Archive for the ‘death and dying’ Tag

Breast Cancer here, in Iowa City

Breast Cancer – How you can become aware here at University of Iowa.

Chelsea Stanley creating awareness on campus

Your body is built to protect you and fix yourself. It’s your personal bouncer and it’s like your mother in the sense it takes care of you. But what happens when a foreign mutation comes in the body?

How cancer happens

Keri Mercer, a Cancer Information Specialist at University of Iowa Hospitals and Clinics, explains that your body has a kill switch. When cells divide, sometimes the mutations divides and that shut off the kill switch.

“The cell has orders to die if it can’t fix itself,” Kerr Mercer explains, “With cancer, if the mutation happens and the kill switch is off, it will grow and divide. And that is how a tumor begins. [It is] more common when we are older because our cells have been dividing more often.”

This is why cancer is more rare in younger women, because younger women’s’ cells haven’t been dividing as long. When breast cancer does happen to women under 30 or so, it’s usually because of genetics.

“Genetic links are not as common as we think. The reality sees that only 5-10% of cancers are genetically linked,” Mercer said. “Usually where that comes from is often time we don’t understand that there are so many types of cancer.”

Testing and  awareness

Breast cancer as well has different types, even if you take two women who both have breast cancer and are in the same stage; they may have a different type of cancer than each other.

Here in Iowa City, the University of Iowa Hospital and Clinics reaches out to the community to try to help them understand cancer and how to catch symptoms. Sometimes some organizations contact them and ask them to come and speak about a certain cancer.

Because there are so many different types of cancer, the UIHC tries to focus on the cancer involved in the cancer awareness month. For example, breast cancer is the main focus for the month of October, as it is everywhere else.

“There has been a lot of awareness done with primary care doctors,” Mercer said. “Most of the are educated to make sure their patients are getting screened.”

Recently, the protocol for women getting mammograms has changed. It used to be women were advised to get them once they turned 40 years old, now it is 50 years old.

“Some [doctors] saw some data that there are false positives. To reduce risk they changed the age range to 50 and up,” Mercer said. “There are still arguments against it. We typically tell patients to start talking to docs to see when to start mammograms.”

Mercer said they are waiting to do testing later because breast tissue is different. When younger the tissue is denser, which makes it harder to see cancer cells.

Genetic Testing

For younger women there is no screening. Mercer says that if you are in a high risk family and have women in the family who diagnosed younger than 40 – they look at your history and recommend the patient who had/has the cancer, get testing done to see if he/she has a mutation (because of insurance). Doctors tend to tell the patients to have the person with the cancer to be tested for the gene and if its positive then see if the person with the mutation has it and if has it there are some things to think about doing from there.

Chelsea Stanley, a junior here at UI, has a long history of breast cancer being common in her family.

“No, I’m not going to get tested for the gene because it’s expensive,” Stanley said. “And having the gene doesn’t mean you’re going to get breast cancer…and not having the gene doesn’t mean you’re not going to get it either. However, getting mammograms, yes, that I’ll do. And feel my boobies of course.”

Mercer says that the awareness not only comes from families, and family history or knowing someone with breast cancer, but it also comes from primary care doctors. Ask you primary care doctors about symptoms, have them check something if you think it is suspicious and they can also refer you to more information or a doctor who may be a specialist in cancer.

What you can do

Here at University of Iowa, student may make an appointment with Student Health Services to speak with a doctor or to get something checked out. They also may have some extra information. University of Iowa Hospital and Clinics also have a lot of resources available to students.

In Johnson County, there have been 342 cases of breast cancer from 2003-2007 according to the Iowa Cancer Registry, 42 of which have died from it.

Breast Cancer: save yourself & grope yourself.

Students can show their suport and reminders by displaying ribbons, stickers, pins, shirts, etc.

Breast cancer, aside from non-melanoma skin cancer, is the most common cancer among women according to the Center for Disease Control and Prevention. Breast cancer is something women tend to worry about and go to their doctors to get checked regularly when they are older. Although breast cancer in younger women is rare, it should still be a concern and women of all ages should become familiar with their body.

Feel the boobies

Leigh Hurst, the founder of Feel Your Boobies Foundation, found a lump in her breast that the doctors didn’t detect. Two years later she was diagnosed with breast cancer under the age of 40.

“Getting in touch with your breasts is the best way to be proactive.  Even though it’s unlikely that you’ll get breast cancer in your 20’s, it does happen, and your risk only increases with age,” Hurst said. “So getting to know how your breasts feel is important so that you are aware if a breast lump or other change occurs and can bring it immediately to a doctor’s attention.”

When Leigh was diagnosed, she realized that developing breast cancer is a risk for anyone – before she was diagnosed she was a devoted runner and a triathlete and had no family history of breast cancer.

Leigh, being a health conscious person, had not thought much about breast cancer and came to the conclusion that the message wasn’t out there enough for young women. So she created the Feel Your Boobies Foundation.

“’Feel Your Boobies’ may seem simply like a fun and provocative slogan, but it’s really our way of asking ‘Are You Doing It?’®,” Leigh said. “Well, are you?”

Many people laugh when they see the “Feel Your Boobies” stickers around or shirts that say “Boobies (feel yours).”

“Our goal is to remind young women to get in touch with their bodies,” Leigh said.  “We believe that our proactive reminder, ‘feel your boobies’, gets through to young women in a way that traditional messages do not.”

Feel Your Boobies is making lots of headway with over two million followers on Facebook and they are also one of the Top 30 largest Causes.

“Getting to know how your breasts feel is important so that you are aware if a breast lump or other change occurs and can bring it immediately to a doctor’s attention,” Leigh said. “Early detection is so important in ensuring survival of breast cancer, since the disease itself cannot be prevented.”

Breast cancer is close to the heart

Chelsea Stanely, a junior at University of Iowa is all too familiar with breast cancer.

“I am worried about getting breast cancer because it runs in my family,” Chelsea said. “4 out of 5 of my mom/her sisters have had it. My mom and one aunt have had it twice. My mom and my aunt that have had it twice, both had double mastectomies to try to prevent it from coming back a third time.”

Chelsea usually does self-exams in the shower once a week, which is a typical spot for women to check, and times it with her menstrual cycle. Also, OBGYNs usually check for you on the annual check-up.

It scares Chelsea that younger women are getting diagnosed because it runs in her family.

“To be proactive, I do the self exams usually every month, to detect any changes or abnormalities, have to doctor do an exam, and get checked out if something doesn’t seem normal,” Chelsea said.

Chelsea helps pass out the Feel Your Boobies stickers around and it helps remind her.

“Telling other people and making other aware is also a good way for me to remember; how can I forget if I’m reminding others?”

Kristyn Loeb, another junior, doesn’t have breast cancer lurking in the corners of her family’s past.

“I’m not really concerned with breast cancer because I don’t ever really think about it, which I probably should do,” Kirstyn said. “Since no one in my family has ever had it then I don’t really worry about it.”

Just because younger women are getting diagnosed, doesn’t mean everyone should worry. But exams and check ups are still a good idea.

“It doesn’t scare me, I think it’s good that women are being diagnosed [and catching it],” Kirstyn said. I have donated money for breast cancer funds and try to do whatever I can to help.”

Kristyn says she doesn’t really know how to do self-breast exams, and that is probably something that is harming women – the lack of knowledge.

Something that may help women is doing some research on it and putting up fun, friendly reminders to check yourself.

“Putting something in my room to help remind me to regularly do self exams would be helpful,” Kristyn said. “Something I see every time I come out of the shower, for instance. Also, if my friends are concerned about being proactive and checking themselves then we can try to remind each other whenever we can.”

What YOU can do

Monthly breast self breast exams are the best way to catch early signs. No one knows your body better than yourself, and as Leigh found out, the doctors may not catch it.

Talk to your doctor if you don’t know how to do a self-exam and your doctor can tell you what to be checking for during your exam.

Symptoms can be a small pea-sized lump or mass, discharge, marble-like hardened area under the skin, a change of appearance or feel, and/or redness of the skin or nipple area.

This doesn’t just affect women. Men can remind their friends, girlfriends/wives, and relatives to feel their boobies and go get mammograms. The earlier it is caught, the better chance there is to overcoming it.

Also, a small percentage of men can get breast cancer. Men’s most common symptom is Gynecomastia, which is an increase in the amount of breast tissue.

Check out Feel Your Boobies Foundation’s page and all the testimonials of women who did it http://www.feelyourboobies.com/ididit.htm.

So make sure to feel your boobies. Laugh about it, but then seriously do it.

Facing the end with grace

Before she began guiding patients through their final stages of life, Ann Broderick followed a fascinating (and global) path to the University of Iowa Hospitals and Clinics.

By Lauren Sieben

Ann Broderick is a woman who loves her job, despite one aspect that troubles her: the recurring misunderstanding of her work as a palliative and hospice care provider.

Ann Broderick

Ann Broderick at the Java House in downtown Iowa City (Photo: Lauren Sieben)

“My job has never been to pull plugs, and it never will be to pull plugs,” Broderick said.

Broderick is an associate professor at the University of Iowa and the director of palliative care at the University of Iowa Hospitals and Clinics.

The World Health Organization defines palliative care as relief for the pain and symptoms of disease, but it is a treatment that “intends neither to hasten or postpone death.”

“We physicians assume that our role is to prevent death; my point is that our role is to prevent premature death,” Broderick said. “Our role isn’t to prevent this physiologic event from happening in every single person.”

A global upbringing

Broderick’s path to palliative care – and to Iowa – was far from linear. Between the time she was born in New Hampshire and the year she left for college at Princeton University, Broderick spent most of her childhood apart from her East-coast roots.

At age 7 she moved to Ghana during her father’s tenure in the Peace Corps. In Africa she developed an unusually keen understanding of international issues for a child.

When Broderick was 9 years old, the family returned stateside to Appleton, Wisconsin, moving every two years for her father’s job. The constant movement left Broderick feeling “a little bit like I was an army brat.”

During and after college, Broderick spent time teaching English in Bogotá, Colombia. She planned to become a K-12 Spanish teacher, but when she faced a dismal job market in the early 1980s, Broderick enrolled in math and science classes. She hoped to market herself as a bilingual teacher in a more specialized field.

”Lo and behold, I got an A in organic chemistry,” she said. “That was a quick moment where I thought ‘Maybe I can go to medical school.’ ”

Iowa City roots

When it came time to consider medical schools, Iowa was a natural first choice.

Broderick’s parents met in Iowa City – her mother’s hometown – and her grandfather was a former researcher and faculty member at the university medical school before he died in a traffic accident in the 1930s.

“It felt natural to come back to Iowa and pick up that legacy,” Broderick said. “It was a professional career that was at its peak and it was really quite a tragic death.”

Her interest in palliative care developed gradually, due in part to her volunteer work at Iowa City Hospice, and also to her father’s death. He was diagnosed with bone marrow cancer in Broderick’s fourth year as a medical student.

“For my father, dying at the age of 69 was desperately premature,” she said. “He still took great pleasure in reading the newspaper and staying up to date with politics and watching the world unfold, as well as watching his family unfold.”

In his 60s, Broderick’s father had also recently graduated from law school. At that stage in life he was unprepared to face death, and he died without receiving hospice services.

“Did that prompt me to do this? Probably,” Broderick said. “Probably the sense that there was an unmet need for my father.

“[My mother], I think, had a sense of shame about her impatience with him, because his care was so exhausting. In retrospect I wish she could have been there as his loving wife, which she was, and not as the person doing personal cares.”

Hospice: “Not doom and gloom”

Hospice is a support network for patients and their families: nurses, spiritual chaplains and social workers work together to address physical symptoms of disease along with spiritual and psychological effects of grief.

Though her father wasn’t able to receive hospice care, Broderick has been able to guide numerous other families through the process.

In 2001, she became the director of the Palliative Care Program at the University of Iowa Hospitals and Clinics.

Along with teaching medical students and residents, Broderick also co-teaches an undergraduate course in the rhetoric department with lecturer Patrick Dolan. The course combines a volunteer commitment at Iowa City Hospice with an in-class reading-and-writing component.

Glen Cox has known Broderick since around 2000, when he began driving his parents to their medical appointments. His father died in 2005, and his mother, at 84, continues to face a multitude of ailments.

“Dr. Broderick was spot on as far as what she wanted to see happen to my parents,” Cox said. “She always took into consideration what their wishes were. She didn’t want to prescribe treatments or medications that would put them through an ordeal they didn’t really need to go through.”

And for Broderick, the patient’s wishes are the core of palliative care. Hospice centers are legally barred from recruiting patients – anyone who receives palliative care seeks it voluntarily.

“We shouldn’t mystify death by saying everybody needs to have time in an [Intensive Care Unit] or have a hospitalized component to their death,” Broderick said. “They might elect not to. And some do … When we arrive we’re not doom and gloom; we’re helping people make decisions.”

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Click to listen a sound bite of the interview with Ann Broderick