Kevin Scarlett survived a rare throat cancer. He shares his story on
Transcription
Kevin Scarlett survived a rare throat cancer. He shares his story on
The Curtis and Elizabeth Anderson Cancer Institute at Memorial University Medical Center Inside the ACI Excellence in cancer care through research, education, and treatment. | Spring 2014 aci.memorialhealth.com Kevin Scarlett survived a rare throat cancer. He shares his story on page 10. Experience Excellence. Cancer in the head, neck, and lungs By Guy Petruzzelli, M.D., Ph.D., MBA, FACS PHYSICIAN-IN-CHIEF, CURTIS AND ELIZABETH ANDERSON CANCER INSTITUTE This issue of Inside the ACI highlights our multi-disciplinary programs for lung cancer and head and neck cancer. An important similarity between lung and head and neck cancer is their relationship with tobacco. The negative health consequences of smoking cannot be over-stressed. In the U.S., tobacco use is responsible for 1 in 5 deaths; 8.6 million people suffer from chronic respiratory or cardiovascular conditions; and smoking-related illnesses cost us billions of dollars in lost wages, reduced productivity, and preventable medical expenses. It’s been 50 years since the surgeon general ordered warning labels be placed on all cigarette packages. Since then, we have seen significant improvements in reducing the incidence of lung and some head and neck cancers. Unfortunately, 1 in 5 Americans continues to use tobacco. Smoking is beginning at a young age, with 20 percent of high school students using tobacco. Annual cancer deaths related to smoking remain significant for patients with lung, esophagus, oropharynx, and larynx cancers. The best way to reduce the risk of lung cancer is to never start using tobacco, and if you do use it, quit. Recently the United States Preventive Services Task Force approved the use of a More than 50,000 Americans low-dose CT scan to screen at-risk patients are diagnosed with cancers of for lung cancer. If you are a current or the mouth, throat, or larynx former smoker, you can call 912-350-LUNG to schedule a lung cancer screening. and an additional 60,000 are See page 4 for more information. diagnosed with thyroid Tumors of the head and neck can cancer each year. develop in the throat, larynx (voice box), nose, sinuses, mouth, tongue, salivaproducing glands, thyroid, and parathyroid glands. More than 50,000 Americans are diagnosed with cancers of the mouth, throat or larynx and an additional 60,000 are diagnosed with thyroid cancer each year. Head and neck cancer deaths have decreased over the past 20 years, and head and neck cancers due to smoking are decreasing. However, we are seeing an increase in the number of head and neck cancers related to infection with the human papillomavirus (HPV). Treatment often requires a combination of surgery, chemotherapy, and radiation. Our cancer treatment program, in collaboration with the physicians of Summit Cancer Care, provides inpatient and outpatient chemotherapy and radiation. Using the stateof-the-art TrueBeam radiation therapy platform, we offer intensity modulated radiation therapy. This precisely targeted radiation allows us to preserve salivary function and dramatically reduce long-term side effects. In our lung and head and neck programs, we emphasize a multidisciplinary approach to care so every patient benefits from the combined expertise of an experienced team that meets regularly to discuss each patient’s care and progress. We encourage patients and their loved ones to participate in a wide range of complementary and alternative treatments, including support groups, nutritional counseling, massage, and more. Please contact me directly with any thoughts or concerns regarding our programs. I can be reached at guypetruzzelli@memorialhealth.com. 2 3 Low-dose CT recommended to screen for lung cancer Too often, lung cancer is not detected until it has reached an advanced stage. This makes it the leading cause of cancer death in our country. However, when the disease is caught early, it may be successfully treated with surgery. For years, researchers have been looking for a reliable screening tool for lung cancer. The National Cancer Institute’s National Lung Screening Trial discovered that low-dose computer tomography (CT) scans can detect non-small cell lung tumors at an early stage. Based on this information, the U.S. Preventive Services Task Force recently began recommending annual low-dose CT screening for people who meet specific criteria. The greatest risk factor for lung cancer is smoking. The likelihood of getting lung cancer increases with age and ongoing exposure to tobacco smoke. While low-dose CT scanning is not a substitute for quitting smoking, it does provide a better chance of catching the disease when it can be treated with surgery or other interventions. The Curtis and Elizabeth Anderson Cancer Institute at Memorial University Medical Center offers low-dose CT for lung cancer screening for just $150. There is no referral needed. To request an appointment or learn more, call 912-350-LUNG (5864). You may be a candidate for low-dose CT lung cancer screening if you meet the following criteria: Age 55-74 years 30 pack-year history of smoking or greater. (A pack-year refers to the number of cigarettes smoked per day for a year. Smoking one pack per day for 30 years equates to 30 pack-years. Smoking two packs a day for 30 years equates to 60 pack-years. Smoking a half-pack a day for 30 years equates to 15 pack-years.) If you’re an ex-smoker, you’ve quit within the past 15 years. Or: Age 50 or older 20 pack-year smoking history. One additional risk factor, including COPD or pulmonary fibrosis; radon exposure; occupational exposure to asbestos, silica, cadmium, arsenic, beryllium, chromium, diesel fumes, or nickel; personal history of cancer; or family history of cancer. 4 Cancer screening guidelines There are nearly 14 million cancer survivors living in the United States. Survival rates are climbing, thanks in part to better screening and early detection. While we don’t have screening tools to catch every type of cancer early, the tests that we do have are very effective and save countless lives every year. The information below provides general screening guidelines. Screening varies based on your personal and family history, so talk to your doctor about the schedule that’s best for you. G EN ER A L C ANC ER SC REENI N G Beginning at age 20, all men and women should have an annual physical that includes an examination of the mouth, skin, lymph nodes, and testes or ovaries. / Breast Cancer Beginning at age 40, women should have a mammogram and clinical breast exam every year for as long as they are in good health. To schedule a mammogram, call 912-350-PINK (7465). - Women in their 20s and 30s should have a clinical breast exam every three years. - Women should conduct monthly breast self-exams beginning in their 20s. / Colorectal Cancer Beginning at age 50, men and women should have a colonoscopy every 10 years or have one of the following: - Flexible sigmoidoscopy every 5 years - Double-contrast barium enema every 5 years - CT colonography every 5 years / Cervical Cancer - At age 21, women should have their first cervical cancer screening test. - From age 21 to 29, women should have a Pap test every 3 years. - From age 30 to 65, women should have a Pap test and HPV test every 5 years (preferred) or continue to have a Pap test alone every 3 years. - Women over age 65 who have a history of normal Pap and cervical cancer test results can discontinue screening. / Lung Cancer See the recently updated screening guidelines on page 4. To schedule a lung cancer screening, call 912-350-LUNG (5864). / Prostate Cancer Starting at age 50, men should talk with their doctor about having an annual PSA blood test with or without a rectal exam. African-American men and men with a family history of prostate cancer should begin screening at age 45. 5 Felishia Finch, lung cancer survivor, and her dog, Jack. Felishia Finch 6 Living, laughing, and loving through lung cancer In the weeks leading up to her 43rd birthday, Felishia Finch of Claxton was not feeling well. She was tired and found it difficult to breathe. She thought maybe she had pneumonia. Her boyfriend insisted she go to the doctor. An X-ray revealed a spot on Finch’s lung. She was quickly referred to the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial University Medical Center in Savannah. “I was bald and green! But I never wore a hat or a scarf. I showed my bald head because I was proud to be alive.” Finch was diagnosed with non-small cell lung cancer. She was told a 6-centimeter tumor had already destroyed half of her right lung. And the tumor had fingers that wrapped around her pulmonary artery. Finch received this news on April 11, 2006 – her birthday. “It was a shock. It brought me to my knees. I felt like I was walking around with a time bomb inside of me,” said Finch. The first step in Finch’s treatment was surgery. But because the tumor was wrapped around her pulmonary artery, it could not be removed. Instead, Finch received 30 radiation treatments to her chest and three rounds of chemotherapy drugs. The treatments did nothing to shrink the tumor. Finch was told she had four years to live. “I didn’t ask God why. I just asked him to help me,” said Finch. She was not about to give up – this was a battle and she was going to fight. Finch stopped looking at lung cancer information online, because it was too depressing. She resolved to enjoy every moment with her boyfriend and her daughter. During that same period, she re-established a relationship with her father, even though they had been estranged for years. He went with her to every treatment. “Looking back, cancer was a blessing to me, because it brought my daddy back to me,” said Finch. She received more chemotherapy, including a grueling treatment of three drugs that required an eight-hour infusion each time. “I was bald and green! But I never wore a hat or a scarf. I showed my bald head because I was proud to be alive,” said Finch. One day after a difficult treatment, Finch’s boyfriend surprised her with a tiny Jack Russell terrier puppy. Finch was thrilled. She named the puppy Jack and she says he was the best therapy she could have asked for. Finch continued the cycle of treatments and scans at the ACI. She and her dad would often crack jokes in the ACI waiting room and try to make the other patients laugh. Finch made it her mission to spread happiness and hope. In August 2008, Finch was in her doctor’s office waiting to hear the results of her latest lung scan. Her doctor delivered wonderful news – the tumor was now just scar tissue. She had beaten the odds. She was a cancer survivor. “I could not have asked for anything better in my treatment. The ACI made my walk through this disease a lot easier,” said Finch. On April 11, Finch celebrated her 51st birthday. Since beating lung cancer, she and her boyfriend have gotten married. She was blessed with a beautiful grandson. She helped her dad through prostate cancer treatment. She continues to receive unconditional love from Jack. And she’s growing her hair long for Locks of Love, an organization that uses donated hair to make hairpieces for children who are bald from medical treatment. Best of all, she remains cancer free. “For me, every day is a blessing. I thank God every night,” said Finch. 7 Our head and neck cancer program The term “head and neck cancer” is used to describe several different types of cancer that may form in the head or neck but are not related to the brain or spinal column. Head and neck cancers typically begin in the cells that line the inside of the mouth, the nose, and the throat. They can affect the lips, tongue, gums, cheeks, the pharynx (the hollow tube that runs from the nose to the esophagus), the voice box, the sinus cavities, the salivary glands, and other cells in the head and neck. The Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial University Medical Center offers a head and neck cancer program led by renowned otolaryngologist and surgeon Guy Petruzzelli, M.D., Ph.D., MBA., FACS. Petruzzelli also serves as physician-in-chief of the ACI and vice president of oncology programs. He has fellowship training in head and neck surgery and specializes in traditional and robotic-assisted surgical techniques. “[Head and neck surgery] is challenging because everything we do as head and neck surgeons, people can see. You can’t hide your work. So you need to be very, very skilled and pay a lot of attention to your surgical technique and your surgical expertise when you take care of patients with tumors in that area,” said Petruzzelli. Many head and neck cancers are linked to tobacco use, alcohol use, and the human papillomavirus (HPV). Head and neck cancers account for 3 percent of all cancers diagnosed in the U.S. each year, and are more common in men and in people over age 50. Symptoms of head and neck cancer may include: - A sore throat or cough that does not go away - A lump in the neck or the sensation of a lump in the throat - Hoarseness or voice change - Frequent choking on food or pain when swallowing - Ear pain that does not go away - Trouble breathing or noisy breathing - A lip or mouth sore that does not heal - A white or red patch or lump on the gums, tongue, or lining of the mouth - Unusual numbness or pain in the mouth, jaw, or neck - Weight loss, excessive perspiration, nervousness, or heart palpitations that have no known explanation - Unexplained changes in your hair or skin If you experience any of these symptoms, tell your doctor. If you are diagnosed with a head and neck cancer, ask for a referral to the head and neck services at the ACI. You can learn more at aci.memorialhealth.com. Head and neck cancer support group Research has shown that support groups can enhance the quality of life for people with cancer. They do this by providing information, education, and an opportunity to share your experiences with people who understand what you’re going through. The Curtis and Elizabeth Anderson Cancer Institute at Memorial University Medical Center hosts a head and neck cancer support group for cancer patients and their caregivers. The group meets monthly on the third Wednesday of the month at 2 p.m. in the ACI conference room. Each session includes a discussion with medical professionals and a group discussion. For more information about the program, call 912-350-7845. 8 Cancer care close to home Memorial University Medical Center serves people in 35 counties spanning two states. To make our services more accessible to people outside of Savannah, the Curtis and Elizabeth Anderson Cancer Institute established a number of satellite offices. When you make your appointment, ask if there is an office near you. Our regional offices include: G EO RG IA Brunswick | 912-350-2299 3226 Hampton Avenue, Suite F James Burke II, M.D., gynecologic oncologist Claxton | 912-350-2299 405 East Long Street Robert Jones, M.D., cardiothoracic surgeon Jesup | 912-350-2700 Jesup Medical Office 131 Peachtree Street Ray Rudolph, M.D., MPH, breast surgeon Richmond Hill | 912-350-2700 Ways Station Shopping Center 3776 Highway 17 Paula DeNitto, M.D., breast surgeon Statesboro | 912-350-2299 23630 Highway 80 East, Unit B James Burke II, M.D., gynecologic oncologist Scott Purinton, M.D., Ph.D., gynecologic oncologist Elena Rehl, M.D., breast surgeon SO UT H C AR OL IN A Okatie | 912-350-2299 14 Okatie Center Boulevard South, Suite 100 Robert Jones, M.D., cardiothoracic surgeon Scott Purinton, M.D., Ph.D., gynecologic oncologist Christopher Senkowski, M.D., gastrointestinal surgeon 9 Across the state and back again: One man’s quest to find the best cancer treatment in Georgia Kevin Scarlett has big plans for the year. The 34-year-old Savannah resident and his wife, Morphia, are raising four children – ages 11, 8, and 5-year-old twins. He plans to start an organization that raises awareness and funds for head and neck cancers. And he’s learning to speak again after his own harrowing battle with cancer. Scarlett has spindle cell sarcoma, a type of cancer that attacks the connective tissues in his throat. His cancer journey began in October 2012 with a sore throat that would not go away. One morning, he began coughing up blood and tissue. He drove himself to the emergency room at Effingham County Hospital. The doctor sent a sample of coughed-up tissue to a lab for testing and told Scarlett to visit an ear, nose, and throat specialist (ENT). In the four days leading up to his ENT appointment, Scarlett began to have trouble breathing. He felt as if he was in a continuous chokehold. The ENT discovered a blockage in Scarlett’s throat that looked like a tumor. He referred Scarlett for a PET scan at a nearby imaging center in Pooler. By this time, Scarlett was having trouble breathing and talking. He was about to begin the PET scan when his doctor received the pathology report from the first tissue mass collected in the emergency room. It was spindle cell cancer and Scarlett needed to be admitted to the hospital immediately. “My first thought was, how was I going to tell my wife,” said Scarlett. “I texted her and told her I needed her to be strong. I asked her to find someone to watch the kids and to contact my doctor immediately.” On November 5, Scarlett had surgery at a Savannah hospital to remove the tumor in his throat. At first, the problem seemed to be solved. He was not referred for any additional cancer treatment. But within a month, Scarlett began feeling the same discomfort. Another tumor had grown in his throat. He had a second surgery on January 15, 2013. Within a month, yet another tumor grew. Spindle cell sarcoma is rare, and Scarlett’s treatment options were limited. But he was determined to find the best treatment and the best doctor. Scarlett contacted the American Cancer Society and asked them to recommend treatment centers in Georgia. He visited hospitals in Augusta and Atlanta, but he knew in his heart that these facilities were not right for him. Scarlett instead spent two weeks at a holistic treatment center in north Georgia called Wildwood Lifestyle Center. 10 “At Wildwood, I learned how to help my body heal with the right balance of diet and exercise. I became a vegetarian and this decision helped in the healing and recovery process for me,” said Scarlett. Scarlett felt rejuvenated and empowered, even though the tumor in his throat was growing rapidly. He decided to have a total laryngectomy at Emory Winship Cancer Institute in Atlanta. Then his doctor at Emory recommended he visit a highly trained expert, Guy Petruzzelli, M.D., Ph.D., MBA, FACS, from the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial University Medical Center in Savannah. Within 24 hours, Scarlett, his wife, and his children were back at home in coastal Georgia, sitting in Petruzzelli’s office. I was referred to Augusta, and sought treatment in Atlanta, only to discover that the best treatment for me was right at home in Savannah. “Dr. Petruzzelli made my family feel very comfortable because he took the time to speak with the kids in a way they could understand. I felt a world of relief to finally be able to relax and focus on healing and the next phase of my cancer treatment,” said Scarlett. “I was referred to Augusta, and sought treatment in Atlanta, only to discover that the best treatment for me was right at home in Savannah.” On April 11, 2013, Petruzzelli performed a total laryngectomy on Scarlett. The complex procedure involves removing the entire larynx (voice box). Scarlett would have to learn a new way to speak. Petruzzelli created an opening in Scarlett’s neck, called a stoma, which he uses to breathe. After surgery, Scarlett had six weeks of radiation treatment at the ACI under the direction of Aaron Pederson, M.D. He credits the team at the ACI with helping him get through the treatment. “Their consistent positive energy and compassion motivated me each day to wake up and drive in for my treatment,” said Scarlett. He also derives strength from his faith and the prayers and support of many people. Today, Scarlett is ready to move on. He received a prosthetic device to help him speak. He continues to live a healthy lifestyle and wants to help others by raising awareness about head and neck cancers. He offers the following advice for anybody diagnosed with cancer: • • • • • • • Realize that cancer is something that is bigger than you, so embrace having a team of people around you to guide you through it. Ask questions, learn as much as you can, and be honest with your doctors about the lifestyle choices you make. Join support groups, either online or through the ACI. Appreciate your caretakers and realize that this experience is affecting them too. Drink three cups of patience each day. You’re going to need it. Stay stress-free as much as possible. This may mean limiting your contact with negative people. Stress affects your immune system. Enjoy each and every day to the fullest. Carpe diem! Kevin Scarlett 11 NON-PROFIT U . S . P O S TA G E 4700 WATERS AVENUE SAVANNAH, GEORGIA 31404 PAID SAVANNAH, GA PERMIT NO. 499 Your gift makes a difference You can support the Curtis and Elizabeth Anderson Cancer Institute (ACI) by making a taxdeductible gift to the Memorial Health Foundation. Gifts to the Foundation help purchase leading-edge technology, fund the ACI’s nurse navigator program, help fund a music therapy program provided by the Savannah Philharmonic, and more. In addition, the Foundation has patient assistance funds that help improve the quality of life for people with cancer. These programs provide fuel cards to ensure that patients can get to their chemotherapy and radiation treatments. They help pay for anti-nausea medicines and massage therapy to help patients cope with the side effects of treatment. These funds also provide counseling, mammograms for women in need, and genetic testing assistance. Gifts of all sizes are appreciated and make a difference. To learn more, please contact Anne Cordeiro at the Memorial Health Foundation at 912-350-8934 or Cordean1@memorialhealth.com.