St. Joe’s Highlights Importance of Early Detection During Breast Cancer Awareness Month

Amy Kirby, MD, FACS

In recognition and celebration of Breast Cancer Awareness Month in October, Amy Kirby MD, FACS, recently participated in a Q&A highlighting the importance of education and the early detection of breast cancer.  Dr. Kirby is a board-certified general surgeon specializing in breast surgery and serves as medical director of the Breast Program at St. Joseph Mercy Oakland hospital.

1. How many people are diagnosed with breast cancer each year?

According to the latest cancer research, there are more than 270,000 new breast cancer diagnoses annually in the United States.  In 2019, it is estimated that more than 42,000 people died as a result of their diagnosis.  Closer to home, 9,310 new cases of breast cancer occurred in Michigan in 2019 and more than 1,400 deaths.

2. Does breast cancer only impact women or is it something men need to be concerned with too?

I do treat men for breast cancer, however, by and large the vast majority of my patients are women.  The lifetime risk of breast cancer for men is 1 in 833, versus 1 in 8 for women.  To put this in perspective, men account for only 1% of newly diagnosed breast cancers each year.

3. When and how should women self-examine for breast cancer?

There are varying opinions within the medical community as it relates to the efficacy of self-exams for breast cancer, however, I strongly believe that women should do a monthly self-exam. 

I have had many patients who have identified cancers through self-exam.  Women know their bodies and should notify their physician if they suspect something doesn’t feel right.

4. At what age should women begin screening for breast cancer?  What should they do if they have a family history of breast cancer?

Women at average risk for breast cancer should begin annual mammograms at age 40.  Women with a family history of breast cancer should begin 10 years earlier than the age when their family member was first diagnosed or at age 40, whichever comes first. 

For example, if a woman’s mother had breast cancer at age 45, the daughter would start her annual mammograms at age 35.  If the mother had breast cancer at 55, her daughter would start mammography at age 40. 

Additionally, women who are considered at high risk (a lifetime risk of over 20%) should have a breast MRI performed in addition to annual mammograms.

5. Are there support groups or other resources for people currently fighting breast cancer?

As is the case at many Saint Joseph Mercy Health System hospitals, St. Joseph Mercy Oakland offers a support group led by breast cancer nurse navigators.  Our navigators are trusted partners that help patients along their care journey.  From diagnosis, through treatment and into recovery, our navigators are available to provide guidance and support.  Our cancer resource center offers additional supportive services for patients and their families.

6. Is there any other information you think is important for people to know about breast cancer?

As women, I know we have busy lives and that it may seem overwhelming at times.  The best advice I can give is to get your annual mammogram and to attend wellness visits with your primary care physician.  Breast cancer treatment is usually very successful, but the most important factor is its early detection. 

We have made remarkable advancements in the treatment of breast cancer.  Women now have access to personalized care plans depending on their particular cancer’s features.

In addition to screenings, Michigan residents should also know that our cancer trials remain open and available amid the COVID-19 pandemic to any patient that meets trial criteria.  I highly encourage all those battling cancer to speak with your doctor and ask if you qualify.

Be a Team: Breast Cancer Survivor Leads Pandemic Response for St. Joe’s and Mercy Health

As the top physician executive of Trinity Health Michigan, Chief Clinical Officer Dr. Rosalie Tocco-Bradley leads St. Joe’s and Mercy Health’s response to the COVID-19 pandemic. As a breast cancer survivor, she remains focused on safely managing her health through routine follow-up exams, staying active, and self-care.  

The following article from Gift of Health has been updated to include Dr. Tocco-Bradley’s progress during the pandemic year 2020.

In this photo from 2018, St. Joe’s care team gathers around their patient, Dr. Rosalie Tocco-Bradley (center). From L-R: Paul Izenberg, MD; Samuel Hirsch, MD, Lynn Joynt, MD; Julie Soriano, MD; Walter Sahijdak, MD; Michael Dorsey, MD, Beth Kimball, MD; Kathleen Beekman, MD, and Jennifer Kulick, MD,

When Rosalie Tocco-Bradley, PhD, MD, Chief Clinical Officer of Trinity Health Michigan thinks about cancer care, she thinks about the team – St. Joe’s experts from multiple fields of medicine and surgery who are there to diagnose, treat and care for our patients.

When she thinks about cancer, she thinks about her mom and even more so her sister, Maria.  “Losing my baby sister to breast cancer left a hole in my heart.  When I think about my personal relationships and all the families we see impacted by cancer, I know I have to do everything in my power to help St. Joe’s and our physicians make care better.” 

Hearing Dr. Tocco-Bradley talk about her sister and the medical team and programs she leads, you understand why she’s described as inspiring, resilient, caring and dynamic.  Her strengths are rooted in experience.  Dr. Tocco-Bradley has not only seen cancer through the eyes of a doctor, administrator, donor, sister, and daughter, you can add patient to that list – she’s fighting the disease herself…for a second time.

“Ro” with her sisters Vinnie, Maria and Toni, taken six months before Maria passed away from cancer.

Even knowing the increased risk factor of family history, Dr. Tocco-Bradley was surprised when she first found a lump in 2007.  “I always had screening mammograms, but I could feel something different,” Dr. Tocco-Bradley said.  “I went in for more testing, and the minute my radiologist walked in to speak with me after my mammogram, I knew.”

Dr. Tocco-Bradley relied on the team at St. Joe’s to treat her breast cancer.  “Most people don’t know how many clinical specialties are actually involved in caring for a cancer patient.  It takes a village.  They saved my life.”

She underwent aggressive therapies – a mastectomy on the right side and chemotherapy, including Adriamycin, known as the red devil, which caused severe nausea and fatigue.  “I’m a hearty girl,” Dr. Tocco-Bradley said. “But I was as sick as a dog.”  With fighting spirit, she continued working throughout treatment and reconstructive surgery. 

In less than a year, Dr. Tocco-Bradley was back to full health and full action.  At home as a wife, mom, host family for USA Hockey players, and biker in the Make-a-Wish/Wish-a-Mile, and, professionally, treating patients, in the OR and pain clinic through Anesthesia Associates of Ann Arbor, going to business school, reviewing grants for Susan G. Komen, mentoring young women interested in medicine, and going on medical mission trips through ReSurge to underdeveloped countries. 

Then, in 2017, Dr. Tocco-Bradley found another lump.  The breast cancer was back.  Without hesitation, she turned to the team at St. Joe’s again who have given her a good prognosis.  “You know, my care has been extraordinary,” she said.  “My doctors, nurses and staff have been available, answered my questions, and collaborated between the various specialties.  I trust the St. Joe’s team with my life.” 

In gratitude for the care she received and would receive and as a leader who is dedicated to continued improvements, Dr. Tocco-Bradley and her husband, Dr. Brian Bradley, were lead donors to the “Life is Remarkable” campaign with a gift of $25,000. 

Donors’ generosity was an investment in St. Joe’s cancer program and team, and the renewal of our Robert H. and Judy Dow Alexander Cancer Center, which reopened in 2018.

“Every family will be touched by cancer and if you don’t know it already, you will know how great it is to not just have a facility, but also a great team to care for you.”

2020 Update:

As the health system’s top physician executive, Dr. Tocco-Bradley leads Marcy Health and St. Joe’s coordinated response to the COVID-19 pandemic. As a breast cancer survivor, she remains focused on safely managing her health through routine follow-up exams, staying active, and self-care.  

How are you doing?  What treatments did you receive?

Following my 2nd mastectomy and 30 rounds of radiation, my energy level was low for some months but now I’m back to my usual fast pace.   During recovery in 2018,, I needed to reduce by Make a Wish fund raising ride from 300 miles to 50 miles but was delighted to manage 300 miles in 2019 – although I seem to be slowing down – LOL.   I view every day as a gift.   In terms of ongoing care, I continue to receive an infusion of Zometa twice a year to diminish my risk of metastatic bone disease and see my oncologist and breast surgeon annually.     

How have you approached continuing recovery and well-being throughout the pandemic?
I never take any day for granted.   I know that being able to live a healthy life is a gift but also takes personal commitment post-breast cancer and during the COVID19 pandemic.  I am acutely aware that the pandemic has created many hardships for people both emotionally and physically.   I attempt to model healthy and safe behaviors for my family, friends and colleagues at work.   And I am blessed to continue serving in a clinical leadership role through our COVID19 response team

As women pay attention to breast health, how safe are mammograms at St. Joe’s right now?
Seeking a mammogram at St. Joe’s is completely safe and essential for women’s health.  I was absolutely adamant that we re-establish our access to mammograms at St. Joe’s as quickly as possible following our first surge of COVID19.   We are now in a great position to provide safe care with our screening protocols, masking and PPE adherence and cleaning protocols.  Mammograms save lives and reduce unnecessary advanced breast cancer disease in woman.   Please don’t stay away.  We are here for you.

To learn more about remarkable care and how you can make a difference, visit:

St. Joe’s Giving Page

Mercy Health Giving Page

Harvest Vegetable and Farro Salad

Serves 6

1 cup serving

Ingredients

Salad

1 cup farro, uncooked

4 cups root vegetables, diced (beets, carrots, parsnips, butternut squash, etc.)

1 can chickpeas, no salt added (NSA), drained, liquid reserved

1 apple, diced

Dressing

2 tbsp reserved chickpea liquid

2 tbsp red wine vinegar

2 tbsp lemon juice

1 tbsp stone ground mustard

¼ cup fresh chives or green onion, chopped

¼- ½ cup fresh parsley, chopped

Directions

  1. Pre-heat oven to 400°F
  2. Place cut root vegetables on a silicon mat lined baking sheet. If not using a silicon mat, use parchment paper or non-stick aluminum foil. Bake root vegetables for 25 minutes. Let cool before combining with other ingredients.
  3. While vegetables roast, cook the farro. Combine 1 cup farro with 2 cups liquid (water or NSA vegetable broth) in a medium saucepan. Bring farro and liquid to a boil, cover and reduce to simmer for 15-20 minutes.
  4. Combine cooked farro, roasted vegetables, chickpeas and apples in a bowl.
  5. To prepare dressing, whisk remaining ingredients together and pour harvest salad.   
  6. Enjoy!

Notes

  • Kuner’s brand of no salt added chickpeas are available at Meijer. Alternatively, if you cannot find no salt added chickpeas, look for low sodium beans where the mg of sodium are less than the calories per serving.
  • Using a silicon mat allows you to cook and bake without the need for oil. Find a silicon mat or “silpat” at Meijer, Walmart, Target or Bed Bath and Beyond.
  • Feel free to substitute the farro and chickpeas for any other whole grain or NSA bean. 

Sean’s Recovery Journey: Fighting COVID-19 and a Stroke with Help from St. Joe’s

After 64 days in the hospital recovering from a stroke and COVID-19, Sean received an enthusiastic clap-out from staff, and a warm welcome home from his family.

OAKLAND – Sean McCusker, a 51-year-old husband and father of three from Livonia, has faced immense challenges in the last six months. Diagnosed with both COVID-19 and a stroke at the same time, he lost his ability to walk and speak fluently, and has battled hard to recover. His determination, along with caring staff members and loved ones, have made his recovery possible.

Sean’s journey began in late March, when he first experienced symptoms of COVID-19. After a telemedicine visit with his primary care provider, he was instructed to quarantine at home, as his symptoms were generally mild. He had a low-grade fever, which dissipated after roughly ten days of quarantine. On the thirteenth day of Sean’s quarantine, he was home with his children when he suddenly began to have difficulties speaking and moving his right arm. He was taken by ambulance to St. Mary Mercy Livonia, where staff determined he had suffered a stroke.

Sean was transferred to St. Joseph Mercy Oakland for stroke treatment. While there, he also tested positive for COVID-19. It remains unclear if his stroke and COVID-19 diagnosis were related, though there is some evidence that COVID-19 may increase stroke risk. Sean required ventilation support for a few days, and then moved to the ICU. His wife Marla shared how difficult this time was, as COVID-19 restrictions meant visitors were not allowed: “It was so hard to not be able to see him. The staff was amazing though; they’d put on PPE and hold a phone up to him so we could FaceTime.”

Continue reading “Sean’s Recovery Journey: Fighting COVID-19 and a Stroke with Help from St. Joe’s”

With Help from Family and St. Joe’s – COVID Plasma Patient Goes Home

St. Joseph Mercy Ann Arbor patient Richard Beckerson was discharged home this week after a long, but successful healing journey.  Back in April, Mr. Beckerson became one of the first COVID-19 patients in Michigan to receive an experimental treatment using plasma from a person who had recovered from COVID-19 in an effort to treat the virus.

With his family’s support, Mr. Beckerson was enrolled into an innovative convalescent plasma program started by The Mayo Clinic with participation from St. Joe’s and hospitals throughout the country.

After four months in the hospital, Mr. Beckerson was met with a celebration from the staff while being discharged home.  Hospital colleagues applauded as he walked out of the hospital with the aid of a walker. Watch Mr. Beckerson’s triumphant discharge from the hospital.

Mr. Beckerson first arrived to the St. Joe’s Emergency Department on March 29 while experiencing respiratory distress.  During his hospitalization, St. Joe’s physicians, nurses, therapists and other support staff worked tirelessly on his behalf as he fought to survive and then rehabilitate himself.

If you have recovered from COVID and would like find out how to donate plasma to help others, click here.

Curried Quinoa Patties

By Alexandra Babcock, MPH, RDN

Enjoy these light, healthy and tasty recipes brought to you by the Lifestyle Medicine Team!

Makes 4 servings

Ingredients

1 cup quinoa, cooked

½ cup carrots, shredded

½ cup mushrooms, minced

2 Tbsp ground flax

6 Tbsp water

1 Tbsp curry powder

1 tsp cumin

Directions:

  1. Lay out cutting board, knife, cheese grater, sauce pan, small mixing bowl, measuring spoons, and mixing spoon. You will also need a greased cookie sheet. Preheat Oven to 350F. Wash all vegetables.
  2. Rinse ½ cup of quinoa under water until water runs clear. Add the quinoa, 1 cup of water, and a pinch of salt to a sauce pan. Bring to a boil then reduce to a simmer until the water is cooked off. This will take approximately 10 minutes. Stir with a fork and set aside to cool. 
  3. While quinoa cooks, peel your carrot. Grate carrot over the cheese grater and place ½ cup into a mixing bowl.
  4. Cut your mushrooms until they are in ½ cm sized, minced pieces. Add ½ cup to the mixing bowl.
  5. Place flax and water into a small bowl. Stir and set aside for 3 minutes until the flax meal gels into a flax egg. Then add the “egg” to the mixing bowl.
  6. Add remaining spices and cooked 1 cup of quinoa to the mixing bowl and stir until combined.
  7. Form 4 patties about a ½ cup each using your hands. Place on the cookie tray.
  8. Bake at 350F for 20-25min or until golden brown.
  9. Serve immediately or freeze in bags for up to 2 months.

Chef Notes:

  • Make more quinoa than the recipe calls for and store it in the fridge for use in meal preparation for up to 5 days. Cook quinoa using 1 part dried grain and 2 parts water.
  • Feel free to use more spices in this recipe. Garlic, turmeric, parsley, and ginger all go well with this dish!

Cooling Summer Bean Salad

By Alexandra Babcock, MPH, RDN

Enjoy these light, healthy and tasty recipes brought to you by the Lifestyle Medicine Team!

Makes 4 servings

Ingredients

1-16oz can Cannellini or Navy Beans

2 medium stalks celery

1 red bell pepper

½ fennel root

¼ cup fennel fronds

Dressing:

½ cup olive oil

1/3 cup white wine vinegar or lemon juice

1 tsp Dijon mustard

Pepper to taste

Directions:

  1. Lay out cutting board, knife, can opener, strainer, large serving bowl, small mixing bowl or jar, and spoon Wash all vegetables.
  2. Open can of beans and rinse with water in the strainer until the water runs clear. Set aside.
  3. Trim ends of celery. Slice celery length wise and dice into ½ inch pieces. Remove center of bell pepper and dice into the same sized pieces.
  4. Remove end of frond of fennel root. Cut length-wise and save half. Lay cut side down and slice thin horizontally.
  5. Chop fronds coarsely.
  6. Add all ingredients to serving bowl and toss.
  7. Make dressing by adding dressing ingredients into small mixing bowl. Stir or shake to combine.
  8. Toss over salad and mix. Serve immediately or place into smaller containers and refrigerate for up to 5 days. 

Rescheduled and Now Relieved

In March, Kassie Sheffer was anxiously awaiting the day of her scheduled thyroidectomy. Experiencing difficulty swallowing, Kassie was ready for the relief the removal of her thyroid would bring. Unfortunately, in late March, Kassie received a call that her surgery would be postponed due to the COVID-19 pandemic.

“I was frustrated but understood,” Kassie said. Her surgeon, Beth Kimball, MD, kept in touch and assured Kassie that if swallowing became even more difficult, she could go to the Emergency Department and the surgery could take place. Kassie waited, and had a successful thyroidectomy in mid-May when surgeries resumed at St. Joe’s.

“I’m typically a very cautious person,” Kassie said. “Going into a hospital with COVID-19 patients should have been nerve-wracking. But it was the opposite. I was ready to reschedule my surgery.”

Kassie received clear instructions from Dr. Kimball and St. Joe’s on what to expect and how to prepare for surgery. She went two days before surgery for a COVID-19 test, which was negative, and knew that visitor restrictions would mean she’d be alone during surgery and her overnight stay.

“Although I was alone, I never felt alone,” Kassie said. “Everyone went out of their way to make sure I was comfortable and were very helpful. Dr. Kimball called my husband immediately after surgery to let him know everything went well and, later, I was able to speak to him myself.”

Kassie also witnessed St. Joe’s safety processes first hand.

“It’s very clear patient safety is a top priority,” Kassie said. “Everyone is screened before entering; you can tell all of the staff are screened too because they have a sticker with a date on their badge. The clinicians are also always explaining what they are doing and how the surgery area is separate from areas where they care for COVID-19 patients. I would tell everyone 1,000 times over that they don’t have to be nervous to receive care at St. Joe’s – it’s safe.”

Kassie is now home, recovering well and conducting follow-up visits with her physicians virtually. Kassie, her husband and the four children she had at St. Joe’s are healthy and glad Kassie’s difficulties are gone for good.

Determined COVID-19 Patient Battles His Way Home

Recovering from COVID-19 can be a long and difficult journey, but a patient’s determination, combined with caring support can make all the difference.  When David Lemble developed a severe cough back in March, he had no idea that he would eventually spend nearly two months on a ventilator, often fighting for every breath.

David and his wife, Tina, knew about COVID and took all the right precautions. When he first developed symptoms, David self-isolated and the family hoped for the best, but after several days, he was having trouble breathing. By March 30, they decided to come to St. Joseph Mercy Ann Arbor and within 12 hours David was placed on a ventilator.

His wife, Tina, a certified nursing assistant (CNA), clearly understood the seriousness.

“I was scared, but I have faith in God, I also have faith in David and our kids,” said Tina. “Never give up, is the one thing I would tell anyone going through this. We always knew that David was going to get off that ventilator and come home, but it was definitely a roller coaster.”

During the many weeks on the ventilator, David fought and recovered from five separate bouts of pneumonia. He was weaned off the vent for four days, but his lungs weren’t strong enough to breathe on their own.

In addition to the resolute support of his family, David received compassionate care from St. Joe’s medical staff every step of the way.

“I can’t express my gratitude enough for the nurses and all the people who took care of David,” Tina said. “There were so many people who selflessly cared for him. Dr. Eugene Liu was so amazing, he went beyond medical support and was there for all of us emotionally.”

David received leading therapies proven to be effective against coronavirus during his hospital stay. He was among the first to have convalescent plasma infusion, which leverages the antibodies from patients who have successfully beat COVID-19, along with Remdesivir, a drug that’s currently in clinical trials that may help shorten recovery time.

After he was stabilized, the long recovery process included extensive breathing treatments along with cardiac and physical therapy to build up heart, lung and muscle strength after months of severe illness.

“I’m encouraged by how well he’s doing and impressed with how hard David has worked to overcome every challenge,” said Stephen Bloom, DO Physical Medicine and Rehabilitation. “His intense determination to get well and the family’s unwavering support are inspiring.”

Over the next several months, Dr. Bloom and the rest of St. Joe’s rehabilitation team will continue working with David to help him return to work at Discount Tire, where he has been employed for over 23 years. During the past two months, the company’s nursing support program has also been assisting the Lemble family, with skilled nurses regularly checking in with Tina to answer questions and provide guidance.

When David finally walked out of St. Joe’s doors on May 27, he was able to see his family face-to-face for the first time in over two months. While happy to return to his loved-ones and home cooked meals, he was overcome with one strong emotion –Gratitude. Before being driven home, he stopped to say: “I appreciate everything that has been done for me. Everyone here has been so kind and helpful to our family. Thank you all, from the bottom of my heart.”