Gynecological Cancer Awareness

September is gynecological cancer awareness month. In 2017, more than 107,000 new cases of gynecologic cancers were diagnosed in American women. Of those, an estimated 31,600 women lost their fight with a gynecologic cancer.

Every woman is at risk for developing a gynecologic cancer. Risk tends to increase with age, and there is always a heightened possibility of cancer due to family history or race. Lifestyle choices such as chronic smoking and obesity can impact one’s risk for developing a gynecologic cancer; for instance, there is a correlation between higher rates of uterine/endometrial cancers in obese women.

“The biggest takeaway for women is to stay mindful of their bodies, report any symptoms that appear even remotely irregular and make sure they have their screenings conducted on a yearly basis. These actions can ultimately save their life,” said Warner Huh, M.D., senior medical officer of UAB Cancer Service Line and director of the UAB Division of Gynecologic Oncology. Screening can result in early detection, when a cancer is more likely to be treated successfully.

“Most people who get a gynecologic cancer don’t have obvious risk factors,” Huh said. “With these types of cancers, what women can control is being screened regularly and seeking medical advice if something doesn’t seem right with their bodies.”

The infographic below explains the symptoms of the top five most common gynecologic cancers. If you have questions, ask your doctor or visit www.uabmedicine.org/WomensCancers.com.

 

 

"My interruption": One woman's diagnosis with cancer

Marie Sutton

Marie Sutton is a strategic communications professional, author, wife and mother of two. She was diagnosed with HER2 positive breast cancer in January 2018. This post originally appeared on her blog and is reprinted here with her permission.

The Birmingham sky was postcard pretty on the Friday that I found out I have Stage 3 breast cancer. Brilliant brushstrokes of cerulean stretched from East Lake to West End and the sun pierced through the sky. It was like the setting of a dream, but the snap of cold in the air reminded me that it wasn’t.

It was lunchtime, and my team and I were interviewing for an opening in our department. The candidate, a woman, was in her early thirties. She had a messy ponytail, cheap mail-order tortoiseshell glasses and wore an ink blue pants suit that revealed her skinny legs. Five minutes into her talk, I wrote the words: “She’s a no.” She rambled and complained about her former employer and my mind drifted toward lunch.

I discreetly pulled out my phone underneath the table and scrolled through emails while she answered the questions from our prepared list. I saw that I had missed a call from an “801” number and my heart began to beat in my chest.

I clumsily excused myself from the room, walked over to a corner of the hallway and dialed my voicemail. The woman's message began with a sigh, and then, in a heavy African accent, said, “Mrs. Sutton, I have your results. Please call me.”

My knees began to buckle and I looked around for a place to go. I walked out onto the student center patio and tried to steady my fingers while calling back the number.

“Are you somewhere where you can talk?” the doctor said.

“Yes,” I said.

“Do you want me to call you back when you can talk?”

“No,” I said. My stomach was in knots and I felt I as if was going to throw up.

“Well...I am the doctor who did your biopsies. Do you remember me?”

“Yes,” I said, becoming annoyed. It had been less than 48 hours since she was pulling tissue from my right breast and lymph nodes. How could I forget?

“Well, we tested all three of the areas and all three came back cancer.”

Her words felt like a sledgehammer to the side of my head. Vibrations were coming from my skull and her words seeped in, in slow motion.  

With each word she spoke – “metastasized” and “mastectomy” – a part of me slowly deflated. I thought of my 10-year-old daughter who loves art and hangs on my every word and of my 9-year-old baby boy who wants to save all the animals and enjoys kissing my cheeks. I thought of the possibility of dying. I was just two weeks shy of my 44th birthday. 

After I hung up, her words were still sitting in my ear. I tried to get them out with my finger, but they were stuck.

I sat and stared for a moment. I spotted a man in the distance on the fifth floor of a parking deck. He was near the edge of the guardrail. “What is he doing,” I thought to myself. Was he going to jump?

Maybe I should jump.

I called my husband and without taking a breath, blurted out, “They said I have cancer.”

“I’m on my way,” he said and immediately came to my job. I walked toward the parking lot in a daze. I left my purse, my car, my keys, my coat. 

When I got into his gray Infiniti, he grabbed my hand and said, "I'm sorry."

I didn’t speak, couldn’t speak.
He held my hand the entire drive. I stared out the window and tried to find words to say.
When we got home, he and I prayed, ate sandwiches, and watched episodes of “Comedians in Cars Getting Coffee.” We didn't know what else to do, so we laughed and cried and braced ourselves for cancer.

Follow more of Marie’s story through diagnosis and treatment on her blog marieasutton.com. 

The Gift of Giving

For many of us, the holidays can become a busy time. Our inboxes and mailboxes are filled. Our to-do lists are a mile long. Most of us are managing busy work schedules with kids, out of town guests, baking and gift wrapping. It can be overwhelming and it’s easy to forget that the holidays are a time for giving and it doesn’t have to by darting from store to store.

There are all kinds of ways to incorporate small acts of giving into your holiday routine. When you give or donate to others, the effect is often much greater, deeper and more meaningful than you think. Some gifts have a ripple effect. Here are a few patients who, because of generous donations like those made to the Silvia Aaron Memorial Fund at the UAB Comprehensive Cancer Center, were able to continue their treatments.

• A widowed patient who was being evicted from her home;

• A mother with three teenage children who was unable to work but needed help with her utilities;

• A woman who was homeless and needed to secure an apartment;

• A father with two young children who was able to pay his car payment so he could travel to UAB for his weekly treatments;

• An 18-year-old patient who recently graduated high school and had to postpone work and college while undergoing radiation treatment.

Donations like these make such a positive difference in people’s everyday lives. This year, while you are busy with holiday festivities, we encourage you to remember how much of an impact your seemingly small gift can make in someone else’s life.

If you are so moved to give in this way, click here to donate. Thank you for your continued support and generous donations to the UAB Comprehensive Cancer Center. 

Happy Holidays! ⛄🌟🎄

Breast Cancer—Early Detection and Screening

October is breast cancer awareness month but women need to be aware of breast health all year long.

“Despite the magnificent strides in breast cancer research, women still need to adhere to screening guidelines recommended for their age group, especially if they have
a family history of breast cancer,” says Catherine Parker, M.D., a fellowship trained breast cancer surgeon at the University of Alabama at Birmingham.

According to the American Cancer Society, there will be 252,710 new cases of invasive breast cancer among U.S. women in 2017. And finding breast cancer early is one of the most important strategies to prevent death from the disease. When breast cancer is found early, it is small and has not spread, making it easier to treat successfully.

“The good news is that we’re living in a time when women are surviving the disease. In fact, the population of survivors is expected to grow,” says Parker. “However, we still need to be vigilant and take measures to protect ourselves.”

The ACS recommends that women who are at average risk for breast cancer start getting mammograms yearly at age 45 but have the choice to start having annual mammograms at age 40. Women 55 and older should switch to mammograms every 2 years, or continue yearly screening.

“Mammograms do not detect every breast cancer. Women at every age should be familiar with how their breasts normally look and feel, as well as be familiar with signs and symptoms of breast cancer,” says Parker. Although there are differing opinions about the benefits of self-breast exams, it is important for patients to know the proper technique, what to look for, and what is their normal; for example, has one breast always been smaller or has one nipple always turned inward; therefore, self-breast awareness should begin in late teens and early 20’s.

The most common symptom of breast cancer is a new lump or mass in the breast. A painless, hard mass that has uneven edges is more likely to be cancer, but breast cancers can be tender, soft, or rounded. For this reason, it is important to have any new breast mass, lump, or change in breast checked by a health care professional.

Other possible symptoms of breast cancer include:
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling of the skin
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• Nipple discharge (other than breast milk)

For women who have a family history of breast cancer, the UAB Breast Health Center offers comprehensive guidance on risk assessment, genetic testing, screenings, and prevention strategies. Furthermore, the Center takes a multidisciplinary approach to cancer care. When patients are diagnosed with breast cancer they are immediately assigned a team of specially trained breast cancer experts (a medical oncologist, radiologist and surgeon) who are able to give them individualized recommendations regarding their diagnosis, treatment, surgery, and recovery. The clinic is also able to offer first and second opinions for any problems related to the breast.

“The program is also able to offer screening and clinical management for women who have an increased risk of both ovarian cancer and breast cancer,” says Parker.


For more information about early detection and screening, click here.

Signs and Symptoms of Ovarian Cancer

The American Cancer Society estimates that in 2017, 22,440 women will be diagnosed with ovarian cancer and 14,080 women will die from the disease. Ovarian cancer deaths account for more deaths than any other cancer of the female reproductive system. However, the rate of ovarian cancer diagnosis has been slowly decreasing over the last 20 years.

Ovarian cancer begins in the ovaries. Ovaries are reproductive glands that only women have to produce eggs. The ovaries are made up of three different types of cells and all three cell types can develop into a different type of tumor.

It is important for women to know the signs and symptoms of ovarian cancer so that the cancer can be detected early and the patient can begin treatment. Symptoms include:

• Bloating
• Pelvic or abdominal pain
• Trouble eating or feeling full quickly
• Urinary symptoms such as urgency or frequency

“The problem with ovarian cancer is that it is often diagnosed at a late stage,” says Michael Birrer, M.D., Ph.D., director of the UAB Comprehensive Cancer Center. “The symptoms are often associated with more common and less serious conditions, and most women wait to get it checked out.” 

Birrer, a medical oncologist, confirms that when ovarian cancer is detected at an early stage the cancer remains confined to the ovary and is often more easily treated.  “Frequency of the symptoms should help women know when to consider seeking additional help from their doctor.”

If you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks, and they can't be explained by other more common conditions, report them to your health care professional, preferably a gynecologist, right away. Other symptoms can include: fatigue, upset stomach, back pain, constipation, pain during sex, menstrual changes and abdominal swelling with weight loss.

“I always say that it’s best for women to be in tune with their bodies,” says Birrer.

Physicians typically provide a physical exam which includes a pelvic exam to look for an enlarged ovary, they may refer you to a gynecologic oncologist who may conduct additional testing including a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound. 

Many women mistakenly believe a Pap test, a cervical smear test, can detect ovarian cancer.  In some unusual cases it may, but so far there is no reliable screening test for ovarian cancer.  Better ways to screen for ovarian cancer are currently being researched.  

Stress Management after Cancer

Cancer treatments can definitely have a physical impact on the body during and after treatments. But did you know that they can also affect the way someone thinks and feels? For many, it’s normal to experience a range of side effects during treatment that can linger for months and sometimes years after treatments end.  In addition, there are a myriad of emotions associated with a cancer diagnosis – such as stress and anxiety.  For some, these feelings can also cause even more physical and emotional disorders like chronic fatigue and depression.

Many cancer survivors experience stress after cancer diagnosis and following cancer treatment. While there is no research that stress actually causes cancer, we do know that stress causes other health problems. “Sustained stress hormones, over a long period of time, may even damage our body on a cellular and molecular level. And, we are just beginning to explore how the mind and body works in relation to our emotional states,” said Teri Hoenemeyer, Ph.D., the director of Education and Supportive Services at the UAB Comprehensive Cancer Center.

It’s important to have ways to cope with and reduce stress. Many cancer survivors find that spending time participating in activities they enjoy can help them feel calm or relaxed. “Often, patients will say that they feel disconnected from their bodies, their emotions, and even their relationships with others after a cancer diagnosis,” said Hoenemeyer. “Engaging in activities that are comforting and meaningful to patients helps them become more introspective and aware of just how much the stress of their disease and treatment can impact how they feel. Once aware, they can then recognize triggers so they can cope and manage better.” Some of the suggestions Hoenemeyer provides for managing and coping with stress include:

• Exercise is a common way to reduce stress—whether you have had cancer or not. Exercise can be as simple as a walk down your street or walking with a friend or neighbor for 30 minutes. Check with your healthcare provider before exercising, it is important not to overdo yourself and your body.
• Mind-Body Techniques refer to activities such as meditation, breathing techniques, or gentle yoga intended to lower your stress level and calm your mind and body. These can be done at-home and whenever you are experiencing stress.
• Creative Outlets include art, music, or dance and gives people a chance to express themselves. You do not need to have experience with art, music, or dance to participate in these activities and have fun doing them. They can be done at home or by participating in a class offered in your community.

All of these activities are great ways for you and your loved ones to reduce stress after cancer. Rehabilitation of the mind and body is an important part of recovery.

Start reducing your stress today and attend this great art event here at UAB:

Lilly Oncology on Canvas, UAB Arts in Medicine and the UAB Comprehensive Cancer Center are putting on an art event to honor anyone with a cancer experience. The event will be held in the UAB North Pavilion of the UAB Hospital on Thursday, August 17, 2017 from 11:00 a.m. – 1:00 p.m. You do not need to have any art experience or supplies, everyone is welcome to attend!

For more information about this art event, contact Dr. Hoenemeyer at tgw318@uab.edu or (205) 934-5772.

UAB Women in Medicine: Elizabeth Kvale, M.D.

Elizabeth Kvale, MD, grew up in Minnesota. She attended MacMurray College in Jacksonville, Illinois to study biology and philosophy. She attended graduate school in philosophy at the University of Illinois, and then shifted to the Southern Illinois University School of Medicine. She completed a residency in Family and Community Medicine at the University of Missouri, where she served as Chief Resident. After completing a service obligation in primary care in Dixon, Il, Dr. Kvale returned to academia to complete a 2-year research fellowship in palliative medicine at UAB.

Why did you decide to become a doctor?

I might not have had much of a choice! My mom is a nurse and my dad was a doctor. All of my family is either preachers or nurses. 


Why did you choose to establish yourself at UAB?
I did my fellowship here, and at first I had no intention of staying. But it’s a terrific environment for what I was focused on. I made a great choice. I’m inspired by my patients every day. They are so brave, beautiful and graceful. I feel fortunate to be a part of what they’re doing.


So you had a pretty positive experience going through medical school. Did you experience any struggles going through as a woman?
I would be lying if I said it was anything but awesome. We all know how lucky we are. I was never aware of any differences between me and my peers. I’m in a discipline were communication is very important. I think being a woman and having natural empathy is almost an advantage, in my case.

What kind of research are you doing right now?
Health services research. I’m particularly focused on how to deliver cancer care and palliative care to patients. There just aren’t enough palliative care specialists and I’m trying to figure out how to give patients the care they need.


I hear you participated in the first Cycliad last May! Why did you decide to do that?
True story. I decided to ride because I really think our navigators are helping people and that ultimately this fundraising effort has the potential to ensure that more cancer patients receive this support. Every event needs people to commit in the first year, and most often those are going to be people who really believe in the cause. My favorite part was getting to know the other 4 individuals who were willing to jump in and ride 1300 miles for this cause, and meeting people along the way that our program has touched and helped.


What kind of advice do you have for women interested in the medical field?
Stay tuned to your empathy and use it to your advantage. In science, it can be easily squashed, but try to stay tuned to it.

UAB Women in Medicine: Wendy Demark-Wahnefried. Ph.D., R.D.

Q&A With Dr. Wendy Demark-Wahnefried 

Wendy Demark-Wahnefried, Ph.D., R.D., is professor and Webb Endowed Chair of Nutrition Sciences and the associate director for cancer prevention and control at the UAB Comprehensive Cancer Center.

What made you decide to pursue a career in the medical field?
I had a desire to help people, but at the same time I wanted to pursue a career that was biology-driven.

What kind of research do you do? What are you working on right now?

 I am a nutrition-scientist. Currently, most of my work is dedicated to the development and testing of interventions 

to improve the overall health and functioning of cancer survivors. In addition, our laboratory is keenly interested in finding out how obesity drives more aggressive cancers and whether weight loss interventions can improve prognosis of both breast and prostate cancer.

What kind of obstacles do you face being a woman in the medical field? Did you face any as you were going to medical school?  

 Although I pursued a pre-med program at the University of Michigan, I ultimately decided to pursue a Ph.D. instead of an M.D. Over the course of my career I have worked in a variety of settings that range from the department of surgery at Duke where there were significantly fewer women, to those in which the gender composition was more balanced. While it may be more difficult for women to initially “be heard” in settings that are more male-dominant, I firmly believe that nothing speaks like success and if you do good work, and you are persistent, you will eventually be recognized. Most of the largest obstacles I have faced in my career are not because I am a woman, but rather due to other factors.

What do you like about working with the cancer center/for UAB?
UAB is the third cancer center under which I have worked. I started at Duke and was there for 17 years rising from a project manager to a full professor and then was recruited to MD Anderson Cancer Center, where I spent three years. I came to UAB and like working here because of the collaborative research environment, the great director [Dr. Ed Partridge] and that fact that at UAB, cancer is more than just a business and there is a true concern about the community.

Do you have any advice for girls wanting to get into the medical field?  

The medical field and particularly the research field is terrifically competitive. You really need to work hard, develop thick skin and keep trying. This is generic advice and applies for both males and females.