Think
Local survivor stories
Awareness
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COVID-19 and breast cancer guidelines
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A Special Publication of The Daily Star, Thursday, Oct. 1, 2020
-Early warning signs for breast cancer -The vital role of a cancer support network -What to expect after cancer treatment ends & MORE!
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Think Pink! - THE DAILY STAR | OCT. 1 AND 2, 2020
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Awareness Cover art created by freepik|www.freepik.com Content in part provided by Newspaper Toolbox and MetroCreative Services. Reproduction in whole or in part without prior written permission is strictly prohibited. Opinions expressed in the publication are those of the authors and do not necessarily represent those of publication management. ©2020. ALL RIGHTS RESERVED.
Did you know? Breast cancer incidence rates vary greatly across the globe. According to the World Health Organization, 19.3 per 100,000 women in Eastern Africa are diagnosed with breast cancer, while that number is nearly five times greater (89.7 per 100,000 women) in Western Europe. So what’s the reason behind that disparity? While a host of factors, including family history, can contribute to a woman’s risk for developing breast cancer, incidence rates in places like Eastern Africa could be so low due to less awareness of the disease in such countries, where education about the importance of breast cancer screening might not be as big a priority as it is in other countries, including the United States. As a result, many incidents of breast cancer in less developed countries may go unreported and, ultimately, untreated. Emphasizing efforts to raise awareness about breast cancer may lead to higher incidence rates in less developed countries, but those same efforts also may compel more women to receive potentially lifesaving breast cancer screenings.
Raising awareness about
breast cancer
Each October, the National Breast Cancer Foundation (NBCF) and other major breast cancer charities sponsor National Breast Cancer Awareness Month, a campaign to educate the public about the disease and encourage people to be proactive about getting examinations and seeking treatment. Breast cancer is the most common type of cancer among women around the world. According to the NBCF, one in eight American women will be diagnosed with breast cancer during her lifetime. It’s estimated that over 250,000 women are diagnosed with breast cancer and more than 40,500 die from the disease in the United States every year. The NBCF was founded in 1991 by Janelle Hail, a breast cancer survivor. When Hail was diagnosed with breast cancer in 1980, there was little information available about the disease and limited treatment options. After recovering from the mastectomy that saved her life, Hail started the foundation as a non-profit organization intended to educate women about the importance of early detection and provide informa-
tion about possible treatments. Today, the NBCF raises funds to support cancer research, runs initiatives to spread awareness and offers many different services, including free mammograms for those in need. Although breast cancer con tinues to affect hund reds of thousands of women, in-
creased awareness and improvements in available treatments have led to a decrease in the number of deaths over the last twenty years. If we all do our part to support the important work of organizations like the NBCF, the number of deaths from breast cancer will almost certainly continue to go down.
ACS Reach to Recovery Women diagnosed with breast cancer who want to speak with someone who has survived the disease can do so thanks to a unique program sponsored by the American Cancer Society. The Reach to Recovery program from the ACS connects current cancer patients with breast cancer survivors via an online chat. Patients, regardless of where they are in their cancer journeys, can connect with volunteers for one-on-one support. Volunteers can help patients cope with treatment and side effects while also offering advice on speaking with friends and family, working while receiving treatment and more. Even people facing a possible breast cancer diagnosis can sign up. The program works by asking patients and volunteers to join the program and create profiles on the Reach to Recovery website (www.reach. cancer.org). Patients then look for a match by searching volunteer profiles, filtering through suggested matches and sending an online chat request to volunteers. Patients and volunteers can then schedule a chat and discuss any concerns patients may have. Volunteers with the Reach to Recovery program are breast cancer survivors who have been trained by the ACS to provide peer-to-peer support to people facing a breast cancer diagnosis. Volunteers can provide support to patients, but are prohibited from offering medical advice. More information about the Reach to Recovery program, including how to join as a patient or volunteer, is available at www.reach.cancer.org.
Medical News Today reports that the symptoms of COVID-19 may be more severe for breast cancer patients. Furthermore, the Centers for Disease Control and Prevention notes that undergoing cancer treatment can weaken the immune system, further increasing a person’s vulnerability to infection. Specifically, targeted therapies, chemotherapy and radiation can weaken the immune system and compromise its ability to fight off the coronavirus. Furthermore, these treatments also may cause lung problems that can exacerbate COVID-19 symptoms, particularly among breast cancer patients whose cancer has metastasized to the lungs. In April 2020, new guidelines for the prioritization and treatment of breast cancer patients during the COVID-19 pandemic were released, compiled by a
group of U.S. medical organizations, including the National Accreditation Program for Breast Centers, the American College of Radiology and the Comprehensive Cancer Network. At hospitals where resources and staff have become limited due to COVID-19 treatment efforts, doctors have had to define which breast cancer patients need urgent care and which can have delayed or alternative treatments. These measures can help balance maintaining positive survival outcomes as well as reducing risk of exposure to the virus, according to the American Society of Breast Surgeons. Breast cancer patients have been broken down into priority levels of A, B and C for urgency of care. • Priority A: A patient has conditions that are immediately life-threatening or require urgent treatment. • Priority B: A patient has conditions that don’t require immediate treatment, but he or she should begin treatment before the end of the pandemic. • Priority C: A patient has conditions for which treatment can be safely put on hold. Breast cancer patients are further urged to take extra caution in their daily activities to help reduce the risk of contracting COVID-19. That means always wearing a mask or another face covering when interacting with other people. This advice may be applicable even if a six-foot distance can be maintained. Wash hands frequently, especially when coming in from public places. If possible, ask a friend or family member to do your shopping or run errands for you to limit exposure to other people and crowds. Breast cancer patients may have to discuss the possibility of altering or delaying treatment for breast cancer with their oncologists because of increased risk factors presented by COVID-19. Together, patients and doctors can work to keep breast cancer patients as healthy as possible. -
October 16
OCT. 1 AND 2, 2020 | Think Pink! - THE DAILY STAR
The novel coronavirus COVID-19 first appeared in late 2019 and has changed life for the forseeable future. While many people are quick to focus on the ways COVID-19 has impacted their abilities to shop, visit with friends and relatives or travel, the virus has made life especially difficult for people with preexisting health conditions.
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COVID-19 and breast cancer guidelines
Think Pink! - THE DAILY STAR | OCT. 1 AND 2, 2020
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“If you believe something is not right,
trust yourself”
By Chrystal Savage
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Contributing Writer
onnie Stanton Schultz, 73, of Warnerville was diagnosed with stage two breast cancer in 1998, at the age of 50.
Schultz said her uncle had had a stroke and, in helping him up, she was injured, causing her breast to swell. As the swelling went down, a visible lump could be seen, despite a recent mammogram that showed no indication of a mass. On April 9 that year, Schultz made an appointment with her regular doctor who immediately recommended she visit a surgeon. By mid-June, Schultz had found a surgeon whom she trusted and, on July 15, she underwent a full mastectomy at Bassett Hospital in Cooperstown. A chemotherapy session every three weeks for a total of eight sessions and subsequent radiation Monday through Friday for eight weeks followed the surgery. At the time, Schultz lived in Milford and worked as a directory assistant representative at Verizon where she was given a leave of absence for medical reasons. “Losing my hair was one of the most devastating things,” Schultz said, recalling a bath where she lost her hair as she washed it. “I just cried,” she said. At the time of the surgery, 35 lymph nodes on the same side of her body as the mass were also removed. “I wanted it eradicated,” she said, another reason Schultz opted out of reconstructive surgery. “I had a family member who had been through breast
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cancer before me. I remember her saying, ‘I came into this world flat-chested, why should I care if that’s how I leave? I have a long life ahead of me still,’” she said. Schultz took a similar approach to her hair loss as well. “At first I used a wig, but then I thought to heck with it — they will take me as I am.” Although it was never confirmed, Schultz believes her encounter with breast cancer was caused by genetic factors in light of various exposure inquiries and the passing of her mother from the same disease. “I thank my uncle for saving my life. If it wasn’t for that event, who knows when they would have found it?” Schultz said. Schultz said she believes a great deal in the work of awareness events and organizations. “Support from someone that has been through it is key. Yes, you have your family and friends, but having someone that even just sits and listens and can truly understand what you’re going through, is important. You don’t have to face it alone,” she said. Schultz further added that a person knows their own body better than anyone else. “If you believe something is not right, trust yourself and have it checked out by a professional right away — don’t wait or be afraid to get second opinions,” she said. Schultz’s life after cancer has been anything but uneventful. Retiring in August from Bassett as the team leader of the call center after eight years in the position and 15 years with the company, and with a new grandbaby born in the same month, Schultz looks forward to remaining physically active and present in the lives of those she cares most about. After more than 20 years of being cancer-free, Schultz said she is excited to enjoy her retirement and to see what her future holds. -
BONNIE STANTON SCHULTZ
“If you believe something is not right, trust yourself and have it checked out by a professional right away — don’t wait or be afraid to get second opinions.” Bonnie Stanton Schultz
Breast cancer affects millions of women across the globe every year. According to the World Health Organization, breast cancer is the most frequent cancer among women, affecting 2.1 million women each year. As daunting as that may seem, the WHO also notes that early diagnosis can greatly reduce a woman’s risk of dying from breast cancer. Women can be proactive in the fight against breast cancer by learning to identify early warning signs of the disease. The nonprofit breast cancer advocacy organization Susan G. Komen® notes that the warning signs for breast cancer are not the same for all women, but the most common signs include a change in the look or feel of the breast or a change in the look or feel of the nipple. A discharge from the nipple is another common warning sign of breast cancer. Physical changes in the breast can vary, but Susan G. Komen® advises women who notice these changes to bring them to the attention of their physicians immediately: • Lump, hard knot or thickening inside of the breast or underarm area • Change in the size or shape of the breast • Swelling, warmth, redness or darkening of the breast • Dimpling or puckering of the skin Women with breast cancer also may notice physical changes in their nipples, including: • Itchy, scaly sore or rash on the nipple • Pulling in of the nipple or other parts of the breast It’s important that women recognize that physical changes in their breasts are not necessarily indicative of breast cancer. In fact, the American Breast Cancer Foundation notes that not all lumps in the breast cause cancer and that many such lumps are benign. Fibroadenomas and intraductal papillomas are examples of benign lumps, though it’s important to note that even benign conditions such as these may put women at greater risk of developing breast cancer. Susan G. Komen® notes that breast tissue naturally has a lumpy texture. If lumpiness can be felt throughout the breast and it feels like your other breast, then it’s likely that this is just the normal texture of your breasts. However, women concerned by a lump or lumpy texture are urged to discuss those concerns with their physicians immediately. Discharge from the nipple is another potential sign of breast cancer, but Susan G. Komen® notes that such discharge is rarely a sign of cancer. Discharges that occur without squeezing the nipple, occur in only one breast or are bloody or clear are potentially indicative of more serious conditions, including breast cancer. Breast cancer is a formidable foe. But women who arm themselves with knowledge of the disease, including its early warning signs, are in better position to overcome it.
OCT. 1 AND 2, 2020 | Think Pink! - THE DAILY STAR
BREAST CANCER
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Early warning signs for
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Think Pink! - THE DAILY STAR | OCT. 1 AND 2, 2020
How to cope with physical changes resulting from cancer treatment Among American and Canadian women, breast cancer ranks as either the most commonly occurring cancer or a close second. The World Cancer Research Fund says there were two million new cases of breast cancer in 2018 across the globe, while the American Cancer Society notes the chance that a woman will die from breast cancer is about 2.6 percent. Fortunately, for most women, a cancer diagnosis is not terminal. Early detection and thorough treatment helps to improve the five-year survival rate, especially for those with cancer that is localized to the breast or has only minimally spread. Women may have to undergo various forms of treatment, including radiation, chemotherapy and surgery. The National Cancer Institute notes that, while they’re effective, breast cancer treatments can cause changes that affect a woman’s physique, body image and sexuality. Some changes will be short-term, such as hair loss
or fatigue. Others may be permanent, such as breast loss or scarring from lumpectomy and mastectomy. Fertility also may be affected, potentially compromising a woman’s ability to get pregnant after treatment. Regardless of the changes, breast cancer patients must realize they are not alone. Scores of women have experienced similar feelings and can be sources of support and inspiration during recovery. In addition, a handful of strategies can help women confront the physical changes resulting from cancer treatment in a positive way. • Understand that it is okay to feel frustrated, upset or angry with the changes that have occurred. It doesn’t make you shallow. Anyone has the right to grieve treatment options that have changed their bodies in various ways. • Attempt to focus on how cancer treatment and the entire experience has made you stronger and more in tune with life. Cancer can be a wake-up
call that sparks positive changes going forward. Focus on your strengths, rather than on what you cannot reverse. • Look for new ways to enhance your appearance, like a new hairstyle. A makeup makeover also can help. Some women like to splurge on a stylist who can help shape a wig or offer them some innovative ideas to change their appearance. • Speak with a doctor about what you can do to treat and camouflage skin changes from treatment. Topical creams may alleviate redness or dry patches while other remedies can minimize surgical scarring.
The changes in body image that breast cancer survivors experience tend to be connected to the features that society characterizes as “feminine.” Loss of one or both breasts can greatly affect body image. However, if mastectomy surgery is necessary, speak with your doctor about reconstruction possibilities. There also are very good prosthetic inserts and bras that can mimic the look of natural breasts under clothing. Physical changes are common after cancer treatment. Women can try a handful of strategies to successfully confront these changes.. -
Test your knowledge: the stages of breast cancer Most people are familiar with the concept that cancers are diagnosed in “stages.” But do you know what this really means? In recognition of Breast Cancer Awareness Month, test your knowledge with these three true or false statements.
1. TRUE OR FALSE: THERE ARE FOUR STAGES OF BREAST CANCER False. The staging system for breast cancer has five stages (zero to four). Stage zero is assigned to ductal carcinoma in situ (DCIS) breast cancer, which means the cancer cells are confined to a duct or lobule. Stage four
is assigned to metastatic breast cancer, which means the cancer has spread to other parts of the body. In general, the higher the stage, the more the cancer has spread through the breasts and to nearby organs.
2. TRUE OR FALSE: THE STAGE CHANGES AS THE CANCER EVOLVES False. A stage describes the location and amount of cancer present in the body when it’s first diagnosed. Since the stage is based on the initial diagnosis, it doesn’t change even if the cancer grows, spreads or comes back following remission. For example, a stage two breast cancer that eventually spreads to the liver will be referred to as metastatic, but it remains a stage two cancer.
3. TRUE OR FALSE: THE STAGING SYSTEM HELPS DETERMINE A PROGNOSIS True. Doctors use the stage of cancer to predict the course of the disease and the patient’s likelihood of recovery. This is possible because cancers that appear in the same part of the body with the same stage tend to have a similar prognosis. The stage is also used to develop a treatment plan and assign patients to appropriate clinical trials if they wish to participate.
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If you’re battling cancer, physical activity can enhance your quality of life. Exercise can help you sleep, stimulate your appetite, improve your mood, reduce stress and boost your energy. Here are three tips for staying active when you’re undergoing treatment for cancer.
1. ADJUST YOUR WORKOUT Always choose safe exercises suited to your current level of health. One option is to implement activities that gently improve your strength and flexibility such as dance, tai chi and yoga. No matter what, be sure to respect your limits. It’s far better to play a less demanding sport than it is to undergo a tough program that leaves you feeling drained and inept.
2. ADJUST YOUR INTENSITY Start out at an easy pace and gradually increase the level of intensity as your become more accustomed to the activity. For instance, if walking is your exercise of choice, start by covering short distances at a leisurely pace. Over time, you can work your way up to longer jaunts and/or a brisker pace. Avoid
pushing too hard, too fast, as you may get discouraged.
3. ADJUST YOUR SCHEDULE Do you feel better in the mornings than you do in the evenings? Then reserve that time of the day to exercise. If necessary, split your workout into one or more shorter segments, or change your routine in some other way that makes sense to you. Always listen to your body and be sure to rest whenever you need to.
CAREFUL! If you have cancer, before beginning any type of exercise program, you MUST talk to your doctor. Depending on your level of health and the treatments you’re undergoing, some types of physical activity may not be recommended. Your oncologist can suggest activities that are safe, efficient and tailored to your specific case.
Exercise has many benefits for people with cancer.
OCT. 1 AND 2, 2020 | Think Pink! - THE DAILY STAR
Three tips for staying active while undergoing treatment
Fighting cancer:
Find nuggets of beauty in each day By Chrystal Savage
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Contributing Writer
essi Raber, 43, was initially diagnosed with, stage zero, Ductile Carcinoma in Situ (DCIS) in July 2017, following what started as a routine woman’s well-check with her midwife, following the birth of her third child. DCIS is the presence of abnormal cells within the milk duct of the breast and is widely regarded as the earliest form of breast cancer. Raber’s well-check unfolded like others before it, except her midwife had a resident who was shadowing her. Both health professionals felt a lump in Raber’s breast during the exam. Despite suspecting that the lump was likely caused by breastfeeding, it was recommended Raber get a mammogram — something she was more than happy to do as her 40th birthday was approaching. “When I got my first mammogram, it took a very long time and I became very concerned. I could tell from the mammogram technician’s demeanor that something was not right,” Raber recounted. “After my first mammogram, I was taken for an ultrasound. I was fairly certain this wasn’t routine, but tried not to panic,” she said. From the ultrasound and an examination, a radiologist at Guthrie Robert Packer Memorial Hosptial in Sayre, Pennsylvania determined that Raber’s breasts were full of calcifications which he explained, in 80 percent of cases, are
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benign or otherwise non-cancerous. He advised that Raber get a biopsy as soon as she could. In a side conversation, Raber witnessed “the radiologist said something ominous to the nurse.” She continued, “That was the moment I knew I most likely had breast cancer despite the statistics being in my favor.” Because of the upcoming Fourth of July holiday, a biopsy would have to be postponed. “That was the first time I would realize the waiting is one of the most difficult aspects of cancer,” Raber said. Raber would have her biopsy a few weeks later, on her 40th birthday. “By then, I had had a lot of time to research calcifications, and knew from what I saw of my mammogram that it was unlikely I was in the 80 percent category, in terms of calcifications,” Raber said. She asked the radiologist if she was part of the 80 percent of calcifcation cases that are non-cancerous. “She told me in her opinion and that the likelihood that I had breast cancer was 92 percent,” Raber said. “The nurses tried to comfort me, but I was in shock, the kind where your brain takes over so you can get home before you melt into a puddle.” Raber still recalls the exact date she received her official diagnosis — July 15, 2017 — as relaying the verdict was delayed so that she might be able to enjoy her birthday party. A genetic test was also performed, finding a gene deletion called CHEK2, which raised her risk for breast cancer even further. On Sept. 12, Raber underwent a double mastectomy with immediate reconstruction using abdominal tissue at Memorial Sloan Kettering Cancer Center in Manhattan. During the surgery it was discovered that Raber had two small tumors in her left breast and one in her lymph nodes. As a result, a complete ancillary dissection was performed, involving the removal of 21 lymph nodes in her left arm. “The surgery was painful and required a long recovery,” Raber said. “Learning about the tumor in and removal of my lymph nodes was an enormous disappointment as it meant my cancer was further advanced than I’d hoped and the lymphedema would be a concern,” she said. “Before I was diagnosed with breast
JESSI RABER
“I would encourage them to find nuggets of beauty in each day, whether it’s time in the warm sun or a crisp breeze rustling the leaves. I would also like to say to those who have had a diagnosis of breast cancer to learn everything they can about their condition and to manage their own health care.” Jessi Raber
cancer, I was enjoying life as a full-time mom. I enjoyed traveling, working out, yoga, snowboarding and spending time with friends. I never felt sick other than your typical mom complaints like fatigue. I had been working out “bootcamp” style and was very fit and strong. I loved sharing my interests with my three children and taught them all how to ski, swim and ride a bike. We loved to explore, go hiking, and see different museums and parks. My husband travels for work, so in the summer we would travel with him and enjoy learning about a new area,” Raber said. Raber recalled the “daunting” wait to receive the results. A week later, a meeting with the surgeon confirmed the news that Raber in fact had stage two breast cancer. For the next four months, Raber she received a form of chemotherapy called Dose Dense ACT and subsequently daily doses of tamoxifen that was intended to continue for the next five to 10 years. A port was installed in her upper right chest to administer the “caustic” medications directly into a large vein that would quickly be emptied into the heart. A portion of the chemotherapy known as Adriamycin is so strong, often referred to as the “red devil,” it has the potential to damage smaller veins and surrounding tissue. “The chemotherapy was taxing. I felt exhausted and sick, and of course I lost all of my hair. Still, I was able to feel well enough that I still skied with my kids most every weekend. I rang the bell after completing chemotherapy in February. It was a wonderful feeling. While minor side effects continued, I got stronger and stronger, returned to full activity,” she said.
“I thought that I had put breast cancer behind me for good,” Raber said. “However, in November of 2019, I began to have back pain and hip pain. I tried a chiropractor and massage. I visited an orthopedic surgeon and he x-rayed my hip, and diagnosed me with snapping hip syndrome.” Raber’s pain did not end there, though, and she was taken to the ER where she was told that she had extensive tumors in her spine, skull, shoulders, pelvis and femurs. “They wanted to perform the spinal surgery right away because there was a danger that the tumors could impinge on my spinal column and to place a large rod into my leg so I would have one leg I could put weight on without risk of fractures, but I was very sick and needed to heal a kidney injury and lower my calcium level before surgery could be performed,” she said. The surgeries were extemely taxing, making walking and performing even the most simple tasks nearly impossible for months. Radiation was also performed on Raber’s pelvis, spine, femurs and shoulders. Raber was diagnosed in February 2020 with metastatic breast cancer, which has no cure and cannot be treated with tamoxifen. After originating in the breast, the disease had metastasized to Raber’s bones. “I have been put on several drugs to manage the cancer and have had countless additional surgeries and rounds of radiation to mitigate compression of my spine and, thankfully, my cancer appears to be under control,” she said. Raber said she wants those who do and don’t have cancer to realize that every day is a gift. “I would encourage them to find nuggets of beauty in each day,
“I think finding a cure is the most important way to honor survivors.” Jessi Raber
whether it’s time in the warm sun or a crisp breeze rustling the leaves,” she said. “I would also like to say to those who have had a diagnosis of breast cancer to learn everything they can about their condition and to manage their own health care,” Raber continued. In regard to breast cancer awareness, Raber said, “Sometimes October is a little much for me. All the awareness ads are a constant reminder that I have breast cancer.” She encourages people to do research on the charities they plan to make donations to for the cause and to make sure the oranizations are worthy of their money. For metastatic breast cancer, Raber recommends Metavivor as it directs a large portion of its money directly into funding breast cancer research. “I think finding a cure is the most important way to honor survivors,” Raber said. -
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Think Pink! - THE DAILY STAR | OCT. 1 AND 2, 2020
HEADCOVERING OPTIONS for cancer patients
A cancer diagnosis can be difficult to process. However, advancements in cancer research over the last several decades have helped more people survive such diagnoses. That should come as good news to people who have recently been diagnosed with breast cancer. The Centers for Disease Control and Prevention says breast cancer is the second most common cancer among women in the United States. BreastCancer.org estimates that 276,000 new cases of invasive breast cancer and around 49,000 non-invasive cases are expected in 2020 in the United States. The Canadian Cancer Society says breast cancer is the most commonly diagnosed cancer among Canadian women, and the second most commonly diagnosed cancer in the country. Breast cancer treatment depends on the stage of the cancer, personal choices as well as doctor recommendations. Other factors like preexisting conditions or health history also may play a role in determining patients’ treatments. In many cases, chemotherapy is included in a treatment plan. Chemotherapy targets fast-growing cancer cells in the body to prevent cancer from spreading and to shrink tumors. However, the American Cancer Society says other normal cells that are fast-growing can be affected by chemotherapy and cause side effects. These cells include blood-forming cells in bone marrow, hair follicles, cells in the mouth, digestive tract cells, and reproductive system cells. This is why many people lose their hair during chemotherapy treatments.
Many women confront chemotherapy-related hair loss with head coverings, and they have various options at their disposal. • Scarves: Many women like to tie lightweight scarves around their heads. These scarves come in various patterns. Pre-tied scarves that can be pulled on also are available. • Cloches: A cloche is a fitted, bell-shaped hat that gained popularity in the 1920s and 1930s. • Turbans: Turban style hats are pull-on options and are knotted or twisted in the front or side. Some may have decorative embellishments on the front. • Baseball hat: Some baseball hats designed specifically for cancer patients provide more coverage than traditional baseball hats by stretching further down the back of the head and neck. They feature a brim and can offer substantial protection while out in the sun. Other baseball hats may come equipped with artificial or real human hair extensions attached inside of the hat to offer stylish options. • Wigs: When a hat or scarf is not desirable, women can consider wigs. Wigs can be undetectable and mimic real hair. To simplify choosing a wig, women can bring a picture of their typical hairstyle. Save a lock of hair from the top front of the head where hair is the lightest to match wig color. Make sure the wig is adjustable. . Hair loss is a side effect of some cancer treatments. Finding head coverings can bridge the gap until hair regrows. -
Risk factors are anything that affects the likelihood that individuals will get a certain disease. In regard to breast cancer, the American Breast Cancer Foundation notes that various factors, some that result from lifestyle choices and others that are not changeable, can increase a woman’s risk of developing breast cancer. Recognizing these risk factors can help women make any necessary changes and even highlight the importance of routine cancer screenings that can detect the presence of the disease in its earliest, most treatable stages.
LIFESTYLE-RELATED RISK FACTORS The ABCF notes that certain habits or behaviors can increase a woman’s risk for breast cancer. But the good news is that women who understand the link between certain habits or behaviors and breast cancer can avoid those behaviors to decrease their risk of developing the disease. According to Breastcancer.org, the following are some habits, behaviors or lifestyle choices that can increase a woman’s risk for breast cancer. • Alcohol consumption: Breastcancer.org notes that researchers have uncovered links between the consumption of alcoholic beverages and hormone-receptor-positive breast cancer. One study found that women who consume three alcoholic beverages per week have a 15 percent higher risk of developing breast cancer than women who don’t drink at all. And while research into the connection is
limited, a 2009 study found a link between alcohol consumption and breast cancer recurrence. • Sedentary lifestyle: Exercise consumes and controls blood sugar and limits blood levels of insulin growth factor. That’s an important connection, as insulin growth factor can affect how breast cells grow and behave. A sedentary lifestyle also can increase a woman’s risk of being obese, which the ABCF notes is a risk factor for breast cancer among postmenopausal women. • Smoking: Smoking has long been linked to cancer, and Breastcancer.org notes that smoking has been linked to a higher risk of breast cancer in younger, premenopausal women.
UNCHANGEABLE RISK FACTORS Unfortunately, many risk factors for breast cancer are beyond women’s control. For example, the ABCF notes that roughly two out of three invasive breast cancers occur in women age 55 and older. Women cannot change their ages, but recognizing the link between age and breast cancer risk is important, as such a recognition may compel more women 55 and older to prioritize cancer screening. Gender and family history are two additional unchangeable risk factors for breast cancer. Women are much more likely to get breast cancer than men. In addition, Breastcancer.org notes that between 5 and 10 percent of breast cancers are believed to be caused by abnormal genes that are passed from parent to child. Women are not helpless in the fight against breast cancer. Knowledge of breast cancer, including its various risk factors, is a great weapon against it as women look to reduce their risk of developing the disease. -
Menstrual history and breast cancer risk Various factors can affect a woman’s risk for breast cancer. Some of these factors, including whether or not a woman is physically active, are within her control. But others are not, and those include when a she started to menstruate. According to Breastcancer.org, women who started menstruating prior to age 12 have a higher risk of developing breast cancer later in life. But that’s not the only link between menstruation and breast cancer risk, as women who go through menopause when they’re older than 55 years of age also have a higher risk of developing breast cancer later in life. Breastcancer.org notes that, over the last two decades, girls have begun puberty at younger ages than girls in previous generations. Researchers have linked that phenomenon to the obesity epidemic and broad exposure to hormone disruptors. A rise in hormones triggers the onset of puberty. The breast tissue of girls who begin menstruating at a younger age tends to be immature and sensitive to hormonal influences, which is associated with a higher risk of breast cancer later in life. Women may not be able to control when they start and stop menstruating, but they can control certain factors that can make them less likely to menstruate early. Breastcancer.org notes that maintaining a healthy weight, exercising regularly and eating nutritious foods are some lifestyle choices that girls and women can make to keep their risk for breast cancer as low as possible. Various factors can increase a woman’s risk of developing breast cancer. Understanding the link between those factors and cancer risk can help women make healthy decisions that benefit both their short- and longterm health.
OCT. 1 AND 2, 2020 | Think Pink! - THE DAILY STAR
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o two women are the same. But when it comes to breast cancer, women from all walks of life share various risk factors for a disease that the World Health Organization indicates is the most frequent cancer among women.
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The risk factors for breast cancer
Think Pink! - THE DAILY STAR | OCT. 1 AND 2, 2020
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Family helped Delhi woman
survive breast cancer By Chrystal Savage
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Contributing Writer
atricia Branigan, 65, of Delhi, was diagnosed with stage one breast cancer in February 2007 at the age of 51. Following a routine appointment with her GYN provider, Branigan recalled that she had not received a prescription for her annual mammogram. “I was feeling fine and had nothing I could feel through self-examination so I thought everything would be normal, just as always,” she said. Only a few days after her mammogram, Branigan was told she would need to have a biopsy — a test that would ultimately come back positive. In light of familial connections to the disease, through both her mother and sister, treatment moved quickly. Branigan had a lumpectomy in March of that year, and testing of the lump came back positive for estrogen and progesterone. It was determined the infected tissue in its entirety had not been removed, so a second surgery would be required. Branigan was scheduled to take an excursion to Spain with an exchange group from Delaware Academy and healthcare professionals assured her it could wait a few weeks. Upon returning, Branigan underwent her second and final lumpectomy. “My surgeon was wonderful and I received great care,” Branigan said of the procedure. Following the surgery, Branigan endured five days of radiation a week for seven weeks. Unfortunately, she had an ad-
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verse reaction to radiation that caused her skin to blister. She was given an ointment, but as time went on and it continued to worsen, Branigan was given the option of discontinuing treatment by radiation. Only two weeks away from a completed treatment, Branigan persisted. “I just wanted it to be over with, so I kept on going,” she said. “At the time I was diagnosed, I had been through a lot of stress,” Branigan said. “My house had flooded and was no longer livable, I was in the process of getting a divorce, my best friend had passed from an illness just a few months earlier, and my daughter left for college with health issues of her own,” she said. As things started to improve with a new apartment for Branigan, she was hit from behind on the road, requiring a new car and medical care. “It seemed to me that my life was falling apart completely,” Branigan explained, before getting candid about those who helped her through her battle. “I met a man who is now my husband. He stood by me through the thick and thin of it; I don’t know what I would have done without him. Not to mention, my sister who came to my appointments with me, asked all the right questions and kept me positive,” she said. Branigan’s life after cancer, although she is still in remission, has been vibrant, “I am remarried and happy to be alive,” she said. Unfortunately, Branigan’s sister passed from the disease in 2015 after a long battle. “She was my rock my whole life. I will forever be grateful to her for all the help and love she gave me,” Branigan said. “I had genetic testing after my sister passed,” she said. “It came back negative. I think my doctors were ever surprised about that.” “I feel that the Relay for Life, Breast Cancer Awareness Month and the American Cancer Society, the majority of people are aware of this awful disease,” Branigan said. “I do, however, have a problem with the insurance companies raising the eligibility of a mammogram to 40 years of age. I ask myself constantly if big pharmaceutical companies have neglected to find a cure for cancer because cancer is a big money-making cow for them,” she said. -
PATRICIA BRANIGAN
“It seemed to me that my life was falling apart completely. I met a man who is now my husband. He stood by me through the thick and thin of it; I don’t know what I would have done without him. Not to mention, my sister who came to my appointments with me, asked all the right questions and kept me positive.” Patricia Branigan
breast cancer. Having loved ones there to help them make sense of those emotions and stay positive as they navigate their way through the treatment process is essential. In addition to providing emotional support, loved ones of breast cancer patients may need to take on additional roles as they help their friends or family members face the challenges that lay ahead. Because of the industry changes noted by Weill Cornell Medicine, cancer caregivers and support networks may need to prepare themselves to take on the following roles, each of which is vital to cancer patients’ survival. • Monitor the disease: Support networks may need to keep track of how their loved ones’ disease is progressing and if there are any complications from treatment. • Manage symptoms: Breastcancer.org notes that treatment causes severe side effects in many women. Such side effects may include nau-
Is 3D mammography right for you? Mammograms take images of breast tissue to determine the presence of abnormalities, including lumps. Women may undergo traditional, 2D mammograms, but increasingly many healthcare facilities are now employing 3D technology because it can provide clearer pictures.
sea/vomiting, diarrhea, constipation, pain, arm swelling, shortness of breath, and skin irritation. Thankfully, most of these side effects can be treated. In addition, Breastcancer.org notes that most side effects ease up after treatment is completed. In the meantime, support networks may need to help patients manage those symptoms, performing a host of tasks to make their loved ones’ lives easier. For example, patients experiencing shortness of breath may be incapable of performing chores around the house. In such instances, members of a support network can tackle those chores until their loved one bounces back. • Administer medication: Breast cancer patients may be too overwhelmed to handle their own medications, so support networks can take over this important responsibility for them. • Assist with personal care: Some patients may experience fatigue after
treatment. In such instances, support networks can help patients maintain their personal hygiene. Support networks can be vital to helping cancer patients overcome their disease and navigate their way through successful treatment regimens.-
A 3D mammogram, also called digital tomosynthesis, takes several different X-rays of the breasts and combines those images to establish a three-dimensional picture. The Mayo Clinic says that a 3D mammogram is typically used to search for breast cancer in people who may have no outward signs or symptoms. It also may be used to help diagnose the cause of a breast mass or nipple discharge. Doctors may suggest 3D imaging to get a better look at any growths or help identify the source of any symptoms a person may be concerned about. Two-dimensional mammograms are still the industry standard. The 3D versions are obtained in a similar fashion by pressing the breasts between two imaging plates. Rather than just taking images from the sides and top to bottom, the 3D version will take multiple angles to make a digital recreation of the breast. Medical News Today says this enables doctors to look at small, individual sections of the breast tissue that may be as thin as just a single millimeter. A study published in the journal JAMA Oncology says cancer detection rates are higher in people who do 3D imaging over time. Three-dimensional mammograms can be useful for women with dense breast tissue or those at higher risk for breast cancer. Although experts at MD Anderson Cancer Center advise any woman who needs a mammogram to get the 3D version. However, 3D mammography may not be covered by all insurance plans. It’s important to note that a 3D mammogram releases the same amount of radiation as a traditional mammogram. It is of no greater risk to the patient, and it is approved by the Food and Drug Administration. Also of note, because 3D mammograms produce more images, it may take a radiologist a little longer to read one than it would a 2D mammogram. Three-dimensional mammograms are an option for women screening for breast cancer.
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The moment a person is diagnosed with cancer can elicit a variety of emotions. Fear of what’s to come is a common reaction to such a diagnosis, and some people may feel alone upon learning they have cancer. But no cancer patient should face their diagnosis and treatment alone. In fact, a strong support network can be vital to patients’ recoveries. According to Weill Cornell Medicine, recent changes in the healthcare industry have shifted the burden of care from the hospital to the home. That underscores the importance of a strong support network. Many of the challenges cancer patients face in the months after diagnosis will be new, and patients can expect a range of emotions. According to Breast Cancer Now, a charitable organization that funds one-third of breast cancer research in the United Kingdom, women may experience emotions such as shock, anger, disbelief, anxiety, and sadness after being diagnosed with
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The vital role of a cancer support network
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Symptoms of male breast cancer Breast cancer is one of the most common forms of cancer diagnosed among the female population. Though breast cancer may seem like a disease that’s exclusive to women, breast cancer can affect men as well. While they have a smaller concentration than women, men have breast tissue, which means it’s possible for them to develop breast cancer. Male breast cancer is most common in older men, but it is important that men recognize that the disease can strike them at any age.
Male breast cancer is most common in older men, but it is important that men recognize that the disease can strike them at any age. SIGNS AND SYMPTOMS Men with breast cancer experience symptoms that are similar to those experienced by women. Possible signs to be aware of include: • skin dimpling or puckering • a lump or swelling, which is typically (but not always) painless • nipple retraction • redness or scaling of the nipple or breast skin • discharge from the nipple, which may be clear or blood-tinged The American Cancer Society advises that sometimes breast cancer can spread to the lymph nodes under the arm or around the collar bone and cause a lump or swelling in these locations. The protrusion may be noticeable even before the original tumor in the breast is large enough to be felt. Men should realize that enlargements or issues affecting both breasts (not on just one side) typi-
cally is not cancer. Enlargement or changes to both breasts in men can be caused by weight gain, medications or heavy alcohol consumption.
TYPES OF MALE BREAST CANCER Various types of breast cancer can affect men, according to the Mayo Clinic: • Ductal carcinoma: Cancer that begins in the milk ducts. Nearly all male breast cancer is ductal carcinoma. • Lobular carcinoma: Cancer that begins in the milk-producing glands. This type is rare in men because they have few lobules in their breast tissue. Especially rare types of breast cancer that can occur in men include Paget’s disease of the nipple and inflammatory breast cancer. Diagnosis BreastCancer.org says that a small study of breast cancer in men found that the average time between first symptoms and diagnosis was about 19 months. This can be startling because early diagnosis can be vital to survival. Through the realization that breast cancer can happen to men and more education and awareness, men can feel more comfortable about discussing changes to breast tissue with their doctors. Male breast cancer is a very real occurrence, albeit a rare one. It is important that men take any abnormalities in their chests seriously. -
Can motherhood help prevent breast cancer? According to the some studies, pregnancy and breast-feeding can reduce the risk of breast cancer. In fact, women who’ve carried at least one pregnancy to term are less likely to get this type of cancer, especially if they bore a child before the age of 30. And mothers of large families are even more insulated as each additional pregnancy further reduces long-term risks.
HOW IT WORKS When a woman is pregnant, her mammary cells are no longer exposed to estrogen, a hormone that promotes the development of several breast cancers. The same thing happens during breast-feeding. In fact, some studies indicate that breast-feeding can protect you from getting breast cancer, and that the longer you breast-feed, the greater the protective effect.
BREAST-FEEDING AND CANCER Are you undergoing treatment for breast cancer and fear that breast-feeding might harm your baby? While cancer cells definitely can’t be passed on through breast milk, chemotherapy drugs and other medications can. This is why breast-feeding is usually not recommended for mothers with cancer. But for advice that’s specific to your case, speak with your doctor.
During pregnancy, mammary cells are no longer exposed to estrogen, a hormone that promotes the development of breast cancer.
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What to expect after
Once the initial shock of a breast cancer diagnosis wears off, many patients are ready to get down to business and begin treatment. Based on data collected by the SEER database, which is maintained by the National Cancer Institute, five-year survival rates for breast cancer in the United States are excellent. If the cancer is localized or regional (spread to nearby structures or lymph nodes), the survival rate is 99 percent and 86 percent, respectively. If the cancer has spread to distant parts of the body, the five-year survival rate is 27 percent. These survival rates underscore the importance of early detection and treatment. Treatment may induce feelings of anxiety among patients. Equally scary can be what to expect after treatment ends. Here’s a closer look at what comes next.
AFTER SURGERY If treatment involves surgery for a lumpectomy or mastectomy, patients will move to into the recovery room after surgery to wake up from anesthesia. BreastCancer.org says if you are feeling any pain, now is the time to speak up, as staff in the recovery room assess your pain and vital signs. Many surgeries are completed on an outpatient basis. However, more invasive surgeries that involve lymph node dissection require a hospital stay. Doctors will set up a schedule of follow-up care to check surgical sites and monitor healing. Radiation or chemotherapy may be used in conjunction with surgery and may continue even after surgery.
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cancer treatment ends AFTER CHEMOTHERAPY Chemotherapy causes an “enormous assault” on the body, according to Marisa Weiss, MD, founder of Breastcancer.org. Many of the hurdles that people feel post-treatment are lasting fatigue. WebMD says a phenomenon called “chemo brain” can occur. This is a mental change characterized by an inability to focus and memory deficits.
and annually thereafter.
In addition, after chemo ends, it may take up to six months for hair to start to grow back, and hair that grows back may be a different color and have a different texture.
Bone density tests and blood and imaging tests also may be recommended if you are taking certain medications or have physical indicators that the cancer might have come back.
AFTER RADIATION The American Cancer Society says side effects from radiation may vary depending on the patient. Extreme fatigue is often noted, and such feelings may come and go. Some people experience skin changes in the radiation treatment area. The skin may appear red, irritated, swollen, or blistered. Over time, the skin may become dry, itchy or flaky. Depending on certain types of radiation treatment, radioprotective drugs may be offered to help protect certain normal tissues.
FOLLOW-UP Doctors will prescribe a regimen for follow-up care. Every few months women may expect a visit at first. The longer you have been cancer-free, the fewer follow-up visits will be required. Mammograms on any remaining breast tissue will be scheduled between six and 12 months after surgery,
Getting back on track after breast cancer treatment can take time. Eventually, life can return to normal, especially for patients with a good support team in place. -
What you should know about 3D nipple tattoos If you need a mastectomy to treat your breast cancer, there are various reconstructive techniques that can be used to restore the shape of the removed breast. For many women, nipple restoration is the final step of this process and helps them close a painful chapter of their lives. Here’s what you should know about 3D nipple tattoos.
THE PROCEDURE 3D tattoos offer a realistic-looking and less invasive alternative to nipple reconstruction surgery. In order for the tattooing to work well, the breast tissue must be healthy and not show any signs of inflammation. As such, you may need to wait up to a year after your mastectomy to get a 3D nipple tattoo. Using oscillating needles coated with pigment, a tattoo artist or medical esthetician will create an image of a nipple and areola on the reconstructed breast. The size, placement and color of the tattoo can be customized to give it as natural of an appearance as possible. While this is a permanent solution, the tattoo can fade as the skin regenerates and touch-ups might be necessary. Alternatively, tattooing can be used to complement nipple reconstruction surgery by adding color and creating an areola around the new nipple.
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