W I N T E R 2 0 1 5
FREE A M AG A Z I N E F O R W O M E N ' S H E A LT H
Outpouring of Support Virginia Gillenwater Kita
Living Life Day by Day
CONTENTS
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Outpouring of Support Virginia Gillenwater Kita Cover photograph © Kentaro Hanamura
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Share your story in PiNK!
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Run for the Cure® News
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Cooking Oil Conundrum
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Sharing Her Silver Lining
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TIPS for Cancer Caregivers
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Living Life Day by Day
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23 The Truth about Bone Health 26 Ask a Question, Change a Relationship FROM TH E FO U N DATIO N (Follows English section) 1. Readership offer 2. Monthly Self-Examination 3. RFTC Products 4. Pick up your free copy of PiNK 5. How you can help 6. Dear Survivor 8. Lemon Project 11. Resources
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Run for the Cure ® Foundation is a registered NPO with the Tokyo Metropolitan Government since 2004. Our mission is to eradicate breast cancer in Japan as a life-threatening disease through education, timely screening, and treatment. Through our activities, the Foundation funds education initiatives, clinical examinations and mammography machines; donates funds to organizations that promote activities specific to the mission of the Foundation; and develops and executes community outreach programs. We have donated six mammography machines to six clinics in areas where women are underserved, more than 14,000 women have benefited from mammograms, with over 3,600 funded screenings. The Foundation holds three annual events open to the general public to raise funds in support of our cause. PiNK is Japan's one and only magazine dedicated to breast cancer. Some 18,000 copies of this quarterly magazine are distributed free-of-charge nationwide through medical institutions, cooking studios, sports shops, libraries and sponsoring companies. Please contact inquiries@runforthecure.org for subscriptions. ®
For more information about how to donate, become a sponsor, and/or volunteer for Run for the Cure Foundation, please visit www.runforthecure.org
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Outpouring of Support Virginia Gillenwater Kita
M
y childhood was marked by the
my right breast, I made an appointment
English speakers. The appointment would
cancer-related deaths of two
to see my ob-gyn. The doctor ordered an
shatter my world. There, I found out that
beloved uncles. I remember feeling a sense
ultra-sound of my breast, and I remember
the symptoms I had thought insignificant
of paranoia as a resultâand made more
thoughts of cancer immediately coming
were potentially indicative of cancer. I
than one trip to the doctor convinced I
to mind. However, three weeks later, the
had just started a new jobâmy dream
had cancer symptoms, which later turned
ultra-sound showed it was ânothing to
job, actuallyâteaching English full-
out to be something perfectly normal. As
worry about.â The doctor also informed
time at a university. I was just two weeks
I grew older, I paid attention to articles of
me that it might grow and become
into my first semester. All this seemed
general interest about cancer. I remember
uncomfortable.
unfathomable.
reading stories of women who ignored
Despite experiencing increasing pain
A biopsy was scheduled and performed
unexplained lumps in their breasts and
in the same spot about six months later,
at a large hospital near my home. We wait-
wondering what was wrong with them.
I ignored it for several months. Being
ed 10 days for the results. On the evening
How could they not investigate something
busy with the year-end holidays, I could
of May 5, 2013, I was diagnosed with Stage
with such obvious potential danger? And
tolerate the discomfort. It wasnât until after
2 invasive ductal carcinoma. The cancer
then a few years later, I became
specialist proposed two alter-
one of those women.
native courses of treatment:
In the United States, my obgyn performed a breast exam at each annual check-up. She also encouraged me to do monthly self-checks, which I did erratically. When I moved
Connecting with other cancer survivors was very reassuring.
immediate surgery, followed by chemotherapy and radiation; or, immediate chemotherapy, followed by surgery, then radiation. My husband and I discussed both possibilities and
to Tokyo with my husband in 2010, I did
my spring vacation that I finally made the
opted to do the chemotherapy first.
not continue any kind of breast exam. A
appointment for what I assumed would
Two weeks later I began
friend recommended an English-speaking
be a routine procedure. Almost a full year
chemotherapy, consist-
doctor who was both an ob-gyn and a
had passed since discovering the lump in
ing of four rounds of
general family practitioner. I began seeing
my breast. At this point in time, I never
FEC (combination of
him for yearly check-ups. However, he
imagined that my condition could have
three chemotherapy
never once examined my breasts, and it
developed into something much worse.
drugs) every three weeks,
never occurred to me to seek out a breast clinicâI never even knew they existed. When I noticed a lump on the edge of
The doctor recommended a ladiesâ
followed by 12 weekly
clinic, because of its more sophisticated
doses of Paclitaxel. As my
equipment, that was popular among
cancer was HER2-positive,
© Kentaro Hanamura 2
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treatments, which con-
humidity, I soon opted for headscarves and
cluded in October 2014.
hats. Losing my hair was one of the most
Prior to surgery, I had
upsetting side effects of the treatment; it
met with a physical thera-
made me look sick and made my condition
pist at my doctorâs recom-
more obvious to others.
mendation. Measurements
My family and friends were incredibly
were taken to evaluate my
supportive during my treatment. Both
range of motion and the
of my brothers came to visit me, and
size of my arm. Following
my parents made multiple trips. I was
surgery, but while still in
hospitalized three times during my
hospital, I was given ther-
treatment, and my mother was there each
apy and instructions on
time. One of my aunts sent soft, hand-
daily exercises to perform
made hats of every shade. Another aunt
after my discharge. I met
sent a prayer shawl. My grandmother sent
with my physical thera-
packages of goodies from back home.
I also began Herceptin treatments dur-
pist regularly for assessment of my post-
Yet, my husband was my most constant
ing the second half of my chemotherapy.
surgery progress. By October 2014, I had
supporter. He cooked healthy, creative
I continued to teach until the end of the
regained my pre-surgery range of motion,
meals; took on my share of the housework;
semester. The side effects were rough, but
and there was no sign of lymphedema.
and attended many meetings with me and
I managed, thanks to the support from my
The most difficult part of the entire
colleagues and students. The kindness and
experience was having to tell my family,
attend, I was fortunate to have a Japanese-
expertise of my nurses and doctors were
friends, students and colleagues about my
speaking friend to accompany me.
also a great comfort. Acupuncture and
illness. Two months prior to my diagnosis,
hypnotherapy helped with the pain and
I had run my first half-marathon with my
from many acquaintances and from people
anxiety. However, after the summer break,
husband. I thought I was in the best shape
with whom I was not particularly close
I took a leave of absence.
of my life. Everyone thought I was so
before my diagnosis. Kind words, home-
healthy. But that was not my reality; I had
made dishes, and other thoughtful gestures
no idea what awaited me.
were greatly appreciated. Connecting with
The chemotherapy substantially reduced the tumor mass; in December, a lumpectomy was performed that removed only
As soon as it became clear I would
my doctor. At times when he could not
I also received support and comfort
other cancer survivors was very reassuring.
five lymph nodes. About two months later,
lose my hair, I told everyone whom I saw
Many of them took the time to exchange
I began a five-week course of radiation
regularly. I made announcements in all
stories by phone, email, or in-person.
treatments. Because my form of cancer
of my classes, and the students were very
Hearing about othersâ challenges and
was hormone-sensitive (ER+/PR+), I also
understanding. Although I wore a wig for
triumphs gave me strength. The outpour-
began taking Tamoxifen around the time I
a few weeks, I never felt like myself in it.
ing of support made me feel like the whole
started radiation. I resumed the Herceptin
With rising temperatures and increasing
world was on my side.
Virginia Gillenwater Kita
© Kentaro Hanamura
Virginia is from the United States and has lived in Japan since 2010. She has taught English in a variety of settings in Santiago, Chile and in Tokyo. Since moving here, she has earned a Masterâs degree in TESOL (Teaching English to Speakers of Other Languages). Virginia, a native English speaker, is fluent in Spanish and is now learning Japanese. She is a licensed public school teacher in her home state of Indiana. She
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grew up in the city of Fort Wayne, where she met her Japanese husband. She is very interested in the connection between nutrition, lifestyle and cancer. Since her diagnosis, she has adopted a mostly plant-based diet. She currently teaches at a private university in Tokyo, and has been accepted into a doctoral program at Temple University, Japan Campus, where she will begin her studies in January 2015.
Share your story in PiNK! Healing Power We have been publishing a âSurvivor Storyâ in the Japanese section of PiNK ever since the quarterly magazineâs launch in 2007. We continue to receive a lot of very positive feedback from both writers and readers. There is the special healing power of writing that allows survivors to open up, reflect back and share their personal journey â sorting their thoughts and embracing their feelings. Readers have commented on how the stories are reassuring, helping them to move forward and providing timely support. Run for the Cure® Foundationâs founder and chairman, Vickie Paradise Green, shared her personal journey as a breast cancer survivor in PiNK fall 2013.
Please keep in mind some basic requirements. In Word format (or similar) and at 800 â1,100 words, please include how you found out you had breast cancer; whether you had annual mammography screenings and if so from what age; whether you regularly self-examined; at which stage you were when diagnosed; whether you had a mastectomy or lumpectomy; what sort of treatment you underwent; and the types of drugs you used if any. Be sure to include your name, age, address, phone number and email. We reserve the right to edit your story for consistency in style regarding PiNK magazine, and crop or resize the photography you submit to fit our layout. The photography should be high resolution, at 300 dpi or more, as you will be on the English cover! You must confirm there is no copyright infringement for photography submitted and/or direct quotes you include from other sources. Please be reassured that we will not use your personal information for any other purpose without your prior consent. There is no compensation for the story you submit. We look forward to hearing from you! For any queries and submissions, email pink@runforthecure.org
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RUN FOR THE CURE® NEWS @RFTCtokyo
Run for the Cure Foundation
Casino Night 2014 Friday, October 17, 2014 at The Westin Tokyo Text Mike de Jong Photos Steve Morin
T
he screams of delight could be heard from across the room. Someone had rolled doublesevens at the craps table and was about to cash in. A few meters away, some well-dressed, financial executives were doubling down on blackjack. Others at a nearby high-roller table were maintaining their poker faces in an intense game of Texas Hold âEm. It was all in a nightâs work â having fun and raising money for a worthy cause â at the second annual Run for the Cure® Foundationâs Casino Night at The Westin Tokyo. This yearâs event was a massive hit, with nearly 300 people in attendance. âIâm here because itâs a fantastic fundraising event,â said Jason Baldwin of the Australian Embassy, placing
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chips on a roulette table. âItâs a fun atmosphere, and there are lots of people. Everyone gets dressed up and makes an effort ⊠and ⊠did I win? Did I win?â He didnât on that bet. Neither did his friend Seth Kloss from the US Navy. But it didnât matter. Each was there to support the fight against a killer disease. âI think itâs a great cause,â said Kloss. âEverybody has somebody thatâs been affected or knows someone [who has], so I think itâs a great cause to bring awareness to the public. For as long as it goes to a good cause, Iâm willing to give [my money] away.â Casino Night is supported by dozens of volunteers, businesses and other organizations. All money raised goes towards Run for the Cure®
Foundationâs education initiatives including this magazine and the Lemon Project seminars. Elio Orsara of Elio Locanda Italiana in Tokyo got everyone bidding during the live auction, as heâs done at the various Foundation fundraisers. He participates mainly because cancer has touched his family. âI lost my father to cancer,â he said. âBut I believe this is something we can beat. And I would do anything to support this because I believe that this terrible disease is something that has to be beaten.â Casino Night attendees also enjoyed spectacular entertainment. Magician Koji mesmerized the audience with his Mahou Magic, while guitarist Steve Gardnerâs slick picking got feet tapping
Run for the Cure ® News
to his version of southern comfort Delta Blues. Suntory Flowers, GreenWings and Bonpoint florist Noriko Kimura helped transform the Westin ballroom into a cascade of beautiful blooms. In her keynote address, Run for the Cure® Foundation founder Vickie Paradise Green highlighted the story of Mika Kume, a dedicated high-endurance athlete and breast cancer survivor. Kume competed in a 100km ultra marathon and a 250km trek across the Gobi Desert this year, barely one year after her cancer diagnosis. âSpeaking for Mika, and all victims of breast cancer,â said Green, âI can tell you that nothing turns your world upside down like the words âyou have breast cancerâ. Few words will ever have a more profound effect.â
âBut the most important thing for victims to know is this: a breast cancer diagnosis is not a death sentence. And the most important thing for a spouse, family member and friend is not to underestimate the power of your love and support,â said Green. âThere is often nothing more reassuring than hearing, âIâm here with you.ââ â[Breast cancer] is one of the big issues in Japan right now,â said Makoto Hasegawa from Deutsche Bank. âAnd we do hear many women having difficulties with breast cancer. So anything I can do to support, Iâm happy to do.â Colleague Aston Bridgman added: âWe will [soon] be celebrating our diversity week. And for us, gender diversity is the main focus. And one of the best ways that we
can make gender diversity real is to talk about health. Breast cancer is one of the biggest threats to womenâs health. So itâs a good fit.â Todd MacDonald of Asian Tigers doesnât gamble or drink. He attended Casino Night in support of a family member: âMy sister-in-law, suddenly, in February, was diagnosed with Stage-4 cancer,â said MacDonald. âShe was here in Japan, and is now in the Philippines because of that. It came out of nowhere.â âI lost my wife to breast cancer about eight years ago, so itâs something close to my heart,â said Donald Gleason, a friend of Elio Orsaraâs. âWhatever can be done to prevent another woman going through the same thing, I totally support.â
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Tokyo Run for the Cure® / Walk for Life 2014 A record number of participants, numbering 1,921 registered runners/ walkers and 94 volunteers, gathered for Run for the Cure®/ Walk for Life 2014 at Tokyoâs Hibiya Park. The venue was amply decorated in pink, including pretty Princettias by Suntory Flowers. There was excitement in the air as everybody prepared for their Run or Walk around the Imperial Palace. The top three finishers among both the male and female runners
were awarded with wonderful prizes from New Balance and Roxy. There also was Tawooâs powerful wadaiko drums and HOOTERSâ cheerleading, and delicious food and refreshments from food trucks. Many tried their luck at the raffle for airline tickets to Saipan by Delta Air Lines and to Guam by UNITED, a 3-night stay at Pacific Island Club Saipan, Saipan Marathon tickets, and a diamond necklace by DIAVANTE. Aromatherapy massages by
kampoaromasalonOHANA, and face painting by Tobin Ohashi Gallery and Tokyo Belle Ãpoque College of Beauty were available. Some 30 lucky women also received a free mammogram in a Mammo Bus run by the Breastopia Healthcare Group, Breastopia Namba Hospital. Asian Tigers Mobility handled the logistics. The Foundation was able to raise JPY11.6 million. We would like to express our gratitude to all of you. See you again next year!
Photos: Victor Chia
For more photos of any of the events, please visit www.runforthecure.org!
Sponsors for Tokyo Run for the Cure®/ Walk for Life 2014 Partner Sponsors: Delta Air Lines, Inc., DIAVANTE, New Balance Japan, Inc., Paradigm, Turkish Airlines, The Westin Tokyo, U.GOTO FLORIST, UNITED Platinum: Servcorp Japan K.K. Gold: Aberdeen Investment Management K.K., Aflac Patron: Bloomberg L.P., Suntory Flowers Ltd. Friend: ABB Japan Group Companies, Adobe Systems Co., Ltd., ANA InterContinental Tokyo, Asian Tigers Mobility, Bristol-Myers K.K., CBRE, Costco Wholesale Japan, Ltd., Crown Worldwide K.K., Deutsche Bank Group, EF Education First Japan Ltd., Ernst & Young ShinNihon LLC, GXS Co., Ltd., HOOTERS, J.P. Morgan, Latham & Watkins Gaikokuho Joint Enterprise, Linklaters Tokyo, Marc Jacobs Japan K.K., Michael Page International (Japan) K.K., Morgan Stanley, Oakwood, Pacific Islands Club Saipan, The Peninsula Tokyo, Philips Electronics Japan, Ltd., QUIKSILVER JAPAN Co., Ltd, RGF HR Agent Japan Division (Recruit Career Co., Ltd.), The Ritz Carlton Tokyo, Robert Walters Japan K.K, RI2750 District Tokyo Hiroo Rotary Club, The Strings by InterContinental Tokyo, SWAROVSKI JAPAN K.K., Uber Japan, Wahl & Case K.K., White & Case LLP, Yale Club of Japan Associate: Adecco Ltd., Ambition Group Japan K.K., Beer Cats, Bellaâs Cupcakes, Citrix Systems Japan K.K, Club 360, CSR K.K., Elana Jade, Euroclear Bank Tokyo Representative Office, Fonterra (Japan) Limited, Google Japan Inc., Harvey Nash Japan K.K., Hogan Lovells Horitsu Jimusho Gaikokuho Kyodo Jigyo, Hynd K.K., IDEXX Laboratories K.K., Kampo aroma salon OHANA, Kyorin University, Marianas Visitors Authority , Ralph Lauren Corporation Japan, Roppongi Hills Club, Shinsei Bank, Limited, SIN DEN, Spring Professional Japan, Ltd., Standard Chartered Bank, United Dental Office Special Thanks: Breastopia Healthcare Group Breastopia Namba Hospital, Hitoshi Ohashi, Tobin Ohashi Gallery, MediaSense KK, Santa Fe Relocation Services Japan K.K, Tokyo Belle Ãpoque College of Beauty, Yoshiko Yamato Photographers: Primrose Sakamoto, Victor Chia MC: Russell Goodall, Soness Stevens Live Performances: HOOTERS, Tawoo, Yoyogi Park Running and Yoga Circle
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Run for the Cure ® News
Fundraising Effort by Servcorp During the summer, Servcorp launched a series of fundraising campaigns at various locations where the company operates. Several times a year, Servcorp organizes such networking events, inviting its customers and clients as a means to better relations and improve communications with them. In the process, Servcorp raised funds of JPY1,727,887 and donated to Run for the Cure® Foundation for our mission to eradicate breast cancer as a lifethreatening disease in Japan. Olga Vlietstra, General Manager Japan, Servcorp presents check to Vickie Paradise Green, chairman, Run for the Cure Foundation
Save the date for our next
Pink Ball extravaganza! Date: Friday, March 20, 2015 Place: The Westin Tokyo Details: runforthecure.org/en/pink-ball/
Tokyo Bosom Buddies Survivor Group in Tokyo for foreigners and English-speaking Japanese. Gatherings at Franciscan Chapel Center in Roppongi once a month. For details, please email pink@runforthecure.org From left to right: Yuki Hirayama, Brenda Bohn, Sarah Smith, Nora Koiwai
Run for the Cure® Partners (Alphabetical order)
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Cooking Oil Conundrum Choose the right cooking oil for the job By Ann Bloom
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A Few Facts About Oil Oil has a relatively short shelf life (three months to one year) because it can become rancid quickly. Exposure to oxygen, heat, and light can diminish the shelf life of oil. Refined oils stay fresher longer, but may also contain more impurities. Dark cooking oils have a shorter shelf life than lighter-colored oils.
W
e have been bombarded with messages about saturated fats, trans fats, monounsaturated fats, and polyunsaturated fats to the point of utter confusion. We know that a Mediterranean diet has been shown to be healthy, so we stock our kitchens with large bottles of extravirgin, unrefined olive oil. But is olive oil our best choice? Sometimes. Although olive oil gets most of the cooking glory, it is not always the right oil for the job. Some oils are indeed healthier than others, but choosing a cooking oil goes far beyond health concerns. Not all oils can be used for all purposes; some are best for hightemperature cooking, whereas others are better for salad dressings and drizzles. Learning to discern the proper oil for the job will help you stock your pantry accordingly. What Exactly Is Cooking Oil? We use the generic term vegetable oil to refer to a number of different cooking oils. In truth, oil can be extracted from a variety of sources: ⢠⢠⢠⢠â¢
Nuts (almond, walnut) Seeds (sunflower, sesame, safflower) Grains (corn) Beans (peanut, soy) Fruits (olive, avocado, coconut)
Characteristics of Oils There are many factors to consider when choosing a cooking oil, including flavor and cooking temperature. Smoke point. Smoke point is the temperature at which an oil begins to smokeâand also the point at which the flavor and the nutritional value of the oil are compromised. Smoke point is a critical factor in choosing the proper oil for the job. The cooking method will determine which oil is most appropriate. If you are searing or frying, you need an oil with a high smoke point, such as grapeseed oil and sunflower oil. Oils with low smoke points, such as olive oil and unrefined walnut oil, are best for low-temperature cooking, like light stir-frying and baking. Unrefined versus refined. Unrefined oil occurs exactly as it does in its plant formâthat is, it has not been through any filtering or chemical processes. These oils are simply left in their virgin state after pressing. Unrefined oils are typically richer in flavor and higher in nutrients; however, they also tend to have a lower smoke point than refined oils. Refined oilsâoils that have had impurities filtered outâcan withstand higher cooking temperatures. Extraction method. There are many methods for extracting oils from
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plants and seeds, including the use of chemical solvents and high heat, both of which can damage the structure and the nutritional content of the oil. Most natural oils are extracted without chemicals or heat via one of two methods: expeller pressing or cold pressing. ⢠Expeller pressing is a chemical-free mechanical process that extracts oil from seeds and nuts. There is no external heat applied during expeller pressing. The temperature reached during pressing depends on the hardness of the nut or seed. Harder nuts require more pressure to extract the oil, which in turn creates more friction and higher heat. ⢠Cold pressing better preserves the nuances of flavor in delicate oils. Oils that are cold pressed are expeller pressed in a heat-controlled environment to keep temperatures below 120 degrees F. Stocking Your Kitchen Understanding the different charac-
teristics of oils will help you stock your kitchen properly with a variety of oils that serve different purposes. Consider having at least three oils on hand: ⢠An oil for high-temperature cooking ⢠An oil for low- to moderate-temperature cooking ⢠A flavorful oil for specialty dishes and dressings If you really want to get carried away, you can supplement these three oils with a good baking oil and a âfinishingâ oil, which can be drizzled on completed dishes for some extra flavor and flair. Most kitchens are stocked with olive oil and canola oil, which are both good and fairly neutral choices. (Canola oil has been steeped in controversy, however, because it is extracted from the genetically modified ârapeseedâ and because it is a polyunsaturated oil that may contain trans fats.) Consider stocking a basic pantry as follows.
Low to moderate smoke point. Olive oil has a moderate smoke point and is a good all-purpose oil. Extravirgin olive oil is best for salad dressings and low-temperature cooking. Avoid frying or roasting with olive oil. High smoke point. While you may be more familiar with canola oil, grapeseed oil is a light oil with a neutral taste and a high smoke point. It is ideal for high-temperature cooking. Grapeseed is a very basic oil that will likely find its way into more kitchens in the future, especially with the controversy surrounding canola oil. Grapeseed oil also works well for baking, when you want no interfering flavors. Flavorful oil. Sesame oil is a flavorful oil with a moderately high smoke point. It is good for stir-frying, international dishes, and dressings. If you always stick with basic oils and want to branch out and get a little more adventuresome in the kitchen, sesame oil is an easy place to start!
Use the smoke point guide below to choose the oils that will best serve your kitchen needs
Avocado oil
Coconut oil (refined)
Peanut oil (refined)
Sunflower oil (refined)
Sesame oil
Canola oil (refined)
Grapeseed oil
Olive oil (refined)
Coconut oil (unrefined)
Olive oil (unrefined)
Peanut oil (unrefined)
Sunflower oil (unrefined)
520
410
350
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450
400
320
450
400
320
450
400
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Sharing Her Silver Lining By Diana Price
W
hen Hollye Jacobs was diagnosed with breast cancer at 39, her first thought was, This could be so much worse. My form of cancer is treatable. Hollye̢۪s reaction speaks volumes about her approach to life and her cancer journey. A self-described optimist, Hollye, a palliative care nurse and a social worker, knew that she had the power to choose how she would move forward through the challenges ahead. She chose to see the silver lining in the cloud that was a breast cancer diagnosis.
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&
Q
with HOLLYE JACOBS, RN, MS, MSW Author, The Silver Lining
Q
: Your blog, The Silver Pen, offers readers insight into your cancer journey and valuable information about managing a cancer diagnosis; what inspired you to also write a book?
A
As she progressed through treatment, which included a double mastectomy, chemotherapy, radiation, and hormone therapy, Hollye shared her experiences through a blog, The Silver Pen (thesilverpen.com), telling her story in a voice that was at once funny, compassionate, and articulate. As she honestly described the challenges she encountered along the way, she also pointed to the many silver liningsâdiscoveries, joys, inspiration born of the tragedy of the diagnosisâthat appeared, creating glimmers of light in the darkness. The positive response Hollye received from the unique meeting of personal experience and professional expertise on The Silver Pen ultimately
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inspired her to write The Silver Lining: A Supportive and Insightful Guide to Breast Cancer (Atria Books, 2014). The Silver Lining offers women both inspiring personal stories from Hollyeâs journey and insightful, empowering information to help guide decisions about the many aspects of treatment and recovery. Hollyeâs text is interspersed with beautiful photographs by Elizabeth Messina that illustrate the honest, uplifting tone of the book and reflect Hollyeâs own graceful aesthetic sensibility. The result is a visual, emotional, and intellectual experience for the reader, providing a foundation of sound clinical expertise and the essential, intangible gift of hope.
: Thank you so much! The Silver Lining is the book that I desperately sought, but could not find, after my breast cancer diagnosis. What I needed was a lifeline, a point of reference, a source of encouragement that was simultaneously honest and informative, practical and supportive, hopeful and serious, clinically credible and visually beautiful. No such book existed. Well, until now.
Q
: How did the idea of âsilver liningsâ evolve through your own cancer journey, and how do you continue to embrace this philosophy today?
A
: From the time of my diagnosis, I realized that I had two choices about how I was going to handle my situation: from a place of fear or a place of hopefulness. I choseâand it was indeed a very active choice for meâhopefulnessâin the form of finding silver linings. When I think about silver linings, it is not Pollyanna-ish as in, âIf you just look for silver linings, then everything will be fine.â The truth is that silver liningsâ
&
A
unfortunately!âdo not take away the nausea, vomiting, pain, and fatigue that can come with a cancer diagnosis and treatment. However, what they do do is provide balance and perspective to buoy you through the darkest of days. During my sideeffect-filled treatment, silver linings came in the form of watching a hummingbird outside of my window because I was too sick to stand or a warm cup of tea that eased the nausea or a get-well drawing that my daughter brought home from school. It was the little things that made all the difference in the world. This silver-lining philosophy transcends illness. It applies to any difficulties and even tragedies that are inevitable in this life. What I know for sure is that silver linings are always present. All we have to do is look for them.
Q
: Your professional background as a palliative care nurse and a social worker provides readers with valuable expertise across a truly comprehensive range of topics in The Silver Lining. How did your professional background affect your own experience with cancer?
A
: As a nurse and social worker turned patient, I found myself in a very unique position, moving from the side of the hospital bed into it. Becoming
a patient gave me a whole new and unexpected conscious sensitivity to the physical and emotional aspects of being a patient, from becoming a human pincushion (because you are stuck with needles seemingly every other day) to contending with the very common feelings of sadness, fear, and anxiety. From the moment of the diagnosis, my clinical experience was my compensatory mechanism. For example, when the radiologist told me that he found seven tumors in my breasts, I reminded myself that patients typically forget virtually everything that comes after hearing the dreaded words, âYou have a tumor.â So, I instinctively knew that I would more than likely forget what I was hearing and needed to start taking notes. Throughout treatment I consistently reassured myself that as a nurse and social worker with experience in an intensive care unit and both pediatric and adult hospice, I knew that there was no one better prepared to handle what I was facing. I knew what questions to ask. I knew how to assemble my healthcare team. I knew how to contend with insurance issues. These were silver linings during my experience.
Q
: For women newly diagnosed with breast cancer who may be picking up The Silver Lining, the idea of all the challenges ahead is no doubt daunting; what tips or words of wisdom would you offer women just beginning the journey?
A
: There are four things that I tell everyone diagnosed with breast cancer. These things also helped me immensely! First, breathe. It sounds easy, I know, but after you hear the words, âYou have cancer,â breathing takes a whole lot of work.
Second, though the diagnosis feels like an emergency, the majority of time it is not. You have time to understand the meaning and process the emotions stemming from the diagnosis. Third, learn everything you can about the diagnosis and then become actively involved in the development and the revision of your plan of care! Fourth, build your team of caregiversâboth personal as well as professional. What I learned for sure is that it takes a village to go through breast cancer.
Q
: The Silver Lining is stylish. It looks different from most cancer guides. It is filled with evocative, beautiful photographs that convey a distinct mood. Can you describe the role that photographer Elizabeth Messinaâs images played on your journey and what you wanted to offer through the visual element of the photos?
A
: The photographic collaboration with Elizabeth was an unanticipated silver lining of my illness. Shortly after surgery, in a gesture of friendship, Elizabeth offered to photograph me. Her vision was one of the brightest and most insightful lights in this dark period. When I looked in the mirror, the reflection that I saw was of illness, scarring, and mutilation. However, Elizabethâs imagery showed my true reflection and reminded me that below the disease I was still me. This book is a combination of my voice and her vision that provides hope, information, and support during the cancer experience.
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: What do you hope that readers will take away from The Silver Lining?
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: It is my hope that this book will be a companion and guide that will support, inform, and inspire everyone whose life is touched by breast cancer.
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TIPS for Cancer Caregivers By Sara Goldberger, LCSW-R
C
aring for a family member or friend with cancer is often very challenging. The experience can be exhausting both mentally and physically, but it actually becomes even more so when you donât take care of yourself. I use a metaphor of a watering can and a garden to drive home this point. If your loved one is a garden, it needs water. If you are the watering can, you will run out of water to nurture the garden. Filling the watering can from a larger reservoir will make sure that there is always enough water to help tend to the garden.
Find Your Support System When a friend or loved one is diagnosed with cancer, it is an emotional time. Roles and expectations may change (or you may wonder if they are going to change). Sometimes it is difficult to talk with your loved one about your feelings because you both have so much going on. Many find that one of the best ways to cope with stress, uncertainty, and loneliness is to talk with others who share similar
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Finding out that a loved one has cancer can be overwhelming. Cancer affects not only the person diagnosed but all those who care about that person. You may be wondering, What should I do now? or How can I help? The following 10 tips are intended to help you tackle the challenges of caring for someone diagnosed with cancer. Here you will find information and resources for caregiversâthose who provide emotional, spiritual, financial, or logistical support to a cancer patient.
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experiences. You can learn from personal experiences how to be effective in your new role as a caregiver. Support groups are a great way to reduce the isolation that you might feel. You can be with others who truly understand what you are going through. Often these groups are great sources of information and practical tips. There are several different kinds of groups, includ-
ing face-to-face, telephone, and online. A support system may not necessarily come in the form of a group. Individual support is also available through your healthcare provider, faith-based communities, and toll-free helplines. The important thing is to get some form of support. To find support in your area, call the Cancer Support Helpline at (888) 793-9355 (in USA).
Gather Information There is truth to the phrase Knowledge is power. There is no way to completely grasp the ups and downs of a cancer diagnosis and treatmentâand you should not be expected to. Being armed with knowledge may help you accommodate
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your loved oneâs needs, however, and put you at ease because you know what to expect. Learn about the cancer diagnosis your loved one has receivedâincluding its stages, recommended treatments, and the side effects of medicationsâ through national patient education programs like those available at the Cancer Support Community (cancersupportcommunity.org). Caring for someone
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with cancer is easier when you understand the basics about the diagnosis, treatment, and side effects. You will feel more in control when you know what to expect. Other good sources of accurate information include the National Cancer Institute (cancer.gov or [800] 422-6237 in USA), the American Society of Clinical Oncology (cancer.net), and the Caregiver Action Network (caregiveraction.org or [202] 772-5050).
Recognize a âNew Normalâ Patients and caregivers alike report feeling a loss of control after a cancer diagnosis. Many caregivers are asked for advice about medical decisions or managing family finances and need to take on new day-to-day chores. It is likely that your tasks as a caregiver will necessitate new routinesâafter all, you are taking on a new role in the patientâs life as well as your own.
Maintaining a balance between caring for your loved one and the daily activities of your own life can be a challenge. It may be helpful to identify the parts of your life that you can still controlâsuch as your own health and relationships. In doing this you will be able to create a strategy for integrating new routines with old ones. It may also help to acknowledge that
your home life, finances, and friendships may change for a period of time. Sometimes the laundry might not get done, or maybe takeout will replace home cooking. Try to manage each dayâs priority as it comesâit is alright to put other tasks on hold. Take a deep breath and realize that the support you provide is priceless.
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Relieve Your Mind, Recharge Your Body It can be easy to feel overwhelmed by the tasks of caregiving. Taking minibreaks is an easy way to replenish your energy and lower your stress. Try simple activities like taking a walk around the block or closing your eyes for 10 minutes in a comfortable chair. Taking time for yourself is not selfishâit is necessary. You are working hard to provide and secure the best care for your loved one.
Time spent recharging your mind and body will allow you to avoid depression and burnout. Research shows that the person you are caring for benefits most when you are healthy and your life is balanced. Seek ways to rejuvenate your spirit. Everyone holds beliefs about life, its meaning, and its value. Many people have a spiritual dimension, whether
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or not they subscribe to a particular religion. Feeling spiritually connected can provide comfort and may also help you put your situation into perspective. Prayer, meditation, and other spiritual practices can ease distress. Finding your own ways to meet this need may also help you recharge.
Take Comfort in Others Caregiving can sometimes take a great deal of time. Many caregivers feel a loss of personal time over the course of the illness. Keep in mind that while you are taking on new and additional responsibilities, you are still allowed a life of your own.
Many seasoned caregivers advise that you continue to be involved with your circle of friends and family. For some, remaining involved might mean playing an active role in school or community activities. For others, it may mean weekly visits with a best friend. Only
you can determine the level of involvement that is right for you, and that level may change over time. No matter your choice, it is certain that you will appreciate having someone to turn to as you care for your loved one
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6 7 8 9 10 Plan for the Future A common feeling among caregivers and people with cancer is uncertainty. It is hard to know what the future holds. Although planning may be difficult, it can help. Try to schedule fun activities on days when your loved one is not feeling the side effects of treatment. You can also give yourselves something to look forward to by planning together how you will celebrate the end of treatment or a phase of treatment. Planning for the future in the long term is also important and can be increasingly stressful for a caregiver when, sometimes, two futures are
being plannedâone based on survival and the other based on the possibility of losing your loved one. All of us, whether we have been diagnosed with cancer or not, should have in place necessary paperwork pertaining to a healthcare agent, a power of attorney, and a will. You can ask your loved one if he or she needs or wants assistance. It is in everyoneâs best interest that you begin this process sooner rather than later. Having essential paperwork under control will allow you to have peace of mind.
Be Mindful of Your Health
Consider Exploring Stress Management Techniques
To be strong for your loved one, you need to take care of yourself. It is easy to lose sight of your own health when you are focused on your loved one. But if your own health is in jeopardy, who will take care of your loved one? Be sure to tend to any physical ailments of your own that ariseâthis includes scheduling regular checkups and screenings. And remember what Mom always said: eat well and get enough sleep.
Even if you have never practiced mindbody exercises before, you may find that meditation, yoga, listening to music, or simply breathing deeply will relieve stress. Research shows that these practices can enhance the immune system as well as the mindâs ability to influence bodily functions and relieve symptoms. Mind-body (or stress reduction) interventions use a variety of techniques to
Accept a Helping Hand
It is okay to have helpers. In fact, you may find that learning to let go and to say yes to offers of help will ease your anxiety and lift your spirits. People often want to chip in but arenât quite sure what type of assistance you need. It is helpful to make a list of all caregiving tasks, small to large. That way when someone asks, âIs there anything I can do?â you are able to offer them specific choices.
help you relax mentally and physically. Examples include meditation, guided imagery, and healing therapies that tap your creative outlets, such as art, music, and dance. If this interests you, seek out guidance or instruction to help you become your own expert on entering into a peaceful, rejuvenated state. Managing your stress is an excellent way to make sure the watering can stays full.
Do What You Can, Admit What You Canât
Throughout these 10 tips, we have touched on many tasks associated with caring for a loved one. Even seasoned caregivers find themselves caught up in the whirlwind of appointments, daily errands, and medicine doses. No one can do everything. It is okay to acknowledge your limits. Come to terms with feeling overwhelmed (it will happen) and resolve to be firm when deciding what you can and cannot handle on your own. Your loved one needs you. You cannot do this alone. Together you can get through.
About the Cancer Support Community The Cancer Support Community (CSC) is an international nonprofit organization dedicated to providing support, education, and hope to people affected by cancer. Likely the largest employer of psychosocial oncology mental health professionals in the United States, CSC offers a menu of personalized services and education for all people affected by cancer. Its global network brings the highest-quality cancer support to the millions of people touched by cancer. These support services are available free of charge through a network of professionally led, community-based centers, hospitals, and community oncology practices, online and over the phone, so that no one has to face cancer alone. Learn more at cancersupportcommunity.org.
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Living Life Day by Day Advances in treatment mean that patients with metastatic cancer are living longer, but challenges remain. By Laurie Wertich
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enelle Jacobson is in her fifth year of chemotherapy. She has undergone about 10 surgeries, including a leg amputation. She copes on a daily basis with the symptoms of cancer and the side effects of treatmentâpain, nausea, and low blood counts, just to name a few. And yet it seems there is no stopping her. After a long career as an information technology specialist for the National Park Serviceâworking in such scenic locations as Glacier National Park, Rocky Mountain National Park, and Grand Teton National Parkâthe 42-year-old has just submitted her medical retirement paperwork. But
Renelleâs is not your average retirement plan: âIâm searching for a treasure,â she explains. Some might assume that the treasure she is seeking is good healthâand indeed Renelle spends a great deal of time focusing on her health and treatment as well as on relationships with family and friends. But her retirement will also allow her time to pursue her search for literal hidden treasureâin the form of a lockbox full of gold nuggets, rare coins, jewelry, and gemstones hidden in the Rocky Mountains by a retired art dealer named Forrest Fenn. âYou have to figure out what keeps you going,â she explains. âIt is
important to have as much of a life as you can. If you canât have it outside your house, then figure out how to have it inside your house.â Renelleâs hunt for Fennâs treasure has been one way she has continued to live a full lifeâsifting through clues and trying to deduce where to look next for the bounty. The thrill of the hunt keeps her going, especially on hard days.
Living with Metastatic Cancer Renelle is one of a growing number of people who are living longer-term with metastatic cancerâcancer that has spread from the original site to one or
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âYou have to figure out what keeps you going,â she explains. âIt is important to have as much of a life as you can. If you canât have it outside your house, then figure out how to have it inside your house.â
more distant sites in the body. Metastatic cancer is generally considered incurable; but, as cancer treatment continues to evolve, more and more patients are living longer with metastatic disease. Renelle was diagnosed with osteosarcoma in October 2009, when a scan revealed a 6-inch tumor in her knee and femur. Despite removal of the tumor and a grueling chemotherapy regimen, the cancer spread to her lungs. She has undergone three lung surgeries and several other cancerrelated surgeries as well as an endless series of chemotherapy regimens. Her leg was amputated in December 2011, but the cancer is aggressive and new tumors continue to develop. Renelleâs treatment is aimed at controlling the cancer. âAbout a year and a half ago, my oncologist told me that she no longer believed I could be cured,â Renelle says. âAround that time we tried my eighth and ninth different types of chemo and found that they actually work. They donât kill the tumors, but they knock them back significantly. So the plan is to pump as much of that chemo into me for as long as I can take it.â At this point Renelle does not get a lot of breaks in treatment. Constant chemotherapy treatment is challenging, but the cancer returns quickly if treatment is paused for any period of time. âIt makes me think my long term is going to be shorter than I thought,â Renelle admits. âIâm not giving up by any means. Iâm just being realistic.â
Understanding Metastatic Cancer Cancer treatment has come a long way in the past few decades, and as a result
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âRenelle Jacobson
the prognosis for metastatic cancer has changed. In fact, some but not all types of metastatic cancer are being treated more like a chronic diseaseâ and some people are living a long time with cancer. âFor most cancers, once they are metastatic theyâre not curable, but they are treatable,â explains Julie Gralow, MD, director of breast medical oncology at the Seattle Cancer Care Alliance. Dr. Gralow explains that about 25 percent of patients with metastatic breast cancer live more than 5 years, and some patients live 10 to 20 years. But every cancer is different, and Dr. Gralow is quick to point out that some patients do die quickly: âWe have this new idea that cancer is a chronic disease, but we have to temper it. Weâre not doing so well for everybody.â David Hyman, MD, an oncologist at Memorial Sloan-Kettering Cancer Center in New York, echoes this sentiment: âPeople now come to us with the expectation that this is a chronic disease like diabetes or hypertension, but I think itâs important not to oversell what we can accomplish.â Quality and quantity of life has improved significantly, but still most patients are dying of the disease.â Dr. Hyman says that average survival is highly dependent on the disease. âWhen patients ask me about their
prognosis, I tell them that we need to see how things go because no patient is an average,â he says.
Advances in Treatment
With or without the âchronic cancerâ label, there is no doubt that treatment of metastatic cancer has improved considerably. The advent of innovative treatment strategies, such as targeted therapies and immunotherapies, has changed the treatment landscape. âWeâre no longer thinking that one size fits all,â Dr. Gralow explains. âWe look at what makes a cancer unique and what makes a patient unique and then we personalize treatmentâto both the patient and the tumor.â Targeted therapies are designed to target specific abnormalities in a tumor and minimize damage to normal, healthy cells. These treatments are often less toxic than systemic treatment like chemotherapy, which cannot differentiate between cancerous and healthy cells. As a result, targeted therapies sometimes offer improved outcomes and reduced side effects. âThis is an evolving story in oncology,â explains Dr. Hyman. âThere have been several significant successes. For example, certain targeted therapies can be added sequentially in the treatment of breast cancer, and this has really changed the course of disease.â In general, though, Dr. Hyman explains that targeted therapies have improved quality of life but have not necessarily improved the cure rate in the metastatic population. Immunotherapy is treatment designed to stimulate the bodyâs immune system to fight the cancer. In essence, this type of treatment helps the
immune system recognize the tumor as foreign and kill it. There have been great strides in the development of immunotherapy agents, particularly for melanoma. Clinical trials are ongoing in a continued effort to develop safe and effective immunotherapy agents. This is really a developing chapter of oncology treatment. Advances in a field known as interventional radiology, a subspecialty of radiology in which minimally invasive techniques are used to deliver radiation to organs throughout the body while sparing healthy tissue, have also contributed to improved treatment in the metastatic population. âInterventional radiologists are able to solve a number of problems. They can place drains, tubes, and stents and do things that were not possible before,â Dr. Hyman explains. âPalliative radiation has become more sophisticated and more targeted, sparing healthy tissue, which has allowed us to use it more frequently and repetitively. These types of procedures have converted things that in the past might have been life-threatening complications to potentially more manageable complications.â Indeed clinical advances in treatment have resulted in longer survival times and improved quality of life for many patients. But that is only part of the story.
Advances in Supportive Care The other part of the storyâand one that maybe does not get as much attentionâis that supportive care has improved. Supportive care is a general term that refers to treatments that help prevent and control the side effects of cancer treatment. These side effects can range from mild to severe, depending on the type and the dose of treatment as well as individual patient characteristics. Depending on the specific treatment, patients may experience fatigue, low
blood counts, hair loss, nausea, vomiting, diarrhea, skin rash, and other side effects. Historically, chemotherapy was associated with debilitating nausea and vomiting, but antinausea medications have improved dramaticallyâand many patients are better able to tolerate treatment as a result. When patients can better tolerate treatment, they can continue to receive their planned dose and schedule of treatment, which improves the odds of controlling the disease. This is an important development for a population of patients that is receiving treatment for longer periods of time.
Physical Challenges of Treatment Yet despite advances in treatment and supportive care, cancer treatment is
not without physical challengesâand because many patients are living longer with the disease, these physical challenges can be frustrating and, at times, downright debilitating. Dr. Gralow explains that patients face two different kinds of physical challenges: symptoms of the cancer and side effects of the treatment. âCancer can cause problems itself, such as pain, shortness of breath, or fluid in the abdomen,â she explains. âBut a lot of the physical challenges patients face depend on the therapy theyâre receiving.â Chemotherapy carries a variety of side effects, but the one that seems to have the largest impact on patientsâ lives is fatigue. Renelle says that she often doesnât have the energy to do a thingâand the chemo also has a domino effect. âItâs not just the chemo, itâs all the in-between stuff and the
Tips from the Trenches Renelle Jacobson has been living with cancer since 2009. She has a list of reminders that help her navigate the challenge. Donât complain. âWhining about something doesnât do any good, and it makes it miserable for the people around me.â Look good. Feel Good. âThe less I look like a cancer patient, the less I feel like a cancer patient,â Renelle says. âItâs hard, and often impossible, to look good while on chemo. I often donât succeed, but I feel itâs important to try.â Have fun. âFunâand anticipating funâis good medicine. I always try to have a fun adventure or project planned.â Laugh. âIt is a bad situation indeed where no humor can be found. I find myself in such ridiculous situations sometimes that I canât help but see the humor. The day I canât laugh at myself is the day Iâm in real trouble.â Stay connected. âKeep up good communication with friends. Itâs crucial.â
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blood work,â she explains. âChemo is hard on the skin, the hair, the teeth, and especially the blood. It knocks my blood counts down to the point where I often need transfusions. I go in every third day or so to get blood work, so I canât be that far away. There are a limited number of places I can go because I might need to get my blood checked.â For someone who loves to travel, that is a frustrating byproduct of treatment. âItâs really hard to stay on chemo indefinitely,â Dr. Gralow explains. Patients who receive long-term chemotherapy can develop neuropathy (nerve damage). Sometimes patients need to switch regimens, not because the drugs are not effective but because of side effects. Some patients are able to take breaks from treatmentâbut in Renelleâs case, the cancer is aggressive and fast growing, so it is becoming more challenging for her to take breaks from chemo. The side effects associated with targeted therapies are milder than those that come with chemo and often include stomach upset, diarrhea, skin rash, and fatigue. The milder side effects, however, can be offset by their frequency. âChemotherapy is given in intervals. That creates a pattern where patients have side effects for a couple of days after treatment and then go back to feeling normal until the next round,â Dr. Hyman says. âMany of the targeted therapies are given every day. Even mild side effects, when experienced on a daily basis, become a huge quality-of-life issue.â
Emotional Challenges of Treatment Equally important are the emotional challenges of living with metastatic disease. âItâs really tough to get your head around having incurable cancer,â Dr. Gralow says. âThat is scary. Depression and anxiety are common. Even when youâre doing well, youâre always afraid
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of what the next scan or the next blood test will show.â Metastatic cancer can have a huge emotional tollânot only on the patient but also on the family. Different patients handle it differently, but most report that attitude is everything. âI just take it day by day and try to focus on positive things,â Renelle says. âI donât know why I have cancer. I just do. It is what it is, so I might as well make the best of it.â How has she made the best of it? By seizing every opportunity to live the life she wants to live. During a break in treatment, she traveled to Australia for a horseback and camping trip in the mountains, thanks to a free plane ticket from a friend. Now that her treatment requires her to stay closer to home, Renelle has turned her attention to the treasure huntâit inspires and energizes her. She feels hopeful, like sheâs gaining on the treasure and not wasting a moment of her life.
Balancing Life and Treatment What Renelle and many other cancer patients have learned is that alongside cancer and its treatment, daily lifeâwith all of its responsibilities and challengesâkeeps on coming. That can be one of the most challenging aspects of living with metastatic cancer: how do you juggle everything? Support is key, and Renelle has a lot of it. She has learned to accept help from friends and family. âThe cancer wonât leave me alone to do the things I want to do, but I just try to appreciate life,â Renelle says. âEvery cancer patient, if theyâre paying attention, receives the gift of knowing that you just shouldnât take anything for granted ever. Itâs a gift I wish I could pass on to everyone without all the ickiness that comes with it.â Dr. Gralow says that this is a common perspective: âA lot of times a metastatic
diagnosis helps you reprioritize what is important in your life. Life is precious. All of us could die at any time. A cancer diagnosis helps us try to get rid of the junk in our life, as much as we can, and make sure that weâre doing the things that are important to us.â For some people that means quitting their job or going on disability. âIâve had patients say, âMy job is not very rewarding.â So they use it as an opportunity to make a change,â Dr. Gralow says. âAny metastatic patient who is in treatment, I can justify helping them get on disability.â Other patients love their jobs, and they find a way to balance work and treatment. Everyone is different, but the common thread is that cancer is the great âre-prioritizer.â âWhatever you want to do, get it in while you can,â Renelle insists. âMake it happen.â
The Future of Metastatic Treatment Doctors have made enormous strides in treating metastatic cancer in the past decade, and the trend will likely continue. âI think the treatment of metastatic disease is really hopeful in the genomics era,â Dr. Gralow says. âItâs certainly going to help us with allowing metastatic disease to become more like a chronic disease. For some patients we may even be able to say weâve cured their metastatic disease.â One promising development: patients are living long enough to gain access to new drugs. They are hitchhiking, so to speak, onto the next treatment strategy. âIn two years weâre going to have a whole bunch of different drugs,â Dr. Gralow says. Translation: As new treatments become available, there is hope for those living with metastatic disease. And hope, it turns out, is perhaps the most important strategy of all. âIâm not going to give up ever,â Renelle insists. Of course not; she still has a treasure to find.
The Truth about Bone Health What really matters when it comes to strong bones? By Mia James
H
ealthy bones are a fundamental part of living and aging well. By keeping our bones strong, we decrease our chance of fractures and are able to perform daily tasks and enjoy our favorite activities. Although certain changes to our bone structure (such as osteoporosisâreduced bone mass and quality) are inevitable as we grow older, there is a lot we can do to stay strong. Published recommendations for bone health include calcium and vitamin D supplementation and weightbearing exercise, among others. As you consider your own strategy, you will want to understand what is likely to have a benefit and what is not, which approaches may or may not work for you, and which tactics might be more hype than help. Calcium and Vitamin D Calcium has long been part of the bone health conversation. More recently, discussions of how vitamin D may help the body absorb calcium have entered
the discussion, and research findings are increasingly teaching us about how calcium and vitamin D may both work to benefit bones. It appears that you are more likely to benefit from vitamin D if you take recommended dosages while also consuming a calcium-rich diet. In 2012 a study published in the New England Journal of Medicine found that women older than age 65 who took more than 800 international units (IU) of vitamin D per day were 30 percent less likely to experience hip fractures and 14 percent less likely to experience nonspine-related fractures. On the other hand, those who took less than 800 IU of vitamin D per day had no significantly reduced risk of fracture. When it comes to how calcium and vitamin D really work, however,
there is some fine print. According to Christopher R. Shuhart, MD, MHA, CCD, from the Swedish Bone Health and Osteoporosis at Swedish Medical Center program in Seattle, for much of the population âcalcium and vitamin D are the foundation for good bone health, but theyâre not treatment.â He therefore encourages patients to avoid focusing on supplements and to instead find more ways to get these nutrients through a balanced diet. And because too much supplemental calcium may increase certain health risks, such as kidney stones, dietary sources are again preferable. Calcium is relatively easy to get through diet. We are all familiar with sources like dairy products, leafy
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greens, and assorted calcium-fortified foods such as orange juice. Some people, however, might still benefit from supplements, says Dr. Shuhart. For example, patients diagnosed with osteoporosis are often prescribed 12,000 milligrams (mg) or more of calcium, an amount that is sometimes difficult to get through diet alone. Vitamin D is not as easy to get through diet (fewer foods contain vitamin D than calcium), but the body will naturally form vitamin D
flashes, night sweats, and more. It also appears that HRT may help reduce fracture risk in postmenopausal women. âHormone replacement therapy has benefits for the right patients,â says Dr. Shuhart. Because there has been concern in the past that HRT may increase the risk of cardiovascular disease and breast cancer, the ârightâ patients tend to be women with low risk in these areas. Calcium and vitamin D may also be helpful for women taking HRT. In 2013
How Is Your Bone Health? Find Out with a Bone Density Test Other than a fracture, it can be difficult to determine the health of your bones without a bone mineral density (BMD) testâwhich, we can all agree, is a better alternative than discovering a weakness through injury. Your doctor can use a BMD test to detect osteoporosis and determine if you are at risk for fractures. The test measures levels of calcium and other minerals that indicate bone density. They are performed most commonly with a dual-energy X-ray absorptiometry (DEXA) scan.
with direct exposure to ultraviolet B sunlight. You need about 10 minutes of unprotected sun exposure to produce a dayâs worth of it. This can be tricky, however, because direct sun exposure can increase the risk of skin cancer, and, depending on where you live, you may not have sun year-round. In such cases, foods such as fatty fish (salmon, mackerel, and tuna), eggs, and fortified foods can bridge the gap, as can supplementation. Hormone Replacement Therapy âMenopause is the biggest factor in bone loss over a womanâs adult life,â says Dr. Shuhart. As estrogen production slows, rates of bone loss speed up. âLosing estrogen,â he explains, âis the biggest driver in a womanâs risk of osteoporosis.â Some women choose to use hormone replacement therapy (HRT) with estrogen alone or estrogen plus progesterone to help them cope with symptoms of menopause, such as hot
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researchers with the Womenâs Health Initiative, a study of more than 30,000 postmenopausal women (many of whom were taking HRT), explored the effects of HRT, calcium, and vitamin D. Participants included both women who took HRT and those who did not. Both groups were given either placebo (an inactive substitute) or 1,000 mg of calcium and 400 IU of vitamin D daily. They found that women who took the supplements along with HRT experienced a significantly reduced rate of hip fracture compared with those given HRT plus placebo. The conclusion: If you are a postmenopausal woman, HRT may help protect your bones, and you may be able to boost its benefits with calcium and vitamin D. Obesity We are well aware that obesity is a significant health risk for many serious conditions, including heart disease, cancer, and diabetes; now it appears
that excess body fat can compromise our bone health as well. A key point in the body weightâbone health conversation is body composition: if muscle constitutes more of your weight, you are more likely to have healthy bones; if extra pounds are due to fat, your bones may be at risk. Though there may be other biological factors at work, Dr. Shuhart explains that body fat is likely associated with poorer bone health, in part due to lower physical activity among people with excess fat. And because less activity can translate into less time outdoors and therefore less sun exposure, this population may not be getting enough natural vitamin D from the sun, either. Excess body fat can also increase levels of bone marrow fat, which increases the risk of osteoporosis. Researchers in a 2013 study determined that obese participants, though otherwise healthy, who had more fat in their blood, muscle, and liver also had higher levels of fat in their bone marrow, which causes bones to weaken. The link between bone marrow fat and weak bones is found in the process that makes bones larger and stronger: resorption and formation (the continuous removal of old bone and addition of new bone). Though researchers do not understand exactly how obesity interferes with this process, it seems that fat either triggers cells to break down bone too quickly or to overpopulate it with fat cells. Alcohol Consumption Drinking moderate amounts of alcohol (10 to 20 grams of alcohol per day, or one or two standard drinks) may help prevent osteoporosis in older women. While this may sound too good to be true, findings suggest that raising your glass to bone health may be a valid measure. Researchers in a 2012 study followed 40 postmenopausal women who were considered moderate drinkers. None of these women were using HRT, so it was not a factor in their bone health. Using
blood markers, the researchers monitored the rate of bone turnover among participants, as increased turnover is a risk for osteoporosis. They found that when the women stopped drinking alcohol for two weeks, bone turnover increased. When they started drinking again, turnover returned to previous levels, possibly due to an estrogen-like effect that alcohol may have in reducing bone turnover. âAlcohol consumption may have a short-term impact on bone metabolism that might be beneficial to bone health,â explains Dr. Shuhart. He says that while this study looked at young postmenopausal women, researchers have made similar findings in the general populationâgiving more credence to the link between alcohol and bone health. While this is great news among women who already enjoy moderate amounts of alcohol, the evidence isnât strong enough to suggest that you should take up drinking to prevent osteoporosis because there are longterm alcohol-related health risks (liver damage, for example) to consider. But if you do drink, enjoy that glass a little more knowing that it is likely not harmingâand maybe even helpingâ your bones. Exercise Along with the well-known stress and weight management benefits that physical activity provides, moving our bodies also plays an important role in bone health. Specifically, weightbearing exercise, or activities where we are on our feet, can help keep bones strong by stimulating them to produce more bone tissue. âGenetically, our bodies are designed to be physical,â says Dr. Shuhart. Our bones need a certain amount of stress to stay strong, which modern life doesnât naturally provide for everyone. âThe more stress bones get, the stronger they get,â he explains. To create this stress (which our
ancestors generated through daily life as they carried out agricultural and other physically challenging tasks), we must turn to exerciseâbut not just any activity. âNot all exercise is created equal when it comes to bones,â Dr. Shuhart says. âTo slow bone loss, you need activities with added load, resistance, and impact, but all of these activities have to be performed safely in osteoporosis patients.â While you might enjoy activities that are not considered weight bearingâsuch as swimming or cycling, which certainly have cardiovascular and other wellness benefitsâ adding weight-bearing, resistance, and impact exercise to your routine will help maintain strong bones. Fun and accessible examples include running, walking, hiking up and down stairs or hills, yoga, weight-lifting, and many more. What You Can Do Study doâs and donâts and fads and facts aside, the takeaway message is that there is plenty you can do in your daily life to help keep your bones strong: eat a calcium-rich diet, get your vitamin D (through sun exposure, diet, or supplements), exercise (including weight-bearing, resistance, and impact activities), consume alcohol moderately (if you do drink), and maintain an ongoing dialogue about bone health with your healthcare team.
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Ask a Question, Change a Relationship By Denise King Gillingham, LMSW, ACC, CPM
W
hen you think of an important relationship in your life, do you recognize it as a living entity that is affected by the choices you make? From choosing to be in the relationship in the first place to choosing how you show up in the relationship, each choice you make has an impact on how the relationship develops. When was the last time you took a step back and asked yourself, How are my choices affecting my relationship, and who am I in my relationship with this person? Taking a closer look at our choices and the roles we play in our relationships can help us grow as individuals and help our relationships thrive. Our roles within relationships are determined by many
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What do I want from the relationship?
Companionship, intimacy, knowledge, funâthe list is long. Whatever your needs, be clear in your thoughts and actions. For example, if you seek companionship and your partner asks if you would mind if she went shopping with a friend on a Saturday, you might suggest that she might not go at a time that you traditionally spend together. Being aware of your needs allows you to express them in a way that is beneficial to your partnership.
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different factors. Professionally, your relationships with your coworkers (and to your work) may be defined by the functions of your position and the reporting structure of your company. As a parent your role in your relationship with your child may be shaped subconsciously by your relationship with your own parents. Your role within an intimate partnership might have more to do with your ideas of how you are âsupposedâ to behave as part of a couple. In each relationship we personalize and mold our roles based on who we are and what we want. Asking questions about the role you play in your various relationships can offer perspective and allow you to nourish your relationships. Try asking yourself the following six questions.
Am I direct?
Do you say what you think, not what you think your partner wants to hear? When we speak directly, from our hearts, we are easier to understand; the message is clear. For example, saying, âIt makes me feel good when you ask me about my day,â offers your partner direct, specific information about what you need. What can you do to make your message more clear?
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Do I choose my roles based on who I am and my values? Work with your partner to divvy up responsibilities. For instance, you may always have done the cooking in your home, while your husband has taken on chauffeuring the kids around to their activities; but your husband may actually like to cook but has never told you because he does not want to invade your turf. He may value cooking, while you value moving around and travel and would be happier behind the wheel, in his current role. Neither person is having his or her needs met. Ask yourself if you are honoring your values when making choices.
âAsking questions about the role you play in your various relationships can offer perspectiveâ
Denise King Gillingham, LMSW, ACC, CPM, is a certified
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How do I react to repair attempts?
Relationships are more successful when efforts to reconcile are accepted by the other person. If you are unhappy about an interaction, discuss the situation with your partner and look at it as an opportunity for growth, as a way of repairing the relationship.
4
How is my relationshipâs positivity index?
One predictor of a healthy relationship that will endure is what John Gottman, author of The Seven Principles for Making Marriage Work, calls the 5:1 ratio. According to Gottman, relationships should have five positive touches for each negative one. Are you making the choice to offer positive touches within your relationships? Remember, even seemingly small gestures, such as a nod, a smile, or a compliment, can be powerful positive touches.
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How do my reactions affect me and my relationships with others? Before you say something in a burst of emotion, consider how your response will affect your relationship. We do not have control over what happens to us, but we can control how we react. What powerful questions can you think of that might change your relationship?
coach and mediator who specializes in helping people navigate relationships skillfully. Denise has always fulfilled her passion for working with people. She brings a multifaceted background to her practice: she has more than 15 yearsâ experience in coaching and mental health as well as a background in outplacement consulting and financial services, and she has practiced in the United States and Europe. Deniseâs experience includes: executive coach, Lee Hecht Harrison; behavioral coach in the prediabetic adolescent and adult weightmanagement programs, St. Lukeâs Medical Center; private therapy practice in Prague, Czech Republic, where she worked with issues ranging from third-culture kids to marriage and family problems; crisis intervention work for New York University, Prague, and The International School, Prague; substance abuse therapy at the Bronx VA Medical Center; and inpatient therapy at The Paine Whitney Clinic. A graduate of Columbia Universityâs School of Social Work and of Franklin and Marshall College, Denise serves on the Board of Directors of the Idaho Mediation Association and is listed on the Idaho Supreme Court roster of custody and visitation mediators. Contact Denise at dkgcoaching.com.
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RESOURCES ã©ã³ã»ãã©ãŒã»ã¶ã»ãã¥ã¢ã»ãã¡ã³ããŒã·ã§ã³ããã³ã¢ã°ã©ãã£ãŒæ©æãå¯èŽ
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ããå©æéã®æäŸãè¡ã£ãïŒè¡ã£ãŠããå»çæ©é¢ã¯äžèšã®ãšããã§ãã
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å¯èŽãã6å°ã®ãã³ã¢ã°ã©ãã£ãŒæ©åšã¯2013幎9æçŸåšãåèšããã 16300人ã®å¥³æ§ã«å©çšããŠé ããŠããŸããæ€èšºãå蚺ããçŽ60%ã®å¥³ æ§ããåããŠãã³ã¢ã°ã©ãã£ãŒæ€èšºãå蚺ããããšã¢ã³ã±ãŒãã«åçã㊠ããããã³ã¢ã°ã©ãã£ãŒæ€èšºãæ®åããŠããªãããšãç©èªã£ãŠããŸãã Below is a list of hospitals where Run for the Cure® Foundation has donated a mammography machine. 16,300 women have received screenings on these machines and 60% indicated it was their first-ever screening.
åèå¥çç é¢ / Chiba Kensei Hospital ã 262-0032 åèåžè±èŠå·åºå¹åŒµçº 4-524-2 (4-524-2 Makuhari-cho, Hanamigawa-ku, Chiba-shi 262-0032) tel. 043-276-1851 www.chibakensei-hp.jp åèæ°éœåžã©ãŒãã³ã¯ãªãã㯠/ Chiba Shintoshin Rurban Clinic ã 270-1337 åèçå°è¥¿åžèæ·± 138 (138 Soufuke, Inzai-shi, 270-1337) tel. 0476-40-7711 www.chibashintoshi.or.jp
èš å ç / Ibaraki ãŸã€ã°ããŠã£ã¡ã³ãºã¯ãªãã㯠/ Matsubara Women's Clinic ã 300-1152 èšåççš²æ·é¡é¿èŠçºèå·æ¬é· 2018-7 (2018-7 Arakawahongo, Ami-cho, Inashiki-gun, Ibaraki 300-1152) tel. 029-830-5151 www.happy-mw.com
å»çæ³äººéŠšä»äŒ è€æç é¢ / Fujikake Hospital ã 509-0214 å²éçå¯å åžåºèŠ 876 (876 Hiromi, Kani-shi, Gifu 509-0214) tel. 0574-62-0030 www.okbnet.ne.jp/~fuj598
Foundation.
æ± äº¬ éœ / To k y o èè·¯å åœéç é¢ / St. Luke's International Hospital ã 104-8560 æ±äº¬éœäžå€®åºæç³çº 9-1 (9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560) tel. 03-3541-5151 www.luke.or.jp æå倧åŠç é¢ ä¹³è ºå€ç§ ⢠ãã¬ã¹ãã»ã³ã¿ãŒ / Shouwa University Hospital Breast Center ã 142-8666 æ±äº¬éœåå·åº æã®å° 1-5-8 (1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666) tel. 03-3784-8000 showa-breast.com
å è ç / Chiba
å² é ç / Gifu
Medical Institutions that support Run for the Cure®
æ±äº¬å ±æžç é¢ / Tokyo Kyosai Hospital ã 153-8934 æ±äº¬éœç®é»åºäžç®é» 2-3-8 (2-3-8 Nakameguro, Meguro-ku, Tokyo 153-8934) tel. 03-3712-3151 www.tkh.meguro.tokyo.jp
ä¹ å· / Ky u s h u 瀟äŒå»çæ³äººåæäŒ çžè¯ç é¢ / Sagara Hospital ã 892-0833 鹿å 島ç鹿å 島åžæŸåçº 3-31 (3-31 Matsubaracho, Kagoshima-shi, Kagoshima 892-0833) tel. 099-224-1811 ãã¬ã¹ããã¢ãªãã°ç é¢ / Breastopia Namba Hospital ã 880-0000 å®®åŽåžäžžå±± 2-112-1 (2-112-1 Maruyama, Miyazaki-shi, Miyazaki 880-0000) tel. 0985-32-7170 www.breastopia.or.jp
å æµ· é / Hokkaido 瀟äŒå»çæ³äººåæ åæã¯ãªãã㯠/ Hokuto Clinic ã 080-0833 垯åºåžçš²ç°çºåºç· 9-1 (9-1 Kisen, Inadamachi, Obihiroshi, Hokkaido) tel. 0155-47-8080 www.hokuto7.or.jp
倧 éª åº / Osaka 糞æ°ã¯ãªãã㯠/ Itouji Hospital ã 559-0016 倧éªåžäœä¹æ±åºè¥¿å è³å± 1-1-6 (1-1-6 Nishikagaya, Suminoe-ku, Osaka 559-0016) tel. 06-6681-2772 www.myclinic.ne.jp/itoujiclinic/pc/index.html å»çæ³äºº çŽå¹žäŒ è±äžæž¡èŸºç é¢ / Toyonaka Watanabe Hospital ã 561-0858 倧éªåºè±äžåžæéšè¥¿çº 3-1-8 (3-1-8 Toyonaka-shi, Osaka 561-0858) tel. 06-6864-2301 www.watanabe-hp.or.jp/hospital
NPOæ³äºº Run for the Cure® Foundation
ã141-0032 æ±äº¬éœåå·åºå€§åŽ3-6-28 Daiwa倧åŽ3äžç®ãã«6é
(Daiwa Osaki 3-chome Bldg. 6F, 3-6-28 Osaki, Shinagawa-ku, Tokyo 141-0032) Tel: 03â-â6420â-â0860
Email: inquiries@runforthecure.org
www.runforthecure.org
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PiNK ⢠W INTE R 2015
Do you really know about breast cancer? What do you know about breast cancer? How can you tell if you have any abnormalities relating to breast cancer? What does it look like? What does it feel like? How can you detect it?
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Here is how to apply to have a Lemon Seminar at your school, company, or other location.
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Number of attendees: minimum 10
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Average length of seminar: 1â1.5 hours
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Language: Japanese or English
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Fee: FREE!
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We ask of you to provide a venue for the seminar equipped with a screen, projector, computer and microphone if necessary. Please contact pink@runforthecure.org for details and reservations.
Campaign designed by worldwidebreastcancer.com
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Education Initiative âThe Lemon Projectâ
Progress Report
T
he Lemon Project was established as a new education initiative for Run for the Cure® Foundation in September 2013. Though the number of Japanese people who have heard of breast cancer is growing, very few know what the symptoms are or how to carry out self-examination. The Lemon Project introduces and enriches an understanding of breast cancer in Japan through seminars on the signs of breast cancer and breast selfexamination procedures, describing key points through the analogy of lemons. Those who attend the seminar learn what breast cancer lumps feel like and practice how to use their fingers for a thorough self-examination, working with silicon breast models. Celebrating the first anniversary this fall, the project further developed between September and November, which included extending its reach in
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the Breast Cancer Awareness Month of October. Through cooperation by upper management, we jointly organized onsite seminars with companies and schools, such as Delta Air Lines, American Airlines, Ralph Lauren, Morgan Stanley, Google and TOYAMA Barber & Beauty School. The seminars were an integral part of their Pink Ribbon activities â at luncheons, and morning and after-work seminars. As of the end of November 2014, The Lemon Project has organized some 40 seminars, reaching around 1,250 men and women at companies and schools, as well as conferences. The positive feedback from those who attended the seminars is encouraging, for example: âI have never had a mammogram before, as I was scared of having one. But learning the importance of early detection and treatment, as well as annual breast cancer screening, I have decided to have an annual screening
from next time on.â Other perspectives received included: âI did not know how to do a breast selfexamination until today. The self-exam practice [during the seminar] using a breast model was very interesting and practical. I will start a monthly self-examination from today.â Breast cancer remains the most common cancer for Japanese women â and with the highest lifetime incident rate. âPink Ribbon,â the international symbol of breast cancer awareness, and âbreast cancerâ can be heard and found often in many places around Japanese cities nowadays; however, many challenges to educate and enlighten Japanese women remain. When comparing annual breast cancer screening rates in Japan and the US, the Health, Labour and Welfare Ministry in Japan shows about 24% of Japanese women over 40 years old have a routine checkup1, whereas approximately 72.5% of American women between the ages of 50 and 74 do so, according to the Centers for Disease Control and Prevention2. Sadly, Japanese public education does not incorporate in the school curriculum any lectures on the importance of routine checkups, the signs of breast cancer, or how to do a monthly selfexamination. Yet, knowledge empowers you and potentially saves lives. The Lemon Project will continue to develop and organize seminars to raise awareness and to share about âsaving your life â and that of your loved onesâ by getting to know oneâs body better.â
1
Center for Cancer Control and Information Services, National Cancer Center, Japan
2
Centers for Disease Control and Prevention (CDC). Cancer screeningâUnited States, 2010. MMWR 2012;61(3):41â45.
PiNK ⢠W INTE R 2015
Campaign designed by worldwidebreastcancer.com
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t our 11th annual Pink Ball held on Friday, March 7th, 2014, we collaborated once again with one of our sponsors this year, S.T. Dupont, to host a "Dear Survivor" corner. All guests had the opportunity to write a personal message to a survivor using the elegant pens created by S.T. Dupont. Toward the end of the evening, three survivors each chose their favorite message, and the authors were awarded a Defi Blue, Red or White Ballpen worth around 30,000 yen each. We thought it timely to share some of these inspiring messages with our readers.
In honor of all those who fought the battle with breast cancer and won, those who are fighting the battle as I am writing this, and those who fought and sadly lost the battle ⊠Fight to the maximum and live your life to the maximum with all your loved ones.
Dear Survivors, Paying the huge respect to every single one of you. Cannot imagine the great strength you all have. Wishing you all the best.
7
PiNK ⢠W INTE R 2015
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My mother and mother-in-law were diagnosed with breast cancer three years ago. My family and my husbandâs family had not had much interaction, but because of this disease, our families started building closer relationships and supporting each other. Treatments were
very tough, but both of them overcame these challenges and are now living their lives to the fullest every day. The disease has brought our families closer together, enabled us to look forward to a future together; and I am grateful for such experiences.
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There is only one âyouâ in this world. For those whom you love, for those who love you, and for yourself, spend joyous, amazing days. You are not alone. I will be praying for you.
I have a younger sister who has been fighting this disease for a long time. Even when things are tough, she never loses her smile. There is always a light coming in from above. Slowly⊠looking forward âŠ
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PiNK ⢠W I N T ER 2015
6
How you can help PiNK èªãžã®ãååã®ãé¡ã
Saving Lives We feel that a vital tool for better informing Japanese women about the value of early detection for survival, especially in medically underserved regions, is PiNK. Our quarterly womenâs magazine is distributed for free at key nationwide locations listed below. Please contact us if you are interested in becoming a sponsor of PiNK by underwriting the printing costs or by broadening our distribution points. The fact remains that regular screening and self-examination are key steps to saving a womanâs life. Please help us to continue getting the word out.
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General Donations
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General donations can be made at www.runforthecure.org with your credit card or through a bank transfer to the below account.
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PiNK ⢠W INTE R 2015
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Pick up your free copy of PiNK Magazine at the following locations Hokkaido Asahikawa 37 Seven Bldg. 2F 7choume 3jo-dori Asahikawa tel.0166-213155 Nail Salon CRYSTAL 1-1-12 2jo-higashi Chuo-ku minami Sapporo tel.011-221-
Toshima-ku tel.03-5914-0471 Katsushika Central Library 6-2-1-3F Kanamachi Katsushika-
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865-6464 Yoga Studio ease space 3-1-37-1F 4jo Kitano Kiyota-ku Sapporo tel.011-885-
9 Kichijouji-minamimachi Musashino-shi Nomura Hospital 8-3-6 Shimorenjyaku Mitaka-shi
7911 Relaxation Plana 9-6-30 6-jo Hassamu Nishi-ku Sapporo tel.011-666-3358 Hokuto
tel.0422-47-4848 Hachiouji Nyuusen Clinic 4-8 4F Misakicho Hachiouji-shi tel.042-655-
Hospital 7-5 kisen Inada-machi Obihiro-shi tel.0155-47-7799 Tohoku Tahibo 3-10-15
5355 Mukaihara Ni-chome Clinic 2-1-19 2F Mukaihara Higashi-Yamato-shi tel.03-5914-
Izumichuo Izumiku Sendai-shi Miyagiken tel.022-772-6201 Ibaraki Matsubara Women's
0471 Kanto-Other Giulietta Garden 17-22-803 Chigasaki Chuo Tsuzukiku Yokohama
Hospital 2018-7 Arakawa-hongo Ami-machi Inashiki-gun tel.029-830-5151 Tokyo St.
Kanagawa tel.045-943-9661 Fujishin Yokohama 1-1 Sakuragicho Nakaku Yokohama
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Chiyoda-ku tel.03-3234-8496 Waseda Eye Clinic 14 Babashitacho Shinjuku-ku tel.03-3207-
Chiba-shi tel.043-246-0350 Fujishin Chiba 3-18-8 Shinchiba Chuo-ku Chiba Rurban Clinic
8101 B&D Sports Shop 2-7-1 Ichigaya Sadobaracho Shinjuku-ku Fujishin Tokyo 8-12
138 Soufuke Inzai-shi Chiba tel.0476-40-7711 Delta Air Lines Executive Lounge Narita
Sumiyoshicho Shinjuku-ku Showa University Breast Centre 1-5-8 Hatanodai Shinagawa-
International Airport United Airlines Red Carpet Club Narita International Airport Niigata
ku tel.03-6426-3905 Temple University Japan Campus 2-8-12 Minami Azabu Minato-
Cancer Centre Niigata Hospital 2-15-3 Kawagishi-machi Chuo-ku Niigata-shi Niigata
ku tel.03-5441-9800 Tokyo American Club 2-1-2 Azabudai Minato-ku tel.03-4588-0670
tel.025-266-5111 Fujikake Hospital 876 Hiromi Kani-shi Gifu tel.0574-62-0030 Chuubu
Tokyo Kyousai Hospital 2-3-8 Nakameguro Meguro-ku tel.03-3712-3151 The Westin
Yoga Studio Reina Park 2-20-11F Oosu Nakaku Nagoya-shi tel.052-253-7768 Nail School
Tokyo 1-4-1 Mita Meguro-ku tel.03-5423-7000 Sunroom YOGA ~Yoga Le Ciel~ 3-27-
"Bi-life support" 1-18-10-907 Izumi Nakaku Nagoya-shi tel.052-253-9169 Fujishin Nagoya
4 Kamimeguro Meguro-ku Resort Yoga Studio HeartOne 2-17-6-1B Jiyuugaoka Meguro-
2-6-6 Meieki Nishiku Nagoya-shi Osaka Itouji Hospital 1-1-6 Nishi-Kagaya Suminoe-ku
ku tel.03-6421-2818 Jiyuugaoka Yoga Studio 1-3-22 Jiyuugaoka Meguro-ku tel.03-3718-
Osaka-shi tel.06-6681-2772 New Balance Osaka 1-6-2 Kitahorie Nishiku Osaka-shi tel.06-
4540 NOS Ebisu (Bar/ Dining/ Event space) 2-3-14-B1 Ebisu-minami Shibuya-ku tel.03-5773-
6578-9040 Toyonaka Hospital 3-1-8 Hattori Nishi-machi Toyonaka-shi tel.06-6864-2301
1727 JZ Brat (Bar/ Dining/ Event space) Cerulean Tower 2F 26-1 Sakuragaokacho Shibuya-ku
Kaizuka Hospital 3-10-20 Hori Kaizuka-shi tel.072-422-5865 United Airlines Lounge
tel.03-5728-0168 charm form (Reservation only) 1-3-18 #A-90 Shibuya Shibuya-ku tel.03-6418-
Kansai International Airport Kinki-Other Ise Red Cross Hospital 1-471-2 Funae Iseshi
7218 New Balance Tokyo 5-50-3 Jinguumae tel.Shibuya-ku tel.03-5774-8576 Jamrock
Mie-ken tel.0596-28-2171 Chuugoku Aroma and Yoga Salon 2-5-12-205 Chuo Kureshi
Cafe 1-21-15 4F Jingumae Shibuya-ku Tokyo Shibuya Corazon (Manicure/ Hairdresser) 40-5
Hiroshima tel.090-9060-1578 Kyuushu Breastopia Namba Hospital 2-112-1 Maruyama
B1 Kamiyamacho Shibuya-ku tel.03-3481-5888 imageMILL Office 3-38-11-703 Jinguumae
Miyazaki-shi tel.0985-28-9616 AKO Bandana 1-9-26 Matsuyama Miyazaki-shi tel.0985-28-
Shibuya-ku Las Chicas Aoyama 5-47-6 Jinguumae Shibuya-ku tel.03-3407-6864 Future
9535 Hair Make Natural
Nail (Nail Salon) 5-47-1-1F Jingumae Shibuya-ku tel.03-6427-3030 Fujishin Aoyama FASTA
7144 Sagara Breast Centre 3-28 Tenokuchi-cho Kagoshima-shi tel.099-224-1811 Kaneko
5-47-1 Jinguumae Shibuya-ku Ginza Plastic Surgery Clinic 1-26-6 4F Minami-Ikebukuro
Clinic 8-6 Kamiaratamachi Kagoshima-shi tel.099-214-2800
(Hairdresser)
4-4152 Totoro-machi Nobeoka-shi Miyazaki tel.0982-37-
eã¡ãŒã«ã¢ãã¬ã¹ã ãè¿ãã«é åžå Žæããªãå Žåã¯ãé£çµ¡ãã ãããæ°åã ãäœæãé»è©±çªå·ã ïŒããå Žåã¯åžæããã¯ãã³ããŒïŒ ãäžèšãŸã§ãç¥ãããã ããã
If you cannot find a location near you, please contact us with your name, address, tel, email, and any past issues you would also like to receive. email: pink@runforthecure.org tel: 03-6420-0860
PiNK ⢠W I N T ER 2015
4
RFTC PRODUCTS ONLINE SHOP
www.runforthecure.org/shop/ ã¹ã¯ããã¹ããŒã»ã¯ãªã¹ã¿ã«ã䜿çšãã ããŽã»ãããŒã Logo Brooch with Swarovski elements
RFTC ãšã³ããã° Eco-bag Â¥ 300
Special edition
Â¥ ïŒ,500
éå® ã¹ãã·ã£ã« ãšãã£ã·ã§ã³
RFTC æºåž¯ã¹ãã©ãã
RFTC strap ¥ 300
RFTC T-shirt 2013 XLã®ã¿
Â¥ 1,000
RFTC ãã£ãã RFTC cap Â¥ 500
2005 L/XL/XXL
UNTIL THERE'S A CURE ãã³ã¯ãã³ã Pink Band
NEW!
ãªã¹ã¹ã¡ïŒ
MïŒL
Â¥ 300
2012 L/XL
RFTC ããã¯åŒé»ããŒã«ãã³
RFTCã¯ãRun for the Cure®/Walk for Lifeã€ãã³ãã®ãªãªãžãã«T-ã·ã£ãã«ããã¥ãŒ ãã©ã³ã¹ãžã£ãã³ã®åè³ããããŠããŸããOur Run for the Cure®/Walk for Life event t-shirt is sponsored by New Balance Japan.
(èªå·±è§Šèšºæ³ã®å³è§£ä»ãïŒæ¥æ¬èªã®ã¿
RFTC Ballpoint pen (Self examination method in Japanese)
Â¥ 300
ãã¥ãŒããã¯ãžã«ã³ã㢠ããã¯ããŒã¯ Cubic Zirconia Bookmark ï¿¥3,360 ã¯ãªã¹ã¿ã« ããŒã ã ã¢ã¹ (ã·ã«ããŒ) çŽ 0.8cm Crystal heart earrings (silver) approx 0.8cm ï¿¥3,675
ãã¥ãŒããã¯ãžã«ã³ãã¢ä»ã ããã°ãã³ã¬ãŒ Bag hanger with cubic zirconria ï¿¥3,780
åååãè³Œå ¥ç¹æ°ããååãäœæãé»è©±çªå·ããèšå ¥ã®ãããã¡ãŒã«/ãã¡ã ã¯ã¹ã§ãç³ã蟌ã¿äžãããåšåº«ã確èªã®äžãéæãåãããåèšéé¡ãã ç¥ããèŽããŸãããªã³ã©ã€ã³ã·ã§ããããããè³Œå ¥ããã ããŸãã
www.runforthecure.org/shop/ 代éã¯ãäžèšéè¡å£åº§ã«æ¯ã蟌ã¿ãã é¡ãèŽããŸãã ïŒæãå ¥ããŸããæ¯èŸŒææ°æã¯åèªãè² æ äžããã Shop online at www.runforthecure.org/shop or email/fax us your order. After we get back to you with shipping fees and
ãã®ååã®å£²äžã®äžéšã RFTC ã«å¯ä»ãããŸãã A portion of the sales will be donated.
stock availabilities, please make payment to below account with your full name - bank fees should be incurred by purchaser.
ãæ¯æãéè¡å£åº§:
Mitsubishi Tokyo UFJ Bank
E-mail: inquiries@runforthecure.org
ãã¯ãïŒ ã©ã³ãã©ãŒã¶ãã¥ã¢ãã¡ã³ããŒã·ã§ã³
Tokuhi) Run for the Cure Foundation
www.runforthecure.org
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PiNK ⢠W INTE R 2015
Shibuya Branch Futsuu 3609116
Tel: 03-6420-0860 Fax: 03-3492-1202
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Monthly Self-Examination èªå·±æ€ 蚺ã§ãã€ãã®æ 觊ãèŠããŠã
You know your body better than anyone else.
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Know your normal so you can detect the
æ© æçºèŠãããªãã®èžãããããŠåœã
slightest abnormality immediately.
æããŸãã
When?
èªå·±æ€ 蚺ã®æ æ
After your menstruation cycle, when breasts
ççãçµãã£ãŠãä¹³æ¿ã®ç·åŒµãè «ãã
are less tender or swollen. If your cycle is irregular or you have reached menopause,
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pick a date you can easily remember and
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check every month.
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How? Raise arms in front of a mirror and examine for
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irritation, swelling or discharge.
è «ãããªãããä¹³éŠããåæ³ç©ã¯ãª ãããèŠãŠç¢ºãããã ã颚åãã·ã£ã¯ãŒã§èº«äœãæŽãæã«ã
While taking a shower or bath, gently explore your right breast and underarm area for lumps with
2
your left hand.
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Examine thoroughly, and remember how it feels.
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Follow patterns shown below, and repeat with the
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other side.
1) èžã®å€åŽããå§ããä¹³éŠã«åãã£ãŠ
⢠Spiral or ring pattern (fig.1), making concentric
ã¹ãã€ã©ã«ã«
rings that tighten in a spiral, starting on the
2) è©ã®ããäžããèã®æ¹ãŸã§ããŸãªã äžäžã« 3) ä¹³éŠããå€ã«åãã£ãŠæŸå°ç¶ã«
outer edges of the breast and ending around 3
the nipple. ⢠Vertical or "up and down" pattern (or "squares") covering the entire breast ⢠Wedge patterns in and out (or "quadrants")
次ã«å³æã§å·Šä¹³æ¿ã調ã¹ãããŸãã ããããã«å¯ãŠè ãé äžã«æããŠèª¿ ã¹ãæ¹æ³ãããã®ã§ããããããæ¹ æ³ã§æ¯æè¡ã£ãŠã¿ãŸãããã
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Lie with one arm tucked behind the head and,
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1
with the other hand, examine the opposite breast. 2
3
å€åãç°åžžãæãããšãã¯ãããã«å°éå»ïŒå€ç§ãä¹³è ºå€ç§ãä¹³è ºç§ïŒã«çžè«ããŸãããã幎ã«äžåºŠã¯ããã³ã¢ã°ã©ãã£æ€èšºã åããäºãæšå¥šãããŠããŸãã觊ã£ãŠãããããªããããªå°ããªãããèŠã€ããããšãã§ããŸãã
If you find any changes or abnormalities, contact your doctor immediately. Some abnormalities cannot be detected by touch alone; therefore, it is recommended that women receive a mammography once a year. ç£ä¿®ïŒé岡ããã»ã³ã¿ãŒ ä¹³è ºå€ç§ é«æ©ãããå»åž«
PiNK ⢠W I N T ER 2015
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PiNK ãæ èª æ è¬ãã£ã³ããŒã³ 第 å 匟 åœéž è çº è¡š ! ! Re a d e rs h i p O ffe r Wi n n e r An n o u n c e m e n t ! A
ãã«ã¿èªç©ºã§è¡ãPIC ãµã€ãã³4æ³5æ¥ å®¿æ³åž2çµ4åæ§ A four-night stay at PIC Saipan, plus Delta Air Lines for two!
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Congratulations to Megumi Fudaki and Chie Hashimoto! ãã¬ãŒã³ãå 容 1. PICãµã€ãã³å®¿æ³åžïŒã¹ãŒããªã¢ã«ãŒã 宿æ³ã 空枯éè¿ãæœèšå èšåïŒã¢ã¯ãã£ããã£ã® ç¡å¶éå©çš 2. ãã«ã¿èªç©ºãµã€ãã³åŸåŸ©èªç©ºåž
Offer details 1. Three-night stay in a Superior Room/ transfers/free use of sports and recreational facilities 2. A pair of roundtrip Delta Air Lines economy class tickets. Validity through:
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DIAVANTE ã¯ãªã¹ã¿ã«ããŒã ã·ã«ããŒãã³ãã³ã
DIAVANTE Crystal Heart Silver Pendant
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DIAVANTE Crystal Heart Silver Earrings
Run for the Cure® Foundation Logo Brooch with Swarovski elements
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Megumi Moriyasu
Yumi Iwasaki
Noriko Nakamura
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