Homer Alaska - News

Story last updated at 4:00 PM on Wednesday, November 2, 2011

Health fair focus: Be your own advocate

By McKibben Jackinsky
Staff Writer

Advocate. A counselor, someone who pleads another's case, who speaks or writes in support of something is Webster's definition of the noun. As a verb, it means to support.

In either case, it sums up the theme of this year's Rotary Health Fair: "It's Your Life ... Take a Day to be Well." The 28th annual Rotary Health Fair will be held at Homer High School from 7:30 a.m.-1 p.m. Nov. 12.

Being an advocate for the health of yourself or someone you love is near and dear to Will Files and Kelly Cooper. Files was diagnosed with prostate cancer earlier this year; Cooper's husband was diagnosed with pancreatic cancer in 2010. He died Jan. 29.

Regular visits with his urologists and results from PSA — prostate-specific antigen —screening alerted Files and his doctors that something was amiss. An increase in PSA may indicate the presence of cancer; Files and his doctors noted the numbers were climbing. In April, the urologist near where Files and his wife winter in Arizona "said maybe we should take a look-see."

Twelve tissue samples were taken; two showed signs of unhealthy cells.

"It's kind of a semi-random testing that gives you an idea, but doesn't give you the total picture," said Files. "What if they had taken 12 samples in different places? Would it have shown more or less?"

Still, those two samples posed the question, "What do you do about it?" With numerous prostate cancer treatments available, Files read and talked to individuals who had undergone different programs. He also listened to his doctors' recommendations and became interested in two treatments: watchful waiting, monitoring his condition over a period of time before deciding a course of action; and hormone therapy, recommended by an Anchorage urologist Files saw after returning to Alaska this summer.

"There are two advantages to hormone therapy," said Files. "One theory is that it knocks the cancer down and it will stay dormant and not be a problem. The other is that if you have hormone therapy for a period of time and decide to do one of the major therapies, the prostate is in good shape for that therapy."

Files chose hormone therapy.

"They give you an anti-testosterone shot once a month and check your PSA. Mine went down after the first one," said Files.

The next injection is scheduled within the next two weeks, a procedure he believes can be done here in Homer.

"They'll do that for the next three-six months and if (the PSA count) goes down or is close to what it is, then maybe they'll just stop it and see what happens," said Files.

One side effect he anticipated was tiring more easily.

"But I don't know if it's hormone therapy or just aging," said the 71-year-old, adding that loss of libido was another side effect. "Other than that, we just live life, play tennis and do all the things we normally do."

The United States Preventive Services Task Force in 2008 stopped recommending prostate cancer screening for men age 75 and older, saying it "provided few health benefits, but led to substantial physical harm and some psychological harm in men age 75 and older." It also stated that evidence was "insufficient to assess the balance of benefits and harms" of screening for men younger than 75. A health alert issued by Johns Hopkins responded to the PSA controversy by saying, in part, "PSA screening is the best test available for the detection of cancer cells in the prostate. Rather than discontinuing use of the only test available to detect the disease early and treat it successfully, efforts should focus on reducing harm."

The alert concluded by saying, "Every man should discuss the benefits and risks of PSA screening with his physician. If you choose to be screened and the result is positive, you and your doctor should discuss whether any further intervention is appropriate or necessary."

In other words, each man is his own best advocate.

"At the present time, for our local health fair the tests are being offered," said Files. "Rotary Club doesn't recommend for or against it. We're just offering the tests. You have to decide if you want to take advantage of them or not. ... Clearly, there's no right answer, no one answer for everybody."

Cooper's husband, known to friends as "Coop," moved to Alaska in 1973, and worked as a journeyman lineman in Valdez and Homer. The couple met and began their life together in 1989. In 2006, he retired. A 2010 Memorial Day weekend visit to South Peninsula Hospital's emergency room led to him being diagnosed with pancreatic cancer.

Desperate for some sign of hope, Cooper and her husband went to Virginia Mason Hospital in Seattle, only to be told Coop "was not a candidate for surgery due to the tumor surrounding an artery and the oncologist didn't feel we were a good candidate for clinical trials in their area."

Returning to Alaska, the Coopers' battled to extend Coop's life. An Anchorage doctor prescribed chemotherapy. Coop tolerated the intravenous application and continued that for six months in Anchorage and Homer. The oral application produced such severe side effects it was called to a halt.

Although the Coopers had insurance, deductibles and out-of-pocket expenses — airfare, rental car, food and lodging — grew to almost $10,000. The American Cancer Society offered some relief with travel expenses. The rest was paid out of the couple's savings.

As her husband's challenges grew, Cooper's role as a caregiver increased. Physicians and nurses at Homer Medical Clinic, the SPH nursing staff and home health aides, and the medical equipment provided by Mark Halpin of Prodigy Medical were only a phone call away. They provided answers for questions, suggestions for handling new situations and encouragement as Cooper figured out how best to meet her husband's needs.

When Coop's limitations made it impossible for Cooper to move her husband, friends were there to help. When she needed to remain at his bedside, others took over tasks needing to be done. When her spirits waivered and her energy ebbed, her friend Julie Woodworth kept close contact and offered a shoulder.

"There wasn't a (pancreatic cancer) support group, but friends and neighbors were a godsend, bringing food, sending cards, calling and just visiting," said Cooper.

When Coop died in January, he was at home, with his family at his side.

Since then, Cooper has focused on urging others to "be an advocate for your and your loved one's health. Know if you are in the risk group." She encourages paying attention to your body and asking for tests, such as the endoscopic ultrasound, if a family member is diagnosed with pancreatic cancer.

Cooper pushed the Kenai Peninsula Borough Assembly to recognize November as "Pancreatic Cancer Awareness Month," and spread the word that:

• In 2011, an estimated 44,030 individuals will be diagnosed with pancreatic cancer in the United States and 37,660 will die from the disease;

• Approximately 60 deaths will occur in Alaska in 2011;

• Pancreatic cancer is the fourth leading case of cancer death in the United States;

• Pancreatic cancer research constitutes approximately 2 percent of the National Cancer Institute's federal research funding.

Cooper participates in an online support group that has more than 700 members and has made herself available locally to others whose lives have been touched by the disease.

She also has launched a letter-writing campaign to urge Alaska Sen. Lisa Murkowski's support of The Pancreatic Cancer Research and Education Act.

"My husband was so brave during his fight all the while knowing he was not going to beat this monster," Cooper wrote to Murkowski. "I owe my husband's memory this same courage in our battle to raise awareness and secure the appropriate funding for research of pancreatic cancer."

On Nov. 12, Cooper will offer information on pancreatic cancer at the Rotary Health Fair. She'll be easy to find. Look for the red-haired woman dressed in purple, the color signifying pancreatic cancer awareness.

McKibben Jackinsky can be reached at mckibben.jackinsky@homernews.com.