UNDATED (MADISON MAGAZINE) -- It's impossible to have a one-size-fits-all conversation about cancer. From diagnosis to treatment, to survivorship and beyond, no single cancer—nor cancer experience—is the same. But for Madison-area residents living with cancer, there is one constant: we are flush with treatment and support options.
"My focus is the person, not the disease," says Efrat Livny, cancer guide and Cancer and Wellness program coordinator at Group Health Cooperative of South Central Wisconsin. "I therefore serve each person in a unique and personalized way."
GHC-SCW and Livny have pioneered a program focusing on providing resources and services to support the whole person—body, mind, heart and spirit. Livny listens to each person that comes to see her, then assesses his or her unique needs, from stress reduction, nutrition and exercise to emotional and social support. She works to connect each patient with complementary care modalities, such as therapeutic massage, energy work or acupuncture. Livny is also a certified massage therapist trained in oncology massage and Zero Balancing, a "gentle form of bodywork that deeply relaxes and helps create balance and alignment." She also facilitates "mind, body and spirit" support groups.
"My job is to help someone remember that they are a person in the middle of all this," says Livny. "They are not the cancer."
Livny herself is a self-described "cancer graduate" of ten years now, and created the Cancer and Wellness program to give others what she felt was lacking when she went through her own cancer journey.
"I wished there was somebody I could sit with in a really focused way, not as a mode of therapy but as a strategist," says Livny. "One with empathy and resourcefulness."
Whether in the early stages of treatment or 20 years after initial diagnosis, people living with cancer have unique needs and challenges. There may be high levels of toxicity in the body from chemotherapy or radiation, requiring a massage session to be applied with less vigor. They may have side effects from treatment such as digestive issues, radiation burns or Lymphedema that require significant care and awareness from specially trained massage practitioners. Regardless of the path each cancer patient takes, it's certainly not the one they initially set out upon and can alter life significantly—but Livny stresses that awareness and engagement are key.
"Cancer really does not equal death," says Livny. "It really doesn't. I encourage people to see it as a part of their life. Things show up in our paths, things we wouldn't wish on anyone. The question is, how can you utilize the resources that you have as a person, whether it's your knowledge, your faith, your family, your creativity, your financial resources, your flexibility at work? We can help you find out where to get help, and how, and from who. Then it becomes an undertaking that's constructive, rather than overwhelming. It becomes hopeful."
Hope is on the minds and hearts of the staff at Turville Bay MRI and Radiation Oncology Center as well, where cancer treatment is applied with a spirit of care and nuanced optimism.
"One of the things I learned a long time ago is that there is always hope," says Dr. Michael Zinda, medical director of Turville Bay. "The hope is different at different points of the disease. Sometimes hope is cure. Sometimes hope is relief from pain. Sometimes hope is a good afternoon, or living until a grandchild is born. You have to focus on each person's needs and realize it's a journey. And that journey may be different for one person than for another."
Zinda says in the midst of difficult challenges, uncertainty and fear, there is still a lot of laughter, encouragement and support at Turville Bay.
"It's really not a gloomy place," says Zinda. "I don't wish my services on anybody, but I consider it a privilege that we can help somebody when the time comes."
MRIs have become increasingly instrumental in planning radiation oncology, and Turville Bay serves about 300 new patients every year. Turville Bay MRI was formed jointly in 1984 between St. Mary's and Meriter hospitals. In 1994, the radiation oncology unit joined the MRI venture and the two businesses are now housed in one building, a stand-alone outpatient center nestled on Turville Bay, just off the Beltline at John Nolen Drive. (Turville Bay also has inpatient facilities inside both St. Mary's and Meriter.) While waiting for treatment or imaging, patients and their family members have access to a beautiful views of the tranquil bay from a sprawling, cozy lamp-lit waiting area, and the entire facility is a manageable, easy-to-navigate size.
At Turville Bay, a specialized team uses CT scans and MRIs to make a four-dimensional computer model of each patient's body, particularly the outline of the tumor or tumors and any minute movement that occurs with breathing. The team including physicists, physicians and dosimetrists spends hours, days or even weeks customizing a radiation plan based on each unique case.
"We cannot only image things we could only dream of before," says Zinda, "but we can also come up with much more sophisticated treatment plans."
One of the critical benefits of the high-tech scans is an ability to determine what surrounding areas are at risk beyond cancer; for instance, when radiating tumors in the neck area, doctors work to spare the dose to the salivary glands, as chronic dry mouth can affect eating and speaking ability for life. In a woman's breast, which is contoured differently in different portions, doctors can adjust the dose within a millimeter in any direction—avoiding hot spots and cold spots, and delivering radiation more precisely, accurately and homogenously. Doctors at Turville Bay also utilize stereotactic radio surgery, "surgery without the knife," radiation they say has the precision of a surgeon with a scalpel.
It all depends, of course, on the specific cancer being treated.
"Part of the art and science of this is understanding that some cancers respond to this and some don't," says Zinda. "We work very closely with the medical oncologists in the community, because the treatment plan has got to involve the primary care doctor, the oncologist, the surgeon, the specialists, the dieticians. It's a team effort."
Zinda says the Madison area is fortunate to have a strong network of cancer resources and support, particularly in education and research. For Turville Bay's part, they are planning their first annual survivors' event June 5 to coincide with National Cancer Survivors Organization's Survivor's Day. The event, an old-fashioned ice cream social, is open to all cancer survivors and their loved ones, family and friends. Most would be hard-pressed to find a person who has not been affected in some way by cancer; even the staff of Turville Bay lost their executive director, Autis Speights, to cancer last January. But they have also watched many, many people survive cancer, and even thrive.
"The idea is to come together and recognize that wherever you're at in the journey," says Zinda, "we're all in this together."
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