Survivor Guide
Suffolk News-Herald Wednesday, October 10, 2018 Page 1B
October is Breast Cancer Awareness Month, and the Suffolk News-Herald is honoring survivors with our special Survivor Guide. Local survivors whose photos were submitted are featured in this section, as well as a wealth of information about how to prevent and overcome breast cancer. We hope, as you read this section, you will take a moment to celebrate our survivors and remember those lost.
Adrienne King 4 years a survivor
Cheryl Bellamy 5 years a survivor
Clatie Clark Eure 7 years a survivor
Crystal Towns 7 years a survivor
Darlene Holmes 6 years a survivor
Elsie Vaughan 19 years a survivor
Iyasha Edwards 2 months a survivor
Jana Bennett 8 years a survivor
Janice Vaughan 11 years a survivor
LaRhonda Hall 14 years a survivor
Mary Blanche Lawrence Bess 18 years a survivor
Sadie Mongomery 5 years a survivor
Vivian Vines Turner 14 years a survivor
Yvonne Jones Randolph 11 years a survivor
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How to juggle work and breast cancer treatment
Age is a risk factor for breast cancer, as the organization Susan G. Komen notes that the older a woman is, the more likely she is to get breast cancer. However, data from the National Cancer Institute indicates that breast cancer rates in women begin to increase after age 40, meaning many women diagnosed with breast cancer have to juggle both their disease and their careers. The nonprofit organization Breastcancer.org says that breast cancer treatments can produce some cognitive side effects that affect thinking and memory. Memory loss and difficulty concentrating are two such side effects that can make it difficult for working women to do their jobs while being treated for breast cancer. Professional women diagnosed with breast cancer may be able to take advantage of shortand long-term disability programs that provide a percentage of their incomes if they are diagnosed with an illness that prevents them from doing their jobs. In addition, Breastcancer. org notes that, in the United States, the Family and Medical Leave Act allows employees to maintain their benefits and keep their jobs while taking up to 12 weeks of unpaid leave to heal from serious health conditions.
Despite those options, many women may want to continue working while receiving treatment for breast cancer. Such women can heed the following tips, courtesy of Breastcancer.org, to overcome any cognitive effects of treatment so they can continue to perform their jobs capably. 4Start taking notes. Start taking notes during meetings, important work-related conversations and even doctor’s appointments to counter any issues
with memory. Keep such notes on a tablet or smartphone so they can be quickly and easily accessed throughout the day. 4Write down deadlines and work schedules. Accomplished
professionals may keep lists of deadlines and work schedules in their heads, but that internal list
might not be so reliable while women are being treated for breast cancer. Make use of the calendar function on your smartphone or tablet to note dead-
lines, even setting alerts so you receive routine reminders when important dates are coming up. 4Make and routinely update a to-do list. Some professional women diagnosed with breast cancer may be juggling work, treatment and their families. Keeping a to-do list and checking items off as they’re completed can help women effectively manage such juggling a c t s and save time. 4 Set realistic goals. Breast cancer treatment can produce a host of side effects, including fatigue. So women who plan to continue working during treatment should be sure to set realistic goals that take into account the effects that treatment may have on their energy levels. If need be, delegate more tasks and ask for more help. —Metro Creative
Reading your pathology report Pathology reports are documents that contain diagnoses after doctors have examined cells and tissues under a microscope. According to the National Cancer Institute, pathology reports, which play an important role in diagnosing and treating cancer, also may contain information regarding the size, shape and appearance of a specimen as it looks to the naked eye. People who are diagnosed with breast cancer may receive pathology reports that indicate the presence of tumor necrosis. According to the nonprofit organization Breastcancer.org, the presence of tumor necrosis means that dead breast cancer cells were found within the tissue sample. Tumor necrosis, though it is often limited to a small area within the tissue sample, suggests a patient is battling an aggressive form of breast cancer.
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Lifestyle choices that can decrease cancer risk The United Nations estimates that the world is home to 7.6 billion people. None of those people, regardless of their ethnicity, race, age or gender, is immune to cancer. According to the World Health Organization, cancer is the second-leading cause of death across the globe. Responsible for nearly 9 million deaths in 2015, cancer is a formidable foe but one that can be defeated. For example, the SEER Cancer Statistics Review released in spring of 2018 indicated that cancer death rates among women decreased by 1.4 percent between 2006 and 2015. Even more encouraging is the decline in breast cancer death rates, which the American Cancer Society says decreased by 39 percent between 1989 and 2015. Various factors have contributed to the decline in cancer death rates. While advancements in treatment protocols and education programs that have emphasized the importance of cancer screenings have had profound impacts, individuals avoiding unhealthy lifestyle choic-
es also has made a difference in reversing cancer death rates. Research into cancer prevention is ongoing, but the following are some healthy lifestyle choices that may help people reduce their cancer risk. 4 Avoid tobacco. The U.S. Department of Health and Human Services reports that cigarette smoking kills almost half a million people in America alone each year. Nearly 10 percent of those deaths occur due to exposure to secondhand smoke. Lung cancer is not the only type of cancer that smoking has been linked to, as the Mayo Clinic notes smoking also has been connected to cancers of the mouth, throat, larynx, pancreas, bladder, cervix and kidney. By avoiding or quitting tobacco, men and women can reduce their own cancer risk and reduce the likelihood that their non-smoking loved ones will develop cancer related to secondhand smoke. 4Eat right. The WHO notes that many countries have implemented programs encouraging the consumption of five or more portions of fruits and vegetables per day. Those pro-
grams are a result of studies showing the potential relationship between a healthy diet and a reduced risk of cancer. For example, the
National Cancer Institute says studies conducted on animals have shown that antioxidants, which can be found in various fruits and vegetables, can prevent the type of cell damage associated with the development of cancer. 4Protect skin from the sun. In 2018, the American Cancer Society notes that more people are diagnosed with skin cancer in the United States each year than all other cancers combined. While overexposure to the sun is not the only way a person can develop skin cancer, protecting skin from the sun is a great way for people to significantly reduce their risk for the disease. The Mayo Clinic recommends people avoid the sun between 10 a.m. and 4 p.m., when the sun’s rays are strongest. People also should apply and reapply generous amounts of sunscreen when spending time outdoors. 4Speak with a physician about immunizations. The Mayo Clinic notes that protecting oneself against certain viral infections also may help men and women reduce their cancer risk. For example, hepatitis B has been linked to liver cancer. Certain people, including those who are sexually active but not monogamous, intravenous drug users and health care or public safety workers who may be exposed to infected blood or body fluids, are at greater risk of hepatitis B than others, and such people should speak with their physicians about being vaccinated. —Metro Creative
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called back for follow-up imaging tests and biopsies to confirm a
the course of your lifetime. Part of helping you stay as healthy
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your initial screening test. You don’t have to wait around to know if
on breast cancer care • Access to cutting-edge technology to find your breast cancer sooner with advanced treatment options • Integrated healthcare team coming together during weekly breast cancer conferences to create a personalized treatment plan
there’s a problem, and treatment can begin immediately if a breast disease or cancer diagnosis is confirmed.
Supporting You Every Step of the Way Whether you’re interested in genetic counseling to assess your breast cancer risk, or you need help coordinating your doctor appointments,
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and extended hours to ensure we fit within your busy schedule • Access to advanced research and clinical trials for new cancer therapies • A nationally accredited program by the National Accreditation
If a breast cancer diagnosis is made, you’ll have access to monthly breast cancer support groups at multiple Sentara hospital locations throughout Hampton Roads. These support groups, led by clinical nurse navigators, connect you with other women who know what
Program for Breast Centers (NAPBC).
you’re going through. We also offer a Facebook support group, which
This organization recognizes breast care centers that achieve
allows you to connect digitally to a group of more than 400 other
and maintain the highest standards of care for women with
women who have experienced a breast cancer diagnosis.
breast diseases
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breast diseases early, so you stay as healthy as possible. Regardless
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of your diagnosis, we help you heal with innovative treatments,
breast health specialists who will work closely with them to
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been affected by breast cancer.
Early Detection Means Better Outcomes One out of every eight women in the United States will be
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diagnosed with breast cancer during her lifetime. Sentara focuses
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Women can trust that when they choose Sentara Comprehensive Breast Centers, that they will benefit from the wide range of services offered, including:
“From 3D mammography to breast-specific gamma imaging, our breast centers offers women advanced technology for the early detection and treatment of breast cancer,” says Dr. Stafford Brown, radiologist at Sentara Healthcare. Many of our breast centers use advanced 3D Mammography to find breast cancer sooner, and more easily than ever before. And
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because of 3D mammography’s accuracy, many women avoid being
To schedule your annual mammogram, visit sentara.com/Mammogram or call 757-736-0040
PAGE 4B | WEDNESDAY, OCTOBER 10, 2018
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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. 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 J oint 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. Breastcancer.org notes that the TNM system
was updated in 2018, but before then was based on three clinical characteristics: 4T: the size of the tumor and whether or not it has grown into nearby tissue 4N: whether the cancer is present in the lymph nodes 4M: whether the cancer has metastasized, or spread to other parts of the body beyond the breast While each of those factors is still considered when determining breast cancer stage, starting in 2018, the AJ CC added additional characteristics to its staging guidelines, which make staging more complex but also more accurate. 4Tumor grade: This is a measurement of how much the cancer cells look like normal cells. 4Estrogen- and progesterone-receptor status: This indicates if the cancer cells have receptors
for the hormones estrogen and progesterone. If cancer cells 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 breast cancers are positive for, helps doctors determine if the cancer will respond to hormonal therapy or other treatments. Hormone-receptorpositive cancers may be treatable with medications that reduce hormone production or block hormones from supporting the growth and function of cancer cells. 4HER2 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
Facts and figures about cancer A global concern in every way, cancer affects people from all walks of life. But as prevalent as cancer is, some facts and figures may still surprise you. 48.8 million: The number of people, according to the World Health Organization, who died from cancer in 2015, making it the second leading cause of death across the globe. 470: Percentage of cancer deaths that occur in low- and middle-income countries. ( Source: WHO) 422: Percentage of cancer deaths across the globe that can be traced to tobacco use. ( Source: Global Burden of Disease Study 2015) 490: Percentage of high-income countries
in which treatment services are available to citizens afflicted with cancer. ( Source: WHO) 4Less than 30: Percentage of low-income countries in which treatment services are available to citizens afflicted with cancer. ( Source: WHO) 425: Percentage of cancer cases in low- and middle-income countries caused by infections such as hepatitis and the human papilloma virus. ( Source: WHO) . 412: Percentage of cancers worldwide linked to viruses. ( Source: National Toxicology Program, National Institute of Environmental Health Sciences) 4 1.69 million:
The number of deaths attributed to lung cancer across the globe in 2015, making it the most deadly cancer in the world. Liver cancer ( 788,00 deaths) , colorectal cancer ( 774,000) , stomach cancer ( 754,000) and breast cancer ( 571,000) were the other most common causes of cancer deaths in 2015. ( Source: WHO) 4 1.16 trillion: Economic cost, in
American dollars, of cancer in 2010. ( Source: International Agency for Research on Cancer) 433: Percentage of cancer deaths that can be linked to five leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use and alcohol consumption. ( Source: WHO)
in ways that are uncontrollable. HER2-positive breast cancers are more likely to spread and return than those that are HER2negative. 4Oncotype DX score: The oncotype DX score h e l p s doc-
tors 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 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. —Metro Creative
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Explaining metastatic cancer Cancer survival rates are on the rise, and that rise can be credited to a host of factors. Advancements in cancer research and treatment have played a big role in rising survival rates, as have the efforts of various organizations to promote cancer prevention and raise awareness about the disease. The World Health Organization notes that between 30 and 50 percent of cancers can currently be prevented by avoiding certain risk factors and implementing evidence-based prevention strategies. However, people can be vulnerable to cancer if they do not pay attention to their bodies or make an effort to protect themselves against certain risk factors for cancer. In such instances, cancer may already have spread to other parts of their bodies, or metastasized, before they are even diagnosed, greatly
reducing their likelihood of surviving the disease. Cancer that spreads to distant parts of the body is known as metastatic cancer and is often referred to as “ stage IV cancer.” According to the National Cancer Institute, when observed under a microscope, metastatic cancer cells feature traits like that of the primary cancer and do not mimic the cells in the part of the body where the cancer is found. That is how doctors can tell that the cancer is metastatic cancer and has spread from another part of the body. When doctors diagnose metastatic cancer, they will refer to it with the same name as the primary cancer regardless of where the metastatic cancer was discovered. For example, the NCI notes that breast cancer that has spread to the lungs will not be referred to as lung cancer, but metastatic breast cancer. In addition,
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stage IV breast cancer, not as lung cancer. —Metro Creative
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Breast cancer survival rates soar A breast cancer diagnosis can be a devastating blow. Upon receiving such a diagnosis, people may begin to ask questions about treatment and the impact cancer may have on their personal lives. Many people who are diagnosed with cancer also begin to wonder about their mortality. An estimated 266,120 new cases of invasive breast cancer and 63,960 new cases of non-invasive, or in situ, breast cancer are expected to be diagnosed among women in the United States this year, according to Breastcancer.org. The good news is that breast cancer incidence rates began decreasing
in 2000 after increasing for the previous t w o decades. In addition, d e a t h r a t e s from
being made in the fight against breast cancer. The most recent SEER Cancer Statistics Review released in April 2018 indicates cancer death rates among women decreased by 1.4 percent per year between the years of 2006 and 2015. The American
breast cancer have been decreasingly steadily since 1989. The National Cancer Institute says that the change in age-adjusted mortality rates are an indicator of the progress
Cancer Society says that decreasing death rates among major cancer types, including prostate, colorectal, lung and breast cancers, are driving the overall shift in survival. The ACS says breast
cancer death rates among women declined by 39 percent from 1989 to 2015. That progress is attributed to improvements in early detection and treatment protocols. For anyone doing the math, over the last 25 years or so, 322,000 lives have been saved from breast cancer. Increased knowledge about breast cancer, early detection through examinations and mammography and improved treatments are helping to drive up the survival rates of breast cancer. Although this does not make diagnosis any less scary, it does offer hope to those recently diagnosed. —Metro Creative
Regrowing and caring for hair after chemotherapy Chemotherapy and radiation are common treatment options for people who have been diagnosed with cancer. While radiation may be targeted at specific areas, chemotherapy is systemic. This means it affects the entire body. As a result, as chemotherapy kills fast-growing cancer cells, it also kills or slows the growth of healthy cells, including hair cells, that divide and grow quickly, explains the National Cancer Institute. When chemotherapy treatment is completed, the body is typically capable of regenerating new hair, but that can take some time. Women who consider their hair a large part of their identity may have strong concerns and fears regarding hair loss and what their hair may look like when it begins to regrow. Understanding what to expect and what they can do to facilitate the regrowth of hair can help women better handle what lies ahead. New hair typically begins to grow within one to two months of the last chemo treatment. Breastcancer.org says people who have undergone chemotherapy may notice soft fuzz forming on their head roughly two to three weeks after the end of chemo. This will be followed by real hair growing at its normal rate
one month afterward. Two months after the last treatment, an inch of hair can be expected. How hair grows back elsewhere on the body, such as the eyelashes and eyebrows, varies from person to person. Experts at the Robert H. Lurie Comprehensive Cancer Center ’s Dermatologic Care Center at Northwestern University in Chicago recommend speaking with a doctor if hair is not regrowing quickly, which
can be the result of low levels of iron or zinc or even thyroid problems. To help the process along, some doctors suggest the use of supplements like biotin. The National Institutes of Health says biotin is a B vitamin found in many foods that helps turn carbohydrates, fats and proteins into energy. There is some evidence that taking biotin can help thicken and speed up the growth of hair and
nails, but more research is needed. Rogaine, the baldness treatment, also may be advised, as it’s been shown to speed hair regrowth in breast cancer patients who have lost their hair, advises Health magazine. It is not uncommon for hair grown after chemotherapy to look and feel different from hair prior to treatment. Someone who once had straight hair may develop a wavy mane afterwards. While drastic changes are not common, blonde hair may darken. As hair grows in, certain areas on the head may grow faster than others. Working with an experienced stylist can help a person achieve a look that is evened out and stylish at any length. Rosette la Vedette, a headwear retailer and cancer resource, suggests making a first trip back to the salon a special experience with a glass of champagne. Cutting hair won’t make it grow faster, but it can help a woman return to a sense of normalcy. —Metro Creative
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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. While some foods, namely unhealthy, highfat/ high-caloric foods, are best avoided, women who have been diagnosed with breast cancer may want to cut some surprising foods from their diets. Preliminary research now suggests limiting the consumption of asparagine, an amino acid, to dramatically reduce the ability of cancer to spread to other parts of the body. A study published in the journal Nature found that reducing asparagine consumption in laboratory mice with triple-negative breast cancer could dramatically reduce the ability of the cancer to travel to distant sites in the body.
Asparagine is found in foods like asparagus, whole grains, soy, seafood, eggs, poultry, beef, legumes and more. While reducing asparagine will not affect the original breast cancer tumor, it could stop cancer from showing up elsewhere in the body. Researchers suspect that many women with breast cancer do not l o s e
their lives to the origi n a l breast cancer tumor, but instead they succumb to metastases or subsequent growths away from the
primary site. “ Our study adds to a growing body of evidence that suggests diet can influence the course of the disease,” said Dr. Simon Knott, associate director of the Center for
Bioinformatics and Functional Genomics at Cedars-Sinai and one of two first authors of the study. The research from this study was conducted
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at more than a dozen institutions. Apart from dietary restrictions, metastasis also could be greatly limited by reducing asparagine synthetase using chemotherapy drug L-asparaginase. More research is needed as to whether similar results can be produced in human trials, making avoiding asparagine currently a helpful but not entirely foolproof method for preventing the spread of breast cancer to other areas of the body. —Metro Creative
Alcohol and breast cancer risk Many people unwind with a glass of wine or a cocktail after a stressful day, and some research suggests that mild to moderate consumption of alcoholic beverages can have various health advantages. According to the Mayo Clinic, moderate consumption of alcohol has been linked to a lower risk of developing and dying from heart disease, possibly reducing the risk of ischemic stroke and potentially reducing the risk of diabetes. However, for some people, the risks of consuming alcohol may
outweigh the benefits. Many studies show that drinking alcohol may increase the risk of breast cancer, advises the research and information organization Susan G. Komen. The group says pooled analysis of data from 53 studies found that, for each alcoholic drink consumed per day, the relative risk for breast cancer increases by about 7 percent. Researchers aren’t quite sure why there is an increased risk of breast cancer associated with alcohol intake, but experts at MD Anderson Cancer Center have
some theories. Some theorize that alcohol can increase levels of estrogen and other hormones that affect breast cancer formation and growth. Excess fat can lead to an increased cancer risk, and the consumption of empty calories through drinking alcohol can lead to unwanted weight gain. Furthermore, those who consume alcohol have increased amounts of folic acid in their systems, which can increase cancer risk. The nonprofit breast cancer organization Breastcancer.org states that, compared to
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women who don’t drink at all, women who have three alcoholic drinks per week have a 15 percent higher risk of breast cancer. Experts also estimate that the risk of breast cancer goes up another 10 percent for each additional drink women regularly consume each day. Keep in mind that a drink is defined as 12 ounces of beer, five ounces of wine or 1.5 ounces of liquor. Women who want to do all they can to reduce their risk of developing breast cancer may want to avoid alcohol. —Metro Creative
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Menopause and breast cancer risk Menopause occurs when a woman’s reproductive cycle is over and she can no longer produce offspring. For many women, menopause occurs around age 50. While menopause itself is not a risk for breast or other cancers, it’s important to know that some symptom treatments and other factors can increase the risk for cancer among menopausal women. The North American Menopause Society says that a woman going through perimenopause and menopause may experience various symptoms, which can range from hair loss to food cravings to hot flashes. The National Institutes of Health indicates some women undergo combined hor-
mone therapy, also called hormone replacement therapy, to help relieve menopausal symptoms such as hot flashes and osteoporosis. This therapy replaces estrogen and progestin, which diminish in a woman’s body after menopause sets in. However, NIH’s Women’s Health Initiative Study has found that women undergoing hormone replacement therapy have a higher risk of breast cancer, among other conditions. WebMD says evidence suggests that
the longer a woman is exposed to female horm o n e s , whether it’s those made by the body, taken as a drug or delivered by a patch, the more likely she is to develop breast cancer. That means that hormone replacement therapy can
increase breast cancer risk and also indicates that the longer a woman remains fertile, the greater her risk for certain cancers. Females who began menstruating before age 12 or entered menopause after age 55 will have had many ovulations. This increases the risk of uterine, breast and ovarian cancers, states the American Society of Clinical Oncology. It also may impact a woman’s chances of developing endometrial cancer. Gaining weight after menopause can also increase a woman’s risk of breast cancer, states the MD Anderson Cancer Center. Therefore, maintaining a healthy weight or even losing a little weight can be beneficial. —Metro Creative