DiversityNursing Blog

By AnneClaire Stapleton

www.cnn.com 

"I had my own personal tanning bed in my home, and so did a lot of my friends growing up. ... Everyone tanned," Willoughby said. "I didn't really even think about the future or skin cancer at the time." 

After one of her classmates in nursing school was diagnosed with melanoma, Willoughby made her first dermatology appointment at age 21. Sure enough, she had skin cancer.

Now 27, Willoughby says she has had basal cell carcinoma five times and squamous cell carcinoma once. She goes to the dermatologist every six to 12 months and usually has a cancerous piece of skin removed at each checkup.

She's become a cautionary tale about the hazards of tanning beds, thanks to a selfie she posted last month on Facebook. The grisly image, taken after one of her cancer treatments, shows her face covered with bloody scabs and blisters. It's since been shared almost 50,000 times.

"If anyone needs a little motivation to not lay in the tanning bed and sun here ya go! This is what skin cancer treatment can look like," she wrote in a post along with the photo. "Wear sunscreen and get a spray tan. You only get one skin and you should take care of it."

One in five Americans will develop skin cancer in their lifetime, according to the American Academy of Dermatology. Exposure to tanning beds increases the risk of melanoma, the deadliest form of skin cancer, said the academy, which reports that more than 419,000 cases of skin cancer in the U.S. each year are linked to indoor tanning.

Melanoma is the most common form of cancer for adults 25-29 years old and the second-most common form of cancer for adolescents and young adults 15-29 years old, according to the academy. Warning signs include changes in size, shape or color of a mole or other lesion, the appearance of a new growth on the skin or a sore that doesn't heal. 

Risk factors for all types of skin cancer include skin that burns easily, blond or red hair and a history of excessive sun exposure, including sunburns and tanning-bed use -- dangers that the blonde, blue-eyed Willoughby now knows all too well. 

Willoughby, a registered nurse who now lives in northern Alabama, said she never expected the Facebook picture of her damaged face to go viral. 

But she's excited to think her story might save someone's life.

"I've lost count of how many people shared it now and told me I've helped them," she said. "It's really cool to hear people say they won't tan anymore. I've had mothers thank me after sharing my pictures with their daughters. People in my hometown said they are selling their tanning beds.

"I never thought about the future when I was in high school; I just tanned because it was normal to me." 

Willoughby knows she'll deal with the consequences of tanning for the rest of her life. She's at high risk for developing melanoma but is now doing everything she can to ensure that she's around for her husband, Cody, and their young son, Kayden, for years to come. 

"Learn from other people's mistakes," she wrote on Facebook. "Don't let tanning prevent you from seeing your children grow up. That's my biggest fear now that I have a two-year-old little boy of my own."

By ANDREW POLLACK

www.nytimes.com 

A Silicon Valley start-up with some big-name backers is threatening to upend genetic screening for breast and ovarian cancer by offering a test on a sample of saliva that is so inexpensiv e that most women could get it.

At the same time, the nation’s two largest clinical laboratories, Quest Diagnostics and LabCorp, normally bitter rivals, are joining with French researchers to pool their data to better interpret mutations in the two main breast cancer risk genes, known as BRCA1 and BRCA2. Other companies and laboratories are being invited to join the effort, called BRCA Share.

The announcements being made on Tuesday, although coincidental in their timing, speak to the surge in competition in genetic risk screening for cancer since 2013, when the Supreme Court invalidated the gene patents that gave Myriad Genetics a monopoly on BRCA testing.

The field has also been propelled by the actress and filmmaker Angelina Jolie, who has a BRCA1 mutation and has written about her own decision to have her breasts, ovaries and fallopian tubes removed to sharply reduce her risk of developing cancer.

But the issue of who should be tested remains controversial. The effort of the start-up, Color Genomics, to “democratize access to genetic testing,” in the words of the chief executive, Elad Gil, is generating concern among some experts.

The company plans to charge $249 for an analysis of BRCA1 and BRCA2, plus 17 other cancer-risk genes. That is one tenth the price of many tests now on the market.

Testing of the BRCA genes has generally been limited by medical guidelines to women who already have cancer or those with a family history of breast or ovarian cancers. Insurers generally have not paid for BRCA tests for other women, and some insurers are not paying at all for a newer type of screening known as a panel test that analyzes from 10 to 40 genes at once.

Dr. Gil of Color said his company’s test would be inexpensive enough for women to pay out of pocket, so that neither the woman nor Color will have to deal with insurance companies. He said the company was starting a program to provide free testing to women who cannot afford its test.

One of the company’s unpaid advisers is Mary-Claire King, the University of Washington geneticist whose work led to the discovery of the BRCA1 gene. Dr. King last year publicly called for testing to be offered to all American women 30 and older.

She said that half the women with dangerous mutations would not qualify for testing under current guidelines, in part because many inherit the mutation from their fathers rather than their mothers and a family history of breast or ovarian cancer might not be evident.

But other experts say that fewer women in the expanded group would be found to have dangerous mutations, raising the overall cost of testing per cancer case prevented. Moreover, expanded testing could result in many more women being told they have mutations that cannot be classified as either dangerous or benign, leaving women in a state of limbo as to whether they have an increased risk of cancer.

“We have to be careful that we are not just increasing this group of worried-well who have incomplete information,” said Dr. Kenneth Offit, chief of the clinical genetics service at the Memorial Sloan Kettering Cancer Center.

Dr. Offit said it was contradictory that Color was trying to expand testing to everyone on the same day the two biggest testing companies were joining forces to try to reduce how often they find these so-called variants of uncertain significance.

Color is planning to allow women to order tests through its website. Another Silicon Valley start-up that did that, 23andMe, had its health testing shut down in 2013 by the Food and Drug Administration.

Color executives say that unlike with 23andMe, a doctor will be involved in every order and in the test results. If a consumer orders the test directly from its website, her information will be sent to a doctor hired by the company to evaluate it.

An F.D.A. spokeswoman said that if doctors place orders, testing companies that operate their own laboratories do not need F.D.A. approval to offer their tests.

Some testing experts question whether Color can provide testing as inexpensively as it claims. While the actual sequencing might be done for less than $250, that is only part of the cost, which also involves interpretation and working with patients and doctors, they say. Other companies generally charge at least $1,500 for complete analyses of the BRCA genes or for multigene tests.

But Dr. Gil said Color has highly automated its processes and will even offer genetic counseling to women. He said the company chose the saliva test rather than a blood one because it’s easier for users but still accurate. Women send the saliva sample to Color for testing.

Dr. Gil received a doctoral degree in biology at the Massachusetts Institute of Technology, studying a cancer gene. But he has spent much of his career at Google and Twitter. The company’s president, Othman Laraki, also worked at Google and Twitter.

Color’s backers — it says it has raised about $15 million — are mainly from the world of high tech rather than life sciences. Its lead investors are the venture capital firms Khosla Ventures and Formation 8. Individual investors include Laurene Powell Jobs, the widow of Steve Jobs; Susan L. Wagner, a co-founder of the investment firm BlackRock; Padmasree Warrior, the chief technology and strategy officer at Cisco; and Jerry Yang, co-founder of Yahoo.

Dr. Offit of Sloan Kettering said that even Myriad, which long had a monopoly on BRCA testing and has the most data, has reported having a 2 percent rate of variants of unknown significance, meaning 2 percent of the time it cannot tell if a variant in a gene increases the risk of cancer or is benign. Other companies might have higher rates. And the rates for some other, less-well-studied genes can be 20 or 30 percent, he said.

The entire testing industry is now scrambling to pool data to lower that rate, and in some cases to catch up to Myriad, which has kept much of its data proprietary as a competitive advantage. Various data-sharing efforts are already underway, including by ClinVar and the BRCA Challenge.

Now there is also BRCA Share, which is based on a database of genetic variants maintained by Inserm, a French government health research institute. Quest Diagnostics agreed to provide money to improve that database and pay for experiments on cells that could help determine whether certain mutations raise the risk of cancer.

“We are going to help them make it better,” said Dr. Charles M. Strom, vice president for genomics and genetics at Quest. He said BRCA Share would be open to others, with LabCorp becoming the first to join.

Participants will have to contribute their data to the database. Companies will pay for access to the data on a sliding scale based on their size, while others will have access to the data without paying, he said.

http://news.nurse.com 

Surgeons are no longer removing most of the lymph nodes in the underarm area when a biopsy near the area shows cancer, a major change in breast cancer management, according to a study published in the Journal of the American College of Surgeons.
Researchers evaluated data from 2.7 million patients with breast cancer in the U.S. and learned to what extent surgeons were following recommendations from the American College of Surgeons Oncology Group Z0011, or ACOSOG Z-11 trial, published four years ago.

They reported that most early-stage breast cancer patients with tumors in their sentinel lymph node who undergo lumpectomy do not benefit from surgical removal of the remaining lymph nodes in the underarm area, called completion axillary lymph node dissection or ALND, according to a news release. They found no difference in cancer recurrence and five-year survival between patients who underwent ALND and those who did not.

Researchers found a dramatic increase in the proportion of lumpectomy patients who underwent only a sentinel lymph node biopsy — SNB — without an ALND. The SNB-alone rate more than doubled — from 23% in 2009 to 56% in 2011, according to the study.

“As far as I know, our study is the first to show that the findings from the ACOSOG Z-11 trial have changed clinical practice for breast cancer patients nationwide,” lead author Katharine Yao, MD, FACS, director of the Breast Surgical Program at NorthShore University HealthSystem in Evanston, Ill., and clinical associate professor of surgery at the University of Chicago Pritzker School of Medicine, said in the release. “The Z-11 trial has had a huge impact because of the lower risks for patients who undergo SNB alone.”

Investigators found that 74,309 patients (of the 2.72 million cases diagnosed between 1998 and 2011) met criteria for having SNB alone but underwent lumpectomy and radiation therapy to the whole breast, according to the press release.

The rate of SNB alone cases reportedly increased from 6.1% in 1998 to 56% in 2011. 
Yao said findings suggest that some practitioners may feel uncomfortable not performing ALND in high-risk patients, and called for more education for surgeons.

JOE PALCA

www.npr.org 

A promising technique for making brain tumors glow so they'll be easier for surgeons to remove is now being tested in cancer patients.

Eighteen months ago, Shots first told readers about tumor paint, an experimental substance derived from scorpion venom. Inject tumor paint into a patient's vein, and it will actually cross the blood-brain barrier and find its way to a brain tumor. Shine near-infrared light on a tumor coated with tumor paint, and the tumor will glow.

The main architect of the tumor paint idea is a pediatric oncologist named Dr. Jim Olson. As a physician who treats kids with brain cancer, Olson knows that removing a tumor is tricky.

"The surgeons right now use their eyes and their fingers and their thumbs to distinguish cancer from normal brain," says Olson. But poking around in someone's brain with only those tools, it's inevitable surgeons will sometimes miss bits of tumor or, just as bad, damage healthy brain cells.

So Olson and his colleagues at the Fred Hutchinson Cancer Center in Seattle came up with tumor paint. They handed off commercial development of the compound to Blaze Bioscience.

After initial studies in dogs showed promise, the company won approval to try tumor paint on human subjects. Those trials are taking place at the Cedars Sinai Medical Center in Los Angeles.

Dr. Chirag Patil is one of those surgeons. He says it's remarkable that you can inject tumor paint into a vein in a patient's arm, have it go to the brain and attach to a tumor, and only a tumor. "That's a concept that neurosurgeons have probably been dreaming about for 50 years," he says.

Patil says they've now used tumor paint on a about a half dozen patients with brain tumors. They use a special camera to see if the tumor is glowing.

"The first case we did was a deep tumor," says Patil. "So with the camera, we couldn't really shine it into this deep small cavity. But when we took that first piece out and we put it on the table. And the question was, 'Does it glow?' And when we saw that it glows, it was just one of those moments ...'Wow, this works.' "

In this first study of tumor paint in humans, the goal is just to prove that it's reaching the tumor. Future studies will see if it actually helps surgeons remove tumors and, even more importantly, if it results in a better outcome for the patient.

That won't be quick or easy. Just getting to this point has been a long slog, and there are bound to be hurdles ahead.

And even if tumor paint does exactly what it's designed to do, Dr. Keith Black, who directs neurosurgery at Cedars-Sinai, says it probably isn't the long-term solution to brain cancer. "Because surgery is still a very crude technique," he says.

Even in the best of circumstances, Black says, surgery is traumatic for the patients, and tracking down every last cell of a tumor is probably impossible. Plus, it's inevitable that some healthy brain tissue will be damaged in removing the tumor.

"Ultimately, we want to eliminate the need to do surgery," says Black. A start in that direction will be to use a compound like tumor paint to deliver not just a dye, but an anti-cancer drug directly to a tumor. That's a goal several research groups, including Jim Olson's, are working on.

Dr. Edward Soffen

Source: www.livescience.com

Dr. Edward Soffen is a board-certified radiation oncologist and medical director of the Radiation Oncology Department at CentraState Medical Center's Statesir Cancer Center in Freehold, New Jersey. He contributed this article to Live Science's Expert Voices: Op-Ed & Insights.

As a radiation oncologist, my goal is to use radiation as an extremely powerful and potent tool to eradicate cancer tumors in the body: These techniques save and extend patients' lives every day. 

Historically, radiation treatments have been challenged by the damage they cause healthy tissue surrounding a tumor, but new technologies are now slashing those risks.

How radiation therapies work

High-energy radiation kills cancer cells by damaging DNA so severely that the diseased cells die. Radiation treatments may come from a machine (x-ray or proton beam), radioactive material placed in the body near tumor cells, or from a fluid injected into the bloodstream. A patient may receive radiation therapy before or after surgery and/or chemotherapy, depending on the type, location and stage of the cancer. 

Today's treatment options target radiation more directly to a tumor — quickly, and less invasively — shortening overall radiation treatment times. And using new Internet-enabled tools, physicians across the country can collaborate by sharing millions of calculations and detailed algorithms for customizing the best treatment protocols for each patient. With just a few computer key strokes, complicated treatment plans can be anonymously shared with other physicians at remote sites who have expertise in a particular oncologic area. Through this collaboration, doctors offer their input and suggestions for optimizing treatment. In turn, the patient benefits from a wide community of physicians who share expertise based upon their research, clinical expertise and first-hand experience. 

The result is safer, more effective treatments. Here are five of the most exciting examples:

1. Turning breast cancer upside down

When the breast is treated while the patient is lying face down, with radiation away from the heart and lungs, a recent study found an 86 percent reduction in the amount of lung tissue irradiated in the right breast and a 91 percent reduction in the left breast. Additionally, administering prone-position radiation therapy in this fashion does not inhibit the effectiveness of the treatment in any way.

2. Spacer gel for prostate cancer

Prostate cancer treatment involves delivering a dose of radiation to the prostate that will destroy the tumor cells, but not adversely affect the patient. A new hydrogel, a semi-solid natural substance, will soon be used to decrease toxicity from radiation beams to the nearby rectum. The absorbable gel is injected by a syringe between the prostate and the rectum which pushes the rectum out of the way while treating the prostate. As a result, there is much less radiation inadvertently administered to the rectum through collateral damage. This can significantly improve a patient's daily quality of life — bowel function is much less likely to be affected by scar tissue or ulceration. [Facts About Prostate Cancer (Infographic )]

3. Continual imaging improves precision

Image-Guided Radiation Therapy (IGRT) uses specialized computer software to take continual images of a tumor before and during radiation treatment, which improves the precision and accuracy of the therapy. A tumor can move day by day or shrink during treatment. Tracking a tumor's position in the body each day allows for more accurate targeting and a narrower margin of error when focusing the beam. It is particularly beneficial in the treatment of tumors that are likely to move during treatment, such as those in the lung, and for breast, gastrointestinal, head and neck and prostate cancer. 

In fact, the prostate can move a few millimeters each day depending on the amount of fluid in the bladder and stool or gas in the rectum. Head and neck cancers can shrink significantly during treatment, allowing for the possibility of adaptive planning (changing the beams during treatment), again to minimize long term toxicity and side effects.

4. Lung, liver and spine cancers can now require fewer treatments 

Stereotactic Body Radiation Therapy (SBRT) offers a newer approach to difficult-to-treat cancers located in the lung, liver and spine. It is a concentrated, high-dose form of radiation that can be delivered very quickly with fewer sessions. Conventional treatment requires 30 radiation treatments daily for about six weeks, compared to SBRT which requires about three to five treatments over the course of only one week. The cancer is treated from a 3D perspective in multiple angles and planes, rather than a few points of contact, so the tumor receives a large dose of radiation, but normal tissue receives much less. By attacking the tumor from many different angles, the dose delivered to the normal tissue (in the path of any one beam) is quite minimal, but when added together from a multitude of beams coming from many different planes, all intersecting inside the tumor, the cancer can be annihilated. 

5. Better access to hard-to-reach tumors

Proton-beam therapy is a type of radiation treatment that uses protons rather than x-rays to treat cancer. Protons, however, can target the tumor with lower radiation doses to surrounding normal tissues, depending on the location of the tumor. It has been especially effective for replacing surgery in difficult-to-reach areas, treating tumors that don't respond to chemotherapy, or situations where photon-beam therapy will cause too much collateral damage to surrounding tissue. Simply put, the proton (unlike an x-ray) can stop right in the tumor target and give off all its energy without continuing through the rest of the body. One of the more common uses is to treat prostate cancer. Proton therapy is also a good choice for small tumors in areas which are difficult to pinpoint — like the base of the brain — without affecting critical nerves like those for vision or hearing. Perhaps the most exciting application for this treatment approach is with children. Since children are growing and their tissues are rapidly dividing, proton beam radiation has great potential to limit toxicity for those patients. Children who receive protons will be able to maintain more normal neurocognitive function, preserve lung function, cardiac function and fertility. 

While cancer will strike more than 1.6 million Americans in 2015, treatments like these are boosting survival rates. In January 2014, there were nearly 14.5 million American cancer survivors. By January 2024, that number is expected to increase to nearly 19 million. 

But make no mistake — radiation therapy, one of the most powerful resources used to defeat cancer, is not done yet. As we speak, treatment developments in molecular biology, imaging technology and newer delivery techniques are in the works, and will continue to provide cancer patients with even less invasive treatment down the road.

Source: www.livescience.com

By MATTHEW FAHR

Barber chairs moved like turnstiles as people from all around the area came to the Romeo Lions Field House to show their support for those fighting cancer.

Volunteer event organizer Michael Fiscus said the Romeo event broke its own record, and is currently ranked fifth nationally for funds raised during the St. Baldrick’s Foundation event.

“It was more crowded than it has been since we began in Romeo,” said Fiscus. “We had wall-to-wall people from 1:30 to 4 p.m.”

In a show of support for children who are enduring the struggle of dealing with cancer and its body-ravaging effects, St. Baldrick’s asks people to show their solidarity with those young souls by shaving their heads.

They came out in force to Romeo with the event currently tallying $317,000 raised to date.

Fiscus said he expects that number to rise as people donate after the fact, pledging donations to those who took part in the event.

Last year, the event raised $302,000, with another $30,000 being donated in the days and weeks afterward.

“In the next few weeks we will be collecting cash that was donated and collecting sponsor matching funds, as well as new donations after people see what their friends and family did for St. Baldrick’s,” Fiscus said.

When the event began six years ago, 18 people shaved their heads and Fiscus raised just more than $14,000 to donate to the foundation, which is dedicated to raising money for life-saving childhood cancer research, and it funds more in childhood cancer grants than any organization except for the U.S. government.

Last year, 525 people shaved their heads.

Fiscus said this year more than 500 people sat down in barber chairs to change their image by shaving their heads, but he said donations went up even with the dip in “shavees,” as he calls them.

He said 16 people were also “knighted” for being involved for seven consecutive years.

“The number of folks returning was high this year,” said Fiscus. “The word is out there, and those who started with us and helped bring in others are back themselves for a good cause.”

With 25 barber chairs and an average of 10 minutes per haircut -- which may have felt like a lifetime for some first-timers -- the Lions Field House did steady business through the day and brought people into downtown Romeo at night as haircuts were done upstairs at Younger’s Tavern until well into the night.

“I think by the time I packed up and was heading out of town, it must have been 11:30 p.m.” Fiscus said. “A lot of people had a good time.”

Fiscus took time out of his chaotic day to look around at those making such a sacrifice for a loved one or friend.

“It can be so moving to see someone commit to something like that,” he said. “You can tell who the people are who are doing this for the first time and the look on their face, but afterward they are proud of what they did.”

He said 90 percent of donations this year for the Romeo event were done online, and donations will continue to be taken all year online at www.stbaldricks.org/events/romeo/

Romeo currently ranks fifth nationwide in event donations, a goal Fiscus was aiming for at the start of this year.

“That is the achievement I am most proud of,” he said. “We are still in fifth today and I don’t know how long we will be there, but being there right now is such an honor.”

Source: www.macombdaily.com

Honor Whiteman

Dogs are often referred to as "man's best friend," and a new study brings further strength to this term after revealing how a rescue dog called Frankie was able to detect the presence of thyroid cancer in human urine samples with almost 90% accuracy.

According to the research team, from the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Frankie - a male German Shepherd-mix - is the first dog that has been trained to differentiate benign thyroid disease and thyroid cancer by sniffing human urine samples.

Thyroid cancer is a cancer that begins in the thyroid gland, situated just below the thyroid cartilage in the front of the neck. Approximately 62,450 new cases of thyroid cancer will be diagnosed in the US this year, and around 1,950 Americans will die from the disease.

Unlike most other cancers, thyroid cancer is more common among younger adults, with almost 2 in 3 cases diagnosed in people under the age of 55.

Diagnostic techniques for thyroid cancer include fine-needle aspiration biopsy, which involves the patient having a thin needle inserted into the thyroid gland in order to obtain a tissue sample.

Senior investigator Dr. Donald Bodenner, chief of endocrine oncology at UAMS, says the diagnostic accuracy of canine scent detection is almost on par with that of fine-needle aspiration biopsy, but it would be an inexpensive and noninvasive alternative.

What is more, he notes many current methods for diagnosing thyroid cancer can be inaccurate, causing some patients to undergo needless surgery.

"Scent-trained canines could be used by physicians to detect the presence of thyroid cancer at an early stage and to avoid surgery when unwarranted," he adds.

Frankie trained to sniff out cancer in human urine samples

For their study, recently presented at The Endocrine Society's 97th Annual Meeting in San Diego, CA, Dr. Bodenner and colleagues obtained urine samples from 34 patients who attended the UAMS thyroid clinic.

All patients showed abnormalities in their thyroid nodules and went on to have biopsies and diagnostic surgery. Thyroid cancer was identified in 15 patients while 19 had benign thyroid disease.

Frankie - who the researchers say had been previously trained to recognize the smell of cancer in human thyroid tissue - was presented with the urine samples to sniff one at a time by a gloved dog handler.

While humans have around 5 million smell receptors, or olfactory cells, dogs possess around 200 million, making their sense of smell around a thousand times stronger than that of humans. 

Frankie alerted the handler to a cancer-positive urine sample by lying down, while turning away from the urine sample alerted the handler to a benign status. 

The authors note that the cancer status of each urine sample was unknown to both the dog handler and the study coordinator.

The handler also presented Frankie with urine samples with a known cancer status in between the study samples so the dog could be rewarded for achieving a correct answer.

30 out of 34 samples correctly identified with canine scent detection

On comparing Frankie's results with those of the final surgical pathology report for the samples, the team found the dog correctly identified the status of 30 out of 34 samples.

The sensitivity, or true-positive rate, of the canine scent detection came in at 86.7%, while specificity, or true-negative rate, was 89.5%. This means Frankie correctly identified a benign sample almost 9 in every 10 times.

The team notes that canine scent detection led to two false-negative and two false-positive results. The researchers now plan to expand their research by teaming up with Auburn University College of Veterinary Medicine, AL, who have agreed to assign two of its bomb-sniffing dogs to thyroid cancer detection training.

This is not the first time Medical News Today have reported on the cancer-detection talent of dogs. In May 2014, a study by Italian researchers revealed how specially trained dogs were able to detect prostate cancer in urine samples with 98% accuracy.

Source: www.medicalnewstoday.com

ELIZA MURPHY

It’s a battle they never thought they’d face, let alone at the same time.

Missy and Brooke Shatley, a mother and daughter from Prairie Farm, Wisconsin, both have cancer. They were diagnosed only 13 days apart.

“It’s that unbelief,” Missy, 38, told ABC News of her reaction when they learned the devastating news. “You feel numb like this can’t really be happening. This is happening to somebody else, it could never be you.”

Missy was diagnosed with stage 2 cervical cancer on December 26, the day after Christmas.

“I went in for my annual physical and that was the result of it,” she explained.

Then on January 8, Brooke, Missy and her husband Jason’s oldest child, was diagnosed with stage 3 ovarian cancer.

“Why us? Why?,” Missy asked. “Is it something in our water? Is it genetic? Why both of us in such a short time frame? The doctor said it’s not the water, it’s not the environment, it’s just a freak act of nature.”

Before Missy’s diagnosis, Brooke, 14, had been experiencing severe abdominal pain that went undiagnosed for several weeks.

“The doctors told us she had a baseball-sized hemorrhagic disc and it would go away on its own and we should just wait,” Missy explained. “We waited for a few weeks and thought, ‘This is ridiculous,’ and we sought a second opinion.”

The Shatley’s then took Brooke to see the same specialist that had just diagnosed her mom days earlier. The devastating news was that Brooke’s tumor was larger than they originally suspected and needed to be operated on immediately.

“It was a four-and-a-half hour surgery,” Missy recalled. “It was a football-sized tumor. It had intertwined in her abdomen. You couldn’t tell by looking at her belly, but it was football-sized.”

The brave mother-daughter duo began undergoing intense treatments at the same time in Marshfield, Wisconsin, about two hours from their home--understandably weighing heavily on husband and father Jason, a dairy farmer, who was traveling back and forth to take care of them while also tending to their other two children and maintaining their farm.

“It’s hard,” Missy said. “Just to even think, ‘That’s my wife and daughter,’ how does anybody deal with that? Plus we have two other kids at home so he’s trying to be a husband, father, keep up with the farm, he’s being pulled in so many directions, how do you even begin?”

This week has been better for the family, however. Both Missy and Brooke are back home, resting and enjoying their time, although possibly brief, out of the hospital.

Missy just completed her final round of radiation and chemotherapy on March 2. She now must wait eight to 12 weeks before they can tell how effective the treatment was on her cancer.

Brooke still has one more round of chemo to complete, tentatively scheduled to begin on March 9.

Although their simultaneous diagnosis has been difficult, Missy says, in a way, it’s been nice to have that newfound bond with her daughter.

“You don’t want to experience it with anybody, but if you have to, doing it as a mother-daughter is helpful,” she said. “You’re bonding over raw emotions. It’s definitely a connection that you form.”

On March 28 their community is holding a benefit for the resilient pair, which Missy says is just one of the generous things they’ve done to help throughout this process.

“Not in a million years could I imagine the outreach we’ve had,” she said. “The surrounding communities have been phenomenal. We have a dairy farm so we’ve had people volunteer to do chores, saw wood, make meals, provide transportation for the other kids when we need it--anything and everything they’ve offered up.”

Most importantly, she added, “Prayers, lots of prayers.”

Source: http://abcnews.go.com

LIZ NEPORENT

Throwing a surprise “Sweet 16” party in the age of cellphones and social media is no easy task. But an entire Virginia community pulled it off for a girl with cancer.

The night of her birthday, Abby Snider thought she was going to give a speech to help raise money for the Stillbrave Childhood Cancer Foundation, a local charity that provides non-medical support for the families of kids with cancer. It was all part of an elaborate ruse to bring the teen to the George Washington Hotel in Winchester, Virginia, last Thursday evening, where 100 people (including a team from ABC affiliate WJLA) were waiting.

Snider, who was diagnosed with leukemia a year ago, spent weeks writing her speech. At the same time a group of friends, family and complete strangers worked quietly behind her back to plan the big bash. AES, a local car service, provided a stretch limo. SAS salon arranged for makeup. Other vendors donated food, flowers, photography and entertainment.

Snider’s parents had wanted to throw her the fancy sweet 16 she has been dreaming about since she was 2, she said, but with the mounting medical bills it just wasn’t in their budget. Tom Mitchell, who runs StillBrave, stepped in to rally local businesses.

“It was amazing to see how many people in community embraced the idea and helped to pull it all together,” he said.

Snider was expecting a car to pick her up for the fundraiser, so she said she was pleased rather than suspicious when a stretch limo pulled up to her house. She thought the makeup session was simply a nice touch too. None of this tipped her off to the party.

But when she walked into the ballroom and everyone shouted, “Surprise,” Snider told ABC News she was blown away.

 “At first I was confused and then I started screaming and then I started crying," she said. “It was awesome. I literally felt like Cinderella for the night.”

Snider said the chemo used to treat her disease has brought her to the brink of death several times. Just recently she spent three weeks in the hospital with acute pancreatitis that resulted from her latest treatment.

“There are times you just want to give up but you have to keep going,” she said. “Even when it’s hard you just have to keep fighting.”

After missing last year’s birthday because she was too ill, Snider said she’d hoped for some kind of party this year, even if it was something small. Mitchell told ABC News he was relieved that all involved managed to keep it a secret.

“I hated lying to her but she definitely bought it hook, line and sinker,” he said.

Mitchell said the only downside to the ruse was that Snider worked so hard on a speech she didn’t get to deliver. But Snider said she’s good with that.

“I was freaking out about it and I was so relieved I didn’t have to give it,” she said. “I’ll save it for another time.”

Source: abcnews.go.com