Video, Part 2: Dr. Miller on what you need to know about Pap smears

Pap smears, annual exams and the HPV vaccine are important tools for all women in the fight against cervical cancer. Unfortunately, not enough women in Kentucky take these preventative actions, says UK Markey Cancer Center gynecologic oncologist Dr. Rachel Miller. We sat down with Dr. Miller to discuss how regular check-ups and Pap smears can help prevent advanced cervical cancer.

Watch our interview with Dr. Miller to learn more about cervical cancer prevention, including a breakdown of the latest Pap smear recommendations.


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Whether planning for a baby or entering menopause, every woman deserves a healthcare provider who respects her values, preferences and personal goals.

Certified nurse midwives partner with women for better health

JoAnne Burris, APRN, CNM

Written by JoAnne Burris, advanced practice certified nurse and certified nurse midwife at UK HealthCare.

Whether planning for a baby or entering the stages of menopause, every woman deserves a healthcare provider who respects her values, preferences and personal goals.

The certified nurse midwife offers a range of medical services and expertise to support women throughout the female reproductive lifespan, not just through pregnancy and birth. Firmly grounded in evidence-based science, the certified nurse midwife is trained to put the patient at the center of her healthcare decision-making.

Some pregnant women believe choosing a nurse midwife for prenatal and postnatal care means forgoing the comforts of modern medicine. Nurse midwives are frequently associated with home birth, but according to the American College of Nurse Midwives, 94 percent of nurse midwives in the U.S. attend births in hospitals. Nurse midwives support birth according to the preferences of the mother, whether she desires an epidural or unmedicated birth.

What makes nurse midwifery unique

From supporting a woman during delivery to providing primary care, nurse midwives can be found throughout the spectrum of women’s healthcare. There are a few distinguishing features of midwifery that every prospective patient should consider.

  • Emphasis on education. Nurse midwives counsel patients on a variety of health topics, from contraception to nutrition to breastfeeding. Rather than giving advice, the nurse midwife offers reliable information and encourages women to make individualized decisions. Consistent with this philosophy, patients acquire knowledge so they can make informed decisions and feel confident about their care.
  • Partnership. Nurse midwifery services are provided in partnership with women and their families in order to empower women to determine their individualized journeys to motherhood. In addition to working in partnership with women, they work in close collaboration with obstetricians, anesthesiologists and neonatologists as a part of an integrated healthcare team.
  • Birth is normal. For healthy, low-risk women, interventions during birth are usually unnecessary. A hallmark of nurse midwifery care is non-intervention in the absence of complications. While nurse midwives are experts in normal birth, they are highly trained to detect complications and will collaborate with physicians when necessary.
  • Founded on evidence-based science. Certified nurse midwives are registered nurses who have earned a master’s of science in nursing with an additional certification in midwifery. They are licensed professionals capable of attending births, writing prescriptions, conducting annual exams and providing birth control counseling as a part of their wide spectrum of healthcare services.

Nurse midwives empower women to take control of their health and birth experience. This sense of control can be a positive influence on the entire family unit. Midwifery is a beautiful healthcare partnership designed to help women realize their potential to be a force for optimal health and wellness.

If you are interested in nurse midwife services, talk to your OB-GYN.


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Cervical cancer is a leading cancers in Kentucky, but it is easily preventable. Through vaccines and screenings, you can take steps to reduce your risk.

Take action to prevent cervical cancer

Dr. Rachel Miller

Written by Dr. Rachel Miller, a gynecologic oncologist at the UK Markey Cancer Center.

At the beginning of the year, many women (and men) set resolutions around health and fitness, often focusing on weight loss. But one of the most important habits women can form revolves around regular health checks, particularly for preventable cancers.

January is Cervical Cancer Awareness Month. Unfortunately, Kentucky ranks in the top 10 in the country for cervical cancer incidence and death rates – a dire statistic considering cervical cancer is largely preventable through vaccination and screening.

Risk-factors for cervical cancer

The human papillomavirus (HPV) causes virtually all cases of cervical cancers. The majority of sexually active women will be exposed to HPV at some point in their lifetime; fortunately, only 5 to 15 percent will develop cervical precancer. An even smaller percentage will develop cancer. Other risk factors include multiple pregnancies, a long duration of birth control pill use, a history of other sexually transmitted diseases and tobacco use.

The importance of the HPV vaccine

Nowadays, you can take an extra step toward protecting your children against cervical and other types of HPV-related cancers through the HPV vaccine. This vaccination used to be a three-dose process, the CDC now recommends that all 11 to 12 year-old children – girls and boys – get just two doses, with the second being given six to 12 months after the first.

Young women can get the vaccine through age 26, while young men can get vaccinated through age 21. Every year, more than 17,000 women and more than 9,000 men get cancer caused by an HPV infection.

Don’t overlook getting a Pap smear

Cervical cancer screening – the Pap smear – is a regular appointment that is often overlooked. This test looks for cancerous cells on the cervix and can even find precancerous changes that have not yet developed into cancer.

I can’t recommend this test enough – at Markey, about 95 percent of cervical cancer patients we treat have not gotten their recommended schedule of cervical cancer screenings. Screenings usually begin at age 21 or three years after first sexual intercourse. Talk to your doctor about a timeline for regular screenings.

Cervical cancer symptoms

One reason the vaccine and screenings are so important is because cervical cancer often doesn’t cause obvious symptoms until its more advanced stages. Some of the most common symptoms reported include abnormal bleeding or bleeding after sexual intercourse, and an abnormal discharge. Many of these symptoms can be mistaken for less serious issues, such as a yeast infection or urinary tract infection.

As the cancer advances further, it can cause urinary blockage, back pain, leg swelling or neuropathic pain, such as a “pins and needles” sensation in the skin.

As you work through your resolutions for the New Year, make taking care of yourself a priority – and that includes scheduling a few regular trips to your doctor.


Next steps:

  • If you or someone you love is interested in receiving the HPV vaccine, schedule an appointment with the Markey Cancer Center online or at 859-323-5553.
  • Markey also offers a comprehensive cancer screening and prevention program, including tests for cervical cancer. Learn more about our program.
Michele Staton-Tindall focuses on substance abuse intervention to help women to make better choices transitioning back to the community.

UK researcher strives to empower at-risk women in Appalachia

Michele Staton-Tindall grew up in rural Appalachia during a time when people felt so safe they didn’t even lock their doors at night. The ensuing drug epidemic that now ravages her former home has dramatically impacted the lives of the Appalachian people and broken that sense of security.

Staton-Tindall, an associate professor in the Department of Behavioral Science at the UK College of Medicine, and a faculty associate at the Center on Drug and Alcohol Research, has made it her mission to make a positive difference in the Appalachian area, particularly for women in the criminal justice population who have fallen prey to substance abuse and high-risk behaviors. Her research focuses on intervention before release from jail to empower women to make healthier and safer choices during the transition back to the community.

As a social worker, Staton-Tindall loves the stories the women tell of their life experiences: real people, real problems and tough choices. Their stories not only inform her research but also fuel the passion for her work as well. At the Center on Drug and Alcohol Research, Staton-Tindall works with professionals across campus who take a multi-disciplinary approach to widespread problems of substance abuse.

Watch the video as Staton-Tindall discusses her research and why it is so close to her heart.


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UK expert says long-acting reversible contraceptives are both safe and effective

Joanne E. Brown, DNP, APRN

Written by Joanne Brown, DNP, APRN, in the UK College of Nursing and Women’s Health at University Health Service.

Long-acting reversible contraceptives are the most effective form of reversible birth control but not the most commonly used. Misconceptions and outdated misinformation prevent many people from realizing the benefits of intrauterine devices (IUDs), contraceptive implants and the birth control shot. While use of these contraceptives has increased over time, they are still much underutilized.

Types of LARCs

IUDs are small devices that are placed inside the uterus. There are several varieties of IUDs, some containing hormones and some without. These various devices can prevent pregnancy for different amounts of time, typically between three and 12 years. The contraceptive implant is a small rod placed under the skin in the upper arm and can prevent pregnancy for up to three years. The Depo Provera contraceptive shot is effective for three months before another shot needs to be administered.

Debunking the misconceptions

One common misconception about LARCs is that they are unsafe. However, not only are LARCs effective, they are also very safe. There are few women for whom using LARCs would not be an option. Additionally, LARCs are safe for use in adolescents, young women and women who have not had children. Of course, it’s important to speak with your healthcare provider about personal and sexual health history and to ask about symptoms that could be cause for concern.

Another misconception surrounding LARCs is that they have a detrimental effect on future fertility. Research has shown about 71 percent of women who wanted to become pregnant conceived within 12 months of removing IUDs. (This is comparable to the general population). It is important to talk to your provider about personal goals regarding future pregnancy; this will impact the type of contraception that is best for you.

The most effective form of reversible contraception

Finally, LARCs are the most effective form of reversible contraception on the market; less than one percent of users will become pregnant. Pregnancy occurs in up to 18 percent of women who use condoms as their primary method of birth control and in about 9 percent of women using oral contraception. This often occurs because of inconsistent or incorrect use. Because LARCs don’t require women to remember anything on a daily, weekly or monthly basis and require a visit to a health care provider for removal, they prevent user error, which often occurs with other forms of contraception.

About 50 percent of all pregnancies in the United States are unintended. It is important that we provide information and access to the safest and most effective forms of birth control. LARCs can provide safety and security for most women, and should be considered along with other forms of contraception.


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5 ways to prevent preterm birth

5 ways to prevent preterm birth

Written by Diana Frankenburger, the childbirth education coordinator for UK HealthCare.

Prematurity and its complications are the leading cause of death in children younger than 5 in the world today. Infants born before 37 weeks gestation have more complications than full-term babies, including problems with feeding and digestion, vision and hearing, and breathing.

Premature report card

Each November, the March of Dimes publishes a Premature Birth Report Card, which grades the U.S. and each state on prematurity rates for the previous year. The goal is to be at 8.1 percent, an objective set by the Healthy People 2020 initiative, a science-based, 10-year program to improve the health of all Americans.

This year, the U.S. has a rate of 9.6 percent, earning a C letter grade. Kentucky’s rate is 10.8 percent, which unfortunately gives our state a D.

Tips to prevent preterm birth

While some risks for premature birth cannot be avoided, there are things you can do to help prevent a preterm birth. Here are a few tips:

  1. Stop smoking, or cut down to less than a half-pack per day. Smoking contributes to preterm birth, and a baby who lives in a house with smokers is also 3.5 times more likely to die of sudden infant death syndrome than a baby who doesn’t.
  2. Avoid alcohol and drugs.
  3. Get prenatal care. Learn more about prenatal care at UK Women’s Health OB-GYN.
  4. Practice oral hygiene and see your dentist. Oral infections can lead to infections that can cause preterm labor.
  5. Practice stress reduction. Be aware of how you are handling stress and get sufficient exercise and rest to help get you ready for your new family member.

Delivering at full term will help your baby be healthier, stronger and avoid the complications that come with preterm birth.


Next steps:

  • Learn more about the UK Birthing Center, the leading facility in Central Kentucky specializing in high-risk pregnancies and deliveries.
  • The Birthing Center also offers a Childbirth Preparation Program, which will help prepare you for the changes that happen during pregnancy, labor, birth and postpartum. Find out more about our class offerings.
Mom Katie Schaftlein bonds with baby Sadie for the first time.

Quintuplets arrive at UK, granting mom a special birthday wish

The smallest of the quintuplets, Sadie, defied her size with her energy, churning her legs inside and out of the womb. Her sister Scarlett, on the other hand, established herself as the calm and docile member of the bunch. And family members have already pinned Lucas, the sole boy in the group, as the sweetheart perhaps a future golfer, his dad speculated.

“They have the same personalities as they did in my belly,” mom Katie Schaftlein said while getting situated for Kangaroo Care bonding with baby Sadie.

Surrounded by her 6-day-old babies in the Kentucky Children’s Hospital Neonatal Intensive Care Unit (NICU), Katie Schaftlein beheld a lifelong dream fulfilled overnight. She always wanted five children, although her husband Lucas thought they might end up with three or four. The couple’s quintuplets arrived as on Katie’s 26th birthday. She delivered five early but healthy babies Sadie, Sofia, Scarlett, Savannah and Lucas at the UK HealthCare Birthing Center before the stroke of midnight on Friday, Nov. 11.

Preparing for quintuplets

The Lexington couple and UK graduates found out early in Katie’s pregnancy that five babies were on the way. They consulted with high-risk obstetrics specialists at UK HealthCare and neonatologists at Kentucky Children’s Hospital in preparation for delivery, with the goal of sustaining the pregnancy through 28-weeks gestation.

An interdisciplinary team of doctors, nurses and therapists from UK Women’s Health, Obstetrics and Gynecology and Kentucky Children’s Hospital coordinated a integrative care plan for the Schaflein quintuplets, whose expected early arrival would require specialty care in the region’s only Level IV Neonatal Intensive Care Unit.

Quintuplets are extremely rare, with the Centers for Disease Control reporting 47 national cases of quintuplets or higher order multiple births in 2014.

On a Friday morning in September, Lucas boarded a flight for a business trip to Japan. As soon as he landed on the other side of the world, he learned Katie, who was 22-weeks pregnant at the time, was admitted to the hospital while he was in flight. He booked a flight back to the U.S. as soon as possible, flying home a couple days later.

“I left her that day and kissed her goodbye, and three four hours later she was in the hospital,” Lucas said.

Five babies in four minutes

Katie remained in the hospital on bed rest for two months before delivering the babies at 29 weeks and five days gestation. Teams of nurses were assigned to each of the five babies upon arrival, and the medical teams made special accommodations to ensure three additional neonatologists were on-call at all times. Five NICU beds were reserved for the Schaftlein quintuplets.

Neonatologists met with the family during inpatient treatment to assess infant development and predict the status of each baby upon arrival. Katie’s ultrasound a day prior to delivery provided the comprehensive medical team with current information on the development status of each baby.

When Sadie’s water broke at 7:30 p.m. on Nov. 11, Dr. Wendy Hansen’s obstetrics team alerted KCH neonatologists to prepare to receive the babies and took Katie into surgery for an emergency caesarian section. The operation started at 11:30 p.m., but all the babies were delivered in time to share a birthday with their mother.

Hansen, who delivered five babies within four minutes, presented each baby to Lucas and Katie before sending the infants to the NICU for precautionary care and respiratory support. Hansen delivered the last baby at 11:56 p.m., a declaration that sent a cheer through the halls of the UK Birthing Center.

“We were worried because we didn’t want them to have two different birthdays,” Katie said. “Everyone cheered, and at that point I was like, ‘Okay, they are out.’”

It takes a team

Dr. Peter Giannone, the chief of the Department of Neonatology at KCH, credits the dedication of the Schaftlein family, as well as collaborative efforts and streamlined communication among obstetricians, nurses, neonatologists and therapists, for a positive outcome for the quintuplets.

The two departments recently formed the Obstetrics, Maternal-Fetal-Medicine, Neonatology, and Infant (OMNI) follow-up care service line, eliminating communication and collaboration barriers common in academic medical systems by coordinating cross-disciplinary efforts and uniting medical teams to enhance family-centered care.

“My biggest memory is the teamwork that everyone showed to pull this off so seamlessly,” Giannone said.

The Schaftlein quintuplets will remain in the hospital for several weeks before they are ready to go home. In the meantime, UK neonatologists will monitor the respiratory strength and development of the babies. Lucas and Katie Schaftlein, as well as family members in Louisville and Lexington, are visiting and bonding with the babies in the NICU.

The couple said they are grateful for the support, dedication and poise of members of their integrative medical team. Katie was put at ease by the calm demonstrated by Hansen as her water broke and delivery was imminent. Several nurses who assisted the family throughout Katie’s hospitalization were present at the delivery to “catch” (or retrieve) each baby to the NICU.

“It came full circle,” Katie said. “Everyone who helped in the beginning was there for the delivery.”


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Media inquiries: Elizabeth Adams, University of Kentucky Public Relations and Marketing, elizabethadams@uky.edu

Tomosynthesis at UK HealthCare

Advanced technology for breast cancer screening

Is it time for your annual breast cancer screening? Do you need diagnostic imaging? Here’s something to consider.

The Comprehensive Breast Care Center (CBCC) at the UK Markey Cancer Center offers state-of-the-art digital tomosynthesis for breast cancer screening and diagnostic services. UK HealthCare is one of only a few medical centers in the state to offer this new technology.

Tomosynthesis is 3-D technology that allows radiologists to see individual breast structures without overlapping tissue. In addition to providing the traditional top and side images of the breasts taken during a regular 2-D mammogram, tomosynthesis allows the technologist to take X-ray pictures of each breast from many angles. A computer then combines all this information into one 3-D image, making it possible to find much smaller and earlier-stage cancers. A tomosynthesis exam will feel no different from a usual mammogram, except that it takes just four seconds longer.

Dr. Margaret Szabunio, associate medical director of the CBCC and division chief of women’s radiology at UK HealthCare, along with her team of dedicated breast radiologists, specialize in using tomosynthesis for the early detection of breast cancer.

“Tomosynthesis produces images in tiny 1 millimeter slices that can be reconstructed into a 3-D image of the tissue, similar to the way a CT scan works,” Szabunio said. “It allows us to look at breast tissue in a way we’ve never been able to before.”

Dr. Mark Evers, director of the UK Markey Cancer Center, says the technology, along with Szabunio and her team’s expertise, have a significant impact on patients.

“Dr. Szabunio’s experience with tomosynthesis digital breast imaging is of great benefit to our patients when it comes to detecting breast cancer in its early stages,” Evers said. “The earlier a cancer is detected, the higher a patient’s chances are for a full recovery. This technology has the potential to save many, many lives.”

The CBCC uses tomosynthesis as a regular screening tool for all women, women who are at a high risk for breast cancer or for women that need diagnostic follow-up for a mammogram that shows an abnormality.

Make an appointment with the CBCC by calling 859-323-2222 or visiting our online appointment request form.


Next steps:

  • Confused about when to get a mammogram? Check out our Q&A with Dr. Szabunio, who tells us why mammograms are so important and what she recommends when it comes to screening.
  • Our latest Making the Rounds blog featured breast cancer specialist Dr. Aju Mathew. He tells us about his newest hobby and which historical figure he most admires. Check it out.
A new study led by UK Markey Cancer researchers and published in the Journal of Cell Science establishes a novel link between cell polarity and cancer-associated inflammation.

Proposed clinical trial could change the game for triple-negative breast cancer

This is the first post in a two-part series about UK Markey Cancer Center researchers’ efforts to improve treatment for triple-negative breast cancer, a deadly form of the disease. Check out Part Two here.

UK Markey Cancer Center Oncologist Dr. Edward Romond spent his career at UK treating and studying breast cancer, even leading major Phase 3 clinical trials on the breast cancer drug trastuzumab in the early 2000s. Commonly known as Herceptin, this drug became a standard of care for patients with HER2-positive breast cancer.

Though he retired from practice last year, Romond continues to work part-time with the research team at Markey, this time pushing toward a cure for a different, more deadly, type of breast cancer.

“Breast cancer, we now recognize, is at least five different diseases that are completely different from each other,” Romond said. “And the hardest nut to crack is this one called triple-negative breast cancer.”

Treating triple-negative breast cancer

Triple-negative breast cancer is a moniker given to a particularly aggressive group of breast cancers that often affect younger women. Unlike the receptor-positive types of breast cancer, which have biomarkers that tell oncologists which treatment the patient should respond to, triple negative breast cancers have no definitive biomarkers. If the patient does not respond well to the current standard of care, it’s up to the oncologist to make an educated guess about which chemotherapy will do the job.

The good news is that triple-negative breast cancers do generally respond well to chemotherapy. However, because triple-negative breast cancers are not the same, and every single patient responds differently to various chemotherapies, it’s difficult to predict which chemotherapy will best treat each patient’s cancer.

But the researchers at Markey are working to change that paradox. Markey’s Breast Translational Group is currently developing a proposed clinical trial that could create a major shift in the way triple-negative breast cancers are treated.

Currently, after a patient is diagnosed with triple-negative breast cancer, she usually receives chemotherapy first to try and shrink the tumor (known as neoadjuvant therapy), followed by surgery to remove as much of the mass as possible. The patients are then monitored for signs of recurrence. If a patient has residual cancer despite getting neoadjuvant chemotherapy, they are at a high risk for recurrence.

Proposed clinical trial

There are currently at least six different types of chemotherapy that can be used as a possible therapy for patients, and each one may affect each individual patient in a different way. To tailor the treatment to each distinct patient, the investigators aim to test the tumors in a set of animal model “avatars” with these different therapies to gauge the response.

Here’s how the proposed trial would work: after the patient’s biopsy, her cancerous tissue would be transferred into a mouse that is bred to grow human tumors, then subsequently into three dozen mice: her “avatars.” While the patient undergoes neoadjuvant chemotherapy and then surgery – a process that can take up to six months – the avatars will be divided into groups, with each group receiving one of the six available chemotherapies.

When the researchers see which avatar group has the best result, they’ll know which chemotherapy should work best for that patient. Knowing this would provide additional options for women who have residual cancer after neoadjuvant chemotherapy, and may reduce their risk for disease recurrence.

“It would prevent us from having to experiment with each individual patient, and end up finding that they didn’t respond to that therapy,” said Kathleen O’Connor, director of Markey’s Breast Translational Group. “If we can do this, then the oncologists will no longer have to guess.”

Disrupting the standard of care

Dr. Aju Mathew, a medical oncologist who treats triple-negative breast cancer patients at Markey, compares his team’s game-changing proposition to the way Uber has altered the use of public and personal transportation.

“We often hear about disruptive technology — Uber being one, for example,” he said. “It disrupted the current paradigm of everyone driving a car on their own or hiring a cab. This trial is our way of disrupting the current standard of care, the current technology, and the current practice of medicine, to try to change the paradigm of ‘one size fits all’ approach for triple-negative breast cancer patients.”

Though the avatar model of research isn’t new, O’Connor notes that not many researchers are using them specifically for the treatment of an individual patient. Using a trial protocol to get the tissues directly from the patient’s biopsy is a key factor in making the research work.

“The important thing is that we need to get the tumor tissue before they’ve been exposed to chemotherapy,” O’Connor said. “This is one of the things that makes our trial unique.”

With the trial design in place, the team just needs to provide ample data showing that growing a patient’s tumor in the avatar from biopsy will work. But to gather that data, they need more funding. Initial pilot funds stemming from Markey’s National Cancer Institute (NCI) designation grant have enabled the team to establish their first set of avatars with tissues taken from patients’ surgeries. But a boost in funding would help them establish the preliminary data for the trial and allow the team to then apply for major federal funding.

“We have a large group of people who have freely given their time up to this point,” O’Connor said. “But we need to have money to protect the time of the researchers doing this work, and we need enough money to get the mice in order to do this.”

Check out the video below to see Markey researchers talk about their triple-negative breast cancer research.


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Triple-negative breast cancer can be difficult to treat, but a new clinical trial currently in development at the University of Kentucky Markey Cancer Center could potentially change the standard of care for this deadly disease.

Mom continues daughter’s fight to raise breast cancer awareness

This is the second post in a two-part series about UK Markey Cancer Center researchers’ efforts to improve treatment for triple-negative breast cancer, a deadly form of the disease. Check out Part One here.

Funding for triple-negative breast cancer has been a major focus for Lexington resident Cindy Praska, whose daughter Whitney was diagnosed with the disease in 2007 at age 24. After undergoing a double mastectomy, chemotherapy and radiation at another hospital, Whitney was deemed cancer-free.

In the years following her diagnosis, Whitney became an advocate for breast cancer awareness and fundraising, becoming actively involved in the Frankfort Country Club’s Rally for the Cure, which has raised money for the Susan G. Komen Foundation and the UK Markey Cancer Center for nearly 20 years.

Though her initial treatment for triple-negative breast cancer was successful, Whitney then developed bone cancer, or osteosarcoma, in 2012. This time, she elected to have her surgery out of state and came to Markey for her chemotherapy. Genetic testing revealed she carried a P53 genetic mutation, which was the cause of her original cancer, and combined with the radiation she had received prior, also caused her osteosarcoma. Despite Whitney’s and her doctors’ best efforts, her cancer metastasized and she succumbed to the disease in November of that year.

Carrying the torch for her daughter, Cindy continues to push for education, awareness and research toward triple-negative breast cancer and is still heavily involved in fundraising.

This Saturday, Oct. 15, Cindy and the team behind the Frankfort Country Club Rally for the Cure have planned a “party with a purpose” called Bourbon & Jazz for the Cure to celebrate the organization’s 20th anniversary. Held at the Frankfort Country Club on Saturday at 6:30 p.m., this special fundraising gala includes a silent and live auction featuring limited-edition Buffalo Trace bourbon bottles, and the funds raised from the gala will directly benefit the research team behind Markey’s proposed triple-negative breast cancer clinical trial.

“Whitney helped bring awareness to this disease, and it is so rewarding to me that work is progressing so that more young women her age will live to marry, have a family, and be able to see their young children grow up,” Cindy said. “It has given me a purpose to be an advocate for these causes and it’s an honor to be supporting Markey, who we called family and home the last year of her life.”


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