Cancer Fundraising

- ...throughout this dialogue. then we're going to open it up to you to ask questions. so you can go ahead and write those if you want to. if you are one that doesn't like to get up and speak publicly and ask questions, you can actually take 'em to the middle and,

katie, you can pick those up. we've got katie towers over there that will help us. the only thing i would ask with your questions is, because we do have limited time, have those questions that are a little bit more broad-based and not maybe specific to maybe your

particular cancer situation, even though there might be an opportunity you can visit with our panels after the program on maybe some more specifics. so with that, i am going to go and we're gonna take you all the way over here and, first of

all, i'm going to have steve-- steve hodges and he's a cancer survivor, but i'm going to have-- i've asked our panel if they would introduce themselves and just give a brief introduction to themselves. and then we're gonna kinda start over and have them speak

a little bit. - thank you. first of all, i'm humbled to be amongst this group. i'm the least scientific person you're going to hear from today but i'm a two-time care provider for my mother and my son, and a cancer survivor myself so

i'll be talking to you about communicating and impacting families of cancer patients and the patients themselves. so look forward to talking to you in a few minutes. - thank you, steve. - my name is john evans. i'm a family physician with

mcfarland clinic in carroll and i'll be talking about the role of the primary care doctor with cancer. basically, i'll be telling you what i don't do first, but the experts do that, and then i'll tell you the rest of the story and also concentrating

on prevention 'cause that's still a huge part of the whole picture here. - hi, i'm mark westberg. i'm a medical oncologist. i belong to a group called medical oncology & hematology associates out of des moines and we've been doing outreach

clinics for 30 years now, i guess, and been coming to carroll for about 30 years and working with all the fine doctors here. i've been asked to talk a little bit about, i guess, since i'm the oldest person here, the changes that have occurred

during my career and, unfortunately, i'm old enough that most of oncology has happened during my career. - hi, i'm cindy schweers. i'm a oncology certified nurse. i've worked in radiation oncology here at st. anthony hospital for

10 years. and i've been part of the healthcare system here for 37 years. and i'm just going to talk about a nurse's perspective on what i see with my cancer patients on a daily basis. - my name is kim durst and i'm

with the american cancer society and i'm the relay for life community manager here in carroll county. and i'm gonna be sharing information with you from the american cancer society and also share some information on the relay for life and

the incredible volunteerism here in carroll county. - thank you, kim. so if you wanna just take that microphone or mics back down to steve. and steve's gonna take about five minutes and just share a little bit of his perspective

as a local carroll resident and cancer survivor. thank you, steve. having provided assistance to patients, family members, one of the things that would come up occasionally would be the question-- or the statement. and this happened numerous times

and it's-- a lot of the things i'm gonna talk about don't pertain just to cancer patients but that's the reference from which we begin so-- people would say, "steve, i don't know what to do and i don't know what to say." and i thought that would be

a good opportunity-- this would be a good platform for me to tell you what to do and what to say. and we've all in this room been-- and actually most-- especially people in iowa, have a connection with, you know, ourselves, our family members,

we all know somebody that's had this bug. and so i wanted to just share some thoughts with you, some, you know, like i said before, there's nothing scientific about this conversation. so one of the things that i would say is, you know, when

cancer impacts you and your family, the last thing you want-- are gonna think about is all the daily tasks that have to be done. you're gonna think about treatment, you're gonna think about money, you're gonna think about transportation.

and so when somebody comes up to one of us in that situation and says, "what can i do for you?" well, that's the least thing on our mind is what that person can do for us because we've got all this other stuff on our mind. so my advice would be don't ask, "what can i do for you?"

give some suggestions about what you're willing to do and what you can do. and in doing that, maybe they'll come back with another idea or something or don't ask at all, just start doing something. and it's not rocket science. and i'm gonna share some

suggestions with you. you've all got your own list of suggestions as well. but for those that just don't have a clue, that's what i'm here for. the-- another thing i want all of us to remember is not only does the patient need

assistance, but so does their family. and along with that comes the fact that they are going to certainly appreciate anything that we do and, you know what? when we get the opportunity to do it, we're gonna enjoy it every bit as much and we'll get

as much reward out of it as they do. so-- and also keep in mind that cancer is not, you know, okay, i'm going to the hospital, i'll be back on monday and everything will be fine. a lot of times-- sometimes that happens but a lot of times

it's a long drawn-out affair. so when you think about assisting somebody, don't think in terms of, "okay, i'll do this and that's good enough," you know? actually, more people are gonna be interested in helping at first.

six months from now, a lot of those people, you know, naturally they've moved on to something else but the cancer's still there, the family's dealing with it and they still need assistance. so think in terms of the long haul.

one of the things that we can do-- this is beginning of my list. but one of the things we can do: just be good listeners. you know, especially, you know, if it's a family member or a good friend or something, a perfect stranger probably is

not going to be the recipient of a in-depth conversation but the-- hearing the information about the patient's concern or the family's concern. just listening. you don't have the answers and, really, you know, the best counselors in the world are

friends, not professionals. and so we all can be good listeners. and you know, well-intended people have said things like, "oh, it'll be okay," or, "god won't throw anything at you that you can't handle." those are well intended but

they're not nurturing, you know? and so just being a good listener and, if there's questions that you can't answer, refer them to their own physician, to the clinic, to the hospital, to, you know, a litany of different professionals that may be able

to answer that question. and one thing i would wanna make sure that you understand is that the american cancer society has many, many-- they have a great website and it's a good opportunity for anybody to gain valuable information. and the next thing i wanted to

talk about was just a simple thing like sending cards. and surprisingly, funny cards or uplifting cards, nurturing cards. not downer cards. i could give you a short story about a woman who used to work in my department when i was

at new hope. and her husband had leukemia, they thought probably caused by agent orange in vietnam. and because he was a veteran at that time-- this was quite a while ago-- the closest place where he could go for a bone marrow transplant was the

state of washington. so every week, and they were there for several months, and every week i'd send 'em a funny card. and 25 years later, i run across this lady here in town and what the first thing out of her mouth was, "i remember you sending

those cards once a week and how much we looked forward to those cards and how it always made us laugh." that's just a simple thing but, here it is, 25 years later, and she's thanking me for doing a simple thing like sending out cards. so here's some other

suggestions. again, like i said, this isn't rocket science. cut the grass, move snow, and you don't have to ask. just go do it. but-- and then take the family, take the patient, take 'em out to eat, go to a movie.

watch their house while they're gone. stay with the patient while the family goes out. watch their kids. take care of their pets while they're away from home. buy them gas cards. buy them gift certificates to

favorite restaurants or restaurants close to the hospital. give them rides. have a fundraiser. and here's another good one. get together with other friends of theirs and plan meals and snacks.

pull weeds in the garden. go to the comedy club. and patients and caregivers out there, please let us help you because we're gonna get every-- you know, we're gonna get as much out of it as you get and so we'd appreciate the opportunity to help others.

- thank you, steve. so you've been very helpful in providing very detailed specific ideas of not only just the perspective of a survivor but what caregivers can do when we have our loved ones being told that they have cancer. okay, we're going to turn to

dr. evans, and go ahead, dr. evans. - okay, thanks. so my talk is about what a primary care provider would do with a cancer patient. and when i visit with a cancer patient right after their diagnosis, i often sit down and

i kinda tell 'em what i don't do first and they look at me kind of strange and i say, "well, i don't do chemotherapy. that's the medical oncologists. and i don't do radiation therapy. that's the radiation oncologists. and i don't do surgery.

that's the surgeon." and they look at me, like, then why am i here? and so i think it's important that-- cancer changed their life, no question, but you have to look at the rest of the patient and how it affects 'em and how it affects their

family and how it affects all their other illnesses and also these really important for a primary care doctor to be a coordinator of their care, to be sure that the left hand knows what the right hand's doing, to be sure that when they got back from their chemotherapy that

they really understood what they went through and what's coming next. we have to wait for the cat scan, we have to see, you know, kinda help 'em walk through it. a lot of times, the medical lingo and the words get pretty heavy so, you know, we talk

a lot about what happens to them physically. are they having pain? are they on pain medicines, are they having side effects, are they constipated? those are the little things that can make a big difference. emotionally, how is it affecting

them? how is it affecting their family? children, their parents? co-workers? would they benefit from counseling or medication? a lot of times, just talking about it, just asking 'em how

they feel can really help because life-changing events are always emotional. what are their other diagnoses? are we looking after hypertension, their diabetes, their heart? you know, cancer changes their life but it didn't change

everything else so we have to be sure that we're taking care of those other things. are we screening for other cancers? you know, we get past the initial treatment and a few years out, well, we can't forget about the other things too.

are they-- how are they doing nutritionally? do they need some help? do they need to visit with the dietician? are they physically doing well? would a therapist be helpful, an exercise program? resources, like acs, american

cancer society, community members, other support groups, things like that can be very helpful to a patient and their families. and the other main emphasis that i would stress as primary care is prevention. we get to see patients,

hopefully, long before they have cancer and hopefully try to prevent that from ever occurring. certainly, all cancers can't be prevented, maybe someday they can, but there's a lot of low-hanging fruit, as i call it, out there.

and of course, the biggest one is smoking. can't be over-stated how important it would be if we lived in a society that didn't have smoking. and how much that would affect the health of the society and the economic impact.

that alone would be enormous. one that hasn't got enough attention is skin cancers and sun damage, melanomas, tanning beds. basically, people under 35 shouldn't be in tanning beds. and getting burned, especially when you're young, is

particularly worrisome for later. melanomas are deadly and they're a major source of illness and death in our young people. the other cancers-- colon cancer can be prevented with screenings. colonoscopies, primarily, can

catch it in the polyp stage and prevent cancer from ever those three alone would save many, many lives if we got everybody on board. and as patients and community, you can educate each other. and events like the relay for life bring awareness to

the community and people get talking about those things 'cause they're not always fun topics to talk about, especially over a thanksgiving dinner. other cancers that can't necessarily be prevented but detected early are very important to get screened for.

breast cancer being a major one. catch it early, very treatable. catch it late, not so much. prostate cancer has gotten a lot of, i think, negative press but i think it's still important to talk about. i think it's important to know where patients are and what

their options are. and another thing, i think, is really important with any cancer or any patient is, are things changing in your body? does your skin look different? is there a new lump? do you not feel right? do you have a new pain?

do you have something you can't explain? something that won't go away? certainly won't always be cancer but oftentimes, those are early signs of cancer that, if found early, are very treatable. and that's really the key, i think to primary care is

prevention, early detection, getting people to the right people to get the definitive treatment. so i will not blabber on anymore and pass it on to my good friend, dr. mark. - thank you, dr. evans. dr. westberg?

- i've been asked to talk about the changes that i've seen and, quite frankly, they've been pretty dramatic. as was alluded to in the film, cancer is not just one disease. it's a lot of different diseases and there's no way i can talk about everything that's happened

in every cancer. when i was a resident, back in the early '70s, we had a handful of drugs that we could treat cancer with, probably no more than 15 or 20. now, there's literally hundreds of drugs and many of them, very effective.

i just want to pick up breast cancer. they've already alluded to the fact in the film how surgery has changed dramatically over our practice lifetime. back in the '40s and '50s, as they said, the surgeons thought more was better.

and when they weren't curing people with mastectomies, they thought, "well, let's cure 'em with radical mastectomies," that being, let's take the muscle along with the breast. and when that wasn't enough, they even went as far as taking lymph nodes from the center of

the chest. none of that changed the outcome, unfortunately. and then bernie fisher came along and did his trials and that resulted in women having less radical surgery but it didn't improve anybody's survival because they were still

dying of breast cancer. so they decided, like bernie fisher said, this is a systemic disease so we need a systemic treatment. and actually, the first systemic treatment happened in the '50s and what they did was they went into the operating room and,

as the woman was having her mastectomy, at the very same time, they injected a drug called cytoxan. just one single dose. and surprisingly, many years later, those trials were still positive and the women who got that treatment had less of

a chance of recurrence than the women who didn't. for some reason, that never really caught on until the '70s and they started doing randomized clinical trials. and unfortunately, in medicine, that's the only way you ever know anything is if you compare

two groups in a randomized fashion and it takes a lot of time. the first trials were done comparing women who both had the same types of surgery. and half of 'em got chemotherapy and the other half didn't. if you can believe this, when we

started this way back in the '70s, the chemotherapy lasted for 2 years. two times a month for two years, you got chemotherapy. and they found that those women lived longer and had less recurrences than women who didn't get the chemotherapy.

the next clinical trials worked well. if that's helpful, maybe less is better. let's go compare one year to two years. and they found out one year was equivalent to two years. so now all of a sudden, the standard became

one year of chemotherapy. the next trial was six months versus a year and they found out six months was just as good as a year. so that became the standard. they then compared four years to six-- or four months to six months and found out four

months was not as good as six months so that's how, at that time, six months kind of became our standard. that was still very indirect treatment, though, in that we thought cancer was just one thing and breast cancer was just one thing and it really isn't.

since then, we've discovered markers on the tumor cells, what we call estrogen receptors, and these cancers behave differently than women who have tumors that are estrogen receptor-negative. there's another marker called her2/neu, which stands for human epidermal growth factor

receptor, and those tumors behave differently. and that opened up a whole new area called targeted therapy where women who are estrogen receptor-positive now, all of a sudden, we can treat them by removing the effects of estrogen in their body.

their tumors are driven by estrogen, if you will. initially, that was done with oophorectomy. take the ovaries out, you remove estrogen, even in post-menopausal women, and sometimes these tumors would shrink down.

since then, we've gotten drugs that eliminate the need for tamoxifen was one of the first ones and now there's another generation of drugs. there's a drug called herceptin which attacks the human growth factor receptor and that's made probably the biggest improvement

in breast cancer survival for that group of women. so you can see things have changed dramatically in breast cancer. we obviously have a long ways to go but things are moving in the right direction. - thank you very much,

dr. westberg. cindy? - hello. tonight, i'd like to focus on the personal aspects of cancer and what i see from a nurse's viewpoint on a daily basis. i am so lucky to take care of the most incredible people

in the world. i get to see not only the cancer aspect of patients but i get to know them as a person. i get to know their families and i get to know the devastating effects that cancer has on these wonderful people, from emotional to physical to financial.

i get to see the resiliency of patients, the capability of a strained body to recover, the capacity to withstand stress and catastrophe. one topic i'd like to discuss tonight is lung cancer. i am disheartened to witness the number of young people

smoking and are chewing tobacco. the american cancer society and many other organizations have done a fantastic job of getting the message out there about the side effects of smoking, stating facts and offering many smoking sensation programs. i have seen patients time and

time again wishing they had stopped smoking years ago. cancer does not know age, race or sex. i have witnessed patients in their 20s and 30s die of this terrible disease. the physical and emotional toll is tremendous but the financial

toll is devastating. oftentimes, these patients cannot work due to their illness and, at times, they are need of spouse, parent or significant other to care for them. the information is out there but no one thinks it will ever happen to them.

i am hoping and praying that through continued education, these people will stop smoking or never start. - thank you, cindy. and last but not least, we've got kim durst. i'm gonna turn this a little bit here, kim, so that you can see

the powerpoint. - thanks. - you're welcome. - i work with the american cancer society and i am the relay for life community manager for here and i also work in three other counties to assist in

the planning of the relay for life events, which is the signature fundraiser for the american cancer society's lifesaving mission. carroll county, along with my other counties, show incredible volunteerism. and carroll county has

record-breaking fundraising as well as showing incredible support for their survivors in this community. and this is their way of fighting back and making a difference. with the american cancer society, it is an organization--

oh, there we go-- that is passionately committed to fighting every cancer and helping every community. and contributions that the society benefits people everywhere, regardless of where they are donated. and we're the largest

community-based voluntary health organization in the world, with four million dedicated volunteers saving lives from cancer every day. cancer has a huge impact on our families, our communities, our country and our world. and that's why

the american cancer society is working so hard to finish the fight against cancer. every year, more than 1.6 million americans hear those words, "you have cancer." it's likely that everyone here today has either helped a loved one, a friend, a colleague,

after a cancer diagnosis or have heard those words, "you have cancer." 1.6 million people are expected to be diagnosed with cancer in 2014-- excuse me, in 2015, and more than 585,000 will die from this disease, which equals almost 1600 people per day.

almost 14 million americans, though, are survivors with a personal history of cancer. some are cancer-free and others are dealing with diagnosis right now. for both men and women in our country, cancer is the second most common cause of death,

exceeded only, very slightly, by heart disease. and cancer accounts for nearly one of every four deaths. here in the state of iowa, they are predicting that 17,630 people are diagnosed with-- will be diagnosed with cancer this next year.

and 6380 people die from cancer-- will die from cancer in the next year. but hey, there is good news so look up because, right now, the cancer mortality rates in the us have fallen by 22% during the past two decades. and that's more than 1.3 million

cancer deaths averted or 500 lives saved from cancer every day. the american cancer society is working to save thousands of lives a day domestically and, one day, 10,000 lives a day worldwide. the american cancer society's

work benefits in every community. although the answers to cancer may not be found here in carroll county, our community helps fund those answers and cures and ultimately benefits from them. and we focus on four different

things. we focus on care. we help people get well. one million people touched by-- each year, we help nearly one million people touched by cancer-- excuse me, my sheets are-- let me back up a minute. okay. we help people stay well by

discovering new ways to prevent cancer, to find it early, spreading the word, setting early detection and prevention guidelines, and promoting cancer care. you know, we help people. each year, we help nearly cancer get the help they need

when they need it. our cancer information specialists answer questions, provide information for people who are dealing with symptoms, pain and stress of cancer and its treatment, navigating the healthcare system, getting rides or finding lodging

and more. whatever help they need, they can call this cancer resource network 24 hours a day, seven days a week, at 800-227-2345. and there's cards on your table to please take home with you to share, whether you need them or you want to give them

to a loved one. we help wherever you need help and we have 45 million visitors to the cancer.org website. cure. we are the largest non-profit. we are the third-- excuse me, we're the largest non-profit funder of cancer research,

contributing to nearly every major cancer research breakthrough and funding 47 nobel prize winners. the site is currently funding 46 grants, totaling more than $24.5 million in the midwest division, and eight research projects just here in iowa,

funding $4.6 million. and we help people fight back. together with our non-profit, non-partisan advocacy affiliate, cancer action network, we have helped enact policies that prevent cancer such as smoke-free laws and others that prevent and curb cigarette

smoking, educate lawmakers on policies that provide access to quality and affordable healthcare, as well as including life-saving cancer screenings and treatments and we encourage increased federal investment in cancer research. one of our primary focuses this

year and for the next few years is 80% by 2018. march is national colon cancer awareness month and the american cancer society is joining forces with nearly 200 organizations toward a shared goal of increasing colon cancer screening

rates nationwide to 80% by 2018. and currently, we're only at 65% and although death rates have decreased by 47% since 1978, one in three adults aged 50 to 75 have not had their cancer screenings for colorectal cancer. educating the public on how

screening saves lives and the simple affordable options that are available is so important. colorectal cancer is the second-leading cause of cancer deaths in men and women combined. and it is preventable, treatable

and beatable. - you may have to skip to-- right, we may have to go to the relay for life [multiple speakers] - so we have an opportunity for community to ask questions. - and real quick, one degree. we're all one degree away from

cancer. and this is something where we're promoting where all of us are one degree with being touched by cancer or having cancer. we have a loved one, family, friend, and so with this, you know, we're working with

legislatures to boost the federal investment in cancer research. and so i'd like to invite everybody to attend. to find out more how you can volunteer with the relay for life, you can visit us next week at the kick-off and that will be

held at the santa maria winery on thursday, march 26, starting at six p.m. we'll work with you and share with you how you can become a team, volunteer, be a sponsor. and as a survivor, please come and celebrate with us because you are why we relay.

and our event for this year, for 2015, is at the carroll stadium on friday, june 26, starting at noon. so we truly hope that you'll join us and be a part of the incredible volunteerism in carroll county in fighting back against cancer.

- thank you. thank you, panel, for sharing your story. and now this is the time for you. we've got-- we wanna get you out the door by 7:30. we're not gonna keep you 'til-- we don't have midnight snacks or

anything like this so we wanna be respectful of the time. and you have been here for quite some time but we want the next few minutes here is if anyone-- here you've got your panel of experts that come from a wide range of perspectives, from survivor to physician to nurse

and to community manager for the relay for life. so if you've got any questions or you wanna hand over any questions to me-- yes? audience: one of the doctors. is there a genetic predisposition for a certain type of cancer to run in

families? - okay, so the question is, "is there a genetic predisposition for cancer, particularly in families?" am i correct? "certain types of cancers that may run into families," so-- - yeah, there certain is--

- do you wanna move your mic, dr. west-- there you go. thank you. - there certainly is. breast cancer's a good example of that. we've known for a long time that if a woman has a first-degree relative that has had breast

cancer, particularly if that person is pre-menopausal, that she has a higher risk of that has been-- or led to testing for what we call brca and what that is, that is a test that looks at the actual genetic makeup of a person. and there's two tests, brca1

and brca2, and if a woman is positive for that, then her offspring has an increased risk of breast cancer both-- and in brca2, both males and females can get breast cancer, for instance. there's a gene for polyposis of the colon that leads to colon

cancer so, yes, there is, but certainly not all cancers are genetic and women ask me sometimes, "how come i have breast cancer? i don't have anybody in my family with breast cancer." and the answer to that is you grew up in a western country.

women who grew up in western civilization, for reasons we don't understand, have a much higher risk of breast cancer than women who grew up in japan, and if you take somebody from japan and move them to the west, within a generation, their risk is equal to somebody who grew up

in the west. so there's a lot of things we don't understand about it too. anyone else? i've got a couple questions here. did anyone else have questions that katie could pick up? if you could just raise your hand.

anyone here have a specific question you'd like to ask? yes? i'm sorry-- audience: i would just like to ask dr. westberg, do you think that the cost of some of the new designer drugs are going to become so prohibitive that in

our country people will even become less able to receive those drugs? - yeah, that is an excellent question. and that was alluded to in the documentary. it astounds me every time a new drug comes out how much more

expensive it is than the drug before. and when i first started in oncology, a drug called adriamycin, for instance, i think it cost about $90. now there's another drug that we use along with adriamycin to treat lymphoma and that costs

about $9000. and there are drugs now that literally cost about $30,000 a month. and at some point, society isn't gonna be able to pay for it. i've been a big proponent of controlling drug prices. we're the only country that

doesn't control drug prices. and i'm kinda getting political here but my own opinion is i think we're subsidizing the rest of the world. - okay. i've got this question but i think there was someone else here. yes? go ahead. and who--

audience: prostate. doctor, what's the way you check the prostate? do you do it by blood, or do you do a manual check on them first? - so the question was with prostate cancer, and there has been a lot of questions about what is the appropriate way

for testing. - it's a good question on the prostate cancer. the digital exam is probably fairly useless unless you can find something suspicious. you only get to observe about a third of the prostate through a digital exam so you're not

looking at much. so if you have a negative visual exam, it doesn't mean a whole lot. the blood test is not perfect, the psa test. it's undergone a lot of scrutiny because not every prostate cancer is invasive and will kill

a person. it's a very-- it's very different than many other cancers. if you live to be 80, your chance of having prostate cancer as a man is very, very high. but that doesn't mean you're gonna die from it. so if you have prostate cancer

as a younger man, and particularly under 60, it's much more likely to be aggressive, invasive and likelier to die from it. so the short answer is the blood test is still the best thing we have but it's still not great. and my advice would be talk to

your doctor about getting screened, see what your family history is, especially if you have a young person under 60 and the family with breast cancer. black people are more likely to have prostate cancer. and see if you do have a rising psa, is it cancer?

if it is, is it invasive cancer? is it something you can watch? is it something you should treat? past 75, most people don't recommend testing at all with blood test and i think that's pretty reasonable because if you acquire it after 75, it's

unlikely to take your life. thank you very much, dr. evans. anyone else have any questions about survivorship, early detection, prevention, how we can fight back against this disease? anyone have a specific question they-- this is your time.

you've got your experts. if you've got the questions, they, hopefully, will have the answers. okay, i've got this question here and if you've got also some thoughts and you don't feel comfortable asking it out loud, feel free to right this

question. this is also to our physicians. "there are men who get breast cancer and the question is, is their treatment the same as women?" and then there's another question added, "and is the cure success rate the same as men and

women," referring to breast cancer. - first of all, male breast cancer is relatively rare. many of the men that we see with male breast cancer are brca2-positive, which we talked about a little bit, earlier. we do treat it fairly similarly.

the surgery is similar. the adjuvant therapy that we use is similar. the cure rates are not as good, probably because men, if they notice a lump in their breast, say, "gosh, i can't have breast that must be something else," most men don't realize they can

get breast cancer. the other thing is men aren't screened for breast cancer, obviously, because the incidence is so low. so oftentimes, it's discovered at a later stage. and then, i've got a question for cindy.

cindy is our radia-- a nurse in the radiation department at st. anthony's regional hospital. and cindy, let me ask you this "my doctor is recommending radiation and i'm very concerned about the types-- this particular type of treatment and the side effects.

you, as a radiation nurse and dealing with this, can you address some of those concerns or questions people might have?" - yes, many times i'll have a patient come in and say, "well, you know, i was at the coffee shop and talked to somebody that had cancer

20 years ago and they burn 'em and i'm just not gonna have treatment." and i hear that more often than not. and what i want people to understand is how things have changed in the last 20 years and how more targeted our radiation

treatments are. and at one time, we did not spare a lot of the healthy organs and tissue when we were treating different types of cancer with radiation. but the machines have gotten so much better and we're able to spare a lot of the vital organs

and tissue surrounding it, parts of the colon when we're treating prostate cancer. things have improved greatly. - i've got just a couple more minutes here, 'cause we wanna get you out of here by 7:30. but i have one question that i'd like to open up to the panel and

whoever feels that-- maybe everyone can kind of give their ideas on this. but you know, the data shows that treatments and we talked about the expensive cost of cancer, but the treatment can cost much more than annual incomes of most families.

and so i'm going to ask kind of a challenging question, is that how can we change and help support families in these circumstances? and how are you seeing other communities such as carroll helping to support families going through not only cancer

but some of the financial challenges that they're faced? dr. westberg: i'll just start out with that. the biggest thing that you all can do is write to your legislators. they don't listen to us, okay? quite frankly, legislators don't

like doctors very much. we aren't big contributors to campaigns and that kind of thing. so they really don't like our lobby. but they really, really do like you guys and if you get in and, god forbid, you would have

cancer, and you find out, "oh, my god, i'm getting a pill that's costing me $10,000 a month and my co-pay is $4000 a month," which is not unusual and, "they've had to scramble to find me co-pay assistance so i can afford it," write to your legislator and tell 'em about it

and tell 'em you aren't happy about it. i think that's the biggest thing that will change this. - thank you, dr. westberg. anyone else wanna chime in on that? it's a hot topic. - go ahead.

- and knowing that we just have a couple of minutes here. - yeah, that's, you know, that's the only thing that's gonna change. those huge numbers are just unfathomable to most people to be able to afford that. the little things that'll, i think, as steve mentioned, are

the fundraisers and helping people with meals and helping them with transportation and all of the little things that add up and end up costing a lot of money. the big-ticket items, the chemotherapy, those are hard to control locally but

the little things make a huge difference and they do add up. and i think small towns are great at rallying around their relatives, neighbors and friends, and carroll county's done a great job. we've had many, many stories with that and so all these crazy

fundraisers and things really do make a difference and, having that support, both financially and emotionally, makes a much more positive outcome on cure rates, i think, when people feel like they're getting help. so you can do something. getting politicians to change

their mind is probably where it's at. that's probably not as easy as, you know, donating and making dinners and driving people so that's what i would say. anyone else wanna make a comment on that topic? okay, with that, i wanna thank--

thank you, as the panelists, and you, as a community, participants, watching ken burns' documentary and having these questions. but i do wanna also acknowledge and, katie towers, if you wanna share anything, i also wanna thank st. anthony's regional

hospital for opening up their doors, their beautiful facilities, and just acknowledging the fact that you also have a state-of-the-art cancer center here and are very fortunate to have treatment here in carroll. but katie, would you like to

share just anything so anyone here is aware of some of the treatments-- yeah, we wanna have you heard. - microphone. - yeah, it's the big one. - well, i just wanna say thank you very much to the iowa public television,

to the cancer care consortium, to the american cancer society, for bringing the preview to carroll. i'd also like to thank our panel of experts for taking the time this evening and for letting us put you through your paces. when we asked you to volunteer

to be on the panel and then we said, "oh, and could we meet with you to plan the panel? and then could we meet with you to review the program?" so we know that it's been a couple of extra meetings and i think it's been a wonderful opportunity to raise awareness

about cancer. we also have, as a follow-up, the relay for life kick-off rally next thursday, as kim mentioned. and i think that's one thing that carroll county and the surrounding area does very well is to talk about cancer and

to talk about the things that we can do, both large and small and we think that we're moving in the right direction in trying to move the marble along with our partners at the american cancer society, iowa cancer consortium, the iowa department of public

health. so thank you very much for being here this evening. - and i wanna give a nice warm applause to our panel and also to iowa public television for allowing us this opportunity to get together, have a nice reception and be able to watch

ken burns' documentary. and mark your calendar for march 30th, 31st and april 1st, and tell your friends that this is gonna be a phenomenal film and it's gonna get people talking and, hopefully, we will someday be able to say that we don't have

to say those words that you have cancer. so thank you very much. [applause]