ENCORE #50! – Does EVERYONE, ALWAYS Need Radiation After A Lumpectomy?

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 August 2013. The root of this one is from: http://www.medicalnewstoday.com/releases/264999.php

One of the most AMAZING things about consistently looking at current breast cancer research is that the discoveries seem to be never-ending. I can’t imagine ever stumbling across a headline that reads, “Scientists Know Everything About Breast Cancer, Research Centers Closed”…

Aside from the shock to breast cancer researchers if they actually reached their ultimate goal, I wonder what the next frontier would be? Certainly the world of research changed when smallpox was finally vanquished or we conquered polio.

At any rate, there’s news now that breast cancer treatment may be taking another turn – women who contemplate a lumpectomy typically follow up with both radiation and some sort of chemotherapy.

One research team is now proposing that treatment centers and doctors WEIGH the advantages and disadvantages of subjecting a woman to sometimes debilitating treatment with radiation. “The most contentious issue surrounds radiotherapy and whether all patients undergoing breast-conserving surgery should receive it. The authors believe that if toxic effects of radiotherapy exceed any oncological gains amongst DCIS patients, it is likely to lead to a higher all-cause mortality rate.”

In other words, it’s a case of “if they don’t need it, don’t do it” school of medicine.

While the research DOES NOT SAY RADIATION TREATMENT IS A WASTE OF TIME OR HARMFUL IN ALL WOMEN, they do note that “Present treatment options for DCIS [ductal in situ carcinoma – the most common form of breast cancer] are acknowledged as being excessive for many patients, and the aim of molecular profiling is to ensure that additional treatments such as radiotherapy are restricted to patients at highest risk of invasive recurrence."

What is molecular profiling? “Molecular profiling [looks at] the [patient’s] genetics and... [looks for] molecules found in the blood, other body fluids or tissues. Based on the information gathered from a patient’s tumor, doctors are able to identify the appropriate therapies that target[s that] patient’s cancer cells.”

So, doctors are working to first detect breast cancer as early as possible, then treat the cancer effectively using ONLY what is needed to heal the patient. This would include the recent push to only remove SENTINEL lymph nodes that test positive for cancer rather than entire lymph node structures along with recent research that indicates that it MAY be possible to reattach the lymph ducts from a limb back into the blood stream if a large number of nodes were removed, thereby reducing the incidence of lymphedema...but that’s the subject of another post!

Targeted treatment for maximum impact with minimal damage? Sounds like a good plan to me.

Resources: http://www.cancercare.org/publications/166-molecular_profiling_personalizing_treatment_for_breast_cancer

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT #30…Breast Cancer: Nigeria

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…

Most people don’t know that for most of 1984, I was in the West African countries of Nigeria, Cameroon, and Liberia.

I got to thinking this morning when I noticed that some of my blog entries have taken a new direction, that I can pretty much talk about whatever I want to talk about.

So, it got me to wondering: what are the breast cancer facts, figures, and treatment in these three developing countries and what does it have to do with me – or you? Two of them have recent histories rife with coup d’etat, civil war, and mass exodus. One of them has had the same president for 34 years.

What have they accomplished for women’s health in relation to breast cancer – and why would it matter to us in the US?

Nigeria: Well…here was study conducted in 1992. That’s almost a quarter century old… (https://www.ncbi.nlm.nih.gov/pubmed/1393468). There DOES seem to be a current drive to help the women in Nigeria and that is what you’ll find below.

“BACKGROUND: In most resource-constrained settings like Nigeria, breast self-examination self-breast examination (BSE) is culturally acceptable, religious friendly and attracts no cost. Women's knowledge and beliefs about breast cancer and its management may contribute significantly to medical help-seeking behaviours. This study aimed to assess knowledge and beliefs of BSE among market women.

METHODS: A descriptive cross-sectional study was conducted among 603 market women in Ibadan, Nigeria (Ibadan is a major city with a heavy Western influence. This is not necessarily representative of MOST women in Nigeria). Data was collected using semi-structured interviews and analyzed using descriptive and analytic statistical methods.

RESULTS: The mean age of the respondents was 34.6±9.3 years with 40% of the women aged between 30-39years. The proportion of married women was 339 (68.5%) with 425 (70.8%) respondents reporting that they do not know how to perform BSE. However, 372 (61.7%) women strongly agreed that BSE is a method of screening for breast cancer. Highest proportion 219 (36.3%) reported that the best time for a woman to perform BSE was 'anytime'. Most of the respondents believed breast cancer is a dangerous disease that kills fast and requires a lot of money for treatment. (Emphasis mine)

CONCLUSION: More efforts are needed in creating awareness and advocacy campaigns in the grassroots in order to detect early breast cancer and enhance prevention strategies that would reduce the burden of breast cancer in Nigeria. - See more at: http://www.cancerindex.org/Nigeria#sthash.vxdUxdCI.dpuf”

The conclusion: “The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need.” http://www.cancerindex.org/Nigeria#sthash.vxdUxdCI.dpuf

Why should this matter to you? Why should the matter to me?

I COULD wallow in guilt. That would be both easy and satisfying! Instead, I’ve decided I’m going to take a character I’ve created in a science fiction short story, and send him on a few adventures. Most likely, he’ll be travelling with a hard-thinking woman who will become his perfect match. They’ve already started out rebuilding the educational infrastructure of Liberia in the future middle of this century. I’m thinking the two of them need to make a trip to Nigeria. Separately – where they’ll meet and butt heads.

The driving issue will be breast cancer education, diagnosis, and treatment in these three West African countries that hold a special place in my heart. From the sale of the stories, I’ll donate the money to breast cancer research in those places…

Resource: http://www.cancerindex.org/Nigeria

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #49! – The Wicked Witch of the West Is DEAD! – Thoughts on the Continuing Life as a Breast Cancer Husband

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 August of 2013…

We started celebrating our 26^th wedding anniversary this past week.

“Started celebrating” because as a teacher, my paycheck “runs out” at the end of the summer, a few weeks before we start work again. This has been true for the past 26 years just as it is true this year.

Because of that, we’ve never had what you’d call a “spectacular” anniversary. Don’t get me wrong, we’ve had many GOOD times! Went to a local dinner theater last year to see the musical XANADU; did a “blockbuster movie” watch the year APOLLO 13 and EXCALIBUR came out topped with supper at the then brand new local Champps. For another we spent a night at a Bed & Breakfast in Stillwater. This year my wife had a quiet day at home while I hurried north to pick up my daughter-in-law and grandkids to ferry them to a doctor appointment – my granddaughter had pneumonia. We had takeout that night from our favorite Chinese restaurant and watched OZ THE GREAT AND POWERFUL. The addition though is that with some old and dear friends of ours, we’ll be spending the Thanksgiving holidays in Wild Eagle, Wisconsin at a resort for a week! That will allow us to celebrate in the style we should have been celebrating all along.

So what does all this have to do with breast cancer?

While it may not be obvious to you, it is to me: we get to celebrate our 26^th wedding anniversary two and (almost) a half years after a breast cancer diagnosis! In 1911 the diagnosis would have been a death sentence. In 1961, she would have been treated with “stone knives and bearskins” with drugs that would have made her violently ill and miserable – and probably wouldn’t have made much difference at all.

Here in the second decade of the 21^st Century, the treatments she received and continues to receive cured her of the cancer and given us a chance to celebrate our...well, when I exclaimed that we could be together for another 26 years, my wife pointed out that I would 90 years old by then. Hmmm...I guess if that’s God’s plan, then so be it. But 90? Whew – that DOES seem old.

At any rate, in the here and now, the point is that we’re planning an extended celebration of our 26^th Wedding Anniversary and those plans rest firmly on the basis of the pain, treatments, research, advances, and drug regimens my wife has experienced since the original diagnosis.

So “...let the joyous news be spread, the Wicked Old Witch at last is dead!” (And no, I DON’T mean the Wicked Witch of the East with the Ruby Slippers – I mean the melted remains of her sister – the Wicked Witch of the Cancerous West!)

Let the celebration continue!

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #50: Breast Cancer and Prostate Cancer In Relatives May Indicate an Increased Chance of Breast Cancer

From the 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.breastcancer.org/research-news/prostate-cancer-related-to-bc-risk

So…my wife had breast cancer. My dad had prostate cancer – but my MOM didn’t have breast cancer and I don’t have prostate cancer…

So, what does this mean for my kids?

Backtrack for a second: I have a BS in biology with additional classes in earth, space, soil, and chemical sciences that allow me to teach (at least one class of) anything from astronomy to zoology. I pretty much know what I’m talking about when it comes to genetics, cancer, and Alzheimer’s. NOT because the degree magically imparted on my special knowledge, but because I can read the reports, papers, abstracts, and scholarly articles and then understand them (sometimes with a bit of research).

So – I made a map, or a Cancer Family Tree. You can see it above.

Based on this article and my Cancer Family Tree, I can say that my daughter is NOT in this class of possible breast cancer risks. My sister isn’t, either.

I can’t say that I’m breathing a sigh of relief because we ALL know that BC is far more complicated than this. But it’s somewhat reassuring.

“‘These findings are important in that they can be used to support an approach by clinicians to collect a complete family history of all cancers -- particularly among first-degree relatives -- in order to assess patient risk for developing cancer,’ said Jennifer Beebe-Dimmer, Ph.D., M.P.H. of the Barbara Ann Karmanos Cancer Institute and Wayne State University, who was the lead researcher. ‘Families with clustering of different tumors may be particularly important to study in order to discover new genetic mutations to explain this clustering.’”

I suppose I’ve “known” this all along, but seeing it in such stark terms, I can see that my family has a long history of cancers…not just one kind: lung, skin, prostate. My wife’s family is just as varied: lung, liver, breast cancers. It looks like my kids have an entire suite of things to keep an eye on. Not to worry. Strides are being made in cancer research all the time. It’s why we host such events as Relay For Life, Susan B. Kommen events, and all the others.

A cautionary note. Any of you ever see I AM LEGEND? “. The story is set in New York City after a virus, which was originally created to cure cancer, has wiped out most of mankind, leaving Neville as the last human in New York...” in a city infested with zombie-like nocturnal things. The movie opens with “Emma Thompson has an uncredited role as Dr. Alice Krippin, who appears on television explaining her vaccine for cancer that mutated into the ‘zombie’ virus.”

The cautionary note? Cancer is complex, varied, and has dozens of factors that affect it. There IS no straight line between genetics, environment, lifestyle and the onset of cancer in Humans. A Human-engineered vaccine against cancer could very easily succumb to natural forces and turn into something terrifying.

On THAT happy thought, see you later!

Image: Personal camera, © Guy Stewart 2016