Access to Care in Western Kansas: Following the Funds in Kansas

“To find the barriers that keep women from getting screened and benefiting from early detection, you have to get out there.” said Nicole Spray, APRN with the HaysMed Breast Care Center (BCC), a three time grant recipient of Susan G. Komen Kansas.

This year the grant is providing for a Breast Health Nurse Navigator to enhance cancer care in Western Kansas. The new Nurse Navigator has been added to guide patients through each step of the health care system from breast biopsy, diagnosis, treatment to survivorship. She will also identify barriers to care such as transportation or financial issues, language barriers and help link patients to resources that will help overcome these barriers. Additionally, the Nurse Navigator will help identify patients who are at high risk for breast cancer and link them with resources to help them manage their increased risk. Lastly, she will help raise awareness of the needs of cancer survivors.  There are over 820 breast cancer survivors living in the region in need of quality survivorship care.

“When you have a patient sitting in front of you,” said Spray.  “You have to be ready to listen.”

She recalled a woman who was confined to a wheelchair, making it difficult to come in to the center for screening from five counties away.  They were able to schedule a mammogram through a mobile screening unit, finding a way for the patient to receive care.

Over the last two years, the Breast Care Center has also used Komen Kansas grant funds to host breast awareness events in Norton, Sharon Springs, Oakley and Hays. This year BCC was able to provide additional educational programs in Scott City and Osborne as well as a breast cancer survivors retreat in Hays.

“A focus group of survivors helped plan the retreat topics,” Spray said.  “This led to a successful event.”

In discussing the educational outreach funded by Komen Kansas, Spray added that you never know the impact of a simple act.  She remembered an instance when a woman received an invitation to the educational outreach event.  She was unable to attend, but the card reminded her she needed to schedule a mammogram.  She was diagnosed, all because of a card in the mail.

When we talked to Nicole Spray, she was excited about the Breast Care Center move to a new area at HaysMed, 2200 Canterbury, located just inside Entrance C, the Main Entrance.  Patients will now be able to complete routine breast exams and imaging tests at the same location.  In addition the BCC also provides risk analysis for women who have not been diagnosed with cancer along with genetic counseling and testing.  Survivors will be able to access more in-depth health monitoring and counseling for lifestyle changes such as diet and exercise.  Any side effects resulting from cancer treatment can also be monitored.

“Women are anxious when they come into the Breast Care Center,” stated Spray.  “Now we have a space that is convenient, calming and soothing.”

Since the opening of the Breast Care Center in May, 2011, 140 women have been diagnosed with breast cancer; an equal amount of women have been treated for precancerous conditions of the breast. Ninety women have had genetic BRCA counseling and testing.

“We are honored to receive Susan G. Komen grant funds”, said Dr. Anne O’Dea, Medical Director of the Breast Care Center. “We feel passionate about providing quality, comprehensive breast services to the women in Western Kansas and are fortunate to have these additional resources to meet the needs for those in our region.”

For more information about the Breast Care Center in Hays

Take Action: Join the Chorus #Komen 365

Advocate, by definition, is a person who argues for or supports a cause or policy.  More specific, it is a person who works for a cause or group; a person who argues for the cause of another person.  As a volunteer with Susan B. Komen, I have met many wonderful “advocates” who work tirelessly to bring awareness to breast cancer, to fund research into the cause and treatment of breast cancer, impact policy in the pursuit of a better quality of life for breast cancer survivors and to bring about life without breast cancer.  A group of wonderful people who argue for and support a cause.

But just as Susan B. Komen started as a promise between sisters, Komen volunteers are often "more specific" and take up the cause of another person.  A mother, a sister, a brother, an aunt, a friend, a co-worker, the list goes on.

This October, there are many ways you can add your voice to the chorus #Komen 365.

§         Encourage a friend to get a mammogram, go with them, have a mammogram party to get the whole group screened

§         Start today planning your participation in next year’s Race, join a committee, become a team captain, get your company involved

§         Check with your Kansas affiliate on how you can join state and federal advocacy to impact policy

§         Look into clinical trials and research studies.  Maybe you will find one to participate in. http://www.cancer.gov/clinicaltrials/search

§         Add your ideas of how you already add your voice or plan to add your voice to the chorus #Komen 365 

To join the chorus #Komen 365

Talk About It Tuesday: Survivorship Today Compared to 30 years ago …

Over the past 30 years, much progress has been made in the fight against breast cancer. More than thirty years ago, when Suzy Komen was told she had breast cancer, people did not say the words breast cancer out loud. It was not talked about in social circles, there was no easy internet access and it certainly wasn’t discussed on mainstream media. Our strides in progress have been significant and we are grateful that talking about breast cancer is no longer taboo.

WAVES OF PROGRESS:

AWARENESS:
First , increased awareness has led to better screening and earlier detection which leads to better prognosis and survival.

RISK FACTORS:
Over the past 30 years, researchers have identified many factors that increase breast cancer risk and a few factors that lower risk. Genetic tests for certain mutations are now used, we know that certain lifestyle choices such as exercising regularly, maintaining a healthy weight, limiting the use of alcohol or menopausal hormones can have an impact on your risk for breast cancer. We know now that breast cancer is not contagious, contrary to the belief just a few short decades ago. Many risk factors are still unknown and many are simply out of our control (the two most common risk factors for breast cancer are being a woman and getting older). Although we have learned a lot, we still do not understand what causes breast cancer to develop at a certain time in a certain person. It’s likely a combination of risk factors, but why a certain combination of factors might cause cancer in one person, but not in another, is still unclear.

TREATMENT:
Other significant advances over the last thirty years have been made that have led to higher survival rates.  Surgical procedures have been developed that are less invasive, use sentinel node biopsy, and improved reconstruction that lead to better quality of life post surgery.  Significant strides in research have led to more options and more effective chemotherapy and hormone therapies.  New targeted therapies have been developed and now even implemented for specific tumor types.  And finally, for metastatic breast cancer, new treatments have not only extended survival, but more importantly dramatically improved quality of life.

SURVIVORSHIP:
There are almost three million breast cancer survivors in the United States today (more than any other group of cancer survivors). Thirty years ago, even when breast cancer was caught early (confined to the breast) the five-year relative survival rate was about 74 percent. Today, the five – year relative survival rate is now 98 percent! And more importantly, the mortality rate has declined 33 percent since 1990 due to early detection and effective treatment.

While Komen continues to work to find a cure for breast cancer, the sheer number of survivors shows the great strides that have been made in early detection and treatment. Today, most breast cancer survivors lead long and fulfilling lives, and Komen is with these survivors at every step of their journey.

Komen Chief Scientific Advisor, Dr. Eric Winer, discusses the scientific progress made in the fight against breast cancer over the past 30 years.

MYTH MONDAY ANSWERS

Did you know that the majority of women diagnosed with breast cancer have no immediate family history? Only about 13% of women diagnosed have an immediate female relative (mother, father, sister, brother or child) with breast cancer. The two most common risk factors for breast cancer are being female and getting older.

 

All women are at risk … Know your Risk!

• Talk to both sides of your family to learn about your family health history
• Talk to your health provider about your personal risk of breast cancer

Inherited genetic mutations:
Only 5%-10% of breast cancer cases in the U.S. are from an inherited genetic mutation, such as BRCA1 or BRCA2. Most breast cancer cases are due to a spontaneous gene mutation, an error in a gene that has occurred in a single cell during your lifetime.
The cause of breast cancer is not known. Although everyone is at risk for breast cancer, having an immediate family member (a parent, sibling or child) with a history of breast cancer increases your own risk of breast cancer by nearly twice the risk compared to a women without a family history.

Click here to learn more about risk factors and prevention

 

Breast cancer can happen to anyone, even if you don’t have an immediate family history. Know you risk and know what it is normal for you. Talk with your provider about your personal risk of breast cancer.
 

Survivorship in Rural Kansas: Following the Funds in Kansas

Weight at diagnosis and weight gain post diagnosis for breast cancer survivors are associated with increased risk of breast cancer recurrence and death.  Rural women have significantly higher obesity rates, and have less access to survivorship care and weight control programs. We discussed this with Susan G. Komen Kansas grantee Christie A. Befort, Preventive Medicine and Public Health, University of Kansas School of Medicine, who is part of a team researching the role of weight control intervention as a key strategy for prevention of breast cancer recurrence in rural populations. The study examines the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations.

 

The 18 month program begins with a six month weight loss phase.  The intervention includes a reduced calorie diet incorporating prepackaged entrees and shakes, physical activity gradually increased to 225 min/week of moderate intensity exercise, and weekly group phone sessions.  This is followed by a one-year maintenance phase with either group phone sessions every other week or a newsletter with the material discussed in the phone sessions.
 

“It is much harder to maintain weight loss,” Befort states.  “The program gives continued support that allows participants to ask questions not only about nutrition and exercise, but talk about other survivorship issues. We're going to help them with sustaining a lifestyle change," Befort adds. "We've all been impressed by the women. It makes the work fun and exciting and worthwhile." ”

The intervention has produced >10% weight loss as well as significant improvements for quality of life including mood, body image, and sexuality. But the research project has produced a lot more than data: participants not only lost weight but also camaraderie has flourished among the women who became acquainted during conference-call sessions. Where do we go from here?  The last research group has enrolled in the Hays/Salina area with about 30 women through 2015.

“The idea is to produce a program that not only works, but is cost effective for sustainability.” adds Befort.  “We are currently research funded, but hope to see policy change that will move preventative programs like this to be paid by health insurance.”

For more information

 

Take Action: Rehab and Strength Training for Survivors

If you were to have knee surgery, physical therapy is always thought to be part of the standard rehabilitation process. But after breast cancer surgery, physical therapy is not always routinely suggested. This is unfortunate, since following breast cancer surgery and treatment, you may experience: pain, swelling, loss of movement and strength of the involved arm, scarring, fatigue, neuropathy, and difficulty with daily activities.  

According to Susan Palmer, PT with Palmer Physical Therapy for Women current research shows that early post-surgical physical therapy can be beneficial in addressing these issues. 
 

Scar tissue, which is the body's way of healing from surgery, can result in very dense tissue under your incision, which is painful and which can restrict your arm's range of motion.  This can put you more at risk for a painful condition known as frozen shoulder. While a physical therapist may not be able to restore one hundred percent of your pre-surgery level of shoulder function, early treatment increase the odds that you'll regain range of motion and strength.

Numbness and/or nerve sensitivity is often experienced at your surgical site. Manual therapy can help restore sensation and relieve nerve pain caused by scar tissue impinging on nerves. Physical therapy can be very effective at releasing scar tissue and thus reducing nerve-related pain.

Cording is a moderate to severe painful tightening that extends down your arm.  This may develop if you've had either a sentinel node biopsy or an axillary node dissection.  Your armpit area can also be painful due to scar tissue. Over time, this condition may resolve on its own, but with manual therapy and therapeutic stretching, it's likely to resolve much more quickly.

Fibrosis and skin tightness can result from radiation after mastectomy surgery that may cause posture and range of motion problems. Manual therapy can reduce these issues and, if initiated early, may prevent them from ever becoming a problem.

 

Risk of lymphedema can be reduced by appropriately progressed strength training.

Palmer adds that chronic pain and postural problems can appear years later if rehabilitation is not complete following breast surgery and treatment. 

 

It is reasonable for survivors to expect to be 98% or better of their prior level.  Therapy can help you get back to that prior level of function and living a healthier, more active lifestyle.

 

Palmer is a member of the Women’s Health, Oncology, and Orthopedic Sections of the American Physical Therapy Association.

 

Talk About It Tuesday: Living Healthy!

Many factors are linked to breast cancer risk. Some risk factors, like being a woman and getting older, are not things you can change. But other factors, like choosing to lead a healthy lifestyle may help lower your chances of getting breast cancer.  First make sure to know factors that may add to your risk.  And make healthy lifestyle choices! 

Start by maintaining a healthy weight and eating right. 

• Eat at least 2 ½ cups of fruits and vegetables every day.
• Choose 100 percent whole grain foods (like 100 percent whole grain breads and cereals, brown rice, popcorn and quinoa) more often.
• Limit red meat and processed meat (choose chicken, fish or beans instead).
• Cut down on "bad" fats (saturated and trans fats), and eat more "good" fats (polyunsaturated and monounsaturated fats, like olive and canola oil).
• Get enough vitamin D and calcium every day. For women and men ages 51 to 70, this means 600 IU of vitamin D and 1,200 mg of calcium. For men ages 51 to 70, this means 600 IU of vitamin D and 1,000 mg of calcium.

Let’s get moving and be physically active. How can physical activity affect breast cancer risk? Exercise can help with weight control. For postmenopausal women, being lean lowers the risk of breast cancer. And, physical activity may lower estrogen levels in women, which can also protect against breast cancer. Physical activity may also boost the body’s immune system so that it can help kill or slow the growth of cancer cells.
 

Finally, limit alcohol intake.  If you drink alcohol, limit to drink less than one drink of alcohol a day (for women and fewer than two drinks a day for men). Those who drink alcohol should try to get enough folic acid, either through a multivitamin or foods like oranges, orange juice, leafy green vegetables and fortified breakfast cereals.
 

These are choices you can make to lower your risk.

Facts for Life:  Healthy Living