Archives for Danielle

Ask the Expert – What is the role of the medical dosimetrist in radiation treatment?

What is a medical dosimetrist?

A medical dosimetrist is a critical member of the radiation oncology team. The dosimetrist’s role is to create a custom treatment plan for each patient to ensure the correct dosage of radiation reaches the tumor while protecting healthy tissue. Patients don’t see us on a daily basis but we are involved in every patient’s treatment.

How do you develop a treatment plan?

We start by performing a CT scan with the patient positioned exactly as they would be for treatment. The scan helps me visualize where the disease is located. Then I use multiple techniques to ‘sculpt’ delivery of radiation to the targeted area and away from critical organs or tissue.

What happens after you create the plan?

It’s reviewed and approved by one of our board-certified radiation oncologists. Our medical physicist double-checks the plan to ensure the linear accelerator will deliver the exact dose prescribed. We perform multiple checks throughout the process to ensure we deliver the safest treatment to every patient. Radiation therapists administer treatment to the patient on a daily basis.

How do you protect healthy tissue from the radiation?

We use multiple techniques, from controlling the angle and intensity of the radiation beam to positioning the patient for treatment. For example, with breast cancer on the left side, it’s important to protect the heart to guard against radiation-related cardiac issues later in life. We have the patient hold a deep breath while the treatment is delivered. It actually pulls the heart away from the treatment area.

What do you like best about working at St. Luke’s Radiation Center?

We have a great team here. We work closely together to achieve the best outcome for our patients. Our goal is to kill the disease but limit side effects the patient may experience.

For more information about St. Luke’s Radiation Center, click here or call (319) 861-6944.

Quality Report: Thyroid Cancer

The incidence of thyroid cancer in the U.S. has been increasing at a rate of five percent per year, making it the nation’s fastest-growing cancer. Ryan Dempewolf,  MD, of Physician’s Clinic of Iowa Ear, Nose & Throat (ENT) says this increase is largely due to more sensitive imaging techniques. “Scans being done for other reasons, such as an ultrasound of the carotid artery, are picking up thyroid nodules at a very early stage,” explains Dr. Dempewolf. He adds, “We have a robust group of primary care physicians and specialists in Cedar Rapids who do an excellent job of following up on these findings.”

Nassif Community Cancer Center Director Kimberly Ivester says specialties including otolaryngology (ENT), radiation oncology and endocrinology collaborate to provide the highest standard of care for thyroid cancer patients. “Our work group of providers from multiple disciplines spent a full year developing protocols
for diagnosis and treatment of thyroid cancer. They established best practices for care coordination, standardized work-up and treatment protocols, and identified key services to provide psychosocial support and enhance quality of life.”

Ivester adds, “Nassif Community Cancer Center care coordinators ensure excellent communication and coordination between providers so patients are supported as they move through diagnosis and treatment. In addition to the providers and care coordinators, dietitians and social workers play an integral role with each patient.”

UnityPoint Health St. Luke’s Hospital provides the full spectrum of thyroid cancer treatment from diagnosis to surgery and radiation therapy including I-131 radioactive iodine. “Through the St. Luke’s Nassif Radiation Center, we provide I-131 radioactive iodine treatment so our patients don’t have to go outside the system for care,” observes Ivester. Genetic testing is also available. And follow-up care including thyroid hormone replacement is managed by Prasuna Rao (Madhavaram), MD, endocrinologist with UnityPoint Clinic Diabetes & Kidney Center.

Nine out of 10 thyroid cancers diagnosed at St. Luke’s in 2014 were stage I or II. Dr. Dempewolf notes early detection allows for more complete initial treatment and a lower risk of recurrence.

He adds, “Because the incidence of thyroid cancer is relatively high, there’s a lot of data available to us. We’ve learned you don’t always have to remove the entire thyroid. Smaller cancers found early give us the option of treating people less invasively and without the need for radioactive iodine, while still getting the same tremendous outcomes.”

Thyroid Cancer Facts

56,870 – Estimated new cases of thyroid cancer in U.S. in 2017.

98% – Five-year survival rate.

3 out of 4  – 75% of patients are women.

91% – Most thyroid cancers diagnosed at St. Luke’s were found in the earliest stages. *

*2014 data from the National Cancer Data Base

In Good Hands – Team approach helps “non-stop runner” slow down to battle thyroid cancer

Regina Buhs began her cancer journey with a visit to her endocrinologist, Dr. Prasuna Rao (Madhavaram) with UnityPoint Clinic Diabetes & Kidney Center.
“I went in for a diabetic check-up and Dr. Rao noticed my thyroid was enlarged,” recalls Buhs. Dr. Rao ordered a follow-up exam, then an ultrasound, which detected a thyroid nodule. In March 2017, a biopsy confirmed Buhs had papillary carcinoma—the most common form of thyroid cancer.

“At the time, we had seven kids living at home,” says Buhs, whose family has included biological, adopted and foster children. “Usually my life feels like it’s non-stop running.”

Instead, Buhs had to make time for her own health. Fortunately, she was in good hands. “I went to Dr. Rao for my diabetes, but I learned as an endocrinologist, thyroids are her specialty. And after the biopsy, she sent me to Dr. Carpenter.”

Dr. Kevin Carpenter, Physicians’ Clinic of Iowa Ear, Nose & Throat (ENT), is also an expert at treating thyroid cancer. After a CT scan showed the cancer was likely in Buhs’s lymph nodes, Dr. Carpenter performed a complete removal of her thyroid and six lymph nodes. “Dr. Carpenter was great,” says Buhs. “He told me he’s done hundreds of surgeries.”

Also helping Buhs on her cancer journey was her Nassif Community Cancer Center care coordinator, Andrea Watkinson. The care coordinator is a patient’s point of contact from diagnosis through treatment and into survivorship. Watkinson communicates with team members, patients and loved ones, connects patients with providers and services and offers education and emotional support. Buhs explains, “I talked to Andrea before and after surgery. She told me what was going on, answered my questions and even scheduled appointments for me.”

Thyroid cancer strikes men and women, but is more common in women. Because the disease does not produce symptoms early on, most cases are found, as Buhs’ was, during a routine exam, or during an imaging study performed for an unrelated reason. For most thyroid cancer patients, the outlook is excellent.

“I told my kids this is the easiest cancer to take care of,” recalls Buhs.

Because her disease was in the lymph nodes, the next step was treatment with I-131 radioactive iodine. “Based on our thyroid cancer protocols, I determine whether radiation treatment is needed,” explains Dr. Rao. “In Regina’s case, I contacted  Dr. Bobby Koneru at St. Luke’s Nassif Radiation Center for I-131 treatment.”

Unlike external beam radiation therapy, I-131 is administered in pill form on an outpatient basis. Prior to the treatment, patients also go on a low-iodine diet to maximize effectiveness. A follow-up full-body scan after Buhs’ treatment revealed no active cancer cells.

Buhs will repeat the scan in one year. Meanwhile, she takes replacement thyroid hormone under Dr. Bobby Koneru Dr. Rao’s care. “After my thyroid was removed, I had no energy at all,” says Buhs. “Now for the most part I feel OK. ”

She adds, “My doctors all worked well together.” Dr. Rao agrees, saying, “The ENT specialists, Dr. Koneru and I work as a team. We developed these protocols as the best way to take care of thyroid cancer patients in our community and each have a role to play. The care coordinator is also essential in educating patients and connecting them to the right team providers at the right time. She also connects patients to the extensive services the Nassif Community Cancer Center offers to meet the unique needs of each patient.”

For more information on thyroid cancer treatment or support services available to all cancer survivors, call the Nassif Community Cancer Center at (319) 558-4876.

Partners in the Fight Against Cancer – Collaboration with Mayo Clinic is a seamless process for Cedar Rapids man

Bryan Gates doesn’t sound like a guy with cancer. This self-described “Bryan with a Y” is easy-going and quick with a joke even when talking about the challenges he’s facing.

Gates, 61, was diagnosed with esophageal cancer in January 2017. This cancer begins in the cells that line the esophagus (the tube that runs from your stomach to your throat) and strikes men more often than women. What causes it is not clear. Says Gates with a laugh, “Maybe it was all that Mountain Dew I drank as a kid!”

He underwent six rounds of chemotherapy, then surgery, with more chemo to follow. Gates adds, “The cancer was causing internal bleeding and I was slowly fading away. I had six blood transfusions before the chemo shrunk the tumor.”

Gates had his first round of chemo as well as his surgery at Mayo Clinic. His sister-in-law is a professor at Mayo, which makes it convenient for him to receive care there. But after his first chemo session, Gates said, “I told them I’d like to get the rest of my treatment at PCI.”

Dr. Bharat Jenigiri of Physicians’ Clinic of Iowa (PCI) Hematology & Oncology is Gates’ physician. Dr. Jenigiri says his practice often collaborates with Mayo Clinic.

“They send a lot of their patients from Iowa to us. And we use e-consults with Mayo when we want a second opinion on a patient’s care here.” These electronic consultations are made possible by UnityPoint Health Cedar Rapids, a member of the Mayo Clinic Care Network.

“It’s a seamless process,” explains Dr. Jenigiri. “The physicians at Mayo have access to UnityPoint Health – St. Luke’s Hospital’s imaging system so they look at the same images I see. We consult with them for complicated cases. We also reach out to them when we are trying to decide between multiple treatment options.”

Gates came through his pre-surgical chemotherapy with minimal side effects. But he learned many chemo patients are bothered by increased sensitivity to cold, especially in their hands. “My wife Julie and I had been thinking about how we could give back to others,” says Gates. “A light bulb went off and we realized we could make hand-warmers. Julie’s sewed about 300 so far. We give them to chemo patients and also to rheumatology patients with arthritis.”

Gates hopes his story will reassure cancer patients who “hear chemo and instantly think they will have a huge problem with side effects. That’s not always the case any more.” Dr. Jenigiri agrees, “There are newer drugs that provide targeted treatment with no side effects. We also have drugs that are really effective at controlling reactions like nausea. We try to find options for each patient that provide the most benefit with the least side effects.”

“Dr. Jenigiri and his staff bend over backwards for you,” says Gates. “You can tell they’re concerned about their patients. I have been subjected to the most effective kindnesses here and deeply appreciate it.”

The partnership with Mayo Clinic provides world-class care, right here at home. Find out more.

Want to show your appreciation for the special caregivers who made your family’s cancer journey easier? The Guardian Angel program is a meaningful way to say “thank you,” while helping to fund programs and services for cancer patients and their loved ones. Call (319) 369-8100 for information on how you can give or click here.

Part of Her Family – Cook Cancer Wellness Program “serves up” compassionate help

Nassif Community Cancer Center was in its infancy when Pam Towe was diagnosed with breast cancer in January 2009. “The wellness program was getting started at just the right time for me,” Towe recalls. That summer, she was asked to take part in a new offering—working out at the cancer center with a personal trainer.

An active tennis player and former head tennis coach at Jefferson High School, Towe jumped at the opportunity. “I’ve never been the type who goes to a gym, but I like to exercise and this was a way to keep my body moving. I said absolutely yes, I’ll do it!”

Towe started working out twice a week with Cancer Exercise Specialist Matt Schmitz…and that was just the beginning. Over the years as the wellness program grew, Towe has tried almost everything it offers. She even serves on a patient advisory board at the center.

“The cancer center offers so many things all year to help cancer survivors and their families and keep us involved,” says Towe. “Exercise has been the top thing for me but I also love the massages. I’ve done meditation, tried reiki and yoga, and I’m hoping to take an art class soon.”

The nutrition program is another favorite. “I don’t always eat healthy enough, so I appreciate the dietitians,” explains Towe. “They’ve gotten to know me and send me healthy recipes they think I’ll enjoy.”

That level of support and understanding—what Towe calls “compassionate help”—is important to her. “Nassif Community Cancer Center has been a godsend for me. There’s always someone you can talk to and you know they’re in your corner.”

Nassif Community Cancer Center helps patients move beyond cancer with wellness for life, whether they are newly diagnosed or well into survivorship like Towe. Through generous support from the family of Jane Borg Cook and other donors, most wellness services are free for cancer patients and their loved ones. Towe says, “It’s a fantastic program. You don’t just surround yourself with people who have had cancer. You can bring anyone, from your spouse to a friend, parent, child or grandchild.”

Towe loves taking her grandkids to the annual Children’s Holiday Celebration, adding, “Everyone is there, from patients going through chemotherapy to children and staff members. It’s such a neat thing and the camaraderie is wonderful.”

Towe’s cancer is in remission, but she continues to be an active part of Nassif Community Cancer Center. “I have my actual family, my tennis family and my book club family,” says Towe. “The cancer center has become another family for me.”

For more information on the Cook Cancer Wellness Program at Nassif Community Cancer Center, click here.

A Gift of Thanks – Grateful Patient donors use the power of “Thank You” to save lives

Fighting cancer isn’t easy. But it helps when you have someone to make your journey easier. Lisa Parsons of Cedar Rapids, who’s battling lung cancer, found a whole team at Nassif Radiation Center. Now she’s giving back in their name.

“I went for treatment every day for 30 days, so I got to know everyone,” Parsons recalls. “Once you walk through those doors, they go above and beyond to make you forget why you’re there. Radiation isn’t fun, but day after day they were always so upbeat and friendly.”

Parsons adds, “It takes a special person to do what these people do. They deserve recognition.”

Parsons chose to honor her exceptional caregivers with a Guardian Angel donation. Guardian Angel, part of Nassif Community Cancer Center’s Grateful Patient program, lets patients and loved ones pay tribute to the special people who helped them along their cancer journey. Their donations, in turn, help fund programs and services that support all cancer patients and their families.

“Hearing the words ‘thank you’ from a patient or family means so much to our team members,” explains Danielle Rauser, development manager for cancer services with St. Luke’s Foundation. She says donations can be made in appreciation of any physician, team member or volunteer for the care they provide to cancer patients and their loved ones. A recognition ceremony is held for every Guardian Angel gift.

Mark Ogden and Iris Muchmore wanted to do something special to recognize Mark’s care team.

Both Mark and Iris have taken advantage of wellness services at Nassif Community Cancer Center and appreciate the support and friendship they’ve found there. “The center is an important resource for cancer patients like me,” says Mark Ogden. “The services they offer, like exercise, yoga and massage, have played a big role in helping us deal with my cancer treatment. Iris and I wanted to thank the team members who have done so much for us.”

A Guardian Angel donation is just one of the meaningful ways patients and loved ones can show their gratitude. Rauser says, “Through our Grateful Patient program you can help someone move beyond cancer to wellness for life when you sponsor a creative art or wellness class. Or you can dedicate a photograph from The Healing Power of Art project in the name of a loved one, or to honor members of your care team.”

“I was truly blessed to have the Radiation Center team on my team—Team Lisa,” says Parsons. “My gift let me say thank you for being my Guardian Angels.”

If you would like to change lives with your gift of thanks, visit here or call Danielle Rauser at (319) 369-8100.

Support When You Need It – Nassif Community Cancer Center helps patient who helps others in return

Christina Ross remembers the day her life changed forever. She was getting ready for major back surgery—a frightening prospect for the 42-year-old single mom of a young son. Then she noticed a lump in one breast. A visit to her doctor revealed a second lump. Ross had back surgery, followed by a mammogram and a biopsy. On October 3, 2015, she received the diagnosis: breast cancer.

“When my back problem occurred, I prayed,” Ross recalls. “I said please don’t let me become paralyzed because I have to take care of my son. Little did I know God was preparing me for cancer.”

Ross says she “received a lot of bad news very fast.” Because the tumors indicated a fast-growing cancer, Rasa Buntinas, MD, of Physicians’ Clinic of Iowa Hematology & Oncology advised starting chemotherapy right away. Admits Ross, “Right then I had to ‘man up.’ I had to prepare myself not just to deal with the cancer, but to tell my son and family. That was going to be hard.”

Psychosocial Services Coordinator Nancy Yeisley met Ross on her first day of chemo. Yeisley says, “Christina hadn’t told her son yet and was very worried. We talked about how to approach the conversation with him and made a plan together. We also agreed she would tell him within the next three days. Christina likes deadlines, so that helped.”

Fortunately, Ross already had a strong support group, starting with her sister Flora “Sandy” Williams. Together Ross and Williams broke the news to Ross’s son Cameron as well as to Williams’ children. “We were prepared for their questions,” explains Ross. “We stressed the cancer was caught early, it hadn’t spread. We knew the kids would take their cue from us. It helped them to see our positive attitude.”

The initial rounds of chemotherapy were followed by surgery on April 25, 2016. “I’m cancer-free as of that date,” Ross beams. Surgery at UnityPoint Health – St. Luke’s Hospital was followed by more chemo as well as radiation therapy at St. Luke’s Nassif Radiation Center.

“The nurses who helped with my chemo treatment were amazing in the love and support they gave me,” adds Ross. “They all deserve a month’s paid vacation wherever they choose! And my radiation team made me feel extra special.”

As Ross moved through treatment and into recovery, she continued to rely on her support network, including Nassif Community Cancer Center. “That cancer center is like an extended family to me!” she exclaims.

Just two months after her diagnosis, Ross and Cameron attended the Children’s Holiday Celebration put on by Nassif Community Cancer Center’s Family Care Program. “We had a great time. Cameron is outgoing—one of the things I love about him—and he had a long conversation with my social worker, Nancy. Later she told me how much Cameron loves me. As a parent, it means so much to hear that.”

Nancy Yeisley notes the holiday season brings special challenges to those facing cancer—whether their own or a loved one’s. She encourages patients and caregivers to reserve their energy for the things that really matter. “When you go through something like cancer, it makes you look at what is important in your life,” says Yeisley. “Cherish the moments you have with the people you love.”

Both the Family Care Program and Nassif Community Cancer Center’s Spirit Fund helped Ross through that first Christmas. Made possible by the generosity of donors and staff, these programs provide needed financial assistance for cancer patients and their families. Ross remembers crying when she saw the gift cards she received. “My son said don’t open the mail any more. Every time you do, you cry,” recalls Ross. “I still cry when I think about it. They really helped me.”

Now Ross is determined to help others. Even while going through treatment, she started volunteering for Gems of Hope—a nonprofit that provides gifts of jewelry on inspirational cards for cancer patients. She also donates to the Spirit Fund to help other patients in need. Christina Ross adds, “Whenever I see patients with this disease, I stop and cheer them on. I say stay strong, you can do it.”

“I know, because I’m doing it.”

Special thanks to the Aiming for a Cure Foundation for helping to establish the Family Care Program. You can keep up with news on cancer care and support services for cancer patients and their families through our free Care Connections newsletter. Subscribe online by clicking here or call (319) 558-4876.

 

Helping You Look Like You – Women fighting cancer get “back to normal” with help from Strands of Strength

A cancer diagnosis changes everything. Even everyday activities like going to work can feel strange. That’s especially true for women who have lost their hair due to cancer treatment.

“I’m a substitute teacher,” says Jody Sloan, 47, who is fighting a recurrence of breast cancer. “I don’t want to explain to kids why I don’t have any hair.” Adds Veronica Wampole, 44, diagnosed with breast cancer in 2016, “I don’t want people to feel sorry for me. I want to look as natural and normal as possible.”

Wampole and Sloan are just two of the many women who have received wigs through Nassif Community Cancer Center partner Strands of Strength. Founded in 2011 by a breast cancer survivor, this nonprofit organization provides wigs free of charge to cancer patients who otherwise could not afford them.

“If a woman is going to have chemotherapy that will lead to hair loss, we talk to her before treatment begins and explain her options,” says Nancy Yeisley, psychosocial services coordinator at Nassif Community Cancer Center. “If she wants a wig but can’t afford it, we give her a voucher from Strands of Strength. She can use the voucher at one of our local participating salons and receive a wig uniquely made for her.”

“Strands of Strength was a huge blessing,” recalls Sloan. “Without the voucher, I probably would have been just a hat and scarf person. But having the wig
has helped so much, especially with my children.” Sloan is the mother of five, ranging from teenage triplets to sons age 7 and 11. Each child has handled Sloan’s illness differently. For some, the thought of Mom losing her hair was especially traumatic. But when Sloan tried her wig for the first time, her daughters exclaimed, “Mom, that looks just like you!”

“I explained after the strong medicine is done, my hair would grow back,” says Sloan. “But until then, ‘looking like me’ helped reassure my kids.”

Wampole says her wig gives her peace of mind. “I’ve been wearing it for six months now and it’s become a part of me.” She likes when co-workers compliment her hair, not realizing it’s a wig. “People can’t tell you’re going through chemo just by looking at you.”

Sloan agrees. “Not all eyes are on me. It feels good to know some things in your life can stay the same.”

For more information on Strands of Strength, call Nassif Community Cancer Center at (319) 558-4876.

More Than She Expected – Care coordination helps pregnant woman battle breast cancer

Pregnancy is a hectic time, especially for a 39-year-old working mom who already has three kids she’s shuttling to school and sports. For Sonya Moses, the one thing she didn’t plan on was being diagnosed with breast cancer at the same time.

“I was 20 weeks pregnant when I learned I had cancer,” recalls Moses. “It was overwhelming. I didn’t know what to do next.”

Fortunately, Care Coordinator Mona Cook was at her side from the start. “Mona took a lot of the stress off,” says Moses. “She walked me through everything, encouraged me to call with questions at any time, even coordinated my surgery and doctor appointments so all I had to do was show up.”

From the time of her diagnosis, Moses was under the care of three physicians—Obstetrician Scott Bemus, Oncologist Rasa Buntinas and Surgeon Kerri Nowell. And because UnityPoint Health – Cedar Rapids is a member of the Mayo Clinic Care Network, the provider team regularly consulted with Mayo experts as well. It was a process Moses said ran smoothly and made life easier for her.

“As my oncologist, Dr. Buntinas was the driver. She communicated with my OB and surgeon back and forth behind the scenes,” explains Moses. “It was so reassuring. I didn’t have to repeat information each time I went to a different doctor. When I saw Dr. Bemus, I could tell he had already reviewed all the notes.”

Moses was surprised when clinic physicians recommended she start chemotherapy immediately. “I never thought they could give chemo during pregnancy. They had to time everything carefully so I finished my fourth treatment three weeks before my planned c-section. All along the way, they told me the placenta would block the chemo from my baby. She came out healthy. In fact, she has more hair than I do now!”

Moses adds, “Losing your hair is the biggest shocker besides finding out you have cancer. I didn’t realize how much wigs cost, but Mona told me about Strands of Strength. I was able to get a wig for free. It looks natural, so when I go out in public, people don’t know.” Moses is also grateful to her “awesome friends and co-workers” who chipped in and surprised her with a second wig.

Battling cancer and dealing with the combined side effects of chemo and pregnancy was challenging, but knowing what was waiting for her helped Moses “march to the end.” Daughter Akenna arrived safely on May 8, 2017. And although Moses has more chemotherapy and surgery ahead, she’s thankful for the support she has received.

“My great doctors, friends, family and co-workers—they all worked together to help me get this far.”

For more information on Nassif Community Cancer Center’s collaborative approach to patient care, click here.

Quinoa, Carrots and Leek Patties

For 6 Persons

  • 4 cup  quinoa
  • 3 leeks
  • 2 carrots
  • 2 tablespoons olive oil
  • 3 eggs
  • 3 sprigs parsley
  • Salt, pepper

 

  1. Rinse quinoa under cold running water. Cook in a pot of boiling salted water for 15 minutes. Drain and set aside.
  2. Wash and finely chop the leeks. Peel and grate carrots. Wash, pat dry, and chop the parsley thinly.
  3. In a skillet, heat 1 tablespoon of oil. Stir fry the leeks and carrots for 15 minutes. Season with salt and pepper.
  4. Combine quinoa, carrots, leeks, eggs and parsley. Form small patties.
  5. Heat the remaining oil in a nonstick pan and cook the patties for 3 minutes on each side.
  6. Drain on paper towels and transfer onto a serving dish.
  7. Serve hot, warm or cold with a green salad.

 

From Eating Well

 

Nutrition Facts: Approx 1/6th of recipe (using ½ tsp salt in recipe) 518 cal, 22 gm protein, 82 gm carb, 12 gm Fat, 10 gm Fiber, and 223 mg sodium.

 

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