Better Health - October 2021 by repubnews

For the most up-to-date information on COVID-19 in Western Mass., go online to masslive.com

Better Health S|

MODERN TREATMENT: Interview with Mercy Medical Center, S3 BREAST SYMPTOMS: Types of changes to watch for, S5 COVID TIMES: Detection and Care, S7

| SUNDAY, OCTOBER 3, 2021

Rays of

Hope 2021

The chances of an individual surviving breast cancer have increased significantly since 1994 when the Rays of Hope event to raise funds to fight breast cancer began. By Cori Urban

Special To The Republican

“This is partly due to better treatments and partly due to screening mammography. Just as important as new treatments is a focus on less aggressive approaches to treatment for the majority of patients who have early-stage disease,” explained Dr. Grace Makari-Judson, associate medical director, Cancer

Services; co-director, Rays of Hope Center for Breast Cancer Research; and chair of Baystate Health Breast Network, Baystate Health. “Less chemotherapy is being given in individuals with estrogen receptor positive cancer. More targeted treatments are given to those with HER-positive cancers. New drugs, including immunotherapy, are available to those with advanced disease.” One in eight women will develop breast cancer in her lifetime; one in 800 men will be diagnosed with breast cancer during his lifetime. So the Rays of Hope Walk & Run Toward the Cure of Breast Cancer again is raising money in support of the women and men in local communi-

ties faced with breast cancer. The Rays of Hope Walk & Run Toward the Cure of Breast Cancer will once again shift from an in-person event to a hybrid event in order to protect the health and safety of the community in light of the fourth wave of COVID-19. On Oct. 24, the event will welcome participants in their cars at Temple Beth El in Springfield as part of a “Pink Parade of Hope” as they show support for the hundreds of individuals living locally with breast cancer and those who are newly diagnosed. Above: Rays of Hope Tribute Flags on display at the 2020 Rays “The pandemic has halted of Hope event. many things, but our research Scenes from the Rays of Hope Walk & Run Toward the Cure for has not stopped, nor has the support we offer survivors and Breast Cancer Hybrid Virtual Challenge 2020 Parade of Hope their families throughout their event. (PHOTOS COURTESY OF FREDERICK GORE & RAYS OF HOPE) journey,” said Kathy Tobin,

director of events and annual giving for Baystate Health Foundation. “Hundreds of local families are affected each year with a cancer diagnosis and they need our support now more than ever.” There also is the opportunity to participate virtually. All survivors can submit their photo in advance for a digital group photo and a virtual program will be open for all to join in and see the impact of this event. People may also email names to be added to the annual tribute flags to be on display.(Email photos and/ or names to raysofhope@ baystatehealth.org.) Last year’s virtual event — necessitated by the COVID-19

SEE RAYS OF HOPE, PAGE S2

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Above: Rays of Hope Founder, Lucy Giuggio Carvalho, with her grandson at the 2020 Rays of Hope event.

Above: Jackie and Al Rodriguez, the 2020/2021 Rays of Hope co-chairmen, are shown here at the 2020 Rays of Hope event.

Rays of Hope

ing mammogram be delayed until at least 4-6 weeks after the vaccine dose. Of course, anyone with a breast lump or problem, should still be seen right away regardless of the timing of the vaccine.” Most breast cancers today are early stage with an excellent prognosis, she said. “Treatments are better and we have gotten better at selecting the patients needing each treatment. Management of treatment related side effects has also significantly improved.” The decision to make the Oct. 24 Rays of Hope event

“Whether it’s clinical information, an insider’s perspective or a shoulder, Rays of CONTINUED FROM PAGE S1 Hope has the professional and pandemic — raised nearly volunteer resources to help $300,000, which was half the survivors connect with what fundraising of the previous will help them. In the candor year. “The result is less money and camaraderie, we offer for research and services. So hope.” this year, Rays of Hope really Jacqueline and Alberto needs a powerful pink effort Rodriguez, of Springfield, are to fulfill our mission,” said the 2020/2021 Rays of Hope Tobin, referring to the pink co-chairmen and are proud color associated with efforts to be the first Hispanic couple to cure breast cancer. in this role. As a breast cancer Funds support the Rays of survivor and a co-survivor Hope Center for Breast Canthey know firsthand how Rays cer Research, programs, serof Hope supports the whole vices and equipment through family while all the money

According to Makari-Judson, nationwide, there has been a trend toward diagnosis of more advanced breast cancers related to women delaying their recommended screening. “During the spring of 2020, routine screening mammography was suspended as per a state mandate. Of course, for women who had a breast problem, mammography continued. New protocols were put in place for cleaning, social distancing and other measures to keep patients and staff safe,” she said. Once screening was allowed

“The pandemic has halted many things, but our research has not stopped, nor has the support we offer survivors and their families throughout their journey.”

Scenes from the Rays of Hope Walk & Run Toward the Cure for Breast Cancer Hybrid Virtual Challenge 2020 Parade of Hope recognition event. (PHOTOS COURTESY OF RAYS OF HOPE)

on line and can be printed from the Rays of Hope website. There is no established KATHY TOBIN - DIRECTOR OF EVENTS AND ANNUAL GIVING FOR BAYSTATE HEALTH fee to participate; to receive the collectible Rays of Hope the Baystate Regional Cancer raised stays in the local area. to resume, mammography hybrid came as the fourth T-shirt individuals must raise Program and Baystate Breast “We have dedicated ourselves sites were backlogged, and wave continues to impact the $50 or more. and Wellness Center and local to raise awareness and funds additional days and hours country. “First and foremost, “The survivors (and to us community programs and to support Rays of Hope to were added. “As the COVID Baystate Health is concerned that means anyone from the services including Cancer continue the incredible work vaccine became available, re- with the health and safety of moment of diagnosis) are House of Hope and Cancer they do locally including ports came in of lymph node everyone in our community our inspiration,” Tobin said. Connection. research at the Rays of Hope swelling occurring under the which is why we are encour“They don’t give up and so “Breast cancer is a difficult Center for Breast Cancer arm on the side of the vaccine. aging people to get vaccinated how can we. We are fortunate topic to address, but Rays Research,” they agreed. Although this is transient and and take all the available to live in a caring community of Hope makes it easier to “We are excited and ask that harmless, it may show up on steps to protect themselves, that literally and figuratively confront by offering a weleveryone embrace the power a mammogram, causing con- their family and friends,” said embraces cancer survivors coming, supportive environof pink and help to raise funds fusion about possible breast Tobin. and those who love them. ment where every individual to support Rays of Hope, this cancer and leading to addiTo register and fundraise Hope comes in so many ways, is respected,” said Michelle big pink hug of help that surtional testing, the doctor said. online go to BaystateHealth. by their presence, fundraisGraci, manager of events for rounds all those locally who “To minimize this risk, it is org/RaysofHope. Traditional ing, sponsorship, willingness Baystate Health Foundation. are affected by breast cancer.” recommended that a screenwalk papers also are available to share their stories and

especially in the dedicated researchers working to find the cure.” The Rays of Hope website provides numerous ideas for creative fundraising as well as support. In addition to individual fundraising, many people form teams to magnify their impact. Some choose to organize events like a bake sale, tag sale or sports outing to meet their personal fundraising goal.

For more information about this year’s Rays of Hope event, call 413-794-8001 or visit BaystateHealth.org/ RaysofHope

Embrace the Power of PINK! October 24, 2021 Drive thru Parade of Hope at Temple Beth El, Springfield Join the virtual challenge: BaystateHealth.org/RaysofHope

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Modern Treatment of

Breast Cancer By Sarah McPartland, MD, MS, FACS

Special To The Republican

I recently had the privilege of caring for a woman in her 70s who was diagnosed with breast cancer. She disclosed her grandmother was treated for breast cancer, at the time a young mother who had felt a lump while breastfeeding. The treatment her grandmother received had been difficult, and my patient was now understandably concerned about her own fate. I could not help but reflect on the extraordinary improvements that have been made in the treatment of breast cancer. For 90 years, beginning back in the 1880s, the treatment of choice for breast cancer was a “Halstead radical mastectomy,” named after William Halstead, an American surgical pioneer. This extensive “one size fits all” treatment involved removal of a woman’s breast, chest wall muscles, and all the lymph node tissue under her arm. The procedure often caused serious disfigurement and complications such as chronic pain, progressive irreversible swelling of the arm, and arm weakness from nerve injury were common. Fortunately, treatment of breast cancer has changed and improved in a dramatic fashion since the days of Halstead. So what is a woman to expect when she is diagnosed with breast cancer? The first thing I tell my pa-

For those woman who have small cancers (typically less than 5 centimeters or about the size of a peach) that have not spread to the lymph nodes or other organs, lumpectomy (sometimes called partial mastectomy) or mastectomy are offered to remove the cancer. Lumpectomy removes the breast mass and a small amount of healthy breast tissue around the mass, called the margin. Lumpectomy can often be performed through a small incision and allows for good cosmetic outcome and preservation of breast symmetry. Mastectomy involves removal of all breast tissue. A traditional mastectomy removes most of the breast skin as well as the nipple and areola. Research has shown that “skin sparing” or “nipple sparing” mastectomies can be a safe option for certain patients. These techniques allow for preservation of the breast skin, and sometimes the nipple and areola. The breast can then be reconstructed using an implant or the patient’s own tissue. At the time of lumpectomy or mastectomy, sampling of the lymph nodes may be performed. Breast cancers usually spread first to the lymph nodes under the arm (axilla). Using a technique called “sentinel node biopsy,” dyes are injected into the breast. These dyes travel to the lymph nodes in the axilla. Through

“The first thing I tell my patients is that there is no longer a “one size fits all” treatment for breast cancer.” a small cut under the arm, the surgeon can then remove these lymph nodes so they can be tested for cancer. Following surgery, additional treatments with breast radiation, chemotherapy, immunotherapy, and/or hormone therapy may be recommended. For women who choose lumpectomy, radiation treatments to the breast after surgery reduce the risk of breast cancer recurrence. Hormone therapy is recommended for women whose cancers use estrogen as a fuel. These oral medications block the effects of estrogen and decrease the risk of the cancer coming back. Immunotherapy options for breast cancer are rapidly growing and evolving. These treatments use the woman’s own immune system to help kill the cancer cells. While surgery remains the first line treatment of breast cancer for most women with early stage disease, women with more advanced cancers, such as those that have spread

size treats all” approach to breast cancer. I encourage every woman with breast cancer to discuss all treatment options with her doctor, and to feel empowered that there are many weapons available to fight this battle.

For information about Mercy’s Center for Breast Health and Gynecologic Oncology, please visit TrinityHealthOfNE.org/ Mercy-Breast-Gyno

Above: Dr. Sarah McPartland, medical director of the Center for Breast Health and Gynecologic Oncology at Mercy Medical Center, an NAPBC accredited program. (PHOTO COURTESY OF MERCY MEDICAL CENTER)

It’s time to make time. Schedule your mammogram today! Early detection of breast cancer is important, and mammograms are safe, fast and easier than you may think. If you or someone you love is concerned about breast disease, Mercy Medical Center offers comprehensive resources for screening, diagnosis and treatment for cysts, lumps, breast pain and breast cancer. For scheduling information, please scan the QR code or visit TrinityHealthOfNE.org/Breast.

TrinityHealthOfNE.org/Breast 3156152-01

tients is that there is no longer a “one size fits all” treatment for breast cancer. Thanks to advances in chemotherapy, hormone therapy, immunotherapy, and the advent of new surgical techniques, women and their physicians have many tools at their disposal to treat breast cancer. When determining the best options for treatment, the “clinical stage” of the cancer is calculated based on the size of the mass and whether it has spread. This is done using physical exam, mammography, and sometimes other imaging tests (such as ultrasound or MRI). The tumor is given a “grade” which reflects how different the cancer cells look compared to a healthy breast cell. The tumor is tested to see if hormones (estrogen and progesterone) cause it to grow. An additional test looks to see if the cancer makes excessive amounts of a certain protein (HER2/neu). All of this information is taken into consideration when developing a treatment plan.

to the lymph nodes, may be offered chemotherapy or other treatments prior to surgery. If the cancer has spread to other organs, chemotherapy, hormone therapy, radiation therapy, and immunotherapy may be used. For elderly women or those with serious medical issues, hormonal treatment alone can sometimes reduce the size of the cancer and slow the spread of the disease, allowing the woman to avoid the risks associated with surgery or chemotherapy. Gone are the days of a “one

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Menstrual history and

Breast Cancer Risk

Are there different types of

Breast Cancer? Women diagnosed with breast cancer may each face a different battle, as there are many different types of the disease. Millions of women are diagnosed with breast cancer every year. According to the Breast Cancer Research Foundation, more than 2.3 million women across the globe were diagnosed with breast cancer in 2020. The BCRF also notes that breast cancer is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide. Breast cancer statistics can give the impression that each of the millions of women diagnosed with the disease is fighting the same battle, but breast cancer is something of an umbrella term. In fact, there are various types of breast cancer, including ductal carcinoma in situ, invasive ductal carcinoma, inflammatory breast cancer, and metastatic breast cancer. Learning about each type of breast cancer can help women and their families gain a greater understanding of this disease.

Ductal carcinoma in situ (DCIS) DCIS is a non-invasive cancer that is diagnosed when abnormal cells have been found in the lining of the breast milk duct. The National Breast Cancer Foundation notes that DCIS is a highly treatable cancer. That’s because it hasn’t spread beyond the milk duct into any surrounding breast tissue. The American Cancer Society notes that roughly 20 percent of new breast cancer cases are instances of DCIS.

Invasive ductal carcinoma (IDC) IDC is the most common type of breast cancer. The NBCF reports that between 70 and 80 percent of all breast cancer diagnoses are instances of IDC. An IDC diagnosis means that cancer began growing in the milk ducts but has since spread into other parts of the breast tissue. This is why IDC is characterized as “invasive.” Though IDC can affect people, including men, of any age, the ACS notes that the majority of IDC cases are in women age 55 and older.

Inflammatory breast cancer (IBC) The NBCF describes IBC as an “aggressive and fast growing breast cancer.” Breastcancer.org notes that IBC is rare, as data from the ACS indicates that only about 1 percent of all breast cancers in the United States are inflammatory breast cancers. Many breast cancers begin with the formation of a lump, but Breastcancer.org reports that IBC usually begins with reddening and swelling of the breast, and symptoms can worsen considerably within days or even hours. That underscores the importance of seeking prompt treatment should any symptoms present themselves.

Metastatic breast cancer Metastatic breast cancer may be referred to as stage IV breast cancer. When a woman is diagnosed with metastatic breast cancer, that means the cancer has spread, or metastasized, into other parts of the body. The NBCF indicates that metastatic breast cancer usually spreads to the lungs, liver,

bones, or brain. Symptoms of metastatic breast cancer vary depending on where the cancer has spread. For example, if the cancer has spread to the lungs, women may experience a chronic cough or be unable to get a full breath. These are not the only types of breast cancer. A more extensive breakdown of the various types of breast cancer can be found at https://www.breastcancer. org/symptoms/types.

Certain breast cancer risk factors, including when women begin menstruating and enter menopause, affect women of all ages. Various factors can affect a woman’s risk for breast cancer. Some of these factors, including whether or not a woman is physically active, are within her control. But others are not, and those include when she started to menstruate. According to Breastcancer. org, women who started menstruating prior to age 12 have a higher risk of developing breast cancer later in life.

But that’s not the only link between menstruation and breast cancer risk, as women who go through menopause when they’re older than 55 years of age also have a higher risk of developing breast cancer later in life. Breastcancer.org notes that, over the last two decades, girls have begun puberty at younger ages than girls in previous generations. Researchers have linked that phenomenon to the obesity epidemic and broad exposure to hormone disruptors. A rise in hormones triggers the onset of puberty. The breast tissue of girls who begin menstruating at a younger age tends to be immature and sensitive to hormonal influences, which is associated with a higher risk

Do You Need a Mammogram? DON’T DELAY. SCHEDULE TODAY.

BREAST CANCER SCREENING SAVES LIVES—AND GETTING A MAMMOGRAM IS SAFER THAN EVER AT HOLYOKE MEDICAL CENTER.

NEED-TO-KNOW NUMBERS

Early detection can be lifesaving. If you’ve put your mammogram on hold due to the pandemic, wait no more. Safety protocols for breast screening are firmly in place at Holyoke Medical Center, including: Screening for COVID-19 symptoms upon entry

Strict social distancing measures

Enhancing already rigorous cleaning and disinfecting practices

of breast cancer later in life. Women may not be able to control when they start and stop menstruating, but they can control certain factors that can make them less likely to menstruate early. Breastcancer.org notes that maintaining a healthy weight, exercising regularly and eating nutritious foods are some lifestyle choices that girls and women can make to keep their risk for breast cancer as low as possible. Various factors can increase a woman’s risk of developing breast cancer. Understanding the link between those factors and cancer risk can help women make healthy decisions that benefit both their shortand long-term health.

98.9%

5-year survival rate for stage I breast cancer

40%

3.5 million

Since 1990, mammography has helped reduce breast cancer deaths by 40% in the U.S.

breast cancer survivors in the U.S.

1 in 8

U.S. women will have breast cancer in her lifetime

Mandating a mask or face covering for all patients and staff.

HOW TO REDUCE YOUR BREAST CANCER RISK

Stay active and exercise.

Maintain a healthy weight.

50 YEARS OLD

the age at which women of average risk should begin annual mammograms

1 in 6 75%

breast cancers occur in women aged 40–49

of breast cancer patients have no family history of breast cancer

Eat fruits and veggies.

Limit alcohol consumption.

✱ The Women’s Center is located at 2 Hospital Dr., Holyoke, MA. To schedule a 3-D mammogram, please call 413.534.2770.

3157210-01

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away after menopause with no treatment needed. Women who see or feel something during their regular self-examination that is different than it was the previous month, should see if it is still there in two to three days. Changes in the breasts that go away in a day or two are common because of hormone levels during menstrual cycles. If the changed area is still there in two to three days, you should have it checked by a doctor. The National Institutes of Health and Dr. Mason recommend calling your provider if you:

Breast Symptoms

• Have a new, unusual or

changing lump in breast tissue that persist

• Do not know how to

properly perform breast self-examination

types of changes to watch for

• Are a woman, age 40 years

or older, and have never had a screening mammogram

• Have discharge from your

nipple, particularly if it is a bloody or brown discharge

By KEITH J. O’CONNOR

some point in their lifetime Special To The Republican whether young or old. Many women will expe“Many of these changes, rience some type of breast such as pain, tenderness and lumps, are the result of symptoms or change during their lives, including lumps, hormonal changes around the swelling, infection, skin irrita- time of your menstrual perition, and various nipple issues ods, during pregnancy, and again as menopause nears,” such as nipple discharge. “While these symptoms said Dr. Mason. A look at the many types of could be a sign of cancer, breast problems that aren’t fortunately most are benign (noncancerous),” said Dr. breast cancer include: Holly Mason, section chief, Breast Pain Breast Surgery at Baystate Health. There are many possible “Some conditions, howevcauses of breast pain including changes in the level of horer, do increase your risk for mones during menstruation. breast cancer while others do not. When a new breast Other causes are menopause, symptom is identified, expert pregnancy and puberty, as evaluation and care are need- well as some medications ed to ensure that the cause or even a poorly fitting bra of that symptom is not breast that does not offer enough cancer,” she added. support. Using heat or ice, as According to Dr. Mason, well as over-the-counter pain medications, may help to almost women will notice a change in their breasts at leviate the pain. Fortunately,

common type of benign breast disease with about 25% of all breast masses turning out to Fibroadenoma be cysts. They often occur in One of the two most comwomen during their repromon types of benign breast ductive years or those who are disease, fibroadenomas are premenopausal. They do not solid breast tumors made up increase your risk of cancer of glandular and connective and often disappear without tissue. Fibroadenomas usually treatment, although in some occur in younger, premenocases a needle aspiration may pausal women and don’t be needed to drain the cyst. increase cancer risk as they do not arise from the ducts or Mastitis This condition occurs often lobules of the breast. A needle during pregnancy when an inbiopsy may be required to confirm the diagnosis. Wheth- fection sets in and your breast er or not a fibroadenoma becomes red, warm and tender. Mastitis often occurs needs to be excised depends when a milk duct becomes on its size and if it is causing pain. Many fibroadenomas blocked during breastfeeding. It is treated with antibiotics can be observed over time. and over-the-counter mediCysts cations to help with any pain. Cysts, which are fluid-filled Sometimes an abscess may sacs that may cause pain and form as a result of the infeccan be felt as a lump in the tion, and doctors may drain it using a needle or it may breast, are the second most

breast pain is not a common symptom of cancer.

require surgery to be drained. It does not increase breast cancer risk. Causes of breast infections other than breast feeding include smoking, trauma and nipple piercing.

• Have symptoms that

interfere with your ability to sleep, and diet changes and exercise have not helped.

Your provider will take your medical history and perform a physical examination to check for lumps or other breast Fibrocystic changes. A mammogram and/ or breast ultrasound may be Breast Changes recommended to assess the Fibrocystic breast changes – breast. These tests will evaloccurring in women between uate any abnormal finding the ages of 30-50 – are usually on a breast exam. If a lump found in both breasts and are is found that is not clearly linked to hormones. They are benign, you may need a breast often described as a lumpibiopsy. For more information on the ness when felt in the breast. This may be due to small Baystate Breast and Wellness clusters of cysts, thickening of Center, visit baystatehealth. the breast tissue and swelling. org/services/breast-care or to Discomfort often occurs just make an appointment with a prior to a woman’s period breast specialist, call 413-794due to hormonal influences 8899. on the breast tissue. Fibrocystic breast changes do not increase your chances of getting cancer and often go

Breast Wellness Series - Virtual Events Keeping Abreast: The Latest Breast Cancer Research Wednesday l October 20 l 6-7 pm Breast cancer care continues to advance as a result of ongoing research efforts. Join Dr. Grace Makari-Judson, Breast Medical Oncologist, Baystate Hematology Oncology, Associate Medical Director, Cancer Services, Co-Director, Rays of Hope Center for Breast Cancer Research and Chair, Baystate Health Breast Network, for a discussion about the latest research regarding breast cancer care and the work to find a cure. Grace Makari-Judson, MD

Web’s Most Searched Questions Answered: Breast Cancer Thursday l October 21 l 6-7 pm Join Dr. Ann-Kristin Friedrich, Breast Surgeon, Baystate Surgical Oncology & Breast Specialists, as she provides expert answers to breast cancer questions like: ‘What can I expect at my breast cancer consultation?” and ‘What stage of breast cancer requires a mastectomy?” Ann-Kristin Friedrich, MD

9 Things You Should Know About Your Breasts Wednesday l October 27 l 6-7 pm Since not all breasts are created equal, there are a lot of myths on breast health. Dr. Holly Mason, Breast Surgeon, Section Chief, Breast Surgery, Baystate Surgical Oncology & Breast Specialists, will help debunk these myths as she leads a discussion on breast health problems and the best ways to improve your breast health. Holly Mason, MD

Timing Is Everything For Mammograms Thursday l October 28 l 6-7 pm We often hear at what age should women start having mammograms, but why is it so important? Join Dr. Jesse Casaubon, Breast Surgeon, Baystate Surgical Oncology & Breast Specialists, for a discussion about how screening mammograms are connected to your health and why timing matters. Jesse Casaubon, MD

>> Visit BaystateHealth.org/BreastSeries to register. There will be time for questions and answers at the end of each virtual event. 3157204-01

BaystateHealth.org

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Women have some control in regard to their risk for

Breast Cancer A physically active lifestyle can help women reduce their risk for breast cancer. No one, regardless of their age, occupation, skin color, or socioeconomic status, is immune to cancer. In fact, individuals might be hard pressed to say no one in their family and/or circle of friends has been diagnosed with cancer at some point. According to the National Cancer Institute, there were 18.1 million new cancer cases across the globe in 2018. Among women, when ex-

cluding non-melanoma skin cancer, no cancer was more prevalent globally than breast cancer. The World Cancer Research Fund reports that, in 2018, breast cancer accounted for 25.4 percent of all new cancer diagnoses in women. That figure is nearly three times as high as the percentage of cases of colorectal cancer, which accounted for the second most new cancer cases diagnosed in women in 2018. It’s understandable to be fearful of such figures, which can make a breast cancer diagnosis seem almost inevitable. However, the Centers for Disease Control and Prevention notes that not all risk

factors for breast cancer are set in stone. Though age and family history, two known risk factors for breast cancer, may be beyond a woman’s control, she still can exercise some control over other risk factors.

activity every week or 75 minutes of vigorous-intensity aerobic activity each week. This should be accompanied by muscle-strengthening activities on two or more days each week. Carrying around extra weight can make moving around more difficult, so the Office on Women’s Health urges larger women to start slowly if it’s been awhile since they exercised. In addition, aging women can speak with their physicians for advice about exercise regimens they should or need not avoid.

Physical activity: The CDC notes that women who are not physically active have a higher risk of getting breast cancer than those who are. The Office on Women’s Health, a division of the U.S. Department of Health & Human Services, notes that women should get two hours and 30 minutes of moderate-intensity aerobic physical

Taking hormones: The CDC notes that

hormone replacement therapies that include both estrogen and progesterone taken during menopause can increase a woman’s risk for breast cancer when taken for more than five years. In addition, the CDC reports that oral contraceptives, such as birth control pills, have been linked to a higher risk for breast cancer. Women can speak with their physicians about how to control hormone-related risk factors for breast cancer.

Alcohol consumption:

breast cancer becomes. Smoking, exposure to chemicals that have been found to cause cancer and changes in hormones related to working night shifts are some additional risk factors for breast cancer that women may be able to control. Breast cancer affects millions of women across the globe each year. Though that may instill a feeling of helplessness, women should know that many risk factors for breast cancer are within their control.

Studies have found that the more alcohol a woman consumes the greater her risk for

MESSAGE TO PATIENTS OF MERCY HEARING CENTER MESSAGE TO PATIENTS OF MERCY HEARING CENTER MESSAGE TO Message PATIENTS OFBreast MERCY HEARING CENTER Supporting Cancer Awareness to the Community

Message the Community Message to the Community Since to Mercy Hearing Centers in Springfi eld and Agawam Veterans COVID-19 MESSAGE TO PATIENTS OF MERCY HEARING CENTER For your protection, our office is currently closed due to the Since Mercy Centers Centers in Springfi and eld Agawam Since Hearing Mercy Hearing in eld Springfi and Agawam MESSAGEMESSAGE TO PATIENTS OF MERCYOFHEARING CENTER CENTER TO PATIENTS MERCY HEARING

at endcrisis. 2018, you might beseeconcerned Our office isof open with regular hours and COVID-19 health Although are unable patients, For your protection, our officethe isour currently closed due towe the For closed your protection, office is currently closed due to theto closedCOVID-19 at thehealth end of 2018, you might be concerned closed at the end of 2018, you might be concerned we are monitoring our telephone messages and email. We will crisis. Although we are tohearing see patients, Since Mercy Hearing in Springfi eldonly. and COVID-19 health Although weCenters are unable to see patients, about yourcrisis. options for care. RestAgawam assured service is unable provided by appointment respond to your message as soon as we can. Follow us on our are monitoring our telephone messages and email. We will we are monitoring our telephone messages and email. We Since Mercy Hearing Centers in Springfi eld and Agawam Since Mercy Hearing Centers in Springfi eld and Agawam about we your options for hearing care. Rest assured about your options hearing care. Rest assured closed at the end ofguidelines 2018, you might bewill concerned We continue tofor follow CDC for your health andDoctors safety. that we are accepting new patients. Our OPEN TO VETERANS, SPOUSES & CAREGIVERS Facebook page updates and information. respond to your message asmessage soon asfor we can.you Follow us on ourcare. respond to your as soon as we can. Follow us onRest our assured closed at the end of 2018, you might be concerned closed at the end of 2018, might be concerned about your options for hearing that we are accepting new patients. Our Doctors that page weofforAudiology are accepting new patients. Our Doctors VA Central Western Massachusetts Healthcare would welcome the opportunity to help you. We Facebook updates and information. Facebook page for updates and information. about your options for hearing care. Rest assured about your options for hearing care. Rest assured When our office reopens, we will contact you to reschedule your that we are accepting new patients. Our Doctors Since Mercy Hearing Centers in Springfi eld and Agawam MASKS ARE REQUIRED of Audiology would welcome the opportunity to help you. We of Audiology would welcome the opportunity to We System is now offering COVID-19 vaccinations to provide MESSAGE TO PATIENTS OFyou MERCY HEARING CENTER your protection, our office is currently closed due tohelp the you. comprehensive hearing evaluations and hearing canceled appointment. Our Doctors ofreschedule Audiology will also beWe aid When office reopens, we will contact to reschedule your When our office reopens, we will contact you to your that our weclosed areFor accepting new patients. Our Doctors that we are accepting new patients. Our Doctors of Audiology would welcome the opportunity to help you. at the end of 2018, you might be concerned COVID-19 health crisis. Although we are unable to see patients, We look forward to seeing you! Veterans, Veteran Spouses andprovide Caregivers. comprehensive hearing evaluations and hearing aid hearing evaluations and hearing aid accepting new patients. We wish you continued good healthyou and canceled appointment. Our Doctors of Audiology will also be canceled appointment. Our Doctors of Audiology will also fiwould ttings and service to adults. Weeld want toWeassured be sure that of provide Audiology welcome the opportunity to help you. We ofcomprehensive Audiology would welcome the opportunity to help you. Wehearing we are monitoring our telephone and email. willbe Since Mercy Hearing Centers inmessages Springfi and Agawam provide comprehensive hearing evaluations and aid are about your options for hearing care. Rest we look forward to seeing you soon! accepting new patients. We wish you continued good health and accepting new patients. We wish you continued good health and respond to your message as soon as we can. Follow us on our fi ttings and service to adults. We want to be sure that you are fittings and service to adults. We tohearing beus, sure that you areyou are closed the end evaluations ofWhen 2018, you might be concerned provide comprehensive hearing and aidto Multiple Dates and Locations Available provide comprehensive hearing evaluations and hearing aidthat fiatpage ttings and service towant adults. We want bebesure that we are accepting new patients. Our Doctors hearing your best. you need we’ll here. we look forward to forward seeing you soon! Facebook for updates andsoon! information. we look to seeing you about your options for hearing care. Rest assured and service toyou adults. We want toWhen be sure that you are ttings and service toyou adults. We want to bebe sure that you are (By Appointment Only/Sorry, No Walk-ins hearingfittings your best. When need us, we’ll be here. hearing your best. When need us, we’ll here. hearing your best. you need us, we’ll be here. of fiAudiology would welcome the opportunity to help you. We

Vaccine Clinics:

MESSAGE TO PATIENTS OF MERCY HEARING CENTER

Message to the Community

Veterans COVID-19

that we are accepting new patients. Our Doctors hearing your best. When you need us, we’ll beofus, here. hearing yourappointment. best. When you need we’ll be here. provide hearing evaluations and hearing canceled Our Doctors Audiology will beWe aid ofcomprehensive Audiology would welcome the opportunity to helpalso you. accepting new patients. We wish you continued good health and ﬁttings provide and service to adults. We want to be and surehearing that you comprehensive hearing evaluations aid are we look forward to seeing you soon! Updates will be posted to: and service adults. Weus, want to bebesure that you are hearingﬁttings your best. Whentoyou need we’ll here. https://www.facebook.com/VACWMASS hearing your best. When you us, we’ll be here. Theneed Finest Hearing Care Doctors Audiology The Finest Hearing Care By By Doctors OfOf Audiology ~ Since 1984 ~ ~ Since 1984 ~ The The Finest Hearing Care By Doctors Audiology The Finest Hearing Care By Doctors Audiology Finest Hearing Care By Doctors Audiology The Finest Hearing CareOf ByOf Doctors OfOf Audiology must pre-register 200 North Main North Building, Suite 103 103 200~North Main Building, Suite ~~Since ~ Since 1984 1984 OPEN TO+Participants VETERANS, SPOUSES & CAREGIVERS ~~Since 1984 ~Street,North Since 1984 ~Street, East Longmeadow, MA 01028 Longmeadow, MA103 01028 200 North MainStreet, Street, North Building, Suite 103 200 North MainStreet, Street,East North Building, Suite 103 +Call (413) 582- 3110 for registration 200 North Main North Building, Suite 103 200 North Main North Building, Suite (413) 525-7979 • www.hampdenhearing.com East Longmeadow, MA 01028 East Longmeadow, MA 01028 VA+Veterans: Central Western Massachusetts Healthcare (413) 525-7979 • www.hampdenhearing.com East Longmeadow, MA 01028 The The Finest Hearing Care Doctors Of Audiology East Longmeadow, MAOf01028 Finest Hearing Care By By Doctors Audiology info@hampdenhearing.com Bring your DD-214 or VA Healthcare ID (413) 525-7979 • www.hampdenhearing.com (413) 525-7979 • www.hampdenhearing.com 525-7979 ~(413) 1984 ~Since Since 1984 ~~ (413) 525-7979 • www.hampdenhearing.com (413) 525-7979 • www.hampdenhearing.com info@hampdenhearing.com System is now offering COVID-19 vaccinations to Susan Bankoski Chunyk, info@hampdenhearing.com 200 North Main Street,North North Building, Suite 103 103 www.hampdenhearing.com 200 North Main Street, Building, Suite Jennifer Lundgren Garcia, Au.D. Au.D. East Longmeadow, MA 01028 Doctor of Audiology Doctor of Audiology info@hampdenhearing.com East Longmeadow, MA 01028 OPEN TO VETERANS, SPOUSES & CAREGIVERS (413) 525-7979 • www.hampdenhearing.com

All VACWM Locations

When our office reopens, we will contact you to reschedule your

Vaccine Clinics:

Veterans COVID-19

Veterans, VeteranOnly/Sorry, Spouses No andWalk-ins Caregivers. (By Appointment

“Honoring America's Veterans by providing exceptional care that improves their health and well-being”

TalkMultiple with your VA primary care team Dates and Locations Available All VACWM Locations about(By scheduling your mammogram. Appointment Only/Sorry, No Walk-ins FITCHBURG | GREENFIELD | NORTHAMPTON | PITTSFIELD | SPRINGFIELD | WORCESTER www.centralwesternmass.va.gov

Updates will be posted to: All VACWM Locations Did you know women Veterans who receive their health https://www.facebook.com/VACWMASS care in the VA are more likely to receive age-appropriate Updates will be posted to: breast cancer screenings than women in private-sector? https://www.facebook.com/VACWMASS

+Participants must pre-register For more information to enroll in for VA health care, +Call (413) or 5823110 registration +Participants must pre-register contact the Central Western Mass Healthcare System +Veterans: Bring your DD-214 VA Healthcare ID +Call 582-Care 3110Team foror registration or speak with your(413) Primary @ 413.582.3027. +Veterans: Bring your DD-214 or VA Healthcare ID

Mental Health | Addiction | Crisis | BHN TeleCare

Get Well. We Can Help. Call BHN today at 413-BHN-WORK (413-246-9675) 24-Hour Crisis Line: 413-733-6661 bhninc.org

“Honoring America's Veterans by providing exceptional care that improves their health and well-being” “Honoring America's Veterans by providing exceptional care that improves their health and well-being”

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(413) 525-7979 • www.hampdenhearing.com info@hampdenhearing.com

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Vaccine Clinics: Don’t wait another year if you Veterans, Veteran and Caregivers. missed yourSpouses mammogram VA Central Western Massachusetts Healthcare System is Dates now offering COVID-19 vaccinations due toand COVID-19. Multiple Locations Available to

SUNDAY, OCTOBER 3, 2021 | 7

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THE REPUBLICAN | MASSLIVE.COM

The importance of

Detection and Care during uncertain times

During both the first and second waves of the COVID-19 pandemic in 2020, the national shutdown caused a major interruption in breast cancer detection and care. By CORI URBAN

Special To The Republican

Breast cancer screening with mammography and MRI were not being performed. Surgeries for breast cancer were being delayed as hospitals were not performing non-emergent surgeries. As the shutdown ended and hospitals resumed screening, there was a backlog of

exact effect the pandemic has had on breast cancer detection and care is still being determined. It is likely that resulting delays to diagnosis and treatment may lead to more intensive treatment requirements and, potentially, increased mortality.” So, the importance of early detection cannot be overstated. “When breast cancer is detected at a lower stage before it has spread to lymph nodes or metastasized to other organs, treatments are less invasive, and the chances of cure are higher,” Kawar said. Breast cancer that is diagnosed at later stages often requires more intensive treatments and survival rates are lower. “This stresses the importance of mammograms, which are very effective at diagnosing breast cancers early.” She advises women who

interest include minimally invasive procedures (including da Vinci® robotic surgery) for patients with gynecologic malignancies and other complex benign gynecologic conditions, radical procedures for treatment of gynecologic malignancies, risk-reducing surgery in patients with familial susceptibility for breast, ovarian and endometrial cancer and oncoplastic breast surgery. Some women choose to have genetic (or familial) susceptibility to breast cancer diagnosed through genetic testing. Blood or cells from a cheek swab are collected, and the DNA in the cells is tested for mutations in the genetic sequence of the common cancer related genes. As testing techniques have improved, the costs of testing have decreased significantly and many genes can be tested

The cost of risk-reducing surgery and breast reconstruction are generally covered by most insurance plans, she added. Kawar believes progress is being made toward a cure for breast cancer. “But, it’s not going to be just one cure,” she said. “As our knowledge increases of the biology and

genetics of breast cancer, newer ways to target treatments are emerging that are dramatically improving the prognosis and extending survival. I believe that one day, we will be able to analyze a person’s cancer and create an individualized treatment. We are already doing that now, but as we continue to un-

derstand more, one day that individualized treatment will be an individualized cure.”

For more information on breast cancer, visit the American Cancer Society’s website at cancer.org.

Kerry Bilski and Larry Pion,

formerly of Kens’ Eyewear in Northampton, are the new owners of Thoren Optical & Safety Products. Licensed Opticians and your local experts who will focus on your vision, comfort and appearance. We provide the best in Sport, Fashion and Safety Eyewear – no matter how complex your correction.

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Oakdale akdale Dental Associates, Early detection is so important.

For us at Oakdale Dental Associates – it is personal. Above: Dr. Nada M. Kawar of Trinity Health Of New England Medical Group consulting with a patient. (PHOTO COURTESY OF TRINITY HEALTH OF NEW ENGLAND)

have put off mammograms because of the pandemic to go get the COVID vaccine and then schedule their mammogram! “The vaccines are safe and effective, and very protective against infection, severe illness and hospitalization,” she said. “COVID is not going away anytime soon, so it is time to take care of your health and to get a mammogram. Delaying screening can lead to detecting cancer when it is more advanced. Early detection is key, and that means the earlier you call to schedule the mammogram, the better.” Kawar’s clinical areas of

simultaneously. “For women with a higher genetic susceptibility to breast cancer, risk reducing surgery can be performed,” Kawar explained. This refers to performing bilateral mastectomy (surgery to remove both breasts). “By removing all the breast tissue, the risk of breast cancer developing is virtually eliminated,” she said. “Mastectomy is often combined with breast reconstruction, where plastic surgery is used to recreate the breast’s appearance with implants or tissue transfer techniques.”

Suzanne Williams

On July 9, 2015 we lost part of our family.

1820 Northampton Street • Holyoke 413-536-1782 • OakdaleDental.com

3140677-01

patients past due for their mammograms. “However, people also remained reluctant to schedule their screening tests. For some, the fear of acquiring COVID remained a larger deterrent to screening than that of being diagnosed with breast cancer,” said Dr. Nada M. Kawar of Trinity Health Of New England Medical Group, who specializes in the care of women’s cancers, treating the full range of gynecologic malignancies, including cancers of the breast, cervix, endometrium/uterus, fallopian tube, ovary, vagina and vulva. “The

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8 | SUNDAY, OCTOBER 3, 2021

THE REPUBLICAN | MASSLIVE.COM

There is hope.

Breast

CANCER

e Ther is . hope

AWARENESS MONTH

During the month of October, Big Y invites you to donate to our Partners of Hope program to benefit local MA and CT organizations dedicated to Breast Cancer research and treatment.

BreastER

CMONTH S CWAARN ENES A

Please purchase a Partners of Hope Ribbon at any register for only $1.00 now through Oct. 27, 2021 or make a donation at bigy.com/Community/ BreastCancerAwareness

l loca s fiting bene nization r orga Cance T C t s MA & to Brea atment re ated h&t dedic researc

3156948-01

BEHIND EVERY GREAT HOUSE IS A GREAT

WOMAN

The Best Way Home

Erin Callahan

Rebecca Rivera

44 Elm Street Westfield, MA 01085 OFFICE: 413.568.9226 CALL/TEXT: 413.406.8126 E-MAIL: terryhooperrealtor@gmail.com

Meet our top two associate brokers at B&B Real Estate with over 20 years combined experience.

Roberta B. Johnson rjohnson@wmasshomes.com roberta.b.johnson@gmail.com www.realliving.com/roberta.johnson

Direct: 413-364-6494 Fax: 413-726-9317 2040 Boston Rd., Suite 18 Wilbraham, MA 01095

1a e

Associate Broker Reheccaew@comcast.net

state@

3) 575-0

(413) 204-1420

Kerrie Baldwin Realtor Cell: 413-847-0831

stake s When the

kerriebaldwin12@gmail.com www.whewaygroup.com Coldwell Banker Realty 136 Dwight Rd., Ste. 2 Longmeadow, MA 01106

are

, b ig b

Broker ust with a

BnBrealeatate.com • MovingWesternMass.com REALTY

413-237-3394 lisasullivan1@comcast.net

Cheryl C. Malandrinos www.lisasullivan.info Coldwell Banker Realty’s #1 WESTERN MA REALTOR

Opening doors one key at a time

Licensed Real Estate Broker 2019 RAPV REALTOR OF THE YEAR MA and CT License

PAT WHEWAY, BROKER SALES ASSOCIATE

Kerrie Baldwin

Wheway Group, Team Leader

Realtor

(413) 478-1166 Cell: 413-847-0831 PatWheway@gmail.com www.WhewayGroup.com

® Real Living Realty Professionals 2040 Boston Road 413-575-5751 Wilbraham, MA 01095

WOMEN IN REAL ESTATE

kerriebaldwin12@gmail.com www.whewaygroup.com

136 Dwight Rd. Suite 2

Coldwell BankerMA Realty Longmeadow, 01106 136 Dwight Rd., Ste. 2 Longmeadow, MA 01106 REALTY