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October 2010 2011

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Think Pink • Sunday, October 16, 2011

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Sally Wade ................................................................................................................................................... 4 Top 25 things I wish people would have told me ..................................................... 6 Practicing breast self-awareness ................................................................................................... 7 Chemo with a side of bananas .................................................................................................... 8 Victoria Bienski .......................................................................................................................................... 9 Healing moves .......................................................................................................................................... 10 Just another day at the office ........................................................................................................ 11 And cancer ran away with the spoon ................................................................................ 12 Understanding the stages of cancer ........................................................................................ 14 Top 10 lists ...................................................................................................................................................... 15 A small step forward & Study: Overweight girls/cancer ................................... 16 Screenings & Safe and Sound ....................................................................................................... 17 Remember the mammogram & Fast facts ........................................................................ 18 Living better means coping better ........................................................................................... 19 Something’s fishy... In a good way ........................................................................................ 20 Understanding breast cancer ......................................................................................................... 21 Origins of the pink ribbon & Treatment goes meta ............................................... 22 Publisher Display Advertising Manager Special Projects

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Jim Wilson Joanne R. Patranella Dawn Goodall Jim Bob Mckown Billy Mau Sal Velasco

Think Pink • Sunday, October 16, 2011

TABLE OF CONTENTS

A portion of the proceeds from Think Pink will be donated to the Susan G. Komen For The Cure® 3

Think Pink • Sunday, October 16, 2011

Counterclockwise starting from top Students and teachers from the Bush School of Government and Public Service joined Wade at the 2010 Relay for Life. Sally Wade celebrates her final treatment at M.D. Anderson in Houston in November of 2010. Wade’s family: (from left) daughter, Connally; son, Mark; Sally and husband, Dr. Herbert Wade.

Brazos Valley Survivors:

Sally Wade

By BILLY MAU The Eagle

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s almost any survivor or doctor will say, the right attitude goes a long way when it comes to beating breast cancer. Sally Wade’s attitude not only carried her through treatment, but also allowed her to continue working with her students through chemo and radiation.

Wade, a lecturer at the Texas A&M Bush School of Government and Public Service, seemingly had little reason to worry about breast cancer. She had no family history of cancer and routinely had mammograms, each coming back clear. She had her first hint that something could be wrong in 2009, but it wasn’t until the following year that those hints became something more. “I didn’t have a lump, I had a calcification,” Wade said. “It had been noticed the year before, but my doctors told me that 80 percent of calcifications are benign. I ended up falling in that other 20 percent.” In February of 2010, Wade’s doctors decided the calcification needed more attention. She first realized everything wasn’t normal when the doctors took more mammogram images than normal. Wade asked the radiologist what was going on and was told the calcification had grown since the year

before and a biopsy was scheduled. The doctors kept telling Wade that the calcification would likely still come back benign, but she had a feeling they were wrong. Surprisingly, this feeling was not one of dread. Wade was sure that her calcification was malignant, but she also was confident that all would be well despite it. “It was very strange because I just had a feeling that it was going to come back malignant,” Wade said, “but I just didn’t worry about it. I had a feeling of total peace through the whole thing and I knew that everything was going to be okay.” Doctors had hoped they caught the cancer early enough that it hadn’t spread, but after performing the partial mastectomy, it was discovered that the cancer had spread to the lymph nodes. That meant chemo and radiation treatment. Wade underwent six months of chemo and six weeks of daily radiation treatment. This began just at the end of the 2010 spring semester, and she was able to take advantage of school being out in the summer during most of the treatment. She was still in treatment when the fall semester started. She was given the option of taking a break until she was done with treatment and had

her strength back, but Wade decided to go ahead with work. “I’m a lecturer and a writing consultant,” she said. “I felt like I had an obligation to the school and to my students to be there for them. “When I was getting radiation treatment, I was able to work remotely over the computer. I could edit papers or answer questions either through email or on the phone.” Casey Braswell, one of Wade’s graduate students, was working on a large group project that Wade was an advisor for. She said she was amazed at how well Wade was able to work despite her situation. “We couldn’t believe it,” Braswell said. “We were getting emails from her at 10:30 or 11 at night when we were all ready to go to bed, but she was still working. She had to approve the information we were using in our project and I was emailing or calling her every day. She had to be very involved and we just didn’t know how she was doing it.” Wade finished her treatment on Nov. 29, 2010 and has been steadily regaining her strength since then. Her bout with cancer not only raised her awareness to the disease, but it did so for her students as well. A group of about 20 of her students

joined her at the last Relay for Life where they also honored the wife of another professor at the Bush School. “The Bush School is like a family,” Braswell said. “When someone goes through a hard time, everyone circles around them for support.” It wasn’t just Wade’s family and students who were there to support her. Former classmates from her days at Baylor would send her encouraging emails on days she was scheduled for chemo and she would always come home from treatment to find special prayer-grams from her church. She in turn is looking for ways to give her support to others now. With her strength back to her now, she is setting out to do the 60-mile Susan G. Komen 3-Day for the Cure walk. She also aims to become more active in the community. She realized that her journey with breast cancer made her part of a sisterhood and she hopes to help others as she was helped herself. “I’ve learned to be thankful for so many things every single day,” she said. “I’m much more relaxed now and I have a real spirit of gratitude – gratitude for the experience I had and my family and friends who supported me.”

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Think Pink • Sunday, October 16, 2011

TOP

Things I wish people would have told me... Source: Pink Alliance Brazos Valley Breast Cancer Support. (bvbcs.org)

1. We cry, we all have cried, but we laugh too! 2. With new treatments, you are not sick all of the time! You can work and carry on a normal life — you just have to rest more. 3. Listen to your body. When you’re tired, stop and rest. When you are feeling okay, follow your usual routine. It will make the time pass faster and make you healthier both physically and mentally. 4. Eat several small meals a day. It keeps your strength up and manages nausea, if you have any. 5. Keep a journal of daily visits, meals brought by, gifts, card, etc. Also write down how you are feeling. It becomes your story, and it is good to look back on your journey. 6. Don’t be afraid to ask for help. People are willing to offer, but often don’t know how to approach you. 7. When people offer to help, believe them. They get as much from helping you as you do. It fills two buckets at the same time! 8. So many “angels” come into your life — and they come in many ways. 9. Have someone accompany you to all your appointments. It is hard to hear/understand/think about everything the doctor is saying when you have so many things going through your mind. Four ears are always better than two! 10. It’s okay to be proactive and ask questions about your treatment and your doctors. 11. Keep a list of questions as you think of them between treatments so you can ask the doctor at your next appointment. 12. If you are sick or hurting, don’t suffer in silence...tell your doctors. 13. It’s okay — and kind of nice — to not wear a wig if you’re not comfortable with it. You look glamorous with your hats and scarves, and cute with your bald head. 14. You will learn that the hair on your head is there for more than looks — it helps your body retain heat. You will probably want to wear a turban to keep your head warm at night and on colder days. 15. If you are having chemo and expect to lose your hair, cut it short. It is fun to have a new hair style, and it makes it easier when you start losing hair. 16. You can get a fringe of hair that looks like hair under hats and scarves without having to wear a full wig. 17. Putting baby powder on your head before putting on your wig makes it more comfortable and absorbs some of the moisture. 18. Buying the wig early helps match color/style to real hair. Or, if you want to, get a wig that is very different than your hair. It’s your opportunity to try new things! 19. If you acquire your wig before your hair has fallen out, keep in mind that it will not fit as tightly without hair. If you purchase your wig, ask if you can return to have it sized later. 20. Get your wig trimmed by your hairstylist or someone with experience with wigs. 21. You can get a free wig and other supplies at the local American Cancer Society office. 22. Not having hair during the treatments allows more time to relax and take OF EXPERIENCE care of yourself. Think how much time you save without having to fix your hair! American Academy of Family Physicians 23. If you are having reconstruction and nipple/areola tattooing, take a picture of your breasts before surgery. That will help you see colors Katherine Kriger, P.A.-C/M.H.P better when you do the tattooing. Accepting New Patients 24. Contact the American Cancer Society — the resources are amazing! Call or e-mail any member of BVBCS (bvbcs.org) — we are here to help. 1121 Briarcrest Drive, Suite 303 25. Talk about your diagnosis. You may save another life.

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breast self-awareness can help women notice changes in the breasts and alert a doctor promptly.

arly detection of breast cancer is the single-most effective way to beat the disease. That is why it is essential for women to conduct their own breast exams to discover any potential anomalies early on. While doctors stress the importance of self-examination, many women still show up for routine wellness visits admitting they don’t do examinations because they simply don’t know how. Perhaps because the practice was given the formal name “breast self-exam.” Today, however, doctors tell women to have “breast self-awareness.” That means women don’t have to follow a set protocol regarding checking for breast changes, and simply being aware of how the breasts look and feel is key. Why the change in the formalities? Doctors have determined that most women

notice a lump in their breasts while doing routine activities, such as bathing or dressing. They also figured out that a formal method of examining the breasts was not necessary. Lumps can be found simply by touching the breasts in any pattern, as long as the entire breast is checked. To demystify the process even further, follow these guidelines. • Breasts are best checked for changes directly after a menstrual period. At this time the breast tissue will be softer and less tender due to diminishing hormone levels. • Look at the breasts every day and notice their appearance and shape. Recognizing subtle differences can help alert a doctor if something is amiss. • Be conscious of these changes: - changes in breast size, shape,

skin texture, or color - dimpling or puckering of the breast - discharge from the nipples - scaliness of the skin - nipple pulling to one side - lump or mass in the breast - enlarged lymph node under the arm Any changes or questions about breast condition should be promptly brought up with a doctor. • Women should know their risk for breast cancer. While there isn’t a definitive genetic correlation, the high rate of breast cancer in one family may mean a particular woman is more at risk. • Get routine screenings at a doctor’s office. Women over the age of 40 should get a mammogram every year.

Think Pink • Sunday, October 16, 2011

Practicing Breast Self-Awareness

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Every is a gift...

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PANDORA supports Breast Cancer Awareness so every woman can enjoy y all of hers.

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Think Pink • Sunday, October 16, 2011

Chemo with a Side of Bananas Cancer patients often suffer from a lack of appetite, but overcoming eating obstacles is key to recovery By Bev Bennett CTW FEATURES

er mouth burning and her sense of smell acute, swallowing medications was a trial for Shari Ichelson Silverman. To ease the discomfort Silverman was advised to tuck the pills inside banana chunks, which are slippery and go down easily. “To this day the smell of a banana makes me throw up,” says Silverman, an Ontario resident, who was diagnosed and treated for acute myeloid leukemia (AML) less than two years ago. You may be fortunate to not have a reaction like Silverman’s during your diagnosis or treatment for cancer. However, you may lose your appetite or be in too much pain to eat; certain aromas or flavors can be unpleasant. Regardless of your unique circumstances, your goal should be to stick with a

healthful diet to the extent you can. Protein foods and plant foods along with adequate calories and fluids all play a role in the healing process, say health experts. Here are tips on foods to incorporate into your meals. Read the sidebar for ideas on overcoming some of the common obstacles to healthful eating. Start with protein, which your body needs to grow tissues and muscles. Skimp and you may feel weak and have muscle wasting, according to Karen Collins, MS, registered dietitian, nutrition advisor to the American Institute for Cancer Research (AICR). “It [lack of protein] can play out in problems healing,” Collins says. You can get protein from simple easy-to-eat foods like cottage cheese, hardcooked eggs, nuts and peanut butter, says Kristina Ratley, registered dietitian with the Dietitians on Call program, American Cancer Society’s South Atlantic Division. Take simple steps to add

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Challenges to Eating Well

If your cancer or treatment is affecting your ability to eat healthfully, a dietitian specializing in cancer care will suggest strategies to overcome common obstacles, such as taste alterations, appetite loss and nausea. You may lose interest in your favorite foods, including coffee, red meat and even chocolate, according to Kristina Ratley, a registered dietitian in South Carolina who works with American Cancer Society’s South Atlantic Division. Food may taste metallic, a frequent problem when you’re undergoing treatment. Try using plastic instead of metal utensils and avoiding canned food, says Ratley. Sharp flavors may be more appetizing, especially if food tastes bitter or like cardboard. Marinate chicken in Italian dressing or sprinkle the dressing over cooked vegetables, says the cancer society dietitian. Eating may be unappealing, causing you to lose too much weight. Choosing foods you’re familiar with and that provide comfort can help, says Daniela Fierini, a registered dietitian specializing in cancer care. “If you’re Italian, put olive oil on your

protein to foods you enjoy. “Add cheese to toast, crackers, sandwiches and soup. Add [diced] turkey to canned soup, ” says Dee Sandquist, registered dietitian in Fairfield, Ia. and spokesperson for the American Dietetic Association. Eating more fruits, vegetables and whole grains is always good advice. Plant foods, rich in fiber, can help prevent constipation resulting from some types of chemotherapy. But see what you can tolerate. High-fiber foods may cause diarrhea and some fruits and vegetables may irritate mouth sores, according to Collins. Select frozen, peeled and chopped fruits and vegetables, which may be easier to prepare and eat. As with solid foods, your fluid needs will depend on your health and comfort level. With some types of chemotherapy and radiation you “need more fluid volume to rid your body of waste from the treatment,” Collins says.

vegetables. Switch from skim to whole milk,” says Fierini, with Princess Margaret Hospital, Toronto, ON. Find a time of day when your appetite is at its peak and eat then. Or, try smaller, more frequent meals, Fierini says. Getting enough fluids is important, but make sure you’re not drinking yourself full so you’re not hungry. “If you’re losing weight because you’re not eating, but drinking a lot of water, you can drink a nutrient-rich beverage instead,” Fierini says. You can drink less during meals so you’re not satiated, and sip fluids the remainder of the day, says Dee Sandquist, a spokesperson for the American Dietetic Association. Those frequent sips may also calm a rocky stomach. But if you’re still nauseous Sandquist recommends starting the day with dry toast or crackers. Even with the changes in appetite during cancer treatment you may once again appreciate your favorite foods. “I’m just beginning to get back my taste for chocolate,” says Shari Ichelson Silverman, a Canadian who underwent cancer treatment during the summer of 2009.

In addition, you’ll want to replace lost fluids if you have nausea and/or diarrhea. Smoothies, milk and chicken broth may be good options for you. You may have been counting calories half your life, but if you underwent surgery you may need more calories now for the healing process. “If you don’t get enough calories your body will burn protein for energy,” Collins says. However, try not to worry about what you can or cannot eat, say the experts.

“When you’re facing cancer treatment, [we] still encourage people to eat healthful foods, but realize they may have appetite limitations. We don’t want eating to be another stress for people,” says Ratley, certified specialist in oncology and co-author of “What to Eat During Cancer Treatment” (American Cancer Society, 2009).

Brazos Valley Survivors: Think Pink • Sunday, October 16, 2011

Victoria Bienski By BILLY MAU The Eagle

ictoria Bienski felt like she was on top of the world just before she was diagnosed with breast cancer in June of 2007. She had just retired after 31 years at Texas A&M and was about to start her new career working with her husband, and her youngest daughter was graduating from A&M and planning a wedding.

In the following days, she talked to her friends and to her pastor and that fear and dread began to go away. She resolved herself to beat the cancer and survive just as her mother did, who lived for 44 years after beating cancer. “Now she was a survivor,” Bienski said. “She had breast cancer at a time when people didn’t talk about it and for that 40 plus years after she was diagnosed, she was cancer free.” Bienski stayed local for her surgery and treatment. Doctors were able to remove the cancer with a lumpectomy instead of a full or partial mastectomy, and she was refered to the St. Joseph Cancer Clinic for treatment. It was there, before she’d even seen a doctor, that she had her first breakthrough in her cancer journey. Since discovering the lump,

Finally her doctor came out and explained to her that the other patient’s treatment was taking longer and needed his attention, but that he wouldn’t leave the building without seeing her that day. As the doctor walked away to go back to the other patient, Bienski came to a realization. “When he left, I thought, ‘That patient needs him more than I do right now,” she said, getting a little choked up at the memory. “That was the first moment of awareness that made me slow down. I realized everything was happening for a reason. I’d always been a go-go-go person – everything had to be right now for me. It was then that I realized I was not the most important person. This other patient was. This other patient needed this doctor.” Chemo and radiation treatment followed for Bienski. This was when she really came to discover the amount of support her friends and

“This is a tremendous community for survivors,” Bienski said. “We have unbelievable medical facilities and the physicians and staffs I saw were top notch. There were times when I would leave radiation and just say to myself, ‘Thank the Lord we have these great facilities right here at home.’” Bienski has been cancer free nearly 4 years now and has become very active in the survivor community. She works with groups locally, as well as with her daughters in the Austin chapter of the Susan G. Komen organization. More importantly, she has a new outlook on life. “I’m more relaxed now and I enjoy the little things more,” she said. “I’ll sit out on the porch with a cup of coffee and enjoy the day, or go out at night just to look at the stars. I also don’t rush as much. If I’m at the grocery store and someone is in line behind me and they only have one or two things, I let them ahead of me. I’m not in a hurry anymore. I have the time to wait a little longer in line because God has given me all this time now.”

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“I’m a type A personality,” she said. “I told them we had to do it that day. I had to know right away. I couldn’t wait another few days for it.”

“Those results were heartbreaking,” Bienski said. “I started thinking that I was going to die and that I’d be gone by the end of the year. Of course, that’s not the right thing for anyone to think.”

Her doctor was late for her appointment. The patient before her was having to run over scheduled time. The wait worried Bienski. It was getting close to 5 pm and she thought they were going to reschedule her for another day. As time ticked away, she became more nervous.

family had to give. Friends brought over meals without being asked so she didn’t have to cook after treatment. Other survivors gave her tips for treatment ranging from what foods help the most to what local fast food places had the ideal kind of ice to chew on during certain parts of treatment.

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Bienski discovered her lump herself and brought it to the attention of her gynecologist during a regular checkup. The gynecologist confirmed the lump and immediately sent her for a mammogram. Mammograms indeed showed the lump and the doctors there suggested she get a biopsy in the following weeks, but that wasn’t soon enough for Bienski.

Bienski was no stranger to breast cancer at that point. Her mother was a breast cancer survivor and she knew others who had beaten the disease, but that was little comfort for her when she first got the news.

Bienski had been in a mode where everything had to be done right now. Everything was hurry-hurry for her. That first visit at the Cancer Clinic was scheduled near the end of the day. She got there early, ready to get in and get things done.

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“It was going to be a big year for me, so it felt like being hit with a ton of bricks to be diagnosed,” Bienski said. “Everything was going wonderfully. When I was diagnosed I, of course, was shocked. I was also angry because this was supposed to be my new time and now it was going to be changed from how I planned it.”

Luckily for Bienski, they were able to fit her in that day and the biopsy was performed. Unfortunately, the results that came back were not good. It was breast cancer.

Think Pink • Sunday, October 16, 2011

Healing Moves Exercise aids in breast cancer recovery By Taniesha Robinson CTW Features

reatment for breast cancer often leaves survivors with stiffness and pain in their arms and shoulders, restricting movement. Fortunately, there’s an everyday solution to this common problem: exercise.

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Physicians have long prescribed arm and shoulder exercises after surgery to prevent pain in the areas surrounding the cancer, but a new review of 24 research studies comprising 2,132 breast cancer patients finds that exercise programs can also help patients recover shoulder and arm movement.

Today, a team comprised of a wide range of health professionals including surgeons and oncologists work together to provide optimal care after breast cancer treatment. “This review demonstrates that early involvement of a new team member who manages exercise or physical therapy is also useful for the best outcome,” says Douglas Blayney, M.D., medical director at the University of Michigan’s Comprehensive Cancer Center. According to the review, starting exercise within the first to third day after surgery might result in better shoulder movement in the early weeks following surgery. However, “starting exercise that soon after surgery may cause more wound drain-

age and require drains to remain in place longer than if exercise is delayed by about one week,” says lead review author McNeely, an assistant professor of physical therapy at the University of Alberta and clinical researcher at the Cross Cancer Institute, Canada. Wounds healed, on average, a day later with early exercise. Fourteen of the reviewed studies compared improvements in shoulder and arm movements of post-treatment groups of women that received an exercise pamphlet with those who did not. Those who followed structured programs including physical therapy regimens in the early postoperative period showed a significant improvement in shoulder range of motion. Blayney said that he finds few things as disheartening as witnessing breast cancer survivors in long-term follow-up who are burdened with a “frozen” shoulder or daily use of a lymphedema sleeve, an elastic compression garment worn over the arm to help move fluid and reduce swelling. “Implementation of modern primary treatment strategies – including early intervention with suitable exercises – should reduce the incidence of these heartbreaking complications,” Blayney says. The Cochrane Collaboration, an international organization that evaluates medical research, published this review, which drew evidence-based conclusions considering the content and quality of existing medical trials on the topic. © CTW Features

Just Another Day at the Office By Anna Sachse CTW Features

hether the motivation is maintaining health insurance, personal finances, a family or simply a beloved career, at some point most people battling or recovering from cancer will have to go back to work. But when your future also includes myriad medical appointments and unknown treatment side-effects, the prospect of returning to your 9-to-5 can make your anxiety levels work overtime. In order to make the process of easing back into your job a whole lot easier, it’s important to know what to expect, understand your rights and research the resources available to you. Here’s your welcome back starter kit. Shaping a Smooth Transition Most cancer survivors are eager to return to work as soon as possible, not only to retain income and benefits, but also to maintain a sense of identity unrelated to their illness, says Barbara Hoffman, JD, a professor at the Rutgers – Newark School of Law and founding chair of the National Coalition for Cancer Survivorship (CancerAdvocacy.org).

Sharing the News Deciding to share your diagnosis with your boss and coworkers is an entirely personal decision. “Your boss is entitled to know only enough information (if any) to assure that you can perform your job safely, and must keep any medical information private,” Hoffman says.

If you opt to share your experience with coworkers, it’s a good idea to be prepared for a variety of reactions, StumpSutliff says. While some people may respond with understanding and offers of help, others may react awk-

Asking for Special Accommodations Under Title I of the ADA, a reasonable accommodation is any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions, Sweeney says. (Acceptable accommodations vary depending on the individual and job, but to qualify, your place of work must have 15 or more employees.) Before invoking any legal protection, Sweeney recommends speaking with an expert such as the Cancer Legal Resource Center (DisabilityRightsLegalCenter. org), which provides free legal advice. The next step is to request the specific accommodation – such as permission to telecommute, flextime to accommodate medical care, change in job hours or duties and workplace modifications – in writing, Hoffman says. You will have to disclose your disability, but you may ask for accommodations at any time before or after you start working and employers are required to engage in an interactive process to determine the best fit for the individual.

Rethinking Career Goals If, after returning to work, you discover that your old job is too difficult to maintain at the present time or you

Other Resources CancerCare (CancerCare. org), Job Accommodation Network (AskJAN.org), Lance Armstrong Foundation (LiveStrong.org), National Cancer Institute (Cancer. gov), Ulman Cancer Fund for Young Adults (UlmanFund. org), and the U.S. Equal Employment Opportunity Commission (EEOC.gov/facts/ cancer.html). © CTW Features

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Kate Sweeney, executive director of Cancer and Careers (CancerAndCareers.org), recommends that you first meet with your healthcare team and get the specifics on your treatment schedule. If the time involved or likely side effects (e.g. fatigue or hair loss) will have an impact on your performance or be impossible to miss, it’s a good idea to inform your supervisor so he or she knows what to expect, Sweeney says. And be sure to provide a list of potential solutions, adds Feuerstein. For example, if you think it will be difficult to multitask, propose alternating between focusing on a necessary task for an hour and then taking 15 minutes to make or return calls.

If faced with an intrusive response, Stump-Sutliff suggests politely but firmly setting boundaries by preparing a response that changes the topic or cuts off the conversation if it goes too far. If the problem is an uncomfortable coworker, suggest that they learn more about the realities of the illness at Cancer.org.

Check with your human resources department to learn more about FMLA and other possible options, such as short-term and long-term disability insurance. Don’t wait until your work performance is already suffering. “If doing a poor job gets you fired, you’ll also lose your health insurance and you can’t collect disability benefits,” StumpSutliff says. “If you need time off to focus on getting well, take it.”

“It can also be helpful to talk to an expert,” Sweeney says. “Cancer and Careers offers free career coaching provided by a roster of professionals, some of whom are cancer survivors themselves.”

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You also might decide that it would be helpful to share your situation with your employer and discuss possible options like flextime, job sharing, working from home, starting with shorter work-

Once you’re on the job, take time during work to relax for a few minutes, says Michael Feuerstein, PhD, a professor at the Biometrics Uniformed Services University of the Health Sciences, Bethesda, Md, and editor of the compilation “Work and Cancer Survivors,” (Springer, 2010). He suggests going for a walk, taking a break to get some water or visiting with a coworker. Getting exercise or utilizing alternative medicines like acupuncture during non-work hours can also help with energy levels and pain.

wardly out of a vague uneasiness about cancer, resent that they had to take on extra duties because of your absence, ask inappropriate questions, or avoid you because they’re afraid of saying the wrong thing.

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That said, while some people may find it easy to transition back into working full-time, for others it may take some adjustment. “You may find that you tire easily or have trouble focusing at first,” says Kimberly Stump-Sutliff, RN, associate medical editor for the American Cancer Society (Cancer.org). Talk with your doctor honestly about the realities of your job and any problems you have that could potentially affect your productivity.

days or working fewer days a week, says Stump-Sutliff. The Americans with Disabilities Act of 1990 (ADA) may help make your case for these alternatives.

“For example, if your company has 50 or more employees, the Family and Medical Leave Act (FMLA) allows many people with serious illnesses to have up to 12 weeks total of unpaid leave per year, while retaining health benefits and job protection,” Sweeney says.

simply find that your priorities have changed, it’s time to start thinking about a new career. Sweeney suggests determining what types of work you might enjoy, your financial needs (including benefits), whether you’d prefer to work from home or part-time, and what you can physically handle. Then, make a list of positions that fulfill those priorities and reach out to your network of friends, family, former colleagues, etc.

Think Pink • Sunday, October 16, 2011

Working while undergoing cancer treatments is a harsh reality. Here’s how to be at your best on-the-job when you’re not at your physical best

appointments, talk to your employer about your needs, Stump-Sutliff says. Under federal and state laws, some employers may be required to allow you to work a flexible schedule.

Managing Continuing Care If you’ll need more than your allotted sick/vacation time to attend continuing treatment and/or follow-up

Think Pink • Sunday, October 16, 2011

And the Cancer

Ran Away With the Spoon Many foods are touted as helping cancer survivors get – and stay – well. Here’s a guide to which foods really do help prevent disease and encourage recovery.

oods that do the best job of nourishing our bodies may, at the same time, cause certain cancers to “starve” – at least in a figurative sense. For example, fresh or frozen berries might inhibit a tumor’s ability to form blood vessels, and without a blood supply, the tumor cannot survive. Other foods can help prevent cancer from forming in the first place.

“The relationship between food and cancer is complex,” says Dr. Mark Fesen, a Hutchinson, Kan.-based oncologist and author of “Surviving the Cancer System” (AMACOM, 2009). Scientific studies can be confusing or even contradictory, but the consensus among doctors and researchers is that a daily diet rich in fruits, vegetables and whole grains can protect against a wide range of cancers.

However, “Your total amount of calories eaten is the most important factor in the risk of developing cancer,” Fesen says. “Obesity is linked to several cancers, including prostate, colon and breast cancers.” Substitute fish, poultry and beans for red and processed meats whenever possible, advises epidemiologist Dr. Julia Greer, University of Pittsburgh School of Medicine.

By Dawn Klingensmith CTW Features

As for supplements, “The only one I recommend is vitamin D,” which reduces the risk of colorectal and breast cancer, says biochemist Richard Beliveau, chairholder in cancer prevention and treatment at the University of Quebec at Montreal. Not all of the following cancer-fighting foods are suitable for people undergoing treatment. Cancer patients have special dietary needs they should

discuss with their physicians. For example, “Your protein needs increase during treatment,” Greer says, “and because of side effects such as mouth and esophageal sores, eating acidic foods such as tomatoes and citrus fruit is a very bad idea.”

Berries

Berries are bursting with compounds that can slow the growth and metabolism of cancerous cells. An antioxidant

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in raspberries has been shown to inhibit cervical cancer growth and may decrease pancreatic cancer risk and skin cancer cell division. Rich in vitamin C, which may fight breast cancer, citrus fruits may also reduce the risk of esophageal cancer. The fruits’ pectin may lower the risk of ovarian cancer and delay the growth of cancerous cells in men diagnosed with recurrent prostate cancer. Peel and eat oranges and grapefruits in sections because spooning them out leaves behind a white membrane packed with cancer-fighting flavonoids, Greer says.

Tomatoes

Tomatoes contain lycopene, which is linked to a decreased risk of pancreatic and prostate cancers. Go ahead and hit the sauce – heating tomatoes does not destroy lycopene; in fact, it enhances it. Ounce for ounce, tomato paste, spaghetti sauce and ketchup contain more lycopene than a raw tomato, Greer says.

Whole grains

High intake levels of whole grains correlate with reduced pancreatic, colon, endometrial and ovarian cancer risks.

Grapes

Red varieties contain high levels of resveratrol, which can decrease or stop the growth of breast, prostate, pancreatic, stomach, liver and colorectal cancers.

Tart cherries

This fruit naturally depletes the body of cancer-causing substances. They can also slow the growth of cancerous cells, particularly in the case of colon and breast cancers.

Pomegranates

Cruciferous vegetables

Studies suggest that broccoli, cauliflower, Brussels sprouts, cabbage and bok choy help ward

Nuts and seeds Nuts and seeds contain healthy monounsaturated fat, which has been shown to protect against breast cancer. The mineral selenium – found in certain kinds of nuts – may inhibit the development or growth of prostate, lung and bladder cancer cells, while also protecting against colon cancer.

Green tea “Tea is the best source of anti-cancer compounds called catechins, and green tea contains about three times as much as black tea,” Greer says. One study showed that drinking three or more cups of green tea each day reduced the recurrence rate of Stage I breast cancer.

Red wine

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Drinking moderate amounts of red wine may decrease the risk of kidney cancer and Hodgkin’s and non-Hodgkin’s lymphomas. But beware: Drinking moderate to heavy amounts of alcohol has been shown to increase the risk of cancers of the upper airway and digestive tract, as well as breast and colorectal cancers. Even one glass of alcohol a day may increase a woman’s risk of getting breast cancer. Beliveau recommends that women limit their intake to one alcoholic beverage per day, and men should have no more than two.

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Dark chocolate Extracts of dark chocolate can inhibit the formation of breast, colon and prostate cancers, and can decrease the division rate of liver cancer cells. A 2003 Cornell University study compared the anti-cancer properties of certain beverages and found that unprocessed cocoa had nearly twice the amount of antioxidants as red wine and up to three times more than green tea.

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Green is good – leafy greens, such as spinach, can decrease the risk of breast, colon, skin, lung, head, neck, ovarian and stomach cancers. “Watercress intake, in particular, is associated with decreased ovarian cancer,” Greer says.

Garlic may reduce stomach cancer and women’s risk of colon cancer. Onions may play a role in fighting lung, colon, bladder, skin, prostate, stomach and endometrial cancers, as well as leukemia. Red and yellow onions pack the most nutritional punch.

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Leafy greens

Garlic and onions

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Pomegranates contain four chemical components that have been shown to inhibit prostate cancer cell growth. Antioxidants found in pomegranates and their juice may also help prevent breast and lung cancer cells from dividing and can even kill cancer cells.

Think Pink • Sunday, October 16, 2011

Citrus fruits

off prostate, lung, breast, head, neck and pancreatic cancers. “The compounds in cruciferous vegetables have been shown to keep cancers from forming, as well as to slow the growth of tumors that are already present,” Greer says.

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Think Pink • Sunday, October 16, 2011

Understanding the Stages of Cancer

Doctors apply numbers to describe the severity of cancer, and understanding those digits can go a long way toward easing the minds of the afflicted By Bev Bennett CTW Features

hen a public figure is diagnosed with cancer you often read about the cancer stage. Cancer staging is one way physicians measure the extent or severity of the disease through the body. Staging is also a gauge used when medical experts plan the appropriate treatments for their patients.

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“Staging is a shorthand way of describing how far the

cancer has progressed,” says Kay Washington, MD, PhD., professor of pathology at Vanderbilt University Medical Center, Nashville. However, without knowing the specifics of any case, it’s difficult to make a generalization about a cancer stage, say medical experts. Although it’s easy to assume the worst, it helps to put cancer staging into perspective. Cancers can be described as stage 0, which is early cancer that is only present in the layer of cells in which it began. Stage 1 is still early and often curable with surgery,

according to Dr. Washington. As the numbers get higher to stages II and III, the cancer tumor may be growing or the cancer may be spreading to nearby lymph nodes and/ or adjacent organs and may require different treatments such as chemotherapy or radiation. Stage IV means the cancer has spread beyond the original site to another organ and is the diagnosis that causes the most anxiety, sometimes to the detriment of the patient, according to Alan Dosik, M.D., oncologist at New York Methodist Hospital, Brooklyn, NY.

Patients who are told they’re in stage IV often rush to the Internet to get more information. Unfortunately the generic prognosis can be so dire, they lose hope, says Dr. Dosik. “Staging is meant to help determine treatment strategies, not [to persuade the patient] to give up,” Dr. Dosik says. He is reluctant to discuss stages because it can depress his patients. In Dr. Washington’s experience, however, patients want to know how advanced their cancer is and accept the concept of stages as a way to describe the disease.

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Whether or not stages are part of the dialogue, the physicians want people to know that stage IV isn’t necessarily a death sentence. Some patients can live a long time with stage IV cancer, if treated appropriately. One goal is to turn cancer into a chronic disease that is ongoing or recurring, but treatable and not fatal, say cancer experts. For more information on cancer, visit the government web site: http://www.cancer. gov © CTW Features

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Things You can do for a Woman Newly Diagnosed with Breast Cancer

1. Create a CD of favorite music for chemo times and “down days”. 2. Collect items for a Comfort Basket (suggestions include: rapid dissolving Tylenol, eye pillow, peppermints, simple reading, music, candles). 3. Host a hat party. Friends bring caps, scarves, or hats to give away. They can also wear the item and give individually telling why that one was selected, then move it to the head of the honoree. 4. Gather happy movies, books and magazines that can help provide stress-free entertainment. 5. Help set up a website, such as Care Pages (www.carepages.com) or Caring Bridge (www.caringbridge. org). These networks allow the woman or her family to update her status, without having to tell her story multiple times to numerous people. 6. Organize meals for the woman and/or her family. 7. Arrange for pet care (walking, vet visits, etc.). 8. Set up carpools to get the children to/from school and activities. 9. Bring lunch to her home for both of you; stay and visit while you eat. 10. Visit often and listen to her journey. Do not say, “At least you’re alive;” “Your hair will grow back;” “This is what you need to do;” etc. She knows these things already.

Think Pink • Sunday, October 16, 2011

Top 10’s

Things You can do for the Family of a Woman Diagnosed with Breast Cancer

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Source: Pink Alliance Brazos Valley Breast Cancer Support. (bvbcs.org)

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1. Go to the website for ideas on telling children about a cancer diagnosis. http://www.cancer.org/docroot/ CRI/content/CRI_2_6X_Dealing_With_Diagnosis.asp 2. Fill jars with a daily treat equaling the length of treatments (i.e. chemo or radiation). The child can have a daily treat; when the jar is empty, treatment is over! 3. Help the woman’s children with school/church projects. 4. Ask how their friends have reacted to the cancer diagnosis; give the children time to talk in a safe environment. 5. Prepare children for questions and rehearse with them what they might say when people ask questions about their mother they don’t want to answer. 6. Organize a carpool to take the children to school, sports activities or music lessons. 7. Organize a sleepover at your home for the children and a few friends. 8. Find ways to support the husband/partner; that person has his/her own journey. Ask one or two friends to not ask about the cancer patient, but to only ask about the support person. 9. Organize a time for the husband/partner to go to dinner/golfing/bowling/ hunting/fishing/a concert/ sporting events/etc. with friends. Provide needed support for the rest of the family. 10. Medical bills, insurance, and multiple forms can create confusion. Offer to organize and track the medical bills and insurance claims.

Think Pink • Sunday, October 16, 2011

A Small Step Forward B Researchers make a groundbreaking discovery of a therapy that slows tumor growth By Danielle Cadet CTW Features

reast cancer researchers may have made a major breakthrough by discovering a revolutionary therapy that slows tumor growth in advanced breast cancer patients. According to a report in a recent issue of the medical journal The Lancet, a novel therapy designed to attack tumors in patients with a genetic mutation in tumor suppressor genes BRCA1 or BRCA2 slowed tumor growth in 85 percent of women with advanced breast cancer. “This is the first time that we have been able

Study: Overweight girls less likely to develop breast cancer as adults (MS)

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wedish researchers have determined women who were heavyset as youngsters have a lower risk for breast cancer than others. According to Dr. Jingmei Li of the Karolinska Institutet in Stockholm, a female’s body weight throughout her life plays different roles in her risk to develop breast cancer. Although being overweight as an infant or an adult may increase the risk, during the window of time when a female is six or seven years of age, being heavier can have an advantage. Dr. Li and her researchers studied 2,818 Swedish women with breast cancer and 3,111 women without the disease. The women were shown a series of nine figure outlines and asked to choose one that best represented their body size at age seven. The findings were that women who had larger bodies during childhood were 27 percent less likely to have breast cancer than women who were leaner as seven-yearolds. Researchers also determined that being heavier as a girl protected women against

all tumor types the researchers studied. The protective effect was even stronger for tumors that didn’t carry estrogen receptors; larger childhood body size reduced the risk of these tumors by 60 percent, while it reduced the risk of estrogen-receptor positive tumors by 20 percent. The reason behind the reduced risk could be due to higher levels of estrogen in the bodies of heavier girls during key moments of mammary development in youth. These estrogen levels may help protect the breasts later on in life. Parents should not go to extreme lengths to increase the weight of girls around the age of seven. Being overweight carries with it its own health risks. “There is definitely no reason for overfeeding of the kids to get them to reach a particular body size,” says Dr. Li. Being overweight as a child does not eliminate the chances of getting breast cancer. Healthy eating, routine self-breast examinations, annual mammography, and physicals with a doctor are advised steps to help women remain healthy.

to take the genetic reason a person has developed cancer and make it a target,” says study co-author Susan M. Domchek, M.D., associate professor of medicine, University of Pennsylvania School of Medicine, and director of the Cancer Risk Evaluation Program at Penn’s Abramson Cancer Center, Philadelphia. “Most of the time we look at what is going on in the tumor itself and then figure out how to target it. But in this situation, the women all had an inherited mutation in either BRCA1 or BRCA2 gene and we could exploit that weakness in the tumor.” She added that this strategy might cause fewer side effects for patients. The new agent, called olaparib, inhibits a protein called poly(ADP-ribose) polymerase (PARP). Both PARP and the BRCA proteins are involved in DNA repair. Although cells seem to be able to

do without one or the other, a tumor that lacks a BRCA gene and PARP puts pressure on the cells, causing them to die. “If you put too much stress on the cancer cell, it can’t take it and it falls apart,” Domcheck says. Since the non-tumor cells in a patient with an inherited BRCA mutation still retain one normal copy of the gene, they are relatively unaffected by PARP inhibition. Domcheck says this is particularly important from the perspective of cancer treatment. Although the results look promising, there is still more to be done. Domcheck says additional trials will be necessary before olaparib or other PARP inhibitors in development will be ready for use in regular practice. She urges patients to join in clinical trials in order to further the research efforts and determine how to best use these drugs.

Screenings

By Billy Mau Eagle Special Project Editor

reast cancer screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. Three main tests are used to screen the breasts for cancer. Talk to your doctor about which tests are right for you, and when you should have them. * Mammogram: The most effective means to detecting breast cancer, a mammogram is an X-ray of the breast. Mammograms can detect breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast

cancer. If you are age 40 years or older, be sure to have a screening mammogram every one to two years. * Clinical breast exam: A clinical breast exam is an examination by a doctor or nurse, who uses his or her hands to feel for lumps or other changes. * Breast self-exam: A breast self-exam is when you check your own breasts for lumps, changes in size or shape of the breast, or any other changes in the breasts or underarm (armpit). Having a clinical breast exam or a breast self-exam does not decrease risk of dying from breast cancer. If you choose to have

clinical breast exams and to perform breast self-exams, be sure you also get regular mammograms. Breast cancer screenings are typically available at clinics, the local hospital or a doctor’s office. If you want to be screened for breast cancer, call your doctor’s office. They can help you schedule an appointment. Most health insurance companies pay for the cost of breast cancer screening tests. For more information on cancer prevention and control, visit the Centers for Disease Control and Prevention Web site at www. cdc.gov/cancer.

Think Pink • Sunday, October 16, 2011

Crucial in Breast Cancer Detection

Safe and Sound A

younger than 19, fewer than 25 per 100,000 cases of breast cancer occur each year. Many benign breast lumps are products of hormonal activity or other normal body functions. While they tend to wax and wane in teenage girls, many are removed in biopsy due to parents’ or doctors’ concerns. Dr. Vade said lumps that require surgical attention are those that show progressive growth, are found in patients who have malignant tumor elsewhere in the body or appear in patients with family history of cancer.

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with breast lumps, including one girl with a lump in each breast. The ultrasounds revealed that 15 of the 21 appeared to be benign, while six were suspicious. Doctors followed up with excisional biopsies, the currently accepted method of treatment, or other clinical exams to test the lumps. They were all benign. Dr. Aruna Vade, lead author of the study and a professor of radiology at Loyola, said that the study suggests an excisional biopsy is not needed if the ultrasound produces unsuspicious results. Excisional biopsies can leave scars or change the shape of the breast. For girls

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surefire way to ascertain whether a breast lump is malignant is to perform a biopsy. But for teenage girls, breast cancer is rare and the biopsy process can leave permanent damages. That’s why a new study’s discovery that ultrasound exams on teenage girls can accurately show if a lump is benign is such welcome news. Radiologists in the study, published in the American Journal of Roentgenology, Leesburg, Va., by the Loyola University Health System, Chicago, performed ultrasound exams on 20 girls ages 13-19

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Teenage girls can use ultrasound exams rather than invasive biopsies to determine if breast lumps are cancerous.

Think Pink • Sunday, October 16, 2011

Remember the

Mammogram

counseling, doctor-generated reminders increase screening rates in low-income women By tanieSHa ROBinSOn CTW FeaTures

mammogram isn’t exactly the type of procedure that women across the nation line up for. Yet, the turnout among low-income women – even with health insurance – continues to trail that of upper-income women. “Health insurance is a necessary condition for screening, but it is apparently not a sufficient condition,” says Nasar Ahmed, Ph.D., chair of epidemiology and biostatistics at the Robert Stempel College of Public Health and Social Work at Florida International University. What may increase the likelihood of mammography screening among low-income

women is counseling, according to research led by Ahmed and published in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research. Ahmed’s group of researchers identified 2,357 low-income women with health insurance who did not receive recommended screening mammograms and randomly assigned them to one of three groups: a control group, a group that received a reminder from their managed care organization in letter form and a group that received a second letter of reminder from their doctor and counseling if still non-compliant to screenings. The screening rate in the

FAST FACTS

OVARIAN CANCER:

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omen should protect their health with routine medical screenings and by being aware of risk factors to certain types of cancers. While breast cancer statistics and annual mammograms are widely known, many women don't have the facts about ovarian cancer, another leading female cancer. Here are some statistics, courtesy of the American Cancer Society (www.cancer.org). * More than 21,000 new cases of ovarian cancer were estimated to be diagnosed in the United States in 2008. Of those cases, more than 15,000 women will die from the disease. * Ovarian cancer is the eighth most common cancer and the fifth leading cause of cancer death. * Researchers think there may be a correlation between the release of eggs and the risk for ovarian cancer. Pregnancy and taking birth

control pills could reduce the risk. * A woman's chance of getting ovarian cancer in her lifetime is roughly 1 in 71. * Women who have had a hysterectomy or a tubal ligation (tubes tied) are at a lower risk for ovarian cancer. * Most ovarian cancers happen after change of life (menopause). Half of all these cancers are found in women over the age of 63. * It appears that obese women have a higher risk of getting ovarian cancer. One ACS study found a higher rate of death from ovarian cancer in women who were overweight. The risk went up by 50 percent in the heaviest women. * During a pelvic exam the doctor will feel the female organs to check their size and shape to determine if there are tumors present.

control population was only 13.4 percent. That rate increased to 16.1 percent for the women who received a letter from their managed care organization. The likelihood of screenings increased 80 percent for those women who received a letter from their doctor and tripled after receiving personal counseling. The rate of the women in the personal counseling group was 27.1 percent, a significant increase but nonetheless, well below general population rates. This study suggests that there are challenges beyond finances that face women of lowincome populations, says James Marshall, a professor of oncology

at the Roswell Park Cancer Institute and a senior editor of Cancer Epidemiology who has no affiliation with the study. “A middle-class person can hop in their car and go to the clinic,” Marshall says. “How does a lowincome woman find someone to watch her kids and find the transportation? Also, middleclass people take the culture of

bureaucracy for granted, but it can be intimidating for lowincome people.” Marshall says that Roswell Park has effective programs where lay health counselors go into churches of low-income areas to reach women. He adds: “A person from the community can make all the difference in the message.”

Think Pink • Sunday, October 16, 2011

Living better means coping better The study focused on 267 women with breast cancer

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oneself was the least used coping strategy and its use remained consistently low over time. Those reporting a poorer quality of life were more likely to use multiple coping strategies at subsequent time points. This finding suggests that people adapt their coping strategies in response to problems with which they are dealing. As quality of life increased, fewer coping mechanisms were needed. “We emphasize, however, that this finding is suggestive and not definitive,” Danhauer says. “The relationship between coping strategies and quality of life is complicated and future studies should examine this reciprocal relationship.”

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breast cancer to see if the opposite might be true – that quality of life determines the use of coping strategies.” The study focused on 267 women with breast cancer, with a mean age of 43 years, who completed surveys within six months of diagnosis and follow-up surveys six weeks and six months later. Researchers discovered that the coping strategies in younger women changed over time. Seeking social support, spirituality, wishful thinking and making changes decreased over time and detachment increased, all leading to positive cognitive restructuring (reinterpreting something stressful as positive or helpful), which was the most frequently used coping strategy. Keeping feelings to

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oping with a cancer diagnosis isn’t easy for anyone, but a new study finds that as a woman’s quality of life increases over time, coming to terms with breast cancer requires fewer coping mechanisms. “It is generally assumed that coping strategies impact quality of life, with more active coping strategies generally associated with better quality of life,” says Suzanne C. Danhauer, Ph.D., assistant professor at Wake Forest University Baptist Medical Center, Winston-Salem, N.C., and lead investigator of these analyses. “This research examined coping strategies over time and the reciprocal relationship between coping strategies and quality of life among younger women with

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Study shows that regular use of fish oil supplements may reduce risk of breast cancer

Something’s Fishy …

In a Good Way

or women, the benefit of a fish filet may go beyond the protein, mental health and the delicious taste. A recent study by researchers at the Fred Hutchinson Cancer Research Center in Seattle links consumption of fish oil supplements with a decreased risk of breast cancer. Regular consumption of high levels of the omega-3 fatty acids, EPA and DHA contained in fish oil supplements was linked with a 32 percent reduced risk of breast cancer in the study led by Emily White, Ph. D, a member of the public health sciences division. The Hutchinson study is the first to link these substances to breast cancer. Previous studies of fish intake and omega-3 fatty acids have been inconsistent. “It may be that the amount of omega-3 fatty acids in fish oil supplements are higher than most people would typically get from their diet,” White said. White and other researchers followed 35,016 postmenopausal women for six years. Initially,

none of the women had a history of breast cancer and each completed a 24-page questionnaire about their use of non-vitamin, non-mineral “specialty” supplements. Six years later, 880 cases of breast cancer were identified. While excitement has emerged with increasing evidence about the health benefits of fish oil, White and other medical professionals encourage caution. “It is very rare that a single study should be used to make a broad recommendation,” said Edward Giovannucci, M.D., professor of nutrition and epidemiology at the Harvard School of Public Health and an editorial board member of Cancer Epidemiology, Biomarkers & Prevention, “Over a period of time, as the studies confirm each other, we can start to make recommendations.” Harvard researchers are now enrolling what they plan to be a study of 20,000 patients on the impact of fish oil supplements and vitamin D on cancer, heart disease and stoke.

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Understanding

According to BreastCancer. org, a nonprofit organization dedicated to providing reliable, complete and current information about breast cancer, only 5 to 10 percent of cancers are due to an abnormality inherited from a parent. While all breast cancers are caused by a genetic abnormality, roughly 90 percent of breast cancer cases are the result of genetic abnormalities that are a result of the aging process and the wear and tear of everyday life.

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Breast cancer is an uncontrolled growth of breast cells. Any type of cancer is the result of mutations in genes responsible for regulating the growth of cells and keeping them healthy. In a healthy body, the cells replace themselves in an orderly fashion, as healthy new cells take over as old ones die out. When mutations occur,

Is Breast Cancer Hereditary?

A PPLE A DAY... AN

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What Is Breast Cancer?

changed cells gain the ability to keep dividing without control or order, producing more similar cells and forming a tumor. In the case of breast cancer, cancerous cells gradually invade nearby healthy breast tissue and make their way into the underarm lymph nodes, which are small organs that filter out foreign substances in the body. If the cancer reaches the lymph nodes, it then has a pathway into other parts of the body. Upon diagnosis, a patient will be told what stage of breast cancer they are in, which tells how far the cancer has spread beyond the original tumor.

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ach year, Mother’s Day in the United States helps shed light on the problem of breast cancer. Heightened efforts at raising awareness of breast cancer around Mother’s Day include the cooperation of many corporations, including Major League Baseball, whose players use pink bats in a show of support for breast cancer victims and survivors. But breast cancer is an issue that extends beyond the month of May, and many people might be surprised to learn of breast cancer’s prevalence. In the United States alone, breast cancer incidence in women is 1 in 8, or roughly 13 percent. In fact, among women in the U.S., breast cancer rates are higher than those of any cancer besides lung cancer. With such staggering figures, it’s important for both women and men (who can also suffer from breast cancer) to gain a greater understanding of this deadly disease.

Think Pink • Sunday, October 16, 2011

Breast Cancer

Origins of the Pink Ribbon

Think Pink • Sunday, October 16, 2011

hese days ribbons are worn for many different causes. Red signifies AIDS awareness. A yellow ribbon has long represented support for armed forces. However, one of the most prominent ribbon colors is pink, which aims to raise awareness of and support for breast cancer. Pink is a color that is uniquely feminine, and it also represents a person full of health and vibrancy; think of little babies pink with life. Pink is also a color that seems the complete antithesis of cancer, and thusly inspires hope for renewed health and survival. There is some controversy surrounding the origins of the breast cancer mascot, the pink ribbon. There are also suggestions that the ribbon was intended to be peach and not pink. In 1992, just about every organization started using ribbons to raise awareness. The New York Times actually dubbed 1992 “The Year of the Ribbon.” Alexandra Penney, the then-editor of Self magazine, wanted to create a ribbon for

the publication’s second annual Breast Cancer Awareness Month issue. The previous year she had worked with cosmetics giant Estee Lauder. Evelyn Lauder, the senior corporate vice president, was herself a breast cancer survivor. Penney thought a collaboration between the magazine and Lauder could see a ribbon on cosmetic counters across the nation, and help sell a few magazines in the process. The trouble was Penney had read a story about a 68-yearold woman, Charlotte Haley, who was producing handmade ribbons in her home. Haley had a number of people in her immediate family who had battled breast cancer and her handmade “peach” ribbons intended to raise awareness about the limited government funds being used for breast cancer research. Haley’s message was spreading by word of mouth. Penney and Lauder contacted Haley and wanted to further collaborate on the peach ribbon theme. However, Haley didn’t want to be involved, saying the effort would be too commercial.

She refused to turn over rights to the use of the peach ribbon. As a result, Penney consulted with attorneys who said to come up with another color, and pink was eventually chosen. Pink had already been associated with breast cancer in the past. Just a few years earlier, the Susan G. Komen Breast Cancer Foundation had given out pink visors to its “Race for the Cure” participants. It had also created a pink ribbon. The pink ribbon quickly took off by leaps and bounds. Millions were distributed by Estee Lauder. There are many philanthropic and commercial businesses who now use the pink ribbon in their breast cancer marketing plans. Every October, women are urged to don pink for Breast Cancer Awareness Month. One can find the pink ribbon adorning everything from cereal boxes to cans of cleanser. Many embrace the pink ribbon as a symbol of hope, one that has done its share of work toward spreading the word about the need for more breast cancer awareness and research.

breast cancer Treatments Go Meta new tests can pinpoint risk for Metastasis

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etastasis via the blood stream is the most common cause of death in breast cancer patients, but a new medical finding could soon make it testable and, ultimately, more easily preventable. In a new study by New York-Presbyterian Hospital/Weill Cornell Medical Center, funded by the National Cancer Institute, researchers identified a new breast cancer metastasis marker called Tumor Microenvironment of Metastasis (TMEM). The density of the TMEMmarker was more than double in patients that developed systemic metastases compared with the patients with only localized breast cancer. “Currently, anyone with a breast cancer diagnosis fears the worst, that the cancer will spread and

threaten their lives,” says senior author Dr. Joan G. Jones, professor of clinical pathology and laboratory medicine at Weill Cornell Medical College. “A tissue test for metastatic risk could alleviate those worries, and prevent toxic and costly measures like radiation and chemotherapy.” According to the National Cancer Institute, 40 percent of breast cancer patients suffer a relapse and develop metastatic disease, and more than 40,000 women die from it each year. “If patients can be better classified as either low risk or high risk for metastasis, therapies can be custom tailored to patients, preventing over-treatment or under-treatment of the disease,” says Dr. Brian D. Robinson, resident in Anatomic Pathology at NewYork-

Presbyterian Hospital/Weill Cornell Medical Center and coauthor of the study. The discovery could directly impact survival rates by giving doctors the ability to assess each individual’s likelihood to develop metastasis based on more accurate information. “Traditionally, the likelihood of breast cancer metastasis is estimated based on tumor size, tumor differentiation – how similar or dissimilar the tumor is compared to normal breast tissue – and whether it has spread to the lymph nodes,” Jones says. “While these are useful measures, TMEM density directly reflects the blood-borne mechanism of metastasis, and therefore may prove to be more specific and directly relevant.”

By MattHeW M. F. MilleR CTW FeaTures

Think Pink • Sunday, October 16, 2011

Breast cancer didn’t catch her by surprise. Because we caught it ﬁrst. October Is Breast Cancer Awareness Month

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One out of every eight women will develop breast cancer. But statistics show more women survive this diagnosis when it is detected and treated early. If you are 40 or older, or are considered at risk, the American Cancer Society recommends a screening mammogram. Do it for yourself. Do it for your family. Do it now.

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Appointments are on a first-come, first-served basis. A physician order is not required, but you must provide your physician’s name when you make an appointment. If you do not have a physician, a list will be provided for your selection. All mammogram reports will be sent to the physician and follow-ups are required to complete your annual breast exam.

Think Pink • Sunday, October 16, 2011

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