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Cate Edwards, daughter of Elizabeth Edwards, became part of the cancer community in 2004 when her mother was first diagnosed with early stage breast cancer. Shocked and defiant, Edwards and her mother assembled the best team of healthcare providers and confronted the cancer with grace, courage and persever-ance.

“I moved back in with my fam-ily to be with my mom through the early stages of her treatment,” said Edwards. “I was sure there was an end to cancer in sight and I wanted to see her through it.”

Less than a year later, they were able to breathe a sigh of relief when Elizabeth’s scans came back clear and she appeared to be in remission. Unfortunately, the cancer was not gone for good.

In 2007 the cancer returned. This time, it was metastatic breast cancer that had spread to the bone, which was treatable but incurable. Advanced

Dr. BeriT MaDsen

It’s October again; breast cancer awareness month. Pink ribbons and pink paraphernalia abound. I hear some people are weary of the pink; I’d like to share my perspective. As

a physician involved with breast cancer for the past thirty years, I reflect on the past and can see how far we have come. Perhaps, the breast cancer awareness movement deserves some credit for that progress.

Since the time I was a medical student and resident in radiation oncology in the early 1980’s, I have had the opportunity to care for many women with breast cancer. The 1980’s were still the early days of breast cancer screening with mammography, and as a result, many patients had advanced cancer at diagnosis. As breast conserving therapy was still controversial, most women underwent mastectomy.

Chemotherapy lasted a whole year and was associated with lots of side effects that we could not easily treat. Most women did not talk about their breast cancer and it was hard to get good information about treatment choices and

outcomes. The breast cancer awareness movement

was launched in the 1980’s to encourage early diagnosis of breast cancer and improve the situation for women facing breast cancer. Through fund raising events like runs and walks as well as a dedication of October as a breast cancer awareness month, millions of dollars have been raised to sponsor breast cancer research and improve information and support for patients.

Research has directly and indirectly led to tremendous advances in early diagnosis, the acceptance of minimal surgical procedures like lumpectomy and sentinel lymph node biopsy, improved radiation techniques, and more effective and better tolerated chemotherapy. Breast cancer survival and the quality of life for women with breast cancer have improved as a result.

Information and support for breast cancer patients is now readily available in this country which has empowered our patients to be advocates for themselves and to get the best treatment available.

The situation has improved since the 1980’s; I believe in large part due to the tremendous success of the breast cancer awareness movement. While there is still much room for improvement in breast cancer diagnosis and treatment, we need to continue to “think pink”.

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Page 4 WaVe OF PINK OCTOBeR 11, 2013

By ManfreD Henne, MD, PHD, Ms

Breast cancer isn’t selective. It can happen to anyone at any age. The thing is, most women know they should have

an annual mammogram but it just seems so darn hard to fit it in. A rule of thumb that I like to share with my patients is to have them schedule their annual 3D mammogram in October, since it is Breast Cancer Awareness month, or close to their birthday. Then it is on the calendar the same time each year. I like to remind them that this is one screening that can literally save their lives and it only takes 30 to 45 minutes out of their day once a year. Additionally, 3D mammography offers the benefits of increased cancer visibility with less compression.

The really good news is that two recent scientific studies (one published in Radiology magazine in January and the other in Lancet Oncology in April of this year) show that 3D mammography discovers 40-50% more invasive breast cancers than 2D mammography or standard film alone. The real chance of finding breast cancer early is being able to compare mammograms from year to year. Even better still is the fact that now the

breast cancer survival rate is close to 100% in women who have an annual mammogram.

As the most current, state-of-the-art technology, 3D mammography has really turned the tide regarding survival rates because of the use of high-powered computing to convert digital images into thin layers or “slices.” These images allow the radiologist to find the

smallest of cancers sooner. I stress to all our patients at InHealth Imaging the importance of having an annual 3D mammogram because early detection improves the chances that breast cancer can be treated successfully, many times without the use of chemotherapy. At InHealth Imaging we have many patients who are cancer survivors because their diagnosis was made early.

InHealth Imaging was the first imaging center in the state of Washington to begin using 3D mammography and now has more than two years of expertise in performing this screening. Additionally, the radiologists at InHealth Imaging see each and every patient after their mammogram, show them the films and explain the results. Because this technology allows more accurate analysis of the breast tissue fewer patients need to be called back for additional diagnostic mammograms or ultrasounds.

Women should not be deterred by the cost of an annual mammogram. Most insurance companies cover annual screening mammograms at 100% and InHealth Imaging is the only practice to offer 3D mammography at no additional charge to the patient, plus no referral is needed. InHealth Imaging also works with cash pay and uninsured patients to ensure that they too have access to 3D screening mammograms.

It is true that the risk of breast cancer increases with age but women also need to know that most breast cancers are found in women without a family history of the disease. The morale of the story is that 3D mammograms save lives.

InHealth Imaging – Saving Lives One 3D Mammogram at a Time!

breast cancer (ABC) is composed of metastatic breast cancer (stage IV) and locally advanced breast cancer (stage III), according to the American Cancer Society. Metastatic breast cancer occurs when the cancer has spread beyond the breast to other parts of the body, such as the brain, bones or liver. Locally advanced breast cancer means the cancer has spread to lymph nodes and/or other tissue in the area of the breast, but not to distant sites in the body.

The advanced breast cancer felt different. The focus turned from becoming a “survivor” to simply surviving, and Edwards and her mom sensed they were

part of a new cancer community.“Before my mom was diag-

nosed with advanced breast cancer, I assumed breast cancer patients fell into two categories - those who were “survivors” and those who were not,” said Edwards. “When Mom’s cancer metastasized, I realized this wasn’t the case. There is a com-munity of cancer patients who are challenged by an unpre-dictable, chronic disease that they could live with for weeks, months or years.”

While there are many resources for early stage breast cancer, information specifi-cally for the ABC community - which includes patients and those who care for them - has been limited. A 2012-2013 global survey of nearly 1,300 women in 12 countries, conducted online

by Harris Interactive on behalf of Novartis Oncology, showed that 70 percent of U.S. women living with ABC often feel iso-lated and left out of the broader breast cancer awareness move-ment. Additionally, 75 percent of women with ABC feel resources to help family and friends cope with and understand the disease would be especially helpful.

To address the unique needs of the ABC community, the “Count Us, Know Us, Join Us” (Count Us) program was developed with guidance from 13 leading cancer advocacy groups. The Count Us program, which is available in English and Spanish at www.advancedbreastcancercommu-nity.org, provides education and support to patients, caregivers, loved ones and supporters.

In honor of her mother, who

passed away in 2010, Edwards has joined Count Us as an ambassador to share her care-giver experience and to help amplify the voice of the ABC community.

“Anyone impacted by this dis-ease - whether a patient, daugh-ter, husband, friend or colleague - is part of the community,” said Edwards. “Living with advanced breast cancer means living with uncertainty, but knowing first-hand the struggles this com-munity faces, there is one thing that’s certain: no one should face it alone.”

Rosalie Canosa, MSW, MPA, LCSW-R, Program Division Director, CancerCare, agrees more support is needed for the ABC community, which has dif-ferent needs than the early stage breast cancer community, espe-

cially when it comes to caregiv-ers who need support as well.

“Seventy percent of women with advanced breast cancer have a caregiver, whether it’s a family member who attends every doctor appointment or a neighbor who brings a meal once a week,” said Canosa. “However, caregivers are often so focused on helping that they underes-timate support they may need over time. That’s why I am happy that Cate is joining the Count Us program, to raise awareness for everyone in the advanced breast cancer community.”

For additional information on the Count Us program and resources for ABC support, as well as video messages from Cate Edwards, visit www.advanced-breastcancercommunity.org.

DaUgHTeRCONTINUED FROM 3

OCTOBeR 11, 2013 WaVe OF PINK Page 5

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More than half of American women liv-

ing with advanced breast cancer feel support from friends and family is not as strong now as when they were first diag-nosed, according to the global Count Us, Know Us, Join Us survey.

American women with stage IV meta-static breast cancer and stage III locally advanced breast cancer - collectively known as advanced breast cancer - must cope with feelings of isolation when their disease progresses - a time when, conceivably, support is needed most. Findings from the sur-vey provide insight as to why and how the expe-riences of women with advanced breast cancer differ from those with earlier stages.

“People diagnosed with earlier stages of breast cancer focus on completing treatment as quickly as possible, putting the experi-ence behind them and becoming a survivor,” says Shirley Mertz, presi-dent of Metastatic Breast Cancer Network and an advisory board member for Count Us, Know Us, Join Us, a program created by Novartis Oncology and 13 cancer advocacy organizations for people impacted by advanced breast cancer.- “In a stage IV diagnosis where cancer spreads or metastasizes, patients must learn to cope with ongoing, never-ending treatments and uncer-tainty that comes with

disease progression.”An estimated 220,000

women in the United States are diagnosed with breast cancer each year, and as many as 30 percent will develop metastatic disease. For these women, whereas support seems to be strong surrounding their original breast cancer diagnosis, some express difficulty in explaining to their loved ones what it means now that their disease has progressed. According to three-quarters of women who participated in the sur-vey, the differences are severe enough that they feel that no one under-stands what they are going through.

“Many women whose disease has progressed feel isolated from broad-er breast cancer support groups that focus on early detection and sur-vivorship, because their cancer will not go away,” says Christine Benjamin,

breast cancer program director at SHARE Cancer Support, and also an advisory board member for Count Us, Know Us, Join Us. “This is why it is critical for women with advanced breast cancer and their loved ones to receive additional emotional support and resources in order to cope with what has become their new normal.”

Benjamin explained that the same type of emotional support and informational resources are especially critical for the approximately 38,000 American women each year who receive an initial diagnosis of advanced breast cancer. Unfortunately, while nearly all of those sur-veyed in the U.S. say that they actively seek out information about their diagnosis on their own (97 percent), exactly 50 percent say that what is available does not address their needs.

What’s more, 70 percent of women say it is hard

to find support groups for advanced breast can-

cer.According to Mertz

and Benjamin, providing support tailored to the needs of women living with advanced breast cancer plays a huge fac-tor in helping them to live better lives. For that reason, Metastatic Breast Cancer Network, SHARE and other advo-cacy organizations work to create programs spe-cifically for women with advanced and metastatic breast cancer and help to provide resources such as Count Us, Know Us, Join Us which offers information and support on its website, www.advancedbreastcan-cercommunity.org, for people impacted by the disease.

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BPT

Nonprofit organizations depend on monetary donations to keep their operations running and support the communities they serve.

Many people, however, want to do more than write a check to local organizations they sup-port, so they become volunteers.

When people choose to donate their time, energy and skills to support a community organization, the impact can be immeasur-able. Plus, volunteering allows people to be actively involved in their community without feeling the budget crunch at home.

People don’t always realize what they gain personally when they volunteer, however. In addition to feeling a sense of community and accomplishment, people can also improve their networking skills, connections and pro-fessional development as they help others.

“Improving leadership, networking and job skills is important in any field, and doing so through community involvement is a

rewarding way to give back,” says Elizabeth K. Warn, senior vice president of community relations at TD Bank. “Volunteering provides the best of both worlds - supporting your local community while developing profes-

sional skills that may help you in the future.” Many companies encourage their employees to volunteer, whether on their own time or through work. TD Bank, for example,

provides several volunteering opportuni-ties for its employees, including TD Tree Days tree planting events. The bank’s year-round Employee Reading Program encour-ages employees to help children keep their reading skills sharp by reading to them in schools, libraries and at youth organizations.

In addition to recognizing their employ-ees’ commitment to volunteer service and the financial needs of community organiza-tions, many companies, such as TD Bank, will also provide financial donations to the charities where their employees volunteer. These donations give an extra boost to the organizations and causes that are personally important to employees, are usually based on the number of hours an employee volunteers, and allows a worker who might not other-wise have the financial resources an oppor-tunity to direct funds to his or her favorite charity or organization.”The benefits of volunteering really are limitless,” adds Warn. “Even a few hours each month can help a neighborhood, a family in need, or an orga-nization attain its goals and make a positive, meaningful impact in the community.”

You can donate your time as well as your money

BPT

Advances in technology have shaped the way we communicate and have enabled the modern-day patient to easily connect with medical experts, patient advocates and oth-ers living with their disease. Through com-puters, handheld devices like tablets and smart phones, and social media, patients are also able to instantly access credible information - something that could not have been imagined until recently. Digital tools and online resources have become especially beneficial for people living with rare health conditions, such as sarcomas or malignant tumors that are often difficult to diagnose.

Sarcoma Awareness Month was recently commemorated in the United States and is an opportune time to raise awareness among those people unfamiliar with sarco-mas, while also empowering patients living with the disease to be their own best advo-cates. One way patients can self-advocate is by using available digital resources to obtain

information about their condition.For example, for patients with gastro-

intestinal stromal tumors (GIST), a rare, life-threatening sarcoma that is primarily found in the gastrointestinal (GI) track and most often found in the stomach or small intestine, the journey to a correct diagnosis may take years as symptoms are not pres-ent in earlier stages of the disease. Once diagnosed, the journey has just begun, and patients should understand how to best manage their disease. Patients with GIST can use online resources to take charge of their health by following these steps:

• Form a healthcare team: Form a multi-disciplinary team of healthcare profes-sionals (e.g., gastroenterologist, medi-cal oncologist, surgeon, pathologist) to ensure that patients and doctors are working together to help achieve the best outcome.

• Continue the conversation: Keep the lines of communication open with a doctor. Don’t hesitate to ask questions or reach out to healthcare professionals

between regular visits.• Connect with others: Join online or

live support groups to connect with other patients and exchange personal experiences. A recent study from Japan showed that in today’s era, social media, including Twitter, are valuable resources for the sharing of psychologi-cal support among the cancer commu-nity.

To further assist patients with GIST with managing their condition, Novartis recently launched two new digital resources:

• The GIST Network YouTube Channel: Featuring videos to support GIST patients and their caregivers with patient stories and tips from medical experts.

• “Assess the Risk” Mobile App: Geared to educate healthcare professionals on how to assess the risk of recurrence of GIST and facilitate the discussion between healthcare professionals and patients.

“With the availability of new digital tools, such as the ‘Assess the Risk’ mobile app, new lines of communication are being formed between patients and doc-tors, which is truly remarkable,” says Dr. Robert Andtbacka of the Huntsman Cancer Institute. “Working with a team of physi-cians and connecting with other patients are both integral parts of the patient jour-ney.”

As technology continues to evolve, it is important that patients living with a rare condition such as GIST continue to be their own health advocates and work with their healthcare professionals to determine a dis-ease management plan that is best for them.

For more information about GIST and to hear other patient stories, please visit the GIST Network Channel on the Novartis YouTube Channel: www.youtube.com/GISTNetwork. Healthcare professionals can download the Assess the Risk” app on a mobile device, by texting APP to 59629 or searching GIST Cancer Risk Novartis in the App Store or Google Play.

Empowering patients to become self-health advocates

OCTOBeR 11, 2013 WaVe OF PINK Page 7

BPT

Every fall, many people review their employer health care options during “open enrollment.” As you start to focus on your health care decisions,

you may also want to consider the safety of information you routinely provide, such as your address, Social Security number and insurance provider. With new private and public health insurance exchanges becom-ing available, you may face a greater risk for medical identity theft.

Medical identity theft is when someone uses another person’s name and information to get medical service or make false claims. Once information is stolen a thief may see a doctor, get prescription drugs or file claims with an insurance provider. Medical identity theft cost the health care industry $41 billion in 2012, with half of all health care organiza-tions affected by the crime.

The threat isn’t just financial: if another person’s information is mixed with yours, your medical records - and treatments - may be affected.

Medical identity theft is receiving greater attention now as it’s not just health providers who collect this information. The Federal Government is collecting data from seven different departments and will transfer it to the Federal Data Services Hub, providing a new way for agencies to verify eligibility for

programs, refunds and tax rebates. This hub is expected to go live Oct. 1, but has some identity theft experts wondering how secure the hub’s data is.

While there is no way you can completely safeguard yourself against identity theft, there are precautions you can take. And, there is help available for people who discov-er their identity has been compromised.

If you’ve been involved in an identity theft situation you’ll need legal guidance to help you through the process of clearing your name and your accounts. ARAG, a global

provider of legal insurance products and ser-vices, has a team of Certified Identity Theft Specialists who’ve handled thousands of cases over the past 12 years. You’ll be paired with a specialist fully versed in identity theft situations, who will walk you through every step of the resolution process.

ARAG also has guidebooks on how to pre-vent identity theft, how to recover if you’re a victim of a health care data breach or other form of identity theft, a tracking sheet to help manage the details you’ll need to do to restore your identity and an affidavit to help

collect information needed to report iden-tity theft to police and other authorities. To further protect your medical information, follow these tips:

1. Be careful about sharing your health plan identification for health services that are supposed to be “free.”

2. Don’t share information with anyone over the phone or by email unless you initi-ated the contact and know who you’re deal-ing with.

3. Keep paper and electronic copies of your medical and health insurance records in a safe place. Shred outdated health insur-ance forms, prescription and physician statements, and the labels from prescription bottles before you throw them out.

4. If you’re asked to provide personal information on a website find out why it’s needed, how it will be kept safe, whether it will be shared and with whom.

5. If you decide to share your information online, look for a lock icon on the browser’s status bar or a URL that begins “https:” the “s” is for secure.

The bottom line is that you need to be aware of how prevalent identity theft is, and that anyone could be a victim. And if you receive a note from your health care provider that a security breach has occurred, know that there is help available to resolve your situation and clear your name.

Five tips to help prevent medical identity theft

BPT

Have you ever gone to fill a prescription and the pharmacist asks if you’d like the generic version of the medication, perhaps reminding you that it is at a considerable cost savings over the brand-named drug? Or you’re told that your insurance will only cover the generic equivalent of what your doctor has prescribed?

The first time this happens, you undoubtedly have many questions: Is there a difference between branded and generic medicines? Will the generic be just as safe and effective? Do insurance companies pre-fer generics? If you have, you’re not alone in

asking these questions.-It’s no secret that the rising costs of

health care services and medications have been affecting millions of Americans - indeed, our economy - and will undoubted-ly continue to do so in the future. However, generic alternatives have proven to be a critical factor in slowing down national health care spending. In fact, generic drug use has saved America’s health care sys-tem approximately $1.07 trillion over the past decade, with $192.8 billion in savings achieved in 2011 alone, according to a 2012 study by the IMS Institute for Healthcare Informatics.

However, while consumers recognize the cost advantage of generic drugs, they

are reminded, from time to time, of the question of quality and efficacy of generic medications versus name-brand equiva-lents. Consumers should know that the U.S. Food and Drug Administration, the federal agency responsible for protecting and pro-moting public health, requires that generic drugs must be identical or “bioequivalent” to brand name drugs in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.

“The U.S. FDA tests generic medicines just as rigorously as their branded counter-parts,” explains Venkat Krishnan, senior vice president and regional director at Ranbaxy Inc. “Generic drugs must meet rigid qualifying criteria before they can

be made available to the general public. At Ranbaxy, we have stringent protocols in place to ensure that our products are both safe and effective, and we stand behind that, focused on our philosophy of ‘Quality and Patients First.’”

People are choosing generics in increas-ing numbers, out of economic necessity and because they are increasingly better informed. Of the 4 billion prescriptions written in 2011, nearly 80 percent were dispensed using generic versions of their brand name counterpart. With generics, consumers have the option of paying a price that is as much as 85 percent lower than name-brand drugs.

If you have questions about switching to a generic prescription, have a conversation with your doctor or pharmacist, or visit www.gphaonline.org for more information and the facts about generic drugs.

More Americans choosing generic drugs

Page 8 WaVe OF PINK OCTOBeR 11, 2013

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3D Mammography discovers 40-50% more invasive breast cancers based on scientific research The real benefit of 3D Mammography is finding breast cancer early The only chance to find breast cancer early is to have an annual mammogram and do a comparison year to year The breast cancer survival rate is close to 100% in women who have annual mammograms InHealth Imaging has patients who are breast cancer survivors who did not need chemotherapy treatments because their diagnosis was made early The risk of breast cancer increases with age Most breast cancers are found in women without a family history of the disease Most insurances, including Medicare, pay 100% of the cost of an annual mammogram.

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