptoms of
an infection are red blotchy skin which feels warm to the touch, swelling and increasing pain. Flu-like
symptoms may also be present with fever and chills. In some cases, as the lymph nodes fight against
infection they may enlarge.
Extreme care should be taken while performing manual lymph drainage. Too much pressure on the skin may
inadvertently increase the blood flow, leading to accumulation of water in the tissues which is not a good
sign. It may lead to unnecessary complications for a lymphedema patient. It is therefore advisable to visit a
trained massage therapist who has the knowledge of the techniques of manual lymph drainage and is also
aware of the contraindications.
A lymphedema massage done rightly can prove to be extremely useful to the patient. But the effectiveness of
the massage lies in the skill of the therapist to direct the flow of lymph correctly. Therefore, training is
essential for manual lymph drainage. The patient may himself learn the technique -it is the ideal way to keep
lymphedema in check. Another essential factor is to keep note of the progress or the decline of the condition
after beginning the lymphedema massage treatment. If the condition worsens, you may have to reassess your
options and make the changes accordingly.
Whether a massage can prevent lymphedema is a matter of debate. However, the fact remains that a
massage therapy can have a very soothing effect which, in many instances, helps to alleviate the pain and
swelling, post surgery. It helps a patient relax and deal better with the trauma and stress that is the result of
the painful condition. The body can heal itself much faster due to the therapeutic effect of the lymphedema
massage. Nevertheless, it is advisable to use the services of a massage therapist, especially trained to deal
with lymphedema patients. Patients who are at high risk of contracting lymphedema must remain alert to the
earliest signs of the disease and opt for preventive measures to keep the problem at bay.
For the best Lymphedema Treatment, visit Mary Walters’s site on how to choose the best Lymphedema
management for your needs.
April 6, 2011 - Survivors put dragon boats to work - Northern Rivers Echo – by Liina Flynn –
As I made my way to Lake Ainsworth at Lennox Head to find out just what dragon boat racing is, a Viking
fantasy of what a dragon boat would look like formed in my mind: a long boat with curved prow, dragon
head and shields attached to the sides (although perhaps without the sword-wielding Viking warriors). When
I arrived at the recreation facility, I was little disappointed to see there was no dragon head on the dragon
boat. However I soon learnt from Rainbow Region Dragon Boat Club president Veda Dorrough that there
is indeed a crimson dragon head! (It’s just that it’s only attached to the boat when the team is competing in a
regatta.)
Dragon boat racing is actually a Chinese tradition that has developed into a worldwide water sport and is
fast growing in popularity in Australia. Instead of the Rainbow Region Dragon Boat being propelled by
Viking warriors wielding swords, I find the crew is a group of women and men wielding paddles. It takes a
maximum of 22 people to propel a boat from start to finish (20 paddlers plus a sweep and a drummer) and
right now, the paddling crew has started their warm up, jumping around and stretching outside the Lake
Ainsworth Recreation Facility boat shed.
Some of them have brought their own paddles along and have gloves to get a better grip on the paddle. I’ll
be borrowing one of the club’s paddles today, along with the other newbies in the crew. I’ve already gained
kudos with the team because I called it a paddle, not an oar; a basic distinction that all dragon boat paddlers
seem to know. The crew is formed into pairs in two lines by team captain John Turner and he goes through
the basics of how to paddle with the new recruits.
It’s almost sunset on Lake Ainsworth. The sun is hanging low in the blue sky, and as the crew pulls the boat
out of the shed and slides it into the water, it makes slow reflective ripples of clouds and sunlight on the lake.
Two of the paddlers hold the boat still while I grab my paddle and make my way onto the boat, carefully
balancing as I slip down to the middle and take my place next to Veda.
As I sit in my seat, Veda tells me I need to turn my body in, back to the water, hip against the boat, with my
outside foot forward and my inside foot under the seat. I seem to have it. Now, with arms outside the boat, I
need to hold the paddle with one hand on top, one on the bottom, then dip it into the water in an A shape.
There’s lots of water splashing, everyone is laughing and the more experienced crew are giving the first-
timers tips on how to improve their paddling. I have a breakthrough moment when I’m shown how to do the
dragon boat rock. It involves rocking forward and back while paddling, feeling the ‘heartbeat’ of the boat,
created by the paddlers’ rhythm. It’s good to know that if I need a break from paddling, all I need to do is
rock ‘n’ roll, still helping to keep the boat’s momentum and smooth motion of gliding through the water. This
really is team-work and, during a regatta, when the team is competing in races, a drummer would also sit on
the boat, keeping everyone in time.
“It’s a precise sport; timing is everything,” Veda says. “As you paddle, try not to touch the boat or the
person in front with your paddle.”
Veda is from Lismore, and she is survivor of breast cancer and one of the founding members of the original
club, Rainbow Dragons Abreast. Six years ago, Veda was involved in a breast cancer survivors’ exercise
group when she heard about a dragon boating group that had started in Darwin for survivors of breast
cancer. The paddling phenomenon was becoming a popular form of exercise for women who had
experienced lymphedema, after having the lymph nodes under the arms removed, and a doctor had
recommended dragon boat paddling as a trial form of exercise for them. The paddling helped the women to
build up their arm and upper body muscles again and the women who had initially trialled it loved it so much
they didn’t want to stop.
Veda formed a local club and committee and after six months of organising and training in the pool to get fit,
the committee had gathered enough sponsorship so they could rent a dragon boat to practise in. A year
later, the Lions Club Trust gave them money to buy their own boat. It wasn’t until about 14 months ago,
after the numbers of women involved in Rainbow Dragons Abreast began to decline, that the group opened
up the club to the wider community. Now there are two clubs, one where the women paddle for fun and
exercise, and the other (now including eight men) that trains for competition in regattas.
“Anyone over 18 is welcome to come along and give it a try,” Veda said. “You don’t have to be a super
athlete and it will increase your fitness. It’s good that the team has a few men in it now. It makes a difference
when you are paddling in a mixed-sex race against some strong Maoris at a regatta.”
Laura, one of the ex-club presidents and a breast cancer survivor, loves the positive feeling in the club, the
joking and the friendliness.
“It doesn’t matter if you make a mistake, everyone is so supportive,” Laura said. “For new people just off
their treatments, it’s a positive experience that helps them get through the emotional and physical hardships.
We laugh and have fun and don’t talk about breast cancer. You might start off being down, but then you feel
great.”
Laura’s partner John Turner joined the club 14 months ago and has now taken over the important role of
team captain and coach.
Today, John is the sweep and stands on the back of the boat, steering with the rudder and calling out “one,
two” with the timing of the strokes, and watching to see if we are all keeping time. He tells us to watch the
leading pair of paddlers (called the strokes); they set the pace and rhythm of paddling for all the crew. I
need to watch the stroke sitting diagonally opposite to me and synchronise with her. Jane, one of the
coaches, explains that when a paddler gets out of time with the others, it starts a ripple through the group
and the water gets disturbed. Every now and then I can feel the boat slow as a paddler loses her rhythm,
then it leaps forward as the paddlers get into time again.
“Let her run,” John calls and we all pull our paddles out of the water and onto the side of the boat in a
position called 10 and 2 (like the clock positions). I’m learning. Everyone is keen to give me tips on my
paddle-holding form and I’m told that the club’s motto is ‘It doesn’t matter if you lose or win, as long as you
look good in the boat’.
We practise swapping our sitting positions. In pairs, one person slides across, then the other steps over
them. The boat rocks lightly, but we are still upright. Lucky I brought my sense of balance with me today.
Veda says the boat has only overturned once when the crew were doing a series of exercises they has never
done before, and they don’t do them anymore.
“Once a dragon boat starts to tip, there’s no bringing it back!” Veda laughed, and stressed to me that it is
actually a very safe sport.
Out on the lake, we practise a fast paddle. I really have to reach forward and pull the paddle through the
water harder than ever before. We move through four levels of intensity, paddling harder, faster, lunging
forward more and rocking back as we pull the paddle through the water. Now it’s more important than ever
to keep time, or I could end up bumping into someone else’s paddle. John calls out for only the front half of
the boat to paddle, while the paddlers at the back pull their paddles in and rock back and forward in time
with the strokes. Before we pull back into shore, John gets us to practise stopping the boat; he has over-
steered us into a wall of lily pads and we are all laughing as the back paddlers start paddling to reverse us
out.
“Good paddling, bad steering,” John says. “It’s hard to turn the boat sometimes.”
Deborah Gibson and Mary Davis from Richmond Hill have been paddling with the club for the past year,
since it was opened to the general community, and now they are both hooked on paddling. Mary loved the
club’s inclusiveness and Deborah has now started training to be a sweep.
“John told me you need to be fit and have good balance to be sweep,” Deborah said. “And you need to
have a loud voice so that when you shout, the people at the front of the boat can hear you.”
The club is in training for the next regatta and travels to different locations for races throughout the year. The
biggest regatta is on during Chinese New Year celebrations, in Sydney on Darling Harbour, where teams
from all across Australia come together to race. The club usually races in 250-metre distance events, so
some fast paddling is called for. It takes the team about one minute and 10 seconds to travel the distance,
but it can take longer depending on the wind, rain and tidal currents. The club has a few trophies and last
year placed third in the final race at Darling Harbour.
“Every time we are lining up to start a race, I think ‘I wish we’d practised harder’,” Veda laughed. “Then
the adrenalin kicks in.”
The crew not only seems to love the fitness regime, but also the companionship and camaraderie. A group
of women have started going to a boxing class together because they met in the club and became inspired to
get fitter. Cathy, one of the crew members, is a weekend regular who used to play soccer but can’t now
because of an injury. She finds that dragon boat paddling is a good low impact sport that people with knee
or leg injuries can get into, and I’m told the oldest paddler on the team is 70.
If you like to get up early and see the sun rise over the lake while having lot of fun in a boat, you can go
along to the NSW Sport and Recreational Facility at Lake Ainsworth and try dragon boat paddling on
Saturdays at 7am or Sundays at 8am. If you like to hang out on the lake before sunset, you can take a ride
with the mystical dragon boat paddlers in the gloaming on Tuesdays and Thursdays at 5pm.
April 7, 2011 - Turner Syndrome Foundation participates in the NJ Marathon Festival - Asbury Park Press
– Written by Donna Villavicencio Reader Submitted –
Turner Syndrome Foundation participates in the NJ Marathon Festival for second year and holds kick off
Treats & Sweets for TS
Turner Syndrome Foundation (TSF) will be participating in the 15th Annual New Jersey Marathon Festival
(NJMF) at the Shore in Long Branch the weekend of April 30 - May 1. This is TSFs second year as a
charity and their first as a beneficiary at the NJMF and they are off to a good start. TSF has already
recruited over 90 participants and hopes to surpass their goal of 100 plus participants and to raise over
$25,000 at this event.
Turner Syndrome (TS) is the leading chromosomal abnormality affecting women and girls and occurs in 1 in
2000 live female births. TS occurs when all or part of the second X chromosome is missing. Girls with TS
only have a small chance of making it to a live birth. Most will miscarry. Of those that do make it, most will
go undiagnosed until their teen years missing valuable and necessary treatments to give them the best
possible life. No two girls with TS are exactly alike but the most common indications of TS are short stature
and delayed puberty. Many of these girls and women also have heart defects, kidney defects, ear issues,
hearing loss, lymphedema, learning disabilities and the list goes on and on. Ask almost anyone and they have
never heard of Turner Syndrome unless it directly affects their life which is why the Turner Syndrome
Foundation was created.
Turner Syndrome Foundation is a 501c3 nonprofit organization whose goal is to support research initiatives,
facilitate educational programs to increase professional awareness and enhance medical care of those
affected by TS. Laura Fasciano, founder and president of TSF and a Holmdel NJ resident, started the
foundation shortly after her daughter was diagnosed with TS at age seven. She sensed their was a difference
but her daughter went undiagnosed for years like many of those affected by TS.
In addition to participating in the NJMF for the second year, TSF will also launch their newest fundraising
campaign, a bake sale called Treats & Sweets for Turner Syndrome, during the Sunday events. This is no
ordinary bake sale. Treats & Sweets for TS is a nationwide effort by those affected by TS to raise
awareness about the relatively unknown syndrome and funds for TSF so they can continue their important
work. 100% of proceeds will go directly into foundation programs to facilitate education, resources and to
provide support
The New Jersey Marathon Festival at the Shore is in its 15th year and expects over 10,000 total
participants and over 30,000 spectators. This is a family friendly weekend with a 3 mile fun run/walk, a 1.2
mile kids marathon, kids races, carnival games, a FunBus and more on Saturday, April 30 and a marathon,
half marathon and half marathon relay on Sunday, May 1. The CareGirlz, a nonprofit organization of talented
6 to 13 year old girls, will also be performing at this years Saturday events in honor of TSF. People come
from all over the country to participate in these events. TSF alone has participants from NJ, NY, PA, CT,
AZ, NE and CA.
If you are interested in helping the Turner Syndrome Foundation by participating as part of Team TSF at this
years New Jersey Marathon Festival at the Shore, by volunteering at the event, or by simply making a
donation, go to www.tsfusa.org. For more information on the New Jersey Marathon Festival at the Shore,
go to www. njmarathon.org.
TSF is also in need of baked good donations from bakeries, restaurants and supermarkets for their Treats &
Sweets bake sale. Please contact coach@teamtsf.org if you able to help.
Turner Syndrome Foundation, PO Box 726, Holmdel NJ 07733. 800-594-4585. EIN#27-1409942
April 7, 2011 - (4/2011) Free Your Feet! - Basil & Spice – by Arthur Rosenfeld –
In 1980, I was traveling in Kenya’s Aberdare mountain range with my father, Dr. Isadore Rosenfeld—
renowned cardiologist and host of Fox News Sunday Housecall—when a runner burst into camp, having
run 26 miles to deliver an urgent medical message. Upon receiving my father’s reply he took a sip of water
and ran back to deliver it.
Being surrounded by the creatures of the African highlands, and having recently left the plains, I managed an
evolutionary perspective on the fact that a man could run a double marathon through the forest—outrunning
lions and all that—but barefoot? How could his ankles, knees and hips take the pounding, never mind his
feet? The deed was unimaginable to someone who wore leather loafers to work and soft sneakers to the
gym.
At that time, I could never have imagined that more than 30 years later there would be a quiet revolution in
the way we see running. In the wake of Christopher McDougall’s bestselling Born to Run—a chronicle of
the exploits of the barefoot running of Tarahumara Indians of Mexico’s Copper Canyon—and perhaps
coincident with a grass-roots re-evaluation of the role of the foot in life, if not love, athletes around the
country are shedding their highly-constructed, heavily cushioned running shoes in favor of high-tech,
minimalist shoes.
This change has been a long time coming. In 1997, Chinese scholar warrior Jwing-Ming Yang discoursed on
the evils of soft shoes at a martial arts symposium I attended in Virginia. Drawing on Traditional Chinese
Medicine several thousand years old, he explained that from the standpoint of Chinese medicine there is a
“heart” in the foot, one that functions like a fireplace bellows to aid in the circulation of fluid that would
otherwise be trapped in the legs, causing it to pool around the ankles because we are, after all, bags of
water with a few stiff sticks thrown in. Wearing a shoe with too much padding on the bottom eliminates this
effect—the sole of the shoe is compressed rather than the sole of the foot—and, to press the analogy, the
heart of the foot does not beat.
Western medicine recognizes the importance of muscular action in circulation of two of the body’s critical
fluids, lymph and blood. Lymph resembles blood plasma and is vital to the immune system. Its relies on a
complex system of tiny valves, and is slowly propelled through the small spaces between tissues and organs
by the action of both smooth and skeletal muscle. Patients whose lymphatic system is obstructed (a
condition called lymphedema that may result from parasites or from radiation treatment for cancer) often
exhibit swelling in the extremities, the result of pooling lymph. One treatment is to wrap the legs with
compression bandages to help accomplish precisely the circulatory “squeezing” to which Master Yang
referred. Blood is moved by muscle too. Arteries have muscular walls that contract to help them carry
oxygen-rich blood to needy tissues, while veins, like lymph, rely on a combination of valves and the pumping
action of skeletal muscles (including those in the hands, arms, legs and feet) to return deoxygenated blood to
the heart.
Everyone knows that high heels are bad for the low back, joints, intervertebral discs and overall posture, but
it turns out that even the raised heel on most athletic shoes is less than ideal as well. Thickly padded, laterally
stabilized athletic shoes were initially conceived to protect ankles, knees, hips and spine from the repetitive
torsional and shocking forces found in running. The idea had merit—and still does for some people—but the
competition of the consumer marketplace led the idea to run amok. Aggressive marketing these days has
most of us, even kids, wearing shoes that in many cases over-protect the foot. The result is that foot muscles
never develop properly, leading not only to effects on circulation, but frequently to problems with tendons,
toes, and nails.
The feet also play a role in the circulation of energy. Acupuncturists, massage therapists, and reflexologists
will tell you that some of the most important “points” are in the foot, including the sole. Barefoot running or
walking, particularly over uneven terrain, stimulates these important points, yielding benefits well known to
Eastern medicine.
In our aboriginal days, we experienced the world through the digits and muscles and skin of our feet just as
much as we do through our hands. Most of us have lost that interface with the world, but we can begin to
get it back by engaging a mind/body practice that uses our whole body and increases our awareness. Tai chi
is especially well suited to this task, as it deliberately concentrates our attention on balance, footwork, and
stability.
It may also help to choose a shoe that allows the foot to function the way it was intended to while at the
same time providing a level of protection from hazards on the roadway or, better, on the trail. Many athletes
have a favorite brand, but for my money a good first step in the awakening of the foot is Nike’s “Free” line,
available as both runners and cross-trainers. These shoes still have a raised heel and look and fit like regular
athletic shoes, but have minimal padding and a hyper-flexible sole. A good next step might be the “Barefoot”
shoes from Merrell or the New Balance Minimus line. At the extreme end of the spectrum is Vibram’s
FiveFinger offerings, shoes that are like gloves for your feet, toes and all.
Transition slowly to one of the less constructed athletic shoes if you want to reap the benefits, though,
because years of relying on cushion, padding, and ankle support weaken the feet and it takes time to
strengthen them again. Many minimal workout shoes will cause foot pain if worn too often and for too long
at the beginning. Specific medical/structural issues aside, the change may cure existing or incipient problems,
but if you rush it, you’re going to be uncomfortable and may even hurt yourself. Try a half an hour here or
there, then an hour, then more, all over the course of a few weeks. Walk barefoot more often, too. Your
feet will love you for it.
April 10, 2011 - Toms River woman finds exercise changes lives - Asbury Park Press – by
LISA COHAN ARONOW –
I came into the fitness business after 22 years in professional services supporting computer consultants. I
liked my work, but hated the commute, the hours, the stress and the feeling that working to support a
lifestyle, although necessary, was wholly unfulfilling.
When the literal and metaphorical smoke of 9/11 cleared, I decided that I had to change my life. I didn't
know what I wanted to do, so I started spending hours at my gym, hanging out from dawn until dusk
working out, talking to the trainers, chatting up new clients and probably being something of a pain. The
owner of the gym said that he'd hire me if I'd become a personal trainer, so I did.
I went to work for the gym, discovering something along the way — many women in their middle years
joined gyms at the advice (or threat) of their doctor. They didn't want to be there, and had preconceived
notions about what their experience was going to be, often resulting in a short, expensive and unsatisfying
relationship. I thought maybe I could do something to help these women achieve their goals in a way that
was comfortable for them.
I established Women's Wellness LLC in 2004 as a fitness company dedicated to working with women over
the age of 50. The company was founded to offer an alternative way of exercising for women who otherwise
would not have a positive experience by joining a gym. The business evolved in the last four years to include
men. My personal training clientele are living with diagnoses of chronic illnesses: diabetes, cardio/pulmonary
disease, Parkinson's, obesity, rheumatoid arthritis, osteoporosis, cancer, to name a few.
Soon after I started the company, I convinced a 57-year-old woman who was obese, had Type II diabetes
and was a breast cancer survivor to take a chance on working with me. I told her that if we worked hard
enough, she could shed the weight, and in doing so maybe reverse the diabetes, or at least positively impact
her tri-glyceride and glucose numbers.
About a year after we started working together, she called me from her doctor's office and told me that we
had done it! He had taken her off all but one of the diabetes and blood pressure medicines, and one of her
cholesterol medicines.
I sat in my car and cried like a baby. She had put her life in my hands, and together we changed it for the
better. From that moment on, it became a personal mission to work with people to ameliorate or obliterate
the vast amounts of medication they were prescribed.
My breast cancer survivor clients are dearest to my heart because the road they travel is hard. Lymphedema
(localized fluid retention) is their greatest concern, but I have proven to them all that by carefully building
their strength and flexibility, they can do what everyone else does.
This is the hardest work I've ever done, and without a doubt the most rewarding.
Lisa Cohan Aronow of Toms River owns Women's Wellness LLC (732-299-7676).
Getting Ahead runs Sundays. If you are a businesswoman interested in writing about your career, please
send your story to Business Editor Dennis P. Carmody at dcarmody@njpressmedia.com
April 11, 2011 - Still not enough awareness of lymphedema - Bizjournals.com – by Athena Merritt -
For breast cancer survivors, like my mom, once the radiation treatment ends another battle begins —
lymphedema.
Which is why my mom has to slip every so often into a back room of Advanced Lymphedema Therapy
Services in Langhorne to see physical therapist Kim Koschineg, who owns the business. When your first
contact with a new patient goes something along the lines of “Hi, nice to meet you, now take off your clothes
I’m going to massage you,” close bonds are formed early, Koschineg joked before a crowded room at the
Sheraton Bucks County Hotel on Saturday.
“It’s very close-up close and personal and we share a lot in our treatment,” Koschineg said. “Many feel
lymphedema is worse than breast cancer treatment. It can strike at anytime.”
Patients, like my mom, and their loved ones, like me, gathered to celebrate Koschineg’s five years in
business, an anniversary she marked with a banquet that also recognized National Lymphedema Day.
“You’re the reason why we like to get up and come to work,” said a very pregnant Koschineg. She is due in
five weeks, and is planning to work right up until her due date, just like with her first child, which comes as
no surprise to her many patients.
Free lunches, free T-shirts and plenty of information on lymphedema flowed out in those three hours, both
from the speakers and from the conversations of those at the tables.
Far too many with lymphedema, a condition that brings fluid retention and a swelling of the tissues, still battle
ignorance when they meet with health practitioners. Drawing blood or taking blood pressure readings from
the arm of someone suffering lymphedema is a no-no, yet women at the table, like my mom, who wear
medical bracelets warning of their condition have still had to stop nurses from doing it. A woman two seats
away from my mom, who has the problem in both arms, said she’s had to explain over and over again that
her blood pressure must be taken from her leg. For others, the frustration stems from not being correctly
diagnosed with the problem.
Like Barbara, whose health deteriorated over 25 years before she Googled “swelling legs” online and
learned about lymphedema herself and became a patient of Koschineg.
“In all those years no one, not one doctor, mentioned the word lymphedema to me,” she told the audience.
Guenter Klose, who trained Koschineg and has been practicing lymphedema treatment for over 26 years,
flew in for the day to serve as the keynote speaker. Progress is being made on many fronts, including patient
advocacy, research and legislative efforts, said Klose, who is the founder of Klose Training & Consulting
LLC in Colorado http://www.klosetraining.com/Home.asp .
“There are more people now than ever working on the problem of lymphedema,” Klose said.
The Lymphatic Research Foundation promotes research. And the American Lymphedema Framework
Project promotes understanding of current treatment and a standard of care, he said. Advocates hope to see
the re-introduction of the Lymphedema Treatment Act this spring, which would bring a change in Medicare
law, he said. But, said Klose, who urged patients and others to pass along what they’ve learned, “It is still
the case that people need this understanding of lymphedema.”
The National Lymphedema Network’s website.
April 12, 2011 - Lymphedema Research Study - Wire Service Canada – by akennedy –
Patients in Ontario living with lymphedema will be involved in University of Pittsburgh Research Study on
Foot Problems.
April 12, 2011 - Toronto, Ontario, Canada
The Lymphedema Association of Ontario is proud of its role in supporting a unique research study that
targets people living in Ontario with lymphedema and the foot problems they experience.
The University of Pittsburgh is conducting a research study of foot characteristics and foot problems of
people with lymphedema of the lower limbs, including the usability and availability of existing footwear. This
study is a collaborative effort of the University of Pittsburgh, Bauerfeind USA, the Lymphedema Association
of Ontario, and the International Lymphoedema Framework.
The ultimate goal of the research study is to improve the availability of clinically appropriate footwear for
persons with lymphedema. Including lymphatic filariasis, acquired lymphedema is the second leading cause
of disability worldwide. One of the key preventative interventions is the provision of footwear, especially
low-cost footwear. Research is needed to objectively measure the foot problems and to report user
satisfaction with current footwear.
Lymphedema is a chronic swelling of a body part, most frequently an arm or leg but can also affect the
trunk, head or neck. Lymphedema is the result of a malfunctioning lymphatic system or as a result of damage
to the lymphatic pathways. Cancer treatment is the leading cause of lymphedema in Canada, as people
acquire the condition as a result of their cancer treatment following surgery or radiation therapy. An
estimated 63,000 persons in the province of Ontario are living with this debilitating condition that remains an
under recognized and untreated health problem.
Adults living with lymphedema in their leg and attending a Lymphedema Patient Conference in Toronto on
June 18, 2011 have the opportunity to participate in the research study that will ultimately improve their
quality of life by addressing the practicalities of footwear in swollen feet for these patients. The Patient
Conference is being held in conjunction with the 3rd International Lymphoedema Framework Conference,
which will attract researchers, clinicians and educators from over 25 countries gathering to further global
implementation of best practice.
Study participants will undergo a series of tests to get objective measures of their feet and legs:
The Bodytronic 300 (Bauerfeind USA) 3D-Scan uses video imaging to create a 3D model of the
participants’ feet and legs and then automatically calculates the following measurements: foot length, width,
arch length, shoe size, foot and leg volume and the pressure that their feet exert on the floor when standing.
A Lymphedema therapist will inspect participant’s feet and legs for skin changes, calluses, blisters, wounds,
and foot deformities with digital images of the feet taken from various angles.
A footwear specialist (pedorthist) will inspect the footwear and document the pattern of wear and tear.
Lastly, participants will be required to complete a series of questionnaires about their experiences with
compression garments and appropriate footwear.
The University of Pittsburgh researchers hope to develop a useful tool for evaluating the use and usefulness
of footwear for a variety of disabling diseases/conditions including lymphedema.
For more information about lymphedema, the work of the Lymphedema Association of Ontario, the 3rd
International Lymphoedema Framework Conference and the University of Pittsburgh Foot Research Study,
please visit www.lymphontario.ca
April 13, 2011 - Devon Medical Products Receives FDA 510(k) Clearance for ArterioFlow(TM) Pump
that Treats Diabetic Foot, Peripheral Arterial Disorders –
Devon Medical Products Receives FDA 510(k) Clearance for ArterioFlow(TM) Pump that Treats Diabetic
Foot, Peripheral Arterial Disorders
Apr. 13, 2011 (Business Wire) — Devon Medical Products, a manufacturer and distributor of creative,
safe, and cost-effective medical devices, today announced it received U.S. Food and Drug Administration
(FDA) 510(k) clearance to market its ArterioFlow™ 7500 arterial pump that treats diabetic foot ulcers,
peripheral arterial disease, and other chronic disorders of the lower extremities caused by reduced blood
supply or ischemia. Devon Medical Products will feature the ArterioFlow 7500 and its line of CircuFlow™
compression pumps that treat lymphedema at the Medtrade Spring Conference at the Sands Expo and
Convention Center in Las Vegas on April 13-14.
According to the 2011 National Diabetes Fact Sheet released by the American Diabetes Association
(ADA) earlier this year, approximately 25.8 million people – 8.3% of the U.S. population – have diabetes.
Various studies show that about 15% of diabetics develop diabetic foot ulcers, or open sores or wounds
that develop as a result of poor circulation, trauma, and vascular complications. Six percent of people who
develop foot ulcers are hospitalized annually due to infection, and 14-24 percent of people with diabetes
who develop a foot ulcer have an amputation.
“Diabetic foot ulcers have proven to be the most common lower extremity injuries leading to amputation,
and the compression therapy provided by the ArterioFlow increases blood flow to promote faster healing
and prevent infection and amputation,” says Dr. John A. Bennett, CEO of Devon Medical Products. “While
prevention of ulcers is ideal, immediate treatment of ulcers that do form is vital. Our goal with the
ArterioFlow and all of our compression devices is to make therapy easy and convenient so that patients will
comply more and in turn avoid terrible health consequences.”
The ArterioFlow applies compression to the foot and calf sequentially through compression sleeves to empty
the veins in the lower extremities. In return, the arterial blood is more easily and readily delivered to the feet
and blood-deprived tissues. The device can also be used to treat peripheral arterial disease, intermittent
claudication, and other chronic disorders of the lower extremities caused by reduced blood supply or
ischemia.
Devon Medical Products’ engineers and product developers designed the ArterioFlow. The company
works with various distributors across the United States and abroad.
Visit Devon Medical Products in booth #1958 at the Medtrade conference for more information.
About Devon Medical Products
Devon Medical Products (www.devonmedicalproducts.com) is an international medical device manufacturer
and distributor that provides the medical community with creative, safe, and cost-effective medical products.
The company has cultivated an exclusive line of innovative medical devices designed to advance healthcare
treatments and maximize safety for healthcare workers and patients worldwide. The company is
headquartered in King of Prussia, Pennsylvania, and has international offices staffed with bilingual engineers,
product developers, and FDA-regulatory experts.
Devon Medical Products
Darren M. Behuniak
Director, Marketing
& Communications
610-755-4958
MED NEWS DOCS:
April 11, 2011
Less Invasive Lymph-Node Biopsy Could Prevent Unnecessary Surgery For Patients With Early Stage
Endometrial Cancer
Sentinel-lymph-node (SLN) biopsy can accurately diagnose lymph node status in patients with early stage
endometrial cancer and provide vital information on the most effective adjuvant (additional) treatment
without the need for complete lymphadenectomy (removal of all the pelvic lymph nodes), thereby reducing
the risk of surgical complications. These findings published Online First in The Lancet Oncology, suggest that
this minimally invasive procedure is a safe and effective alternative to more extensive lymph node removal.
Accurately determining how far cancer has spread, a process known as staging, is used to plan the most
effective treatment for patients. Traditional surgery (lymphadenectomy), involving the removal of all the
pelvic lymph nodes, is associated with an increased risk of complications including lymphocysts and
lymphoedema (swelling caused by excess fluid build-up), and has shown little benefit in patients with early
stage endometrial cancer.
A few small retrospective studies have suggested that doctors could evaluate endometrial cancer using SLN
biopsy, a less invasive procedure involving the excision of just a few nodes instead of all regional lymph
nodes*.
The SENTI-ENDO trial was designed to investigate the performance of SLN biopsy at predicting lymph
node status in patients with early stage endometrial cancer. Between July, 2007, and August, 2009, 133
patients with early stage endometrial cancer from nine centres across France underwent SLN biopsy
followed by complete lymphadenectomy.
SLN was successful in 77% of cases in the right hemipelvis and 76% in the left hemipelvis, with an overall
detection rate of 98%.
No false negative cases were recorded in 100% of hemipelvises, so all healthy lymph nodes were correctly
identified. Using the patient as the unit of analysis, the less invasive technique produced a negative predictive
value (probability that patients who test negative result are correctly diagnosed) of 97% and sensitivity (rate
of true positives) of 84%.
No complications were reported during SLN biopsy.
The authors say: "The SLN procedure provides data to tailor adjuvant therapy without increasing the risk of
intraoperative and early postoperative complications. Therefore, the SLN procedure alone could be
recommended for low-risk and intermediate-risk endometrial cancer."
They conclude: "Further studies are needed to evaluate the cost-effectiveness of systemic lymphadenectomy
compared with lymphoscintigraphy and the SLN procedure, and the effect of the SLN procedure on
adjuvant therapies and quality of life."
In a Comment, Henry Kitchener from The University of Manchester, Manchester, UK suggests that SLN
biopsy can now be considered standard care: "The procedure seems feasible (almost 90% of women had
detectable SLNs), and it seems reliable in terms of negative predictive value and sensitivity when ultrastaging
of SLNs is implemented."
Notes
*During the SLN biopsy, a radioactive colloid and/or blue dye are injected pericervically and follow the
path that tumour cells are most likely to take from the tumour to the lymph nodes. The first(s) node(s) to
absorb the dye and/or radiocolloid, the sentinel node(s), is removed and biopsied.
April 15, 2011
Breakthrough Breast Cancer Report Finds Lymphoedema Services Are Not Meeting Breast Cancer
Patients' Needs –
Breakthrough Breast Cancer today published a report claiming more needs to be done across the NHS to
meet the needs of breast cancer patients who develop lymphoedema after their treatment. The
recommendations, which form part of Breakthrough's 'Constant Reminder? Living with Lymphoedema'
report, aim to ensure everyone who develops lymphoedema after breast cancer has access to services that
can give them the best possible quality of life.
Lymphoedema can occur following some forms of breast cancer treatment and is caused by a build up of
excess fluid in the tissues. This can cause long term swelling in the arm, hand or upper parts of the torso.
Although the physical effects are clear to see, it is often the psychological and social effects that have the
greatest impact and can lead to low self esteem and depression. Although breast cancer treatment is not the
only cause of the condition, it is estimated that at least one in five patients who undergo surgery for the
disease will go on to develop lymphoedema in their arm.
Breakthrough surveyed 200 people who had experienced lymphoedema after breast cancer treatment and
found that in some parts of England, patients are not getting access to vital care for the condition due to
inequalities in services provided. This means that in some cases people have to travel long distances, wait for
treatment, or even go without the services they need. The report suggests, amongst other things, that
monitoring of lymphoedema patients, education and training for healthcare professionals and local referral
guidelines all need to undergo change to improve patient experience.
Maggie Alexander, Director of Policy, Education and Influencing at Breakthrough Breast Cancer, says,
"This condition can have a real impact on everyday life -some people find it difficult to work, wear normal
clothes, or undertake everyday tasks such as gardening or playing with children and grandchildren.
With more people surviving breast cancer, we need to make sure that people who develop lymphoedema
after breast cancer treatment have the care they need to live their lives with the best possible quality of life.
Unfortunately we have found that some patients simply aren't being given the access to services they need to
help them live with their lymphoedema.
We hope our Constant Reminder report will spur people on to push local commissioners and healthcare
professionals to implement a series of changes, that will allow for an improved quality of life for all
lymphoedema patients."
About the report
-- The National Cancer Action Team (NCAT), in early 2010, published a care pathway for the treatment of
patients with or at risk of lymphoedema. This guidance sets out the care that all cancer patients at risk of
lymphoedema, including those treated for breast cancer, should receive. Many of the recommendations in
Breakthrough's report draw upon the detailed recommendations included in the NCAT pathway.
- Breakthrough has also produced a standalone campaigner's toolkit, Your guide to taking action locally -
England, for people who are interested in driving forward changes on this issue in their area.
Key recommendations in the report include:
-- The number of patients diagnosed with and treated for the condition should be recorded to improve
estimates of the number of cases of lymphoedema in their area
-- A range of appropriate lymphoedema services should be commissioned through primary, cancer and
specialist lymphoedema services and appropriate treatments should be provided. These should be available
to all patients who need them in the area. The appropriate setting for care should be considered based on
patients' needs (e.g. community care and secondary care)
-- Education and training should be given to all healthcare professionals (including primary care, cancer,
palliative, and allied healthcare professionals) regarding lymphoedema signs and symptoms and best practice
for risk reduction and management
- Local referral guidelines and systems should be developed to enable relevant primary, cancer and palliative
healthcare professionals to refer directly to local lymphoedema services.
Breast cancer in the UK
- Nearly 48,000 women are diagnosed with breast cancer each year in the UK.
- Breast cancer is the most commonly diagnosed cancer in the UK.
- 1 in 8 women in the UK will develop breast cancer at some point in their lifetime.
- Around 1,000 women die of breast cancer every month in the UK.
- Around 300 men are diagnosed with breast cancer every year in the UK.
- More women than ever in the UK are surviving breast cancer thanks to better awareness, better screening
and better treatments.
Source:
Breakthrough Breast Cancer
April 13, 2011 - FDA approves Devon Medical pump for diabetic ulcers - Bizjournals.com – by John
George –
The American Diabetes Association estimates 25.8 million people in the United States, or 8.3 percent of the
population, have diabetes.
About 15 percent of diabetics develop diabetic foot ulcers, which are open sores or wounds that develop as
a result of poor circulation, trauma, and vascular complications.
From that group, 6 percent end up in the hospital because of an infection and 14 percent to 24 percent
require an amputation.
A King of Prussia medical-device company has a new device aimed at helping improve some of those
statistics.
Devon Medical Products has received Food and Drug Administration marketing clearance for the company’
s ArterioFlow 7500 arterial pump, which was developed to treat diabetic foot ulcers, peripheral arterial
disease, and other chronic disorders of the lower extremities caused by reduced or restricted blood supply.
The ArterioFlow 7500, and its line of CircuFlow compression pumps that treat lymphedema (swelling in the
legs and other body parts), will be on display by Devon Medical at the Medtrade Spring Conference in Las
Vegas Wednesday and Thursday.
“Diabetic foot ulcers have proven to be the most common lower extremity injuries leading to amputation,
and the compression therapy provided by the ArterioFlow increases blood flow to promote faster healing
and prevent infection and amputation,” said Dr. John A. Bennett, Devon’s CEO. “While prevention of ulcers
is ideal, immediate treatment of ulcers that do form is vital.”
April 19, 2011 - A new way to zap cancer – WPTV – by Amanda Kahan –
George Pittman is back in class and back in the saddle.
He's a volunteer math and science tutor and he just loves watching little minds grow. Also growing in this
prostate cancer survivor: malignant melanoma like these in his left leg. Doctors cut out four in less than a year.
Mercy Medical Center's Vadim Gushchin treated him with an intense, isolated blast of chemotherapy. Using
small catheters like this one, surgeons infused a massive dose of chemo into George's leg alone.
The procedure took just 30 minutes.
In a third of cases though all nodules disappear. The old method meant larger incisions and catheters. This is
minimally invasive all-around.
Good news for George who got back to class as fast as he could.
Getting back up to speed shouldn't be a problem.
BACKGROUND: Chemo Blast is a surgical procedure to allow you to get high doses of chemotherapy
only in one limb (an arm or leg). The benefit of method is that you do not get effects of the anticancer
treatment in other areas of your body. After years of advancements, Isolated Limb Infusion -- or ILI -- is a
minimally invasive technique that uses the same principles of regional high-dose chemotherapy but through
smaller catheters. These specific catheters allow are similarly used by cardiologists to study vessels of the
heart. For many people, ILI is the only option to avoid amputation. (Source: Mercy Medical Center)
WHAT TO EXPECT IN THE OR: You will be admitted to the hospital and should expect to stay for four
to five days. This procedure is done in the surgery area. You will receive general anesthesia. The limb to be
treated will be warmed to help the chemotherapy have the most effect. A type of tourniquet is used to stop
the flow of blood in and out of the limb being treated. This also prevents the chemotherapy from spreading
throughout your body. The chemotherapy will be given through an incision into a major artery and vein in the
limb to be treated. After surgery you will have a bandage (dressing) over the surgical site. If you had any
lymph nodes removed during the surgery you will likely have a drain in place to prevent fluid build-up. You
may spend the first night in the Surgical Intensive Care Unit where you will have frequent attention. The
pulse, color, sensation and movement will be checked often on the affected limb. You will be given
medication to help control pain.
Before discharge you and your caregivers will be instructed about all your care needs. After you go home
you will still need to care for your wound, for a drain, to manage swelling. (Source: The Ohio State
University Medical Center)
POSSIBLE SIDE EFFECTS: Wound infection/separation: You will be told how to care for the surgery site
after you leave the hospital.
Nerve damage: You may have damage to nerves in the limb treated with chemotherapy or from swelling that
may occur after the procedure.
Pain: You will be checked and treated for pain while in the hospital. Pain medication will be used to help
control pain after your discharge as well.
Swelling or Lymphedema: The treated limb will have a tendency to swell. You will be given instruction how
you can help manage swelling. This may include patient education handouts to help you care for this
condition.
Skin changes: The skin on the treated limb will be discolored and may peel. Gentle skin lotions with no
alcohol may be used. The lotion should not be used near the incision or wound.
Blood clots or vein inflammation: These are more rare complications. It is possible but not likely that blood
clots may develop in the artery or vein of the treated limb.
FOR MORE INFORMATION, PLEASE CONTACT:
Stacey Sherman
Institute for Cancer Care at Mercy Medical Center
(410) 332-9349
(Information provided by Ivanhoe)
April 19, 2011 - CCH expands breast health and oncology support services - Sauk Prairie Eagle –
Columbus Community Hospital recently expanded breast health and oncology support services with the
addition of a Breast Health Patient Navigator Program under the direction of Cathy Butterbrodt-Oines,
RNC, breast health specialist.
"As a breast health patient navigator, I support patients following their mammogram and diagnosis by guiding
them through the various services involved and connect them with appropriate resources and support," said
Butterbrodt-Oines.
"The program is complimentary for the patients of CCH," added Butterbrodt-Oines, who emphasizes the
program as a team approach involving the physician, the breast health specialist, the medical imaging
department, the laboratory, the surgeon, the dietician and a lymphedema specialist.
"Breast health begins with receiving regular mammograms," stated Butterbrodt-Oines.
CCH's medical imaging department offers digital mammography by appointment by calling 623-1210.
For more information regarding the breast health program at CCH call 623-6434.
April 20, 2011 - CHS in Florence now offers a Lymphedema program – SCNow – By Nicole Boone –
Carolinas Outpatient Rehabilitation Centeris proud to announce the addition of the Lymphedema Program.
Janice Spicer recently completed the lymphedema certification course and is now a certified lymphedema
therapist.
Lymphedema is the chronic accumulation of protein rich fluid in the interstitial space and can develop into
elephantitis of the limb if not treated. Treatment may consist of manual lymph drainage (MLD) followed be
compression bandaging using short stretch bandages for management of volume reduction, as well as, to
provide low resting pressure and high working pressure for further volume reduction. Once the limb is
decongested, the patient can be measured for compression garments that will replace bandages during the
day.
For more information on the Lymphedema Program, please contact Janice Spicer at Carolinas Outpatient
Rehabilitation Center at 661-4360.
April 21, 2011 - A 'Pioneer' in Breast Cancer Survivors' Quality of Life Delivers Komen Distinguished
Lecture at UM School of Nursing - UMB News –
Patricia Ganz, MD, a medical oncologist who has studied the late effects of cancer treatment, delivered the
2011 Komen Distinguished Lecture at the University of Maryland School of Nursing (UMSON),
emphasizing that greater attention should be paid to the consequences associated with the improved rate of
survival for women with breast cancer.
She spoke on April 14 in the UMSON auditorium, and her remarks were simulcast with the support of the
Maryland Affiliate of Susan G. Komen for the Cure for viewing by UMSON nursing students at the
Universities at Shady Grove in Rockville, Md., and by nursing students at Bowie State University in Bowie,
Md., and Coppin State University in Baltimore.
The decline in breast cancer mortality means that for many women "cancer is now a chronic disease," said
Ganz, director of cancer prevention and control research at the , Jonsson Comprehensive Cancer Center,
University of California, Los Angeles. For cases of early-stage breast cancer, the five-year survival rate
exceeds 90 percent, and continued improvement is expected. "But there is a cost to women and their
families in the form of time, money, and human, interpersonal, and existential costs," Ganz said.
The lecture was made possible by a grant to UMSON from the Komen Maryland Affiliate to advance
education and practice in the treatment of breast cancer. Principal investigator of the grant is Sandra
McLeskey, PhD, RN, a professor at UMSON and co-director of the Komen Maryland Affiliate Nursing
Partnership along with Deborah McGuire, PhD, RN, FAAN.
McLeskey, left, is shown in the photo with Ganz, center, and McGuire, a professor at UMSON who will be
the next principal investigator. McGuire introduced Ganz as "a pioneer" in studying quality of life of cancer
patients and survivors.
Breast cancer treatment now includes use of combined modality therapy and prolonged adjuvant and/or
maintenance therapies, such as endocrine therapies that are given for about 10 years to many women, Ganz
said. The risk of second malignancies is greatly reduced. However, benefits may need to be weighed against
harm, Ganz said, as she and other researchers attempt to learn why some women appear susceptible to
certain late effects after treatment.
Breast cancer survivors report premature menopause, infertility concerns, body image changes, and
lymphedema, which is swelling in the arm on the side of their breast cancer surgeries. These findings came
from a study in which Ganz and colleagues interviewed 1,100 women in the Washington, D.C., and Los
Angeles areas about their experiences as breast cancer survivors.
Along with early detection, advances in drug therapies have increased longevity. Yet these treatments are
often linked to long-term physical effects, including symptoms of persistent fatigue. Ganz said post-treatment
fatigue remains under-reported and under-treated in breast cancer survivors despite its severity.
In a follow-up of the women in their study five years after diagnosis and treatment, researchers found that
one-third reported persistent fatigue. Many also were experiencing pain, sleep disturbances, mood
disruptions, menopausal symptoms, and cognitive dysfunction that may have been related to early
menopause. Associated medical conditions included anemia, cardiovascular disease, and cardio-respiratory
disease.
"It [the fatigue] is like being wiped out by a bad flu," and so pervasive that women "don't have energy to do
any kind of leisure activity," said Ganz. She said it is unlike an ordinary feeling of being tired and may be
linked to biologic characteristics of the patient, or to the treatment.
"In terms of its impact on quality of life, this is one of the most distressing symptoms that patients report,
behind only pain and nausea, and can interfere with the ability to work, to care for their families, and their
concerns about fighting the cancer," she added.
"Attention to symptom management means there can still be a good life after cancer," Ganz told an audience
made up primarily of nursing students, educators, and health care practitioners. She suggested that breast
cancer survivors must be questioned about symptoms and treated proactively. Despite what she called
"substantial disruptions in their quality of life," women may not expect relief once the cancer is under control.
"If we don't ask, they may not bring it up," Ganz said.
Strategies to cope with these late effects include recommending moderate exercise, suggesting that those
with cognitive issues avoid distraction, and treating when appropriate for anxiety, insomnia, and depression,
among other conditions. Women of childbearing age may want their eggs to be harvested prior to therapy in
the event they become infertile after treatment.
McLeskey announced that the Komen Maryland Affiliate has awarded the School a sixth year of funding to
advance education and practice. This additional support of $204,738 will continue a multi-pronged initiative
that includes the two partner institutions and will expand to a third - Salisbury University - in June.
The Komen Maryland Affiliate Nursing Partnership has previously grown to include the School of Social
Work and the School of Pharmacy. Starting in June, new partners will include the University of Maryland
Marlene and Stewart Greenebaum Cancer Center and the University of Maryland Medical Center.
April 22, 2011 - Cancer prevention, treatment topics at Jefferson Healthcare symposium - Peninsula Daily –
PORT TOWNSEND — Jefferson Healthcare hospital will host a free cancer symposium at Fort Worden
State Park on Saturday.
Specialists will tell about the latest in cancer prevention and treatment from 9 a.m. to 3 p.m. in the Fort
Worden Commons and No. 204 buildings.
Among the presenters will be Dr. John Choe, director of the Cancer Prevention Clinic at the Seattle Cancer
Care Alliance, and Dr. Paul Stehr-Green.
Choe will present a keynote address at 9 a.m. on the latest information about cancer prevention, and Stehr-
Green will present “Cancer Clusters: Is There More Cancer in Your Neighborhood? Exploring the Myths
and Realities.”
Other presenters include a variety of oncologists and physicians who diagnose and treat cancer in all its
forms and will present information on specific ones such as skin, prostate, lung and breast cancers.
The topics of the other seminars and workshops are “The Prostate Cancer Dilemma,” “Cancer Screening:
What Works and What Doesn’t,” “Integrative Oncology,” “Saving Your Skin,” “Breast Cancer Update,”
“Lung Cancer Update,” “Eating for Survival,” “Lymphedema, Prevention and Treatment,” “Coping with
Cancer: Balancing Your Inner Life While Juggling Life With Cancer,” “Chemotherapy Basics” and “Cervical
Cancer and HPV.”
Local resources will be shared for those who are facing cancer now.
Community education
Local Jefferson Healthcare physicians identified cancer as a focus for community education in 2011 because
of its far-reaching effects and because many cancers can be prevented or detected early if people can
identify their risk factors and modify certain behaviors and lifestyle practices.
The majority of the seminars and workshops will be presented twice — both in the morning and the
afternoon — so that the maximum number of guests will be accommodated.
The keynote address, however, will be presented one time only.
Throughout the day, attendees will be encouraged to ask questions of the experts after each presentation.
Lunch will be available through the Bon Appetite Servery, in the Commons.
A limited number of lunch tickets will be available for purchase in the lobby of the Commons for $10 on a
first-come, first-served basis
Prize drawings will take place throughout the day.
A detailed program for the symposium is at www.jeffersonhealthcare.org.
For more information, phone 360-385-0610.
April 22, 2011 - Next in line for competitive bidding: Vents and manual wheelchairs? - HME News - By Liz
Beaulieu –
BALTIMORE – Because CMS thinks Round 1 is going so well, industry stakeholders wouldn’t be
surprised if the agency expands more than the number of competitive bidding areas in Round 2.
“The fear is that they see such incredible success that they’ll take the product categories in Round 1 and add
to them in Round 2,” said Cara Bachenheimer, senior vice president of government relations for Invacare.
Earlier this month, CMS officials shared with members of the Program Advisory and Oversight Committee
(PAOC) a list of the 20 product categories under consideration for Round 2. The list contains the nine
product categories in Round 1 plus infusion pumps and related drugs; manual wheelchairs; off-the-shelf
orthotics; negative pressure wound therapy devices; nebulizers; ventilators, TENS devices; commode chairs;
patient lifts and seat lifts; blood glucose monitors; and lymphedema pumps.
The product category on the list that’s particularly worrisome to industry stakeholders: ventilators.
“I don’t know how you would competitively bid vents, because it’s such a clinically and service intensive
product,” said Wayne Grau, vice president of supplier relations and government affairs for The MED Group.
A product category that industry stakeholders are fairly certain CMS will try to slip into Round 2: manual
wheelchairs.
“CMS plans to improve coding for manual wheelchairs, but they put that on hold, so that’s a pretty good
indication that they’ll be in,” Bachenheimer said. “The question is whether they will exclude some of the
higher-end chairs. The expenditures there aren’t significant, so CMS may be receptive to excluding those.”
Industry stakeholders were able to get complex power wheelchairs (Group 3) excluded from Round 1, but
it took an act of Congress.
A product category that raised eyebrows: patient lifts and seat lifts. Providers often consider these products
cash items.
Unfortunately, at the end of the day, money, not quality of care, will drive CMS’s decision, industry
stakeholders say.
“CMS is charged with targeting the product categories with the highest price tag or those where the
beneficiary co-pay is the most,” said Walt Gorski, vice president of government affairs for AAHomecare
April 23, 2011
Massage therapy licensing adds credibility to industry - PennLive.com –
When Denise Nickey developed chronic neck and shoulder pain from long hours hunched over a drafting
table, she went to a massage therapist for relief.
The former commercial art designer was so impressed with the results that she decided to become a
massage therapist herself.
“I love it. Being able to help people feel better is a wonderful feeling. It brings a lot of purpose to what I do,”
said Nickey, 42, who has been a certified massage therapist for almost 15 years. “Many of my clients have
chronic conditions. To be able to give them hope and lift them up a little bit is very rewarding.”
The Wellsville resident trained at a massage therapy clinic and started out working for a chiropractor. She
now contracts with Papillion Skin Transformation Center in Lemoyne and Journey to Wellness in Dillsburg.
She currently specializes in lymphatic massage, which is gentler than deep penetrating massage and aimed at
recharging the body’s lymph system and improving immunity.
“It’s not digging out a trigger point or a knot in a muscle. It’s more subtle energy type work,” explained
Nickey, who said lymphatic massage is as in demand as deep massage.
For a person who has lymphedema — a blockage in the lymphatic system that prevents lymph fluid from
draining well — or another condition where excess fluid is stored, lymphatic massage can help offload the
body of extra fluid, Nickey said. It can also clear out toxins such as lactic acid, heavy metals or chemicals in
the body, she said. She uses a vibrational machine to help stimulate the lymph flow.
Some of her patients come for relief of lymphedema caused by a mastectomy that included removal of
lymph nodes in the arm. Others come to find relief from symptoms of Lyme disease, fibromyalgia or side
effects of chemotherapy. Others come simply for routine “maintenance” — to keep their immune system
functioning well.
“People are changing their focus as far as what the body needs to maintain good health,” she said. “This is
very cleansing, rejuvenating and anti-aging. It eliminates the lactic acid and free radicals that cause premature
aging.”
Though more and more people are realizing the therapeutic benefits of massage, therapists say the
profession recently got a boost to its credibility with a licensure requirement to practice in Pennsylvania.
“It really is raising the standard for the profession,” said Brenda Schuck, president of the American Massage
Therapy Association Pennsylvania Chapter. “You’re going to have more skilled therapists rather than
someone who just massages someone’s shoulders and calls themselves a massage therapist.”
Sharon Crane, a certified massage therapist with Shaffer Chiropractic in Mechanicsburg, said licensure will
bring a new level of respect and integrity to the profession.
“It will also separate the trained professionals from the pornographic massage parlors, the extreme of which
is sex trade,” she said.
The law prohibits anyone without a license from advertising themselves using terminology associated with
massage therapists, including even the word “massage.”
“Massage therapists have been licensed in Alabama, where I come from, for years, and we don’t have that
type of connotation anymore. I think licensure in Pennsylvania will help change the mindset here,” said
Georgeanne Pritchett, who recently completed a Master Bodyworker program with the Utah College of
Massage Therapy and is nationally certified. She is in the process of applying for her Pennsylvania license.
“Massage has such great benefits for body, mind and spirit,” said Pritchett, who practices at the Family
Wellness Center in Lower Paxton Twp. “I think the standards that therapists have to meet for licensing will
bring us more clients who will benefit from that.”
Perhaps now, more doctor and chiropractic offices and hospice clinics will offer massage as an alternative
therapy, Schuck said.
Licensure might also open the door for insurance companies to consider covering massage therapy services,
therapists said.
Nickey, who doesn’t offer insurance billing for her services, said she has seen a slight drop in business due
to the slow economy, but overall “people who see the value of it and the results continue to come.”
She charges between $65 and $75 an hour and sees many of her clients on a monthly basis.
Nickey received her Pennsylvania license at the end of February after completing the requirements and
paperwork. She had to take an updated CPR class for health providers and get proof from the Associated
Bodywork and Massage Professionals, a professional organization, that she is a member, among other
things.
Licensure brings a sense of accomplishment, she said.
“I still do the same thing, but I have a piece of paper that says I’m licensed and now I’m recognized like any
other licensed professional,” she said. “We are a legitimate profession with highly qualified and skilled
professionals, and we should be treated as such.”
About the law
Anyone who practices massage therapy in Pennsylvania is required to be licensed by the Pennsylvania
Department of State.
Since it began issuing licenses in January, the State Department has assigned more than 800 licenses and
receives 25 to 45 applications daily, according to Kevin Murphy, director of public relations for the
department.
The license, which costs $65, must be renewed every two years. Continuing education is required for
renewal. The law also provides for standards of professional conduct and includes requirements for
treatment areas and equipment.
Different licenses are offered depending on a massage therapist’s education level and training. Temporary
practice permits, good for six months after completion of their education, are issued to those who need to
take a licensure exam.
Here are some examples of requirements, which may vary according to each license:
Proof of graduation from high school or the equivalent
Certification of good moral character form, filled out by two people not related to you
Criminal background check
CPR certification
Letter of good standing if you are licensed in another state
Proof that you have been in active, continuous practice between Oct. 9, 2005, and Oct. 9, 2010 (for
example, tax returns or proof of membership as a practitioner from a board-approved professional
association)
Exam scores from a national certification examination board
Proof that you completed a massage therapy program of at least 500 hours
For more information about which license to apply for and what is required for each, visit the Department of
State website at www.dos.state.pa.us/massagetherapy
April 25, 2011
Backus plans annual Pink Fair for May 5 - TheDay.com –
Sorry Tina this was an announcement for an activity that has now passed May 5th
Cancer Survivor? Getting Massage? Here's What You Should Know - Opposing Views - by Cinco Vidas –
Last month, I attended an extensive training taught by Morag Currin, author of Oncology Esthetics, A
Practitioner’s Guide. I wanted to learn more about which spa treatments are safe during cancer treatments,
and which may be ill-advised.
Morag, founder of Touch for Cancer, is a wealth of knowledge, and I learned so much from her. The main
thing I want to tell my readers is this: It’s important to feel good during and after cancer, and I believe that
spa treatments—particularly massage—can help reduce side effects and produce pain-killing endorphins. It
is equally important, however, to educate yourself, and find an esthetician or massage therapist that knows
what he/she is doing. Particularly if you’ve had lymph nodes removed, be very cautious in your selection. A
therapist who doesn’t know any better may perform the wrong technique or massage too close and increase
your risk of lymphedema, a long-term condition that can create chronic and painful swelling.
“Studies of massage for cancer patients suggest massage can decrease stress, anxiety, depression, fatigue
and pain,” Morag says. “A physical connection through touch is really important for any person when not
feeling well, and with any health challenges as it provides comfort.”
She goes on to warn, however, that regular spa treatments and pressure may trigger lymphedema, or
exacerbate an existing case of it. Other things that may put you at risk of injury include a recent surgery,
fragile skin (that may tear), pain, neuropathy, wounds, or radiation burns.
The main thing to remember is to be gentle, gentle, gentle, and follow these tips:
1. Avoid all aggressive therapies during cancer treatments, including deep tissue massage, hot stone
therapy, Swedish massage, Shiatsu, sports massage, and anything that feels too rough.
2. Call before you go to the spa. Ask about licenses and certifications. Check the website. And ask if
anyone on staff has experience working with not only cancer patients, but you’re particular condition. Check
Morag’s website for a list of certified oncology estheticians in your area.
3. Observe when you go for your appointment. Does your esthetician ask questions? At the very least,
he/she should have you fill out an extensive form detailing your medical treatments including surgery,
chemotherapy, radiation, lymph node removal, ports, incision locations, white blood cell count, etc.
Someone who doesn’t take the time to know this about you isn’t educated—go to someone else.
4. Ask about the type of products they’re planning to use. Ask to see the bottle and the ingredient list.
Allow them to use only safe and nurturing formulas that are fragrance-free and made without sulfates,
phthalates, and other potentially harmful ingredients. (Take our ingredients to avoid card with you.)
5. Stop anything that feels uncomfortable. If anything hurts or feels uncomfortable to you, tell the esthetician
to stop. He/she should be more than willing to listen to you and make adjustments. If not, care enough about
your health to leave.
April 27, 2011
Komen awards community grants - LubbockOnline.com –
The Lubbock Area affiliate of Susan G. Komen for the Cure, one of more than 125 affiliates nationwide
dedicated to bringing an end to breast cancer, recently awarded eight community grant programs with
awards totaling more than $318,000 to support local breast health education and breast cancer screening
and treatment programs.
This year’s recipients include:
■ The American Cancer Society, Reach to Recovery, $13,110
The American Cancer Society’s Reach to Recovery program provides vital education and support to many
breast cancer survivors by women who are themselves breast cancer survivors. Reach to Recovery
volunteers educate women undergoing breast cancer treatment and provide newly diagnosed patients with
post-surgical accessories related to breast surgery and/or lymphedema.
■ Covenant Health System. Mobile Mammography, $75,810.30
Covenant Health System’s Mobile Mammography program provides screening mammography to women in
rural and underserved communities. The program provides one-on-one education for patients about how to
detect a lump or abnormality in their breast, mammography screening for early detection and diagnostic
follow-up care. It also allows for screening and diagnostic services through Arrington Comprehensive Breast
Center.
■ Covenant Health System, Breast Cancer Survivorship, $6,623
Arrington Comprehensive Breast Center will provide a breast cancer survivorship program to women
across the South Plains and will target women who have been diagnosed with breast cancer and their
caregivers. The program will offer support through diagnosis, treatment, grief and survivorship.
■ Joe Arrington Cancer Center, Chorus of Angels, $28,700
The Chorus of Angels financial assistance program is designed to alleviate expenses that create barriers to
essential treatment for financially vulnerable breast cancer patients of the Joe Arrington Cancer Center.
Expenses for basic needs such as transportation and lodging are almost never covered by insurance and
Chorus of Angels can help alleviate many of these out-of-pocket expenses. ■ Texas AgriLife Extension
Service, Friend to Friend, $7,826.56
Texas AgriLife Extension Service’s Friend to Friend program will work to educate rural women within the
Lubbock Area Affiliate’s service area about breast health and preventative breast cancer screenings. The
Friend to Friend program will target women in seven of the affiliate’s 16 counties.
■ UMC Foundation, Breast Cancer Prevention, Diagnosis & Treatment, $70,268
University Medical Center and the Southwest Cancer Treatment & Research Center provide
comprehensive breast health services including prevention, diagnosis and treatment for the communities of
West Texas. The Breast Cancer Prevention, Diagnosis and Treatment program will promote breast cancer
prevention through targeted education, screening mammography, diagnostic services, and treatment options
for women who do not have adequate health care coverage.
■ UMC Foundation, Celebrate Today, $8,386
The Celebrate Today program will provide supplies, assistance and specialized services to breast cancer
patients in the Lubbock Area Affiliate’s service area. Supplies will include lymphedema sleeves,
lymphedema compression garments, wigs, transportation and housing assistance to those with financial
barriers.
■ The YWCA of Lubbock, Breast and Cervical Health Initiative, $107,818
The YWCA of Lubbock’s Breast and Cervical Health Initiative is devoted to educating women about
breast cancer and the importance of early detection through breast self-exams, clinical breast exams and
screening mammography. In addition, the program offers free breast health and breast cancer education,
screening and diagnostic services to medically underserved women in the Lubbock Area Affiliate’s 16
county service area.
Trinity Rehabilitation Services achieves three-year accreditation - Quad-Cities Online –
Press release submitted by Trinity Regional Health System
Trinity Medical Center's inpatient rehabilitation program has been re-accredited for a period of three years
by CARF, the Commission on Accreditation of Rehabilitation Facilities, an international accrediting body
that helps organizations measure and improve the quality of their programs and services. This is the 12th
consecutive three-year accreditation awarded to Trinity Rehabilitation Services since 1978.
Trinity received the three-year accreditation, the highest honor possible, after a rigorous peer review process
testing each standard the program upholds. The accreditation demonstrates Trinity's ability to continuously
improve efficiency and service delivery, establishing quality care that is measurable and accountable. CARF
surveyors specifically noted areas of excellence to be effective communication among staff and the patient as
well as the high degree to which the patient is involved in the rehabilitation process.
Trinity's rehabilitation team coordinates care by meeting together weekly to discuss programs and goals.
Members of this team include physiatrists, (physicians specializing in rehabilitation medicine), rehabilitation
nurses, physical therapists, occupational therapists, speech pathologists, social workers, program managers,
case managers, nutrition services, psychologists/rehabilitation counselors, recreation therapists and pastoral
care staff.
Trinity's Rehabilitation Services offers a variety of individually tailored programs. In addition to the
comprehensive integrated inpatient rehabilitation program, Trinity provides comprehensive outpatient
physical, occupational and speech/language therapy, rehabilitation counseling and pediatric rehabilitation
services;; aquatic therapy; pain management; hand therapy; sensory integration; vestibular and balance
rehabilitation; lymphedema management therapy; women's pelvic health therapy; stroke care and support
group; as well as specialty services for patients with Muscular Dystrophy and related neuromuscular
disorders, for amputees and for those who need neurodevelopmental and early intervention treatment.
Trinity Rehabilitation Services was created in 1970, the first program of its kind in the Quad-City area.
Since 1978, it has maintained maximum accreditation in comprehensive inpatient rehabilitation by CARF.
CARF is an independent, not-for-profit accrediting body promoting quality, value and optimal outcomes of
services through a consultative accreditation process that centers on enhancing the lives of the persons
served. Since 1966, CARF has established consumer-focused standards to help organizations measure and
improve the quality of their programs and services.
For information, contact Jodi Dykema, director of Trinity's Rehabilitation Services, (309) 779-3131.
Cancer could not shake woman's faith - Eastern Arizona Courier - By Diane Saunders –
When Sandra Villa was stricken with breast cancer in 2008, she lost her hair from chemotherapy and her
breasts in a double mastectomy, but she did not lose her faith in God or her sense of humor.
“I thank God. He was there with me the whole time,” Villa said in a recent interview.
She and her sister, Sally Martinez, are both Duncan residents who plan to participate in the annual Relay for
Life on May 6 and 7 at the Graham County Fairgrounds. The event begins at 6 p.m. May 6 and ends at 9 a.
m. May 7.
Relay for Life is an annual event that recognizes cancer survivors and honors the memory of those who died
from this dreaded disease.
Villa recalled the dark days after her breast cancer diagnoses.
“I did not accept it. I said ‘I do not have cancer,’” she said.
Reality did not set in until the chemotherapy ports were placed in her body. Her aggressive cancer was
attacked on several fronts, including four chemotherapy treatments, a month of daily radiation treatments and
another round of six chemotherapy treatments in addition to the double mastectomy.
She received chemotherapy at the cancer center at Mt. Graham Regional Medical Center and radiation at a
facility in Tucson.
Martinez said she was given a prescription for nausea medication to pick up at a local pharmacy while Villa
underwent her first session of chemo. To her surprise, Villa did not need the medicine after the initial
treatment or after subsequent treatments.
“When I was done with my chemo, I went and had my hamburger and my fries and my soda,” Villa said.
She lost her hair, though, as most chemotherapy patients do.
“I cried about my hair falling out,” she said.
Villa‘s unusual reactions to medical procedures continued after she had her mastectomy. She did not need to
take pain medication after the procedure. She also healed faster than expected.
“Everybody was amazed at her recovery,” Martinez said. “I never saw her cry. I never saw her complain.”
Before her bout with cancer, Villa performed home services for the handicapped. Because her cancer
surgery included removal of lymph nodes she has lymphedema — swelling caused by having fewer lymph
nodes — in her left arm. This has limited her ability to lift or move heavy objects.
Villa said she believes God has a plan for her. Part of that plan includes sharing her faith.
Susan G. Komen for the Cure of Southwest Florida gives out more than $1 million in grants - The News-
Press - by CHRISTINA CEPERO
Susan G. Komen for the Cure of Southwest Florida gave $1,015,235 in grants Wednesday, surpassing $1
million for the first time.
Thirteen nonprofits that serve Lee, Collier, Charlotte, Glades and Hendry counties received 14 grants, the
most the Komen affiliate has given. The grants will go toward education, screening, diagnosis and treatment
in the fight against breast cancer.
NCH Healthcare System received more than $42,400. Breast health navigator Lynn Hurley, who has
guided more than 250 women diagnosed in the past year through treatment, said she feels like NCH got $1
million.
“Because every program that Komen gives money to, I’m able to tap into that,” Hurley said.
Lee Memorial Health System received $199,000.
“When they find out there’s something there (a grant), even though they’ve been diagnosed with cancer, the
burden’s lifted,” said Lee’s breast health navigator, Dara Leichter.
The Komen affiliate received $1.55 million in requests from the 13 organizations.
“The grant requests and needs in the community have exceeded the amount that we’ve had to disburse, but
the amount that we’re giving to the community is bigger than ever,” said grants committee member Carol
Flegel. Each grant application was reviewed five times.
Most of the money was raised by 12,000 participants at the March 12 race at Coconut Point Mall in Estero.
The awards were presented at a luncheon of about 125 Komen board members, sponsors and grant
recipients at Bayfront Bistro on Fort Myers Beach.
“It’s amazing to me how we passed the $1 million mark with this economy,” said Monica Young, Komen’s
education committee chairwoman. “People trust us and I think people understand what our mission is. We
really do want to see a world without breast cancer.”
Young lost her 25-year-old daughter to breast cancer 15 years ago.
“This is really a proud day because we get to recognize the people that are on the frontlines,” she said.
“They are out there in the community; they are facing the people who are in need at a really desperate time.”
April 28, 2011
Grant to aid local breast cancer patients, survivors - Glens Falls Post-Star – by Lydia Wheeler –
Glens Falls Hospital wants to highlight its breast cancer patients in Washington County.
The hospital recently received a $29,790 grant from the Northeastern New York Affiliate of Susan G,
Komen for the Cure, which is working to better the lives of people who have had or are currently facing
breast cancer.
Because Washington County is considered an under-served population in the region, Vickie Yattaw, an
oncology resource nurse at Glens Falls Hospital, said the money will be used to offer more services to
Washington County residents in more convenient locations within the county.
Of the approximately 150 newly diagnosed cancer patients who come through the cancer treatment center
at Glens Falls Hospital each year, roughly 60 are from Washington County, Yattaw said.
She said the hospital is looking for a place hold exercise classes. One such class is currently held in
Greenwich, close the hospital's Greenwich Medical Center.
Part of the Komen grant money will also cover copays for Washington County breast cancer patients
receiving rehabilitation treatment through the STAR (Survivorship Training and Rehabilitation) Program.
"For anyone that has gone through cancer treatment, whether it be surgery, chemotherapy or radiation, they
usually have some long-term side effects from those treatments," Yattaw said. "We hook patients up with a
physical therapist to help get them back to the way they were before their treatment."
And because insurance typically does not cover lymphedema products, the grant will be used to purchase
lymphedema sleeves and a pump.
The devices are needed because, sometimes in surgery or in radiation, lymph nodes in the breast can be
damaged or removed, Yattaw said. That can disrupt the flow of lymphatic fluid, causing the arm to swell.
If left untreated, the arm can remain swollen, so Yattaw said lymphedema sleeves act as a compressing
garment to keep the swelling under control.
The grant money will also help fund a free breast cancer survivors retreat that's held the first weekend of
December each year. Breast cancer survivors interested in attending should contact Yattaw at 926-6639.
This is the second year Glens Falls Hospital has received funding from the Northeastern New York Affiliate
of Susan G. Komen for the Cure organization to dedicate specifically to Washington County.
A total of $277,860 was distributed to 13 local organizations involved in the fight against breast cancer in
New York. The money was raised through the 16th annual Susan G. Komen Northeastern New York Race
for the Cure held last October in Albany and through other fundraising efforts and funds received from the
Susan G. Komen for the Cure national organization.
Komen Foundation gives grants in excess of $1 million - Cape Coral Daily Breeze – by By BOB PETCHER
The Southwest Florida Susan G. Komen for the Cure awarded a record-setting dollar amount of grants to
13 nonprofit organizations in five counties at its annual grants luncheon at Bayfront Bistro on Fort Myers
Beach Wednesday.
The local affiliate, which raises much of its funding through its annual Race for the Cure event, gave
$1,015,235 from its 2011-12 grant cycle to provide education, screening, diagnosis and treatment in the
fight against breast cancer. This is the first time the Komen Foundation has exceeded $1 million, an increase
of 23 percent over last year's grant totals.
The grant recipients were Cancer Alliance of Naples, Virginia B. Andes Volunteer Community Clinic,
LIGHT of Southwest Florida, Family Health Centers of Southwest Florida, NCH Healthcare System,
Collier Health Services, Partners for Breast Cancer Care, Senior Friendship Centers, Gulfcoast South Area
Health Education Center, Manatee County Health Department, Lymphedema Resources Inc.,
Neighborhood Health Clinic and Lee Memorial Health System, which was presented nearly $200,000 from
Snook Bight Marina and Bayfront Bistro resident owner Joe Yerkes.
"It was obvious to me that we had to give something back to the community. What impressed us most
(about the Southwest Florida Susan B. Komen Foundation) was the percentage of the money that goes right
to the community in Lee and Collier counties," said Yerkes. Over the past two years, the "All-Aboard Fest,"
featuring a fund-raising wine dinner and live auction at Yerkes' businesses, has resulted in donations of more
than $140,000.
The Komen affiliate has dished out more than $4.7 million to local nonprofits since 2002. Seventy-five
percent of the money raised stays in the local communities to create life-saving education programs and
funding for breast health.
Executive Director Miriam Ross attributes distribution success to advocates, sponsors, event participants
and any other donation contributor. She thanked her board members for their help in the reviewing and
selection operations.
"It's a pretty long process, but it's an important process," she said.
Roughly 75-100 people attended the luncheon, emceed by NBC2 meteorologist Robert Van Winkle.
"Back in 1982, the survival rate for breast cancer was only about 74 percent. Now, here we are in 2011,
and I'm proud to say that the survival rate is close to 98 percent right now," he said. "Komen was just given
a 4-star rating from Charity Navigator (a watch dog agency) for the fifth year in a row."
Breast cancer survival begins at home. Many of the grant presenters and awardees echoed the sentiment
that women - mostly mothers - neglect their own health to care for the children.
Cape Coral's Susan Murphy was not one of them. She found a lump in her breast, had a physical done and
scheduled appointments with a radiologist. In May 2010, she was diagnosed with a very aggressive form of
breast cancer at the age of 44. She said that since she found the lump early, they were able to remove
everything.
Since she could not afford the necessary insurance, Murphy was referred to Dara Leichter with Lee
Memorial Health System to apply for a grant that helped her cover the cost of having surgery, chemotherapy
and radiation.
"Within one day I got the grant from Susan G. Komen," she said. Murphy was named the 2011 Honorary
Team New Balance Member for the Race of the Cure.
"The other thing that this affiliate is doing, besides the money it raises, is the education," said Leichter, breast
health navigator for the health system's Regional Cancer Center. "I'm starting to see women coming to my
office now that are in an earlier stage, because they know that there is somebody out there.
- Meghan McCoy contributed to this report
April 30, 2011
Q&A with Peoria breast surgeon Lynne Jalovec - Peoria Journal Star - By JENNIFER DAVIS –
Imagine a day in the not-too-distant future when your family doctor runs genetic tests on you - specific
screenings based on your family medical history.
And then imagine if your particular cancer cells could be compared with other cancer patients worldwide to
determine a tailor-made treatment program proven to work.
These are just a couple of the exciting advancements that Dr. Lynne Jalovec, a Peoria breast cancer
surgeon, sees on the horizon.
"I envision, and I know someone is going to say it sounds far-fetched, but my guess is that it will be a routine
thing for doctors to run genetic tests on you," Jalovec says. "They'll look at your family history and say, 'We
should run this as a wellness check.'"
We talked with Jalovec, who has been practicing for more than 20 years. Always exploring the cutting edge
of breast cancer research, Jalovec was No. 1 in the country for including patients in a national clinical trial of
sentinel lymph node biopsies that is fast becoming standard care.
Below is an edited version of our interview.
Q: What is happening on the frontlines of breast cancer?
A: A couple of things. In surgery, there's big news. When a patient comes in with breast cancer, most
patients, if the cancer was caught early, have a choice to keep their breasts rather than remove their breasts.
But the choices are there. If they want their breasts removed, fine. But they have a choice of keeping their
breasts.
About 10 years ago, we started investigating and very rapidly adopted a new way of looking at lymph
nodes. Lymph nodes are checked on cancer patients to see if their cancer has spread. So, we started
looking at and rapidly adopted a technique called sentinel lymph node biopsy.
We use a tracer to find the lymph nodes that drain the breast first. And we take those out and test them in
surgery. If there's no cancer in those lymph nodes, then the woman gets to keep her other lymph nodes.
Now, why is that important? Well, the other lymph nodes, when you take all of them, you increase a
woman's risk for a condition called lymphedema of the arm.
Well, this trial was very innovative and very scary for women. What it did was, women who had a sentinel
node positive were randomized into having all the lymph nodes taken or no more taken. And then you were
put into a group by computer randomization. Some of them went back to surgery and had all the lymph
nodes taken, and some of them did not. I will tell you that they had difficulty finishing the trial, and that's one
problem with this article. Women had a hard time volunteering for this. It might screw you up.
In fact, Peoria, with Dr. (Denise) Mammolito and myself, we were in the top 10 accruers in that trial. So, we
were instrumental in getting that trial accomplished. So, I ended up, I was actually No. 1 in the country. So,
people know Peoria. And not just because of me, please don't get that impression. It's because of the
cooperative nature of our breast cancer management here in a small community. You don't usually get this in
a place like Peoria. You get this in Chicago, at a place like Northwestern.
Now, we don't start our own research here too much in breast cancer. We're not, necessarily, developing
the trials, but we're participating in the major trials as much as we can to give our patients what's new out
there. So, we could offer our patients sentinel node biopsies because we were right on the cutting edge of it.
Right when it started, we were there.
Q: So, this is now the standard of care?
A: At six years, this is an early trial, but it is giving us data to, again, move ahead in breast cancer surgery to
do less so we can cause less harm. It took a long time for surgeons to accept lumpectomies as an alternative
to mastectomies. In their heads, with all their training, theoretically, more is better. They didn't have
chemotherapy like we do today. They didn't have the hormonal therapy we have today, the anti-cancer
hormonal therapy.
So, we have better systemic treatment then we had 20 years ago, and that is impacting and allowing us to do
less surgery and have fewer side effects of our surgery.
This is, for women who know what lymphedema is like, they all wish we had known this before, but they
look at it as, 'This is great because if my daughter gets breast cancer she may not have to go through what I
went through.'
Lymphedema is not as horrible as they make it out to be. Most women have mild to moderate (symptoms.)
It's not horrible.
Q: So, this is great, but it also seems there is a rise in women choosing double mastectomies, particularly
when you have stars like Christina Applegate choosing that route. Is that a trend you see here?
A: We have seen an increased rate of prophylactic (preventive) mastectomy. The reconstruction is better -
no ifs, ands or buts - and women know that. The reconstructive surgeons are out there talking about it. You
hear people talking about how much nicer they are.
The other thing is, women are talking to each other more. They're going on the Internet more. You're right.
People like Christina Applegate, stuff like that, is influencing women to say, 'Look, I think I'm just going to
have both of them off.'
What we try to explain to women is that prophylactic mastectomies are appropriate for some women. If you
have a high risk for breast cancer. If you're known to be genetically positive for the BRCA 1 or 2, then,
certainly, it's a very good option. Now, there is another time that I see women choosing it that I think is not
wrong. If you need to have a mastectomy because you have multiple cancers in your breast or a very large
breast. If you need a total mastectomy on one side, many times you're going to have something done on the
other side to match.
If she's 35 or 40 years old, she's got a lot of years ahead of her to maybe get another cancer. So sometimes
they'll ask, 'What about my other breast? Can I have my other breast removed?' So, we'll explore it. We
talk about it. It's not going to affect survival. In those women, it's not going to make their survival better. Not
the women who already have cancer. Their survival is impacted by the cancer they already have. That
cancer is going to leave them with a risk of dying, if they had invasive cancer. They'll always have some risk
that it's going to come back and take their life. The chance of getting a second breast cancer in the opposite
breast is only 7 percent in 10 years. And if you're taking the pill therapy, the anti-estrogen pill, it's half of
that: 3 percent. And we're following them.
A prophylactic mastectomy may be beneficial for symmetry or for psychological benefit more than anything.
And then for the people who are genetically at risk, there is a benefit for them because their risk for breast
cancer is much higher.
When you talk about lumpectomy and a quick sentinel node (removed), they're back at work in two weeks
like nothing ever happened. When you talk mastectomies and reconstruction, it's eight weeks off work
typically and a lot longer than that before you feel normal again.
Q: Is there anything else new that you are excited to see coming?
A: Another new area for breast cancer is Oncotype DX. This is revolutionary.
A simple way to describe it would be to say we're doing gene profiling of a person's cancer. We're not
doing BRCA testing. We're not looking at their genes to see if they have a higher risk for cancer. We're
looking at someone's genetic makeup of their cancer, their particular cancer, and we're comparing it to the
genetic makeup of what I call banked tissue on previous cancer patients that an organization called the
National Surgical Adjuvant Breast and Bowel Project (NSABP) has. This is a clinical trial organization that
does a lot of breast cancer research. That group was ingenious 20 years ago because what they did was
when patients participated in trials, they signed a paper that said they could collect tissue and bank it, freeze
it. So, they have all these women's cancers on file. And they have results from clinical trials in which patients
had hormonal therapy versus hormonal therapy with chemotherapy. And they know the genetic makeup of
the people and they looked to see how did they do. Could you predict how they were going to do? And the
answer is, yes, we can. That's very exciting.
Now, a result of this is, women who used to get chemotherapy routinely are not all getting it. So the side
effects of chemotherapy are being able to be avoided. So, there's a cost benefit to society because we're
talking $50,000 to $60,000 for chemotherapy. It's expensive, more if you do certain chemotherapies with
newer drugs. And the side effects of chemotherapy can be long-term. Some women have neuropothies,
where they get tingling in their hands and feet that are long-term. Some women will go on to develop
leukemias later on, 10 to 15 years later. So, it's a low risk, but if you didn't need the chemo to begin with,
why have the risk?
So, again, you see that everything is geared towards we want to individualize the treatment of breast cancer
so that if you need chemotherapy, fine. If you need it, you assume the risks. But if you don't need it, let's not
give you the side effects. Let's not make you take something you don't need.
This is big. It was adopted around the country in the matter of a year. It was unbelievable how quickly it got
adopted by the medical oncologists.
This is a test that is already commercially marketed. They were able to use the tissue they had banked to
actually run the test and see if they could make some predictions. They could, is what they found. They
could stratify people into risks, and they could predict what someone was going to do in certain categories
of treatment. It is routinely used nowadays.
There's a new thing in radiation called partial breast irradiation. They abbreviate it PBI. Done with multiple
techniques, it can be delivered to the patient, for lumpectomy patients.
The standard radiation right now is six weeks. Daily treatment, six weeks. There's a Canadian regime that is
15 treatments, which would be about half that. This one is five days, twice a day. Pretty nice. The long-term
results are still pending. But lots of women are being offered this, and we offer this in Peoria.
Q: It's been over a year since the controversial study came out that suggested women not start getting
mammograms until age 50, and then get them every other year. Have you seen any effects from that report?
A: Nothing changed. I had a fear of that. We have not really seen (any change.)
I think there was immediate media attention to it. The American Cancer Society came out strong, saying
we're not changing our guidelines. The American College of Surgeons came out strongly. Probably the only
organization that kind of supported (it) were the gynecological organizations, but even they kind of hushed
up after the people who really deal with breast cancer, the surgeons and oncologists, came out strongly.
You start mammography at age 40, and it's every year after 40. We recommend women consider starting
earlier if their mother had breast cancer at a young age, so 10 years earlier than your mother. And if
anybody is genetically positive or they have strong family histories, their doctors help them determine when
to start.
But that scared me to death because I thought, 'Oh, my God, we're taking a step backwards.'
We've made all these strides to improve breast cancer survival. The breast cancer mortality rate since 2000
has dropped by 2 percent per year. So, in the last 10 years, we made a 20 percent improvement in survival.
That's not just drugs, that's early detection.
I will tell you that mammography is not perfect. There have been articles about breast self-exam, slamming it.
What I would say is this: The data is lacking on whether breast self-examination improves survival. What we
do know is that early detection helps with survival. That would suggest that if we can find it, especially in a
young woman who is not mammograming yet, if we can find it earlier, we may impact survival. For the
woman who feels, breast self examination makes her nuts - I'm so scared I can't do it - the lack of data
would say, 'Relax, you're probably not going to hurt yourself by not doing it.'
But all doctors tell their patients, 'Know your body.'
If you're having a change in the way you're body is acting, you're supposed to go see a doctor. A change in
your normal physical health is supposed to be noted because it could be an indicator of a medical problem.
Examining your breasts is just an extension of that. It's not perfect either. But, it doesn't cost anything to do it.
Q: What else can we do to guard against breast cancer?
A: That's where we're struggling because exactly what to tell women is tough. We know some things that
can lower your risk for cancer in general and breast cancer. One of the things is maintaining normal body
weight.
So, being overweight is a risk factor for breast cancer. It appears that high fat diets may be a risk for breast
cancer. So, doing exactly what they say we should do for good health, which is maintaining our weight.
Don't eat high fat diets. You want to eat more protein and vegetable and fruit diets, more natural,
unprocessed food. Things like that. Those all seem to impact on breast cancer risk, but to a small degree.
One of the things we did learn in the last 10 years with the woman's health initiative study, and I believe the
publication was in 2002. This was the one that showed combination hormones, which is estrogen and
progesterone hormones, after menopause do slightly increase your risk for breast cancer if taken beyond
four years. So, at about the four-year mark, you start to see a slight rise in risk. So, what happened after
that article was published? A lot of women threw out their hormones. And do you know what happened to
the incidence of breast cancer? It dropped significantly.
So, we do know some things. We know that taking combination hormones when you go into menopause is
probably not the best idea unless you really, really, really need to do it. It doesn't mean you can't do it, but
the idea is we don't need hormones the rest of our lives. We were meant to go into menopause. It's OK to
go into menopause, whether we like it or not. There are things that women can use to help with menopause
symptoms.
The problem is, that is only going to reduce cancer a small amount. We need to understand better what is it
in our environment that is putting us at risk, beginning when we're this big.
Because, if you notice, breast cancer, like all cancers, increases with age. Cancer is a disease of genetic
changes in our DNA in our cells that is no longer being repaired. As we get older, our repair mechanisms
aren't working as well. So, the DNA in our cells are mutated by outside influences, what a lot of people call
carcinogens. Carcinogens in the air we breathe, the foods we eat, the water we drink.
But even just the lack of the ozone layer is giving us more exposure to radiation from space and such. All of
that influences or affects the DNA in our cells over years, and as we get older, our repair mechanisms aren't
working so it's cumulative, and we start to see more cancer as we age.
So, if we improve our repair mechanisms in our cells or if we can get rid of more of the carcinogens in our
environment - and I'm wondering if some of this drop in cancer incidence is due to, you know, there's more
people trying to eat organic. There's more encouraging of having people check for radon in their homes,
especially in places like Illinois. You get the radon out of the homes, these kids aren't exposed to it anymore,
and you may be dropping cancer incidences as they get older.
Q: Anything else we should know?
A: One of the things I tell my patients is, if a patient wants to go out of town for a referral, we gladly send
them. But I also make sure the patients understand that I would not leave Peoria to go get breast cancer
treatment. Now, if I had something that was so way out there that no one has ever seen - but that's pretty
unusual for us because we've seen just about everything. And it's not wrong to seek an outside opinion,
never wrong.
But, I have another breast surgeon, Dr. Mammolito, to go to. I would have her do my breast surgery. I
would stay here and have my chemotherapy, and I know all the main breast surgeons in the country. I know
them by first name
Bob Main selected as 2011 Chattanooga Area Manager of the Year - Chattanooga Times Free Press - by
Mike Pare
When Bob Main started his job 23 years ago, he was the first, and only, employee of Siskin Hospital for
Physical Rehabilitation.
“I was given the chance of a lifetime to be able to design and build and staff a hospital,” said Main, who
oversees the only freestanding, not-for-profit rehabilitation hospital in Tennessee that now employs nearly
400 people.
Main has been tapped as the 2011 Chattanooga Area Manager of the Year. The award, in its 24th year, is
made annually by area business groups, including the Chattanooga Area Chamber of Commerce, which pick
a manager deemed to have made a significant contribution to the area.
Main, the 67-year-old president and chief executive of the Chattanooga hospital, said he has had
opportunities to leave the city but stayed.
“I’ve got a lot of blood, sweat and tears in this place,” he said about the 109-bed facility that marked its
20th year in 2010. “We’ve got a team that really cares about people.”
The Buffalo, N.Y., native said Siskin is “providing services to the community that were never there before.”
“In rehab circles, if you ask anybody and say Siskin Hospital, they’ll say Chattanooga, Tennessee. We’ve
got a national reputation,” Main said.
Dr. John Boxell, who chairs the Siskin Hospital board, called Main “a compassionate person, committed, an
extremely hard worker.”
“He’s constantly looking for ways to enhance care for the patients he serves,” Boxell said.
At Siskin, its staff deals with not just patients but their entire families, Main said.
“Their whole life has been altered,” he said. “We’ve got a chance to rebuild that lifestyle. It’s amazing what
the human spirit can do.”
Siskin provides a lot of free care, the hospital CEO said, and it doesn’t have an endowment or foundation to
speak of from which it can draw.
“That comes out of the hospital operation, but we’re doing well,” he said.
In 2009, the most recent year for which the hospital’s financial records are available, Siskin reported a net
gain in income of more than $2.5 million on revenues of nearly $32.5 million.
According to the selection committee that picked Main for the award, the Chattanooga area has benefited
from Main’s vision of providing specialized programs such as a brain injury unit and lymphedema, balance
and dizziness, and driving evaluation programs.
Main worked with his staff to develop the Fitness Center at Siskin Hospital, which provides a place where
disabled and able-bodied people, whether former patients or not, can exercise side-by-side with the benefit
of using specially designed equipment developed for their needs.
Main said the biggest change in his job over the years is that it has “gotten tougher because no one wants to
pay for service anymore.”
When Siskin opened, its average patient stay was 33 days, he said. Today, it’s 15 or 16 days, Main said.
“We have to fight to get patients certified for care,” he said.
In Tennessee, for example, TennCare won’t pay for inpatient rehabilitation, which Main said is highly
unusual.
“People don’t think about rehab until they need it,” he said.
Looking ahead, Siskin officials are continuing to eye the area’s needs and to fill them, Main said, including
preparing for health care reform. That includes looking at getting into an accountable care organization, one
of the provisions in the reform bill in which service providers work together to offer a seamless continuum,
he said.
“We’re monitoring very closely what’s happening in Washington,” Main said.
Boxell said Main is well-deserving of the recognition.
“Siskin is one of the leading rehabilitation hospitals in the country,” he said. “What he has demonstrated in
leadership, longevity and commitment and compassion has paid dividends for our region.”