October 2019 A Special Supplement to
Times
THE
A quick guide to breast cancer, its symptoms and treatment KATE REYNOLDS For The Times In 2018, there were more than 2 million new cases of breast cancer in the United States, with 63,960 new cases of non-invasive breast cancer. Breast cancer is the most diagnosed cancer in women and the second most common cancer overall. What is breast cancer? Breast cancer is a disease in which breast cells grow out of control, dividing and creating new cells that don’t function normally. These extra cells form a mass — commonly known as a tumor — that is sometimes noncancerous. These tumors usually stay in one spot on the breast and do not cause health problems. Others can be cancerous. Breast cancer often starts out small, too small to be felt, and that is why annual screenings are important, health officials report. There are different kinds of breast cancer and it all depends on which breast cells turn into cancer. It can spread to different part of the breast’s three main parts: lobules, ducts and connective tissue.
Preventive mastectomy More women who find they are at high risk for breast cancer are choosing to have health breasts removed to reduce their chances of getting the disease. The surgery, called preventive (or prophylactic) double mastectomy, is often accompanied by breast reconstruction.
Breast cancer in men While breast cancer is mainly considered a woman’s disease, men can be diagnosed as well. A man’s lifetime risk for breast cancer is about 1 in 1,000. The American Cancer Society has estimated that in 2019, about 2,670 new male breast cancer cases will be diagnosed and about 500 men will die from the disease. Many people don’t realize that cells in any part of the body can turn into cancer cells, spreading to other areas of the body. Cancer knows nothing about gender.
What causes breast cancer? While the exact cause is not known, several factors can provide insight into the diseases’s cause. Some of those factors include family history; lifestyle choices such as smoking and/or alcohol consumption; and obesity. If a patient has breast cancer in one breast, there is an increased chance the other breast will develop cancer. If a woman becomes pregnant at an older age or has never been pregnant, she will have an increased risk of developing breast cancer.
Breast cancer symptoms Symptoms can range anywhere from swelling and skin changes to lumps. Unfortunately, many breast cancers have no obvious symptoms. Self-exams help, but there are times when a lump may be too small to notice. Usually an abnormal area
will show up during a screening mammogram. In other situations, the first sign of breast cancer is a new lump. While a painless, hard lump with uneven edges is usually diagnosed as cancer, sometimes a tender, soft, rounded lump also will signify cancer. According to the American Cancer Society, swelling of all or part of the breast, skin irritation (rash) or dimpling, breast pain, nipple pain or the nipple turning inward, redness, thickening or scaliness of the nipple or breast skin, a nipple discharge that’s not breast milk or a lump under the arm could all be breast cancer symptoms. But any of these changes also can be signs of a cyst or infection. That’s why it’s important to talk to a doctor and have any changes checked for a cause.
radical mastectomy and reconstruction. Chemotherapy uses a drug combination to destroy cancer cells or slow down their growth. Radiation uses high-energy rays to kill cancer cells. If the cells have hormone receptors, drugs like inhibitors or blockers that help destroy cancer cells by cutting off hormones. Targeted therapy uses drugs that block breast cancer cell growth, often
reducing side effects found in other therapy forms. The most common form of cancer in women is breast cancer. But it can be successfully treated. Regular yearly routine mammograms and breast exams can detect cancer early. If it’s detected early enough in its initial stages, breast cancer can be successfully treated. But the key is to make sure annual screenings are a part of your routine.
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Treatments According to the National Breast Cancer Foundation, surgery is the most common breast cancer treatment. During surgery, the tumor is removed. Other surgical options can include partial mastectomy,
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Yearly screenings are a necessity KATE REYNOLDS For The Times When retired La Salle County Health Department public health nurse Cathy Larsen learned she had breast cancer, she was stunned. At age 60, she never pictured herself with breast cancer because she followed all the steps she advocated for her patients. “I was not symptomatic yet,” Larsen said. “I didn’t have a lump. As a nurse, I spent a lot of time advocating self-breast exams and yearly mammograms, so when I was diagnosed, I never never stopped to think it could happen to me. As a matter of fact, after my yearly mammogram, I walked out of the office saying, ‘See you next year,’ assuming all was well.” Despite her health training and experience, Larsen said she reacted like anyone who receives a positive diagnosis would act. “It stopped me in my
It’s your decision to fight it or accept it Larsen said at first, she didn’t tell anyone she had breast cancer. “I kept it to myself until I was ready to talk about it for a couple of reasons,” she said. “First, I had to have time to think about my choices. Once I took time to consider everything, I knew I had only two options. I could accept the diagnosis and believe everything would be all right or I could fight the diagnosis and do nothing about it and not be OK. “Second, I had to be prepared to tell my family in a way that would minimize the trauma and stress I knew they would feel,” she continued. “But I had to wait until I had come to terms with it myself. Otherwise, I would have said, ‘Oh my gosh, I just found out I have breast cancer’ and that wouldn’t have helped anyone.” Larsen said she had to accept the diagnosis and face it head-on in order to survive. “Since breast cancer chose
tracks,” Larsen said. “I mean, my diagnosis felt totally wrong because I didn’t have a lump or any other symptoms. I had all kinds of questions like, ‘Why me? How did this happen to me?’ and ‘Can I do this?’ There was no way this could be true.” Larsen said once reality set in, she had to try coming to terms with it. “After I went through being afraid and asking those questions, one thing was clear to me,” she continued. “Whether you discover a lump in your breast or simply find out from a mammogram, annual screenings are so important.” Larsen said if she had not gone in for a screening, the cancer would have spread before it was discovered. Her breast cancer was aggressive, and she credits the screening for catching it early enough to save her life. “I’m proof that early detection is the best prevention,” she said. “It’s absolutely true.”
me, I chose to accept it and keep my head up while doing the things I had to do to save my life.”
that was a huge thing. Once they became involved, they could tell everything really was going to be all right.”
Important to have a support group
Local resources
Larsen’s treatment included radiation and chemotherapy. For her, support of family and friends was extremely important. “I don’t know how anyone with cancer could not seek support,” Larsen said. “Whether it’s family, friends or even a cancer support group, you need to have people around you.” Larsen has two granddaughters, ages 5 and 7 years old at the time. She and her daughter made sure they were part of the support group. “We thought it was important for them to know what I was going through, to help them know I was going to be OK,” she said. “During chemo, my hair did fall out and I wore a lot of hats, so I wanted to make sure they weren’t afraid of that change. We also took them along for some of my treatments, and
Larsen found an American Cancer Society office in Streator that she said turned out to be a valuable resource. “I can’t say enough good things about The American Cancer Society,” Larsen said. “They do so much to support women dealing with breast cancer issues. The office in Streator was really helpful and there’s also a Cancer Boutique that offers everything needed to help woman look good and feel better about themselves.” Streator’s American Cancer Patient Resource Center & Wig Boutique offers free wigs, scarves, hats and pamphlets provided by the American Cancer Society; assistance with rides to doctor visits; financial help when staying out of town for treatments; advice with insurance questions;
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BREAST CANCER | The Times - Delivering Your Community • Tuesday, October 1, 2019
Advice from a breast cancer survivor
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Continued from page 3 networking opportunities with patients of a similar diagnosis; plus 24/7 telephone support at 800-227-2345. All services and materials are free. For post mastectomy and cancer patients, a Cancer Boutique offers a private setting where patients can find specialty products like breast prostheses, surgical bras and breast enhancements. Patients also can find skin care products and lotions, all with cancer patients in mind. “Patients can walk away with bags of cosmetics or find beautiful hats and scarves that definitely help women feel better about themselves” Larsen said. The Streator center is open 10 a.m. to 2 p.m. Mondays and Wednesdays at the OSF Center for Health-Streator, 111 Spring St., on the East Wing of fifth floor. Morris Hospital’s Radiation Therapy Center also offers a Look Good, Feel Better program. For more information, visit morrishospital.org/ events or call 815-364-8915.
Sharing her experience Larsen talks about being a breast cancer survivor because other women need to know they are not alone in the fight. “Part of my own cancer acceptance is that I believe there has to be a reason why I received my diagnosis,” Larsen said. “What I’ve come up with is that I can now relate to other women, try to make the situation as positive as I can for them.” Part of Larsen’s breast cancer experience was learning it wastes energy to fight the diagnosis. Instead, it helps to accept it and start funneling energy toward healing. That’s a lesson she wants to help other patients learn sooner. “I’ve been able to take something bad and make it better,” she said. And she has one vital piece of advice to women who haven’t been diagnosed. “I know that if I didn’t make yearly mammograms a part of my life, I would never have known I had breast cancer. So, I can’t say it enough: make sure you get screened every year without fail. I’m proof that your life depends on this.”
Contributed
Morris Hospital mammography technologists (from left) Dawn Johnson, Sarah Brooks and Melissa Craig raise awareness for breast cancer early detection at a previous Hip Hop for Hope event.
Hip Hop for Hope: A ladies night out Event offers entertainment plus cancer education that can save women’s lives In recognition of Breast Cancer Awareness Month, Morris Hospital is hosting a free community event, Hip Hop for Hope, from 6 to 7:30 p.m. Friday, Oct. 18, in the former Shabbona School gym, 725 School St., Morris. Attendees should enter through door number 18 on the south side of the building. This special ladies night out event will feature a hip hop exercise class, breast cancer awareness
education, refreshments, door prizes and giveaways. Free T-shirts are guaranteed to participants who register by Thursday, Oct. 10. The gym will be decorated with black lights, disco balls and pink ribbon décor. Hip Hop for Hope is open to women of all ages. Participants are encouraged to wear pink to show support for breast cancer awareness. According to the American Cancer Society, 1 in 8 women in the United States will develop breast cancer. On its website, ACS says getting regular screening test is the most reliable way to find breast cancer early, when it’s
easier to treat successfully. “Our event is really about raising awareness for breast cancer early detection by bringing women together with their friends in a fun and positive setting,” said Terri Jacob, registered nurse and breast health navigator at Morris Hospital. “Every day through my role as a breast health navigator, I have the opportunity to see that breast cancer early detection really does make a difference. Our goal through Hip Hop is to empower women to take care of themselves.” Reservations can be made by going to morrishospital.org/events. For more information, call Morris Hospital at 815-705-7685.
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““Annual Annual m mammography ammography detects breast breast cancer c a n ce r detects at its its early early stages, stages, at giving the the best best options options giving for treatment treatment and and for the best best chance chance for for living living the longer, healthier healthier life.” life.” a longer, ~ TTerri Ter erri er ri Ja Jaco Jacob, cob, co b, RN, RN, MSN MSN Cert Ce Certified rtiified Breast rt Brea Br east ea st Health Heal He alth al th Navigator Navi Na viga vi gato ga torr to
For women at average risk, these simple guidelines from the American Congress of Obstetricians and Gynecologists can help detect breast cancer early:
· Examine your breasts on a regular basis so you know how they
normally look and feel. Report any changes to your healthcare provider.
· Have a clinical breast exam every 1-3 years between ages 25-39. Beginning at age 40, have a breast exam by a healthcare provider every year. · For women at average risk without symptoms of breast cancer, talk to your provider about having an annual screening mammogram beginning at age 40.
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Researchers have identified a protein that may be a risk factor for both high blood pressure and breast cancer. Previous studies have found women with high blood pressure have about a 15% increased risk of developing breast cancer compared to women with normal blood pressure. High levels of the protein GRK4 (G-protein coupled receptor kinase 4) have been shown to cause high blood pressure, also called hypertension. The new study, presented recently at the American Heart Association’s Hypertension Scientific Sessions in New Orleans, showed the GRK4 protein was present in breast cancer cells but not in normal breast cells. “Cancer and hypertension share common risk factors,” said Dr. Wei Yue, the study’s lead investigator and a research scientist at the University of Virginia School of Medicine in Charlottesville. “Our laboratory’s previous research on GRK4 found that it is regulated by an oncogene called c-Myc, which plays a role in many cancers, including breast cancer. This led us to hypothesize that GRK4 could be a link.” Nearly half of all adults with high blood pressure are women. After age 65, women are more likely than men to have high blood pressure. Pregnancy, birth control medications and menopause can all increase the risk of developing high blood pressure. If left untreated, it can cause health problems such as heart disease, stroke and vision loss. In women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death. “While previous studies have shown that breast cancer risk is in-
creased in hypertensive women, this study adds to the current knowledge by providing the molecular mechanisms that underlie this association,” said Dr. Vesna D. Garovic, chair of the division of Nephrology and Hypertension Research at the Mayo Clinic in Rochester, Minnesota. Garovic, who was not involved in the new research, said studies like this one that identify the molecular mechanisms and signaling pathways that cause a disease to develop can provide new insights into treatment options. Not all breast tumors are the same. The study looked for GRK4 in two specific types of breast cancer, known as hormone-sensitive and triple-negative. “Our conclusion may not be applicable to other types of breast cancer,” said Yue. Garovic noted GRK4 genetic variations may not be the same in all racial groups. Studies that look for GRK4 in women with breast cancer across racial and ethnic groups, she said, may provide insights into previously reported race-based differences in tumor type, treatment response and outcomes. GRK4 is one of seven GRK proteins. Other studies have looked for GRK2 and GRK5 in different types of cancers, but Yue said their group is the first to look for a link between GRK4, high blood pressure and breast cancer. “No one else is working on this,” she said. Yue said this molecule is unique because it’s not normally expressed – meaning made into a protein by a gene – in breast tissues, making it a potential target for drug development. “A drug that targeted GRK4 could potentially be used to treat the patients with hypertension and breast cancer.”
Mammography Screenings really do SAVE LIVES.
5 BREAST CANCER |
Scientists find link between high blood pressure and breast cancer
The Times - Delivering Your Community • Tuesday, October 1, 2019
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rising in middle-aged Americans Rates falling in seniors MARIE MCCULLOUGH The Philadelphia Inquirer (TNS) PHILADELPHIA — The risk of developing cancer increases with age. But a new analysis of federal cancer data suggests that the obesity epidemic is making the demographic picture more complicated. Case Western Reserve University researchers found that rates of obesity-related cancers are rising among people aged 50 to 64, and declining among senior citizens, so middle-aged people make up a growing proportion of those cancer diagnoses. “Obesity can accelerate the development of cancer,” said Nathan A. Berger, senior author of the study published online Wednesday in JAMA Network Open. The study analyzed 2.7 million cases of 13 types of cancers known to be associated with obesity — breast, ovarian, uterine, liver, thyroid, gall bladder, bile duct, esophageal, multiple myeloma, kidney, pancreas, stomach, and meningioma — between 2000 and 2016. The researchers parsed the data by sex, race, and ethnicity. They also analyzed 3.4 million cases of non-obesity-related cancers for the same period.
Scientists have found that cancer can be fueled A growing body of studies have linked excess weight to rising rates of cancer among younger adults. The Case Western study did not find significant increases in rates of obesity-related or non-obesity related cancers for the youngest group, ages 20 to 49. In contrast, ages 50 to 64 had increased rates of both obesity-related and non-obesity related cancers —
but this trend was more pronounced for cancers linked to excess weight. For those age 65 or older, meanwhile, the rates generally fell — a finding that the researchers acknowledge is contrary to previous studies. For example, among white males with obesity-associated cancers, the proportion of those who were ages 50 to 64 increased from 28% in 2000 to 34% in 2016, while the proportion of those 65 or over decreased from 62% to 57%. One limitation of the study is that it relied on a federal cancer surveillance database that lacks information about body mass index, or BMI, the measure of body fat based on height and weight. “Thus,” the authors say, “we were unable to determine whether obesity-associated cancers actually occurred in individuals with high body adiposity.” However, the pervasiveness of unhealthy weight is clear. In the U.S., about 40% of adults over age 20 are obese, defined by a BMI of 30 or greater; that rises to 72% if overweight individuals are included, according to government data. One implication of the new study, the authors say, is that as people turn 65 and qualify for Medicare, “more … will be cancer survivors with a high burden of mental health problems, functional impairment, and medical bankruptcy.” Lead author Siran M. Koroukian, a Case Western population health researcher, said the changing demographics should also make physicians watch out for cancer, even in younger patients. “Time and again, people go in with symptoms and doctors don’t suspect cancer.” Above all, the findings point to the need to fight obesity. “These findings,” they conclude, “have important public health implications and suggest that interventions to reduce obesity and to implement individualized screening programs are needed.”
Help us bring
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FIGHT!
Early detection is the most effective weapon we have in the fight against breast cancer. OSF HealthCare wants to make sure every woman 40 or older, or who is at high-risk for breast cancer, gets a mammogram regularly. Our goal is to perform at least 900 mammograms by the end of October – Breast Cancer Awareness Month. Throughout the month, we’ll bathe the hospital in pink spotlights so your community’s commitment to fighting breast cancer shines bright. Every woman who gets a mammogram at OSF HealthCare now through October receives a pink tote bag (while supplies last).
Local cancer support groups PINK RIBBON CLUB, breast cancer, 5:30 p.m. fourth Wednesday each month, First Congregational Church, 1431 Fourth St., Peru, 815-220-0342, ivbrca.com. SISTER SUPPORT BREAST CANCER, 1 p.m. first Thursday each month, IVCH Special Procedure conference room, 815-223-7878 CANCER, “I Can Cope,” Radiation Therapy Center of Morris Hospital, 1600 W. U.S. 6, morrishospital.org/events, 815-364-8915. CANCER, 8:30 to 9:30 a.m. second Wednesday each month, Valley West medical office building, 815-786-9198, valleywest.org/cancer. CANCER, 6 p.m. second Monday each month, special procedures conference room just off the West Street lobby at IVCH, 815-780-4618. CANCERCARE, 1 p.m. second Wednesday each month, Fox River Church, 2785 E. U.S. 52, 815-695-9926.
Call your preferred location to schedule a mammogram appointment. Ask us about our convenient weekend hours! Mendota (815) 538-7206 Ottawa (815) 431-5471 Streator (815) 673-4517
MARIE MCCULLOUGH The Philadelphia Inquirer (TNS)
models to add or substitute meats, the researchers found breast cancer risk was further reduced by swapping poultry (chicken, turkey, hens, duck, goose or game birds) for red meat (beef, veal, pork, lamb and game meat). The associations didn’t change when the researchers made adjustments for factors that could skew the findings such as family history of breast cancer, obesity, physical activity and alcohol consumption. The magnitude of the effects, good or bad, on breast cancer risk was relatively small. And the new study is just the latest to weigh in on an unsettled area of research. While many studies suggest vegetarian diets are a good strategy to ward off a number of cancers, particularly colon cancer, the association between red meat consumption and breast cancer risk has been inconsistent. Why might red meat make a difference? Lab and animal studies have found that iron, fat and certain acids found in red meat can increase tumor formation. Another theory
Good news for women who can’t quite bring themselves to go vegetarian, but don’t mind giving up burgers and steaks: A new study finds red meat may increase breast cancer risk, while substituting poultry may lower it. The study, published in the International Journal of Cancer, looked for links between meat consumption patterns and the incidence of breast cancer in 42,012 women from the U.S. and Puerto Rico who were followed for an average of 7.6 years. During that period, 1,536 invasive breast cancers were diagnosed. The researchers, led by Columbia University epidemiologist Jamie J. Lo, found that women who consumed the most red meat — a quarter of a pound or more per day — had a 23% higher risk of invasive breast cancer compared with women who consumed the lowest amount. Meanwhile, women with the highest consumption of poultry had a 15% lower risk than those with the lowest consumption. Using mathematical
Dreamstime | TNS
A new study finds red meat may increase breast cancer risk, while substituting poultry may lower it. involves the cancer-causing byproducts that result from cooking or grilling red meat at high heat. Poultry’s possible protective effect is even more speculative.
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“While the mechanism through which poultry consumption decreases breast cancer risk is not clear,” senior author Dale P. Sandler of the National Institute of Environmental Health Sci-
ences said in a press release, “our study does provide evidence that substituting poultry for red meat may be a simple change that can help reduce the incidence of breast cancer.”
7 BREAST CANCER | The Times - Delivering Your Community • Tuesday, October 1, 2019
Eating poultry instead of red meat may lower breast cancer risk
The Times - Delivering Your Community • Tuesday, October 1, 2019
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