2015 think pink breat cancer awareness section

| Sunday, October 4, 2015 1

think PINK

BREAST CANCER AWARENESS MONTH

PERSEVERANCE PAYS OFFWoman’s insistence on biopsy likely saved her life | A6

RIDE PINKWomen’s motorcycle group gears up to help | A2

PINK ANGELS CALENDARMeet this year’s 12 models – all breast cancer survivors | A3

OcalaStarBanner

■ PUTTING THE CUFFS ON CANCER | A5 ■ UNIVERSITY RESEARCH ADVANCEMENTS | A7 ■ CALENDAR & RESOURCES | A11

SUNDAY, OCTOBER 4, 2014

2 Sunday, October 4, 2015 |

CONTRIBUTING WRITERSMarian Rizzo

Kathy Ryan Cole Carlos E. Medina

Jeff Schweers Chris Curry

CONTRIBUTING PHOTOGRAPHERSAlan Youngblood

Doug EngleBruce Ackerman

Erica Brough

EDITORSusan Smiley-Height

DESIGNERJessica Shafran

GateHouse Center for News & Design

ON THE COVER: ON THE COVER: June Brine, right, survived breast cancer and had both

breasts removed. She is shown with her daughter Michelle Stephens in Brine’s Sum-

merfield home on Sunday, Sept. 13, 2015. (ALAN YOUNGBLOOD/STAFF PHOTOGRAPHER)

thinkPINKOcalaOcalaStarBannerStarBanner

By Carlos E. MedinaCorrespondent

Lori Timmreck wanted to open a place where women who have had mastectomies and are battling breast cancer could come to get specialty items in a boutique setting rather than a clinical one.

More than seven years ago, Timmreck opened All About You Women’s Boutique, which offers supplies to women who have little or no insurance. On Oct. 10, the Silver River Chapter of Women in the Wind, a motorcycle group, will hold a poker run to raise funds for the boutique’s charity fund.

Because the boutique could not be a for-profit and a non-profit at the same time, Timmreck asso-ciated herself with the All4One Alliance, which administers the funds raised for the boutique charity fund under All4One’s non-profit designation.

“All the money raised by the ride is going to women locally that are in need. They can come in here and

not worry about the cost,” said Timmreck. “It’s great that Women in the Wind wants to help make a difference in Ocala.”

Women in the Wind has chapters across the country and world. The Silver River chapter was founded by Nancy Ihasz, who started riding in 1979 after a divorce.

“We thought doing a Ride Pink event would be a great way of sup-porting a local charity,” Ihasz said. “We’re going to dress up in pretty silly outfits and have fun.”

The ride will cover about 75 miles and stop at several local busi-nesses, which are helping sponsor the ride. Motorcycles and cars will be included in the ride, which ends on the Ocala downtown square. The cost per poker hand is $15 for drivers and $5 for passengers, with additional hands available for $5 each.

For Debbie Gibson, the ride will combine both her passions. She is the current chapter president of Women in the Wind and works at All About You. She also is a breast

cancer survivor who underwent amastectomy.

“It’s great when you can helppeople that are going through thesame thing you have,” Gibson said,adding she has been in remission for10 years.

All About You offers a wide varietyof mastectomy supplies includ-ing bras, prosthetics, compressionsleeves and wigs.

“I’ve been a certified fitter for20 years and had a passion to helpwomen. The facility I was working atdidn’t have a wide selection of sup-plies. I wanted to offer women more.It’s been a struggle, but when yousee a smile on a woman’s face, that’swhen you realize this is what I wassupposed to do,” Timmreck said.

The ride will award prizes for bestcostume and best decorated bike orcar.

“It’s going to be a lot of fun for agood cause,” said Ihasz, who sisterand mother both are breast cancersurvivors.

For information about the ride,contact Ihasz at 207-8129.

RIDE PINK

Women's cycling group to hold poker run

Debbie Gibson, Ann Van Deusen and C.J. Messenger, members of the Silver River Chapter of Women in the Wind motorcycle club, get ready for the Ride Pink event on Oct. 10. SUBMITTED PHOTO.

Oct. 10 event proceeds will support charity fund

3rd Friday every month • 6 PM - midnight (or whenever you give up)692 NW 30th Ave - EOC room @ Marion Co Sheriff’s Office

$5 per person to attend

Bring your favorite craft project: scrap booking, cards, needlework,jewelry, painting etc and join a group of creative crafters. Great way

to get new ideas and share tools etc.

For more information or to sign up, call Claire at 732-5982

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Historic Downtown Ocala�s Lifestyle Store

Open M-Sat: 10-522 So. Magnolia (352) 690-2121

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surprises galore!

By Kathy Ryan ColeCorrespondent

The stories of each of Marion County's 12 new Pink Angel Calendar models is unique and personal. But they all share one commonality - breast cancer.

The identities of the 2016 angels were revealed during a recent fashion show event at Hilton Ocala. The fundraising benefit, in partnership with the All 4 One Alliance and All About You Women's Boutique, raised money so breast cancer survivors without insurance can obtain needed supplies and accessories.

The emcee for the show, former calendar angel Ariane Anderson, now of Tampa, lik-ened the breast cancer survivors to incense.

“When incense is crushed, then it really is potent. We sur-vivors were being crushed, but not destroyed,” Anderson said. “We all have stories. Unfor-tunately, the story of having cancer is becoming more com-monplace. Even though we face Goliath, many defy the odds.”

This year's angels are:

JANUARYSharon Jank, whose breast

cancer was discovered after a second mammogram. Part of her treatment included proton beam radiation that was only available in Jacksonville at the time. She commuted for two months to receive needed treat-ments. She has been cancer free since October 2013.

“Check yourself regularly, and if is doesn't seem right, get it checked out,” she said. “Stay-ing focused and praying is what got my family and I through it.”

FEBRUARYMargaret Renaud said her

breast cancer was discovered by mammogram in 2013.

“I have undergone a mastec-tomy, chemotherapy, radiation therapy, hysterectomy and the

initial stages of breast recon-struction — with no shortage of complications along the way,” Renaud said. “I wouldn't wish this experience on anyone, and yet I am grateful for the lessons that it has and continues to teach me in appreciating the blessings I have.”

MARCHShirley Gould's cancer was

caught early, but because it was an aggressive form.

“It was agreed upon for me to have chemo treatments and a five-year estrogen blocker,” Gould said. “Nothing about cancer is easy, but with love and support it is better.”

APRILSue Tucci called herself

“a perfect example of what happens when you ignore mammograms.”

Tucci's diagnosis was Stage 4 metastatic breast cancer. After treatment, Tucci said, “I am living out my life as a chronic cancer patient.”

MAYNikki Smith is a single mom

who was diagnosed in April 2008.

“Within a week of diagnosis, I was in surgery to have a mastec-tomy and so began my journey as a breast cancer survivor,” Smith said. “At the end of the day I choose to focus on all I have gained instead of all I have lost. I had cancer, but cancer never had me.”

JUNENancy Kibler's cancer was

found by accident during a random tissue study follow-ing breast reduction surgery. Twenty years later, another lump was discovered in the same breast. Kibler had a mas-tectomy and reconstruction and has been cancer free since 2007.

“I may not have a perfect body, but God saved me twice, and I know without Him in my life, I could not have faced this on my own,” Kibler said.

JULYLynn Sardinas, although

symptom free, decided at age 35 to have a mammogram. She was diagnosed with two types of cancer in her right breast.

“It was so hard to wrap my head around a cancer diagno-sis when I was the healthiest

and fittest I had ever been,” Sardinas said. “After the initial shock wore off, I pulled together a butt-kicking cancer team that helped me navigate a double mastectomy, a three-month chemotherapy regimen and breast reconstruction.”

AUGUSTCrystal Main said her cancer

journey started in 2010, with surgical procedures and 40 radiation treatments only to return in 2012.

“This time it was in both breasts, and I had radical bilat-eral mastectomy surgery,” Main said. “I attempted twice for reconstruction and both times failed due to mass infec-tion. I thank God every night for allowing me to see another day. I learned my breasts didn't make me who I am — that took some time.”

SEPTEMBERSavi Marayan said that after

a mammogram and ultrasound, when both the doctor and a nurse came into the room, she knew something was wrong. It was confirmed in 2014 that she had triple positive breast

cancer. That led to a left mas-tectomy followed by six roundsof chemotherapy and a year of taking Herceptin. She then had breast reconstruction.

“I can finally see the light at the end of the tunnel,” Marayan said. “I am very thankful and blessed to have so much love and support from family and friends. “

OCTOBERAbby Jones was diagnosed

in 2014 with four primary can-cers. She had her left kidney and a portion of her lung removed, plus a bilateral mastectomy and reconstruction.

“Praise God none of my can-cers has spread and I am cancerfree. I am beyond grateful for each day I get to spend living my life for today,” Jones said.

NOVEMBERTammy Smith was diagnosed

with triple negative breast cancer in 2008. The cancer wasaggressive and required six che-motherapy treatments and 33 of radiation. She spoke of receiv-ing wonderful family support, including from her husband, and added, “I could have not made it through without my faith and trust in God.”

DECEMBERRenee Waldron was diag-

nosed with Stage 4 metastatic breast cancer in 2014.

“My first response was, 'My God is bigger!'”

Waldron spoke of her journeyas being “an emotional roller coaster.”

“It shouldn't take a diagnosislike this to make one slow down and enjoy each new day as the gift it truly is, but it did me,” Waldron said. “The world, my faith, my family and friends arebeautiful.”

To learn more about the annual Pink Angels Calendar, call 236-2599 or visit http://aaywb.com/


PINK ANGELS

Calendar models symbolize victory over breast cancer

Savi Marayan

Sharon Jank


By Melissa EricksonMore Content Now

Having trouble sleep-ing through the night makes it hard to function during the day and is a public health epidemic, according to the Centers for Disease Control and Prevention. Breast cancer patients are part of the estimated 50 million to 70 million people affected by sleep disorders.

Insomnia is a common side effect of medical treatments and medica-tions aimed at saving their lives. According to Breast-Cancer.org, insomnia can be caused by treatments Ixempra (chemical name: ixabepilone), a chemo-therapy medicine; Tykerb (chemical name: lapa-tinib), a targeted therapy; and hormonal therapies Arimidex (chemical name: anastrozole), Aroma-s i n ( c h e m i c a l n a m e : exemestane) and Faslo-dex (chemical name: fulvestrant). Some pain medications also can cause sleeping problems.

Insomnia affects your mood and energy, leaves you feeling fatigued and makes it hard to concen-trate, said sleep expert Dr. Ilene Rosen, who serves on the board of directors for the American Academy of Sleep Medicine.

“Studies show that i n s o m n i a n e g a t i v e l y affects work performance, impairs decision-making and can damage relation-ships,” she said.

If you are having trou-ble sleeping, the first step

is to make sure you areemploying good sleephygiene, Rosen said. Hereare some of her tips forovercoming insomnia:

• Keep a regular sleepschedule, making sure togo to bed when you aresleepy and wake up at thesame time every morning– even on the weekends.

• Make sure your bed-room is quiet, dark and alittle bit cool – it shouldremind you of a cave.

• Avoid caffeine in theafternoon as this can keepyou awake at night.

• No screens for at leastan hour before bedtimeor in the bedroom. Thatmeans no TV, no phones,no tablets. The blue lightthey emit can hinder mel-atonin production, whichis what makes you sleepy.

• Feel the need for anap? Limit yourself to nolonger than 10-20 min-utes in the early afternoonwhen you feel a naturalincrease in sleepiness,Rosen said. “Naps of 30minutes or longer maycause grogginess or ‘sleepinertia,’ and it can delaythe performance benefitsof a nap,” she said.

“Sleep, exercise andn u t r i t i o n a r e t h r e epillars for a healthy life-style. A recent surveyfound that individualsreported sleeping betterif they exercised regu-larly. Research has foundthat exercise before bedmay be OK – however,those suffering frominsomnia should avoidvigorous activity in thehours immediately beforebedtime,” Rosen said.

SLEEP

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By Kathy Ryan ColeCorrespondent

“Great venue, beautiful campus” is how breast cancer survivor Sangi Blair describes the site of this year's Making Strides Against Breast Cancer walk in Ocala.

The annual American Cancer Society event will take place at the College of Central Flor-ida, 3001 SW College Road, Ocala, on Saturday, Oct. 17. Registration and check-in begins at 7:30 a.m. with the three-mile walk starting at 9 a.m.

Blair who was diagnosed with breast cancer at 38, has been cancer-free for 15 years. She said the walk is “a celebration both of cancer survivors and those who passed away.” To her, the most compelling part of the day is the opening ceremony and breakfast for survivors and their caregivers.

Blair, who is CF's Academy Coordinator for Law Enforce-ment, and also the wife of Sheriff Chris Blair, said there are three "F"s necessary for coping with the disease: Faith, family and friends.

“Cancer is a word, not a sen-tence. It does not define you,” she said.

Blair served as the Making Strides chairman in 2013 when, she stated proudly, the local law enforcement team raised $60,000 and won the coveted title of generating the most funding in all of Florida.

She said this year’s event again will feature the pink patrol cars of the four par-ticipating law enforcement agencies, which include the Marion County Sheriff’s Office, and the police departments of

Ocala, Dunnellon and Belleview. Drivers of the pink vehicles, according to Blair, volunteer as their personal lives have been impacted in some way by cancer.

This year’s walk chairman is Tina Atha of Anthony, who has participated in the walk for the past five years.

“I volunteer to honor my friend Linda Murphy, who is a cancer survivor. I am involved in giving back to non-profit agencies. That is what you are supposed to do,” said Atha, who also is a 4-H leader in the community.

Jessica Clayton, an American

Cancer Society employee and community manager for the walk, encourages people to vol-unteer for the event.

“It is so important to support the walk because cancer touches everyone. If someone has not been impacted personally by breast cancer, they know some-one who has – friends, family and co-workers. By becom-ing involved in Making Strides Against Breast Cancer individu-als are able to give back to the community and fight to end this terrible disease,“ she said.

Clayton said 2,800 walkers participated last year.

“All funds raised through the

walk support research, pro-grams and services offered by the American Cancer Society for breast cancer patients, sur-vivors and their families. Funds are raised through corporate sponsorships and community fundraising events. The goal for 2015 is 145 registered teams. A team may be one or 200 people. There is no registration fee or minimum fundraising require-ment. Every team member raising $100 or more receives a free T-shirt,” Clayton said.

One team, called Hooked Up for Tatas, recently held a fish-ing tournament in Crystal River. Ninety fishing teams raised

$6,000. The team was headed by Bryan and Corin Caracciolo. She said an extra $1,000 also was raised, which went to help a cur-rent cancer patient, Jen Hoop.

Corin Caracciolo said this was the second year of the tourna-ment, which was started in honor of her mother, Susan Onorato of Ocala, who is a 15-year cancer survivor. She said better atten-dance was achieved this year by holding the fishing contest in August instead of in October as before. More than 300 people attended and caught fish includ-ing kingfish, and grouper. She expressed excitement over “new and innovative ways” in which to do fundraising.

An example of that can also be seen in the “Putting the Cuffs on Cancer” event. It is a dinner and silent auction to be held 5 to 10 p.m. Thursday, Oct. 8, at the Longhorn Steakhouse at 307 SE 17th St., Ocala. Law enforcement officers will be servers and their tips will be donated to the walk.

Last year’s top fundraising teams for the walk included Marion County Public Safety, $19,063; TTFE (Saying Ta Ta Forever to Breast Cancer), $5,450; Claire’s Crops, Cards and Crafts, $5,000; Pink Bob-bers, $3,574; Team Race Attack, $1,759; Team Ocala Eye, $1,600; Team Marie, $1,583; and Posi-tively Pink, $1,545.


WALK FOR THE CAUSE

Making strides against breast cancerAnnual event will draw thousands to college campus

To learn moreFor information about the Making Strides Against Breast Cancer walk set for Saturday, Oct. 17, at the College of Central Florida, 3001 SW College Road, Ocala, visit www.makingstrideswalk.org/ocalafl or go to the Facebook page of Making Strides Against Breast Cancer of Ocala FL.

Marion County Sheriff’s deputy Rob Rath talks about menu items with Taneka Wilson, front and Roniesha Brown at Eaton’s Beach Sandbar and Grill during the Tip-A-Cop fundraiser for Breast Cancer at the Weirsdale resort on Saturday, Sept. 19, 2015. Custom-ers look over a Sheriff’s Office cruiser decorated to support the cure for breast cancer, which was on display during the event. Volunteers from area law enforcement agencies helped serve meals during the event to raise money for a Making Strides Against Cancer team that will participate in the upcoming annual walking event in Ocala. ALAN YOUNGBLOOD/STAFF

PHOTOGRAPHER


By Marian RizzoCorrespondent

June Brine is the kind of woman who weighs the facts and then makes up her own mind about things. So, in December 1980, after find-ing a lump in her right breast during a self examination, she made a life-saving decision.

Though three doctors told her the lump was harm-less, she took the advice of her former mother-in-law and insisted on a biopsy. The test came back posi-tive for a Stage 3 aggressive breast cancer. One week later, Brine had a mastec-tomy. During the surgery the doctor found two more lumps and removed 23 sus-picious lymph nodes, Brine said.

“The doctor felt he got all the cancer, so I had a new lease on life,” she said. “Let's face it, if I hadn't listened to my mother-in-law, I would never have seen my 25th birthday.”

Brine was a newly-wed at the time, having been married 18 months before. It was a busy December. The Christmas holiday was right around the corner. Her grandmother had just died when Brine learned she had cancer. She also had two aunts who died of the dis-ease. Brine tried to remain optimistic.

“After my mastectomy, I was lying in the hospital and

my arm was in a sling, and I said, 'I wonder if I'm going to be OK?'” Brine said. “I felt a reassuring hand on my thigh, and I sensed that I was going to be OK. And I was OK. And I'm still here. It wasn't the end of the world, it was the beginning of a new life.”

Brine faced months of physical therapy, mostly range-of-motion exercises. Because the doctor had removed all the cancer, she did not need chemotherapy or radiation treatments. Then she faced another deci-sion when the medical staff cautioned her not to have children.

“I said, 'No, no, no. I have a different opinion. The good Lord put me here to have children,'” Brine said.

One year later, Brine had reconstructive surgery. And, in 1984, she gave birth

to her first child, Michelle Kimberly (Stephens). Since doctors had not removed her left breast, Brine was able to nurse her firstborn child.

The following year, how-ever, doctors recommended removal of the left breast. They said there was a higher recurrence rate after the age of 30.

In 1987, Brine gave birth to a son, Matthew. Because of complications, she also had to have a complete hysterectomy.

Now 59, Brine has been a Realtor with Properties of The Villages for nearly 20 years.

An avid cook, she also likes to travel, and she grooms her own yard, a flourishing tropical oasis with tall ivy-covered oaks and a variety of plants that give it a park-like setting. She credits her son Matthew with the rock-scaping, and praised former Belleview High School stu-dents who helped her pull weeds in recent years.

M e a n w h i l e , B r i n e ' s daughter Michelle, 31, is two months pregnant with her first child, which will give Brine a second grand-child along with Matthew's 3-year-old daughter, Lil-liana Grace. Brine happily shows off pictures of the family she had been warned not to have.

Michelle and her husband Erik are looking forward to

PERSEVERANCE PAYS OFF

Woman's insistence on biopsy likely saved her life

Breast cancer survivor went on to volunteer to help others

June Brine, front, survived breast cancer and had both breasts removed. She is shown with her daughter Michelle Stephens and son Matthew Brine in her Summerfield home on Sunday September 13, 2015. ALAN YOUNGBLOOD/STAFF PHOTOGRAPHER

“The doctor felt he got all the cancer, so I had a new lease on life. Let’s face it, if I hadn’t

listened to my mother-in-law, I

would never have seen my 25th

birthday.”June Brine

SEE BIOPSY ON PAGE 10


By Jeff Schweers Staff writer

There are as many differ-ent types of breast cancer as there are people who have the disease. It is not a one-size-fits-all disease so there is no single treatment.

Its heterogeneous nature makes developing better ther-apies for breast cancer all the more challenging to treat, say the doctors and researchers at the University of Florida dedi-cated to stopping a disease that claims over 40,000 lives in the U.S. each year.

“A wide range of types come through our door,” says Dr. Paul Okunieff, chairman of the UF Department of Radiation Oncology and director of UF Health Cancer Center.

Okunieff is bullish about some of the emerging, cutting edge research being conducted here at UF’s College of Medicine and Shands teaching hospital in cre-ating personalized treatment, particularly the research being conducted at a molecular level.

UF is putting millions of dol-lars a year into breast cancer research, with a broad range of laboratory and clinical studies from exploring new therapies and diagnostics to pinpointing the exact genetic makeup of a person’s individual cancer.

“More and more, we are learning that different types of cancers don’t come from classes themselves,” Okunieff said, referring to the classes of squamous cells, which starts in cell linings and can lead to skin cancer, and adenocarcinomas, which start in glandular cells and cause breast cancer.

“While that is what they look like under microscope, what we are looking at more and more are the specific driver genes that make it a cancer,” he said. “If you knew the driver mutations you could have targeted drugs

that attack those mutations.”Dr. Coy Heldermon, an assis-

tant professor of medicine and oncologist who specializes in treating breast cancer using stem cell and gene replacement therapies. He’s had success developing therapies from patient-derived xenografts —growing human tumor cells in mice.

“We put a tumor from a wom-an’s breast into a mouse breast,” he said.

If it succeeds in growing, he and his team can transfer the same genetic material into 50 other mice and start develop-ing therapies designed to treat that particular patient.

However, the process takes a year to 18 months — longer sometimes than would actually help the patient, he said. “I am

not offering as a way to treat patients, but using it as a way to collaborate with people for drug discovery,” Heldermon said.

Once they have enough tumors, they can do clini-cal trials of different patients, trying different drugs on the tumors and seeing which ther-apy shrinks the tumor with the least side effects.

Heldermon tells his patients it’s like figuring out which fuels work best with which engines. Some work on gasoline, some on diesel and some on ethanol.

Imagine he and his collabora-tors as mechanics working in a giant garage. But instead of fig-uring out how to make engines run, they are trying to find the best way to shut them down.

“They are testing whether that inhibitor will block that

engine in the cells of the tumor,” Heldermon said.

Heldermon has collaborations with many other researchers at UF. One collaboration in particular is with Brian Law, a pharmacologist studying a particular cell pathway called CDCP1, a protein that is a driver for cancer cell mutation.

L a w h a s d e v e l o p e d a n inhibitor for that protein that Heldermon is testing on dif-ferent xenografts in various combinations to see what works most effectively. Two of the major unmet needs in breast cancer treatment have been the inability to treat metastatic disease and to combat drug resistance, Law said.

“Tumors initially respond then become resistant to the drugs,” Law said. “Once that

happens there are limited options going forward.”

He’s working on breaking thecode on the CDCP1 protein to figure out how to stop it from causing cancer to spread —metastasize — throughout the other organs in the body.

Using tumor cells of a patient grown inside a mouse helps them hone in on the genetic dif-ferences that cause cancer and differ from patient to patient.

“There is not one magic bullet that can cure all cancer,” Law said. “We need to personalize medicine,” which means under-stand the mechanisms driving the cancer.

UF researchers are also trying to break the code on a particu-lar type of breast cancer that has mystified physicians. It’s called triple-negative cancer becauseit is defined by what it lacks rather that what causes it.

“When you describe some-thing by what it is not, you don’t know what it is,” said Karen Daily, a clinical based investi-gator at UF.

Daily belongs to a cooperative of scientists at other institutes conducting trials on patients with triple-negative cancer whose initial chemotherapy and surgery didn’t remove all the cancer.

They study the tumor to try to identify the mutations that lend themselves to a drug already onthe shelf that may have been used in other cancer settings and aggressively treat them following surgery instead of the normal follow-up routine.

“The ability to do this kind of genomic testing on tumors where we are looking at mul-tiple genes and do it rapidly at a low cost has really just kind of exploded in last five years or so,” Daily said. “It really is an exciting time to be in oncology because there is a lot of potential to better understand cancer and have better treatment options.”

RESEARCH

One approach doesn't fi t all: Tailoring therapies

From left to right, researcher Ling Bao Ai, under graduate research assistants Alex McNally and Priya Shil, and lab manager Kelsea Grant, perform a procedure in which they will extract a human tumor grown in a mouse. They are working in the laboratory of Dr. Coy Heldermon, assistant professor of medicine at the Academic Research Building at the University of Florida. ERICA BROUGH/STAFF PHOTOGRAPHER

Keeping in shape, inside and out



Lifestyle choices absolutely make an impact in breast cancer. In addition to regular health exams with a doctor, there are plenty of things a woman can do to control her breast health.

● EXERCISE REGULARLY: “Regular exer-cise and healthy diet are associated with reduced risk of developing breast cancer and can also reduce the risk of developing a breast cancer recurrence,” said Dr. Rachel Layman, a breast oncol-ogist with the Ohio State University

Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Colum-bus, Ohio. The recommendation is for patients to have at least 30 minutes of moderate to vigorous exercise at least fi ve days a week.

● MAINTAIN A HEALTHY WEIGHT: “Although we don’t know for sure why exercise helps, it is likely related to a variety of factors, such as maintaining a healthy weight in addition to hormonal factors such as effects on estrogen and insulin,” Layman said.

● EAT RIGHT: There is no specifi c food

that will keep cancer away, but the best diet to lower the risk of cancer is one that is low in fat, high in fruits and vegetables and with limited red and processed meats. “Your diet should allow you to maintain a healthy weight,” said Dr. Joan Kramer, Winship Cancer Institute of Emory University breast cancer expert.

● WATCH YOUR DRINKING: “Alcohol does increase the risk of breast cancer, and in terms of breast cancer risk the less you drink, the better, since even as little as one alcoholic drink a day is linked to a small increase in risk,” Kramer said.

● KNOW YOUR HISTORY: “Although women with a family history have an increased risk of breast cancer, only 15 percent of women with breast cancer have a family history of the disease. Some women think that they won’t get breast cancer because it doesn’t run in their family, but that isn’t true,” Kramer said.

● GET CHECKED: “Most women should have an annual mammogram and clini-cal breast exam once per year starting at age 40, although recommendations can differ based on individual risk fac-tors,” Layman said.


Yoga’s rejuvenating and ther-apeutic effects make it a popular exercise regime for millions of people. For breast cancer patients and survivors, yoga not only helps control physical functions like breathing, heart rate and blood pressure, it offers some surprising benefits, too.

“Yoga can improve the quality of life for breast cancer patients in several ways,” said Dr. Janice Kiecolt-Glaser, director, Insti-tute for Behavioral Medicine Research, Ohio State University College of Medicine. Kiecolt-Glaser was the lead author of a recent study that found that yoga can lower fatigue and inflammation in breast cancer survivors. The women in the study were less fatigued than women not practicing yoga, and the more women in the study

practiced yoga, the better their results.

“Fatigue is a really important quality of life marker for breast cancer patients because it has such a pronounced effect on daily life. The fatigue is not like being short of sleep but rather the kind of fatigue that can permeate the day and the abil-ity to do many daily activities,” Kiecolt-Glaser said.

FATIGUE FIGHTERIt’s estimated that perhaps

30 to 40 percent of longer-term breast cancer survivors have debilitating fatigue after treatment, Kiecolt-Glaser said. Women stressed with fatigue are often so tired that they’re less likely to exercise.

“The less they exercise, the more tired and the weaker they may be, so it’s a downward spiral. Yoga was a way of inter-rupting that spiral and getting

women the opportunity to learn a new skill that was not too physically demanding and that helped the fatigue substan-tially,” she said.

Sleep issues are often com-monplace in breast cancer patients and survivors “much more so than their age mates in the general population who haven’t had cancer,” said Kiecolt-Glaser. Yoga can help relieve the insomnia caused by breast cancer treatments and medications.

STRESS RELIEVERFor women with breast cancer

undergoing radiation therapy, a mind-body approach to yoga offers health benefits beyond fighting fatigue, according to research from the University of Texas MD Anderson Cancer Center.

Women who practiced yoga exercises that incorporated

controlled breathing, medita-tion and relaxation techniques into their treatment plan expe-rienced improved ability to engage in daily activities, better general health and better regu-lation of the stress hormone cortisol. Women in the yoga group were also better equipped to find meaning in the illness experience, which declined over time for women in the other groups.

“The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult,” said Dr. Lorenzo Cohen, professor and direc-tor of the Integrative Medicine Program at MD Anderson.

W h a t w a s t h e i m p o r -tant ingredient in yoga that

benefits breast cancer patients and survivors?

“Because yoga has several different components – breath-ing, meditative and movement or postures – we don’t know which of those was potentially most important. We assume they were all important or that one was more important than the others,” Kiecolt-Glaser said.

BEFORE YOU BEGINBefore starting any new work-

out program, women should check with a physician.

“One of the nice things aboutyoga, especially a restorative yoga like hatha yoga training, is that it is relatively low demand in terms of physical limitation,” Kiecolt-Glaser said. Check with the teacher and ask what kind of class it is and if back or otherphysical issues can be addressed easily in class.

MIND AND BODY

REMEMBER TO BREATHEThe surprising benefi ts of yoga for cancer patients, survivors


By Chris CurryStaff writer

Five days a week for six weeks in late 2012, Kelly Jones left her assistant principal job at Fort Clarke Middle School in Gaines-ville in the late morning and traveled to Jacksonville.

There, she would lie down on a treatment table as a beam of protons accelerated to nearly the speed of light shot radiation into the left side of her chest.

Diagnosed with breast cancer in March 2012, Jones went through surgery, chemother-apy and conventional radiation treatment with X-rays.

In an effort to ensure the cancer did not return, she also went to the University of Florida Health Proton Therapy Institute in Jacksonville for treatment that relied on a massive nuclear

particle accelerator, a medical use of a product of some high-level physics research.

Three years later, Jones, now 41, remains cancer free.

“Everything is good so far,” she said. “That is what we hope will continue.”

Meanwhile, UF doctors in

Jacksonville continue to move deliberately into the use proton therapy for some breast cancer patients.

The UF proton therapy treat-ment center opened in 2006 and is now one of 14 operating in the nation, with another 11 planned, according to the National Asso-ciation for Proton Therapy.

Over the last decade, the UF center has treated more than 6,000 cancer patients with proton therapy. But the center’s use of proton therapy to treat breast cancer started more recently and is not yet widespread. The breast cancer program started in 2012 and has so far treated a little more than 50 women, said Dr. Julie Bradley, a radiation oncologist at the Proton Therapy Institute.

Bradley said UF has decided to focus the proton treatments on more advanced cases of breast

cancer, including cases that have spread to the lymph nodes.

Bradley said the proton therapy is more precise than traditional radiation treatments and avoids exposing healthy tissue and organs like the heart and lungs to radiation.

“The main benefit is we can decrease the side effects,” Brad-ley said.

In Kelly’s case, the cancer was in the left breast and doctors used proton therapy to avoid delivering a dose of radiation to the heart that could, in the long-term, lead to cardiac disease or mortality.

Right now, Bradley is leading a long-term UF clinical study on women with left breast cancer to determine if traditional radi-ation therapy leads to changes in heart function that women who went through proton therapy

did not have.Given the expensive price of the

facilities- the UF institute was $125 million - patient cost is one reason why proton therapy is not more widely used. Out of pocket costs can be “extremely high,” Bradley said and “insurance bar-riers are significant.”A National Public Radio report from last year said proton therapy can be three to six times conventional treat-ments and many insurers do not cover the treatments. do not costs can sometimes run three to six times higher than conventional treatments and many insurers do not cover proton therapy.

Kelly said the treatment would have been beyond her means if the costs were not cov-ered because she was part of the clinical trial.

“It was worth the drive,” she said.

UF HEALTH

Doctors delve into proton therapy treatment for breast cancer

The UF Health Proton Therapy Institute in Jacksonville has three treatment rooms equipped with 360-degree rotating gantries to deliver proton therapy from any angle. PHOTO COURTESY OF RYAN KETTERMA


When you hear the words, “You’ve got breast cancer,” you’ll most likely be over-whelmed with emotions. Asking the right questions will give you valuable information to get the best care.

“Following a breast cancer diagnosis, women may feel totally lost, scared or maybe even numb,” said Joni Avery, spokes-woman at Susan G. Komen, which offers a variety of topic cards with pertinent questions to discuss with your doctor. Print them out at ww5.komen.org.

“It’s universal to feel help-less, but a woman needs to be prepared. Go into the doctor with a list of questions, take it out and refer to it. Take someone with you if pos-sible,” said Sara Goldberger, senior director of programs for the Cancer Support Com-munity, which offers a helpline staffed by health-care profes-sionals from 9 a.m. to 9 p.m. Mondays through Fridays at 888-793-9355.

“Even though you’ll be scared, you need to educate yourself. It will decrease your anxiety and make you feel more in control,” Goldberger said.

Here are some questions suggested by Avery and Goldberger:■ What kind of breast cancer do I have?

“Not all breast cancers are the same,” Goldberger said. Most breast cancers start in the cells that line organs and tissues in the breast, most commonly in the milk ducts, accord-ing to the American Cancer Society. Others can occur in the breast itself.■ What is the stage of my breast cancer and what does that mean?

The cancer staging system, 0-4 (IV), shows the severity of the cancer as well as the tumor’s size and rate of metastasis, Goldberger said.■ Has it spread anywhere else?

The most common places for breast cancer to spread are the lymph

nodes, liver, lungs, bones and brain, according to the National Cancer Institute.■ Is it treatable?

“What are the standard treatments and what are my other options?” Goldberger says to ask. “Can I get treatment locally or do I need to go to an academic center?”■ What is my prognosis?

“It’s a hard question, but most people fi nd it easier to cope when they know their prognosis and treat-ment options,” Goldberger said.■ What are the side effects?

Life-saving breast cancer medi-cines and treatments can cause unpleasant temporary side effects.

“Depending on who you are and

how you live your life, you may choose different treatments,” Gold-berger said. A treatment that causes numbness wouldn’t be a good choice for an artist. A family caregiver who needs to work every day may choose oral chemotherapy over infusions or radiation therapy.■ Should I get a second opinion?■ Are there any clinical trials available?

Treatment of breast cancer has greatly improved over the past 30 years because of the fi ndings from clinical trials, which test the safety and benefi ts of new treatments, diag-nostic methods and screening tests, Avery said. Talk to your doctor to see if a clinical trial is right for you.

DIAGNOSIS

Need to know: Questions to ask your doctor


the birth of their first child in February.

“We've been looking for-ward to this for a long time,” Michelle said. “I eat a healthy lifestyle. I don't smoke. I don't do anything that would increase my chances of get-ting breast cancer. My mom's a very strong individual. She did always encourage me to do self-checks and to go to my mammograms.”

Had Brine not discovered the lump and insisted on a biopsy 36 years ago, she believes she wouldn't be here today. She praised her physicians, Dr. Charles Neustein and Dr. R. Asoken, for their quick action.

“If cancer does return, I have the greatest doctors to help me fight it,” Brine said. “Living with the knowledge that I beat cancer does not mean that I do not think about

it. I try to live a healthy and happy life.”

Brine is a strong advocate of preventive checks, such as mammograms and self-examination. Part of the healing, she said, came from the support she received from friends and family. After her first mastectomy, she also was visited by a volunteer with the Reach to Recovery program.

Founded in 1953 by Terese Lasser, the program came under the American Cancer Society in 1969. Trained volunteers give comfort and answer questions of cancer patients and their relatives. While they do not give medi-cal advice, they are able to share their own experiences as cancer survivors.

“Reach to Recovery is very important for anyone newly diagnosed with cancer,” said Maureen McGuinn, program manager for the society's Jacksonville-based North Central Florida office. “It's unique, because we match

patients with a survivor who had a similar type of cancer, and the same or similar treat-ment. We try to match as closely as possible to all the demographic information we collect.”

The volunteer connects with the patient and keeps an ongoing supportive relation-ship, McGuinn said.

“At one time they did in-person visits,” she said. “Now most visits are done over the phone or via email--or Face-book. It's not as personal as the in-person visits, but they still maintain a connection.”

One of the volunteers who connected with Brine was Ocala resident Carole Immel.

Though Immel had not had cancer, she started a Reach to Recovery chapter in Marion County in response to a sug-gestion by a friend, the wife of a local physician.

“The nurses at the hospi-tal would call me if they had a patient with breast cancer,” Immel said. “At that time, we

would go to the hospital with little kits for the patient. I got to know June Brine.”

At one point, Brine asked if she could be a volunteer. It was recommended that she wait until she had com-pletely healed. Then she took the American Cancer Society training.

“She just jumped into it,” Immel said. “She was positive and had researched as much as she could. She wanted to help others.”

Brine said she counseled more than 100 people who were diagnosed with breast cancer. They included women—and men—of all ages. Her young-est patient was a 16-year-old girl. One of the oldest was an 80-year-old man.

Brine gives them the same pep talk she gave herself.

“Life is to be lived to the fullest each new day,” she said. “ Life goes on and scars heal. You're still the same person you always were. It does not change who you are.”

BIOPSYCONTINUED FROM PAGE 6

June Brine, right survived breast cancer and had both breasts removed. She shows her daughter Michelle Stephens an Ocala Star-Banner newspaper clipping from when Michelle was a baby and the newspaper wrote about June’s cancer. ALAN YOUNGBLOOD/STAFF PHOTOGRAPHER

Specializing in Bras/Lingerie &After Breast Surgery Care Products • ABC & BOC Certified fitters

• Immediate and long term solutions forour breast cancer clients

• We submit your insurance claims• Large selection of post-surgery products

You need a Post-Surgery Breast Consultationand Fitting. Come in today so the ABC & BOCcertified fitters at Unique Lingerie can help you fityour Unique needs.

About UsEdna Turner-DeGenests, the owner of UniqueLingerie, Inc, was trained in Bermuda in 1987 as aMastectomy/Bra fitter. While completing her finalyears of law enforcement in Ocala, Florida she openedher first boutique on Silver Springs Blvd in the OcalaShopping Center. In 2009 she relocated the boutiqueto Market Street at Heathbrook Plaza.

Unique Lingerie, Inc. is the one place in the Ocalaarea for you to find the right bra. We cater to allwomen and specialize in what we call the “ForgottenFemale”. She is the woman that cannot get a properfitting undergarment at the typical department storebecause these stores do not provide the fitting servicewe specialize in.

WEDNESDAY, OCT. 7: Presentation - National Breast Cancer Awareness, learn about detection and prevention, 2 p.., The Windsor of Ocala Assisted Living and Memory Care, 2650 SE 18th Ave., Ocala. RSVP. (873-8000)

THURSDAY, OCT. 8: Tip-A-Cop/Putting the Cuffs on Cancer - Law enforce-ment offi cials serve meals for tips, proceeds benefi t Making Strides Against Breast Cancer walk, 5 to 10 p.m., Longhorn Steakhouse, 307 SE 17th St., Ocala.

SATURDAY, OCT. 10:■ Ride Pink: Poker run sponsored by The Silver River Chapter of Women in the Wind, Inc., 8 a.m, Begins at All About You Women's Boutique, 4901 E. Silver Springs Blvd. Ocala. $15 poker hands for riders, $5 for passengers. (207-8129)

■ Zumbathon: 11 a.m.-1 p.m., Marion County Sheriff's Offi ce, Multi-Purpose Room, 692 NW 30th Ave., Ocala. $10 adults, $5 kids. ([email protected] .us)

■ American Cancer Society Cattle Baron’s Ball - Hats, Horses and Hope, 6-10 p.m., Polo Club, 703 Buena Vista Blvd, The Villages. $150 per person, benefi ts American Cancer Society. (813-319-5902 or www.cattlebaronsballlakesumtermarion.org)

WEDNESDAY, OCT. 14:Dining for Dollars to benefi t Michelle-o-Gram - Long-horn Restaurant, 307 SE 17th St, Ocala. Attendees can look on Michelle-o-Gram facebook page for coupons to bring to the restaurant. (http://www.michelleogram.com/)

SATURDAY, OCT. 17:Making Strides Against Breast Cancer 5K - The annual fundraiser walk, which draws thousands of partic-ipants, most of whom are attired in pink, steps off at 9 a.m. at the College of Central Florida, 3001 SW College Road, Ocala. To register, visit http://main.acsevents.org/site/TR?pg=entry&fr_id=70040.

SATURDAY, OCT. 24:PowerAde Run - Benefi ts Michelle-o-Gram, sponsored by The Villages Advanced Imaging. (407-687-7419 or 352-750-1551)

MONDAY, OCT. 26

Shop Talk: Breast Cancer Awareness: Surviving and Thriving - Speaker will be clinical psychologist Sarah Rausch Osian, 11 a.m., Klein Center, College of Central Florida, 3001 SW College Road, Ocala. RSVP by Oct. 16. (854-2322, ext. 1912 or www.cf.edu/shoptalk)

ONGOING

First Monday each month: American Cancer Soci-ety program “Look Good…Feel Better," 2-4 p.m., Robert Boissoneault Oncology Institute, 2020 SE 17th St., Ocala. Call 800-227-2345 for eligibility details.

First Wednesday each month: Women with Breast, Ovarian or Cervical Cancer and Survivors, 6-7 p.m., Robert Boissoneault Oncology Institute, 2020 SE 17th St., Ocala. First time attendees must call to register; 732-0277.

Third Saturday each month: "Scapbook Crops, Cards & Crafts" group, event supports breast cancer research. Group meets at the Marion County Sheriff's Offi ce community building, 692 NW 30th Ave., Ocala. For details, including special events such as Oct. 16 crop with a Halloween theme, and Nov. 20 crop with turkey/covered dish dinner and more, call Claire Wilder at 732-5982 or email [email protected].


CALENDAR OF EVENTSAll About You Women's Boutique: 4901 E. Silver Springs Blvd., Suite 505, Ocala; also, the All 4 One nonprofi t; 236-2599.

American Breast Cancer Foundation:877-539-2543.

American Cancer Society, Inc.:■ Information, free items such

as wigs, bras, softies, turbans and hats.

■ Road to Recovery — Volun-teers transport patients to and from treatment.

■ Reach to Recovery — Early one-on-one support for women facing a breast cancer diagnosis; also, breast cancer survivors serve as role models to breast cancer patients after surgery.

■ Look Good…Feel Better Classes — Cosmetologists teach cancer patients techniques to help restore appearance and self-image during treatment.

■ Relay For Life — Nearly 5,200 events nationwide each year, several held locally.

■ Making Strides Against Breast Cancer — Annual 5K fun-draising event, Oct.17, College of Central Florida. Registration starts at 7:30 a.m., walk starts at 9 a.m. It is free to register and no minimum fundraising require-ment. To register, visit www.makingstrideswalk.org/ocalafl

■ Hope Lodges — In Gaines-ville and Tampa, offering cancer patients and families a free place to stay when they travel for treatment.

All programs are free and offered in Ocala, Marion County and surrounding areas. The local offi ce is at 13940 US 441, Bldg. 200, Suite 205 The Villages, FL 32159. To learn more, call Jessica Clayton, Community Manager, Making Strides Against Breast Cancer, 240-5058; toll free 1-800-227-2345 or visit cancer.org.

Cancer Alliance of Marion County: Various information on topics such as transportation, help with costs, etc.; http://crushcan-cermc.org/contact/contact.html.

Living in Fear Ends (LIFE) Support Group: New Covenant Missionary Baptist Church, 606 SW Broad-way St., Ocala; 622-7877.

Michelle-O-Gram: Nonprofi t helps with costs of mammograms; 469-6006 or http://www.michel-leogram.com.

National Breast and Cervical Cancer Early Detection Program: 1-800-226-6110.

North Florida Regional Medical Center Breast Health Program: 6500 Newberry Road, Gainesville; 800-611-6913.

Ocala Health System: Ocala Regional Medical Center, West Marion Community Hospital, The Cancer Center, 1431 SW First Ave., Ocala; 401-1000.

Ocala Royal Dames for Cancer Research, Inc.: Funds cancer research, hosts special events, offers program at College of Central Florida and more; 622-7363 or www.ocalaroyaldames.org.

Ocala Women's Imaging Center: 1901 SE 18th Ave., Building 200, Ocala; 671-4300.

Robert Boissoneault Oncology Institute: 2020 SE 17th St., Ocala; 732-0277.

Sisterhood of Survivors: Ocala WestUnited Methodist Church, 9330 SW 105th St., Ocala; 854-9550 or www.ocalawestumc.com.

UF/Health Breast Center: Chemo-therapy, radiation, hormone therapy and breast reconstruc-tion, for benign and cancerous conditions.; https://ufhealth.org/uf-health-breast-center/overview or 265-7070.

UF/Health High Risk Breast Cancer Clinic: Prevention measures for women who are above-average risk for cancer based on family history or prior breast biopsies; https://ufhealth.org/uf-health-breast-center/high-risk-clinic or 265-7070.

■ Unique Lingerie, Inc., 4414 SW College Road, Ocala; 629-5590

We Care Program: Medical care for people without insurance; 732-9235.

Women's Cancer Support Group: Robert Boissoneault Oncology Institute, 2020 SE 17th St., Ocala; 732-0277.

RESOURCES

FROM TOP: FROM TOP: Claire Rae, left, and Carol Seace talk about their projects during the Scrapbook, Crops, Cards, Crafts Breast Cancer fundraiser at Ocala Emer-gency Operations Center in Ocala, Florida on Saturday, Sept. 19, 2015. Wilder is the director of the group. ■ From Left, Jackie Abel, Beverly Godfrey and Carol Huff-man work on cards during the Scrapbook, Crops, Cards, Crafts Breast Cancer fundraiser. The group meets every third Friday and a couple of Saturdays a year to do crafts and raise money for breast cancer.ALAN YOUNGBLOOD/STAFF PHOTOGRAPHER

2015 think pink breat cancer awareness section

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