2009 Archives

Simple blood test to detect breast cancer?

  • Posted on December 31, 2009 at 4:50 pm

What a fabulous early New Year’s gift!

Yesterday Scottish scientists reported their initial finding that a sugar change in blood may signal the presence of breast cancer.  This research could lead to a simple blood test to screen patients for the onset of breast cancer. Providing a blood sample would be much less intrusive and less costly than a biopsy.

A U.S. charity has supplied the scientists with funding to conduct additional research on this exciting preliminary discovery. The original article can be found at http://www.eveningtimes.co.uk/news/editor-s-picks-ignore/blood-test-could-hold-key-to-breast-cancer-1.995228. Let’s pray that the initial results will be confirmed in 2010. I, for one, would opt for a simple blood test any day over a biopsy, even a fine-aspiration biopsy.

On that note of optimism, have a blessed, safe and healthful New Year!

Jan

Breast cancer recurrence from moderate alcohol intake

  • Posted on December 20, 2009 at 5:56 pm

Red wine has an aspirin-like effect, reducing the blood’s ability to clot, and also contains antioxidants. It’s great for the heart, but what about breast cancer? Perhaps the jury is finally in on this issue.

The latest study of breast cancer survivors who consume alcohol was reported in San Antonio, TX this month (http://www.medpagetoday.com/MeetingCoverage/SABCS/17444). Funded by the National Cancer Institute, the eight-year research project showed that early-stage breast cancer survivors who drank an average of at least three to four alcoholic beverages per week had a 34 percent higher risk of recurrence than those who drank less than one drink per week or no alcohol.  (One drink is defined as a 5-ounce glass of wine, a 12-ounce glass of beer, or a 1.5-ounce shot of liquor.)  This risk was even higher for those who were post-menopausal, overweight or obese.

Per WEEK, not per day? So much for enjoying the entire Mediterranean diet guilt-free.

Precisely how alcohol consumption influences breast cancer risk is not fully understood, says the lead researcher on the study, Marilyn L. Kwan, Ph.D., a staff scientist at Kaiser Permanente in Oakland, CA.  But estrogen, which fuels the growth of most types of breast cancer, is likely a culprit. “It has been suggested that alcohol could increase the risk of breast cancer by increasing estrogen metabolism and circulating levels of estrogen, thus promoting growth of the tumor,” says Dr. Kwan. “A similar mechanism might be responsible for increasing the risk of breast cancer recurrence.”

As a lymphedema patient-advocate I know Dr. Kwan and have great respect for her work. I plan to take her research seriously.

During the seven years between my first diagnosis and my recurrence, I might have averaged at least three drinks of wine a week.  I’m post-menopausal, although not overweight. And I will be going off Arimidex (which reduces estrogen levels in the body) in early March. Therefore, I will call my oncologist to determine what these results mean for me. It appears from the study that two drinks a week did not increase the risk of recurrence, but is that okay for me personally?

Like Dr. Kwan, I encourage early-stage breast cancer survivors or their caregivers to consult their medical professionals to assess personal risk. Breast cancer is such a diverse disease, and red wine in small-to-moderate amounts might benefit those with a personal or family history of heart disease.

My poor oncologist. Is he prepared for my next question-of-the-week about lifestyle choices? But I am compelled to ask. A second recurrence is not one of my New Year’s resolutions! And non-alcoholic drinks can be pretty tasty. Just ask my non-imbibing Christian friends, who engage wine-drinking Christians in constant debates about the biblical propriety of consuming alcohol.

Here’s a Martinelli’s toast to your health for the New Year, and a very Merry Christmas.

Jan

Could Exercise be a Fountain of Youth?

  • Posted on December 9, 2009 at 3:20 pm

A new study has revealed, at a molecular level, why those who regularly exercise are healthier as they age.  The active people had cells that, when viewed under a microscope, were younger than those of the inactive people who participated in the study. This finding may explain how exercise helps prevent degenerative diseases associated with aging, such as heart attacks, diabetes and cancer.

Even though I got cancer at 43 despite my regular running routine, I believe this study: exercise is vital to health and keeps people youthful. Perhaps I would not have endured my grueling treatments as well if I had not exercised regularly before cancer struck.

The article describing this research can be found at: http://www.webmd.com/fitness-exercise/news/20091201/molecular-proof-exercise-keeps-you-young?ecd=wnl_skin_120909

A blessed Thanksgiving

  • Posted on November 25, 2009 at 3:49 pm

Thanksgiving is a time of year to reflect on our lives and count our blessings, one by one, as the hymn goes. I have just been advised to stop taking Arimidex, an anti-estrogen daily pill I have taken for over six years. My former oncologist counseled me to stay on this pill for life, but my new doctor believes there is no further benefit, and there are even risks, in taking it longer than needed. So I will be stopping it starting in the New Year.

Since I had a recurrence two years after I got off tamoxifen in 2001, I am a bit apprehensive about discontinuing my daily Arimidex. It’s like a security blanket, but with prickly side effects. My doctor said I could take Evista (raloxifene) for a further five years to ward off my anxiety. But the possibility of experiencing deep vein thrombosis, stroke or other nasties from this tamoxifen-like drug do not seem worth it. And like Arimidex, this drug has no generic equivalent. So it would further drain my bank account as well as my estrogen.

This Thanksgiving I’m resolved to throw my fears out the window, to be grateful to God that I no longer need any adjuvant drug. I believe I’ve done all I can do to reduce my risk of another recurrence by enduring a bilateral mastectomy, two aggressive courses of chemo and a year of Herceptin.

Perhaps being off Arimidex will be like pressing the “Pause” button on my post-menopausal symptoms. Maybe my hair will have a chance to thicken and my night sweats, hot flashes and joint pain will subside. Maybe I’ll even lose weight! What a wonderful blessing all that would be. But if I don’t recover any youthful traits, that’s okay, too. My heavenly Father knows best. And for that I am the most grateful as we wrap up 2009.

A joyous and blessed Thanksgiving to one and all!

Jan

New mammography screening guidelines

  • Posted on November 17, 2009 at 9:05 pm

As a breast cancer survivor who found her cancer at 43,I couldn’t let another day go by without commenting on yesterday’s breast cancer screening recommendations from a panel of experts. In case you haven’t heard, the U.S. Preventive Services Task Force recommends that women under 50 of low or average risk scrap being routinely screened for breast cancer.  Their rationale?  The risk of false positives and unneeded radiation and biopsies outweighs the benefits of blanket screening. A cost-benefit analysis also played into this recommendation. This panel still suggests mammograms for women with a family history of breast cancer or who are otherwise at high risk. For more details check out http://www.healthcentral.com/breast-cancer/news-417459-98.html?ic=6006.

These latest guidelines are controversial.  The American Cancer Society, the American College of Radiology and some other experts disagree with the findings. Still, insurance companies might well use this panel’s newest release as an excuse not to cover mammograms for women in their forties.

I’d be interested in your opinion. Please join in taking the survey I’ve created on this controversial subject by clicking on the following link: http://www.surveymonkey.com/s.aspx?sm=MT1uhaKNg50glsw0BibO_2bw_3d_3d. Once the results are in, I will share them with you.

Happy Thanksgiving to one and all!

Jan

Cancer Patients Seek Honesty, Informality in Doctors

  • Posted on November 13, 2009 at 3:46 pm
Cancer patients want straight talk from their doctors, according to a written survey recently reported  in WebMD Health News (http://www.webmd.com/cancer/news/20091104/cancer-patients-want-honesty-from-doctors?ecd=wnl_brc_111009).  The survey reflected responses from over 500 survivors of breast, lung or prostate cancer.

A large majority of patients (95%) appreciated honesty in their doctor regarding their odds of survival and how long they might live.  Prostate cancer survivors were more likely than lung cancer patients to want their doctors to be upfront about survival chances: 97% vs. 91%.

In addition, the survey revealed that patients welcome informality in their doctors. Almost 75% preferred to be addressed only by their first name, and even more were fine with their doctor not wearing a white coat.  Most wouldn’t mind a hug after two months of radiotherapy, and a third of women cancer survivors indicated a desire to have their hands held by their oncologists during critical office visits.

Further survey findings reveal that most patients (84%) welcome a detailed explanation of their treatment plan, and an even higher percentage (95%)  said they want their physician to use laypersons’ terms when discussing the details.

As to spiritual matters, 40% of survey respondents indicated they would like to share their own beliefs with their doctor. The results indicated that patients don’t appreciate doctors imposing their own spiritual views, but would like doctors to affirm the individual patient’s own belief system.

I consider these findings refreshing. Patients long for an informal, straight-forward and detailed conversation with their oncologists, similar to what we had before doctors stopped making house calls. Anything the doctors can do to incorporate these findings into their practice would be very beneficial for cancer survivors struggling to understand their prognosis and treatment options. The personal touch is in.

Thanking our caregivers

  • Posted on October 29, 2009 at 1:33 pm

As Breast Cancer Awareness month winds down, if you are a survivor, remember to thank the people in your life who have  supported you throughout your cancer journey. It may be your husband who measures the liquid in your surgical drains. It may be your prayer partner a continent away who listens without judgment to your fears and doubts. It may be your church friend who provides meals or cleans your house after surgery.  Or it may be your coworker who covers for you seamlessly when you miss work to visit the doctor. These angels on earth enable us to bear our burdens more gracefully. Kudos and blessings to all these selfless caregivers.

Newly diagnosed with breast cancer?

  • Posted on October 17, 2009 at 1:50 pm

Wonder where I have been during October, Breast-Cancer Awareness Month?  Busy with book signings, Reach to Recovery training for the American Cancer Society, and my new job as church secretary.  But I am still very much engaged in the cause.

Here’s some interesting information for those who are newly diagnosed with breast cancer or know someone who is:

1. For aid in decision-making about breast-cancer treatment, visit  www.mytreatmentdecision.com.

2. An interesting study about surgical decisions was published recently in the Journal of the National Cancer Institute (www.cancerconsultants.com/surgical-decision-making-early-stage-breast-cancer).  Regardless of race or ethnicity, more women with early-stage breast cancer who were active in their own decision-making chose mastectomy than those who made a “shared or surgeon-based decision,” even though mastectomies and lumpectomies have been shown to be equivalent.  Women concerned about recurrence or the effects of radiation were more likely to opt for mastectomy than those who did not share those concerns. In contrast, women concerned about body image or their spouse’s opinion were more likely to undergo a lumpectomy than those who did not voice those concerns.

This finding rang true for me:  when I first had breast cancer at 43, I was concerned about body image and chose lumpectomy.  But when at 53 I was diagnosed with a recurrence in the same breast, body image went out the window, and I chose a bilateral mastectomy.  After my second bout with cancer I wished I had chosen a mastectomy the first time to avoid the recurrence and radiation effects.  God had His reasons, however (one of them being to tell my story), and I’m good with that.

Happy October!

Jan

Late-Stage Breast Cancer Patients Benefit from Breast Surgery

  • Posted on September 29, 2009 at 6:58 pm

The main treatment for most breast cancers is surgery to remove either the affected part of the breast (lumpectomy) or the entire breast (mastectomy).  If the cancer has spread, however, surgery is generally only offered if the breast tumor causes pain or other symptoms.

A new study reported in WebMD Health News challenges this thinking about women diagnosed late with breast cancer.  A recent review of pertinent medical records reveals that patients whose cancer had already metastasized to other parts of the body lived about a year and a half longer if their breast tumor was surgically removed.  Women should ask their doctors about these new research findings, which, if confirmed, may lead to major changes in treatment of this population of patients.  For further information see:  http://www.webmd.com/breast-cancer/news/20090922/surgery-improves-late-stage-breast-cancer?ecd=wnl_brc_092909

Detecting regional cancer spread with less pain

  • Posted on September 28, 2009 at 5:40 pm

As a newly diagnosed breast cancer survivor in early 1996 I had 14 lymph nodes removed from my armpit (axial dissection) to detect breast cancer spread (stage my tumor).  All 14 were clean of cancer.  After chemo was complete that same armpit was radiated, further increasing my risk of developing lymphedema. In 1997 I developed arm swelling that was diagnosed as lymphedema.

Sound primitive by today’s standards?  You bet it was!

The sentinel lymph node (SLN) biopsy became the standard of care a year or two after my diagnosis as a much less invasive way to stage the cancer. To identify the SLN(s), the surgeon injects a radioactive blue dye near the tumor. The surgeon then uses a scanner to find the SLN(s) containing or stained with the radioactive dye. Once the SLN(s) are located, the surgeon makes a small incision in the skin overlying the SLN and removes the lymph node(s).

The SLN(s) is/are then checked for the presence of cancer cells by a pathologist (a doctor who identifies diseases by studying cells and tissue under a microscope). If cancer is found, the surgeon will usually remove more lymph nodes during the biopsy procedure or during a follow-up surgical procedure. SLN biopsy may be done on an outpatient basis or require a short stay in the hospital.

But every procedure involving cancer staging or treatment, it seems, comes with a cost.  A most recent article on the topic published by Ivanhoe Broadcast News  (www.healthscout.com/news/1/8022281/main.html?ic=6006) reports that patients experience excruciating pain when injected with the radioactive tracer as part of the SLN procedure.

Here’s the good news:  Eugene Woltering, M.D., a professor at the Louisiana State University Health Sciences Center in New Orleans, recently developed an alternative radioactive blue dye for use in the SLN biopsy.  A study found that this dye, which lights up hard-to-see lymph nodes likely to be cancerous, works equally as well as the older dye, but without the pain.  Further, the new procedure exposes the patient to one-third less radiation than the current one.

Kudos to Dr. Woltering for another advance to ease the journey for breast cancer patients, just in time for October, breast-cancer awareness month.

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