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Archive for May, 2010

Promise me that you’ll give FAITH a fighting chance.

…and when you get the choice to sit it out, or dance.

‘I Hope You’ll Dance’

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This is a wonderful story of a mother and her child. I have removed the family name for respect.

I was diagnosed with breast cancer on September 22, 2008. What I am about to say will most likely leave you scratching your head, but it’s truly how I feel. I am lucky. Now let me explain my position.

When I say “lucky,” I don’t mean that I bought a scratch-off ticket with high hopes of revealing a breast cancer diagnosis. Instead, I look at it as breast cancer, compared to other cancers, is so treatable and manageable when caught early.

Because I had wonderful doctors—my ob/gyn in particular, who is an advocate of early detection—I am a survivor. He suggested (as he does with all of his patients) that I get a mammogram between my 35th and 36th birthday. My mammogram came back perfect. The facility that did the mammogram called me and mailed a letter to me, both indicating no problems. However, my ob/gyn’s nurse called me and said that the doctor wanted me to get an ultrasound. Imagine my surprise.

First, I thought they had the wrong person. After all, I wasn’t pregnant, and that is the only time I ever had an ultrasound. The nurse educated me on the fact that ultrasounds are used on women, in addition to the mammogram, to see through dense breast tissue. I pointed out that my mammogram was perfect and that I got a letter saying so. However, the nurse said my doctor read the comments section and saw that the radiologist wrote, “Dense bilateral breast tissue.” Mammograms cannot see through that dense tissue, so an ultrasound is required.

Thank goodness my ob/gyn read past the perfect mammogram and moved on to the comments section. The ultrasound revealed a one-centimeter tumor. While small, the tumor had already left the milk duct and spread to the breast tissue. A biopsy revealed that the tumor was indeed Invasive Ductal Carcinoma (IDC).

Since the cancer had already spread, it was necessary to find out just how far it had gone. Did it travel through my nodes and bloodstream, finding a home someplace else in my body? Needless to say, the days and weeks that followed were filled with full body scans, tests, and anxiety about the unknown.

Let’s face it: my son was four years old at the time I was diagnosed. Every mother knows that the will to survive comes in part from wanting to be here for yourself, but in larger part because your child needs you to be here.

How did this affect my son? The chemotherapy drugs that I had both caused hair loss. There was no doubt about it, I would soon be bald. Knowing this ahead of time, I prepared my son. I told him, “Mommy has a disease called cancer, and the doctors have to get me better. The medicine they use will make my hair fall out, but that’s good. The doctors said if my hair falls out, it means the medicine is working.”

Even with preparing him for Mommy to be bald, it was still strange to him. Fortunately, I was able to stay strong (again, for him more so than for myself). I saw him looking at my bald head one day with a puzzled expression on his face. I asked him what he thought about my new look. True to a child’s honesty, he said, “I think it looks bad. I can almost see your brain.” Quickly, I put that fear to rest by pointing out that only my hair would fall out, and that I still had two layers protecting my brain—my skin and skull. He seemed at ease with that explanation and said, “Mom, do you want to put on matching bandanas and play pirate?” Believe me, I didn’t feel great, but if ever there was a time to pull it together and smile, it was then. And so we went out back and played pirate.

While breast cancer and treatment were not all pleasant, it was imperative to find the positive in everything. Early detection, great doctors, technology, wonderful family and friends were all factors that helped me pull through. My hope is that, like breast cancer, great strides are made toward making other cancers more manageable. So when you make your donations, whatever the cause, know that you are helping real people, moms like me.

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Certain changes in DNA can cause normal breast cells to become cancer. DNA is the chemical in each of our cells that makes up our genes — the instructions for how our cells work. Some inherited DNA changes (mutations) can increase the risk for developing cancer and cause the cancers that run in some families. For instance, BRCA1 and BRCA2 are tumor suppressor genes — they keep cancer tumors from forming. When they are changed (mutated), they no longer cause cells to die at the right time, and cancer is more likely to develop.

But most breast cancer DNA changes happen in single breast cells during a woman’s life rather than having been inherited. So far, the causes of most of the DNA mutations that could lead to breast cancer are not known.

Risk factors

While we do not yet know exactly what causes breast cancer, we do know that certain risk factors are linked to the disease. A risk factor is something that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, drinking, and diet are linked to things a person does. Others, like a person’s age, race, or family history, can’t be changed.

But risk factors don’t tell us everything. Having a risk factor, or even several, doesn’t mean that a woman will get breast cancer. Some women who have one or more risk factors never get the disease. And most women who do get breast cancer don’t have any risk factors. Some risk factors have a greater impact than others, and your risk for breast cancer can change over time, due to factors such as aging or lifestyle.

Although many risk factors may increase your chance of having breast cancer, it is not yet known just how some of these risk factors cause cells to become cancer. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.

Risk factors you cannot change

Gender:

Being a woman is the main risk for breast cancer. While men also get the disease, it is about 100 times more common in women than in men.

Age:

The chance of getting breast cancer goes up as a woman gets older. About 2 out of 3 women with invasive breast cancer are 55 or older when the cancer is found.

Genetic risk factors:

About 5% to 10% of breast cancers are thought to be linked to inherited changes (mutations) in certain genes. The most common gene changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes. Other gene changes may raise breast cancer risk, too.

Family history:

Breast cancer risk is higher among women whose close blood relatives have this disease. The relatives can be from either the mother’s or father’s side of the family. Having a mother, sister, or daughter with breast cancer about doubles a woman’s risk. (It’s important to note that 70% to 80% of women who get breast cancer do not have a family history of this disease.)

Personal history of breast cancer:

A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast. This is different from a return of the first cancer (called recurrence).

Race:

White women are slightly more likely to get breast cancer than African-American women. But African American women are more likely to die of breast cancer. At least part of the reason seems to be because African-American women have faster growing tumors, but we don’t know why this is the case. Asian, Hispanic, and Native-American women have a lower risk of getting and dying from breast cancer.

Dense breast tissue:

Dense breast tissue means there is more gland tissue and less fatty tissue. Women with denser breast tissue have a higher risk of breast cancer. Dense breast tissue can also make it harder for doctors to spot problems on mammograms.

Certain benign (not cancer) breast problems:

Women who have certain benign breast changes may have an increased risk of breast cancer. Some of these are more closely linked to breast cancer risk than others. For more details about these, see our document, Non-cancerous Breast Conditions.

Lobular carcinoma in situ:

Women with lobular carcinoma in situ (LCIS) have a 7 to 11 times greater risk of developing cancer in either breast.

Menstrual periods:

Women who began having periods early (before age 12) or who went through the change of life (menopause) after the age of 55 have a slightly increased risk of breast cancer. They have had more menstrual periods and as a result have been exposed to more of the hormones estrogen and progesterone.

Earlier breast radiation:

Women who have had radiation treatment to the chest area (as treatment for another cancer) earlier in life have a greatly increased risk of breast cancer. The risk varies with the patient’s age when they had radiation. The risk from chest radiation is highest if the radiation were given during the teens, when the breasts were still developing. Radiation treatment after age 40 does not seem to increase breast cancer risk.

Treatment with DES:

In the past, some pregnant women were given the drug DES (diethylstilbestrol) because it was thought to lower their chances of losing the baby (miscarriage). Recent studies have shown that these women (and their daughters who were exposed to DES while in the womb), have a slightly increased risk of getting breast cancer. Exposure:

Questions and Answers.

Breast cancer risk and lifestyle choices

Not having children or having them later in life: Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer. Being pregnant many times and at an early age reduces breast cancer risk. Being pregnant lowers a woman’s total number of lifetime menstrual cycles, which may be the reason for this effect.

Recent use of birth control pills:

Studies have found that women who are using birth control pills have a slightly greater risk of breast cancer than women who have never used them. This risk seems to go back to normal over time once the pills are stopped. Women who stopped using the pill more than 10 years ago do not seem to have any increased risk. It’s a good idea to talk to your doctor about the risks and benefits of birth control pills.

Using post-menopausal hormone therapy (PHT):

Post-menopausal hormone therapy (also known as hormone replacement therapy or HRT), has been used for many years to help relieve symptoms of menopause and to help prevent thinning of the bones (osteoporosis).

There are 2 main types of PHT. For women who still have a womb (uterus), doctors most often prescribe estrogen and progesterone (known as combined PHT). Estrogen alone can increase the risk of cancer of the uterus, so progesterone is added to help prevent this. For women who no longer have a uterus (those who’ve had a hysterectomy), estrogen alone can be prescribed. This is known as estrogen replacement therapy (ERT).

Combined PHT:

Use of combined PHT increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer. Breast cancer may also be found at a more advanced stage. Five years after stopping PHT, the breast cancer risk seems to drop back to normal.
ERT:

The use of estrogen alone does not seem to increase the risk of developing breast cancer very much, if at all. But when used long-term (for more than 10 years), some studies have found that ERT increases the risk of ovarian and breast cancer.
At this time, there seem to be few strong reasons to use PHT, other than for short-term relief of menopausal symptoms. Because there are other factors to think about, you should talk with your doctor about the pros and cons of using PHT. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.

Not breast-feeding:

Some studies have shown that breast-feeding slightly lowers breast cancer risk, especially if the breast-feeding lasts 1½ to 2 years. This could be because breast-feeding lowers a woman’s total number of menstrual periods, as does pregnancy

Alcohol:

Use of alcohol is clearly linked to an increased risk of getting breast cancer. Women who have one drink a day have a very small increased risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. The American Cancer Society suggests limiting the amount you drink to one drink a day.

Being overweight or obese:

Being overweight or obese is linked to a higher risk of breast cancer, especially for women after change of life or if the weight gain took place during adulthood. Also, the risk seems to be higher if the extra fat is around the waist. But the link between weight and breast cancer risk is complex. And studies of fat in the diet as it relates to breast cancer risk have often given conflicting results. The American Cancer Society recommends you stay at a healthy weight throughout your life and avoid gaining too much weight.

Lack of exercise:

Studies show that exercise reduces breast cancer risk. The only question is how much exercise is needed. One study found that as little as 1 hour and 15 minutes to 2½ hours of brisk walking per week reduced the risk by 18%. Walking 10 hours a week reduced the risk a little more. The American Cancer Society suggests that you exercise for 45 to 60 minutes 5 or more days a week.

Uncertain risk factors

High fat diets:

Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be linked to how much fat they ate. Researchers are still not sure how to explain this difference. More research is needed to better understand the effect of the types of fat eaten and body weight on breast cancer risk.

The American Cancer Society recommends eating a healthy diet that includes 5 or more servings of vegetables and fruits each day, choosing whole grains over processed (refined) grains, and limiting the amount of processed and red meats.

Antiperspirants and bras: Internet e-mail rumors have suggested that underarm antiperspirants can cause breast cancer. There is very little evidence to support this idea. Also, there is no evidence to support the idea that bras cause breast cancer.

Abortions:

Several studies show that induced abortions do not increase the risk of breast cancer. Also, there is no evidence to show a direct link between miscarriages and breast cancer.
Breast implants: Silicone breast implants can cause scar tissue to form in the breast. But studies have found that this does not increase breast cancer risk. If you have breast implants, you might need special x-ray pictures during mammograms.

Pollution:

A lot of research is being done to learn how the environment might affect breast cancer risk. At this time, research does not show a clear link between breast cancer risk and environmental pollutants.

Tobacco Smoke:

Most studies have found no link between active cigarette smoking and breast cancer. An issue that continues to be a focus of research is whether secondhand smoke (smoke from another person’s cigarette) may increase the risk of breast cancer. But the evidence about secondhand smoke and breast cancer risk in human studies is not clear. In any case, a possible link to breast cancer is yet another reason to avoid being around secondhand smoke.

Night Work:

A few studies have suggested that women who work at night (nurses on the night shift, for instance) have a higher risk of breast cancer. This is a fairly recent finding, and more studies are being done to look at this.

Last Medical Review: 09/29/2009
Last Revised: 09/29/2009

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The Saddest Video

It is said this is one of the saddest videos ever made.

Yes its sad, but she died knowing she was loved.

As Patrick Swayze said ‘The LOVE inside, you take it with you’. I really believe this , no one can stop you loving, not even Cancer.

For me this video is not sad but makes me realise it is today that matters.

Life is put together with lots of moments and moments are all we have. I intend to enjoy every single one of them.

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Nipple discharge can often be a symptom of breast cancer Women may notice discharge from their nipples during a self breast exam, clinical breast exam, or even inside their bras or blouses.

Although nipple discharge is most often related to a benign condition, it can indicate breast cancer. Nipple discharge for most women is not cancerous. You may want to see a doctor just to be on the safe side.

If discharge occurs only on one side, or happens without being squeezed or stimulated, an exam is absolutely necessary. A woman should also be concerned if the discharge is like an egg white, sticky, or bloody. Your doctor may want to schedule a mammogram to rule out breast cancer.

Keep in mind that most cases if nipple discharge are not cancer. Nipple discharge can be normal in some cases, and abnormal in others. A simple visit to the doctor can determine this.

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What lymphoedema is

Lymphoedema is pronounced lim-fo-dee-ma. It is chronic swelling, usually of an arm or leg. It happens because cancer, or the effects of treatment, block the normal fluid drainage channels of the lymphatic system. Fluid called lymph begins to collect in an area and does not drain in the normal way. So the area swells. The information on this page is mainly for people who have lymphoedema following treatment for breast cancer.

About 1 in 5 people (20%) will have lymphoedema of the arm after breast cancer treatment that includes surgery to remove lymph nodes or radiotherapy to the lymph nodes in the armpit. If lymphoedema is not treated, it will get worse. It can be painful and make it difficult to move your arm.

Lymphoedema is becoming less common because many specialists now use a procedure called sentinel lymph node biopsy so that they can just remove a few lymph nodes and avoid damaging lymph channels. They also try to avoid giving women both surgery and radiotherapy to the armpit as this combination greatly increases the risk of causing lymphoedema.

Preventing lymphoedema

After treatment, some things can increase fluid collection in your arm and increase your risk of lymphoedema. These include

Infection in a cut or graze

Insect bites

Severe sunburn

Putting too much strain on your arm too early

So you can help to prevent lymphoedema by

not using your arm for anything heavy until you are told you can

Not letting anyone take blood, give injections or take your blood pressure from the treated arm, unless it is an emergency and there is no other option

Wearing gloves when gardening or doing housework

Taking care when playing with pets

Using insect repellent and high factor sunscreen

Using nail clippers rather than scissors and not pushing your cuticles back

Using an electric razor rather than a manual one if you shave under your arms

Avoiding anything that will increase the temperature of your skin, like very hot baths or showers, sitting too close to a heater, saunas, steam rooms and sunbeds

Using a non scented moisturiser or oil on your skin each day to help it stay moist and supple

Using a thimble when sewing

Continuing to do the arm and shoulder exercises you were taught after your surgery

If you get a cut or scratch on your arm, however small, wash it well and cover it until healed. If you see any redness or swelling around the cut, see your GP straight away. You may need antibiotics.

Remember – lymphoedema can start at any time after you have been treated for breast cancer. It is important to take these precautions for the rest of your life.

Treating lymphoedema

If you get lymphoedema because of your cancer or its treatment, it cannot be completely cured. But symptoms such as swelling and pain can be treated. Treatment for lymphoedema aims to reduce swelling and prevent the fluid building up again. The treatment takes a while to show results. You should notice the swelling going down within a few weeks. But it can come back, so you will always need to be careful and get some help if you have problems.

At the first signs of swelling in your arm or leg you should see a doctor or nurse. For example, you may notice that your watchstrap, rings or clothes are getting tighter.

Treatment for your lymphoedema aims to push excess fluid back out of your arm. There are different ways of doing this. You may have

An elastic sleeve to wear, from the wrist to the top of your arm

Your arm bandaged up with a particular type of stretchy bandage that your lymphoedema specialist puts on

A special type of massage called manual lymphatic drainage (MLD)

Exercises that help the fluid to drain from your arm

All these are very specialist treatments. Ask your breast care nurse, surgeon or GP to refer you to a lymphoedema specialist. You need to have your arm or leg measured and properly assessed. Wearing a badly fitting elastic sleeve or stocking can make the swelling worse. The British Lymphology Society have a register of lymphoedema practitioners.

Your nurse or lymphoedema specialist will also teach you how to do gentle exercises at home to help prevent or decrease swelling in your limbs. You will get the most benefit from the exercises by wearing your stocking or sleeve when you are doing the exercises. Heavy lifting or too much repetetive exercise could make lymphoedema worse. So be sure to stop exercising if your skin is starting to become red, hot and sweaty. But a US trial in 2009 tried a programme of progressive weight lifting for arm lymphoedema. In progressive weight lifting, the weight and number of exercises is increased very slowly. The researchers found that this type of carefully supervised exercise can help to stop lymphoedema getting worse and can help to reduce symptoms such as discomfort or pain in the affected arm in some women.

Doctors have been looking at a new way of treating lymphoedema after radiotherapy. This is called hyperbaric oxygen therapy (HBO). They think that high presssure oxygen treatment can help improve the flow of lymph and so reduce swelling. The patients in the trial have hyperbaric oxygen treatment in a special chamber that contains compressed air. A qualified attendant sits in the chamber, along with up to 6 other patients. While in the chamber they breathe in 100% oxygen through a special hood. An early trial of HBO has taken place in the UK. This trial is now closed and we are waiting for the results.

Other ways of helping to control the symptoms of lymphoedema include

Eating a healthy diet and staying at a healthy weight

If you are overweight it is much more difficult to control limb swelling. If you begin to put on a bit of weight, you will notice that your treatment sleeves will not fit as well as they used to, and will be less effective. You will either need to be fitted for new ones, or to lose weight. If you would like some help with healthy eating tips or losing weight, ask your doctor to refer you to your hospital dietician. There is information about the right weight for you in CancerHelp UK.

Some people have said that spicy foods and alcohol increase the swelling in their affected limb. Some people find that travelling by plane seems to increase the swelling but there is no research evidence to prove this.

Positioning your affected limb

You can help to prevent further swelling of your affected arm by positioning it carefully. When you are sitting down, rest your arm on a table, cushions or pillows rather than hanging it down by your side. Other tips are

Don’t carry heavy shopping or other things with your affected arm – ask for help even if it makes you feel uncomfortable

Don’t repeatedly stretch your arm – for example, by hanging out washing on a clothes line

Wear your watch or any other jewellery on the arm that is not affected

Don’t cross your legs when you are sitting down

Don’t have blood taken from the affected arm

Your feelings and getting support

You may feel very angry, upset and embarrassed by the swelling in your arm. After going through a diagnosis of cancer, then tough treatment, it may feel too much to have to cope with lymphoedema. It is not easy.

Many people find it very hard, so do give yourself time to adjust to what has happened. If your arm is very swollen, it can change your whole image of yourself and may affect your self esteem. You may feel less attractive or find it more difficult to go out and socialise. With time things get easier but it does not always help to hear this at first.

Some people find that it helps to talk to someone else who has been through similar experiences. Not everyone wants to do this or feels they need to. But if you want to talk to someone else, there are lots of organisations offering help and support to people with lymphoedema. The organisations can put you in touch with someone else who has lymphoedema. It also helps to talk to your friends and family. If you are feeling very down about what has happened, then do let someone know. You might find it helpful to read the section in CancerHelp UK on low mood, anxiety and depression. This includes information on how to help yourself cope when you feel low.

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Monday 14th September 2009. Patrick died and I was lost.

I had followed the news and knew he was very sick but one month before I had seen a photograph in one of the ‘TRASH’ magazines (as he liked to call them) he looked so well.

There was a web page where fans could send messages. I wrote to Lisa telling her how sad I was for her and her loss.

I was also advanced Grade IV, I am one of those ‘Special’ people Patricks doctor spoke of. Few, if any, survive .

I am here and Patrick is not, but he will never know, or maybe he will. Patrick believed we had a soul that lives on after death. I hope it is true Patrick and that you know how much you helped me to fight the battle you so sadly lost.

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