2019 Survivor Guide

Survivor Guide

Suffolk News-Herald Sunday, October 20, 2019 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.

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Suffolk native plans benefit concert

BY TRACY AGNEW EDITOR

Davon Bagley is a Suffolk native who wanted to do something about the high rate of breast cancer in Suffolk, so he’s helping the best way he knows how: holding a gospel concert to honor survivors and raise money.

The resulting event, Hampton Roads Praise Fest, will happen this week.

“I’m from Suffolk originally,” Bagley said recently. “There has been a very high amount of young females I know personally

that are coming down or dying from breast cancer. I wanted to figure out a way I could bring awareness to the situation the best way I knew how.”

According to an analysis by the Institute for Health Metrics and Evaluation at the University of Washington, female breast cancer in Suffolk in 2014 occurred at a rate of 36.4 per 100,000 population — much higher than the 27.6 in Virginia or 25.9 across the nation.

The Oct. 25 event, hosted by Karlton Humes, will feature artists including Vashawn Mitchell,

Jonathan Nelson and Le’Andria Johnson, all Grammy nominees. The event will also honor gospel music legend Richard Smallwood, whose music has been recorded by artists such as Destiny’s Child, Whitney Houston and Chaka Khan.

Part of the proceeds from the concert will be donated to the Tidewater affiliated of the Susan G. Komen Breast Cancer Foundation, Bagley said.

At the concert, they will also give away two $500 grants for medical wigs “to deserving people who are battling cancer right

now” in a partnership with Gluxe Beauty Co., Bagley said. People hoping to receive a wig should send an email stating why they are deserving of the grant in 100 words or less to hamptonroadspraisefest@ gmail.com with the subject line “GRANT.” They do not have to be present to receive one of the grants.

In addition, a tribute to breast cancer survivors will be shown at the event. Anyone who is a breast cancer survivor should send their photo, name and number of years they have been a

Men can get breast cancer, too The color pink has become synonymous with raising awareness about breast cancer. Each Mother’s Day, professional baseball players don pink attire and even use pink bats to raise awareness about breast cancer, while many pink T-shirts and ribbons can be seen during annual walks that aim to raise money for breast cancer research.

These efforts and others involving the color pink are often inspired by good-natured attempts to support female friends and relatives who have been diagnosed with breast cancer, but it’s important to note that this potentially deadly disease can afflict anyone, including men.

The overwhelming majority of breast cancer patients are female. In fact, the National Breast Cancer Foundation reports

that less than 1 percent of all breast cancer cases develop in men. However, BreastCancer.org notes that more than 2,600 men were expected to be diagnosed with breast cancer in 2019. Men who overlook breast cancer and its potential symptoms could be putting themselves in jeopardy, however unlikely that may be.

How do men get breast cancer?

The fact that men don’t have breasts does not prevent them from getting breast cancer. That’s because men’s bodies have breast tissue and even small amounts of breast-stimulating hormones. According to BreastCancer.org, most males bodies don’t utilize these hormones all that much, which is why their breast tissue stays flat and small. However,

some men, and even boys, utilize the hormones more than others, and even develop breasts, which are typically just mounds of fat. But in some instances males develop real breast gland tissue, which can be a byproduct of abnormal hormone levels or certain medications.

What are some risk factors for male breast cancer?

Instances of male breast cancer are so rare that the disease has not been the subject of substantial research. But researchers have learned that various factors can increase a man’s risk for breast cancer. Learning these risk factors is important, as men are not typically screened for breast cancer, which means it’s often diagnosed in its later, less treatable stages.

4Age: The average age of men diagnosed with breast cancer is 68. That’s not too surprising, as age also increase women’s risk for the disease.

4Elevated estrogen levels: Men with elevated estrogen levels are at

greater risk of developing breast cancer than those with normal levels. Estrogen levels can increase due to various factors. Men who take hormonal medicines may experience elevated estrogen levels, while being overweight also increases those levels. Alcohol limits the liver’s ability to regulate estrogen levels, so men who are heavy drinkers also may be elevating their risk for breast cancer.

4Klinefelter syndrome: This condition affects about one in 1,000 men and is characterized by lower than normal levels of the male hormone androgen and higher than normal levels of the female hormone estrogen.

4Radiation exposure: Men who have been treated with radiation to the chest have an increased risk of developing breast cancer.

Men are not immune to breast cancer.

Recognizing that and understanding risk factors for male breast cancer can save lives.

—Metro Creative

How reproductive history can affect breast cancer risk

Various factors can contribute to the development of breast cancer. Many women may not be aware that their own reproductive history could be affecting their risk.

Data indicates there is a correlation between the amount of reproductive estrogen present in a woman’s body and her chances of developing breast cancer. There is evidence that women who either begin menstruating at a young age or cease menstruation at a later age have an increased risk for breast cancer. Fluctuating estrogen and progesterone during menstrual cycles can affect mammary epithelial cells, immune cells and the extracellular matrix, according to a 2011 study titled “The immune hallmarks of cancer,” that was published in the journal Immunotherapy.

The Centers for Disease Control and Prevention says women who had early menstrual periods (before age 12) or those who started menopause after age 55 are exposed to estrogen longer,

increasing their risk of getting breast cancer. Susan G. Komen advises that, according to a pooled analysis of data from more than 400,000 women, for every year older a woman was at menopause, her breast cancer risk increased about 3 percent.

Prior to menopause, estrogen in the bloodstream is largely caused by the production of estrogen in the ovaries. After menopause, when the ovaries stop producing estrogen naturally, estrogen can be produced by stores in body fat. Women who have a highe r con-

centration of body fat or are largely sedentary may have higher levels of estrogen, which affects their cancer risk.

Conversely, although reproductive hormones are elevated during pregnancy, having children helps reduce breast cancer risk over time. Data published in the Lancet in 2002 reveals after a transient increase in risk for breast cancer, peaking at about five years after giving birth, having at least one child is associated with a decrease in the long-term risk of developing breast cancer compared with the risk among women who never had children. This protective effect increases with number of children; each birth reduces the relative risk of breast cancer by about 7 percent.

Reproductive history is another consideration in breast cancer develop-

ment. Women can speak to their gynecologists if they suspect a high risk due to estrogen exposure.

—Metro Creative

survivor to hamptonroadspraisefest@gmail.com

by Oct. 21.

The event will take place at 7 p.m. Oct. 25 at Grove Church, 5910 W. Norfolk

Road, Portsmouth.

General admission is $30; tickets are available at hrpf19.ticketlocity.com.

Call 650-8886 for more information.

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SUNDAY, OCTOBER 20, 2019 | PAGE 3B

SUBMITTED PHOTO

Jaqueline Beale, left, credits Dr. Nicole Yeshtokin with saving her life after she felt a lump during a self-exam and went in for treatment.

‘I wanted to shout it to the world, I’m a survivor!’

FROM STAFF REPORTS SUFFOLK NEWS-HERALD

Last October, Jaqueline Beale was diagnosed with stage 3 breast cancer one year after her annual mammogram came back clean. “This has changed my whole life,” said Beale.

When a self-exam didn’t feel right, she knew she needed to make a difficult call. Dr. Nicole Yeshtokin with Southampton Memorial Hospital is the doctor who first diagnosed Beale with stage 3 breast cancer and performed the double mastectomy.

Although the surgery could have been performed by other hospitals in Norfolk, Beale said it was Yeshtokin’s compassionate care and consideration of her feelings that kept her in Franklin. “Dr. Yeshtokin, she’s my Godsent angel,” Beale said

about the surgeon who she credits with saving her life. “She’s a sweet and beautiful person.”

Beale continued, “I thank God that I’m here.

God has given me a second chance at life.”

She said through it all, Yeshtokin was by her side offering support and a warm smile.

While a self-exam revealed a lump in Jaqueline, the American College of Radiology recommends an annual mammogram for women of average risk starting at age 40. According to the CDC, one in eight women will be diagnosed with breast cancer.

“If you don’t get screened, you may never know,” said Yeshtokin.

Screening mammograms like the ones offered at Southampton Memorial Hospital can help detect breast cancer in its earliest and most treatable stages.

“We can treat nearly all

breast cancers if we find it early enough,” Yeshtokin added.

Southampton Memorial Hospital is offering 2D Screening Mammograms for $99 through a partnership with MDSave.com.

The offer is available until Oct. 31, and the vouchers expire one year from the date of purchase.

To request an appointment with Dr. Yeshtokin: 4757-562-6181 4MySouthamptonDoc. com, click on “Providers” To learn more about the $99 Mammogram Special from Southampton Memorial Hospital: 4Get a referral from your physician or health care professional 4Go to mdsave.com/ mammogram to purchase your voucher (Select 2D Mammograms, then click on Southampton Memorial Hospital) 4Call SMH’s Imaging Center to schedule your mammogram 757-569-

6408 4Bring the $99 mammogram voucher to your appointment This is for a digital 2D mammogram screening of both breasts, for women who exhibit no signs or symptoms of any disease, complaint, or abnormality.

It also includes computer-aided detection (CAD) of lesions obtained during the mammogram.

Appointments are on a first-come, first-served basis. An order from a physician or qualified health care provider is required. If the patient does not have a provider, a list will be provided for selection. All mammogram reports will be sent to the provider, and the patient is responsible for follow-up.

Check with your insurance provider to confirm coverage for a screening mammogram.

The three most common types of breast cancer

Millions of women across the globe are diagnosed with breast cancer every year. The World Cancer Research Fund and the American Institute for Cancer Research notes that more than two million new cases of breast cancer were diagnosed in 2018, making the disease one of the most commonly occurring cancers in the world.

Upon receiving a breast cancer diagnosis, patients typically have a number of questions, including which type of breast cancer they have. The American Cancer Society notes that there are many types of breast cancer, though some are more common than others.

Learning to distinguish between the more common types of breast cancer, which include invasive ductal carcinoma, ductal carcinoma in situ and invasive lobular carcinoma, can help patients and their support teams better understand this difficult yet beatable disease.

What are carcinomas?

The ACS reports that most breast cancers are carcinomas. Carcinomas are tumors that start in the epithelial cells that line

organs and tissue throughout the body. Carcinomas can spread to other parts of the body, even though they do not always do so.

Invasive ductal carcinoma Sometimes referred to as “IDC,” invasive ductal carcinoma accounts for between 70 and 80 percent of all breast cancers, making it the most common type of the disease, according to the National Breast Cancer Foundation.

Invasive means the cancer has spread from the milk ducts, where IDC originates, to the surrounding breast tissues.

Ductal carcinoma in situ Ductal carcinoma in situ, or DCIS, is a noninvasive breast cancer that starts inside the milk ducts. BreastCancer. org notes that “in situ” means the cancer is still in its original place, not having spread beyond the milk duct to any surrounding breast tissue. That’s helpful to know, as it calms patients’ fears knowing the cancer has been caught before

it could metastasize, or spread. One out of every five new breast cancer cases is DCIS. While that might sound alarming, BreastCancer.org notes that DCIS incidence rates are possibly so high because people are living longer than they used to (a person’s r i s k for breast cancer

increases with age) and education about breast cancer screening appears to be working, compelling more women to get mammograms.

Invasive lobular carcinoma The ACS notes that roughly 10 percent of all invasive breast cancers are invasive lobular carcinomas, or ILC. The word “lobular” means that the cancer began in the lobules, which produce milk and empty out into the ducts that carry milk to the nipple.

When a person is diagnosed with ILC, that means the cancer has broken through the wall of the lobule and has started invading the tissues of the breast. Over time, ILC can spread to the lymph nodes and possibly even other areas of the body.

The type of breast cancer a person has will affect his or her treatment. As prevalent as breast cancer may seem, it is beatable, and many people overcome the disease and go on to live happy, full lives.

—Metro Creative

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Breast cancer screening guidelines Cancer screenings are widely recognized as a vital component of personal health care.

Catching cancer in its earliest stages greatly improves patients’ survival rates, and screening is often the most effective way to find cancer before it grows and spreads to other parts of the body.

Women who recognize the importance of breast cancer screenings also likely recognize just how conflicting advice about screening is. For instance, the Centers for Disease Control and Prevention lists breast cancer screening recommendations from seven different o rg a n i z a t i o n s on their web-

site. These organizations include the U.S. Preventive Services Task Force, the American Cancer Society, the International Agency for Research on Cancer, and the American Academy of Family Physicians.

Women who visit the site expecting consensus among these respected organizations might be surprised to learn that no such universal agreement exists.

Breast cancer is a complicated disease, so it’s understandable why there would be differences of opinion within the medical community regarding when women should and should not be screened.

But recognizing that breast cancer screening is a complicated issue won’t help women learn when they should be screened.

Working with a physician they trust and being open and honest about their health and their family history of

breast cancer can help women make the most informed decisions about when and how often to be screened.

In the meantime, women can consider these screening guidelines from Memorial Sloan Kettering Cancer Center, whose cancer experts devised the guidelines based on their extensive experience treating breast cancer patients.

Women at average risk The MSKCC defines being at average risk as having: 4no symptoms of breast cancer 4no history of invasive breast cancer (breast cancer that has spread beyond the milk ducts) 4no history of ductal or lobular carcinoma in situ (abnormal cells that are confined to the milk duct, or lobule) 4no history of atypia (atypical hyperplasia, a form of benign breast disease) 4no family history of breast cancer in a first-degree relative (parent, sibling or child) 4no suggestion or

evidence of a hereditary syndrome such as a BRCA mutation (evidence would be multiple first- and/or second-degree relatives with breast cancer or ovarian cancer) 4no history of mantle radiation (a radiation therapy used to treat Hodgkin’s disease and some other conditions) MSKCC recommends that women between the ages of 25 and 40 who are at average risk schedule an annual clinical breast examination.

Women 40 and older should have an annual mammogram in addition to their annual clinical breast exam. Women with dense breast tissue may be advised to have an ultrasound as well. All women should consider performing monthly self breast exams beginning at age 20. Doing so helps women become familiar with their breasts, and that familiarity may alert them to abnormalities down the road.

Women at above-average risk Women whose risk of developing breast cancer is above-average

Breast cancer signs and symptoms Breast cancer is a formidable foe.

According to the World Health Organization, an estimated 627,000 women lost their lives to breast cancer in 2018. But women are not helpless in the fight against breast cancer, as the WHO notes early detection is critical and could potentially save thousands of lives each year.

A proactive approach is a key component of protecting oneself against breast cancer. While the National Breast Cancer Foundation notes that many breast cancer symptoms are invisible and not noticeable without a professional cancer screening, women can keep an eye out for certain signs of breast cancer they might be able to detect on their own. Monthly self-exams can help women more easily identify changes in their breasts. During such self-exams, women can look for the following signs and symptoms and are advised to report any abnormalities they discover to their physicians immediately.

4Changes in how the breast or nipple feels: The NBCF says nipple

tenderness or a lump or thickening in or near the breast or underarm could indi- cate the presence of breast canc e r .

Some women m a y notice changes in the skin texture or an enlargement of the pores in the skin of their breast. In many instances, skin texture has been described as being similar to the texture of an orange peel. Lumps in the breast also may indicate breast cancer, though not all lumps are cancerous.

4Change in appearance of the breast or nipple: Unexplained chang-

es in the size or shape of the breast; dimpling anywhere on the breast; unexplained swelling or shrinking of the breast, particularly when the shrinking or swelling is exclusive to one side only; and a nipple that is turned slightly inward or inverted are some signs and symptoms of breast cancer that can affect the appearance of the breast or nipple. It is common for women’s breasts to be asymmetrical, but sudden asymmetry should be brought to the attention of a physician.

4Discharge from the nipple: The NBCF notes that any discharge from the nipple, but particu-

larly a clear or bloody d i s charge, could be a sign of breast cancer. The NBCF also advises women that a milky discharge when they are not breastfeeding is not linked to breast cancer but should be discussed with a physician.

Learning to recognize the signs and symptoms of breast cancer can increase the likelihood of early diagnosis, which greatly improves women’s chances of surviving this disease.

—Metro Creative

face more complicated screening decisions. This includes: 4women with a family history of breast cancer in a first-degree relative (parent, sibling or child) 4history of atypical hyperplasia (a form of benign breast disease) 4history of lobular carcinoma in situ (abnormal cells that are confined to the milk duct, or lobule) 4history of mantle

radiation (a radiation therapy used to treat Hodgkin’s disease and some other conditions) before the age of 32 4genetic predisposition for breast cancer (for example, women with a BRCA mutation) For screening guidelines specific to each of those situations, visit the Memorial Sloan Ketting Cancer Center online at www.mskcc.org.

—Metro Creative

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Body image and breast cancer treatment The physical changes that can result from breast cancer are well-known.

However, breast cancer also can lead to emotional changes. In fact, treatments that are designed to beat cancer can have negative effects on a woman’s body image and self-esteem.

Body image is a complex post-treatment concern for breast cancer patients and survivors, and one that may not be as widely addressed as other issues.

A study titled “Body Image in Younger Breast Cancer Survivors” that was published in the journal Cancer Nursing found that body image is a large concern and has a profound impact on aspects of cancer survivorship, particularly among young breast cancer survivors.

The American Cancer Society notes that many women experience various changes in appearance while undergoing cancer treatments. These can include anything from changes in weight (increase or decrease), hair loss, surgical removal of breasts, scarring, lack of sexual interest from fluctuating hormones, and much more. Even though health care providers are good at targeting the

immediate challenges of the disease, emotional support is not always part of their post-treatment follow-up.

Mary Jane Esplen, a psycho-oncologist at the University o f

To r o n t o , says she has heard from breast cancer survivors who have battled with body image after treatment. In various therapy sessions, Esplen has learned that some women give up swimming and wearing swimsuits, while others avoid mirrors or get dressed in the dark.

Esplen advises that participating in post-treatment therapy and support groups can help women battling body image issues after breast cancer treatment.

It’s important that women undergoing breast cancer treatm e n t

recognize that many of the physical effects of treatment are temporary or can be mitigated. For example, hair loss can be traumatic, but with time, hair will regrow. In the interim, women can wear

fashionable wigs and head covers.

Some treatment-related changes may be permanent. A complete or partial mastectomy can transform the way the breasts look or make them less sensitive to touch. Many women opt to have reconstructive surgery or use a breast prosthesis.

One change women may not anticipate is how chemotherapy can affect their hormone levels and their sexual interest or response.

Being open with a romantic partner about physical and emotional feelings can help couples effectively w o r k together to find various workarounds to assist with pain and other sexual issues.

Many women struggle with body image and emotional changes following breast cancer treatment. With patience and a strong support network, various issues can be addressed and possibly remediated.

—Metro Creative

PAGE 6B | SUNDAY, OCTOBER 20, 2019

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Using diet and exercise to prevent breast cancer When it comes to breast cancer risk, some things are beyond a person’s control. Women might not be able to do much in regard to their genetic makeup and family history, each of which can elevate their risk for breast cancer, but many risk factors are within women’s control.

A healthy diet and routine exercise may help women reduce their risk of developing breast cancer. Being overweight is a strong risk factor for breast cancer for women who are 18 and older, advises Stanford Health Care. Even 10 percent weight gain (or 15 pounds on a 150-pound woman) increases breast cancer risk as well as the risk of recurrence.

Diet and exercise can play a pivotal role in reducing breast cancer risk, and it’s important for women to understand just how much good healthy diets and routine exercise can do for them in regard to fighting breast cancer.

4Stanford Health Care says some studies suggest limiting dietary fats in the diet, particularly those that come from animals, to reduce breast cancer risk. These include butter, full-fat dairy, poultry skin and fatty meats. Reducing intake of dietary fats, especially animal fats, may protect against diseases sensitive to hormones, like breast cancer.

4Data from the Women’s Healthy Eating and Living study suggests that soy consumption from whole foods and soy milk for any breast cancer type is probably safe, despite public perceptions. Avoid soy supplements and concentrated soy that comes in many soy protein powders until more about their effects is known.

4 The American Cancer society links alcohol consumption to a higher risk of various cancers, including breast cancer. The more alcohol a person drinks, the higher his or her cancer risk.

The ACS recommends no more than one drink per day for women and two for men. A five-ounce glass of wine is considered one drink.

4Susan G. Komen says a high b o d y mass index has been associated with increased risk for p o s t menopausal breast cancer.

Exercise may help reduce risk by altering metabolism, hormones and breast density.

4Inflammation is an immune system response to injury or illness.

However, when inflammation is chronic, it can damage DNA and lead to cancer, advises the National Cancer Institute.

Deep marine fish; dark, leafy green vegetables; bright, multi-colored vegetables; black teas;

and spices like turmeric can help fight or prevent inflammation.

4The ACS recommends adults get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week (or a combination), preferably spread throughout the week to keep body weight in check.

4Stanford Health Care says consumption of high amounts of sugar can increase

insulin levels and result in weight gain, each of which can lead to breast cancer. Limit intake of sugary snacks and refined carbohydrates, opting for healthy alternatives such as fruit, vegetables, beans, whole grains, dairy and soy milk.

Tips to make mammograms more comfortable Mammograms remain one of the best methods to detecting breast cancers, giving women the opportunity to start treatment early if cancer is detected. In countries with early access to quality screening and treatment, breast cancer survival rates are now greater than 80 percent.

The organization Mammography Saves Lives says that, since 1990, mammography has helped reduce breast cancer mortality in the United States by 40 percent. Mammograms usually take around 20 minutes. During a traditional mammogram, a woman’s breast is placed between two plates. One plate holds the breast in place,

while the other takes images, and the breasts must be compressed to get clear pictures of breast tissue.

Some women find the process to be uncomfortable.

Even though mammograms are an essential part of preventive health care, many women avoid them because of pain and other discomfort. However, women should not put off mammograms because they are worried about discomfort. There are many ways to avoid pain during mammograms that can make the entire experience more comfortable.

4Schedule the mammogram for a week after a menstrual period when hormonal swings are less likely to increase breast sensitivity.

4Caffeine can make the breasts more tender.

Reducing caffeine consumption for two weeks before the mammogram can help.

4Keep your feet and

trunk facing forward and simply turn your head at the mammogram machine.

4Reduce tension by breathing deeply a few times before the procedure.

4Try a pain reliever before the mammogram.

4Ask the mammography center if it has padding, as cushioning between the breasts and the plates of the mammogram machine can reduce pain.

—Metro Creative

Debunking common myths associated with breast cancer

Cancer claims the lives of millions of people across the globe every year. But the fight against cancer is anything but hopeless, as the World Health Organization notes that between 30 and 50 percent of all cancer cases are preventable.

Learning about cancer is one of the best ways for people to protect themselves from this deadly disease.

Researchers continue to learn more about cancer every day and routinely discover that information once thought to be accurate was actually off-base.

D e s p i t e researchers’ best efforts, some myths about cancer still prevail. Some of these myths are about cancer in general, while others refer to s p e - c i f i c cancers, including breast cancer.

Myths about breast cancer can be a s harmful as accurate information is helpful, so learning the truth and debunking those myths can be an important part of women’s preventive approach to breast cancer.

4 M y t h : Drinking milk increases your risk for b r e a s t c a n - cer. The American Cancer S o c i e t y notes that early studies raised concerns that drinking milk from cows treated with hormones could increase a person’s risk for breast cancer. However, ensuing research failed to find a clear link between the two. In fact, a 2002 study published in the International Journal of Epidemiology found no significant association between dairy fluid intake and breast cancer risk.

4Myth: Lumps indicate breast cancer. The National Breast Cancer Foundation says that only a small percentage of breast lumps turn out to be cancer.

However, abnormalities or changes in breast tissue should always be brought to the attention of a physician.

4Myth: Mammograms cause breast cancer to spread. This myth is rooted in the incorrect notion that breast compression while getting a mammogram causes the cancer to spread. However, the NBCF insists that cannot happen. In fact, the National Cancer Institute touts the benefits of mammograms while the ACS recommends women between the ages of 45 and 54 get mammograms every year. For additional breast cancer screening guidelines, visit the ACS at www. cancer.org.

4Myth: Women with a family history of breast cancer are likely to develop breast cancer, too. This myth is dangerous because, if taken at face value, it can give women with no family history of breast cancer a false sense of security. However, the NBCF notes that only about 10 percent of individuals diagnosed with breast cancer have a family history of the disease.

The Centers for Disease Control and Prevention note that a woman’s risk for breast cancer is higher if she has a first-degree relative, including a mother, sister, daughter, or even a male family member, who have had the disease. But breast cancer can affect anyone, regardless of their family history.

Information is a valuable asset in the fight against breast cancer. Learning to decipher between accurate and false information can be especially valuable.

—Metro Creative