DMochelle Fashions Magazine December 2014

For Breast Cancer Survivors 1

y name is Donna Michelle Kittrell and owner of DMochelle Fashions, my passion is to help heal the wounds of hurting people inward as well as their outward appearance. My background in Retail with ten years of Management experience working for Victoria Secret and Nordstrom as a Bra Specialist Fitter. This amazing experience with taking time with clients who had Mastectomy surgery has given me the understanding of their needs. It is a delightful feeling when they would walk out of my presence feeling great with smiles after the tears and embarrassed. I also worked for New York Presbyterian Hospital in the Breast Clinic. I wanted to bring sunshine to their faces. There has been very close family and friends who have passed away from Breast Cancer.

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In the 2012, I started writing my vision on DMochelle Fashions (one's physical attractiveness, especially with regard to the use of cosmetics and other methods of enhancing their lives). By the end of that year, I was diagnosed with Breast Cancer as Stage 0 Cancer (thank God I had a mammogram early) and had surgery (two lymph nodes were removed and tissue removed from the left breast) at the beginning of the year of 2013 along with radiation treatments. I am now "Cancer Free."

DMochelle Fashion Means: A beautiful women, her reputation as great beauty and the combination of qualities that make something pleasing and impressive to look at, listen to and great smiles. Her personal and physical attractiveness, especially with regard to the use of cosmetics and other methods of enhancing her goodness. " Surely he hath borne our griefs, and carried our sorrows: yet we did esteem him stricken, smitten of God, and afflicted.

But he [was] wounded for our transgressions, [he was] bruised for our iniquities: the chastisement of our peace [was] upon him; and with his stripes we are healed."

Isaiah 53: 4-5

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CONTENTS

December 2014

4 Origins of the Pink Ribbon These 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.

5 DMochelle Fashions Photoshoot at Bryant Park

Special: Poem 43 A posture of thankfulness

7 DMochelle Fashions

certain area, but chemo can work throughout the whole body.

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      Health and Wellness         14 Word Of the Month -

Chemotherapy Chemotherapy is the use of medicines or drugs to treat a disease, such as cancer.

Many times this treatment is just called chemo.

Surgery and radiation therapy remove, kill, or damage cancer cells in a

28 Thyroid Cancer Causes A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

38 Nikki’s Naturals

42 In Deep Thought Ja'Dee Murphy .

By: Errand Zo Phillip

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Origins of the Pink Ribbon These 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.

"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.

Researched and provided by Pamela Henderson (20 years Cancer Survivor)

The trouble was Penney had read a story about a 68-year-old 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 4

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Designed by DMochelle Fashions

Design by DMochelle Fashions 7

Designed by DMochelle Fashions

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Designed by DMochelle Fashions

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Designed by DMochelle Fashions

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Designed by DMochelle Fashions

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Top tips for breast cancer prevention 1. Avoid becoming overweight. Obesity raises the risk of breast cancer after menopause, the time of life when breast cancer most often occurs.

Avoid gaining weight over time, and try to maintain a body-mass index under 25 (calculators can be found online).

2. Eat healthy to avoid tipping the scale.

Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Eat lean protein such as fish or chicken breast and eat red meat in moderation, if at all. Eat whole grains. Choose vegetable oils over animal fats.

3. Keep physically active. Research suggests that increased physical activity, even when begun later in life, reduces overall breast-cancer risk by about 10 percent to 30 percent. All it takes is moderate exercise like a 30-minute walk five days a week to get this protective effect.

4. Drink little or no alcohol. Alcohol use is associated with an increased risk of breast cancer.

Women should limit intake to no more than one drink per day, regardless of the type of alcohol.

5. Don’t smoke. Research suggests that long-term smoking is associated with increased risk of breast cancer in some women.

their babies for at least a year in total have a reduced risk of developing breast cancer later.

7. Avoid hormone replacement therapy.

Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to recommendations to decide what type of screening you need and how often you need it.

If you are at high risk for breast cancer, such as having a particular gene like a BRCA gene, or have a strong family history or have had high-risk benign breast disease in the past, talk with your doctor about other options for you which might include: A. Extra screenings. For some women, MRI or ultrasound screenings can add valuable information to regular mammogram screening.

B. Estrogen-blocking drugs. Women with a family history of breast cancer or who are over age 60 should talk to their doctor about the pros and cons of estrogen-blocking drugs such as tamoxifen, raloxifene, and aromatase inhibitors.

C. Prophylactic surgery to remove breasts and/or ovaries. Women who have had both breasts surgically removed reduce their risk of breast cancer by over 90 percent. Women who have had both ovaries removed have about half the risk of developing breast cancer as women with intact ovaries. Clearly these options are most appropriate for women at very high risk.

6. If you bear children, breast-feed your babies for as long as possible. Women who breast-feed

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Merry Christmas and a Happy New Year to all from DMochelle Fashions

Thank you for your Support for 2014 and greater things are coming in 2015. God Bless.

John 1:14 (NIV) 14

The Word became flesh and made his dwelling among us. We have seen his glory, the glory of the one and only Son, who came from the Father, full of grace and truth.

LUKE 2:10 12

Our mission is to share the good news of great joy that will be for all the people.

May God fill your home with his peace and joy this Christmas.

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Word of The Month:

Chemotherapy What is chemotherapy and how does it work?

Chemotherapy is the use of medicines or drugs to treat a disease, such as cancer. Many times this treatment is just called chemo. Surgery and radiation therapy remove, kill, or damage cancer cells in a certain area, but chemo can work throughout the whole body. Chemo can kill cancer cells that have metastasized (meh-TAStuh-sized) or spread to parts of the body far away from the primary (original) tumor. More than 100 chemo drugs are used in many combinations. A single chemo drug can be used to treat cancer, but often multiple drugs are used in a certain order or in certain combinations (called combination chemotherapy). Multiple drugs with different actions can work together to kill more cancer cells. This can also reduce the chance that the cancer may become resistant to any one chemo drug.

You and your doctor will decide what drug or combination of drugs you will get. Your doctor will choose the doses, how the drugs will be given, and how often and how long you’ll get treatment. All of these decisions will depend on the type of cancer, where it is, how big it is, and how it affects your normal body functions and overall health.

What is the goal of chemo?

Depending on the type of cancer, its stage (how far it has spread), and where you are in the treatment process, chemo can be used to: Cure the cancer. Keep the cancer from spreading. Slow the cancer’s growth. Kill cancer cells that may have spread to other parts of the body. Relieve symptoms caused by cancer.

Your doctor will talk to you about the goal of your chemo before you start treatment.

Will chemo be my only treatment for cancer?

Sometimes chemo is the only treatment you need. More often, chemo is used along with surgery or radiation therapy or both. Here’s why: Chemo may be used to shrink a tumor before surgery or radiation therapy. It may be used after surgery or radiation therapy to help kill any remaining cancer cells. It may be used with other treatments if your cancer comes back. When chemo is given after surgery to kill any cancer cells that may still be present, it’s called adjuvant therapy. When chemo is used to shrink a tumor before surgery or radiation therapy, it’s called neoadjuvant therapy.

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A checklist of questions to ask your doctor or nurse Before choosing chemo as a treatment option, you should understand the expected benefits, side effects, and risks. Consider asking your doctor or nurse these questions. It may help to write down questions to take with you to your next visit. Learn as much as you can about your treatment, and get an idea of the expected outcome. What’s the goal of chemo for my cancer? What are the chances that the chemo will work? Are there other ways to reach the same goals? How will I know if the chemo is working? What will we do if this chemo doesn’t work? What are the risks and side effects of the chemo I will be taking? How do these side effects compare with side effects of other treatments? How will I get the chemo, how often, and for how long? Where will I get chemo? What can I do to get ready for treatment and decrease the chance of side effects? Will I need to change my diet in any way? My activities? My work? Exercise? Sexual activities? Will I also need surgery, radiation, or both? If so, when and why? What results can I expect? If I have chemo after surgery or radiation, will it kill any remaining cancer cells? Could chemo be used alone? Can I take part in a clinical trial? How much will chemo cost? Will my health insurance cover it? If the insurance company asks for a second opinion, or if I would like to get one, can you suggest someone for me to see? Here are some tips to help you remember your doctor’s answers: Take notes during your visits. Don’t feel shy about asking your doctor to slow down if you need more time to write. Ask questions if you don’t understand something. If you can, record your visit so you won’t miss anything. But first ask your doctor if it’s OK to record your talks. Consider taking a friend or relative with you to help you understand what your doctor says during the visit, to take notes, and to help refresh your memory afterward.

You might want to look at our booklet called After Diagnosis: A Guide for Patients and Families for more ideas about the things you and your family may want to

Should I get a second opinion?

One way to find out if a suggested treatment is the best one for you is to get the opinion of at least one other doctor before starting treatment. Your doctor should not mind if you get a second opinion. In fact, some insurance companies require you to get one. Often, the results of any tests you have already had can be sent to the second doctor, so you won’t have to repeat them. Find out if your insurance company covers second opinions before you get one.

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Where will I get chemo?

The place you get your treatment depends on which chemo drugs you’re getting, the drug doses, your hospital’s policies, your insurance coverage, what you prefer, and what your doctor recommends.

You may be treated with chemo: At home In your doctor’s office In a clinic In a hospital’s outpatient department In a hospital Some of these settings may have private treatment rooms, while others treat many patients together in one large room. Talk to your doctor or nurse ahead of time so you know what to expect your first day.

How often will I need to get chemo and how long will it last?

How often you get chemo and how long your treatment lasts depend on the kind of cancer you have, the goals of the treatment, the drugs being used, and how your body responds to them. You may get treatments daily, weekly, or monthly, but they are usually given in on-andoff cycles. This means, for example, that you may get chemo the first 2 weeks and then have a week off, making it a 3-week cycle that will start over again after the week off. The break allows your body to build healthy new cells and regain its strength. Many people wonder how long the actual drugs stay in their body and how they’re removed. Most chemo drugs are broken down by your kidneys and liver and then are removed from your body through your urine or stool.

The time it takes your body to get rid of the drugs depends on many things, including the type of chemo you get, other medicines you take, your age, and how well your kidneys and liver work. Your doctor will tell you if you need to take any special precautions because of the drugs you are getting. (See “How can I protect myself and those I live with while I am getting chemo?” in the section called “Chemo safety” for general safety tips to follow at home.) If your cancer comes back, chemo may be used again. This time, you may be given different drugs to relieve symptoms or to slow the cancer’s growth or spread. Side effects may be different, depending on the drugs, the doses, and how they’re given.

How will the chemo be given to me?

Into a Vein Most chemo drugs are put right into your bloodstream through a tiny, soft, plastic tube called a catheter. A needle is used to put the catheter into a vein in your forearm or hand; then the needle is taken out, leaving the catheter behind. This is called intravenous (intruh-VEEN-us) or IV treatment. Intravenous drugs are given in these ways: The drugs can be given quickly through the catheter right from a syringe over a few minutes. This is called an IV push. An IV infusion can last from 30 minutes to a few hours. A mixed drug solution flows from a plastic bag through tubing that’s attached to the catheter. The flow is often controlled by machine called an IV pump. Continuous infusions are sometimes needed and can last from 1 to 7 days. These are always controlled by electronic IV pumps. The needles and catheters can scar and damage veins with ongoing chemo. Another

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option is the central venous catheter (CVC). The CVC is a bigger catheter that’s put into a large vein in the chest or upper arm. It stays in as long as you’re getting treatment so you won’t need to be stuck with a needle each time. With a CVC, IV medicines can be given more easily. Blood can also be drawn from CVCs. Many different kinds of CVCs are available. Some are soft tubes that stick out of the skin and require no needles.

Another type is a port, which is like a small drum with a thin tube going into the vein. Ports are permanently placed under the skin of the chest or arm during surgery. Special needles are then stuck through the skin into the port to use it. Many people talk about CVC options with the doctor even before starting treatment. Some find out during treatment that they need a CVC because their hand and arm veins are not going to last to complete the planned chemo. Your doctor can help you decide if you need a CVC and the right type of CVC for you.

Other routes Depending on the drugs and where the cancer is, chemo also may be given in one or more of these ways:  Orally or PO – This means by mouth. You swallow the chemo as a pill, capsule, or liquid – just as you do other medicines. This is usually more convenient because the chemo can often be taken at home. If you take chemo drugs by mouth, it’s very important to take the exact dosage, at the right time, for as long as you’re supposed to do so. For more information, please see our document called Oral Chemotherapy: What You Need to Know. Intrathecal or IT – The chemo is put into the spinal canal and goes into the fluid that surrounds your brain and spinal cord. This fluid is called the cerebrospinal fluid or CSF. Chemo put into the CSF is carried throughout the brain and spinal cord. You may either have a needle put right into your spine to quickly give the drug, or a longterm catheter and port can be put under the skin on your head during surgery. This port is called an Ommaya reservoir. The Ommaya is a small drum-like device that has a small tube attached to it.

The tube goes into the CSF in a cavity of your brain. The Ommaya stays in place under your scalp until treatment is done. Intra-arterial – The chemo drug is put right into an artery to treat a single area (such as the liver, an arm, or leg). This method helps limit the effect the drug has on other parts of the body and is called regional chemo. Intracavitary – Chemo drugs may be given through a catheter into the abdominal cavity (the space around the bowels and other organs in the belly; this is called intraperitoneal chemo) or chest cavity (the space around the lungs and other organs in the chest). Intramuscular or IM – The drug is put in through a needle into a muscle (as an injection or shot). Intralesional – A needle is used to put the drug right into a tumor in the skin, under the skin, or in an internal organ. Topical – The drug is put right on an area of cancer on the skin as a cream, gel, or ointment.

Does chemo hurt?

You already know how it feels to take a pill or rub medicine on your skin. And you’ve probably felt the brief discomfort of a shot before. IV medicines should not hurt after the first needle stick to put in the catheter. If you feel pain, burning, coolness, or anything unusual while you are getting chemo, tell your doctor or nurse right away.

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What are clinical trials?

Clinical trials are carefully designed research studies that test promising new cancer treatments. You may want to talk to your doctor about this option. Patients who take part in research studies will be the first to benefit from these treatments. The study results will also help other patients. In a clinical trial, you get either standard treatment or a new treatment that’s thought to be as good as – or maybe better than – the standard treatment.

Studies are never done to see if you would recover from cancer without treatment at all. As with any other medical care, you are free to withdraw from a clinical trial at any time and seek other treatment options.

To learn more about clinical trials: Call us for a free copy of Clinical Trials: What You Need to Know, or read it on our website. The American Cancer Society offers a Clinical Trials Matching Service to help you find clinical trials that might be right for you. The service is available by telephone from 7:30 a.m. until 7 p.m. CT Monday through Friday at 1-800-303-5691, or you can fill out a screening questionnaire anytime at ww.cancer.org/clinicaltrials. The National Cancer Institute (NCI) can also give you a list of clinical trials that might be right for you.

Call 1-800-422-6237, or visit the NCI’s website at www.cancer.gov.

Can I take other medicines while I’m getting chemo?

Some medicines may alter the effects of your chemo. To be sure that your treatment works as well as it can, tell your doctor or nurse about any and all prescription and nonprescription medicines, vitamins, herbs, and supplements you are taking. Make a list with the name of each drug, the dose, how often you take it, who prescribed it, and the reason you take it. Be sure to include the things you may not think of as medicines, even those you take every now and then.

This includes aspirin, herbal and dietary supplements, vitamins, minerals, and all over-the-counter medicines.

Share this list with all of your doctors. Your cancer doctor (oncologist) will tell you if you should stop taking any of these medicines before starting chemo. After your treatments start, check with your oncologist before taking any new medicines or supplements and before stopping any you already take.

How will I know if the chemo is working?

Your cancer care team will check how well your treatments are working by doing certain tests. This may include physical exams, blood tests, bone marrow biopsies, scans, and x-rays. Ask your doctor about the test results and what they show about your progress. You may have side effects, but these side effects do not tell you whether treatment is working.

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How do I give my permission for chemo treatment?

You’ll be asked to give your written permission to get chemo based on your understanding of the drugs your doctor recommends. Know the answers to all of these questions before you sign the consent form. Which chemo drugs will I be given? How will the drugs be given to me? How often will I need to get chemo? How long will my treatments last? What side effects could I have? How likely is it that this treatment will work?

The specifics of the consent form may vary from state to state, but the form usually states that your doctor has explained your condition to you, how the chemo could benefit you, the risks of treatment, and the other options available to you. Your signature on the form means that you’ve gotten this information and you are willing to be treated with chemo. This process is called giving informed consent.

Chemo safety Can I be around my family and friends while I’m getting chemo?

Very few treatments do require you to avoid close contact with loved ones for a short amount of time. If this is something you’ll have to do, your doctor will tell you about it when going over treatment options. Most chemo drugs make you less able to fight infection. It’s very important that you stay away from anyone who is sick. The best way to prevent infection is by washing your hands often, especially before touching your face, nose, mouth, or eyes. Ask your family and friends to do the same when they are with you. For more information, see “How will chemo affect my blood cell counts?” in the section called “Increased chance of bruising, bleeding, infection, and anemia.” For more information on being at home with family and friends during treatment, please see Helping Children When a Family Member Has Cancer: Dealing With Treatment and Caring for the Patient With Cancer at Home: A Guide for Patients and Families. They can be read online, or call us to have free copies sent to you.

How can I protect myself and those I live with while I’m getting chemo?

There are many things you can do during and after chemo to keep yourself and your loved ones from being affected by the chemo drugs while your body is getting rid of them. It takes about 48 hours for your body to break down and/or get rid of most chemo drugs. Most of the waste comes out in your body fluids – urine, stool, tears, and vomit. The drugs are also in your blood. When chemo drugs get outside your body, they can harm or irritate skin – yours or even other people’s. Keep in mind that this means toilets can be a hazard for children and pets, and it’s important to be careful. Talk to your doctor about these and any other precautions you should follow.

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During – and for 48 hours after – chemo: Flush the toilet twice after you use it. Put the lid down before flushing to avoid splashing. If possible, you may want to use a separate toilet during this time. If this is not possible, wear gloves to clean the toilet seat after each use. Both men and women should sit on the toilet to use it. This cuts down on splashing. Always wash your hands with warm water and soap after using the toilet. Dry your hands with paper towels and throw them away. If you vomit into the toilet, clean off all splashes and flush twice. If you vomit into a bucket or basin, carefully empty it into the toilet without splashing the contents and flush twice. Wash out the bucket with hot, soapy water and rinse it, emptying the wash and rinse water into the toilet, then flushing it. Dry the bucket with paper towels and throw them away. Caregivers should wear 2 pairs of throw-away gloves if they need to touch any of your body fluids. (These can be bought in most drug stores.) They should always wash their hands with warm water and soap afterward – even if they had gloves on.   If a caregiver does come in contact with any of your body fluids, they should wash the area very well with warm water and soap. It’s not likely to cause any harm, but try to take extra care to avoid this. At your next visit, let your doctor know this happened. Being exposed often may lead to problems, and extra care should be taken to avoid this. Any clothes or sheets that have body fluids on them should be washed in your washing machine – not by hand. Wash them in warm water with regular laundry detergent. Do not wash them with other clothes. If they cannot be washed right away, seal them in a plastic bag. If using throw-away adult diapers, underwear, or sanitary pads, seal them in 2 plastic bags and throw them away with your regular trash.

Will I be able to work during chemo treatment?

Whether you can continue work, school, and other activities depends on your treatment and how it affects you. For some treatments, you may need to stay in a hospital for a week or more, but many people are able to keep working during treatment. You might be able to schedule your treatments late in the day or right before the weekend so that they interfere with work as little as possible. If chemo makes you tired, try to adjust your work schedule for a while. You may be able to arrange a part-time schedule or work from home. If you get health insurance from your employer, you’ll want to keep your job during treatment. Federal and state laws may require some employers to allow you to work a flexible schedule during your treatment. To find out more about keeping your health insurance and your rights as an employee, call your local American Cancer Society office or our toll-free number. You can also find out about employment-related rights by contacting your congressional or state representatives.

Chemo side effects What causes side effects?

Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body, they can affect normal, healthy cells that are fastgrowing, too. Damage to healthy cells 20

causes side effects. Side effects are not always as bad as you might expect, but many people worry about this part of cancer treatment. The normal cells most likely to be damaged by chemo are blood-forming cells in the bone marrow; hair follicles; and cells in the mouth, digestive tract, and reproductive system. Some chemo drugs can damage cells in the heart, kidneys, bladder, lungs, and nervous system. In some cases, medicines can be given with the chemo to help protect the body’s normal cells.

What should I know about side effects? Every person doesn’t get every side effect, and some people get few, if any. The severity of side effects (how “bad” they are) varies greatly from person to person. Be sure to talk to your doctor and nurse about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them. For more information, see the section called “When to call your doctor.” Your doctor may give you medicines to help prevent some side effects before they happen. Some types of chemo cause long-term side effects, like heart or nerve damage or fertility problems. Still, many people have no long-term problems from chemo. Ask your doctor about the long-term risks of the chemo drugs you’re getting. While side effects can be unpleasant, they must be weighed against the need to kill the cancer cells.

How long do side effects last?

Most side effects slowly go away after treatment ends because the healthy cells recover over time. The time it takes to get over some side effects and regain energy varies from person to person. It depends on many factors, including your overall health and the drugs you were given. Many side effects go away fairly quickly, but some may take months or even years to completely go away. Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs.

Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later. People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your doctor. You may be able to change your medicine or treatment schedule. Your doctor or nurse also may be able to suggest ways to reduce any pain and discomfort you have.

What are common side effects?

Most people worry about whether they will have side effects from chemo, and, if so, what they’ll be like.

Here’s a review of some of the more common side effects caused by chemotherapy. We also share some tips on how you can manage them.

Fatigue from cancer treatment Fatigue is one of the most common side effects of cancer treatment. It can range from mild tiredness to feeling completely wiped out. It’s different from feeling tired after a long day and doesn’t get better with rest or sleep. Fatigue tends to be the worst at the end of a treatment cycle. Like most other side effects, it usually goes away over time after chemo ends.

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Things that may help with fatigue: Get plenty of rest, and allow time during the day for rest periods. Talk with your doctor or nurse about a regular exercise program. Exercise can actually reduce fatigue. Eat a well-balanced diet, and drink plenty of liquids. Limit your activities. Do only the things that are most important to you. Get help when you need it. Ask family, friends, and neighbors to pitch in with things like child care, shopping, housework, or driving. For example, you might ask neighbors to pick up some items for you at the grocery store while doing their own shopping. Get up slowly to help prevent dizziness after sitting or lying down. Let your doctor know if you are having a hard time sleeping at night.

You can learn more in our document called Fatigue in People With Cancer, which you can read online or call us to have a free copy sent to you.

Hair loss from chemotherapy Hair loss can be distressing. But not all chemo drugs will make you lose your hair. Some people have mild thinning that only they notice. Your doctor will be able to tell you if your chemo is likely to cause hair loss.

If you do lose your hair, it will almost always grow back after the treatments are over. But it might be a different color or texture. You can lose hair on all parts of your body, not just your scalp. Eyelashes and eyebrows, arm and leg hair, underarm hair, and pubic hair all may be affected. Hair loss usually doesn’t happen right away. More often, it starts after a few treatments. At that point, your hair may fall out slowly or in clumps. Some people shave their heads when this happens. Any hair that remains may become dull and dry.

Things that may help with hair loss: Use mild shampoos. Use soft-bristle hair brushes. Use low heat if you must use a hair dryer. Don’t use brush rollers to set your hair. Don’t dye your hair or get a perm. Have your hair cut short. A shorter style will make your hair look thicker and fuller. It also will make hair loss easier to deal with if it does happen. Use a sunscreen, hat, scarf, or wig to protect your scalp from the sun. Use a satin pillowcase.

Sometimes, either during the regrowth of your hair or when you are bald, your scalp may feel extra tender, dry, and itchy. It may help to keep your scalp clean by using a moisturizing shampoo and conditioner. Also, use gentle creams or lotions on your scalp as needed. Even a gentle scalp massage may make your scalp feel better.

After chemo, your hair’s texture and fullness may change. Hair dyes contain chemicals that can damage hair.

There’s no research that supports hair dye doing more damage to hair after chemo, but most doctors recommend patients do not color their hair until it returns to normal. This may be as long as 6 months after treatment.

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Should I cover my head if I lose my hair?

Some people who lose all or most of their hair choose to wear turbans, scarves, caps, wigs, or hairpieces.

Others leave their heads uncovered. Still others switch back and forth, depending on whether they are in public or at home with family and friends. Here are tips to follow if you choose to cover your head with a wig or hairpiece: Shop for your wig or hairpiece before you lose a lot of hair so you can match your natural color, texture, and style. You may be able to buy a wig or hairpiece at a specialty shop just for cancer patients. A sales person may be able to come to your home to help you. You can get more tips or even buy a wig or hairpiece through our “tlc” Tender Loving Care® catalog. Call us for a free copy or visit the “tlc”TM website at www.tlcdirect.org. If you would prefer to borrow rather than buy a wig or hairpiece, call us or check with the social work department at your treatment center. If you need a hairpiece because of cancer treatment, it’s a taxdeductible expense. It may also be at least partly covered by your health insurance. Be sure to check your policy, and ask your doctor to write a prescription for a “hair prosthesis.” Do not use the word “wig” on the prescription.

Increased chance of bruising, bleeding, infection, and anemia after chemotherapy Chemo often causes decreases in your blood cell counts. Blood cells are made in the bone marrow. Three important parts of your blood affected by chemo are: Platelets, which help blood to clot and stop bleeding White blood cells, which fight infection Red blood cells, which carry oxygen to cells Chemo destroys some of the bone marrow cells so fewer blood cells are produced. A drop in the levels of any one of these cells leads to certain side effects. Your doctor will check your blood cell count by doing a test called a complete blood count or CBC. This will be done often during your treatment.

Bleeding or clotting problems Platelets are the blood cells that help stop bleeding by plugging up damaged blood vessels and helping your blood to clot. If you don’t have enough platelets, you may bleed or bruise more easily than usual, even from a minor injury. A shortage of platelets is called thrombocytopenia (throm-bo-sy-toe-PEEN-ee-uh).

Report these signs of thrombocytopenia to your doctor: Unexpected bruising Small flat red spots under your skin Red or pink urine Black or bloody bowel movements Any bleeding from your gums or nose Bad headaches Dizziness Pain in joints and muscles

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Your doctor will check your platelet count often during your treatment. If it falls too low, you may need a platelet transfusion. There’s nothing you can do to help increase your platelet count, but there are some precautions you can take: Don’t take any medicine without first checking with your doctor or nurse. This includes aspirin and aspirinfree pain relievers, like acetaminophen (Tylenol®), ibuprofen, and any other medicines you can buy without a prescription. Some of these medicines can make bleeding problems worse. Don’t drink any alcohol (beer, wine, or liquor) unless your doctor says it’s OK. Use an extra-soft bristle toothbrush to clean your teeth, and talk to your doctor before using dental floss. If you have a runny nose, blow gently into a soft tissue. Take care not to cut or nick yourself when using scissors, needles, knives, or tools. Be careful not to burn yourself when ironing or cooking. Use a padded glove rather than a potholder when you reach into the oven. Avoid contact sports and other activities that might cause an injury. Drink plenty of fluids and eat enough fiber to reduce your chances of getting constipated. Use an electric shaver instead of a razor. When bending over, keep your head above your heart.

Infection A low white blood cell count decreases your ability to fight infections. One type of white blood cell, called the neutrophil (new-trow-fill), is especially important in fighting infections. A shortage of neutrophils is called neutropenia (new-trow-PEEN-ee-uh). Infections can begin in almost any part of your body and most often start in your mouth, skin, lungs, urinary tract, and rectum. If your white blood cell count drops too much, your doctor may hold treatment, give you a lower dose of chemo, or, in some cases, give you a growth factor shot that makes your bone marrow produce more white blood cells. When the chemo used is known to cause very low white blood cell counts, growth factor shots may be used to help keep this from happening.

While there’s nothing you can do to raise your white blood cell counts on your own, you can do things to help prevent infection, such as:  Wash your hands often during the day, especially before you eat and after you use the bathroom. Stay away from crowds. Stay away from people who have diseases you can catch, such as colds, flu, measles, or chicken pox. Do not get any immunization shots (vaccines) without first checking with your cancer doctor. Stay away from people who have recently had an immunization, such as a vaccine for chicken pox or small pox. Check with your doctor about which vaccines are important and how long you should stay away from people who have had them. Clean your rectal area very well but gently after each bowel movement. Ask your doctor or nurse for advice if the area becomes sore or if you have hemorrhoids. Also, check with your doctor before using enemas or suppositories. Don’t cut, bite, or tear the cuticles of your nails. Be careful not to cut or nick yourself when using scissors, needles, or knives. Use an electric shaver instead of a razor to prevent breaks or cuts in your skin. Use an extra-soft bristle toothbrush that won’t hurt your gums, and talk to your doctor before using dental floss. Don’t squeeze or scratch pimples. Take a warm (not hot) bath, shower, or sponge bath every day. Pat your skin dry using a light touch. Don’t rub.

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Use lotion or oil to soften and heal your skin if it becomes dry and cracked. Clean cuts, scrapes, and broken skin right away with warm water and soap. Use an antibiotic ointment and cover with a bandage. Wear waterproof gloves when gardening or cleaning up after animals and others, especially small children.

Wash your hands afterward, since gloves can have holes that are too small to see. Even if you are extra careful, your body may not be able to fight infections when your white blood cell count is low. Look out for and check your body regularly for signs and symptoms of infection. Pay special attention to your eyes, nose, mouth, and genital and rectal areas. Symptoms of infection could be: Fever of 100.5°F or greater when your temperature is taken by mouth Chills Sweating Loose stools (This can also be a side effect of chemo.) A burning feeling when you urinate A bad cough or sore throat Unusual vaginal discharge or itching Redness, swelling, or tenderness, especially around a wound, sore, pimple, IV site, or central venous catheter Abdominal (belly) pain Report any signs of infection to your doctor right away. If you have a fever, don’t use aspirin, acetaminophen (Tylenol), or any other medicine to bring your temperature down without first checking with your doctor.

For much more detail on the immune system, infections and cancer, and how to prevent them, please see Infections in People With Cancer. It can be read online, or call us for a free copy.

Anemia Anemia (uh-nee-me-uh) is when you have too few red blood cells, and your body tissues don’t get enough oxygen to do their work.

You may have these symptoms: Extreme tiredness (fatigue) Dizziness Pale skin A tendency to feel cold Shortness of breath Weakness Racing heart You can’t do anything to increase your red blood cell counts, but there are things that may help with anemia.

Try the ideas listed in the section called “Fatigue” (see above) if your anemia is making you feel very tired.

Let your doctor or nurse know if you have any of the symptoms listed above. If your red blood cell count falls too low, you may need a blood transfusion. Some people can be treated with a growth factor – a drug used to boost the number of red blood cells the bone marrow makes.

You can get a lot more information in Anemia in People With Cancer. Call for a free copy, or read it on our website.

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Nausea and vomiting Nausea and vomiting are 2 of the most dreaded side effects of chemo. How often you have these side effects and how bad they are depends on the drugs you are getting and how they affect you. Nausea and vomiting may start during treatment and last a few hours. Sometimes, but less often, severe nausea and vomiting can last for a few days. Be sure to tell your doctor or nurse if you are very nauseated, if you have been vomiting for more than a day, or if the problem is so bad that you can’t keep liquids down. Nausea and vomiting can almost always be lessened by a change in the way you eat and with drugs that help relieve both symptoms (these drugs are called anti-emetics). Different anti-emetics work for different people. You may need to try more than one before you get relief. Don’t give up! Keep working with your doctor and nurse to find the anti-emetics that work best for you.

Some people getting chemo feel queasy even before treatment begins. This is called anticipatory nausea, and it’s very real. The best way to handle anticipatory nausea is by taking anti-emetics to prevent vomiting, and by using relaxation techniques.

Things that may help with nausea and vomiting: Avoid big meals so your stomach won’t feel too full. Eat frequent, small meals throughout the day instead of a few large meals. Drink liquids at least an hour before or after mealtime instead of with your meals. Eat and drink slowly. Stay away from sweet, fried, or fatty foods. Eat foods cold or at room temperature so you won’t be bothered by strong smells. Chew your food well for better digestion. If nausea is a problem in the morning, try eating dry foods, such as cereal, toast, or crackers, before getting up. (Don’t try this if your mouth is too dry, or if you have sores in your mouth or throat.) Drink cool, clear liquids, such as apple juice, tea, or ginger ale that has lost its fizz. Suck on ice cubes, mints, or tart candies. (Don’t eat tart candies if you have mouth or throat sores.) Try to avoid odors that bother you, such as cooking smells, smoke, or perfume. Rest in a chair after eating, but don’t lie flat for at least 2 hours after you’ve finished your meal. Wear loose-fitting clothes. Breathe deeply and slowly when you feel nauseated. Distract yourself by talking with friends or family members, listening to music, or watching a movie or TV show. Use relaxation techniques.

Call us or go to our website to get more tips and details in our document called Nausea and Vomiting.

Other chemo side effects and tips to manage them Appetite changes There may be days when you just can’t eat because of things like nausea, taste changes, or mouth and throat problems. You also can lose your appetite if you feel depressed or tired.

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When you have a poor appetite, try these tips: Eat small meals or snacks whenever you want. You don’t have to eat 3 regular meals each day. Vary your diet, and try new foods and recipes. Take a walk before meals whenever you can. This may help you feel hungrier. Change your mealtime routine. For example, eat by candlelight or in a different place. Eat with friends or family members. When eating alone, listen to the radio or watch TV. If you live alone, you might want to arrange for Meals on Wheels or a program like this to bring food to you. Ask your doctor, nurse, or local American Cancer Society office about services in your area.

For more information, please see our booklet called Nutrition for the Person With Cancer During Treatment: A Guide for Patients and Families or Nutrition for Children With Cancer.

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Thyroid Cancer Causes and Risk Factors What are the risk factors for thyroid cancer?

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But risk factors don’t tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may have few or no known risk factors. Even if a person with thyroid cancer has a risk factor, it is very hard to know how much that risk factor may have contributed to the cancer.

Scientists have found a few risk factors that make a person more likely to develop thyroid cancer.

What are the risk factors for thyroid cancer?

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But risk factors don’t tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may have few or no known risk factors. Even if a person with thyroid cancer has a risk factor, it is very hard to know how much that risk factor may have contributed to the cancer.

Scientists have found a few risk factors that make a person more likely to develop thyroid cancer.

Gender and age For unclear reasons thyroid cancers (like almost all diseases of the thyroid) occur about 3 times more often in women than in men.

Thyroid cancer can occur at any age, but the risk peaks earlier for women (who are most often in their 40s or 50s when diagnosed) than for men (who are usually in their 60s or 70s).

A diet low in iodine Follicular thyroid cancers are more common in areas of the world where people’s diets are low in iodine. In the United States, most people get enough iodine in their diet because it is added to table salt and other foods.

A diet low in iodine may also increase the risk of papillary cancer if the person also is exposed to radioactivity.

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Radiation Exposure to radiation is a proven risk factor for thyroid cancer. Sources of such radiation include certain medical treatments and radiation fallout from power plant accidents or nuclear weapons.

Having had head or neck radiation treatments in childhood is a risk factor for thyroid cancer. Risk depends on how much radiation is given and the age of the child. In general, the risk increases with larger doses and with younger age at treatment. Before the 1960s, children were sometimes treated with low doses of radiation for things we wouldn’t use radiation for now, like acne, fungus infections of the scalp (ringworm), or enlarged tonsils or adenoids. Years later, the people who had these treatments were found to have a higher risk of thyroid cancer. Radiation therapy in childhood for some cancers such as lymphoma, Wilms tumor, and neuroblastoma also increases risk. Thyroid cancers that develop after radiation therapy are not more serious than other thyroid cancers.

Imaging tests such as x-rays and CT scans also expose children to radiation, but at much lower doses, so it’s not clear how much they might raise the risk of thyroid cancer (or other cancers). If there is an increased risk it is likely to be small, but to be safe, children should not have these tests unless they are absolutely needed.

When they are needed, they should be done using the lowest dose of radiation that still provides a clear picture.

Several studies have pointed to an increased risk of thyroid cancer in children because of radioactive fallout from nuclear weapons or power plant accidents. For instance, thyroid cancer was many times more common than normal in children who lived near Chernobyl, the site of a 1986 nuclear plant accident that exposed millions of people to radioactivity. Adults involved with the cleanup after the accident and those who lived near the plant have also had higher rates of thyroid cancer. Children who had more iodine in their diet appeared to have a lower risk.

Some radioactive fallout occurred over certain regions of the United States after nuclear weapons were tested in western states during the 1950s. This exposure was much, much lower than that around Chernobyl. A higher risk of thyroid cancer has not been proven at these low exposure levels. If you are concerned about possible exposure to radioactive fallout, discuss this with your doctor.

Being exposed to radiation when you are an adult carries much less risk of thyroid cancer.

Hereditary conditions and family history Several inherited conditions have been linked to different types of thyroid cancer, as has family history. Still, most people who develop thyroid cancer do not have an inherited condition or a family history of the disease.

Medullary thyroid cancer About 1 out of 3 medullary thyroid carcinomas (MTCs) result from inheriting an abnormal gene. These cases are known as familial medullary thyroid carcinoma (FMTC). FMTC can occur alone, or it can be seen along with other tumors.

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The combination of FMTC and tumors of other endocrine glands is called multiple endocrine neoplasia type 2 (MEN 2). There are 2 subtypes, MEN 2a and MEN 2b, both of which are caused by mutations (defects) in a gene called RET.  

In MEN 2a, MTC occurs along with pheochromocytomas (tumors that make adrenaline) and with parathyroid gland tumors.

In MEN 2b, MTC is associated with pheochromocytomas and with benign growths of nerve tissue on the tongue and elsewhere called neuromas. This subtype is much less common than MEN 2a.

In these inherited forms of MTC, the cancers often develop during childhood or early adulthood and can spread early. MTC is most aggressive in the MEN 2b syndrome. If MEN 2a, MEN 2b, or isolated FMTC runs in your family, you may be at very high risk of developing MTC. Ask your doctor about having regular blood tests or ultrasound exams to look for problems and the possibility of genetic testing.

Other thyroid cancers People with certain inherited medical conditions have a higher risk of more common forms of thyroid cancer.

Higher rates of thyroid cancer occur among people with uncommon genetic conditions such as: Familial adenomatous polyposis (FAP): People with this syndrome develop many colon polyps and have a very high risk of colon cancer. They also have an increased risk of some other cancers, including papillary thyroid cancer. Gardner syndrome is a subtype of FAP in which patients also get certain benign tumors. Both Gardner syndrome and FAP are caused by defects in the gene APC. Cowden disease: People with this syndrome have an increased risk of thyroid problems and certain benign growths (including some called hamartomas). They also have an increased risk of cancers of the thyroid, uterus, breast, as well as some others. The thyroid cancers tend to be either the papillary or follicular type.

This syndrome is most often caused by defects in the gene PTEN. It is also known as Multiple Hamartoma Syndrome and PTEN Hamartoma Tumor Syndrome Carney complex, type I: People with this syndrome may develop a number of benign tumors and hormone problems. They also have an increased risk of papillary and follicular thyroid cancers. This syndrome is caused by defects in the gene PRKAR1A. Familial nonmedullary thyroid carcinoma: Thyroid cancer occurs more often in some families, and is often seen at an earlier age. The papillary type of thyroid cancer most often runs in families. Genes on chromosome 19 and chromosome 1 are suspected of causing these familial cancers.

If you suspect you might have a familial condition, talk with your doctor, who might recommend genetic counseling if your medical history warrants it.

Family history: Having a first-degree relative (parent, brother, sister, or child) with thyroid cancer, even without a known inherited syndrome in the family, increases your risk of thyroid cancer. The genetic basis for these cancers is not totally clear.

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Do we know what causes thyroid cancer?

Thyroid cancer is linked with a number of inherited conditions (described in the section “What are the risk factors for thyroid cancer?”), but the exact cause of most thyroid cancers is not yet known.

Certain changes in a person’s DNA can cause thyroid cells to become cancerous. DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than just how we look. It also can influence our risk for developing certain diseases, including some kinds of cancer.

Some genes contain instructions for controlling when our cells grow and divide into new cells. Certain genes that help cells grow and divide or make them live longer than they should are called oncogenes. Other genes that slow down cell division or make cells die at the right time are called tumor suppressor genes. Cancers can be caused by DNA changes that turn on oncogenes or turn off tumor suppressor genes.

People inherit 2 copies of each gene – one from each parent. We can inherit damaged DNA from one or both parents. Most cancers, though, are not caused by inherited gene changes. In these cases, the genes change during a person’s life. They may occur when a cell’s DNA is damaged by something in the environment, like radiation, or they may just be random events that sometimes happen inside a cell, without an outside cause.

Papillary thyroid cancer Several DNA mutations (changes) have been found in papillary thyroid cancer. Many of these cancers have changes in specific parts of the RET gene. The altered form of this gene, known as the PTC oncogene, is found in about 10% to 30% of papillary thyroid cancers overall, and in a larger percentage of these cancers in children and/or linked with radiation exposure. These RET mutations usually are acquired during a person’s lifetime rather than being inherited. They are found only in cancer cells and are not passed on to the patient’s children.

Many papillary thyroid cancers have a mutated BRAF gene. The BRAF mutation is less common in thyroid cancers in children and in those thought to develop from exposure to radiation. Cancers with BRAF changes tend to grow and spread to other parts of the body more quickly.

Both BRAF and RET/PTC changes are thought to make cells grow and divide. It is extremely rare for papillary cancers to have changes in both the BRAF and RET/PTC genes. Some doctors now advise testing thyroid biopsy samples for these gene mutations, as they can help diagnose cancer and may also affect the patient’s outlook (see “How is thyroid cancer diagnosed?”).

Changes in other genes have also been tied to papillary thyroid cancer, including those in the NTRK1 gene and the MET gene.

Follicular thyroid cancer Acquired changes in the RAS oncogene have a role in causing some follicular thyroid cancers.

Anaplastic thyroid cancer These cancers tend to have some of the mutations described above and often have changes in the TP53 tumor suppressor gene and the CTNNB1 oncogene as well.

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Medullary thyroid cancer People who have medullary thyroid carcinoma (MTC) have mutations in different parts of the RET gene compared with papillary carcinoma patients. Nearly all patients with the inherited form of MTC and about 1 of every 10 with the sporadic (non-inherited) form of MTC have a mutation in the RET gene. Most patients with sporadic MTC have gene mutations only in their cancer cells. Those with familial MTC and MEN 2 inherit the RET mutation from a parent. These mutations are in every cell of the patient’s body and can be detected by testing the DNA of blood cells.

In people with inherited mutations of RET, one RET gene is usually normal and one is mutated. Because every person has 2 RET genes but passes only one of them to a child (the child’s other RET gene comes from the other parent), the odds that a person with familial MTC will pass a mutated gene on to a child are 1 in 2 (or 50%).

Can thyroid cancer be prevented?

Most people with thyroid cancer have no known risk factors, so it is not possible to prevent most cases of this disease.

Radiation exposure, especially in childhood, is a known risk factor for thyroid cancer. Because of this, doctors no longer use radiation to treat less serious diseases. Imaging tests such as x-rays and CT scans also expose children to radiation, but at much lower doses, so it’s not clear how much they might raise the risk of thyroid cancer (or other cancers). If there is an increased risk it is likely to be small, but to be safe, children should not have these tests unless they are absolutely needed. When they are needed, they should be done using the lowest dose of radiation that still provides a clear picture.

Blood tests can be done to look for the gene mutations found in familial medullary thyroid cancer (MTC).

Because of this, most of the familial cases of MTC can be prevented or treated early by removing the thyroid gland. Once the disease is discovered in a family, the rest of the family members can be tested for the mutated gene.

If you have a family history of MTC, it is important that you see a doctor who is familiar with the latest advances in genetic counseling and genetic testing for this disease. Removing the thyroid gland in children who carry the abnormal gene will probably prevent a cancer that might otherwise be fatal.

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Increased Screening Has Led to Rise in Thyroid Cancer Misdiagnosis

By Dr. Mercola Thyroid cancer appears to be on the rise in many areas of the world, although recent research suggests this may be more due to over-diagnosis than an actual increase in incidence.

In the US, the rate of thyroid cancer has doubled since 1994.1 In South Korea, it has become the most commonly diagnosed type of cancer, having increased 15-fold in the past 20 years.

However, some cancer experts note that the situation in South Korea is likely due to increased screening and misdiagnosis of harmless tumors. As noted in the featured article:2 “South Koreans embraced screening about 15 years ago when the government started a national program for a variety of cancers — breast, cervix, colon, stomach and liver.

Doctors and hospitals often included ultrasound scans for thyroid cancer for an additional fee of $30 to $50... Although more and more small thyroid cancers are being found, however, the death rate has remained rock steady, and low.

If early detection were saving lives, death rates should have come down. That pattern — more cancers detected and treated but no change in the death rate — tells researchers that many of the cancers they are finding and treating were not dangerous.”

The Risks of Over-Diagnosis Finding tiny benign tumors that really do not need treatment is known as over-diagnosis—a phenomenon that is also common in other kinds of cancer screening, particularly breast cancer.

It’s emotionally difficult to take a “wait and see” approach once a tumor has been noted on a test or scan, but treating it can do far more harm than good if it’s benign. Far more people die with thyroid cancers than from them.

Left alone, a benign, slow-growing tumor might never cause a problem—indeed as many as one-third of people die with small thyroid tumors that remained undetected throughout their lives,3 and the cancer didn’t actually cause their death.

Removing and treating harmless tumors, however, can lead to a slew of cascading health problems. For example, surgical removal of your thyroid means you need to take thyroid hormones for the remainder of your life.

For many, this will lead to less than optimal hormone function. Chronic hormone deficiency, depression, and other symptoms of low thyroid function can become lifelong companions as a result... Surgical removal of the thyroid can also result in accidental damage to your vocal cords and/or parathyroid glands.

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In South Korea, two percent of patients suffer vocal cord paralysis, and 11 percent end up with hypoparathyroidism as a result of damage to the parathyroid glands—the latter of which detrimentally affects calcium regulation in your body.

Experts Call for Restraint in Screening for Thyroid Cancer The answer, some cancer experts say, is to simply reduce screening that finds these tiny, harmless cancers.

One of the South Korean authors of the featured paper4 goes so far as to propose thyroid cancer screening should be banned. As noted by the New York Times: “[C]ancer experts said the situation in South Korea should be a message to the rest of the world about the serious consequences that large-scale screening of healthy people can have.

‘It’s a warning to us in the US that we need to be very careful in our advocacy of screening,’ said Dr. Otis W. Brawley, chief medical officer at the American Cancer Society. ‘We need to be very specific about where we have good data that it saves lives.’ ...These tiny cancers, called papillary thyroid cancers, are the most common kind and are the sort typically found with screening. They are known to be the least aggressive.

The epidemic was not caused by an environmental toxin or infectious agent, said Dr. H. Gilbert Welch of Dartmouth, an author of the paper.5 ‘An epidemic of real disease would be expected to produce a dramatic rise in the number of deaths from disease,’ he said. ‘Instead we see an epidemic of diagnosis, a dramatic rise in diagnosis and no change in death.’ ...[T]he lesson from South Korea should be heeded, said Dr. Barnett S. Kramer, director of the division of cancer prevention at the National Cancer Institute. ‘The message for so long is that early detection is always good for you,’ he said.

But this stark tale of screening gone wrong ‘should acutely raise awareness of the consequences of acting on the intuition that all screening must be of benefit and all diagnoses at an early stage are of benefit.’”

One in Eight Women Have Thyroid Disease While the actual incidence of thyroid cancer may not be on the rise, thyroid disease has become very prevalent in today’s world, courtesy of a number of different lifestyle factors.

According to Dr. Christiane Northrup, MD, one in eight women aged 35-65 has some form of thyroid disease6—underactive thyroid being the most common. More than one-quarter of women in perimenopause are diagnosed with hypothyroidism, in which insufficient amounts of thyroid hormone is produced.

Thyroid hormones7 are used by every cell of your body, which is why the symptoms can vary so widely. For example, thyroid hormones regulate metabolism and body weight by controlling the burning of fat for energy and heat. Thyroid hormones are also required for growth and development in children. Symptoms of hypothyroidism may also include but are not limited to the following:

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Fatigue, loss of energy, and general lethargy

Cold intolerance

Muscle and/or joint pain

Decreased sweating

Depression

Puffiness

Weight gain

Coarse or dry skin and hair

Hair loss

Sleep apnea

Carpal tunnel syndrome

Forgetfulness, impaired memory, and inability to concentrate

Menstrual disturbances

Decreased appetite

Impaired fertility

Constipation

Fullness in the throat and hoarseness

Increased risk of heart disease

Increased “bad” cholesterol (LDL)

Weakness in extremities

Emotional instability

Blurred vision

Mental impairment

Decreased hearing

Bradycardia (reduced heart rate)

The Effect of Thyroid Disease on Mental Health Depression and other mental health problems are perhaps particularly notable symptoms of thyroid dysfunction—if nothing else because it’s a common side effect that is easily overlooked and therefore misdiagnosed. If your depression is due to an underactive thyroid, clearly the answer to your problem is not an antidepressant but rather addressing your thyroid function... As explained by Dr. Northrup: “The thyroid is a butterfly-shaped gland located in the area of your neck just below the Adam’s apple. It’s part of the endocrine system, and it secretes the hormones thyroxine (T4) and triiodothyroxine (T3), which regulate the body’s metabolic rate. Thyroid function is very complex and exerts a profound effect on the function of nearly every other organ in the body. Therefore, smooth functioning of the overall body chemistry depends on the health of your thyroid gland.

It is not uncommon for women with thyroid problems to suffer from depression. One explanation for this is that the most biologically active form of thyroid hormone, T3, is actually a bona fide neurotransmitter that regulates the action of serotonin, norepinephrine, and GABA (gamma aminobutyric acid), an inhibitory neurotransmitter that is important for quelling anxiety.”

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It’s important to realize that thyroid dysfunction is a complex issue, with many variables. As noted by Dr. Northrup, midlife hypothyroidism can be related to underlying estrogen dominance, in which case taking thyroid hormone fails to address the root of the problem. Medications can also disrupt your thyroid function, in which case the most appropriate remedy may not be to add thyroid hormone.

Known thyroid-disrupting drugs include steroids, barbiturates, cholesterol–lowering drugs, the antiepileptic drug Dilantin, and beta-blockers. Heavy metal toxicity is yet another factor that can be part of the problem (to learn more about this, please listen to my interview with Dr. Jonathan Wright, below). Last but not least, Dr. Northrup8 also points out that thyroid disease oftentimes has an emotional/spiritual component: “Thyroid disease is related to expressing your feelings, something that until relatively recently had been societally blocked for women for thousands of years. In order to have your say—and maintain your thyroid energy—you must take a fearless inventory of every relationship in which you feel you don’t have a say...

One more thing, thyroid disorders are also related to our relationship to time. The thyroid is adversely affected by feeling as though there’s never enough time or that you are running out of time. This feeling also results in adrenal burnout (which is related to thyroid disorders.). Our culture’s relationship to time is very unbalanced... A starting point here is to realize that you have all the time there is. Literally. And all the time that anyone else has—24 hours in a day.

You can change your relationship to time by changing the way you pay attention... Take regular moments during the day to simply put your attention on something. Notice a beautiful flower. Or a tree. Or the sky.

Slow down and pay attention. Eventually this little practice will improve your relationship to time.”

The Importance of Iodine for Thyroid Function Iodine is the key to a healthy thyroid and efficient metabolism. Even the names of the different forms of thyroid hormone reflect the number of iodine molecules attached -- T4 has four attached iodine molecules, and T3 (the biologically active form of the hormone) has three -- showing what an important part iodine plays in thyroid biochemistry.

As your body cannot produce its own iodine, it must be obtained from your diet. Iodine is sequestered into your thyroid gland, where it is incorporated into the thyroid hormones thyroxine (T4) or triiodothyronine (T3). In healthy individuals these hormones are precisely regulated by thyroid-stimulating hormone (TSH), and are required by all metabolically active cells in your body. Unfortunately, iodine deficiency is extremely common these days, and while toxic exposure plays a significant role in thyroid disease, this nutritional deficiency is an important factor.

More than 11 percent of all Americans—and more than 15 percent of American women of child-bearing age—have urine iodine levels less than 50 micrograms per liter (mcg/L),9 indicating moderate to severe iodine deficiency. An additional 36 percent of reproductive-aged women in the US are considered mildly iodine deficient (<100 mcg/L urinary iodine). The American Academy of Pediatrics recommends taking an iodine supplement during pregnancy, as most pregnant women are deficient.10 Your iodine levels can also be affected by toxic exposures. Iodine is a member of a class of related elements called "halogens," which includes bromine, fluorine, and chlorine. When they are chemically reduced, they become "halides" (iodide, bromide, fluoride, and chloride). Most people today are exposed to these halogens/halides via food, water, medications, and environment and these elements selectively occupy your iodine receptors, further deepening your iodine deficit. Additional factors contributing to falling iodine levels include:

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Water fluoridation

Diets low in fish, shellfish, and seaweed

Vegan and vegetarian diets

Decreased use of iodized salt

Less use of iodide in the food and agricultural industry

Use of radioactive iodine in many medical procedures, which competes with natural iodine

Take Control of Your Thyroid Health Thyroid hormones are used by cells throughout your body, making it very important to address your thyroid health. Again, iodine is the key to a healthy thyroid, and it’s also important for the prevention of breast cancer. If you’re not getting enough from your diet (in the form of seafood), you’d be well advised to consider taking a supplement, ideally a high-quality seaweed supplement (be sure to check its source to avoid potential radioactive contamination), or other iodine-containing whole food supplement.

As for thyroid hormone replacement, you have two basic options: bioidentical or synthetic hormones.11 Bioidentical thyroid hormones—which are what I recommend using—include Nature-Throid and Westhroid.

They’re made from desiccated pig thyroid glands and contain the full spectrum of thyroid hormones: T4, T3, T2, and T1. Synthroid (generic brand: Levothyroxine) is synthetic, and contains only T4. Keep in mind that in some cases, if you're borderline hypothyroid, you may actually only need an iodine supplement rather than a thyroid hormone replacement.

With regards to screening, there’s ample evidence suggesting that thyroid cancer screening is unnecessary unless you have reason to suspect cancer. Also remember that screening does not equate to prevention.

Addressing your thyroid health is far more important and beneficial than relying on screening to alert you to a potential problem. Especially considering that the chances of over diagnosis are great, and treating an otherwise harmless tumor may result in greater harm than leaving it alone and simply focusing on lifestyle factors such as diet and detoxification to improve your thyroid health.

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For years our family suffered with dry skin and eczema.

We tried everything on the market, nothing worked but with some trial and error we developed products that were better than anything weâ&#x20AC;&#x2122;ve purchased in the past.

Our products are 100% natural and use only the best organic unrefined Ghanaian Shea Butter extracted directly from the Shea nut and combined with virgin coconut oil and other essentials.

The desire to help our family became the catalyst for the creation of Nikki's naturals.

Our family and friends have experienced the bountiful benefits of Nikki's Naturals and so should you.

The amount of time required for optimum results may vary.

Eczema and dry skin require four to six weeks of daily use in conjunction with black soap.

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Nikki’s Naturals L.O.C Method procedure 1.

2.

3.

4.

5.

Wash hair with Nikki’s Naturals Black Soap Clarifying Shampoo a. The shampoo lathers quickly and easily so a lot of product is not required. b. You may want to wash hair twice to remove all the environmental toxins and oil build up.

Towel dry hair a. Hair should be moist but not dripping wet.

Apply leave-in deep root stimulator a. Place approximately a quarter sized amount of the Leave-in Deep Root Stimulator in your palm. b. Rub between palms. c. Apply to scalp with the pads of your fingertips. d. Apply to hair by gently pulling from root to tips.

Cover head with plastic cap and sit under dryer with medium heat for 30 minutes (for optimal results). a. Your hair should still be damp. b. Optionally you can use a plastic cap with no heat for an hour.

If your hair is dense/very thick then do not rinse out the leave-in deep root stimulator. a. De-tangle in sections. Remember to de-tangle from the ends and work your way up to the roots. b. Apply Whipped Shea Hair Cream to scalp as well as shaft of hair. Twist/braid as usual let dry. c. Style as usual i. If blow drying or flat ironing hair, apply Whipped Shea Hair Cream as a finishing cream to add luster, bounce and sheen.

d. If your hair is fine or relaxed rinse out the Leave-in Deep Root Stimulator with warm water. i. Blow dry or dry as usual. ii. Add Whipped Shea Hair Cream as a finishing cream.

How to cleanse with Nikki’s Naturals Soft Black Soap Black soap works by cleansing the skin but without harsh chemicals and is not your regular run-of-the-mill antibacterial grocery store soap. The “authentic” recipe for black soap calls for cocoa pod, roasted plantain skins, palm kernel oil, coconut oil, palm oil and natural sodium.

Basically the ash from the plantain skins saponify the oils turning them into soap unlike traditional soap that uses sodium hydroxide.

When you wash with it, black soap goes to work by penetrating the skin to remove impurities. It does not remove existing acne, instead it helps to prevent excessive oil production and bacterial growth which help to create acne in the first place.

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How to use Face/Body application 1.

Wet hands or wash rag with warm to mildly hot water.

2.

Wet face or body with warm to mildly hot water.

3.

Apply approximately a dime sized amount for face or a little more than a quarter sized amount of the Soft Black Soap in your palm or wash rag for body a.

Rub between palms or wash rag b.

You may feel small pieces of plantain skin and cocoa pod ash i. This ash is created in the production of the Raw Black Soap ii. Remove the ash (the ash may irritate or scratch the skin) 4.

Apply soap to face or body rubbing in a circular motion a.

Wash soap off face after 15 to 20 seconds b.

Wash soap off body c.

Pat face and/or body with dry with towel 5.

Apply approximately a thumb nail amount of Nikki’s Naturals Whipped Shea Body Mouse to face and use discretion while applying to body making sure to get full coverage. a.

The Whipped Shea Butter spreads uniformly and easily b.

The Shea Butter’s healing and moisturizing properties restore collagen, even skin tone and rejuvenates the skin.

Wash face with Nikki’s Naturals Soft Black Soap once or twice a day.

Although black soap has a lower pH between 7 and 8 in comparison to traditional soap our skin has a pH of about 4 to 5 so using black soap is like getting a mini peel with each use.

The benefits of using Raw African Black Soap are many but we recommend it be used responsibly 1.

Do not leave the soap on face for an excessive amount of time. a.

This can cause irritation and possibly dryness of the skin 2.

Do not wash your face with the soap more than twice a day a.

This can cause irritation and possibly dryness of the skin i. Everyone’s skin is different but apply this a as general rule 3.

The most important thing to remember when using Black Soap is to MOISTURIZE a.

Using lotions that are water based do not moisturize as well and Shea Butter and in some cases have a drying effect.

4.

Use Nikki’s Naturals Unrefined Grade A Whipped Shea Butter Body Mousse for optimal results

Nikki’s Naturals Black Soap and Shea Body Mousse Nikki’s Naturals Soft Black Soap and our Shea Butter Body Mousse are a perfect complement to one other.

The benefits of using Nikki’s Naturals Soft Black Soap Protects Against Photo Aging Antioxidants in black soap protect the skin from free radical damage, which is a cause of premature skin aging, wrinkles and facial lines.

Improves Skin Tone Black soap firms and tones skin and improves skin texture, for more supple and glowing skin.

Fades Skin Discolorations 40

Black soap helps even out and fade brown spots and discolorations.

Reduces Inflammation and Skin Irritations Black soap helps reduce inflammation and skin irritations. It is soothing on dry and irritated skin, relieving dry patches, rashes and red areas.

Helps to Heal Problem Skin It eases the symptoms of skin conditions like acne. Users have said that black soap helps lessen, treat and clears acne, gets rid of blackheads, psoriasis and eczema.

Has Deep Cleansing Action Black soap has antibacterial and anti-fungal properties and is great for deep pore cleansing. It also is effective at removing makeup.

It Alleviates Razor Bumps It is often used by men during shaving for deep cleansing and less irritation.

It's an Effective Exfoliate The ashes in black soap provide exfoliating properties to remove dead skin cells and thereby improves fine lines, soften and rejuvenate rough skin.

The benefits of using Nikkiâ&#x20AC;&#x2122;s Naturals Shea Butter Body Mousse Skin and Hair Natural Ultra-Care What makes Shea butter an extraordinary skin care and an amazing body healer is its richness in precious constituents, which include unsaturated fats with a large proportion of "unsaponifiables" components, essential fatty acids, phytosterols, vitamin E and D, provitamin A and allantoin. All these are natural and make Shea butter a superfood for your skin and hair. Listed are some of the benefits of Shea butter: Reduces wrinkles - fine lines and scars repairing - Antioxidant - Anti-inflammatory Deeply moisturizing - Stimulating for the superficial microcirculation - Skin strengthening Skin protecting - UV protecting - Skin regenerating - Collagen production stimulating (makes the skin stronger, more supple and younger) - Minor cuts and burns healing Muscle ache healing Physical endurance enhancer

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The Body Healer Given its high content in anti-inflammatory and healing components, Shea butter helps the healing of skin disorders and problems like: Eczema, - psoriasis - rash, - hives - insect bites - poisonous plants contact dermatitis - skin cracks - burns - minor cuts

Different Types of Shea Butter, Different Qualities Not all Shea butters are created equal when it comes to quality and efficiency. They come in different types depending on how they have been extracted from the nuts: refined or unrefined. You want to make sure that you get the unrefined organic Shea butter, here is why...

Refined Shea Butter

Refined Shea butter has been extracted with chemical process (with hexane mostly), which involves bleaching, deodorizing and overheating. All of these deeply altering chemical processes yield a white odorless Shea butter that has lost all of its deep moisturizing, anti-aging, protecting and healing properties.

Unrefined Shea butter

The raw Shea butter in its natural state has been extracted manually or mechanically. It has a mild nuttysmoky scent and a golden to light ivory color. The odor can be removed thanks to a mild steam treatment that doesn't degrade the Shea butter. The raw or deodorized Shea butter is what you want to use because it has retained all its precious skin moisturizing, anti-aging and healing properties.

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A posture of thankfulness

I am grateful, I am appreciative, I am much obliged!

When I was released through the corridors of time, I came here weighty with potential, carrying powerful gifts and inestimable treasures.

Here to make a marked difference, To touch the World with a unique essence…

Drawing from this infinite source, through a process called Thankfulness.

The vicissitudes of life took aim and arrows fell my way, Harsh hands of cause and its effects.

But look closely at the cracks beckoning the light....

They are openings through which the inner treasure can sparkle and shine.

For sufferings and pain broke my protective hull, not my spirit…

And my truth fell out vivacious, audacious, and courageous.

I am broken not bent, and I am thankful!

Even though suffering is a human condition, I can let it be my usher into deeper levels of life expression.

Through my surrender I let it fish out of the depths, gems from the land locked waters of my soul.

Let it be my springboard that propels into new levels of spiritual enlightenment, Compassion for self and for humanity.

Having felt the same aches and distress that others feel, I can give comfort.

Sufferings provide a platform; pain's podium screams, "I understand", It makes me able to walk the bridge of vulnerability and have access to everyone.

I can use it, and I am thankful!

Today is a new day and for it I am thankful!

Regrets will not yoke me to the past But through eyes of self compassion, I look at distant memories and issue my release.

Time has signed off on those pages, but today is mine I must stay in step with time.

Lovingly forgiving myself even as I am forgiven, aware of the new mandates that come with the dawn.

Seeing life as a process, there is no grand arrival!

Yet submitting to the sharp shears of growth and disconnecting from the excess that fell to the ground.

Pounds lighter, able to move purposely through levels of love, Partner with the Divine, vessel for His expression.

I am free and growing, I am thankful!

Thankfulness is a tune any heart can sing Those who have seen and know its rewards bellow its songs.

It is a bridge to better, it is a magnet for favor, and it is the fragrance of humility.

It is an advocate, it’s a ticket, and it is a key that unlocks.

Thankfulness supersede mere words, it’s the feeling of gratitude resting heavy in the core…

That then oozes and leaks through the attitude the lips and countenance.

I choose this posture!

I am grateful, I am thankful!

-Errand Zo Phillip …All Rights Reserved

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"Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these”. Luke 18:16

T

he gift of beauty is such a blessing to share, that I wanted to inspire every little girl to feel beautiful. I wanted to share something so unique and personal that little girls all over the world could feel as if they were are all the same. This is how The Princess Kingdom was created.

My name is Shanae White and I’m 29 years old. I’m an entrepreneur, wife and proud mother of two beautiful little girls named Tyler and Taylor. My two Princesses are my life. They are my inspirations and motivations. In fact, they’re truly the brains behind The Princess Kingdom. It is through their eyes that I’m able to live my dream as a children’s fashion designer.

My TPK collection was inspired by the little girls I would randomly meet in my community. I would use my gift of photography as a form of outreach to help build confidence in little girls. I would plan free events for girls where they would wear my clothing and shoes, while being pampered by professional hairstylist, nail technicians, and makeup artist. I can’t even sum up the joy I would get when these girls would smile. The looks on their pretty faces was simply priceless. I know that this was definitely my calling.

One thing I’ve realized through my journey is that every girl just wants to feel beautiful. I believe that is through my love for fashion and children that I will continue to inspire little girls to feel like Princesses.

Shanae White Contact Information Shanae White Phone 240-431-9613 Email: ThePrincessKingdom@gmail.com Facebook: TPK ThePrincessKingdom Instagram: ThePrincessKingdom

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"In Deep Thought"

Ja'Dee Murhpy

"My Soul Speaks To Him" Good Evening Family and Friends,

I

am excited to embark on the new adventures that the new year will be providing, I want to said thanks to all once again for your continuing support and especially your encouragements, to say you all had inspirited me, wanting to be better man, human and an artist.

It is truly a blessing to have people who believes in you, as well as it's important for us to believe in ourselves. I believe that there is a greater hand in motion, that ties those spiritual connections that binds us.

We give off a glow, a light, that attracts others to us, and sometimes we don't know why, I believe that light is the power of God, a truth that is seen when others looks upon you with a smile, because they see the good in you.

We have purpose in life, a creating force that is to share what we see in our hearts, that is beautiful, wonderful, exciting and intriguing. We are passionate about our dreams, our goals, to be lifted and give thanks, the blessing to having another day. Be grateful, be humble, reaching out, to grow with grace, and not with anger or hate, but with love. A time when our world is in pain, we see the defeats, but we strive to do better, we are survivors, it is in a nature, but as we are survivors, what is it that we give back to our communities that is positive, something that we can embrace, that we all can benefit from and not just the I. The Artist in me is political, caring, devoted, claiming, daring and will seek to evoke an emotion that in effort hopes to bring enjoy, a positive knowledge for others as well as self. I would love to see peace for all men, but at this time I know we have a long way to go, but I am not giving up on that dream...I am not giving up on my people, all people!

My friends out there know who you all are, I want you to know I care about you, this is my thanksgiving, peace and love to you all, Be Amazing, because you are!

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DONNIE McCLURKIN

Duets

Click on Link to Listen to a Sample of Donnie McClurkin Duets

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Hezekiah Walker New Video "Every Praise" Click on link to watch video

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DMochelle Fashions-Kittrell of DMochelle Fashions is the featured Designer, Designs exclusively made for Breast Cancer Survivors will be on the Runway at the New York Black Expo.

New York Black Expo December 13, 2014 Time: 11:00 AM to 8:00 PM

Hotel Pennsylvania 401 7th Avenue @ 33rd Street

Across the Street from Madison Square Garden

DIRECTIONS MTA Trains: 1, 2, 3, A, B, C, D, E, N, R, Q to 34th St MTA Buses: M34 and M34A to 34th St/7th Ave NJ Transit Buses/Trains to Penn Station Discount Parking Provided By

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Keri D. Singleton Book "The Wanderer's Game"

Listen to Keri D. Singleton on FLO Empire Radio Every Monday at 8:00 PM

Click on picture to go to website 49

718-350-0172

DMochelle Fashions utilize Strike-A-Pose Studios for rehearsals as she debut her Clothing Line for Breast Cancer Women on May 31, 2014. website: www.dmochelle.com

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Brother-Michael Katlow Cox 1-347-495-8811 Facebook: katlow257 / Memorie4lifephotography Twitter: @katlow257 / @memorie4life Instagram: katlow257 LinkedIn: Brother-Michael Katlow Cox http://www.memorie4life.com

WELCOME From Brother-Michael Capturing moments also captures a Life Time Of Memories and with "Memorie 4 Life Photography" those moments are captured. Our Motto is "One Picture, One Word, Beautiful."

Brother-Michael "Katlow" Cox looks forward to helping you capture your moments for a Life Time.

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DMochelle-Fashions Kittrell Editor-In-Chief DMochelle Fashions Magazine Designer - DMochelle Fashions

Brother-Michael Katlow Cox Publishing Editor Photographer DMochelle Fashions Magazine President of Memorie 4 Life Photography

Pamela Henderson Director Of Research (20 year cancer survivor)

Mark Anthony Jenkins Director Of Marketing DMochelle Fashions Magazine CEO & President of New York Black Expo

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