Think Pink 2021

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A Special Publication of The Daily Star, Wednesday, Oct. 6, 2021

Think Prevention, early detection are keys to cancer treatment

Cancer fight is team effort for

mother and daughter AND MORE!


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Did you know? Though most breast cancer survivors don’t get cancer again, the American Cancer Society notes that they are at higher risk for getting some types of cancer. According to the ACS, the most common second cancer in breast cancer survivors is another breast cancer. That only underscores the importance of continuing to get screened even after successful treatment. In addition to a second breast cancer, breast cancer survivors have a greater risk of developing salivary gland cancer, cancer of the esophagus, stomach cancer, colon cancer, uterine cancer, and ovarian cancer. The risk for thyroid cancer, sarcoma, melanoma of the skin, and acute myeloid leukemia also is greater after successful treatment for cancer.

BREAST CANCER AWARENESS MONTH

Understanding the role of genetics

NT – Have you ever wondered why some people are more at risk of developing breast cancer than others? While many factors can come into play, including the person’s age, lifestyle and environment, about 10 percent of cases are the result of a genetic predisposition. Since October is Breast Cancer Awareness Month, here’s a look at the role that genetics play in this all-too-common disease.

GENES AND THEIR VARIANTS A mutation is a change in the DNA sequence of a gene, which can potentially disrupt its proper functioning. While some gene variants occur naturally during your lifetime, others are passed down from your parents. This means that if either your mother or father has a gene variant, there’s a

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50 percent chance you’ll inherit it. The danger is if this mutation is in the BRCA1 or BRCA2 gene, which are the most common causes of hereditary breast cancer.

HEREDITARY RISK FACTORS In addition to having a higher risk of breast cancer, people with this genetic mutation are also more likely to: • Be affected by cancer before the age of 50 • Have more than one type of cancer at the same time • Develop rare types of cancer • Have family members with the same type of cancer Do you think you might be genetically predisposed to breast cancer? If so, ask your doctor for a referral to a specialist who can review your family and medical history and assess your level of risk.


Navigators ease the process for cancer patients By Allison Collins

tion with the radiation department and there’s a few in the network. There are other hospitals that have nurse navigators, and it is becoming more common. (Patients) definitely appreciate navigators and most of the people do use us.

Contributing Writer

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or years, nurse navigators in the Bassett Healthcare Network have been making a hard time easier. Sara McCulley, a registered nurse and nurse navigator with the Bassett Cancer Institute, said a navigator’s role is support-centric and comprehensive. “We introduce ourselves to patients that have been newly diagnosed with cancer and help them through whatever treatments are needed and we help see if there’s anything they need before they see the doctors,” she said. “We help (patients) decide when to see the doctors and in what order and help with barriers — transportation, education — and try to make sure everything is done in a timely manner. We decrease time frames for treatment; sometimes people are scheduled not in the right order or scans can be missed, so we just kind of help make sure it’s a smooth process. “We usually follow (a patient) from initial diagnosis through survivorship,” McCulley continued. “We always tell them they can give us a call for anything. We’re there when needed.”

“In the cancer treatment center, we have three (nurse navigators),” McCulley continued. “I’m usually in Oneonta and there’s another in Cooperstown, and we follow breast, colon, rectal, anal and lung cancer; there’s another that follows a few different ones, like head and neck and OB-GYN, and she goes to all the different sites. They’re trying to get more nurse navigators … and there is a need.” Though there is no specific training required for the program, McCully said, nurse navigators “typically have had experience in the cancer center … or are certified for oncology.”

“They’re realizing how navigation is helping patient care and improving patient care and help with the barriers.” Sara McCulley

Such guidance, McCulley said, is vital. “Everything can get kind of overwhelming, so it’s nice to have the extra support from the navigators,” she said. “So much is thrown at them during consults, so we are there to just listen and give support and answer any questions they might have and make sure everything is set up for chemo or whatever is needed. We coordinate appointments, make sure they understand what they’re going through, getting all the correct testing … and assess for insurance and

transportation needs even before they’re seen. We make sure they’re comfortable.” McCulley said fellow nurse Amy Monahan started the program in 2015, and it’s been growing since. “They’re realizing how navigation is helping patient care and improving patient care and help with the barriers,” she said. “It was (unique) at the time when she started it, but I know they do have naviga-

McCulley said nurse navigators at the Bassett Cancer Institute handled about 300 patients last year, 172 of whom were hers. McCulley said, historically, “a lot” of those patients have been individuals with breast cancer. “Initially, navigation started with breast cancer, because that’s the most patients that we see,” she said. “We have a lot of breast cancer patients.” McCulley said, while breast cancer patients represent a majority, she’s seen the impact breast cancer awareness efforts have had. “I would say there is more knowledge about preventative measures, because awareness has been out there for a while,” she said. “It does seem like awareness is definitely helping. We also have a lot of different organizations that help financially with breast cancer, because there’s a lot more support with breast cancer than with other cancers.”-

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Prevention, early detection are keys to cancer treatment By Allison Collins Contributing Writer

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ccording to experts at Bassett Healthcare Network’s Cancer Institute, familiarizing people with preventative measures is at the heart of raising, and continuing, breast cancer aware-

ness.

Dr. Anush Patel, Bassett Chief of Medical Oncology, said mammograms top the list. “I think the best thing to have is mammograms for prevention, and mammograms start at age 40 for average patients,” he said. “Every woman’s primary care physician can measure out what is their risk, and that depends on family history and any indicaDR. ANUSH PATEL tions, but for most people … mammograms start at 40 and, depending on different guidelines and what they find on the initial mammogram, (continue) every year or every two years. That’s the best screening tool we have.” “Screening is an important way to find a cancer early and offer treatment before the tumor gets larger,” Dr. Timothy Korytko, radiation oncologist at Bassett Cancer Institute, said in a written statement. Advancing mammogram technology, Patel said, has made the method more valuable than ever. “We know mammograms save lives,” he said. “We do see a lot more early breast cancer than late-stage or metastatic, and early stage means more chance of a cure, so I think getting early mammograms is the key. We’re lucky to have that testing in our community and we do mammograms throughout the network — everywhere — and they are read by a board-certified, mammogram-trained, dedicated radiologist; that’s what they do, read tons of them, every day, and they’re picking up even the smallest lesion that could be missed otherwise. They’re phenomenal at picking up the nuances of the mammogram, so that has definitely enhanced our diagnostic capabilities and, as soon as (a patient) is diagnosed, I can treat them and cure them sooner.” Korytko, too, said innovations in radiation are having an impact.

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“I think the best thing to have is mammograms for prevention, and mammograms start at age 40 for average patients.” Dr. Anush Patel

“Last year, we installed a new True Beam Linear Accelerator at Bassett in Cooperstown,” he said. “This is a highly precise machine which delivers radiation treatment. With this machine, we can perform deep inspiration breath-hold treatment to lower radiation exposure to the heart. When you take a deep breath, the heart moves away from the breast, and using this equipment allows the radiation beam to turn on and off only when the breath is held the same way. Treatments take only 10 to 20 seconds, so the treatment can be completed over the course of just a few deep, controlled breaths.

“Another way to reduce dose to the heart and improve the radiation dose in the breast is through the use of a prone positioning,” Korytko continued. “This is a special way to position patients for radiation and it is available at our Cooperstown and Oneonta sites.” Experts said, following a diagnosis, Bassett breast cancer patients have a “comprehensive” support network. “I think we have quite a phenomenal system set up here at Bassett,” Patel said. “Anyone diagnosed with breast cancer would have a nurse navigator assigned to them to help them. This is emotionally, and physically, of course, a very stressful time, and a nurse navigator guides them through the whole process: coordinating apDR. TIMOTHY KORYTKO pointments with radiation and oncology; we have our own social worker and nutritionist; and there’s a financial counselor. We’re trying to take all the burdens off their hands and do what’s important to get their health back. “Then there’s the team approach,” Patel continued. “We have one of the best models of comprehensive care. Together, we make decisions as a consensus, so we get information from everyone; we sit down and review their mammograms or CAT scans and biopsies and all the input on the plan. It is very smooth, with the navigation, and we all work so well together that I think patients get what they need in a timely manner.” “We truly have a comprehensive, team-based approach to cancer care,” Korytko said. “As part of any patient’s evaluation in radiation oncology, the doctor and patient work together to decide on the best way to approach their cancer care. All the doctors and support staff have the patient front and center in their mind and come together to make the right plan for each patient. We also have a lot of depth to our team, evidenced by our national accreditations with the American College of Surgeons and American Society of Radiation Oncology. We offer comprehensive, high-tech treatment, clinical trials (and) supportive care, all with a personal touch. Every patient diagnosed with breast cancer is assigned a nurse


navigator who helps to coordinate visits and make sure we are helping the patients the best we can. The evaluation and treatment plans are always done in a team environment, with the surgeon, radiation oncologist and medical oncologists all involved to help the patient at the right time. “This last year, we also started a survivorship clinic for the entire network,” he continued. “There are now more cancer survivors than there are patients getting active treatment. A lot of times, a cancer diagnosis is a wakeup call to make a person’s health more important in their lives. At this clinic, we focus on how to deal with side effects of treatment and how to improve overall health through lifestyle interventions like exercise, activity, diet and sleep and stress management interventions. The clinic sees patients in Foxcare (in Oneonta) and Bassett in Cooperstown one half-day per month and the visits can be remote or via telemedicine.” Korytko and Patel said Bassett’s approach, paired with advancing technologies, makes for highly personalized patient care. “Diagnosis and treatment (have) become very individualized and more specific to the patient and the tumor type,” Korytko said. “Breast cancer is not onesize-fits-all.” “Technology … has significantly improved over the last decade, so we have a new radiation machine

and it’s a lot more precise,” Patel said. “We always practice evidence-based medicine, so we always go by national guidelines, and we really follow those. From a medical oncology perspective, we do a specialized test. The breast cancer now is not the breast cancer thought of 20 years ago, when everyone got the same (treatment); now, it’s a lot more personalized care. We’ve learned a lot more about the kinds of tumors … and we are personalizing the treatment based on the patient. The plan is not one; it’s precise medication specific to the patient with minimal side effects, and that has dramatically changed in the last 10 or 20 years. This helps us with how aggressive to be and how to avoid side effects. We can personalize (treatment) … and we adopted that very quickly at Bassett. We have multiple trials going on and nurses and all of us physicians dedicated to research … so that also keeps us at the cutting edge of science, but we can bring all this expertise from clinical trials to everyday practice.” Breast cancer awareness efforts, experts said, are helping the cause, though overcoming patient anxiety around screening, especially through the COVID-19 pandemic, remains an obstacle. “Thanks to all this type of attention, I think people are less afraid of talking about a cancer diagnosis and are more aware that it is a common condition,” Korytko said. “Unfortunately, there has been in-

creased anxiety about entering a health care setting these days, due to the pandemic. These services are all still up and running, so it is important for patients to keep up with their testing. Breast cancer screening should not be skipped or delayed, so please talk to your doctor about starting or continuing screening mammography, colonoscopy and other preventative health care visits.” “People do get scared of the testing, but doing that has shown that we can improve the natural course,” Patel said. “Any cancer, if you can catch it early, you can cure it, mostly, and breast cancer is the poster child for that, and thankfully that’s where most of the patients fall now. I think what I see that has the strongest effect is someone telling their loved ones, ‘I had a mammogram, so you should get it.’ “And seeing those things does have an effect, because everyone knows ‘Go Pink,’” he continued. “Everyone has that awareness — it is everywhere, pink hats and pink ribbons — so I think it sends a message that goes out, and I think it does make a difference to bring people’s attention to getting their mammogram done. We have amazing cancer care; I just want people to be more knowledgeable and not be afraid. Many people don’t want to get screening because they don’t want to know if they have cancer, but that’s why we have to.” -

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Are there different types of

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breast cancer? MCS – Millions of women are diagnosed with breast cancer every year. According to the Breast Cancer Research Foundation, more than 2.3 million women across the globe were diagnosed with breast cancer in 2020. The BCRF also notes that breast cancer is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide. Breast cancer statistics can give the impression that each of the millions of women diagnosed with the disease is fighting the same battle, but breast cancer is something of an umbrella term. In fact, there are various types of breast cancer, including ductal carcinoma in situ, invasive ductal carcinoma, inflammatory breast cancer, and metastatic breast cancer. Learning about each type of breast cancer can help women and their families gain a greater understanding of this disease.

other parts of the breast tissue. This is why IDC is characterized as “invasive.” Though IDC can affect people, including men, of any age, the ACS notes that the majority of IDC cases are in women age 55 and older.

Ductal carcinoma in situ (DCIS)

Metastatic breast cancer

DCIS is a non-invasive cancer that is diagnosed when abnormal cells have been found in the lining of the breast milk duct. The National Breast Cancer Foundation notes that DCIS is a highly treatable cancer. That’s because it hasn’t spread beyond the milk duct into any surrounding breast tissue. The American Cancer Society notes that roughly 20 percent of new breast cancer cases are instances of DCIS.

Invasive ductal carcinoma (IDC) IDC is the most common type of breast cancer. The NBCF reports that between 70 and 80 percent of all breast cancer diagnoses are instances of IDC. An IDC diagnosis means that cancer began growing in the milk ducts but has since spread into

Inflammatory breast cancer (IBC) The NBCF describes IBC as an “aggressive and fast growing breast cancer.” Breastcancer.org notes that IBC is rare, as data from the ACS indicates that only about 1 percent of all breast cancers in the United States are inflammatory breast cancers. Many breast cancers begin with the formation of a lump, but Breastcancer.org reports that IBC usually begins with reddening and swelling of the breast, and symptoms can worsen considerably within days or even hours. That underscores the importance of seeking prompt treatment should any symptoms present themselves. Metastatic breast cancer may be referred to as stage IV breast cancer. When a woman is diagnosed with metastatic breast cancer, that means the cancer has spread, or metastasized, into other parts of the body. The NBCF indicates that metastatic breast cancer usually spreads to the lungs, liver, bones, or brain. Symptoms of metastatic breast cancer vary depending on where the cancer has spread. For example, if the cancer has spread to the lungs, women may experience a chronic cough or be unable to get a full breath. These are not the only types of breast cancer. A more extensive breakdown of the various types of breast cancer can be found at https://www.breastcancer.org/symptoms/types.

Breast Cancer affects mothers, daughters and friends from all walks of life. Help in the ongoing fight against breast cancer by scheduling a mammogram for yourself today! Also, encourage others you know to do the same. Early detection does save lives.

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Cancer fight is team effort for

mother and daughter By Allison Collins

M

Contributing Writer

other-daughter Schenevus residents Carleen and Heather Henderson, 62 and 37, are celebrating being cancer free together. Carleen recently marked her fifth year in remission, after a June 2016 Stage 2 breast cancer diagnosis. The diagnosis, Carleen said, followed a routine mammogram.

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“I had a mammogram done in June 2016 and that’s when they saw a spot,” she said. “Then I had all the biopsies and everything and that’s when they found out it was breast cancer. I first had it removed in July, but then I tested positive for BRCA, but at that time, decided to do chemo first, so I had that for six months then, the next February, I had the bilateral mastectomy and reconstruction.” According to the Centers for Disease Control, BRCA1 and BRCA2 are “two genes … important to fighting cancer (because) they are tumor suppressor genes.”

Su rv ivo rs

“When they work normally,” cdc.gov notes, “these genes help keep breast, ovarian and other types of cells from growing and diving too rapidly or in an uncontrolled way.” Changes or mutations to the genes, the site continues, “prevent them from working normally, raising a person’s risk for breast, ovarian and other cancers.” According to the National Breast Cancer Foundation, BRCA is an abbreviation for “BReastCAncer gene.” About one in 400 people, nationalbreastcancer.org says, carries mutated BRCA1 or BRCA2 genes, increasing not only the likelihood of developing cancer, but also its onset at an earlier age. It was her mother’s genetic discovery, Heather said, that spurred her own.

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“We caught it just right when everything was happening,” Heather continued, noting that she, too, was diagnosed with Stage 2 cancer. “I’m thankful for genetic testing and being able to know that people can do that now and that we have that research, because if we didn’t, I would’ve never gotten a mammogram at least until I was 40, so you’re looking at six years that I could’ve had the lumps. If it wasn’t for genetic testing … that pretty much saved my life.” CARLEEN HENDERSON

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Witnessing her mother’s cancer journey, Heather said, was galvanizing. “I automatically went through with the double mastectomy, right after they found the spots, and I did 16 weeks of chemo,” she said. “I could’ve just done a single (mastectomy), because when they did the mammogram, they only saw spots on one (breast), but I wanted to do the double, because you run the risk.

HEATHER HENDERSON

“When my mom tested positive for the BRCA gene, my sister and I went and had the genetic testing done,” she said. “I tested positive for the gene as well, but my sister did not. So, I had my first mammogram and everything was fine and I was going to go ahead with a double mastectomy anyway, just to be preventative, but by the time I had my second

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mammogram, I already had cancer in both breasts. My mom had it, then a year later I had a mammogram, then another year later in June 2018, that’s when … they found the spots.

“I’m a very positive person, so I just kind of looked at it like, ‘Oh, well, crap. Either my sister or I was going to get it and I’m the stronger of the two, so that’s why I probably got it, so let’s just do this and get it over with,’” Heather continued. “That’s how it’s been the whole time; I don’t lead with, ‘I’m Heather and I’m a breast cancer survivor.’ I just lead with, ‘I’m Heather,’ and if they know me, then they know that’s part of my story. It was definitely scary, but I had a whole support system and having my mom go through it before me, it was almost just another page in our book.” Both women credited that support system with buoying them through diagnosis, treatment and recovery.


ful, the whole thing. Even people that had cancer before would come in and say, ‘Come on, you can do this.’ Every six months now, I see my surgeon, and then the six months after that, I see my oncologist, so we rotate and they make sure you always have that care.”

“I’m thankful for genetic testing and being able to know that people can do that now and that we have that research, because if we didn’t, I would’ve never gotten a mammogram at least until I was 40, so you’re looking at six years that I could’ve had the lumps. If it wasn’t for genetic testing … that pretty much saved my life.” Heather Henderson

“It was scary when I had it, but we’re a very supportive family,” Carleen said. “Even through my chemo and all that, Heather was there and took me to work — I worked throughout, we both did; I worked at the hospital and, at that time, I was in medical records, so I was working every day — so, with the family and work and everybody sitting with us, we had great support. “When my daughter got it, I felt very guilty … thinking it was my fault,” Carleen continued. “You really had to overcome that, because it’s just something that happens.” Carleen is a health educator for Living Well, part of Bassett Health Care Network. Heather, who said she took on coaching her nephew’s junior varsity basketball team during chemo in addition to working, is employed in the adventure department at the Clark Sports Center in Cooperstown. Bassett’s Cancer Center, Carleen and Heather said, also proved an integral part of their recovery. “The people in the cancer treatment center were like your family,” Carleen said. “It was just wonder-

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“January 2019 was my last treatment, and they still know me by name,” Heather echoed. “I can’t say enough about the Bassett Cancer Center – the nurses, everybody, even someone that just saw you one time.” Support from the Schenevus and surrounding communities, Heather said, was also affirming. “You don’t realize it until something happens, but we live in such great communities,” she said. “I had random people after my surgery bringing me dinner to my house and my best friend planned a benefit for me. I thought it was going to be a little Chinese auction, and there were people out the door. So many people showed up to just help or donate. It’s crazy to me to see such communities. You really see how big the community is.” Despite their can-do approach, Carleen and Heather said, breast cancer has shaped them indelibly. “(The hardest part) is the scars and what you have from your surgery,” Carleen said. “And it was tough with chemo, because I was sick quite a bit, but you just kind of go with the flow. It would be hard if my husband had cooked me something to eat, because I’d take one smell of it and I’d want to throw up. I couldn’t eat. For a while it was just applesauce and soup that you live off. Now, you just change your life habits.” “The worst part, for me, because I’m 37 and I had to have a double mastectomy, was the physical nature of your body after something like that,” Heather said. “People joke with you that, at least you get new boobs, but if you really look at yourself after … I look like the guy from the Nightmare Before Christmas with the slits in his face. Definitely the physical — you lose your hair, and you get kids who aren’t disrespectful, but don’t understand the process and will walk up to you and say, ‘You look funny with no hair,’ and you just have to become a stronger person

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Mother-daughter breast cancer survivors Heather and Carleen Henderson are shown in this undated photo. to overcome all those flaws with your body. I work out a lot now and I’ve changed my whole lifestyle, just because of the difference in my body and just to make me feel better.” And, Carleen and Heather said, they’ve learned from their survivorship. “I was at a point where I thought I could do it all myself,” Carleen said, “but it’s OK to ask for help.” “My biggest thing is, it’s OK to be upset,” Heather said. “It’s OK to be frustrated and it’s OK to be hurt and scared. I think a lot of us try to go through this not realizing that it’s OK to cry and it’s OK to have a bad day and not want to get out of bed. It’s OK to be upset but, at the end of the day, we still have to push through it. I found myself a lot with that, where I wouldn’t let myself get upset or cry, but my biggest piece of advice now, when people ask, is it’s OK. I should’ve done that more and let it out more and cried more.” -

“It’s OK to ask for help.” Carleen Henderson

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Breast cancer signs and symptoms MCS – 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, Inc.® 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. • Changes 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 indicate the presence of breast cancer. Some women may 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. • Change in appearance of the breast or nipple: Unexplained changes 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. • Discharge from the nipple: The NBCF notes that any discharge from the nipple, but particularly a clear or bloody discharge, 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.

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How physical activity can help in the fight against breast cancer MCS – Breast cancer is a complex disease that affects millions of women across the globe each year. Though the American Cancer Society reports that only about 4 percent of women diagnosed with breast cancer in the United States are under age 40, women of all ages can take steps to protect themselves against this deadly disease.

Exercise benefits women in myriad ways, and that includes lowering their risk for breast cancer. The ACS notes that researchers are increasingly linking exercise to a reduced risk for breast cancer. Though the reasons behind that link remain unclear, some theorize that the positive effects of exercise on body weight, inflammation, hormones, and energy balance could

be why regular physical activity helps women reduce their risk for breast cancer.

Body weight and breast cancer The National Cancer Institute reports that being obese after menopause can significantly increase a woman’s risk for breast cancer. In addition, the ACS attributes the rise in hormone receptor-positive breast cancers to an increased prevalence of excessive body weight. Routine exercise is a highly effective way to lose weight and keep weight off, which in turn could lower women’s risk for breast cancer.

Being sedentary and breast cancer Exercise is a not a sedentary activity, and that could be another reason why women who are physically active have a lower risk for breast cancer. The ACS notes that more than one study has linked sitting time to a higher risk of various diseases, including breast cancer. Researchers with the ACS analyzed data from 77,462 women, who

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they followed for an average of 15.8 years. None of the participants had cancer when the study started, but researchers found that women who sat for six or more hours per day during their free time had a 10 percent greater risk for invasive breast cancer than women who sat for less than three hours per day during free time.

Does physical activity really reduce breast cancer risk? The human body is complex, and a host of factors, including those like age that women have no control over, can affect cancer risk. However, engaging in routine physical activity seems to be an effective way for women to reduce their risk for breast cancer. In fact, the Breast Cancer Research Foundation estimates that one-third of all breast cancer cases could be prevented with positive lifestyle choices that help women maintain a healthy weight, including exercise. Routine physical activity can be a significant weapon in women’s arsenal as they continue their efforts to prevent and overcome breast cancer.

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How breast cancer treatments

can affect the immune system MCS – Treatment for breast cancer is highly effective. Fiveyear survival rates for breast cancer have increased dramatically in recent decades, and much of that success can be credited to cancer researchers and campaigns designed to inform women about the importance of screenings. Breast cancer is highly treatable, but treatment typically leads to some unwanted side effects. According to Johns Hopkins Medicine, women undergoing treatment for breast cancer may experience a host of side effects, including fatigue, pain, headaches, and dental issues. Cancer treatments, most notably chemotherapy, also can take a toll on women’s immune systems.

Why does chemotherapy affect the immune system? Cancer is caused by an uncontrolled division of abnormal cells in the body. According to

Breastcancer.org, chemotherapy targets these abnormal cells, but also can affect fast-growing cells that are healthy and normal. So chemotherapy can damage cells throughout the body, including those in bone marrow. When bone marrow is damaged, it’s less capable of producing sufficient red blood cells, white blood cells and platelets. Breastcancer.org notes that the body is more vulnerable to infection when it does not have enough white blood cells.

Does chemotherapy always weaken the immune system? The effects of chemotherapy on the immune system depend on various factors. According to Breastcancer.org, a patient’s age and overall health may influence the effects of chemotherapy on their immune systems. Young, healthy patients may be less vulnerable to infections from weakened immune systems

than aging, less healthy patients. However, Susan G. Komen notes that the median age for breast cancer diagnosis in the United States is 63, so many patients are likely to be affected by the impact that treatment can have on their immune systems. The length of treatment and amount of medicines patients receive also can affect the impact of chemotherapy on patients’ immune systems. Breastcancer.org notes that being administered two or more chemotherapy medicines at once is more likely to affect the immune system than just one medication.

Other treatments Chemotherapy is not the only treatment that can affect breast cancer patients’ immune systems. The Cancer Treatment Centers of America® notes that surgery, radiation, CAR T-cell therapy, stem cell transplants, and even immunotherapy can affect the immune system. Surgery can overtax the immune system and compromise its ability to prevent infections and heal wounds caused by the procedure. Like chemotherapy, radiation therapy can damage healthy cells and lead to an increased risk of infection. And while immunotherapy is designed to boost the immune system by helping it recognize and attack cells more effectively, it also can lead to an overactive immune system that attacks healthy cells. Cancer treatment is often highly effective. However, patients may need to work with their physicians to combat treatment side effects that can adversely affect their immune systems.

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The road to recovery continues after cancer treatment ends MCS – The American Cancer Society reports that the five-year survival rate for all cancers combined that were diagnosed between 2009 and 2015 was 67 percent. That’s a noteworthy and encouraging statistic, though global figures compiled by Ourworldindata.org indicate that fiveyear survival rates following diagnosis are significantly lower in poorer countries. In addition, the road to recovery for cancer patients typically does not end when treatments are completed.

that cancer survivors typically return to the doctor every three to four months during the first two to three years after treatment. After that, survivors may see their doctors once or twice a year. Follow-up care is vital for cancer survivors, as it provides their doctors an opportunity to determine if patients are experiencing any side effects from treatment. These appointments also allow doctors to determine if the cancer has returned or spread to other parts of the body. In addition, follow-up visits provide an opportunity for cancer survivors to bring up any symptoms or questions they might have. Patients can ask about ways to reduce their risk of cancer recurrence and seek advice on getting back to normal, including how quickly they can begin exercising and how to approach new fitness regimens if they were inactive prior to diagnosis.

The National Cancer Institute notes that many cancer survivors have indicated that information and support was abundant during their treatment. However, once treatment stopped, a new wave of questions and uncertainty soon emerged. For example, the NCI points out that many cancer survivors recognize that life after treatment is less about “getting back to normal” than it is about discovering the new normal. In fact, the Memorial Sloan Ketting Cancer Center reports that most people indicate it takes between six and 12 months after they complete chemotherapy before they truly feel like themselves again.

The road to recovery from cancer may be filled with uncertainty. But cancer survivors should recognize that millions before them have survived the disease and gone on to live full, happy lives. A patient approach to recovery can help cancer survivors overcome any obstacles they may encounter along the way.

Follow-up care also is a vital part of recovering from cancer. The NCI notes

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Breast cancer in men: 5 signs to look for

Ways to reduce your risk of breast cancer

NT – Did you know that men can develop cancer in their breast tissues and ducts? Although it’s significantly more common among women, breast cancer can affect men too. That’s why it’s important to learn about this disease and remain vigilant. In fact, since there’s no screening program available for men, this type of cancer is often diagnosed late. Here are some symptoms to watch out for:

NT – October is Breast Cancer Awareness Month, which makes it an ideal opportunity to learn more about one of the most common cancers among American women. Since about one in eight women will develop breast cancer at some point in her life, here are some ways you can lower your risk.

1. The presence of a lump. It could be in the armpit or chest and often isn’t painful.

2. Discharge from the nipple. This can cause crusting, and bleeding may also occur.

3. Swelling of the chest. It can happen suddenly and may or may not cause pain.

4. Ulcers on the chest. Look for open sores on the skin that don’t heal.

5. An inverted nipple. It’s possible that your nipple

will suddenly point inward. According to the American Cancer Society, breast cancer is 100 times less common among white men than white women, and about 70 times less common among Black men than Black women. Nevertheless, approximately 530 men die from this disease each year. If you have any symptoms, don’t hesitate to consult your family doctor.

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DID YOU KNOW? Having at least one full-term pregnancy, particularly before the age of 30, lowers a woman’s risk of developing breast cancer in her lifetime. Breastfeeding can also protect against this type of cancer.

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Maintain a healthy body weight. Being obese increases your risk of breast cancer. Eat well and exercise regularly to help you manage your weight. Be physically active. Research shows that regular exercise can lower your risk of breast cancer. Aim to do at least 150 minutes of aerobic activity per week. Limit your alcohol intake. Since drinking alcohol can increase your risk of breast cancer, you should limit yourself to less than one drink per day. Don’t smoke. Get the help you need to quit smoking, or avoid developing the habit altogether. You should also steer clear of second-hand smoke. Follow screening guidelines. While a mammography won’t prevent cancer, it can catch the disease early, giving you more treatment options and a better prognosis. For more information about breast cancer prevention and treatment, visit breastcancer.org.

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The role of staging

when diagnosing breast cancer MCS – A cancer diagnosis can be overwhelming, and people who receive such news may be flooded with a wide range of emotions. When delivering such a diagnosis, doctors share vital information about their patients’ disease. Those details can go a long way toward easing patients’ concerns. Staging is an important component of cancer treatment. The National Cancer Institute notes that stage refers to the extent of the cancer, including how large the tumor is and whether or not it has spread, or metastasized. Learning the stage of the cancer, which is typically expressed on a scale of 0 through IV, helps doctors understand how serious the cancer is and the patient’s chances of survival. Staging also is used to plan treatments and potentially identify clinical trials that may serve as treatment options. The American Joint Committee on Cancer oversees the breast cancer staging system and utilizes the TNM system. Breastcancer.org notes that three clinical characteristics, referred to as “T, N, and M,” are used to calculate the stage of the cancer: • the size of the tumor and whether or not is has grown into nearby tissue (T) • whether the cancer is in the lymph nodes (N) • whether the cancer has spread, or metastasized, into other parts of the body beyond the breast (M) Additional characteristics were added to the AJCC’s TNM breast cancer staging system in 2018. Though this has made determining the stage of breast cancer more complex, Breastcancer.org notes that it’s also made staging more accurate. That improved accuracy increases the likelihood that doctors will choose the most effective treatment plan for their patients, which should ease

those patients’ concerns as they begin treatment. Staging is complex, and patients should know that staging alone does not dictate prognosis. The following breakdown, courtesy of the NCI, is a brief description of the five stages of cancer (stages O through IV). A more detailed description of breast cancer stages can be found at https://www. breastcancer.org/symptoms/diagnosis/staging. • Stage 0: This is diagnosed when abnormal cells are present but have not spread to nearby tissue. Stage 0 is also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer. • Stages I through III: Cancer is present in these stages. The higher the number, the larger the tumor is and the more it has spread into nearby tissues. • Stage IV: The cancer has spread into distant parts of the body. Staging plays an important role in treating cancer. Recognizing the role of staging can help patients better understand their disease and the direction of their treatments. More information about staging is available at www.cancer.gov.

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