Sunday 12 June 2011

Breast Cancer Treatment: Coping With A Mastectomy

As women, especially American women, much of our femininity is centered on our breasts.  No matter where you look, there are pictures, billboards, commercials, television shows, and movies with women with these beautiful breasts and ample cleavage.  The thought of losing one or both breasts, to breast cancer, can be devastating for many of us.  Sure, there's reconstruction, but will it ever really look the same again?  Even if you have reconstruction, you'll never have sensation there again and, for many of us, that definitely affects our sexuality.

I went through two separate mastectomies, for my breast cancer, despite the fact that I wanted them both done at the same time.  Two different surgeons told me that wasn't necessary.  They found out, later, that it was, as I had the same breast cancer in both breasts.  Through these surgeries, I learned a few things about what to expect, and how to get up and running again, after a mastectomy for breast cancer. 

The first thing to realize is that, apart from the emotional aspect of such an operation, this is a simple surgery.  The breast is composed, mostly, of fatty tissue and, of course, milk ducts and lobes.  The removal of this breast tissue is way easier than operating on an organ, but carries much more emotional impact for most of us.  Most surgeons will get as much of the breast tissue out as they can to help alleviate the chance of a recurrence of your breast cancer.  You will typically wind up with a horizontal scar about four inches long.  The scar may be red for quite a while but, ultimately, should fade to where you can hardly see it anymore.

You want to be sure to take loose-fitting, button-down shirts (raiding your hubby's closet is helpful) with you, to the hospital, as you won't be able to raise your arms over your head for a while.  You will also need a sports bra and I would highly recommend one that fastens in the front.  They will put that on you after your surgery.  Typically, you should be able to stay in the hospital for one night.  If you're going to have lymph nodes removed, a small pillow, to slip under that arm, will help make you more comfortable.  Check with your local American Cancer Society as they may have small pillows for you.  An extra pillow to hold to your chest, if you need to cough, sneeze, or laugh, can help keep your incision from hurting.

When you wake up, you will have a couple of drain tubes for each side you have done.  These tubes are important as they allow the excess fluid, which your body will produce, to drain out.  If you didn't have them, the fluid would have to be aspirated with a needle.  The drains, even though they're no fun, are better than that.  These drains will have to be emptied a couple of times a day and you will have to write down how much fluid you drain so the doctor will know when you've slowed down enough to remove them.  You may not know where to put these drains under your clothing.  I pinned mine up to the sports bra and that way, they didn't pull when I moved. 

When you get home, plan on having someone there to help you for the first few days.  You won't be allowed to reach into your cabinets and definitely won't be able to clean house or pick up your children, if you have little ones.  You'll be sent home with pain meds and definitely take them if you need them.  Studies show that you will heal faster if you keep yourself out of pain, so don't be afraid to take them as prescribed.

If you have a recliner, you might consider moving it into the bedroom as you won't be able to lie flat for a while.  You'll need to sleep in a partial sitting position.  If you don't have one, or don't have space for it in your bedroom, lots of pillows will work, too.  That's what I used.  Just be sure you have enough pillows to keep yourself comfortable propped up. 

If you would like someone who's been there before you to visit with, be sure to call your local American Cancer Society and ask for a Reach 2 Recovery volunteer.  This is an American Cancer Society program where they try to match you with one of their volunteers who have as similar experience as you're facing.  This woman will come visit you and will bring you all sorts of brochures and information on conventional treatment.  She will also bring you a list of exercises you can start to do to regain your mobility and range of motion.

This is VERY important.  It hurts to stretch your arm up, after surgery, but if you haven't had reconstruction, and you don't start soon, you will lose that range of motion.  I would recommend starting to gently, slowly reach your arm up … let your body be your guide … the day after your surgery.  This is ONLY if you have not had reconstruction.  If you have, let your plastic surgeon tell you when to start stretching.  Push to where it hurts just a little, but do not push too far past that.  Little by little, you'll find yourself able to stretch a little farther every couple of days.

Most of all, allow yourself to heal emotionally, as well as physically.  Some of us just can't look at that incision right away.  That's OK.  Take as much time as you need.  I know I felt like some kind of freak with no breasts and, even six years later, I still do sometimes.  But remind yourself that these scars are your battle scars.  They do not make you less of a woman.  They make you a warrior.

Halve Your Risk Of Breast Cancer?

We hear it all the time…lose weight for your health. Few people however, realize the extent to which this is critical to their physical well-being and ultimately their life expectancy.

In January 2003, the Journal of the American Medical Association featured a study finding that obesity appears to lessen life expectancy, especially among young adults. The researchers compared Body-Mass Index (BMI) to longevity and found a correlation between premature death and higher BMIs. For example, a 20-year-old white male, 5’10” weighing 288 pounds with a BMI of greater than 40 was estimated to lose 13 years of his life as a result of obesity.Jamie McManus, M.D., F.A.A.F.P. and author of “Your Personal Guide to Wellness” notes that while this study referenced extreme levels of obesity, there are still millions of overweight people in developed countries with a life expectancy rate that is three to five years less than their healthy-weight counterparts. She also estimates that there are 600,000 obesity related deaths each year in America.

Just how does obesity shorten our lifespan? The answer to this question is complex, yet there is a clear link between obesity and the development of cancer. An extensive study conducted by the American Cancer Institute involving 750,000 people showed that obesity significantly increased the risk of cancer developing in the following organs: breast, colon, ovaries, uterus, pancreas, kidneys and gallbladder.

Michael Thun, MD, vice-president of epidemiology and surveillance research for the American Cancer Society (ACS) says one reason obesity may raise cancer risk is because fat cells produce a form of estrogen called estradiol that promotes rapid division of cells, increasing chances of a random genetic error while cells are replicating, which can lead to cancer. In addition, fat centered around the abdomen may increase insulin and insulin-like growth factors in the blood, which may increase cancer risk.

"Women who are obese after menopause have a 50% higher relative risk of breast cancer," notes Thun, "and obese men have a 40% higher relative risk of colon cancer…. Gallbladder and endometrial cancer risks are five times higher for obese individuals”.There is evidence that cancer rates in developed countries are increasing at 5 to 15 times faster than developing countries. A major contributor to this alarming reality has proven to be diet. In populations where the diet consists mostly of fresh fruit and vegetables and whole grains – in contrast to the typical Western diet of fatty meats, refined flours, oils and sugars – the risk of cancer is much lower.

The interaction of diet and the development of cancer is an active field of research and Dr David Heber, M.D., Ph.D. and author of “What Color is Your Diet”, says “It appears that diet has its most significant effects after the cancer has already formed, acting to inhibit or stimulate the growth of that cancer”. At the risk of oversimplifying a complex set of interactions, the typical Western diet that leads to obesity may actually act to stimulate the growth of cancer cells.It is never too late to improve your health through healthful eating and adopting a more health-giving lifestyle. Here are simple steps to follow which can make an immediate improvement to your health and vitality.

<b>1. Check your Body Mass Index (BMI) to determine if weight has become health risk. </b>According to the Centers for Disease Control and Prevention, 60% of Americans are overweight, defined as having a BMI (a ratio of height to weight) over 25. Of those, nearly half (27%) qualify as obese, with a body mass index of 30 or more. In 1980, just 15% of Americans were considered obese. You can check your BMI at the website below.

<b>2. Match your diet to your body’s requirements. </b>If you eat and drink more calories than your body requires you will put on weight. Learn to control calories and portion sizes, make recipes leaner, and eat infrequently from fast food restaurants. Also learn how to snack with healthful choices.

<b>3. Color your diet with a large variety of colorful, cancer-fighting fruit and vegetables. </b>There are seven different color ranges of both fruit and vegetables and by choosing between 5 to 9 daily serves from a wide range of fruit and vegetables, we are extending our consumption of cancer (and other disease) fighting nutrients.

<b>4. Eat lean protein with every meal.</b> Protein provides a powerful signal to the brain providing a longer sense of fullness. The right source of protein is essential to controlling your hunger with fewer calories and necessary to maintain your lean muscle mass. Choices of protein should be flavored soy shakes with fruit; the white meat of chicken and turkey, seafood such as shrimps, prawns scallops and lobster and ocean fish or vegetarians may prefer soy based meat substitutes.

<b>5. Rev up your metabolism with activity. </b>If you want to enjoy a lifetime of well-being, exercise is a key ingredient. Colleen Doyle, MS, RD, director of nutrition and physical activity for the American Cancer Society (ACS), says adults should do something for 30 minutes each day that takes as much effort as a brisk walk. Children should be active for an hour each day. We are more likely to develop habits around things we enjoy, so seek activities which you enjoy doing. It is also helpful to build physical activity into your daily routine: use the stairs instead of the escalator or lift at work, park your car in the parking bay furthest from the super marketing and don’t use the remote control to change TV channels.

<b>6. Get support to ensure you develop a healthful eating plan and reach your goal weight. </b>Whilst a small percentage of people possess the discipline to lose weight, many obese people have developed strong thoughts and habits concerning the food they eat. In order to establish new habits, most people respond well to some form of consistent encouragement and coaching. A study, “Effects of Internet Behavioral Counseling on Weight Loss in Adults at Risk of Type 2 Diabetes” shows that participants who had the support of weight loss coaching lost more weight than those who didn’t. The study concluded that the support of a weight loss coach can significantly improve weight loss results.

Being overweight or obese has been identified next to smoking, as the most preventable major risk to developing cancer. Even small weight losses have been shown to have beneficial health effects. So it’s never to late to start and you can never be too young or too old to be concerned about your health and do something about achieving a more healthy weight.

(c) 2003 Kim Beardsmore

Sunday 5 June 2011

What You Need To Know If Your Mother Had Breast Cancer

If your mother had breast cancer, you have an increased chance of developing it yourself. Knowing your family history, understanding your personal risk, getting appropriate screening tests and making lifestyle choices are important steps toward good breast health, according to the Susan G. Komen Breast Cancer Foundation.

"If breast cancer runs in your family, understanding your risk and how to approach your breast health is important to both your physical and emotional well-being," says Cheryl Perkins, M.D., senior clinical advisor for the Komen Foundation.

Family History and

Increased Risk

If your mother, sister or daughter has breast cancer, your risk of developing the disease is two to three times greater than a woman without this family history. However, being at increased risk for breast cancer does not guarantee you will develop the disease. Talk to your provider to discuss your personal risk and his/her recommendations for regular screening. Regular screening usually includes mammography, clinical breast exams and breast self-exam. Additional screening may be recommended depending on your personal risk.

Gene Mutations and

Genetic Testing

Only 5 to 10 percent of all breast cancer is due to heredity. Genetic testing can determine if you inherited the mutated BRCA1 or BRCA2 genes, which are key in the development of some breast cancers. However, having a mutated gene does not guarantee that you will get breast cancer. If you have concerns about your family history and personal risk, talk with your doctor about whether genetic testing is right for you.

Taking Preventive Steps-Making Healthy Lifestyle Choices

Many factors can increase a woman's chance of getting breast cancer. While some risks, such as being a woman and getting older, are out of your control, others can be managed. For example, risk factors such as consuming alcohol, lack of exercise and being overweight are all factors that you can modify.

Helping Your Mother Through Breast Cancer

If your mother is diagnosed with breast cancer, she needs your support. From diagnosis through treatment and beyond, your mother's co-survivor network of family and friends will be a vital part of her support system.

Will My Breast Cancer Come Back? Reducing the Risk of Breast Cancer Recurrence After Surgery

More than 215,000 women are diagnosed with breast cancer every year. For many of them, surgery to remove the tumor is just the first step in the battle against the disease, often followed by radiation and/or chemotherapy. After that, these women may need to decide with their doctor whether to have "adjuvant therapy"-medication to help prevent their cancer from coming back.

When a woman's breast cancer does come back or spreads to other parts of the body, she may be at greater risk of dying from the disease. Women whose breast cancer is detected in the nearby lymph nodes at diagnosis and those who receive chemotherapy after surgery are considered to be at increased risk for breast cancer recurrence.

Postmenopausal women whose early-stage breast cancer is hormone-sensitive have a new option as their first hormone therapy following surgery. The U.S. Food and Drug Administration recently approved Femara® (letrozole tablets) on December 28, 2005 for this type of use. This approval was based on a median of 24 months of treatment. The study is still ongoing to determine the long-term safety and efficacy of Femara. Already a leading breast cancer treatment, Femara is now the only medicine in a group called aromatase inhibitors that is approved for use both immediately following surgery and after five years of tamoxifen. The FDA granted Femara a priority review, a distinction reserved for medications that could potentially offer a significant improvement compared to products currently on the market.

A panel from the American Society of Clinical Oncology, the country's leading group of oncologists, recommends aromatase inhibitors, such as Femara, be part of the optimal adjuvant treatment for this group of women.

"One of the greatest fears confronted by women who have been treated for early breast cancer is that their cancer will come back. With Femara, we now have an option that can help address that fear early on, even in patients who we know face the greatest risk of recurrence," said Matthew Ellis, MD, PhD, FRCP, director of the Breast Cancer Program at Washington University in St. Louis.

In a large clinical study of post-surgery breast cancer treatment, researchers compared the effectiveness of Femara and tamoxifen, another drug prescribed after surgery. An analysis performed after 26 months showed that Femara reduced the risk of breast cancer coming back by 21% over the reduction offered by tamoxifen. Patients taking Femara also showed a 27 percent reduction in the risk of the cancer spreading to distant parts of the body.

In this study, women at increased risk of recurrence experienced the greatest benefit from Femara. Femara lowered this risk by 29 percent in women whose breast cancer had already spread to the lymph nodes at the time of diagnosis and by 30 percent in women who had prior chemotherapy. The results also showed that in these high-risk women, Femara reduced the risk of cancer spreading to distant parts of the body by 33 percent and 31 percent, respectively.

In this study, Femara was generally well tolerated with the most common side effects including hot flashes, joint pain, night sweats, weight gain and nausea.

Tips for Living Healthy

Discuss postsurgery treatment options with an oncologist. Whether you're one, five or 10 years beyond your diagnosis, taking care of your overall health and well-being can also reduce your risk of cancer coming back and give you the energy to do the things in life that you love.

&#8226; Practice good nutrition

&#8226; Exercise regularly

&#8226; Tap into a support network

&#8226; Take time out for yourself

Editors Note: Important safety information

Femara® (letrozole tablets) is approved for the adjuvant (following surgery) treatment of postmenopausal women with hormone receptor&#8722;positive early breast cancer. The benefits of Femara in clinical trials are based on 24 months of treatment. Further follow-up will be needed to determine long-term results, safety and effectiveness.

Talk to your doctor if you're allergic to Femara or any of its ingredients. You should not take Femara if you are pregnant as it may cause fetal harm. You must be postmenopausal to take Femara. Some women reported fatigue and dizziness with Femara. Until you know how it affects you, use caution before driving or operating machinery. There was an increase in cholesterol in patients on Femara versus tamoxifen (5.4% vs. 1.2%).

In the adjuvant setting, commonly reported side effects were generally mild to moderate. Side effects seen in Femara versus tamoxifen included hot flashes (33.7% vs. 38%), joint pain (21.2% vs. 13.5%), night sweats (14.1% vs. 13.5%), weight gain (10.7% vs. 12.9%) and nausea (9.5% vs. 10.4%). Other side effects seen were bone fractures and osteoporosis.