Bout of Pneumonia Leads to Shocking Breast Cancer Diagnosis

DEAR DR. ROACH: My 73-year-old wife has been diligent in getting her mammograms done, plus blood tests and doctor’s visits every three months. In November 2021, she came down with what seemed like a very bad cold that was actually confirmed by X-ray to be pneumonia. After two rounds of different antibiotics, she had lost 35 pounds, and it left her with weakness and a lingering cough. A CT scan later indicated that she “either has cancer or had cancer in the past.”

Multiple tests later, it was determined that there was a tumor at the 12:00 position in her breast and a tumor in her stomach that had spread to her pelvis and bones in her legs. She started taking letrozole and Ibrance, and although extreme fatigue is the most common side effect, they appear to be working.

My question is, how could this initial breast cancer have gone undetected for some time with all of the regular testing and not set off alarms? As bad as the pneumonia was, it allowed her to receive a diagnosis of a disease that eluded detection by current screening methods and very good physicians. -- Anon.

ANSWER: I am so very sorry to hear about your wife. Breast cancer is not just one disease. We think of breast cancer as something that can be easily cured if it is found early, but if you wait too late, it becomes difficult or impossible to cure. Some breast cancers do act that way, but others are much more indolent -- they grow slowly and may never get to the point where they threaten a person’s life.

Unfortunately, there are some breast cancers that can become metastatic (spreading to different sites such as the lymph nodes, bones, liver or lungs) before they are detectable at all by even the most sensitive tests, such as a mammogram or MRI. By the time they are found, because of symptoms, they are incurable by surgery and require systemic treatments like chemotherapy and hormonal therapy.

Most metastatic breast cancer is incurable, but newer treatments have improved life expectancy, with the average being three years. Screening for breast cancer is unable to save all lives. More effective treatment, in combination with regular screening, will be necessary to continue to progress against this horrible disease.

***

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

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WORKPLACE GIFTING ETIQUETTE: GET GIVING RIGHT

Giftgivingintheworkplacecanbe challenging territory to navigate. And as anyone who has received an inappropriate gift or something that really wasn’t useful can attest, he or she probably doesn’t want to face a situation in which a gift leads to office gossip.

According to a poll conducted by Harris, around half of workers plan to gift at least one business associate around the holidays but are confused about what to give. Too often it’s up to workers to navigate these etiquette minefields on their own, but the following tips can help the process go smoothly.

Keep it impersonal. Impersonal doesn’t mean it’s acceptable to grab anything off the shelf. But the gift should not be something that wouldoffendtastesorsentiments. Avoid clothing, perfume, jewelry, or accessories. Lotions and other scented items are also ill-advised. Skip your boss. Etiquette experts say that gifts should flow downward not upward in the realm of employment ranking. That means it’s best to stick with gifting colleagues who are on the same level as you. Buying a gift for the boss may look like you’re simply trying to score brownie points instead of offering a meaningful gift.

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Adults who decide to return to school after a long layoff are following a popular path. According to the education resource Education Corner, a growing number of career colleges and vocational training schools now offer bachelor’s and graduate degree programs geared toward working adults. People return to school for various reasons, including the chance to learn new skills or further develop their existing skills. Some return to school because they are changing careers, while others may have lost a job or desire a promotion and feel that attaining a higher level of education or new skills can make reaching that goal more likely.

Adults who hope to return to schoolmightbesurprisedtolearn that the educational landscape has changed considerably since they were last in a classroom.

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DID YOU KNOW?

Howhouseholdsearntheirincome haschangeddramaticallyoverthe last several decades. According to a Pew Research Centeral analysis of the Decennial Census andAmericanCommunitySurveys integrated Public Use Microdata Sample files, in 1960 only fathers worked in 70 percent of American households. That figure has dropped in each ensuing decade and by 2012 fathers were the sole earners in just 31 percent of American households. While one in four households in American were dual income households in 1960, by 2012 that figure had risen to 60 percent. While those figures represent dramatic changes, the number of households in which mothers are the sole earners has not changed all that much since 1960. In 1960, mothers were the sole earners in just 2 percent of American households. Fifty-two years later 6 percent of American households featured mothers as the sole earners.

“Don’t be afraid to fail. Don’t waste energy trying to cover up failure. Learn from your failures and go on to the next challenge. It’s OK to fail. If you’re not failing, you’re not growing.” –H. Stanley Judd