BREAST CANCER AWARENESS OCTOBER 2019 | A1
Breast Cancer
AWARENESS GUIDE
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A2 | BREAST CANCER AWARENESS OCTOBER 2019
In Honor Of...
May 25, 2020 is my 5 year mark. It’s when the doctors and researchers say your chance of recurrence drops significantly. It’s when we can breathe again...live again. But I’ve got news for breast cancer. I had it; it never had me. I remember the day vividly...and all the days, tests, and procedures leading up to that day. My best friend came over to help keep my mind off the call that we knew would be coming. Dr. Margenthaler would be calling with my pathology results. News that would take me to my knees. There are so many details that I’d like to write about but I know space is limited. Let’s just say that me and my cancer threw those doctors every curve ball we could. Incorrect initial diagnosis...Her2 positive (very aggressive) BRCA2 positive...first chemo literally almost killed me. My family says I was a trooper. I never lost my smile or my positivity or my will to fight. I had an indescribable faith that God would see me through. Here it is...almost 5 years later. Cancer changed me. It made me realize and appreciate that even small things in life are important. It has softened my heart in ways and hardened it in others. I’ve lost friends and gained new ones. My body has changed in many ways. Cancer took my breasts but it did not win. I’m still here...enjoying life and family. I’d be lying if I said that every oncology appointment didn’t bring some anxiety and apprehension. But I have peace in my heart that no matter what happens in the future, my God, my family, and my friends will be by my side!! -Angi Akins, Ironton, Mo
ing the Great Depression, was high school valedictorian, was married to the love of her life (Robert Eaton) and raised 7 wonderful children. She was an artist and avid reader with a quick wit. - From those who love you still.
In Loving memory of Edie Glauser. After a valiant and graceful battle with cancer she returned to her Father in Heaven’s arms on February 12, 2005. - Eydie Kerfoot LE Simply Healthy Skin My name is Kelley Man- ion. I’m 48, and live in Park Hills. I found out a couple month’s before turning 40 that I had invasive ductal adenocarcinoma breast cancer. I’m an eight year survivor! In March of 2011, I found a walnut size lump. With in a week, I had been to the doctor, had my mammogram, ultrasound and biopsy. One of the hardest parts for me, was hearing the radiologist say “ I guess you know, you have breast cancer.” I cried for 2 days, and had enough of that. I had to be strong for my kids. One was a junior in high school, and the other would be starting kindergarten. Chemo, radiation, and treatments were pretty easy. Having a good attitude is the key! I had faith in my doctors, family and friends. It’s not easy having a double mastectomy, reconstruction, and remembering how you used to look, but knowing I’m happy and alive is all I need. Some women and men aren’t that fortunate, but I thank God for keeping me here. -Kelley Manion., Park Hills
tremely difficult time did Sue give up hope. She was still the spunky and sassy woman that her family knew and loved. “Sue is one of the strongest women I know and not one time during her fight did she ever ask for pity or expect anyone to change how they treated her. She kept calm and knew that this was a fight she was going to win. I was lucky enough to be by her side in the hospital the morning of the surgery and see her come out that afternoon. She even joked with me not long after.” - Maddi (her great great niece) When a loved one is battling cancer they need to remember they are not alone. Their families, other survivors and the community are there to support them in any way they can. -Brandi Petrie Being the daughter and niece of the women who impact my life the most, I would have to say it was a very hard time for me and my family. Seeing my mom and aunt go through having breast cancer truly tested me. At every moment of my life during that time I prayed for fast healing for them both. I knew that they were strong and would get through it, however not knowing the for sure outcome had me in every kind of emotion. I am truly blessed to say I still have them in my life and to say I thank god every day for that. I will always support breast cancer awareness because it has been a huge part of my life. I honor all the men and women who have won the fight as well as the ones who have sadly lost the battle against the viscous disease.
In memory of Jaquie Jean (LogsSue Alcorn was diagnosed two -Anonymous den) Eaton who left us too soon on years ago with Breast Cancer. She July 21st, 2007. She was born dur- had a lump removed not long after the diagnosis and has since made a full recovery. She still has regular With all of our love and support to Grandmother of Amanda, checkups to make sure that she is all affected by breast cancer. Co-Founder Harold’s Famous Bee Co. cancer free. Her family was right -Daily Journal next to her through the whole journey. Not one time during this ex-
Mary Agnes Juliette February 3, 1929 - September 5, 2004
In Memory Of Jaquie Jean (Logsden) Eaton Born August 25, 1932 Died July 21, 2007
To honor the strength and courage of those that have fought, or are still fighting breast cancer and their families.
From the McFarland Family
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BREAST CANCER AWARENESS OCTOBER 2019 | A3
The Reach of Breast Cancer About 3.5 million women are living with breast cancer in the United States, and more than 12% of women will be diagnosed with breast cancer in their 573-783-3381 1-800-392-4711 lifetimes. www.brec.coop
Did you know that breast cancer is the second most common cancer in women? Or that men can get breast cancer? Or that, when caught and treated early, many types of breast cancer have almost a 100% cure rate?
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tized to other organs, the treatment of which has a 99% fiveyear survival rate. Breast cancer, like all types of cancer, doesn’t have a lot of easy answers about what causes it or what people can do to lessen their chances of developing a tumor. However, researchers have identified some contributing factors. A family history of cancer is a big one. Women whose grandmothers, mothers or sisters had breast cancer should talk to their doctors about effective testing techniques at an earlier age than is normally recommended. Other possible factors include having dense breast tissue; exposing breast tissue to estrogen because of late menopause, never giving birth, early menstruation or being older at the birth of a woman’s first child. Taking hormones also may contribute. Health factors like alcohol use and obesity also may contribute to cancer risk for all cancers. We don’t know how to prevent cancer, but there are steps women can take that are thought to reduce the risk of breast cancer; these protective factors include estrogen-only hormone therapy after a hysterectomy, healthy eating and exercise and other lifestyle factors.
Breast cancer — which occurs when breast cells grow out of control, form a tumor and become malignant — affected more than 250,000 people in 2018, according to the National Cancer Institute. About 3.5 million women are living with breast cancer in the United States, and more than 12% of women will be diagnosed with breast cancer in their lifetimes. The number of deaths from breast cancer is 20.6 per 100,000 women per year; the death rate among all cancers (men and women) is 163.5 per 100,000 people, so breast cancer has a much higher rate of survival. It typically responds very well to treatment; almost nine out of 10 women treated for breast cancer are alive five years after their diagnoses. The success Supporting the Fight for a Cure of treatment is heavily dependent on how Lost Cove On The Square early in the cancer’s Kevin and Mariea Tate development it’s diagOwners nosed; more than 60% 573-366-7779 102 West Russell marieatate56@yahoo.com Virgin Oils and Balsamic of cases are found in Vinegar, Essential Oils,Teas the early stages of canDiffusers, Shirts, Lilarose and Unique one of a kind items cer, before it’s metastaWe will be closed from Oct. 12th to Nov. 6th
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It affects our mothers, sisters, wives and friends. It affects people of every age, sex and race, and is the leading cancer among white and African-American women. This October, National Breast Cancer Awareness Month, pink is everyone’s color. Increasing Breast Cancer Awareness, One Person at a Time... Early detection can save lives, and mammograms are the most important tool in diagnosing breast cancer. There is no cure for breast cancer, but mammograms can save lives by finding breast cancer as early as possible. Every woman, beginning at age 40, should schedule a mammogram and a physical every year. Women should also perform a thorough breast self-exam once a month. Help spread awareness in your community by educating your neighbors and friends on the signs and symptoms of breast cancer, and encourage the women you know to schedule a mammogram today.
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A4 | BREAST CANCER AWARENESS OCTOBER 2019
What to Watch For
Since early diagnosis plays such an outsized role in successfully treating breast cancer, people should know what signs to look for and what the screening process will like when you go to the doctor. Symptoms
According to the American Cancer Society, the most common symptom of breast cancer is a new lump or mass in the breast that wasn’t previously there. A mass that is painless and hard and has irregular edges is more likely to be cancer, but malignant tumors can be soft, tender, round or painful. When you find a new lump, go to the doctor. This means women need to know what their breasts look and feel like, so regular self-exams are beneficial. Other possible symptoms include swelling of the breast, skin dimpling or irritation, breast pain, nipple retraction, pain or discharge or the skin of the breast or nipple turning red, scaly or thick. Breast cancer also can manifest in swollen nodes in the armpit or around the collarbone.
Screenings
During your annual physical, your doctor will examine your breasts and lymph nodes for changes. This will typically be the first step even when you go in knowing something has changed. Breast tissue can change with time;
women develop cysts, and menstruation and menopause can affect tissue as well. Your doctor also will ask you about your family history with all types of cancer, but particularly breast, uterine and ovarian cancers. Based on the exam and discussion, she may decide further testing, such as an ultrasound, is needed. In an ultrasound, the doctor is able to isolate the affected area and get a visual of sorts of the lump; its size, shape, density and other factors
How does breast cancer affect your bones?
exercise, as physical activity plays a vital role Did you know that breast cancer treatments in maintaining healthy bones. To stay active could affect patients’ bone density? Indeed, both chemotherapy and hormone therapy des- without draining too much energy during tabilize bone marrow and weaken bones in ad- treatment, prioritize low-impact activities such as walking. dition to reducing ovarian function and, Lastly, consult your healthcare team for supconsequently, levels of estrogen (a hormone that contributes to the development of healthy port! Your doctor, nurse, pharmacist, nutritionist and physiotherapist can all provide vabones). It’s estimated that women who unluable advice on how to better care for your dergo breast cancer treatment lose between bones, both during and after treatment. There two and four per cent of their bones’ calcium within the first year of treatment. (This loss is are also tests that measure patients’ bone deneven more apparent in premenopausal sity and evaluate the risk of developing osteowomen.) Furthermore, bone deterioration acporosis. If needed, certain types of medication celerates in women already experiencing oscan help strengthen bones and prevent degeteoporosis. nerative disease. Make sure to get informed! Therefore, if you’re currently undergoing treatment or are about to start, make sure to adopt a well-balanced diet rich in calcium (milk, cheese, lentils, vegetables, etc.) and vitamin D (egg yolks, fish, liver meat, etc.). Calcium is essential for maintaining strong, healthy bones, while vitamin D allows your bones Breast cancer treatments could to better absorb calyour bones — consult cium. It’s equally im- weaken your healthcare professionals portant to get enough for preventive advice!
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can help her determine if this is a tumor or a cyst or just a change in fatty breast tissue. Another screening is a mammogram, which is an X-ray that can find tumors that aren’t felt with physical exams. These are recommended for all women 40 years old and older, but women who are at higher risk may start them earlier. In addition to tumors, mammograms can find small calcium deposits that are a sign of breast cancer.
How to communicate your emotional state following diagnosis People diagnosed with breast cancer often find it difficult to express how they’re feeling for several reasons: discomfort, fear of upsetting loved ones, anger, etc. However, keeping your emotions bottled up inside consumes a great deal of energy that would be better used to fight the illness. Sharing your feelings could help you manage stress and provide you comfort in a time of need. Therefore, whenever you’re ready: • Talk to someone with whom you feel comfortable. If it’s too difficult to speak to a loved one about your diagnosis, consider joining a support group. • Don’t be afraid to cry or experience intense emotions like anger. Remember, there’s no right or wrong way to feel following a cancer diagnosis. • Try to describe how you’re feeling in simple terms to facilitate the conversation and allow the person you’re communicating with to better understand your mindset. If you’re having trouble formulating what you’re feeling, just say so. • Don’t fear silence — it’s actually an effective coping mechanism. And if you’re usually one for jokes, don’t hesitate to use humour to help dissolve tensions when confronting difficult situations. Is talking about your diagnosis too painful? Writing (emails, poems, etc.) and making art (sculpting, painting, etc.) are equally constructive when it comes to self-expression. Lastly, if you’re tired of constantly having to repeat yourself, ask someone to be your spokesperson and deliver personal messages or status updates about your condition on your behalf.
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BREAST CANCER AWARENESS OCTOBER 2019 | A5
Breast Cancer Treatment
For the most part, breast cancer is quite treatable. Much of its treatability depends on what stage the cancer is when diagnosed — the earlier, the better. The National Cancer Institute, a branch of the National Institutes of Health, lists several options for treatment — surgery, radiation, chemotherapy and hormone or targeted therapy. Sometimes, surgery is all that’s needed; in other cases, cancer patients may need several of these types of treatment to fight the tumor.
SURGERY
Almost all people with breast cancer will require surgery. Patients may get a lumpectomy, in which the tumor, other affected tissue and the surrounding normal tissue are arrived. In the early stages of cancer, this may be sufficient. For more advanced cancer, a total mastectomy, or removal of the entire breast that is infected with cancer, or a double mastectomy may be required. Many patients with one or both breasts removed opt for follow-up reconstructive surgery after treatment. Breast cancer often spreads to
lymph nodes first, so removing some of those nodes may be necessary. Doctors may opt to remove the first lymph node to receive drainage from a tumor, known as a sentinel lymph node, since that is where cancer is likeliest to spread. RADIATION AND CHEMOTHERAPY Chemotherapy, which pumps heavy drugs into the body to slow or stop the growth of cancer cells, can be used before surgery to shrink a tumor or after surgery to kill any cancer cells still in the body. Done before surgery, this can lessen the amount of tissue that needs to
be removed. Radiation, in which X-rays are used to destroy cancer cells, can be used after surgery. Both treatments have been shown to help people survive cancer, but they also serious and harmful side effects on the patient.
Hormone therapy gets rid of hormones, which can cause breast cancer to grow, so reducing the production of hormones like estrogen or stopping them from feeding the cancer can help to destroy cancer cells still in the body. Targeted therapy uses drugs to HORMONE AND TARGETED target specific cancer cells without hurting healthy cells; this can THERAPY Both of these treatments are used include antibodies, which deliver after surgery with the purpose of cancer-fighting drugs to the cankilling any remaining cancer cells. cer cells instead of attacking
Fertility preservation and breast cancer treatment Hearing the words “You have breast cancer” can trigger a whirlwind of emotions, especially among women of childbearing age who still want to grow their family. Cancer treatments risk leaving women infertile; however, ongoing research into fertility preservation methods is increasingly offering cancer survivors the possibility of having biological children post-treatment.
Oncofertility is a field of medicine that explores and expands options for the reproductive future of cancer survivors.
October is Breast Cancer Awareness Month. Sponsored by the National Breast Cancer Foundation and the American Cancer Society, this annual health campaign aims to raise awareness of the causes and consequences of the disease and provide women across America with the information and support they need to have the life they’ve always dreamed of. HOW DOES TREATMENT AFFECT FERTILITY? A woman needs an adequate number of healthy eggs in her ovaries to get pregnant naturally. These eggs are all made before she’s born and spontaneously die with age; however, invasive drugs and forms of treatment can damage and kill eggs prematurely (e.g. chemotherapy) or delay pregnancy, giving eggs time to age naturally (e.g. hormone therapy). FERTILITY PRESERVATION OPTIONS If you’re a young woman recently diagnosed with breast cancer, your doctor may recommend the following courses of action to ensure a bright reproductive future:
• In vitro fertilization (IVF). Colloquially referred to as the “test tube baby” technique, IVF stimulates the growth of eggs, collects them and fertilizes them in a test tube to create embryos, which are later implanted in the woman’s uterus. • Frozen embryo transfer (FET). FET is a cyclical treatment that involves thawing frozen embryos from previous IVF cycles
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The American Society of Reproductive Medicine (ASRM) has found that for women less than 35 years old, frozen eggs have just as good a chance at creating life than frozen embryos. (or a donor) and transferring them back into the woman’s uterus. FET is considered the most effective fertility preservation strategy to date; however, women who are single or not yet married may feel more comfortable freezing eggs that haven’t yet been fertilized with their partner or an anonymous donor’s sperm.
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A6 | BREAST CANCER AWARENESS OCTOBER 2019
Breast Cancer’s Emotional Toll
Both the cancer and treatment take a hard toll on the body, leading to fatigue, nausea, lowered immunity and many other symptoms. But it also takes a mental toll, both on the person with cancer and his or her family and friends.
The American Cancer Society talks about how people fighting breast cancer often find themselves overwhelmed with emotion, including depression, anxiety, fear and other feelings of distress. Even after successful treatment, survivors may feel stress and worry. The ACS says many people are concerned the cancer will come back, or they still feel or see physical effects from the treatment, including surgery scars and other changes to their body, or effects on other parts of life, such as altered relationships or missing out on opportunities at work. Cancer is also an expensive disease, leading to financial worry. Breast cancer can bring with it specific emotional
issues. Mastectomies mean women’s bodies look dramatically different, and they may not like their new look or may struggle to get accustomed to it. Survivors often worry about changed sexuality after breast cancer; this is even more pronounced in young women who have gone through treatment. They worry about the effects of the cancer and subsequent treat-
ments on their fertility. Chemo also has been connected to early menopause in some women. Family members, friends and caregivers also may experience many emotions, along with worry that they can’t help a loved one or don’t know what to do. According to the ACS, treatment for these emotional issues during and
after treatment are critical for overall good health. Many hospitals or cancer treatment centers offer support groups for survivors and family members; talk to your oncologist or primary care provider about connecting with one of those groups, or ask for a referral for a counselor who specializes in such issues. Churches can often be a source of support for peo-
ple, while others prefer to join an online support group. For people with questions or who want general support, the ACS’ Reach to Recovery program matches people in treatment with a local volunteer who had breast cancer who can provide answers, offer support and help make cancer treatment be a less isolating experience.
Breast Cancer in Men
Breast cancer occurs in breast tissue, which both women and men have. Although it’s rare, male breast cancer does happen.
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It’s diagnosed and treated similarly in all genders, so early diagnosis remains key. The science around the cause of male breast cancer is unclear, according to the Mayo Clinic, same as most types of most cancer, though male breast cancer is even more mysterious. People of all genders are born with some breast tissue and milk-producing glands (lobules) that transport milk to the nipples and fat. When a girl hits puberty, she develops more breast tissue, and boys do not. Boys, however, do still have the breast tissue with which they were born. The most common type of breast cancer in men is ductal carcinoma, which begins in the milk ducts. Just as with women, there is research indicating a family history of breast cancer increases the likelihood of a man getting the disease. Gene mutations like BRCA2 (the same mutation actress Angelina Jolie had that put her at a high risk of breast cancer) increases a man’s risk of breast cancer and prostate cancer. Older age remains a risk factor, as does exposure to estrogen, obesity or liver or testicular disease. Men who are born with Klinefelter’s syndrome, a genetic condition in which some boys have more than one copy of the X chromosome, also increase a man’s likelihood of contracting breast cancer. Early diagnosis and treatment is critical for best outcomes in male breast cancer, which can be harder since it’s not always the first condition tested for, so knowing the symptoms is important. These include a painless lump in or thickening of the breast tissue, changes to the nipple (redness, scaling or turning inward) or nipple discharge or changes to the skin covering the breast area. Men who see these symptoms should ask their doctor for further assessment. According to the Mayo Clinic, diagnosis and treatment is similar to what women experience: clinical breast exams, medical imaging that enables the doctor to see problem areas, or a biopsy, during which the doctor extracts tissue from the suspected tumor and tests it. Male breast cancer is often hormone-related, so doctors may recommend hormone therapy in addition to surgery, chemotherapy and radiation. 00 1
BREAST CANCER AWARENESS OCTOBER 2019 | A7
A breast cancer diagnosis is scary, and often patients don’t know what to ask when their doctor tells them what’s happening.
Questions to Ask
Although you have a cancer treatment team and you’ll have opportunities to ask questions at subsequent appointments, it can be helpful to have an idea of what you need to know as you go to follow-up appointments and meet other care providers. Don’t be afraid to ask your doctor about their experience treating this type, getting a second opinion and any detail you don’t understand. This can help you not only get the information you need but also take some measure of control over your life during a difficult time. The American Cancer Society has lists of questions to help you.
• How long should I expect treatment to last? • What side effects will I experience? WHEN YOU’RE DIAGNOSED • What treatment do you recommend/what • How big is the cancer? Where exactly is the regimen would you do if you were diagnosed with tumor? this type of cancer? • Has it spread to lymph nodes or other organs? • Are clinical trials an option? Should I look at • What stage is it? What does that mean? that? • Who else will be on my treatment team? • Will I lose my hair? How will treatment affect • How much will this cost? What does my my daily life? insurance cover? Is there a patient advocate who • What happens if this treatment doesn’t work? can help me through the financial side of this? • How will we know if the treatment is working? BEFORE AND DURING • Are there ways to manage side effects? TREATMENT • What lifestyle changes should I make during • What are my options for treatment? What are treatment — a different diet or exercise regimen, the positives and negatives of each?
for example? • If I experience depression or anxiety, what resources are available?
SURGERY
• What type of surgery is best for me? • Should I consider a full mastectomy, even though the cancer hasn’t spread? • How long will recovery take? How much of that will be in the hospital versus at home? • What will happen during recovery? Will I have stitches or staples, will there be a drain coming out of the site? • What are my options for breast reconstruction? What are the risks?
Visiting someone with breast cancer? Keep this in mind When visiting someone with a serious medical condition — like breast cancer, for example — we sometimes do or say the wrong thing, despite our good intentions. If you’re looking to bring someone comfort in their time of need, follow these pieces of advice: • Always call before your visit, even if the rendezvous was planned. It’s possible that the person may not be well enough or in the mood for visitors. Should this be the case, don’t take offense and suggest another day for your visit instead. • Always be willing to lend an attentive ear. Mute your cellphone and don’t interrupt. Let them talk freely and respect their moments of silence. Avoid giving medical advice or comparing their situation to someone else’s. And no matter what you do, don’t pretend to understand how they’re feeling (unless you’ve been diagnosed with cancer yourself) or say that everything will be alright. Instead, ask them how
they’re feeling and let them know you’re there to help, however that may be. • Remember that it’s your presence that counts; you’re not obligated to uphold a conversation. If neither of you feels like talking, consider doing an activity together instead like watching a movie curled up on the couch. Furthermore, acts of compassion like a warm embrace often speak louder than words. • Lastly, don’t exhaust your host by overstaying your welcome. You could also take advantage of your visit to offer more
concrete support like accompain the process — your own health nying your ailing friend to their and well-being are just as impordoctor’s appointment, preparing tant. their meals, taking them shopping, etc. Better yet, why not organize an outing to the movie theatre or spa to help them clear their mind, if only temporaPUBLIC TRANSPORTATION FOR ANYONE! rily? However you 700 East Highway 72 • Fredericktown, MO 63645 choose to offer your support, try not to ex800.273.0646 haust yourself email: contactus@ridesmts.org • www.ridesmts.org
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Breakthroughs
Because it is so common, many scientists study breast cancer, looking for causes, better diagnosis and treatment options and even a cure.
The National Cancer Institute shared some of the latest breakthroughs in breast cancer research, including clinical research that could lead to improved care at every stage of cancer treatment. Clinical trials are often available for prevention, screening and treatment; ask your doctor for options.
Assessment tools must be measured in terms of their effectiveness not only in finding malignant tumors but in not creating false positives, i.e. telling a woman she has cancer when she doesn’t. This procedure is being tested for that effectiveness.
TREATMENT
Breast cancer can be divided into subgroups DETECTING that affect the way doctors treat them, using specific hormone therapies to target cells. A BREAST CANCER Breast cancer already is one of the easi- study on patients with an estrogen receptor est-to-find cancers; mammograms and cancer found a test that looks at certain genes other imaging tools are effective and wide- can help some women safely avoid chemo. ly used in identifying and diagnosing The Food and Drug Administration has tumors. Scientists are looking for ways to approved several breast cancer treatments that enhance the current options available for target specific cell-growth molecules, and breast cancer screening, such as 3D mam- more of these treatments are being developed. mography, a procedure that takes pictures There have been advances in the treatment from a variety of angles around the breast of hormone receptor-positive advanced breast cancer that have been shown to proand then builds a 3D-like image. long the time until chemo is needed, possibly extend survival and prevent relapse. In HER2-positive breast cancer (HER2 is a protein; elevated levels are found in some women with breast cancer), the FDA has approved a number of therapies that show positive effects in treating this type of cancer, preventing a relapse or keeping the disease from spreading to the brain.
OTHER RESEARCH
Researchers also are looking at the effectiveness of screening across communities, why black women are more likely to be diagnosed with aggressive forms of breast cancer and are more likely to die of breast cancer than white women as well as issues related to breast cancer survivors, including their continued physical and mental health, sleep disturbances, financial impacts and more.
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