Saturday, March 28, 2015

BREAST CANCER RESEARCH RIGHT NOW! #31: Breast Cancer, Stress, and INCREASING Quality of Life


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From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: http://www.sciencedaily.com/releases/2015/03/150323075936.htm

As you can imagine – or know from personal experience – a diagnosis of breast cancer and stress are practically twin diagnoses.

But how many women – or couples – get help in dealing with the stress? While I can’t speak for everyone, I CAN say that no one mentioned “stress reduction” when my wife got the news four years ago. No one said, “You should take up meditation.” No one suggested going on retreat. No one gave my wife a list of stress-reducing exercises. It wasn’t even a THOUGHT...

“Women with breast cancer who participated in the study initially used stress management techniques to cope with the challenges of primary treatment to lower distress. Because these stress management techniques also give women tools to cope with fears of recurrence and disease progression, the present results [fifteen YEARS later] indicate that these skills can be used to reduce distress and depressed mood and optimize quality of life across the survivorship period as women get on with their lives.”

While this article offers hope for those who get a breast cancer diagnosis, I had to go elsewhere to get the “skinny”. Below you’ll find suggestions and directions for some practical ways to reduce stress. I can’t say as a doctor that starting a year or four years or even ten years later will have the same effect on quality of life in people who have a breast cancer diagnosis, BUT I think I can say with confidence that it won’t hurt anyone – patient or partner.

Two-minute relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly.

Mind relaxation. Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful" or a short phrase such as "I feel quiet." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.

Deep breathing relaxation. Imagine a spot just below your navel. Breath into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

And in general:

Keep a positive attitude.

Accept that there are events you cannot control.

Be assertive instead of aggressive. "Assert" your feelings, opinions or beliefs instead of becoming angry, combative or passive.

Exercise regularly. Your body can fight stress better when you are physically fit.

Eat well-balanced meals.

Rest and sleep. Your body needs time to recover from stressful events.

Don't rely on alcohol or drugs to reduce stress.

While all of this sounds perfectly reasonable standing four years after those first days of horror; and understanding that the LAST thing you want to hear is “relax”; it might have been helpful if the doctor or nursing staff had done this for us – BOTH of us.

There is nothing though, to stop us from starting this now!


Saturday, March 21, 2015

ENCORE #9 ! – “Why are so many people dying of cancer?”


http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg
From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in a September 2012 post…

Not the first person who ever asked this; not the first time we’ve ever asked it – http://breastcancerreaper.blogspot.com/2011/06/why-do-so-many-women-have-breast-cancer.html is there an ANSWER?

Anecdotally, I’ve heard that the reason so many people are dying of cancer is because we simply live longer. The average life expectancy of all Humans on Earth is 67.2 years.

So? That seems like a really short time! How can that be? What did it USED to be? Hmmm…according to Wikipedia (always my initial go-to source), the average lifespan in Greece, Rome, and Inca/Mayan times was 28; in the Caliphates of northern Africa and the Middle East it was 35. That was what, like 2500 years ago? Right.

So it’s pretty much doubled.

I’ve heard that the reason we get cancer now is that even though cancer was PRESENT then, it didn’t have enough time to kill the person it was growing in. People died of old age before symptoms of various cancers like unintentional weight loss, fever, being excessively tired, and changes to the skin appeared. As well, coughing, difficult or painful swallowing, changes in bowel habits, easily felt masses, coughing up blood, or blood in the bowels, the bladder, or the uterus, localized pain or even painless swelling, and possibly a buildup of fluid in the chest or abdomen could be attributed to lots of things in the ancient world, up to and including the Black Death!

While Hippocrates observed tumors of various types (including breast cancer) in ancient times when life expectancy was only 28 years; and the Egyptians were actually removing tumors 2000 years before the birth of Christ, no one had a real handle on cancer until scientists and doctors started to pool their knowledge in the 1700s and 1800s. By then, life expectancy had increased to about 36 years.

“….cancer…[has] always been with us. People have been getting cancer from the earliest days of their existence (whenever that might be). Heck, most animals get cancer. Even some plants get cancer-like growths...the potential for cancer is in each and every living creature…we also know quite convincingly, and all nonsensical prehistoric arguments aside, that the incidence of cancer has increased dramatically over the last century.” (Written by a man who has no credentials except that he likes to write disparagingly…)

“Incidence: In 2000-2004, across Australia, there were 3,083 cancers diagnosed among Aboriginal and Torres Strait Islander people. The most common cancers diagnosed among Indigenous males in this period were of the lung, bronchus and trachea (19% of all male cancer reported), prostate cancer (10%), colorectal cancer (10%), cancer of unknown primary site (6%), and lymphomas (5%). The most common cancers diagnosed among Indigenous females were breast cancer (25% of all female cancer cases reported), cancer of the lung, bronchus and trachea (12%), colorectal cancer (9%), cancer of the cervix (7%) and cancer of unknown primary site (6%). In the same period, more new cases of cancer were reported among Indigenous females (1,598) than Indigenous males (1,485) compared with the non-Indigenous population.” (http://www.healthinfonet.ecu.edu.au/chronic-conditions/cancer/reviews/our-review)

So, what about cancer among non-aboriginal Australians? Go to the site above and scroll down to the chart. If Aboriginal Australians, who eat pretty much the way they always have (this isn’t just “city aboriginals” – this is ALL of them), have cancer – some types being more common among THEM than non-indigenous Australians. Statistics speak more loudly than someone who uses the phrase “nonsensical prehistoric arguments”.

Conclusions? None really except to say that cancer has been with us for a long, long time. There are some cancers that were more common then, some are more common now. “Why are so many people dying of cancer?” So many is a relative term. And the fact is that it’s not important, really. Even mister “nonsensical” and the Australian government will agree that cancers of ALL TYPES needs to be destroyed.


Saturday, March 14, 2015

GUY’S GOTTA TALK ABOUT…#13: Lumps. Bumps. Divots. Scars.


From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

I have a divot in my forehead.

My wife has a divot in her side. Both sides, actually.

Breast cancer – skin cancer in my own experience – is all about divots.

Define divot (plural divots)

1.A torn up piece of turf (e.g. by a golf club in making a stroke or by a horse's hoof).

2.A disruption in an otherwise smooth contour.

It’s the second definition that concerns me here.

After discovery and confirmation four years ago this week, the breast cancer specialists we were working with looked at several options. One of them, used in cases where the cancer was discovered early and was small, is called a “lumpectomy”. In this procedure (I was just struck this MOMENT by the sterility of this word. It sounds so clean and simple. Like when I did “cookbook labs” as a science teacher. It involved steps students would follow to achieve a very specific result. For lots of kids, it involved reading and rereading the procedure, their finger under the step they were following so they could get it “right”. Lumpectomies are nowhere NEAR this simple and involve invasive methods that deform the breast...) “Lumpectomy is the removal of the breast tumor (the "lump") and some of the normal tissue that surrounds it.

Lumpectomy is a form of “breast-conserving” or "breast preservation" surgery. There are several names used for breast-conserving surgery: biopsy, lumpectomy, partial mastectomy, re-excision, quadrantectomy, or wedge resection. Technically, a lumpectomy is a partial mastectomy, because part of the breast tissue is removed. But the amount of tissue removed can vary greatly. Quadrantectomy, for example, means that roughly a quarter of your breast will be removed. Make sure you have a clear understanding from your surgeon about how much of your breast may be gone after surgery and what kind of scar you will have.”

While this makes an attempt at realism, nothing can quite convey the results but a person who experienced it.

My wife had a double mastectomy which is the most extreme form of breast cancer surgery possible.

I can NEVER know what that’s like. I can only imagine it.

Since my own skin cancer surgery, I’ve had a tiny, non-life-threatening taste of what it might possibly feel like to have a lumpectomy. One of the cancers on my face was on my forehead. Using the Mohs procedure (described here: http://breastcancerreaper.blogspot.com/2014/11/guys-gotta-talk-about-9face-and-breast.html) layers of tissue that have cancer cells are removed, tested, then the incision is either closed or another layer of cells are removed and tested. The end result, after healing and recovery, has been a “divot” in my forehead. Touching it right now, I can ASSURE you that it is gigantic and I’m positive everyone sees it but out of politeness, ignores it.

Right. I work in a high school. Politeness is something we work on in our kids every day because about half of them have never experienced it at home. If anyone noticed a divot in my forehead, they’d tell me. Ergo: it’s not noticeable.

My wife had me look at a small lump on her left side the other day, asking, “Is this one of the places that the drains went in?” A matched spot above it confirmed that it is, indeed, the place where one of the drains exited the surgical field four years ago. She also has a scar where the port was placed in order to do chemotherapy.

Lumps. Bumps. Divots. Scars.

These are clearly the legacy of breast cancer – of any kind of cancer. I’m sure plastic surgery could clear up many of them, yet I feel no compulsion at all to GET the surgery. I wonder why...

Sorry for the rambling commentary. But that’s where I’m at today...

Saturday, March 7, 2015

ENCORE # 8! – Take Tamoxifen for TEN Years Instead of Five!


http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg
From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December, 2012...

One of my favorite movies is GALAXY QUEST.

In it, characters from a defunct STAR TREK-act-alike TV show are thrown into a real world alien conflict and expected to be the parts they acted…

At one point, Sigourney Weaver (who plays Gwen DeMarco who plays Lt. Tawny Madison) and Tim Allen (who plays Jason Nesmith who plays Captain Peter Quincy Taggart) have to cross through metal chompy crusher things and then run over a one-foot wide bridge that passes over an endlessly deep hole that is windy…all while aliens are trying to kill them with phasers.

Sigourney Weaver stops and utters an expletive that is VOCALIZED as “Screw this! The sucker who wrote this scene should die!” If you watch her lips, she utters quite a different expletive…

After hearing my wife’s reaction to the recommendation by the American Association of Cancer Research, I might have heard one expletive – but I’m pretty sure the one she was thinking was akin to the one in GALAXY QUEST.

Why?

First: What does tamoxifen do? Some breast cancer cells require estrogen to grow. Estrogen locks on to a cancer cell in certain places and helps it grow. When a person takes Tamoxifen, it’s broken up into parts that lock into the same places that estrogen does – but they STOP the cancer cell from growing. “…tamoxifen acts like a key broken off in the lock that prevents any other key from being inserted, preventing estrogen from binding to its receptor.”

There is also a second  methodology for treating breast cancer that is NOT being changed at this time and that is the use of aromatase inhibitors that work by stopping the production of estrogen. [This is the drug regimen my wife is following at present]: Anastrazole is called an aromatase inhibitor whose primary problem is that it weakens bone structure; though it CAN cause: “Constipation, diarrhea, nausea, vomiting, upset stomach, loss of appetite, body aches and pains, breast swelling/tenderness/pain, headache, dry mouth, scratchy throat, increased cough, dizziness, trouble sleeping, tiredness/weakness, hot flashes/hot flushes, vaginal bleeding, hair thinning, and weight change can occur…mental/mood changes, numbness/tingling/swelling of the hands or feet, persistent cough, unusual vaginal discharge/burning/itching/odor, unusually stiff muscles, pain/redness/swelling of the arms or legs, vision changes, bone pain, bone fracture, signs of infection…”; Letrozole can cause “hot flashes, hair loss, joint/bone/muscle pain, tiredness, unusual sweating, nausea, diarrhea, dizziness, sleeping trouble, (unlikely) bone fractures, mental/mood changes, swelling of arms/legs, blurred vision…(rarely) blood clots.”

Any time a drug is taken, its purpose is to change the body in some way – INTENTIONALLY for the better, but there are almost always side effects. With tamoxifen, the main ones are: hypercalcemia (A higher-than-normal level of calcium in the blood [causing] loss of appetite, nausea, thirst, fatigue, muscle weakness, restlessness, and confusion…constipation, form a heart block, lead to calcium stones in the urinary tract, impair kidney function, and interfere with the absorption of iron)…as well as causing “hot flashes, nausea, leg cramps, muscle aches, hair thinning, or headache…(unlikely) vision changes (e.g., blurred vision), eye pain, easy bruising/bleeding, mental/mood changes, swelling of ankles/feet, unusual tiredness.”

While it is TRUE that taking tamoxifen DOES lower the risk of breast cancer recurrence, it seems to me that researchers should CONTINUE to find new ways of dealing with this devastating disease!

UPDATE 2015: The research announced 2012 was confirmed recently in a general announcement/recommendation by the American Society of Clinical Oncology – though now with very clear guidelines. (http://www.asco.org/press-center/asco-guideline-update-recommends-tamoxifen-10-years-women-non-metastatic-hormone)