Breaking the News: How Katie Clarke Told Her Children About Her Breast Cancer Diagnosis

Tuesday, October 29, 2013 12:20 PM comments (0)

Katie Clarke was diagnosed with breast cancer in 2011. She underwent a bilateral mastectomy with reconstruction at NorthShore Glenbrook Hospital, followed by four months of chemotherapy and a year-long course of Herceptin treatments at Evanston Hospital. 

Before her own diagnosis, and in memory of her best friend who lost her own life to the disease in 2006, Katie and her family would make a point of cheering on the participants of the three-day breast cancer walk in Chicago armed with motivational signs and licorice. This, and her own breast cancer journey, would later inspire Katie and her sister to found The Licorice Project, an organization devoted to spreading joy during a difficult time and bringing together breast cancer patients, survivors, families and friends. 

In part two of her NorthShore patient story, Katie shares one of the most difficult but important moments following her breast cancer diagnosis:

Katie ClarkeI’m often asked, “How and when did you tell your kids you had breast cancer?” My husband and I agreed that we wanted to be open and truthful about everything as soon as my diagnosis was confirmed. We turned to my breast surgeon, Dr. Winchester at NorthShore University HealthSystem, for advice on what to say to our three middle school-aged boys. We planned a family meeting and decided that I would do the talking.

I began the conversation by telling them that I’d found a lump in my chest, to which my youngest shouted, “You’re pregnant!?” When I said, “No,” he answered, “Phew!” I told them that the lump was in my breast and they wanted to know immediately if it was cancer. When I said that it was, they all began to cry. It broke my heart to see them so sad and frightened. Holding their hands, I assured them that the doctors were very encouraged and had given me a good prognosis since the lump was very small and I had caught it early. I explained to them that there would be many steps, tests and procedures. I explained that it would take time and patience but that when I finished the therapy, I would be okay. Of course, many questions followed:

“Are you going to die?”
“Will you lose your hair?”
“Will you get a wig?”
“Who knows about this already?”
“Can we tell people?”
“What should we say?”
“Does this mean we can get breast cancer?”
“Are people going to bring us dinners?”

My husband and I answered the questions as best as we could, which, of course, led to even more questions. Since school was about to end for summer vacation, we assured the boys that all their summer plans would stay intact. We wanted to keep their lives as “normal” as possible. The family meeting concluded with lots of hugs and kisses.

Telling our children that I had cancer was the hardest thing I’ve ever had to do; however, it was also one of my proudest moments because of the strength and composure that I maintained during such a difficult conversation. There’s no right or wrong way to explain a cancer diagnosis to children. Each family will deal with it in their own unique way and to the best of their ability.

 

Flu Season: Protecting Your Family from the Bug

Thursday, October 24, 2013 9:00 AM comments (0)

flu seasonEvery flu season is different but there’s one thing you can count on: there will be one.  Flu season in the U.S. can begin as early as October and continue into late May. Perhaps you’ve already noticed an uptick in coughing and sneezing on the train, in the office or at school, but it’s not too late to take action and keep your family happy and healthy throughout flu season. 

Curtis Mann, MD, Family Medicine at NorthShore, shares some top tips for keeping the flu from catching up with you and the rest of your family this season:

  • Vaccinate! The annual flu vaccine is the best way to protect against and prevent the spread of  the flu. Everyone over the age of six months can and should be vaccinated against the flu each year, especially children under five and people over 65 because they are at high risk for serious flu-related complications.
  • Wash your hands. You, but especially your hands, come into contact with millions of germs and bacteria every single day. You can pick them up from surfaces, computer keyboards and the shake of a hand. Regular handwashing is one of the very best ways to avoid spreading illness and getting sick. Washing your hands frequently throughout the day can’t get rid of everything but it prevents the build-up of germs. It only takes a little water, some soap and the ABCs—don’t stop washing until you get to Z.
  • Remember your devices. One of the best ways to prevent the spread of germs, especially during flu season, is to keep surfaces clean. Countertops and door handles are obvious hotspots but when was the last time you disinfected your phone or tablet? Phones and tablets go everywhere you go, but unlike hands, they aren’t washed after every trip to the bathroom and then they spend the majority of their time near your hands, nose and mouth. Studies show that phones and tablets are likely to carry many of the same contaminants in the same numbers as the door handle of a bathroom.  Wipe down the screens and bodies of your gadgets regularly with a non-alcohol based cleaner. 
  • Be healthy to stay healthy. The key to avoiding illness is stay healthy on a day-to-day basis. Make sure you are getting adequate sleep, stay active with exercise, make sure you are managing your stress levels and eat a healthy, well-balanced diet whenever possible. 
  • See your doctor. If you think you were exposed to someone with the flu, anti-viral drugs, which are 70-90% effective, can help prevent you from developing the flu. 
  • And a friendly reminder. You can't get the flu from the flu shot or nasal spray, so vaccinate, vaccinate, vaccinate!

Do you make sure to get the flu vaccine every year? 

Finding the Strength to Smile: Krissy Posey's Breast Cancer Diagnosis at Twenty-Eight

Tuesday, October 22, 2013 9:00 AM comments (0)

When Krissy Posey was diagnosed with breast cancer at only 28, the first words out of her mouth were, “Okay. Just tell me what I need to do next.” Her next steps were to get a second and third opinion before returning to NorthShore for treatment, choosing the expertise of Katharine Yao, MD, and the team of caregivers at NorthShore Kellogg Cancer Center for a bilateral mastectomy and chemotherapy, followed by reconstruction. 

In her NorthShore patient story, Krissy recounts the difficult and surprising moments of her battle with breast cancer, but also how and why she found the strength to smile: 

How did your journey to diagnosis begin?
I hadn’t started mammograms since I was only in my twenties. I don’t really have a family history of breast cancer other than a great-aunt who has been battling the disease for over 10 years.

I came home from work one day and, as I was stepping out of my work clothes, I felt an itch in my right breast. When I went to scratch it, I felt a small mass. I was on the phone with my sister at the time and told her I felt a lump in my breast and she encouraged me to get it checked out.

What went through your head when you learned that you had breast cancer at only 28?
I was at work when I received the call from my doctor, Catherine Dillon. She asked me if I wanted to come into the office for the results. I told her to just lay it on me. After she told me that she didn’t have good news, that the test came back indicating cancer, my response was, “Okay. Just tell me what I need to do next.” 

Dr. Dillon said the doctors wanted to see me right away. In a matter of two hours, I was told that I had cancer, made my way to the hospital and was sitting in a room with Dr. Yao discussing my diagnosis and next steps. I remained calm and at peace during this time. Yes, it was all happening so fast but after I got off the phone with Dr. Dillon, I prayed and then called my family to tell them the news. 

What stood out about your care at NorthShore?
After receiving a second and even third opinion at other healthcare facilities, I came back to Northshore for treatment. My team of doctors included: Catherine Dillon, MD, Obstetrics/Gynecology; Katharine Yao, MD, General Surgery; Teresa Law, MD, Medical Oncology; Mark Sisco, MD, Plastic Reconstruction Surgery and, of course, all of their fabulous nurses.

My team of doctors and nurses are simply the best in the business. I wasn’t just a patient to them; I was a person. They showed care and concern, and made what could have been a very traumatic time in my life a lot easier to get through. I never second guessed the treatment I received. I trusted the doctors and their recommendations. 

What was the most difficult part of treatment?
The doses of Adriamycin Cytoxan (chemotherapy drug). The nurses call it the “Red Devil,” and now I know why. The medicine is red and really takes a toll on your body. After a while, I couldn’t even eat or drink anything red without getting nauseated. 

What surprised you most about the experience?
This may sound bad but I was surprised that I didn’t “look” as sick as I thought I would during such an extensive treatment plan. It was important to me to look as “normal” as I could and not show many signs of weakness for two reasons: 1) That’s how I chose not to let the disease get the best of me and 2) I wanted to remain strong for my family. I knew if they saw me in a certain condition that it would really worry them.

What advice would you give other women currently undergoing treatment?
Try to be positive, see what good can come out of this situation and smile. I know you are going through a lot but if others see you can smile through all of this, it not only gives them hope but it also does something good for you too.

 

Think Pink: Breast Cancer History, Risk Factors and Prevention [Infographic]

Wednesday, October 16, 2013 11:56 AM comments (0)

This October during National Breast Cancer Awareness Month, help us spread the word about the importance of early detection and prevention.  Yearly mammograms can help identify breast cancer in its early, treatable stages and various lifestyle changes may help reduce your risk of developing the disease. 

NorthShore University HealthSystem has created a breast cancer infographic that includes a brief history of the disease, risk factors and preventative measures. Click on the image below to view our full breast cancer infographic and find out what you can do now to reduce your risk. 

breast cancer infographic

One Step at a Time: Katie Clarke’s Journey from Patient to Breast Cancer Mentor

Tuesday, October 15, 2013 2:47 PM comments (0)

Katie Clarke was diagnosed with breast cancer in 2011. She underwent a bilateral mastectomy with reconstruction at NorthShore Glenbrook Hospital, followed by four months of chemotherapy and a year-long course of Herceptin treatments at Evanston Hospital. 

Before her own diagnosis, and in memory of her best friend who lost her own life to the disease in 2006, Katie and her family would make a point of cheering on the participants of the three-day breast cancer walk in Chicago armed with motivational signs and licorice. This, and her own breast cancer journey, would later inspire Katie and her sister to found The Licorice Project.

In part one of this two-part series, Katie shares her NorthShore patient story, from her road to diagnosis, to what’s next for her and the passion project born from her experience with breast cancer:

Katie ClarkeHow did your journey to diagnosis begin?
In 2011, at the age of 45, I found a lump in my breast, despite the fact that I had diagnostic mammograms every six months for the previous 1 1/2 years and no family history of the disease. An examination, diagnostic mammogram, ultrasound and biopsy confirmed the diagnosis. 

How did you feel in the weeks after diagnosis and during treatment? What was hardest? What was surprising?
I felt scared and overwhelmed in the weeks following my diagnosis. There were so many appointments, tests and decisions to make in a short amount of time. During treatment, I felt sick for a couple of days after chemotherapy but then felt fine for the next two weeks, and even went back to substitute teaching until the next round of chemo. I just did what I was told by the doctors; I kind of felt like I was on autopilot. 

I didn't really process my emotions until I was finished with treatment. Then I thought, "What just happened to me?" Once I regained my energy, I had trouble "re-entering" my active and hectic family life. My priorities had changed: I wanted to just relax and enjoy a slower-paced life with my family.

I would say the hardest times were recovering from surgery and the management of lymphedema. But what surprised me were the silver linings that I encountered, especially all the wonderful people I met along the way. 

What brought you to NorthShore for your treatment?
My father, Dr. William Kerr, is a physician at NorthShore. Evanston Hospital has been a part of my family's life forever. I have received all my medical care there. 

David Winchester, MD, Surgical Oncologist, was recommended by my OB/GYN’s office. Dr. Winchester and I live in the same community. We know each other personally through our children's sports teams. I never imagined I would become one of his patients. I’m honored to call him both my doctor and friend.  

I felt well cared for by everyone at NorthShore, especially everyone on my care team: Dr. Douglas Merkel (oncologist), Dr. Joseph Feldman (lymphedema), Dr. Kim Grahl (internal medicine), Dr. William Banzhaf (obstetrics and gynecology), Bonnie Ryszka (oncology nurse), Meg Madvig (Kellogg social worker), Maria Sobel (physical therapy for lympedema massages) and Patricia Piant (acupuncture). The staff at NorthShore is loving, knowledgeable and compassionate. I feel so lucky to have been taken care of by the incredible staff at NorthShore!

What do you know now that you wish you’d known before/during treatment?
I wish I had been more knowledgeable about the long-term effects of lymphedema. (Editor’s Note: Lymphedema is a swelling that occurs in arms and legs, but generally only in one limb. It’s caused by a blockage in the lymphatic system, which prevents lymph fluid from draining. Lymphedema can be caused by another condition or a disease that damages lymph nodes or vessels, like surgery, radiation, cancer and infection.)

Katie Clarke 2What helped you most during treatment?
Family members and friends accompanied me to all of my treatments (17 in total). I chose to use these days as an opportunity to spend unique quality time with friends and family. 

Where did the idea for The Licorice Project come from?
Shortly after my treatment began, I started mentoring others and sharing resources and tips that had been helpful to me. It’s so important to connect with others who have “been there, done that” and can help manage expectations. At the same time my sister, Kendra, was getting involved in the Chicago startup scene. Together, we wondered what we could do to help make the journey less overwhelming for future breast cancer patients and the people who care about them. We searched for a way to use technology to connect and empower people but to also facilitate offline relationships. The Licorice Project was our answer.

Our goal is to change the breast cancer experience by connecting people locally, sharing resources, and making it easier to give and receive help. We focus on the practical, social and emotional aspects of having breast cancer, and strive to complement what the medical community and other cancer organizations are doing. 

Why Licorice? 
While participating in our first breast cancer walk, we were touched by those who came out to cheer us on and give us treats—like licorice. That inspired us to begin our own family tradition of handing out licorice to walkers in Chicago as they passed through our neighborhood. This simple gesture made people feel happy and upbeat and brought a smile to their faces. Our hope is that The Licorice Project will improve the lives of everyone affected by breast cancer and spread a little unexpected joy along the way.

What’s next? For you? For The Licorice Project?
I feel great! I will continue to have my blood work done and see my doctors every three months. I’m passionate about mentoring newly diagnosed patients and honored to serve on the Oncology Patient Advisory Board at NorthShore Kellogg Cancer Center.

As for The Licorice Project, we are focused on building our local community and the team. Eventually we hope to expand it to numerous locations across the U.S. so we can provide hope and inspiration to as many people as possible.

What advice would you give to newly diagnosed women?
The best advice someone gave me was to take this journey in stages, one step at a time, otherwise it will be too overwhelming. Try to accept help from others—it’s good for you, your family and the people who want to support you.

 

Crossing the Finish Line: Race-Day Tips for New Marathoners

Friday, October 11, 2013 10:31 AM comments (0)

marathonYou’ve come all this way. You’ve spent months training and run hundreds of miles to prepare for race day. Don’t let a preventable injury keep you from crossing that finish line or ruin the prospects of running marathon number two in the near future.

From mile one to the final stretch, stay injury-free with these tips from Carrie Jaworski, MD, Director of Primary Care Sports Medicine at NorthShore: 

  • Don’t try something new on race day. This rule applies to nearly everything. Don’t eat a food you haven’t eaten during training. It could upset your stomach and result in more time than you would like spent in the restrooms along the race route. Don’t wear clothing you haven’t worn before, from shorts and shirts to socks and shoes. Untested clothing might feel fine at mile five but by mile 18 you could be dealing with race-ending chafing or blisters.
  • Start slow and maintain a steady pace. Don’t let the excitement at the starting line get the best of you. There are 26.2 miles ahead of you, so conserve your energy and start slow. Passing and weaving amongst the thousands of runners at the starting line also increases the possibility of injury from tripping and falling. Maintaining a steady pace means you’ll finish strong instead of struggling to the end. 
  • Have a plan about fluid intake. Prepare ahead of time by staying hydrated on the days leading up to the race. Your urine should be clear yellow, not dark. On race day, you should alternate water and an electrolyte drink at the pace you established during your training. Be careful to avoid drinking at every fluid station, as that can increase your risk of hyponatremia (low blood sodium). A good rule of thumb is to drink 4-6 ounces every 15-20 minutes after the first 30-60 minutes of exercise.  Be sure to consume gels with water. And don’t forget to hydrate after the race as well!
  • Listen to your body. If the race doesn’t go as planned, don’t ignore what your body is telling you. There are medical aid stations throughout the course and at the finish line to help you if you are unsure. Remember, no matter what happens, you have already succeeded by all the hard work you put in to get to the starting line.
  • Bring a change of clothes. Always have a change of warm, dry clothes waiting for you after the race. You’ll need to keep your muscles warm to avoid cramping after the race is over. Depending on the weather, if you sit in sweat-soaked clothes for too long, you risk developing hypothermia.
  • Stretch! Make sure to stretch and roll out sore muscles soon after finishing the race. Stretching after the race is an important way to help minimize muscle soreness the next day. Scheduling a massage for the next day is good too!

Wishing Chicago Marathon runners, old and new, a happy and successful race day from NorthShore University HealthSystem. 

Meet Your Protein Needs Without Meat

Thursday, October 10, 2013 2:44 PM comments (0)

Protein is an essential element of a healthy, well-balanced diet. In fact, protein makes up a large part of all your body’s cells, which is why it is so important that you get enough each day. And that’s especially true for those following a vegetarian, nearly vegetarian or vegan diet who don’t get their daily requirement from protein-rich sources like meat. The good news is that reaching your daily protein needs doesn’t mean having to include more meat or even any meat all.Vegetarian-Protein

Just how much protein do you need on a daily basis? Women need approximately 46 grams and men 56 grams of protein each day. Pregnant women and breastfeeding mothers need to add additional protein to their diets. On average, it is recommended that they get 70 grams each day. Athletes and active individuals also require more protein based on the length, frequency and intensity of their workouts, which could mean increasing their protein intake by 50% more than a non-active man or woman.

Nearly every food contains some amount of protein but there are plenty of protein-rich, vegetarian-friendly options out there too. It might surprise you just how much protein there is in some of these healthy, meatless foods.

Jennifer Panicko, RD, LDN at NorthShore, shares some of the best veggie-friendly options to maximize daily protein intake:

  • Lentils. These pack a serious protein punch with 18 grams of protein per cooked cup. 
  • Greek yogurt. All dairy products are good sources of protein but Greek yogurt kicks it up a notch with approximately 20 grams per 6-ounce serving.
  • Chickpeas. There are 8 grams of protein per serving of chickpeas. Chickpeas also happen to be the main ingredient in hummus. Put it on crackers or veggies for a high-protein snack.
  • Beans. This one won’t surprise you. Most beans—black, pinto, soy—are heavy hitters when it comes to protein, with approximately 7 to 10 grams per serving. They’re also lower in calories than meat-based proteins and have lots of fiber and antioxidants.
  • Fruits and vegetables. That’s right! They are great sources of protein as well. Avocados have about 5 grams of protein per serving and a cup of spinach has 5 grams too.
  • Eggs. Many vegetarians won’t eat eggs but for lacto-ovo vegetarians (consume dairy and eggs), they are a great source with 6 grams per egg.
  • Tempeh and Tofu. These whole soy alternatives are great sources of protein with 8-12 grams per 3-ounce serving.
  • Quinoa. This grain is a complete protein, meaning it has the same protein content and quality of an egg! This super grain packs 8 grams of protein in 1 cooked cup.

What are some of your favorite vegetarian protein sources?

Finding the Style of Yoga That’s Right for You

Friday, October 04, 2013 1:11 PM comments (0)

yogaIntrigued by yoga but not sure where to start? For beginners, yoga’s many styles and moves might be a bit overwhelming but don’t be deterred. Yoga is a great exercise for people of all ages, activity levels and body types; it’s just a matter of finding the one or combination of styles that’s right for you.

Finding the right style of yoga comes down to assessing your current level of fitness/ability and determining what you hope to achieve by adding yoga to your fitness routine.  Some styles are better suited to athletes looking to increase flexibility and stamina, while other more gentle styles are ideal for those with injuries or chronic medical conditions. But no matter the style, all yoga increases strength, flexibility and balance, while also releasing tension and calming the mind. After all, the goal of yoga is to create a bond between the mind and the body. 

Polly Liontis, Yoga Instructor and Licensed Massage Therapist, highlights some popular styles of yoga and discusses the health benefits and required fitness levels of each:

Hatha yoga focuses on breathing exercises and basic poses. Its more basic approach makes it an ideal style for beginners who need to accustom themselves to yoga’s poses and relaxation techniques.
Benefits: Hatha reduces stress, increases concentration and promotes a feeling of overall relaxation. It’s also great for the core.
Who can do it? Anyone, regardless of age or ability, can do Hatha!

Iyengar yoga is a form of Hatha yoga that focuses on alignment and precision during movement. Often straps, blankets and blocks are used to enable beginners and those with injuries to achieve the correct positioning without putting excess stress on muscles and joints.
Benefits:  Like all styles of yoga, Iyengar is a mind and body exercise. It promotes balance, builds muscle and can help with recovery after an injury.
Who can do it? Iyengar yoga is a gradual yoga. By including props and allowing one to progress slowly from one move to the next, it’s great for just about anyone, especially those with less mobility after an injury.

Vinyasa yoga seeks to synchronize movement with breath. The key to Vinyasa is to flow smoothly from one movement to the next, which is why it is also frequently referred to as Vinyasa Flow.
Benefits: Vinyasa gets you moving more than Hatha so there’s the added cardiovascular benefit. It also builds lean muscle, improves strength and flexibility, and tones abdominal muscles.
Who can do it? It’s a bit more physically demanding and fast-paced than Hatha, but Vinyasa is still great for beginners and those looking to move from beginner to intermediate level. 

Ashtanga yoga is a form of power yoga that is fast-paced and intense with lunges and push-ups. The six-move sequence flows rapidly from one strenuous pose to the next and is paired with Vinyasa-style breathing. 
Benefits: Like with any style of yoga, Ashtanga reduces stress and improves coordination and balance. It’s quite a workout too, which means the added benefit of potential weight loss and full-body toning. 
Who can do it? Ashtanga yoga is best for fit people who wish to maintain or increase their strength and stamina. It would be helpful to be familiar with the six basic poses in the Ashtanga sequence before jumping into an Ashtanga class.

Bikram yoga, also known as hot yoga, is practiced in a humid room with temperatures kept at 95 - 100 degrees. All Bikram sessions are 90 minutes and consist of the same 26 poses and two breathing exercises.
Benefits: The heat of Bikram facilitates a deeper stretch, and increased perspiration helps flush and cleanse toxins from the body. It’s a gently intense workout with weight-loss possibilities.
Who can do it? The heat might make it a bit of a stretch (no pun intended) for beginners but after you’ve gotten the hang of the heat and the poses, it’s a good yoga style for intermediates looking to push themselves to new levels.

Have you tried yoga? Do you have a favorite style?

Ovarian Cancer: Early Diagnosis Is Essential

Monday, September 30, 2013 1:35 PM comments (0)

Dr. KirschnerCurrently there is no early detection test for ovarian cancer. Until such a test exists, raising awareness about the signs and symptoms of ovarian cancer is essential to early diagnosis. If diagnosed and treated early, ovarian cancer survival rates are over 90%. 

As part of Ovarian Cancer Awareness Month, Carolyn Kirschner, MD, Gynecologic Oncology, answers questions on ovarian cancer, from things you can do now to reduce your risk to the early symptoms you just might overlook. 

What are some early signs of ovarian cancer that might be overlooked or ignored? How do you know when it is time to see a doctor? 
Abdominal pain, bloating, being full after eating a little, new constipation or diarrhea, urinary frequency, fullness in the pelvis, low back pain, nausea/vomiting, fatigue are all possible symptoms of ovarian cancer—but are vague and may be symptoms of other problems. If symptoms occur several times per week for a month, medical care should be sought. Start with a good primary care physician who can do an exam and then possible imaging studies.

What is the most cost-effective screening test for early detection of ovarian cancer?
Most experts would say that screening should only be performed on women who are at increased risk of ovarian cancer, for example those with a BRCA gene or a strong family history of ovarian cancer. These people may be screened with ultrasound and serum (blood) CA125. Unfortunately, there may be false positives, especially in younger women, which may result in unnecessary tests or even surgery.

Is it possible to mistake ovarian cancer for fibroids on both a transvaginal ultrasound and a pelvic MRI?
Yes, mistaking ovarian cancer for fibroids can happen. Fibroids are common and ovarian cancer is not. Fortunately, imaging has greatly improved, so this mistake does not happen commonly these days. If there are any questions or concerns about a diagnosis, a woman who undergoes ultrasound and/or MRI imaging can and should request a disc with the images on them and get a second opinion.

If there is a family history of the disease but no BRCA gene mutations, is your risk for developing ovarian cancer still higher? What can you do to reduce that risk?
Most ovarian cancer is not hereditary, so risk should be the same as the general population, which is less than 2%. While never having children seems to be associated with an increased risk of ovarian cancer, I would never recommend getting pregnant just to decrease the risk. If you are premenopausal, oral contraceptives may decrease your risk. Birth control is protective because it prevents ovulation. It is theorized that breaks in the surface of the ovary, which occur with ovulation, may result in injuries that can lead to cancer. Vitamin D may also be protective. 

Diet is important. Cancer risk is increased with obesity. I recommend a plant-based, whole-grain diet. Limit saturated fats, white flour and refined sugar. I am a firm believer in exercise for weight control and sanity.

Keep in contact periodically with the genetics staff, in case there is a breakthrough in this area.  NorthShore has a high-risk clinic through Division of Gynecologic Oncology, and this may be a good way of staying on the "cutting edge.” 

What is the best scan for ovarian cancer? CT, MRI, ultrasound or PET?
Each has its advantages. The ultrasound is the least invasive, least expensive and does not use radiation. The CT and MRI look at anatomy. The PET looks at function. For screening, the ultrasound is best.

A Health Reporter's Personal Experience with Prostate Cancer - by Dr. Barry Kaufman

Friday, September 27, 2013 1:45 PM comments (0)

When the fourth biopsy in four years revealed some of the cancerous cells were now more aggressive than during the previous four years of active surveillance, I found it very hard to accept that the other shoe had actually dropped. I'd been sailing along with a Gleason 3 + 3, the least aggressive prostate cancer category. I hoped/believed the numbers would stay that way as I lived through the rest of my 70s and into my 80s and who knows how long from there. After all, my father had lived with prostate cancer and died from unrelated issues at 86.

As with so many other men, I had the first biopsy after a PSA test suggested a possible problem. In my case the PSA had risen slowly over a decade from 1.4 to 3.7, but being 67 at the time and research changing some of the previous thinking about PSA levels in older men, the initial urological surgeon and I decided a biopsy was a reasonable option.  

My fears after getting the news from the fourth biopsy were:

  1. How do I decide whether to stop active surveillance and treat the cancer?
  2. If I decide on treatment, which treatment and with whom?  

dr. KaufmanNavigating My Treatment Options
The urologist who had been following me urged surgery (he performs robotic prostatectomy) and I provisionally scheduled the operation for six weeks hence. I needed time for the biopsy site to heal, digest the diagnosis, and collect and process more information.   

As a dentist turned health reporter, my almost 40 years as a health journalist turned out to be a mixed blessing as I tried to intelligently navigate the daunting amount of often contradictory and confusing information, even for a health professional. I discovered one of my greatest strengths as a reporter—the ability to thoroughly and unemotionally research virtually any health topic—failed me dismally because this time I was too emotionally involved. I would read the same sentence or paragraph over and over or talk at great length to trusted sources and come away even more confused. Yes, get the cancer out. No, you can safely keeping watching. Surgery? Robotic or open? Radiation? But what type? Or perhaps one of the less tested treatment options? You can imagine the toll this emotional roller coaster took on my family: Arline my wife of 41 years and my two sons.

Finding My Advocate: A Six Week Journey
As the six weeks dwindled to two, I still felt uncertain—and frightened—about my decisions and options. While agonizing on the phone one night with my older son he said, “Stop it, Dad!  More than most, you are in a position to find one voice you can trust who can guide you to a decision that you and mom can live with. Find that voice."

I did: Dr. Charles Brendler, Co-Director of Northshore's John and Carol Walter Center for Urological Health.  I was referred to Dr. Brendler by a close personal friend of mine, who is also a physician and serves as a department head at a major Chicago medical center. He told me Dr. Brendler was the person he would see if he were in my position. Now I understand why.

During the nearly two hours Dr. Brendler spent with Arline and me, he painstakingly reviewed my medical records, gently and carefully examined me, and, for most of the two hours, engaged with us in heartfelt conversation. He reassured both of us, spoke caringly about our feelings on the personal and intimate issues unleashed by prostate cancer and its treatment, and offered compassionate understanding and objective advice.

Three decisions emerged from our meeting. Two involved additional confirmation of the status of my prostate cancer, one via MRI (Dr. Brendler supported my desire to have the scan) and the other through a second opinion of the interpretation of my four biopsies.  The third and most important was the deciding to accept Dr. Brendler’s recommendation to see a urologic surgeon, who, because of his unparalleled skill in performing open prostatectomies, would be the best fit for me. 

When Arline and I exited Dr Brendler's office and walked through the parking lot, we looked at each other and breathed the first sigh of relief in more than a month because we knew we had found peace with my prostate cancer journey. We followed through on each of the decisions and three weeks after our fateful meeting my prostate was removed by the surgeon Dr. Brendler recommended. The cancer was locally contained and completely removed.

Thanks to active surveillance, I had four years without treatment. And thanks in large part to Dr. Brendler, I remain totally continent and am on the road back to sexual function seven months post-surgery. I’m grateful beyond words that when my son urged me to find the one voice I could trust, the voice I heard was Charles Brendler's.  

 

× Alternate Text