Watertown Daily Times - 10/1/2012

Cancer patients find help, healing at area facility

By Samantha Christian

Throughout her life, Watertown resident Donna Koser has been familiar with cancer. Her first and second husbands both lost battles with the disease, but Koser still thought she was invincible.

That was, however, until she went in for her annual mammogram three years ago and doctors discovered she had breast cancer.

“It kind of shocked me,” said Koser, now 78. “But I thought, well, this is as it is.”

After undergoing a mastectomy in 2009, Koser was treated with chemotherapy for nearly five months followed by six weeks of radiation at the UW Cancer Center Johnson Creek. The facility offers local access to leading-edge research, prevention, education and treatment for virtually all types of cancer in joint collaboration with Fort HealthCare, UW Health Partners Watertown Regional Medical Center and UW Health.

As with any form of cancer, however, there is always a chance it can come back. In Koser’s case the cancer reappeared this spring in her right lung. Another round of chemotherapy was completed in July, and she is currently being given a monthly hormonal inhibitor injection at the cancer center.

Instead of allowing the disease to overwhelm her, Koser has remained positive. She has been grateful for the many prayers and cards sent to her by friends and family. “I think that does help to know people are there behind you. It all goes back to having a positive attitude and faith. Right now I take each day one at a time,” she said.

Koser recently went back to the UW Health Partners Watertown Regional Medical Center to continue her 16th year as a volunteer. “I’m starting to do things that I did before because I miss being among people,” she said.

Koser said part of the reason she feels optimistic about her future is the care she has received during treatments and checkups at the cancer center.

“I was a little apprehensive at first, but everyone welcomes you and you get to know them on a personal basis,” she said. “It’s wonderful and I feel so comfortable coming here. I actually miss them when I’m not here. They treat you just like family.”

The feeling is mutual for patients and the cancer center staff. “When people come through the door, they are instantly family, and we treat them each as special as they are,” said Joanne Todd, office assistant. “I am a survivor myself. And, yes, my own experience has led me this way, but also the compassionate care that we provide to people in a time when they are on such a hard journey.”

Caring environment

As a smaller clinic, the UW Cancer Center Johnson Creek allows patients more one-on-one time with medical staff.

“(Patients) see the same radiation therapist each day, the same receptionist in the morning when they are on their way in and out, the same nurses, and everybody gets to know each person we take care of,” said Dr. Beth Anderson, radiation oncologist. Anderson spends one day a week at the cancer center and the other four in Madison primarily treating women’s cancers.

Between the clinic, radiation and chemotherapy areas there could be a range of 10-50 patients coming to the cancer center each day depending on physician and patient schedules. Since the cancer center opened in 2005, approximately 300 new patients are seen each year.

Dianna Swingen, registered nurse, enjoys having a connection with families and patients. “We really make sure patients are satisfied with their questions and needs, and we go above and beyond to make patients happy,” she said. “Obviously the downside is losing them. But it’s still rewarding when spouses come in afterward and talk to you and just thank you for going through that (experience) with them. It was second home to them, unfortunately, and they want that closure, too.”

Fellow co-worker Cara Biddick, registered nurse, noted how she can sometimes spend an hour just sitting and chatting with patients during their chemotherapy sessions, not only to answer questions but also just to get to know them better. “The patient and family support is what I enjoy most because it is a very scary diagnosis to have. I think there are so many questions and unknowns for patients, which is really where nurses can play a big role,” she said.

“We try to keep it as homey and informal back here as possible,” said Biddick in reference to the chemotherapy area where patients have access to snacks, TV and their own window to look outside. “I think people really enjoy watching nature,” she said.

The rooms are designed to give patients the choice of private areas, semi-private areas and a group setting with nine patients able to be serviced at a time.

Since treatments can last anywhere from a few minutes for an injection or radiation to almost eight hours for chemotherapy through a port or intravenously, family members or friends often come along to appointments for moral support and to help pass the time.

“Especially at holidays, families come from far away to see how their family member is handling the chemo and put into perspective their cancer experience,” said Lynda Persico, director.

Even when the cancer center is closed after hours and on weekends, doctors can still be reached at any time by a 24-hour phone line if patients have questions or concerns. “When patients call in with a problem, they know who is on the other end of the phone,” said Biddick.

Close to home

Situated on a hill with trees wrapping around its south and east sides, the UW Cancer Center Johnson Creek maintains a rural feel and allows natural light to enter its 14,300-square-foot facility.

“Because it’s a rural type community, we wanted to bring in wood and natural sunlight to make (patients) feel comfortable in a high-tech area,” said Persico. “It reflects on a very positive patient experience.”

While inside the quiet, easily accessible one-floor building, you would hardly realize Highway 26, a movie theater, restaurants and shopping centers are just around the corner.

Having commuted to Madison from Lake Mills for a year, Swingen admitted she wanted to work closer to home because “it’s a zoo (driving) up there.”

“It’s a wonderful facility to take care of people,” said Anderson. “It’s nice being able to spread outside of that main Madison hub a little bit and bring the same kind of care that we give to people in Madison to people out here without making them have to drive all the time.”

For the most part, cancer procedures and checkups for patients can be done entirely at the cancer center. “For breast cancer the vast majority of care that people need can be done right here. There would only be certain very specialized procedures that might need to be done in Madison or Milwaukee,” said Anderson. “This clinic has all the expertise and equipment to take excellent care of someone with breast cancer, and it’s a very caring environment.”

Anderson explained the pros and cons of radiation. Apart from the side effects such as fatigue and skin reactions, “it’s a time commitment coming here each day for three to six weeks, and that’s one of the main reasons we try to put facilities in places that are close to right where people live.”

However, she said the benefits often outweigh the costs. “For a woman with a locally advanced cancer, there’s a survival benefit associated with doing radiation, and in that standpoint we would even do radiation if she had a mastectomy.”

Such is the case of Penny Bamke, 42, of Hustisford. When she was diagnosed with breast cancer on Feb. 1 during a regular mammogram, Bamke decided to opt for a double mastectomy as a preventative measure. “I didn’t want to just do the lumpectomy and then have to come back and find out that it had gone over here,” she said, pointing to the other side of her chest. “It might not have, but I just said, ‘No, take them off.’”

After the surgery and chemotherapy, Bamke chose to have her radiation treatments at the cancer center in part because of the short drive each day after working in Watertown. “I was glad this was here. It helped because I heard stories of people that had to drive an hour just to go in for 15 minutes and then drive home an hour,” she said.

Bamke recently started her 33 radiation sessions. She looks forward to the anticipated treatment completion date of Nov. 2. “I’m on the road to recovery,” she said. “My oncologist was extremely happy with the biopsy of all my tissue, and there was no cancer in there at all.”

Although most patients come from the Watertown and Fort Atkinson service areas since they are the referring physician base, Persico noted patients as far away as Lake Geneva have chosen to be treated at the facility.

“The advantage we have as well is that patients seen at the UW have parts or all of their treatments here and still maintain a specialist at UW that they are seeing,” said Persico. “With gas prices, avoiding driving in cities, having something close to home and being comfortable in the setting (the cancer center) has really been very successful.”

Collaborative approach

In late 2002, discussions between Watertown and Fort Atkinson started to evolve around improving their cancer services in the community.

“In order to do that, they collaborated with UW Health and decided to build a cancer center that would be owned by all three partners,” said Persico, who was brought in to help with the building design and to manage the facility.

An advisory committee was created with representatives from Watertown Memorial Hospital, Fort HealthCare and University of Wisconsin Paul P. Carbone Comprehensive Cancer Center. Input was also gathered from the Survivor’s Circle cancer support group as to what they envisioned the center to be like.

“The whole idea was to bring academic cancer care into a community environment,” said Persico, referring to the cancer center’s mission statement: “To provide world-class care locally, in a center that is a model community-and-university partnership. Patients and families have access to cutting-edge research and treatment protocols in a nurturing, compassionate and hope-filled environment.”

“We’ve implemented some things on a collaborative level to help the hospitals, and the university has an academic perspective so we’ve brought research here as well,” said Persico.

Employees within the center itself uphold this collegial approach.

“We work as a team,” said Swingen. “Because we’re such a small clinic we just try to float to meet the needs on a day-to-day basis, and everyone’s really willing to do that,” said Biddick, adding that she enjoys the flexibility to help out in many areas of the cancer center.

As a registered nurse, some duties may include helping in the clinic, seeing patients with doctors, preparing drugs and administering chemotherapy, prepping for radiation, educating patients and families as far as what to expect with treatments and side effects, providing emotional support and researching insurance coverage programs to help those struggling financially to receive drug assistance.

There are also two types of doctors at the cancer center which provide experience-based care: medical oncologists and radiation oncologists. Some patients see one or the other while many, like breast cancer patients, see both.

For instance, a radiation oncologist may meet with patients before or after surgery to educate them about what radiation might be like and the risks involved to keep cancer from coming back. Patients would also meet with a medical oncologist, such as Dr. Michael Eastman, medical director, to be aware of how to reduce the chances of it coming back systemically.

According to Anderson, during a patient’s first consultation the doctor will talk about things that represent risk factors for developing cancer, such as their reproductive history and family history.

“Family history is a big thing because we always want to pay attention to women who might have an increased risk for having one of the BRCA familials,” said Anderson, referring to the mutation of a gene that can produce a hereditary breast-ovarian cancer syndrome. “We teach them how to do self breast exams and then we talk about the role that radiation therapy can have in improving their outcome.”

The cancer center also works collaboratively with Watertown and Fort Atkinson’s efforts for screenings, such as mammograms and prostate and cancer screenings, explained Persico.

“Part of the treatment process is the education process as well,” said Persico. “Before they are treated we go through explaining the drugs, the side effects, the treatment process, and it’s repeated as they go through. The doctor tells them, the nurses reinforce it and then it’s reinforced again.”

Since there is a lot of information coming at a patient during this difficult time in his or her life, it is often easy to forget some things. “We encourage the family to be with them because of that anxiety. Sometimes you don’t hear everything, so it’s nice to have another pair of ears. And questions will come up, as soon as you get in the car, when you get home, at work,” said Persico. “We’re available to answer questions, but hopefully we’ve covered it on our end to educate.”

Patients are encouraged to do additional research and ultimately make the medical decisions on their own. “Read up on everything you can get your hands on, because there is some stuff that is missed that, if you would have known at the beginning, you might have done something different,” said Bamke. “But everything works out for a reason, I guess. Life’s short. Don’t sweat the small stuff. Just go with the flow.”

Cutting-edge technology

The UW Cancer Center Johnson Creek treats patients using radiation, chemotherapy and clinical trials through Wisconsin Oncology Network as well as national trials.

“There are Phase III trials which we know is something that works and we’re trying to add or change the schedule somewhat. We carry out those trials here for different diagnosis (such as) breast or prostate. It depends what trials are available,” said Persico.

If radiation is needed, doctors will perform a simulation using CT scans to map out and locate the tumor area. A computerized treatment plan can also be made showing a 3-D image of how to treat patients and how much radiation to apply to a certain area while sparing the normal tissue, explained Persico. A Varian CL21EX linear accelerator is used to deliver the treatment using intensity-modulated radiation therapy.

In addition to equipment used to administer treatments, the cancer center also uses an advanced computer system which is connected to UW. “Because of the complexities of electronic medical records (such as X-rays), our staff has access to Watertown, Fort Atkinson and UW, so we can get whatever medical information we need,” said Persico. “Electronic medical records have really improved communication between physicians and facilities and has allowed faster collaborative efforts.”

Celebrating life

Aside from providing expert care to patients from a medical perspective, the UW Cancer Center Johnson Creek also helps patients feel better about themselves by boosting their self confidence.

Scattered throughout the cancer center are baskets containing hats that patients are welcome to take with them. Volunteers at Johnson Creek Public Library have made and donated the hats of all fabrics (such as knitted, velour and fleece), colors and styles for patients experiencing hair loss due to cancer treatments.

In addition, patients can be fitted for free wigs or hairpieces.

“I go through the wigs with the ladies and help fit them for a wig so that when they come in they walk out with a wig they feel comfortable with,” said Joanne Todd, who is also the coordinator for the Look Good … Feel Better program.

Look Good … Feel Better is a two-hour program offered four times a year every three months through the American Cancer Society (ACS) for a small group of women who have been diagnosed with cancer. The cancer center hosts this program, which will be held next on Dec. 10. Advanced registration through the ACS is required.

During the program, a group of three beauty professionals from A Hair Off Main in Watertown go to the cancer center to explain skin care, wig care and proper makeup techniques since their skin and hair will go through changes during treatments, explained Todd. Each woman is given a free makeup kit offered through the ACS which is valued at $250.

“We try to make it a very positive experience for them because they’ve been through so much and they are all going through the same journey,” said Todd.

“I decorate the room up so it’s not so sterile and we try to get it to be more of a spa feeling and not a clinical feeling for the women to take their worries off,” she added. Todd also plays soothing music and offers refreshments to the group. “I’m hoping to take them into another place that is relaxing and fun to make them feel extra special.”

The UW Cancer Center Johnson Creek is located at 250 Doctors Court in Johnson Creek. For more information call 920-699-3500 or visit www.uwjohnsoncreek.org.