92-year-old war veteran reflects on cancer diagnosis

When John Hogan’s family moved to Seattle in 1941 John took the opportunity to join the Army. It was during World War II and there was plenty to do. He was stationed at Fort Lewis, where he trained for nine or 10 months before the Japanese bombed Pearl Harbor. A truck driver in the 41st Infantry Division and the 162nd Infantry Regiment, he eventually headed to Australia to help defend the South Pacific. At age 92 and on hospice care, John recalled fondly his time in the Army – and the day he headed home.

He saw combat in New Guinea, the Philippines and South Pacific Islands before the war ended. “Truman drops the biscuit on Japan. Bang the war is over. I’d been there 42 months and we came home in 19 days – into Hawaii and San Francisco,” John recalled. “The most beautiful sight you ever seen - we were coming home going under the Golden Gate Bridge on a beautiful day. Your morale is 400 percent above normal. We saw three Christmases in the South Pacific and those palm trees don’t look like Christmas.” Back up to Fort Lewis and John was honorably discharged, a Technician 5.

November is a special month for John’s family in two ways. First, it’s National Home Care and Hospice Month. Second, it’s Veteran’s Day. While John received hospice care, his military service was also being honored by the staff of Providence Hospice of Seattle, who listened to him talk about his time in the Army and acknowledged his service. During this year’s National Home Care and Hospice Month Providence Hospice of Seattle is also moving forward with its We Honor Veterans program, which offers end-of-life care designed specifically for veterans. John Hogan didn’t know anything about hospice care when he was diagnosed with cancer in May and his doctor offered him a range of choices – from aggressive treatment to care focused on comfort and quality of life.

“Two options – medical, chemo and the rest of the stuff,” said John, who was chipping golf balls in his backyard until he was suddenly diagnosed. “I said, no, I don’t want that. I want this one – to live normally, live comfortably, have the nurse come in and that’s the way I want to go.” And that’s how it went duing his time on hospice care John lived in the Greenwood home where he and his wife Betty of 51 years raised their three children.

Providence Hospice of Seattle provided the nurses, walker, wheelchair, social worker, medicine, and other services he needed. John got to enjoy time with his children and grandchildren and all the friends and neighbors who visited him. “It’s the best,” he said of the hospice care. “I couldn’t imagine help like this. It’s wonderful.” Added Betty, “We really couldn’t get along without them because I wouldn’t know what to do.” John said the thing that surprised him most about his disease was having so many people come by his home to say hello. “The advantage, when you get cancer, the good Lord’s telling you you’re not only here for a certain period and you know that. You have an appointment with me. You don’t know the date, but at least you know it’s coming closer.”

His priest from Christ the King parish, just down the street, offered spiritual comfort. John reflected on everything he’d gone through in life, including his military duty. Born in Butte, Mont., in 1918, John never graduated from high school, but worked several jobs – in department stores, as a waiter, in the cooper mines – before his family moved to Seattle. After being discharged from the Army he worked in the shipyard at Tacoma on flat top aircraft carriers, then came to Seattle and found a job at a lumber yard in Ballard, where he worked for 15 years before working for the railroad. At age 41 he met and married Betty, who volunteered in the Catholic Seaman’s Club coffee shop. The have three children and six grandchildren. John’s favorite thing during his last months of life was seeing those grandchildren, although he was no longer able to play ball with them in the backyard. But he remained philosophical.

“It’s hard. But there’s a reason. There are no accidents out there. Everything you do is providential. You’ve got to believe that.” As for the care he received? “Gee, it’s a good program. I would tell anybody before they go to their maker to take a trip through hospice first.”

Providence Hospice & Palliative Care proudly supports the national We Honor Veterans program (www.wehonorveterans.org),which offers end-of-life care designed specifically for those who have courageously served our country. For more information about our services and locations, visit www.ProvidenceHospiceWashington.org.

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Support in unexpected places

Elizabeth stands with Dr. Kevin Haughton, Providence physicianElizabeth McDonnel is an RN at Providence St. Peter Family Medicine Clinic in Olympia, Washington. She was also just diagnosed with breast cancer.

She didn’t tell her co-workers for awhile, not wanting to bring attention to herself. When they did find out she was overwhelmed by their support.

Most notably, they purchased (with their own money) pink lanyards to wear their name badges with. They also chose a day to all wear pink. When Elizabeth showed up that day and realized everyone was dressed in shades of pink she asked if they were celebrating breast cancer awareness month. They answered, “No, we’re celebrating you.”

“I was crying the entire day,” says Elizabeth. “I had no idea the depth of support that was in my clinic, my workplace. It’s comforting to know they are behind me.”

What about you? Have you received unexpected support from someplace you didn’t expect? We'd love to hear about it in the comments section!

7 'take charge' tips from our new breast cancer navigator, Andrea Potter, RN

Welcome breast cancer navigator Andrea Potter, RN!Many of you may already know or recognize me because I have been caring for cancer patients in the community for the past eight years. The Providence Regional Cancer System is like family to me. I began my nursing career here and know the doctors, the staff and the community.

In recognition of Breast Cancer Awareness month, I want you to feel empowered as your own health advocate. Remember that you are not just a patient, but that you are the customer and should be made comfortable and happy. Here are some ‘take charge’ tips:

• Simplify things by keeping a journal and calendar to track symptoms and appointments.
• Be honest with your doctor about how you’ve been adhering to your treatment plan.
• It’s ok to seek a second opinion.
• Keep your own medical file and request copies of your records.
• Let me help you with practical problems that can get in the way like temporary housing, transportation or financial support.
• Take care of your emotional health by using counseling or integrative therapies.
• Keep up on changes in breast cancer research.

I am here for you throughout this journey, and the sky’s the limit to the resources I can help you access and support I can provide.

Customized treatments enhance breast cancer care

Editor's Note: This article originally appeared in the September/October 2011 issue of Vital Signs.

Not all breast cancers are the same, and tailoring treatments for different types is becoming increasingly common in cancer care. This approach has improved cure rates in some patients and allowed others to avoid unnecessary treatments.

At Providence Regional Cancer Center, medical oncologists utilize various methods to customize therapies. Gene analysis is one technique, which may be used when it’s not clear if a patient’s particular form of breast cancer will benefit from chemotherapy.

“The gene analysis test we use looks at 21 genes and gives us an idea of whether the patient has a low, intermediate or high likelihood of recurrence,” said Maury Blitman, MD, medical oncologist at Providence Regional Cancer Center (pictured left.) “Patients with a high recurrence score will typically benefit from chemotherapy, while those with an intermediate or low recurrence score will not gain additional benefit over the hormonal therapy they have already been prescribed.”

For other breast cancer patients, including the 20 to 25 percent who have what’s known as HER2-positive cancer, “targeted” therapies have shown success. This type of breast cancer occurs when the HER2/neu gene mutates, which can result in cancer that is often less responsive to chemotherapy.

However, says Dr. Blitman, physicians now know that combining chemotherapy with Herceptin®, a drug that specifically targets a protein created by the HER2/neu gene, can improve treatment response and increase cure rates.

As cancer physicians and researchers continue to discover new ways of tailoring treatments, the possibility of curing breast cancer – or at least managing it as a chronic medical condition – is becoming reality.

Advice from Bob: A patient's top tips

Editor’s Note: The following article was developed by a Providence Regional Cancer System patient, Robert R. Largen and his wife/editor Rosemary Shold. Bob received a diagnosis of “stage four, non-smoking, Agent Orange induced, lung cancer on October 31, 2001.” Below are some of his top tips for how he personally manages his cancer. The views reflected below are his own. If you’d like add your own tips, please leave a note in the comments.

1. Have someone accompany you to any doctor’s appointments or consultations. This person will help you absorb all the information that comes at you. Take notes.
2. Repeat back to the nurse or doctor any instructions that are given to you. Follow the instructions as closely as you can.
3. If possible, have a health professional other than the treating doctors and nurses guide you through the process. (Editor’s Note: Bob has a daughter Catherine, who is also an RN. There are many resources like this in our community, please don’t be afraid to ask if you’d like to be directed to one).
4. Keep a daily log of your health. It is a helpful resource when the nurse and doctors ask, “How is the patient doing?” And, “When did the symptoms start?” We found that the combination of happiness for making it through the day and fearfulness for what tomorrow may bring made for very poor long term memory.
5. Do something each day to better the future for the family, e.g., estate planning, distribute possessions, contact your pastor, open or close bank accounts, etc.
6. Make each day count. Achieving what is essentially a positive attitude is difficult as it is easy to be drawn down in the morass of the situation. This activity requires extreme mental discipline.
7. Take advantage of any counseling offered by the hospital or clinic.
8. Develop a network of support. We sent out 45-50 letters informing people of my diagnosis. As a result, each day’s mail brought something for me to look forward to. (Editor’s Note: This is an excellent example of where an electronic network like Caring Bridge would be helpful, Providence is currently in the process of linking up with this resource.)
9. Try to keep as near normal routine as possible in a situation in which everything has changed. We celebrated my 75^th birthday with a card party. I received over 100 cards in the mail. Once again, each day’s mail brought something to look forward to.

Have your own tips? Leave us a note in the comments!

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