Casey’s Story: Learning she has cancer for a second time

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I have always considered myself a normal girl with a fairly normal life.  Married to a great guy. I am healthy and active with 3 kids and a precious granddaughter who, along with my husband, are the loves of my life.   We have lived in Knoxville for the past 18 years and feel blessed to have found this great part of East Tennessee to work, raise our kids and find wonderful friends.  I have been working at Provision for two years now as a Care Coordinator, a position that I feel very comfortable with since I am a breast cancer survivor and can easily empathize with the patients. Recently, after two years at this job I love, I was again diagnosed with breast cancer.  Although I have never blogged a day in my life, when presented with the opportunity to share my journey and my point of view from both sides of treatment, I thought it would be another way to help others facing cancer and radiation therapy – and for that reason, I was all in.

In 2012, while busy raising my then young teenagers, I was diagnosed with early stage breast cancer. My particular diagnosis required a bilateral mastectomy and reconstruction, and subsequent  chemotherapy and immunotherapy.  Relatively straightforward and at times challenging, but doable.

As a Care Coordinator, we are often the first person an individual who has been newly diagnosed with cancer or a concerned family member or friend speaks with when they call Provision CARES Proton Therapy for information.  Almost always, this person is anxious, scared and uninformed about their illness.  We do our very best here at Provision to provide a compassionate ear while collecting patient records and facilitating a consult date so that our radiation oncologists, clinical nursing and radiation therapy teams can address the patient’s treatment needs in a timely manner.

To hear for the second time in 6 years, “you have breast cancer” is enough to rock anyone’s world.  I heard this news in the fall of 2018. Now, this mom of 3 children and one beautiful 6-year-old grandchild, was full of shock, fear and dread of what was in my immediate future: a whole lot of treatment that would NOT BE FUN and would cause me to again, lose my hair and my energy.  And then maybe eventually… my life.  We knew nothing at this point only that here we were AGAIN.  It was a very dark time for my family.  And for me.

Once the shock wore off, the Care Coordinator part of me began to surface. I knew immediately what I had to do to combat this disease for the second time.  After a bilateral mastectomy and reconstruction in 2012, along with chemotherapy, I realized that radiation therapy would be in my immediate future.  Recurrent breast cancer requires and arsenal of incredibly bright practitioners, along with state-of-the-art drugs and treatment.  I knew right away that with left sided breast cancer, Proton Therapy is the recommended treatment in order to spare the heart and lungs from unnecessary radiation exposure.  I knew that we (Provision) had a brilliant clinical team and a caring and conscientious support staff, state of the art technology and extensively trained radiation therapists.

This was not going to be a sprint…. but more of a marathon.  As a former triathlete of 30+ years, I tend to think of things in segments or parts.  Chemotherapy was the swim portion of the race.  I hated getting in the pool, but knew I had to put the time in.  Biking is fast and deliberate, and I related that to my surgery.  Let the surgery be seamless and without complications  (no bike wrecks).  Get that cancer outta there!   The last part of a triathlon is the running segment and I compare that to my upcoming radiation treatments.  At this point you are tired and simply want a cold drink and some shade. But one must push on at this point and finish strong.  Just like you surround yourself with training partners you trust and who make you feel good about your efforts, the same is true for your radiation treatment team.

I knew, without a doubt, that I would be well taken care of at Provision from start to finish.  With all of this in mind, I also feel that everyone’s cancer journey is different.  In this series of blogs, I’m sharing a little peek into my journey which I hope will give you or a loved one faced with a cancer diagnosis some peace of mind and maybe a smile along the way.

To continue to follow my journey and read updated blog posts, please follow Provision on Facebook.

 

New Study confirms proton therapy results in fewer side effects for many cancers.

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In the largest side-by-side comparison study of its kind, proton therapy was found to have fewer side effects while maintaining similar survival rates when compared to traditional X-ray radiation therapy.

The study, led by Washington University School of Medicine in St. Louis and the Perelman School of Medicine at the University of Pennsylvania,  included almost 1,500 patients receiving combined chemotherapy and radiation therapy for lung, brain, head and neck, gastrointestinal and gynecologic cancers that were localized to one part of the body and had not metastasized.    A combination treatment of chemotherapy and radiation therapy is a standard treatment leading to cure for many non-metastatic cancer.  However, it is common for patients of this treatment regimen to experience severe side effects that can significantly reduce quality of life and in some cases require hospitalization, trading cure for side effects.

Proton Therapy is an advanced form of radiation therapy that uses protons to deliver the radiation directly to the tumor.  Protons are positively charged particles that have a unique characteristic allowing more of the radiation dose to be directly deposited at the tumor.  There is minimal entrance dose and no exit dose, significantly reducing radiation received to nearby healthy tissue and organs when compared to X-ray therapy that uses photons which travel all the way through the body and pass through healthy tissue on the way out.  Both proton and X-ray radiation therapy are FDA approved.

According to the research, after controlling for differences between the groups, such as age and additional medical problems, the researchers found that patients receiving proton therapy experienced a two-thirds reduction in the relative risk of severe side effects within 90 days of treatment, compared with patients receiving X-ray radiation therapy. “We looked at grade-three side effects—including pain or difficulty swallowing, difficulty breathing, nausea, or diarrhea, among others—often severe enough for patients to be hospitalized,” says the study’s lead author Brian Baumann, an adjunct assistant professor of radiation oncology in the Perelman School of Medicine and an assistant professor of radiation oncology at Washington University School of Medicine in St. Louis. “Our clinical experience is that concurrent chemoradiation therapy patients treated with protons, rather than photons, tend to have fewer side effects. While there is some literature supporting that finding for several disease sites, we did not expect the magnitude of the benefit to be this large.”

Furthermore, the researchers found no difference between the two groups in survival, suggesting that proton therapy was just as effective in treating the cancer even as it caused fewer side effects.  Overall survival at one year for the proton therapy group was 83 percent of patients versus 81 percent for the X-ray radiation therapy group.

To learn more about the benefits of proton therapy, visit our proton benefits page.

Source:  Baumann BC, Mitra N, Harton JG, Xiao Y, Wojcieszynski AP, Gabriel PE, Zhong H, Geng H, Doucette A, Wei J, O’Dwyer PJ, Bekelman JE, Metz JM. Comparative effectiveness of proton therapy versus photon therapy as part of concurrent chemo-radiotherapy for locally advanced cancer. American Society of Clinical Oncology poster session. June 1, 2019.

Celebrating Nurses Week 2019

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Content and information were written in conjunction with Lindsay Chandler, RN, BSN, OCN Nursing Manager for Provision CARES Proton Therapy Knoxville

May 6th-12th is a week of excellence for every nurse, and marks a time to acknowledge accomplishments, compassionate patient care and professionalism for the nursing society. The conclusion of Nurses Week is May 12th, in honor of the mother of nursing, Florence Nightingale. Florence Nightingale was born on May 12th, 1820, and she was the innovator of modern nursing. It was through her teaching, compassion, leadership and influence, that the world of nursing has evolved into what it is today.

2019 itself is a hallmark celebration for the nursing community. There are over 4 million Registered Nurses in the United States of America, and registered nurses comprise the largest group in healthcare! The American Nurses Association created the tagline for this year’s National Nurses Week is “4 Million Reasons to Celebrate” which is a nod to nurses’ sheer numbers and an open invitation to #ThankaNurse for enriching our lives and the world we live in.

May is also Oncology Nurse Month.  As a cancer treatment facility featuring proton therapy, Provision CARES Proton Therapy Centers would also like to take a moment to highlight the role of the Oncology Nurse.  Oncology Nurses care for people of all ages who are diagnosed with cancer.  Oncology nurses provide support not only to patients, but their caregivers and families  during an especially stressful time in their lives.  An Oncology Nurse can gain knowledge through professional development and complete an examination to become an Oncology Certified Nurse (OCN). This certification signifies that a nurse has the knowledge and proficiency to care for patients with the diagnosis of cancer and marks a level of high achievement in the Oncology community.

Please join us in recognizing all the compassion and dedication our amazing nursing team provides at Provision Cares Proton Therapy Center.  Our nursing team is responsible for documenting detailed health assessments for patients newly diagnosed with cancer, providing patient education founded on evidence-based practice, providing recommendations for screenings and follow up suggestions for abnormal values to ensure early intervention, administering medications, assisting in procedures, utilizing assessment skills and critical thinking to triage and identify acute or emergent conditions, participate in interdisciplinary team rounds to provide the highest quality of patient care.

Provision would like to acknowledge nurses throughout our country and how they influence and inspire as they practice their art of healing. Happy Nurses Week 2019!

 

National Doctors’ Day: Meet The Doctors of Provision CARES Proton Therapy Centers

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In honor of National Doctors’ Day this Saturday, March 30, Provision would like to take a moment to honor and celebrate the excellent care that our physicians provide. This annual event was first recognized in 1933 on the anniversary of the first time general anesthesia was used in surgery and became an official national holiday in 1990.

In Knoxville, we celebrate three doctors providing advance cancer treatment to our patients.

Dr. Ben Wilkinson, MD is a Radiation Oncologist and Medical Director for Provision CARES Proton Therapy Knoxville.  Dr. Wilkinson joined Provision from Willis-Knighton Cancer and Proton Therapy Center in Louisiana.  During his time in Louisiana, he served as an assistant professor of radiation oncology for LSU School of Medicine where he taught medical students, residents and fellows. He has also authored or co-authored over 30 peer-reviewed manuscripts, review articles, and book chapters. Dr. Wilkinson is committed to community outreach and was named a More Than Pink Hero by the Susan G. Komen Foundation.  He is a board member for Radiating Hope, a non-profit that provides radiation treatment equipment to developing countries including Panama, Senegal, and Nepal.

Dr. Allen Meek, MD is also a Radiation Oncologist as well as Medical Director of Provision Medical Group.  Dr. Allen Meek comes to Knoxville from Long Island, New York where he was the Founding Chairman of the Department of Radiation Oncology at Stony Brook University Medical School and a Professor for over 28 years.  While in New York, Dr. Meek received numerous awards, including Top Doctors in New York and Best Doctors in the USA, along with awards for Humanitarianism and Environmental Stewardship. Also, he was just recently recognized as a 2012 U.S. News and World Report Top Doctor and one of the Best Doctors in America® for 2014.

Dr. Robert Lavey, MD, M.P.H is a Radiation Oncologist for Provision CARES Proton Therapy Knoxville.  Dr. Lavey has been board-certified in Radiation Oncology since 1988.  He graduated magna cum laude from Harvard University and earned his Doctorate in Medicine from Stanford University. He completed his residency in radiation oncology at Duke University and was awarded National Institutes of Health Postdoctoral Fellowships in the Stanford University Department of Medicine and the University of California, Berkeley School of Public Health.  Dr. Lavey has advanced the treatment of cancer as the Principal Investigator or Radiation Oncology Coordinator of 15 internationally conducted clinical trials sponsored by the United States National Cancer Institute (NCI).  He held leadership roles in three NCI-funded international cooperative clinical trial groups.  He has written 40 peer-reviewed scientific articles in medical journals and 24 chapters in oncology textbooks.

In Nashville, we celebrate our two doctors providing proton therapy cancer treatment to our patients.

Dr James R. Gray, MD, FACRO is the Medical Director for Provision CARES Proton Therapy Nashville.  Dr. Gray studied biomedical engineering at the University of Tennessee in Knoxville, graduating with highest honors. He then studied medicine at Vanderbilt University on a scholarship with the US Navy. After discovering his fascination with oncology and radiation therapy, he trained in radiation oncology at Memorial Sloan-Kettering Cancer Center in New York City and was the recipient of a Clinical Oncology Fellowship from the American Cancer Society. He has also initiated and been involved in local and multi-institutional clinical trials, and has authored or co-authored over 50 peer-reviewed manuscripts, book chapters and abstracts, including presentations at national meetings. He has been active in the American Cancer Society at the regional level and has been recognized with the local John C. Tune Award and the St. George National Award.

Dr. James Zhu, MD PhD is a Radiation Oncologist at Provision CARES Proton Therapy Nashville.  Dr. Zhu majored in electrical engineering at the University of California at Berkeley, and then finished his PhD in biomedical engineering. Dr. Zhu received his medical education at the University of California in San Diego. During his residency in radiation oncology at the University of Florida, Dr. Zhu went through rigorous training to use proton therapy as an integral part of the residency curriculum. As an established researcher, his work has been published in multiple peer-reviewed medical and engineering journals and presented at many national and international conferences. He was a chief resident and honored with the Radiological Society of North America (RNSA) Roentgen Resident Research Award.

Proton Therapy can treat multiple types of cancers including prostate cancer, breast cancer, lung cancer, head and neck cancer and many other solid-tumor based cancers.  Our physicians not only offer high quality diagnostic and treatment services, they are advancing cancer care through commitment to research, multidisciplinary collaboration, and community outreach.  To all our doctors, thank you for all you do for our patients and our community!

 

Provision CARES Celebrates Social Work Appreciation Month: Meet Marriah Mabe

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March is Social Work Appreciation Month and this year’s theme is ELEVATE SOCIAL WORK.

Each day, nearly 700,000 social workers nationwide work to elevate and empower others, giving them the ability to solve life’s problems, cope with personal roadblocks, and get the services they need.

Provision CARES Proton Therapy Knoxville has one of the best in the field, Marriah Mabe.  Marriah joined Provision in July 2017, and she has already accomplished a lot since that time.  Marriah was instrumental in starting the Provision CARES Proton Therapy Ethics Committee.  She has developed a library of patient literature and a database of financial and community support resources for cancer patients.  Marriah has led several staff education, support, and appreciation initiatives.  She currently oversees several programs, including the Art Therapy Program, and serves as chair of the Provision CARES Ethics Committee and leads the Pediatric Program Committee.

In Marriah’s daily work, she assesses cancer patients for depression and anxiety and offers preliminary counseling and referral for advanced mental health services as needed.  Often, we forget that the costs of cancer care go beyond financing of treatment; people facing cancer are also facing lost time from work on top of additional co-pays for medications and appointments.  Marriah helps connect patients to financial assistance resources for food, medication, lodging, and transportation.

We appreciate and recognize Marriah as well as all social workers for the jobs they serve in helping others.

Provision CARES Proton Therapy Knoxville Announces New President Carl Koella

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For Immediate Release:

Knoxville, Tennessee (February 4, 2019) – Provision CARES Proton Therapy Knoxville, a member of the Provision CARES Cancer Network, announces that Carl Koella III has been named President, effective February 4, 2019.

Mr. Koella has served on the Board of Directors of Provision CARES Proton Therapy Knoxville since 2015, and in his new role as President, he will oversee the management, operations, and clinical services for both Provision CARES Proton Therapy Knoxville and Provision Radiation Therapy at the Dowell Springs campus in Knoxville. “It will be a privilege to advance the access of proton therapy to cancer patients in the East Tennessee region,” says Koella.

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Breast Cancer Fighting Nutrients and Where to Find Them

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Each year, thousands of people are diagnosed with breast cancer. In fact, one in eight women will be diagnosed with cancer in their lifetime. However, with today’s knowledge and resources, cancer diagnoses are gradually becoming fewer and fewer.

While cancer is not preventable, today’s nutritional science shows that a strategic diet can be one of the biggest factors in minimizing the risk of breast cancer. That’s right — research has repeatedly shown that certain foods can act as preventative medicines. In fact, changing what you eat and how you exercise can prevent up to 30% of breast cancer diagnoses.

No food item can prohibit cancerous cells from developing, but there are a few that can significantly lower the risks of developing cancer. Foods high in fiber, like beans, nuts, and whole wheat bread can help lower amounts of estrogen, reducing the risk of breast cancer. Additionally, foods like salmon, walnuts, and oysters can help produce Omega-3s, essential fatty acids that aren’t produced naturally in the body. These fatty acids help with inflammation, which can easily damage healthy tissue. Sulforaphane, found in arugula, cabbage, and broccoli, and carotenoids, found in carrots, tomatoes, and sweet potatoes, have both been found to reduce the risk of breast cancer in increased levels.

While no one cancer case is the same, those who have increased intakes of these types of foods and nutrients have been shown to have an overall lower risk of developing breast cancer. A well-balanced diet and exercise routine is important for a lot of things: physical strength, heart and organ health, and mental health.

This goes to show that the food you choose to eat and how you treat your body has more of an impact than people may originally think. Continue reading to learn more about what specific foods and nutrients can help thwart a breast cancer diagnosis.

breast cancer fighting nutrients

Nurses Week 2018

Nurses Week 2018

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Content and information provided by Lindsay Chandler, RN, BSN, OCN Nursing Manager for Provision CARES Proton Therapy Knoxville

May 6-12 is a week of excellence for every nurse, and marks a time to acknowledge accomplishments, compassionate patient care and professionalism for the nursing society. The conclusion of Nurses Week is May 12th, in honor of the mother of nursing, Florence Nightingale. Florence Nightingale was born on May 12th, 1820, and she was the innovator of modern nursing. It was through her teaching, compassion, leadership and influence, that the world of nursing has evolved into what it is today.

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Maintaining a Healthy Nutritional Status When Diagnosed with Head & Neck Cancers

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Content and information provided by Casey Coffey MS, RD, LDN Registered Dietician for Provision CARES Proton Therapy Knoxville

As we raise awareness of head & neck cancers during the month of April, it is important to be aware of the unique challenges that are at risk when diagnosed with head and neck cancer. Studies for patients who choose proton therapy treatment for head and neck cancers have shown less side effects during first 3 months after treatment and quicker return to normal function. The potential side effects for head and neck cancer patients make swallowing food and fluids difficult and sometimes painful. Malnutrition affects an estimated 40 – 80% of cancer patients – particularly those with gastrointestinal or head and neck cancers.

The four main nutritional goals for cancer patients include:

  • Strive to maintain a healthy weight
  • Consume foods and beverages for managing cancer and treatment-related side effects
  • Select and eat healthy foods that supply the body with fuel and nutrients for repair and healing
  • Reduce risk of cancer recurrence and the development of a second malignancy

Many patients do not realize the importance of nutrition while under treatment. Primary goals of nutrition therapy are to prevent or reverse nutrient deficiencies, preserve lean body mass, support the immune system, and minimize and manage the impact of nutrition related symptoms and side effects to maximize quality of life. Adequate nutrition is more than just maintaining body weight. The foods we eat contain nutrients necessary to support healing and restoration but also to support our healthy cells as well. Adequate nutrition has been shown to improve outcomes in cancer patients, improve strength and energy, avoid dose reduction or treatment breaks.

Make Every Bite Count.

Initially, it is recommended patients eat what they can tolerate while focusing on protein with each meal and including whole foods (minimizing the processed nature of foods). Why? Well, quality counts. High quality foods, which are those that are less processed, are more nutritious due to their higher nutritional value. As treatment progresses and possible side effects begin, the ability to swallow can become difficult. If difficulty to swallow becomes a problem for head and neck cancers, here are three ideas on how to maintain nutritional value through your diet:

  • Graze throughout the day on nutrient dense foods: Nutrient dense foods that have been fortified with protein and additional calories without adding volume and lots of sugar or highly processed foods. Some examples are olive oil, butter, coconut oil, coconut butter, peanut butter, heavy cream, half & half, or any nut butter.
  • Alter texture of foods to improve tolerance: focus on soft or smooth foods such as, bananas, watermelon, canned fruits, peach, pear, and apricot nectars, pureed or mashed vegetables, oatmeal, cooked cereal, cottage cheese, yogurt, milkshakes, custards, puddings, gelatin, macaroni and cheese, scrambled eggs, and ground meats.
  • Avoid irritating foods, such as, citrus fruits or juices, spicy or salty foods, pickled or vinegary foods, tomato-based foods (salsa, spaghetti sauce, and pizza), rough or dry foods, hot spices (pepper, chili powder, nutmeg, cloves, and curry).

For more information about how to overcome nutritional challenges when diagnosed with head & neck cancers or to learn about proton therapy, contact our CARE Team at 865-229-4689.

 

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Volunteer Appreciation in the “Volunteer State”

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This week, April 15-21, Provision will celebrate Volunteer Appreciation Week by honoring our very own Proton Volunteer, Mrs. Sue. Sue and her husband retired to Knoxville from Washington, DC in 2001. She has been a volunteer for Provision CARES Proton Therapy Knoxville since 2016 and has been filling the proton center with extra joy and smiles ever since. (more…)