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Today is the one-year anniversary of my initial proton therapy consultation visit at Penn Medicine. This time last year I was nearing the Thanksgiving holiday with a guarded hopefulness. After being diagnosed with prostate cancer earlier in May, it was time to get moving on a treatment and I wanted to learn more about proton therapy at Penn Medicine.

I was guarded because there were some hurdles to clear. Wanting to have proton therapy and being a good candidate for the treatment are two different things. After my consultation I needed to undergo testing and evaluation to find out if I was a good fit for treatment. I would also need insurance approval.

To complicate everything, I did not live in Philadelphia. Being in New York, I was still 180 miles away, which made a daily commute out of the question. I would need to commute weekly but where was I to stay? Could I afford it? Would I be able to continue working to support my family back home?

The answers to those questions gradually and wonderfully unfolded between Thanksgiving and December holidays last year. I remember thinking that it would be understandable for me to be depressed during the holidays. However, it turned out to be my best holiday season ever as I anticipated starting my proton therapy in the New Year.

On this anniversary I find myself in Philadelphia again for volunteer work, and it has provided me with the time and perspective to consider all that I am thankful for.

I am thankful that I live in America, and that I am fortunate enough to have a job when so many aren’t working. But there is much more for me to be thankful for this time.

Last year I was thankful for the hope to have a chance to survive. This year I am thankful for my post-treatment outcome.

Today, I am disease-free, and my PSA is continuing its downward trend.

I have experienced very minimal effects of proton therapy– almost not worth mentioning. I am forever thankful to many people, without which, my survival could have not happened.

I dedicate this writing to those that helped me get to this anniversary and I owe each of them an un-repayable debt of gratitude. I hope to honor each one as I attempt to pay my debt forward through helping others that may find themselves in a similar position to mine a year ago.

I wish everyone their best Thanksgiving ever.

My special thanks to:

• My wife and 4 terrific children for allowing me to travel to Philadelphia for 2 months
• My personal physician for lighting the fire to move my tail (pun intended) and get treatment
• My employer for allowing me the flexibility to travel to Philadelphia for my treatment
• Bob Marckini for blazing a well-marked trail for other prostate cancer patients to follow
• My radiation oncologist for his professional, personal care and medical know-how
• My Host for Hospitals family – my second family - including their puppy
• My proton therapists (Proton 2 and 4!) – you guys are the best of the best! Gold medal!
• The nursing staff – you run an efficient operation, but always take time to deliver personal care
• The reception staff – nothing happens without you – you are the first smiles of the day
• My fellow Penn Medicine patients – we had a good time didn’t we? Well didn’t we?
• The Penn Medicine volunteers – you guys do so much and mean so much to us

In this guest post from her own personal blog, Jane reflects on her choice to get nipple and areola tattoos as part of breast reconstruction following a bilateral prophylactic mastectomy.

For as long as I can remember, I've been a straight arrow. Growing up, I kept my room neat, did my homework and chose as my friends similarly minded. I did what I was supposed to do, completed what I started, wore little makeup, didn't get my ears pierced until middle school, and never, ever considered getting a tattoo.

Fast-forward four decades.

Not much about my personality has changed, but I do have two tattoos, and when they faded to the point that they were nearly invisible, I chose to have them redone. Don’t bother looking for a decorative rosebud on my shoulder, an alluring bird behind my ear or an inspiring phrase in Latin inked down my spine, however. You won’t find any such tattoos on my skin. In fact, it’s not likely that you’ll ever see my tattoos at all.

That’s because I chose to get nipple and areola tattoos as the final step in the reconstruction of my breasts after I had a bilateral prophylactic mastectomy several years ago.

Like Angelina Jolie, I’d tested positive for a BRCA gene mutation, and this genetic defect – which is 10 times more prevalent among Ashkenazi Jews than in the general population – significantly increased my lifetime risk of developing breast, ovarian and several other types of cancer.

I always knew I’d get the tattoos – so much so that I never even considered not getting them, despite my straight-arrow personality. They were a part of the plan from the beginning, relieving me of the need to research and ponder all the options; list the pros and cons of each; and think, rethink and over-think my decision a thousand times. I’d already done all of that in making the choice to have the prophylactic bilateral mastectomy and reconstruction in the first place.

All told, I had three separate surgeries over the course of 18 months.

Individually and collectively, they took a tremendous toll on my body and on me, and the scars – both physical and emotional – remain. Although they continue to heal a bit each day, I’m not sure they’ll ever fade completely.

15 months after the last surgery, my body finally was ready for the tattooing. Once the tattoos healed, I could hardly believe the incredible power they had to transform my transplanted tissue mounds into breasts. For the first time since my mastectomy, my “faux” breasts looked like real breasts, and my body looked complete. More than transforming my breasts or completing my body, my tattoos restored the rest of me – my spirit, my soul, my deepest self – to wholeness.

Although I will never again be the person I was before my BRCA test, I’m still a straight arrow – with tattoos. Every day, they remind me of the strength and courage it took for me to change my life’s course to ensure that my genetics would not dictate my destiny. My tattoos remind me, too, that the path I’m on is the right one for me, that I’m lucky to be where I am, and that the same strength and courage that helped guide me on that journey to wholeness continue to guide me today.

Jane E. Herman, is a BRCA2 mutation carrier and volunteers as an Outreach Coordinator for FORCE: Facing our Risk of Cancer Empowered in New York City and blogs regularly about her BRCA journey and other slices of her life at JanetheWriter Writes… 

What does classical music have to do with hereditary breast and ovarian cancer?

This fall at the Jewish Community Center in Manhattan, the fifth season of PREformances with Allison Charney begins, with funds raised benefiting The Basser Research Center for BRCA of Penn Medicine’s Abramson Cancer Center and programs at the Jewish Community Center in Manhattan that promote early detection of cancer and care for those living with breast and ovarian cancer.

Given that one in forty carrier individuals of Ashkenazi Jewish ancestry carries a mutation in the BRCA1 or BRCA2 genes, the series also plays an important role in educating the community about hereditary forms of breast and ovarian cancer.

PREformances affords celebrated classical musicians the opportunity to try out new concert repertoire in front of understanding audiences prior to performing it in major venues.

Read the Examiner article on PREformances and hear Allison Charney sing here.

The Basser Research Center for BRCA at Penn Focuses on BRCA1 and BRCA2

The Basser Research Center for BRCA supports research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

The Basser Research Center for BRCA was established with a $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center for BRCA will contribute to all stages of research and clinical care relevant to BRCA-related cancers.

Jessica Bemis is a full-time, working mom of two who lost her husband to testicular cancer in November 2011. Since then, Jessica has been sharing her story on her blog, Hope for Young Widows and working to bring awareness and hope to women and men who have lost their spouses to cancer.

In trying to find ways to celebrate Jim’s life I thought a lot about his favorite things to do, see, work, travel, etc. One way the boys and I have memorialized Jim each year since his death is by releasing balloons on his birthday. The boys write cards to Jim, and then we attach them to balloons and watch them disappear into heaven as if dad received them. It has helped the boys to have a connection to their father.

Some other ways to memorialize your spouse is by requesting that in lieu of flowers a donation be made to a charity or other organization in remembrance of the person; a tree can be planted accompanied by a plaque with your tribute; a trust can be set up to help surviving family members; etc. For us, we chose to memorialize Jim with an annual 5k race.

Jim was an avid runner; he had a passion for running and weight lifting. His dream was to own a gym one day. From spring through fall he would look forward to running in 5k races to support various charities. Jim had a great friend, Mike, who also enjoyed running or rather grew to enjoy running after a 5 mile run through Valley Forge Park. Mike reached out to me to discuss creating a 5k race in honor of Jim’s memory.

The event raises money for Bringing Hope Home, a local charity in the area. Bringing Hope Home helps families struggling to pay their bills while receiving cancer treatments. Aligning the memorial with Bringing Hope Home is a great way to give back to the community and honor Jim at the same time.

Here is Mike’s story…

As I grow older, I realize that some of the most life-changing events are the small but powerful interactions to which we often give inadequate meaning while we wait for the large things (marriage, children, career, etc.) to define us. You have all heard the word nudge. What does it really mean? While to many it may seem a small thing, a nudge is really a push, a stubborn unwillingness to give up, acquiesce, or settle for less than success. Jim epitomized what I call the powerful Tao of Nudge.

For those who knew him it is no surprise that, Jim was first and foremost a devoted family man; son, brother, husband and father. There are so many words that could be used to describe Jim: funny, loyal, determined, courageous, encouraging, forthright, caring, inspiring and loving. He brought these traits to bear in all that he did, whether it was work, running (one of his favorite pastimes), encouraging others, or hanging with friends and family.

Jim was the Tao Nudge in his triumphing repeatedly over adversity and teaching others to do the same, throughout his fight with cancer. Not only was his 18-month battle with cancer a fight he planned on winning, he remained a father, friend and a stubborn mule when it came to giving up or even getting upset at setbacks and nearly innumerable procedures. All the while Jim was an inspiration to me and surely many others. There was a moment, a run actually, that Jim and I went on as a training run leading up to my very first Valley Forge 5 miler..

When Frank McKee was diagnosed with prostate cancer, he wanted to find the best possible treatment to fight his disease. Frank did extensive research about prostate cancer treatments and learned about proton therapy for prostate cancer, the world’s most advanced form of radiation therapy.

"For me, I wanted to treat the cancer. I wanted to be done with it," Frank said. "And, I wanted to be done with it in a way that had a minimum amount of side effects and affect my life the least."

"That’s why I picked proton therapy."

In this video, Frank discusses his diagnosis, and why he chose proton therapy at Penn Medicine.



Learn more about prostate cancer treatment at Penn including proton therapy for prostate cancer. 

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting the Basser Research Center for BRCA.

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

Basser Research Center for BRCA 1 and 2

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

The Basser Research Center — BRC for BRCA — will support research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

“We hope that the Basser Research Center will eliminate BRCA-related cancers and, in doing so, provide a road map for curing other genetic diseases,” Mindy and Jon Gray said. “We also want to make sure that families have a center dedicated to helping them with the complex issues arising from a BRCA diagnosis. As Penn graduates, we are fortunate that our alma mater has the world-class medical facilities and gifted researchers essential for this mission.”

The Center will be located within Penn’s Abramson Cancer Center at the Perelman School of Medicine. The gift will create an endowed professorship in the field of oncology to be known as the Basser Professorship, recruit additional faculty, enhance core technologies such as bioinformatics and DNA vaccine production, launch an annual lectureship and establish the Basser Prize to honor cutting-edge research.

The Grays’ gift will support research with a particular focus on interdisciplinary work and an acceleration of bench-to-bedside implementation of scientific findings.

Susan Domchek, associate professor of medical oncology and current director of the MacDonald Women’s Cancer Risk Evaluation Center at the Perelman School of Medicine, will serve as the founding executive director of the Basser Research Center and will lead its strategic direction.

Read the full press release about the Basser Research Center.

Learn more about the Basser Research Center.

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

Ursina Teitelbaum, MD, is a Penn Medicine assistant professor of medicine and medical oncologist specializing in gastrointestinal cancer, caring for older adults and symptomatic management of cancer patients.  In the second of two posts, Dr. Teitelbaum discusses Penn Medicine’s personalized approach to gastrointestinal treatment.

The era of personalized medicine is truly “here and now” in the field of colorectal cancer therapy at Penn Medicine, and it is exciting to work in a cancer center that has so much to offer in this regard.  Penn’s Abramson Cancer Center is devoted to tissue banking and studying strategies to further individualize cancer treatment. When it comes to cancer treatment, one size truly does not fit all.

Beyond traditional therapies, Penn has a very active program in experimental therapeutics or early phase clinical trials — some of which are very well suited for patients with gastrointestinal malignancies like colorectal cancer.  These early phase studies offer therapy for patients who have exhausted standard options and are fit enough to pursue innovative, experimental regimens.

Outside of clinical trials, I also work closely with specialty-trained surgical oncologists who are able to perform advanced surgeries, such as hepatic metastatectomies, thoracic resections, and HIPEC (hyperthermic Iintraperitoneal chemotherapy).  Penn also provides liver-directed therapies offered by interventional radiologists such as transarterial chemoembolization, radioembolization and radiofrequency ablation.

The Roberts Proton Therapy Center is able to deliver pinpoint radiation to tumors with decreased radiation toxicity to the surrounding tissues – this is particularly relevant for patients with liver cancer as the liver is a very sensitive organ.

All of these treatments can be combined to help patients live longer with a better quality of life, and may help patients take breaks from chemotherapy.

Caring for patients – beyond medicine

Beyond treatment, Penn’s cancer physicians strive to care for patients and their loved ones as a whole, recognizing that everyone in the family and friend network is affected by the illness.  I’m grateful that Penn offers nurse navigation, cancer counseling and supportive services, as well as excellent nutrition support.  I work closely with dedicated GI cancer nutritionists who help monitor patients through every phase of their therapy. Penn also has very well established survivorship programs to help patients during their cancer therapy and beyond.

I feel very fortunate to have many therapy options to offer patients.  Whenever I meet a new patient in my clinic, I actively review all the resources available and how best to sequence his or her care.  Every new patient is discussed in a multidisciplinary conference with the medical oncology group, radiation oncologists and surgical oncologists  — and interventional radiology and pathology is often in attendance as well as other support caregivers. 

This team approach helps open every possible avenue for every patient.

The future of colorectal cancer care

During the past 10 years, I have seen colorectal cancer become more treatable due to the discovery and approval of many new chemotherapies for colorectal cancer and biologic antibody therapies.  Even if a patient’s disease isn’t curable, I am confident that it is treatable.  Physicians used to measure life expectancy in months with metastatic disease, but now patients live years – and these are good years.

I collect magnets from all of the distant ports of call that my patients visit as a symbol of the full and active lives they are living, even when undergoing active therapy. Together we celebrate every birthday and joyful life event that these advanced therapies enable my patients to enjoy.

Learn more about the Abramson Cancer Center’s Gastrointestinal Cancers Program.

This cancer-fighting recipe for Rosemary-Lemon White Bean Dip is perfect to take to a summer picnic or party. And, it's healthy.

Limonene, a compound shown to have anti-cancer properties in laboratory animals, is found in the rind of the lemon.

Rosemary and garlic have a number of phytochemicals with bacteria killing and cancer-fighting properties.

Cannellini beans are a high in fiber and protein. They also contain B6, which may contribute to maintenance of healthy immune function.

 

 

Rosemary-Lemon White Bean Dip

Yields 2 cups


Ingredients

• 2 cups cooked white beans (i.e. cannellini), drained but moist
• 1 to 3 cloves garlic
• ¼ cup + 1 tbsp extra virgin olive oil
• 2 tsp minced fresh rosemary
• The zest of 2 lemons

Directions

1. Put the beans in the container of a food processor with 1 clove of garlic, along with a pinch of salt, blend and add the ¼ cup olive oil in a steady stream to the mixture, until smooth. Add more garlic, to taste.
2. Beat in the rosemary, lemon zest and remaining tbsp of olive oil, add more salt and pepper as needed.
3. Use immediately, can be refrigerated for up to 3 days.

Nutrition Facts/serving: 65 kcals; 4 grams of fat; 2 grams of protein; 1.5grams of fiber; 5 grams of carbohydrates


Recipe credit: Mark Bittman, author of Food Matters Cook Book (2010)

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012 Focus On Melanoma Conference In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

In 2010, Katie Schmitz, PhD, FACSM, associate professor of medicine at the Perelman School of Medicine, and a group of her colleagues published a study that changed how patients and doctors think about exercise and lymphedema in cancer patients.

Dr. Schmitz's Physical Activity and Lymphedema (PAL) study demonstrated that a slow, gradual, supervised program of weight lifting not only didn't make lymphedema worse in women who either had the condition or were at risk for it following treatment for breast cancer, it actually had measurable benefits.

These benefits were measured in terms of the ability of patients to function and their overall quality of life. For patients with lymphedema, the risk of flare-ups for patients on the exercise program was reduced by 50%, and for those patients at highest risk for developing lymphedema (those who had five or more nodes removed from their axilla), the expected incidence of lymphedema was 90% less than expected.

Until Dr. Schmitz's data was published, it was standard procedure to tell patients at risk of lymphedema to rest and avoid any kind of activity with the affected arm.

Dr. Schmitz doesn't mince her words. Exercise is important for everyone, including cancer patients. For cancer patients, to be safe and effective, it needs to be done in what she calls a "rehab" mode, meaning that it tailored to the individual needs and abilities and aimed at rebuilding or regaining lost conditioning.

Now, Dr. Schmitz is extending to her work to patients with other types of cancer and those at risk for lower extremity lymphedema, which often occurs in melanoma patients. Her LEG-UP Pilot study is recruiting patients to assess whether the same kind of exercise program is safe and effective for this group. Preliminary results demonstrate that this program works for lower extremity lymphedema as well, with participants experiencing increased strength, increased capacity to walk and no worsening of their condition.

Conditioning and deconditioning are the keys to treatment. When we have cancer and undergo treatment, it is normal to lose some level of strength and flexibility. The disease and its treatment, along with the emotional challenges that are part of the experience, can all lead to a body that is weaker, less able to respond to stress or resist infection and inflammation. The right kind of exercise rebuilds that strength, restores function and enhances overall health and the sense of well being.

Dr. Schmitz's advice to cancer patients, including those who are at risk for or have lymphedema: Find a supervised exercise program that works for you. Go slowly and gradually. Be evaluated on a regular basis by a physical therapist who is knowledgeable about cancer, and keep moving.

If you are concerned about lymphedema following cancer treatment, watch our new video,
"Cancer-related Lymphedema: What You Need to Know.” This video guide features experts from the Abramson Cancer Center and Good Shepherd Penn Partners, recognized as one of the nation's best and most comprehensive lymphedema treatment programs.

The Abramson Cancer Center is pleased to present the Penn Women’s Cancer Conference, a day-long conference dedicated to topics on women’s cancer including prevention, diagnosis, treatment, genetics and living well after breast cancer and gynecologic cancer treatment.

This conference was one of the first in the country to address the issues and concerns of breast and gynecologic cancer survivors and their families.

Whether at risk for women’s cancer, newly diagnosed or long term survivor, attendees received up-to-the-minute information including; the latest laboratory research, treatment advances, clinical trials, and survivorship issues.

There are two different tracts for the day including Focus On Gynecologic Cancers Conference and Life After Breast Cancer Conference.

Join Us for Focus On Gynecologic Cancers Conference

Date: Friday, October 25, 3013
Time: 7:30 am to 2:30 pm
Location: Hilton Hotel, 4200 City Avenue, Philadelphia PA

Register for Focus on Gynecologic Cancers Conference here.

Can’t Make the Conference?

Can’t make this year’s conference? Be sure to follow @PennMedicine on Twitter with the hashtag #OvarianACC to follow the day’s topics and discussions, or watch the live stream at pennmedicine.org/Abramson/ovarianlive.

Join us for the 21st Life After Breast Cancer Conference

Date: Friday, October 25, 3013
Time: 7:30 am to 3:30 pm
Location: Hilton Hotel, 4200 City Avenue, Philadelphia PA

Register for the 21st Life After Breast Cancer Conference here.

Can’t Make the Conference?

Can’t make this year’s conference? Be sure to follow @PennMedicine on Twitter with the hashtag #BreastACC to follow the day’s topics and discussions, or watch the live stream at pennmedicine.org/Abramson/womenscancerslive.

This powerhouse recipe has kale, sweet potatoes and the sesame seed paste called tahini. An equally delicious substitution is with sunflower seed butter which also is a good protein, vitamin E and iron source.

For the calorie conscious the olive oil can also be reduced to 2 1/2 tablespoons.

Wilted Kale and Roasted Potato Salad

Serves 4 as a main dish, or 6 as a side dish

Ingredients

• 1 lb Yukon gold potatoes, cut into 1-inch pieces
• 1 lb of sweet potatoes, peeled and cut into 1-inch pieces
• 1/3 cup olive oil
• 1/2 tsp each salt and pepper
• 1 shallot, finely chopped
• 1/3 cup grated Parmigiano-Reggiano cheese
• 1/4 cup well-stirred tahini
• 2 garlic cloves
• 2 tablespoons of water
• 2 tablespoons fresh lemon juice
• 3/4 pound of kale, stems and center rib removed, leaved thinly sliced

Directions

1. Preheat oven to 450 degrees with rack in upper third
2. Toss potatoes with oil, salt and pepper. Spread evenly on a pan and roast for 10 minutes. Stir and roast for another 10 minutes.
3. Stir in shallot and cheese and roast another 5 - 10 minutes until golden and soft.
4. Puree tahini, garlic, water, lemon juice for 1 minute. Add a bit of water if it is too thick.
5. Place sliced kale in large salad bowl. Add hot potatoes and toss with tahini mixture. Cover for 10 minutes as the potatoes cool and wilt the kale.
6. Serve hot, at room temperature or cold.

Source: Gourmet: December, 2008 as found on epicurious.com

Just one serving of this salad a day should be enough to keep the doctor away. Onions are rich in the phytochemical quercetin, which has also been shown to have beneficial effects against lung cancer that are totally worth the tears.

Carrots and parsley belong to the Umbelliferae family but boast different cancer fighting properties.

Carrots are high in vitamin A, which is known to promote lung health so much so that studies have shown just eating one carrot a day could cut the risk of lung cancer in half. Parsley commonly used to garnish, contains many volatile oils and phytochemicals that have cancer protective attributes.

Shredded Beet Salad

Ingredients:
2 cups of cooked, peeled and shredded red beets
1 cup shredded carrots
½ c fresh parsley (chopped)
3 Tbs olive oil
2 Tbs lemon juice
2 Tbs onion (chopped)
1 Tbs sugar
½ tsp salt
Pepper to taste

Mix together and chill.  Toss salad with the following dressing recipe.  Also optional is to serve on a bed of lettuce topped with 2 sliced hard-cooked eggs.

Adapted from: Simply in Season: a World Community Cookbook by Mary Beth Lind and Cathleen Hockman-Wert

For more cancer fighting recipes and nutrition information visit www.pennmedicine.org/karnell.

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2015- Focus Melanoma and CAN Prevent Skin Cancer Conferences. In this blog, she discusses advances in melanoma treatment and research.

Lynn Schuchter, MD, had to delay her presentation, ”10 Years, Reflections on the Journey,” while The Broad Street Line, a men’s a cappella group from Temple University, began serenading the conference chair and program leader for Penn’s Melanoma Program with their version of Somewhere Over the Rainbow.



No song, and no moment, could have better captured the tone, and the content of the May 17th conference, which brought together over 350 patients and family members to hear Dr. Schuchter and her colleagues discuss the extraordinary progress that has been made against melanoma in the last few years.

Schuchter used the familiar computer keyboard to frame her presentation:

• The Home Key—Because Penn is a home to its patients and to the people who care for them.
• The Shift Key—To denote the “seismic change” in how melanoma is treated, especially the shift away from one treatment fits all approach to one that is far more individualized and targeted.
• The Delete Key—To delete cancer, and melanoma
• The ALT Key—Dr. Schuchter called for better, more clear cut answers to the questions that patients ask about how they can incorporate alternative therapies and help themselves to stay healthy.
• The End—To acknowledge that melanoma still takes an enormous toll, and that many people still lose their battle to this disease. Schuchter stressed that, while pain remains part of the journey, that she and the Penn staff view taking care of melanoma patients as “an enormous privilege.”
• The Asterisk—For the many unexpected things, “the miracles that happen every day,” the people who come to Penn with advanced disease and are cancer free today.
• The “F” Keys—Because as Dr. Schuchter said, “I have no idea what these are about, and in melanoma, we have a lot of important clues, but we don’t yet know what they mean.”
• The Power Button—Because “we all have so much more power to control this disease.”
• The Hope Button—A new key, for the hope that everyone shares.

Dr. Schuchter concluded her presentation by showing the video Fire with Fire, highlighting the remarkable new approach to immunotherapy that Penn has pioneered with leukemia patients, and will soon begin using in clinical trials for melanoma patients.

Watch the Fire with Fire video below.


The conference ended with a standing ovation for Dr. Schuchter, the Penn melanoma team and the patients and caregivers who were there, along with a special “toast” of sparkling cider and a 10th year anniversary cake.

Penn’s Abramson Cancer Center invites patients, family members and anyone interested in learning about melanoma risk, prevention, diagnosis and treatment to attend Focus On Melanoma.

Focus On Melanoma is a free educational conference featuring a keynote address by Singer/Songwriter and Survivor,  Charlie Lustman, 

Penn’s Focus On Melanoma Conference addresses the personal and medical issues facing people with melanoma including those in treatment, survivors, their loved ones, relatives and caregivers.

The conference provides patient-focused information on the latest advances in melanoma risk, prevention, diagnosis, treatment, symptom management and psychosocial issues. It is also an opportunity to network and gain support from other melanoma patients and survivors.

Who Should Attend

• People newly diagnosed with melanoma
• Those at risk for melanoma
• Melanoma survivors
• Family members, caregivers or health care providers of melanoma patients/survivors
• Those diagnosed with a pigmented lesion and their family members/caregivers

Join Us

Time: 8 am to 3 pm
Date: Friday May 16, 2014
Location: Hilton Hotel located at 4200 City Avenue, Philadelphia, PA
Registration: Register here or call 800-789-PENN (7366)
Cost: FREE

Unable to Attend?

If you are unable to attend in person, follow Penn Medicine on Twitter for event information before the conference date, and live tweeting throughout the conference with the hashtag #MelanomaACC.

FREE Skin Cancer Screening

Have your skin checked by a Penn dermatologist to determine your risk for developing skin cancer.
Date: Saturday, May 17, 2014
Location: Smilow Center for Research (attached to the Perelman Center for Advanced Medicine- PCAM)
 
Appointments are necessary and space is limited.

Call 215- 662- 2737 to make your reservation.

Last week’s op-ed piece by Angelina Jolie has brought to the forefront BRCA testing, and choices women make regarding their BRCA status and preventative measures against breast and ovarian cancer.

It also raises the question: Is BRCA testing only for men and women who are of means? Who can afford genetic testing for BRCA?

Is BRCA testing covered by insurance?

BRCA testing is usually covered by insurance if the patient meets certain criteria. There are different types of BRCA testing, ranging in cost from $475 to $4000. Genetic counselors are helpful in determining what type of testing is indicated. Testing is less expensive once a mutation has been identified within a family.

Insurance coverage and criteria varies by insurance plan, and genetic counselors are excellent at determining whether insurance is likely to cover the testing. Insurances more readily cover testing of people with a personal history of cancer and ideally, testing in a family starts in an individual who has had a BRCA-related cancer at a young age.

This first person to undergo testing in the family has complete sequencing of both the BRCA1 and BRCA2 genes. This costs about $3300 and if no mutation is found, an additional $700 test looking even more closely at both genes may be necessary. For individuals of Jewish ancestry, a simpler test can often be performed that looks at just the common BRCA mutations within that population, for a cost of $575. Lastly, once an individual in a family test positive, other family members typically only require testing for a single mutation which is a simpler test that costs about $475.

There are also options for individuals who lack insurance coverage of genetic testing. Uninsured individuals may be eligible for free testing via the laboratory. Under-insured individuals can apply for financial assistance through an organization called Cancer1Source and depending on where they are tested, may have access to institutional earmarked charity funds.

Another insurance question that often arises is whether a positive result will make it harder for an individual to get health insurance. Legislation passed in 2008 bars discrimination based on genetic test results for the majority of health insurance companies and plans. This legislation extends to protect people from discrimination based on genetic test results in the realm of employment. It is important to note that no such protections are in place for things like life and long-term disability insurance, so some consider putting these in place before testing is performed.

Learn more about BRCA testing at the Basser Research Center for BRCA.

Today was a very weird day, wasn't at work as I was accompaning a friend as moral support to a meeting. I have to admit that I'm a creature of habit so this threw me right off but I think I still managed an ok day -

Breakfast - oats, natural yoghurt, chopped apple and honey
During day - two minging vending machine coffees, a diet coke, 3 clemintines and a polo mint!
Lunch - home made brocolli and cauliflower soup, apple
Dinner - chicken, red pepper, bok choy and cabbage stir fry with soy and ginger
Evening - a britvic orange diluted between 3 soda waters

Started the day by doing Davinas new DVD - (the Kick fit section) as I would usually go to the gym on a Monday after work but with being off work thought I would do that instead. Its the first time I've done it, it was ok but didnt wear me out enough, perhaps I need to put more effort into it!


- Posted using BlogPress from my iPhone

On the news this morning they were saying that today should be the warmest day of the year so far in the North East. Its a shame that the horrible wind had to go and steal the warmth away! I've spent most of the day in my fleecy hoody to keep me warm as our office is an old drafty building. I'm still happy though as at least you can really feel that spring is finally on its way!

I didn't have to be in work till a bit later this morning so I thought I would try and work out for a few minutes longer. I did Jillian Michaels 30 Day Shred Level two and the first two circuits of Level 3. I don't think I have ever sweated so much in my life! After that I had a serious craving for a green monster so used up the last of my bag of spinach (about 2 big handfuls) some frozen blueberries, oats, vanilla whey powder, ground flax and a tablespoon of peanut butter (I briefly considered not adding the pb to save on calories after my weight gain / excessive food this week but then I thought screw that! pb just makes this extra delicious.)


It looks a really strange colour but tastes fabulous! I got to sit down and savor it instead of having to rush about getting ready like usual which was lovely.

Lunch was another juicy nectarine - these taste beautiful at the moment, just the perfect ripeness!


Followed by another bowl of Chilli Bean soup. It was just what I needed to warm me up in the drafty office!

My mid afternoon snack was a pear and some cottage cheese


I was working late again tonight so I made up some dinner last night in the form of roast veggies (brocolli, sweet potato, red pepper, red onion) with diced turkey steak fried off in a little oil with hot chilli powder. I've never ever thought of roasting brocolli until I read about other bloggers doing it. It tastes lovely, will be doing it more often!

*word heavy post* – but I hope you’ll find it interesting :-)

Last week I took ‘The Kind Diet’ out at the library. I’ve wanted to read it for a while so I was glad that the library had it in stock.

‘The Kind Diet’ is written by Alicia Silverstone (yes, her from Clueless!)

Usually with these diet / recipe books I skip the diet bit and go straight to the recipes but I decided to read this book properly.

The book is very well written and has an approachable and friendly tone. I was worried that it might be a bit ‘meat eaters are evil’ but it wasn’t like that at all. The book begins with some discussion about ‘nasty’ foods – meat, diary, eggs, refined sugars etc and why they should be avoided. This argument naturally includes the cruelty many animals experience as part of the modern food industry but also looks at the health and environmental reasons to consider switching to a plant based diet.

The book then goes on to offer three levels of involvement in living the Kind Diet – flirt, vegan and superhero. Flirt is for people who are looking to dip their toes in the vegan pool. Superhero is vegan but with a large focus on eating a macrobiotic diet (lots of sea vegetables, avoiding nightshade veggies, processed soy etc) and the Vegan plan is for people who are ready to commit to being vegan but don’t want to go as far as the macrobiotic Superhero plan.

Azuki Bean and Kobocha Squash – from The Kind Life Website

The book then has two recipe sections with Vegan and Superhero dishes. The Flirt and Vegan are encouraged to try recipes from both. Examples of recipes include Moroccan couscous with saffron, crispy tofu slices with orange dipping sauce, black soya bean and kabocha stew, squash and onions, chocolate peanut butter cups and lemon poppy seed pound cake (yum!)

The only problem I have with the recipes is the amount of specialist ingredients used such as umeboshi vinegar and seitan etc (although I’ve just found a lot of the ingredients on Goodness Direct under the macrobiotic section)

Overall this is an excellent book for anyone who is considering converting to a vegetarian / vegan diet – the arguments are put across in a clear and convincing way without trying to ‘guilt trip’ you into changing your lifestyle. The recipes could be better but there are a few good ones that I’m planning on trying out.

Definitely worth a read if you are considering becoming a vegetarian or vegan!

My musings on vegetarianism and veganism

Veggie fave – Moroccan chickpeas with olives and salad 

Ok, this is going to be a bit of a ramble so please bear with me…

I feel that over the last couple of years I’ve been on a huge journey that has taken me from being 5 stone over weight, eating hugely processed crap to gradually improving my diet, limiting processed foods, eating more ‘health’ foods, expanding my palate, learning to cook, enjoying cooking, gaining a real interest and passion in nutrition and gradually increasing my fitness. I’ve gone from being a bit of a protein junkie to accepting the importance of quality carbohydrates and grains in my diet and I’m no longer afraid to eat them in case I gain weight.

    Veggie fave – Vegetable Chilli with salad

I’ve also noticed that over the last few months I have very gradually started to eat less meat. This started when I did my Big Budget Challenge as I identified that meat is expensive – especially good quality meat, so I ended up eating more tofu, beans and lentils instead.

I agree with lots of the arguments (although not all of them) included in The Kind Diet. I believe that meat production on its current scale is unsustainable and damages our environment. I also believe that animals are subject to some horrendous suffering as part of the modern food industry and I’m saddened by the mass consumption of meat with little or no respect for the lives of animals. This is where I believe organically produced meat is much better, both for the animals involved and your health when consuming them.

Veggie fave – Soba Noodles with veggies and spicy peanut butter sauce

I’m also at a place where I feel that I would like to improve my lifestyle so that I’m living more sustainably both on a personal level (saving money, reduce, re use and recycle) and on a bigger picture level – being more environmentally friendly, food miles etc. I feel more of a link now than ever before between myself, how I live my life, what I eat and nature. I know that’s getting a little deep but that’s kind of where my heads at right now!

Oh – and don’t get me wrong, I have no judgement on what others choose to eat or not eat, we all have differing opinions and are on different paths and should do right for our own values.

Veggie fave – Thai Red Tofu Curry with steamed veggies and brown rice noodles

So with all that in mind here’s a couple of things I’m going to be trying to do over the next few months:

• Buy more organic food – I have mentioned my local organic food box scheme that I’ve just signed up for. Yes, its more expensive but I hope to save money not purchasing as much meat to make up for it.
• Buy more locally produced food – the produce in my organic vegetable box is all grown in North Yorkshire
• I will endeavour to only buy organic meat, free range eggs and organic dairy (as much as possible – as this is more difficult with the dairy) – In the past I’ve usually just bought cheap mass produced meat which is no doubt packed with antibiotics and other nasties. This means that I may only eat meat once or twice a month and less diary than I do now (I have always bought free range eggs), but when I do it will be the best I can afford.
• I will experiment with eating more vegan meals – I love vegan food – give me a spicy bean burger over a beef burger any day! I can’t get enough of beans, lentils and tofu!

Veggie fave – Basil Tofu with brown rice, stir fried broccoli and brussel sprouts with spicy peanut butter sauce

I don’t think that this is going to be too difficult for me, I looked back over old blog posts and most days I eat vegetarian and some days vegan without even realising. Just to be clear – I’m not officially going vegetarian or vegan (yet!) I’m certainly in the ‘flirt’ phase right now.

Newly found favourite – Tofutti Organic Vanilla Soya dessert

I do have a couple of queries that I’m hoping some of you veggies / vegans can give me your opinions on:

• How much soy is too much? I love my tofu and soy milk and have now discovered things like soy ice cream and soy cheese and would like to eat more of these instead of diary but I’m aware that there’s an argument that too much processed soy (soy protein isolate I think its called) is bad for you – any thoughts?
• I know that Quorn isn’t vegan but I do like it, its cheap and importantly – the hubby likes it too! What’s your views on Quorn? I guess I would just be eating it a couple of times a week if that but I’m really interested in peoples views.

Have you read The Kind Diet? What did you think? To all you vegetarians and vegans do you have any tips for me in trying to eat a more plant based diet?

Well I wasn't very good after I posted last night, I had a major raid of the kitchen cupboards due to the hunger monster. I was just ravenous! I kind of binged, but not on anything unhealthy so I don't feel really bad about it, but I still feel I bit guilty. I started off with a small bowl of brown rice puffs and chocolate rice milk, then when I had finished them I went back for another bowl, and then another bowl which finished the packet of rice puffs. After I had them I decided to finish off the last few dates in the cupboard. Still hungry, so I went back and had a handful of raisins and goji berries, still bloody hungry! So I chopped up a carrot and sprinkled with cinnamon and ate that too. I took these pics to remind myself of what I had eaten as well as trying to make sure that I didn't blow things out of proportion when I would undoubtfully feel guilty the next day. Looking back at the pics it wasn't too bad but I was a total glutton with the rice milk and rice puffs.


Unsuprisingly I went to bed with a bit of a food baby in my tummy!

Anyway, I'm not going to dwell on it, I haven't had a little binge like that for quite a while so I think perhaps my body just needed it, or I just couldn't resist that chocolate rice milk!

This morning I was up nice and early and had a cup of green tea and a Trek Oat Crunch bar for pre run fuel.


This tasted really good, just like the Trek Cherry flap jack it has more sugary ingredients, however I think this just makes it perfect for pre workout. This was the last of my products from Natural Balance Foods, I'm gutted! I think I'm going to make a purchase from their website. A full review post and GIVEAWAY to follow in the next couple of days!

I then headed out for my run. It was really good, I can feel my confidence growing each time I run. I did 9 miles this morning in 1hr 27, I can't get my exact breakdown as I lost GPS signal around mile 3 and that just completetly knocked everything off. At least I know I'm still coming in under 10 min a mile, however I really want to improve this for the Great North Run.

When I got back I stretched, showered and then made breakfast, I was starving! I started off with a slice of toasted rye bread with crunchy peanut butter and strawberry jam followed by my best green monster smoothie in a bowl to date, made with loads of spinach, chocolate rice milk, scoop of chocolate whey, frozen banana and a few mixed frozen berries. This blended really well but stayed thick and creamy. I felt like I was eating a fruity chocolate ice cream, yum!


I spent the rest of the morning trying to chill out a bit and started to go through my old magazines in preparation for my inspiration board. I didn't realise that I had so many old magazines to sort through, I usually go through them after a couple of months to tear out any bits of inspiration, but its been a while!

For lunch I had more turkey, hummus and lettuce wraps with carrot and cucumber followed by an apple and a little peach.


I popped to see my Mam and Dad and then my friends Claire and Kate before heading into town to meet up with the Hubby. I snacked on a banana bread nakd bar I had popped in my bag mid afternoon. I picked up a few bits and pieces at the shops including some cropped running tights, and anti blister socks, a beaded and embroidered top for my holidays, some hazelnut and almond rice milk, posh new teas to try out and some new bras for my much smaller boobs! (due to the weight loss)

For dinner I made some baked salmon with ginger, soy and a little maple syrup and served it with a load of stir fried veggies including brocolli, savoy cabbage, courgette, carrot, mushrooms and red onions.


For desert I had more of my chocolate tofu pudding which was utterly delicious!


I then thought I would try out one of my new teas. I bought a box of tea pigs chocolate flake tea, I had read about tea pigs stuff in a magazine then checked out their website and knew I would want to give this flavour a try.


It tasted lovely, just like regular tea with a slightly chocolately taste, yum!

Drinks - water, green tea, chocolate flake tea.

He's a quick goofy pic of me, I haven't put a recent pic of me on the blog since I first started it so I thought I should pop one on!


Sorry, this post seems to have ended up really long! Hope you are all having a really good weekend what ever your up to. I'm just chuffed that I still have another two days off, woo hoo! x

Can you believe it is now December? This has been such an unexpectedly awesome month! I certainly met my goal of having fun :-) I did completely fail with my aim of sorting out my bedroom and living room decor, never mind it does look ok as it is, and pretty festive right now:

I got some star lights for hanging round our bed frame for Christmas, I think they look so pretty :-)

Great things from this month:

• I enjoyed a brilliant Bonfire Night
• I had a great time as a punk at my best friends 30th Birthday Party
• Enjoyed the Durham Lumiere Festival
• Kicked off Secret Santa (so excited!)
• Completed another two assignments for my course – I only have the final one to go!
• Worked out according to my training plan and enjoyed my set back week
• Was chosen to be a healthy hero for Healthy Magazine!
• Had my Apple Pie Green Smoothie recipe chosen to be included in Kris Carr’s e recipe book!
• Started to make plans for delivering healthy living programmes in the community at some point next year
• Got my allotment!

I’ve continued trying to balance out my eating and be more intuitive. I’ve generally been pretty good but I have had a couple of over eating episodes on an evening again. As always, I’m trying not to beat myself up on it but it is a habit I’m really trying to address, not because of issues relating to weight gain or size, but because I feel so crap physically and mentally when it happens. I’m working on accepting that having a snacky evening sometimes is completely normal! I have loads of thoughts on weight maintenance and the scales and what not but I think I need at least one wordy post for all of that!

In December I’d like to…

source

• Continue the good run I seem to be on at the moment and enjoy everything Christmas has to offer!
• Not feel guilty when I enjoy extra / richer foods
• Continue to workout fairly consistently
• Enjoy some really delicious seasonal food!
• Get my head around the whole allotment thing and have a plan of action ready for next year
• Start writing up a plan of action for my community healthy living programmes
• Finish my Diet and Nutrition course!

The course work and action plans for the allotment and community stuff are going to take some work but if I’m going to achieve what I want I need to be super duper organised!

The Big Budget Challenge – how I did and what I’ve learned

See this post for the rules and guidelines I set myself for the last two months. I’ll be honest, I think I did ok but not brilliant. I managed to clear a credit card and generally feel like I’ve taken control of my finances. I did go over my grocery budget, however I feel like I’ve completely changed the way I shop for food. I also feel like I’ve developed lots of good habits that I’m hoping are going to stick and make me more frugal in the future:

• Cooking beans from scratch – I had never cooked beans from scratch and doing the Big Budget Challenge prompted me to try. Its so easy I’m pretty sure this is a habit I’ll be keeping up!
• Sold stuff on eBay – This was a great way to get a little income out of un worn clothing. I need to get into a habit of having regular clear outs .
• I changed my skin care routine – instead of using expensive face wipes I now use face cloths and Lush Ultrabland cleanser which is cheaper and more environmentally friendly. I also started using coconut oil as a night moisturiser
• I got back into the habit of shopping at multiple stores – Lidl, Aldi and Green Grocers which has an awesome discount!
• I reminded myself of what my grocery staples are.
• I started to make sure I prioritise the ‘extras’ that I like to buy, especially more expensive health foods, and realised that I really don’t need as many as I thought!
• Started checking out budget themed websites and blogs for inspiration and making good use of discount codes and online deals
• Put my name down on the allotment list and got my plot!
• Started making my own raw nut butter – best discovery ever!

I think that doing the challenge has given me the reality check I needed and it made me realise how truly blessed I am for all that I have in my life outside of materialistic things. It made me see that I simply could not continue spending money the way I had been. I think the fact that I’ve gone over my grocery budget each time means that realistically I need to increase it a little, but even then I will still be saving over £50 what I was spending before I set the challenge.

Due to the job scare we had with James in the middle of the challenge I think I can safely say that the challenge doesn’t end here for me. That just proved how tough times are right now, and James is still only on contracted work so we need to be prepared for the worse case scenario. Overall I’m so happy that I set myself this challenge and big thanks to everyone who has read and commented on all my posts!

Huge thanks also to everyone that took part in the challenge. It really meant so much to me that I wasn’t in it alone and I think we have all learned so much by doing it. Three big cheers to all my Big Budgeters and their round up posts!

Jemma @ Celery and Cupcakes

Alissa @ Not Just Apples

Sarah @ Every Day’s a Picnic

December Sponsors

Big thanks to my current sponsors Sarah @ Every Day’s a Picnic and Cat @ Knitting Running Eating for being long term blogger sponsors. Thanks again to iHerb, Goodness Direct and Viva Pure for supporting me and offering up some fab discounts and giveaways over the last year! I’m not accepting any new sponsors for December but hopefully I’ll be back next year with plenty of new bloggers, new brands and great giveaways!

As always if this is something your interested in check out my sponsorship page for more details!

How was November for you? Do you have any goals for December? Have you got your Christmas decorations up yet? I’ve just put my little Christmas tree up and I’m feeling so excited!