RECONSTRUCTION QUESTIONS
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DEALING WITH THE FINANCIAL BURDEN
PAINT PINK it all
2020
Coping with
cancer A dietician shares tips from her own breast cancer journey
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Gifts with purpose By Melissa Erickson More Content Now
If you have a friend or a loved one going through breast cancer treatment, avoid the “cancer sucks” cards and travel mugs and offer your support with a gift from the heart. Grace Eleyae satin-lined knot turban $34.95 graceeleyae.com Turn up the style while covering up hair loss due to chemotherapy with a satin-lined knot turban from Grace Eleyae, a family-run, female-owned business. The comfortable jersey knit fabric and satin lining hide adjustable drawstrings. The pretend knot makes this an easy, ready-to-wear piece. The benefits of the satin lining
— eliminates bedhead, locks in moisture, fights frizz — will make this turban a go-to accessory now and later.
DoorDash $25+ Doordash.com Mom may be in recovery, but the family still needs to eat. Ease her burden with gift cards for food delivery. The best option is to buy gift cards directly from local restaurants if possible. If not, opt for a food delivery service like DoorDash that provides takeout and delivery from over 310,000 restaurants in 4,000 cities across the country.
AnaOno Miena robe $68 anaono.com Soft, pretty and comfortable, the Miena robe from AnaOno is a great loungewear piece for breast surgery and
post-reconstruction recovery. The lightweight robe is perfect for recovery days when it’s tough to pull tops on and off over the head. The silky and breathable modal fabric won’t irritate healing areas. It features a front tie closure belt and low cut armholes for comfort. Available with and without drain management belts for post-op fluids.
Mastectomy post op chest pillow $50 Pinkpepperco.com This must-have chest pillow goes underneath the arms and over the breast area to protect incision sites. Made from 100% cotton, this washable pillow is great for the entire healing process starting in the hospital bed to the ride home, where it protects sensitive areas from the seatbelt, during recovery and after.
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‘You are stronger than you think’ Dietitian and survivor offers advice from her cancer experience
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egistered dietitian Jennifer Smith of White Lake, Michigan, is not just a nutrition expert — she’s a breast cancer survivor. At 34, Smith was a healthy, busy wife and mother of three girls (ages 7, 4 and 2) building her own nutrition private practice, when she was diagnosed with stage 3 breast cancer. There was no family history of breast cancer. She endured chemotherapy, a double mastectomy with lymph nodes removed, and radiation. Experts offer solid advice, but survivors know what to expect on a daily basis. “It has been over a year since I was diagnosed and no one can prepare you for the roller coaster of physical, emotional and mental symptoms that a cancer diagnosis, treatment and even going into survivorship put you through,” Smith said. One day at a time “My general advice to people living with breast cancer
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is to take everything one day at a time,” said Smith, a breast cancer dietitian and lifestyle coach at joyenergynutrition.com. “Focus on taking care of yourself. Find support. You are stronger than you think. You can and will get through this.” From diagnosis, breast cancer can feel overwhelming. Women are quickly thrown into a world full of appointments, testing, poking and prodding, Smith said. Beneficial treatments often come with adverse side effects. “It feels like this new world you have entered will never come to an end. You feel like you are never going to make it to the other side of treatment, but I promise that you will,” she said. “Try to focus on the treatment or obstacle that you are going through at the moment instead of always looking ahead to what is next.” Take care of yourself Women and mothers often put themselves last as they are busy caring for partners and families. It can feel selfish to take
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Jennifer Smith with her husband and daughters the day before her first chemo treatment. [JOYENERGYNUTRITION.COM]
time for ourselves, even if it’s for things that will help keep us healthy like exercising or taking a mental health break, Smith said. “It’s OK if treatment side effects leave you exhausted and you spend the day resting on the couch instead of always doing. It’s OK if you let other people help you,” she said. “Learn to take the time to allow your body to heal and to lean on other people because no one can do it all themselves.” Talk to someone “Find a support group, a therapist, a Facebook group. Find someone who understands your struggles,” Smith said. “Cancer is a huge burden to take on, and sometimes you need help wading
through all the emotional and physical crap it puts you through.” Show vulnerability While others may call you a “brave warrior,” you may not feel that way, Smith said. “You don’t feel very strong or brave when you look into the mirror and see a pale, bald, scared version of yourself staring back,” she said. “You don’t feel strong or brave when you are feeling so depressed and crappy that you can’t bring yourself to get out of bed in the morning. Showing that vulnerability leads to courage and bravery and strength. “You are so, so much stronger than you know and give yourself credit for. You can and you will do this.”
“It feels like this new world you have entered will never come to an end. You feel like you are never going to make it to the other side of treatment, but I promise that you will. Try to focus on the treatment or obstacle that you are going through at the moment instead of always looking ahead to what is next.” Jennifer Smith
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By Melissa Erickson
Sunday, October 11, 2020 | Daily Press
How to deal with fears of By Melissa Erickson | More Content Now
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etter treatments and technology lead to increasing breast cancer survival rates, but many women still fear their cancer may return. “Fear of cancer recurrence is a very normal and common emotion for breast cancer survivors,” said registered nurse Lawana Evans, a cancer survivor who is an oncology nurse navigator with Thompson Cancer Survival Center in Knoxville, Tennessee, part of Covenant Health. “There is never a 100% guarantee that the cancer will not return, so it is very natural to worry about recurrence at some point.” Defined in the literature as “the fear
that cancer may return or progress in the same place or another part of the body,” fear of recurrence is one of the most common concerns that breast cancer patients report, even months and years after completion of surgery and treatment, said Jean-Philippe Laurenceau, professor in the department of psychological and brain sciences at University of Delaware. Laurenceau is leading an interdisciplinary team of researchers from University of Delaware and the ChristianaCare Helen F. Graham Cancer Center and Research Institute in Newark, Delaware, to examine how the fear of cancer recurrence affects the well-being and relationships of breast cancer patients and their spouses or partners.
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Debunking common myths
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associated with breast cancer
ancer claims the lives of millions of people across the globe every year. But the fight against cancer is anything but hopeless, as the World Health Organization notes that between 30 and 50 percent of all cancer cases are preventable. Learning about cancer is one of the best ways for people to protect themselves from this deadly disease. Researchers continue to
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learn more about cancer everyday and routinely discover that information once thought to be accurate was actually off-base. Despite researchers’ best efforts, some myths about cancer still prevail. Some of these myths are about cancer in general, while others refer to specific cancers, including breast cancer. Myths about breast cancer can be as harmful as accurate information is helpful, so learn-
ing the truth and debunking those myths can be an important part of women’s preventive approach to breast cancer. • Myth: Drinking milk increases your risk for breast cancer. The American Cancer Society notes that early studies raised concerns that drinking milk from cows treated with hormones could increase a person’s risk for breast cancer. However, ensuing research
failed to find a clear link between the two. In fact, a 2002 study published in the International Journal of Epidemiology found no significant association between dairy fluid intake and breast cancer risk. • Myth: Lumps indicate breast cancer. The National Breast Cancer Foundation, Inc.® says that only a small percentage of breast lumps turn out to be cancer. However, abnormalities or changes in breast tissue should always be brought to the attention of a physician. • Myth: Mammograms cause breast cancer to spread. This myth is rooted in the incorrect notion that breast compression while getting a mammogram causes the cancer to spread. However, the NBCF insists that cannot happen. In fact, the National Cancer Institute touts the benefits of mammograms while the ACS recommends women between the ages of 45 and 54 get mammograms every year. For additional breast cancer screening guidelines, visit the ACS at www.
cancer.org. • Myth: Women with a family history of breast cancer are likely to develop breast cancer, too. This myth is dangerous because, if taken at face value, it can give women with no family history of breast cancer a false sense of security. However, the NBCF notes that only about 10 percent of individuals diagnosed with breast cancer have a family history of the disease. The Centers for Disease Control and Prevention note that a woman’s risk for breast cancer is higher if she has a first-degree relative, including a mother, sister, daughter, or even a male family member, who have had the disease. But breast cancer can affect anyone, regardless of their family history. Information is a valuable asset in the fight against breast cancer. Learning to decipher between accurate and false information can be especially valuable.
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Impact on others
Give it time
“Breast cancer not only affects the person involved, but has a significant impact on the family or support team,” Evans said. “It interferes with normal activities that you once enjoyed. Goals and plans for your life may change after a cancer diagnosis. It makes long-term planning difficult because you are unsure of your future. Fear can become overwhelming and all-consuming if you allow it.” Intrusive thoughts and worries can significantly impact daily life. Signs that clinical intervention would be warranted include excessively checking the body for signs or symptoms of cancer, avoiding people or places that remind one of cancer, or having persistent thoughts of death, Laurenceau said. “A normal ache or pain also can cause distress and fear for a survivor,” Evans said. “Another anxiety trigger is hearing about someone with a similar diagnosis who has relapsed or passed away. It is also very normal
“Immediately after treatment, there was not a day that went by that I did not think about recurrence,” Evans said. “I worried that every ache or pain might be cancer. But after eight years, there are weeks that go by when I do not think about my cancer. I can have a normal headache without wondering if it is cancer. Time heals.” Sharing helps. Join a support group, Evans said. Check with your treatment team for a list of common signs of recurrence, Laurenceau said. “Do what you can to decrease the chance of recurrence: Follow-up with routine monitoring and appointments, eat a healthy diet and exercise regularly, eliminate risk factors such as smoking, and consider joining a cancer survivorship program if available in your community,” Evans said. “Most health behavior changes are more sustainable when patients do them with a supportive significant other,” Laurenceau said.
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to be anxious prior to scans, blood tests, follow-up appointments or around a particular date of significance in your cancer journey.” Sharing your fears with a partner can help because it promotes normalization of the fears and produces social support and
intimacy, Laurenceau said. “Talking about fears can also engender a sense of ‘we-ness’ between survivors and partners that can reduce the feelings of aloneness many breast cancer patients experience at various points in the survivorship trajectory,” he said.
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Cancer journey essentials By Melissa Erickson More Content Now
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ach woman’s breast cancer journey is unique, so what they deem essential can range from kind words of encouragement to a surgery prep kit filled with comfy clothing. “There are actually two essential things a woman needs going through breast cancer treatment: One is a network of friends and the other is a diary,” said Dr. Steven Quay, founder of Seattle-based Atossa Therapeutics.
“Research has shown that an average of nine friends and family are recruited to accompany women to their treatments during the entire course. Schedules and emotional exhaustion for the friends is why you need a big group.” Recording a daily diary is an essential exercise that offers both spiritual and medical benefits. “Questions will come up in the middle of the day and if you don’t write them down immediately to ask your health care provider at your next visit, you will just forget them,” Quay said.
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Sunday, October 11, 2020 | Daily Press
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Find a walking buddy
“Breast cancer treatment is not one size fits all. In the age of precision medicine, your team of doctors and care providers will recommend the plan that best fits your cancer, your life and your needs.”
“No matter how difficult your treatment, it’s almost always possible to go for regular walks, and so much more pleasurable to do so with a friend even if you have to stay six feet apart,” said Meg Hirshberg, founder of Anticancer Lifestyle Program. “It’s ideal to walk in nature, but even during city strolls, you will get the benefits of exercise and fresh air, as well as the camaraderie and support that come from sharing time with a friend.”
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Dr. Anjali Malik, a radiologist at Washington Radiology
because it can be painful for women to lift their arms, Cristine said. Robes and kimonos won’t irritate sore areas. Shirts and tops with handy compartments make it easier to access chemo ports or store drain ports. Blankets and wraps are handy because treatment side effects may cause a patient’s body temperature to fluctuate, she said.
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Look for personalized treatment Choose a cancer home that can offer personalized care and access to clinical trials, said Dr. Justin Favaro, owner of Oncology Specialists of Charlotte, Pennsylvania. “Every case is different, so going with someone who has access to the best treatments gives you the best shot,” he said. Take a team approach “Breast cancer treatment is not one size fits all. In the age of precision medicine, your team of doctors and care providers will recommend the plan that best fits your cancer, your life and your needs,” said Dr. Anjali Malik, a radiologist at Washington Radiology, with locations in the D.C. Metro area. A good team can help keep you up-to-date with the latest scientific advances. For example, it’s a myth that consuming soy products increases the risk of developing breast cancer. “Soy consumption has been shown to decrease recurrence in breast cancer survivors,” Malik said.
Sunday, October 11, 2020 | Daily Press
Cheer her on
Create a comfortable space
Simple things make a big difference, said Caitlin James, who was diagnosed with invasive ductal carcinoma in 2018 and is ongoing maintenance treatment. “My mom would come over and make dinner sometimes, and not having that pressure of worrying about dinner made such a difference. My aunt would send me letters in the mail. Little things like that that let you know people are cheering for you is really important,” James shared through The Patient Story (thepatientstory. com). “It’s important for your mental health, but I also think it’s important for your physical health, too. Going through chemotherapy can feel really isolating and lonely. Having your caregivers around really helps you through the process both physically and mentally.” Dress for recovery Essential clothing items can make treatment and post-surgery recovery much more comfortable, said Mary Cristine, creator of Chic Cancer Couture
Cancer treatment can be intensely exhausting, said Rachel MadorHouse, a certified genetic counselor with Ironwood Cancer and Research Center in Scottsdale, Arizona. “Creating a cozy and relaxing resting environment can be a way to make treatments easier,” she said. Invest in soft sheets, soft lighting and unscented candles. Consider taking up a new hobby like meditation. “Some people find that playing soft classical music or listening to the sounds of waves can help them find relaxation during their treatments,” Mador-House said.
A loose-fitting T-shirt with internal drain management pockets would be an essential clothing item in recovery. [AMAZON]
(chiccancercouture.com). Women want loose fitting clothing that zips, snaps, ties or buttons
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The costs of
CANCER By Melissa Erickson | More Content Now
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THE VITAL ROLE OF A CANCER SUPPORT NETWORK
he moment a person is diagnosed with cancer can elicit a variety of emotions. Fear of what’s to come is a common reaction to such a diagnosis, and some people may feel alone upon learning they have cancer. But no cancer patient should face their diagnosis and treatment alone. In fact, a strong support network can be vital to patients’ recoveries. According to Weill Cornell Medicine, recent changes in the healthcare industry have shifted the burden of care from the hospital to the home. That underscores the importance of a strong support network. Many of the challenges cancer patients face in the months after diagnosis will be new, and patients can expect a range of emotions. According to
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he financial cost of breast cancer can be staggering, even for those who have good health insurance. The most common form of cancer except for skin cancer, breast cancer will kill an estimated 42,170 women in the United States this year and an estimated 279,100 will be diagnosed, according to the American Cancer Society. About 1 in 4 will have to borrow money, go into debt or file for bankruptcy to pay for treatment, according to a 2019 report from the U.S. Centers for Disease Control and Prevention. “Unfortunately, the costs of any complex treatment are a burden on Americans, irrespective of insurance,” said Dr. Derek Raghavan, president of the Levine Cancer Institute, Charlotte, North Carolina.
Breast Cancer Now, a charitable organization that funds one-third of breast cancer research in the United Kingdom, women may experience emotions such as shock, anger, disbelief, anxiety, and sadness after being diagnosed with breast cancer. Having loved ones there to help them make sense of those emotions and stay positive as they navigate their way through the treatment process is essential. In addition to providing emotional support, loved ones of breast cancer patients may need to take on additional roles as they help their friends or family members face the challenges that lay ahead. Because of the industry changes noted by Weill Cornell Medicine, cancer caregivers and
support networks may need to prepare themselves to take on the following roles, each of which is vital to cancer patients’ survival. • Monitor the disease: Support networks may need to keep track of how their loved ones’ disease is progressing and if there are any complications from treatment. • Manage symptoms: Breastcancer.org notes that treatment causes severe side effects in many women. Such side effects may include nausea/vomiting, diarrhea, constipation, pain, arm swelling, shortness of breath, and skin irritation. Thankfully, most of these side effects can be treated. In addition, Breastcancer.org notes that most side effects ease up after treatment is completed. In the meantime,
support networks may need to help patients manage those symptoms, performing a host of tasks to make their loved ones’ lives easier. For example, patients experiencing shortness of breath may be incapable of performing chores around the house. In such instances, members of a support network can tackle those chores until their loved one bounces back. • Administer medication: Breast cancer patients may be too overwhelmed to handle their own medications, so support networks can take over this important responsibility for them. • Assist with personal care: Some patients may experience fatigue after treatment. In such instances, support networks
can help patients maintain their personal hygiene. Support networks can be vital to helping cancer patients overcome their disease and navigate their way through successful treatment regimens.
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“Any kind of cancer is a big hit financially. If you have great health insurance it’s less of a burden, but breast cancer affects women and their families in significant ways financially,” said Mark Pilon, executive director of Susan G. Komen Los Angeles. Insurance almost never covers all costs, said Raghavan, referring to time away from work, transportation, babysitting and co-pays that can be substantial, especially with some newer drugs and treatments. “Even with great insurance deductibles alone will be a big hit, $1,500 to $5,000 before treatment even starts,” Pilon said. Complex care leads to financial hardship for many people. “Transportation issues can have a significant impact on breast cancer patients undergoing radiation who must come from a distance daily for a period of weeks to receive treatment. For rural patients this becomes even more of a challenge where public transportation will not travel outside of county lines or there is no public
transport system,” Raghavan said, Even if a woman has insurance she often must navigate various tactics insurance companies may use to avoid paying, such as very complex precertification forms, fine-print limitations to reimbursement that may not be clear when patients sign up, and health insurance running out, Raghavan said. “We are recently seeing women with new plans on the market that advertise coverage at an affordable/ appealing cost for lower income earners, only to find that actual treatment is not covered, only screening,” Raghavan said. Unexpected extras such as complications of care with hospitalization and blood tests that are not covered by insurance often emerge, Raghavan said. Because of side effects women also need to purchase personal items that are not considered essential and, more often than not, fall outside insurance parameters. For example, a woman coping with alopecia during treatment may want to purchase a
Unexpected extras such as complications of care with hospitalization and blood tests that are not covered by insurance often emerge.
wig but she may not have the $375 or more it costs out of pocket. The American Cancer Society recommends that at age 40 women begin getting screened annually for breast cancer, but for some women basic screenings can be a financial hardship, Pilon said. “If breast cancer is diagnosed early women have good overall survival, but the cost of a screening can be prohibitive for some women,” Pilon said. Without insurance a mammogram can cost $100 or more depending on where a woman lives. “Screening is generally available to women with insurance, although the U.S. Preventive Services Task Force has set age limits that prevent younger women from being screened by many programs,” Raghavan said.
“For uninsured women it can be a huge issue, as many states do not provide coverage.” For example, in the Charlotte, North Carolina, region, a great deal of mammographic screening is supported purely by philanthropy, as the state and county have essentially run out of resources to provide mammography for all eligible and appropriate women, Raghavan said. “For women near the poverty line, they simply cannot afford the cost of mammography,” he said. COVID-19 is only making things worse, as screenings were deemed elective early on in the pandemic, which will lead to later detection and more costly treatment, Pilon said. The Affordable Care Act provides free mammograms every one to two years for women 40 and over. The Susan G. Komen Foundation and the National Breast Cancer Foundation provide free and low-cost breast cancer screenings across the country. Find out more at komen.org/breastcancer-helpline.html and national breastcancer.org/our-programs.
Is 3D mammography right for you? ward signs or symptoms. It also may be used to help diagnose the cause of a breast mass or nipple discharge. Doctors may suggest 3D imaging to get a better look at any growths or help identify the source of any symptoms a person may be concerned about. Two-dimensional mamA 3D mammogram, also called mograms are still the industry ammograms take images of digital tomosynthesis, takes sev- standard. The 3D versions are breast tissue to determine eral different X-rays of the breasts obtained in a similar fashion by the presence of abnormalities, pressing the breasts between two and combines those images to including lumps. Women may imaging plates. Rather than just establish a three-dimensional undergo traditional, 2D mammograms, but increasingly many picture. The Mayo Clinic says that taking images from the sides and top to bottom, the 3D version will a 3D mammogram is typically healthcare facilities are now take multiple angles to make a employing 3D technology because used to search for breast cancer digital recreation of the breast. in people who may have no outit can provide clearer pictures.
Medical News Today says this enables doctors to look at small, individual sections of the breast tissue that may be as thin as just a single millimeter. A study published in the journal JAMA Oncology says cancer detection rates are higher in people who do 3D imaging over time. Three-dimensional mammograms can be useful for women with dense breast tissue or those at higher risk for breast cancer. Although experts at MD Anderson Cancer Center advise any woman who needs a mammogram to get the 3D version. However, 3D mammography may not be cov-
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ered by all insurance plans. It’s important to note that a 3D mammogram releases the same amount of radiation as a traditional mammogram. It is of no greater risk to the patient, and it is approved by the Food and Drug Administration. Also of note, because 3D mammograms produce more images, it may take a radiologist a little longer to read one than it would a 2D mammogram. Three-dimensional mammograms are an option for women screening for breast cancer.
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with autoimmune issues may not react well to tissue expanders and breast implants. The type of reconstruction may also be a limiting factor especially if a woman is undergoing further treatment like radiation, which may delay reconstruction, Jones said. “Women with stage 4 metastatic disease may be better served by conserving her body’s energy to fight disease,” Chen said. Implants vs. autologous reconstruction
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What to consider before
reconstruction By Melissa Erickson | More Content Now
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uestions abound for women considering breast reconstruction surgery. The most important include now versus later and the choice between breast implants or autologous reconstruction, using a woman’s own tissue. Whichever decisions a woman makes about her surgical options, it’s imperative that she understands what to expect from the surgery, recovery and how her new breast will look and feel, said Dr. Constance M. Chen, board-certified plastic surgeon and breast reconstruction specialist in New York City. How to find a specialist Most surgeons work in a cohort and will refer a patient to a plastic surgeon for breast reconstruction, said plastic and reconstructive surgeon Dr. Nicholas Jones, Nip & Tuck Plastic Surgery, Atlanta. Reach out to friends for word-of-mouth referrals if needed, he said. Visit breastcancer.org and various breast cancer
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support groups such as Young Survivors Coalition or Facing Our Risk of Cancer Empowered, Chen said. “Not all plastic surgeons do all types of breast reconstruction, and many will steer you to the techniques that they are capable of performing,” she said. Women should do their own research. Look online and speak with as many other patients who have gone through techniques that they’re interested in as possible, Chen said. The Women’s Health and Cancer Rights Act guarantees that health insurance must cover breast reconstruction in connection with mastectomy/ lumpectomy whether done immediately or years later, Jones said. A good candidate The best candidates for breast reconstruction are healthy non-smokers without significant underlying medical concerns, Chen said. Diabetics and women with a body mass index of over 30 may have a higher incidence of wound healing problems and infections, she said. Women
Implants are easier and quicker operations that only involve the chest, but some women are concerned about the long-term safety, Chen said. “There is no donor site and no additional scarring or healing. On the other hand, implants are a foreign body and will often need to be changed over time,” she said. Complications like painful capsular contracture and infection are relatively common, especially over time, Chen said. Autologous reconstruction uses a woman’s own tissue to create a soft, warm breast that looks and feels like her original breast. It is much bigger surgery that involves other parts of the body as donor sites and requires more healing and scarring upfront, Chen said. “Older techniques that involve sacrificing muscle may also be more painful and compromise the donor site. Newer microsurgical techniques that spare the muscle are less painful and preserve the donor site, but take longer and require access to a surgeon who does or even specializes in microsurgical breast reconstruction,” Chen said. With these newer techniques autologous reconstruction may be significantly better than implants, especially in the long term. “The reconstructed breasts will be soft, warm and living and will grow and shrink with the woman’s body. Unlike implants, autologous reconstruction is permanent, although the results can be and often are tweaked in subsequent surgeries to adjust size, shape, symmetry and overall outcome,” Chen said. Risks “Breast reconstruction, like any surgery including mastectomy, is trauma to the body and will cause inflammation and require healing,” Chen said. Be sure to ask about the risks and benefits of each option, including how reconstruction or implants will interfere with chemotherapy and radiation as well as how long it will take to recover. “Before allowing someone to cut into your body and permanently alter it, it is worth it to do your research and ask a lot of questions. In the right hands, breast reconstruction is a restorative operation that can significantly improve a woman’s health and life,” Chen said.
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Using diet and exercise to prevent breast cancer
hen it comes to breast cancer risk, some things are beyond a person’s control. Women might not be able to do much in regard to their genetic makeup and family history, each of which can elevate their risk for breast cancer, but many risk factors are within women’s control. A healthy diet and routine exercise may help women reduce their risk of developing breast cancer, while poor lifestyle choices can increase that risk. For example, being overweight is a strong risk factor for breast cancer for women who are 18 and older, advises Stanford Health Care. Even 10 percent weight gain (or 15 pounds on a 150-pound woman) increases breast cancer risk as well as the risk of recurrence. Diet and exercise can play a pivotal role in reducing breast cancer risk, and it’s important for women to understand just how much good healthy diets and routine exercise can do for them in regard to fighting breast cancer.
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• Stanford Health Care says some studies suggest limiting dietary fats in the diet, particularly those that come from animals, to reduce breast cancer risk. These include butter, fullfat dairy, poultry skin, and fatty meats. Reducing intake of dietary fats, especially animal fats, may protect against diseases sensitive to hormones, like breast cancer. • Data from the Women’s Healthy Eating and Living study suggests that soy consumption from whole foods and soy milk for any breast cancer type is probably safe, despite public perceptions. Avoid soy supplements and concentrated soy that comes in many soy protein powders until more about their effects is known. • The American Cancer society links alcohol consumption to a higher risk of various cancers, including breast cancer. The more alcohol a person drinks, the higher his or her cancer risk. The ACS recommends no more than one drink per day for women and two for men.
A five-ounce glass of wine is considered one drink. • Susan G. Komen® says a high body mass index has been associated with increased risk for postmenopausal breast cancer. Exercise may help reduce risk by altering metabolism, hormones and breast density. • Inflammation is an immune system response to injury or illness. However, when inflammation is chronic, it can damage DNA and lead to cancer, advises the National Cancer Institute. Deep marine fish; dark, leafy green vegetables; bright, multi-colored vegetables; black teas; and spices like turmeric can help fight or prevent inflammation. • The ACS recommends adults get at least 150 minutes of moderate-intensity or 75 minutes of vigorousintensity activity each week (or a combination), preferably spread throughout the week to keep body weight in check. • Stanford Health Care says consumption of high amounts of sugar can increase insulin levels and
result in weight gain, each of which can lead to breast cancer. Limit intake of sugary snacks and refined carbohydrates, opting for healthy alternatives such as fruit, vegetables, beans,
whole grains, dairy, and soy milk. Diet and exercise is vital to overall health and can help women reduce their risk for breast cancer.
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What to know about
Magseed markers By Melissa Erickson More Content Now
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new and more accurate option in breast cancer surgery called Magseed is giving women better outcomes, with fewer needing repeat surgeries because their cancer wasn’t completely removed. Before a lumpectomy, a tumor must be precisely marked. Traditionally that has been done with a wire, which can move before surgery and lead to surgeons missing cancerous tissue. FDA-approved for breast localization since 2016, Magseed changes the way a tumor is located and marked. Smaller than a grain of rice, magnetic and made from medical grade stainless steel, Magseed can be placed into a tumor any time before surgery. It is not radioactive.
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The Magseed is a tiny magnetic marker (detail shown above) implanted with a needle (top image) that is used to accurately mark a tumor for surgeons to detect and remove as completely as possible using a Sentimag probe. [ENDOMAG IMAGES]
Once implanted Magseed stays and a breast cancer survivor. in place. On the day of surgery the The wire is externally exposed, magnetic marker is detected with a which can be distressing to see for handheld magnetic wand. Known as the patient, and runs the risk of being a Sentimag, the wand can pinpoint bent, dislodged or moved out of place the location of the while the patient is Magseed within the waiting for surgery, [Magseed] is simpler body to a millimeter in Peled said. two ways, by numeriand more effective than “Taking away the the traditional guidecal count and audio experience of [placwire-based localization ing] the wire on the tone. It is simpler and methods, which have day of surgery removes been in use since the more effective than the anxiety for women. mid-to-late 1970s. traditional guide-wireIt allows them to just based localization focus on the procedure methods, which have itself,” she said. been in use since the Because it’s more mid-to-late 1970s. The wire method precise, the Magseed method often requires a woman to arrive about two removes less breast tissue than with hours earlier and necessitates sched- wires. uling coordination between radiol“The wire, when you think about ogy and surgery, said Dr. Anne Peled, it, is almost barbaric. You’re walka breast, plastic and reconstructive ing sound the medical center with a surgeon practicing in San Francisco wire sticking out of you,” said Peled,
a mother of three young children and triathlete who had no family history of breast cancer. Placing the Magseed is easy, fast and efficient, less invasive and more effective in marking, she said. Doctors estimate that 20% to 40% of women who have lumpectomy to remove early-stage breast cancer need to have more surgery later because their cancer wasn’t completely removed the first time, according to Breastcancer.org. Rates of second surgery for Magseed are between 6.5% and 12.5% compared to the wire. “This is a dramatic benefit. Women want a successful procedure,” Peled said. The Sentimag system has been used to treat more than 90,000 women around the world, and is used in over 450 hospitals across 35 countries.
Sunday, October 11, 2020 | Daily Press
What to expect O
after cancer treatment ends
nce the initial shock of a breast cancer diagnosis wears off, many patients are ready to get down to business and begin treatment. Based on data collected by the SEER database, which is maintained by the National Cancer Institute, five-year survival rates for breast cancer in the United States are excellent. If the cancer is localized or regional (spread to nearby structures or lymph nodes), the survival rate is 99 percent and 86 percent, respectively. If the cancer has spread to distant parts of the body, the five-year survival rate is 27 percent. These survival rates underscore the importance of early detection and treatment. Treatment may induce feelings of anxiety among patients. Equally scary can be what to expect after treatment ends. Here’s a closer look at what comes next. After surgery If treatment involves surgery for a lumpectomy or mastectomy, patients will move to into the recovery room after surgery to wake up from anesthesia. BreastCancer.
Sunday, October 11, 2020 | Daily Press
org says if you are feeling any pain, now is the time to speak up, as staff in the recovery room assess your pain and vital signs. Many surgeries are completed on an outpatient basis. However, more invasive surgeries that involve lymph node dissection require a hospital stay. Doctors will set up a schedule of follow-up care to check surgical sites and monitor healing. Radiation or chemotherapy may be used in conjunction with
surgery and may continue even after surgery. After chemotherapy Chemotherapy causes an “enormous assault” on the body, according to Marisa Weiss, MD, founder of Breastcancer.org. Many of the hurdles that people feel post-treatment are lasting fatigue. WebMD says a phenomenon called “chemo brain” can occur. This is a mental change characterized by an inability to focus and memory deficits.
In addition, after chemo ends, it may take up to six months for hair to start to grow back, and hair that grows back may be a different color and have a different texture. After radiation The American Cancer Society says side effects from radiation may vary depending on the patient. Extreme fatigue is often noted, and such feelings may come and go. Some people experience
skin changes in the radiation treatment area. The skin may appear red, irritated, swollen, or blistered. Over time, the skin may become dry, itchy or flaky. Depending on certain types of radiation treatment, radioprotective drugs may be offered to help protect certain normal tissues. Follow-up Doctors will prescribe a regimen for follow-up care. Every few months women may expect a visit at first. The longer you have been cancer-free, the fewer follow-up visits will be required. Mammograms on any remaining breast tissue will be scheduled between six and 12 months after surgery, and annually thereafter. Bone density tests and blood and imaging tests also may be recommended if you are taking certain medications or have physical indicators that the cancer might have come back. Getting back on track after breast cancer treatment can take time. Eventually, life can return to normal, especially for patients with a good support team in place.
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