Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

As the holidays approach, we wanted to take a moment to celebrate you, our patients and survivors, who make our work so rewarding.

Please see the link below for a video tapestry of the women who have inspired us and continue to motivate us to deliver the best care we can.

We hope they encourage you as you meet your own challenges, and know we are here for you as we were for them. As always, we welcome your feedback and encourage you to share this with the survivors and supporters in your life. Read their stories here.

On behalf of all of us at the Women’s Cancer Center at Fox Chase, we wish you and your family a joyful holiday and a happy, healthy new year.

Be well,

Bob

Margaret skiing with 2 of her 3 children

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

I’d like to introduce you to Margaret Zuccotti – an amazing woman with an inspirational story of hope.  A self-identified “lifer” at Fox Chase (she’ll be a patient here for the rest of her life), Margaret explains how it feels to walk in her shoes.

Be well,

Bob

In November 2006, I was diagnosed with stage 4 inflammatory breast cancer. That fall, I found a lump in my breast while nursing my youngest child. After a month of tests and waiting and more tests and more waiting, the ugly extent of my cancer was revealed: I had a large tumor in my breast, multiple cancer spots on my liver and a single cancerous spot on my skull. The decision to go to Fox Chase for my treatment was easy. The advice to work with Dr. Lori Goldstein was the best.

Margaret takes time out for a run.

This said, I was terrified about my first appointment at Fox Chase. Thankfully, Dr. Goldstein immediately put me at ease. She reinforced that I was in the right place, doing the right thing and helped me realize that no one faces cancer alone. This hospital is the place to be when you want a team of experts looking out for you. Dr. Goldstein outlined my treatment plan, gave an overview of the chemotherapy regimen, and fielded all my questions. She told me I would have weekly chemotherapy with Taxol and Herceptin. I also learned I was to have cancer treatments for the rest of my life.

As a “lifer” I am learning the value of what makes this hospital so special. When I come in for an infusion, I am greeted by name, and I receive a beeper allowing me to go anywhere in the hospital while I wait. The courtyard is one of my favorite places here. I can work on my computer, enjoy a cup of coffee and almost forget where I am.

Margaret and her husband, Andy

Naturally, I spend the most time in the infusion room and love the nurses-Karen, the Donna’s, Yolanda, Tammy-there are too many to name. We joke, catch up about our kids, and talk sports while they get down to the business of administering my infusion. They are thoughtful, helpful, and knowledgeable- and all are great listeners.

Whether being tested, receiving treatment, or recovering from a surgery cancer patients face fear on a regular basis. Such anxiety can be paralyzing. Yet at the same time, fear can be tamed, if not quite conquered. Fox Chase and the wonderful people here have help me see past fear through their professionalism and confidence.

Rock climbing with her kids

Not only do my regular visits to Fox Chase help me overcome my anxiety, but the knowledge that there are cancer professionals working tirelessly to defeat this disease: Knowing there are specialists striving to understand everything about their field to insure that their patients receive the very best information and cancer care options-it all provides another kind of peace of mind about how unique a place Fox Chase is, and always will be.

Today, it pains me when I see people arriving at the hospital for the first time- arms wrapped around piles of paperwork and copies of scans, talking nervously with loved ones. It saddens me because I know what they are going through. However, when I enter this hospital now it is without fear but with confidence. Though I don’t enjoy my infusions every three weeks, I like to think that just entering the building makes my cancer cells nervous!

Margaret Zuccotti

Read Margaret’s story.

Sculptor, John Magnan
(Photo: Nelson Mare, New Bedford, MA)

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

For many people, art serves as a healthy outlet throughout the healing process. For some, it might simply calm anxiety, for others it may help articulate what they are feeling or experiencing. As you walk through the Women’s Cancer Center you will notice a number of powerful pieces of art on display, and in the coming months, you will see additional pieces. I asked John Magnan, the creator of the exhibit, to share with you the story behind the art, because I think you will find there is deep meaning in it for all of us.

Be well,
Bob

As an artist, finding a space to display my work that appropriately complements its message is important to me. That is why I donated my exhibit, Body Image/Body Essence to the Women’s Cancer Center at Fox Chase.

This exhibit, composed mostly of sculpture, began as a response to my wife Mary being diagnosed with ovarian cancer in 1999. Like many caregivers, I was powerfully affected by the shock of her diagnosis, as well as the surgery and treatment which followed. Mary served as a partner, supporter, critic, model and tireless editor of the exhibit. Without her determination to persevere in the face of frightening odds, I would not have been able to do this.

Artistically, Body Image/Body Essence explores the distinction between who I am and what I look like, a conflict faced by women with ovarian cancer after its invasive surgery and treatments. The exhibit, a visual vocabulary for ovarian cancer awareness, also addresses other aspects of a changed self image – both somber and lighthearted. Issues of scarring, fatigue and fertility are explored in some pieces, but I also aimed to honor the sense of humor that is so important when looking at the lighter ramifications of “chemo brain” or hair that refuses to grow back the same as before.

My fondest wish for my art is that it validates the various emotions that living with cancer involves. In times of stress, we all want to be validated. We want to know that we are not alone, and that our trials and tribulations are valid. Cancer patients deal with huge loss and with compromise; they need to know that we know it.

I chose to donate the work to the Women’s Cancer Center because of Fox Chase Cancer Center’s President and CEO, Michael V. Seiden, who, at the time was leading the gynecologic cancer program at Massachusetts General Hospital. Seiden served as Mary’s oncologist from her diagnosis until her passing. The art will be displayed in the new Women’s Cancer Center upon its completion in spring 2010. Until then, selected pieces from the exhibit will be displayed in various locations within the space.

As I created these sculptures, I came to see the exhibit as a narration of a survivor’s transition from what came before ovarian cancer to a new reality. As you walk through the Women’s Cancer Center, I hope this exhibit will help you feel connected to the many women who have lived with cancer and that you draw strength from it for your own journey.

I invite you to read the fall 2009 issue of “Forward,” in which the Women’s Cancer Center is prominently featured.

John Magnan, Sculptor

In an odd, poorly-timed coincidence, two separate recommendations about cancer screening came out recently that are sure to confuse women and cancer doctors alike. One set focused on mammograms to detect breast cancer and the other on Pap tests to detect cervical cancer.

Both sets of guidelines suggest women should delay their first screens for each of the cancers, among other suggestions. Both aim to balance the legitimate need of society to manage its health care costs while providing individuals with the care they need, using data to inform the process.

In effect, however, the difference between the two sets of recommendations is stark. The mammography recommendations may lead to harm and even death for some women. The Pap test recommendations, in contrast, will reduce waste while maintaining high quality care.

Before I explain why, let me tell you the one thing that every person should know about cancer screening: it works. Any interpretations of the new recommendations that undermine that simple fact will cost lives. Colonoscopies, Pap tests, mammograms, and PSA tests are among the best tools we have in our arsenal for preventing deaths from cancer.

So why are the new recommendations for mammography from the U.S. Preventive Services Task Force so misguided? To illustrate, one recommendation offered by the task force is to push first mammograms back until age 50 for women without a family risk for breast cancer from the current age of 40. While this will indeed reduce costs by limiting the number of screenings performed, the outcome will be unhelpful to many women and disastrous for some, particularly those who develop breast cancer prior to menopause.

Only a minority of all breast cancer cases is hereditary, so the rest result from causes that are not yet well understood. We know too that tumors in pre-menopausal women tend to be more aggressive than those arising in those who are post-menopausal. These guidelines would essentially abandon women between 40 and 50 without a known family risk for breast cancer, and, without screening, more of these women would die of breast cancer.

For this reason, doctors at Fox Chase Cancer Center and other top cancer centers are keeping to the guidelines previously laid out by the American Cancer Society and the American College of Radiology. Annual mammograms should begin at 40 for most women.

Amid the clamor and debate about the mammogram recommendations, the American College of Obstetricians and Gynecologists released their updated recommendations for when women should begin having annual Pap tests. It was unintentionally bad timing on their part, as their announcement has been in the works for months.

What is different about this second set of recommendations? This group counsels that women in the general population can safely wait until age 21 for their first Pap test, and women younger than 30 can get the exam every other year. After age 30, women who have had 3 consecutive normal pap reports can be screened every 3 years, they say. Importantly, these guidelines do not apply to women at increased risk for cervical cancer. The recommendations are backed by data that support the assertion that this screening schedule will reduce the number of screenings performed without compromising care.

Regardless of your politics, I think we can all agree that we need to control rising health care costs. Unfortunately, cancer screening presents as tempting, low hanging fruit. After all, relatively few of the people ever screened actually have cancer.

But we cannot fool ourselves into trading lives for the appearance of efficiency. In practice, it costs far less to screen for and treat early stage cancers than it does to treat cancers at later stages – in terms of both the financial cost of treatment and the personal cost to patients and their families. The results are better too – we are far more successful at treating early stage cancer. That is the message that must not be lost as we try to parse the news about cancer screenings presented over the past week.

In a time when over a third of women do not have an annual mammogram, whether from a lack of access or a lack of awareness, we cannot afford to confuse the situation. When mammograms and Pap tests are used appropriately, fewer women die.