Ask a Pro – Prostate Cancer Awareness

Ask a Pro – Prostate Cancer Awareness

With Dr. Cole Kreofsky, Radiation Oncologist
Bismarck Cancer Center

 Q: I am a 72 year old male and have prostate cancer. Are there any new treatment options available?

A:  The Bismarck Cancer Center performs HDR Prostate Brachytherapy as an additional option for the treatment of prostate cancer. This procedure involves using a radiation source (probe) that is delivered through a series of catheters that are temporarily placed within the prostate using ultrasound guidance, while the patient is sedated.  The physician is then able to deliver a higher radiation dose to the prostate and minimize the side effects to the tissue surrounding it. This provides a very precise high dose treatment given over a shorter period of time with minimal side effects. We are confident this new prostate treatment has been instrumental in advancing the way we treat cancer and ultimately create better patient outcomes. 

The benefits of HDR Brachytherapy are: Radiation to healthy tissue is minimized, reducing the potential for side effects; the procedure is done on an outpatient basis, so no hospital stay is necessary; and the patient is not radioactive after treatment, therefore no exposure to family or pets.

Prostate Cancer Awareness Month

Prostate Cancer Awareness Month

What Causes Prostate Cancer?

By the American Cancer Society

Researchers do not know exactly what causes prostate cancer. But they have found some risk factors and are trying to learn just how these factors might cause prostate cells to become cancer cells.

On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. DNA is the chemical in our cells that makes up our genes, which control how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than just how we look.

Some genes control when our cells grow, divide into new cells, and die:

  • Certain genes that help cells grow, divide, and stay alive are called oncogenes.
  • Genes that normally keep cell growth under control, repair mistakes in DNA, or cause cells to die at the right time are called tumor suppressor genes.

Cancer can be caused by DNA mutations (or other types of changes) that keep oncogenes turned on, or that turn off tumor suppressor genes. These types of gene changes can lead to cells growing out of control. DNA changes can either be inherited from a parent or can be acquired during a person’s lifetime.

Inherited gene mutations

Some gene mutations can be passed from generation to generation (inherited) and are found in all cells in the body. Inherited gene changes are thought to play a role in about 10% of prostate cancers. Cancer caused by inherited genes is called hereditary cancer. Several inherited mutated genes have been linked to hereditary prostate cancer, including:

  • BRCA1 and BRCA2: These tumor suppressor genes normally help repair mistakes in a cell’s DNA (or cause the cell to die if the mistake can’t be fixed). Inherited mutations in these genes more commonly cause breast and ovarian cancer in women. But changes in these genes (especially BRCA2) also account for a small number of prostate cancers.
  • CHEK2, ATM, PALB2, and RAD51D: Mutations in these other DNA repair genes might also be responsible for some hereditary prostate cancers.
  • DNA mismatch repair genes (such as MSH2, MSH6, MLH1, and PMS2): These genes normally help fix mistakes (mismatches) in DNA that can be made when a cell is preparing to divide into 2 new cells. (Cells must make a new copy of their DNA each time they divide.) Men with inherited mutations in one of these genes have a condition known as Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC), and are at increased risk of colorectal, prostate, and some other cancers.
  • RNASEL (formerly HPC1): The normal function of this tumor suppressor gene is to help cells die when something goes wrong inside them. Inherited mutations in this gene might let abnormal cells live longer than they should, which can lead to an increased risk of prostate cancer.
  • HOXB13: This gene is important in the development of the prostate gland. Mutations in this gene have been linked to early-onset prostate cancer (prostate cancer diagnosed at a young age) that runs in some families. Fortunately, this mutation is rare.

Other inherited gene mutations may account for some hereditary prostate cancers, and research is being done to find these genes.

Acquired gene mutations

Some genes mutate during a person’s lifetime, and the mutation is not passed on to children. These changes are found only in cells that come from the original mutated cell. These are called acquired mutations. Most gene mutations related to prostate cancer seem to develop during a man’s life rather than having been inherited.

Every time a cell prepares to divide into 2 new cells, it must copy its DNA. This process isn’t perfect, and sometimes errors occur, leaving defective DNA in the new cell. It’s not clear how often these DNA changes might be random events, and how often they are influenced by other factors (such as diet, hormone levels, etc.). In general, the more quickly prostate cells grow and divide, the more chances there are for mutations to occur. Therefore, anything that speeds up this process may make prostate cancer more likely.

Some research has found that men with high levels of another hormone, insulin-like growth factor-1 (IGF-1), are more likely to get prostate cancer. However, other studies have not found such a link. Further research is needed to make sense of these findings.

As mentioned in Prostate Cancer Risk Factors, some studies have found that inflammation in the prostate might be linked to prostate cancer. One theory is that inflammation might lead to cell DNA damage, which could contribute to a normal cell becoming a cancer cell. More research is needed in this area. Exposure to radiation or cancer-causing chemicals can cause DNA mutations in many organs, but so far these factors haven’t been shown to be important causes of mutations in prostate cells.

Ask a Pro – Nutrition during cancer treatments

Ask a Pro – Nutrition during cancer treatments

Dr. Reynolds, Radiation Oncologist, Bismarck Cancer Center

Ask a Pro With Dr. Reynolds, Radiation Oncologist, Bismarck Cancer Center

Q: Do I need to eat differently during my cancer treatment?

A: Good nutrition is especially important if you have cancer because both the illness and its treatments can change the way you eat. They can also affect the way your body tolerates certain foods and uses nutrients. Eating well while you’re treated for cancer might help you:

  • Feel better and keep your strength and energy
  • Maintain your weight and your body’s store of nutrients
  • Better tolerate side-effects
  • Lower your risk of infection and heal faster

During cancer treatment you might need to change your diet to help build up your strength and withstand the effects of the cancer and its treatment. This may mean eating things that aren’t normally recommended when you are in good health. For instance, you might need high-fat, high-calorie foods to keep up your weight, or thick, cool foods like ice cream or milk shakes because sores in your mouth and throat are making it hard to eat anything. The type of cancer, your treatment, and any side affects you have, must be considered when trying to figure out the best ways to get the nutrition your body needs.

Join the Circle of Hope

Join the Circle of Hope

It is hard enough to deal with the news of a cancer diagnosis, but the transportation and lodging for daily treatments in Bismarck is an unbelievable emotional and financial burden on a family living in rural North Dakota.

This is a very common story for individuals receiving treatment at the Bismarck Cancer Center (BCC). Daily treatments create stress and financial concerns during what is already a very difficult time. To help, the BCC provides patient lodging and gas cards to ease these financial burdens during treatments.

Patients and their families can receive gas cards or stay in one of our fully furnished apartments that are within walking distance to the Cancer Center. These apartments create a safe home away from home allowing the individual and family to focus on healing.

For as little as $.50 per day, or $15 per month, your participation in the Circle of Hope monthly giving program helps provide one night stay for a very grateful family.

The Bismarck Cancer Center’s Circle of Hope is a monthly donation program to help form income to fund services to local cancer patients and their caregivers. It’s the easiest way to give and ensure that the BCCF receives your ongoing support. Your recurring monthly donation means, together, we will help people and make a difference.
Your monthly donation will mean so much to someone fighting cancer. A recurring online donation is secure and flexible. You choose the amount you wish to give each month and you can change, or cancel, your pledge at any time. Sign up now and make your first donation by credit card online.

Ask a Pro Head and Neck Cancer with Dr. John Watkins, Radiation Oncologist, Bismarck Cancer Center

Ask a Pro Head and Neck Cancer with Dr. John Watkins, Radiation Oncologist, Bismarck Cancer Center

Q: I have heard head and neck cancer are on the rise. Who should be screened for this type of cancer?

A: . In short, everyone. An oral cavity and upper oropharyngeal exam are standard aspects of annual medical wellness and dental examinations. Historically, older adults, and particularly those who used smoked or smokeless tobacco products, and/or who drink alcohol to excess, were most commonly diagnosed with mouth and throat cancers. However, over the past decade, there has been a significant rise in younger patients with minimal or no history of tobacco or alcohol use. These have been identified as associated with the human papillomavirus (HPV), a common virus to which most adults have been exposed; however, only a small amount of people develop cancer from HPV. There is no current recommendation to screen for HPV.

Head and neck cancers start in the tissues and organs of the head and neck. They include cancers of the larynx (voice box, or “throat”), lips, mouth, nose, and salivary glands. Most head and neck cancers begin in the squamous cells, which are cells that line moist surfaces such as those inside the head and neck.

Screenings consist of a dentist or doctor visually examining your head, neck and mouth to look for any masses, lesions or swelling. They’ll compare both sides of your neck for enlargement, while feeling your lymph nodes. They’ll also check your voice, as progressive hoarseness or other voice change may be a sign of a tumor. For questions, please contact your healthcare provider for more information.

Coronavirus Update

Coronavirus Update

***UPDATE June 26, 2020***

We continue to put the safety of our patients and employees at the forefront of all of our efforts.
Beginning Monday, June 29, our visitor policy has changed and we will now allow one guest to accompany our patients to their appointments.



An update on our support services:
* Yoga for healing is being held online! Contact  or text/call 701-319-0156 for the yoga link.

* Monthly support groups are being held at Sertoma Park with social distancing practices in place. 

* Massage therapy is coming back with limited sessions and times. Enjoy that well-deserved massage.

* Our REACH Coordinator is now meeting face-to-face at the clinic. 

Please feel free to contact the clinic with questions, 701-222-6100.


What is Survivorship?

What is Survivorship?

What is Survivorship?

A person who has had cancer is commonly called a cancer survivor. “Co-survivor” is sometimes used to describe a person who has cared for a loved one with cancer.

Not everyone who has had cancer likes the word “survivor.” The reasons for this may vary. For instance, they may simply identify more with being “a person who has had cancer.” Or if they are dealing with cancer every day, they may describe themselves as “living with cancer.” Therefore, they may not think of themselves as a survivor.

Living with a history of cancer is different for each person. But most people have the common belief that life is different after cancer.

Other common reactions that people have after cancer include:

  • Appreciating life more.
  • Being more accepting of themselves.
  • Feeling more anxious about their health.
  • Not knowing how to cope after treatment ends.

Understanding survivorship

Cancer survivorship has at least two common meanings:

  • Having no signs of cancer after finishing treatment.
  • Living with, through, and beyond cancer. This means that cancer survivorship starts at diagnosis. It includes people who receive treatment over a longer time. Their treatment can lower the chance of the cancer coming back or help to keep the cancer from spreading.

The phases of survivorship

There are 3 phases of survivorship:

  • Acute survivorship starts at diagnosis and goes through to the end of initial treatment. Cancer treatment is the focus.
  • Extended survivorship starts at the end of initial treatment and goes through the months after. The effects of cancer and treatment are the focus.

Permanent survivorship is when years have passed since cancer treatment ended. There is less of a chance that the cancer may come back. Long-term effects of cancer and treatment are the focus.



Survival statistics

The number of people who have had cancer has gone up significantly over the last 45 years in the United States. In 1971, there were 3 million people with cancer. Today there are more than 15.5 million.

  • About 67% of today’s cancer survivors were diagnosed five or more years ago.
  • About 17% of all cancer survivors were diagnosed 20 or more years ago.
  • Nearly half (47%) of survivors are age 70 or older.

 Most cancer survivors have had common cancers:

  • 23% – breast cancer
  • 21% – prostate cancer
  • 9% – colorectal cancer
  • 8% – cervical, uterine, or ovarian cancers
  • 8% – melanoma

Higher survival rates may be due to the following major improvements in cancer prevention and treatment:

  • Screening tests may find cancers earlier. These tests include:
    • Mammography for breast cancer
    • Prostate-Specific Antigen (PSA)for prostate cancer
    • Colonoscopy for colorectal cancer
    • Pap test for cervical cancer

Existing treatments are being used in better ways:

Learn more about the history of cancer research on the American Society of Clinical Oncology’s website.

Surviving cancer: What to expect

At the end of treatment, a person has less frequent contact with the health care team. Survivors may have:

  • Relief that treatment is over
  • Uncertainty about the future
  • Increased anxiety
  • Fear that the cancer will come back
  • Guilt about surviving, having lost others to cancer
  • Physical, psychological, sexual or fertility problems
  • Relationship struggles
  • Discrimination at work
  • A social network that now feels like it is not enough

 Changes in Relationships

When active treatment is over, some survivors’ needs change, and relationships may shift. For example:

  • Some friends may become closer, while others keep themselves at a distance.
  • Families can become overprotective. Or it may feel as if they are no longer being as supportive.
  • Relationship problems from before the cancer diagnosis can surface again.

What you can do:

  • Understand that the entire family changes from the cancer experience in ways they may not be aware of.
  • Work through these changes to get the support you need.
  • Maintain open and ongoing communication.
  • Realize that when and how you share your diagnosis is a personal choice.
  • If you choose to talk about your journey, set limits on what you share.
  • Think about what coworkers might ask you about during and after treatment. Decide in advance how you want to answer their questions.

*Adapted from the American Cancer Society’s publication and the National Cancer Institute’s Office of Cancer Survivorship.

Ask a Pro – Prostate Cancer Awareness

Ask a Pro


With Dr. Cole Kreofsky, Radiation Oncologist

Q: I just finished up treatment for colon cancer last month.  I’m wondering when I’m considered a survivor?

A: An individual diagnosed with cancer is considered a survivor from the moment of diagnosis through the balance of their life. Cancer survivorship is the experience of living with, through, and beyond cancer. Today, more people than ever are surviving cancer because of better prevention, early detection, and treatments. As a result, more attention is being placed on the long term adjustment of patients and their families to the physical, emotional, and practical impacts of a cancer diagnosis. Having cancer is often one of the most stressful experiences in a person’s life. In response to these needs, many clinical programs that attend to the needs of patients are referred to as ‘support groups’.

The Bismarck Cancer Center and the surrounding areas, offer multiple groups for survivors and their loved ones to help you through your cancer journey. For a complete list of cancer support groups in your area, go to or call (701)-222-6100.

Tips to drink more water

Tips to drink more water

Your body is about 70% water, and drinking enough of it is vital for optimal health. While everyone knows that it’s essential to stay hydrated, doing so can be challenging at times.

Here are a few of my favorite tips to drink more water.

Set a daily goal – If you’re a goal-driven person, set a daily goal, or challenge someone to see who can meet their goals throughout a week. 

Merely setting a goal or having some friendly competition can be motivating and make you more likely to make positive hydration changes that will last. It can also help to record your progress, which can keep you motivated to achieve your goal, beat the competition, and make drinking water a habit. 

Drink one glass of water before each meal – A simple way to increase your water intake is to make a habit of drinking one glass of water before each meal.

If you eat three meals per day, this adds 3 cups to your daily water intake, and sometimes your body may mistake feelings of thirst for hunger. Before eating, you should drink a glass of water to help determine whether you are feeling true hunger.

Drink one glass of water per hour at work, or while working from home – If you work a standard 8-hour workday, drinking a glass of water each hour you’re at work adds 8 cups to your daily water intake.

Fill up your water bottle as soon as you start your workday, and at the top of every hour, take time to drink some water. This will help you reach your daily goals with little trouble.  

Sip throughout the day – Sipping on water consistently throughout the day is another easy way to help you meet your fluid goals. Reaching for a sip of water regularly will keep your mouth from getting dry and may even help keep your breath fresher.

 Eat more foods high in water – Another simple way to get more water is to eat more foods that are high in water. Pack these foods as snacks or work them into your meals. 

Fruits and vegetables that are particularly high in water:

  • Lettuce: 96% water
  • Celery: 95% water
  • Zucchini: 95% water
  • Cabbage: 92% water
  • Watermelon: 91% water
  • Cantaloupe: 90% water
  • Honeydew melon: 90% water

In addition to their high fluid content, these fruits and vegetables are packed with vitamins, minerals, and antioxidants that promote your overall health.

Drink one glass of water when you wake up and before bed –An easy way to boost your water intake is to simply drink one glass when you wake up and another before you go to bed. 

A glass of cold water in the morning may help wake you up and boost your alertness. Who couldn’t use that?

Drinking water before bed can keep you from waking up with a dry mouth and bad breath. However, it might make you get up in the middle of the night, so you’ll have to weigh the pros and cons of this tip.

The bottom line – Adequate water intake is essential to good health. The National Academy of Medicine estimates that most people need 90–125 ounces of fluid per day, including fluid from water, other beverages, and food.

It can be challenging to drink water habitually, especially with busy schedules and workdays. But you can change that around by choosing some of these simple tips to boost your daily water intake and strive to be healthier with minimal effort.