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BREAST Breast surgery
• AU T U M N 2 0 0 1 • Carol Franc Buck C breast ARE center newsletter Photo: Eyewire.com THE IMPORTANCE OF CLINICAL TRIALS Hands and Petri Dishes Laura J. Esserman, MD, MBA Director, Carol Franc Buck Breast Care Center Our autumn newsletter is focused on clinical trials. Why? Because clinical trials are one of the key tools to help us learn how to better treat and prevent breast cancer. There are several types of clinical trials. We often refer to them by Phases. When you are testing a new treatment that has never been tested before, we usually start with a Phase I study, where we check to make sure the treatment is safe. In a Phase II study, we are gathering data to prove that it is effective. Why is this necessary? Often, treatments that appear very promising in animal or laboratory studies may not turn out to be useful. Once we show that a treatment works, we apply what we consider the “gold standard”, a traditional Phase III randomized study. Why does it have to be randomized? Right now, this method for testing is still the best way to find out if a treatment that seems really effective is not just the same or worse than standard treatments. This happened with bone marrow transplants. It is tempting to just use a new drug and assume that it is better, but we have learned the hard way that it needs to be compared in a randomized study. Some studies are organized by biotechnology companies or drug companies to test a new drug that they have developed. Sometimes the new drug is originally developed at a University, but the process of producing and marketing a drug is subse- quently done by a company, since that is their business. Except for Phase I studies (to test safety), most industry-sponsored tri- als are conducted at several participating centers at the same time. Some studies are “cooperative group” studies. Several times a year, physicians get together to design clinical studies that they think will help answer important questions about how to best treat breast cancer. Many different hospitals, practices, and cen- ters participate in these group studies. These trials are carefully reviewed to make sure they are safe and important, and once they are approved by the National Cancer Institute, the NCI financially supports the trials. Patients from all over the country (and sometimes Europe) participate in these studies. The last type of trial is one designed by physicians and scientists to answer questions that they think are important or to test new discoveries that are designed at their own institution. Clinical trials are used to test procedures, drugs, exercise, foods such as soy, and even tools to help us make better decisions and collaborate with our patients. Our patient advocates serve as important liaisons to help explain how clinical studies work (see their article on page 4.) They are a great resource for our patients. It is our goal to constantly improve what we do. That is why we believe so strongly in measuring and testing our efforts. Our hope is to have better options for our patients every year. We are incredibly grateful to all of you who have joined in this fight with us! HIGHLIGHTS OF CLINICAL TRIALS A clinical trial is a research study that tests new ways to prevent, diagnose or treat diseases such as breast cancer. Virtually all of the improvements in cancer care have occurred because of clinical trials. The following is just a selection of the many ongoing clinical trials at the Breast Care Center. We've grouped the trials by the type of treatment or situa- tion patients face, such as prevention, surgery or metastatic cancer. For more information, please contact the coordinator listed for each trial. I think I am at risk for breast cancer. What can I do to prevent it … … if I am premenopausal? Soy vs. Tamoxifen to Reduce Breast Density Contact: Kelly Adduci, (415) 885-7578, firstname.lastname@example.org Breast density is a marker for breast cancer risk. It can be changed with diet. This trial will examine whether soy or tamoxifen can change breast density or the types of cells that are found in the breast ducts. We are also going to draw blood to measure serum hormone levels to hopefully help us to figure out whether some women bene- fit more than others from soy or tamoxifen. This study is for premenopausal women with dense breasts who are at higher risk for breast cancer. Women who participate will have a 50% chance of being assigned to soy, a 25% chance of being given tamoxifen, or a 25% chance of being given a placebo. The study will go on for six months, after which, participants are free to pursue whatever therapy they choose. Pilot Study of Deslorelin, Estradiol and Testosterone in Women at High Risk of Breast Cancer to Reduce Breast Density to Enhance Mammographic Screening Contact: Laura Brandt, (415) 353-7029, email@example.com We are trying to develop drug combinations for the long-term treatment of premenopausal women who are at known high risk of breast cancer, in particular women with a BRCA1 gene mutation. The aim of this study is to reduce breast density, which is a known risk factor for breast cancer. This particular study is a one-year trial. The long-term aim is to achieve substantially reduced breast cancer risk and to enhance the efficacy of premenopausal mammographic screening in these women. … if I am postmenopausal? Study of Tamoxifen and Raloxifene (STAR) for the Prevention of Breast Cancer Contact: Leslie Hendricks, (415) 353-7319, firstname.lastname@example.org In this study, women will receive either raloxifene or tamoxifen to determine which one is more effective in preventing invasive breast cancer. Women will be eligible for this trial if they are postmenopausal and at risk for developing invasive breast cancer. Please call the study coordinator for further information and to deter- mine your breast cancer risk. … if I am postmenopausal and want to use herbs to relieve menopausal symptoms? A Phase I Trial to Assess the Toxicity of Chinese Herbs to Treat Hot Flashes and Menopausal Symptoms Contact: Holly Hough (415) 353-7288, email@example.com Healthy women who have not menstruated for at least 6 months are eligible to participate in this study. All participants will receive an herbal formula containing 21 different Chinese herbs. The goal of the study is to assess the safety and feasibility of Traditional Chinese Medicine in alleviating hot flashes and other symptoms associated with menopause. I am going to have surgery for breast cancer. What studies am I eligible for, and what are they looking for? AT THE BREAST CARE CENTER SURGERY cont’d. Detection and Significance of Micrometastases and Immune Function in Primary Breast Cancer: A Prospective Outcome Study. Contact: Teresa Seo, (415) 885-7638, firstname.lastname@example.org This study is open to any woman who has been diagnosed with early (Stages I-III) breast cancer, but has not yet completed all breast cancer surgery. Micrometastasis (MM) occurs when cancer cells break loose from their original site in the breast and circu- late in the bloodstream. This process goes undetected until the cells invade other organs and grow large enough to cause symptoms. Our study will look at three types of tests for early detection of micrometastasis, and will study the relationship between these tests, immune function and recurrence of breast cancer. This study will help us to improve care for future patients, learn more about how to predict whether breast cancer will spread and whether a woman needs chemo or hormonal therapy, and who can avoid further treatment. This study may help us find potential genetic markers for metastasis. If we find a reliable, easy method of detecting circulating cells (MM) in the blood and bone marrow, we can, in the future "tailor therapy", using MM to follow response to therapy The study has been designed to make it easy to participate. At the time of your surgery, a blood and bone marrow sample is taken while you are under anesthesia. Therefore, the procedure is painless and adds only a few minutes to your surgery. I will have surgery, but I am treated with chemotherapy first (neoadjuvant chemotherapy). Are there any studies I can enter? MRI and Core Biopsy Study Contact: Meghan Shayhorn, (415) 353-7357, email@example.com This is a very special study being done at four institutions around the country, including UCSF. There are many types of breast cancer, and they respond differently to chemotherapy treatment. It may be possible to learn more about each cancer by studying the changes in core biopsies and MRI images during chemothera- py. Our goal is to predict whether the tumors will shrink enough after chemotherapy so that further treat- ment and surgery will become unnecessary. The information gained from this trial will help us learn how to tailor treatment, so each person will benefit most and not have to go through unnecessary treatments which do not affect their form of breast cancer. If you are starting with chemotherapy before surgery, you can par- ticipate in this study. We have several other studies designed for patients undergoing surgery – ask any of the surgeons at our center about studies you might be able to participate in. I am about to undergo chemotherapy. What studies am I eligible for that might help with the side effects? Randomized, Double Blind, Placebo-Controlled Study to Assess the Feasibility, Toxicity and Efficacy (Phase I/II) of A Chinese Herbal Therapy (CHT) for Symptom Management in Women Undergoing Chemotherapy for Stage I/II/III Breast Cancer Contact: Marina Kenzer, (415) 885-7328, firstname.lastname@example.org This study will use a formula of 21 Chinese herbs to see if they alleviate the side effects of chemotherapy. Though many of these herbs are widely available, this particular formula has been created specifically for this study and has received an Investigational New Drug license from the FDA. This study is randomized; patients have an equal chance of receiving the herbal therapy formula or a placebo. This is our only way to establish a clear effect. However, all patients will continue to have access to regular supportive measures (including standard medications) for side-effects of chemotherapy throughout the trial. Participants will begin taking the herbal formula or placebo two weeks before their first chemotherapy treat- ments, and will take it each day for a six-month period. Throughout the trial, patients' progress and the side effects of chemotherapy and herbal therapy will be followed closely by the Breast Care Center's research METASTATIC CANCER: WHAT DO YOU DO NOW? (excerpted from a letter by the Breast SPORE Advocacy Core) There is no way to prepare for the news, “Your cancer has spread and is now metastatic.” You probably went through treatment your first time around, with the hope of being cured. “Why do I have to do this again,” and “what do I do now?” are very common questions. Unfortunately, no one can answer the “why” question yet. You are unique and so is your disease. The term “metastatic” can cover many different types of cancer recurrences, and you will have to digest even more information about your cancer and treatment options. Through your sense of shock, fear, and anger you will need help. You’ve made a good choice in coming to the UCSF Breast Care Center, which is part of the only Comprehensive Cancer Center in Northern California recognized by the National Cancer Institute. The Breast Care Center doctors, nurses, and counselors are up to date on the latest cancer research and can help you consider your best options. One important information source is the list of available studies called clinical trials. There are no easy answers, but some of the newest approaches to treatment may offer the greatest chance for buying the time you need to take advantage of continued improvements in treatment and care. We believe in knowing your options as you make decisions for YOU. Remember, there is hope. Many people are living longer lives with metastatic cancer and viewing it as a chronic disease. You Are Not Alone. For information and support, you can contact the UCSF Cancer Resource Center (CRC) on the 1st floor of 2356 Sutter (across from Mt. Zion hospital), at (415) 885-3627 or at http://cc.ucsf.edu/crc/. The CRC or your medical providers can help you connect with other women who have metastatic breast cancer. We also invite you to learn more about cancer research, and how you can help as a patient advocate by contacting Peggy Devine at (415) 502-2986. -Chira Chen, Deborah Collyar, Peggy Devine, Bambi Schwartz, and Linda Vincent [ CLINICAL TRIALS CONT. ] team, which includes a medical oncologist, epidemiologist, and licensed herbalist/ acupuncturist. The exami- nations by the Traditional Chinese Medicine practitioner, herbal formula, and any laboratory work needed specifically for the study will be provided free of charge. This trial is the first in the United States to investi- gate the use of herbal therapy for breast cancer and is one of several clinical trials on alternative breast cancer therapies currently being conducted at the Breast Care Center. I have metastatic (advanced) breast cancer. What studies am I eligible for and how will they help me... ? … if I am told my breast cancer is HER-2/neu positive? An Open Label Dose Escalation Study of Autologous Dendritic Cells Loaded with HER500-GM-CSF (APC8024) in Patients with Metastatic Breast Cancer Overexpressing HER-2/neu Contact: Marina Kenzer, (415) 885-7328, email@example.com In this study, we are investigating a vaccine or immune system treatment for breast cancer. This treatment, called APC8024, uses activated dendritic cells (important immune system cells) that are prepared from blood cells. These blood cells are removed from patients, altered in the laboratory, and then infused back into the body. Researchers believe that APC8024 may stimulate the immune system to attack breast cancer cells. Many breast cancers have high levels of Her-2/neu, an oncogene that is involved in cancer growth. In this study, patients’ own dendritic cells will be removed from their body and exposed in a test tube to Her-2/neu; afterward, these cells will then be reinjected as a vaccine back into the body. The goal of the vaccine is to stimulate patients’ immune system to attack cancer cells containing Her-2/neu. The purpose of the study is to learn the highest safe dose of the cancer treatment drug APC8024, to learn about the side effects of giving this drug, and to determine if APC8024 stimulates the immune system to fight breast cancer. In general, dendritic cell treatments appear to be very safe, and most patients have had no major side events. If the trial proves the safety of this treatment, we might be able to design a similar trial for patients with early stage disease. … if I was previously treated for my metastatic breast cancer? Multicenter, Open-Label, Phase III, Randomized, Active-Controlled Trial Evaluating The Efficacy, Safety, And Pharmacokinetics Of Rhumab Vegf (Bevacizymab), In Combination With Xeloda (Xeloda) Chemotherapy, In Patients With Previously Treated Metastatic Breast Cancer Contact: Heather Terry (415) 885-7318, firstname.lastname@example.org This trial, for patients with previously treated metastatic breast cancer, will test a drug therapy that blocks the formation of new blood vessels to pre- vent cancer cells from growing or to keep it from spreading to other parts of the body. Solid tumors cannot grow beyond the size of a pinhead without the forma- tion of new blood vessels. The process by which new blood vessels form is called angiogenesis. One of the proteins known to activate angiogenesis is the vascular endothelial growth factor (VEGF). In this randomized trial, we are testing a drug that attacks VEGF. This antibody, called rhuMAb-VEGF, will be given in combination with Xeloda, a powerful oral chemotherapy agent effective in the treatment of advanced breast cancer. The study is enrolling anyone with advanced breast cancer whose disease Artwork by Diana Moy has progressed after one or two chemotherapy regimens. In this trial, we are testing the effects of an anti-angiogenesis therapy in women with metastatic disease, but if the results are promising, the goal is to use this approach in patients with earlier stages of disease to prevent the cancer from spreading. Phase II, Multi-Center Trial of Angiozyme in Patients with Metastatic Breast Cancer who Have Failed at Least One Course of Chemotherapy for Metastatic Disease Contact: Tanja Odzak (415) 885-3772, email@example.com In this study, we are trying to determine the response rate of growing tumors to Angiozyme, a potential new cancer drug. This is the first time this drug is being given to cancer patients. This is another type of drug that attacks the cells which make new blood vessels and allow tumors to grow. In this study we are: • determining the disease response, • assessing the treatment's safety and tolerability, • and determining the body's immune response to this potential drug. Patients with metastatic disease who have a growing tumor and who have had at least one type of chemotherapy can participate. … if my breast cancer has spread to the chest wall? Phase I/II Trial of Intratumoral Injection with Onyx-015 in Patients with Metastatic Breast Cancer to the Chest Wall. Contact: Marina Kenzer, (415) 885-7328, firstname.lastname@example.org Cancer that returns and grows on the skin over the chest is very hard to treat. We are trying to see if we can shrink these tumors by directly injecting the new drug ONYX-015 into the tumor in the chest wall. Onyx- 015 is an experimental anticancer drug – actually a genetically modified version of a cold/flu virus. It was designed to attack cancer cells, specifically those in which a certain gene, the p53 tumor-suppressor gene, does not function. Onyx-015 is an example of the new wave of cancer therapies emerging based on researchers' growing under- standing of the molecular mechanisms of cancer and viruses. The drug was developed by Dr. Frank McCormick, the Director of the UCSF Comprehensive Cancer Center. … if I am interested in using an alternative medicine treatment? A Pilot Safety, Feasibility, Efficacy and Correlative (Phase I/II) Study Assessing Herba Scutellaria Barbatae (HSB) for Metastatic Breast Cancer. Contact: Holly Hough (415) 353-7288, email@example.com Women who have been diagnosed with metastatic breast cancer are eligible to participate in this study. Participants will be taking a Chinese herb, Herba Scutellaria Barbatae (also known as Ban Zhi Lian), as their only cancer therapy. Please call the coordinator for more information. There are a number of other important studies for women who are going to have chemotherapy and/or hormone therapy. Please ask any of the providors at the BCC about studies you might be able to participate in, or check our website at www.ucsfbreastcarecenter.org. INTRODUCING SUZANNE EDER, NP We are very happy to welcome Suzanne Eder at the Breast Care Center as a Nurse Practitioner. Suzanne began her nursing career in her native New York City. After receiving her bachelor's degree in nursing from Hunter College, she worked at The New York Hospital, where she was one of the founding nurses of an AIDS unit. In her nine years on the unit, Suzanne was a strong advocate for patients and staff and worked to educate the hospital community about AIDS. After moving to California, Suzanne joined the bone marrow transplant unit at UCSF, where she worked for 3 years. During this time, she completed a family nurse practitioner program at UCSF. As a family nurse practitioner, Suzanne has worked in primary care and in an asthma specialty pro- gram. She recently returned to UCSF to work in the Breast Care Center, focusing on breast cancer follow-up and prevention. We are thrilled that she joined our nursing team to contribute her nursing expertise and her passion for improving the quality of life for breast cancer survivors and women at risk. INTRODUCING MINDY GOLDMAN, MD We would also like to formally welcome Mindy Goldman, MD, who has joined our team to take charge of our follow-up program. This program is designed for patients who are one year or more past their initial treatment and are transitioning to a follow-up program. Patients will be referred to the program by their Breast Care Center provider. Mindy is a gynecologist with a special interest in issues of concern to breast cancer survivors. “Educating women about their health and helping them to be active participants in clinical deci- sion-making is one of the most satisfying parts of my job,” she says. Mindy Goldman graduated from the University of Vermont College of Medicine in 1989 and com- pleted her residency here at UCSF. She has been a faculty member in the department of Obstetrics, Gynecology and Reproductive services at UCSF since 1993 and is currently the Associate Director of the UCSF Obstetrics and Gynecology residency training program. QUESTIONS FROM OUR PATIENTS Dulcy Wolverton, M.D. Q: I had a bi-lateral mastectomy with implants. When it comes time for my yearly mammogram, should I consider a sonogram instead of a mammogram? Should I have both? I am worried that my implants will “pop”. A: Because there is no remaining breast tissue after a mastectomy, breast imaging is rarely useful in checking the reconstructed breast, with or without an implant. Mammography cannot "see through" an implant. Also, the presence of an implant that has only skin over it prevents evaluation of the skin itself. The skin cannot be moved far enough from the implant to be looked at separately from the implant. For these reasons, we at UCSF do not use mammography on a patient who has had a complete mastectomy. An exception is the case of subcutaneous mastectomy. This is the removal of the inner breast tissue through an incision under the breast. The breast skin and nipple are left intact. The procedure is primarily performed as a preventive measure for women who are at a very high risk of developing breast cancer. Because the nipple is not removed, there remains the possibility of some breast tissue being left behind the nipple. In those cases, we do perform mammographic follow-up. However, because women with subcutaneous mastectomies also have essentially only skin overlying the implant, mammography is a relatively futile exercise. Subcutaneous mastectomy is rarely used today for prevention or treatment. For similar reasons, ultrasound is also of little value in screening a patient after a mastectomy. The best method for following women who have had mastectomies, with or without reconstruction, is still a thorough, properly performed physical examination of the breast. If there is a concern that some breast tissue has been left within the area of the reconstructed breast, then contrast-enhanced breast MRI is probably the most sensitive technique available to detect and evaluate the possibility of a recurrence of cancer. At this time, however, MRI is not considered a good tool for general screening. It is extremely expensive and may not be covered by most insur- ance companies. Contrast-enhanced breast MRI is not widely available. Since the technique is new and still developing, it may not be well performed in non-academic community settings. THE LYMPHEDEMA PROgram Photo: Marina Kenzer by Cheryl Ewing, MD The development of lymphedema (abnormal swelling of a body part, usually an extremity) after sur- gical or radiation therapy for cancer can be particularly devastating and debilitating to patients who are coming to terms with their cancer diagnosis and treatment. In the San Francisco Bay area, com- prehensive treatment for lymphedema is extremely limited. Many health care providers at UCSF have recognized the necessity to provide specialized services to patients at risk or in need of treat- ment for lymphedema. Early detection and aggressive therapy offers the best opportunity to prevent or minimize the crippling complications of lymphedema. A group of health care providers at UCSF are working together to develop a comprehensive lym- phedema program. The group includes myself as well as Dr. Gary Abrams, two physical therapists, Nancy Byl and Rita Arriaga, the Breast Care Center's nursing coordinator, Deborah Hamolsky, and Nina Jaaj, the administrator. The program will initially provide care for patients with lymphedema related to their cancer treatment. Eventually, we hope to include any patient with lymphedema. The program will focus on three groups: Group I will be patients at risk for lymphedema, i.e. those patients that have an operation such as a lymph node dissection or radiation therapy that will place them at high risk for lymphedema. Following surgery or radiation treatment, this group of patients and their families will receive educa- tion on the prevention and early detection of lymphedema. The goal is an early intervention to pre- vent or, if necessary, treat lymphedema. Group II will consist of patients with diagnosed lymphedema, after a medical evaluation. To rule out cancer recurrence, blood clot, infection or other causes for abnormal swelling, these patients will be referred to a comprehensive lymphedema program with certified lymphedema therapists. The treatment includes manual lymph drainage, massage, bandaging, and fitting for compression gar- ments. In addition to direct clinical care, the lymphedema program provides patient and family education for ongoing self-care, nutrition, and prevention. Psychosocial services will also be offered to assist patients in returning to normal life activities. Group III will be for patients with lymphedema that develop neuromusculoskeletal impairments or motor dysfunction. They too will receive appropriate physical therapy. Our goals for the Lymphedema Program are not only to provide a very needed service, but also to establish clinical trials and research which may improve the prevention and treatment of lymphedema. For questions regarding the program, please contact Nina Jaaj at (415) 353-7908. If you would like to help by making a tax-free donation, please contact Meridithe Mendelsohn at (415) 885-7558 C ALENDAR Communicating with Your Physician Monday, September 24, 5 - 8pm UCSF Comprehensive Cancer Center, 1600 Divisadero Street, 3rd Floor Conference Room Join us for this free, interactive workshop to discuss ways to communicate more effectively with your physician and other members of your medical team. Learn ways to maximize your time with the physician, get your mes- sage across, and ensure that your questions are addressed. In this workshop, you’ll learn how to: prepare for office visits, ask for the information you Her-2: The Making of Herceptin, a need, track your symptoms more effectively, keep track of your medica- Revolutionary Treatment for Breast Cancer tions, direct questions to the appropriate individuals in your medical team, by Robert Bazell better ensure that members of your medical team are communicating. Now out in paperback, Her-2: The Making This free workshop is led by Keren Stronach, MPH, Director of the Ida of Herceptin, a Revolutionary Treatment and Joseph Friend Cancer Resource Center at UCSF, Merijane Block, or Breast Cancer is the account of how a Program Manager of the Breast Cancer Fund, and Caryn Aviv, Director of new breast cancer drug is created and the Program for Collaborative Care of the UCSF Breast Care Center. how it impacts the lives of actual Please RSVP to the Cancer Resource Center at (415) 885-3693. patients. Prepare for Surgery Her-2 is the biography of Herceptin, 1st Thursday of every month, October 4, November 1, December 6, 7 -9 pm he drug that is used in patients UCSF Cancer Resource Center, 2356 Sutter Street, 1st Floor with recurring, aggressive breast cancer who are Her-2/neu positive. Patients undergoing a surgical procedure would find this program particu- The drug works by inactivating larly helpful. This program helps patients prepare for an upcoming surgery Her-2/neu, a protein that makes by teaching them mind-body techniques. Past participants have comment- cancer cells grow especially ed that they were more relaxed and calm prior to surgery, and felt more quickly. In rare cases, Herceptin positively about the surgery experience. To register, call the Cancer caused some patients' cancers to Resource Center at (415) 885-3693. disappear completely; in others, Benefits Counseling t slows its progression and 2nd and 4th Thursdays of every month, 3 - 6pm gives patients months or years UCSF Cancer Resource Center, 2356 Sutter Street, 1st Floor hey wouldn't otherwise have A benefits counseling session may help cancer patients understand how to had. Unlike chemotherapy or access disability income benefits through both public programs (e.g., SDI, adiation, Herceptin has no dis- SSDI and SSI) and private programs (e.g., STD, LTD and life insurance). abling side effects. (It has, how- Counselors can also answer questions about Medi-Cal and Medicare and ever, caused heart problems help make decisions about their health insurance plan. To set up a one- when combined with certain hour appointment, call the Cancer Resource Center at (415) 885-3693. ypes of chemotherapy.) Robert Bazell, chief correspondent The Bay Area Breast Cancer Forum of NBC News, presents a tale of This is a monthly gathering of health care providers, researchers, patients, dramatic discoveries and strong per- patient advocates, friends and families. Topics are varied, but the emphasis is onalities, showing the combination on clinical trials and research. The meeting takes place on the second of scientific investigation, money, poli- Wednesday of the month in Conference Room 1 on the 3rd Floor of the new ics, ego, corporate decisions, patient UCSF Comprehensive Cancer Center at 1600 Divisadero. At 6:00pm, there ctivism, and luck involved in moving a is a light dinner; from 6:30-8:00pm a discussion led by Dr. Debu Tripathy. drug from the lab to treatment. Please contact Fern Hassin at (415) 885-3738 for more information. PATIENT PORTRAIT: SMILES FROM ESCALON When Margie Reichmuth's breast cancer returned for the third time, she and her husband Steve decided they needed an expert. “I developed cancer in a clavicular lymphnode. My general oncolo- gist in Modesto had never treated a case like that. I knew I needed to go to a clinic where they see nothing but breast cancer patients.” Dr. Charles Dollbaum, one of our oncologists at the Breast Care Center, had the kind of expertise the Reichmuths were looking for. After a thorough evaluation, he drafted up a treatment plan that they could take back with them to their local physicians. “Dr. Dollbaum's positive outlook really made a difference”, Margie tells us. She maintains a cheerful attitude herself and signs all her e- mails “Smiles From Escalon” . Escalon is the small farming town where her husband was born and raised and her two teenage sons, Matthew and Douglas attended the same schools as their father and grandfather. The sup- port the family have gotten from the community has helped a lot during Margie's fight with breast cancer. “It's like going to war – it helps to know you have a whole army behind you. Just when you don't feel good, somebody calls. Or brings over chocolate brownies”, she smiles. Even more than chocolate brownies Margie cherishes the love she has received from her family. She feels blessed that both her husband and her sons were completely supportive when she needed them. “When I had my bilateral mastectomy, Steve had to help me go to the bathroom – and he made it seem like I was still a queen in his eyes.” Steve admits that the first diagnosis “hit me like a ton of bricks”. With so much information sud- denly thrown at him, at first he "went on autopilot". But he very quickly got involved in his wife's care and educated himself on the disease, to the point where other people started calling him for information. “Being able to help others was therapeutic”, he says. And even though the boys were still kids at the time, the Reichmuths decided right at the begin- ning that they were going to be upfront about everything. “My youngest son was only six”, says Margie. “He was so sweet. I would be asleep on the couch after radiation, and he would come home and rub my face with his chubby hands and ask me: Want a snack, mommy? I would feel sort of guilty – my little boy taking care of ME! That was the most difficult thing; to put up with all the treatments and the side effects and still be a mom. Yet life doesn't stop. You have to keep going.” Even during chemotherapy, the Reichmuths tried to have as normal a family life as possible. Their sense of humor helped. “After my first chemo, we went to Doug's highschool baseball game. People around couldn't believe it – what, you just had chemo? And I would say, yes – so please don't rattle the stands too much, because my balance is still off from the anti-nausea medicine.” When asked what advice he would give other husbands, Steve stated after some reflection: “Be your own advocate. You can't just sit down and let the medical profession take care of it all. You have to inform yourself, and be clear on what you want. You may even have to push for a cer- tain treatment, if you feel it is necessary and if the doctors are not being aggressive enough. Don't be afraid of aggressive treatment. When you look at your whole lifespan and what you might gain, treatment lasts only a short time. The rewards outweigh the downside.” The Reichmuths remain determined not to let this be a negative experience. “It has brought our family closer together. We now cherish everything. Other people see that, and it gives them hope.” Margie tells us she is “ecstatic to have such good care at the Breast Care Center. Dr. Dollbaum is my Captain in this war”, she declares with a big smile. MATT’S RIDE FOR CANCER When Patti Allen, was diagnosed with breast can- cer in 1990, her fifteen-year old son Matt wasn't sure how to show her his love and support. Eleven years later, she is a breast cancer survivor, and in her honor, Matt came up with a spectacu- lar idea to help others in their fight against the disease. He decided to embark on a cross country bike ride to raise awareness and funds for breast cancer. Matt and his Mom, Patti “Ride for Cancer” started in Long Beach, California, cov- ered 6,000 miles over four months, and ended in Bar Harbor, Maine, in mid-August. Along the way, Matt visit- ed breast cancer treatment centers all over the country and wrote about his experiences in his journal, which he pub- lished along with many pictures on his website. He encouraged his readers to donate to the centers he visited, as well as to national breast cancer organizations. In May, Matt paid us a visit at the BCC. Meridithe Mendelsohn, our Administrator, showed him around and talked to him about new treatments and the clinical trials we are working on. Matt was impressed and exclaimed on his website: “WOW! What a setup they have!” He posed for a picture with Meridithe in front of our healing tiles created by those touched by cancer. Matt in front of the Golden Gate Bridge Thanks to Matt's “pit-stop”, we received a number of donations from all over the United States. Great job, Matt! We were thrilled to meet this remarkable young man and congratulate him on the completion of his grand ride! For more information, check Matt's website: www.rideforcancer.com, or e-mail patti@ridefor- cancer.com Matt & Meridithe at the BCC Carol Franc Buck C breast ARE center newsletter Editor: Sarah Paris Design: Greta Berger Printed by : UCSF Reprographics THANK YOU FOR YOUR SUPPORT We wish to thank the following benefactors for contributions received since the last newsletter appeared (April – July 2001) Guardian Angels Ben & Janice Greenberg Joann & Richard Goelzer William Rodarmor 40,000+ Helen Ittner Joe Goldenson Lawrence & Janet Rogers- The Cancer League Sam & Vera Jaffe Virginia Graham Simi Robert Kessler James & Judith Bell Ellen Rush Sue and Howie Kuramitsu Greenberg William Rutter 20,000+ in memory of Judi Likins Jeanifer & Kenneth Grullon- Jerome Schofferman Soroptimist Foundation Candice & Jonathan King- Centeno Michael & Anne Simons- Meyers Constance Hale-Ganahl Castleman Angels Dexter & Kathleen Lowry Paul Herrick Evelyn Spence 5,000+ Susan Manetas Marcy Herrick Arnie & Eda Spielman- The Women's Foundation / Eleanor Robison-Kasch Ira Herskowitz Bauchner Patricia Chang Paula Roemer Jeanie & John Hohenwater Jim & Phyllis Sproul Crow Canyon Women's Golf Amy & Robert Shi Faye Honorof Elizabeth & Patrick Stine Association Millicent Tomkins John C. & Mary Hooper H.R. & Mildred Stine Armida Winery Marc Van Der Hout Ronnie Jacobs Peter & Marna Taylor Jackie Voigt Michael & Susan Jacobson- Harry & Frances Terraneau 1,000+ Michael Welch Tigges Phyllis Uppman-Florin Astrid Flood Gary & Debora E. Williams- Joshua Kosman Heather Walton Herman Lynne Lancaster Sheridan & Karen Warrick Benefactors 25-99 Lawrence & Lori Lapides Richard & Leah Waskey- 500+ Susan & James Acquistapace Parker & Mathilde Maddux Denola Advanced Silicon Distributing Tway & Joyce Andrews Wendy & Jeffrey Mandel Angela White FMC BioPolymer Corp. / Joseph & Linda Barlow Lichtman William & Lynette Sharrann Simmons in Allan & Carol Basbaum Wilburt & Carol Martin Winegarden memory of Judi Likins Ian Berke Benjamin Martin & Carol George & Kristine Xifo Ruth Greenberg in memory of Marilyn Berlin Weir Peter Xifo Anna Hazan Meryl Brod Victoria & Ronald Mazzella Salvatore & Virginia Xifo United Way of the Bay Area Cynthia & Patrick Cadam- Elissa Miller Julia & Vladimir Zagatsky Brown Jonathan & Anne Milner- In memory of Judi Likins: Nina & Raymond Cavola Miller Eric Foretich 200+ Byron & Teri Conrad Mary T. Mills Christine and Andrew Gray Julie Ann & Zach Hall- Robert & Joan Cooke-Lafore Jr Florence Moore Catherine and Norman Giacobassi Christine Cottone Joseph & Celeste Kushino Kali Hamano David & Kathleen Sue Criley Morningstar Todd Nishikawa Douglas Hanahan Robert & Barbara Debaun Kathleen Murphy Sandra & Don Prince Barbara Isackson Jerome & Esther Delson Nora Louise Nielsen Brie Sansoota In memory of Judi Likins: Leslie DeVore New Ventures West Carol and Steven Scialabba Carol Kawakami Pat & John Dutro Cynthia Parks Scott Sodetani Margaret & Robert Powell Sandra & Edwin Epstein Claudette Parrish Edward Poor In memory of Olive Goodman: Laura Euphrat Joyce De Soto Francis & Eberle Ewing- Julia & John Poppy 100+ Mary Margaret & Greg Anna Loftus Crowley Lauretta Sanders Paul & Judy Fayollat Emily Filloy Rankin Joanne Feldman Laura Robertson Donna & Chris Svedise Abigail Ginzberg Elizabeth & Louis Tricerri Special Youth in Motion Award Colin Kelly and Nico Deliveyne literally climbed a mountain on our behalf & raised over $1,200 for the Breast Care Center. A special report on their climb will be included in the next newsletter. • AU T U M N 2 0 0 1 • newsletter center ARE C breast Carol Franc Buck FAX: (415) 353-7021 Surgery: (415) 353-7111 Oncology: (415) 353-7070 For appointments call: Franking Code #2714 San Francisco, CA 94143-1710 San Francisco 1600 Divisadero Street, Box 1710 University of California UCSF Comprehensive Cancer Center PA I D The Carol Franc Buck Breast Care Center U.S. Postage Nonprofit Org. Mark your calendars! Don't forget to come to our annual “Taste for the Cure”, our own delicious fundraiser. It takes place this year at San Francisco's beautiful City Hall on Sunday, September 30, 2-6 p.m. We will start with an open forum on breast cancer prevention. Come learn about what we are doing, and what you can do yourself. Then stay for the great food & music! You might want to bid on one of our silent auction items such as a kayaking trip in Ireland or dinners at some of the Bay Area's top restaurants). More details at www.tasteforthecure.org We have a new website address. Please check us out at: or call (415) 353-7201 for tickets! www.UCSFbreastCARECENTER.ORG Remember: This event helps to support the work we do at he Breast Care Center.
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