Amy Sales

Amy Sales, MSW, LCSW-C

My role as a social worker in the cancer center can be very humbling at times to say the least. Complete strangers often share their intimate feelings during their darkest times, and they allow me to support them whether it be through a hug or an action-oriented task to solve a problem. It’s an honor to be a part of their lives. Seldom do people work in a profession where their roles intersect with our personal lives but mine did this past weekend as I accompanied my 13 year old daughter to the funeral of one of her classmates who died after battling leukemia.

I privately counted my blessings that my child is healthy and that this loss was not mine to bear, only to be reminded that in some small way, it was all of ours to own through the eyes of the youth that sat in that church. They looked much too young to be experiencing such a loss. I could have chosen the easier path, opting to quickly dismiss this event with a simple “pat on the head” and an overbooked calendar which would not have permitted time to attend this funeral. But, that’s not how growth and coping skills are achieved. We face the “hard” things on a regular basis . Sometimes, we are forced to, but other times, we face hardship because we know that it will eventually allow for the best outcome – even under the worst of circumstances.

The support that occurs daily within our cancer center doesn’t stay here. As much as we would like to separate our work from personal life—we don’t and we can’t. Life’s lessons that are gained here are used to guide our relationships with family, friends, community and yes – even our children.

I encourage everyone to not “pass” on the difficult moments that life has to offer (whether it be in your professional or personal life) because the sense of acceptance, closure, and lack of regret that can be obtained will last a lifetime.

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Elissa Bantug

Elissa Bantug

Do you know your social worker?  You should.  We’ve listed 5 ways that social workers can help cancer survivors.   Elisabeth Tamasi, clinical social worker at the Johns Hopkins Kimmel Cancer Center, discusses these five tips.

1. Sexuality, Intimacy and Body Image

“Social workers are great resources to help start a dialogue with you and your partner about intimacy and sexuality,” says Tamasi.  It may seem like an insurmountable issue and one that’s difficult to discuss, but social workers can offer great advice and help you find additional resources if problems are physical, multifaceted or need a consultation with a medical provider.

2. Managing Fear or Anxiety

“It’s normal and happens to many patients,” according to Tamasi.  “Anxiety or depression following cancer treatment can be part of the healing process.”  Social workers can discuss these issues with patients and look forward to improving over time.  A social worker can also identify when feelings of sadness and anxiety may be interfering with everyday life and help you decide if further medical intervention could be helpful.

3. Family Issues

Cancer affects many people in a family beyond the patient.  Fears or concerns by children, partners, parents, siblings, or extended family members are often present.  Social workers can work with family members and help address changes in the family dynamic.

4. Social and Professional Life

After all you have gone through with cancer, re-establishing social relationships can be a challenge.  Sometimes friends don’t understand what you’ve been through or have their own concerns and fears.  Tamasi says that social workers can give advice on how to maintain relationships.  When you return to work, they can also help patients who may need employment modifications or want to change career goals.

5. Financial Impact

Employment dilemmas, insurance and reimbursement bureaucracies, financial struggles, interpersonal challenges can all coincide with depression, fear, and anxiety.  Seeking help from a social workers can identify assistance programs, fill out insurance paperwork, and assist with financial planning.

“Social workers can be a lifeline for patients getting back to their everyday life,” says Tamasi.

How do you find an oncology social worker?

Most cancer centers have social workers trained specifically in oncology social work and are there to help offer you and your family support.  Oncology nurses may be a good person to ask how to connect with a social worker. 

If you are a Johns Hopkins patient and are looking to find a social worker, call (410)955-8934 or stop by the main office of Patient and Family Services at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, located in Suite 1210 of the Harry and Jeanette Weinberg Building directly off the main lobby.

More about Breast Cancer Survivor Care

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March is colon cancer awareness month. How much do you know about protecting yourself against colon cancer? As Dr. Luis Diaz of the Kimmel Cancer Center says, “No one should die from this disease.” Yet, colon cancer is the 3rd most common cancer diagnosed in both men and women in the US, and the 2nd leading cause of cancer death in men and women, combined.*  What can you do to protect yourself?

Get screened. Eat healthy foods. Cut out the salt -- that’s a tough one for some of us. Watch your weight and exercise! 

Colon Cancer IQ Test

Question: What's the best screening tool to detect colon cancer in its earliest, most treatable stage?
Answer: Colonoscopy

Question: At what age do you need to begin having colonoscopies to screen for colon cancer?
Answer: Regular colonoscopies should begin at age 50 and possibly even earlier if there’s a history of colon cancer in your family.  The American Cancer Society lists screening guidelines for several cancers, including colorectal.

Question: Name one colon cancer research project at Johns Hopkins.
Answer: Scientists are working on a blood test that detects colon cancer and many other exciting discoveries happen each day that have changed the way we treat colon cancer today.  Read about: Building the Best GI Program and A Genetic Revolution

Question: How long does it take for a pre-cancerous colon polyp to become deadly?
Answer: Colon cancer starts as a series of genetic changes that take 20-30 years, in general, to become deadly.  So, get screened!

Score
If you answered:
1 correctly - Keep reading this blog!  Get educated about cancer.
2-3 correctly - You're on the way to a healthy colon IQ.
4 correctly - Bravo!  You're a colon cancer wiz!

*American Cancer Society

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Patients, caregivers, friends, family, doctors, nurses and researchers...we're proud to introduce a new blog in the Johns Hopkins family.  The Our Cancer blog, authored by Laurie Singer Sievers and previously hosted by National Public Radio (NPR), has a new home here. 

Johns Hopkins is a natural landing spot for Our Cancer.  It was here that Laurie's husband, Leroy, battled colon cancer and blogged his experience on NPR's My Cancer.  Leroy and Ted Koppel, a long-time friend and colleague of the Sievers,' produced a Discovery Channel program called Living with Cancer, and during the taping of the program's segments at Johns Hopkins, was where I first met Laurie.

Laurie has produced news programs for the major television networks for more than 40 years, and she's got a life's worth of stories from her experiences covering the world.  But it's the cancer journey as Leroy's caregiver that she's talking about now on Our Cancer.  Where Leroy's My Cancer blog ended when he died is when Laurie began blogging on Our Cancer.  Reading both blogs, I've cried, laughed, questioned, and reminisced, but one thing's for sure -- Leroy and Laurie have touched our lives like no other pair.  And we're glad -- no, honored that we are hosting the Our Cancer blog.    

We have a lot to learn from and share with the Cancer Matters and Our Cancer blog communities.  Please join me in welcoming Laurie -- you can subscribe to receive rss feeds or emails with updates on new posts.  Let the discussion begin!

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About ten years ago, researcher Bert Vogelstein appeared with Katie Couric on the Today Show to announce new research on a stool test for colon cancer.  Since then, he's mapped scores of cancer genomes to boost knowledge about cancer-related genes, and the Brupbacher Foundation in Zurich has now awarded Vogelstein a prize for his research on the fundamentals of colon cancer development. Vogelstein also has been tapped to serve as one of 17 inaugural Gilman scholars for the Johns Hopkins University.  The designation honors leading faculty and staff members across the University.  Bravo!

Couric, of course, now anchors CBS Evening News, and recently, her medical reporting team aired a story featuring Johns Hopkins head and neck cancer expert Sara Pai, M.D., discussing HPV as a major cause of head and neck cancer.

Pai was recently promoted to Associate Professor at Johns Hopkins.  I interviewed her recently for a Q&A on HPV and head and neck cancer.

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Evan Lipson

Evan Lipson, M.D.

As an oncologist, I am privileged to care for people who are fighting cancer.  I'm also fortunate to see the interesting and meaningful ways my patients bring joy and satisfaction into their lives.   Some people strengthen relationships with loved ones, becoming ever closer with family and friends.  One man with lung cancer I spoke with is back in touch with his children after having been estranged for many years.  Other people concentrate on activism – starting foundations or fundraising.  Many derive fulfillment by creating something – art, poetry or music, perhaps.  I have started to collect stories from people who are living with cancer about the ways they "add life to their days."

One of my patients, Chris, is a three-time cancer survivor. He and his wife Jenny founded “Romance for a Cure,” an organization that raises money for cancer research by selling cookies, cakes and other treats every Valentine's Day. Or, as Chris calls it, “a bake sale on steroids.”

Click on the arrow below to hear more.

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The Centers for Disease Control (CDC) and National Cancer Institute (NCI) issued a report today estimating the number of cancer survivors at nearly 12 million people. This is more than double the number of cancer survivors from 10 years ago. Cancer centers nationwide are leading efforts to understand the unique needs of survivors, including follow-up care, employment, family issues, and create programs that ensure those needs are being met. It's a sure bet that we'll see the ranks of survivors rise to even greater levels.

Read Elissa Bantug's series on Survivorship, and watch the ABC World News story below.

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Dr. Bill Nelson discusses recent breast cancer studies and new recommendations on end of life care from American Society of Clinical Oncology (ASCO). Listen to these topics discussed in the most recent Cancer News Podcast.

First, Nelson reviews recent findings from the New England Journal of Medicine on lymphedema and exercise. Removing lymph nodes during breast cancer surgery is part of staging and is used to find out the extent cancer spread.  Lymphedema is a side effect from lymph node removal.  Lymphedema can occur when drainage of tissue fluid in the breast becomes backed up due to the removal of the lymph nodes. Painful arm swelling may occur. Previously, women had been advised to avoid exercise when their lymph nodes have been removed, but this recent study suggests women can exercise without the worry of lymphedema.

The second study takes a look at sentinel lymph node biopsy (only removing lymph nodes cancer spreads to first) verses axillary lymph node dissection (removing all lymph node). Each study looked at overall outcomes.  The results found both procedures appearing to be more or less equivalent among certain types of patients. Nelson explains what makes a patient a good candidate for each procedure and why.

Finally, Nelson discusses the recent recommendations from the American Society of Clinical Oncology on terminating treatment and end-of-life care.  The recommendations explain that physicians need to talk to patients earlier regarding when to end cancer treatment and palliative care.  Nelson adds that physicians should have clear and informative discussions with patients on specific treatment options.  Patients should know the potential benefits of anti-cancer treatments, and other palliative treatments to improve quality of life.   It’s important to make sure patients’ informed preferences really drive their cancer care.

Play the Podcast

Program Notes
0:34 – New England Journal of Medicine’s study on Lymphedema and exercise
1:10 – What is a lymph node and why it needs biopsied
1:30 – Removing all lymph nodes (axillary lymph node dissection)
2:15 – Side effect of removing all lymph nodes – Lymphedema
2:40 – Study finding – Exercise is okay among women who have had lymph nodes removed
3:10 – Difference between sentinel lymph node and axillary lymph node dissection
3:20 – Sentinel lymph node biopsy, using color dye and scans to find cancer lymph nodes
4:10 – Overall outcomes of sentinel lymph node biopsy vs. axillary lymph node dissection
4:23 – Who’s a good candidate for sentinel lymph node biopsy vs. axillary lymph node dissection
5:36 – Recommendations by ASCO about terminating treatment and end of life care
7:43 – Experimental treatment near end of life care, when to have discussion with your physician
8:35 - END

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Amy Sales

Amy Sales, MSW, LCSW-C

Consider this blog to be a "pep talk" of sorts to those of you who are working so hard on a regular basis to support and help those living with cancer.  All great coaches and teachers lead by example.  You owe it to your patients, family, and most importantly yourself to exercise and eat right.

We work in a busy environment where time often moves at the speed of light.  Therefore, one may make the argument that there isn't enough time to dedicate to your health and well-being.  I am here today to challenge you on that notion.  There are 24 hours in a day and you CAN find 30 to 60 minutes to move.  I know, because I do it.  I am not going to mislead you, "making the time" can be difficult and the list of excuses are plenty.  But, the benefits far exceed the excuses .

Continue reading ““My message to fellow health care professionals: Make the time …”” »

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Ben is a fun-loving 13 year-old who enjoys skateboarding and playing the drums. In January of 2006, Ben was diagnosed with Ewing’s Sarcoma, a rare cancer that is found in bones and soft tissue.  He was 8 years old.  Doctors diagnosed the disease after he started experiencing hip pain, which is unusual for a child his age.  Ben’s mother, Sue, brought him to his pediatrician where he took x-rays of Ben’s hip and found a tumor in his hip joint. The pediatrician then referred him to Johns Hopkins. Ben underwent surgery to have his hip joint and a large part of his bone removed. After surgery, Ben underwent a year of chemotherapy. Because of the amount of bone that had to be removed, Ben had to wear a body cast that stretched from under his arms to below his knees for six weeks.

Four and a half years later, Ben is now cancer free. “Ben’s cancer is a part of our history. It will always be a part of who we are,” explains Sue, “but it’s just that…it’s not the black cloud you think it will be.”

Watch Ben’s Story

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