Fall 2010 Issue

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Welcome to the Fall 2010 issue of Life to the Fullest, the Swedish Cancer Institute’s newsletter for cancer survivors throughout our community. In this issue we have included articles about genetic testing, body image and how to eat right to fight free radicals. We have also included information about the 3rd Annual Cancer Survivors event on Sept. 25, and our ongoing classes and support groups. We hope you will find the newsletter helpful and that you will consider sharing it with your family and friends. To download and print a copy of the newsletter, click the newsletter icon at the top of this page.

An Invitation to Celebrate Survivorship

The Swedish Cancer Institute has extended an invitation to Swedish cancer survivors and one family member or friend to the third annual Cancer Survivors Event, Saturday, Sept. 25, from 9 a.m. to noon. The event is free, but registration by Sept. 17 is required to ensure all participants can be accommodated. To register, call 206-386-2502 or register online at www.swedish.org/classes.

The celebration, which will be held at the Arnold Medical Pavilion at 1221 Madison Street in Seattle, will include a continental breakfast (beginning at 8:30 a.m.), informative workshops, exhibits and an opportunity to share personal stories and experiences. Each participant will be able to attend three of the one-hour workshops. Topics include:

  • Genetic Profiling to Diagnose and Treat Cancers (Jeffery Ward, M.D., president, Washington State Medical Oncology Society)
  • Spotlight on Health Care Reform: Insurance Reform in Washington (Liz Mercer, Washington State Office of the Insurance Commissioner)
  • Genetic Testing: How It Can Help Survivors (Robert G. Resta, C.G.C., genetic counselor, Hereditary Cancer Clinic, Swedish Cancer Institute)
  • Navigating Resources for Survivorship (Shannon Marsh, American Cancer Society navigator, Swedish Cancer Institute)

Don’t miss out on this opportunity to celebrate life to the fullest. Space is limited, so register today by calling 206-386-2502 or going online at www.swedish.org/classes.

Is Genetic Counseling Right for You?

Robert Resta, M.S., C.G.C., Hereditary Cancer Clinic, Swedish Cancer Institute

Genetic counseling can be a critical component in the treatment and prevention of cancer. Although most cancer is not hereditary, at least 10 percent of all breast, colon and ovarian cancers have a significant genetic component. Clues to the hereditary nature of a cancer may be found in your family history, the age of onset of the cancer, the characteristics of the tumor and your ethnicity.

The best way to determine if a cancer is hereditary, and what that might mean for you and your family, is to visit with a genetic counselor. Genetic counselors are health care providers who have a graduate degree in genetic counseling and have been certified by the American Board of Genetic Counseling.

A typical genetic counseling session involves a review of your family and medical history to determine the hereditary component – if any – to your cancer. The genetic counselor will:

  • Outline the genetic testing options appropriate for your situation
  • Explain how genetic testing may be important for guiding your medical care
  • Explore the emotional and psychological issues that stem from genetic testing
  • Help you better understand the implications of your cancer for your children, siblings, and other relatives

Patients with hereditary cancers may be at risk for other cancers; therefore, genetic counseling can help make sure you and your family get the best advice about the appropriate screening and prevention practices to minimize cancer risks.

Genetic testing may or may not be a good option for you for many reasons. The genetic counselor will help you make the choice that is best for you. If you decide to have genetic testing, which usually involves a blood draw or a saliva sample, the genetic counselor can arrange the testing and help you navigate the health-insurance maze. Fortunately, federal legislation passed in 2008 (Genetic Information Non-Discrimination Act, or GINA) forbids health insurers from using genetic information as a pre-existing condition.

Coping With Genetic Test Results

Robert Resta, M.S., C.G.C., Hereditary Cancer Clinic, Swedish Cancer Instittute

Genetic counseling can be as much an emotional experience as it is a medical experience. It may test your psyche, as well as your genes.

Some emotionally sensitive issues that commonly arise during genetic counseling include:

  • Facing your mortality or the mortality of your loved ones
  • Results that may strain your sexual and emotional relationship with your partner or other loved ones
  • The impact surgery, such as mastectomy or oophorectomy, may have on your sexuality and body image
  • The need to consider addressing complicated or uncomfortable relationships with your family
  • Discussing the death of a parent, sibling or other close relative
  • A positive genetic test result that might evoke feelings of anxiety, guilt, shame and social stigma
  • A negative result that may induce “survivor guilt”(e.g., “Why did my sister get the gene and I did not? She has three little children to take care of, but I have no children dependent on me”)
  • Spiritual crisis, such as questioning your faith in God
  • Feeling overwhelmed with information and decisions

To schedule an appointment with a genetic counselor at the Hereditary Cancer Clinic at Swedish Cancer Institute, call 206-215-4377.

Some people experience none of these reactions, whereas other people experience many of them. Individuals, even those in the same family, may experience them with different levels of intensity. It is important to know that these are normal, human reactions to a stressful situation.

We encourage you to discuss your feelings with your genetic counselor, physician, therapist or other health-care provider. Your social network – friends, family and members of support groups – can also be an important source of strength and comfort. Don’t hesitate to seek referrals to professional counselors and therapists who can help you work through these complex emotions and reactions. And, most importantly, don’t judge yourself by how others respond to similar news. You are unique and, therefore, your reaction to your genetic testing results will be unique.

In the Eye of the Beholder
Breast Cancer Treatment and Body Image

Dorcas Dobie, M.D., Psychiatry, Swedish Cancer Institute

The diagnosis of breast cancer can set a woman back on her heels. The dizzying array of tests, the difficult decisions about treatment options, and the treatment itself can bring on an entirely new set of emotions that are personal and complex.

Body image – the way a woman feels about herself when she looks in the mirror – is very individual. It is also difficult to predict from one patient to another. For many women, however, body image is a key factor affecting their treatment decisions when faced with a breast cancer diagnosis.

Many things determine what a woman sees when she looks in the mirror: her age and place in the life cycle, her concept of beauty, her role models growing up, her beliefs about sexuality, her relationships at work and home, and her weight, fitness and overall health. By adulthood, most women have negotiated a truce with the mirror when they get dressed in the morning. The diagnosis of breast cancer, however, can transform the mirror into a magnifying glass – amplifying old uncertainties and fears.

It is important to remember that these concerns are not trivial, even when compared to fears about mortality. Considering body image during the treatment decision-making process is absolutely normal.

A woman who is past her reproductive and child-rearing years may elect breast-conserving surgery because she cannot imagine herself without breasts – they are critical to her self-image. A young woman who has lost loved ones to breast cancer may request a prophylactic mastectomy despite her youth. Some women adjust to their new body contours and forego breast reconstruction. Others may elect to pursue reconstructive surgery as soon as possible after a mastectomy. And, for many women, the public prospect of losing their hair may be more demoralizing than the more private prospect of losing a breast.

Fears thrive in silence. Concerns about becoming unattractive or “damaged” are common. Talking through these concerns with the medical team, a life partner, or trusted family and friends, can help clarify priorities and make tough decisions easier. It can also be extraordinarily helpful to connect through support groups and survivor networks with the millions of other women who have struggled with these same dilemmas. Even the strongest, most self-reliant woman can benefit from sharing her fears and concerns in order to make the transition from feeling damaged to feeling healed.

The Corner on Healthy Living
Our Love/Hate Relationship With Free Radicals

Brian Higginson, R.D., C.D., Clinical Nutrition Specialist, Swedish Cancer Institute

Many factors can influence the development of cancer. Genetics, environment, lifestyle and diet are all thought to be major contributing factors. Because of the variety of influences, as well as the wide range of types of cancer, it is difficult to generalize and pinpoint the exact combination of factors that may cause cancer to develop or reoccur. It is safe to say, however, that most people who have experienced cancer want to know what they can do to reduce their risk of recurrence.

Controlling What We Can

Although we cannot change our genetic makeup and it may be difficult to control environmental factors, we can control the foods we eat. For years researchers have studied foods and tried to link them to the development of cancer. Recently, there have been numerous reports about “superfoods,” but there is limited evidence that any one food is able to protect us all from cancer.

Research has, however, identified one villain that naturally occurs in our bodies – the free radical. Our bodies have a love/hate relationship with free radicals. We need these molecules to keep our bodies functioning and to help protect against infections. But, free radicals are unstable molecules that are constantly trying to become stable by grabbing their missing components from normal, healthy cells. When our bodies have too many free radicals, they can damage or kill healthy cells and tissues, and even damage or change our DNA, which can lead to cancer. How we live and what we eat can determine the level of free radicals in our bodies. Consuming too much meat, processed foods and alcohol, and smoking and stress are among the contributing factors to high levels of free radicals.

Fight Hard by Eating Well

To increase the consumption of potential anti-cancer compounds and to provide our bodies with the tools to keep our free radicals under control, we should eat a variety of foods that are rich in vitamins, minerals and anti-oxidants, and we should focus on unprocessed foods. Foods that have not been processed retain more of their naturally occurring vitamins, minerals and anti-oxidants. Anti-oxidants are the weapon of choice in the battle to neutralize our free radicals when they are out of control.

There are many foods that contain anti-oxidants. In addition to fruits and vegetables, anti-oxidants are in beans and legumes, nuts and seeds, and whole grains (oats, brown rice, whole wheat, and more exotic grains like quinoa and kamut). Many organizations, including the American Cancer Society and the American Institute for Cancer Research, recommend we increase the vitamins, minerals and anti-oxidants we consume by filling at least three-fourths of our meal plate with plant-based foods.

The more well-known vitamins and nutrients found in plants, such as vitamins C and E, beta-carotene, selenium and lycopene are widely recognized for their anti-oxidant capabilities. There are many plant compounds, however, that have not been isolated, identified, purified or extensively studied. For example, ginger and curry, which are frequently used in Asian-style cuisine, have been shown to have anti-inflammatory qualities. There is also evidence of a correlation between the color of fruits and vegetables and the level of anti-oxidants; therefore, it is better to eat those that are bright colors. There are many excellent and beneficial choices, including red and yellow peppers, citrus fruits, spinach, kale, Swiss chard, broccoli, blueberries, strawberries, sweet potato, papaya and mango – to name just a few.

A good rule of thumb to be sure you are giving your cells a fighting chance against your free radicals: include a fruit and/or vegetable with every meal and snack you eat every day. Remember, your mother may not have known the science behind her frequent admonition – but she was spot on when she told you, “Be sure to eat your fruits and vegetables.”

Life After Treatment
Achieving a Milestone – Looking to the Future

Surviving cancer is a complex journey that is as unique as the individuals who are receiving treatment or supporting a loved one. It is a journey of the mind, the body and the spirit. Although it begins abruptly on the day you receive your diagnosis, the end of the journey is not so well defined.

For many cancer survivors, each day of treatment represents one step closer to the end of their cancer journey. The last day of treatment is an accomplishment to be celebrated. It is also a milestone that opens the door to the next phase of life, which may bring with it different, although related, physical and emotional issues.

Swedish Medical Center is pleased to offer a special three-part class, Life after Treatment, to help cancer survivors, and their friends and families, make this important transition.

The class, which is offered at no cost to participants, includes opportunities for individuals to share their own experiences, and to hear about and discuss various survivorship topics. Topics include recent research on the challenges cancer survivors may face and the strategies to deal with those challenges, how to lead an “anti-cancer” lifestyle, and the process of healing the whole person.

Those who attend the class learn how to create an action plan that will help them through their transition. Multiple resources are also made available to participants, including published materials, an up-to-date reading list, websites and information about organizations that provide support.

Life after Treatment (3-class series)
When: Wednesday, Oct. 5, 12 and 19 5:30 - 7 p.m.
Where: Swedish Cancer Institute
Arnold Building (A-Floor West in the Donald A. Tesh, M.D., Conference Rooms A and B)
Cost: There is no cost to participants.
To register, please call 206-386-2502.

For more information about this special opportunity for cancer survivors or to register for the next series of classes, please call 206-386-2502.

Spotlight on Sharing
Swedish Cancer Support Groups

The Swedish Cancer Institute offers a variety of support groups for cancer survivors and their families and caregivers. Support groups give you an opportunity to meet with and find extra strength from others, to share your experiences, and, possibly, even help someone who might be struggling with a challenge you have learned to overcome. Each group has the benefit of an experienced Swedish Cancer Institute support group facilitator, and all groups are open to anyone in the community – whether they are receiving care at Swedish Medical Center or at another cancer center in the community. The Cancer Institute is fortunate to be able to provide this valuable service at no cost to the participants. For more information about the following support groups, where they meet and whether registration is required, please call 206-540-0477.

Breast Cancer Support Group
Second and fourth Wednesdays, 4-5:30 p.m.

After Breast Cancer: What’s Next?
Wednesdays, January through October

Living with Cancer Support Group
Weekly on Thursdays, 1:30-3 p.m.

Brain Tumor Support Group
First and third Wednesdays, 1-2:30 p.m.

Brain Tumor Caregivers Support Group
First Wednesday of the month, 1-2:30 p.m.

Caregivers Support Group
Weekly on Thursdays, 1:30-3 p.m.

Gynecological Cancers Support Group
Weekly on Tuesdays, 10:30 a.m. – noon

Lung-Cancer Advocacy and Educational Support Group
First Thursday of the month, 4-5:30 p.m.

Prostate Cancer Educational Support Group
Third Thursday of the month, 8:30-9:30 a.m.

Grief and Bereavement Group
Second and fourth Wednesdays, 12:30-2 p.m.

Focus on Education
Healing Through Creating

Art activities and knitting can be healing experiences that help restore the spirit of cancer survivors. Swedish Cancer Institute offers two opportunities for cancer patients to participate in these activities. For more information or to register for these free sessions, please call 206-386-3200.

Art Therapy: An Approach for Healing

Prior art experience or training is not required for individuals who would like to participate in this confidential, supportive and individualized activity. The goal of art therapy is to use various art mediums to visually and verbally examine health issues through self-exploration. Appointments, which are 50 minutes long, can be scheduled on Tuesdays or Thursdays, 9 a.m. to 6 p.m., or on Wednesdays, 9 a.m. to 1 p.m.

Knit for Life™

A network of volunteers uses knitting as a healing experience to enhance the lives of cancer patients, their families and caregivers. The group provides a supportive environment for beginning and experienced knitters. Materials are provided. The group meets Mondays, from 6-8 p.m., on Swedish Cherry Hill campus, and on Thursdays, from 1-3 p.m. on Swedish First Hill campus.

The Quest for Knowledge

There are many different types of cancer - and cancer patients come in different sizes, shapes, genders and ethnic backgrounds. And, yet, there is one trait that is fairly common among all of them – the desire to seek information so they can become more knowledgeable about their disease and their treatment options.

The Swedish Cancer Institute is pleased to offer patients, family members and caregivers a variety of classes and workshops at no cost to the participants. There are art and craft classes, as well as sessions that focus on exercise, nutrition, beauty, meditation, and an assortment of other topics that are geared to healing the mind, the body and the spirit.

Registration is required. To learn more about the variety of classes, and their schedules and locations, or to register for a class, please go online to www.swedish.org/classes, or call 206-386-2502.

We hope you’ll let us help you in your quest for knowledge – and that you’ll bring a friend.

Share the News and Your Ideas

We hope you have enjoyed this issue of Life to the Fullest and that you will consider sharing it with your friends and family members. Anyone can join our mailing list by sending his or her name and e-mail address to full.life@swedish.org.

We also encourage you to let us know about topics you would like us to include in future issues or questions you would like answered by our experts at the Swedish Cancer Institute. Send your ideas and questions to full.life@swedish.org.

About Our Authors

DobieDorcasMDDr. Dorcas Dobie is a psychiatrist with the Psycho-Oncology Clinic at the Swedish Cancer Institute. She received her medical degree from the University of Michigan School of Medicine, and completed a psychiatry residency and a fellowship in geriatric psychiatry at the University of Washington. Dr. Dobie is board certified in general psychiatry and geriatric psychiatry, and is currently a clinical associate professor of psychiatry at the University of Washington School of Medicine. She works closely with Swedish Cancer Institute physicians to integrate customized psychiatric care plans into their patients’ treatment plans.

BrianHigginsonBrian Higginson, R.D., C.D., is a clinical nutrition specialist with the Swedish Cancer Institute. Brian developed an interest in nutrition when he was exposed to naturally-raised foods at a very young age. He received a bachelor’s degree in nutritional sciences from the University of Connecticut, and completed his dietetic internship at Marywood University in Scranton, Penn., in 2000. Brian enjoys teaching community classes and helping individuals to make lifestyle changes that enable them to reach their nutritional goals. His interests include cardiovascular health, diabetes, weight loss, digestive disorders, maternal health, organic/local foods, and providing cooking demonstrations.

RobertRestaRobert Resta, M.S., C.G.C., has been a genetic counselor at Swedish since 1983. He received his master’s degree in genetic counseling from the University of California at Irvine and is certified in genetic counseling by the American Board of Medical Genetics and the American Board of Genetic Counseling. Mr. Resta was editor-in-chief of the Journal of Genetic Counseling from 1995-2001, and has been a member of the editorial board of the American Journal of Medical Genetics since 1995. He has published numerous articles and given many presentations about genetic counseling locally, nationally and internationally.