Though not one of the most common cancers, Marcie Lindstrom, APRN, says she’s seen liver cancer cases rise in recent years in line with national trends. Luckily, the gastroenterology provider at OSF HealthCare says treatment has evolved, too. And it’s another reminder to know your body and see your health care provider regularly because liver cancer is more treatable when caught early.

The liver: A recap

A primer on what the liver does for us: Lindstrom says the liver sits underneath the right ribcage and cleans toxins from our blood, helps digestion and produces proteins needed to live. In other words, it’s not an organ you can live without like a gallbladder or one kidney.

Liver cancer: Hidden and harmful

Lindstrom says primary liver cancer describes when the cancer starts there, and secondary liver cancer is when it spreads there (medical term: metastasizes), most commonly from the lungs, breasts or colon. Secondary is more common than primary.

“There are multiple causes of liver cancer. A person is at a higher risk if they have a damaged liver,” Lindstrom says. “Things that can cause a damaged liver include alcohol. So heavy alcohol use [is a risk]. Viruses that can infect the liver such as hepatitis B and C [are risks]. And we’re seeing an increasing number of people having fatty liver disease. That puts people at risk for liver damage. That damage can progress to cirrhosis [scarring], and cirrhosis puts you at a higher risk.”

These liver issues can be fatal if untreated. And unfortunately, Lindstrom says liver cancer often comes with no symptoms.

Diagnosis and treatment

That’s where regular visits to your primary care provider, and if needed, a specialist like a gastroenterologist or oncologist come in.

Lindstrom says your provider will go over your risk factors: do you have a family history of liver issues? What’s your own health history, specifically with hepatitis? How often do you drink alcohol? What’s your daily diet and exercise routine?

“If we determine somebody has a lot of scarring of the liver, they should be on regular surveillance looking for liver cancer,” Lindstrom urges. “Every six months, they should get some imaging and possibly a blood test that helps to detect cancer.” The person could also have a biopsy of their liver, where a provider will take a sample of liver tissue and send it to a laboratory to find out exactly what’s wrong.

Chemotherapy, radiation therapy, immunotherapy and liver transplant surgery are possible treatments.

“A liver transplant could be required if the tumor isn’t very large, but there’s a lot of damage or scarring of the liver,” Lindstrom explains.

Prevention

Lindstrom says if it’s caught early, liver cancer can be treated and even cured. Some things to keep in mind to avoid the disease:

• Eat a healthy diet, avoiding things like processed food, high sugar food and high fat food that can lead to liver issues.
   
• Get moving to avoid things like obesity, diabetes and high cholesterol. The American Heart Association says to aim for 150 minutes of exercise per week spread out over several days.
   
• If you do develop chronic conditions like diabetes, see your provider regularly to stay on top of managing the issue.
   
• Know your family history of liver and other health issues.
   
• Limit alcohol or avoid it altogether.
   
• There’s no vaccine for hepatitis C, but there is treatment. There is a vaccine for hepatitis B. The United States Centers for Disease Control and Prevention says the shots are safe, effective and have a schedule. Talk to a provider to see if you’re on schedule or if you need a shot now, for example if you’re at high risk.
   
• Take other steps to avoid hepatitis: practice safe sexual relations, avoid blood-to-blood contact with others and don’t share or reuse needles.
  
  “You have a history of blood transfusions prior to 1992. You got a tattoo or piercing in a less than sanitary situation,” Lindstrom lists as other hepatitis risk factors. “I’d recommend getting screened. In fact, it’s a current recommendation to be screened for hepatitis C at least once in adulthood.”
  
  Lindstrom says providers list 1992 as a hepatitis C benchmark because that’s when blood screenings were developed.

Learn more

Read more about how to keep your digestive system healthy on the OSF HealthCare website. Cancer care at OSF HealthCare also includes the OSF HealthCare Cancer Institute in Peoria, Illinois, which provides comprehensive care for the region.

Interview clips

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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

Country star Toby Keith had died after a 2 ½-year battle with stomach cancer. 

Keith shocked fans with the news that he had been diagnosed in the fall of 2021. The 62-year-old Keith revealed that he spent six months undergoing surgery, chemotherapy and radiation treatments and had to cancel all of his concert dates before going public with his diagnosis.

There are about 26,000 cases that occur in the United States a year including 11,000 deaths. Stomach cancer accounts for about 1.5% of all cancers.

Stomach cancer, also known as gastric cancer, is the growth of cancer cells in the lining and wall of the stomach. While breast, colon and prostate cancers tend to get more media attention, stomach cancer is nothing to ignore. 

The symptoms aren’t always easily identified. Feeling bloated after eating, heartburn, upper abdominal pain and unintentional weight loss are just some signs of a potential problem.

“Unfortunately, with stomach cancer, you don't see symptoms when it's early,” says Katie Nagel, an oncology nurse navigator for OSF HealthCare. “But as it starts to progress, you might see some symptoms that include nausea, vomiting, you feel full quicker than you usually do, fatigue. You might notice blood in your stool. It's important to know that most of the time those don't mean cancer, but it's important to let your doctor know if those persist.”

Risk factors for stomach cancer include:

• Age - most people are diagnosed with stomach cancer in their late 60s or older
• Sex – stomach cancer is more common in men than women
• Obesity – being overweight may increase the risk of stomach cancer
• Race – stomach cancer is more common in Hispanics, African Americans and Asians

“A lot of risk factors are ones that we can control,” says Nagel. “That includes smoking tobacco, heavy alcohol consumption, which is three or more drinks every day. And then a diet high in sodium and a diet high in processed meats. Obesity in general, puts you at higher risk.”

 If you experience any of these symptoms for more than a few weeks, Nagel stresses the importance of making an appointment with your primary care physician as soon as possible.

“Just pay attention to your body,” she says. “Don't talk yourself out of letting your doctor know if you've noticed a lingering symptom or even anything that might seem small, but that might be the very early start of something that's going to get bigger. Everything is more treatable  the earlier we catch it, so just listen to your body and talk to your doctor.”

While there isn’t screening for stomach cancer like there is for colon and breast cancer, Nagel says there are things you can do, including diet modification, exercise and avoiding a sedentary lifestyle.

The good news is incidence rates of stomach cancer have dropped about 1.5% every year in the last decade in the U.S. 

Advances in the treatment of stomach cancer, which include chemotherapy, immunotherapy and surgery, have made an impact as well.

And celebrities like Toby Keith sharing their story can only help when it comes to awareness of this disease.

“That is also drawing awareness to the issue, and I think makes people feel less alone," says Nagel. "I'm not the only person in the world that has this, other people are going through something similar and makes you feel a little bit better, a little less alone.”

For more information on stomach cancer, visit OSF HealthCare.

 

Interview Clips 

B-roll

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

It can be an embarrassing ailment, but experts say it’s time to talk about it.

Urinary incontinence is when a person leaks urine by accident.

Uwais Zaid, MD, a urologist at OSF HealthCare in Alton, Illinois, says urinary incontinence can wreak havoc on a person’s social life and intimacy with partners. In other words, you can’t go out and have a good time with friends if you don’t know when you’re going to suddenly “go.”

“It can be associated with medications. It can be associated with aging,” Dr. Zaid says. “It can be associated with certain surgeries. A lot of our cancer survivors, whether they're from prostate cancer, cervical cancer, uterine cancer…they can have effects to their urinary control.

“Things as normal as having children,” Dr. Zaid adds as a cause.  “Over time [childbirths] can wreak havoc on the pelvic floor and on the urinary sphincter, and you can have urinary accidents as a result.”

While incontinence is often associated with older people, Dr. Zaid says all those precursors apply to any age.

Dr. Zaid says urinary incontinence breaks down into four groups.

• Stress: This is when the bladder sphincter does not work as well. Simple things like coughing, sneezing, laughing or bending over could provoke a release of urine.
• Urge: “When the bladder has a mind of its own,” Dr. Zaid remarks. This is when you have to go and you just can’t make it to the bathroom in time. Dr. Zaid adds that hearing or seeing certain triggers like running water or jingling of keys as you rush to enter your home might provoke urge incontinence.
• Overflow: This occurs when your bladder is full. This is the opposite of urge incontinence, Dr. Zaid says, and is associated with infections and kidney issues.
•  Functional: This applies to someone who may have normal bladder control but can’t get to the toilet in time due to physical limitations like arthritis.

A health care provider will ask you about your symptoms and health history to see which type of urinary incontinence is ailing you. Testing would typically follow. Each type of incontinence, generally, has its own treatment plan.

• Stress: A provider may recommend pelvic floor physical therapy as treatment. For women, a small device can be inserted to stop leaks. Surgery is also an option.
• Urge: You may be told to cut back on caffeinated food and drink, spicy food and alcohol. Medicine and surgery are also options.
• Overflow: “That's where we need to make sure we're not missing anything like a blockage - for women, a prolapse and for men, an enlarged prostate.” Dr. Zaid says.  “A stone in the bladder. A tumor in the bladder. And we also need to make sure the kidneys are functioning okay.”
• Functional: Since people with this type of incontinence may have a normal bladder, external solutions are necessary. For example, keeping your route to the bathroom clear of obstacles like chairs and doors. For older adults with physical limitations, have a walker handy for when the need to go arises.

Other tactics include urgency suppression, when you distract yourself from thinking about urinating. You could take long, relaxing breaths or sit completely still.

Timed voiding is when you schedule times to urinate. Dr. Zaid says this can work in both directions. If you are urinating too frequently, set a timer on your phone to go every hour. Then when you get comfortable, you can increase the time. If you are holding on to your urine too long, set a plan, get comfortable then decrease the time.

The bottom line: if something seems off about your bathroom visits or if friends or family remark “You’re sure in there a lot,” see a doctor.

“If you’re chronically wet down below, it increases your risk of fungal infections and skin breakdowns,” among other serious health issues, Dr. Zaid says.

Interview clips

Previous coverage

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