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KNOWING YOUR BODY AND YOUR OPTIONS, D3 SOMETIMES WE JUST DANCE: Breast cancer survivor story, D5 EVERY TWO MINUTES: A woman is diagnosed with breast cancer, D7
| SUNDAY, OCTOBER 7, 2018
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BREAST CANCER SURVIVORSHIP PROGRAM HELPS SURVIVORS
‘move foward
in life’
By Anne-Gerard Flynn
Special to The Republican
Baystate medical oncologist Grace Makari-Judson has been treating breast cancer patients for 25 years. She knows their concerns continue even as their treatment becomes less institution based, and they may progress to seeing their oncologist once every six months for five years and then a nurse practitioner annually. She said this is why the Breast Cancer Survivorship Program exists. It is part of the Baystate Health Breast Network that is funded by Baystate’s annual Rays of Hope, A Walk & Run Toward the Cure of Breast Cancer, now in its 25th year. “We are thrilled that we have the opportunity to help people along the continuum,” Makari-Judson said. “It is not just about helping someone at the time of diagnosis or at the time they need their immediate treatment.” Makari-Judson is co-director of the Rays of Hope Center for Breast Cancer Research, chairs the breast network and is a professor of medicine at the University of Massachusetts Medical School-Baystate. “It was one of the first things we set up 25 years ago,” said Makari-Judson of the program that is part of the Baystate Regional Cancer Program. “We said we need a place where women could focus on not just getting their breast exam and breast imaging but also reinforcement of lifestyle. A place where we could help them manage any kind of menopause symptom in the absence of estrogen and also assess them to see if any
of the other things they are experiencing in their health may be due to late concerns related to their treatment or may be signs of breast cancer recurrence. Those things are done very well by breast specialists.” She added, “A lot of people especially when they are first diagnosed with cancer - they are sort of on overdrive and then they get through their surgery, they get through their chemotherapy, they get through their radiation and all of a sudden we say to them, ‘I only need to see you now every six months until we get to the five-year point” and it hits them what did I go through this past year?” “It is not uncommon for people to have these fears of cancer recurrence and they can’t get that out of their head, they can’t concentrate and this can happen at the six, the 12 month point,” Makari-Judson said. “We have terrific social workers and we offer relaxation therapy, guided imagery, hypnosis so people can get those thoughts out of their mind and move forward in life.” Survivors are given a booklet with a background sheet on their diagnosis and treatment with recommended follow-up care. There is a section related to health promotion topics like bone and heart health, diet and sexual health, as well as a section on genetic counseling/testing and one on additional resources. There is also a section on managing the side effects of cancer treatment. “When we recommend
who are on tamoxifen. In the post-menopausal women who are on aromatase inhibitors they get more joint pain.” She said the temptation is for women to say, “I don’t like how I feel on this medicine and and they quit, and we know from studies that show that when women quit early that impacts negatively on the process.” “We want them to be able to stay on their medications. We want them to be able to do whatever they need to do to help them to tolerate them,” Makari-Judson said. She added, “Someone who goes through natural menopause their gynecologist writes them a prescription for hormone replacement.” “How are we going to deal with hot flashes, how are we going to deal with vaginal dryness, how are we going to deal with sleep difficulty in the absence of estrogen,” she said. Makari-Judson said the survivorship booklet offers “helpful guides” based on research in terms of “what people can do” with some of the guides “related to lifestyle factors.” “We are very much believDr. Grace Makari-Judson is co-director of the Rays of Hope ers in helping people to help Center for Breast Cancer Research, chairs the Baystate Health themselves,” Makari-Judson Breast Network and is a professor of medicine at the University said. of Massachusetts Medical School-Baystate. “For example spicy foods, (ANNE-GERARD FLYNN PHOTO) caffeine, alcohol sometimes these will trigger a hot flash agnosed with breast cancer monal treatment for breast and women will say, ‘I still have the type that is estrogen cancer that is going to be for want my morning cup of coffee. I am still going to have hot receptor positive. This means a minimum of five years,” flashes afterward but at least I the hormone may aid the Makari-Judson said. recognize it and can deal with growth of cancer cells so these “Tamoxifen or aromatase it but maybe I will leave out women may be prescribed inhibitors are anti-estrogens that are effective in the afternoon coffee.’” post surgery medication that post-menopausal women. The She added, “Women who will either block the effect of menopause symptoms are exercise regularly tend to estrogen in breast tissue or tough in the younger women have less hot flashes.” prevent its production. treatment for breast cancer whether it is chemotherapy or hormone-related treatments or both, people have side effects we need to help them deal with,” Makari-Judson said. “We want them to succeed. We want them to stay on their treatment. This is extremely important in their overall outcomes.” Many women newly di-
Reductions in estrogen level, generally associated with menopause, can affect bone health and result in a variety of other symptoms such as vaginal dryness and the sudden feelings of warmth known as hot flashes. “A large percentage of breast cancer patients have hormone receptive positive cancers and they are going to be recommended a hor-
“Exercise helps sleep. It helps mood. Exercise is an important part of what we recommend,” Maraki-Judson said. “Women who exercise, stretch, do far better than women who are sedentary.” She said exercise, along with “adequate Vitamin D,” can help with joint aches experienced by some postmenopausal women taking the aromatase inhibitors, and that some women take a prescription medicine to reduce this associated pain. “There is a prescription medicine called duloxetine - and we participated in a clinical trial looking at its use - that can help reduce the joint pain,” Makari-Judson said. “People on the drug got immediate relief in the study, but at the end of the six months of the study everyone was about the same. Meaning over time people get used to the pain or it lessens and it isn’t as much of an issue, but joint pain can be a big issue in the beginning because people want to stop the meds.” Makari-Judson said survivors continue to be seen at the Baystate Breast & Wellness Center, where she works closely with nurse practitioner Gerri Lynn Smith, even after their multi-year course of hormone-related treatment ends. She added a yearly mammogram and checkup can be done together so a survivor “does not have to make more than one visit to more than one place.” “This is a big plus and the women also like knowing that they are still being cared for under the big umbrella,” Makari-Judson said.
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KNOWING
Your Body and Your Options By Tiera N. Wright To Lisa Planeta, MD, FACS, of the Breast Care Center at Mercy Medical Center, knowledge is an important part of the breast cancer journey. “We try to encourage women to be aware of changes in their breasts,” says Dr. Planeta, who underscores the importance of educating women to look for signs of cancer such as “lumps, nipple discharge, and changes in the skin,” as well as providing information about the myriad of options available before and after a cancer diagnosis. While every case is different, Dr. Planeta says in addition to receiving breast exams, women of “average risk” should begin receiving mammograms at age 45, per the recommendation of the American Cancer Society. “And those mammograms should be done every year until age 54, and then done
Once diagnosed, Dr. Planeta’s advice for patients can be summed up in five words; “education”, “second opinions”, and “don’t panic”. While a breast cancer diagnosis is frightening, helping the patient develop a clear understanding of her individual condition and the options available to her are vital to both patient and physician. “It’s important to involve the patient in the surgical process based on the type, size, and location of the cancer, as well as any genetic risk factors she may have,” says Dr. Planeta. Two surgical treatments for breast cancer are lumpectomy and mastectomy; the former involves the surgical removal of cancerous lumps or breast tissue, while the latter refers to the removal of the breast. “For early stage breast cancer, the current guidelines suggest lumpectomy. But in cases where the removal of the
While a breast cancer diagnosis is frightening, helping the patient develop a clear understanding of her individual condition and the options available to her are vital to both patient and physician. “It’s important to involve the patient in the surgical process based on the type, size, and location of the cancer, as well as any genetic risk factors she may have,” says Dr. Planeta. every other year according to guidelines,” continued Dr. Planeta. “If someone has a history of abnormal biopsies or a family history of cancer, those recommendations will change.” It is very rare for women under the age of 35, or even 30 to be diagnosed with cancer. “I haven’t seen any evidence that it is more common in younger women than it was 10, 15 or 20 years ago,” explains Dr. Planeta, adding, “0.4% of breast cancer diagnosed are in women under 30, so it’s uncommon. About 5.5% of breast cancers are diagnosed in women under 40.” Dr. Planeta maintains that options like genetic testing are available for women who potentially fall into those categories, but she also stresses the importance of education before seeking any tests. “I recommend genetic testing according to national guidelines,” says Dr. Planeta, who also lists pricing as a detriment to those seeking to be tested if the tests are not covered by insurance.
cancer leaves the breast with a deformed appearance, we opt for mastectomy,” says Dr. Planeta. “I try to avoid mastectomies because there is no survival advantage of a mastectomy over lumpectomy. I advocate for breast conservation if it is reasonable and possible.” Dr. Planeta further explains there is a risk of recurrence after either treatment. “For most women who have a lumpectomy, we recommend radiation to lower local recurrence risk. It doesn’t lower the risk to zero.” She concludes, “if someone has a recurrent cancer after lumpectomy and radiation, I usually recommend a mastectomy as the treatment.” Dr. Planeta strongly urges women to continue to be examined after their treatment and recovery, as the risk doesn’t ever fully go away; “you are not eliminating the possibility of a local recurrence with a mastectomy, but you are lowering the risk.” Dr. Planeta also emphasizes the importance of lifestyle
factors such as maintaining a healthy body weight and regular exercise as preventative measures against cancer. “Exercise is good for your
heart, your muscles, your mind, and it even lowers your breast cancer risk,” says Dr. Planeta. “Prevention is better than treatment. I encourage our community to embrace good health by making better lifestyle choices.” Lastly, throughout her career Dr. Planeta has seen
a lot of advancements in the breast cancer field; such as the industry trend toward breast conservation and “sentinel node sampling.” Both resulted in less invasive surgical treatments, with the latter decreasing the risk of lymphedema (swollen arms). “It seems strange to say, but
hopefully one day, my skills will be in less demand,” says Dr. Planeta, “that’s one goal, to eliminate the need for surgery, and the other to further research to prevent breast cancer.”
Lisa Planeta, MD, FACS,
oversees all elements of the Breast Care Center at Mercy Medical Center. A leading board-certified surgeon with extensive experience, Dr. Planeta treats patients with a variety of breast disorders and counsels them about the risks, diagnosis and treatment of benign, pre-malignant and malignant lesions. A graduate of the University of Vermont’s College of Medicine, Dr. Planeta completed her internship and residency in general surgery at New England Medical Center in Boston. Dr. Planeta has an undergraduate degree in Molecular Biophysics and Biochemistry from Yale University.
OCTOBER IS BREAST CANCER AWARENESS MONTH
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If you or someone you love is concerned about breast
We provide streamlined access to all
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• Supportive services such as counseling and support groups • Genetic testing and counseling • Second opinions and information about treatment options • Community resources for transpor-
Breast Care Center 271 Carew Street, Springfield, MA 01104 413-452-6600 • MercyCares.com (Next to the Sister Caritas Cancer Center. Please park in the Cancer Center parking lot.)
tation, childcare or other needs
D4 | SUNDAY, OCTOBER 7, 2018
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THE REPUBLICAN | MASSLIVE.COM
Can diet prevent
breast cancer from spreading? Healthy diets that include plenty of antioxidant-rich fruits and vegetables that can boost the body’s natural immune system can help people in their fight against cancer.
diet can influence the course of the disease,” said Simon Knott, Ph.D., associate director of the Center for Bioinformatics and Functional Genomics at Cedars-Sinai and one of two While some foods, namely cally reduce the ability of the first authors of the study. The unhealthy, high-fat/high-cacancer to travel to distant sites research from this study was loric foods, are best avoided, in the body. conducted at more than a dozwomen who have been diagAsparagine is found in foods en institutions. nosed with breast cancer who Apart from dietary restriclike asparagus, whole grains, tions, metastasis also could want to prevent the spread of soy, seafood, eggs, poultry, be greatly limited by reducing cancer to other areas of their beef, legumes, and more. bodies may want to cut some While reducing asparagine will asparagine synthetase using chemotherapy drug L-asparasurprising foods from their not affect the original breast ginase. diets. cancer tumor, it could stop More research is needed as Preliminary research now cancer from showing up elsesuggests limiting the consump- where in the body. Researchers to whether similar results can tion of asparagine, an amino suspect that many women be produced in human trials, acid, to dramatically reduce the with breast cancer do not lose making avoiding asparagine ability of cancer to spread to their lives to the original breast currently a helpful but not other parts of the body. A study cancer tumor, but instead they entirely foolproof method for published in the journal Nature succumb to metastases or sub- preventing the spread of breast sequent growths away from the cancer to other areas of the found that reducing asparagine consumption in laboratory primary site. body. mice with triple-negative “Our study adds to a growing breast cancer could dramatibody of evidence that suggests
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WOMEN IN REAL ESTATE CS10031
course of mon Knott, tor of ormatics mics at of two udy. The udy was an a doz-
restriccould reducing e using -aspara-
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SUNDAY, OCTOBER 7, 2018 | D5
THE REPUBLICAN | MASSLIVE.COM
Survivor Sometimes we just dance
Above: Lindsey Bubar, center with sunglasses and flowing pink scarf, at last year’s Rays of Hope Walk & Run Toward the Cure of Breast Cancer. Top right: Lindsey Bubar dancing before her surgery at Baystate Medical Center.
By Keith O’Connor
a lump on her breast just one week after turning 35. She When Lindsey Bubar of East called her OB/GYN doctor, Longmeadow learned that who saw her the same day and she had breast cancer, the referred her to the Baystate first thing that went through Breast & Wellness Center. A her mind while sitting in her biopsy on July 26 last summer doctor’s office was to think revealed Bubar had invasive about her two boys, Jackson, ductal carcinoma. She was 9, and Brady, 4. stunned. No one else in her “I found myself asking, ‘Can family had ever had breast I dance with my boys at their cancer. However, despite the wedding,’” Bubar said. emphasis on family history For Bubar and other womfor many cancers, about 90% en, the news is good. Breast of breast cancers occur in cancer survival rates have women who have no family improved steadily since the history. 1970s for all women diag“Invasive ductal cancer is nosed. The improvement is the most common form on due to increased awareness, breast cancer, which affects improved and earlier detecsome 80% of women diagtion and better treatment. nosed. It has an excellent When the disease is confined survival rate with immeto the breast and surrounding diate treatment,” said Dr. Nada Kawar, Bubar’s breast tissues, survival at 5 years surgeon, a member of the is 99%. According to the Baystate Regional Cancer American Cancer Society, as Program’s Gynecologic Onof January 2016, 3.5 million cology Department, as well as American women are breast the Baystate Breast Specialcancer survivors. Many of ists. “While the risk of breast these women are free of cancer increases with age, 1 in disease and some continue 220 women will be diagnosed to live with the disease and in their 30s like Lindsey.” undergo treatment. Bubar first underwent six While Bubar said she didn’t months of chemotherapy to regularly perform monthly self-breast exams, she noticed shrink her tumor before unSpecial to The Republican
dergoing a lumpectomy this March, during which only the tumor and some surrounding tissue was removed. However, what was to be a “simple” operation as Bubar put it, turned out to be more complicated after she received a phone call from Dr. Kawar. “The surgical specimen unexpectedly showed more cancer and the best approach was a mastectomy followed by radiation. While chemotherapy had shrunken the tumor, it had not eliminated it. Further surgery and treatment was the best approach for long term survival,” said Dr. Kawar. “It was a huge surprise to me and very disappointing to learn that I would need a mastectomy. I could hear it in her voice….that Dr. Kawar was disappointed in having to take the next step (a mastectomy). However, I knew that I was in good hands. I cried for a minute, and then said, ‘Let’s do it. Let’s get it on the calendar,’” said Bubar. Following her mastectomy on April 11, Bubar underwent 7 weeks of radiation (29 rounds). Her treatment ended in July and Bubar is now in
remission. While Bubar is looking forward to that day when she can dance at her sons’ weddings, she has already experienced the dance of her lifetime (other than at her own wedding). “My cousin, Nicole Diffley, is a surgical tech in Baystate Medical Center’s Daly Operating Rooms. She and I are close, like sisters. In addition, she put this idea in my head about dancing before my operation. Nicole stopped in before my surgery, and when Dr. Kawar arrived, she asked her if we could have a dance party. Dr. Kawar pulled out her cell phone, asked me what I wanted to dance to, and the next thing I knew we were all dancing to Whitney Houston’s ‘I Wanna Dance with Somebody (Who Loves Me),’” said Bubar. “It meant a lot to me that Dr. Kawar supported my cousin’s request the way she did….dancing with me in her scrubs and everyone else in the room. It was incredible proof that she gets it when it comes to doing the best for her patients, knowing only too well that setting the right tone for a patient can have ex-
ponential returns on healing,” she added. For an uplifting look at that spontaneous dance party that sent Bubar off to surgery with a smile, go to facebook.com/ baystatehealth. Bubar is looking forward to joining thousands of other survivors on Sunday, Oct. 21, at the 25th anniversary Rays of Hope – A Walk and Run Toward the Cure of Breast Cancer. “I’m having breast reconstruction the next day, so I’m going to have plenty of nervous energy to use up while walking,” she said. Today more women like Bubar are choosing breast reconstruction after mastectomy. “We are fortunate that the medical community recognizes the significant benefit for the patient in addressing the physical, psychological and emotional impact of treatment required for breast cancer. One of the ways that we do this is to address the asymmetry caused by surgery and radiation,” said Dr. Benjamin Schalet of Baystate Plastic Surgery. “Breast reconstruction procedures
Dr. Nada Kawar, a member of the Baystate Regional Cancer Program’s Gynecologic Oncology Department, as well as the Baystate Breast Specialists.
are not considered cosmetic. In fact, federal law requires insurance companies to cover breast reconstruction as part of cancer treatment. Our plastic surgeons are always improving and using the best techniques available. We work closely with the breast surgeons, medical oncologists and radiation oncologists to create a treatment plan individualized to each patient.” Schedule your mammogram today. Call 413794-8874 or visit baystatehealth.org/getscreened. Also, for more information on Rays of Hope, visit baystatehealth.org/ raysofhope.
“Being at Rays of Hope last year was overwhelming in the best way possible - I felt like I was being hugged tightly the whole time.” Lindsey, breast cancer survivor, with her sons Jackson and Brady
We walk and run for the survivors, for the fighters, for the research and for those we carry in our hearts. Make the #ROHPinkyPromise, start fundraising, and join the movement on Sunday, October 21 with more than 20,000 others in celebration of the 25th anniversary of Rays of Hope Walk & Run Toward the Cure of Breast Cancer.
CS10031
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Planning Meals WHILE YOU’RE HAVING TREATMENT
If you plan ahead for your treatment, you can save your time and strength by using delivery services, preplanned menus, and your friends’ help with cooking and shopping. On days when you’re feeling good, you may want to cook large portions of food that you can divide up and freeze. Then on days when you’re not feeling so good, you can simply defrost something. Eat your largest meal that has the most nutrients whenever you feel the best and have the most energy during the day. You might end up having soup or a casserole for breakfast, but that’s OK — it’s best for your body.
Helpful suggestions from women who have gone through breast cancer treatment Make every bite count
Choose nutrient-dense, but not caloriedense, foods and beverages rather than empty calories. Vegetable lasagna or a salad is a much better choice than a bag of chips and a can of soda pop.
Take a multi-vitamin
If you can’t eat enough food. Ask your doctor to recommend a multivitamin for you.
Use a stool or chair
So you can sit down while cooking food if you’re tired.
Keep foods handy
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Don’t be self-conscious about accepting offers of help from friends and family with cooking or shopping. And don’t be afraid to ask for help if you need it. Your family and friends may not know what you need done, so tell them. They love you — when they can help you, they feel good! Here are some tips to make it easy for you, your family, and your friends:
Keep a basic grocery list on hand
so it’s easy for someone else to go to the store for you.
Write out menus for several meals
(including recipes) that you like, so people who want to help have a guide.
Keep a list of foods
that appeal to you on your not-so-good days so your friends will know what you can tolerate the best.
string cheese, or nuts and raisins. Small snacks between meals can help you eat enough protein and calories.
Consider a liquid protein supplement
If you’re having trouble getting enough protein. Commercial products are available. Ask your doctor or registered dietitian for product recommendations and other eating tips.
Check to see if you qualify for Meals on Wheels service
The American Cancer Society also offers information on meal delivery services. Call 1-800-ACS-2345 to learn about resources in your area.
Talk to a registered dietitian
And have your diet evaluated if you’re not sure if your diet is balanced. Tell the dietitian that you’re undergoing cancer treatment and want to make sure that your diet is the best it can be.
Have groceries delivered
Consider ordering groceries online, or phoning or faxing in an order to a store that delivers.
Try shopping at a farmer’s market or outdoor stand
If there’s one near you. You might be better able to cope with food in the open air than in a store where smells are trapped inside.
Buy in bulk
When you’re feeling good, go shopping and buy several packages of food that will stay fresh so you don’t have to go to the store as often.
Ask for help
Taking the groceries out to the car and loading them. Most stores are happy to provide this service if you ask. Or ask a friend to go shopping with you and help you put the groceries away when you get home. Learn More At breastcancer.org
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WHAT RESEARCH SAYS ABOUT
marijuana & cancer
Attitudes about marijuana are changing. Such changes are reflected in legislation that has legalized marijuana in many areas and, in some instances, unofficially decriminalized possession of small amounts of marijuana in other places. Shifting attitudes about marijuana, also known as cannabis, may be attributed to various factors, including medical research. Though research studying the effects of marijuana on recovering cancer patients is ongoing, cancer patients and their families may be curious about the potential for cannabis to assist in their recoveries.
What is marijuana?
Marijuana is a plant that originated in central Asia but is now grown in many parts of the world. According to the National Cancer Institute, the cannabis plant produces a resin that contains compounds known as “cannabinoids,” which are active chemicals that, when ingested, affect various parts of the human body, including the central nervous system and the immune system. One
active cannabinoid is cannabidiol, or CBD, which the NCI notes may relieve pain and inflammation without making users feel the “high” that other cannabinoids produce.
What are some other potential effects of cannabinoids?
The NCI notes that research has shown that cannabinoids may be able to do more than relieve cancer patients’ pain and inflammation. While additional research is necessary, the NCI says cannabinoids may be able to block cell growth. The NCI points to studies in mice and rats that have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth and blocking the development of blood vessels that tumors need to grow. Cancer is marked by the uncontrolled division of abnormal cells, so the potential for cannabinoids to block that growth is a significant benefit. In addition, the NCI cites laboratory and animal studies that have shown that cannabinoids may be able to kill cancer cells while protecting normal cells.
Studies have shown that cannabinoids may have an effect on various types of cancer, including breast cancer and liver cancer. The NCI notes that a laboratory study of delta-9-THC, the main active cannabinoid in marijuana, in liver cancer cells indicated that the cannabinoid damaged or killed the cancer cells. Another laboratory study of CBD in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that CBD caused cancer cell death while having little effect on normal breast cells. Societal attitudes about marijuana are shifting, and ongoing research regarding its potential benefits in treating cancer may be changing the way the medical community views marijuana as well.
Have cannabinoids been linked to particular cancers?
Did you
know?
EVERY
TWO MINUTES, a woman is diagnosed with breast cancer. So it’s important to get recommended mammograms and take advantage of the most current technology available for detection and treatment of the disease.
the biopsy device (a fine, hollow needle) to that exact location, and tissue samples are extracted. Advantages of 3D-guided biopsy include greater precision, a shorter procedure time and less total X-ray exposure than biopsy guided by standard mammographic X-rays. The need for regular mammograms is nearly universal for women. Early detection and treatment of breast cancer significantly improve patient outcomes— and save Holyoke Medical Center’s lives. Women’s Center screens The HMC Women’s Center patients with 3D mammogcan help you make a proacraphy. Compared to traditive, informed decision about tional mammography, this your breast health. Learn technology is more effective more at HolyokeHealth.com/ at discovering cancer in WomensCenter where you dense breast tissue, and has can download our free guide, a lower rate of false positives What’s Your Risk? For an appointment, call 413.534.2770. for women who don’t have Join Holyoke Medical Cencancer. ter at an upcoming Women’s Other imaging studies Health Event in honor of used to detect breast cancer include ultrasound and MRI, Breast Cancer Awareness which sometimes are ordered Month: for high-risk individuals or Breast Cancer to identify specific areas of Screening Clinics the breast that look suspicious on a mammogram. If The HMC Oncology breast imaging confirms a Department will be holding suspicious finding, a biopsy is free Breast Cancer Screenperformed, removing a small ing Clinics throughout the month. Screenings take about sample of breast tissue for 15 minutes. Registration reanalysis in the laboratory to quired. To register, call (413) determine whether the cells 534-2576. are cancerous. In addition to 3D mammog- October 5, 12 & 19, 2018, raphy, Holyoke Medical Cen- 12:00-2:00 PM ter also offers 3D stereotactic Love Your Legs! breast biopsies, and is one An evening dedicated to of few hospitals to have this capability. In 3D stereotactic understanding your veins and leg circulation. Tips, breast biopsy, the surgeon uses images from a 3D mam- education, and more will be mogram to pinpoint the exact provided by HMC Vascular location in the breast from Surgery and the Wound Care which to take tissue for anal- Center. ysis. The system positions
Thursday, October 4, 2018, 5:30-6:30 PM in the HMC Auxiliary Conference Center
Zumba is for Everyone!
Come to this free introductory class and learn to Zumba at your own pace! The class will be taught by HMC’s very own Holly Larkin, RN, and Phil Warren! Drop in for as long as you’d like! Monday, October 15, 2018, 5:30-6:30 PM in the HMC Auxiliary Conference Center
Paint & Self-Care
Come to an evening all about you! Liz Drozdal, LMHC, will give a short presentation on self care, followed by a guided painting project with Jill Kovalchik to help ground yourself. Space is limited - registration required. There is a $10 fee for supplies. Thursday, October 18, 2018, 5:30 - 7:00 PM
Fresh Cooking
Join Marissa Chiapperino, HMC Clinical Nutritionist Navigator, for a three-course cooking demonstration for flavorful, healthy meals in the new Holyoke Community College MGM Culinary Arts Institute. Samples of the food will be provided. Space is limited - registration required. Tuesday, October 23, 2018, 5:30 - 7:00 PM
Register online at www.holyokehealth. com/events or by calling (413) 534-2789.
Mammograms Save Lives!
mates that roughly 480 men will die from breast cancer in 2018, when more than 2,500 new cases of invasive breast cancer will be diagnosed in men. In addition, the ACS notes that black men diagnosed with breast cancer tend to have a worse prognosis than white men. Though breast cancer may be a disease widely associated with women, men should not hesitate to report any discomfort to their physicians,
as the National Cancer Institute notes that men are often diagnosed with breast cancer at a later stage than women. The ACS suggests that men may be less likely to report symptoms, thereby leading to delays in diagnosis. The more advanced the cancer is at the time of diagnosis, the lower the patient’s survival rate. Men are urged to report any discomfort or abnormalities in their chests to their physicians immediately.
Offering
3D-Mammography and extended evening and Saturday hours.
The Women’s Center at Holyoke Medical Center offers the latest technologies— including 3D mammography—to detect and treat breast cancer. Early detection is the key to a successful treatment and recovery.
Make your mammogram appointment today! Call (413) 534-2770. 03095965
While the vast majority of breast cancer diagnoses involve women, men are not immune to the disease. According to the American Cancer Society, the lifetime risk of getting breast cancer is about one in 1,000 among men in the United States. By comparison, the risk for women in the United States is one in eight. While a man’s risk for breast cancer is considerably lower than a woman’s, the ACS still esti-
HolyokeHealth.com
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THE REPUBLICAN | MASSLIVE.COM
Determining
breast cancer stage
When receiving treatment for breast cancer, women will learn about cancer staging. According to the nonprofit organization Breastcancer.org, determining the stage of the cancer helps patients and their doctors figure out the prognosis, develop a treatment plan and even decide if clinical trials are a valid option.
Breastcancer.org notes that the TNM system was updated in 2018, but before then was based on three clinical characteristics:
surement of how much the cancer cells look like normal cells.
Estrogen- and progesterone-receptor status:
This indicates if the cancer cells have receptors for the hormones estrogen and progesterone. If cancer cells
for, helps doctors determine if the cancer will respond to hormonal therapy or other treatments. Hormone-receptor-positive cancers may be treatable with medications that reduce hormone production or block hormones from supporting the growth and function of cancer cells.
Typically expressed as a number on a scale of 0 through IV, breast cancer stage is determined after careful consideration of a host of factors. are deemed estrogen-receptor-positive, then they may receive signals from estrogen that promote their growth. Similarly, those deemed progesterone-receptor-positive may receive signals from progesterone that could promote their growth. Testing for hormone receptors, which roughly two out of three
HER2 status: This helps
doctors determine if the cancer cells are making too much of the HER2 protein. HER2 proteins are receptors on breast cells made by the HER2 gene. In about 25 percent of breast cancers, the HER2 gene makes too many copies of itself, and these
extra genes ultimately make breast cells grow and divide in ways that are uncontrollable. HER2-positive breast cancers are more likely to spread and return than those that are HER2-negative.
Oncotype DX score: The
oncotype DX score helps doctors determine a woman’s risk of early-stage, estrogen-receptor positive breast cancer recurring and how likely she is to benefit from post-surgery chemotherapy. In addition, the score helps doctors figure out if a woman is at risk of ductal carcinoma in situ recurring and/or at risk for a new invasive cancer developing in the same breast. The score also helps doctors figure out if such women will benefit from radiation therapy or DCIS surgery. Determining breast cancer stage is a complex process, but one that can help doctors develop the most effective course of treatment. More information is available at www.breastcancer.org
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T: the size of the tumor and whether or not it has grown into nearby tissue
N: whether the cancer is present in the lymph nodes
M: whether the cancer has
metastasized, or spread to others parts of the body beyond the breast While each of those factors is still considered when determining breast cancer stage, starting in 2018, the AJCC added additional characteristics to its staging guidelines, which make staging more complex but also more accurate.
www.pvcu.org
03095452
Typically expressed as a number on a scale of 0 through IV, breast cancer stage is determined after careful consideration of a host of factors. The staging system, sometimes referred to as the TNM system, is overseen by the American Joint Committee on Cancer and ensures that all instances of breast cancer are described in a uniform way. This helps to compare treatment results and gives doctors and patients a better understanding of breast cancer and the ways to treat it.
Tumor grade: This is a mea- breast cancers are positive