It seems "defeat" just isn't in John Cashen's vocabulary. A survivor in more ways than one, John has overcome not only a catastrophic natural disaster, but also fought cancer with unyielding resilience.
In 2005, as flood waters from Hurricane Katrina rose and threatened his New Orleans home, John took an axe to his attic's ceiling, climbed atop his roof and tied himself to his chimney so he wouldn't be swept away. Days later, no help had arrived, so John untied himself and swam to an overpass where he was rescued by a helicopter. He joined the rest of his family in Georgia.
Since then, John has become a proud citizen of LaGrange. A master of everything Mardi Gras, John runs a local krewe and is a natural at building parade floats from the foundation up. But when he was diagnosed with lung cancer in 2019, he summoned his fighting spirit, squared his shoulders, and faced his cancer journey head on.
JohnCare
Published on October 14, 2020
Last updated 10:58 AM October 10, 2023
A master of everything Mardi Gras, John runs a local krewe and is a natural at building parade floats from the foundation up.
For patients like John, there’s a lot of different aspects we take into consideration when creating a treatment plan. We pull all factors together—like general health, medicines, personal preferences and family concerns—to create the best care plan possible.
- Dr. Robert Taylor
Wellstar Radiation Oncologist
Listen to John's story
A troubling diagnosis
It all began with lung discomfort and tiredness that he just couldn't shake, no matter how much sleep he had each night. Concerned, he visited his primary care provider to get to the bottom of the issue.
After John's vital signs revealed low blood pressure, the doctor sensed something bigger might be happening behind the scenes. John underwent diagnostic testing, including bloodwork and X-rays, to find the cause of his fatigue.
"When the X-rays came back, my doctor noticed a spot in the upper left lobe of my lungs," John said, remembering the fuzzy dot on the X-ray screen. "I had been feeling tired and run down, but overall, I didn't feel that bad."
The troubling results pointed to a clear answer: lung cancer. Even though John didn't notice many red flags when it came to his health, his body was battling a disease he couldn't see.
According to Mayo Clinic, many patients may not experience any symptoms in the early stages of lung cancer. Once the warning signs—such as coughing, shortness of breath, chest pain and hoarseness—set in, the disease may already be at an advanced stage.
After a round of CT and PET scans, the concerning lung spot appeared to be growing in size, even after just a short few days.
Without delay, John was on a mission to find the right health partner to treat his lung cancer before it had the chance to spread.
Cutting-edge cancer care
Soon after the concerning X-ray results, John sought out the medical opinions of several different doctors. All of the professionals recommended a biopsy and other surgical means to treat his cancer.
However, John was firmly against any invasive treatments. That's when he crossed paths with Wellstar Radiation Oncologist Dr. Robert Taylor, who suggested a solution.
"When John first came into the office, he was very worried about the prospect of surgery," Dr. Taylor said, recalling their first meeting at Wellstar West Georgia Medical Center. "He knew about many cancer treatments and was seeking the least invasive option possible."
After discussing John's concerns about surgery, the physician suggested an innovative cancer treatment called stereotactic ablative radiotherapy (SABR).
"SABR is like virtual surgery. Using X-ray technology, you can "reach" inside of a patient and virtually cut out the tumor," Dr. Taylor explained. "When the patient leaves a treatment session, they feel the same as when they entered. There is no surgery or downtime."
For John, this was the perfect, non-invasive option to take care of his cancer, quickly and effectively. He also left the consultation feeling like an equal partner in the process.
"Dr. Taylor explained everything to me clearly," John said. "He knew I wasn't a physician, so he spoke to me in a way that I could understand and laid out all my treatment options."
When building a custom care plan for any patient, Wellstar always takes a personalized approach.
"For patients like John, there's a lot of different aspects we take into consideration when creating a treatment plan," Dr. Taylor shared. "We pull all factors together—like general health, medicines, personal preferences and family concerns—to create the best care plan possible."
With a clear path forward and renewed hope, John felt confident trusting Wellstar with his lung cancer care.
Care right around the corner
A short time later, John began SABR treatments at Wellstar West Georgia Medical Center. With the most advanced cancer technology right in LaGrange, he didn't have to travel out of his way for treatment.
For the hard-working father and grandfather, the access to quick and convenient cancer treatments fit right into his busy schedule.
"Typically, this type of radiotherapy is delivered in about five separate treatments, in 30-minute intervals," Dr. Taylor said, explaining how the specialized treatment works. "The sessions are often done just a few days apart."
Without any incisions or other invasive measures, SABR uses concentrated radiation beams to target tumors precisely. Because his lung cancer was localized, the focused doses could treat the affected areas without damaging the healthy tissues.
Dr. Taylor was pleased with John's health progress throughout the treatment, and his prognosis was quickly looking up.
"John had no side effects and responded very well to treatment," said Dr. Taylor. "One time, he even asked if the machine was turned on because he couldn't feel a thing."
From start to finish, John kept a positive attitude about his cancer care. "The treatments weren't painful. It was a half-hour long, so just long enough for a good nap."
Wellstar offered support every step of the way, addressing John's concerns and crafting an effective cancer treatment plan. But the care didn't end when he left the building.
"During my treatment, the Wellstar team helped me through everything. Afterward, they would call me often to see how I was feeling and ask if I was eating enough," John beamed. "Wellstar is full of caring people. It's not just for show."
The radiation sessions were successful. Just months after the initial diagnosis, John was pronounced cancer-free. His yearly scan and monthly check-ins have all shown no signs of the disease returning either.
Now, John can get back to life and what really matters: planning his annual Mardi Gras parade for family and friends. Moving forward, he will always consider Wellstar to be an essential part of his health krewe.
"My Wellstar care team made me feel like I was a person, not an object they were trying to fix. Nobody treats you like Wellstar."
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Prostate Cancer Screening in Black Men
Screening for prostate cancer is crucial for early detection and to help provide the best possible outcome. It is especially important for Black men to be vigilant about screening, as they are disproportionately impacted by this cancer.
About 1 in 6 Black men will be diagnosed with prostate cancer in their lifetime, compared to 1 in 8 white men, according to a report from the American Cancer Society. Prostate cancer is the second leading cause of cancer death in Black men.
The American Cancer Society recommends that men at an average risk of developing prostate cancer begin screening when they are 50, but Black men should start earlier—at age 45 if they have no family history of prostate cancer, and at age 40 if any of their male relatives have had prostate cancer. Wellstar takes a personalized approach to cancer screenings, with clinicians discussing benefits versus risks of screening and helping patients evaluate their risk.
“Despite many physicians being aware of this and following this practice, Black men continue to be diagnosed with and die from metastatic prostate cancer. This is a trend that desperately needs to be reversed,” said Wellstar Primary Care Physician Dr. Earl Stewart. “We have adequate screening tools that do not even require a digital rectal examination.”
The Prostate-Specific Antigen (PSA) blood test is more accurate than the digital rectal examination in helping to detect prostate cancer, according to Dr. Stewart. Patients should also discuss family history with their relatives. “Patients knowing their family history is so crucial in having those discussions with primary care physicians to determine the best age at which to start screening,” Dr. Stewart said.
Screening for prostate cancer is as simple as making a preventive appointment with your primary care physician, discussing your family history with him or her, and having a PSA blood test. This test may be performed during an annual physical or wellness visit. Shared decision making between physician and patient is important to discuss your risk, your need for testing and next steps to take if your PSA level is elevated and concerning. Knowing your risk can save your life.
“I know many personally who are near and dear to me who had the disease and who unfortunately died from complications of metastatic prostate cancer,” Dr. Stewart said. “I know many more who lived because they had the conversation and dared to move forward with appropriate screening at the appropriate age.”
Highlights
4 Common Questions About Gynecologic Cancer—Answered
The gynecologic oncologists at Wellstar care for women at all stages of life, treating a variety of conditions with compassion and offering advanced care options. Our team are experts in treating cancers such as uterine, ovarian, cervical, vaginal and vulvar cancers. Here, we answer common questions about gynecologic cancer care with the help of Dr. Rosa Miller Polan, a gynecologic oncologist at Wellstar Cobb Medical Center.
What is a gynecologic oncologist?
Gynecologic oncologists are specialists trained in the multidisciplinary management of patients with cancers of the female reproductive tract. Trained originally in obstetrics and gynecology, gynecologic oncologists treat patients with complex benign gynecologic issues, as well as gynecologic cancer patients who may need surgery, chemotherapy, immunotherapy or a combination of different treatments.
When should you seek care?
Gynecologic cancers have different warning signs. When a person experiences concerning symptoms, a physical exam, including a pelvic exam, should be performed. Cervical and vaginal cancer symptoms include abnormal vaginal discharge, vaginal bleeding and pain. The most common warning sign for uterine cancer is abnormal vaginal bleeding. In postmenopausal women, any bleeding or spotting is abnormal and should prompt an evaluation.
Ovarian or fallopian tube cancer symptoms include bloating, constipation, pelvic or abdominal pain and difficulty eating or feeling full quickly. Vulvar cancer symptoms include itching, burning, discoloration, and new bumps or lumps on the skin outside of the vagina.
Who is at risk for developing gynecologic cancer?
Women who smoke cigarettes are at elevated risk for cervical, vaginal and vulvar cancer development. People who are immunosuppressed and those who have tested positive for the human papillomavirus (HPV) are also at increased risk. Genetics can contribute to the development of uterine, ovarian or fallopian tube cancers and these types of cancers can run in families. Obesity and use of hormone replacement therapy can put women at risk for the development of uterine, ovarian and fallopian tube cancers. A history of infertility, endometriosis and pelvic radiation are also risk factors for developing gynecologic cancer.
What services are available at Wellstar?
At Wellstar, gynecologic oncologists provide comprehensive care for patients with gynecologic cancers, including administering chemotherapy and performing surgeries when needed. As high-volume pelvic surgeons, gynecologic oncologists also care for patients who need elective and emergent complex benign gynecologic surgery.
For many patients, robotic-assisted surgery offers a minimally invasive approach with less associated blood loss, shorter hospital stays and fewer post-operative complications. Gynecologic oncologists are some of the top users of the innovative DaVinci 5 robotic surgery platform. Performing complex gynecologic cancer surgeries, minimally invasive or otherwise, requires the type of highly specialized and multidisciplinary teams that work at Wellstar—and an infrastructure of resources to ensure patients have access to best-in-class care in their own backyard.
Learn more about gynecologic oncology at Wellstar at wellstar.org/gyncancer.
Highlights
Stroke prevention and the future of stroke care
This article was originally published on
Atlanta Business Chronicle on May 19, 2023.
Stroke is the fifth leading cause of death in the United States. The Georgia Department of Public Health reports the state had the 12th highest stroke death rate in the country. Georgia is also part of the “stroke belt,” an area of the southeastern United States with stroke death rates 30% higher than the rest of the nation.
As the leading — but preventable — cause of disability, stroke can happen at any age.
Stroke is a medical emergency, meaning the blood flow to an area of the brain is cut off, depriving brain tissue of oxygen and nutrients. When this happens, brain cells start to die and abilities controlled by that area of the brain, such as speech or muscle control, are lost.
New drugs and new advanced treatments — such as the Tigertriever and Artemis — are helping reduce the death and disability impact of stroke, as well as comprehensive care programs and innovative hospital partnerships that expand stroke services into rural areas.
Physicians from Wellstar Health System and the CEO of a hospital in northeast Georgia joined Atlanta Business Chronicle to discuss stroke prevention and the future of stroke care.
Panelists & moderator
- Dr. Rishi Gupta, Endovascular Neurologist and Co-Medical Director of Neuro Care
- Dr. Ashis Tayal, Vascular Neurologist, Wellstar, Director of Neuro Care Network
- Van Loskoski, CEO, Stephens County Hospital
- David Rubinger, Market President & Publisher, Atlanta Business Chronicle; Moderator
What is stroke, screening and secondary prevention
David Rubinger: Dr. Tayal, set the stage for us about the definition of stroke.
Dr. Ashis Tayal: A stroke is a sudden injury of the brain due to blockage or rupture of an artery in the brain. Injuries to the brain and disability can vary significantly.
The most common, ischemic stroke injury, is due to obstruction of an artery that causes a loss of blood flow to a critical part of the brain which damages the brain rapidly.
The other type of stroke is hemorrhagic stroke, where there’s a rupture of an artery, bleeding into the brain, or the surfaces of the brain, and that is called an intracerebral hemorrhage or a subarachnoid hemorrhage.
Rubinger: I think Americans have become a little better educated as to who’s at risk for stroke, but why don’t you walk us through that. Who would be a potential stroke candidate?
Tayal: High blood pressure, or hypertension, is the most common risk factor for both ischemic and hemorrhagic strokes. High blood pressure is an extremely common but controllable condition. Almost 80% of people have hypertension as they’re getting older.
Other risk factors include diabetes associated with elevated blood sugars causing accelerated blockage of arteries and high cholesterol, which can be related to diet and genetics.
Atrial fibrillation, a common heart arrhythmia that occurs as people get older, also places people at risk for the most severe and disabling types of strokes. And plaque buildup in specific arteries of the neck and brain also leads to an increased risk of stroke.
Smoking is another risk factor. Many adults still smoke despite a lot of progress in stroke treatment, and smoking puts people at risk for different types of stroke.
Rubinger: What about atmospheric things like stress and other areas like that? How does that play into it? Or do those things manifest themselves because of the other underlying physical conditions?
Tayal: I don’t view stress, in and of itself, as a risk factor for stroke. I think that’s more related to people’s environments and their own personalities and how they respond to stress. I do think people who are under undue stress can have poor lifestyle habits, and those poor lifestyle habits, whether poor eating habits, smoking, weight gain or lack of exercise, can lead to conditions that increase the risk for stroke.
Rubinger: So how is the healthcare system doing treating strokes? Do you believe that what’s going on at the primary care provider’s office is helping or do we have a way to go?
Tayal: In the United States, preventive care has improved the treatment of risk factors that lead to stroke, but communities must maintain routine checkups as many of the risk factors are silent.
There are improved treatments for hypertension, more aggressive treatment for diabetes, and more efforts at smoking cessation. Just the fact that we treat hypertension better than we did a generation ago has had a great impact on lowering the prevalence of stroke.
That being said, some of the most exciting work on stroke has often been done in the area of acute treatment of stroke with clot-busting drugs, catheter-based treatments and medications to protect the brain during an acute injury.
Rubinger: Has pharmacology gotten better in terms of the hypertension medicines that are out there? Have anti-cholesterol medicines improved in recent years?
Tayal: In the past, healthcare providers were often undertreating people with hyperlipidemia — high cholesterol — and not fully appreciating the benefits of significant reductions in cholesterol levels. For example, we’ve learned that driving cholesterol down into much lower ranges under 55 mg/dL can benefit our patients who have vascular disease as a cause for their stroke.
In the fight against high cholesterol, newer medications that prevent the absorption of cholesterol are now available. Recent developments have led to the discovery of a new underutilized class of drugs called PCSK-9 inhibitors that are highly effective.