• Changed demeanor, like mood swings
   
• Frequently stepping away, like asking to go to the restroom a lot at school

“They want to go smoke because they’re addicted already. They need that time. They have to go hide,” says Thompson, a breast health navigator. “Same thing at home. They constantly go to their room or bathroom.”

• New odors coming from your child or their belongings. Williams, a radiation therapist, notes that the smell could be good, like minty.
   
• Listen for kids using new phrases. Vapes are also called hookahs, pens, tank systems and mods.

Adults should also know the changing look of vapes. Boyd says they could be in plain sight in your child’s room, and you could miss them. Vapes can look like computer flash drives, ink pens, key fobs, candy canisters and even handheld video games.

Talking to kids

First and foremost, Boyd suggests taking a loving tone when talking to kids about the dangers of vaping. Don’t start by accusing them of wrongdoing.

“Gather information. Encourage them to open up. Make it a safe place,” Boyd says. “If they don’t feel comfortable talking to mom or dad, maybe try somebody at church, an older sibling, a school counselor or a teacher. Find those accountability people.”

If your child has a hard time opening up, talk to their pediatrician so they can broach the subject at the next appointment. During the appointment, offer to step out of the room so the child isn’t nervous to talk about their habits.

Thompson adds to keep kids active. If you’re playing backyard baseball with them, you know they’re not vaping.

“We want you to be healthy and live a long life,” she adds, suggesting words to use with your child. Not to mention the money you’ll save.

What about smoking?

How does smoking a traditional cigarette or cigar play into all this?

Boyd says some people see vaping as a way to quit smoking. She says that’s a bad idea. Talk to your health care provider instead about medication and other options.

At OSF Moeller Cancer Center, Boyd, Thompson and Williams offer a smoking cessation program. Providers can refer patients to the program, or they can self-refer by calling (618) 474-6791. OSF then connects the person with resources to quit and provides regular check-ins. Schools, businesses and community groups can also call to see how they can benefit from the program.

“Working on oncology, we see the back end. We see patients who have been 30-year smokers. They have a CT scan, and they find an abnormal mass,” Thompson recalls. “So we try to catch them early. We have younger patients who are seeing their primary care provider. Their provider says they’ve been smoking for five years, and they put the referral in. Well, we just saved them 25 years of smoking if we can get them to stop now.”

“Don’t see it as a failure,” if you can’t quit right away or if you relapse and smoke a few, Boyd adds. “Try again. We’re not all made the same. Quitting looks different for everyone”

Interview clips - Karen Boyd

Interview clips - Heather Thompson

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Breast cancer is one of the most common cancers in the United States, says Heather Thompson. And she would know. Thompson is a breast health navigator at OSF HealthCare, helping patients navigate appointments, insurance and more. And Thompson is, herself, a breast cancer survivor.

But what many in the cancer space might not realize, Thompson says, is that breast cancer can affect men. It’s rare, with 1% of men statistically getting it, Thompson says. But it’s worth knowing how to spot, prevent and treat it.

“There can be severe cases. A lot of times, men don’t notice things or worry about things like women might,” Thompson says. “The cancer is there longer and has a chance to metastasize [spread] and get into their lymph nodes. A lot of times, men will get gynecomastia. That can cause swelling in the breast tissue and a mass.” Those gynecomastia masses can limit a man’s ability to feel a cancerous lump, delaying care.

Breast cancer basics

Genetics (i.e. a family history of cancer), alcohol use and smoking all put you at a higher risk for breast cancer.

So do men need to do monthly self-checks and get mammograms like women are told to? Not always, Thompson says. You should talk with your primary care provider about a plan, especially if you have a family history of breast cancer. That plan could involve genetic testing or blood work to check estrogen levels (since estrogen feeds cancer cells). But day to day, Thompson says to just keep an eye on your breasts. Look for inverted nipples, lumps, redness or achiness.

“Men really do not require regular screening or imaging for breast tissue. That is not in the American Cancer Society guidelines or any other guidelines,” Thompson says. “However, men should monitor their bodies for anything irregular. Then, get it addressed right away. Don’t wait. You might be in that 1%.” Thompson adds that if any type of cancer spreads, it can be fatal.

Treatment for male breast cancer typically involves a mastectomy, or the removal of breast tissue, Thompson says. This could be after cancer is found. Or it could be preventive if you’re at high risk, like the case of actress Angelina Jolie.

“There’s not much tissue that a man has,” Thompson points out, allaying fears that your chest will look significantly different. She says you won’t have a nipple, and your chest will be flat. But that’s about it. “We will still test those lymph nodes during surgery to make sure the cancer hasn’t spread.

“After that, there’s special testing called oncotype,” she adds. This looks at the likelihood of cancer returning. “If it’s a high score, those people sometimes have to have chemotherapy or radiation.”

Changing minds

Thompson knows men can be apprehensive about seeing a doctor in general. But when breast cancer enters the conversation? She’s heard things like “I’m not a woman. I don’t need to worry about that.”

At OSF Moeller Cancer Center in Alton, Illinois, where Thompson works, she sees one to two men per month come in for imaging. Most, she says, are cases of gynecomastia that can be managed by the person’s primary care provider. But some do hear the words “It’s cancer.”

“I tell them they’re not alone,” Thompson says. “Other men have gone through this. We have a roadmap to treat it.”

Learn more

Read more about cancer care, specifically breast cancer care, on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

Interview clips

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A federal panel recently advised women get a mammogram every other year starting at age 40, rather than 50.

And the American Cancer Society estimates that in 2023, nearly 300,000 women in the United States will learn they have breast cancer. About 43,700 women will lose their life due to the disease.

The headlines are reminders to know your breast cancer risks. While many risks are out of your control, there’s just as much you can control, says Heather Thompson, a breast health navigator at OSF HealthCare.

Major risks you can control

• Active lifestyle and healthy eating: Thompson puts it plainly. If you eat junk, you’ll feel like junk. And any exercise will give you more energy and burn fat. Fat produces estrogen, which feeds cancer cells.

“You want to make sure you’re well-maintained with your weight, even after menopause,” Thompson says.

• Taking hormones: This impacts your ovaries, reducing or adding estrogen. Whether you’re at a routine appointment or you have been diagnosed with breast cancer, talk to your provider about what hormones you’re taking.

“We don’t encourage people who are having menopause symptoms [like hot flashes] to take hormones,” Thompson lists as an example. “We encourage other things to help treat those. It eliminates those estrogen cells increasing.”

• Alcohol and smoking: They are a risk for any type of cancer. But Thompson says one drink per day can increase a woman’s breast cancer risk by 12%. Alcohol is sugary, and that’s a fuel for estrogen.
   
• Night shift work: Thompson says our body expects to sleep when the sun goes down. Night work throws that off.

                “You’re getting artificial light all night. That changes the melatonin that the body naturally makes,” Thompson explains. “When your melatonin is off, it increases estrogen.”

                If you don’t work the traditional day job, see if you can work different shifts so you are not up all night all the time.

Risks you can’t control

• Age: Thompson says women generally develop breast cancer at age 50 and above. 
   
• Family history and genetic mutations: A family history of breast cancer puts you at a higher risk. Thompson says the higher risk is often seen on the person’s mother’s side of the family. For example, your mother and her sister (your aunt) may have breast cancer, and so you’d need to talk to your provider about your risk.

              Some women diagnosed with breast cancer and who have a family history may undergo a genetic test.

“Those tests can tell us if this is something being passed down from generation to generation,” Thompson says.

• Reproductive history: Young women who develop menstruation before age 12 and women who go through menopause after age 55 have an increased risk.

“That gives them a longer time with their ovaries working. They’re producing estrogen,” Thompson says.

• Dense breast: More tissue and less fat mean a dense breast and an increased cancer risk, Thompson says. Usually, the younger you are, the denser your breast is. The density of your breast is something that will be noted on every mammogram result. Thompson says mammogram technology is getting better at finding cancer in dense tissue. An early diagnosis may mean a better outcome.

Takeaways

Make sure your health care provider knows about your circumstances so they can decide on the best preventive care, like a different schedule for mammograms. Some of the information to have handy: a family history of cancer and any physical change you noticed during your monthly breast self-check.

Learn more about breast health and breast cancer care on the OSF HealthCare website.

Interview clips

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A breast cancer survivor's toolkit
Say yes ma'am to the mammogram
FDA dense breast rule promotes earlier cancer detection
A woman's battle with breast cancer
Prevention of breast cancer starts with awareness

Family – literally and figuratively – is a word Fred Smith, 88, knows well, too. After his diagnosis around four years ago, he’s gotten radiation treatment on his neck and intravenous (IV) chemotherapy at OSF Moeller Cancer Center.

“The nurses were so friendly,” Fred says.

“They’re a wonderful couple,” says Jill Pruitt, a licensed practical nurse and certified oncology navigator at OSF Moeller Cancer Center. Pruitt is another part of that support system for cancer patients.

“They’re always positive,” Pruitt adds of the Smiths. “They put their trust in God. They put their trust in us. No matter what news is thrown at them, they take it and go with it.”

Happy anniversary

On August 1, 2024, Fred Smith was due for his first chemotherapy treatment. When Neva called to schedule the appointment, she mentioned it was the couple’s 65^th wedding anniversary but said there was no need to postpone the session.

What greeted Fred and Neva in the infusion bay: cake, a banner and well wishes from OSF Mission Partners.

“It was a monumental day,” Pruitt says.

Fred, Neva and Jill all have the same take-home message: A support system when battling cancer is crucial, and you should find the right people and things that lift you up.

“Stay encouraged, and have friends who encourage you,” Neva says. “When I had [my cancer treatment,] I listened to a lot of gospel music. That helped me.”

“I always say my prayers at night,” Fred adds. “It’s not a religious thing. I’m just so thankful I found this hospital.”

“It’s very important to have someone there with you for support,” Pruitt says. “Someone to give you a ride or bring you a warm meal. As you’re going through [cancer treatment,] you don’t always feel like cooking or cleaning your house.”

Learn more

Read more about cancer treatment at OSF HealthCare, including the OSF Cancer Institute in Peoria, Illinois, the hub of cancer care at OSF. If you need help in your cancer journey, contact the health system, church or social service agency near you to see if they offer patient navigators, social workers, support groups or other resources. Pruitt also says OSF and other health systems use the American Cancer Society’s resources.

Interview clips - Fred and Neva Smith

Interview clips - Jill Pruitt

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In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby

Fast forward to June of 2023, and Sandford’s world is about to change again.

Three, two, one.

The door at OSF Moeller Cancer Center in Alton, Illinois, opens, and Dr. Manpreet Sandhu walks in. She tells Sanford he has cancer in his upper intestine, liver and lymph nodes. It’s in an advanced state and not curable. Devastating news for anyone.

But cancer wasn’t about to slow down the 67-year-old from Brighton, Illinois. He’s still bull riding on a senior tour during chemotherapy, making him a prime example of why staying active during cancer can help in the fight.

Jack’s journey

A Virginia native and Army veteran, Sandford came to southern Illinois around a decade ago to take a manufacturing job. He rode bulls off and on during that time, earning the nickname Sandman.

In late May of 2023, Sandford was at a rodeo and got sick.

“I was throwing up and couldn’t ride,” he recalls.

At first, he and his wife thought it was food poisoning.

“My wife cooks great food, though,” Sandford says, ruling idea one out.

Next stop: seeing a doctor.

Sandford went to OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois. Providers quickly told him more advanced imaging was needed to get to the bottom of things. Then came the cancer diagnosis and a treatment plan.

“I’m here every other Monday getting chemo,” Sandford lays out matter-of-factly. “I get sick. I have my bad days and good days. It makes you irritable and hard to be around. But you just have to not really think about it that badly. You just need to keep moving forward.”

Why staying active is important

In her early visits with Sandford, Dr. Sandhu says it was clear that he wanted to stay active. It’s advice she would give anyone on a cancer journey.

“We have conversations with our patients to see where they are and what their goals are,” says Dr. Sandhu, a medical oncologist.

“Chemotherapy medicines are strong. They will make your muscles and bones weak,” she adds. “If we maintain our physical strength, we’re able to counteract those side effects better. In addition, staying active also improves immune health.”

Pursuing hobbies can also boost your mental health and bring a sense of achievement, Dr. Sandhu adds. It’s something critical during a difficult cancer fight.

“Start slow. Small steps,” Dr. Sandhu advises. “We tell our patients: one day at a time. We’re not going to look five years out. We’re going to look to tomorrow.”

For example, Dr. Sandhu sees people who are on chemotherapy and think they are too weak to exercise. She suggests starting on a pedal bike, then progressing to walking. And don’t make it a chore. Do it outside with family or friends. Find joy in the activities.

Sandford agrees, especially about having a support system. He’s lucky to have two: his family by blood and his bull riding family.

“We always take care of each other. We have a prayer service before rodeo,” Sandford says.

Ride on

Sandford is now the oldest bull rider on his senior tour. He’s had ups (placing high in competitions) and downs (a broken collarbone thanks to a mean old bull). But he’s not hanging up his jacket anytime soon.

“The man upstairs put a bump in the road for me. He didn’t tell me to quit,” he says.

Three, two, one. On to the next challenge.

Interview clips - Jack Sandford

Interview clips - Dr. Manpreet Sandhu

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October is Breast Cancer Awareness Month, and that has many thinking about the disease that afflicts hundreds of thousands in the United States each year.

People like Cathy Keller. When she visited the ribbon cutting for OSF Moeller Cancer Center in 2019, she had no idea she’d be using the services two years later.

Now, the 66-year-old Godfrey resident is telling other breast cancer patients: you can get through it, too.

“You have to roll with the punches,” Keller says.

The numbers

Heather Thompson is a breast health navigator at Moeller Cancer Center and was with Keller from the beginning. She, too, is a breast cancer survivor.

Thompson says one in eight women will develop breast cancer. Older people are at a higher risk than younger, but younger people typically have more aggressive cancer.

“A huge, huge problem,” as Thompson puts it.

Thompson explains that woman make hormones, especially estrogen, all their life.

“A lot of the hormones in [a woman’s] body are like a fuel to a cancer cell,” Thompson explains. “When you get an abnormal cell, estrogen in our bodies fuels that cell and produces and produces. And you get a mass. And then you have breast cancer.”

Thompson says those breast cancer tumors can develop over time.

Alejandro Sanz, MD, is a surgeon at OSF HealthCare in Alton who specializes in breast cancer. He says around 233,000 U.S. residents hear the words “You have breast cancer” each year. Around 40,000 people die annually from the disease.

Expect the unexpected

Keller got her diagnosis in April of 2021, followed by a lumpectomy the next month. In June, she wound up under the care of Manpreet Sandhu, MD, and James Piephoff, MD, oncologists at Moeller Cancer Center, for chemotherapy and radiation. Keller says she knew she would get the best care at Moeller.

Keller’s first round of chemotherapy produced the serious allergic reaction known as anaphylactic shock, and at that point she wanted to quit, as the treatment was preventative. But Dr. Sandhu advised against that.

“She took it upon herself to find a chemo that would not affect me at all,” Keller says.  “And it didn't. The way it was delivered was very different from the way the first chemo was delivered. I didn't have to take the Benadryl. I didn't have to take the steroids.”

To put it a different way: Dr. Sandhu “went to bat for me,” Keller says with conviction and a slight tear in her eye.

 But Keller wasn’t out of the woods yet. Midway through the new type of chemotherapy, she began to suffer neuropathy, or nerve damage that typically results in loss of feeling in your hands and feet.

 Dr. Sandhu proposed a simple solution.

 “I would hold on to little Ziploc bags of ice,” Keller explains. “And they put them on my feet so that the smaller vessels would constrict a little bit so I wouldn't get all that chemo right back down in there.”

The life hack worked long enough to earn Dr. Sandhu’s OK to end that particular treatment.

Keller’s lesson in all this: Expect a bumpy road, but know you have to stick with your cancer treatment. And trust that your providers are doing the best for you.

 Dr. Sanz says providers will hold up their end of that commitment, too.

 “There's a lot of information involved. Patients can get confused about it. So I take care of that. I try to spend a lot of time with my patients explaining this. Going through the images,” Dr. Sanz says.

“A lot of my patients have never seen their own mammogram,” he adds.  “They’ve never seen their own tumor. How does it look?”

Find support

Keller says not only was she not going to battle cancer alone, the disease wasn’t going to interrupt her routine. She worked out with a kettlebell weight. And Keller and a friend still walked the hills near Keller’s home twice a week, sharing laughs and stories.

She got support from her biological family and work family. One female student at Alton High School, where Keller works, told Keller she temporarily lost her hair due to a serious infection.

“If she can come to school and have her peers see her with her short hair now, knowing she had long hair earlier in the year, I don't have to wear my wig anymore,” Keller says. “So I saw her two or three days after I started wearing my regular hair, and I told her, ‘You are my inspiration’.”

Watch your health

Dr. Sanz and Thompson want women to commit these numbers to memory: Start getting a yearly mammogram at age 40. If you have a family history of breast cancer and get an order from your primary care provider, you can start as young as 30.

“Screening is the best tool we have at this moment in order to decrease the mortality of cancer,” Dr. Sanz says.

Thompson adds that unless you’re approaching end of life care, there’s no reason to stop getting the yearly breast checks.

“Women who are thriving and are doing well and have the chance of living the next five years, by all means get their mammogram,” Thompson urges. “Because we can give them that five years by saving them and finding and diagnosing and treating right away.”

Thompson says monthly self-checks of your breasts are equally as important.

“Any woman of any age should do a monthly check. Pick a day out of the month. I want to do it on the first. I'm going to check both breasts,” Thompson suggests. “That way you know your breast. You know how they feel. You know if you have lumpy breasts or not. And so if something changes, something seems abnormal, something feels different, then you get it checked [by a health care provider].”

 Dr. Sanz is all-in on both types of breast checks, too. That’s because 80 to 90% of the patients he sees who are later diagnosed with breast cancer don’t present any symptoms like breast pain or skin abnormality. Rather, they are in Dr. Sanz’ office because a mammogram caught something.

Learn more about breast cancer prevention and treatment on the OSF HealthCare website.

Interview Clips - Cathy Keller

Interview Clips - Heather Thompson

Interview Clips - Dr. Alejandro Sanz

A survivor of four types of cancer, you can understand why Kristi Fetter was a little skeptical that a support group would be the magic to turn her mood around.

Five years later, it’s a 180 degree change of opinion for the Granite City, Illinois, woman.

“They helped me a lot with their knowledge. They’re caring,” Fetter says. “With all the other women there who have been through the same thing that I've been through, that helps too because you're on the same walk.”

Fetter and those who run the Caring Circle cancer support group at OSF HealthCare in Alton, Illinois, are talking about the importance of having people to lean on – whether you’re dealing with cancer or some other hardship.

From attendee to leader

Patient navigators Heather Thompson and Karen Boyd head up the Caring Circle group in Alton. And you couldn’t ask for a better leader than Thompson. Herself a breast cancer survivor, she attended a support group at OSF during her cancer journey. Now, she counsels women who are in that same position. And attendance has grown from just a few to dozens.

“It’s just an amazing group,” Thompson says. “Karen and I look forward to it just as much as the women do.”

Support groups also provide an outlet for some who may not otherwise have an option that allows them to express how they’re feeling.

“Maybe they can’t share certain feelings with their family because they don’t want to upset them.” Thompson says. “They might not want to tell them things that they can share with other people outside their network.”

It’s not all bad

Fetter and Thompson are also trying to break the stereotype that support groups are just sitting in a circle and crying. Sure, emotional conversations happen. Group members can get sick or pass away. But there’s much more. Fetter says guest speakers swing by to teach things like exercising and mental health care. Group members share what’s going on in their lives, which sometimes leads to social outings together. Encouragement cards, crafts and high fives are common. And of course, everyone can bond over a good breakfast.

“We've made cards and sent them over to [service members]. We've sang over in the nursing home at Christmas time to elderly people,” Thompson says. “So we try to do things for other people to take away our problems.”

“I’ve made a lot a good friends,” Fetter says.

“Being alone is being alone,” Fetter adds. “You feel like you've got nobody to talk to. You get depressed. So when you come out [to a support group], you're hanging out with other friends. It lifts your spirits.”

Check with your health care provider or visit the OSF HealthCare list of events to see what support groups are offered near you.

Interview Clips - Kristi Fetter

Interview Clips - Heather Thompson

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