Lisa Bourdon-Krause, a head and neck cancer survivor, talks about the treatment she received that the University of Michigan Comprehensive Cancer Center that preserved her speech.
For 44 years of marriage, Karen and Larry Ganzini have balanced each other. Karen is a talker; Larry is quiet. Larry isn’t keen to show his soft side; Karen feels worse when she bottles up emotions.
Nearly 10 years ago, Karen was diagnosed with breast cancer. Although Karen says that cancer almost feels like second nature now, issues due to the couple’s differing communication styles have cropped up as the disease has progressed to stage IV. Karen and Larry support each other, but it was still difficult to talk about certain aspects of Karen’s cancer.
When Karen learned about a new pilot program to help patients and their caregivers cope better, the Ganzinis signed up. The program was offered by the Ann Arbor branch of the Cancer Support Community, a nonprofit organization dedicated to providing education and support to people with cancer.
“I asked the question about hospice, and my husband really didn’t want to go there at this point. He doesn’t like to talk about the end, and I understand that,” Karen said. “But I need to know what it’s going to be like.”
By enrolling in the pilot program, Karen got her answers, and both Ganzinis agreed that the experience helped them feel better about their situation. The program, called FOCUS, is based on University of Michigan Comprehensive Cancer Center research that has shown that patients and caregivers benefitted from meeting with a nurse to provide them with information and support.
Judy Mackey was already reeling from the news that she would have to take Gleevec every day for the rest of her life to keep gastrointestinal cancer at bay. But the news only got worse. The pharmacist told her she had fallen into the notorious Medicare Part D doughnut hole, effectively leaving her without any prescription insurance. When Mackey learned that Gleevec costs $5,100 per month, she was devastated.
The pharmacist recommended she go to the Practical Assistance Center, a new office on Level 1 of the University of Michigan Comprehensive Cancer Center, to find out whether she was eligible for financial assistance with her prescriptions. It was nearly 5 p.m. on a Friday, so Mackey didn’t think she’d get help that day. But she was surprised to find that social work assistant Maureen Marhofer, L.L.B.S.W., was not only willing to stay late to work through all of her questions, but was able to fax an application for financial assistance to Gleevec’s manufacturer, Novartis.
By Tuesday, Mackey had learned she was eligible for a free supply of Gleevec.
The culture of medicine has changed: Gone are the days when doctors dispensed treatment with a paternalistic air. As medicine has advanced, patients have more choices about how they can approach their care. Combined with the vast amount of health information available on the Internet, patients are educating themselves and partnering with their physicians to make informed medical decisions.
Consider Rosemary Ireland Black’s story. She’s a tall, willowy woman, but her stomach suddenly started to bloat. She went to the doctor twice, and he said nothing was wrong. So she went back a third time and demanded a CT scan.
“He said, ‘What for?'” Ireland Black said, recalling her doctor’s skepticism. “And I looked at him and said, ‘Because I want one.'”
The scan revealed a suspicious spot on her pancreas, so her doctor referred her to a surgeon in metro Detroit. During an appointment with the surgeon, Ireland Black’s husband noticed the word “malignant” on one of his wife’s medical reports. Until this moment, the couple hadn’t realized they were dealing with pancreatic cancer.
Women making a decision about breast cancer surgery should include a plastic surgeon in that discussion. Several options for breast reconstruction give women choices, with each choice carrying its own risks and benefits.
“The decision tree is complicated. A plastic surgeon ultimately has to walk through the choices with patients and help them consider which option is best for their individual situation and preferences,” says Adeyiza Momoh, M.D., assistant professor of plastic surgery at the U-M Medical School.
As more younger women at high risk of breast cancer choose to have their breasts removed before cancer develops, a procedure called a DIEP (Deep Inferior Epigastric Perforator) flap has become increasingly popular. The technique involves transplanting tissue from the woman’s abdomen into her chest. But unlike traditional tissue reconstruction, called a pedicled TRAM flap, where the entire rectus muscle was included with the flap, a DIEP flap involves a complex approach to dissecting out the small blood vessels and leaving the muscle behind. The blood vessels are then reconnected to blood vessels in the chest.
The technique preserves the abdominal muscle function and typically has fewer abdominal complications. Continue reading