Minimally invasive bariatric surgery produces steady and lasting
Transcription
Minimally invasive bariatric surgery produces steady and lasting
GoodHealth BLOUNT MEMORIAL HOSPITAL FALL 2016 ❂ LIVE HEALTHIER AND HAPPIER PHOTOGRAPHER DON DUDENBOSTEL PAGE 3 PAGE 4 PAGE 7 PAGE 8 Minimally invasive bariatric surgery produces steady and lasting weight loss. State-of-the-art prostate cancer screenings and treatments save lives. Meet Dr. Ryan Skinner, dermatologist and fellowship-trained Mohs surgeon. You’re not alone. Learn about our cancer programs and support groups. www.blountmemorial.org BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 GOOD HEALTH FOCUS: Cosmetic Treatments and Procedures Are you considering cosmetic surgery or a non-surgical anti-aging treatment? By the time most people hit their 40th birthday, some visible signs of aging are reflected in the mirror. Years of sun damage and stress, lifestyle factors such as tobacco and alcohol use, and the after-effects of giving birth and breastfeeding all take a toll on the body. While aging is a fact of life, looking much older than you feel can have a negative impact on your self-esteem, body image and ability to get a job (particularly after age 50). Since July’s opening of Blount Memorial’s new Center for Dermatology and Plastic Surgery at Springbrook (page 6), we’ve been fielding more questions from patients about cosmetic, or aesthetic, procedures. We’ve addressed the three most commonly asked questions below with answers from Blount Memorial plastic and reconstructive surgeon Dr. Matthew Becker. Dr. Matthew Becker Plastic and reconstructive surgeon Medical School: University of Texas Southwestern Medical School, Dallas Board Certifications: American Board of Surgery American Board of Plastic Surgery The Center for Dermatology and Plastic Surgery at Springbrook 220 Associates Blvd., Alcoa, TN 37701 865-238-6400 For more information, call The Center for Dermatology and Plastic Surgery at Springbrook at 865-238-6400. Q: Does health insurance cover the cost of cosmetic procedures? A: Insurance companies do not cover any cosmetic procedure. However, some procedures that people commonly think of as "cosmetic," such as removing extra skin from the upper eyelid or removing excess skin from the abdomen may be covered on a case-bycase basis. Each insurance company has its own criteria for coverage, and our staff is available to assist with questions our patients may have about their specific plans. Q: The salon where I get my hair done recently became a “medical spa” offering anti-aging treatments such as Botox® and dermal fillers. Does the word “medical” mean that physicians administer the treatments? A: Not necessarily. In Tennessee, a medical spa is defined as “any entity, however named or organized, which offers or performs cosmetic medical services.” In general, an affiliation with a physician is all that is required to open a medical spa and train technicians (such as aestheticians or cosmetologists) to administer treatments. The term “medical spa” typically describes a day spa offering non-surgical cosmetic treatments (such as lip augmentation, laser hair removal, CoolSculpting and Botox®) as well as traditional hair, nail, facial, makeup and massage services. ON THE COVER: This issue features photographer and prostate cancer patient Don Dudenbostel. To ensure all cosmetic, or aesthetic, dermatology services are performed in a safe and sterile environment, the American Society for Dermatologic Surgery advises consumers to choose locations staffed by board-certified physicians including dermatologists and/or plastic surgeons. Due to their relevant training, physicians from these specialties are experts in aesthetic procedures. In our clinic, 2 specifically, there is not a one-size-fits-all approach to facial rejuvenation. Dr. Becker uses his experience and expertise to create an individualized plan to address the needs of each patient, which ensures the bestpossible results. As with any medical treatment, always do your research and ask questions before having any cosmetic procedure. Know the potential benefits and risks of any treatment. Find out if a board-certified physician will be performing your procedure, or will be supervising another trained and experienced health care provider, such as a physician’s assistant or registered nurse. Ask what happens in case of a medical emergency or if another unforeseen health issue arises during or after your treatment. Q: I’ve never understood why anyone would have surgery for cosmetic, not medical, reasons. Now that my breasts look deflated— a result of breastfeeding my three kids over the past five years—I’m wondering if I might be a candidate for some sort of breast enhancement procedure. Does Blount Memorial offer anything for mothers to help restore breast shape and a positive body self-image? A: Yes. Dr. Becker is a specialist in aesthetic and reconstructive breast procedures. In particular, he has extensive experience in helping moms who are dealing with postpartum deflation, a common problem among women who have had children. Milk production causes a woman’s breasts to increase in size. When she stops breastfeeding, the breasts dramatically decrease in size resulting in sagging and deflation. A breast lift can address the sagging and shaped implants can replace lost volume. Shaped implants, something Dr. Becker specializes in and travels the country teaching other surgeons how to use, have many different profiles and dimensions. For example, an implant that is a little taller than it is wide provides more fullness up top. With breast implants and all aesthetic breast procedures, Becker works with each patient to achieve the appropriate size and look for her frame. For a free consultation with Becker, call The Center for Dermatology and Plastic Surgery at Springbrook at 865-238-6400. 14.2 million minimally-invasive cosmetic procedures were performed in the United States in 2015. Source: American Society of Plastic Surgeons BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 Reach your weight loss goals with bariatric surgery. Minimally invasive approaches reduce your stomach’s capacity, helping you feel full faster and stay full longer. If you’ve tried and failed multiple times to lose a significant amount of weight, bariatric surgery at Blount Memorial could be the tool you need to dramatically improve your health and quality of life. Blount Memorial board-certified bariatric surgeon Dr. James Ray is an expert in Laparoscopic Adjustable Gastric Banding, or Lap-Band®, and sleeve gastrectomy, or gastric sleeve. Among the region’s leading Lap-Band® specialists, Dr. Ray has performed approximately 1,000 of the procedures during the past 12 years. In addition, he has published his results in peer-review journals and has presented at international conferences. His 2010 Lap-Band® guide has been used in training nationwide. Below, he explains how Lap-Band® and gastric sleeve work, and the potential benefits of each procedure. ☎ MAKE AN APPOINTMENT To schedule an initial consultation with Dr. Ray or to get more information about surgical weight loss at Blount Memorial, call East Tennessee Medical Group at 865-984-3864. LAP-BAND® HOW IT WORKS: During this procedure, the surgeon makes a few very small incisions in the patient’s abdomen. A viewing tube with a small camera (laparoscope) is inserted to give the surgeon precise, high-definition views inside the body. Guided by the camera images, the surgeon uses long, thin instruments to place a small, bracelet-like band around the upper part of the stomach to separate it from the lower part. This creates a small pouch with a narrow opening that goes into the larger, lower part of the stomach. GASTRIC SLEEVE HOW IT WORKS: The surgeon removes approximately 75 to 80 percent of the stomach, including the portion producing the hormone ghrelin, commonly called the “hunger hormone.” This results in the stomach taking on the shape of a banana or “sleeve,” which holds much less food. Although originally intended as the first step in a two-stage procedure for super-obese or high-risk patients, the gastric sleeve now is commonly and successfully used for weight loss in people with a Body Mass Index (BMI) greater than 40. POTENTIAL BENEFITS: • No cutting or stapling of the stomach • Natural anatomy is left intact • Adjustable • Reversible • Low risk of regaining weight (if the patient follows the required diet and exercise guidelines) • Low surgical risk POTENTIAL BENEFITS: • No implantable device requiring adjustment • Simple alternative to gastric bypass • Typically, faster weight loss than with Lap-Band® • Lose up to 75 percent of excess weight • Improve or cure obesity-related health problems, such as diabetes LAP-BAND® AND GASTRIC SLEEVE: WHO’S ELIGIBLE? Lap-Band® and gastric sleeve generally are appropriate for people ages 18 and older whose serious weight loss attempts in the past have had only short-term success. To be medically qualified for any bariatric procedure, patients need to have a Body Mass Index (BMI) of at least 40, or a BMI of at least 35 plus one or more obesity-related medical conditions (such as adult-onset diabetes, gastric reflux, infertility, joint pain caused by arthritis and sleep apnea). In addition, patients cannot be suffering from any other disease that may have caused the excess weight. Before being approved for surgery, all patients must demonstrate that they are prepared to make major changes in their eating habits and lifestyle. ◆ DR. JAMES RAY Bariatric and general surgeon 3 BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 B LOUN T MEMOR IA L CA N CER CEN T ER D Focusing on Early Detection Finding prostate cancer early increases treatment options and survival rates. on Dudenbostel is most comfortable behind the camera, not in front of it. For nearly 50 of his 67 years, the Loudon County resident has been a professional photographer. His award-winning work appears in galleries, museums, national magazines and other publications, including Good Health. Dudenbostel’s experience photographing cancer survivors and other patients treated at Blount Memorial helped him face his own cancer diagnosis with confidence, he says. “Because I had been working with a number of Blount Memorial cancer patients, I didn’t panic,” recalls Dudenbostel, who was diagnosed with prostate cancer in November 2015. “The day I found out I had to have the biopsy, in fact, I was photographing a prostate cancer survivor. My experience [both as a photographer and as a patient] with Blount Memorial gave me complete confidence in a cure. I didn’t doubt for one second that they would knock it [the cancer] out.” Since Dudenbostel’s cancer was caught early and confined to the prostate gland, he was given a choice of treatments: watch and wait, surgery, external beam radiation, low-dose radioactive seed implantation (brachytherapy) or Proton treatments. After extensive research, including talking to prostate cancer survivors, he chose seed implantation at Blount Memorial. Blount Memorial board-certified radiation oncologist Dr. Daniel Green introduced prostate seed therapy (see right) to Blount County in 2013. Green’s expertise was a factor in Dudenbostel’s decision to choose Blount Memorial and “I came to the conclusion brachytherapy for his treatment. that seed implants were “I came to the conclusion that seed implants were right right for my lifestyle. I didn’t for my lifestyle,” explains Dudenbostel. “I didn’t want to have want to have to go to the to go to the hospital every day for 30 or 40 treatments, and I hospital every day for 30 didn’t want surgery. When I researched Dr. Green and found or 40 treatments, and I he had performed more than 2,000 seed implants, I knew that didn’t want surgery. When this was the guy I wanted to do my procedure. He’s done so I researched Dr. Green and many, I believe he could do them blindfolded.” found he had performed On Nov. 3, 2015, Dudenbostel had 120 seeds implanted in his prostate. The outpatient procedure only took about 90 more than 2,000 seed minutes, and was his only treatment for the cancer. Except implants, I knew that this for some initial swelling, fatigue and urinary inflammation, was the guy I wanted Dudenbostel reports that the side effects were minimal. to do my procedure. Three months after the procedure, Dudenbostel had his first follow-up PSA (prostate specific antigen) test. Before the seeds were implanted, his PSA level was 7. (According to the American Cancer Society, men with a PSA level between 4 and 10 have about a one in four chance of having prostate cancer.) This time, his PSA was only .28. “The PSA level just fell off the side of the mountain following the treatment,” Dudenbostel says. “By using seeds, I was able to get about 60 percent more radiation delivered directly to the site without any damage to surrounding tissue.” Now that he is a cancer survivor, Dudenbostel willingly shares his experience in hopes of helping other men realize the importance of regular prostate screenings. Since Dudenbostel faithfully gets a physical each year, his primary care doctor, East Tennessee Medical Group internal medicine physician Dr. Richard Gaddis, was able to monitor changes in the prostate over time. Dudenbostel points to this ongoing prostate health care as the reason why his cancer was 4 DON DUDENBOSTEL detected in an early, highly treatable stage. “Over a period of about four or five years, Dr. Gaddis watched my PSA start to climb very slowly,” adds Dudenbostel. “When it got above 4, he put me on antibiotics suspecting infection. The levels would drop and then rise again. When the PSA got up to 7, that started to be a warning sign…a serious one.” He continues, “Prostate cancer is a big deal. It is one of the biggest killers of men. Allowed to get out of control, it will kill you. Early detection and regular examinations are key.” ◆ BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 Learn more about prostate seed implantation therapy at Blount Memorial. WHO’S ELIGIBLE? Candidates include men diagnosed with early-stage prostate cancer. BENEFITS: Precise targeting of the tumor, sparing of surrounding healthy tissue and fewer visits and side effects than standard therapies HOW IT WORKS: Typically, prostate seed implantation is a one-time, five-step process (described below). Treatment is customized, however, to fit each patient’s specific situation. Radioactive seeds are inserted through needles into the prostate gland. The number of seeds implanted depends on the size of the prostate. Following the procedure, X-rays are taken to document the position of the seeds. The total time spent at the hospital on procedure day is generally five to six hours. About one month after the procedure, a CT (computed tomography) scan of the prostate gland is taken to verify that the seed placement was adequate and to calculate the radiation dosage each area of the gland will receive. PSA blood tests are administered during follow-up visits with the urologist and/or radiation oncologist. The first test generally is conducted three months after the procedure. Additional testing takes place every three to six months. Individual patient results vary, however, it may take 12-36 months for PSA levels to drop to their lowest point. “If you’ve been diagnosed with prostate cancer and either do not want surgery or aren’t a candidate for surgery, radioactive seed implantation is an option to consider. It is a one-time procedure that is minimally invasive. Essentially, there is no recovery time.” —Dr. Daniel Green Radiation oncologist Is surgery the best option for you? Minimally invasive, robotic-assisted prostate surgery speeds recovery. If prostate cancer hasn’t spread outside the prostate gland, surgery may be the recommended treatment. According to the American Cancer Society, the main type of surgery for prostate cancer is a radical prostatectomy. In this procedure, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles. Traditional prostate surgery requires a large incision and a hospital stay. For eligible patients, however, Blount Memorial offers a minimally invasive, outpatient option: robotic-assisted radical prostatectomy using the hospital’s state-of-the-art da Vinci Si system. Unlike conventional open surgery or other laparoscopic methods, the robotic-assisted approach uses a 3-D HD vision system and tiny instruments. This advanced technology helps surgeons make extremely precise excisions and repairs, minimizing the chance of damage to nerves and blood vessels. DR. RUSTAN VAN WYK Urologist and urologic surgeon Blount Memorial’s expert urologists are specially trained in robotic-assisted procedures. To schedule an appointment with urologist Dr. Rustan Van Wyk or Dr. James Briggs at East Tennessee Medical Group- Surgery and Urology (located in the Blount Memorial Physician Office Building), call 865-980-5260. 5 BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 Skin cancer doesn’t discriminate. No matter your ethnicity or skin tone, check your skin regularly to look for changes. When 24-year-old Alia Rodriguez noticed that a mole on her chest was growing larger and changing in color, she says that the word “cancer” never crossed her mind. “I’m Hispanic and have darker skin, so I didn’t think I had to worry about skin cancer,” adds Rodriquez. She’s not alone. According to researchers, there’s a common misconception among all Americans that people with darker skin are immune from skin cancer. This belief is inadvertently reinforced by many skin cancer public health campaigns, which focus on and use images of lighter-skinned people. In fact, Hispanic Americans are more likely than other Americans to be diagnosed with skin cancer in its later stages, when it's more apt “Dr. Mokaya was really to be fatal. From 1992 to 2015, according the data from the Cennice and explained ters for Disease Control and Prevention, the annual melanoma that it was good thing (the deadliest form of skin cancer) incidence rate for Hispanics I had come in when increased by more than 20 percent. I did because skin Fortunately for Rodriguez, when the mole grew to roughly cancer can spread.” the size of a pencil eraser she asked her primary care doctor to take a look. As a precautionary measure, her physician referred Rodriquez to Blount Memorial board-certified dermatologist Dr. Kemunto Mokaya. During that initial visit in April 2016, Mokaya biopsied the mole in a simple, in-office procedure. The tiny scar from the biopsy already had healed, Rodriguez recalls, by the time Mokaya called a week later with the results. “When Dr. Mokaya called to tell me that the mole was basal cell carcinoma, one of the most-common types of skin cancer, I was shocked. Dr. Mokaya was really nice and explained that it was good thing I had come in when I did because skin cancer can spread.” ALIA RODRIGUEZ Mokaya performed a second, in-office procedure to remove the entire mole. The resulting scar, while small, serves as a constant reminder about the importance of skin protection and regular skin checks, Rodriguez explains. “I do try to be more careful now, and I know I need to see Dr. Mokaya if I notice any changes in a mole or on my skin. If I don’t notice anything, I’ll go to the dermatologist every six months for a check. If I do see anything, I won’t wait.” ◆ Healthy skin begins here. New Center for Dermatology and Plastic Surgery at Springbrook opens in Alcoa. From anti-aging wrinkle reduction to skin cancer removal, The Center for Dermatology and Plastic Surgery at Springbrook is equipped to meet any medical or aesthetic dermatology need in one convenient location. Blount Memorial board-certified plastic and reconstructive surgeon Dr. Matthew Becker, boardcertified dermatologist Dr. Kemunto Mokaya, and fellowship-trained Mohs surgeon and board-certified dermatologist Dr. Ryan Skinner lead the center’s expert skin health team. Available services include: acne and acne scarring treatment Botox® and dermal fillers customized skin care plans featuring SkinMedica and Avene full-body skin screenings infectious dermatology Mohs Micrographic surgery to treat skin cancer pediatric dermatology removal of benign lesions and moles skin cancer excisions treatment of hair, nail and pigment disorders; precancerous skin conditions; and rashes and itches For more information or to make an appointment, call 865-238-6400. From left: Dr. Kemunto Mokaya, Dr. Ryan Skinner and Dr. Matthew Becker 6 BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 MEET OUR PHYSICIANS Dermatologist Dr. Ryan Skinner Mohs Micrographic surgery is widely accepted as the most-effective treatment for most types of skin cancer. Thanks to the recent addition of Dr. Ryan Skinner to the Blount Memorial Physicians Group, patients now can access this highly specialized surgery right here, close to home. Dr. Ryan Skinner is the county’s only fellowship-trained Mohs surgeon and sees patients at the new Center for Dermatology and Plastic Surgery at Springbrook in Alcoa. “I’m excited about the opportunity to bring the Mohs technique to Blount County,” says Skinner, who, in addition to being an expert surgical dermatologist is an active father of five who enjoys playing and watching a wide variety of sports including basketball, football, golf, basketball, snow skiing, volleyball and wakeboarding. The Mohs technique, developed in the 1930s by general surgeon Dr. Frederic Mohs, involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (called clear margins). The approach requires fellowship-trained Mohs surgeons such as Skinner to be highly skilled in cancer surgery, pathology and reconstructive surgery. Since Mohs enables surgeons to precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed, the procedure is especially appropriate for skin cancers that: Develop on the nose, eyelids, lips, hairline, hands, feet and other areas where preserving cosmetic appearance and function are important Have recurred after previous treatment or are likely to recur Are located in scar tissue Are large Have edges that are ill-defined Grow rapidly Mohs surgery has the highest success rate (up to 99 percent) of all skin cancer treatments. It’s most commonly used to remove basal and squamous cell carcinomas, the two most-common types of skin cancer. While successfully removing the cancer is the top priority, Mohs does offer the added benefit of smaller scars than traditional excision procedures. In addition, since Mohs fellowship-trained surgeons are trained in reconstructive procedures, it is possible to reduce or even eliminate the appearance of any scar using skin flaps, skin grafts, collagen injections and other techniques. These cosmetic procedures may be performed at the same time as Mohs surgery or at a later date. Additionally, because plastic and reconstructive surgeon Dr. Matthew Becker shares an office with Dr. Skinner, the two can collaborate and plan each patient’s reconstruction together as needed, optimizing the patient’s outcome. DR. RYAN SKINNER Specialty: Surgical Dermatology Skinner emphasizes that Mohs surgery is appropriate for all skin cancers, and that he would prefer to identify cancers early—before the Mohs technique is needed. “It’s important to check your skin regularly and to schedule an annual visit with a dermatologist,” Skinner says. “When we can find skin cancers early, then the surgeries don’t have to be that extensive. If people wait too long, it’s not uncommon to end up losing an ear or a nose when, if it were taken care of earlier, only a small, minor procedure would have been required.” He adds, “Skin cancer is nothing to mess around with. Basal cell is the most-common type of skin cancer, which leads some people to believe it’s no big deal. While basal cell is not going to kill somebody if they wait to get treatment, the cancer doesn’t stop growing on its own. Also, there are aggressive kinds of skin cancers, such as melanoma, that are deadly and very dangerous. If you notice something on your skin, get it checked out.” ◆ Medical School: Midwestern University—Arizona College of Osteopathic Medicine, Glendale Dermatology Residency: Lewis Gale Hospital Montgomery/ New River Dermatology, Blacksburg, Va. Mohs Micrographic and Reconstructive Larkin Hospital, Miami, Fla. Surgery Fellowship: To schedule an appointment with a Blount Memorial board-certified dermatologist, call: 7 Dr. Ryan Skinner Dr. Kemunto Mokaya 865-238-6400 865-238-6400 BLOUNT MEMORIAL GOOD HEALTH ❂ FALL 2016 HEALTH NEWS YOU CAN USE SCREENINGS SAVE THESE DATES Free September Prostate Cancer Screenings Get cancer-related information and support at these upcoming programs Breast Cancer Support Group Mondays, noon - 1:30 p.m. Sept. 19, Oct. 17, Nov. 21, Dec. 19 Blount Memorial Cancer Center second floor, conference room 2 Every Friday and Saturday in September Fridays, 10 a.m. - 5 p.m. Saturdays, 8 a.m. - noon East Tennessee Medical Group 266 Joule St., Alcoa Men age 40 and older (and younger men with a family history of prostate cancer) are encouraged to take advantage of this free screening opportunity. The PSA (prostate specific antigen) test takes less than 15 minutes and is a simple blood draw. There’s no fee and no insurance is billed, however, registration is required. To register, call 865-984-3864. Considering bariatric surgery? Attend one of these free seminar to learn about surgical weight loss at Blount Memorial. Thursdays, 6 p.m. Sept. 8, Oct. 13, Nov. 3, or Dec. 1 East Tennessee Medical Group 266 Joule St., Alcoa Board room, second floor Blount Memorial Hospital offers the expert information, programs and support people need to safely and effectively achieve their weight loss or management goals. Learn more about the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program at a free, no-obligation seminar presented by Blount Memorial board-certified bariatric and general surgeon Dr. James Ray. For more information or to register, call 865-984-3864. This support group is open to all breast cancer survivors, regardless of where they received treatment. The support group meets the third Monday of each month. For more information, call 865-977-5534. Preserve your memories by scrapbooking in this monthly art program. This support group is for cancer patients, survivors and their families. All supplies are furnished. Participants should bring the photos they wish to use. For more information or to register, call 865-977-5534. Head and Neck Resource Support Group Thursdays, 2 - 3:30 p.m. Sept. 1, Oct. 6, Nov. 3, Dec. 1 Blount Memorial Cancer Center second floor, conference room 2 Look Good, Feel Better Mondays, 10 a.m. – noon Oct. 3, Nov. 7, Dec. 5 Blount Memorial Cancer Center second floor, conference room 2 This support group is dedicated to raising awareness and meeting the needs of head and neck cancer patients. Members meet the first Thursday of each month. Patients and their families are welcome to attend. For more information, call 865-977-4729. This national program is dedicated to teaching women who are cancer patients the techniques to help restore their appearance and self-image. Presenters are Annette Manley and Joyce DeVooght, licensed cosmetologists; and Joan Speck, Blount Memorial Hospital volunteer. Women who currently are receiving either chemotherapy or radiation therapy at any hospital are invited to attend any one session free of charge. To register, call the Blount Memorial Cancer Center at 865-977-5534. Blount County Prostate Cancer Support Group Mondays, 6:30 p.m. Sept. 19, Oct. 17, Nov. 21 Blount Memorial Cancer Center conference room 1 and 2, second floor This group is open to all prostate cancer patients, survivors and their spouse/care partner, regardless of where they received or will receive treatment. Meetings include an informative prostate health-related education presentation on topics including prostate cancer terminology and staging, treatment options, short- and longterm side effects and rehabilitation. For more information about the group, call 865-977-5534, Pat Smith at 937-369-7641 or Gene Thompson at 865-984-4903. 8 LifeStories Mondays, 9 a.m. – 1 p.m. Sept. 26, Oct. 24, Nov. 14, Dec. 12 Blount Memorial Cancer Center second floor, conference room 1 Managing Your Cancer Tuesdays, 1 - 4 p.m. Sept. 13 and 27, Oct. 11 and 25, Nov. 8 and 22, Dec. 13 and 27 Blount Memorial Cancer Center second floor, conference room 2 This informative class is designed to teach newly diagnosed cancer patients and their families or caregivers about managing their cancer with a special focus on chemotherapy administration and its side effects. For more information or to register, call 865-273-4004.