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stronger together hope

love

awareness

BREAST cancer awareness month

Spread the

, Find the

CURE

Special Supplement to The Mitchell Republic • October 2020


stronger together

Spread the HOPE, Find the CURE

love hope

BREAST cancer awareness month

what’s inside

Mammograms more comfortable.............................................................................. 2 Never loose hope.............................................................................................................................3 Most common types of breast cancer.................................................................. 4 Head-covering options............................................................................................................. 5

Local courage & positivity. positivity..................................................................6 ................................................................6

October 2020

LEARN HOW TO MAKE MAMMOGRAMS MORE COMFORTABLE

M

Metro Creative ammograms remain one of the best methods to detecting breast cancers, giving women the opportunity to start treatment early if cancer is detected. In countries with early access to quality screening and treatment, breast cancer survival rates are now greater than 80 percent. The organization Mammography Saves Lives says that, since 1990, mammography has helped reduce breast cancer mortality in the United States by 40 percent. Mammograms usually take around 20 minutes. During a traditional mammogram, a woman’s breast is placed between two plates. One plate holds the breast in place, while the other takes images, and the breasts must be compressed to get clear pictures of breast tissue. Some women find the process to be uncomfortable. Even though mammograms can be essential parts of preventive healthcare, many women avoid them because of pain and other discomfort. However, women should not put off mammograms because they are worried about discomfort. There are many ways to avoid pain during mammograms that can make the entire experience more comfortable. ► Schedule the mammogram for a week after a menstrual period when hormonal swings are less likely to increase breast sensitivity. ► Caffeine can make the breasts more tender. Reducing caffeine consumption for two weeks before the mammogram can help. ► Keep your feet and trunk facing forward and simply turn your head at the mammogram machine. ► Reduce tension by breathing deeply a few times before the procedure. ► Try a pain reliever before the mammogram. ► Ask the mammography center if it has padding, as cushioning between the breasts and the plates of the mammogram machine can reduce pain. By taking these steps, women may be more comfortable during mammograms, which can play a vital role in the detection and ultimate treatment of breast cancer. 

Vaccine development..................................................................................................................8 Male breast cancer symptoms....................................................................................... 9 Pain management..........................................................................................................................10 Understanding a metastatic diagnosis....................................................................11 l ay o u t c r e d i t s :

Cover and page design: Jen Phillips Section editor: Luke Hagen Contributors: Mitchell Republic Staff MetroCreative 001776371r1

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October 2020

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Spread the HOPE, Find the CURE

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Spread the HOPE, Find the CURE

October 2020

3 most common types of

breast cancer The

Metro Creative Millions of women across the globe are diagnosed with breast cancer every year. The World Cancer Research Fund and the American Institute for Cancer Research notes that more than two million new cases of breast cancer were diagnosed in 2018, making the disease one of the most commonly occurring cancers in the world. Upon receiving a breast cancer diagnosis, patients typically have a number of questions, including which type of breast cancer they have. The American Cancer Society notes that there are many types of breast cancer, though some are more common than others. Learning to distinguish between the more common types of breast cancer, which include invasive ductal carcinoma, ductal carcinoma in situ and invasive lobular carcinoma, can help patients and their support teams better understand this difficult, yet beatable disease.

What are carcinomas?

The ACS reports that most breast cancers are carcinomas. Carcinomas are tumors that start in the epithelial cells that line organs

rates are possibly so high because people are living longer than they used to (a person’s risk for breast cancer increases with age) and education about breast cancer screening Invasive ductal carcinoma appears to be working, compelling more Sometimes referred to as “IDC,” invasive women to get mammograms. ductal carcinoma accounts for between 70 and 80 percent of all breast cancers, making Invasive lobular carcinoma it the most common type of the disease, The ACS notes that roughly 10 percent of all according to the National Breast Cancer invasive breast cancers are invasive lobular Foundation, Inc. Invasive means the cancer carcinomas, or ILC. The word “lobular” has spread from the milk ducts, where IDC means that the cancer began in the lobules, originates, to the surrounding breast tissues. which produce milk and empty out into the ducts that carry milk to the nipple. When a Ductal carcinoma in situ person is diagnosed with ILC, that means Ductal carcinoma in situ, or DCIS, is a the cancer has broken through the wall noninvasive breast cancer that starts inside the milk ducts. BreastCancer.org notes that of the lobule and has started invading the “in situ” means the cancer is still in its tissues of the breast. Over time, ILC can original place, not having spread beyond the spread to the lymph nodes and possibly even milk duct to any surrounding breast tissue. other areas of the body.

and tissue throughout the body. Carcinomas can spread to other parts of the body, even though they do not always do so.

That’s helpful to know, as it calms patients’ fears knowing the cancer has been caught before it could metastasize, or spread. One out of every five new breast cancer cases is DCIS. While that might sound alarming, BreastCancer.org notes that DCIS incidence

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Headcovering options for cancer patients

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Spread the HOPE, Find the CURE

October 2020

A

Metro Creative cancer diagnosis can be difficult to process. However, advancements in cancer research over the last several decades have helped more people survive such diagnoses. That should come as good news to people who have recently been diagnosed with breast cancer. The Centers for Disease Control and Prevention says breast cancer is the second most common cancer among women in the United States. BreastCancer.org estimates that 276,000 new cases of invasive breast cancer and around 49,000 non-invasive cases are expected in 2020 in the United States. The Canadian Cancer Society says breast cancer is the most commonly diagnosed cancer among Canadian women, and the second most commonly diagnosed cancer in the country. Breast cancer treatment depends on the stage of the cancer, personal choices as well as doctor recommendations. Other factors like preexisting conditions or health history also may play a role in determining patients’ treatments. In many cases, chemotherapy is included in a treatment plan. Chemotherapy targets fastgrowing cancer cells in the body to prevent cancer from spreading and to shrink tumors. However, the American Cancer Society says other normal cells that are fast-growing can be affected by chemotherapy and cause side effects. These cells include blood-forming cells in bone marrow, hair follicles, cells in the mouth, digestive tract cells, and reproductive system cells. This is why many people lose their hair during chemotherapy treatments.

Many women confront chemotherapy-related can consider wigs. Wigs can be undetectable hair loss with head coverings, and they have and mimic real hair. To simplify choosing a various options at their disposal. wig, women can bring a picture of their typical hairstyle. Save a lock of hair from the top front ► Scarves: Many women like to tie of the head where hair is the lightest to match lightweight scarves around their heads. These wig color. Make sure the wig is adjustable. scarves come in various patterns. Pre-tied scarves that can be pulled on also are available. Hair loss is a side effect of some cancer treatments. ► Cloches: A cloche is a fitted, bellFinding head coverings shaped hat that gained popularity in the can bridge the gap 1920s and 1930s. until hair regrows. 

► Turbans: Turban style hats are pull-on options and are knotted or twisted in the front or side. Some may have decorative embellishments on the front. ► Baseball hat: Some baseball hats designed specifically for cancer patients provide more coverage than traditional baseball hats by stretching further down the back of the head and neck. They feature a brim and can offer substantial protection while out in the sun. Other baseball hats may come equipped with artificial or real human hair extensions attached inside of the hat to offer stylish options.

MetroCreative

► Wigs: When a hat or scarf is not desirable, women

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Weins brings courage, positive attitude to breast cancer fight Spread the HOPE, Find the CURE

October 2020

Local woman stresses importance of mammograms for early detection By Erik Kaufman Mitchell Republic

“She’s never in a bad mood.” That is Sarah Reyelts’ description of Michelle Weins, one of her employees at Arnies at First & Foster in Mitchell. The co-owner of the store with 12 employees said even in a tight-knit family of workers like the one she oversees everyday, Weins stands out for her consistently positive attitude, her friendly nature with customers and her rock-steady work ethic. Those are characteristics she has maintained even as she has gone through one of life’s most difficult challenges. In March, Weins was diagnosed with breast cancer, and ever since has been waging a battle faced by people around the world every day. “(I had a mammogram just) so I didn’t have to hear the doctor ask me if I had one,” Weins told the Mitchell Republic. “So, I did it. And that led to an ultrasound.” That ultrasound led to a biopsy a couple of weeks later, and shortly afterward, she got the news that she did, indeed, have breast cancer. “You just feel like, what am I going to do now? It’s just such a shocker. You don’t realize how shocking it is,” Weins said. “You don’t know what stage it is. Is it going to take your life? There are so many things to think about. You go to work thinking about it.”

The National Breast Cancer Foundation estimates that 276,480 women will be diagnosed with breast cancer in 2020. Weins is one of them. As it is for many, the revelation was a shock that brought with it uncertainty, fear and questions about the disease and its treatment.

Weins, 53, said she was lucky having received a diagnosis of Stage 1 cancer. She soon began consulting with a surgeon in Sioux Falls, and by April she had undergone a left partial mastectomy. Doctors also removed some lymph nodes to make sure the cancer had not spread. She learned about undergoing chemotherapy and radiation treatments and the mechanics of how cancer affects the body. She talked with an oncologist and he recommended a path for treatment. It was an overwhelming flow of information to take in for someone who just a couple months earlier had not even really considered having herself screened. It was an eye-opening experience, she said. “Oh, you learn a lot. I definitely learned a lot,” Weins said.

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Michelle Weins talks about her cancer She endured 12 rounds of chemotherapy a week, and experienced the common side effect of losing her hair. While she had heard that that may be one of the things she would have to deal with, having it actually happen was still something for which she was not fully prepared. But she knew it was a tradeoff she needed to make if she wanted to beat cancer. “I started losing it in chunks. Every day in the shower more kept falling out,” Weins said. “Well, it’s the way it is. This is what you gotta do. This is what you gotta go through. That’s just what a person goes through.” She completed her chemotherapy sessions and will continue to undergo radiation through October, which is recognized as National Breast Cancer Awareness Month. And for all intent and purposes, everything seems to be going well, though she said she won’t know more about her prognosis until her treatments are complete, probably a year down the road. Like many cancer patients, she has a close support group that helps her along the way. Her mother accompanied her on hospital visits, her son ran errands when she needed help, her pastor counseled her and her fellow employees at Arnie’s had special hoodies made indicating they were all on “Team Michelle.”

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October 2020

It’s support that means a lot to her, she said. “They’re very good people,” Weins said. “They’re behind me 100%.” In fact, she was anxious to get through treatments so she could get back on her feet and retake her post at Arnie’s greeting customers. “I was ready to go to work. I grew up on a farm, and you don’t just stop work,” Weins said. “The people I work with are just fabulous. I love the sweatshirt. Everybody got one at work and took a picture with thumbs up.” Reyelts said Weins is the type of person who inspires others to want to help her through difficult times. Her personality and work ethic make her an admired member of the staff, and it is inspiring to see her continue to fight through her challenges with that positive mental attitude everyone at the store has experienced. “She is easy to back up. She’s gone through this whole process and has not called in sick one time. Not one time. That work ethic is unbelievable,” Reyelts said. “She knows that she has to keep going and she does that, and the little

things like supporting her with hoodies for everybody to wear? That’s a drop in the bucket for what she’s done for Arnie’s.” Customers know her for her engaging banter. She remembers names and personal stories. And she’s quick with a laugh. She makes a difference in the day of both her fellow employees and the customers walking through the door, Reyelts said. “She is all Michelle, all day and everyday. She’s been here for six years, and I truly have never seen her in a bad mood. Not one day, and she works five days a week. That’s a lot of days to be in a good mood,” Reyelts said. “She’s just a good soul.” Weins said she is ready to continue her cancer fight for the long haul, thanks to the treatments she has received and the support she receives from family and her friends at Arnie’s. But she noted that the most important part in her journey was finally making the choice to have a mammogram. Early screening can mean the difference when fighting a disease that will kill an estimated 42,000 women this year in the United States alone.

She put it off. She implores others not to. “They can catch things with that mammogram. You don’t like it. It’s uncomfortable. It’s unbelievable how much cancer is out there. Just don’t be scared to go get a mammogram, because that will detect it,” Weins said. “You don’t want to miss a mammogram.” Detection is the first step to recovery, she said. Once you take that leap, you give yourself a fighting chance to drive the cancer back and get back to your life. For Weins that means getting back to work at Arnie’s and seeing her friends and customers on a daily basis. With their backing, she is confident she can stay the course and do what needs to

attitude doesn’t hurt, either, she said. “Some people bah humbug and feel sorry for themselves, but you can’t do that. You can’t make yourself feel miserable. You have to be the fighter. It ain’t gonna help if you don’t take care of it. You’re the one who has

it,”

Weins said. 

be done to get back to full health. And a good

Michelle Weins was diagnosed with breast cancer in March and has undergone surgery, chemotherapy and radiation as part her treatments to fight the disease. She has approached her challenges with an upbeat attitude that has inspired many, including her fellow employees at Arnie’s at First & Foster. She said she encourages women to not put off mammogram screenings for the disease, which can be crucial in the early detection of cancer. Matt Gade / Republic

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stronger together

Spread the HOPE, Find the CURE

BREAST CANCER

VACCINES IN DEVELOPMENT

B

Metro Creative reast cancer affects both men and women and the family and friends who support them as they navigate diagnosis and subsequent treatments. According to the most recent statistics from BreastCancer.org, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the United States in 2020. That estimate includes 48,530 new cases of noninvasive, or in situ, breast cancer. The average five-year survival rate for women with invasive breast cancer is 91 percent. While that’s good news, what if there was a breast cancer vaccine that could eliminate the threat of breast cancer? A vaccine may not be that far into the future. An experimental breast cancer vaccine already has been developed by Dr. Leishna Emens at the Johns Hopkins Kimmel Cancer Center. Clinical trials are underway, but the concept behind the vaccine is to activate the immune system and cause immune cells that are typically unable to detect cancer cells to attack the cancer in the breast and throughout the body. Early studies point to modest, but real improvement in survival rates. Dr. Emens continues to work with her team to study the efficacy of the vaccine. Other vaccines also have been in the works. Researchers at the Mayo Clinic, supported in part by the Artemis Project of the National Breast Cancer Coalition, also are trying to develop a vaccine that will prevent breast cancer. Dr. Keith Knudson, who is developing this vaccine, has seen some evidence of elimination of the breast cancer tumor, as well as some evidence of the immune system responding. Dr. Knudson’s team is seeking more trial subjects to continue testing the vaccine. Science and medicine are working tirelessly to develop a vaccine that can prevent or cure breast cancer. There is still more work to be done, but early trials offer some hope that this disease may soon be defeated. 

October 2020

love hope

FACTS cancer Surprising facts about cancer

Metro Creative Cancer affects the lives of millions of people every day. Cancer can affect every aspect of patients’ lives as well as the lives of their families. Researchers recognize that there is still much to learn about cancer. The following are some facts about cancer that may surprise you, courtesy of the American Cancer Society, The World Health Organization, The Canadian Cancer Society, and The National Cancer Institute. ► An estimated 1.8 million new cancer cases will be diagnosed in the United States in 2020, and 606,520 people will lose their lives to cancer in 2020. ► Seventy percent of all deaths from cancer occur in low- and middleincome countries. ► There are more than 100 types of cancer, and any part of the body can be affected. ► Eighty percent of all cancers in the United States are diagnosed in people 55 years of age or older. ► On average, 617 Canadians will be diagnosed with cancer every day, and 228 will die from cancer each day. ► Prostate, lung and colorectal cancers are the most commonly diagnosed cancers in men. Breast, lung and colorectal cancers are the most commonly diagnosed cancers in women. ► Roughly 67 percent of Americans diagnosed with cancer survive five or more years after diagnosis. ► Between 30 and 50 percent of cancers are preventable. Tobacco use is the single largest preventable cause of cancer in the world. ► Between 1991 and 2017, there have been two million fewer cancer deaths for the most common types of cancer in the United States. ► Lung cancer and colorectal cancer account for 14 percent and 12 percent, respectively, of new cases of cancer in Canada. ► Maintaining a healthy body mass index, exercising regularly and eating high amounts of fruits and vegetables are some ways to reduce cancer risk. 

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October 2020

breast cancer B SYMPTOMS OF MALE

reast cancer is one of the most common forms of cancer diagnosed among the female population. Though breast cancer may seem like a disease that’s exclusive to women, breast cancer can affect men as well. ► While they have a smaller concentration than women, men have breast tissue, which means it’s possible for them to develop breast cancer. Male breast cancer is most common in older men, but it is important that men recognize that the disease can strike them at any age.

Signs and symptoms

Men with breast cancer experience symptoms that are similar to those experienced by women. Possible signs to be aware of include: skin dimpling or puckering ► A lump or swelling, which is typically (but not always) painless ► Nipple retraction ► Redness or scaling of the nipple or breast skin ► Discharge from the nipple, which may be clear or blood-tinged The American Cancer Society advises that sometimes breast cancer can spread to the lymph nodes under the arm or around the collar bone and cause a lump or swelling in these locations. The protrusion may be noticeable even before the original tumor in the breast is large enough to be felt. Men should realize that enlargements or issues affecting both breasts (not on just one side) typically is not cancer. Enlargement or changes to both breasts in men can be caused by weight gain, medications or heavy alcohol consumption.

► Ductal carcinoma: Cancer that begins in the milk ducts. Nearly all male breast cancer is ductal carcinoma. ► Lobular carcinoma: Cancer that begins in the milk-producing glands. This type is rare in men because they have few lobules in their breast tissue. Especially rare types of breast cancer that can occur in men include Paget’s disease of the nipple and inflammatory breast cancer.

Diagnosis

BreastCancer.org says that a small study of breast cancer in men found that the average time between first symptoms and diagnosis was about 19 months. This can be startling because early diagnosis can be vital to survival. Through the realization that breast cancer can happen to men and more education and awareness, men can feel more comfortable about discussing changes to breast tissue with their doctors. Male breast cancer is a very real occurrence, albeit a rare one. It is important that men take any abnormalities in their chests seriously. 

MetroCreative

Types of male breast cancer

Various types of breast cancer can affect men, according to the Mayo Clinic:

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October 2020

How to manage pain medications during breast cancer treatment Metro Creative Breast cancer researchers have worked tirelessly over the last several decades as they work to eradicate the disease once and for all. While breast cancer still affects millions of women across the globe each year, advancements in treating the disease have dramatically improved five-year survival rates, providing patients and their families with hope as well as a realistic expectation of a long, healthy life after cancer. According to Breastcancer.org, women diagnosed with breast cancer in 2020 and beyond have an array of treatment options to fight their disease. That marks a

stark contrast from recent history, when treatment options were considerably more limited. Though treatment options have expanded and improved survival rates, women diagnosed with breast cancer can still expect to confront some side effects as they navigate their way through treatment. Pain is one of the more common symptoms breast cancer patients experience, both before diagnosis and during treatment. In fact, breast cancer treatment plans typically include strategies to address pain. Breastcancer.org notes that most breast cancer patients can get complete relief for their pain. However, it may take some time before the right formula is found and patients can return to enjoying daily activities. The American Cancer Society notes that medication is typically part of cancer patients “pain treatment plans. Breast cancer patients unaccustomed to taking medication each day can consider these tips to effectively manage their medications as they progress through their treatments. ► Take your medication on a regular schedule. The ACS advises cancer patients who have been diagnosed with chronic pain to take their medications around the clock on a schedule, rather than taking it only when pain is severe. Schedules can be adjusted, but patients should not do so

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on their own. Pain medication schedules should only be adjusted after speaking with a physician. ► Familiarize yourself with pain medication side effects. Pain medications may produce side effects such as sleepiness and dizziness. The ACS notes that these symptoms typically improve after a few days, but cancer patients must recognize the threat they pose. Patients may need help getting up or walking, and the ACS discourages patients from driving while on pain medication until they are sure of the effects of the medicine. ► Do not crush or break pills. Many medicines are time-release medications in pill form. Taking broken or crushed pills can be very dangerous. Only patients who get the go-ahead from their physicians to take crushed or broken pills should do so. ► Monitor your side effects. No two people are the same, so some cancer patients may react differently to pain medications than others. Keep track of any abnormalities and side effects you experience while taking pain medicine. Discuss them with your cancer care team during each doctor visit, and report severe or uncomfortable symptoms to your physician immediately. Pain medication can help breast cancer patients overcome a common side of effect of both their disease and their treatments. Learning to manage pain medications is vital for patients as they recover from their disease. 

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October 2020

Understanding a metastatic breast cancer diagnosis

A

Metro Creative metastatic breast cancer diagnosis can be overwhelming. Sometimes referred to as stage IV breast cancer,’ metastatic breast cancer is cancer that has spread from the breast to another part of the body, and many patients diagnosed with this disease are overcome with emotions that can be difficult to process. Though some women are diagnosed with metastatic breast cancer on their first trip to the doctor, BreastCancer.org notes that nearly 30 percent of women diagnosed with early-stage breast cancer will eventually develop metastatic disease. Such women may be left with a host of questions, and some may even question their previous treatments, especially when considering early diagnosis is often touted as the best way to beat breast cancer. In such instances, direct conversations with a physician can be a woman’s best ally, as can a general knowledge of metastatic cancer.

How does metastatic breast cancer occur?

Women who have beaten breast cancer in the past naturally wonder how the cancer spread to other parts of the body to become metastatic breast cancer. It can be especially confounding because metastatic breast cancer, as noted by the Susan G. Komen organization, most often arises months or years after an initial treatment for breast cancer. This occurs because cancer cells can break away from the tumor in the breast and travel to other parts of the body. Some may travel through the bloodstream, while others may move through the lymphatic system. The lymphatic system is a large, complex network of nodes and vessels that’s responsible for removing bacteria, viruses and cellular waste products. The Metastatic Breast Cancer Network notes that it’s fairly easy for breast cancer cells to travel away from the breast. However, only a select few of these cells tend to survive and grow in other organs, as the body typically rejects or attacks things it does not recognize. But metastatic cancer cells seem familiar enough to the body that it allows them to grow.

how long cancer cells will be inactive before they begin to grow and become detectable. Part of what makes a metastatic breast cancer diagnosis so difficult to handle is that many women who receive such diagnoses had beaten breast cancer in the past. In fact, the MBCN notes that doctors may speak of breast cancer as a disease that can be treated and then ends. But recurrence is always a possibility, as sometimes cancer treatments leave cancer cells behind. WebMD notes that even a single cancer cell can grow into a new tumor. The Susan G. Komen organization notes that roughly 34 percent of women who have had metastatic breast cancer in the United States today have been living with it for five years. It’s important for women who receive such a diagnosis to remember that figure as they fight this disease. More information about metastatic breast cancer can be found at www.mbcn.org. 

Why did I get metastatic breast cancer?

The MBCN notes that doctors have conducted extensive research on the process of metastasis, but to date it’s impossible to predict

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