Breast Care

DECEMBER 2018 | FUTUREOFPERSONALHEALTH.COM

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An Independent Supplement by Mediaplanet to USA Today

Breast Care Dr. Kristi Funk shares some shocking facts and misconceptions about inherited breast cancer

LEARN how survivorship care plans can help breast cancer survivors put their life back on track

DISCOVER the story of Bridget Swinney, who reveals how a stage 4 breast cancer diagnosis changed her life

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Life after breast cancer varies widely from person to person. Survivorship care plans can help.

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in this issue

More needs to be done to address the current gap in research related to stage 4 breast cancer.

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Everyone should be aware of these five things that can greatly reduce the risk of breast cancer.

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How Patient Navigators Provide a Path Through Cancer Care Evidence has shown an improvement in five-year survival rates of breast cancer patients who were navigated from screening through treatment.

We know that individuals who hear the words, “You have breast cancer,” have concerns about their future. But, many also have questions. How will I get to treatment?

How will I pay for it? How do I even begin?

Hurdles to treatment The complexities of the cancer care system, coupled with socioeconomic challenges faced by many patients, can create serious barriers to women receiving timely care. Treatment centers may be hours away, insurance coverage may limit options and family doctors who carry heavy caseloads of myriad health issues may not know how to best coordinate breast cancer care.

These barriers are strongly correlated with breast cancer disparities — that is, differences in cancer outcomes among specific population groups, such as race, ethnicity, socioeconomic status or age. For example, African American women in the United States are roughly 40 percent more likely

to die of breast cancer than Caucasian women. However, some research shows that we could significantly reduce mortality if we connect patients to timely care that is available today.

How we make progress One way to overcome these obstacles and ensure that every breast cancer patient is connected to quality and timely care is through patient navigation. It’s exactly

what it sounds like. A trained patient navigator (who could be a nurse, a social worker or a lay person) helps guide patients through barriers and within the complex cancer care system.

Take, for example, a woman named Marta, whose breast cancer diagnosis was devastating.

How could she cope when the nearest doctors were 90 miles from her home? A trained navigator funded by Susan G. Komen accompanied Marta to her surgeon’s office and provided her with an audio recording and written summary of the treatment plan. Gas cards helped Marta with her travel expenses.

Coordinating care with a radiation oncologist near a friend’s home in another city was another key factor in Marta’s decision to complete her treatment. The navigator helped Marta connect with low-cost services in her local community. With treatment now completed, Marta is committed to finding her “new normal” as a survivor.

Marta is just one of many women that are helped by breast cancer navigation programs each year. With more than 40,000 American men and women dying of breast cancer annually, it is critical that we support the expansion of patient navigation to save more lives. We must continue to ensure every person has the access and resources they need to overcome breast cancer. n Mediaplanet Editorial

Publisher Dana Lenkowsky Business Developer Mac Harris Managing Director Luciana Olson Designers Chris Espino, Tiffany Pryor, George Kalache Copy Editor Laura Parker Director of Sales Shannon Ruggiero Director of Business Development Jourdan Snyder Director of Product Faye Godfrey Lead Editor Mina Fanous Production Manager Josh Rosman Production & Social Media Coordinator Bria Mastroianni Cover Photo Karen Ray Photography All photos are credited to Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve USA Today.

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Reducing the Racial Disparities in Breast Cancer Survival Despite advances in breast cancer treatment and survival, minority groups face higher mortality rates.

In the past 10 years, breast cancer death rates have dropped significantly. In spite of this, the disease remains the most common cancer in the world among women. Just as concerning, significant racial disparities in cancer mortality also persist.

Why Metastatic Breast Cancer Research Needs More Funding Although breast cancer research funding covers many areas of prevention and treatment, it doesn’t properly address needs for those with stage 4 cancer.

other 75 percent progressed to stage 4 from an initial earlier diagnosis.

“The result is a huge gap in breast cancer research and very few treatment options available for MBC patients.”

Metastatic breast cancer (MBC), also known as stage 4 cancer, is incurable and is responsible for the deaths of nearly everyone who dies from breast cancer. MBC is when the cancer has spread outside the breast to other parts of the body — typically the bones, lungs, liver or brain. A recent study estimates that as of January 2017 there are nearly 155,000 women living with MBC in the United States alone and about 25 percent of them were diagnosed at stage 4 from the beginning; the

Necessary awareness This group is an understudied population, and this is indeed an underfunded stage of breast cancer. The result is a huge gap in breast cancer research and very few treatment options available for MBC patients.

The majority of breast cancer funding and pink ribbon campaigns have gone to awareness, prevention and treatment for early-stage disease.

However, about 30 percent of those with early stage breast cancer will eventually metastasize, and many

breast cancer patients are not even aware of that fact. The average prognosis for MBC has remained at just three years for decades. Thanks in large part to the hard work of many patient advocates raising awareness and dedicated researchers, this is starting to change.

We are finally starting to see the needle moving. More money is slowly starting to go toward studying treatment for MBC. As a result, better treatments have started to become available and the group’s five-year survival rate doubled, from 18 percent in 19921994 to 36 percent in 2005-2012. That’s progress in the right direction and we need to keep going until this is made a chronic disease, not a three-year death sentence.  Mediaplanet Editorial

Who’s at risk?

In fact, breast cancer is the number one cause of death among Hispanic women, and black women have the highest death rates from the disease of all racial and ethnic groups. According to an October 2016 report published by the Centers for Disease Control and Prevention (CDC), black women are 41 percent more likely to die from breast cancer than white women.

But that is not the case everywhere, contends Lisa Richardson, director of CDC’s Division of Cancer Prevention and Control. “There are places where black women have equal mortality, and black and white women have lower mortality from breast cancer than the national average,” she says. These places may be the key to reducing disparities in survival.

The towns are located across the country, from South Carolina to Massachusetts.

What’s next?

“The next step is to visit those communities and learn what’s different so that we can figure out how to spread those things,” Richardson says. Potential solutions to reduce the disparities include: increasing education regarding family history, increasing screenings for breast cancer and emphasizing the importance of physical activity and a healthy diet.

Another step, Richardson says, is researching the subtypes of cancer and how they can affect minority groups. Her work at the CDC involves the Precision Medicine Initiative and the Cancer Moonshot, programs that promote research about individualized care and the most pressing needs for cancer control.

“Black women have always had aggressive cancer,” Richardson explains. “As we learn more and more about what makes the cancer that way, we’ll be able to make a treatment breakthrough and hopefully do a better job predicting who is going to get cancer, so that we can prevent that cancer.”

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Got Breasts?

10 Tips to Reduce Your Cancer Risk

What percentage of breast cancer comes from an inherited genetic mutation, like BRCA? The answer is only 5-10 percent.

In fact, 87 percent of women diagnosed with breast cancer do not have a single first-degree relative with breast cancer.

Genetic mutations clearly elevate the risk of cancer, but they only account for 20 percent of all breast cancer. We could go a long way to eradicating the vast majority of breast cancer if women understood more about how their daily choices can impact the risk of developing breast cancer. Lifestyle habits regarding nutrition, alcohol, exercise, weight, hormone replacement therapy and stress and environmental toxicities set the scene for wellness — or illness. It’s a personal choice. We have more control over this disease than we might think.

These tips come from “Breasts: The Owner’s Manual.” Paying attention to these steps will help reduce the cellular changes that lead to chronic illnesses — everything from heart disease, stroke, diabetes, obesity, Alzheimer’s disease and cancer.

1. Eat plant-based meals. These release nutrients into the bloodstream and help boost immune function while suppressing disease-causing inflammation. Consume fruits and vegetables like broccoli, leafy greens, berries, legumes, lentils, beans and

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pesticides and synthetic compounds. Wash your hands frequently. Replace plastic with glass and steel, filter your water and choose organic household products, food and cosmetics.

2. Avoid red meat, chicken, turkey and fish. Also, try and avoid most dairy (milk, butter, cheese) as well as eggs. Limiting animal protein and fats will also give you more energy and help you “Limit feel more productive.

3. Fat cells produce estrogen, and estrogen fuels 80 percent of all breast cancer. Get to your ideal body weight and stay there.

4. Every week, get five hours of exercise (if you can talk while working out), or 2.5 hours (if you’re super sweaty and can’t carry a conversation).

the impact of environmental exposures such as radiation, industrial emissions, pollutants and pesticides.”

5. Drink three cups of green tea per day. A squeeze of lemon will boost the tea’s antioxidant power. Try and keep your alcohol intake limited to one drink per day, and choose red wine over white.

6. Limit the impact of environmental exposures such as radiation, industrial emissions, pollutants,

7. Pray, meditate, practice deep breathing, do tai chi or yoga. Forgive others, be grateful and smile.

8. Don’t smoke.

9. Stay hormone-free. Consider herbs, acupuncture and exercise to alleviate menopause symptoms in an effort to avoid the estrogens in hormone replacement therapy.

10. Finally, seek out positive, encouraging friends, family members and other social support networks.

Control the controllable in your life. Health comes from giving positive daily attention to the spiritual, physical and emotional areas in your life. Maintaining a healthy lifestyle is your first line of defense. n Dr. Kristi Funk, Co-founder, Pink Lotus Breast Center

PHOTO: KAREN RAY PHOTOGRAPHY

peas. Don’t forget healthy fats like avocado, nuts, seeds, olives and flax seeds.

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Survivorship Care Plans Can Help You Live Your Best Life After Breast Cancer Life after breast cancer varies widely from person to person.

Here’s how a survivorship care plan can make all the difference.

Because of better diagnostic tests and advances in treatments, people are living longer than ever after being diagnosed with breast cancer. However, life after breast cancer can look very different from survivor to survivor.

How survivorship care plans work Scherberger, 64, of Madison, AL, was diagnosed with breast cancer in both breasts in June 2016. Fortunately, Scherberger’s treatment was successful with a combination of chemotherapy drugs. “I decided I was going to be better on the other end of this experience, in every way,” she says.

To meet the goal of remaining not only cancer-free but in good overall health, Scherberger sees various specialists as part of a survivorship care plan — a personalized plan for monitoring and maintaining health after a cancer diagnosis. Chemotherapy and other treatment drugs may cause long-term effects in breast cancer survivors, putting them at higher risk of developing other diseases, including high blood pressure, osteoporosis and heart disease.

The Institute of Medicine recommendeds that all cancer survivors receive a survivorship care plan after they finish treatment. Besides a summary of the diagnosis, survivorship care plans should include a written summary of all the cancer treatments a person has had, as well as a personalized follow-up plan developed by the person’s oncologist.

Scherberger now also monitors her bone density and is working with her gynecologist to maintain her vaginal health. With the help of a dietician, she also lost an impressive 53 pounds since finishing chemotherapy.

“I decided I was going to be better on the other end of this experience, in every way,” Scherberger says.

Focusing on the future Unfortunately, not all cancer survivors have a survivorship care plan. Some research suggests that the number of cancer survivors who have these plans is below the rate recommended by national cancer agencies.

“Survivorship care plans have been recommended for years, but most patients still aren’t getting them,” says Marisa Weiss, M.D., the chief medical officer and founder of Breastcancer.org. “We must do better. Upon completion of treatment, each person needs to know how to stick to ongoing therapies, lead the healthiest lifestyle possible and follow a program of close surveillance.”

After primary breast cancer treatment is done, it’s important to focus on what’s most important: good health.

Jamie DePolo, Senior Editor, and Pamela Rafalow Grossman, Contributor, Breastcancer.org

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What’s It Like to Live With Stage 4 Breast Cancer?

Bridget Swinney was diagnosed with metastatic breast cancer, or MBC, when she was in her early 30s. She reveals how the diagnosis impacted her life and how her health habits have changed.

What is the one thing you want women going through treatment to know?

I would like other individuals — both men and women — to know that while everyone’s cancer experience is unique, they are not alone. I was diagnosed with metastatic breast cancer, or stage 4 breast cancer, in my early 30s. I was a wife and a mother to a young child at the time. I really longed to have someone who could relate to my situation. I found this connectivity through the support of my nurse navigator, my health care team, social media support groups and my family and friends.

I also recommend watching TV and treating yourself to a comfy pair of pajamas.

Can you describe your recovery journey and what you learned from it?

Metastatic breast cancer is when the cancer has spread from outside the breasts to other organs or bones throughout the body. MBC can be treated, but not cured. Therefore, I will be in some form of treatment for this disease for the rest of my life. That being said, the easiest way I can describe my life with cancer is like a dance. I take steps forward and glide when my disease is stable. Then, I take a dip when there is progression of the disease or new tumors.

I have learned the importance of quality of life, so I am comfortable and strong enough to participate and enjoy this dance alongside my loving family.

How has your life changed since you were first diagnosed?

Life has changed both dramatically, and not at all. I strive to keep everything as normal as possible for my daughter and husband. A barrage of appointments, extreme fatigue and other side effects made full time work overwhelming. To create normalcy and better quality of life, I chose to step away from my teaching career. Taking these steps was a huge change, but it has allowed a more open schedule for me to volunteer regularly and focus on my family. I am also passionate about fundraising for metastatic breast cancer research. MBC receives less than 7 percent of all breast cancer funding and has no cure. Generating dollars for research helps discover new drugs and therapies that will improve the quality and quantity of the lives of people living with MBC. How have your overall health habits changed?

My overall health habits have definitely changed since my diagnosis. I am more aware of what is in the foods and products I purchase for my family. We have switched to organic produce and foods, along with natural personal care and cleaning products. The less chemicals and ingredients, the better. I’m also having to adopt a new “live life” vs. “rest body” lifestyle due to my increased fatigue. Simple tasks can now become exhausting. I find short rests and meditation aid in adding much-needed peace and balance to my busy life as a mother, wife and woman living with cancer. n

Expanding precision medicine with comprehensive breast ultrasound

Did you know that women with dense breast tissue have a 4-6 times higher risk of breast cancer, and that mammography may miss up to 50% of cancers in dense breasts?* Mammography remains the gold standard for breast cancer detection. To support a comprehensive approach to breast care, automated 3D ultrasound offers unique imaging capabilities as an adjunct to mammography for women with dense breast tissue.

The ACUSON S2000™ Automated Breast Volume Scanner aids in tissue characterization, intervention and monitoring of breast disease: · A single-system solution with 2D, 3D imaging and advanced technologies for measuring tissue stiffness (elastography) · Automated hands-free acquisition to provide image consistency and a comfortable patient experience Working to improve women’s health, Siemens Healthineers offers a comprehensive multimodality portfolio of precision breast imaging solutions. www.siemens-healthineers.us/breastcare

*http://densebreast-info.org © 2018 Siemens Medical Solutions USA, Inc.

“Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far-reaching effects.”

Remembering Nancy Cappello, PhD, Breast Density Advocate Founder of Are You Dense, Inc. and Are You Dense Advocacy, Inc., Nancy Cappello passionately advocated for the special diagnostic needs of women with dense breast tissue. Through her work she touched and will continue to touch women throughout the world. Nancy will be greatly missed. Her legacy will live on.

Dalai Lama

Siemens Medical Solutions USA, Inc., Ultrasound