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Deborah, of Robeson, defeats disease

How Cancer Starts

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Deborah, of Robeson, defeats diseaseLooking back at her life-changing experience, Godwin says her faith in God also helped her get through her diagnosis and treatment.

Why cancer comes backUnderstanding why cancer returns can help patients and their loved ones prepare to fight all over again.

Free radicals, antioxidants and cancerMen and women concerned about cancer and the role that antioxidants can play in cancer prevention should discuss their diets with their physicians.

9

cancerawareness

2 Cancer Awareness September27,2019•The Robesonian

Cancer can affect various areas of the body. For those newly diagnosed with cancer, they

may be unsure of what comes next, especially if the cancer isn’t well known.

Sarcoma is a cancer that some people may have heard about but are unsure of how it affects the body. Sarcoma is the general term for a broad type of cancers that begin in the bones and in the soft, connective tissues of the body. These tissues include muscle, fat, blood vessels, nerves, tendons, and the lining of the joints, according to the Mayo Clinic.

Scientists aren’t entirely sure what causes soft tissue sarcomas. The American Cancer Society says that some risk factors can make a person

more likely to develop these cancers. Certain genes carry the recipes for developing sarcomas, and these may be present in certain families. However, DNA mutations in soft tissue sarcomas are more so a result of exposure to cancer-causing chemicals or radiation, says the ACS.

Some people may experience no symptoms, while others may develop a lump. Certain symptoms of sarcomas include:

•Pain that affects the local tissues, nerves or muscles.

• Inflammation from tumor growth.

• Inability to move joints or muscles, depending on the location of the cancer.

Other symptoms depend on which soft tissue is affected. For example, tumors in the gastrointestinal system may produce blood that shows up in the stool.

There are more than 70 types of sarcomas, so proper diagnosis and treatment is essential.

Visit MayoClinic.org or Cancer.org for lists of the more common sarcomas. Imaging tests, biopsy, and then treatment with radiation, surgery, chemotherapy, or targeted treatments may be advised for people diagnosed with sarcoma, who can speak with an oncologist about their prognosis.

Many people have been diagnosed with cancer or have a loved one who has received such a diagnosis. In fact, according to estimates

from the International Agency for Research on Cancer, by 2030 there will be 21.7 million new cases of cancer. That estimate means cancer cases will have increased considerably since 2012, when the IARC reported there were 14.1 million new cases of cancer.

The World Health Organization notes that between 30 and 50 percent of cancers can currently be prevented by avoiding risk factors and implementing evidence-based prevention strategies. That requires men, women and children to learn as much as they can about cancer, including how it grows.

The Canadian Cancer Society notes that the human body is made up of trillions of cells that are grouped to form tissues and organs. Each cell contains genes within its nucleus that tell it when to grow, work,

divide, and die. In healthy people, cells follow these instructions. However, sometimes a change in DNA or damage to DNA can result in mutated genes that don’t work properly. In such instances, the communication between genes and cells is mixed up, and that miscommunication can cause cells that should be resting to divide and grow uncontrollably. That uncontrolled growth can lead to cancer.

The CCS notes that gene mutations can sometimes be inherited. In other instances, genes may mutate as the body ages and the genes wear down. External factors, such as cigarette smoke, ultraviolet radiation from the sun and alcohol can damage genes, paving the way for mutations to transform genes from normal cells into cancer cells. No cell in the body is immune to becoming a cancer cell.

While there are no ways for people to guarantee they won’t get cancer, avoiding tobacco and embracing a

healthy lifestyle that includes routine exercise and a diet that’s rich in fruits and vegetables can help men, women and children reduce their cancer risk.

How cancer starts

Understanding sarcoma

The Robesonian•September 27, 2019 Cancer Awareness 3

Doctors and patients have many different tools available in the war against cancer. Imaging

is one of the essential resources used in such battles. Imaging helps screen and diagnose cancer and can be used to guide treatments and determine the efficacy of various therapies. Therefore, advancements in imaging can have profound effects on the ability to manage — and hopefully in the future — prevent or cure the disease.

The goal of cancer imaging is to detect the smallest possible number of tumor cells at the earliest possible time. Traditionally, X-ray, ultrasound, magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography have been utilized as key

cancer imaging techniques. These technologies are being studied and advancing.

Imaging probes are one area of imaging worthy of attention. The Center for Probe Development and Commercialization, a supplier of radiopharmaceuticals, is developing the next generation of molecular imaging probes. They are designed to detect responses to chemotherapy in breast cancer patients. CPDC also has started to manufacture another probe designed to identify hypoxic tumors. These probes work on a molecular level, according to data published in 2013 in the International Journal of Biomedical Imaging. Molecular imaging has the potential to greatly enhance understanding of various cancers.

Another cancer imaging and evaluation tool that is being produced and tested is called the MasSpec Pen, which enables a controlled and automated delivery of a water droplet to a tissue surface during tumor surgery or diagnostic exploration to extract biomolecules. The sample taken can immediately tell if cancer cells are present and distinguish tumors from healthy tissue.

Imaging has merged nanotechnology and conventional imaging tools with new developments. These technologies are still in the testing phase. Novel diagnostic probes with nanoparticles can improve imaging results. A 2018 review paper published in the Journal of Controlled Release looked at how nanotechnology could improve the imaging and treatment of lung cancer. For example, gold nanoparticles work better than iodine-based agents for CT imaging. Similarly, superparamagnetic iron-oxide nanoparticles can be utilized with MRI for the ultra-sensitive reactions they produce.

Other imaging technologies in the works involve combining and improving the workflow of various methodologies. Philips Medical Systems’ Ingenia MR-RT Oncology Configuration is a comprehensive solution that allows radiation oncology departments to integrate MRI into their computed tomography-based radiation treatment planning.

In addition to the imaging evolution itself, researchers have realized the limitations of the human eye to discern abnormalities or small changes from images collected. Therefore, technological advancements are enabling artificial intelligence to look for key signs in images and correlate changes to the aggressiveness of the disease. This can improve treatment success rates and reduce the chances for human oversight.

Imaging plays a key role in cancer diagnoses and therapies. Improving cancer imaging can improve treatment plans now and in the future.

Breakthroughs in imaging technologies can help fight cancer

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MAMMOGRAMS. YOUR BEST DEFENSE

AGAINST BREAST CANCER.

McLeod Regional

Breast cancer is the number one cancer treated at McLeod Health each year. Studies show that early detection can lead to survival rates of 90% or higher. Mammograms are the best tool for early detection and can identify abnormalities before they are felt.

McLeod Health has the area’s only nationally accredited breast health program. From screening and diagnosis to recovery, we are leading the way in the fi ght against breast cancer.

Mammograms are off ered at each of our locations and our mobile mammography unit travels across the region to provide convenient access to this life-saving technology.

To schedule a mammogram, call 843-777-2095 or visit McLeodCancer.org.

THE REGION’S ONLY NATIONALLY ACCREDITED

COMPREHENSIVE CANCER PROGRAM


Deborah Godwin’s breast cancer story started with her arm.

“Back in April of 2016, I had just woken up that night because my arm was hurting,” Godwin said. “I started feeling around, and my hand just happened to feel a lump on my right breast.”

That morning she called her gynecologist, Dr. Tawanda Williams of Southeastern Women’s Healthcare at The Oaks, who scheduled her to come in for an exam the same week. Afterward, Williams referred her to Southeastern Radiology Associates (SeRA) for a mammogram and ultrasound. Godwin, who has worked for Southeastern Health for 31 years, at that time worked at Southeastern Health Heart and Vascular on the campus of Southeastern Regional Medical Center.

“I just want to let everyone know, especially our ladies here in Robeson County, that it’s very important that you have your screenings done, your annual mammograms, and to keep up with them. Not only can they help catch cancer earlier, but when you do have a problem, like I did, it’s easier for the radiologist to determine what’s happening when they have your past mammograms on file to refer to, to see the changes that have occurred.”

Unfortunately, Godwin’s exam results

pointed to the need for a biopsy, which finally confirmed her breast cancer.

“It was stage two, and it was what is called triple negative,” said Godwin, who lives in the Allenton community outside Lumberton. According to the CDC, triple-negative breast cancer does not have any of the receptors that are commonly found in breast cancer, allowing for fewer options for treatment.

Nine rounds of chemotherapy, a double mastectomy, reconstructive surgery, and 27 rounds of radiation later, Godwin finished her cancer treatments in January 2017.

“I was very thankful that I completed everything in less than a year,” said Godwin, now 51. “When I first started my treatments, they told me I was going to have to have 16 chemo treatments, but I ended up only having nine because I responded so well to it. Everyone says the first four treatments are the hardest, they’re the bad ones, but after my second treatment, I couldn’t feel the lump anymore.”

Godwin did her chemo and radiation treatments at Southeastern Health’s Gibson Cancer Center in Lumberton.

“Gibson was awesome,” Godwin said. “The nurses, the doctors, everyone was so caring. Anything that you needed, they were there for you. If I came in having a bad day, they were there to encourage me. It was wonderful.”

Godwin said the medical staff at GCC were more like mentors in how they helped her get through her treatments.

“I think I struggled the most with the radiation. I did not want to do it,” she said. “But when Dr. (Thomas) Walden talked to me, he helped me understand why I needed to do it.”

Looking back at her life-changing experience, Godwin, who now works in

the scheduling department at SeRA, says her faith in God also helped her get through her diagnosis and treatment.

“Everything I went through, I had to depend on the good Lord,” she said. “My faith grew stronger, and I stood on that.”

Screening mammograms can be scheduled at SeRA by calling 910-671-4000.

Deborah, of Robeson, defeats diseaseBy Roxana Ross

Deborah Godwin is a cancer survivor who urges women to have their annual mammograms. A mammogram and ultrasound confirmed Godwin had breast cancer.

CouRTeSy phoToSouTheASTeRn heAlTh


Pave the road to

preventionOctober 2019

Tuesday, October 1Southeastern Radiology Associates Open House

& Lighting of the Pink Ribbon209 W. 27th Street

5 p.m. - Open HouseOpen house to feature new diagnostic 3-D mammography machine with new SmartCurve™ comfort paddles as well as a sneak peek at new breast

coil MRI technology coming to SRMC in 2020. Mammography scheduling will also be available.6:30 p.m. - Reception

6:45 p.m. - Lighting ceremonyFeaturing remarks from Radiologist Dr. Sam Armani

and local breast cancer survivors.

Wednesday, October 2International Walk to School Day supported by

SeHealth’s Community Health ServicesParticipating Schools: Southside Ashpole Elementary School, 7:15

a.m.; R.B. Dean Elementary School/Townsend Middle School, 8:30 a.m.; Fairgrove Middle School, 9:30 a.m.; Rowland Norment Elementary

School, 2 p.m.; W. H. Knuckles Elementary School, 2 p.m.; Piney Grove Elementary School, Tanglewood Elementary School

Breast Cancer Awareness EventsThursday, October 17Breast Cancer Health Fair

11 a.m. - 1 p.m.Biggs Park Mall

Physician Assistant Catherine Gaines will speak about breast cancer at CHEC at 11 a.m., followed by a lap around the mall as part of a Walk

with a Doc series. Booths will be located throughout the mall with educational information about prevention, detection and treatment of

breast cancer. Mammography scheduling will also be available.

Saturday, October 19Mammogram Madness

8 a.m. - 4 p.m.Southeastern Radiology Associates

209 W. 27th StreetWomen ages 40-74 who have not had their annual screening mammogram may walk-in or pre-register for mammograms

in advance by calling (910) 671-4000.

October 21 - 31Walktober: Breast Cancer Awareness Month

Sign in at SeHealth’s CHEC at Biggs Park Mall, walk �ve laps (one mile) around the mall, and sign out at CHEC to be eligible to win a

$500 mall gift certi�cate. Participants are encouraged to wear pink. Winner will be drawn on Oct. 31.For more information about events,

call (910) 671-5595.

To schedule a mammogram, call (910) 671-4000.


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Researchers continue to make strides as they look for ways to defeat cancer. In many areas of

the world, significant progress has been made in regard to improving cancer survival rates.

While cancer treatments continue to evolve and help people fight and ultimately overcome their disease, cancer is a formidable foe that can sometimes return. Understanding why cancer returns can help patients and their loved ones prepare to fight all over again.

Why does cancer come back?

Cancer patients who have finished successful treatment may be disheartened to learn that their cancer has come back. According to Cancer Research UK, cancer can come back if treatment failed to get rid of all the cancer cells. In such instances, the cells left behind may grow into a new tumor. Some cancers also can spread to other areas of the body, forming new tumors elsewhere.

Cancer also might come back if it has become resistant to the drugs used to treat it. Cancer cells are mutated cells in which the genes within them make the cells behave differently from normal, healthy cells. Cell mutations vary, and some might make cancer cells resistant to drugs used during chemotherapy, targeted therapy and hormone therapy. Multi-drug resistance occurs when cancer cells have become resistant to many drugs at the same time.

Does the type of treatment matter?

Cancer can come back regardless of which type of therapy or therapies doctors initially employ to get rid of it.

•Surgery: Cancer can return after surgery if any cancer cells were left behind during the operation. Small cancer cells sometimes break away from the primary cancer prior to surgery, and these are too difficult for surgeons to see and remove during surgery. Surgeons who suspect they left some cancer cells behind may recommend additional treatment to attempt to kill any cancer cells still in the body.

•Chemotherapy: Cancer occurs when cells do not die and begin to grow uncontrollably. Chemotherapy aims to kill cells that are attempting to double and form new cells. However, all cells do not divide at the same time. This is why chemotherapy involves a series of treatment sessions, as physicians hope stretching treatment out over time will enable them to catch as many dividing cells as possible. Some cancer cells left behind after chemotherapy may fall victim to the body’s immune system, while others will simply die off. But some may survive and ultimately divide, prompting cancer to return.

•Radiation: Radiation therapy aims to prevent cells from growing and dividing by making small breaks in the DNA inside the cells. Radiation therapy is common and effective, but it can leave cancer cells behind. When it does, those leftover cancer cells can lead to a recurrence of cancer.

No one wants to receive a single cancer diagnosis, much less learn that their cancer has returned after treatment. But cancer can return, and when it does, it’s important that patients fight just as hard as they did during their initial treatment sessions.

Why cancer comes back

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Cancer affects people from all walks of life. According to estimates from the World

Health Organization, cancer will cause 9.6 million deaths worldwide in 2018.

Part of the reason cancer is so deadly is that it can affect any part of the body and spread to other parts of the body. Lung and colorectal cancers cause more deaths than any other forms of the disease, but stomach cancer results in 783,000 deaths across the globe each year, making it the third-leading cause of cancer deaths.

There are various types of stomach cancers. Because early detection is often so important, learning about the different types of stomach cancers can be a great first step toward protecting yourself against this deadly disease.

Adenocarcinoma

According to the American Cancer Society, about 90 to 95 percent of stomach cancers are gastric adenocarcinomas. These cancers develop from the cells that form the mucosa, which is the innermost lining of the stomach.

Various genetic and environmental conditions can increase your risk of developing gastric adenocarcinoma. The online resource My Virtual Medical Centre (www.myvmc.com) notes that such conditions include:

•Family history of gastric cancer

•Blood group A

•Hereditary nonpolyposis colon

cancer syndrome

•Low socioeconomic status

•A diet that is low in fruits and vegetables

•Smoking

•Consumption of salted, smoked or poorly preserved foods

Gastric adenocarcinoma is rare before age 40, but incidence rates steadily

increase after that point before peaking in the seventh decade of life.

lymphoma

Gastric lymphomas are cancers of the immune system that are sometimes found in the wall of the stomach. Lymphoma is a malignancy of the lymphatic system, which is a network of nodes, or knots of tissue, connected by vessels. These nodes drain fluid and waste products from the body,

acting as filters that remove foreign organisms and cells.

Gastric lymphomas are non-Hodgkins lymphomas. My Virtual Medical Centre notes that most cases of gastric lymphoma occur in people age 50 or older. However, incidences of gastric lymphoma among people younger than 50 who are affected by HIV and/or AIDS are increasing.

Gender is a risk factor for gastic lymphoma, as males are affected two to three times more often than females. In addition to age and gender, chronic infections such as hepatitis C increase a person’s risk for gastric lymphoma.

Gastrointestinal stromal tumor

The ACS notes that gastrointestinal stromal tumors, or GISTs, are rare. However, they can form in the wall of the stomach. Some may be cancerous, while others may not be. Though GISTs can be found anywhere in the digestive tract, most are found in the stomach.

Age is one of the risk factors for GISTs. Though they can be diagnosed in people younger than 40, GISTs are most common in people between the ages of 50 and 80.

Genetics also may increase a person’s risk for GISTs. Though rare, primary familial GIST syndrome is an inherited condition that increases a person’s risk for GISTs. Carney-Stratakis syndrome and von Recklinghausen disease are two additional genetic conditions than can increase your risk of developing GISTs.

More information about stomach cancer is available at www.cancer.org.

The types of stomach cancer10 Cancer Awareness September27,2019•The Robesonian

C ancer is a formidable foe. According to the World Health Organization, the global cancer

burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. The WHO notes that current estimates indicate one in eight men and one in 11 women will die from cancer.

Statistics like those from WHO paint a scary picture, but those who have been diagnosed with cancer or watched as a brave loved one fought the disease know it is far scarier than any statistic. However, despite its prevalence, cancer can, and often is, beaten. Preventive efforts like applying sunscreen before spending time in the sun and adhering to cancer screening guidelines can help people lower their risk for cancer and/or detect it early, when the disease is most treatable.

People looking to lower their risk for cancer will uncover lots of information, some legitimate and some questionable, by simply entering “cancer prevention” into an online search engine. Two of the terms that are likely to pop up in such a search are “free radicals” and “antioxidants.” Understanding these terms and their relationship to cancer can shed light on the disease.

What are free radicals?

The National Cancer Institute notes that free radicals are highly reactive chemicals that have the potential to harm cells. Free radicals form naturally in the body and actually play a key role in various cellular processes. However, high concentrations of free radicals can damage all major components of cells, including DNA and cell membranes.

Researchers have long felt that the damage caused by free radicals may play a role in the development of cancer.

What are antioxidants?

Antioxidants, some of which are made by the body, are chemicals that interact with free radicals and neutralize them, thereby preventing the damage that they can cause. The body needs more antioxidants than it can produce on its own and gets most of them via a person’s diet. These are referred to as dietary antioxidants, which can be gleaned from foods like fruits, vegetables and whole grains. The NCI notes that some dietary antioxidants are available as dietary supplements.

Can antioxidant supplements prevent cancer?

According to the NCI, analysis of nine randomized controlled clinical trials did not provide evidence that dietary antioxidant supplements can prevent cancer. However, this should not discourage people from consuming antioxidants in foods, which the NCI notes contain complex mixtures of antioxidants, vitamins and minerals.

Men and women concerned about cancer and the role that antioxidants can play in cancer prevention should discuss their diets with their physicians.

Free radicals, antioxidants and cancerThe Robesonian•September 27, 2019 Cancer Awareness 11

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