UVA Health System Blog

Stories about the patients, staff and services of UVA


The Detective Work of Autoimmune Disease

On October 31, 2014 | At 8:25 am

Angela Crowley, MD, is up-front about it. Accurately diagnosing an autoimmune disease can be tricky.

UVA rheumatologist Angela Crowley finds autoimmune diseases fascinating.

UVA rheumatologist Angela Crowley, MD, finds autoimmune diseases fascinating.

“People on average see six doctors over a period of 4 years before they get a diagnosis.”

This is because, in general, autoimmune diseases tend to arrive unpredictably, disguised as other conditions, offering only confusing clues as to what they are.

Why Are Autoimmune Diseases So Mysterious?

One reason is that the list of what’s considered to be autoimmune is long and ranges from the very common to the extremely rare.

Did you know? The following are all autoimmune diseases:

  • Celiac disease
  • Diabetes type 1
  • Multiple sclerosis (MS)
  • Psoriasis
  • Inflammatory bowel disease

While very different, all these disorders have one thing in common: They occur when a person’s immune system decides to attack healthy body cells. Instead of fighting infection with antibodies, the body produces autoantibodies. The body is essentially fighting itself.

Where and how this self-attack occurs determines the disease and its symptoms. But the occurrence of these symptoms is not simple, clear or predictable. Other situations make diagnosis problematic:

Asymptomatic or Delayed Symptoms. You can have osteoporosis, for example, and have no symptoms at all — only getting diagnosed after a bone fracture. Or with ankylosing spondylitis, the average diagnosis timeframe is 10 years — about how long it takes for the condition to be visible on an X-ray.

Common symptoms. Or you could have severe joint pain as a result of any number of autoimmune diseases, but lack any other symptoms to help doctors determine exactly which one you have. Vasculitis, for instance, is systemic, which means, along with causing inflammation of blood vessels, it can cause pain anywhere and everywhere in your body.

Co-Conditions. Your celiac disease or Grave’s disease could lead to or just show up with rheumatoid arthritis; having both means one condition can mask the other.

Misconceptions. You might be in pain and avoid seeing a doctor. “People ignore their pain, thinking they are too young to have arthritis, which isn’t true,” says Dr. Crowley. “It can happen to kids. Rheumatoid arthritis and osteoarthritis are two different things.”

Mimics. Dozens of diseases can look like MS, for instance, from lupus to other neurological conditions. And it takes time to rule out.

Uniqueness. Lupus in one person can show up with a set of symptoms completely different than the ones that show up in another person. Doctors can’t rely on symptoms alone to determine the nature of the affecting disease.

Diagnosing Autoimmune Disease

Varied, numerous and inherently elusive, the diagnosis of autoimmune disease can be tough detective work.

But what might seem daunting to others is precisely why Crowley became a rheumatologist. “I find it to be fascinating. Everyone is different, so I’m surprised and challenged daily. It’s really rewarding to be able to identify a rare disease and to be finally able to give a patient an answer to symptoms and something that can help them. Or to find a rare presentation of a common disease.”

So how does one diagnose if you can’t count on symptoms entirely?

Myth vs. Fact: Celiac Disease

The proliferation of gluten-free options at restaurants and grocery stores might look like just another trend. But celiac disease is a serious autoimmune disease. And though sometimes treated as such, it is not an allergy one can grow out of or ignore. If a person with celiac disease ingests gluten, she can trigger a number of symptoms, not all stomach-related; over time, eating gluten can give rise to more autoimmune diseases.

Diagnostic tests include, but are not limited to:

  • Antinuclear antibody (ANA) test—the presence of autoantibodies does not automatically mean you have an autoimmune disease, but a high level can indicate lupus, scleroderma, juvenile arthritis, others
  • Comprehensive metabolic panel
  • Tests associated with inflammation and arthritis
  • Urinalysis

Rheumatoid arthritis I can usually diagnose in the first visit; it’s normally straightforward.” Which is good, since it’s very important to be diagnosed early. “The earlier we can treat it, the more likely it is that it will be easier to treat later on and you won’t need as much medication.”

Which is why Crowley is excited about the advances being made in the field.

The latest? “We have a new imaging technique, a new type of CT scan, to diagnose gout. We’ve never been able to do it with imaging before. I’ve had patients who didn’t know it was gout until we used this technique. To diagnose gout you have to look at joint fluid and see gout crystals, but there’s not always a big collection of joint fluid to examine. Or you can look at uric acid, but some people have high levels of uric acid and no gout. You might suspect, from the symptoms and the blood tests, that the person has rheumatoid arthritis. Which is a problem, as rheumatoid arthritis and gout require very different treatments.”

But with the dual-energy 3D CT scan, diagnosis is straightforward. “The gout crystals look green. Fun pictures,” adds Crowley.

Flares & Triggers: Autoimmune Disease

While an ultimate cause for autoimmune disease remains unknown, research has shown that:

  • People can have a genetic propensity for an autoimmune disease
  • A trigger can activate or turn on the gene
  • Suspected triggers include environmental, chemical, sunlight, stress, drugs and infection factors
  • These triggers can cause a disease to “flare” up
  • These disorders can appear at any and all ages, making it difficult to pinpoint exact causes

Another thing is clear to Crowley and others in the field. “In the last two decades, we’ve seen a significant increase in autoimmune diseases, and a lot of experts think it’s the environment.”

Specific research has shown that tobacco use can turn on these genes, and gum disease can turn on rheumatoid arthritis genes.

But as with most aspects of autoimmune disease, these are hints, not answers. “We suspect it’s not just one thing, not one sole cause.”

No Quick Fixes: Treatments and Hope

There are no known cures for autoimmune diseases. Rheumatologists look to medications, supplements and physical therapy for the relief of symptoms and suppression of the immune system.

Crowley says that’s no reason to lose hope. “There is a lot of good research going. We have a lot of great treatment options. One hot topic in research is trying to predict the right treatment for each person. We have to do trial and error to see what can put someone in remission, but with more knowledge about disease features and genetics, we can narrow down the options and go straight to the most appropriate medicine right away.”

Stress and Self-Care

Along with medication, Crowley advises her patients to practice good self-care. She knows living with an autoimmune disease can be stressful. “People break down into tears in my office at least once a day,” she says.

But stress can make symptoms worse. “People get flared up when stressed, so I tell people we can’t fix the situations, but we can control the response. Good sleep and exercise are things we can work on. Tai chi and yoga are good for the body and mind (and there’s free videos for these on YouTube),” and can help manage symptoms. She also checks patients’ vitamin D levels, which are important for bones and the immune system.

Open for Business: UVA Rheumatology on Pantops

You can visit Crowley at her office on Pantops, where there’s plenty of free parking and friendly staff. View clinic directions, hours, contact info.

And while there aren’t published studies showing that diet benefits autoimmune diseases, she does see that diets can affect individuals, some of whom find that removing gluten, dairy, meat, sugars, fats and artificial ingredients help.

Even without a cure, Crowley finds her work rewarding. “We can put someone in remission and take them from not being able to do much of anything to being able to return to work and play ball with their kids. I get to develop relationships with people. It’s a team approach between us and our patients.”

And because an autoimmune disease can affect various parts of the body, Crowley also teams up with doctors in other fields. She doesn’t just treat one thing, she says. “We treat the person as a whole.”

Do You Have an Autoimmune Disease?

It’s hard to know without the care of a specialist like Crowley. If you have inflammation, joint pain or other vague symptoms, see your primary care physician for a referral. You can even schedule an appointment with Crowley herself!

Filed under : Healthy Living,Rheumatology,Women's Health | By
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Home Team Care: UVA Helps Neurologist, Royals Fan Defeat Cancer

On October 29, 2014 | At 9:33 am

Think about the support groups around you, the people you see and interact with most often. Your family and friends are the people you likely trust the most. But what about your coworkers? Would you trust them with your health? Ted M. Burns, MD, did, and he never once had a second thought about the care he would receive from his fellow coworkers at UVA.

Neurologist Ted Burns and his wife

Burns attributes part of his successful recovery to his family, including his wife and three kids.

Doctor and Patient Role Reversal 

A neurologist at the UVA Neurosciences Center, Burns is familiar with the ins and outs of hospital life and providing exceptional patient care. However, when he was diagnosed with squamous cell carcinoma in his left frontal sinus cavity, he wasn’t prepared to become the patient himself. “It was shocking,” says Burns, “but I knew the doctors’ reputations and felt really comfortable with everything they were doing with my diagnosis.”

A non-smoker in his 40s, Burns never expected to be diagnosed with cancer in the sinus above his eye. The news was hard on his wife and three young kids. Burns’ parents temporarily relocated from Kansas to Charlottesville to support him through the treatment process and help share the parenting responsibilities.

In Good Hands

Burns’ treatment began in March 2013 with daily doses of radiation for five weeks. He then received surgery on his head and sinuses, followed by five months of chemotherapy. His care team featured various physicians with whom he had previously shared patients: Paul Levine, Mark Shaffrey, David Drake, Paul Read, Leslie Blackhall, John MacKnight and Geoffrey Weiss. Being treated by doctors who Burns had seen in their professional element gave him a sense of security and ease about the process. “I didn’t worry about their competence or quality of care,” he says, “I knew they were the experts.”

Learn More
Skin Cancer
Support for Cancer Patients
Cancer Care at UVA

Throughout the process, Burns rarely asked questions. Instead, he put full trust and confidence in his doctors and focused on returning healthy to his family and his work. The treatment process was tough, leaving Burns with a lack of energy and limited mobility during the day. So, he took up a childhood pastime and followed his favorite baseball team throughout the 2013 season.

A native of Kansas City, Burns grew up a loyal Royals fan and a baseball enthusiast. Temporarily out of work, baseball was Burns’ escape. From spring training through a successful season, following the Royals provided him with source of entertainment to take his mind off his treatments. Almost a year later, Burns is gradually recovering and says that he feels better after every month.

Burns' children

Burns’ three children

The Royal Treatment

One part of the treatment process had a significant impact on Burns, one that is often overlooked – the kindness he received from everyone at the Emily Couric Clinical Cancer Center. From the registration desk and infusion center to every nurse and doctor, Burns felt he was treated kindly and compassionately during every visit. He recalls being greeted as Mr. Burns, not Dr. Burns, indicating that many staff members were unaware of his employment status at UVA. This enabled him to experience firsthand the kindness that patients receive on a daily basis at the Cancer Center.

Now back at work, Burns uses his experience to simulate the positive aspects of his treatment and apply that to his patients and other areas of the hospital. “There was an outpouring of kindness from that building,” says Burns. He believes the Cancer Center should be an example for all clinical departments in the hospital for genuine interaction with every patient.

Some say that Burns’ recovery has a lot to do with his dedication to the Royals, but Burns will tell you that it was due to exceptional care at UVA and devoted support systems both inside and out of the hospital. As the Royals battle the San Francisco Giants in the 2014 World Series, we hope their potential victories bring Burns and his family good memories and great health.


Podcast Tuesday: What Is Neurofibromatosis Type 1 (NF1)? [AUDIO]

On October 28, 2014 | At 8:25 am

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Podcast Tuesday: A Q&A for Expecting Parents [AUDIO]

On October 21, 2014 | At 9:57 am

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Podcast Tuesday: Understanding Muscular Dystrophy [AUDIO]

On October 14, 2014 | At 9:36 am

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Back on Her Feet: This Patient Doesn’t Let Cerebral Palsy Stop Her

On October 13, 2014 | At 9:08 am

When Mary Nay turned 70, she celebrated by walking a mile at her gym. The next year, she turned 71 and walked two and a half miles.

Her commitment to fitness would be impressive no matter what, but Mary has cerebral palsy and walks with two canes. She has muscular issues in her legs, hips and knees that make walking challenging. She also has trouble hearing.

Mary Nay, a Virginia author who has cerebral palsy

Author Mary Nay, who wrote “Hardly Handicapped” about her life with cerebral palsy.

But besides exercise, she fills her days working at Walmart, spending time with her husband, children and grandchildren, and promoting the book she wrote last spring, “Hardly Handicapped: Walking Through Life with Cerebral Palsy.”

“She could come up with a whole list of excuses if she tried,” says Bentley Calhoun, MD, who sees Mary at UVA’s primary care clinic at Forest Lakes and walked the last lap with her on her 71st birthday. “But unlike most, she has managed to turn excuses into motivation.”

A Cerebral Palsy Diagnosis

Mary’s parents first realized something was off when she didn’t sit up or crawl. The family lived in Farmville, and taking Mary to the doctor meant driving to Richmond or a specialist in Maryland. It took many doctors’ visits to get a diagnosis of cerebral palsy, which meant her muscles didn’t communicate well with her brain.

Eventually Mary started walking. Doctors put her legs in braces and assigned her exercises to build the muscles in her legs and discourage her from walking on tiptoe.

Mary mostly stayed at home with her parents and older sister. She wore the braces until age four or five, but even after they came off, she was well aware that she couldn’t run or play hopscotch like the other girls could.

Starting school was scary. “I walked in the door, and I saw all these kids looking at me,” she recalls. “I didn’t like that, and I didn’t know how to deal with it, because I had never been in public that much. So I cried and cried and cried and didn’t want my mom to leave. The teacher let my mom stay one week, but finally I had to let go.”

After that rough week, Mary flourished. She became good friends with a pair of twins, Joan and Martha. She couldn’t play sports, so she kept the score. In high school, she was allowed more time than most students to change classes, due to what she calls her “clumsy walk.”

Mary recalls she felt bad when she noticed her classmates were starting to date and nobody asked her out. “I knew: ‘Forget it Mary, that’s not going to happen.’” But that changed too — she dated one boy in 11th grade and attended senior prom with another.

That same year, her classmates announced they wouldn’t go on their senior class trip to New York City if Mary couldn’t go. The school’s sports coach came along and helped her get around, and she got to go to the top of the Empire State Building.

Finally, at graduation, Mary’s parents wanted to walk across the stage with her. The girl who had clung to her mom on her first day of school was horrified by that idea. “I said, ‘If you don’t let me walk by myself, I’m not graduating.’” So she walked alone.

Declining Mobility

After graduation, Mary attended Woodrow Wilson Rehabilitation Center, which provides vocational training for people with disabilities. She then moved to Charlottesville, 60 miles from her hometown, to look for a job. She ended up at Comdial, a telecommunications company, where she worked in many departments for over 31 years. She also had a part-time job for 23 years at political polling firm Cooper & Secrest, where she eventually became a supervisor.

At Comdial, Mary’s mobility began deteriorating. Early in her career there, she struggled to quickly walk down the long hallways, so she got a mobility scooter to help her. But “my mobility went down fast and big time,” she says. She became overdependent on it, and her leg muscles weakened, until she had trouble walking and keeping her balance.

“Today, I wish that I could not have used the scooter, but the past is in the past,” she says.

Calhoun, Mary’s longtime physician, felt she could do better. In 2011, after almost 30 years of scooter overdependence, he referred her to an exercise rehabilitation program through a nearby gym. She began using exercise machines to strengthen the muscles in her legs, and the gym became her second home. “My whole energy level changed,” she says.

Between Dr. Calhoun’s support and care and the exercise program, things started to turn around for Mary. When she drove, she used to use her hand to lift her leg back and forth between the gas and break pedals. As she exercised, she discovered she could move it without the help of her hand.

And finally, she began walking longer distances again, which led to walking a mile around the gym’s track on her 70th birthday.

Author Mary Nay working at WalMart

Mary sits on a stool when working at her WalMart register.

“As her level of health improved, so did her audience,” Calhoun says. “Mary Nay, who has spent much of her adult life relying on assistance for mobility, was walking. And not just walking, but walking an entire mile around the track. You should have seen it. It was like a little mini circus there at the club. Family members, club members, health care providers and curious onlookers all cheering for Mary as she crossed the finish line.”

Mary, in turn, credits Calhoun with referring her to the program and advocating for her so work and life are easier. After retiring from Comdial and Cooper & Secrest, she got a job at Walmart. Calhoun advocated for her, telling her managers she couldn’t lift much weight and needed a stool to sit on. “I would recommend him to the top of the mountain,” she says. “He is not only my doctor but my friend.”

Writing “Hardly Handicapped”

Mary’s book and reputation at her gym have turned her into a local celebrity. She was featured in The Daily Progress, and she’s had multiple book signings. At one, she had a reunion with her old friend and doctor, Peyton Taylor, MD, who she hadn’t seen in years.

“In June 2014, when The Daily Progress wrote a great story about me, he saw it and called to say he was proud of me,” she says. “Then, to my surprise, he came to my book signing. We had such a great reunion.”

Mary started writing because she hopes to inspire others with disabilities. “I hold no grudges that I am born handicapped,” she says. “I do believe God made me this way for public awareness, so people could see what you have to do to have a life. And you can have a life. I’ve got one. I’m married, I have three daughters, a job, I’ve done it.”

It’s been hard. People have made comments, but you have to decide what you want to do, whether you want to accept it or let it tear you down. And I chose to put a smile on my face and go for the gold.”

Where to find the book: Mary’s book is available at Barnes & Noble in Charlottesville. You can also purchase her book through Tate Publishing.

Filed under : Patient Stories,Primary Care | By
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Joe Thomas Takes Charge of T-cell Lymphoma Diagnosis and Encourages Others

On October 9, 2014 | At 10:42 am

Denial and acceptance: two feelings Joe Thomas felt when he discovered he had a rare form of blood cancer called T-cell lymphoma. The local radio talk show host and program director for WCHV had noticed early warning signs but neglected to take a closer look. “I didn’t want it to be cancer,” he says.

Joe Thomas discovered he had a rare form of blood cancer called T-cell lymphoma while visiting UVA for other symptoms.

Joe encourages others to take control of their health through his podcasts supporting UVA Health System and UVA Cancer Center’s Support Services.

A Charlottesville resident, Thomas visited the UVA emergency room for a blood clot in his right leg impeding his blood flow. At the time, he thought it was unrelated to any serious conditions. It wasn’t until Thomas’ doctors urged him to look into the cause of his condition that he was diagnosed with T-cell lymphoma.

A type of non-Hodgkin lymphoma, T-cell lymphomas are a rare form of lymph node cancer. While most non-Hodgkin lymphomas are of the B-cell variety, the T-cell lymphomas are typically more aggressive than their B-cell counterparts, though some patients have a very mild course. T-cell lymphoma has a wide range of symptoms, including:

  • Unexplained fevers or chills
  • Drenching night sweats
  • Unintended weight loss
  • Enlarged lymph nodes
  • Enlarged spleen or liver
  • Change in blood cell counts
  • Rash

T-Cell Lymphoma: An Unexpected Diagnosis

Thomas may have entered the emergency room looking to treat his blood clot, but he is more than happy UVA took the time to examine his overall health. The UVA team discovered a large mass in his lymph gland and immediately determined treatment options. “From that moment on, everyone has been stellar,” says Thomas.

To diagnose T-cell lymphoma, caregivers may test blood and do a bone marrow biopsy and spleen analysis. Thomas underwent a couple of biopsies, a CT scan and a PET scan for the final diagnosis. From the initial investigation of his condition until the last day of treatment, Thomas spent about seven months under UVA’s care, spearheaded by Craig Portell, MD.

He contributes his successful recovery to Portell’s straightforward and hands-on approach to care. Thomas felt comfortable throughout the process, knowing the decision for every test, procedure and treatment. “It is very comforting to be confident that you were getting the straight information,” he says.

Thomas’ Advice for Other Cancer Patients

His words of wisdom to others: “Diet feeds cancer,” he says. While reviewing the results of his PET scan, Thomas noticed that cancer cells eat refined sugar, enabling them to continue growing. Since then he and his wife, Elaine, have become vegans and carefully monitor the amount of sugar they ingest.

Thomas stresses the importance of a healthy diet while undergoing treatment and says this is the reason he had few side effects while undergoing chemotherapy. Preparing for treatment includes having the right foods to provide your body with the energy it needs. He never felt fatigued, nauseous or uncomfortable enough to miss a day of work.

Thomas urges others to take charge of their health full force. He feels a can-do attitude and a valuable support system contributed to his successful outcome. “It is doable; we can beat these cancers,” says Thomas.

He encourages others in similar situations to seek out UVA Cancer Center’s Support Services division to address their concerns and get the care they need. The division features dietitians, social workers, and chaplains who work between the patients and nurses and oncologists to make the process as helpful as possible.

Caring Beyond Cancer Radio Segments

Thomas is featuring UVA’s cancer support services on his WCHV radio show. Listen to the segments so far:

Read More About Blood Cancer

September was Blood Cancer Awareness Month, and we introduced two other patients:

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Podcast Tuesday: What’s an EMG Test? [AUDIO]

On October 7, 2014 | At 10:09 am

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“Be The Match” Stem Cell Transplant Saved Molly Bass’ Life

On October 2, 2014 | At 3:36 pm

If you knew your stem cells could save another person’s life, would you Be The Match? The Be The Match® registry is the world’s largest and most diverse bone marrow donor registry, offering patients potential cures for immune disorders and blood cancers.

Through the Be the March Program, Molly Bass got a stem cell transplant to treat her Hodgkin’s lymphoma and large T-cell lymphoma.

Molly and her non-related donor match, Sam Cato, meeting for the first time after her stem cell transplant

UVA Cancer Center’s Bone Marrow and Stem Cell Transplant Program has been designated as a National Marrow Donor Program and now has access to the Be The Match registry. With this program, UVA patients now have access to more than 22.5 million potential donors and 601,000 cord blood units on U.S. and global registries. Patients in need of transplants will be able to receive treatment in-house without traveling to other hospitals around the country.

Prior to this program, receiving transplants was not nearly as accessible or convenient. Molly Bass, a Charlottesville resident, endured a two-year battle with Hodgkin lymphoma and large T-cell lymphoma that took her all the way to Seattle for a life-saving transplant.

A Journey To Seattle

Bass started working at the University of Virginia in 1994 as the assistant director of the Jefferson Scholars Foundation. In 2001, she began losing weight and experiencing itchy feet, dizziness and severe fatigue. Like most, she attributed it to the stress of a busy job and an active lifestyle.

It wasn’t until she felt a lump on the side of her neck and noticed swollen glands that she went to see a doctor. Results from a CAT scan highlighted tumors covering the bulk of Bass’ chest. The next day, Bass was scheduled for surgery to biopsy one of the enlarged lymph nodes. Awaking from surgery she was informed of the news: She had Hodgkin lymphoma. Taking control of her health and treatment options, Bass sought a second opinion, and to her surprise, she was told she had large T-cell lymphoma.

After three different chemo regimens, extensive radiation and two relapses, additional tests determined Bass was affected by both forms of cancer, a rare occurrence. For the best chance at long-term survival, the doctors recommended tandem stem cell transplants. At UVA, Bass was able to harvest her own stem cells needed for her first transplant. Family members were typed for the second transplant but no matches were found.

Without access to the Be The Match program, UVA didn’t have the capacity to find her a non-related donor match and perform the second necessary transplant. Her best option was to travel to Seattle, spending an initial $2,500 out of pocket to find a match.

Traveling to Seattle took a toll on Bass, as she had to leave her house, job, friends, family and her beloved Bernese Mountain dogs. Luckily Bass and her mother were able to stay with friends for the four-month period, but relocation during a time of stress and uncertainty was no easy feat. Through it all, she always managed to keep a positive outlook on the situation. “The transplant was just one more thing I had to do,” says Bass.

The Life-Saving Match

Bass’ donor match, Sam Cato, never gave much thought to donating his stem cells. He had an understanding that it was something people just did in the off chance that it could save someone’s life. Born on the same day nine years apart, Cato and Bass were meant to be a perfect match.

In 2005, after her recovery, Bass and her father flew to Chicago to thank Cato in person. He greeted Bass with a bouquet of red roses as she stepped off the plane. It was an emotional day for both of them. “How do you thank someone who saved your life?” asks Bass.

Bass is a strong advocate for the Be The Match program. About 70 percent of patients don’t have a match in their family and rely on unrelated donors to save their lives. “The ethnic variety of people is becoming more diverse; matches are not as clear cut anymore,” says Bass. “The more people who are typed, the more people are going to be matched.”

She is amazed at the changes and technological advances that are available today to help improve the survival rate of cancer patients. She believes the Be The Match program will help UVA continue to deliver leading-edge treatment to patients locally and within surrounding areas.

Stem Cell Transplants at UVA

Find out more about treatment at UVA:

Another Blood Cancer Patient’s Story

Last week, we met Jim Bryant, who was told he had 3-5 years to live after his mantle cell lymphoma diagnosis. Watch a video to see how Jim is doing now.

Filed under : Cancer,Patient Stories,Transplant | By
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Vote for Your Favorite Mobile Mammography Design!

On October 1, 2014 | At 9:33 am

October means crisp days and pumpkin spice everything. But it’s also Breast Cancer Awareness Month, a chance to share stories and the latest research, treatment and detection news.

Mobile mammography helps women get mammograms in Virginia.

The current mobile mammography unit, which served 1,400 women last year.

This year, we’re asking for your help. We’re getting a new mobile mammography unit. This van travels around Virginia, bringing mammograms to your workplace or community. The new unit will feature 3D mammograms (tomosynthesis) and breast ultrasound.

But we need help with the design! Voting is open now through October 31, and we’ll share the winner in November. Check out the options and vote for your favorite.