Post treatment care for cancer survivors

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by Marissa Lorenz
October is National Breast Cancer Awareness Month and, increasingly, Americans have come to recognize it by the pink ribbons, shirts, walk-a-thons, et cetera that have become a commonplace reminder. But the mission is more important than just that recognition.

Begun in 1985, a primary aim of the month-long campaign has been to promote early detection through regular breast exams and mammography. Organizations are dedicated to increasing awareness of the disease and offering information and support to those affected by breast cancer. And charities work to raise funds for ongoing research into prevention, diagnosis, and treatment.

According to statistics from the American Cancer Society (ACS) about American women, about 1 in 8 will develop invasive breast cancer during her lifetime, breast cancer is the most commonly diagnosed cancer after skin cancer, it has the highest cancer-related death rate after lung cancer; experts estimated over 276,000 new cases of invasive breast cancer in 2020, over 48,000 new cases on non-invasive breast cancer, and over 42,000 deaths from breast cancer.

The ACS estimated 2,600 new cases of invasive breast cancer to be diagnosed in men in 2020 and noted that a “man’s lifetime risk of breast cancer is about 1 in 883.”

“It’s quite overwhelming when you first find out. Most likely, you didn’t know that you had it when they discovered it. It’s not usually something that you can feel or see or anything,” says Kremmling’s Lurline Underbrink-Curran, who has been open about her diagnosis and treatment during the time she was still serving as Grand County Manager and the County’s lead negotiator of the Colorado River Cooperative Agreement and the Windy Gap Project.

“The treatments are difficult, at best,” she explains. “And even when you’re done, you don’t get to say you’re cured. You can only say you’re ‘cancer-free.’ And that may last, and that may not last.

So every time you go for a check-up, you have a lot of anxiety. There is that unknown always.”

Fortunately, due to earlier detection and advances in treatment and ongoing women’s health care, breast-cancer death rates among women have been slowly declining. Which also means that more and more women are living with active breast cancer or a history of breast cancer. The ACS determined that number to be more than 3.5 million American women in January of 2020.

Ongoing monitoring will have to take place for the rest of their lives. Patients with advanced breast cancer may have to continue treatments, such as chemotherapy or hormone therapy. And those who are fortunate to have ended their treatment may be left with scar tissue, pain, numbness, lymphedema (fluid buildup in arms or legs), and bone-density issues. They may experience reduced cognitive function, ongoing fatigue and depression, infertility, or other hormone-related imbalance.

“Staying as strong as you can, helps with your recovery,” observes Underbrink-Curran, who says that she had always exercised and practiced yoga regularly. “I really believe that helped with the neuropathy [numbness].”

Holistic oncology rehab & body work
Other care may become valuable also, like counseling for depression and anxiety, support groups, or massage therapy, such as that offered by Michelle Licha-Oros of Michelle Licha-Oros Medical Massage Therapy in Kremmling, who specializes in scar tissue massage and lymph drainage therapy.

Licha-Oros first became interested in oncology rehabilitation in 2008, when a client had come to her with neck and shoulder pain after a double mastectomy and radiation therapy.

“She told me she found the scars to be an upsetting reminder of her cancer history,” recounts Licha-Oros. “Hearing her story was profound. Physically, it was evident to both of us that the scar tissue was the root of her neck and shoulder pain. I had to be careful with her delicate skin and a compromised lymph system. Emotionally, I was the first therapist she allowed to
see and work on her scars.”

“This was vulnerable ground for both of us. As a result of this experience, I have dedicated myself to learning about breast cancer recovery and how massage therapy can help. I’ve been on a path to help cancer survivors get out of pain and live a fuller life after cancer treatment.”

Licha-Oros has since pursued additional skills and training in the oncology rehab field, building experience with a wide range of tissue traumas, including melanoma and liver tumor removals, skin grafts and biopsy sites, lipoma and cyst removals, as well as other injuries and surgeries.

“A properly designed program of massage therapy, exercise therapy, and lymphedema management can reduce long-term side effects that lead to unnecessary pain and suffering,” outlines Licha-Oros.

“The appearance and sensations you may have developed around the scars, the tightness in your skin and muscles, the strength you have lost, the changes in your posture and breathing, and your diminished sense of overall well-being — all these things can change!

“Physical therapists can guide you through mobility and strengthening exercises during the different stages of treatment and recovery. Many PTs are also lymphedema specialists or complete decongestive therapists (CDT), trained in the treatment of lymphedema. Oncology-trained massage therapists, such as myself,” she continues, “use hands-on therapy skills, including MLD, to safely and effectively treat scar tissue, skin tightness, tissue stiffness, shoulder mobility, range of motion, swelling, and post cancer treatment pain.”

“Other therapies and practices, like acupuncture, chiropractic, yoga, Pilates, and personal training can also contribute to long-term well being,” Licha-Oros urges. “Holistic rehabilitation plays a critical role in the long-term quality-of-life component in survivorship. It is important for professionals to communicate also. Patients may have different needs, and we all hold one piece with which we can assist in someone’s healing, providing what they deserve for body, mind, and spirit.”

Other supports for cancer patients & post-treatment survivors
Grand County’s remote rural nature adds to the challenges of ongoing care. Local patients are treated in various regional care systems whose familiarity and support networks they leave largely behind when returning home. However, there are additional resources within reach.

Middle Park Health has a specialized team of breast health specialists, “offering the most compassionate and comprehensive care.” They provide routine screening, diagnostic screening or breast treatment and have a team of skilled physical therapists. And the Middle Park Medical Foundation is raising money to build a 1,200 square-foot infusion center with one private room and three free-standing pods for antibiotic, immunoglobulin, and chemo therapies, in order to “bring oncology home” to Grand County.

Mind Springs Health in Granby offers a free mental health support line for all community members, including those experiencing stress, anxiety, depression, or other mental distress in relation to cancer or cancer recovery. Regular counseling appointments can be made by calling the Mind Springs office, where they are accepting new clients with or without insurance or Medicaid coverage.

Makena Line, Program Director at Mind Springs, says that they have also offered presentations or workshops to support groups, focusing on coping skills, self-care, resilience practices, and mindfulness techniques. “We are always willing to present to any group, organization, or business who would like help with these things,” she assures.

And the “Taking Steps for Cancer” fund, managed by the Mountain Family Center, is designated to help ease the financial burdens experienced by families impacted by cancer, such as gas, lodging, and meals accumulated for treatment-related travel.

The Fund is maintained by the “Taking Steps for Cancer” volunteer group, who raises money at several events a year, such as the annual Taking Steps 5k and Spirit Polar Plunge in Grand Lake. Assistance is available regardless of income or insurance status, and each client can receive up to $2,500 per year in reimbursement.

Resources and actions
For more information on oncology massage, go to www.s4om.org. For more on lymphedema, visit www.lymphnet.org.

Meet the MPH team by calling 970-887-5839.

To donate to Middle Park Medical Foundation’s oncology fund, go to middleparkhealth.org/foundation.
Mind Springs Support can be reached at 877-519-7505. Schedule appointments at 970-887-2179.

For assistance or to donate to the Cancer Fund, call 970-557-3186 or email [email protected]

If you would like to find out more about volunteering with Taking Steps for Cancer, email Judy Eberly at [email protected]