After a mastectomy, a patient may wish to have breast reconstruction, which involves multiple steps to prepare for implants. Until now, implants were only available for average-size breasts. Now, a new Food and Drug Administration-approved option is available for larger sizes. Norton Plastic & Reconstructive Surgery providers performed the first implant procedure in Kentucky using MENTOR MemoryGel Enhance silicone implants.

“Despite being a standard part of post-mastectomy care, reconstruction options have not kept pace with the diverse needs of today’s patient population,” said Brian P. Thornton, M.D., plastic and reconstructive surgeon with Norton Plastic & Reconstructive Surgery, who performed the first procedure with the new implant. “Patients who require a larger-volume implant than what was previously available now have an option that helps them feel whole again.”

The American Society of Plastic Surgeons reports that 157,740 women underwent breast reconstruction in 2023. However, many more did not have access to a reconstructive implant that would restore their breast size to what it once was.  

Silicone implants are desired by many patients because of their natural look and feel. Often, they also are lighter weight.

“We want every woman to have an option to feel like themselves again after undergoing a mastectomy,” Dr. Thornton said. “Until now, this was not possible and made a breast cancer diagnosis that much more traumatic.”

Breast reconstruction after mastectomy is available through Norton Healthcare’s Breast Health Program, accredited by the National Accreditation Program for Breast Centers (NAPBC). The program offers comprehensive services, from screening through diagnosis, employing several patient navigators to make the patient journey seamless and as comfortable as possible.

“Patients who must undergo a mastectomy often have decreased self-confidence, concerns about their physical appearance and even feelings of loss,” Dr. Thornton said. “It’s important for every person needing this part of the healing process to have options and a path forward.”

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“If a patient has a suspicious finding on a screening, we move rapidly to make sure everything possible is done to get answers for them,” said Joseph Flynn, D.O., MPH, FACP, chief administrative officer, Norton Medical Group, and physician-in-chief, Norton Cancer Institute.

With two locations, Norton Cancer Institute Downtown and Norton Cancer Institute – Brownsboro, the center combines four multidisciplinary components to fight lung cancer: prevention, screening, diagnosis and treatment.

Lung cancer prevention: Smoking is the single biggest lung cancer risk factor, so smoking prevention and cessation are key. For anyone who smokes, the sooner you quit, the lower your lung cancer risk becomes. Norton Healthcare continues to expand smoking cessation options for patients and the public.

Lung cancer screening: Early diagnosis of lung cancer is critical. Low-dose CT scans, which can detect even the smallest tumors, are used to screen for lung cancer in individuals who meet established age and smoking history criteria. The center’s integrated screening component delivers two important benefits for patients:

• A navigator to assist patients through the screening process with education and resources
• Rapid access to a team of specialists if a suspicious finding is detected

Lung cancer diagnosis: The Comprehensive Lung Center works with patients and their primary care team to develop a treatment plan specifically for each patient’s physical and emotional needs. Fortunately, not all nodules identified by CT scan are cancerous, but when lung cancer is diagnosed, patients see a team of highly trained specialists who work together toward the common goal of a cure.

The Comprehensive Lung Center has specialists in cardiothoracic surgery, radiation, medical oncology, pulmonology and other disciplines, who are available to see the patient in one visit. This provides convenience for the patient and is important to the specialists who work together to develop a comprehensive care plan.

Lung cancer treatment: No cancer patient should have to wait to start the journey toward a cure. The Comprehensive Lung Center combines compassionate, whole-patient care with advanced technology and treatment. Customized treatment plans may include surgery, chemotherapy, radiation and targeted molecular therapies for certain subtypes of lung cancer.

Patients have access to numerous clinical trials through Norton Cancer Institute’s research program.

Therapeutic and supportive care services include yoga, massage, art and music therapy, nutritional counseling, and support groups — all available from day one.

In recent years, research has demonstrated up to a 20% decrease in lung cancer mortality for people at high risk who undergo lung cancer screening with low-dose CT scans.

“As with all forms of cancer, the earlier lung cancer is detected and the earlier treatment can begin, the better the chance for positive outcomes,” Dr. Flynn said. “Should you be diagnosed with cancer, we know you will have many questions and want answers right away. That’s why we offer same-day appointments with a cancer specialist.”

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Oaks Day honors women who have survived or are in treatment for breast or ovarian cancer. You’ll see this year’s 151 honorees walking the turf track in the Survivors Parade prior to the running of this year’s Oaks race.

This day also is an opportunity to talk about prevention and early detection of these cancers that affect nearly 300,000 people a year in the United States. Breast cancer alone is one of the top causes of cancer death in women — second only to lung cancer — according to the American Cancer Society. The Centers for Disease Control and Prevention show Kentucky’s rates of breast and ovarian cancer as similar to those of the entire nation: More than 133 women out of 100,000 women are expected to receive a new diagnosis of breast cancer in Kentucky this year, and 10 out of every 100,000 will get ovarian cancer.

Thankfully, high-profile events such as the Kentucky Oaks help call attention to these issues. However, they do more than that: They raise funds critical to bringing down these statistics. Churchill Downs will donate to two organizations, one of which is Norton Cancer Institute, the leading provider of breast cancer care in Louisville and Southern Indiana. Funds specifically benefit the Derby Divas Breast Health Center. In fact, Churchill Downs has donated more than $1 million in support to charities over 16 years to fund cancer screenings and care for underserved women.

We know that the breast cancer death rate has been on the decline since 1989. While there are constant innovations in cancer treatment, awareness and screenings have increased thanks to events such as the Kentucky Oaks — and the funding it raises.

If you’re taking a trip to Churchill Downs for this year’s Oaks, enjoy your day. But also be sure to recognize the importance of the pink (and teal) that you will wear. And know that just by being there, you are part of saving lives.

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Today, he’s a bit more cautious about how much time he spends in the sun. In the past three years, Randy has had two basal cell carcinoma skin cancers removed from his face, the first requiring significant reconstruction due to the lesion’s proximity to the left side of his nose and eye socket.

Randy said he didn’t think too much about the initial spot at first. When it grew more noticeable, he asked his primary care physician about it. According to Randy, his family medicine physician, Karalee Bessinger, M.D., at Norton Community Medical Associates primary care in Carrollton, Kentucky, referred him to a dermatologist in LaGrange, Kentucky. That doctor wanted to refer him to a facility in Louisville, Kentucky, because of the lesion’s location and the intricate surgery it would take to remove it.

Not one for city traffic, Randy sought another opinion, turning to Jonathan Hanson, M.D., otolaryngologist (ear, nose and throat specialist) with Norton King’s Daughters’ Health in Madison, Indiana. Dr. Hanson met Randy in January 2022 and assured him that he could remove the lesion and provide any necessary reconstruction.

“The art of facial reconstructive surgery takes into account a lot of factors,” said Dr. Hanson, adding that about 15% of his practice includes skin cancer removals on the face, ears, head and neck. “Elasticity of the skin varies from the nose to the cheek to the eye. It’s also important to factor in the shape and location of a patient’s natural skin lines and contours. The goal is to meet surgical needs while minimizing any noticeable incisions when healing is complete.”

During Randy’s first surgery, Dr. Hanson opened a large flap on the left side of Randy’s face, following the natural skin lines under his eye to the edge of his mouth. After fully removing the cancerous lesion, he carefully stitched the seam back together using the natural skin folds along his cheek and eye. Today, you would never know Randy underwent significant facial surgery.

“He’s a fabulous doctor,” Randy said. “He told me exactly what he was going to do and followed up with everything he said he was going to do.”

In May 2024, Randy returned to Dr. Hanson for a second area of concern: an elongated bump just below his right eye. A less extensive surgery was needed, and Dr. Hanson again developed a plan of action and executed it perfectly.

“One reason I enjoy the work is the creativity,” Dr. Hanson said. “Every face and every person is unique. There’s no cookbook or recipe.”

After a life spent farming, working at a factory and serving his country in the Army, Randy relishes his slower pace. He enjoys being home, spending time in his self-proclaimed man cave and watching car racing on television. He and his wife, Carolyn, still live on a 60-acre farm outside Carrollton, near family and friends.

These days on the farm, one thing is different. If you see Randy outside mowing or working on a project, he’s wearing a straw hat. It’s a small price to pay to help keep the sun off his face.

“The earlier we find skin cancers, the better,” Dr. Hanson said. “The smaller they are, we get much better results. It’s easy to ignore them. Any spot that is raised or pigmented or grows or changes needs to be reviewed by a family provider. If they think it’s suspicious, the patient can be referred for follow-up.”

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Anyone with a cervix should get their first Pap smear at age 21 and another every three years before turning 30. Those ages 30 to 65 should have a Pap test every three to five years.

“If you are younger than 21, the American College of Obstetricians and Gynecologists (ACOG) says you do not need this type of screening,” said Amy E. Farrell, M.D., OB/GYN with Norton Women’s Care.

What is a Pap smear test?

A Pap smear (also referred to as cervical cytology or Pap test and named for its developer George Papanicolaou, M.D.) can detect abnormal, precancerous cervical cells. 

Precancerous changes to cervical tissue, or cervical dysplasia, won’t cause any symptoms, but can be identified through lab testing. A Pap test is a very effective cervical screening test. Early detection allows for early treatment, which can be the most successful. A regular Pap smear can identify abnormal cervical cells before they develop into cancer. Even if cervical cancer has started to develop, a Pap test can detect it and lead to early treatment that can preserve fertility. 

READ MORE: What’s the right age to start getting Pap smear tests?

The test is very brief, and while it may be a bit uncomfortable, it doesn’t hurt. You’ll lie on your back with your feet in stirrups and a drape over your legs. Your gynecologist or other health care provider will insert a speculum in your vagina to hold it open to provide access to your cervix. A small brush collects cervical cells and is placed in a tube for testing.

For two days prior to your Pap smear test, refrain from vaginal sex, stop using tampons, vaginal creams, medicines, lubricants or douches. Schedule your appointment for after your period ends. If you have your period on the day of the exam, contact your provider, as menstruation could alter the results.

A pelvic exam is not the same thing as a Pap smear. Although they commonly occur during the same visit, both tests are not a requirement for every appointment. They serve as important ways to keep you healthy, including prevention of certain medical conditions and screening for cancer.

According to ACOG, a pelvic exam is not necessary — unless certain symptoms are present or there is a risk of specific conditions — but a patient and provider should make this decision together.

Is a Pap smear also an HPV test?

Cervical cells collected during a Pap smear are also tested for HPV, a very common virus that often has no symptoms and clears up in a year or two without causing cancer. An HPV infection that persists for many years can lead to precancerous changes that can develop into cervical cancer. 

HPV testing and vaccination can significantly reduce the risk of cervical cancer.

After an abnormal Pap test result

If you get an abnormal Pap test or HPV result, you and your provider will discuss next steps, which could include:

• A review of your medical history with an emphasis on relatives who may have had cervical or another gynecologic cancer
• A physical exam that includes feeling your lymph nodes for any abnormalities
• Follow-up test called a colposcopy: This test gives your health care provider a magnified view of the surface of your cervix. As with a Pap smear, you’ll lie on your back, and your provider will insert a speculum in your vagina to provide access for the colposcopy. The exam causes no more discomfort than a Pap smear. A weak solution of acetic acid (the same acid in vinegar) will be applied to your cervix to highlight abnormal areas. A small piece of cervical tissue may be removed for a biopsy to determine whether there are signs of cervical precancer, cancer or neither. 
• A cone biopsy retrieves a bit of tissue for testing and can serve as treatment by removing all the abnormal cervical tissue. The small piece of tissue is cut in the shape of a cone and may leave you with some discomfort for about a week.

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The Pat Harrison Resource Center offers free support services to patients throughout their cancer journey, regardless of where they receive their cancer treatment. The center reaches thousands of cancer patients, survivors and their families each year.

The resource center was created by Southern Indiana real estate agent Pat Harrison, whose own battle with breast cancer inspired her to create a place of healing and hope for other cancer patients. Pat recognized just how important it was to have a welcoming and healing environment where cancer patients can receive information, guidance and resources while connecting with other patients and families going through similar experiences.

Thanks to Pat’s inspiration and generous donations through the Norton Healthcare Foundation, her vision was realized in partnership with Norton Healthcare and Norton Clark Hospital. Today, her namesake center serves as one of five Norton Cancer Institute Resource Centers, carrying forward the mission of offering support at every step in the cancer journey, from diagnosis to survivorship.

Free comprehensive support

The Pat Harrison Resource Center is committed to offering all services at no cost. These services provide emotional and mental support to help cancer patients feel whole and empowered during one of the most challenging times of their lives, regardless of their financial situation.

Services include:

• Community support and counseling groups
• Classes and seminars on cancer education and survivorship
• Private educational sessions with oncology-certified nurses
• Complementary therapies, such as massage, music therapy, art therapy, and yoga
• Mastectomy resources for breast cancer patients
• Nutritional counseling for a balanced diet during treatment
• Wigs, turbans, hats, and head coverings
• Access to a lending library for additional resources
• Information on clinical trials and treatment advancements

Compassion is at the core of the Pat Harrison Resource Center. Patients and their families can expect to find warmth and comfort from those who understand quality of life is just as important as longevity to a patient with cancer. Staff at the center will help support each patient’s well-being while helping them navigate the critical moments between treatments, medical appointments and beyond.

Patient testimonial: Johnna Webb

Cancer can be a challenging journey, but the Pat Harrison Resource Center provides patients with the knowledge and comfort they need to face their cancer with strength and courage.

After Johnna Webb, of Charlestown, Indiana, was diagnosed with invasive ductal carcinoma, she was introduced to Deborah L. Pirtle, R.N., OCN, an oncology patient navigator and advocate at the Pat Harrison Resource Center.

According to Johnna, Deborah’s role went beyond typical support — Johnna felt like she had a supportive friend who was always checking in, listening and advocating for her health care needs and wishes.

“Deborah even attended my care team’s tumor board meeting and made sure to contact me afterward to help ease my mind,” Johnna said. “She promised that she would be there every step of the way.”

Deborah’s continued check-ins and personalized care made a major difference as Johnna weighed her treatment options, including surgeries. The Pat Harrison Resource Center provided Johnna with free booklets and detailed education materials about her treatments and medications, including what to expect, which offered immediate answers and peace of mind.

Johnna has recovered from her lumpectomy and radiation treatments and continues to attend appointments with her oncology team. Deborah continues to call regularly with updates and to offer support, according to Johnna.

“The Pat Harrison Resource Center provided me with extra hope and confidence that I could beat cancer,” Johnna said. “I encourage anyone facing cancer to utilize this invaluable resource in the Southern Indiana community.”

Hope for patients and their families

Cancer can be beatable, especially when patients feel supported. The Pat Harrison Resource Center focuses on patients, but recognizes that caregivers and family members are part of the healing journey as well. Family members also can access resources to help cope with caring for a loved one with cancer.

No one should face cancer alone

The Pat Harrison Resource Center is located at 1206 Spring St., Jeffersonville, IN, 47130. For more information or to access the center’s services, call (812) 288-1156 or visit NortonHealthcare.com/CancerPatientResources.

About the Norton Healthcare Foundation

As the philanthropic arm of Norton Healthcare’s not-for-profit adult services, the Norton Healthcare Foundation raises funds to support initiatives at Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Clark Hospital, Norton Hospital, Norton King’s Daughters’ Health, Norton Scott Hospital, Norton West Louisville Hospital and Norton Women’s & Children’s Hospital.

Thanks to support from our community, caregivers and our hospitals can stay up to date with medical advances and technology, thereby maintaining the community’s access to high-quality health care.

Funds raised also make a difference for the more than 400,000 patients and their families who come to us for care each year by supporting the purchase of new equipment, providing programs and education, and funding research spanning Norton Cancer Institute, Norton Heart & Vascular Institute, Norton Neuroscience Institute, Norton Women’s Care and other adult health services.

Learn more or make a donation to help the Norton Healthcare Foundation continue to support patients in our community.

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Monica H. Vetter, M.D., gynecologic oncologist at Norton Cancer Institute in Louisville, is on a mission to help prevent cervical cancer across Kentucky.As a Louisville native and graduate of the University of Louisville School of Medicine, she is passionate about caring for other women in her hometown.“I want all women to be protected,” she said. “I want to make sure we’re giving patients the opportunity to be aware and have a good relationship with a physician so they feel like they can advocate for themselves.”Dr. Vetter has experience treating all gynecologic malignancies, including cervical, uterine, ovarian and vulvovaginal cancers. She also specializes in integrating robotic-assisted surgery for gynecologic oncology and helps patients gain access to national and international clinical trials. As a subspecialized provider who focuses solely on patients with gynecologic cancers, Dr. Vetter’s has expertise in treating those conditions to give patients better health outcomes.

“They live longer. There’s a higher chance that they’re cured. There’s a higher chance they’re going to be offered an opportunity to get into a clinical trial if they need to,” she said. “That’s why our subspecialty is so important within the Norton Healthcare system — it improves the outcomes of our patients diagnosed with gynecologic cancers.”

Kentucky’s high rate of cervical cancer

Cervical cancer is almost entirely preventable, thanks to the screening techniques used by Norton Healthcare providers and facilities. Pap smears can detect abnormal or precancerous cells or HPV infections that can increase a person’s risk of developing cancer.

“If you can identify these cells early, you can intervene so that a person never goes on to develop cervical cancer,” Dr. Vetter said.
However, Kentucky has one of the worst rates of the disease in the U.S. According to the Centers for Disease Control and Prevention, there are 9.9 cases of cervical cancer per 100,000 women in Kentucky, compared with the national average of just 7 cases per 100,0000.

Kentucky’s higher rate of cervical cancer — fourth worst in the country — is often driven by low adherence to cervical cancer screening guidelines, whether it’s due to a lack of access of gynecologic care in rural areas, or simply a busy mom who hasn’t gotten around to making an appointment. Sometimes, people put off the screening because they feel too embarrassed. Dr. Vetter wants to reassure patients that there is no reason to be hesitant. 

“I think there’s a lot of reluctance to talk about cervical cancer and Pap smears, because getting a Pap smear is very intimate with your physician. It can be something people think is embarrassing, because, as a society, we don’t talk about the female reproductive system a lot,” Dr. Vetter said.
Early-stage cervical cancer often has few or no symptoms. When there are symptoms, they’re usually mild, like bleeding during sex or bleeding in between periods, which can be easy to write off as “normal” or not worth bringing up with a health care provider.

“Women may chalk it up to, ‘Oh, I just had an irregular period this month,’ or “My cycles are just a little bit off.’ And if you’re a busy, working woman, you may not even really notice it,” Dr. Vetter said.

Preventing cervical cancer today

Women should be screened for cervical cancer starting at age 21. Patients between the ages of 21 and 29 should receive a Pap smear every three years, while ages 30 to 64 should get a Pap smear with an HPV screening every five years, or a Pap smear every three years.
 
If abnormal cells are detected early, there are surgical interventions that can prevent the development of cervical cancer. Norton Cancer Institute offers cancer patients the most modern treatments and access to hundreds of clinical trials. Dr. Vetter estimates she is one of a relatively small number of gynecologic oncologists in Kentucky. She knows how important it is to establish a comfortable rapport with patients and strives to make every person comfortable discussing sensitive issues about their reproductive health.

“When our relationship is based on transparency and trust, it’s better for everyone,” she said. “Being approachable, straightforward and thoughtful goes a long way when caring for someone.”

Monica H. Vetter, M.D., is a board-certified gynecologic oncologist with Norton Cancer Institute. Dr. Vetter earned her medical degree from the University of Louisville School of Medicine in Kentucky. She completed her residency in obstetrics and gynecology, and a fellowship in gynecologic oncology at The Ohio State University College of Medicine in Columbus. Dr. Vetter is a member of the Society of Gynecologic Oncology, American Society of Clinical Oncology, and the American Medical Association, and is a fellow of the American College of Obstetricians and Gynecologists.

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The trial principal investigator is Tianhong Li, M.D., Ph.D., of the University of California, Davis Comprehensive Cancer Center. OncoC4 Inc. enrolled its first patient under the care of site investigator John T. Hamm, M.D., of Norton Cancer Institute in Louisville, Kentucky.

“It is very exciting to be part of this journey,” Dr. Hamm said. “As oncologists, we know we need better answers, and through clinical trials like this, especially in the past five years, we have seen rapid improvements in cancer care and treatment.” 

The Phase 1 ONC-841 clinical trial (NCT06352359) will study the medicine given by IV infusion to  patients with advanced/metastatic solid tumors, meaning various types of cancer that have spread beyond the cancer’s primary site, with a goal of reducing the tumor size and slowing the spread.

Norton Cancer Institute works through Norton Research Institute for clinical trials. Norton Research Institute has roughly 750 research studies currently underway, investigating medications, devices, outcomes, disparities and biology in multiple medical specialties. Of those, more than 100 are open clinical trials specific to cancer and 34 are Phase 1, which tests the safety, side effects, dosing and timing of a new treatment.

Dr. Hamm’s current clinical trials and studies

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The ride begins in front of the Norton Cancer Institute, where every day, patients undergo the latest cancer treatments, research is conducted, and people support their loved ones.

For most riders, getting on the bike is personal. For Chris Crews and his wife Monica, this event is part memorial, part victory ride and part holiday.

A diagnosis

After a chiropractor’s X-ray showed some irregular results in 2010, Chris went to his family physician. There were more tests, including a CT scan and a biopsy, which confirmed the worst: cancer. Chris was eventually diagnosed with lymphoma. He was 36 years old.

Through it all, Chris’s mom, Alberta, was there for him. “She was my biggest supporter,” he said. Mother and son spoke often over the years of intense treatments, including chemotherapy and radiation. Finally, Chris was in the clear – the oncologist told him to keep up with yearly bloodwork with his regular physician.

The family didn’t have very long to revel in Chris’s cancer-free status — Alberta was diagnosed with colorectal cancer in 2017. During her treatment, it was Chris’s turn to be a source of comfort, information and support for his mom. “She would call to talk about treatments and what to expect and that kind of thing.”

A Special Bond

Chris and Alberta always had a close relationship. “I’m much younger than my three older siblings, so they were out of the house by then,” Chris said. He was eight when his father passed away. “It was just me and my mom.” Alberta focused on her son and her Catholic faith to get her through difficult times.

They spoke often, especially during their respective cancer diagnoses. Two themes stand out to Chris about chats during that time, wisdom from a woman who had lived 73 years in this world: life is short and take care of your health. “My diagnosis and then my mom’s diagnosis really made me aware of my health in general,” he said.

Perhaps the strong bond between mother and son, catalyzed by their cancer diagnoses, was what made her death in 2018 so devastating.

Just like riding a bike

A vacation in 2019 sparked Chris and his wife Monica into more serious cycling. “We rented bikes on the trip and when we got back, we started biking for health reasons.” That was also their first year participating in Bike to Beat Cancer.

“It’s odd, I remember my first oncology visit at Norton Cancer Institute. There were these brochures in the waiting room for Bike to Beat Cancer,” Chris said. “I thought, ‘Well, that’s interesting but that’s not for me.’” Little did he know that less than a decade later, he and his wife and a team of supporters would create their own little holiday around this event.

Since 2019, Chris, Monica, and a rotating team of family and friends have ridden in BTBC. “We have always done 35 miles, but maybe this year we will make the jump to 62, or maybe 100,” the couple said.

A Holiday in September

For the Crewses, BTBC is a celebration, a memorial and an athletic event all rolled into one two-day event. “It really starts the day before the actual ride, at the Celebration of Courage,” Chris said. “Picking up packets and so forth, it all has a very welcoming and festive feel.” The next day, after fueling up with breakfast, they head to the starting line.

“There’s a tremendous sense of community, of support,” Chris said. “They treat the riders so well, it’s a really well-run and organized event. We look forward to this all year.”

Riding this route mimics a cancer journey. “There are ups and downs, there are times when you feel really good, and times when you have to push through,” Chris said. “My mom and I, during our treatments, rallied around the idea of one day at a time. If that’s too much, get through the next 6 hours. If that’s too much, get through the next hour. Or the next 15 minutes.” The name “Team 182” is a reference to Alberta’s days in retail. “Her timeclock number was 182,” Chris said. “Her motto was to just keep going, moving forward, one foot in front of the other.” Or in this case, one more push of the pedal.

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