OCTOBER 2021
A Special Supplement to
BREAST CANCER AWARENESS
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OCTOBeR 2021
Early warning signs for breast cancer
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reast cancer affects millions of women across the globe every year. According to the World Health Organization, breast cancer is the most frequent cancer among women, affecting 2.1 million women each year. As daunting as that may seem, the WHO also notes that early diagnosis can greatly reduce a woman’s risk of dying from breast cancer. Women can be proactive in the fight against breast cancer by learning to identify early warning signs of the disease. The nonprofit breast cancer advocacy organization Susan G. Komen® notes that the warning signs for breast cancer are not the same for all women, but the most common signs include a change in the look or feel of the breast or a change in the look or feel of the nipple. A discharge from the nipple is another common warning sign of breast cancer. Physical changes in the breast can vary, but Susan G. Komen® advises women who notice these changes to bring them to the attention of their physicians immediately: ≥Lump, hard knot or thickening inside of the breast or underarm area ≥Change in the size or shape of the breast ≥Swelling, warmth, redness or darkening of the breast ≥Dimpling or puckering of the skin
Women with breast cancer also may notice physical changes in their nipples, including: ≥Itchy, scaly sore or rash on the nipple ≥Pulling in of the nipple or other parts of the breast It’s important that women recognize that physical changes in their breasts are not necessarily indicative of breast cancer. In fact, the American Breast Cancer Foundation notes that not all lumps in the breast cause cancer and that many such lumps are benign. Fibroadenomas and intraductal papillomas are examples of benign lumps, though it’s important to note that even benign conditions such as these may put women at greater risk of developing breast cancer. Susan G. Komen® notes that breast tissue naturally has a lumpy texture. If lumpiness can be felt throughout the breast and it feels like your other breast, then it’s likely that this is just the normal texture of your breasts. However, women concerned by a lump or lumpy texture are urged to discuss those concerns with their physicians immediately. Discharge from the nipple is another potential sign of breast cancer, but Susan G. Komen® notes that such discharge is rarely a sign of cancer. Discharges that occur without squeezing the nipple, occur in only one breast or are bloody or clear are potentially indicative of more serious conditions, including breast cancer. Breast cancer is a formidable foe. But women who arm themselves with knowledge of the disease, including its early warning signs, are in better position to overcome it.
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BREAST CANCER AWARENESS
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DID YOU KNOW? A 2017 study published in the journal Cancer Epidemiology, Biomarkers and Prevention found that about one-third of women diagnosed with metastatic breast cancer in the United States live at least five years after diagnosis. Also known as stage IV breast cancer, metastatic breast cancer is the most advanced stage of the disease. Metastatic breast cancer refers to breast cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body. Patients diagnosed with breast cancer also should know that improved treatments may further their chances of surviving a diagnosis, even a diagnosis of metastatic breast cancer. In fact, the American Cancer Society notes that survival rates are based on women who were diagnosed and treated at least five years earlier. In the time since those survival rates were documented, treatments could have advanced even further, potentially improving the five-year survival rates for metastatic breast cancer.
The risk factors for breast cancer N
o two women are the same. But when it comes to breast cancer, women from all walks of life share various risk factors for a disease that the World Health Organization indicates is the most frequent cancer among women. Risk factors are anything that affects the likelihood that individuals will get a certain disease. In regard to breast cancer, the American Breast Cancer Foundation notes that various factors, some that result from lifestyle choices and others that are not changeable, can increase a woman’s risk of developing breast cancer. Recognizing these risk factors can help women make any necessary changes and even highlight the importance of routine cancer screenings that can detect the presence of the disease in its earliest, most treatable stages.
Lifestyle-related risk factors
The ABCF notes that certain habits or behaviors can increase a woman’s risk for breast cancer. But the good news is that women who understand the link between certain habits or behaviors and breast cancer can avoid those behaviors to decrease their risk of developing the disease. According to Breastcancer.org, the following are some habits, behaviors or lifestyle choices that can increase a woman’s risk for breast cancer. ≥Alcohol consumption: Breastcancer. org notes that researchers have uncovered links between the consumption of alcoholic beverages and hormone-receptor-positive breast cancer. One study found that women who consume three alcoholic beverages per week have a 15 percent higher risk of developing breast cancer than women who don’t drink at all. And while research into the connection is limited, a 2009 study found a link
between alcohol consumption and breast cancer recurrence. ≥Sedentary lifestyle: Exercise consumes and controls blood sugar and limits blood levels of insulin growth factor. That’s an important connection, as insulin growth factor can affect how breast cells grow and behave. A sedentary lifestyle also can increase a woman’s risk of being obese, which the ABCF notes is a risk factor for breast cancer among postmenopausal women. ≥Smoking: Smoking has long been linked to cancer, and Breastcancer.org notes that smoking has been linked to a higher risk of breast cancer in younger, premenopausal women.
Unchangeable risk factors
Unfortunately, many risk factors for breast cancer are beyond women’s control. For example, the ABCF notes that roughly two out of three invasive breast cancers occur in women age 55 and older. Women cannot change their ages, but recognizing the link between age and breast cancer risk is important, as such a recognition may compel more women 55 and older to prioritize cancer screening. Gender and family history are two additional unchangeable risk factors for breast cancer. Women are much more likely to get breast cancer than men. In addition, Breastcancer.org notes that between 5 and 10 percent of breast cancers are believed to be caused by abnormal genes that are passed from parent to child. Women are not helpless in the fight against breast cancer. Knowledge of breast cancer, including its various risk factors, is a great weapon against it as women look to reduce their risk of developing the disease.
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Symptoms of
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MALE BREAST CANCER
reast cancer is one of the most common forms of cancer diagnosed among the female population. Though breast cancer may seem like a disease that’s exclusive to women, breast cancer can affect men as well. While they have a smaller concentration than women, men have breast tissue, which means it’s possible for them to develop breast cancer. Male breast cancer is most common in older men, but it is important that men recognize that the disease can strike them at any age.
Signs and symptoms
Men with breast cancer experience symptoms that are similar to those experienced by women. Possible signs to be aware of include: ≥skin dimpling or puckering ≥a lump or swelling, which is typically (but not always) painless ≥nipple retraction ≥redness or scaling of the nipple or breast skin ≥discharge from the nipple, which may be clear or bloodtinged
The American Cancer Society advises that sometimes breast cancer can spread to the lymph nodes under the arm or around the collar bone and cause a lump or swelling in these locations. The protrusion may be noticeable even before the original tumor in the breast is large enough to be felt. Men should realize that enlargements or issues affecting both breasts (not on just one side) typically is not cancer. Enlargement or changes to both breasts in men can be caused by weight gain, medications or heavy alcohol consumption.
Types of male breast cancer Various types of breast cancer can affect men, according to the Mayo Clinic: ≥Ductal carcinoma: Cancer that begins in the milk ducts. Nearly all male breast cancer is ductal carcinoma. ≥Lobular carcinoma: Cancer that begins in the milk-producing glands. This type is rare in men because they have few lobules in their breast tissue. Especially rare types of breast cancer that can occur in men include Paget’s disease of the nipple and inflammatory breast cancer.
October 2021
Diagnosis BreastCancer.org says that a small study of breast cancer in men found that the average time between first symptoms and diagnosis was about 19 months. This can be startling because early diagnosis can be vital to survival. Through the realization that breast cancer can happen to men and more education and awareness, men can feel more comfortable about discussing changes to breast tissue with their doctors. Male breast cancer is a very real occurrence, albeit a rare one. It is important that men take any abnormalities in their chests seriously.
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Menstrual history and breast cancer risk
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Is 3D mammography right for you? M ammograms take images of breast tissue to determine the presence of abnormalities, including lumps. Women may undergo traditional, 2D mammograms, but increasingly many healthcare facilities are now employing 3D technology because it can provide clearer pictures. A 3D mammogram, also called digital tomosynthesis, takes several different X-rays of the breasts and combines those images to establish a three-dimensional picture. The Mayo Clinic says that a 3D mammogram is typically used to search for breast cancer in people who may have no outward 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 mammograms are still the industry standard. The 3D versions are obtained in a similar fashion by pressing the breasts between two imaging plates. Rather than just taking images from the sides and top to bottom, the 3D version will take multiple angles to make a digital recreation of the breast. 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 covered
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.
arious factors can affect a woman’s risk for breast cancer. Some of these factors, including whether or not a woman is physically active, are within her control. But others are not, and those include when a she started to menstruate. According to Breastcancer.org, women who started menstruating prior to age 12 have a higher risk of developing breast cancer later in life. But that’s not the only link between menstruation and breast cancer risk, as women who go through menopause when they’re older than 55 years of age also have a higher risk of developing breast cancer later in life. Breastcancer.org notes that, over the last two decades, girls have begun puberty at younger ages than girls in previous generations. Researchers have linked that phenomenon to the obesity epidemic and broad exposure to hormone disruptors. A rise in hormones triggers the onset of puberty. The breast tissue of girls who begin menstruating at a younger age tends to be
immature and sensitive to hormonal influences, which is associated with a higher risk of breast cancer later in life. Women may not be able to control when they start and stop menstruating, but they can control certain factors that can make them less likely to menstruate early. Breastcancer.org notes that maintaining a healthy weight, exercising regularly and eat-
ing nutritious foods are some lifestyle choices that girls and women can make to keep their risk for breast cancer as low as possible. Various factors can increase a woman’s risk of developing breast cancer. Understanding the link between those factors and cancer risk can help women make healthy decisions that benefit both their shortand long-term health.
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The role of staging when diagnosing breast cancer
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cancer diagnosis can be overwhelming, and people who receive such news may be flooded with a wide range of emotions. When delivering such a diagnosis, doctors share vital information about their patients’ disease. Those details can go a long way toward easing patients’ concerns. Staging is an important component of cancer treatment. The National Cancer Institute notes that stage refers to the extent of the cancer, including how large the tumor is and whether or not it has spread, or metastasized. Learning the stage of the cancer, which is typically expressed on a scale of 0 through IV, helps doctors understand how serious the cancer is and the patient’s chances of survival. Staging also is used to plan treatments and potentially identify clinical trials that may serve as treatment options. The American Joint Committee on Cancer oversees the breast cancer staging system and utilizes the TNM system. Breastcancer.org notes that three clinical characteristics, referred to as “T, N, and M,” are used to calculate the stage of the cancer: ≥the size of the tumor and whether or not is has grown into nearby tissue (T) ≥whether the cancer is in the lymph nodes (N) ≥whether the cancer has spread, or metastasized, into other parts of the body beyond the breast (M) Additional characteristics were added to the AJCC’s TNM breast cancer staging system in 2018. Though
BREAST CANCER AWARENESS
October 2021
Various factors that could affect breast cancer treatment
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this has made determining the stage of breast cancer more complex, Breastcancer.org notes that it’s also made staging more accurate. That improved accuracy increases the likelihood that doctors will choose the most effective treatment plan for their patients, which should ease those patients’ concerns as they begin treatment. Staging is complex, and patients should know that staging alone does not dictate prognosis. The following breakdown, courtesy of the NCI, is a brief description of the five stages of cancer (stages O through IV). A more detailed description of breast cancer stages can be found at https://www.breastcancer.org/symptoms/ diagnosis/staging. ≥Stage 0: This is diagnosed when abnormal cells are present but have not spread to nearby tissue. Stage 0 is also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer. ≥Stages I through III: Cancer is present in these stages. The higher the number, the larger the tumor is and the more it has spread into nearby tissues. ≥Stage IV: The cancer has spread into distant parts of the body. Staging plays an important role in treating cancer. Recognizing the role of staging can help patients better understand their disease and the direction of their treatments. More information about staging is available at www.cancer.gov.
reatment for breast cancer is often successful. For example, data from the American Society of Clinical Oncology indicates that the five-year survival rate for women diagnosed with non-metastatic invasive breast cancer is 90 percent, while the average 10-year survival rate for such cancers is 84 percent. Those figures reflect advancements in treatment and the effectiveness of campaigns designed to encourage women to receive routine breast cancer screenings as part of their preventive health care regimens. Once doctors have diagnosed breast cancer, they will consider a host of factors as they try to determine a course of treatment. ≥Stage: The National Breast Cancer Foundation, Inc. notes that treatment options depend on the stage of the disease at the time of diagnosis. Stage is usually expressed in a numerical value between 0 and IV, with 0 being the least severe form of the disease and IV being the most advanced (i.e., metastatic). ≥Tumor size and location: The Cleveland Clinic notes that the size and location of the tumor also affects how doctors will approach treatment. In general, the smaller the tumor, the more easy it is to treat the disease. Where in the
breast the tumor is located also will affect the treatment plan. Doctors often employ a combination of treatments such as chemotherapy, radiation and surgery to treat breast cancer, and such an approach may be more likely to be employed if the tumor is large. ≥Pathology tests: Pathology is the science of causes and effects of diseases. When treating patients for breast cancer, doctors order pathology tests so they can better understand how the disease is affecting their patients’ bodies. For example, the Cleveland Clinic notes that pathology tests like hormone receptor tests and human epidermal growth factor receptor (HER2/neu) can indicate if hormones or growth factors are helping the cancer grow. The results of these and other pathology tests can then help doctors determine an effective course of treatment. ≥Personal characteristics: Doctors will consider women’s age, general health and family history when mapping a course of treatment. In addition, doctors discuss menopause with women when determining a course of treatment. Breastcancer.org notes that some breast cancer treatments can bring on menopause more abruptly than it would happen otherwise, so doctors will consider women’s history with menopause when determining treatment.
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Breaking down breast cancer surgeries D
octors will discuss a host of treatment options upon diagnosing a patient with breast cancer. The course of treatment is ultimately determined by various factors, including the stage of the disease at the time of diagnosis. Doctors and patients now have more treatment options than ever before, and many women confronting breast cancer will undergo a combination of treatments en route to beating their disease. The National Breast Cancer Foundation, Inc.® reports that surgery is the most common form of treatment for breast cancer. Surgical procedures vary, and the following rundown can help women understand their options.
Lumpectomy The NBCF notes that a lumpectomy procedure typically removes the least amount of breast tissue necessary to get the tumor out. Surgeons Additional procedures also will remove a small amount or margin of surrounding tissue, but not Doctors may need to perform some additional procedures after breast the breast. The American Cancer Society notes that a lumpectomy is classified as a breast-conserving surgery. The NBCF describes a lumpectomy cancer patients undergo a lumpectomy or mastectomy. In such instances, as the least invasive breast cancer surgery and notes that the procedure doctors may remove and examine lymph nodes to determine if the cancer has spread and to what extent it has spread. The NBCF notes that a senis highly effective. tinel lymph node biopsy is performed so doctors can examine the lymph node closest to the tumor, as this is where cancer cells are most likely Mastectomy to have spread. Identifying the sentinel lymph node involves injecting Surgeons remove the entire breast during a mastectomy. The online dye or radioactive substances into the tissue. The lymph nodes that are medical resource Verywell Health notes that there are reasons for and most susceptible to cancer will be marked by the dye or substances inagainst getting a double mastectomy, and some women who must have jected. Doctors may perform an axillary node dissection, which involves one breast removed also have the other healthy breast removed. There the removal of the axillary lymph nodes located in the underarm. Lymph are various types of mastectomies, including skin-sparing mastectomy, nodes do not always need to be removed, but doctors will often conduct simple mastectomy, modified radical mastectomy, and partial mastecto- a sentinel node biopsy or an axillary node dissection when performing a my. Each type is different, and what’s recommended to one patient may lumpectomy or mastectomy. not be recommended to another. Doctors who recommend mastectomy Surgery is the most common treatment for breast cancer. Women dican break down each option so patients can make the most informed agnosed with breast cancer can discuss the pros and cons of common decision possible. surgeries as they begin their fight against their disease.
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October 2021
WHAT ARE CLINICAL TRIALS? Breast cancer treatments are highly effective, which is one reason why the National Cancer Institute can report that the fiveyear survival rate for non-metastatic breast cancer is 90 percent. However, in certain situations, doctors may feel that the existing standard for breast cancer treatment may not be enough to help women overcome their disease. In such instances, doctors may discuss clinical trials with women battling breast cancer. The American Cancer Society defines clinical trials as research studies in which people volunteer to help doctors find ways to prevent or treat disease. The National Breast Cancer Foundation, Inc.® points out that all current standards of treatment began as clinical trials. However, that does not mean women diagnosed with breast cancer should automatically sign up to participate in clinical trials. There are pros and cons to participating in clinical trials, and breast cancer patients can speak with their medical teams about the advantages and disadvantages of each trial they’re considering. One myth worth dispelling is that clinical trials are only an option for people who have been diagnosed with advanced stage cancer. In fact, the NCI notes that clinical trials are available for all stages of cancer. A database of NCI-supported clinical trials can be found at https://www.cancer. gov/about-cancer/treatment/clinical-trials/search.
HORMONE THERAPY is an option to treat breast cancer H ormone therapy is one of the many types of treatment used in the fight against breast cancer. Hormone therapy helps address breast cancers that are affected by hormones like progesterone and estrogen. With such cancers, the breast cancer cells have receptor proteins that attach to estrogen and progesterone to help the cancer cells grow. Hormone therapy treatments, also called endocrine therapy, help stop the hormones from attaching to receptors. The therapy also can decrease the body’s production of certain hormones. The Mayo Clinic says
hormone therapy is only used for breast cancers that are found to have receptors for estrogen or progesterone. Doctors refer to these types of cancers as estrogen receptor positive (ER positive) or progesterone receptor positive (PR positive). Doctors who specialize in analyzing blood and body tissue will study a sample of cancer cells to see if they have receptors for estrogen or progesterone. It is important not to mistake hormone therapy for breast cancer with menopausal hormone therapy, which is sometimes called hormone replacement therapy, advises the National
Cancer Institute. With menopause treatments, progesterone and estrogen may be used to relieve symptoms of menopause. Cancer hormone treatment does the opposite. The therapy blocks the growth of ER or PR positive breast cancer cells. Typically, drugs are used to stop estrogen and progesterone from helping breast cancer cells grow; otherwise, drugs or surgery will be used to keep the ovaries from making these hormones. Radiation therapy aimed at the ovaries also may help stop hormone production. Various drugs may be used during the course of
hormone therapy. These include aromatase inhibitors that block estrogen production. Other drugs called selective estrogen receptor modulators bind to estrogen receptors to prevent estrogen from attaching to cancer cells. The NCI notes that research has shown that adjuvant hormone therapy after surgery for ER-positive breast cancer causes reduced risks of breast cancer recurrence, including new breast cancer in the other breast, for at least five years. Sometimes hormone therapy can be used to prevent breast cancer in women who are at increased risk of developing the disease.
The Mayo Clinic says that an oncologist will determine the type of hormone therapy that will be right for a particular type of receptor positive breast cancer. There are some side effects of hormone therapy that depend on the type of treatment. Hot flashes, night sweats, vaginal dryness, mood
swings, loss of libido, and risk of blood clots may be possible. Doctors can weigh the risk between the benefits and side effects of hormone therapy. In addition to chemotherapy, radiation and surgery, hormone therapy may help some patients overcome a breast cancer diagnosis.
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October 2021
Don’t Put Off Life-Saving Mammograms
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By TRINITY HEALTH
f you’ve delayed getting a mammogram during the coronavirus pandemic, you’re not alone. The Centers for Disease Control and Prevention (CDC) reports that breast cancer screenings in the U.S. including mammograms, ultrasounds, and MRIs, dropped sharply this past year, with one study putting the decline at 87% for breast cancer screenings. In rural areas, the drop was even greater – 89%. Barriers to care included temporary suspension of breast screening services due to COVID-19 and fear of COVID exposure. Jim Coffin, Administrative Director of Trinity Health’s Radiology and Imaging Department, says delayed care due to the pandemic has been a concern. “It’s impossible to know how many people delayed getting a mammogram,” Coffin said. “We know that people put things off, and that’s important because our radiologists find breast cancer every single week with
screening mammography. If patients skipped a mammogram or a younger woman reached the age of eligibility and didn’t get their first mammogram, then part our population didn’t get the care they needed.” As COVID-19 cases subside and vaccination efforts continue, healthcare providers are encouraging patients to prioritize their health and seek timely treatment. The American College of Radiology says a resurgence of COVID-19 and its delta variant has caused some mammography sites in the country to again reduce daily appointments, but that hasn’t happened at Trinity Health, according to Coffin. Trinity has instituted COVD-19 safety protocols to help ensure that women can safely get their yearly mammograms. “Women were smart to ‘play it safe,’ but now playing it safe means continuing to schedule your mammogram. Missed appointments can lead to delayed cancer diagnoses, unnecessary breast cancer deaths, and more aggressive treatment. That
shouldn’t happen,” he adds. Nearly all breast cancers can be treated successfully if found early. The most effective method of detecting breast cancer at an early, treatable stage is the yearly mammogram. The American College of Radiology and Society of Breast Imaging recommend that women start getting annual mammograms at age 40, and even earlier if they are at a higher risk. Coffin says breast tomosynthesis (tomo), also known as 3D mammography, has proven to be a revolutionary screening and diagnostic tool to improve the early detection of breast cancer. It has provided radiologists the ability to detect breast cancer even in dense breast tissue with amazing precision. “We’re now able to find and treat cancer at an earlier stage,” he said. But a comprehensive breast imaging program requires more than mammography. Coffin says Trinity Health has invested in the full range of advanced technologies to catch cancers as early as possible. Ultrasound
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is offered, of course, and this past year, Trinity Health upgraded its breast MRI program with a 3T breast MRI coil to provide even better service to patients and community. Now, breast cancer that is difficult to see on dense breast tissue can be better evaluated by radiologists. “The challenge now is to implement strategies to get people to return to care,” Coffin said. “We need to emphasize how important screening is and let people know that measures are being taken to ensure their safety.”
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October 2021
DID YOU KNOW? Though most breast cancer survivors don’t get cancer again, the American Cancer Society notes that they are at higher risk for getting some types of cancer. According to the ACS, the most common second cancer in breast cancer survivors is another breast cancer. That only underscores the importance of continuing to get screened even after successful treatment. In addition to a second breast cancer, breast cancer survivors have a greater risk of developing salivary gland cancer, cancer of the esophagus, stomach cancer, colon cancer, uterine cancer, and ovarian cancer. The risk for thyroid cancer, sarcoma, melanoma of the skin, and acute myeloid leukemia also is greater after successful treatment for cancer.
Symptoms that may arise after cancer treatment
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he road to recovery from cancer can be long. Though millions of cancer survivors across the globe have recovered and gone on to live happy, full lives, many of those survivors face myriad challenges along the way, including symptoms that can linger or even first appear long after treatment has ended. According to the Memorial Sloan Ketting Cancer Center, a majority of cancer survivors indicate it takes between six and 12 months after completing chemotherapy before they feel like themselves again. During that six- to 12-month period, and potentially even beyond that, cancer survivors may experience an assortment of symptoms.
≥Fatigue: Fatigue is one of the most common side effects patients feel during cancer treatment, but it doesn’t always go away once treatment ends. The Dana-Farber Cancer Institute notes that fatigue is one of the most common complaints survivors have during the first year after treatment. Doctors and researchers have yet to figure out why fatigue can linger after treatment ends, though the DFCI recommends various strategies to help survivors combat post-treatment fatigue. One such strategy includes planning days in advance so survivors can be active at the times of day when they generally feel most alert and energetic. In addition, short naps between activities and a regular sleep schedule may help combat fatigue.
≥Pain: Pain is another symptom that often arises both during and after cancer treatment. Many cancer survivors have reported feeling skin sensitivity, pain or numbness in the hands and feet and pain in a missing limb or breast after treatment ends. Doctors may prescribe medications, physical therapy, acupuncture, and or even surgery to help cancer survivors overcome post-treatment pain.
≥Swelling: The DFCI notes that some cancer survivors experience lymphedema, a type of swelling caused by the buildup of lymph fluid. Lymphedema typically affects the arms or legs, and may affect the body right after surgery or months or years after treatment. Lymphedema can cause significant pain. Doctors may recommend various strategies to combat lymphedema, including eating a high-protein, low-salt diet. Some cancer survivors develop lymphedema after an insect bite, so doctors may advise patients to be especially vigilant in regard to protecting their arms and legs from insect bites as well as cuts and sunburn.
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≥Dental issues: The DFCI indicates that dental issues often affect people who have been treated for cancer. Radiation to the head and neck can cause issues with teeth and gums, the lining of the mouth, the glands that make saliva, and jawbones. Dry mouth, cavities and jaw stiffness are just a few of the conditions that can arise from treatment-related dental issues. Consultations with a dentist can help cancer survivors overcome these issues, though the DFCI warns that some may never go away. Cancer survivors may experience various symptoms shortly or long after treatment ends. Survivors can work with their physicians to overcome these symptoms as they continue on their road to recovery.
October 2021
BREAST CANCER AWARENESS
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How to reduce risk of breast cancer recurrence
The road to recovery continues after cancer treatment ends
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he American Cancer Society reports that the five-year survival rate for all cancers combined that were diagnosed between 2009 and 2015 was 67 percent. That’s a noteworthy and encouraging statistic, though global figures compiled by Ourworldindata.org indicate that five-year survival rates following diagnosis are significantly lower in poorer countries. In addition, the road to recovery for cancer patients typically does not end when treatments are completed. The National Cancer Institute notes that many cancer survivors have indicated that information and support was abundant during their treatment. However, once treatment stopped, a new wave of questions and uncertainty soon emerged. For example, the NCI points out that many cancer survivors recognize that life after treatment is less about “getting back to normal” than it is about discovering the new normal. In fact, the Memorial Sloan Ketting Cancer Center reports that most people indicate it takes between six and 12 months after they complete chemotherapy before they truly feel like themselves again. Follow-up care also is a vital part of recov-
ering from cancer. The NCI notes that cancer survivors typically return to the doctor every three to four months during the first two to three years after treatment. After that, survivors may see their doctors once or twice a year. Follow-up care is vital for cancer survivors, as it provides their doctors an opportunity to determine if patients are experiencing any side effects from treatment. These appointments also allow doctors to determine if the cancer has returned or spread to other parts of the body. In addition, follow-up visits provide an opportunity for cancer survivors to bring up any symptoms or questions they might have. Patients can ask about ways to reduce their risk of cancer recurrence and seek advice on getting back to normal, including how quickly they can begin exercising and how to approach new fitness regimens if they were inactive prior to diagnosis. The road to recovery from cancer may be filled with uncertainty. But cancer survivors should recognize that millions before them have survived the disease and gone on to live full, happy lives. A patient approach to recovery can help cancer survivors overcome any obstacles they may encounter along the way.
A breast cancer diagnosis can change patients’ lives in ways they never imagined. That’s especially so in the rare instances when women under 40 are diagnosed with the disease. According to the American Cancer Society, it’s uncommon for women under 40 to receive a breast cancer diagnosis. In fact, data from the ACS indicates that only about 4 percent of all women diagnosed with breast cancer in the United States are under age 40. But 4 percent is nothing to brush aside, especially when the ACS estimates that more than 300,000 women in the United States are diagnosed with breast cancer each year. That means roughly 12,000 women under 40 in the U.S. will be diagnosed with breast cancer this year, and many of those women will understandably express concerns about cancer recurrence in the years to come. The medical experts at Johns Hopkins Medicine note that learning to cope with fears of breast cancer recurrence is an important part of the recovery process. Those same experts note that various lifestyle changes can help women regain their health, strength and optimism and quell any fears they have about cancer recurrence. ≥Take care of yourself, both emotionally and physically. Johns Hopkins Medicine urges breast cancer survivors to put their own needs first sometimes. That can be difficult for younger breast cancer survivors with children at home, but prioritizing their own emotional well-being can help women overcome their fears of recurrence. Support groups can connect women with fellow breast cancer survivors, and women should not hesitate to discuss any fears or concerns with their doctors. It’s also vital that women prioritize their physical well-being. Routine exercise and a healthy diet can help women reduce stress and maintain a healthy weight, which can reduce risk for recurrence. ≥Stay on top of screenings and vaccinations. Another way to reduce the risk of cancer recurrence is to stay up-to-date on screenings, flu shots and vaccinations. Annual physicals and screenings for cardiovascular conditions like high cholesterol and diabetes can help women stay on a healthy path forward. ≥Monitor vitamin D levels. Johns Hopkins Medicine notes that the Nurses Health Study found a link between low levels of vitamin D and breast cancer incidence. It remains unknown if vitamin D supplements can lower risk of breast cancer recurrence, but maintaining sufficient levels of vitamin D can promote overall health. Women can speak with their physicians about vitamin D and which supplements to consider. In addition, spending 20 minutes per day in the sunshine while wearing sunscreen with a minimum SPF of 30 can help women reach recommended levels of vitamin D. Cancer recurrence is a significant concern for survivors. However, various strategies can help women reduce their risk for recurrence and help them regain their optimism for the future.
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BREAST CANCER AWARENESS
October 2021