breast cancer – Best Health

Waiting Until Age 50 for Mammograms Is Too Late—Especially for Black Women

Christina Frangou — Mon, 13 Mar 2023 11:00:49 +0000

Heather Campbell, a chemical engineer who lives in Calgary, was 44 and had never had a mammogram when she found a lump in her left breast.

Every morning, after completing her skincare regimen, Heather Campbell would rub her fingers in small circles around her breasts, feeling for any changes. On the morning of Friday, October 13, 2017, when she was 44, her fingers bumped against a hard bulge on the side of her left breast. Shocked, Campbell stopped, palpated the lump again and decided shed wait a day before she worried. Breasts change all the time, she told herself. Then she headed to her downtown Calgary office, where she worked as a chemical engineer. The next morning, she checked her breast once more. The lump was still there.On Monday, she called her doctor and got an urgent referral for a diagnostic mammogram. Campbell had never had a screening mammogram, which is the best way to detect breast cancer early and is known to reduce deaths from the disease. Canadas national guidelines, last updated in 2018, recommend that women without a family history of breast cancer have mammograms every two to three years, starting at age 50. Campbell was not due to begin screening for another six years.She remembers standing there, nervous and topless, with her breast squeezed between two plates. The mammogram was immediately followed by an ultrasound. Afterward, as Campbell sat in the screening room without a shirt or bra on, a radiologist came in and told her: We have concerns.I was like, what are you talking about? This is insane, says Campbell. Cancer didnt run in her family. She was four months into a dream job at AESO, Albertas electric system operator, working on their renewable electricity program. She was dating a man she liked, and she still hoped to have children. Campbell returned to her office, sat down in her cubicle and shook, whispering her worst fears into the phone as she spoke to a friend.After that, everything moved quickly: a biopsy; a diagnosis of invasive ductal carcinoma, the most common type of breast cancer; then referrals to a surgeon, a medical oncologist, a chemotherapy support class and a fertility clinic.Over the next six months, Campbell received a half-dozen rounds of chemotherapy, followed by a partial mastectomy that removed 45 percent of her left breast. Staff at the fertility clinic told her that, because of her age, her eggs could not be frozen. Because her breast cancer was estrogen positivemeaning the presence of the hormone in her body contributed to its spreadthe medication used to stimulate her ovaries to harvest her eggs would have also stimulated her cancer, making it worse.(Related: How to Do a Self Breast Exam)In June 2018, she began a three-week regimen of daily radiation treatments, with Saturdays and Sundays off. To reduce her estrogen levels, she had a full hysterectomy and oophorectomy in July 2020.Campbell believes that if she had been screened earlier, she would have been diagnosed at an earlier stage, and spared some of the painful treatments that left her scarred, infertile and too sick to continue at her job.If I had been screened at 40, I probably would have had a little lumpectomy. Maybe a radiation or two, says Campbell. I might have still had children.Campbell is one of many patients, researchers and physicians in Canada who are calling for earlier breast cancer screening for all women, but especially for Black women. Delays in screening may be particularly devastating among Black women, but no one can yet say so with certainty here in Canada. Unlike in the United States, Canada does not collect the race-based data that could demonstrate any heightened breast cancer risks for Black women.But ample evidence from the U.S. shows that Black women are more likely than white women to be diagnosed with aggressive breast cancer at a young age, more likely to be diagnosed with cancer at an advanced stage and more likely to die at a young age from these cancers. Despite these patterns, Black women dont have the same opportunities for screening, genetic testing, treatment and clinical trial participation as white women, U.S. studies show.Without race-based data in Canada, there is no evidence to suggest Black women here experience similarly terrible outcomes. And, yet, there is also no evidence to show that they do not.

Aisha Lofters is a family physician and health equity researcher focused on inclusive cancer care at the Womens College Hospital in Toronto.

Aisha Lofters, a family physician and chair in implementation science at the Peter Gilgan Centre for Womens Cancers at Torontos Womens College Hospital, said she and her colleagues noticed that they were seeing many Black women with aggressive or advanced cancers in their 30s and 40s. These women found lumps on their ownaccidentally or during self-examsrather than by mammograms.To Lofters, this pattern suggests something is wrong. Sometimes the best evidence is peoples stories. Its what they are telling you, she says.Lofters is cautious about applying American data to Canadian women. The two countries health and economic systems differ enormously, she points out. The populations are not comparable. The Black population in Canada is more diverse genetically than the Black population in the United States. Black women in Canada are more likely to have ancestral roots from throughout Africa, whereas Black women in the U.S. more often have ancestry that can be traced to West Africa, reflecting the deep history of people being taken from nations in that region and enslaved in the Americas.Moreover, race is not biological, but is a social construct, says Lofters. This is an important distinction: Genetic predispositions to illnesses depend largely on ancestrywhere someones roots areand not race. Even so, she says, American research is sending a signal about breast cancer and Black women with West African ancestry that Canadians should not, and cannot, ignore. We need to recognize that signal, get people aware of it and produce the best research, she says.(Related: The Forces That Shape Health Care for Black Women)In the U.S., non-Hispanic Black women have a 45 percent higher risk for invasive cancers before age 50 than non-Hispanic white women. This study, which was published in the journal Cancer in 2021, found that Black women are more likely to die from breast cancer before they are 50. Another study that looked at nearly 200,000 women between the ages of 40 and 84 who had undergone a screening mammogram found that Black women have a nearly threefold risk for triple-negative breast cancer, one of the most aggressive subtypes.As a result of this growing body of evidence, the American College of Radiology and Society of Breast Imaging updated their screening recommendations to highlight the heightened cancer risk for Black women and other women of colour. The organizations called for annual mammography screening beginning at age 40 for all women but noted that any delays in screening disproportionately harm women of colour.In Canada, the national guidelines on cancer screening come from the Canadian Task Force on Preventive Health Care, a committee set up by the Public Health Agency of Canada. The task force consists of 15 volunteers with expertise in primary care and disease prevention. In the most recent guidelines, from 2018, screening mammography for women in their 40s is not recommended. They made the case that the benefits did not outweigh the risks of overdiagnosispicking up tumours that are unlikely to cause harm. Women aged 50 to 74 should be screened every two years, they said. The authors added a caveat for women in their 40s: Some may wish to be screened based on their values and preferences. In this circumstance, care providers should engage in shared decision-making with women who express an interest in being screened, they wrote. But in the studies used by the task force, few Black women were included (they relied heavily on data from Scandinavian countries). And the reality is that Black Canadian women have been diagnosed under the age of 50 after being told they are ineligible for screening mammography.(Related: Womens Health Collective Canada Is Addressing the Gap in Womens Health)

Mother of three Dawn Barker-Pierre wanted a mammogram when she turned 40, but her family doctor told her she didnt need one until she hit 50. At 44, she was diagnosed with triple-negative breast cancer.

Dawn Barker-Pierre was born in Barbados and moved to Toronto as a child. A mother of three, she wanted a mammogram when she turned 40. When she asked her family doctor, she was told she didnt need it until age 50. Two years later, she asked again, but was told no a second time: She had no history of breast cancer in her direct family and she was healthy, with no lifestyle behaviours that would increase her risk.Barker-Pierre had felt dismissed by her doctors before, however, with prior questions about health changes shed noticed. The first was skin-colour changes under her eyes, which can be associated with thyroid issues, but when she asked for further tests, she was sent to a dermatologist. Eventually, she insisted on getting bloodwork, and persisted until her labs revealed she was suffering from hypothyroidism.A few months later, at age 44, she discovered a lump in her breast one night while she was watching TV. Her doctor sent her for a mammogram. As the technician performed the scan, she told Barker-Pierre that the healthcare team would not be able to determine when things started changing in her breast because there were no previous scans in her records to compare against. That floored me, she recalls.Barker-Pierre, whose youngest child was 12 at the time, was diagnosed with triple-negative breast cancer, which is typically fast-growing and hard to treat. The cells in triple-negative breast cancer dont have receptors for the hormones estrogen and progesterone, and they do not, generally, make large amounts of the HER2 protein. But most targeted therapies and medications (like tamoxifen or Herceptin) used in breast cancer treatment go after that protein or those hormone receptors. With triple-negative breast cancers, the main treatment options are chemotherapy, with its host of toxic consequences; surgery; and immunotherapy. Overall, there are no targeted treatment options for what is a more aggressive cancer, says Andrea Covelli, a surgical oncologist with Mount Sinai Health Network whose research is focused on health inequities.

Juliet Daniel, a professor and cancer biologist at McMaster University in Ontario, has led groundbreaking research showing that Kaiso a gene she discovered, is highly expressed in the breast cancer tissues of Black women compared to Caucasian women.

Triple-negative breast cancer is more common in Black women, and this has been shown consistently in studies across different countries, says Juliet Daniel, a professor and cancer biologist at McMaster University. Daniels work is personal: Her mother died from ovarian cancer four days before Daniels undergraduate convocation from Queens University, and this came a few months after the death of a close family friend who had breast cancer. These losses shook Daniel, who had planned to pursue medical school. After finishing her bachelors degree, she decided she didnt want to work in a hospital where she might be faced with patients dying of cancer because drugs had not yet been created to treat their disease. Instead, she became a cancer researcher, focused on solutions and treatments. Decades later, in 2009, she herself would face a breast cancer diagnosis.In 1999, Daniel had discovered a gene that, later, she found was associated with a number of cancers, including triple-negative breast cancer. She named the gene Kaiso, after the West African music that inspired calypso, the musical genre thats deeply ingrained in the culture of Barbados, Daniels birthplace. Over the last 20 years, Daniel has led groundbreaking research showing that Kaiso is highly expressed in the breast cancer tissues of Black women compared to Caucasian women, and that women with high levels of Kaiso expression are less likely to survive breast cancer.Daniel believes there is more than enough evidence to begin screening women by age 40. I would say that young Black women should be having a baseline mammogram at the age of 40 if possible, she says, adding that she would like to see Canadas national guideline changed to recommend a mammogram for all women at 40, as the risks of screening younger women (such as false positives that could result in needless biopsies or even surgery) are outweighed by the benefits. The earlier breast cancer is diagnosed, the higher your probability of survival, she says.Changing the nationwide recommendations will only address one barrier affecting Black women in Canada when it comes to the prevention and treatment of breast cancer. There is evidence at the provincial level to show that Black women are dealing with multiple obstacles in the cancer care system. This can have deadly or life-altering consequences. In Ontario, research conducted by Lofters and her team has found that women who immigrated from the Caribbean and Latin America wait longer for a diagnosis, are diagnosed at later stages and have a longer interval from diagnosis to the start of chemotherapy for reasons that not well-understood. Another study showed that women in Canada who were born in a Muslim-majority country were less likely to have regular breast cancer screening. In Nova Scotia, Black women are less likely to get mammograms; Black women in that province also told researchers that they had difficulty navigating the health-care system, and that they faced racism from clinicians.For Daniel, these findings come as no surprise. She often hears stories from women who feel doctors dismissed their concerns about cancer and told them they were too young for a mammogram. Thats irresponsible, says Daniel. At a minimum, they should ask about family history and send those patients for an ultrasound rather than telling the patient theyre too young to have breast cancer. In many ethnic communities, she notes, women can face a stigma after a cancer diagnosis. When women come in to ask about screening, they should be welcomed into the system rather than turned away, she says.Daniel and Lofters both work with Olive Branch of Hope, a Toronto-based organization that raises awareness and supports Black women with breast cancer. They want more education among all women about the risks of breast cancer at all ages. They also want better training for physicians, including a designated course on equity, diversity and inclusion where doctors would be educated about cultural sensitivity, including the challenges that non-white patients experience, and the damage and the hurt that causes to many non-white, equity-seeking, equity-deserving patients, regardless of disease, says Daniel.The Canadian task force says it will release an updated, nation-wide breast cancer screening guideline sometime early in 2023. In the meantime, several provinces have modified their policies and brought down the recommended age to begin screeningbut whether this increases access for any one individual will depend on where she lives. In British Columbia, Nova Scotia and Prince Edward Island, women in their 40s are encouraged to talk to their doctor, and are eligible for screening every two years. Alberta recently announced a new policy recommending regular mammograms beginning at age 45. All other provinces recommend that screening begin at 50 for women who do not have a family history of breast cancer.Women of colour are also underrepresented in the research that helps set cancer treatment guidelinesa pattern that reflects, in part, a deep suspicion in the Black community that grew out of historic mistreatment by scientists, says Lofters. She urges women and men who are diagnosed with breast cancer to participate in clinical trials. If research is carried out on mostly white or racially homogeneous populations, were not getting the diversity that we need among people in the trial, and then we dont know truly how broadly applicable the findings are, she says. Lofters, Daniel and Covelli are trying to address this in Canada by proactively seeking out Black women to participate in studies to learn about inequities in the system.(Related: Incredible Black Women Who Are Changing Canadian Health Care)In Calgary, Campbell is now almost five years out from her diagnosis. Her life looks very different today. She worked throughout her chemotherapy treatments, but found that the drugs left her unable to do basic math in her head, and she felt she could not perform at work in the way she wanted to. Having to walk away from [my dream job] was almost as heartbreaking as the cancer, she says. She took time off and returned to the workforce in a different role.Campbell knows firsthand that disparities exist for Black women with breast cancer, and it goes beyond screenings, diagnoses and prognosesits also a widespread failure to recognize that not all breast cancer patients have the same needs. When Campbell developed skin rashes and facial scars from her chemotherapy, she saw three dermatologists for help with her eczema. They said her concerns were not uncommon in Black patients, but they did not have an answer, she says. A fourth specialist reached out to a group of Black dermatologists who finally offered advice.Nearly two years after her lumpectomy, Campbell went to a plastic surgeon to discuss breast reconstruction. As she looked through the catalogue with photos of breasts post-surgery, she did not see a single breast of a woman of colour. She couldnt tell what the scars would look like her on skin. Campbell walked out. She eventually had two reconstruction surgeries, using a newer technique: autologous fat grafting, in which fat is removed from her abdomen and injected into the breast.Campbell still feels frustrated that Canada does not collect the race-based data that could identify any disparities experienced by Black women with breast cancer. These gaps exist here, independent of socioeconomic status, she insists. In the absence of data, stories like hers are the best evidence we have.Im not poor. Im an engineer. My second degree is in law. I can read all the medical information quite fine. I even know how the drugs I use are made, says Campbell. So help me understand why I had such a miserable time with breast cancer. It has nothing to do with my poverty or access to medical care.Next: As a Cancer Journey Coach and Breast Cancer Survivor, Im Changing the Narrative for Cancer

The post Waiting Until Age 50 for Mammograms Is Too Late—Especially for Black Women appeared first on Best Health.

Why Is It a Challenge for Women to Get Flat Closure After Mastectomy?

Anne Borden King — Mon, 31 Oct 2022 11:00:52 +0000

In the waiting room at the breast imaging centre, there is a sea of women in blue gowns. Some are seated. Some are standing, leaned against the wall, looking at their phones or just looking around. They are young and they are old. Tall, short, fat and thin with hair and without. On this day there are no men, but Ive seen them here because men get breast cancer, too. I close my eyes and my sisters in blue fade like waves on a horizon. I focus on the metallic chatter from the TV and the clamoring ring of a phone no one has answered. I want to hear music; I want to hear the street sounds. I dont want to be here. None of us do. Yet all our hope lies here, in the waiting room.One of the cruel aspects of this disease is that it hits us in such an intimate part of our bodies. Practically speaking, the breast is more expendable than some other parts of us. We can remove a breast and go on living. But theyre also an inextricable part of who we are. Theyre a site of pleasure. They also feed our babies. They represent, in many ways, the cycle of life.So, when someone takes a waterproof pen and draws a map across them or leads us into a dark biopsy room to remove a part of them, a part of us can go missing, too. When a patient is told she can potentially save her life by having a breast removed, it raises a complex array of feelings. Breasts, while not necessary for our lives, are far from vestigial. And it can be very painful when we have to say goodbye in part or in full to them.Maybe thats why in the past 50 years theres been such an emphasis on reconstructive surgery to rebuild (or build anew) the breast thats taken. The right to breast reconstruction has long been understood as an issue of freedom, bodily autonomy and choice. In Canada, breast reconstruction is funded as a part of our national health system because although its an aesthetic procedure, it has a positive impact on some patients mental health.There is another option aesthetic flat closure (going flat). Today, about one out of seven women in Ontario having breast-conserving surgery or mastectomy gets a flat closure. Google going flat and youll find Instagram selfies of lush, tattooed flat closures and coverage of fashion shows featuring women who chose to go flat, with an emphasis on body positivity. Through Flat and Fabulous blogs and social media groups, women share photos of the beautiful, flat-style dresses theyve found for their weddings and of date nights, smiling with their partners, no prostheses required. Judging from the community thats been growing over time, going flat has been a positive choice for many women.But most Canadian healthcare websites make only passing mention of the choice to get a flat closure or no mention at all.Ive been wondering why.

When Abigail Bakan, a political science professor at the University of Toronto, had a bilateral mastectomy in 2016, she decided from the start she didnt want reconstruction. I said no. And they had it on my record, she told me. But members of her cancer care team asked her, repeatedly, if she was sure. Thats when I started thinking, Why are they are continually asking the question and theres only one right answer? The right answer is youre supposed to say yes.A social worker on Bakans cancer team recommended that she attend the Breast Reconstruction Awareness Day event in Toronto, known as BRA Day. BRA Days are held at various venues across North America, including community centres, convention centres and hospitals. It features seminars for patients about different reconstruction techniques as well as a Show and Tell Lounge where breast-reconstruction patients tell their stories (and show results) to women whove been referred to the event by their physicians.The logo for BRA Day features a pink cancer ribbon with a symmetrical pair of loops resembling breasts and the tagline Closing the loop on breast cancer. The logo reflects the idea that constructing a new breast can be a liberating alternative to wearing a prosthesis or facing potential social stigma around appearing without a prosthesis. As Toni Zhong, a Toronto-based plastic surgeon and conference organizer, put it: We now know that you dont have to live with a mastectomy defect for the rest of your life and there are options available that can restore your breast to make you feel and look good or certainly better.But what if a patient doesnt see her mastectomy or lumpectomy as awkward or a defect?The women in the Flat and Fabulous movement are pushing back against the idea that theyre not whole without their breasts, blending online organizing around breast cancer care with image galleries that bring greater visibility to women who have chosen flat closure. One organization, Not Putting on a Shirt, uses social media to provide vetted information on topics such as body image, communicating with providers, emotional health and local community supports.In this sense, the Flat and Fabulous movement has done more than introduce a new aesthetic option. Its pushed for better shared decision-making and choice (two concepts that are key in the reproductive rights movement) in breast cancer care. This shift is needed. Across Flat and Fabulous platforms, women are telling their stories of recovery from botched surgeries or of explanting implants for various reasons, including serious health issues.Yet many say that they were not made aware of risks, statements that are borne out in research. A cross-sectional survey in the U.S. in 2017 found that just 43.3 percent of breast cancer patients had made a high-quality decision (about reconstruction), defined as having knowledge of at least half of the important facts and undergoing treatment concordant with ones personal preferences. Many hospital websites and most of the major American clinical breast-reconstruction decision aids do not include the option of flat closure (a notable exception being the Breast Advocate app, developed by plastic surgeon Minas Chrysopoulo).This kind of information gap can have a negative effect on womens quality of life. A 2017 study confirmed earlier research that patients are more likely to express decision regret when they have not been engaged in shared decision-making around post-mastectomy decisions, with this being true both for women who wanted reconstruction and those who wanted a flat closure. Patients often felt pressure from their clinicians to choose one option or another, according to the study, with some feeling that bias was at play and others feeling rushed to decide on the spot.It may seem odd that some women must press their surgeons to get a flat closure, but it happens. A study of 931 women in 2021 by UCLAs Jonsson Comprehensive Cancer Center found that 18 percent of recent mastectomy patients had been told there were no options for them to choose to go flat. In five percent of cases, women were given surgical results that they didnt ask for, with the surgeons leaving additional tissue instead of a flat closure; what the researchers called intentional flat denial.According to Deanna Attai, a California-based breast surgeon who co-authored the study: Some patients were told that excess skin was intentionally left despite a preoperative agreement to perform a flat chest wall closure for use in future reconstruction, in case the patient changed her mind. Attai notes, We were surprised that some women had to struggle to receive the procedure that they desired.There is also the problem of a data gap, with little information collected on how satisfied women are when they choose to go flat. Recent data is interesting, however. A 2019 systematic review of 28 studies found that women who went without reconstruction fared no worse and sometimes better than those with reconstructed breasts, with no notable differences in terms of quality of life, body image and sexuality. Some of this was confirmed by results of the 2021 UCLA study that Attai co-authored, which showed that 75 to 90 per cent of women who underwent mastectomy without reconstruction were satisfied.But in a data-driven field, there needs to be more research to form a better understanding about navigating the decision-making process.(Related: How to Do a Self Breast Exam)

The history of breast cancer surgery is a grim chronicle of trial, error and slow progress. Lumpectomies have been performed since at least the 14th century. Rudimentary mastectomies are documented in the 19th century, including the mastectomy of Abigail Nabby Adams, the daughter of U.S. President John Adams, who underwent an early mastectomy while tied to a chair in her parents home with no anesthetic or antiseptic.In the late 19th century, American surgeon William Halsted developed the radical mastectomy, removing the whole tumour in one piece along with the pectoral muscles, lymphatic vessels and axillary lymph nodes. While the procedure saved lives, it also led to pain and disability.In the early 1930s, the modified radical mastectomy was developed, sparing some women pain by retaining muscle in the chest. Then, with advances in radiation and chemotherapy, research showed that some classes of patients who were treated with a lumpectomy (removal of tumour with an extra margin of tissue) and radiation had similar survival rates to women treated with only a mastectomy. As a result, in the late 1980s, the concept of breast-conserving surgery became more popular.Before reconstruction became commonplace, women who had mastectomies were typically offered a range of prostheses balls of cotton fabric and wool placed in the bra or bras with built in shelves and prosthesis.Although surgeons in the first half of the 20th century experimented with reconstructions that used the womans own tissue (autologous reconstructions), it wasnt until 1963 with the development of silicone breast implants that reconstruction surged in popularity. But these implants also created health risks and led to numerous recalls, explants and class action lawsuits.They still carry risks and complications. Most recently, textured breast implants, which were used in thousands of procedures, were pulled off the market by Health Canada in 2019 because of a rare risk of lymphoma. Amazingly, some women have struggled to get provincial health coverage to have them removed. Women in the U.S. are similarly battling with insurers for coverage to have various types of breast implants removed.In 1979, the first modern autologous breast reconstruction was performed, opening a door to alternatives for women choosing reconstruction. These procedures continue to carry risks, however, including limited mobility in sport as well as mastectomy skin flap necrosis (tissue death) that can cause scarring, deformity and lead to more interventions. A 2018 study of 2,300 Canadian and American women who had breast reconstruction between 2012 and 2015 found that women with autologous reconstruction experienced higher rates of complications than women with implants.

The choice to go flat has just recently begun to be normalized within the mainstream of cancer care. The term aesthetic flat closure was only adopted by the National Cancer Institute (U.S.) in 2020. And some of the loudest voices for a new approach have come from women who experienced flat denial. In Quebec, Marie-Claude Belzile wrote in 2017 that her experience inspired her to make change to health care in her community: I had to fight with my breast surgeon to be flat. Even after I told him multiple times I wanted to go flat, he wrote on my surgery form reconstruction, expanders. He finally respected my choice and did a good job, but the fight I had to go through should have never happened. Belzile, who passed away in 2020 from metastatic disease, started a Facebook page called Tout aussi femme after being diagnosed with stage IV breast cancer. She also founded a French-speaking flat support group called Les Platines.Many women (opt out) for comfort, others are athletes and many womenwant it to stay simple. Reconstruction is not a simple process, says Attai, adding that in the past few years more of her patients, especially those with smaller breasts, are opting out of reconstruction.Women who use their back muscles for work or athletics may be wary of latissimus dorsi flap surgery (which I was offered) because there is a risk it can compromise shoulder function. This and other procedures carry risks including infection and necrosis. Complications may lead to further interventions. In the U.S., one in three women develop a postoperative complication from breast-reconstruction surgery within two years and one in five require additional surgery. In five per cent of cases, reconstruction fails.While a patient can give informed consent when knowing the risks, too often breast cancer patients have not been made aware of those risks. The UCLA study found that just 14 percent of patients were aware of potential complications of reconstruction but 57 percent reported that they had been informed of the potential benefits to reconstruction procedures. The team concluded that: Implementation of uniform surgical management and improved respect for patient consent in this population would result in significantly improved patient experiences.I was interested to see the word consent in the UCLA paper. While breasts are a part of gender, sexuality and reproduction, terms like choice, consent, shared decision-making and autonomy common in the lexicon of gynecology seem less common in breast cancer care.I asked Todd Tuttle, a professor of surgery at the University of Minnesota, whether professional organizations in the field of breast cancer would be offering more guidance on fostering informed decision-making. Theyre going to have to, he said, pointing out, weve moved from paternalism, where the treatment plan was basically dictated by the surgeon often to the womans husband, toward an atmosphere of greater choice and autonomy for patients. Tuttle notes that whether patients decide to have reconstruction or go flat, one key quality of life indicator is whether they felt they were able to have a real choice in the decision.If you give them enough time and enough information, theyre more likely to be happy five years afterward and theyll feel like they made the right decision. Those people who are not satisfied often felt rushed or pushed, he says. I think time is probably one of the most important aspects of shared decision-making for breast cancer.In Canada, our underfunded systems lead to a different kind of rush. In seeking to care for everyone but with limited resources, our clinics lack capacity. Time often seems like a luxury but with reconstructive surgery, waiting can actually help mitigate risk. A 2018 study found that patients who delayed reconstruction were significantly less likely to develop complications than those who chose to do their reconstruction immediately.I think we dont talk as much with patients as we used to, says Tuttle. Theres all this documentation on electronic medical records and doctors are trying to get all that done instead of just talking to patients. The only way you can have those (important) conversations is by taking your time and listening.As we spoke, I thought back to the day of my diagnosis. I had brought a list of questions to the appointment (which I attended alone, due to COVID restrictions). My doctor pulled out a pen and wrote a series of quick notes about the specifics of my diagnosis on the rooms examining table paper. After he rushed off to see other patients and I was alone in the room, I carefully tore the examining table paper, folded it and put it in my purse to read later with my husband. When I got home, it was inscrutable an experience we would have again when results were posted in the online Patient Portal.It was all information, to be sure. But it didnt replace a conversation.I switched to a different hospital, with a doctor who scheduled an in-depth introductory Zoom meeting about my care and choices. I remember being grateful that she took the time. I also recall that this conversation took place at 8:30 p.m. My new provider was making time for her patients by working after hours. Most likely, it was the only way she could.The problem with breast cancer is you have to make these irreversible life decisions in a really short time, says Tuttle, and youre making the decisions at probably the most stressful point in your life.

Throughout breast cancer treatments, our relationship with our bodies changes. During chemo our hair falls out, our weight fluctuates, bizarre things happen to our fingernails and skin. We get sick and sometimes cant stay awake. The radiation burns us; those put into chemical menopause are doused in hot flashes. Pain and discomfort are part of the whole deal. And while there are some small decisions we have control over during treatment, most of us simply take the treatment plan handed to us if we want the best chance to get well. The choice of whether to reconstruct or go flat is different. This decision isnt about fighting cancer; its about healing from the fight.After my lumpectomies for synchronous bilateral cancer, I was offered a reconstruction. Because they removed more tissue from the right than the left, the plastic surgeons plan was to recreate a symmetry between my right and left breasts. But this choice would have involved a lot more than ticking off a box and signing a consent form (which I was offered in a flurry of papers before even seeing the consulting plastic surgeon) and after months of cancer interventions that had too often kept me away from family and work, the thought of more surgeries exhausted me. I was ready to start reconnecting with my body, which already had become a site of multiple, difficult interventions. For me, rebuilding my relationship with my body didnt involve rebuilding my breasts.I was also not convinced by BRA Days claim that I could close the loop on breast cancer with plastic surgery. As I write this, I have a 20-year prescription for preventative meds in the hopes of staving off metastasis. Breast cancer is a part of my life now. What if, instead of closure through a facsimile of my pre-cancer body, I strive to accept the myriad ways that fighting cancer has changed me? Could accepting my post-treatment body help make the reality of survivorship easier, too?Some of my concerns were like those of Isabelle (who chose not to use her last name), an Ottawa patient whose choice to go flat was supported by her health team. I made the choice to have prophylactic mastectomies because I have a high risk of developing breast cancer, and I watched my mother die from it, she told me. That part of the choice was easy. What I had not really considered was the reconstruction. In debating a post-mastectomy plan, she said, I didnt want to do anything that would require a long recovery, multiple surgeries, time away from the sports and activities I love Going flat meant that I would not take any additional risks with my health.Isabelle echoed a common theme among women who go flat: a sense of wanting to move on with life. I dont feel like I am losing my femininity, that I will look like less of a woman, she said. My breasts fed my two babies Now I want to be around for those babies for as long as I can.With all the aspects of cancer we dont have control over, the aesthetic decisions carry an extra weight; theyre personal, yet they also have cultural meaning. As Belzile wrote: My vision is that the more we speak out about our realities and our fights, the more itll change the culture and society I see a way for getting visible to each other and to others and get validated for who we are. I see a future where women are respected and taken as the only person competent on whats best for her.

Back in the waiting room, my mind travels to my visit a year ago, waiting to go down the hall for surgery. X-rays of my tumours would be taken in surgery that day and sent to me later via a secure hospital server. I opened the images late one night and was struck by their appearance, like variegated blossoms in white and black excised and sampled for cells to see if they got it all. They tried to get it all. We tried, all summer, fall and winter. Did we? I wonder: Did we get it all?I open my eyes and look around the room. Every face tells a story and everyone here is waiting for some kind of news. Here, our breasts are imaged, mapped and ultrasounded, pressed in the mammogram machine, deconstructed in biopsy. We sit patiently, hold our breath; we bleed, blink back tears. Then at the end of the appointment, we take the elevator down and step back into everyone elses world to find our way. To reconstruct, resurrect or rediscover who we are.PQ: What if a patient doesnt see her mastectomy or lumpectomy as awkward or a defect?PQ: Most of us simply take the breast cancer treatment plan handed to us if we want the best chance to get well. The choice of whether to reconstruct or go flat is different. This decision isnt about fighting cancer; its about healing from the fight.”This story was originally published on healthydebate.caNext: Jeanne Beker on Finding Community and Support Through Her Breast Cancer Diagnosis

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How to Do a Self Breast Exam

Rebecca Gao — Tue, 04 Oct 2022 12:00:00 +0000

In Canada, breast cancer is the most common cancer and the second-most common cause of death from cancer among women. On average, 75 Canadian women are diagnosed with breast cancer every day.Despite how common breast cancer is, the early signs and symptoms can be hard to spot. While every province has a breast cancer screening program, they dont alwayscatch breast cancer early. (This is especially true if your province only mandates screenings every two yearsa lot can change in that time.) And we know that the earlier breast cancer is detected, the higher the likelihood of survival and recovery.Regular screenings and attending all your physical check-ups are the most important tools for detecting breast cancer, but at-home breast exams are also a useful way to catch any abnormalities. Here is why regularly examining your breasts is important, as well as how to do a breast self-exam.(Related:How to Embrace Your Sexuality After a Diagnosis)

Why are at-home breast self-exams so important?

Gaining awareness of whats normal for your body and noticing (either on sight or by feel) when theres been a change means you can promptly report it to your healthcare provider. You cant know theres been a change unless you know what your normal breast tissue feels like and youd only know if youre doing breast self-exams often, says Dr. Paula Gordon, a clinical professor at the University of British Columbia.That said, Gordon also emphasizes that there are many cancers that arent detectable by a self-exam and that at-home breast examinations should augment regular mammograms and other tests. Understanding your entire body and anything that changes is important, but first and foremost, discuss any changes with your doctor who is familiar with your risk factors, adds Cathy Ammendolea, the Chair of the Board of the Canadian Breast Cancer Network.

How do I examine my breasts at home?

Before jumping into the how, its good to set up the when: your breasts size, texture and lumpiness fluctuates depending on where youre at in your menstrual cycle, making it tricky to know what your norm is. If youre still menstruating, Gordon recommends doing your breast self-exam a few days after your period. Before your period, its normal for your breast tissue to feel lumpier and sore. This ensures youre comparing apples to apples each time, says Gordon. If youve gone through menopause, give yourself an exam periodically.To perform a self-exam, start with the visual check. Stand in front of your mirror, topless, and turn side to side, checking for lumps and changes in your nipples. Then, lift your hands above your head. After that, place your hands on your hips and flex your chest muscles. Both moves can help you see lumps that you wouldnt otherwise see.(Related:Sofia Vergara’s Thyroid Cancer Experience Is an Important Reminder for All)Next is the feel test. Unless you have really small breasts, you should be doing your self-exam like a breast surgeon does it: lying back at about a 30-degree angle (for example, lying down in bed with your head propped up on a few pillows). Keep your fingers flat and bent slightly at the knuckles, use the undersurface of your fingers to squish your breast tissue against your ribcage. Then, feel for lumps and any changes by going around the circumference of your breast to the nipple and then feeling the nipple as well. Finally, check your armpits, where there may be enlarged lymph nodes. Reach your hand over to hold onto the opposite shoulder and then, using your other hand, squish the tissue and fat of your armpit against your rib cage and feel for any lumps.Gordon suggests checking out this video by breast surgeon Dr. Liz ORiordan as a guide:

What sorts of breast changes should I be looking out for?

Generally, when doing a visual examination (ie., looking at yourself topless in a mirror) you should check for any lumps, redness, dimpling, skin sores, growing veins, thick skin and pores that look more prominentwe call it skin of an orange, because your skin looks like an orange peel, says Gordon. Notice if your nipple is sunken or if theres a crust on the nipple. Also, look out for any discharge that comes out on its own. Clear or bloody discharge that spontaneously seeps without your intervention should be checked out by your doctor, says Gordon. If you have discharge, but you really need to force it in order for it to come out, that usually isn’t a cause for concern.Then, when youre touching your breast, feel for any abnormal textures, lumps or areas of unusual firmness. “Everyone has texture or lumpiness in their breast, but its unique to us, says Gordon. People who do periodic breast self-exams are experts in whats normal for them. We intuitively remember what the normal texture feels like and if we notice a slight change, thats when the alarm bells go off.(Related:What Doctors Want You to Know About Breast Cancer)

What should I do if I do discover a concerning change in my breast?

If you notice something different in your breast tissue, contact your healthcare provider and ask for a mammogram or another form of testing. If you have dense breast tissue (which you can find out when you get a mammogram), itll make it harder to detect some forms of breast cancer. So, make sure you ask your doctor for an alternate form of breast cancer screening (like an ultrasound) in addition to a mammogram, depending on your age. Ultrasound would be a reasonable first test for women younger than 30-35.Next: The Canadian Provinces with the Highest Rates of Cancer

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Jeanne Beker on Finding Community and Support Through Her Breast Cancer Diagnosis

Rebecca Gao — Fri, 30 Sep 2022 18:30:36 +0000

Since being diagnosed with breast cancer in May of this year at age 70, beloved fashion journalist Jeanne Beker has been candid about her journey. Canadians know her as the stylish icon from Fashion Television, and Beker has been focusing on staying positive and making others less afraid of cancer. Beker started chemotherapy earlier this year and has since been documenting it allfrom losing her hair, to the kind nurse who preps her for chemo, to the rigamarole that is a mid-treatment pee breakfor her followers on Instagram.We spoke to Beker about her diagnosis, her support system and how shes staying upbeat.

What was the diagnosis process like?

I had just had a routine mammogramI go every two years, though I wish I had been going every year because I didn’t know that people with dense breasts really have to be checked a lot. So, a couple days after my mammogram, my doctor called and said they had discovered something. I had been feeling totally normalfine, perfect. I never felt anything lumpy in my breasts or anything. They called me back for a biopsy and an ultrasound and MRI. Then I got that call that changed my lifethat call that nobody wants to get. Those first few days, as anyone can attest to, were incredibly dark and very scary because you don’t know exactly what’s going on and how bad it is, or if they can treat it. It’s just awful, and you go down 5,000 rabbit holes.

What happened next?

I got an appointment with a doctor at the breast clinic of Princess Margaret Cancer Center. She’s a surgeon, and she immediately made me feel better by telling me that the prognosis is good and the cancer had been caught early. I had to see the oncologist the following week, who’s another rock starthey’re all rock stars at Princess Margaret. The oncologist told me it’s not only treatable, it’s curable. When I heard that, I just felt so relieved. He told me about three different treatment options, and I decided to do 12 rounds of Taxol [a form of chemo], followed by surgery and radiation, because it was a bit easier to maintain my lifestyle with that treatment route. Im glad I went that way because it was quite tolerable, and Im done chemo. My surgery will happen later in October.I’m hanging on and feeling very positive and very grateful. When I was growing up, most people [with cancer] had really bad outcomes. But the landscape has changed. Research, especially in the field of breast cancer, has progressed to such a brilliant degree. Things are changing all the time. So I just feel incredibly lucky. There’s been so many silver linings to this journey as well.

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A post shared by Jeanne Beker (@thejeannebeker)

Tell me about those silver linings?

One of them has been my Instagram. Social media can be the root of all evil, but when used correctly, it can also be an incredible way to communicate and touch people and be touched by people. When I decided to go public with my journey, it wasn’t a big decision at all. I was like, of course I’m going to put it on my Instagram because I’m all about authenticity. And this is something very real that I’m living with. It’s something that I know affects so many womenone in eight women are going to be diagnosed with breast cancer in their lifetime. Why wouldn’t I want to reach out and tell people who have been watching me and supporting me all these years? I felt I owed it to themand I owed it to myselfto be that open and honest.I just actually held the hand of a very dear friend of mine who, for about a year and a half, went through her own cancer journey. It was during the pandemic and she was very alone. She didn’t want to tell anybody. Shes not a public person, so I understand wanting privacy, but I thought at the time that I would never be able to do that. It was just too much of a burden.So, I started telling people about my diagnosis and the response [on social media] has been phenomenal. The positivity that I was getting back was phenomenally heart-swelling and my spirits were so lifted. Even if they just sent emojis, it was just such a joy to me.(Related:What Doctors Want You to Know About Breast Cancer)

How have your friends and family supported you since the diagnosis?

All my friends have been fantastic. They’re always texting, emailing, calling, checking up on me. Even people I didnt think I was very close to were asking if there was anything they could do for me. If I needed someone to pick me up for treatment, or go with me to the hospitalthat kind of support was just so nice. But I think most importantly, my daughters have been great. My youngest daughter lives in the Yukon and drove all the way out here to be with me. And my other daughter lives nearby and she’s just been fabulous. My sister in LA has been incredibly supportive and positive. Even though I’ve just spoken to her on the phone, she’s offered to come here.And, first and foremost, my partner. We’ve been together for seven years. He was with me when I got the phone call and without skipping a beat, he said, Don’t worry, we’ll get through this together. He comes to all my doctor appointments with me. He’s just my biggest cheerleader, and I’m so lucky to have that kind of support. And then I’ve got my big goldendoodle dog who acts as a therapy dog. He just just comes and cuddles me whenever I need it. I am really looking forward to the [CIBC Run for the Cure] on Sunday, where Ill talk and meet with other women with breast cancer.

Tell me a bit about your advocacy work around the Canadian Cancer Society CIBC Run for the Cure.

The community of women that you find [after youre diagnosed] is phenomenal. You feel like youre in some kind of special club with these women. Granted, its a club that you may not have wanted to be part of, but once you’re in it, everybody is so supportive of one another. It’s such a wonderful feeling to know that you’ve got so many hands to hold. I think the whole event is just so incredibly inspiring, besides the fact that it raises so many funds.

What do you hope that people learn from your story?

I hope that women become aware of the fact that they better go for a mammogram on a very regular basis. I think a lot of women put it off because it’s not a pleasant experience. But its really important to go in!And, I want to remind people to live your life to its fullest, as much as you canand appreciate every glorious second of it. I’ve never savored life more. I mean, the whole diagnosis just made me realize how much I was in love with my life. All of a sudden, the world seems like an even more beautiful place. I really hope to be able to stick around for a lot longer.This interview has been edited and condensed.Next: How to Do a Self Breast Exam

The post Jeanne Beker on Finding Community and Support Through Her Breast Cancer Diagnosis appeared first on Best Health.

What Doctors Want You to Know About Breast Cancer

Mary Jo DiLonardo — Mon, 05 Oct 2020 11:11:08 +0000

Breast cancer is a disease that starts when cells in the breast begin to grow out of control. While cancer cells most often form a lump that can sometimes be felt on a self-exam or noticed on a mammogram, some people don’t show obvious signs of the disease. Thats why its important to regularly examine your breasts so you can quickly notice any unusual changes.

Breast cancer symptoms

New lump in the breast or armpit
Swelling of part or all of the breast
Dimpling in the skin that might look like an orange peel
Breast or nipple pain
Red, dry or flaky skin on the breast or around nipple
Nipple turning inward
Any change in the shape or size of the breast
Nipple discharge (other than breast milk)
Swollen lymph nodes under the arm or around the collar bone

These symptoms can also be signs of other conditions besides breast cancer. Still, if you find any changes in your breast, its important that you see your doctor for an exam and tests.(Related: Cervical cancers risks every woman needs to know.)

Types of breast cancer

There are many types of breast cancer. They are described as either invasive or noninvasive, which is also known as in situ (a Latin term that basically means “in place”). Invasive cancersductal carcinoma and lobular carcinomaspread from the breast ducts or lobules to other parts of the breasts.Noninvasive or in situ cancer ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS)does not spread outside its original location.Several less common types of breast cancer include: Pagets disease, inflammatory breast cancer, Phyllodes tumour, and angiosarcoma.

Breast cancer risk factors

Researchers dont know what causes breast cancer, but certain risk factors make you more likely to develop it, according to the Canadian Cancer Society. Some of them are out of your controllike your age and having a family history of the disease. But some things you can change, like losing weight if you are overweight, limiting alcohol, or quitting smoking.

Risk factors you cant control

Gender: Most breast cancers occur in women. Based on Canadian Cancer Society statistics, it is estimated that 27,400 women compared to 240 men will be diagnosed with breast cancer in 2020.Age: Your risk goes up as you get older. Most breast cancers occur in women between 50 and 69 years of age.Family history: Most women who have breast cancer dont have a family history of the disease. But if you have a close female relative (mother, sister, or daughter) with cancer, that almost doubles your risk.Personal history: If youve already had breast cancer, you have a higher risk of developing it again.Genes:Women who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are more likely to develop breast cancer.Having dense breasts: Dense breast tissue can make mammograms harder to read. People with dense breasts have a higher risk of developing breast cancer than women with non-dense breast tissue.Menstrual history: Your odds increase if you started your period before age 11 or you didnt go through menopause until age 55 or later.Having certain breast conditions:Some benign conditions such as papillomas (growths that can occur in the milk ducts of the breast) or a radial scar (a type of lesion that can look like breast cancer on a mammogram but is not) may raise your chances of being diagnosed with breast cancer. (Although in some cases they may not be associated with higher risk, so talk to your doctor about your particular condition.)

Risk factors you can control

Drinking alcohol: The risk increases the more you drink.Being overweight:Older women who are overweight or obese have a higher risk of developing breast cancer.Not exercising:Exercising helps prevent cancer. In a 2016 meta-analysis of 38 studies, the most active women had up to a 21 percent lower risk of breast cancer than those who were the least active.Smoking: Breast cancer, like so many diseases, is also linked to smoking.

How breast cancer is diagnosed

If you notice a change in your breast or if something unusual appears on a mammogram, your doctor will do an exam and possibly order some diagnostic tests to better understand whats causing your symptoms. According to the Canadian Cancer Society, these typically include:Breast ultrasound: This imaging test uses sound waves to make detailed pictures of areas inside the breast. It can help tell the difference between fluid-filled cysts and solid masses.Mammogram: This is a detailed X-ray of the breast that looks at lumps or other issues. (Related: 8 reasons to request an earlier mammogram.)Magnetic resonance imaging (MRI): This body scan uses a magnet linked to a computer to make detailed images of areas inside the breast.Biopsy: For this test, your doctor removes fluid or tissue from your breast to be examined under a microscope. Sometimes your doctor will use a needle to remove the sample and other times they will make a small cut in your breast to remove samples for testing.

Treatments for breast cancer

If tests show that you have breast cancer, you’ll work with your health care team to find the best treatment plan for you. Surgery is one of the most common treatments for breast cancer, but some women also have additional treatments such as chemotherapy or radiation. Here are some options:Surgery: Surgery is the most common treatment for breast cancer, according to the Canadian Cancer Society. There are several types:

Breast-conserving surgery The surgeon removes only the part of the breast that contains the cancer, along with some surrounding tissue. How much they take out depends on things like where and how big the tumour is. Types of this surgery include lumpectomy, quadrantectomy, partial mastectomy, and segmental mastectomy.
MastectomyA surgeon removes the entire breast, including sometimes nearby tissue. There are several kinds of mastectomies. Removing both breasts is a double mastectomy.
Lymph node removalYour doctor might remove lymph nodes if cancer has spread outside the breast.

Radiation therapy:Radiation uses high-energy rays to destroy cancer cells. Traditional radiation uses a machine that transmits radiation from outside your body. With a newer type called brachytherapy, a surgeon places radioactive pellets inside the body that transmit radiation for a while.Chemotherapy:Cancer-destroying chemotherapy drugs are either injected into your veins via IV or are taken by mouth. Its often given before or after surgery.Hormone therapy:Certain cancers grow in response to some hormones. This treatment works by blocking your bodys production of those trigger hormones.Targeted therapy: These drugs attack specific cancer cells. They usually dont harm normal cells as much as chemotherapy or radiation.Immunotherapy:These drugs use your bodys immune system to fight cancer cells.Clinical trials: Ask your doctor if there is a clinical trial available for breast cancer and whether it would be a good choice for you.

How to prevent breast cancer

There are some risk factors that you cant avoid. However, there are many lifestyle habits that can help prevent breast cancer: maintain a healthy weight, exercise regularly, quit smoking, and limit or dont drink alcohol.Adding certain foods to your diet like olive oil, salmon and nuts may help lower your cancer risk as well.(Related: Learn more about how your diet can help reduce your risk of developing breast cancer.)

Screenings and self-exams

Doing monthly breast self exams and having regular mammograms can help find cancer at an early stage. Recommendations for how often you should get a mammogram may depend on your age, family history of cancer, and certain risk factors.The Canadian Cancer Society recommends:

Women 40-49: Mammograms are an option, if your doctor thinks you need it.
Women 50-74: Get a mammogram every two years.
Women 75 and older: If you and your doctor think you need it.

Genetic testing for breast cancer risk

If you have a history of breast cancer in your family, your doctor might suggest genetic testing to see if you have a genetic mutationlike the BRCA1 or BRCA2 gene mutationthat would increase your chances of developing the disease.If you have a concerning mutation, talk to your doctor about preventive options. A prophylactic mastectomy or surgical removal of both breasts has been found to reduce the risk of breast cancer in high-risk women by about 90 percent, according to the National Cancer Institute.Next: 8 Household Products That May Be Linked to Breast Cancer.

The post What Doctors Want You to Know About Breast Cancer appeared first on Best Health.

22 Myths Gynecologists Want You to Ignore

Charlotte Hilton Andersen — Thu, 25 Jun 2020 18:54:18 +0000

“It’s just a yeast infection, so you can call in a prescription.”

“Treating problems over the phone, even ones that may seem as minor as a yeast infection, is rarely a good idea. There are othercommon vaginitis problems that can seem very similar but are vastly different in the way we treat them. Yeast infections, bacterial vaginosis, and trichomoniasis share common symptoms of discharge, irritation, itching, and burning. I’ve even found herpes in patients who were sure it was ‘just a yeast infection.’ Most gynecologists and other womens health care providers will squeeze you in for a quick visit to make sure you get the right treatment.” Steven A. Rabin, MD, board-certified ob-gyn, Burbank, California. (Plus, here’s what else gynecologists wish you knew about yeast infections.)

“Yogurt will fix a vaginal infection.”

“One of the worst pieces of advice I’ve heard from a patient is one who actually put yogurt into her vagina because a friend told her the probiotics in yogurt would help with her yeast infection. Unfortunately, she used strawberry flavoured! It didn’t work and there’s been no evidence in the literature to prove this to be true.” Nicole E. Williams, MD, gynecologic surgeon and founder of The Gynecology Institute of Chicago.

“If I want to have a baby I should have sex when I’m ovulating.”

“Most women think,incorrectly, that intercourse should be timed after ovulation. But to maximize your chances of conception you should be having sex right before you ovulate.” Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine, New Haven, Connecticut

“Standing on my head will increase my chance of getting pregnant.”

“I have had manywomen think that they can increase their chances of conceivingby standing on their head or elevating their legs after intercourse. But sperm are highly motile and standing on your head, or any other positions post-intercourse, will do nothing to improve the chances of pregnancy.” Linda Girgis, MD, board-certified family physician in private practice in South River, New Jersey

“Birth control pills will make me fat.”

“It’s a very common belief that birth control pills cause weight gain or will give you cancer. However, studies comparing large groups of women who take and do not take birth control have shown no difference in weight gain. Also, when taken for long periods of time, birth control pills have shown to decrease ovarian and endometrial cancers by 50 percent.” Richard K. Krauss, MD, board-certified ob-gyn at Penn Medicine

“It takes three months after stopping birth control to be fertile.”

“Despite this popular myth, as soon as a woman is not using a contraceptive method, she is fertile. It can take up to one year to conceive but as far as the pill is concerned, a woman is fertile as soon as she stops taking it.” Veronica Gillispie, MD, obstetrics and gynecology department at Ochsner Baptist Medical Center in New Orleans. (Here’s what else you should know before going off the birth control pill.)

“My mom had no problem getting pregnant at 40.”

“While it is true that age of menopause can be a heritable trait, conceiving in your late 30s and 40s is a challenge, no matter your genetics. A 25-year-old woman at the peak of her fertility in life has a 15-20 percent chance of achieving a pregnancy per month. By age 40, this number drops to less than five percent per month. While there are no blood tests to directly check for egg quality, we know, through testing thousands of embryos through IVF [in-vitro fertilization], that after age 40 around 85 to 90 percent of a womans embryos will be genetically abnormal. The answer is, dont wait! If you are focusing on your career or have not met the right partner, consider a method of fertility preservation such as egg freezing.” Anate Aelion Brauer, MD, board-certified in reproductive endocrinology and ob-gyn, assistant professor of ob-gyn at the NYU School of Medicine

“I’m bleeding even though I’m postmenopausal. It must be stress.”

“While stress can cause irregular or missed periods in a premenopausal woman,anybleeding in a postmenopausal woman is abnormal. Once a women is through with menopause, usually by age 52, she should never ever bleed again. Never! Postmenopausal bleeding can be benign, but can also be a sign of cancer of the uterus, cervix or vagina, and you should see your doctor right away.” Rene Volny Darko, DO, board-certified ob-gyn in Altoona, Pennsylvania

“Breast cancer is the most common killer of women.”

“Many women think that breast cancer is the most common cause of death of women over the age of 40. But the facts show that cardiovascular disease causes four times more deaths in women over the age of 40, far more than all kinds of cancer combined.” Dr. Krauss

“Breast cancer doesn’t run in my family so I’m safe.”

“Women sometimes think they can’t get breast cancer if theyhaveno family history of the disease.This is often used as an excuse to not go for mammograms. But the truth is that the majority of women who get breast cancer have no family historyit can happen to anyone. Mammograms can detect cancers at a small, curable stage, and can be lifesaving.” Ronit Sugar, MD, board-certified breast surgeon at Aria Health, Philadelphia

“IUDs are dangerous.”

“Intrauterine devices [a tiny device implanted in the uterus to prevent pregnancy] get a bad rap as being dangerous. The truth is modern IUDs are the safest and most effective form of temporary birth control methods that we have. Progesterone containing IUDs also can actually reduce pain and bleeding with a womans menstrual period.” Dr. Krauss

“Hormone treatments will kill you.”

“Many patients think that taking hormones is harmful and that you should let nature take its course and ageas biology intended. But the truth is that hormone therapy is not deadly.Even in the ominous 2002 Women’s Health Initiatives study, we can see that the women who used just estrogen during the first decade of their menopause had an almost 30 percent reduction in all causes of deathand a20 percent lower incidence of breast cancer. With a broad brushstroke, the hormone story was painted as a death sentence for all users but in reality after your ovaries retire and you are estrogen deficient, there is a safe and acceptable way to restore low levels that hasmore benefits than risks.” Dr. Rabin

“Once I’m done having children, I no longer need to see my ob-gyn.”

“Just because you are finished having children doesnt mean that you should skip your gynecologist visit. Your ob-gyn will still want to discuss your overall health like your blood pressure, weight, family planning, and any other health screenings you may need, such as for STIs, cervical cancer, breast cancer and ovarian cancer.” Cherrell Triplett, MD, an ob-gyn at Southside OBGYN in Indianapolis and clinical assistant professor at the Indiana University School of Medicine. (Psst: These contraception myths can put your health at risk.)

“I’m in a monogamous relationship, I don’t need Pap smears.”

“Patients have told me that because they’vebeen married for many years, havent had sex in many years, or havealways had normal Pap tests that they don’t need Pap smears. However,allwomen should be screened for cervical cancer. HPV, the virus that can cause cervical cancer, is so common that virtually all sexually active women will get it at some point in their lives. And it may not have been detected previously because it can remain dormant for years before it starts causing damage to cells that can lead to cancer. Thats why women ages 30 to 65 should be sure theyre screened with a Pap test and HPV test together at regular intervals.” Dr. Triplett

“I’m pregnant so I’m eating for two!”

“Sadly it is not true that when you’re pregnant you can eat whatever you want. For a singleton pregnancy, you need an average of 300 to 350 calories extra a day during the first and second trimester and 500 calories in the third trimester. Excessive weight gain in pregnancy puts the mom at increased risk for diabetes during pregnancy, other medical complications, and increased chances of needing a C-section.” Diana Ramos, MD, ob-gyn, co-chair of the National Preconception Health and Health Care Initiative

“I can’t eat spicy food on my period.”

“Because the food we eat plays such a vital role in every aspect of our lives, it is often thought to influence several bodily functions and organ systems including the menstrual cycle. Some women think that eating certain foods can alter or hasten the end of their period. But the truth is thatmenstrual cycles are controlled by hormones. The effect of eating spicy (or any other) food is likely mental rather than physiological.” David G. Diaz, MD, a reproductive endocrinologist at Orange Coast Memorial Medical Center in Fountain Valley, California

“I’m healthy and active, so getting pregnant should be easy.”

“Many women believe that if you are healthy and active, you will never have infertility problems. But this is not true. The healthiest and most active people may still have one of the many issues that cause infertility.” Shahin Ghadir, MD, ob-gyn at Southern California Reproductive Center

“Pregnant women shouldn’t exercise.”

“Exercise during pregnancy is important for many reasons. Regular exercise reduces stress and increases energy, ensures you gain the right amount of weight in pregnancy, improves common discomforts in pregnancy such as constipation and insomnia, as well as helps prevent pregnancy-related diseases such as elevated blood pressure and gestational diabetes. Research even shows that labour itself is easier and shorter in woman who engaged in regular exercise throughout their pregnancy. ” Dr. Aelion Brauer. (Keep in mind that this is how soon you can exercise after giving birth.)

“We’ve been checked for STIs so we don’t need condoms.”

“Even if your partner goes to their doctor to get an STI (sexually transmitted infection)check and gets a clean bill of health, there are still illnesses that can be passed through sexual activity, like HPV and herpes, that are difficult to find during a routine checkup as they can hide on a man’s penis or in a womans vagina. You wouldn’t know you had them unless there is an active wart or lesion. Condoms are still the best way to prevent sexually transmitted infections even if your new partner tests negative for STIs during their pre-sex health care checkup.” Sherry Ross, MD, an ob-gyn and womens health expert at Providence Saint Johns Health Center in Santa Monica, California

“The pull-n-pray method works.”

“Withdrawal isnotan effective method of birth control.The reality is that there are sperm in the pre-ejaculate and all it takes isone sperm to become pregnant!” Diana Ramos

“I’m carrying high so I must be having a girl.”

“Despite what many old wives’ tales say, you cannot tell the babys sex from any outlying signs. Your baby naturally lowers during the third trimester in preparation for birth and it has nothing to do with the babys gender. Similarly, how you carry the baby has more to do with its weight and size than anything else. Any heartburn you may experience is simply due to the womb pushing your stomach upwards, not the babys gender.” John D. Bertrand, MD, ob-gyn at Walnut Hill, Dallas

“Drinking human breast milk has health benefits for adults.”

“The benefits of breast milk are immensefor babies. ButI once had a patientwhoshowed up in the emergency room with a severe headache despite ‘hydrating myself with my own breast milk.’ The patient was swallowing her own breast milk and not getting any extra fluid from the outsideshe was only recycling her own bodily fluids! Really the only person who should be drinking breast milk is the infant. Gerardo Bustillo, MD, ob-gyn at Orange Coast Memorial Medical Center in Fountain Valley, California

Next, read up on the questions you should always ask your gynecologist.

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Do Hair Dyes and Straighteners Cause Breast Cancer?

Brooke Nelson — Tue, 21 Jan 2020 16:58:55 +0000

A number of lifestyle habits can help reduce breast cancer risk, including exercising and avoiding alcohol and weight gain. But what about your hair habits? Some studies have suggested that women who frequently use hair straighteners or hair dye may face a higher risk of breast cancer than nonusers, but others have not found a link.(Thesehousehold products may be linked to breast cancer.)For example, Kefah Mokbel, MD, a breast surgeon at the Princess Grace Hospital in central London and colleagues conducted a meta-analysis of eight case-controlled studies performed between 1980 and 2017. The report, published in the journalAnticancer Research in 2018, found that women who usedhair dye had an 18.8 percent higher risk of breast cancer compared with women who didn’t use hair dye. However, in these types of case-controlled studies, a person with a condition like breast cancer is matched to a similar person their age who doesn’t have cancer. Researchers look at potential risk factors, but sometimes people have what’s called a recall biasa person with an illness might be more likely to remember using a product like hair dye than someone who was never sick.Dr. Mokbel concluded: “Although further work is required to confirm our results, our findings suggest that exposure to hair dyes may contribute to breast cancer risk.”Typically, hair professionals advise women to touch up their hair color every four to six weeks. Dr. Mokbel recommends dying your hair no more than five or six times a year, as well as consider using products with natural ingredients like beetroot and henna.(See the stars who’ve battled breast cancer.)The findings of Dr. Mokbel’s study were replicated in a 2019 study published in the InternationalJournal of Cancer. In that study,researchersat the National Institutes of Health (NIH) looked at a group of46,709 women, and those who used permanent hair dye and hair straighteners were at ahigher risk of breast cancer. Compared with people who never used permanent hair dye, black women had a 45 percent higher risk and white women had 7 percenthigher risk of breast cancer if they said they used permanent hair dye. Chemical hair straightener use was tied with an 18 percent higher breast cancer risk among both black and white women; however, black women were more likely to use the product (74 percent versus 3 percent).It’s important to note that the women in the NIH study had a higher risk of breast cancer based on their family history. The findings may not be applicable to a general population and warrant further investigation.Another caveat: These studies can only highlight a link or association between the two and can not prove that the dyes or straighteners were the cause of the higher risk. According to the Susan G. Komen Foundation, “research studies show the use of permanent hair dye does not increase the risk of breast cancer.” Hair dye is rated as “Not related to breast cancer risk (neither increases nor decreases risk).” In this table, the group compares hair dye to other well-known cancer risk factors.If you’re worried about your own risk, one of the best ways to protect yourself is to regularly schedule mammograms and conduct self-exams frequently, doctors say.Next, see the breast cancer advancements that will change how we fight the disease.

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8 Household Products That May Be Linked to Breast Cancer

Denise Mann, MS — Mon, 21 Oct 2019 19:50:33 +0000

What experts know about breast cancer and household exposures

There has been plenty of progress in diagnosing and treating breast cancer in recent years. In fact, theres been a decades-longdecline in the breast cancer death ratedue to better prevention, earlier screening, and better treatments, according to 2019 data from the American Cancer Society (ACS).However, breast cancer is still the mostcommon cancer in womenafter skin cancer. The risk factors that have the biggest impact on breast cancer tend to be hormonal, like starting menstruation early or going through menopause late (after 55), or having a family risk of the disease. Other factors that canreducethe risk includeexercise, earlier pregnancy, and longer breastfeeding, according toBreastcancer.org. Even yourdiet can help reduce your risk of breast cancer.Researchers are working tirelessly to look at other possible breast cancer risk factors, including those inside your home. There are so many types of chemicals that we are exposed to and they can get into our bodies, especially our breasts, saysMarisa Weiss, MD, director of Breast Radiation Oncology and Breast Health Outreach at Lankenau Medical Center in Ardmore, Penn, and founder and president ofBreastcancer.org. Many of these chemicals are endocrine disruptors, meaning that they can look and act a lot like the hormone estrogen, which is known to fuel the growth of some breast cancers, she explains.While its not clear if and how endocrine disruptors may contribute to cancer at the levels most people encounter in their daily lives, here are a few that have been studied.

Phthalates in some air fresheners and cleaning products

Phthalates are commonly used in air fresheners and are known to mimic the effects of estrogen in the body. In one study,women who reported using air fresheners had an increased risk for breast cancer. Keep in mind that the study looked at women already diagnosed with breast cancer who were asked to recall past use. This type of study can be tricky, as people with a condition may be more likely to recall using a product then those without it. (Its known as recall bias.) Air fresheners may also contain terpenes, which can react with background ozone to form formaldehyde, a carcinogen, as well as benzene and styrene, both of which have been linked to breast cancers in animals, the study authors write inEnvironmental Health. (Although studies in animals arent always applicable or true for humans.) Thebreast loves hormones so if it looks, smells or tastes like hormones, your breasts can respond and it can be dangerous over time, Dr. Weiss says.The researchers also asked women about theproducts they used to control mould or mildew in their homes. Specifically, endocrine-disrupting antimicrobials, phthalates, and alkylphenolic surfactants are often in mould and mildew products, the study authors note. If you are concerned, use vinegar and water or baking soda and water to clean your home, Dr. Weiss suggests.

Parabens in some cosmetics

Many of the products that you use on your face and body may contain chemicals known as parabens. Common parabens used as preservatives in your makeup includemethylparaben, propylparaben, ethylparaben, and butylparaben. Parabens can penetrate the skin and act like a very weak estrogen,potentially turning on the growth of hormone-receptor-positive breast cancers, according toBreastcancer.org.We do know that breast is most susceptible to effects of these chemicals during key windows such as pregnancy, breastfeeding, puberty and menopause, saysMary Beth Terry,PhD, professor of epidemiology at Columbia University in New York City.It may be that these times matter the most and would therefore be the best times to limit exposure. (Heres more information about parabens from theFood and Drug Administration.)

Alcohol in your nightly nightcap

While not a household product in the traditional sense of the word, wine or cocktails may be part of your nightly routine. Justone glass of wine or other alcoholic drink a day raises the risk of breast cancer, according to a review from American Institute for Cancer Research and the World Cancer Research Fund. Remember thatstandard drink sizes are 12-ounces for a beer, 5-ounces for wine or 1.5 to 2 ounces for shot of spirits, the study authors point out. We do know that alcohol intake can increase breast cancer risk, Dr. Weiss says.

Phthalates in some nail polishes

Nail polish can contain phthalates, whichhavebeen linked to hormone disruption. Many nail polishes also contain formaldehyde, a chemical that also may raise cancer risks, according to theOccupational Safety and Health Administration.

Pesticides in gardening products

Pesticides are regularly used, especially in the United States, to minimize damage to crops and maximize harvest production. In 2011,research inToxicological Sciencessuggested there may be alink between the herbicide atrazine and breast cancer, according to studies in rats. However, studies of exposures in people in the population provide no support for a causal relationship between atrazine exposure and breast cancer, they concluded.The EU banned atrazine in 2005 after it demonstrated harmful effects on wildlife and was found abundantly in human drinking water; however, approximately seventy million pounds of atrazine are applied annually in the United States, primarily to control weeds in corn and sorghum crops, says Kristi Funk, MD, FACS, Breast Cancer Surgeon and Medical Director atPink Lotus Breast Centerin Los Angeles. To the extent that it is financially feasible, choose organic foods whenever possible. Just keep in mind, nutritionists never buy these organic foods.

Triclosan in some antibacterial products

The key ingredient that makes a soap antibacterial is a compound called triclosan, which has beenlooked at ina slew ofanimal and cell culture studiesbreast cancer being one of them, according to research in theInternational Journal of Environmental Research and Public Health. TheFood and Drug Administrationhas said that the impact on human health is still being studied but that triclosan-containing products dont have any benefit over regular soap and water when it comes to killing germs. Its inexpensiveand most likely saferto limit your exposure of triclosan, saysNancy Elliott, MD, a breast cancer surgeon and founder ofMontclair Breast Center, in Montclair, New Jersey.

BPA in some canned foods

A recentstudyinEnvironmental Researchfound thatcanned soups and pastas were linked to higher levels of BPAorbisphenol A, a known endocrine disruptor.BPA is used to make polycarbonate plastic. BPA leaches from can linings into foods and ultimately into us, warns Dr. Elliot. BPA increased the occurrence of breast cancer in laboratory animals, even in small doses. You can look for foods sold in BPA-free cans, or Dr. Elliot recommends purchasing frozen food instead. However, these arethe canned foods nutritionists actually buy.

Particles generated by your fireplace

Polycyclic aromatic hydrocarbons (PAH) can be emitted from fireplaces, space heaters and even cooking fumes, saysTerry. We have found higher exposure in the blood and tissues in women with breast cancer, she says. “Air filters may help clear PAH from indoor air.”While researchers work to answer questions about how (or if) these household products affect breast cancer risk, there are things you can do today to proactively protect your health. We know that exercising regularly, eating a healthy diet and drinking alcohol in moderation can reduce risk for developing breast cancer, and that a regular screening can diagnose breast cancer early when it is in its most treatable stages, says Dr. Weiss.Next, learn aboutpreventative mastectomies and who should consider it.

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Preventative Mastectomy: These Are the Only Women Who Should Consider It

Abbi Henderson — Mon, 21 Oct 2019 14:15:08 +0000

Can breast cancer be prevented?

Canadian Cancer Society predicts, in 2019 alone, 26,900 women will be diagnosed with breast cancer. A startlingly large figure.

However, thanks to extensive research and advances in tech, there are preventative measures that those considered to be high-risk of developing breast cancer can take. One (but by no means the only) approach that could reduce the risk in high-risk women is a prophylactic (preventative) mastectomy.

What is a mastectomy?

In simple terms, a mastectomy is an operation during which one (unilateral) or both (bilateral) of the breasts are removed. The surgery is predominately used as a form of treatment for those diagnosed with cancer, but can also depending on the individual and personal circumstances be an option for women with a very high risk of developing breast cancer.

“There are different kinds of mastectomies depending on whether a women is having reconstruction [where the breast is rebuilt using an artificial implant or a womans own tissue] at the same time or not,” says Dr. Adena Scheer, surgical oncologist at St. Michaels hospital and assistant professor at the University of Toronto. “If we are doing a reconstruction we want to save the skin (imagine peeling an orange out and leaving the peel to be filled in) and in some cases, if it’s a preventative mastectomy, and depending on patient preference and original breast size, we may preserve the nipple and areola as well.”

“At our centre and many across Canada the general surgeon or surgical oncologist does the mastectomy and a plastic/reconstructive surgeon does the reconstruction afterwards,” she says. “It is typically day surgery, depending on the type (if any) of reconstruction.”

So, how do you know if you are classed as high-risk?

What makes you high-risk of developing breast cancer?

If you are considered high-risk, it means that your risk percentage is around double (or higher) that of the average woman, which equates to a 25 percent and up lifetime risk of developing breast cancer, according to Dr Scheer, and there are numerous elements that can determine your risk percentage.

“There are factors that increase a woman’s risk that are potentially modifiable, and then there non-modifiable risk factors,” says Dr. Scheer. “Examples of modifiable risk factors are heavy alcohol intake and a sedentary lifestyle. Non-modifiable risks include a strong family history of breast or breast-related cancers, a history of radiation exposure (typically for childhood lymphomas) and genetic mutations such as the BRCA 1 and 2 gene (among others).”(See if your diet can affect your risk for breast cancer.)

Research suggests that around 5-10 percent of breast cancers are caused by an inherited gene mutation (whereby there are alterations within a gene which mean that the cell it controls, essentially, isnt working properly), and that BRCA 1 and 2 gene mutations occur in around 1 in 500 people. However, a woman with the BRCA 1 or 2 gene is five times more likely to develop breast cancer than those without the gene.

Be sure to consult your GP if you believe yourself to be high-risk, who will advise on appropriate prevention measures for you and your specific situation. There are, in fact, a number of methods they may suggest (Check out these breast care advancements that can change how the disease is fought.)

Is a mastectomy the best form of prevention?

“If a women is considered high-risk we tend to recommend enrolment in the high-risk screening program offered through the Ontario Breast Screening Program,” says Dr. Scheer. “This program does not offer prevention, but early detection.It involves an assessment of risk, genetic testing if indicated and, if a woman qualifies, a yearly mammogram and breast MRI starting at the age of 30.”

Prophylactic mastectomies, and sometimes oophorectomies (removal of the ovaries), are discussed as options for women with a known genetic mutation, such as the BRCA 1 or 2 gene, according to Dr. Scheer, but it isnt the only option. High-risk screening and medication can also be used.

“For women with a family history, but not a high-risk family history, I recommend starting routine mammograms 10 years earlier than the youngest family member affected, or at age 50 (whichever is first),” advises Dr. Scheer. “In North America women tend to be more surgically aggressive and opt for mastectomy and reconstruction when they are considered high-risk, whereas in Europe they tend to opt for high-risk screening.”

A 2016 US study which looked at the number of mastectomies over a 9-year time period confirms Dr. Scheers theory. It found that the rate of bilateral mastectomies without any diagnosis of breast cancer rose from 2.1 to 4.4 per 100,000 adult women double the amount. This could, perhaps, have been influenced in-part by the “Angelina affect,” increased awareness surrounding gene mutations and preventative mastectomies following Angelina Jolies decision to undergo the procedure in 2013 after testing positive for the BRCA1 gene mutation. (See other celebs who have inspired us with their strength in dealing with breast cancer.)

Studies suggest that a preventative mastectomy has the potential to reduce the risk of developing breast cancer in high-risk women by around 90 percent. However, there are serious factors to consider before signing up to surgery, including mental wellbeing.

How can a mastectomy affect mental wellbeing?

Any invasive surgery or, indeed, risk of illness, has the potential to trigger anxiety and depression, whether or not there is prior history of mental illness. This is true of mastectomies too, even when they are preventative.

Dr. Scheer believes there to be a difference in the effect a mastectomy has on mental health depending on the type of surgery. “There are many studies looking at the impact of mastectomy on a woman’s mental health,” she says. “Most have shown a benefit, in particular in the short term, to immediate reconstruction, versus delaying reconstruction or opting for no reconstruction at all. It’s hard to wake up without a breast.”

An IJPC study investigating the relationship between body esteem and mental health in breast cancer patients confirms Dr. Scheers belief. It found, after monitoring women that had breast-conserving surgery, immediate breast reconstruction following mastectomy and a mastectomy alone, that a mastectomy in general has a “negative impact on emotional, psychological, and social functions because patients experience circumstances similar to that of an amputation.” However, those able to have immediate breast reconstruction are likely to experience higher psychosocial wellbeing than someone having a mastectomy alone.

All things considered, there is no simple answer when it comes to preventing breast cancer. There is no guaranteed approach, sadly, and the method that works best for you will depend on your risk percentage and access to, and affordability of, preventative measures, to name a few. Step one, though, is to take your concerns to your GP, and together you can devise a plan of action.

Next, read about how one woman’s life changed for the better after breast cancer.

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8 Reasons to Request an Earlier Mammogram

Jenn Sinrich — Wed, 09 Oct 2019 21:14:01 +0000

According to Health Canada, “women who are 50 to 74 years of age should have screening mammograms every two to three years.”The American Cancer Society suggests women ofnormal risk begin annual mammographyat 45. Meanwhile, women as young as 20 can getbreast cancer. As a result, theres a bit of a gray area when it comes to what doctors recommend for their patients. The underlying evidence supporting the use of screening mammography stems from nine randomized trials that began between 1963-1991 in the United States, Sweden, the United Kingdom, and Canada and studied women at average risk for breast cancer, explainsKristi Funk, MD, FACS, breast cancer surgeon and medical director atPink Lotus Breast Center. However, that data is now decades old and new advances in the field of breast cancer detection and treatment have caused experts to question whether or not the guidelines deserve a makeover. Heres a look at some of the reasons why you might want to consider requesting yearly mammograms well before the age of 50.

You have a personal history of breast cancer

Even if you didnt have full-blown breast cancer, but a high-risk lesion was found via biopsy from your breast, you should be getting mammograms earlier than the recommended age of 45 for average-risk women. Specifically, women who have had a breast biopsy that shows precancerous cells (specifically, atypia orLCIS) should request an earlier mammogram, says Dr. Funk. (Check out these breast cancer advancements that can help the fight against the disease.)

You have a family history of breast cancer

Awomans risk of breast cancernearly doubles if she has a first-degree female relative who has been diagnosed with breast cancer. First degree means your mother, sister, or daughter. If two of those first-degree relatives have been diagnosed with breast cancer, your risk rises to 60 percent, or five times higher than average. Researchers also know that your risk also goes up if a brother or father has been diagnosed, although they are not sure the exact increase in risk posed by this circumstance. Add these foods to your plate tohelp lower your risk of breast cancer.

You know of genetic mutations in your family

There are many gene mutations that have a link to cancer, but the most common for breast cancer are BRCA1 and BRCA2. On average, women with a BRCA1 mutation have up to a 72 percent lifetime risk of developing breast cancer and 69 percent risk for women with a BRCA2 mutation, saysNancy Elliottof Montclair Breast Center. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. Experts recommend that anyone with these mutations be monitored carefully and discuss risk with a doctor who specializes in breast cancer.

You were exposed to radiation therapy between ages 10 and 30

Research published in theJournal of the National Comprehensive Cancer Networkhas linked exposure to ionizing radiation as one of the key risk factors for thedevelopment of breast cancer. Much of the data come from the study of atomic bomb survivors as well as women who were exposed to medical radiation for either diagnostic or therapeutic purposes. If you were exposed to radiation for any reason during the ages 10 to 30, discuss it with your doctor to determine the ideal age to start mammograms.

Theres a history of cancer in your family

Thelifetime risk of developing cancerover the course of your life is about 1 in 3, which explains why most people have a family member or friend whos been diagnosed with cancer. But if there happens to be a great deal of cancer in your familywhat seems like more than usualits worth mentioning it to your doctor to see if you qualify for an earlier mammogram. Particularly, if you have two or more family members on the same side with breast, ovarian, pancreatic, prostate, melanoma, uterine, colon, and/or stomach cancers, you should request an earlier mammogram, says Dr. Funk.

You have dense breasts

Dense breast tissue is quite common, and researchers have unfortunately linked it to an increased risk of larger tumors ormore advanced cancerat diagnosis. Dense breast tissue can make it more difficult to detect problems on a mammogram, which is why women at high risk and/or with dense breasts may benefit from a more sensitive test: breast MRI. Unfortunately, weve seen women skip their MRI and then get diagnosed down the road, says Dr. Elliott. We always wonder if it could have been caught earlier and if they could have avoided chemotherapy.

You notice a lump that doesnt go away

Its not uncommon for womenespecially young women who are still experiencing a monthly menstrual cycleto notice alump in the breast. This is even more likely if you are breastfeeding, as the breast tissue is constantly changing due to milk production. Most of the time there is nothing to worry about and the lump goes away on its own. However, if you notice a palpable breast lump that doesnt go away with your menstrual cycle (if you still have cycles),Tara Shirazian, MD, a gynecologist at NYU Langone Health, recommends requesting a mammogram.

You experience nipple discharge or changes on the skin

Nipple discharge is common in women with breast cancer. In fact, it is the thirdmost common symptom after breast painand the presence of a lump, according to research published inRadiologia Brasileira. If you notice nipple discharge that is persistent and especially if it is one-sided, schedule an appointment with your primary care physician or gynecologist who may recommend that you schedule an earlier mammogram.

How can you find out your risk?

One in eight (12 percent) women will be diagnosed with breast cancer during their lifetime, according to Health Canada. To determine whether youre at average or increased risk,Health Canada recommends having regular screening tests. The American Society of Breast Surgeons(ASBrS) recommends undergoing formal risk assessment for breast cancer between ages 25-30 and theAmerican College of Radiology(ACR) andSociety of Breast Imaging(SBI) advise all women to undergo risk assessment at age 30, explains Dr. Elliot. These results help women and their physicians determine when they should start screeningand what type of screening theyll need, she says. High-risk women may need to be screened earlier and should consider supplementary screening, such as ultrasound or MRI (in addition to annual 3D mammography).

Next, learn how one weekend completely changed her life after breast cancer.

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10 Stars Who’ve Inspired Us With Their Strength In Dealing With Breast Cancer

Karen Kwan — Wed, 14 Aug 2019 14:10:58 +0000

Stars and breast cancer in the public eye

Julia Louis-Dreyfus recently shared the news that she has been diagnosed with breast cancer on social media.

One in eight women are diagnosed with breast cancer. Today, I am the one, tweeted the star of Veep. She went on to say she is surrounded by supportive friends and family and has fantastic insurance through her union. The bad news is that not all women are so lucky, so lets fight all cancers and make universal health care a reality, said the 56-year-old actress.

Shes just one of the many stars who have been diagnosed with breast cancer. This month being Breast Cancer Awareness Month, raising awareness and funds for the cause is the focus–too many of us who have been touched personally in some way by this cancer. Louis-Dreyfus is just one of the celebrities who’ve been diagnosed with it; so many have inspired us with their strength and resilience.

Angelina Jolie

Diagnosed with breast cancer at the age of 36, Jolie revealed in 2013 that she has undergone a double mastectomy a couple of months prior. Two years later, the star had her fallopian tubes and ovaries removed after her doctor found signs of early cancer. Jolie has a family history of breast cancer; she lost her mother, aunt and grandmother to the disease.

Shannen Doherty

photo credit: shutterstock

The Beverly Hills 90210 star revealed in 2015 at the age of 44 that shes been diagnosed with breast cancer. Currently undergoing treatment, Doherty has said she is exercising, eating healthy and keeping a positive outlook. Throughout her treatment, she’s been very open about her battle, sharing her journey on social media and fighting like a girl.

Rita Wilson

Wilson was diagnosed at the age of 58 in 2015 only after seeking a second opinion. She’s since had a bilateral mastectomy and encourages people to seek out a second opinion since you don’t have anything to lose in doing so.

Wanda Sykes

As a comedienne, she’s used to performing and making people laugh. But when it came to her breast cancer diagnosis and treatment, the star was frank with friends, family and her fans about dealing with the disease.

Sheryl Crow

The songstress was diagnosed with breast cancer not long after splitting with longtime beau, Lance Armstrong. Crow had lumpectomy and radiation treatment. She’s been quoted as saying her breast cancer brought a lot of clarity when it came to her perspective on life.

Christina Applegate

photo credit: shutterstock

Applegate was 36 years old when she got her diagnosis. With her mom having had to fight cancer twice, Applegate opted to have a double mastectomy even though cancer was only found in one breast.

Cynthia Nixon

It was after a routine mammogram that the Sex and the City alum learned she had breast cancer. The mom of three was 40 years old at the time and later became an ambassador for Susan G. Komen for the Cure. Later on, in 2012, she played a cancer patient and shaved her head for the role for the Broadway show Wit.

Kylie Minogue

In 2005 at the age of 36, Minogue was diagnosed with breast cancer. This was after an initial misdiagnosis that she only spoke about a few years after; she chose to speak about her initial misdiagnosis in order to stress the importance of early detection and encourage getting second opinions. She’s spoken about how the experience of having to grow your hair and eyelashes back deeply shifted her perspective.

Giuliana Rancic

Her treatment for breast cancer was very much in the public eye. Then in her 30s, the fashion and entertainment reporter was very vocal in her struggle with fertility and other post-op issues. She had a son with her husband via surrogate.

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Better Health After Breast Cancer: How Samantha Harris Changed Her Life

Alyssa Ball — Fri, 19 Oct 2018 19:30:48 +0000

Breast cancer is a life-changing experience that can affect you in tremendous ways you never thought possible.Samantha Harris, an Emmy-award winning television host known for her time spent in front of the camera on Entertainment Tonight and Dancing with the Stars, knows this especially well. In 2014, at the age of 40, Harris shared the news of her shocking breast cancer diagnosis with the world. A diagnosis that quite literally blindsided her when she found a lump 11 days after a clear mammogram. So when asked what motivated her to become so open about her diagnosis, she promptly replied: The thought occurred to me that there might be another woman out there whos walking around with a lump that she found that a doctor told her was nothing. Thats why she chose to openly share her story and that was the very moment she decided to not let her diagnosis devour her. Instead, it ignited something so powerful within her; it compelled me to become the healthiest version of myself, ever, says Harris, which she considers to be the best thing to come from her diagnosis.Using her journalism background, she wanted to get to the bottom of what caused her cancer, and find out why 1-in-8 women are diagnosed with breast cancer over the course of their lifetime.What she found when she dug into that research? It all came down to what I was putting in, on, and around my body that not only led to cancer but so many other prevalent diseases today and, that there’s actually changes I could be in control of, she says. Changes like controlling how she ate and exercised, and how to rid herself of toxic relationships, as well as the toxins that were lurking in her beauty products and household cleaners. Inspired to help others, these findings led her to write a book (released in September),Your Healthiest Healthy an 8-step program that allows women to take away that hopeless and out-of-control feeling and actually learn how to take back their health.And taking back her health was exactly what she did. After recovering from a double mastectomy and understanding the day-to-day changes she needed to make in order to improve her overall health, Harris did have a few regrets. “I really wish I hadn’t consumed so many packaged and low-fat foods,” she says. “And that I wasn’t afraid of fat because literally, I was afraid of fat and would avoid eating avocados and nuts and seeds which are incredibly important for our overall health.” Embracing these healthy fats has been just one of the first steps she’s taken. “I found that once I started adding healthy fats into my diet, I became more energized,” she says. (Learn why this woman chose not to have breast reconstruction after a double mastectomy.)It was also eye-opening for Harris to learn how to properly read a nutrition label beyond just calories and fat. Especially when it came to sugar, she couldn’t believe how fooled we are as consumers. “Because the ingredients are listed by weight, if a manufacturer needs to put a lot of sugar in a product but doesn’t want the consumer to be aware of it, theyll use different types of chemical compounds of sugar like sucrose, glucose, galactose, and cane syrup,” she says. “What they do then is add them all in using a bunch of different types of sugars, then sugar itself doesnt end up being one of the top three ingredients listed on that very nutrition label.” The U.S. FDA recently made changes to the requirements of nutrition labels and, Health Canada has also implemented a food labelling changeto help Canadians better understand the sugar content of their food.Along with making sure that [as women] we take control of our knowledge, Harris believes it is important to understand the inner-workings of our bodies. “If I hadn’t been exercising regularly and really aware of minor changes, I may have really easily missed finding that lump and, who knows how long I would have gone without finding it,” she says. But in order to learn how to better understand your body and your health, Harris advises taking thesesmall steps first if you want the changes from her 8-step program to last.Nutrition:“Fill your plate at least half full of veggies at every meal,” says Harris. “That might look like a morning smoothie with spinach and kale, a large chopped salad with beans at lunch, and a black bean burger for dinner.”Exercise: “If you’re someone who is completely sedentary, try walking for five to 10 minutes a day around the block,” she says. “And if youre someone who’s active but are too busy to fit in a solid 30-minute workout four to six days a week, take 30 minutes and break it up into 10-minute increments throughout the day. (Those three increments will have the overall same benefits as a solid 30 minutes.)”Well-being: “We have to remember that its not just about what we are eating and how were working out, but it’s also about who we surround ourselves with,” she says. “People who cause anxiety and add stress to our lives is a trap so the key is to be able to identify and kick to the curb the toxic relationships in your life.”And in honour of Breast Cancer Awareness Month, Harris has one final piece of advice for thatwoman who was just diagnosed or is currently going through treatment or recovery: Ride the wave. “Know that the waves of emotion are unavoidable but temporary, and its totally normal to have feelings of rage, frustration and confusion but remember that those moments will pass.Today, cancer-free, Harris explains what those two words truly mean to her. Jubilations and still fear,” she says. There’s always that fear once youve gone through breast cancer that it can come back. But that fear won’t stop her from living her healthiest healthy life.Editors Note: If youre interested in learning more about Samantha Harris breast cancer journey or have any questions about her new book, Your Healthiest Healthy, she wants to hear from you.Related: Shop These Canadian Picks to Support the Fight Against Breast Cancer

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‘I Needed to Grieve the Loss of My Breasts’

Melissa Greer — Thu, 11 Oct 2018 16:40:11 +0000

In honour of Breast Cancer Awareness Month, Canadian intimates brand Knix has partnered with Rethink Breast Cancer on a campaign featuring survivors and current employees at Rethink. Several of these “breast cancer badasses” are smack in the middle of their breast cancer treatment or recovery like Sarah (far left), who was photographed just one week after her first chemotherapy treatment, and Inessa (far right), who was 13 weeks pregnant went she underwent a single mastectomy and 18 weeks pregnant when she was photographed for the Rethink Collection.Of course each womans experience is unique and while breast reconstruction was the right choice for women like Alanna (second from left) and Jackie (second from right), it wasnt the right choice for Nikki (centre).Throughout October, Knix is sharing each woman’s story alongside a photo of her wearing the Rethink Collection. The campaign launched with Nikki’s photo, below. We asked Nikki to share her thoughts on the campaign, femininity and why it’s time to shake up the conversation around breast cancer.

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My body was screaming to heal. It was telling me not to put any more unnatural things into it. I didnt want more surgery than I needed. Women are not just their bodies and their breasts and whatever they come with. The power of femininity is within. – @nikkileighmckean, wearing the Athletic High Rise in Passion. Introducing our new special edition Rethink Collection with a portion of proceeds going to @rethinkbreastcancer who support young women affected by breast cancer. Shop for a good cause through the link in our bio????

A post shared by Knix (@knixwear) on Oct 3, 2018 at 12:25pm PDT

Youre part of Knixs incredibly powerful campaign in support of Rethink Breast Cancer. How did you feel about your image? Its pretty powerful. Did you feel powerful? Or did you feel vulnerable?I feel the same way everyone else feels about it. Its powerful. Although I know its me in the image, in some ways I feel like I am just the vessel to speak to an audience. This image is powerful for so many reasons and as a creative lifestyle photographer myself as soon as I saw the image it was like wow thats it! As a storyteller its always my aim to create imagery that provokes someone in a way that allows people to feel something and spark a conversation. This image does exactly that and thats a beautiful thing it just so happens to be me in the image!I think there are always moments of vulnerability in all situations when we let go but overall I felt a strong sense of knowing that if this image could make its way out into the world, it would allow people to shake up the conversation about breast cancer and more importantly about honouring our truth and following your heart.Related: Stop Believing the BS 10 Cancer Myths, BustedWhat do you hope women (and men) who see the campaign take away from the images?I hope they take away that there is beauty in everything and everyone if we choose to see it. That we are not broken and that we are radiant human beings untouched by anything or anyone.I read on your website feelthat.ca that your doctor just assumed you would have breast reconstruction after your double mastectomy. Tell us about your decision not to have reconstruction. Why do you think some people are surprised by this?My choice to not reconstruct was personal and very intuitive. The doctors first suggestion was to do a DIEP flap which is a type of breast reconstruction in which blood vessels, skin and fat are removed from the lower abdomen and transferred to the chest to reconstruct the breast after a mastectomy. I quickly began to feel like a mad science experiment and as much as the DIEP flap seemed like the most natural way to rebuild my breasts and give me a “tummy tuck” at the same time (as it was mentioned) it most certainly didnt feel right. I had to remind the Plastics team that just two years ago I had cervical cancer and received aggressive radiation treatment to the abdomen area. I dont know about you but it most certainly didnt feel right to put that highly radiated area on my just diagnosed breast cancer.Then came the question, well what size would you like to be? when referring to the implant option, however, every time I thought about putting something foreign into my body I literally felt a physical sensation of no in my body, so I really honoured that for myself. I think everyone assumes every woman would opt for reconstruction as its a huge loss to have them just cut off and be left with nothing. I think the medical teams want to make sure they are providing patients with a way of piecing the body back together and fixing what is considered broken. But as you can imagine its not as easy as piecing body parts back together, the entire process is devastating. For me, I needed to grieve the loss of my breasts and it didnt feel right to replace them with something that wasnt mine. Please also keep in mind that this wasnt my first rodeo it was my second cancer diagnosis in just two years and I had a strong message that my body wanted to heal and I needed to give it the best opportunity to do so.People were definitely surprised by this some even disturbed. I get all sorts of comments, looks and judgements but at the end of the day its what Im comfortable with and honestly, I love my scars and my flat chest and Im still breathing above ground, so for me thats a win, win. It has been my experience that people are able to grieve the diagnosis and loss along with me because of my decision of no reconstruction because not only can they physically see it but I am open and honest about my decision and I feel an immense sense of support and witness people actually feeling. Friends and family often cry about my decision and I think thats healthy because it means that they are actually processing the information. I have spoken to other women who have had reconstruction and the largest complaint is that people assume that they should all be happy for a “free boob job!” and thats just not the truth. A mastectomy is NOT a boob job, its a decision that is risky, scary, life-altering and extremely painful.What (if anything) needs to change about the way breast cancer is perceived?Im not sure I feel that anything specific needs to change about the way breast cancer is perceived. Its like assuming everyone has tasted a freshly picked Ontario strawberry at exactly the right time of year. If youve only ever eaten store bought strawberries from the local chain grocery store then you dont know until you know. We cant always change peoples perceptions on a particular subject but I do believe we can teach people how to be more mindful, more compassionate and more loving. If we took time out to look within, then the knowledge is already there free of judgement.Knowledge is power and intuition is the best free advice youll ever get. Trust your gut and if you dont have the tools to understand when your body is talking to you, I encourage you to start exploring how. We have to slow down first to be able to listen to the whispers before they become too loud. We need to learn how to ask for help and then when given the help, we need to receive that help with grace.Related: Canadian Model Elly Mayday Wants to Show You What Ovarian Cancer is Really LikeCan you share a little about your experience with cancer and treatment?Cancer and treatment has the ability to unlock the beauty and beast in every living thing that touches you. It touches parts of your physical and spiritual being that you never thought was imaginable. It tests you. It brings you so close to the feeling of death you can smell it, taste it. And then, moments later you find yourself stopped in the middle of a crazy street during rush hour while staring at a newly bloomed flower blowing in the wind. As people rush by and bump shoulders, giving glares at you for taking a pause and all you can think to yourself is Ive walked this path for almost 10 years and Ive never noticed any of these beautiful gardens and how at the same time everyday the sun touches them in a way that sends sparkles in the sky. It has the power to rocket ship you to the most present moment you have ever experienced because its not possible to think or do anything else because your new found acute awareness of life and all of its truth is so strong. There is so much beauty and sadness in all these moments.What do you wish people knew about helping a friend or family member through cancer and treatment?To be fully present and live with an open heart to stay connected to the world around you. Be still. Be quiet. And most of all its no ones responsibility to fix or change anything sometimes the most important thing is to sit with what is and acknowledge the absolute mess that a cancer diagnosis brings to families lives. We are so quick to fix or resume normal activities within our busy lives that we miss out on what is truly happening and I think the true healing is when our insides feel heard.As patients and caregivers, we cant ever expect and assume everyone outside of your experience will understand what you are going through its just not possible, and its not always necessary. In a perfect world it would be nice, but its just not going to happen and to be honest, I wouldnt wish everyone around me to fully understand what it is that I was going through.What I found to be most helpful is feeling unconditional love and support with the platform to be heard and seen as a divine being, not a weak, frail, broken sick person. We actually took the word sick out of our home because it doesnt serve me and there is a huge sense of fear attached to it. Also, when I think of a sick person I see an image of someones head in the toilet right? Thats not always the case with cancer treatment, I mean some days it is but its so much more than sick. I tried very hard to understand and articulate what I was feeling in each moment so that I could acknowledge it and help my friends and family understand what I was going through without the need to fix or change anything. It seems like a lot to be going through something so difficult and also be a teacher but when we are clear with what we need then our needs are met and the people that want to help have clear instructions on how to help and actually feel like they are making a difference.During October, 5% of sales from the limited edition Rethink Collection will go to support Rethink Breast Cancer.Plus, use the code RETHINK with any purchase on Knix.ca and Knix will donate an extra $5.Shop 9 more Canadian brands giving back for breast cancer awareness month.

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10 Reasons Summer Camp is Even Better as an Adult

Kate Daley — Wed, 27 Jun 2018 10:56:22 +0000

The Grown-Up Camper Trend

“Grown-ups want to go back to camp because they want to connect with themselves again,” says Negin Sairafi, one of the founders of Camp Reset, an adult camp outside Toronto. “It is so easy in our digital age to be overly consumed with our to-do lists and calendars.”Adult summer camps attract professionals from all over to bond over a shared nostalgia. “The opportunity to rediscover my childhood was very appealing, the chance to go back to a life that was more simple and where play took centre stage,” says 38-year-old Torontonian Susan Debreceni, who has attended Camp Reset.Grown up camps fill a need to get back to basics and offer an experience full of new friendships, wellness activities, gourmet food and of course, partying with no counsellors to say lights out.Read on for more reasons to pack your bags for adult summer camp.

Make New Friends

When you’re a kid at camp, you might make a friend and then build your friendship slowly as you reunite yearly in your cabin. “We recognize that the older we get, the harder it gets to make new friends,” says Sairafi. “[At camp] you’re surrounded by likeminded people, in an environment that breaks down social norms so the possibilities are endless.” Adult camps offer a shared bonding experience but thanks to technology you have the opportunity to stay in touch once you pack up.

Do a Digital Detox

Harken back to a time where there were no cell phones to check, Instagram account’s to update or work emails to answer- life was about roasting marshmallows over the fire and spending all day in the lake. Many camps, Reset included, ask you to check your devices when you arrive so you can really turn off and tune out.

Embrace Nature

Not all camps are simply fun and games either – SOS Wilderness Camp in Northern Saskatchewan takes adults on outdoor survival courses where you can learn how to find your own food and water. It’s definitely not “glamping” but you’ll be happy you did it should you ever get lost in the woods.

Learn New Skills

Many adult camps simply offer general debauchery but others offer skill-building courses like cooking, pottery, science classes or music. Hone your talents or pick up a new set that you can show off when you return to the office. And you don’t need to choose anything professional either-many camps offer to teach participants things like yoga, ropes courses and arts & crafts.

Party Hard

The fun and games never have to end at adult camps like Camp No Counselor, which offers theme parties, where campers can don getups (think superheroes or cowboys), and indulge in an open bar. Funky cocktails and local craft beer sponsors make for an experience that will suit more mature palettes.

Stay in Luxury

Run-down cabins filled with creepy crawlies are fine when you’re a 10-year old but why stay in the dumps when you can bunk in a high-end version? Unroll your sleeping bag in state-of-the-art facilities at grown-up camps that offer ice cream shops, movie theatres and pristine beaches.

Eat Gourmet

Forget cafeteria food, grown-up camps offer grown-up meal options. Camp’s like Two Islands Weekend enlist A-list chefs from Southern Ontario to cook up delish meals like a seafood boil and taco bar. They also accommodate vegan, gluten-free and vegetarian diets so you don’t have to subsist on granola bars hidden in your backpack.

Skip Vacation Planning

Booking and organizing your vacation can take more time than the actual vacation itself and can often add a lot of pre-vacay stress. Adult camps offer the freedom to simply show up and have fun, no prep required. Pick from an assortment of activities each day that simply require a bathing suit and towel.

Play All Day

Sign up for a Beyonc dance class, make a friendship necklace, play zorb soccer or enjoy some stand up paddleboarding at camps like Two Islands Weekend. This type of getaway is perfect for the active types who can’t sit still but also suits those who like to simply chill. There’s an option for everyone-and no one to call your parents if you don’t feel like participating.

Embrace Nostalgia

The best part of camp as a kid was that feeling of getting away from the every day-and your parents. “I came back feeling completely reset with a fresh attitude and inner motivation,” says Debreceni of why she loved the grown-up version and has already signed up to go back again next year. “I never anticipated how life-changing attending an adult summer camp would be.”Related: Your Camping Essentials Checklist 10 Great Places to Go Glamping in Canada Canada’s 10 Best Summer Camps for Grown-Ups

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These Breast Cancer Advancements Will Forever Change How You Fight This Disease

Best Health — Thu, 31 May 2018 20:28:05 +0000

Breast Cancer Advancements: New perspective

Breast cancer now fits the criteria of a chronic disease, along with the likes of high blood pressure, asthma and diabetes, says Dr. Ardythe Taylor, medical director of Breast Cancer Supportive Care in Calgary. People live with the impact of these for long periods of time and can still die from them, but not necessarily, explains Dr. Taylor. Breast cancer fits that category now according to the World Health Organization. Women may need medication for years, and some side effects will persist, but there are ways to medically manage it. And, even among women with metastatic breast cancer, many are living for a decade or more, she says, though side effects are challenging and medication may be required for years. Thats the new picture of breast cancer.Make sure you read up on why being vocal about breast cancer is so important.

Breast Cancer Advancements: Health-care helpers

We now have professional health-care advisors called patient navigators to help patients through their treatment journeys. (If you’re getting treatment, here’s exactly what you should be eating.)Dont have access to a patient navigator? The pages of Dr. David Palmas new book Taking Charge of Cancer offer an easy stand-in. Dr. Palma, a radiation oncologist at the London Health Sciences Centre and cancer researcher with the Ontario Institute for Cancer Research, offers guidance on getting the best cancer treatment, including advice on where to get treatment, how to get a (free) second opinion and what questions to ask your doctor. Theres no way to plan for a cancer diagnosis, but this book can help patients figure out what happens next.

Breast Cancer Advancements: The return of HRT

In 2002, the Womens Health Initiative study, which was investigating the effects of hormone replacement therapy (HRT), was abruptly halted when some of the study authors claimed that giving women estrogen-progestin was linked to a rise in breast cancer and heart attacks. HRT, which was previously given to women to stave off the unpleasant and unhealthy side effects of menopause, fell out of use as women and doctors believed it to be dangerous. (Here are some shocking ways menopause can affect your brain.) But, 15 years later, researchers have revealed that the precaution was all hype. Now experts say that not only is there no increased risk of breast cancer for women under 60 who take HRT, theres also a protective effect for hip bones and the heart.

Breast Cancer Advancements: Whole-patient healing

Dr. Taylor says holistic care centres that address the needs of breast cancer patients as a whole person and their families and not just the disease are an emerging field in oncology. At the Breast Cancer Supportive Care centre physicians, health coaches, psychologists, psychiatrists and more work together to help people impacted by breast cancer through their cancer journeys. The team educates patients about their surgeries; assists with practical matters, like figuring out how much time they need off work; helps with treatment side effects; offers support to family members and kids; and counsels patients through fears, anxiety, depression and body image issues all of which can arise when a womans life is turned upside down by cancer. Our wellness model includes physical, mental, emotional, relational and spiritual wellness, she says.Check out which Canadian provinces have the highest cancer rate.

Breast Cancer Advancements: Reconstruction

Each October, the Canadian Cancer Society partners with plastic surgeons to put on over 30 BRA Day (Breast Reconstruction Awareness Day) events across Canada. Each event features local sponsors, like implant companies and nipple tattoo artists, who explain their services. The highlight is the Show and Tell Lounge, where women who have had breast cancer and reconstruction show off the results of their surgeries and have intimate conversations about their experiences with women who are facing reconstruction decisions. This can be an empowering experience that gives women a chance to explore their options, says Natalie Witkin, senior manager partnerships & programs, Canadian Cancer Society. Its a very emotional experience as well. And although the odds are high when it comes to developing cancer, it’s not as black and white as you think.

Breast Cancer Advancements: A network on the net

Dr. Palma says one of the biggest changes for modern cancer patients is that theyre more likely to seek connections online than in support groups. Cancer Hope Network is one example of a website that connects women with breast cancer to survivors who volunteer their time to listen and share their own experiences. It allows people to get support in ways that were never possible in the past, says Dr. Palma.Check out the daily habit that could reduce your cancer risk by 20 percent.

Breast Cancer Advancements: Community coordinating

When cancer strikes, friends and family gather round to lend their support, which often comes in the form of food. But, inevitably, a patient will find her fridge overflowing with lasagna some days and bare on others. Thats where Meal Train comes in. The website coordinates loved ones who offer help, with an online sign-up where they can schedule those homemade meal deliveries.Here are 10 celebs who’ve inspired us with their strength in dealing with breast cancer.

Breast Cancer Advancements: Proactiveprotein defence

For many women, the greatest fear is that the disease will spread. Dr. Peter Siegel, associate professor in the Department of Medicine and associate director of the Rosalind and Morris Goodman Cancer Research Centre at McGill University, and his team have had promising successes as they work to stop metastases. Theyve identified a protein called GPNMB that is involved in the spread of breast cancer and melanoma. GPNMB expression actually increases in cancer cells in response to chemo or targeted therapies. Now using a special drug that targets that protein, Dr. Siegel and his team are learning to better manage cancers that overexpose GPNMB. Weve been able to show in preclinical models that when combining these standard-of-care therapies with this new antibody drug conjugate, you get much better control of the disease, says Dr. Siegel.These 3 cancers are on the rise in Canada. Here’s what you should know to protect yourself.

Breast Cancer Advancements: T-cell attackers

One of the most exciting areas of cancer research is focused on immunotherapy using the bodys natural defences to defeat the disease. Until recently, breast cancer was thought to be resistant to these tactics. But now, Dr. Siegels colleague, Dr. Morag Park, principal investigator at McGills Park Lab, is identifying subsets of breast cancer that show a robust response from T cells (white blood cells that fight invaders) versus those that do not. Dr. Parks team is looking for ways to reactivate those fighter cells. Think all this research sounds too far off to help today? Its not. At the Park Lab, scientists take cancerous tissues from patients and put them into animal models to test how those specific cancers grow and react to different treatments, which is particularly helpful when a patient is resistant to a current treatment and her doctors need to know which options her cancer will respond to.If you’re taking birth control, make sure you know why it can increase your risk of developing cancer.

Breast Cancer Advancements: Zen connection

When the physical fight is over, todays patients can focus on their spiritual health. Shawna Rich-Ginsberg, senior manager of support and education at Rethink Breast Cancer, says many health and wellness retreats have sprung up to help women cope. (Visiting Quebec City? Here are some wellness adventures that are a must.) Rethink, for one, hosts Stretch Heal Grow, a Muskoka, ON, getaway where women can do yoga, meditation and body image workshops. Its not about sitting around talking about cancer, says Rich-Ginsberg. Its more about connecting with yourself, finding that community and meeting other people who are going through the same thing.

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Why This Star Felt It Was Her Duty to Talk About Her Health

Samantha Speisman — Thu, 03 May 2018 14:54:27 +0000

While It seems relatively common now, stars didnt always talk about their health struggles.

Sometimes a close friend would divulge personal information. Maybe paparazzi would snap a big name leaving a clinic or a hospital it was rare to hear about a diagnosis or treatment plan straight from the source.Related: Are your odds of developing cancer really a 50/50 chance?But its not that way anymore. Stars are using their platform to raise awareness for little-known diseases or to talk about prevention and share ways for fans to keep themselves safe.

Celebs are sharing their personal health struggles

In the last few years, Selena Gomez has raised the profile of lupus, Hugh Jackman has warned the world about the dangers of skin cancer and Angelina Jolie has talked openly about Bells palsy, hypertension and preventative cancer surgeries. (She famously wrote an op-ed in the New York Times about having a double mastectomy.)Related: This former Bachelor contestant got reconstructive surgery after a double mastectomy.

Christina Applegate’s cancer diagnosis motivated her to speak out

But theyre not the only ones. Stars around the world have made it their mission to improve their fans health including Christina Applegate. Diagnosed with breast cancer in 2008, the 46-year-old actress has been vocal about the disease and about womens health ever since. Like Jolie, Applegate underwent a double mastectomy, and then decided to have her ovaries and fallopian tubes removed to lower her risk of recurrence.Related: These 10 celebs have inspired us with the way they handled cancer.Like so many others in Hollywood, Applegate felt it was her duty to help other women, saying When I first came out about my breast cancer I didnt want to talk about it, but I had to, because young women were getting it, and people werent understanding that. She also notes the misconception that breast cancer is an old womans disease, women that were 36 were getting breast cancer, or women that were 28 were getting breast cancer, and they were opting not to get MRIs when they were high-risk because of the cost.Saying thats when her activism came out, Applegates now made it her mission to educate women about the importance of MRIs when it comes to cancer screenings. The Emmy award-winning actress says the scan saved her life: An MRI saved my life. Had I waited for my mammogram, I would be dead right now.Related: This Pretty Little Liars star explains why she gained 70 pounds.

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10 Questions You Need to Ask Your Doctor

Best Health — Thu, 03 May 2018 08:00:00 +0000

Have you ever left your doctor’s office and then realized you forgot to ask about something that’s been worrying you?

Do you wonder what the latest studies recommend you do to take preventive action against things such as osteoporosis and breast cancer? We consulted the experts to compile this list of 10 key things to ask your doctor.

1. Am I getting the best cancer screening possible?

When it comes to breast cancer screening, mammograms are the best option for women who are at average risk and aged 50 to 69, says Heather Chappell, senior manager, cancer control policy of the Canadian Cancer Society. But ultrasound and MRI testing may be a good adjunct to mammograms for women who are at a higher risk, such as those with a family history of the disease.”Ultrasounds and MRI are not necessarily more reliable than mammograms unless they’re used in conjunction with a mammogram,” says Dr. Jan Christilaw, senior medical advisor for provincial women’s health programs at the BC Women’s Hospital & Health Centre. Mammograms can detect tiny calcifications that may indicate early breast cancer, ultrasounds may offer more follow-up clarity for women with dense breasts, and MRIs may be useful for women at high risk.Related: Your doctor can tell these things just by looking at you.If you do have a family history of breast cancer, testing for BRCA1 and/or BRCA2 genes can help your doctor develop a customized prevention plan for you. For cervical cancer testing, while Pap smears often first detect the disease, human papillomavirus (HPV) tests are increasingly used as an adjunct. The technology is still in limited distribution, however.

2. Am I clinically obese?

Some 5.5 million Canadians are obese, with a body mass index (BMI) of 30 or higher. And even though obesity opens the door to type 2 diabetes, heart disease and cancer, only about 40 percent of those affected get advice from their doctor. “For many physicians, once you’ve finished an appointment, there is very limited time left to talk about weight,” says Pedersen, an endocrinologist at the University of Calgary. Ask the doctor to measure your waist: 31 inches (80 centimetres) or higher could spell trouble. Then ask for his or her advice on treatment options because if you are clinically obese, even a five to 10 percent weight loss will benefit your health.Related: What aren’t you telling your doctor? It could be hurting your health.

3. Could my back or joint pain indicate a chronic illness?

Ovarian and pancreatic cancers and even kidney stones can show symptoms through back pain. In a Tokyo Women’s Medical University study, 30 percent of patients who had pancreatic cancer suffered from abdominal or back pain. And diseases such as lupus often reveal themselves through joint pain.

4. Should I worry about hypertension before I’m 50?

Yes, if you had a hypertensive pregnancy or have a family history of high blood pressure. “We know that within 10 years of that pregnancy, women have an increased risk of significant hypertension, and their cardiac risk goes up 10 years earlier than the general population,” says Christilaw. What we do to our arteries in our 30s and 40s is critical: “Eat a reasonable diet low in cholesterol, maintain a normal weight, and exercise,” suggests Christilaw.

5. Should I get a bone density screening even though I’m young?

If you are under 50 and have a family history of bone deterioration, ask your doctor if you should get screened, says Tanya Long of Osteoporosis Canada. If you’re over 50, you should be assessed, and if you have one or more major, or two or more minor, risk factors, a bone mineral density test is recommended. (Anyone over 65 should have this test.) Doing weight-bearing and resistance exercises three times a week reduces risk. And women over 50 should get 1,500 milligrams of calcium and at least 800 International Units (IU) of vitamin D daily. For those under 50, it’s 1,000 milligrams of calcium and at least 400 IU of vitamin D daily.

6. Why won’t this severe headache go away?

“Severe” means a headache with excruciating pain levels that you’ve never experienced before: Whether it’s a single headache or a recurring pain, dial your doctor. And if it’s accompanied by nausea, vomiting, seizures, or other neurological symptoms, get to an ER. It may only be a migraine, but it could also be a ruptured aneurysm a potentially fatal bursting of a widened or bulging blood vessel in the brain. If it’s caught in time, you can recover.Related: Don’t lie to your doctor especially about these 5 things.

7. Why won’t my flu symptoms go away?

The flu usually lasts three to four days, with fever, chills, dry cough, aches and pains. But if it continues past four days, you may have a secondary infection pneumonia, mononucleosis, strep throat, a staph infection or even early-stage lung cancer. “Especially if there’s a chronic cough or if you’re coughing up coloured sputum, you need to be seen,” says Christilaw.

8. Should sexually transmitted infections worry me?

If you have a new sexual partner, regardless of your age, there’s a risk of STIs. HIV-positive cases have increased in the past five years for those over 30, due in part to more active sex lives among older adults and poor HIV awareness. Not using a condom during sex is a concern because your chances of developing an infection increase as you age. “Post-menopausal women have thinner vaginal tissues and are more at risk of chafing, and those are risk factors for developing HIV,” says Christilaw. Chlamydia, gonorrhea and HPV are also on the rise. “If you’re post-menopausal and you get gonorrhea, you may not have the heavy discharge a younger woman does. So you can get sicker before you know you have an infection.”

9. Why am I experiencing abdominal discomfort?

Feeling bloated, gassy or achy may indicate something more serious than a bad meal. Chronic discomfort can point to conditions such as appendicitis, ovarian cysts, diverticulitis and pelvic inflammatory disease. To be sure, your physician may, along with pressing on your abdomen, order an X-ray. “If you’re in severe pain, if it gets worse within 24 to 48 hours, if you have a fever or if your bowel patterns have changed over time, you should be seen,” says Christilaw.

10. Why do I have heartburn and shortness of breath?

The signs of heart trouble in women may be more subtle and long-lasting than the chest pain and arm numbness you’ve heard about for men. “Women having heart attacks might feel short of breath or sick,” says Christilaw. “Heartburn is the number one thing it’s confused with.” Chronic heartburn could also indicate GERD gastroesophageal reflux disease, in which stomach acid comes up into your esophagus. If these symptoms arise suddenly, or persist, get a formal diagnosis.Related: What if no one believed you were sick?

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How Your Diet May Help Lower Your Risk For Breast Cancer

Alex Mlynek — Wed, 01 Nov 2017 01:06:14 +0000

How does your diet effect your risk of developing breast cancer?

Are you unsure whether or not diet affects breast cancer? The truth is, there arent many solid answers when it comes to how diet and breast cancer risk work, says PaulineWisdom-Gilliam, a registered dietitian at the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto.Theres no definitive research to show that specific foods increase your risk of developing breast cancer, she explains.However, there is a connection between alcohol and your risk of breast cancer, which is why she recommends that women drink no more than one glass of alcohol a day. And, though it hasnt been proven yet, she says that some research shows that higher insulin levels may put people at greater risk of developing breast cancer.Its still in its early days on that point, but she encourages people to avoid sugary drinks and be mindful of added sugars.As for foods that are protective against breast cancer, Wisdom-Gilliam says that soybeans and flaxseed both of which contain phytoestrogens may help lower your risk. Especially in young women whose breasts are still developing.

Why you should tweak your diet

While there may not be many foods that target breast cancer, there are ways to tweak your diet to potentially reduce your overall cancer risk. But where to start?Focus on eating mostly plant-based foods and as many different types of them as possible. Try out a rainbow of fruits and veggies, give different whole grains a whirl, and expand your repertoire of legumes.Theres protection in variety, she explains. Youre more likely to cover your bases in terms of nutrients and cancer-fighting phytonutrients by eating many types of these foods in their whole form. Why whole? Many beneficial compounds are thought to be prevalent in the skins of fruit.Wisdom-Gilliam also suggests limiting red meat (beef, veal, pork and lamb) to no more than 18 ounces a week and avoiding processed meats altogether. Proteins like fish and poultry are fine, but she recommends trying to have at least two vegetarian meals each week.If you’re ready, here’s several days worth of eating tips that may protect you from developing breast cancer.

Soy central

Soy has gotten a bad rap for being linked to breast cancer. But research shows that it may help to protect us.If soy isnt usually part of your diet, try to get more of this potentially protective food into your meals.Add steamed edamame to your menu as a starter, make a salad that features these bright green legumes or, for breakfast, consider a tofu scramble.You can even make dessert with tofu think smoothies, puddings and cakes.

Watch the heat

The way you prepare foods may have an impact on your risk of cancer. Theres a possibility that meat cooked at high temperatures, such as grilling, can form potential cancer-causing compounds, says Wisdom-Gilliam.Polycyclic aromatic hydrocarbons [PAHs] are found in the smoke and adhere to the meat.And then there are heterocyclic amines (HCAs), which form when meat proteins react to intense heat on the grill, she says.To get around this, marinate your meat ahead of cooking, which may stop it from charring, or precook your meat so that it spends less time on the grill.Any type of marinade will help, but citrus marinades are particularly good because they contain antioxidants that may block those compounds from forming.Also, think about what your protein and other nutrient-dense options are beyond red meat, including fish, chicken, veggies and fruit.

Curb your cravings

Since theres a chance that added sugars may increase your risk of breast cancer, find a replacement for your sweet fave. One classic swap for ice cream is to blend frozen bananas with berries, peanut butter or cocoa powder,if youre craving chocolate.While fruit contains natural sugars, Wisdom-Gilliam says that theres no need to avoid it. In fact, she suggests eating a wide variety of fruit.

Avoid processed meat

Avoiding processed meat is recommended as a way to reduce your risk of cancer, but that doesnt mean that the occasional slice of bacon or salami is off the table, saysWisdom-Gilliam.Its about balance.If youre having a hot dog and you combine it with a great salad, youre going to get lots of other vitamins, minerals and anti-cancer compounds, she says. In a sense, thats protective when youre having a hot dog at the ballgame or at your family barbecue.

Make healthier food swaps

To incorporate more vegetarian meals into your weekly plan while reducing your red meat consumption, look for new proteins and whole-grain dishes.Instead of a pot roast for supper, consider making a nut roast. Or try pulled chicken in place of pulled pork. Quinoa is very versatile and can be used to bulk up a number of dishes, including chilis and salads.You can also make meatballs with ground turkey or add white beans to top off your favourite pasta.

The post How Your Diet May Help Lower Your Risk For Breast Cancer appeared first on Best Health.

Breast Cancer Diet: Exactly What To Eat When Getting Treatment

Best Health — Thu, 19 Oct 2017 01:54:04 +0000

Undergoing treatment? Create a breast cancer diet plan

There is no one-size-fits-all solution when it comes to what to eat while undergoing cancer treatment, says Megan Morrison, a registered dietitian at the Princess Margaret Cancer Centre in Toronto. Creating a nutrition plan depends on the individual, cancer diagnosis and side effects of treatment.Nutrition plans can vary based on the cancer site, stage and/or planned treatment that the individual receives.

Get your protein

That said, there are common goals when creating a nutrition plan: Maintaining and improving nutritional status and reducing the risk of malnutrition.Morrison says that foods packed with good-quality protein, such as fish, poultry, beans, lentils, chickpeas, nut butters and nuts, are crucial to helpthe body heal while rebuilding the immune system and strengthening muscles.

Always stay hydrated

Some treatment side effects, such as nausea, vomiting, sore mouth and throat, taste and smell changes, low or decreased appetite, weight loss, constipation and diarrhea, can impact your nutritional intake.With nausea, especially if its severe, Morrison says that fluids are important to prevent dehydration, so drinking water first and foremost or 100 percent juices or eating soup is a good idea.

It’s all about timing your food

Of course, solid foods are essential, but she suggests eating solids and drinking liquids separately. You dont want to fill up on liquids before eating calorie, protein and nutrient-rich solids.Eating small, bland snacks (avoid super-spicy, fatty, greasy foods) throughout the day is a good idea, too, as skipping meals can make nausea worse. And its good to be mindful of temperature.We recommend trying colder food items because they dont smell as strong, she says.Making every bite nutritionally dense and high in calories and protein is key so that you get the most benefits from the smallest amount.If someone is having an omelette, instead of having a plain omelette, add shredded cheese and avocado, she suggests. If someone is trying vegetables or mashed sweet potatoes, add olive oil to those foods when cooking them.

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5 Pink Items That Support Breast Cancer We Actually Love

Lisa Hannam — Wed, 18 Oct 2017 17:01:42 +0000

Not just your basic tee

This shirt is part style, part empathy. The sales of this Missoni T-shirt will give 100 per cent of the revenues toward a local breast cancer charity, including Rethink Breast Cancer.Missoni Key To The Cure Tee, $45 saks.ca.Have you read this: 10 Stars Whove Inspired Us With Their Strength In Dealing With Breast Cancer

You will want to sit for this

This gorgeous chair is a limited-edition shade for the month of October. And 100 per cent of the proceeds go towards Rethink Breast Cancer.Saint Tropez Chair, $500 at Calligaris Toronto.Concerned about your risk? Know someone going through treatment. We have all your questions about breast cancer answered.

Getting some face time

Moisturizer and serum is something we are were going to buy, so why not help the Rethink cause. Especially with 100 per cent of the proceeds (and a minimum donation of $5,000).Indeed Labs Hydraluron Moisture Serum and Moisture Jelly, $22.99 each at indeedlabs.ca.Check out 13 Things You Need To Know About Your Breasts.

Wear your heart on your short-sleeve

These cute tees have a great message women, even young women, should get checked regularly for breast cancer. And 100 per cent of the proceeds go to Rethink Breast Cancer.8008135 tees, $18 each at select H&M stores.Think breast cancer only affects those women who have it in genetically from their family? Think again. We bust that and nine other cancer myths.

Worth a smile

Have pride in your pout. From all sales of lipsticks and lip glosses this month, 10 per cent will go toward Rethink.Gee Beauty lipstick and lip gloss, $26 to $30 each at geebeauty.ca.Want some more good-for-a-cause retail therapy? Check out all of the brands that are supporting Rethink Breast Cancer.

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All Your Questions About Breast Cancer, Answered

Know Your Options: The Definitive Guide to Choosing The Best Medical Treatments — Wed, 11 Oct 2017 20:34:00 +0000

What is breast cancer?

Breast cancer begins when abnormal cells start to grow and eventually form a tiny mass (tumour) in the breast. About 90 per cent of the time, this malignancy occurs in the milk ducts (called ductal carcinoma), or in the milk glands (called lobular carcinoma).Sometimes, an overgrowth of abnormal cells along the lining of a milk duct stays confined to one spot, or in situ, a condition known as ductal carcinoma in situ, or DCIS. Only rarely, however, does a tumor develop in the connective tissue or fat that makes up the rest of the breast.At diagnosis, a breast cancer tumour is classified by stage from 0 for the smallest to IV for the most serious to indicate a tumour’s size and whether malignant cells have spread elsewhere in the body.You may already know the stage of your disease. This is important because it helps clarify the best treatment options for your particular case. Another important factor determined at breast cancer diagnosis is whether the tumour is hormone receptor-positive (hormone sensitive).

Who is at risk for breast cancer?

The majority of breast cancer cases are in women aged over 50, and the incidence rises with age. The earlier the diagnosis and the start of treatment, the better your chances of survival.

Treatment for breast cancer

No single breast cancer treatment strategy works for everyone. Whats recommended for you may not be whats best for another woman.In general, key factors in determining the best treatment will be the tumours size, aggressiveness, and location. The earlier the stage and the smaller the tumour, the more likely that surgery can remove it all and offer a total cure. There are also good options for more advanced stages, where the cancer has spread beyond the breast.In designing a treatment, your doctor will also consider your age and general health, the size of your breasts, and whether or not youve gone through menopause. The strategy youre ultimately given will probably feature a mix-and-match of surgery, chemotherapy or hormone-blockers, and radiation.Deciding which approach will be most successful for you can be tricky. Its normal to feel scared and overwhelmed by all the information and differing opinions you are offered. The appeal of one treatment over another can be frustratingly small. The most difficult program may not necessarily be the best: Some arduous regimens increase success rates by as little as one per cent.On the bright side, unless the breast cancer is advanced, you have at least several weeks to research various options before starting treatment. See other doctors to confirm your diagnosis and discuss the treatment plan recommended for you. If you get two different opinions, see a third or fourth doctor.Try to find experts you feel comfortable talking with about your fears being anesthetized for surgery, losing part of your femininity, having cancer develop elsewhere in your body. Good doctors are familiar with such concerns and can give you insightful ideas for handling them. The decision is then up to you; many women find that writing in a journal and talking with friends and family leads them to a decision that they feel comfortable with.

Medications for breast cancer

After surgery for a stage I, II, or III cancer, you and your doctor make a decision about using anticancer drugs.Both chemotherapy and hormone therapy can be enlisted to patrol the whole body and destroy wayward cancer cells. This is often referred to as systemic therapy.The heavyweight here is chemotherapy, which benefits most women with breast cancer. Whether youre pre- or postmenopausal, whether lymph nodes are involved or not, youre more likely to enjoy a long-term, relapse-free recovery if you undergo chemotherapy. Chemotherapy destroys normal healthy cells, as well as cancerous ones. So while it reduces the risk of cancer in another part of your body, your doctor wont recommend it if it poses more of a health risk than cancer. Chemotherapy probably wont be suggested if you have a cancer unlikely to spread, are over age 70, or are otherwise quite ill.Most women start chemotherapy after surgery for breast cancer and continue treatments for about three months. If you have a relatively large tumour (more than 5 centimeters), your doctor may suggest presurgery chemotherapy with six months or so of additional chemo after surgical recovery. Good results have been seen by prolonging chemotherapy in women with lymph node involvement.Chemotherapy agents all work a little differently. Some are taken orally, others by IV or injection. Side effects vary as well: If your reactions are very severe, talk with your doctor about switching drugs. Most regimens are given in cycles. Combinations such as CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) or CA (cyclophosphamide and Adriamycin) are common. The hormone-receptor status of the tumour is also a factor in choosing chemotherapy. For example, adding paclitaxel (Taxol, derived from the Pacific yew tree) after CA further lowers the risk of recurrence with a hormone-receptor negative tumour.If the tumour is hormone-positive, you will receive hormonal therapy (anti-estrogen treatment) following surgery regardless of your age, menopausal status, lymph node involvement, or the tumour size. Anti-estrogen therapy is helpful even if only a tiny amount of hormone action is present: It can prevent your own estrogen hormones from stimulating cancer cells and growing new tumours.The most common form of anti-estrogen therapy is a class of medications called selective estrogen receptor-modulators (SERMs). Most widely used is tamoxifen (Nolvadex), which blocks estrogen from latching onto breast cell receptors through trickery: Because tamoxifen closely resembles estrogen, breast cancer cells accept it instead. This prevents your own estrogen from delivering its growth (and cancer-stimulating) signal. It also prompts the cancer cells to die. Tamoxifen cuts the risk of a new cancer in the other breast by 50 per cent and reduces the risk of cancer elsewhere in the body. Studies show that taking it for five years is better than for one to two; hot flashes and vaginal discharge are common side effects. If you have the BRCA1 gene (a genetic mutation linked to an inherited form of breast cancer), tamoxifen probably won’t help prevent a new cancer, but it might fight breast cancer thats already there. Tamoxifen also lowers the risk for cancer if you have BRCA2, another gene variation.New hormone therapy agents called aromatase inhibitors (AI) target estrogen by blocking the action of an enzyme (aromatase) crucial to estrogen production. These drugs wont help if youre premenopausal, because they cant keep up with your ovaries prodigious natural estrogen output. You can benefit, however, if youre postmenopausal and your breast cancer is advanced. The new drug anastrazole (Arimidex) appears to be at least as effective as tamoxifen.Another treatment option for premenopausal women with hormone-positive tumours is medical or surgical removal of the ovaries. This halts production of estrogen, which fuels breast cancer growth, but it also ends fertility and can be emotionally taxing. If a breast cancer is very aggressive and has spread, the doctor may recommend a biological agent, the monoclonal antibody drug trastuzumab (Herceptin). It blocks the growth of cancer cells in about 30 per cent of cases by targeting a protein (HER2) abundant in some tumors.

Lifestyle Changes

A good treatment strategy for breast cancer considers your emotions as well as your body. Here are a few things you can do:

Join a support group. This can be tremendously important in helping you deal with fear, anger, loneliness, betrayal by your body, despair, and other feelings. There are groups to help your kids and other family members cope as well.
Exercise regularly. Many women report exercise helps them tolerate therapy better. Ask about special arm and shoulder exercises if youve had lymph node surgery.
Eat a balanced and nutritious diet. Good eating can bolster your bodys drive to stay healthy and fight the breast cancer.
Keep weight under control. Excess pounds may lower your odds or raise the risk of a cancer recurrence.
Concentrate on de-stressing. Get plenty of rest; then explore techniques such as biofeedback, massage, and meditation.

Related Procedures for Breast Cancer

The first step in breast cancer treatment is surgery to determine, among other factors, exactly what kind of tumour it is and whether it contains hormone receptors. A surgeon or radiologist performs this initial procedure, called a biopsy. The next step for most women is to have the cancer excised. This is your best shot at a cure, at stopping the cancer from getting any bigger or spreading. If retaining the natural shape of your breasts is important to you, discuss different reconstruction options with a plastic surgeon.For tumour removal, there are also a number of options.

If your tumour is stage I or II, your surgeon should be able to remove the cancer completely, keeping your breast largely intact. Procedures called a lumpectomy or a partial mastectomy are used. Youll then need six or seven weeks of radiation to the breast to destroy any leftover cancer cells. Thousands of women now choose one of these breast-conserving approaches. The latest major research trials indicate your chance for long-term survival is the same with a lumpectomy as with partial or even radical mastectomy.
If your tumor is stage III or at an early stage but you have small breasts, you may be better off having the entire breast removed with a procedure called a mastectomy. There are several variations. Most women have an operation called a modified radical mastectomy, which removes breast tissue, chest muscle lining, and axillary nodes. Only if the cancer has spread to muscles in the chest will a surgeon recommend a radical mastectomy, in which the breast, nodes, and muscles beneath the breast are removed. Sometimes presurgery chemotherapy shrinks a tumor sufficiently to make lumpectomy possible. Finally, a total mastectomy is a treatment option for DCIS.

After surgery, many women pursue radiation therapy, or radiotherapy, to destroy any wayward cancer cells in the breast, chest wall, or underarm area. (Sometimes radiation is recommended before surgery to shrink a tumor.) Sometimes key to surviving breast cancer, radiation is often worth the discomfort of fatigue, red or blistered skin, skin color changes, and other possible side effects. On a positive note, technical innovations in radiation have reduced the risk of such side effects.Widely recommended external beam radiation focuses two opposing beams of high-energy x-rays on the breast, angling them away from vital organs. The procedure is done five days a week, for about five weeks. Additional, even more precisely focused radiation is often given for another one to two weeks.If youve had a lumpectomy for a small, early tumour, and are postmenopausal, you may be a candidate for internal radiation therapy, or brachytherapy. In this procedure, radioactive seeds (the size of rice grains) are implanted directly into the site of the excised tumor, where cancer is most likely to recur. You only need twice-a-day treatments for four or five days, and side effects appear to be mild. Much about this new technique remains unknown, but early results indicate that for some women, brachytherapy is as effective as standard radiation at preventing recurrence of breast cancer.The latest findings show that combining radiation with breast-conserving surgery for stage I or II breast cancer offers the same odds for long-term survival as mastectomy. But without the postsurgery radiation, the risk of recurrence at or near the original tumour site is much higher. So if youre slated for a mastectomy, your doctor will likely recommend radiation therapy, especially if your tumour is large or many lymph nodes (usually four or more) are involved. Its less certain that radiation will benefit you if fewer (one to three) lymph nodes are involved.

Questions for Your Doctor

What are my chances of surviving this breast cancer?
What side effects can I anticipate from this treatment?
Will my figure ever recover? What about reconstruction?
Does this mean Im at greater risk for other cancers?
What experience do you have with breast cancer? Whats your patients survival rate?

Living with Breast Cancer

If you have been diagnosed with Breast Cancer, you will be faced with some life-altering decisions. To help you get through the process, here are a few quick tips to help you take control of the situation:

Bring a friend along. When discussing treatment options with your doctor, have an advocate in the room to take notes and pose questions you cant ask. Even better: tape record the appointment. You can later review what was said at your leisure.
Pose key questions to yourself. Feeling comfortable with a treatment choice is critical, because theres often no right choice. Ask yourself: What feels best for me? Can I manage the side effects? What kind of support can I expect from family or friends?
Sign up for a clinical trial. This can put you in the hands of highly experienced doctors.
Plan for a wig. Before you lose your hair from chemo, visit a wigmaker to choose a style and colour that match your own. A hairdresser can add finishing touches. With a doctors prescription, insurance companies will cover the expense.

Prevention of Breast Cancer

Be choosy about fats. Certain types of fats seem to increase estrogen levels, which in turn raise breast cancer risk. A recent Swedish study has suggested that monounsaturated fats may help reduce risk and polyunsaturated fats may increase it. Lean toward monounsaturated oils like olive and canola, and omega-3 fatty acids, found in salmon, sardines, and herring. Steer clear of trans fats, found in stick margarine, packaged baked goods, and snack foods (check for partially hydrogenated on the label), and the polyunsaturated fats abundant in corn, sunflower, and safflower oils.
Bring on the fibre. Fibre binds up excess estrogen and carries it away through your intestinal tract. Good sources include beans, brown rice, whole-grain breads and cereals, and many fruits and vegetables.
Eat your fruits and veggies. In particular, get enough cruciferous vegetables, such as broccoli, cabbage, and cauliflower all of which can boost cancer-fighting enzymes.
Savour soy. Isoflavones in soy foods are weak estrogen-like compounds that block the action of estrogen, which may contribute to breast cancer. Use soy flour in recipes, add tofu to soups or main dishes, eat green soybeans, or drink soy milk.
Avoid additives. When possible, buy hormone-free organic meats, poultry, and dairy foods. Be sure to wash fresh produce and, when feasible, remove peels to get rid of pesticide residue.
Get active. Studies show that women who exercise at least four hours a week reduce their breast cancer risk by 37 percent as compared with less active women. Exercise may cut estrogen production by burning calories and reducing fat.
Keep on top of it. Mammograms can detect breast cancer two to five years before you can feel a lump. If youre age 50 to 69, have a mammogram and a clinical breast exam at your doctors office every two years. (High-risk women may need more frequent mammograms.) Also, if youre still menstruating, be sure to do a monthly breast self-exam 7 to 10 days after the beginning of your period. If youre postmenopausal, do your self-exam on the same day each month. It is estimated that if every woman examined her breasts monthly and had mammograms at the recommended times, it would save more than 15,000 lives in North America each year.
Consider a SERM. Tamoxifen a common breast cancer treatment may also help prevent the disease. But many doctors believe its side effects (increased risk of endometrial cancer and blood clots) outweigh its benefits. It should be considered only for high-risk women. Researchers are now studying a newer selective estrogen receptor modulator, Evista, which may have similar benefits but fewer side effects.
Try vitamin E. In a small study at SUNY-Buffalo, participants with a family history of breast cancer had an 80 percent lower risk for developing breast cancer if their diets contained 10 or more IU per day of vitamin E. Ask your doctor or nutrition counselor about the dosage thats safe for you.
Limit your alcohol. Too much alcohol is linked with increased risk for breast cancer. Limit yourself to no more than two or three drinks a week.

The post All Your Questions About Breast Cancer, Answered appeared first on Best Health.

Stop Believing The BS – 10 Cancer Myths Busted

Lindsay Kneteman — Wed, 11 Oct 2017 20:09:23 +0000

1. We havent made any progress fighting cancer

This is one of the biggest cancer myths. In June, a report from the Canadian Cancer Society revealed that one in four Canadians will die from cancer. But while that number sounds terrifying, in 2017, More than half of all people survive their cancer diagnosis, points out Dr. Robert Nuttall, the organizations Assistant Director of Health Policy and a co-author of the report, 70 years it was 25 per cent.

2. Cancer is a modern disease

Theres nothing new about the existence of cancer; signs of malignant tumours have even been found in Egyptian mummies. What is different is that our increasing lifespans mean that more of us are likely to experience cancer nearly one in two Canadians will develop the disease in their lifetimes. Cancer is, for the most part, a disease of aging, explains Nuttall, About 90 per cent of all cancers occur in people 50 and over.

3. Whether or not you get cancer completely depends on your genes

So that you will only get cancer if a close family member does is one of those popular cancer myths. While there are over 100 different types of cancer, only about five per cent of them are the result of purely hereditary factors, says Nuttall. These include certain kinds of breast, colorectal, prostrate and ovarian cancers. The rest are caused by aging, lifestyle choices such as smoking and factors we dont yet understand.

4. Bras cause breast cancer

Weve all seen the rather detailed Facebook memes about how we should be tossing our bras aside for the sake of our health. Nuttall is also familiar with them and this popular cancer myth, and he found that they generally dont make sense when compared to how and where breast cancer develops. As well, there is no research that backs up this idea, Bra wearing habits dont play a role in the risk of breast cancer, he says.

5. Sunscreen triggers more cancers than it prevents

We need to stop with cancer myths like this one. Certain ingredients found in many chemical sunscreens have come under fire lately as being possible carcinogens. But, explains Nutall, while some research has shown that high doses of these chemicals can be damaging under very specific conditions, these results havent been reproducible when actual sunscreen formulas are tested and there is no evidence that using them causes cancer. We know for sure that the sun is by far the biggest cause of skin cancer, he says, Sunscreen, when applied properly, is an effective strategy at blocking your skin from harmful UV.Check out 8 Bad Excuses to Not Wear Sunscreen.

6. Cell phones give you brain cancer

While cell phone use is soaring, Brain cancer rates are actually not going up, points out Nuttall. While there is some research that links heavy cell phone usage to brain cancer cases, he cautions about drawing any conclusions, particularly since much of this research depends on peoples recollections, People who have cancer maybe overplay cell phone usage while people who dont have cancer downplay it.Also, did you know? Maria Menounos Is Recovering From Brain Surgery.

7. Sugar feeds cancer

All of a bodys cells, including cancer ones, are fueled by glucose, a type of sugar, so technically this myth is true. But sugar, even the refined white stuff, doesnt cause or accelerate the disease, says Nuttall. The problem with sugar is that too much of it can easily lead to weight gain and, Being overweight is a risk factor for cancer.

8. The right diet can prevent (or even cure) cancer

Studies about the about the nutritional values of certain superfoods have aggravated this and other popular cancer myths. No specific diet can guarantee that you wont end up with cancer, explains Nuttall, nor is there any combination of foods that will cure it. However, a poor diet can increase your odds of getting the illness. The Canadian Cancer Society recommends a diet thats high in fruits and vegetables while being sensible when it comes to salt, sugar and fat.

9. Cannabis oil cures cancer

It is being studied, says Nuttall but right now there is no reputable research that shows that cannabis oil has any kind of impact on cancer, All we see are anecdotes online. To stay on top of the latest developments in the war on cancer, Nuttall recommends visiting Cancer.ca, the official site of the Canadian Cancer Society.You might find this interesting: Celebrities and Weed: Which Celebs Smoke Pot For Medical Reasons?

10. Sharks dont get cancer

This is myth has its origins in the 1992 bestselling book, Sharks Dont Get Cancer, which claimed that eating shark cartilage is an effective cancer treatment. However, there is no evidence to support that idea and the fact that sharks do get cancer has been well established.Speaking of animals and cancer, have you read this: Yes, Dogs Really Can Smell Cancer

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Is Cancer Funny? Lana Schwarcz Is Touring Canada To Prove It Is

Lisa Hannam — Wed, 06 Sep 2017 17:50:46 +0000

Do you think cancer is funny? Lana Schwarcz does

Can you laugh about cancer? Most people couldnt and dont. But for Lana Schwarcz, shes made a career out of it. Sound strange? Its not really. Read on to learn how this comedienne discovered her #BHmoment by making cancer funny.

What do you do for a living?

Im a puppeteer and a stand-up comic.

What is your #BHmoment?

Turning a cancer diagnosis into entertainment. I say that I made Theatre Lemonade out of Lemons.I toured that same show, Lovely Lady Lump, around the world. Twice. It meant that I could raise awareness, but also share the cancer experience from a personal perspective, and a funny one. I have received so many personal emails from survivors and families of cancer patients thanking me for sharing the story. And if I can get every single audience member to never use the word journey to a cancer patient again, then I have done my job.

How did you make that happen?

I started by writing a blog while going through treatment. Obviously as a comic it was important for me to make it as entertaining as possible. I then wrote a script, tried many of the gags out on unsuspecting comedy audiences, did some trial shows, and then bang. I suddenly had this critically acclaimed show that started winning awards around the world. It took about a year.

What did you learn from your experience?

That you can make anything funny. Its made me think that perhaps I should try my hand writing a comedy about abortion.

Would you do anything differently?

No. Because I did it in the uniquely Lana way I do everything underfunded and unpaid, but I have no control over that. And I love the way I push through to get things done.I want people to understand that laughter is the ship that keeps you afloat while you are wading through that sea of muck, cos the only alternative is to sink.

Why is your life better now since you started touring?

I am alive. And I know of at least three women who have contacted me after seeing the show and they were promoted to get screened as a result their cancers were found early, and they are undergoing a relatively easy treatment.They say that you feel better when you give something rather than receive it. And thats very true. When I hear of women who have been prompted to get screened early, and who ask about their own breast density which is a higher risk factor than family history I tear up, because I know I was a major part of that life-saving awareness.

What is the biggest tip you tell friends?

Laugh. And be honest. And only surround yourself with people you love and who love you. Because you dont need the other stuff.

Anything else you want us to know?

Yes. There is some information about breast density I would love to share. My own breasts were extremely dense, which is a high risk factor for breast cancer, and it also effectively hides the cancers in a mammogram meaning that approximately 50 per cent of cancers in women with dense breasts get missed. Also, the show is travelling to Calgary Fringe, Edmonton Fringe, Victoria Fringe and Vancouver Fringe and wed love to get as many women there as possible.To find out if Lana will be performing near you, check out the website for Lana Schwarcz: lanaschwarcz.com.https://www.instagram.com/p/BX6OGLZlihO/?taken-by=lanaschwarcz

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Former Bachelor Contestant Lesley Murphy Gets Breast Reconstructive Surgery Post-Double Mastectomy

Ashley Kowalewski-Pizzi — Tue, 11 Jul 2017 15:21:26 +0000

Almost three months after getting a preventative double mastectomy, former Bachelor contestant Lesley Murphy revealed that she got breast implants.Murphy, who appeared on Sean Lowes season of The Bachelor, had a double mastectomy back in April after medical tests revealed that she was BRCA2 positive, According to the Canadian Cancer Society, would have a 40 to 85 per cent chance of developing breast cancer at some point.

Lesley Murphys surgery

After having expanders placed in Murphys chest post-mastectomy, she went back into surgery for breast reconstructive surgery, which resulted in 500 CC breast implants, though she didnt know what she was going to come out with.My plastic surgeon said he tried many different variations and after consulting every woman in the hospital he decided on 500 CC implants, which is actually smaller than my expander side, she explained, likening the expanders to having two big boulders on her chest.

More and more women are opting for mastectomies

Murphy isnt the first celeb to make this courageous decision.Oscar-winning actress Angelina Jolie Pitt took the same preventative measures back in 2013 and then later had her ovaries and fallopian tube removed in 2015 after she was also at high-risk for breast and ovarian cancer from carrying the mutated BRCA1 gene.Actress Christina Applegate also underwent a double mastectomy in 2008 after being fully diagnosed with breast cancer and not just the mutated gene.

About those BRCA genes

The BRCA1 and BRCA2 genes can be passed down hereditarily, and women who have a family history of breast or ovarian cancer are often eligible for genetic screening. And these genetic tests can provide early detection and preventative measures to both cancers.With the risks for breast cancer being anywhere from 40 to 85 per cent and ovarian cancer being 15 to 65 per cent with a positive diagnosis on these genes, preventative mastectomies and oophorectomies (surgery to remove the ovaries) are often the clearest decisions, as in the case of these celebs, to ensure there is no risk of cancer in the future.

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13 Things You Need To Know About Your Breasts

Lauren Gelman, RD.com — Thu, 13 Apr 2017 15:40:18 +0000

Self exam? Here’s what to really look for

Do you need to schedule a formal, sit-down monthly breast self exam to inspect every single centimetre? No. Experts now recommend against routine self exams, saying that they create unnecessary anxiety and dont actually lower the risk of dying from breast cancer. But you should know what the red flags are: A lump or thickening in the breast or underarm area; swelling, warmth or redness; a change in size or shape, dimpling or puckering of the skin; an itchy, scaly sore or rash on the nipple; nipple discharge that starts suddenly; or new pain that doesnt go away.

Lumps may freak you out, but theyre usually not cancer

In fact, 80 percent of lumps biopsied turn out not to be cancerso dont panic if you uncover one while youre showering or getting dressed. Odds are its a kind of cyst. Fibrocystic breast changesin which breast tissue is overreacts to hormones, which results in lumps and cystsaffect 50 to 60 percent of women.Of course, the worst thing you can do is ignore it and hope itll just go away. Always see your doctor any time you spot anything abnormal.

Experts don’t often agree about mammogram screening

In 2009, the United States Preventive Services Task Force came out with controversial guidelines about delaying mammograms to age 50 (from 40) and getting them every two years (instead of annually). Experts who think women should still get annual mammograms starting at age 40 believe that delaying the screenings would miss too many cancers and lead to poorer outcomes among those eventually diagnosed. Those who support the new guidelines believe that too-early mammograms lead to too many false positive results (and corresponding over-treatment, including follow-up scans and biopsies), as well as over-treatment of breast cancers that may not actually be life threatening. What you decide to do may come down to how risk-averse you are, what your health insurance will cover, and what your doctor thinks.If you’re going for your first mammogram, readHow to Prepare for Your First Mammogram.

85 percent of women wear the wrong size bra

The right undergarments can make you look thinner, improve your posture, and ease pain in your back, neck, and shoulders. You need to toss bras after they’re well worn, or if you gain or lose weight. Plus, you should get measured for ones that provide the right support. Some signs of a proper fit: The band in the back is snug, and doesnt ride up; and your breasts fit withininstead of bulging overthe cup.

Its normal for one to be larger than the other

Were not as symmetrical as you may think. About half of women have a pretty notable difference in size, with the left breast often larger than the right. Make sure your bra fits the bigger breast, and use a pad to help fill out the smaller one. If a change in size is sudden, let your doctor knowit could be the sign of an infection, lump or cyst.

Evolution just might be the reason men are obsessed with breasts

The main reason for breasts is to nourish and feed babies. When a baby nurses, your brain becomes flooded with the bonding hormone oxytocin, which is designed to get you to focus on taking care of your infant. Some researchers think a similar mechanism designed to strengthen romantic relationships is at work between you and your partner. Oxytocin is also released when a partner stimulates your breasts, which causes you to bond with and feel more affection for him. Also, looking for a new sports bra? Learn how to Find the Best Sports Bra for You.

Slimming down may reduce your risk of breast cancer by half

A study published earlier this year found that overweight postmenopausal women who shed just five to 10 percent of their body weight slashed their breast cancer risk in half. (Fat can raise levels of the hormone estrogen, which is known to fuel certain kinds of breast cancer). Whats more, another recent study found that women who are overweight when diagnosed with breast cancer have a higher risk of recurrence than thinner women.Exercise is also a boon for breasts: A cancer study released this summer found that women who worked out 10 to 19 hours a week had a 30 percent reduced risk of breast cancer. Not only can exercise reduce body fat, it also lowers levels of stress and inflammation, which can affect how your immune system treats cancer cells.

Skip that second glass of wine to reduce cancer risk

Theres no doubt that drinking is linked to an increased risk of breast cancer, which is why experts recommend limiting your intake to one glass a day and even less if you have a higher breast cancer risk (due to family history or other reasons). A study in the Journal of the American Medical Association published last fall found that women who had just a few cocktails a month had a 15 percent higher risk of cancer; those who drank more (the equivalent of two drinks a day) had a 51 percent greater chance of developing breast cancer over the next few decades.

You likely need more vitamin D

Many of you have too-low levels of this vitamin, which is a shame considering that it is linked to a reduced risk of breast cancer. One study presented at a meeting of the American Society of Clinical Oncologists a few years ago found that breast cancer patients deficient in D were 94 percent more likely to have their cancer spread than those with normal levels and a paper published earlier this year found that women diagnosed with breast cancer with higher vitamin D levels had better survival rates. The RDA for vitamin D is 600 IU, but some experts recommend getting 1,000 IU or more. Ask your doctor and consider taking a supplementits hard to get that much from your diet or the sun alone.

Not sleeping? You’re increasing your cancer risk

More research points to a correlation between not sleeping at night and a higher cancer risk. A study of women in the Danish Army, published this spring in Occupational and Environmental Medicine, found that those who worked at nighthad a 40 percent increased risk of breast cancer compared to those who didnt. It’s likely the hormone melatonin to blame, which regulates sleep cycles and may also affect estrogen levels. Sleep deprivation at night may also suppress the immune system, allowing cancer cells to grow.

Smoking increases risk for cancer and make breasts less perky

Though cigarettes do raise the risk of breast cancer slightly, theyre especially harmful among heavy-duty smokers who start early, a study published last year in the Archives of Internal Medicine found. Women who smoked at least a pack a day for at least 30 years had a 28 percent higher breast cancer risk. Chemicals found in cigarettes also break down elastin, the protein that keeps us nice and perky. One study led by a University of Kentucky plastic surgeon a few years ago found that smoking, age and the number of a womans pregnancies are the main factors that affect sagging.

This is what menopause does to your breasts

Hot flashes get all the attention, but we go through a lot during menopause. And the years leading up to it too. Breast tendernessthe kind youre used to getting around your period and early on in pregnancycan strike and get worse. We may start leaking fluid because hormone fluctuations can raise levels of the hormone prolactin (the same one that triggers us to start churning out milk after you have a baby). Your milk ducts can get clogged during this transitional time as well, which can cause green or black discharge. And break out the tweezers: You may start to find errant hairs on the nipples now. (Waxing, lasering, and shaving work too.)

The real reason breasts sag as you age

Over time, collagen and elastin breaks down and we cant help but start to let loose. Also, hormonal changes cause us to contain more fatsoft, spongy and prone to droopingwith age. Theres not a lot you can do about it, short of wearing a more supportive, well-fitting bra or opting for a breast lift.

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