ENCORE #77! – Bone Density Scan

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 2014.

The word today is “osteoporosis”.

My wife just had a “bone density scan” done and the doctor said that the indications are that she has the beginning stages of this disease.

So I thought I’d take a step back and do a “translating the doctors” column.

First of all – why does the bone density of a breast cancer patient matter. (I won’t be using the last letter of the alphabet, a question mark or the mathematical symbol for nothing – they have stopped working.) At any rate, bone density matters: “Osteoporosis is a condition in which the bones become less dense and more likely to fracture.”

Sounds simple enough. Factors that figure into the disease are on this site, too. The problem is that: “Women who have had breast cancer treatment may be at increased risk for osteoporosis and fracture for several reasons. First, estrogen has a protective effect on bone, and reduced levels of the hormone trigger bone loss…Studies suggest that chemotherapy also may have a direct negative effect on bone. In addition, the breast cancer itself may stimulate the production of osteoclasts, the cells that break down bone.”

In order to monitor patients during treatment and afterwards, doctors do something called a “bone scan”. What’s THAT mean (question mark)

Here’s a simple explanation of what happens: “The DXA (= Dual-energy X-ray Absorptiometry) machine sends a thin, invisible beam of low-dose x-rays with two distinct energy peaks through the bones being examined. One peak is absorbed mainly by soft tissue and the other by bone. The soft tissue amount can be subtracted from the total and what remains is a patient's bone mineral density…it feature[s a] special software to compute and display the bone density measurements on a computer monitor.”

The question now is does this mean you should panic – and the doctor’s advice is “NO!” While osteoporosis can’t be “cured”, you can take steps to lessen the effects. “Getting enough calcium and vitamin D is essential to building strong, dense bones when you're young and to keeping them strong and healthy as you age.”

And you do that by eating well “…food is the best source of calcium. Dairy products, such as low-fat and non-fat milk, yogurt and cheese are high in calcium. Certain green vegetables and other foods contain calcium in smaller amounts. Some juices, breakfast foods, soymilk, cereals, snacks, breads and bottled water have calcium that has been added. If you drink soymilk or another liquid that is fortified with calcium, be sure to shake the container well as calcium can settle to the bottom.”

In our case, my wife is planning to increase her calcium intake – while she uses the chocolate “calcium chews”, she’ll add in the foods.

So if SHE’S not panicking, no reason for anyone else to panic! Be smart and eat well and take the drugs prescribed. If we end up going that route, I’ll do another post. But for now, this is what we know!

Resources: http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/osteoporosis_breast_cancer.asp, http://www.radiologyinfo.org/en/info.cfm?pg=dexa, http://nof.org/articles/10#CALCIUMSOURCES

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

GUY’S GOTTA TALK ABOUT #39…Looking Forward To the Day It’s All Just A Bad Memory

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…

Since the chemotherapy ended a couple of years ago, we don’t talk about cancer any more.

Sometimes that’s strange; sometimes it’s an attempt to, not exactly pretend, but block out parts of those years. Like when I see the Christmas picture the family took that year, I see many things that were different – my daughter-in-law is pregnant with our SECOND grandchild.

Dad doesn’t have Alzheimer’s.

Mom is alive.

My great-niece hasn’t been born yet.

My nephew, my niece, and my daughter are all still unmarried.

Everyone is smaller.

Mom and Dad are in the center and the rest of us are gathered around them…

And then there’s my wife. She has no hair. She’s standing just a few months post-chemotherapy.

So much has changed that a little thing like breast cancer shrinks to “just one more thing”. It sounds like it should be a huge part of our lives forever and while it IS, it’s no longer the monster it seemed back then. Of course there are shadows of “recurrence”. Of course there are consequences for fighting back against so horrible a disease.

But, I have a strange feeling this is exactly as it should be. Once beaten, we SHOULD bury the demon; or cast it back into its fiery Hell to burn with the rest of the trash that gathers around lives both lived well and lived badly. But maybe she SHOULD forget. My daughter and I both shake our heads when my wife says, “I just don’t remember that much from that whole time.”

My daughter and I look at each other and one of us says, “We do.” Because it’s true. We remember every treatment, every suction bag draining, every bandage change, every tear shed, every moment of hopeless horror, every bag of Red Devil poison pumped into her bloodstream targeting the fastest growing cells in the body – which is why hair growth cells (follicles) died along with the cancer cells. We remember it; and are thankful that my wife DOESN’T.

It’s something that should stay forgotten, and if I have unexpected flashbacks, that’s OK so long as the cancer stays beaten and my wife continues to enjoy her job, our kids, kids-in-law, foster kids, grandkids, and old friends. Puzzles are a joy again rather than a distraction from pain; food is fun rather than a chore.

It’s OK to forget some things. I look forward to the day that this is all so long past that it’s barely a bad memory.

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

ENCORE #76! – 12 Inspiring Quotes From Men Who Care For Women With Breast Cancer – or Who Have Survived Breast Cancer Themselves

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 June of 2014…

“For people who don't know me, I practiced medicine in Casper, Wyoming for 25 years as an orthopedic surgeon, taking care of families in Wyoming. I've been chief of staff of the largest hospital in our state. My wife is a breast cancer survivor.” – John Barrasso (US Senator, Wyoming)

“Men are incredible caregivers when given the opportunity. But they are underserved in education about support,” – Marc Heyison (Author, Founder – Men Against Breast Cancer)

“At the clinic she went to, they said, ‘Here is some information,’ and it was a tri-fold paper that said what to expect, and to be supportive, he recalled. Well that’s not really enough. You need more than that. I tried to get help, but there was nothing there to go to.” – Chris Wrobel (Husband and caregiver of a breast cancer survivor)

“All of the reality TV I've done has usually been simultaneously an opportunity to create awareness or raise funds for my mom's breast cancer organization.” – Stephen Baldwin (American actor, director, producer and author)

“One of the things we've always tried to do is help others with our story. Whether it's with the infertility issues, whether it's with the breast cancer, we said we're gonna turn these negatives into positives. And if we can help others by sharing our story, then it's worth it.” – Bill Rancic (Husband and caregiver of Giuliana Rancic, Italian American television personality and journalist)

“I have experienced firsthand the tremendous impact breast cancer has on the women who fight it and the loved ones who support them. This is a disease that catches you unaware and, without the right resources, leaves you feeling frightened and alone.”

– Ricardo Antonio Chavira (American actor, Desperate Housewives, and son of a breast cancer victim)

“Men get it. I think us men need you women to help us survive.” – Peter Criss (Drummer from the heavy metal band KISS)

“I learned that it is better to tell people what they mean to us now, rather than to save it for a eulogy at a funeral service.” – David (breast cancer survivor)

“We all know people – mothers, sisters, daughters, neighbors – who have dealt with breast cancer, and it’s wonderful when we know people who are really surviving.” – G Roy Duhé (PhD, breast cancer researcher)

“When we embrace uncertainty, it can be very liberating. If you can accept the uncertainty, it allows you to live life every day.” – Victor Gospodinoff (Caregiver and husband of breast cancer survivor)

And lastly, something I said that resonated…with me…

“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…” – Guy Stewart

Resource: http://www.menagainstbreastcancer.org/wp-content/uploads/2013/04/bookComplete-1.pdf 

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

GUY’S GOTTA TALK ABOUT…Alzheimer’s #12: A CONFIRMED Method to Help Prevent Dementia!

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

It's called “Speed of Processing”.

According to the site listed below: “Processing speed involves one or more of the following functions: the amount of time it takes to perceive information (this can be through any of the senses, but usually through the visual and auditory channels), process information and/or formulate or enact a response. Another way to define processing speed is to say that it’s the time required to perform an intellectual task or the amount of work that can be completed within a certain period of time. Even more simply, processing speed could be defined as how long it takes to get stuff done.”

Hmmm…this sounds like something people have to do in order to get into the civil service – specifically into the Post Office. https://www.test-guide.com/postal/free-postal-exam-questions/postal-exam-473-part-a.html

When I was a cashier in a grocery store, we had to do processing – before the advent of UPC stripes, we had to read the price on the top of the item, and type it in by touch. Today, cashiers don’t have to do anything except position the purchase and pass it over a glass screen. I suppose though, that it requires a certain amount of processing skill…

Of course, at the third site listed below, YOU TOO can purchase this BRAIN-SAVING program!!!!!! For only $100 a month (paid annually. If you choose the monthly payment plan, you pay $130 or so a year). I also have no idea how hard it would be to get out of your contract – there’s no “your money refunded if not absolutely satisfied!!!!!” mentioned on the page…

Do I sound sarcastic? Do I sound obnoxious? Do I sound bitter? My attitude springs from the thought that with the prevalence of Alzheimer’s and other dementias and the costs associated with the disease (https://www.alz.org/facts/?gclid=EAIaIQobChMI-KyetoPV1wIVA7XACh0sWgPbEAAYASAAEgJYoPD_BwE) (we pay $5000/month for my father to live in a Memory Care Unit of a very nice retirement apartment community), you’d think that the program would be offered free-of-charge, promoted by the Atheists of America and the TransHumanist Society of Earth and by the Pope, the Dali Lama and any of the other people listed here: https://globein.com/b/10-most-influential-spiritual-leaders-around-world-4.

But this is the first I’ve ever heard of it. How about you? If there is strong evidence that it will prevent dementia, why aren't the "pro-vaxxers" screaming for it to be provided to everyone on Earth whether they want it or not?

Hmmm...OH! It must not serve someone's narrow political agenda -- I mean all it would do is save people from spending their twilight years answering the television remote when the phone rings...

Sarcastic? Bitter? Obnoxious? You bet your ass!

Resource: http://news.medicine.iu.edu/releases/2017/11/brain-exercise-dementia-prevention.shtml, http://www.mghclaycenter.org/parenting-concerns/grade-school/intro-processing-speed/,  https://www.brainhq.com/world-class-science/published-research/active-study?lead_id=google-search-text-custom-ACTIVE_Study&gclid=EAIaIQobChMI5_mGguvT1wIVl7jACh2CdgRlEAAYASAAEgLF9fD_BwE, https://medicine.iu.edu/blogs/research-updates/brain-training-dementia-prevention/

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg

ENCORE #75! – Breast Cancer Wisdom 10

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 April of 2014.

When I started this site, I was looking for a title for it and stumbled across STA ND BY HER. Excited, I began to skim through the site. When I discovered a forum, I was nearly ecstatic. I’d finally be able to talk with other men about how they felt about breast cancer in their wives, sisters, aunts, mothers, and friends!

Not.

The forum had been overrun by spambots. I tried it today – and it’s dead. As a doornail. Here’s the message:

General Error

SQL ERROR [ mysql4 ]

Unknown MySQL server host 'standbyherbbphp.db.5015781.hostedresource.com' (0) [2005]

An sql error occurred while fetching this page. Please contact an administrator if this problem persists.

Men continue to say nothing about breast cancer and their feelings. There is no international network. No national clearinghouse. There’s barely state and local fora for men to talk.

Is that because men generally DON’T talk? That was the premise of my website. Three years later, most of the men I know STILL don’t talk. There is a man at work whose wife went through breast cancer treatment around the same time my wife did. Do we talk? Commiserate? Share?

Nope.

Shortly before my wife was diagnosed, an old acquaintance of mine eventually came out to an online group he ran and I participated in that his wife had been diagnosed with breast cancer. I offered what comfort I could – but it was a cold comfort because we hadn’t seen each other in decades. Four months later, my wife got the diagnosis. This friend offered more than comfort – he was THERE for me. We still hadn’t seen each other, but through him, his wife offered support to my wife. Some time later, we met for lunch and while we STILL didn’t talk about breast cancer and how it affected us and our wives, we sat at the same table and simply “were” together.

The late Madeleine L’Engle once wrote, “When I am constantly running there is no time for being. When there is no time for being, there is no time for listening.” (Walking on Water: Reflections on Faith and Art)

I think I’m beginning to see that men are never going to talk to each other – they find it helpful instead just to “be” with each other. Knowing that there are others like them who struggle with their beloved women dealing with breast cancer is, maybe, enough for most men.

John W. Anderson and me – and others – though will talk with our computers. After all, since I started the blog, I’ve gotten nearly 16,000 hits. I figured out in my head last night as I was coming home with Chinese food, that that is roughly ten hits a day. Who hits the site? No idea; there have only been 16 comments. *shrug* I am not only resigned to that now, I’m actually OK with it. I may never know if I helped anyone by doing this site – but now I understand that just BEING here may help some.

And that’s OK with me.

Resource: http://www.barnesandnoble.com/w/stand-by-her-john-w-anderson/1100313600?ean=9780814413913

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

BREAST CANCER RESEARCH RIGHT NOW! #57: A Possible Bright New Tomorrow in Treating Certain Types of Breast Cancer!

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:

Effect of neoadjuvant chemotherapy on tumor-infiltrating lymphocytes and PD-L1 expression in breast cancer and its clinical significance

Whew!

In plain English?

Neoadjuvant: sometimes doctors will use chemo to shrink tumors they’ve discovered BEFORE they do lumpectomies or even radical mastectomies. They’re discovering that not only does the chemo shrink the tumors, they also seem to boost the body’s own immunity response.

Some other terms I came across in reading the article I linked to below:

Immune markers: Cluster of Differentiation (abbreviated as CD) is a method used to identify and investigate the outside of certain molecules that are targets on cancer cells for chemotherapy. CD molecules can act in many ways, often acting as receptors or molecules that turn receptors on that are important to the cell. When a cell gets a certain set of signals, the behavior of the cell can change. Other CDs cause cells to stick together.

Tumor infiltrating lymphocytes: white blood cells (the ones that fight infections) that, when they increase makes it more likely that a breast cancer patient will STAY cancer free.

Programmed death ligand 1 – (the PD L1 in the title of the article) an increase in this protein ALLOWS cancer cells to grow by stifling the production of cancer-toxic cells in the area around a tumor.

The cells that fight cancer secrete cytotoxins – “cell poisons” – that exert anti-tumor activity by causing a response that destroys chemo-damaged cells. That may then lead to your own immune system kicking in to fight the cancer. The balancing act comes from the possibility that the chemo that damages the cancer cells MIGHT kill the lymphocytes that are supposed to kill the tumor cells…

So, all together: current research is studying the effect of shrinking tumors with chemotherapy making it so that there will be LESS surgery, and that when there IS surgery, it’s not as invasive. As well, the use of neoadjuvant therapy can also stimulate the body’s own immune system – but there is a fine line between initiating your own body to protect itself and destroying that same defense system.

We’ll see how far we can get in the future – there may conceivably come a time when at the first sign of certain types of breast cancer, doctors start the tumor-shrinking therapy, followed by the removal of what remains, and the “hyper-activation” of the body’s own defenses to complete the treatment.

Now THAT will be a brighter tomorrow!

Resources: https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-017-0884-8

Image: http://peggyrcc.com/wp-content/uploads/2012/07/35-neoadjuvant-therapy-axitinib-43-yp-wf-s-p-12-weeks-axit.jpg?w=300

ENCORE #74! – Reconstruction Part 11 – Breast Reconstruction Challenges…

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 April of 2014.

While it may seem an obvious choice to some who are outside of the breast cancer community (are there ANYONE who is?) breast reconstruction is not an easy choice.

After months that include radical mastectomy, chemotherapy, hair loss, and recovery, the decision to “go under the knife” again is not one that women take lightly.

Even so, new research shows that more and more women are undergoing the procedure to rebuild what was once there. “Researchers found that 46 percent of patients received reconstruction in 1998 but that figure rose to 63 percent by 2007.”

While this article was informative, from a layperson’s point of view, I find the authors somewhat narrow-minded – perhaps even “ignorant” – about certain things, and that bothers me.

For example, “The study also revealed dramatic variation in reconstruction based on geographic region, from a low of 18 percent in North Dakota, to a high of 80 percent in Washington, D.C. This was largely associated with the number of plastic surgeons working in each state…Any time we see geographic variations in practice patterns, we worry that care is not being appropriately individualized and that patients are not being offered all their options. It’s important to make sure women have all the information they need about breast reconstruction and are aware that it is an option...” (emphasis mine)

REALLY? REALLY? Have any of the authors even visited North Dakota? Clearly not! I actually have friends from ND – and some from DC. As a whole, ND is a very conservative state with a preponderance of farmers and has a frontier attitude. A “I can take it” sort of way of looking at the world. I would say THIS has a larger effect on the number of women getting reconstruction after mastectomies than “the number of plastic surgeons”. Did the authors consider that the attitude of your average NoDak would drive out plastic surgeons; they’d be seen as superfluous parasites. And DC’s plastic surgeons? REALLY? REALLY? In a city where the highest rollers are broadcast nationally and internationally with close-ups and in press conferences on a minute-by-minute basis, plastic surgeons would FLOCK there to make sure our politicians look pretty on TV and in webcasts!

That seems such a no-brainer, it makes me wonder about the rest of the study.

This seeming blindness brings into question another statement: “The researchers also note that more women are receiving implants rather than recreating breasts using tissue from other parts of their body, called autologous reconstruction. Autologous techniques tend to deliver better cosmetic results and higher satisfaction, but it’s a time-consuming, demanding operation that requires a longer hospital stay and recovery time. The researchers raise concern that current medical reimbursement discourages surgeons from offering autologous reconstruction.”

REALLY? Choosing a long, difficult surgery with a lengthy recovery time after…a long difficult surgery with a lengthy recovery time doesn’t seem a natural aversion-reaction by breast cancer survivors and can be more sensibly ascribed to INSURANCE COMPANY PRESSURE????

Hmmm. My further comment here would be that perhaps the authors – maybe even more breast reconstruction plastic surgeons – should cast more widely when interpreting their research data. Even so, the update on the subject was reasonable and even though the interpretation was narrow-minded, the DATA was sound.

Resource: http://www.mcancer.org/news/archive/more-women-receiving-breast-reconstruction-after-mastectomy-study-finds

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