PUBLISHED BY
SOUTHERN LAKES NEWSPAPERS LLC OCTOBER 2018
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treatment • Manage side effects Tips to stay •on the job
October is Breast Cancer Awareness Month
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THINK PINK 2018
How to get better care from your doctor ave you ever wanted to ask your doctor a question but didn’t because you felt uncomfortable? Experts say that an impersonal relationship with your doctor could be preventing you from receiving the best care possible. “Your doctors should feel like valued members of your family – and you a part of theirs. That’s how I operate in my practice and what I aim to foster in my patients,” says Dr. Ken Redcross, who brings nearly 20 years of experience to his new book dealing with this subject, “Bond: The Four Cornerstones of a Lasting and Caring Relationship with Your Doctor.” Whether you have a new doctor or you’ve been at the same practice for years, your patient-doctor bond may be on faulty ground. But it doesn’t have to be, suggests Dr. Redcross. He believes that by establishing these four essential qualities in your patient-doctor relationships, you’ll pave the way to receiving better care:
Trust Trust is essential in any relationship, including the one with your doctor. There is no sharing without trust, and sharing is crucial when it comes to receiving the best possible care.
Communication No relationship can be sustained without open and honest communication
on both sides, but developing healthy communication habits takes practice, effort and willingness.
Respect Respect is treating others with common courtesy, good social manners and appreciating each other’s humanity. This means respecting each other’s experience, knowledge and time.
Empathy Empathy is the ability to sense another person’s emotions and to be able to place yourself in his or her shoes, which is a valuable quality in a doctor. However, many physicians strive for a state of “concerned detachment,” which is the opposite of empathy. At the same time, patients can be more empathic too; taking the time to consider everything their doctors may be dealing with on the day of their visit. Building a great relationship with your doctor leads to practical benefits, says Dr. Redcross. In dealings with his own patients, he finds that great communication paves the way for better treatment. “Recently, a patient of mine was dealing with muscle pain and we had a long conversation about different options. Initially, I recommended that she take traditional pain reliever with naproxen sodium every morning. However, by talking through all the options and what best fit her situation including her overall medical history, preferences and more, we settled on using
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Arnica montana, a lower-risk plant-based pain reliever instead,” says Dr. Redcross. “Feeling comfortable enough with your doctor to challenge a suggestion and have a long and complete conversation is key. Unfortunately, such discussions between
patients and doctors are rare.” To learn more about the book, as well as about building better relationships with your doctors, visit, BondByDrRedcross. com.
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At a time when doctor’s visits seem more routine and formulaic than ever before, experts say that receiving individualized care is possible, and it all starts with building strong relationships with your health care providers.
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Early detection and better treatment options are improving the chances of surviving breast cancer. The five-year net survival rate for breast cancer in the United States is 85 percent.
Breast cancer survival rates STOCK PHOTO Think Pink
Determining breast cancer stage
w
hen receiving treatment for breast cancer, women will learn about cancer staging. According to the nonprofit organization Breastcancer. org, determining the stage of the cancer helps patients and their doctors figure out the prognosis, develop a treatment plan and even decide if clinical trials are a valid option. Typically expressed as a number on a scale of 0 through IV, breast cancer stage is determined after careful consideration of a host of factors. The staging system, sometimes referred to as the TNM system, is overseen by the American Joint Committee on Cancer and ensures that all instances of breast cancer are described in a uniform way. This helps to compare treatment results and gives doctors and patients a better understanding of breast cancer and the ways to treat it. Breastcancer.org notes that the TNM system was updated in 2018, but before then was based on three clinical characteristics:
T: the size of the tumor and whether or not it has grown into nearby tissue N: whether the cancer is present in the lymph nodes the cancer has metastasized, or spread to other M: whether parts of the body beyond the breast
While each of those factors is still considered when determining breast cancer stage, starting in 2018, the AJCC added additional characteristics to its staging guidelines, which make staging more complex but also more accurate. • Tumor grade: This is a measurement of how much the cancer cells look like normal cells. • Estrogen- and progesterone-receptor 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 See CANCER STAGE, Page 4 progesterone-receptor-positive may receive signals
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 personal 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 Breastcancer.org. According to the latest statistics presented by the Canadian Breast Cancer foundation, 26,300 women and 230 men had been diagnosed with breast cancer in Canada in 2017. 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 decreasing steadily since 1989. The National Cancer Institute says 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 says that decreasing death rates among major cancer types, including prostate, colorectal, lung, and breast cancers, are driving the overall shift in survival. The ACS says 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. A similar scenario has unfolded in Canada. Breast cancer mortality rates in Canada recently decreased to 21.4 percent, down from 21.8 percent in 2011, states data from the Canadian Cancer Society. Currently, the fiveyear survival rate for breast cancer among Canadians is 87 percent, and the five-year net survival in the United States is 85 percent. Increased knowledge about breast cancer, early detection through examinations and mammography and improved treatments are helping to drive up the survival rates of breast cancer. Although this does not make diagnosis any less scary, it does offer hope to those recently diagnosed. (METRO CREATIVE)
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• Cancer stage
(Continued from page 3)
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-receptorpositive cancers may be treatable with medications that reduce hormone production or block hormones from supporting the growth and function of cancer cells. • 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 HER2negative. • Oncotype DX score: The oncotype DX score helps doctors determine a woman’s risk of early-stage, estrogenreceptor 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. More information is available at www. breastcancer.org. (METRO CREATIVE)
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Determining breast cancer stage is a complex process, but one that can help doctors develop the most effective course of treatment.
Can diet prevent breast cancer from spreading?
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Healthy diets that include plenty of antioxidant-rich fruits and vegetables that can boost the body’s natural immune system can help people in their fight against cancer. While some foods, namely unhealthy, high-fat/highcaloric foods, are best avoided, women who have been diagnosed with breast cancer who want to prevent the spread of cancer to other areas of their bodies may want to cut some surprising foods from their diets. Preliminary research now suggests limiting the consumption of asparagine, an amino acid, to dramatically reduce the ability of cancer to spread to other parts of the body. A study published in the journal Nature found that reducing asparagine consumption in laboratory mice with triple-negative breast cancer could dramatically reduce the ability of the cancer to travel to distant sites in the body. Asparagine is found in foods like asparagus, whole grains, soy, seafood, eggs, poultry, beef, legumes and more. While reducing asparagine will not affect the original breast cancer tumor, it could stop cancer from showing up elsewhere in the body. Researchers suspect that many women with breast cancer do not lose their lives to the original breast cancer tumor, but instead they succumb to metastases or subsequent growths away from the primary site. “Our study adds to a growing body of evidence that suggests diet can influence the course of the disease,” said Simon Knott, Ph.D., associate director of the Center for Bioinformatics and Functional Genomics at
Cedars-Sinai and one of two first authors of the study. The research from this study was conducted at more than a dozen institutions. Apart from dietary restrictions, metastasis also could be greatly limited by reducing asparagine synthetase using chemotherapy drug L-asparaginase. More research is needed as to whether similar results can be produced in human trials, making avoiding asparagine currently a helpful but not entirely foolproof method for preventing the spread of breast cancer to other areas of the body.
(METRO CREATIVE)
STOCK PHOTO Think Pink
Preliminary research suggests limiting the consumption of asparagine to reduce the ability of cancer to spread to other parts of the body. Asparagine is found in foods like asparagus, whole grains, soy, seafood, eggs, poultry, beef and legumes.
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Getting through the rough patches 3 POTENTIAL SIDE EFFECTS OF BREAST CANCER TREATMENTS Cancer is a painful, potentially lifethreatening disease. Though discomfort might be the first warning sign that compels people to visit their physicians on the road to receiving a cancer diagnosis, cancer treatments can produce a host of side effects, including pain, as well. According to the Sidney Kimmel Cancer Center, breast cancer treatments can create both long-term side effects and late side effects. Long-term side effects are those that begin during treatment and continue after all treatments have stopped, while late side effects refers to symptoms that can appear weeks, months or even years after treatments have ended. The list of potential side effects of breast cancer treatments is lengthy, but may include the following conditions or issues.
Fatigue The nonprofit organization Breastcancer.org notes that fatigue is the most common side effect of breast cancer treatments, with some estimates suggesting it affects as many as 90 percent of all patients. Some breast cancer patients may experience fatigue after treatment and find it’s worsening because they are eating less and not getting enough nutrients. In such instances, the initial fatigue may make people too tired to cook, ultimately contributing to more fatigue when they are not eating or eating convenient yet potentially unhealthy foods. Cooking healthy foods in bulk when fatigue is not overwhelming and accepting others’ offers to cook is a great way for cancer patients to ensure their diets are helping them combat fatigue and not making fatigue worse.
Lymphedema Johns Hopkins School of Medicine notes that, following breast cancer treatment, some patients may suffer from
lymphedema, a condition characterized by the accumulation of lymphatic fluid in the tissues. Lymphedema most often occurs in the arms, but can contribute to swelling in other parts of the body as well. Why some people suffer from lymphedema after treatment and others don’t is a mystery, though surgeons at Johns Hopkins Breast Center have noticed a low occurrence of lymphedema in patients who have undergone sentinel node biopsies or axillary node dissection. Breast cancer patients are at risk of lymphedema for the rest of their lives after treatment, and while there’s no way to prevent it, patients should avoid getting needle sticks or blood pressure tests in arms where lymph nodes were removed. In addition, any injuries or cuts in arms where lymph nodes were removed should be treated with vigilance.
Infertility Many women will stop menstruating while undergoing chemotherapy or after chemo treatments, and that cessation is often temporary. These irregularities may be traced to hormonal therapies that make the ovaries stop producing eggs. However, in some instances, even premenopausal women may have trouble getting pregnant after hormonal therapy. Breastcancer.org notes that women whose periods do not return after treatment may still be fertile, but also notes that women who are close to menopause when beginning chemo may become permanently infertile. Women who have been diagnosed with breast cancer who are concerned about post-treatment infertility should speak with their physicians immediately about their prospects of getting pregnant after treatment, including fertility treatments and the potential safety risks of getting pregnant after being diagnosed with breast cancer.
(METRO CREATIVE)
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Breast cancer treatments save lives every day. When discussing treatments with their physicians, breast cancer patients should ask questions about potential short- and long-term side effects.
WHAT TO EXPECT
before and after mastectomy surgery Mastectomy is a treatment for women diagnosed with breast cancer or those who are genetically predisposed to cancer. The removal of one or both breasts, mastectomy surgery may involve removing just the breast tissue or, in some cases, the lymph nodes as well. Data from the Agency for Healthcare Research and Quality says their analysis points to a 36 percent increase of both single and double mastectomies between the period of 2005 and 2013, the most recent year for data. Women on the precipice of mastectomy surgery will naturally have many questions concerning the procedure and projected recovery. The process of recovering is different for everyone, and not all mastectomies are the same. The following is a general idea of what patients can expect before and after mastectomy surgery.
Before surgery A mastectomy is performed under general anesthesia, advises the nonprofit group Susan G. Komen. Therefore, patients should expect to undergo routine physical exams and may require a surgical pre-clearance from a doctor and the surgical hospital or center. Blood tests and an EKG may be ordered as well. Prior to surgery, patients can begin making plans for childcare, meal preparation, shopping, work requirements, and more. As mastectomy is an invasive procedure, patients may experience pain and fatigue after surgery. Having various plans in play well before the surgery date can relieve some stress and help patients focus on their recoveries. Purchase comfortable clothing that will be loose around the arms and chest. Zipup tops or those with front buttons afford easy access. Some women also opt to get
fitted for post-op garments, including a lymphedema sleeve. Lymphedema is a swelling of the area, and it is a common side effect. It is helpful to be prepared before such items are needed.
After surgery Mastectomy surgeries typically last between two and three hours. Some may last longer if reconstruction is performed at the same time. Patients will be admitted to a hospital stay for a day or two and moved to a recovery room, and will need to be driven home upon discharge. Expect to be bandaged and possibly have a surgical drain at the wound site. The nonprofit resource Breastcancer.org says the drain usually remains in place one to two weeks after surgery. Fluid will have to be emptied from the detachable drain bulb a few times per day. Sutures that are dissolvable will not require removal.
Patients should follow the recovery plans outlined by their doctors. Rest is most important during this time, so do not overdo exercise or other activities, although some movements to relieve shoulder stiffness may be advised. Pain, numbness, itching, and myriad other symptoms may occur. Take pain medications only as needed and directed. Weakness is expected in the arms and shoulders. Ask for help lifting, moving or picking up items. Emotional side effects can be just as profound as physical ones. Fear of the cancer, body image issues and a sense of loss can occur. Having a strong support team can help, as can speaking with a professional counselor. It can take several weeks to start feeling like oneself again after mastectomy surgery. Learn more at Breastcancer.org.
(METRO CREATIVE)
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On the job
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How to juggle work and breast cancer treatment
Age is a risk factor for breast cancer, as the organization Susan G. Komen notes that the older a woman is, the more likely she is to get breast cancer. However, data from the National Cancer Institute indicates that breast cancer rates in women begin to increase after age 40, meaning many women diagnosed with breast cancer have to juggle both their disease and their careers. The nonprofit organization Breastcancer.org says that breast cancer treatments can produce some cognitive side effects that affect thinking and memory. Memory loss and difficulty concentrating are two such side effects that can make it difficult for working women to do their jobs while being treated for breast cancer. Professional women diagnosed with breast cancer may be able to take advantage of short- and long-term disability programs that provide a percentage of their incomes if they are diagnosed with an illness that prevents them from doing their jobs. In addition, Breastcancer.org notes that, in the United States, the Family and Medical Leave Act allows employees to maintain their benefits and keep their jobs while taking up to 12
weeks of unpaid leave to heal from serious health conditions. Despite those options, many women may want to continue working while receiving treatment for breast cancer. Such women can heed the following tips, courtesy of Breastcancer.org, to overcome any cognitive effects of treatment so they can continue to perform their jobs capably.
Start taking notes Start taking notes during meetings, important work-related conversations and even doctor’s appointments to counter any issues with memory. Keep such notes on a tablet or smartphone so they can be quickly and easily accessed throughout the day.
Write it down Accomplished professionals may keep lists of deadlines and work schedules in their heads, but that internal list might not be so reliable while women are being treated for breast cancer. Make use of the calendar function on your smartphone or tablet to note deadlines, even setting alerts so you receive routine reminders when important dates are coming up.
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Many women continue working while being treated for breast cancer. A few simple adjustments can help such women overcome many treatment-related obstacles.
Have a to-do list
Set realistic goals
Some professional women diagnosed with breast cancer may be juggling work, treatment and their families. Keeping a to-do list and checking items off as they’re completed can help women effectively manage such juggling acts and save time.
Breast cancer treatment can produce a host of side effects, including fatigue. So women who plan to continue working during treatment should be sure to set realistic goals that take into account the effects that treatment may have on their energy levels. If need be, delegate more (METRO CREATIVE) tasks and ask for help.
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H l 5Tnua An
The shops of ROCHESTER are painting the town pink in support of
Breast Cancer Awareness
Friday, Oct. 19
4:30 to 7:30 p.m.
Main Street in Rochester will be lit up in PINK. A great reason to get out with your friends. Come early and shop our unique shops, enjoy refreshments. Specials on gifts, fashions, home décor, beauty and well being.
Chinese Lantern Lighting by the Gazebo at the River at 7:40 p.m. with Prayer/Remembrance Service
Carp é Di em S kin C are
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• 15% Off All Products • $25 Advanced Microspa/ Micro Channeling
JOIN US and HELP SUPPORT A GREAT CAUSE
• Refreshments
Fitness & Health LLC
• Wine Tastings • Specials & Sweet Treats
10/20 • 4:30 to 7:30 Drink Specials • Pink Mumbler - $3.50 White Zinfandel - $4.50
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Formerly Finders Keepers • See our NEW look • Refreshments
For info, contact Kristine at (262) 676-9460
e stin Kri by
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PINK Wear eceive and r off 20% rchase u your p EAWAYS G K PIN IV
Pink Velvet Cupcakes w/ Rose Wine
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We will be selling pink luminaries for $5 each and Chinese Lanterns for $10 each through 10/20. Buy one for yourself or in honor of a friend or loved one. All proceeds donated to Breast Cancer Research.
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