A personal and complex killer takes center stage again this week in Sioux Falls health care.
Breast cancer is the target as Sanford Health prepares to give details of a $100 million initiative it hopes will redefine research and treatment. Officials plan an announcement Wednesday as part of the system’s annual five-day gala at Sanford Center at Lewis Avenue and 54th Street North.
“I don’t know what they have up their sleeve, but it will be exciting to find out,” said Denise Kolba, director of health care partnerships for the American Cancer Society.
The event will push forward an effort by Sanford in a cause that for years has driven both Sioux Falls health giants, Sanford and Avera. The two systems are on parallel tracks aiming at similar goals. But breast cancer is extraordinarily complicated, a disease with many subdiseases, and one that doesn’t lend itself to a Jonas Salk moment akin to conquering polio in the 1950s.
“There are at least three types of breast cancer we treat, probably more when we look down on the DNA level,” said Dr. Amy Krie, medical director of the Avera Breast Center. “The last 10 years, we have made huge progress in sorting that out.”
It’s the personal that makes breast cancer the apple of the eye in science. Events bearing that out this week will hearken back to 2007, when billionaire-banker T. Denny Sanford pledged $400 million to the Sioux Valley system, since renamed Sanford. The money was for four priorities, including, as officials said in 2008, to find a cure for juvenile diabetes.
This week suggests a similar math, with another $100 million from the retired banker, this time for a single cause, breast cancer.
Andrew Richburg, executive vice president at Sanford, said it’s an apt comparison. Breast cancer and diabetes will now be twin targets, with an obvious difference.
“Diabetes is incredibly expensive, an awful disease,” he said. “But the way breast cancer touches women in our lives, someone’s wife or best friend or mom or daughter, it is a very personal disease. It impacts us emotionally in a much more significant way.”
T. Denny Sanford lost his mother to breast cancer. Richburg’s mother, Fran, is a survivor, and he has a daughter, Annie, 13.
“It’s a bad disease,” said Dr. Patrick Nelson, a diagnostic radiologist for MedXray who works with Avera and Sanford. “It hits from old women to young. It’s everybody’s mother or sister or grandmother. There’s no one I know of that doesn’t have somebody they know with breast cancer.”
No comfort in the odds in case of music teacher
Jan Weier, 57, an elementary music teacher in Freeman, never saw it coming. She eats right and gets her exercise walking with friends near the family farm in Turner County, where her husband, Jim, raises corn, sheep and soybeans.
Family math led her to think she was safe. Her brother died of lymphoma at age 29. Her dad lived to 81, her mother to 82. “I thought it was one in four for cancer,” she said.
Last October she learned otherwise. She was especially tired one evening, and something felt odd. She did a self-exam and the next day called her doctor.
“The first night, I thought this is not looking good,” Weier said last week at the Avera Cancer Institute.
November began five months of chemotherapy. In May, surgeons performed a bilateral mastectomy. Radiation followed for six weeks in June and July.
Weier shakes her head when asked of a mammogram. She never had one. She has four children and was busy with her parents, who died in 2008 and 2009.
“I don’t know how it just got past me. I always felt good. I still felt good. At this point, it doesn’t make a difference.”
Beginning with lump under the arm
Eva Horner, 49, a Hudson resident, found a lump under her right arm last November. A physician looked at it then and again in February, when it had grown the size of a marble. She was due for her annual mammogram, which came back fine, she said, but she wanted the lump gone. Things unraveled from there. Doctors removed three lymph nodes in March and used a needle to withdraw tissue for a biopsy that revealed cancer. Chemotherapy was April to July. Tuesday, she returns to Sanford for a bilateral mastectomy.
“My daughter Jen said, ‘Wow, a lot has happened in five months,’ ” Horner said.
Sanford and Avera have been targeting breast cancer since the 1980s, when they were Sioux Valley and McKennan. Efforts intensified in recent years, with a broader reach into genetics and use of the immune system.
‘A key to unlocking the disease and treating it’
Richburg said the latest mega-gift will serve as seed money for change ahead for Sanford, which could range from expanding its cancer center at 18th and Euclid to hiring a team of scientists. He thinks a Jonas Salk moment is out there for breast cancer.
“We absolutely believe that,” he said. “Everyone believes there is a key to unlocking the disease and treating it before it becomes a disease. There has to be science behind what makes the disease that could also prevent the disease.”
Progress might be incremental, a noose that closes in on the disease in its various forms.
“We’re never not going to have breast cancer,” Nelson at MedXray said. “Our goal is to find it as soon as we can and treat it effectively. When we do that, people do great.”
Krie notes at Avera that the future in breast cancer is targeted therapies, such as herceptin and armoatase inhibitors. They let specialists attack cancer without damaging healthy cells, which improves cure rates with lesser side effects. “The inhibitors have already revolutionized how we treat cancers,” Krie said.
But mammogram rates hold up the gains. Almost half of women forgo the advice of an annual screen after age 40. Avera and Sanford both run mobile mammography units in the region to make screening as handy as a 10-minute coffee break. They’ve helped thousands of women – Sanford estimates 39,000 in the past 12 months – but they miss many.
“We’ve made incredible progress in treatment,” Krie said. “But we still do a totally lousy job in getting people to get mammograms.”
Weier accepts her situation.
“I panicked more because I did not want my family to change their life because I had cancer. I thought I can get through this because of help from God and people in church. I felt every day the power of prayer is very real,” she said.
Her schoolchildren helped. She told them something wasn’t right. They asked whether she’d be OK and asked, “Are you going to get a wig?” The answer to both: yes.
In Hudson, Horner thought her problem would be the heart. Her mother died of a heart attack at 57 and a sister at 51. She is No. 10 of 11 siblings. None has had cancer.
The experience has been a speed walk in a valley of emotions. She lost her hair, as predicted, early in chemotherapy.
“A lot of women would cut their hair completely off. I didn’t want to do that. It was very tough watching it come out in handfuls, but I just couldn’t make myself do it.”
Getting a wig was hard. Looking in the mirror was hard. Her most difficult day is just ahead, with surgery Tuesday. “It’s not so much I’m dreading it,” she said. “I’m not quite sure what it is. I’ve had Lasik surgery on my eyes, and I’ve had two children. This is going to change my outward appearance.”
Friends helped. Team Eva had 37 people at a cancer walk last spring. Neighbors brought in meals. And she’s adapting. She wears a bonnet on bike rides around town.
Reach reporter Jon Walker at 331-2206 or 800-530-6397.
