6 things to check before swallowing that pill

What do you do when your doctor recommends an expensive medication?

Pharmacist Andrew Burgdorf from the Upstate Cancer Center offers this advice:

  • Andrew Burgdorf, PharmD

    Andrew Burgdorf, PharmD

    Find out how much of the bill your health insurer will pay, so you know how much you will owe. Upstate provides financial counselors to help patients understand expenses.

  • Ask whether the drug manufacturer offers co-pay assistance, and explore options through organizations such as the American Cancer Society or the Cancer Financial Assistance Coalition.
  • Think twice about purchasing more than a one-month supply at a time. If your medication needs change, you cannot return the drugs for a refund.
  • Double-check the instructions regarding dosage and frequency and whether the pills should be taken with food or on an empty stomach.
  • Make sure your health care provider and pharmacist know about any supplements you take, including fish oil, since some supplements could reduce the effectiveness of some cancer drugs.
  • Ask your health care provider and/or pharmacist what side effects are to be expected, what symptoms may signal an adverse reaction — and what to do if you experience a reaction.

Pharmacists such as Burgdorf, who specialize in oncology, can answer more specific questions.

This article appears in the summer 2015 issue of Cancer Care magazine.


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What was hair today is gone tomorrow — to raise money to fight pediatric cancer


Shown before the St. Baldrick’s event are (from left) Russell Kincaid, Tracy Kalinowski, Clare Rauch, Sharon Huard, Alex Kalinowski, Christopher White and Michelle Bergquist. All are Upstate employees except Alex, who is Tracy Kalinowski’s son.

StBaldricksAfter001 (1)

Shown after getting their heads shaved for St. Baldrick’s are (from left) Tracy Kalinowski, Russell Kincaid, Clare Rauch, Sharon Huard, Alex Kalinowski, Christopher White and Michelle Bergquist.

Several Upstate employees were among the 570 people having their heads shaved at Kitty Hoynes Irish Pub & Restaurant in Syracuse on March 1 to raise money for the St. Baldrick’s Foundation.

The Upstate Golisano Children’s Hospital has received grants from St. Baldrick’s that pay for research to find cures for childhood cancers and that help survivors live long, healthy lives. Donations are still coming in, but the event at Kitty Hoynes this year raised about $450,000.

Pictured before and after the St. Baldrick’s event are Tracy Kalinowski, who works in the pediatric infusion center; Russell Kincaid, from radiation oncology; Clare Rauch, senior assistant librarian; Sharon Huard, who works in student affairs; Alex Kalinowski, son of Tracy Kalinowski; Christopher White, who works in the pediatric infusion center; and Michelle Bergquist, who works in the library.

This article appears in the summer 2015 issue of Cancer Care magazine. 

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Electronic cigarette use soars among teen smokers


While traditional cigarette smoking declines among U.S. high school students, and stays the same among middle schoolers, the increasing use of electronic cigarettes and water pipes called hookahs means that tobacco use among teens remains steady.

The use of electronic cigarettes by teens is soaring, causing concern among health experts who question the safety of the battery-powered devices and complain that they are creating a new generation of nicotine addicts.

E-cigarettes create an inhalable vapor by heating liquid nicotine – in flavors such as candy or fruit – in a disposable cartridge or refillable tank. The vapor lacks the tar of traditional cigarette smoke but still contains cancer-causing chemicals, said Leslie Kohman, MD, a lung surgeon and medical director of the Upstate Cancer Center. While the U.S. Food and Drug Administration has declared the main component of e-cigarettes, propylene glycol, safe for eating, she said, “Inhaling it is very different because the lungs absorb things in a very different way than the intestinal tract.”

smoke page 10Kohman is concerned about the lack of regulation, too. “E-cigarettes are manufactured in various locations around the world with no manufacturing controls, no safety controls whatsoever,” she said. The FDA has proposed regulations, and a group of health organizations in New York state is trying to add e-cigarettes to the state’s Clean Indoor Air Act so the devices would be prohibited anywhere cigarettes are prohibited.

Also, since an 18-month-old boy from the Albany area died after swallowing a small amount of liquid nicotine, New York state now requires childproof packaging of liquid nicotine.

The sale of tobacco products, including e-cigarettes and liquid nicotine, to those younger than 18 years of age is illegal in New York state. Some local jurisdictions have set the age higher: In Onondaga County, where Upstate Medical University is located, the minimum age is 19. In New York City, it’s 21.

Data from the U.S. Centers for Disease Control and Prevention tracks smoking rates among high school and middle school students, revealing underage tobacco use. Experts fear that three of every four teen smokers will continue into adulthood because almost 90 percent of adult smokers say they first tried cigarettes as teens.

This article appears in the summer 2015 issue of Cancer Care magazine.

Hear Kohman’s radio interview about the dangers of e-cigarettes.

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Caring for a child who has cancer, and the siblings who do not

Aliya Hafeez, MD

Aliya Hafeez, MD

Psychiatrist Aliya Hafeez, MD answers a question with which many parents grapple after one child is diagnosed with cancer…

Q: My middle child has been diagnosed with leukemia, so much of my energy is focused on her treatment. What can I do so I don’t lose touch with my older and younger daughters during this time? They are 16, 10 and 3.

A: A good place to begin would be to ask your daughters how they feel that their sister is sick. Also ask them how they feel about all your attention and energy going into caring for her.

Offer to spend some time individually with each of your other children along with your sick daughter. That way maybe they can become your little helper in taking care of her.

If time allows maybe a date night with each individual child would be helpful in reconnecting you both.

Aliya Hafeez, MD, is the chief psycho-oncologist at the Upstate Cancer Center and a cancer survivor. Reach her at 315-464-3615.

This article appears in the summer 2015 issue of Cancer Care magazine.

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How a tumor is diagnosed

As serious as it is, cancer is usually not an emergency, urologic oncologist Srinivas Vourganti, MD, told visitors to the Upstate Cancer Center this spring.

Srinivas Vourganti, MD

Srinivas Vourganti, MD

A cancer diagnosis is a step-by-step process that has to be complete before exploring treatment options. If you rush to judgment with incomplete information, you may face unnecessary treatments or therapies that don’t jibe with your beliefs.

Vourganti said to think of a suspicious lump as a dog barking in your back yard. The bark could belong to a variety of dogs, from a toy poodle wearing a collar to a rottweiler foaming at the mouth or something else entirely. You won’t know for sure until you do some research.

Depending on the type of cancer suspected, that research will include a series of medical tests. If cancer is found, doctors work with laboratory specialists on TNM staging. This takes into account the tumor size (T), whether cancer has spread to the lymph nodes (N) and whether it has spread elsewhere, or metastasized (M).

They use TNM staging and other factors to help create an individual treatment plan.

This article appears in the summer 2015 issue of Cancer Care magazine.

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Soothing nourishment for those with mouth sores

This recipe for milk and rice soup from the “Betty Crocker Living With Cancer Cookbook” offers soothing nourishment to those with mouth sores. And because milk is added to bananas and rice in this dish, it can be an effective remedy for diarrhea as well.


1 cup uncooked regular long-grain rice

2 cups water

2 bananas

2½ cups skim milk

2 tablespoons sugar


In a 2-quart saucepan, heat rice and water to boiling. Reduce heat to low; cover and simmer about 15 minutes or until water is absorbed and rice is tender. Let stand about 10 minutes or until cool enough to eat, or refrigerate.

In medium bowl, completely mash bananas. Stir in cooked rice, milk and sugar. Serve immediately. Cover and refrigerate any remaining soup.

Nutritional information

This recipe makes four servings. One serving contains: 310 calories, ½ gram fat, zero grams cholesterol, 70 milligrams sodium, 500 milligrams potassium, 67 grams carbohydrates, 9 grams protein and 2 grams dietary fiber.

This article appears in the summer 2015 issue of Cancer Care magazine.



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Cart provides comfort items to patients in Cancer Center

Brandon Spillett, of Syracuse, an Upstate volunteer, shows the Comfort Cart, which offers items to patients at the Upstate Cancer Center. (PHOTO BY DEBBIE REXINE)

Volunteers at the Upstate Cancer Center staff a cart full of comfort items that they make available to outpatients and inpatients. A Kobalt tool cart was purchased with donations from Lowe’s Home Improvement Store and Room 2 Smile, an organization started by Brandon Spillett, of Syracuse, after his father, Daniel, died in 2005. Voss Signs wrapped the cart with a large vinyl decal so that the cart blends in with the center’s theme of nature. Spillett is an Upstate volunteer.

On top of the cart: Cancer Care magazine, brochures about services at the Upstate Cancer Center.

Top drawer: lip balm, hand sanitizer, personal tissue packs, blank greeting cards, toothbrush-and-toothpaste packs and mouthwash.

Second drawer: American Cancer Society information and referral forms for various services the society makes available.

Third drawer: decks of playing cards, Crazy 8’s and Go Fish, plus paperback sudoku and crossword puzzle books.

Fourth drawer: small water bottles, hand lotion, throat lozenges

Bottom drawer: a dozen Kindles, loaded with periodicals, to lend to patients.

This article appears in the summer 2015 issue of Cancer Care magazine.


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A new perspective: Hodgkin lymphoma changed her body and her mind

Emily Breclaw took some time off during her cancer treatment but returned to swimming with the Liverpool Jets during her sound round of treatment. (PHOTO BY SUSAN KAHN)

Emily Breclaw took some time off during her cancer treatment but returned to swimming with the Liverpool Jets during her sound round of treatment. (PHOTO BY SUSAN KAHN)


Emily Breclaw underwent four rounds of chemotherapy, each lasting a couple week. She deal with three day of nausea, and soon after that subsided, and soon after that subsided, she had whole-body muscle aches with which to content, but she said “I felt better going through chemo than I did for the eight months before.”

Breclaw, 16, a sophomore at East Syracuse Minoa High School and a competitive swimmer, was sick for almost a year. She would get tired. She had low-grade fevers every night for five months, and night sweats. She would get out of breath. A blood test revealed anemia; iron supplements did not help. Breclaw struggled to concentrate and sometimes fell asleep in class.

Breclaw says that as a cancer survivor, she has a new perspective on what's important in life. (PHOTO BY SUSAN KAHN)

Breclaw says that as a cancer survivor, she has a new perspective on what’s important in life. (PHOTO BY SUSAN KAHN)

“I would have to do my homework standing up because otherwise I would fall asleep,” she recalled.

Over the summer, she developed stomachaches and pain in her ribs. She also dealt with itchiness, and her trouble breathing got worse. Her family doctor ordered a chest X-ray and located a mass the size of an orange. He sent Breclaw to Upstate Golisano Children’s Hospital, where pediatric oncologist Gloria Kennedy, MD, began caring for her.

She was admitted to the hospital that Friday, Oct. 24. She had a biopsy the next day.

When Breclaw learned she had cancer, she was not surprised. “I kind of knew it was coming,” she said. “You know how some people say they kind of knew? Something in me just knew.”

The next week was full of medical appointments to prepare Breclaw and her parents for the chemotherapy that began Nov. 4. She was found to have Hodgkin lymphoma, a cancer that begins in the white blood cells. The American Cancer Society says Hodgkin lymphoma accounts for about 3 percent of childhood cancers.

Breclaw missed a lot of school and a lot of swimming. She returned to classes in January, having lost her hair during treatment. “I went back with a hat, and people were OK with it. They didn’t care at all that I didn’t have any hair,” she said. “A few weeks after that, I started getting a little hair. I didn’t wear a hat, and everybody was OK with that, too.”

She returned to school with a more mature way of thinking. Before cancer, she was shy, prone to worry what people thought of her and quick to complain about trivial matters.

Now, as a cancer survivor, Breclaw has confidence. Little things that used to concern her are unimportant. And, she has a perspective that causes her to think before complaining. “I stop and think about the struggles I endured and the struggles that some children are still enduring.”

SymptomsLayout 1

An enlarged lymph node is the most common symptom of Hodgkin lymphoma, often appearing as a lump or bump on the side of the neck, in the armpit or groin. Other symptoms people may experience include fevers that come and go, drenching night sweats, unexplained weight loss, exhaustion, itchiness and loss of appetite. (Source: American Cancer Society)

This article appears in the summer 2015 issue of Cancer Care magazine, which features Breclaw on its cover.

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Seeking families with young children for study on child mental health

A pair of mental health researchers at Upstate are studying new ways to classify mental health disorders in children and looking to change the way psychiatric disorders are understood and diagnosed in the future.

Stephen Faraone, PhD, and Stephen Glatt, PhD, are analyzing genetic variation and basic cognitive abilities within families. Their goal is to  provide a better basis for a new diagnostic system that is less subjective than what is currently used.

If you are the biological parent of a child between the ages of 6 and 12 years, you may be eligible to participate in their study, which is funded by the National Institute of Mental Health.

The research team is recruiting about 700 families (2,800 individuals) and looking at a broad spectrum of childhood behaviors, including children who are developing typically with no mental health concerns, as well as those who may have mental health concerns or behavioral problems. Parents and their children will complete a series of questionnaires and computer-based tasks and provide a blood sample for genetic analysis.

The study procedure takes up to 3 hours for the family, and each participant is financially compensated. To enroll or learn more, contact research assistant Pat Forken at 315-464-5619.

Hear an interview about this research


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What to expect at your first visit

The main entrance to the Upstate Cancer Center.

The first appointment at the Upstate Cancer Center is usually a consultation that lasts at least 1½ hours and involves the oncologist and other members of the treatment team who will discuss options and recommendations with the patient. Oncologists will have reviewed radiology and laboratory results and other information from referring physicians prior to the patient’s arrival.

Before arriving:

  • Do some research on the type of cancer you have. Find resources at upstate.edu/cancer under the “cancer types” tab.
  • Write down specific questions.

    Atrium of the Cancer Center.

    Atrium of the Cancer Center.

  • Learn about your physician at upstate.edu/hospital/providers
  • Let the appointment scheduling staff know if translation services or interpretation for the hearing impaired are needed.

What to bring:

  • Completed medical history form, located at upstate.edu/cancer under “your first visit.”
  • Referring physician’s name, address and phone number.
  • List of prescription medications, over-the-counter medicines and supplements.
  • List of questions.
  • Family member or friend who can help listen and take notes.
  • Health insurance cards, plus your employer’s name, address and phone number if you are covered under an employer’s insurance program. Also, living will or advance directives, if you have them.
  • Parking ticket for validation.

For questions, please call 464-HOPE (4673).

This article appears in the summer 2015 issue of Cancer Care magazine.


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