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thinkpink october is Breast Cancer awareness month

inSiDe page 3: early detection saves lives page 5: Know the warning signs page 7: The power of philanthropy

KnoWing your maKe-up — The BRCA1 gene, pictured above, is one of several genetic risk factors for breast cancer. Making sure you take the proper steps for genetic risk assessment can be a daunting task. Getting a good picture of your family’s DNA can help. Photo Wikipedia commons

In the genes When determining the risk factors for family members after a diagnosis, consensus can be hard to find By Heather Bailey Staff Writer When my youngest sister was diagnosed with breast cancer in her early 30s, it shook my family deeply and required some soul searching. But soon enough, it would also require some gene searching. Early tests revealed that my sister did

not carry the BRCA1 and BRCA2 gene; the genes that have been shown to have significant risk increases for both breast and ovarian cancers, and led actress Angelina Jolie to undergo a pre-emptive double mastectomy and hysterectomy. However, several months into her treatment, my sister returned from an appointment with her doctors at Stanford Medical Center and said they had told her that we should consider genetic testing as a family. In fact, her oncologist felt that myself, my other sister and our mother should be considered at “significant increased” risk for cancer. In large part this was because my sister was so young when she got diagnosed. But, it was also because my

mother’s mother had had breast cancer, my mother’s sister had died from it, and my mother’s niece had also had it. There seemed to be a concerning family link, even if the “most famous” genetic link wasn’t present. However, in consultation with our own doctors and in doing our own research, we found the research into familial links outside of the BRCA1 and BRCA2 genes to be woefully small, and to find that the knowledge level of an average doctor to vary wildly. In fact, we often were given conflicting information both about the usefulness of genetic testing and the degree of increased risk the rest of us might be facing.

See genes, page 6

october 10, 2019


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Early detection is best survival predictor By Sue Labbe

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ccording to the Centers for Disease Control and Prevention (CDC), breast cancer is the second most common cancer in American women proceeded in prevalence only by skin cancer. In the early stages of breast cancer when the tumor is small and most easily treated it is typically not associated with any symptoms. The most effective method of detecting early breast cancer is mammography. When woman at average risk of breast cancer follow the American Cancer Society recommendations for breast cancer screening using mammography, breast cancer can often be identified several years before physical symptoms develop. Numerous published randomized controlled screening trials suggest that mammography reduces the risk of dying from breast cancer by 20 to 40%. Breast cancer survival is largely dependent on the stage and size of tumor at diagnosis. According to the American Cancer Society Surveillance Research published in 2017, the overall five-year

result statistically they are more likely survival rate is 99% for localized to be diagnosed at a later stage of disease, 85% for regional disease and cancer. This delay in detection directly 27% for distant-stage disease. correlates to an increased relative Over the last decade breast cancer mortality rate. death rates have declined significantly. In 2015 the American Cancer Society This can be attributed to both early updated its screening guidelines for detection and improvements in women at average risk for breast treatment options. cancer. Current guidelines are as There does, however, remain a follows: disparity in mortality rates among • Women ages 40 to 44 years of age women living in poverty, those with should have the option to begin annual less education and those who lack mammography. health insurance. • Women 45 to 54 years should have The Affordable Care Act requires annual mammography. Medicare and all health insurance • Women more than 55 years old who plans to fully cover screening have a life expectancy of 10 years or mammograms. more should have annual or biennial Uninsured women in California can screening receive free mammography. breast cancer • Anyone who screenings presents warning through the signs and/or Every Woman Counts (EWC) uninsured women in California symptoms of breast cancer program. EWC can receive free breast cancer should receive is part of the diagnostic Department of screenings through the every evaluation. Health Care Woman Counts program. We can all do Services' our part to save a Cancer life by spreading Detection and the word to every Treatment woman we know Branch — routine breast (CDTB). cancer screening with mammography Unfortunately, many improves survival rates and leads to a socioeconomically disadvantaged greater range of treatment options, women are unaware that they could including less-extensive surgery. receive this free screening and as a

Oncology options I

magine being diagnosed with cancer, going through chemotherapy and then getting sidelined by an infection. Unfortunately for people with cancer, this is a serious potential side effect of chemotherapy. Each year, more than half a million people with cancer are treated with chemotherapy, which may weaken their immune system (a condition known as neutropenia), making them more vulnerable to getting an infection. According to the Centers for Disease Control and Prevention (CDC), an infection linked to neutropenia is one of the most dangerous side effects of chemotherapy that can put a patient in the hospital, delay their treatments or even cause death. That's why back in 2009, CDC and the CDC Foundation, with financial support from Amgen Oncology, set out to develop innovative ways to educate people about this side effect and steps they can take to reduce their risk of infections during chemotherapy. The Preventing Infections in Cancer Patients (PICP) program is now celebrating its 10-year anniversary, and continues to provide evidence-based resources for patients, caregivers and healthcare professionals. To celebrate this milestone, the program has developed its first-ever public service announcement (PSA) highlighting the importance of infection prevention during chemotherapy and tips on how people with cancer can lower their infection risk. Housed in a free mobile app and on

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PreventCancerInfections.org, the fully animated virtual provider TINA (Talking about Infection and Neutropenia Awareness) is an interactive tool for patients and providers. For patients, TINA will ask and answer the user's questions about infection risk and the steps they can take to protect themselves. For oncology providers, TINA allows the user to role-play and practice a conversation with an emotionally responsive and interactive virtual patient. The PICP program is also available in Spanish, including a Spanish-language version of TINA (TINA en Espanol). One in three Hispanic men and women are diagnosed with cancer each year, yet there are few Spanish-language resources available, according to the American Cancer Society. "An infection during chemotherapy is serious, yet many cancer patients are not aware of what they can do to lower that risk," said Dr. Darryl Sleep, senior vice president, Global Medical and Chief Medical Officer at Amgen. "I couldn't be prouder of the work we've done with CDC and the CDC Foundation over the past 10 years to provide evidence-based, educational resources to patients and their families." For more information about PICP and its English and Spanish resources available for patients, caregivers and providers, visit preventcancerinfections.org. — BPT

Size and spread of disease linked to making it through treatment.

Sue LaBBe is the medical director at

Alliance Medical Centers in Healdsburg and Windsor. Labbe said the best way to increase chances of survival for breast cancer is early detection.

We owe it to our mothers, daughters, wives, sisters and friends to share this message and increase screening rates especially among socioeconomically disadvantaged women who may not be aware that programs exist to cover the cost of screening.

thinkpink october is Breast Cancer awareness month

a special supplement to the october 10, 2019 edition of:

The Healdsburg Tribune The Windsor Times

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Print & Digital Creative: Rollie Atkinson, Heather Bailey, Laura Hagar Rush, Zoë Strickland, Andrew Pardiac, Katherine Minkiewicz, Maci Martell, Jim Schaefer Advertising: Teresa Elward, Carol Rands, Allie Sesser, Brad Schmaltz Administration: Sarah Bradbury, Jan Todd All contents are copyrighted by © 2019 Sonoma West Publishers, Inc. PO Box 518, Healdsburg, CA 95448

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Test if chemo is right for you

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s a commercial airline pilot with nearly 30 years of experience, Diane Sandoval, age 50, is no stranger to making difficult decisions. However, she faced one of her toughest challenges not in the skies, but when she discovered a small lump in her left breast during a self-examination. Her worst fear was confirmed after a visit to her doctor when she was diagnosed with earlystage breast cancer. Following an inconclusive mammogram and ultrasound, Diane learned she had several small tumors. She underwent a mastectomy to remove the tumors followed by breast reconstruction, ultimately putting her piloting career on pause. The next big question was whether Diane should receive chemotherapy or not, so her physician recommended a genomic test: the Oncotype DX Breast Recurrence Score test. This tool has been proven to determine whether chemotherapy will be beneficial for individuals recently diagnosed with early-stage breast cancer. The test provides a personalized score based on the biology of the patient's tumor that can help tailor treatment decisions for their individual cancer. Recent results from the largest breast cancer study ever conducted, called TAILORx, confirmed that the test clearly identified the 70% of women with early-stage breast cancer who receive no benefit from chemotherapy, as well as the remaining 30% of women for

whom chemotherapy can be lifesaving. Diane is one of the nearly 1 million women who has put chemotherapy to the test with this genomic test. Her Recurrence Score result was 13, which confirmed that her risk of experiencing a breast cancer recurrence was low and she would not benefit from chemotherapy. As a result, Diane felt confident that she could forgo chemotherapy and its associated harsh side effects. If you have breast cancer, it's important to take an active role in your health by learning about your available treatment options. An ongoing, collaborative discussion with your doctor is key in determining what treatment option best fits your individual needs. Below are a few questions to ask your doctor: • What stage is my breast cancer and what are the chances of my cancer recurring (coming back) after surgery? • Can you order the Oncotype DX test to determine if I will benefit from chemotherapy? • What are my treatment options? What do you suggest for me and why? • What are the benefits of each treatment option? What are the drawbacks/side effects of each one? Breast cancer patients and caregivers can visit ChemoYesorNo.org to download the full physician discussion guide and learn more about the test. — BPT

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Warning signs of breast cancer Due to the regular use of mammography screening, most breast cancers in the U.S. are found at an early stage, before warning signs appear. However, not all breast cancers are found through mammography. If you have any of the warning signs described below, see a health care provider. If you don’t have a provider, one of the best ways to find a good one is to get a referral from a trusted family member or friend. If that’s not an option, call your health department, a clinic or a nearby hospital. If you have insurance, your insurance company may also have a list of providers in your area. Warning signs The warning signs of breast cancer are not the same for all women. The most common signs are a change in the look or feel of the breast or a change in the look or feel of the nipple or nipple discharge. In most cases, these changes are not cancer. One example is breast pain. It's more common with benign breast conditions than with breast cancer, but the only way to know for sure is to get it checked. A lump in your breast A lump or mass in the breast is the most common symptom of breast cancer. Such lumps are often hard and painless, though some may be painful. Not all lumps are cancer, though. There are a number of benign breast conditions (like cysts) that can also cause lumps. Still, it’s important to have your doctor check out any new lump or mass right away. If it does turn out to be cancer, the sooner it’s diagnosed the better. Swelling in or around your breast, collarbone, or armpit Breast swelling can be caused by inflammatory breast cancer, a particularly aggressive form of the disease.

Swelling or lumps around your collarbone or armpits can be caused by breast cancer that has spread to lymph nodes in those areas. The swelling may occur even before you can feel a lump in your breast, so if you have this symptom, be sure to see a doctor. Skin thickening or redness If the skin of your breast starts to feel thicker like an orange peel or gets red or scaly, have it checked right away. Often, these are caused by mastitis, a breast infection common among women who are breast feeding. Your doctor may prescribe antibiotics to treat the infection. If your symptoms don’t improve after a week, though, get checked again, because these symptoms can also be caused by inflammatory breast cancer. This form of breast cancer can look a lot like a breast infection, and because it grows quickly it’s important to diagnose it as soon as possible. Breast warmth and itching Like skin thickening and redness, breast warmth and itching may be symptoms of mastitis – or inflammatory breast cancer. If antibiotics don’t help, see your doctor again. Nipple changes Breast cancer can sometimes cause changes to how your nipple

looks. If your nipple turns inward, or the skin on it thickens or gets red or scaly, get checked by a doctor right away. All of these can be symptoms of breast cancer. Nipple discharge A discharge (other than milk) from the nipple may be alarming, but in most cases it is caused by injury, infection, or a benign tumor (not cancer). Breast cancer is a possibility, though, especially if the fluid is bloody, so your doctor needs to check it out. Pain Although most breast cancers do not cause pain in the breast, some do. More often, women have breast pain or discomfort that is related to their menstrual cycle. This type of pain is most common in the week or so before their periods, and often goes away once menstruation begins. Some other benign breast conditions, such as mastitis, may cause a more sudden pain. In these cases the pain is not related to the menstrual cycle. If you have breast pain that is severe or persists and is not related to the menstrual cycle, you should be checked by your doctor. You could have cancer or a benign condition that needs to be treated.

For breast health or breast cancer information, call the Breast Care Helpline: 877-465-6636 or email helpline@komen.org.

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Continued from page 1 According to breastcancer.org, about 5 to 10% of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child. Research has found that you are substantially more likely to have a genetic mutation linked to breast cancer if you have blood relatives (grandmothers, mother, sisters, aunts) on either your mother's or father's side of the family who had breast cancer diagnosed before age 50; there is both breast and ovarian cancer on the same side of the family or in a single individual; you have a relative(s) with triple-negative breast cancer; there are other cancers in your family in addition to breast; women in your family have had cancer in both breasts; you are of Ashkenazi Jewish (Eastern European) heritage; you are African American and have been diagnosed with breast cancer at age 35 or younger; or a man in your family has had breast cancer. The average woman in the United States has about a 1 in 8, or about 12%, risk of developing breast cancer in her lifetime. Women who have a BRCA1 mutation or BRCA2 mutation (or both) can have up to a 72% risk of being diagnosed with breast cancer during their lifetimes. However, current medical research is beginning to uncover mutations in other genes are also associated with breast cancer. These genetic mutations are much less common and don't seem to increase risk

getting

as much as BRCA1 and BRCA2 mutations, which are considered rare. Still, because these genetic mutations are even rarer, they haven't been studied as much as the BRCA mutations. However, what was made clear to my family over time is that there are two separate issues at play: one is potential genetic mutation leaving one vulnerable to heritable cancers and the other is simply increased familial risk associated with heredity and cancer. According to breastcancer.org, having a “first-degree” female relative — such as a mother, sister or daughter — diagnosed with breast cancer your risk level is automatically doubled. If you have two first-degree relatives diagnosed, your risk is five time higher than the national average. In fact, a study of 40,000 women in Sweden (16,000 who had been diagnosed with breast cancer and 24,000 of their sisters) showed that sisters of women diagnosed with breast cancer have a lifetime of increased risk of disease, though the researchers did find that the amount of increased risk changed over time. Between ages 20 and 40, sisters of women diagnosed with breast cancer have a nearly 6.5 times higher than average risk of breast cancer. After age 50, this risk drops to about double the average risk of breast cancer. This pattern was the same no matter how old the first sister in the family was when diagnosed with breast cancer, a contrast to earlier studies, which had erroneously concluded that a sister’s risk drops when

stronger

she bypassed the diagnosis age of their sibling. All of the women in my immediate family consulted with their doctors and each other. It was decided since my mother had the “trifecta” of first-degree relatives (her mother, sister and daughter had all had breast cancer), she would undergo the genetic testing and then based on her results, myself and my other sister would make our decisions accordingly. I went with my mother to the genetics office and helped her fill out a truly gigantic questionnaire on family history. This proved to be challenging as my mother didn’t know much about the various fates of female relatives from her childhood, and sadly she’s the only one left in her family that could possibly know. Given these knowledge gaps, she underwent the genetic testing, though at the time the list of potential genes was not as full as it is now. Still, her screening showed no obvious genetic mutation red flags, which was both a blessing and a challenge. On the one hand, it’s good to not have to face decision like the ones Angelina Jolie had to make. One the other, this notion of “increased risk” becomes and even larger, more amorphous cloud of uncertainty. I took my mother’s findings to my doctor, and after some review, I set up a phone appointment with a genetics counselor, Sandy Woo. Ultimately, the feeling was that it was unlikely to be a

GENES:

What was made clear to my family over time is that there are two separate issues at play.

genetic mutation causing our family breast cancers, we were clearly at an increased risk and would need to consider a higher level of vigilance. Working in my favor is my age, as I’m the oldest sibling and nearly 10 years older than my sister who was diagnosed. Also, I’ve had a child and was on hormonal birth control for a relatively short period of time as I didn’t tolerate it well, though these two items represent a minimal alteration of risk. In the end, my doctors and I have chosen a middle way: I have an increased screening schedule. I have had both a breast MRI and an ultrasound, as well as regular mammograms, and I have mammograms more frequently than the guidelines for my age group would suggest. While screening does not prevent disease in any fashion, it does provide some sense of control in a situation that has none. The questions of genetic testing and other screenings are very personal, and should be made by each individuals in consultations with the doctors and loved ones. The important thing to know is that there isn’t a wrong answer.

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Giving shows hope is greater than fear By Breanne Beseda

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t is nearly impossible to find someone who has not had a close friend or family member stricken by breast cancer. My own mother began her fight with breast cancer at just 40 years old. Over nearly three decades, she has been diagnosed three different times with multiple types of breast cancer, and I have helped to care for her as she has endured countless hours of surgeries, therapies and treatments (along with all of their many side effects). This year, as I prepare for my 40th birthday with my own young children by my side, I feel lucky to be relatively healthy, but the fear is constantly in the back of my mind. Breast cancer is scary, and with good reason — for women in the U.S., breast cancer death rates are higher than those for any other cancer besides lung cancer. The average lifetime risk of breast cancer is 12%. For me? More than 40%. Genetics matter greatly in determining our risk, along with several individual health and environmental factors. An estimated 332,000 new cases of breast cancer are expected to be diagnosed in women in the U.S. this year. As of January, more

funding than 3.1 million continues to women in our significantly country, about 42,000 women are grow each year, including those thanks to the in current active expected to die this year from amazing treatment, have breast cancer, even though generosity of some history of donors. Locally, breast cancer. death rates have been we see the power Unfortunately, of philanthropy we still lose too decreasing since 1989 thanks for this disease many women to to a reduction in hormone through the this disease. Healthcare About 42,000 therapy, an increase in early Foundation’s women are detection methods, an efforts created expected to die more than a this year from increased awareness. decade ago by breast cancer, Mary Ellen even though Smith and a death rates have number of other women who been decreasing since 1989 thanks to a established “Girlfriends for a Cure.” reduction in hormone therapy, an Through their hard work, they made increase in early detection methods, an sure that northern Sonoma County increased awareness. women had access to free Just as awareness and early mammograms if they could not afford detection are growing, so is the to pay for them. And, our continued possibility of a cure. Thanks to the investments in local clinics provide Susan G. Komen Foundation and other access for early detection to the dedicated nonprofits such as the uninsured and underinsured. American Cancer Society, the National Volunteerism is important, too. Cancer Institute, the Cancer Research Currently, the American Cancer Institute and more, significant Society deploys volunteers in our area investments are being made each year to drive cancer patients to their to fund research for a cure, as well as treatments. What a lifesaver, literally, treatments, screening, education and for single people or those with working psychosocial support programs serving spouses who cannot drive themselves millions of people worldwide. The power of philanthropy makes all to care. These rides can be accessed by calling 800-227-2345 and volunteers are the difference. Nonprofit research

making an impact through philanthropy

Breanne BeSeDa is the development manager for Healthcare Foundation Northern Sonoma County.

always sought for this service, too. Though the fear remains real, hope is bigger and stronger. I hope we see a cure for breast cancer in my lifetime, and when I consider the capabilities of our children with science and technology, my hope transforms into expectation. We all have a chance to make an impact through donating, advocating for policies focused on women’s health, and volunteering in causes that matter. I ask you to join me in accepting the challenge to do more.

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Reduce the risks and live a healthier life lthough there is no sure way to prevent breast cancer, there are several things you can do that may lower your likelihood of getting it. Other factors, including family history, also increase your risk, but most women who get breast cancer (about 8 out of 10) do not have it in the family.  Here are five ways to help protect your breast health:

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1. Watch your weight. Being overweight or obese increases breast cancer risk. This is especially true after menopause and for women who gain weight as adults. After menopause, most of your estrogen comes from fat tissue. Having more fat tissue can increase your chance of getting breast cancer by raising estrogen levels. Also, women who are overweight tend to have higher levels of insulin, another hormone. Higher insulin levels have also been linked to some cancers, including breast cancer. If you’re already at a healthy

3. Limit time spent sitting. Evidence is growing that sitting time increases the likelihood of developing cancer, especially for women. In an American Cancer Society study, women who spent six hours or more each a day sitting when not working had a 10% greater 2. Exercise regularly. Many risk for invasive breast cancer studies have found that exercise is a compared with breastwomen who sat healthy less than three habit.  Having more fat tissue can hours a day, and The increase your chance of an increased risk American for other cancer Cancer getting breast cancer by types as well. Society raising estrogen levels. also, recommends 4. Limit getting at women who are overweight alcohol. Research least 150 tend to have higher levels of has shown minutes of that women who moderateinsulin, another hormone. have two to three intensity Higher insulin levels have also alcoholic drinks a activity or 75 day have about a minutes of been linked to some cancers, 20% higher risk vigorous including breast cancer. compared to activity each women who don’t week. (Or a drink at all. combination Women who have one drink a day of both.) Moderate-intensity have a very small increase in risk. activities are at the level of a brisk Excessive drinking increases the risk walk that makes you breathe hard. of other cancer types, too. And don’t cram it all into a single The American Cancer Society workout — spread it out over

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Five ways to reduce your risk of getting breast cancer

weight, stay there. If you’re carrying extra pounds, try to lose some. There’s some evidence that losing weight may lower breast cancer risk. Losing even a small amount of weight — for example, half a pound a week — can also have other health benefits and is a good place to start.

recommends women have no more one alcoholic drink in a single day. A drink is 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of hard liquor. 5. Avoid or limit hormone replacement therapy. Hormone replacement therapy (HRT) was used more often in the past to help control night sweats, hot flashes and other symptoms of menopause. But researchers now know that postmenopausal women who take a combination of estrogen and progestin may be more likely to develop breast cancer. Breast cancer risk appears to return to normal within five years after stopping the combination of hormones. Talk with your doctor about all the options to control your menopause symptoms, and the risks and benefits of each. If you do decide to try HRT, it is best to use it at the lowest dose that works for you and for as short a time as possible. 

— BPT

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THere’S a LoT To KnoW about cancer. Listed below are 10 facts that cover treatment such as radiation and its effectiveness as well as what the most risky types of cancer are.

Professionals provide facts on cancer Ten facts to know about cancer risks and treatment here are more than 100 types of cancer that impact people of all backgrounds. It's likely that cancer has touched you or someone close to you. There is a lot to know about cancer and its effects on people in the United States and around the world. How many of these 10 cancer facts do you know? • Cancer is prevalent: In 2019, there will be an estimated 1.7 million new cancer cases diagnosed in the U.S., according to the American Cancer Society (ACS). What’s more, approximately 39 out of 100 women and men will develop some form of cancer in their lifetime. • Skin cancer is the most common cancer for women and men: For women, the next most common cancers are breast cancer, lung cancer and colorectal cancer. For men, the next most common cancers are prostate cancer, lung cancer and colorectal cancer.

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• Most cancer patients will receive radiation therapy: About two-thirds of all cancer patients will receive radiation therapy as part of their treatment, according to the American Society for Radiation Oncology (ASTRO). Radiation therapy, or radiotherapy, is the use of various forms of radiation to treat cancer and other diseases. Radiation therapy has been an effective cancer treatment for more than 100 years. • Some cancers are preventable: Not using tobacco is the single best way a person can prevent cancer from developing. Many cases of skin cancer could be prevented by protecting the skin from the sun's ultraviolet radiation and indoor tanning devices. Taking action like avoiding tobacco and getting immunizations against cancercausing infections can help protect you. • Radiation therapy destroys cancer cell DNA: Radiation therapy works by damaging the DNA within cancer cells, destroying their ability to reproduce and causing the cells to

die. When the damaged cancer cells are destroyed by radiation, the body naturally eliminates them. Normal cells can be affected by radiation, but they can repair themselves in a way cancer cells cannot. • Survival rates are increasing: The five-year relative survival rate for all cancers is 69%, which means that 69% of all patients diagnosed with cancer survive beyond year five. Treatment advances and earlier diagnosis for some cancers have contributed to the improved survival rates. Some cancers, such as prostate and breast, can have more than a 90% five-year survival rate if diagnosed early. • Radiation therapy can cure some cancers: When used as part of a cancer treatment plan, radiation therapy can destroy tumors that have not spread to other parts of the body. It can also reduce the risk that the cancer will return after surgery or chemotherapy, or shrink the cancer before surgery, notes ASTRO. • Tobacco use is the most preventable cause of death in the

U.S.: About 30% of all cancer deaths are caused by smoking, notes the ACS. Cigarette smoking increases the risk of at least 12 cancers: oral cavity and pharynx, larynx, lung, esophagus, pancreas, uterine cervix, kidney, bladder, stomach, colorectum, liver and myeloid leukemia. • Screening is available for some cancers: The benefits of screening for some cancers such as breast, lung, colorectal and cervical, may outweigh the potential risks for select, at-risk people. The U.S. Preventative Services Task Force is responsible for all consumer screening recommendations. • Radiation therapy can be external or internal: With external radiation, a machine directs the highenergy waves at the cancer and some of the healthy tissue surrounding it. When internal radiation is used, a radiation source can be delivered by an intravenous injection or by inserting radioactive pellets or wires directly into the tumor.

— BPT

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THere’S more To aSSeSSing riSK than looking at your age, and getting tested at a younger or older age is still important.

Age alone shouldn’t determine treatment O

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every possible option and then work together as a team to make the best treatment decision for you, regardless of your age." Breast cancer treatment today is no longer a "one size fits all" approach. What is best for one woman may not be right for another. To address this

ne in eight women in the U.S. will develop breast cancer in her lifetime. Many will be surprised to learn that age is a major barrier when it comes to patients accessing the information they need to make a better-informed treatment decision. Age shouldn't affect your chances of getting the right breast cancer treatment, yet an analysis from the National Cancer Institute revealed that patients under the age of 40 and over 70 are far less likely to get a genomic test called the Oncotype DX Breast Recurrence Score test compared to patients 40 to 70 years old. This is a concerning reality since, based on research from more than 100,000 patients, Oncotype DX definitively identifies the vast majority of women with early-stage breast cancer who receive no benefit from chemotherapy, and the important minority of women for whom chemotherapy can be life-saving. The test provides patients with a personalized score based on the biology of their tumor that can help

tailor treatment decisions for their would have appreciated knowing more individual cancer. about my options, even if it would Younger and older women face have been a lot of information to different kinds of challenges when handle." diagnosed with breast cancer, In contrast, Lenhard was able to however, assumptions about cancer look at various treatment options and a patient's age can make it hard through an open dialogue with her for both groups of women to access doctor when she was diagnosed with the information they need to make an early-stage breast cancer at 75 informed treatment decision. Take it years old. Lenhard was convinced from breast cancer survivors Amanda she would need chemotherapy and Nixon and Bunny Lenhard, who was surprised when her doctor embarked on different treatment recommended taking the Oncotype journeys based on their age. DX test to determine if chemo was Nixon was 27 years old when she necessary. Lenhard's Recurrence was diagnosed with rare inflammatory Score was 20, which meant she breast cancer. While Nixon's doctor would not benefit from wanted to treat her cancer chemotherapy. In talking with her aggressively doctor, Lenhard due to her age, decided to forgo there was no chemotherapy and additional Breast cancer treatment today receive radiation information instead. For is no longer a “one size fits disclosed Lenhard, this regarding all” approach. What is best for access to other information one woman may not be right treatment enabled her to options, like develop a for another. genomic comprehensive testing. and personalized "At the time treatment plan. of my diagnosis, I didn't feel like I was "Age is just a number, and it should a partner with my doctor and I didn't not affect your options when it comes realize I could ask questions about my to your breast cancer treatment," said Lenhard. "Ask your doctor about treatment options," Nixon said. "I

age matters, but it shouldn’t keep you from getting the proper type of care

younger and older women face different kinds of challenges when diagnosed with breast cancer. need, the No Matter My Age campaign encourages all breast cancer patients to ask their doctors about accessing the information they need to make the right treatment decision, no matter their age. Visit NoMatterMyAge.org to learn more about how a genomic test can help you better understand and personalize your treatment options. Educating women about genomic testing could help spare hundreds of thousands from unnecessary chemotherapy, while ensuring that those who may receive life-saving benefit from the treatment receive it.

— BPT

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Breast Cancer. Let’s ƫ ƫ ƫ ƫ ƫ ƫ ƫ Fight ƫ ƫIt.ƫ Together. ƫ From GIRLFRIENDS to the from our ƫ ƫ ƫ FOR ƫA CURE ƫ ƫ proceeds ƫ ƫ ƫ signature ƫ ƫ fundraisers, ƫ YOU help us fund our mission to fight breast cancer and provide better health for all. ƫ ? ? The Healthcare Foundation ? ƫ ? ? Northern Sonoma County ? ? ? is Sonoma ? ƫ County’s ? ? leading ƫ health ƫproponent ƫ ƫ ƫ for the ƫ ƫ ƫ of ƫ all ƫwho live, work ƫ ƫ ƫ and play inƫ the ƫ ƫ? of our beautiful northern region county. ƫ ƫ ƫ ƫ ƫ ƫ ƫ We partner with, lead and convene other ƫ ƫ ƫ ƫ ƫ ƫ funders and nonprofits to identify issues ƫ ƫ ƫ ? ƫ and create solutions. Since our inception ? ? ? ƫ ? inƫ 2001, ? we’ve ? granted more than ƫ $26 ? million ? towards ?community ƫ health needs, ? including Healdsburg District Hospital’s ? ? ? ƫ technology improvements ? ? ? ? funding ? ? purchases ƫ ? Suite, ? MRI, and? the of? the CT ? ? ? ? for Women’s Diagnostic Center? equipment ? diagnosis ? ? breast cancer, ? ƫ better of prostate  ? ? and more. cancer 

Our past health access contributions of ƫ ƫ ƫ ƫ ƫ ƫ  eachƫ to Alliance Medical ƫ nearly ƫ $1 million ƫ ƫ ƫ ƫ Valley  ƫ Center and ƫ Alexander ƫ ƫ Healthcare ƫ haveƫ provided cost ƫ ƫ reduced ƫ ƫ or ƫ free access ƫ ƫ for women ƫ and ƫ families ƫ ƫ to get the ƫ medical ƫ ƫ dental ƫ ƫ and care they need. We invite you to become a Healthcare Hero ƫ and pledge ƫ ƫ your ƫ ƫ ƫ at any levelƫ for support ƫ ƫ threeƫ years.ƫ Your contribution ƫ ƫ ƫ will the next ƫ ƫ ƫ ƫ ƫ ƫ ƫ be an investment to help us develop ƫ ƫ ƫ ƫ ƫ ƫ ƫ To learn a healthier community for all. ƫ ƫ ƫ ƫ ƫ ƫ ƫ Foundation, ƫ moreƫ aboutƫ the Healthcare ƫ ƫ ƫ please ƫ call ƫ 707.473.0583 or ƫ ƫ ƫvisit ƫhealthcarefoundation.net.

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