Breast Cancer

Awareness EDUCATION • UNDERSTANDING EMPOWERMENT An advertising supplement produced by Peninsula Daily News & Sequim Gazette

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OCTOBER 2018

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Peninsula Daily News & Sequim Gazette

October 2018

Breast Cancer Awareness Month

With 3D Mammography we can detect more invasive cancers sooner, and with up to 41% more accuracy. In the fight against breast cancer, Jefferson Healthcare is committed to bringing you the right care, right here at home.

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Determining stage of cancer assists in a treatment plan patients a better understanding of breast cancer and the ways to treat When receiving treatment for it. breast cancer, women will learn Breastcancer.org notes that the about cancer staging. TNM system was updated in 2018, According to the nonprofit organibut before then was based on three zation Breastcancer.org, determining clinical characteristics: the stage of the cancer helps patients • T: The size of the tumor and and their doctors figure out the prog- whether or not it has grown into nosis, develop a treatment plan and nearby tissue even decide if clinical trials are a • N: Whether the cancer is present valid option. in the lymph nodes Typically expressed as a number • M: Whether the cancer has on a scale of 0 through IV, breast metastasized, or spread to other cancer stage is determined after parts of the body beyond the breast careful consideration of a host of While each of those factors is still factors. considered when determining breast The staging system, sometimes cancer stage, starting in 2018, the referred to as the TNM system, is AJCC added additional characterisoverseen by the American Joint Com- tics to its staging guidelines, which mittee on Cancer and ensures that make staging more complex but also all instances of breast cancer are more accurate. described in a uniform way. • Tumor grade: This is a meaThis helps to compare treatment surement of how much the cancer results and gives doctors and cells look like normal cells. BY METROCREATIVE

Breast Cancer Awareness

is an advertising supplement published by the Peninsula Daily News & Sequim Gazette 305 W. First St., Port Angeles, WA 98362 147 W. Washington St., Sequim, WA 98382 peninsuladailynews.com | 360-452-2345 sequimgazette.com | 360-683-3311 regional publisher | Terry R. Ward general manager | Steve Perry advertising director | Eran Kennedy section editors | Brenda Hanrahan and Laura Lofgren

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• Estrogen- and progesteronereceptor status: This indicates if the cancer cells have receptors for the hormones estrogen and progesterone. If cancer cells are deemed estrogen-receptor-positive, then they may receive signals from estrogen that promote their growth. Similarly, those deemed progesterone-receptor-positive may receive signals from progesterone that could promote their growth. Testing for hormone receptors, which roughly two out of three breast cancers are positive for, helps doctors determine if the cancer will respond to hormonal therapy or other treatments. Hormone-receptor-positive cancers may be treatable with medications that reduce hormone production or block hormones from supporting the growth and function of cancer cells.

>> STAGE, Page 4

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Peninsula Daily News & Sequim Gazette

October 2018

<< STAGE, from Page 3 •  HER2 status: This helps doctors determine if the cancer cells are making too much of the HER2 protein. HER2 proteins are receptors on breast cells made by the HER2 gene. In about 25 percent of breast cancers, the HER2 gene makes too many copies of itself, and these extra genes ultimately make breast cells grow and divide in ways that are uncontrollable. HER2-positive breast cancers are more likely to spread and return than those that are HER2-negative. •  Oncotype DX score: The oncotype DX score helps doctors determine a

woman’s risk of early-stage, estrogen-receptor positive breast cancer recurring and how likely she is to benefit from post-surgery chemotherapy. In addition, the score helps doctors figure out if a woman is at risk of ductal carcinoma in situ recurring and/or at risk for a new invasive cancer developing in the same breast. The score also helps doctors figure out if such women will benefit from radiation therapy or DCIS surgery. Determining breast cancer stage is a complex process, but it is one that can help doctors develop the most effective course of treatment. For more information, visit breastcancer.org.

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Breast Cancer Awareness Month

Research shifting opinions on marijuana and cancer BY METROCREATIVE

Attitudes about marijuana are changing. Such changes are reflected in legislation that has legalized marijuana in many areas and, in some instances, unofficially decriminalized possession of small amounts of marijuana in other places. Shifting attitudes about marijuana, also known as cannabis, might be attributed to various factors, including medical research. Though research studying the effects of marijuana on recovering cancer patients is ongoing, cancer patients and their families may be curious about the potential for cannabis to assist in their recoveries. WHAT IS MARIJUANA? Marijuana is a plant that originated in central Asia but is now grown in many parts of the world.

>> MARIJUANA, Page 5

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Breast Cancer Awareness Month

Peninsula Daily News & Sequim Gazette

<< MARIJUANA, from Page 4 According to the National Cancer Institute (NCI), the cannabis plant produces a resin that contains compounds known as “cannabinoids,” which are active chemicals that, when ingested, affect various parts of the human body, including the central nervous system and the immune system. One active cannabinoid is cannabidiol, or CBD, which the NCI notes may relieve pain and inflammation without making users feel the “high” that other cannabinoids produce. WHAT ARE SOME OTHER POTENTIAL EFFECTS OF CANNABINOIDS? The NCI notes that research has shown that cannabinoids may be able to do more than relieve cancer patients’ pain and inflammation. While additional research is necessary, the NCI said cannabinoids might be able to block cell growth. The NCI points to studies in mice and rats that have shown that cannabinoids may inhibit tumor growth by causing cell death, blocking cell growth and blocking the development of blood vessels that tumors need to grow. Cancer is marked by the uncontrolled division of abnormal cells, so the potential for cannabinoids to block that growth is a significant benefit.

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Cancer is marked by the uncontrolled division of abnormal cells, so the potential for cannabinoids to block that growth is a significant benefit. In addition, the NCI cites laboratory and animal studies that have shown that cannabinoids may be able to kill cancer cells while protecting normal cells. HAVE CANNABINOIDS BEEN LINKED TO PARTICULAR CANCERS? Studies have shown that cannabinoids may have an effect on various types of cancer, including breast cancer and liver cancer. The NCI notes that a laboratory study of delta-9-THC, the main active cannabinoid in marijuana, in liver cancer cells indicated that the cannabinoid damaged or killed the cancer cells. Another laboratory study of CBD in estrogen receptor positive and estrogen receptor negative breast cancer cells showed that CBD caused cancer cell death while having little effect on normal breast cells. Societal attitudes about marijuana are shifting, and ongoing research regarding its potential benefits in treating cancer may be changing the way the medical community views marijuana as well.

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­— Metrocreative

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While the vast majority of breast cancer diagnoses involve women, men are not immune to the disease. According to the American Cancer Society, the lifetime risk of getting breast cancer is about one in 1,000 among men in the United States. By comparison, the risk for women in the United States is one in eight. While a man’s risk for breast cancer is considerably lower than a woman’s, the ACS still estimates that roughly 480 men will die from breast cancer in 2018, when more than 2,500 new cases of invasive breast cancer will be diagnosed in men. In addition, the ACS notes that black men diagnosed with breast cancer tend to have a worse prognosis than white men. Though breast cancer may be a disease widely associated with women, men should not hesitate to report any discomfort to their physicians, as the National Cancer Institute notes that men are often diagnosed with breast cancer at a later stage than women. The ACS suggests that men may be less likely to report symptoms, thereby leading to delays in diagnosis. The more advanced the cancer is at the time of diagnosis, the lower the patient’s survival rate. Men are urged to report any discomfort or abnormalities in their chests to their physicians immediately.

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October 2018

Peninsula Daily News & Sequim Gazette

Breast Cancer Awareness Month

Healing Adventure Retreat slated

Dave Long; and several naturerelated projects. “Being surrounded by this In the past seven years, more peaceful setting makes it easy for than 100 cancer survivors and body and mind to unwind and their companions have gathered relax. You just show up to be nurfor a weekend retreat that protured with great food and comvides a safe and educational setpassionate company,” she said. ting in Olympic National Park. “SOE is an amazing vision The dates are set for the come to life for those moving foreighth annual Healing Advenward after a cancer diagnosis,” ture Retreat at the Olympic said Mikel Townsley, patient navNatureBridge Campus, located igator at the Olympic Medical on the shores of Lake Crescent. Cancer Center. Slated for May 17-19, 2019, “As a member of the profesthis program is presented by sional oncology community, it is Survivor’s Outdoor Experience thrilling to extend this opportu(SOE). nity to our patients.” SOE is a nonprofit geared Participants of the retreat also toward providing cancer surviwill hike and canoe with Naturevors an opportunity to learn Bridge staff. about the benefits of living a The program has been so suchealthy and active lifestyle. cessful in Port Angeles that Participants include individuGanster, a Pittsburgh native, will als who have been diagnosed be taking the SOE program with cancer, plus a partner if “back home.” they choose to be accompanied. “We want to open up an ave“The goal is to assist particinue for cancer survivors in other pants in gaining strength, hope areas to benefit from SOE and a sense of the future” said retreats. I’m looking forward to program coordinator Jack Ganster. “We promote an environment SUBMITTED PHOTO duplicating our efforts here back in Western Pennsylvania,” that allows participants to feel at Healing Adventure Retreat participants stop for a photo at NatureBridge last year. Ganster said. ease talking about their situaThe Pittsburgh SOE retreat is tion. They can open up and share a weekend retreat that features was a beautiful, caring time spent Activities during the Healing with our group in a way that presentations, outdoor activities, with folks who freely share their Adventure Retreat have included scheduled for summer 2019. For more information about they may not with other folks.” good food and many memories. cancer journey. It is great to tell “Who is a Survivor,” presented by The program brings a small this free program, visit survivor “I met so many wonderful peo- your story in an accepting enviGanster; “From Surviving to group (12 to 16 people) together Thriving” with Dr. Heath Foxlee; soutdoorexperience.org or phone ple that I’ll never forget,” said ronment with people who have in a remarkable setting to enjoy “Healthy Cooking” with chef Ganster at 360-477-1619. John Little of Port Ludlow. “It been through the same thing.” SUBMITTED BY JACK GANSTER

ALCOHOL AND BREAST CANCER RISK Some research suggests that mild to moderate consumption of alcoholic beverages can have various health advantages. According to the Mayo Clinic, moderate consumption of alcohol has been linked to a lower risk of developing and dying from heart disease, possibly reducing the risk of ischemic stroke and potentially reducing

the risk of diabetes; however, for some people, the risks of consuming alcohol might outweigh the benefits. Many studies show that drinking alcohol may increase the risk of breast cancer, advises the research and information organization Susan J. Komen. The group says pooled analysis of data from 53 studies found that, for each alcoholic drink consumed per day, the relative risk for breast cancer increases by about 7 percent. Researchers aren’t quite sure

why there is an increased risk of breast cancer associated with alcohol intake, but experts at MD Anderson Cancer Center have some theories. Some theorize that alcohol can increase levels of estrogen and other hormones that affect breast cancer formation and growth. Excess fat can lead to an increased cancer risk, and the consumption of empty calories through drinking alcohol can lead to unwanted weight gain. The nonprofit breast cancer organization Breastcancer.org

states that, compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15 percent higher risk of breast cancer. Experts also estimate that the risk of breast cancer goes up another 10 percent for each additional drink women regularly consume each day. Keep in mind that a drink is defined as 12 ounces of beer, five ounces of wine or 1.5 ounces of liquor.

­— Metrocreative

Breast Cancer Awareness Month

Peninsula Daily News & Sequim Gazette

October 2018

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The more you shop, the more we’ll donate. Please join us in support of Operation Uplift, Port Angeles Cancer Support Group. Shop at Angeles Millwork & Lumber Co. and Hartnagel Building Supply on PINK SATURDAY, October 27th, 2018 and we’ll donate

5% of ALL RETAIL SALES to Operation Uplift!

Smoothies assist healing process BY DANIELLA CHACE

Smoothies can provide effective nutrition to help prevent and heal breast cancer by adding foods rich in nutrients proven to target breast cancer cells. I created these recipes for my book. “Healing Smoothies: 100 Research-Based, Delicious Recipes That Provide Nutrition Support for Cancer Prevention and Recovery.” They provide high-quality nutrition during treatment, as part of a prevention program for yourself or for those who have a genetic risk for breast cancer. These smoothies are rich in antioxidants that help reduce the inflammation that causes post-treatment fatigue so they are an excellent addition to support healing after chemotherapy or radiation.

Ingredients: ½ cup coconut water ½ cup frozen strawberries ½ cup frozen mango ½ cup pineapple ½ tablespoon lemon juice 2 tablespoons chia seed Combine all ingredients in a high-power blender or food processor and blend until smooth. Drink immediately. Serves: 2 Nutrition Facts (per serving) Calories: 144 Fat: 5 grams

>> SMOOTHIES, Page 9

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October 2018

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<< SMOOTHIES, from Page 7 Carbs: 20 grams Fiber: 8 grams Protein: 4 grams CHERRY CARROT Carrot juice carotenoids reduce oxidative stress and provide protection from recurrence in women previously treated for breast cancer. This earthy and wholesome smoothie has a fresh scent and a subtle sweet flavor. Ingredients: ½ cup carrot juice ½ cup frozen pineapple ½ cup frozen dark sweet cherries ½ cup frozen green tea ice cubes 2 tablespoons hulled hemp seed Combine all ingredients in a highpower blender or food processor and blend until smooth. Drink immediately. Serves: 2 Nutrition Facts (per serving) Calories: 108 Fat: 3 grams Carbs: 17 grams Fiber: 3 grams Protein: 3 grams GRAPEFRUIT ROSEMARY Nobiletin is one of the bioflavonoids found in citrus fruits like lemons, oranges, tangerines and grapefruits. Nobiletin has anti-inflammatory and anti-cancer actions and the potential to suppress metastasis of breast cancer. This frosty blend has a perfect balance of citrus with a hint of bitterness from the grapefruit and rosemary. The flavor and fragrance are energizing, making this an excellent morning blend.

Peninsula Daily News & Sequim Gazette Ingredients: 1 cup grapefruit ½ cup cherries ½ cup orange juice ½ cup frozen green tea ice cubes 2 tablespoons hulled hemp seed 1 tablespoon fresh rosemary Combine all ingredients in a highpower blender or food processor and blend until smooth. Drink immediately. Serves: 2 Nutrition Facts (per serving) Calories: 144 Fat: 3 grams Carbs: 25 grams Fiber: 2 grams Protein: 4 grams KUMQUAT CHERRY CITRUS Cherries, cherry juice and cherry concentrates are all rich sources of polyphenol anthocyanins that contribute to the process of apoptosis, or the destruction of cancer cells. This tart and sweet blend has bright cherry and citrus flavor and fragrance. Ingredients: 2 kumquats ½ cup orange juice ½ cup cherries ½ cup frozen green tea ice cubes 2 tablespoons chia seed Combine all ingredients in a highpower blender or food processor and blend until smooth. Drink immediately. Serves: 1 Nutrition Facts (per serving) Calories: 243 Fat: 10 grams Carbs: 27 grams

STRAWBERRY & BASIL LEMONADE Basil contains powerful antioxidants that protect against cellular damage and provide proven protection against breast cancer development. This light smoothie has a fresh basil fragrance and sweet strawberry flavor with a citrus finish. Ingredients: ½ cup strawberries ½ cup fresh basil leaves ½ cup water ½ cup frozen green tea cubes 2 tablespoons chia seed 1 tablespoon lemon juice Combine all ingredients in a highpower blender or food processor and blend until smooth. Drink immediately. Serves: 1 Nutrition Facts (per serving) Calories: 166 Fat: 10 grams Carbs: 8 grams Fiber: 14 grams Protein: 7 grams Daniella Chace, MSc, CN and nutritionist, is the author of more than 20 health books, including “Healing Smoothies,” “Turning Off Breast Cancer” and “Superfood Smoothie Bowls.” She is the host of Nutrition Matters, playing locally on KPTZ, and is a medical nutritionist in private practice in Port Townsend. Her books are available at The Port Townsend Library, Imprint Bookstore in Port Townsend and Port Books & News in Port Angeles. To learn more about her work, visit DaniellaChace.com.

Breast cancer survival rates on an uptick BY METROCREATIVE

A breast cancer diagnosis can be a devastating blow. Upon receiving such a diagnosis, people may begin to ask questions about treatment and the impact cancer may have on their lives. Many people who are diagnosed with cancer also begin to wonder about their mortality. An estimated 266,120 new cases of invasive breast cancer and 63,960 new cases of non-invasive, or “in situ,” breast cancer are expected to be diagnosed among women in the United States this year, according to Breast cancer.org. The good news is that breast cancer incidence rates began decreasing in 2000 after increasing for the previous two decades. In addition, death rates from breast cancer have been decreasingly steadily since 1989. The National Cancer Institute said that the change in age-adjusted mortality rates are an

indicator of the progress being made in the fight against breast cancer. The most recent SEER Cancer Statistics Review released in April 2018 indicates cancer death rates among women decreased by 1.4 percent per year between the years of 2006 and 2015. The American Cancer Society (ACS) said that decreasing death rates among major cancer types, including prostate, colorectal, lung and breast cancers, are driving the overall shift in survival. The ACS said breast cancer death rates among women declined by 39 percent from 1989 to 2015. That progress is attributed to improvements in early detection and treatment protocols. For anyone doing the math, over the last 25 years or so, 322,000 lives have been saved from breast cancer. Currently, the five-year net survival rate for breast cancer among in the United States is 85 percent.

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October 2018

Peninsula Daily News & Sequim Gazette

Breast Cancer Awareness Month

Breast cancer risks increase with age SUBMITTED BY JEFFERSON HEALTHCARE

Cancer continues to be the second leading cause of death in the United States, second only to heart disease. According to 2015 data from United States Cancer Statistics (USCS), female breast cancer is ranked first in the diagnosis of new cancer. The risk of getting breast cancer increases with age. Jefferson County ranks No. 1 in the state for the population with the oldest median age (half higher, half lower) at 54.7 years. Those factors make local access to screening and early detection of breast cancer imperative.

cancers and decreases the chance of being called back for another look by up to 40 percent. 3D mammography finds cancers earlier and reduces false positives.

WHEN TO SCREEN Recommended guidelines vary for the age at which to start regular screenings as well as their frequency, but the American Cancer Society, the CDC and the American College of Radiology all agree mammograms are the gold standard for breast cancer detection. Pre-existing risk and age are factors which should be considered by physicians and women in discussions about screenings. Most insurance companies cover annual mammograms, giving women the opportunity to screen annually. EARLY SCREENINGS When patients have questions about Finding cancer early means treatment is more likely to be successful. Breast can- radiation associated with mammograms, the mammography team at Jefferson cer screenings check for cancer before Healthcare explain that levels are well there are signs or symptoms of the disease. In East Jefferson County, screenings below Federal Drug Administration standards and the harms of screenings are are available through the Imaging & negligible when compared to having or Radiology Department at Jefferson dying from breast cancer. Healthcare. 3D mammography reduces false posiTo meet the needs of our community, Jefferson Healthcare invested in advanced tive recall rates by up to 40 percent, which technologies and facilities. Tomosynthesis, reduces overall exposure. The mammography team at Jefferson also known as 3D mammography, is an Healthcare offers this advice: “Good breast improved screening and diagnostic imaging tool available at Jefferson Healthcare. care involves a combination of three 3D mammography can detect cancers oth- important steps: monthly self-exams, an annual exam by a health care professional erwise hidden. It finds 27 percent more

A holistic approach at Jefferson Jefferson Healthcare holds National Accreditation with Commendation from the Commission on Cancer (CoC) of the American College of Surgeons. This accreditation recognizes Jefferson Healthcare compliance with the CoC’s rigorous quality care standards and maintains excellence in the delivery of comprehensive patient-centered care for most cancers, including breast cancer. The journey to accreditation has allowed for the development of a more holistic approach to cancer care at Jefferson Healthcare. While the Oncology Department priorand mammograms.” If you have questions, contact your primary care provider or Imaging & Radiology at Jefferson Healthcare at 360-3852200, ext. 2100, or visit jeffersonhealthcare. org/imaging. Jefferson Healthcare, 834 Sheridan St. in Port Townsend, is a public hospital district providing services to residents of East Jefferson County.  SUPPORT GROUPS Studies suggest that support groups reduce fear, anxiety and depression and help patients cope better with their emo-

itizes treatment options such as chemotherapy and radiation, its care team also recognizes the importance of supplemental treatments for patients. Such services can actually optimize traditional treatments and prove to be mutually beneficial lines of care.   Support services can include physical therapy, genetic counseling, nutritional counseling, pain management, survivorship programs, home health and hospice services, clinical trials and more. By providing these services, Jefferson Healthcare treats the whole patient, not just the disease. tional responses to cancer. “Look Good, Feel Better” meets quarterly. This program’s goal is to help women deal with the physical side effects of cancer treatment. Sponsored by the American Cancer Society, it provides assistance with hair, skin, nutrition, wigs and head wraps. The next meeting is Monday, Nov. 5, at 10 a.m. in the Oncology Clinic at Jefferson Healthcare. Call Lisa Lawrence to register at 360385-2200, ext. 2040. 

>> AGING, Page 11

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<< AGING, from Page 10 The Advanced Cancer Support Group is open to patients diagnosed with advance disease and meets the first and third Thursday of each month from 12:30 p.m. to 2 p.m. in the third floor Remax Building conference room at 2500 W. Sims Way. Call Lawrence to register 360-385-2200, ext. 2040. Jefferson Healthcare offers the Breast Cancer Support Group throughout the year. Each meets for eight consecutive weeks, and participants have the opportunity to meet others who share similar experiences. Groups are open to patients with a current or past breast cancer diagnosis. Call Lawrence to learn more. For additional information on support groups, visit jeffersonhealthcare. org/events-support-groups.

Peninsula Daily News & Sequim Gazette

October 2018

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Regrowing and caring for hair undergone chemotherapy might notice soft fuzz forming on their head roughly two to three weeks after the end of chemo. Chemotherapy and radiation are common This will be followed by real hair growing at treatment options for people who have been its normal rate one month afterward. diagnosed with cancer. Two months after the last treatment, an While radiation may be targeted at specific inch of hair can be expected. areas, chemotherapy is systemic. How hair grows back elsewhere on the body, This means it affects the entire body. such as the eyelashes, eyebrows and pubic As a result, as chemotherapy kills fastarea, varies from person to person. growing cancer cells, it also kills or slows the Experts at the Robert H. Lurie Comprehengrowth of healthy cells, including hair cells, sive Cancer Center’s Dermatologic Care Centhat divide and grow quickly, explained the ter at Northwestern University in Chicago National Cancer Institute. recommend speaking with a doctor if hair is When chemotherapy treatment is comnot regrowing quickly, which can be the result pleted, the body is typically capable of regenerating new hair, but that can take some time. of low levels of iron or zinc or even thyroid Women who consider their hair a large part problems. To help the process along, some doctors sugof their identity may have strong concerns and gest the use of supplements like biotin. fears regarding hair loss and what their hair may look like when it begins to regrow. The National Institutes of Health said bioUnderstanding what to expect and what tin is a B vitamin found in many foods that they can do to facilitate the regrowth of hair helps turn carbohydrates, fats and proteins can help women better handle what lies into energy. ahead. There is some evidence that taking biotin New hair typically begins to grow within one can help thicken and speed up the growth of to two months of the last chemo treatment. hair and nails, but more research is needed. Breastcancer.org said people who have Rogaine, a baldness treatment, also may be BY METROCREATIVE

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advised, as it’s been shown to speed hair regrowth in breast cancer patients who have lost their hair, advised Health magazine. It is not uncommon for hair grown after chemotherapy to look and feel different from hair prior to treatment. Someone who once had straight hair may develop a wavy mane afterwards. While drastic changes are not common, blonde hair might darken. As hair grows in, certain areas on the head may grow faster than others. Working with an experienced stylist can help a person achieve a look that is evened out and stylish at any length. Rosette la Vedette, a headwear retailer and cancer resource, suggests making a first trip back to the salon a special experience with a glass of champagne. Cutting hair won’t make it grow faster, but it can help a woman return to a sense of normalcy. It can be nerve-wracking to wait for hair to regrow after chemotherapy. But patience and understanding the road ahead can assuage any fears breast cancer patients may have about regrowing their hair.

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Helping People Grow and Change

Port Angeles Office

118 East 8th Street • Port Angeles, WA 98362 Ofc. (360) 457-0431 • Fax. (360) 457-0765

Sequim Office

1490 North 5th Avenue • Sequim, WA 98382 www.peninsulabehavioral.org 892215240

8A2215207

-Mental Health Services for Men, Women & Children-

“I opted for a Genius™ 3D™ mammogram because early detection is what saved my life." – BREAST CANCER SURVIVOR AND NINE-TIME GRAMMY® AWARD WINNER SHERYL CROW

AVAILABLE AT

8A2215218

CALL (360) 565-9003 TO SCHEDULE YOUR GENIUS™ 3D™ MAMMOGRAM.