Thousands of NWA residents turned out to show their support for breast cancer victims and the ongoing fight against the deadly disease Saturday, April 30, 2011, during the 13th annual Komen Ozark Race for the Cure at the Pinnacle Hills Promenade in Rogers. More than 16,000 were registered for the event’s races. Northwest Arkansas Newspapers staff photographers Marc F. Henning and Justin Wedgeworth spent the morning documenting the event in photos.
By Dan Craft
Whether tortoise or hare, no runner wants to end up face-down on the race course. With that in mind, there are a variety of simple ways runners can plan ahead to help them- selves get to the finish line on race day.
Most competitive runners train regularly, and conditioning programs for rookies generally last at least six weeks. Conditioning isn’t advisable with just one week until this year’s Race for the Cure, according to running websites and local experts.
“If you’re not an experienced, regular runner, the basics are simple,” said John McDonnell, a former University of Arkansas track coach.
“Don’t start too fast. You can always kick it up in the last mile or so if you feel like you’ve got it left in you. With the new 10K race, runners who are used to a 5K should be especially careful if they’re going the extra distance for the first time.”
Long-distance runners traditionally eat extra carbohydrates in the days lead- ing up to a race, a practice known as carb-loading, for extra stamina. That’s generally not necessary for 5K or 10K races, according to runningworld.com. A light breakfast high in carbs and potassium should be plenty to get a runner through the 3.1-mile 5K or the 6.2-mile 10K races.
Any problems during the race will be made worse by dehydration, so drinking plenty of water starting the night before the race is advisable, said Becky Stewart of Central EMS in Fayetteville.
“Hydration is the thing that keeps other problems at bay,” she said.
Another way to keep hydrated is to absorb extra electrolytes in the days leading up to the race, McDon- nell said. Electrolytes help the body retain water, cutting down on the need to drink during the race, he said.
“You can actually drink too much water. If you drink so much it drains the electrolytes out of your system, your body will be in real trouble,” McDonnell said. “A sports drink right before the race is better than water, because it adds electrolytes instead of stripping them out.”
Another common mistake is dressing for the weather at the starting line, according to sportsmedicine.com. The site recommends dressing as if it’s 15 degrees warmer than the actual temperature, to avoid overheating once the race is under way.
While many participants in Race for the Cure wear team T-shirts, anyone planning on running competitively shouldn’t choose a new shirt on race day, McDonnell said.
“Race day isn’t the time to break in anything new, whether it’s shoes, shorts or a shirt,” he said. “Unless you can get in some training in a team shirt and get used to it, it’s not a good idea for anyone looking to compete.”
Central EMS paramedics only had to take one runner to the hospital after the Hogeye Marathon and Relays earlier this month, Stewart said. That woman collapsed just a few hundred yards from the finish, so the ambulance crew wheeled her across the line on a stretcher before placing her in an ambulance.
“We like to see everybody finish and nobody need medical attention,” Stewart said.
That goes for the paramedics themselves as well. Central has about a dozen employees competing in the various Komen events.
By Teresa Moss
Farah Buck felt scared and guilty when she was diagnosed with breast cancer a little more than a year ago.
Buck, 35, of Springdale has six children.
“Being diagnosed young, you go through a state of shock especially if you have a family,” Buck said. “You have to wake up and know you have this in your body.
“I think the scariest thing was all my children and being a young mom and just thinking about not being around to raise them,” Buck said. “I really felt a lot of guilt. I had this new baby and all of a sudden I had this surgery, chemo and radiation and I could not hold him and spend time with him.”
She completed radiation therapy in December. She said the support of family, friends, her church and Washington Regional Cancer Support House helped her.
The support house is one of many organizations in the region to receive endorsement from Ozark Affiliate of Susan G. Komen for the Cure. The house was awarded $120,080 this year. Washington Regional Medical Systems was awarded $54,920.
Nonprofit groups in Northwest Arkansas offer a variety of breast cancer services including counseling, transportation, education and medical.
Lauren Marquette is the director of mission services for the Ozark region’s Susan G. Komen for the Cure Foundation. She said nonprofit groups in Northwest Arkansas do a great job of covering the medical, emotional and financial needs of those diagnosed with breast cancer.
“Really organizations try to cover every aspect,” Marquette said.
The support house, in Bentonville and Fayetteville, is among many organizations in Northwest Arkansas that help women and men fight cancer. The house offers several support groups, a lending library and educational tools for patients.
Susan Earnest, a breast cancer navigator, works with Washington Regional Medical Center to help patients such as Buck through the process. She contacts patients diagnosed with breast cancer and informs them of options. She also attends doctor appointments, along with chemotherapy and radiation sessions.
“One of the great services that a navigator can provide is that they can sit down with a woman and discuss their options,” Earnest said. “I usually have plenty of time to sit down and talk with them as long as they want to.”
Buck found a lump in her left breast after her son was born in November 2009. Doctors thought the lump was a normal reaction to breast feeding but ordered a mammogram. The test showed small amounts of calcifications, which are calcium salt buildups. The buildups can sometimes be cancerous. Buck said the amount she had was so small doctors didn’t expect it to be an issue.
A surgery revealed the lump was not a threat, but found other undetected cancer cells had spread throughout Buck’s breast and into lymph nodes.
“It shocked everyone,” she said. “It shows how unpredictable cancer is. I feel very fortunate because it was caught.”
Buck underwent a double mastectomy, chemotherapy and radiation treatments. She still takes a drug to rid her body of estrogen as a way to keep cancer from returning.
Buck said Earnest was there for her from her first biopsy.
“Throughout this experience, she was so supportive,” Buck said. “She gave me a lot of material to read so I could understand what I was going through.”
Support groups also have helped her, Buck said. In groups, Buck has been able to meet other young women fighting breast cancer.
“I think it helped my kids to see other people like me and their kids and to realize that there are other people,” she said.
Buck said her experience would have been much harder without the services that the center provides.
“I wouldn’t have known how to find other people like myself,” she said. “I would have been more isolated and not as informed of what I was going through without all the literature and tutorials I got from Susan and the support home.”
Providing Hope
Hope Cancer Resources in Springdale is a nonprofit organization that offers cancer services to women and men who either have little or no health insurance or have a financial need.
Gay Prescott, the organization’s vice president for development, said its main mission is to help patients receive otherwise unaffordable prescriptions, pay living expenses, get transportation and receive education services.
“Cancer is a very expensive disease,” Prescott said. “Maybe patients will fall short on a car or rent payment. We are able to help them with that.”
Transportation services also help patients throughout Benton, Carroll, Madison and Washington counties. The service is offered to those who either cannot afford transportation or cannot drive because of a medical condition.
Prescott said free counseling helps patients and families overcome breast cancer. She said the organization also provides Spanish translators for non-English speakers. The translators accompany patients to doctor appointments and explain treatments to them.
Clinic Help
NWA Fayetteville Free Health Clinic offers free breast exams, education and reference services to uninsured or low-income families.
“There are about 60,000 people in Northwest Arkansas who do not have insurance,” said Monika Fischer, executive director of the clinic.
Fischer said early detection of breast cancer can help patients find treatment before the disease has progressed to an expensive and long recovery state.
The center is also able to educate women on how to do a self-exam along with the importance of doing them, Fischer said.
Marquette said several other organizations offer free breast exams including Washington Regional’s Bentonville and Fayetteville locations along with the Community Clinic at Siloam Springs Medical Center.
American Cancer Society
The American Cancer Society has an office in Rogers that offers several breast cancer services. The organization offers education along with several programs such as Reach to Recovery. The program connects cancer patients with specifically trained survivors. The survivors offer emotional support and guidance.
Fink Holloway of Wesley was diagnosed with breast cancer in 2007. She used the Reach to Recovery program.
“It helped me know what to expect,” Holloway said.
She has since joined it as a volunteer and calls newly diagnosed women all across the state.
Holloway said sometimes another woman who has been through it can explain medical procedures in a way that connects with a patient better than a doctor’s explanation.
“I think it is really valuable to speak with someone who had had to deal with it,” Holloway said. “It is especially encouraging if the person you are talking to came through it without a reoccurrence.”
By Christie Swanson
Northwest Arkansas is large enough to offer top-notch doctors and facilities to treat breast cancer, local health officials say. It’s small enough that those specialists work in groups to discuss individual cases from detection to recovery.
The ability to stay close to home allows patients a larger support network and better access to their doctors, said Dr. Danna Grear, a clinical breast radiologist who helps lead a weekly breast conference of health care providers at Washington Regional.
“If you combine the small town feel with the confidence of providing excellent care, you have the perfect combination. So often people have to choose one or the other,” she said. “That’s what we try to do, offer both.”
Statistics seem to back up her claims. The breast cancer mortality rate is 19.65 and 19.90 per 100,000 people in Washington and Benton counties, respectively, according to the 2009 Community Profile by the Ozark Affiliate of Susan G. Komen for the Cure. The national rate is 22.8 per 100,000.
The area’s three largest hospital systems bring doctors from several specialties together to discuss breast cancer cases in weekly or semi-weekly conferences.
“It provides better care because we bounce ideas off one another. We’re not working in an isolated situation,” Grear said.
The American Cancer Society reports 1 in 8 women face invasive breast cancer in their lives. The chance of dying from the cancer is 1 in 35. With the Census Bureau estimating 213,694 women in Benton and Washington counties in 2009, the rate would have equaled 53,423 women with breast cancer.
Highlands Oncology Group, the area’s lone provider of radiation and chemotherapy, saw 369 new breast cancer patients last year, up from 334 patients in 2009. Higher numbers point to increased detection efforts, said Dr. Anthony Hui of Northwest Arkansas Pathology Associates.
Northwest Arkansas is among the state’s best in detecting and treating cancer, said Paul Cunningham, senior vice president of the Arkansas Hospital Association. He said the three large hospital systems along the Northwest Arkansas corridor — Washington Regional, Northwest Health and Mercy Medical Center — and the area’s population growth helped draw in specialty services.
Some rare forms of breast cancer, such as Paget’s disease, which starts on the nipple, may require treatment at specialized facility such as MD Anderson Cancer Center in Houston or the Mayo Clinic in Rochester, Minn., Hui said.
“But those cases are uncommon,” he said.
Shelli Engle attests to the area’s options. The Springdale resident was diagnosed in June 2004 with breast cancer. At age 31, she purchased her first home and said she was in great shape. Then she felt a lump in her breast.
With her young age and no family history of the disease, she was not overly worried when she went in for an ultrasound. Radiologists will often perform ultrasounds first in young, low-risk patients. What the doctors saw led to a mammogram, a biopsy the next day and a cancer diagnosis the next.
Engle had no family in the area and wanted a second opinion closer to loved ones. She traveled to Dallas and had doctors at Baylor’s Smith Breast Center give her another look.
“They basically said the same thing as the doctors here said, and I was very comfortable with the doctors here,” she said.
She decided to have all her treatment done in Northwest Arkansas. Now going on nearly seven years of being cancer free, she does not regret that decision.
“I knew my doctors here were just a phone call away, and I would get that interaction rather than just being one patient out of a thousand in Dallas,” Engle said.
Team Approach
Patients receive better treatment when medical professionals work together, Grear said. A group of 20 medical professionals discussed three cases during the April 14 conference at Washington Regional Medical Center. Three is a low number. The group usually hears at least twice that many.
Conferences pull together surgeons, oncologists, pathologists, radiologists, primary care physicians and plastic surgeons. Groups that provide other, nonmedical assistance also participate in these gatherings to discuss patient treatment options.
Washington Regional holds a weekly breast conference and Northwest Health System offers weekly tumor conferences. Mercy Medical Center holds its breast conference every other week.
Grear said Washington Regional’s breast conference started about 10 years ago after several physicians attended a multidisciplinary course.
“There were turf battles over who was going to take care of patients, and we wanted to get a team spirit,” she said. “It took some time, but we are there.”
The team approach also gives a patient more confidence because more people are discussing the case, Grear said.
“It makes patients feel better that someone is looking out for them,” she said.
Cancer Navigation
Breast cancer navigators help women facing the disease. These people are called navigators because they lead women through every aspect of treatment, providing comfort, support and resources. Local hospitals receive significant funding for these programs through the Susan G. Komen for the Cure Ozark Affiliate.
Susan Earnest is Washington Regional’s navigator. She works out of the Cancer Support Home. She said she has 35 women she follows every month and adds between six and 12 patients weekly. The needs of the women vary, and she may only have one visit with some and be connected for years with others.
“What I try to do is give women the whole, big picture,” she said.
Initially Earnest provides newly diagnosed women with a wide array of facts about the disease, treatment options and support systems. What she doesn’t do is give opinions or treatment advice.
Additional contact may come by attending doctor’s or hospital visits.
Mercy will get a breast cancer navigator Monday, according to Dorothy Farmer, mammography supervisor. The hospital had a nurse navigator who devoted much of her time to medical duties. Farmer said the new navigator will guide patients through the whole process, working closely with surgeons and oncologists.
Detection, Diagnosis
The Northwest Arkansas Cancer Registry estimates the area will have 250 to 300 breast cancers diagnosed this year. An estimated 82 women died from breast cancer in the two-county area in 2004, the most recent mortality data available on the registry.
Early detection is key to lowering the mortality rate. The five-year survival rate is 98 percent for cancer patients whose disease has not spread beyond the breast when diagnosed, the American Cancer Society reports.
The Arkansas Department of Health lists six active mammography centers in Benton and Washington counties. Ann Wright, the department’s director of communications, said these facilities are not issued a license, but must have equipment registered with the Arkansas Department of Health, Radiation Control; and the facility and its equipment must be accredited by the federal Food and Drug Administration.
Grear helped co-found The Breast Center in 2003. She said the center performs about 20,000 mammograms a year, with about 15,000 being screening mammograms.
Screening mammograms are used to check for breast cancer in women showing no signs or symptoms. Diagnostic mammograms are used to check for the disease after a lump or other sign or symptom is found.
The center diagnosed about 170 women with breast cancer in 2010. The newest facility, the Northwest Breast Imaging Center at Willow Creek, opened in October.
“We are doing 1,000 mammograms a month. It’s increased by about a third since we opened,” said Dr. Christie Phelan, medical director.
Northwest ordered a second mammogram unit because of the high demand.
“Northwest Arkansas has so many good facilities,” Phelan said. “I think we have enough facilities that all women should have no problem getting mammograms.”
About 30 percent of women in Washington and Benton counties reported no recent mammograms in Komen’s Community Profile. If a mammogram shows a possible tumor, the next steps involve getting additional views of the questionable area, with an ultrasound or MRI, and a biopsy. These are done by the radiologist.
The removed tissue is examined by a pathologist. Northwest Arkansas Pathology Associates is the only local lab. Hui, who helped start the group in 1988, said there are pathologists out of the area who examine samples, but they don’t have the connection to the rest of the local medical community. The independent lab works with all local hospitals.
Hui also serves on the Washington Regional Board of Directors and runs the hospital’s breast conference.
“We are part of the circle of care,” he said. “We do a diagnosis and reports go the surgeon and oncologist.”
Surgery, Recovery
Dr. Michael Cross is a surgical oncologist and the area’s only surgeon dedicated to breast cancer. General surgeons can also remove tumors, and there are 18 in the two-county area who operate on breast cancers.
Sometimes patients undergo chemotherapy prior to surgery to shrink a tumor and make it easier to remove, Cross said. Radiation and chemotherapy are often used following surgery to ensure cancerous cells have been destroyed.
Highlands Oncology employs seven medical and three radiation oncologists. Medical oncologists administer chemotherapy and radiation oncologists use radiation therapy.
The center has three radiation machines and two chemotherapy suites in Fayetteville, said Kathey Parker, Highlands administrator.
Highlands is planning to open the Benton County Cancer Center in Rogers on July 5. The all-inclusive 50,000-square-foot facility will replace a Bentonville site. The center will include radiation therapy, a large chemotherapy suite, physician offices, coffee shop, retail pharmacy and diagnostic clinic.
Parker said patients often have the ability to participate in clinical trials.
Cross said the area also attracts patients from other parts of the country based on the reputation on some of medical professionals. He said he is seeing more complex cases and a younger population in recent years.
Hui said the number of breast cancer patients younger than 40 has increased because of better detection.
“That’s what we want,” he said.
The size and scope of the cancer help a patient and her surgeon chose the best course to follow: a lumpectomy, which removes only the tumor and a small amount of surrounding tissue, or a mastectomy, which removes the breast and surrounding tissue and lymph nodes. Some women opt for a bilateral mastectomy, which removes both breasts.
“I think the pendulum has shifted and more women are getting a mastectomy and being less conservative,” Cross said.
Woman opting for the bilateral mastectomy do so as a precaution.
Breast reconstruction often occurs immediately following cancer surgery. Cross said the process is not new, but the team approach is.
“I am in the operating room the whole time,” he said. “When reconstruction is done right away, women have fewer complications.”
Four plastic surgeons in the two-county area perform breast reconstruction.
Throughout their battle against breast cancer, women are finding tools close to home.
“I’ve been all over the world, and I think we can stand shoulder to shoulder, or even better, than anywhere,” Hui said. “If it was someone in my family, I would want them treated here.”