Thursday, January 26, 2012

Your Cancer Survival Plan: “Life After Treatment” Programs That Help You Cope

By Britta Aragon on March 11, 2011 | 4 Comments

Once we have been declared cancer free, we may think that we’re all done. It’s over. Yay, right? In a way, it is, but only one part of the journey. I know from my own experience, from having watched my father go into remission five times, and from the stories I’ve heard from other survivors that “surviving” isn’t an ending—it’s really a new beginning. After all, cancer leaves us with a body we no longer understand. We may have scars, missing parts, swelling, unexplained aches and pains, numbness, and fatigue. Emotionally we feel like we’ve been through a war. The rush of treatment is over and suddenly all the fear, sadness, and loss bubble to the surface. “Who am I now?” and “What just happened to me?” are some of the questions I asked myself after surviving cancer at 16 years old.

Fortunately, there is help. Many cancer centers, realizing that the struggle doesn’t end once the radiation stops, are creating survival programs that help people cope with the changes they face after treatment is over. The Cancer Wellness Center at Piedmont Health Care is one of them, helping survivors cope with programs like yoga, music and art therapy, social events, and massage. Doors are open to all cancer patients and survivors, no matter where they received treatment. Georgia Cancer Specialists, a Top 10 private cancer practice in the U.S., has implemented a “Life After Treatment” program to help patients cope with post-treatment doctor’s visits, tests, and concerns like fatigue and hair loss for months to years after treatment is over.

The Winship Cancer Institute is working on a similar program to offer follow-up care. They plan to implement a volunteer program that will match newly diagnosed patients with survivors, as well as offer treatment for the various long-term side effects of chemotherapy and radiation. “It is important to understand that it takes time to recover and adjust to life after a cancer diagnosis,” Winship’s site says. “Determining what is the new normal may take some time.”

The Nebraska Medical Center in Omaha, Nebraska offers a survivorship program that “helps address the physical and emotional challenges the cancer survivor experiences.” The Dana-Farber Cancer Institute in Boston provides the “Perini Family Survivor’s Center” to help survivors “access post-treatment follow-up care, including counseling and monitoring of long-term side effects of treatment.” They even include a specialized survivor program for children.

The list goes on. In fact, these programs are becoming so popular that you’re likely to find one at a cancer center or hospital near you. The point is that experts around the nation, from doctors to counselors to oncologists to survivors themselves, all realize that surviving cancer is a task best tackled with help and support from others.

“Far too many distressed cancer survivors are left to suffer alone,” said Mike Hobday, head of Macmillan Cancer Support. “It’s great that people are surviving cancer, but we cannot dessert them after their initial treatment is over.”

Fortunately, more survivor programs are in the works. Whether or not you have one available to you, realize that your journey doesn’t end when treatment stops. Seek support from counselors, support groups, nutritionists, massage therapists, acupuncturists, financial counselors, or whatever you need.

“Whether you are coping with the debilitating effects of therapy or you have no external physical evidence of the disease, research validates what you already know: cancer causes change,” writes Sherri Magee and Kathy Scalzo in Picking Up the Pieces. “Once your cancer treatments have ended, you face the challenging task of picking up the pieces of your life and putting them back together again.”

http://cincovidas.com/your-cancer-survival-plan-%E2%80%9Clife-after-treatment%E2%80%9D-programs-that-help-you-cope/

Study Emphasizes Sun Protection over Water Consumption for Beautiful Skin

We’ve all heard that drinking 8 glasses of water a day keeps your skin glowing and dewy. However, a recent investigation by the British Nutrition Foundation found that protecting your skin from the sun along with maintaining a healthy diet is much more important in achieving a healthy complexion and fighting the signs of aging.

While drinking water is important as part of adequate nutrition, forcing down 8 glasses a day to keep your skin hydrated may not be necessary. According to the BNF, “There currently appears to be very little scientific evidence relating to the effects of water consumption on skin hydration, and whether drinking more or less water actually has any impact on skin appearance.” Instead, eating a healthy range of fruits and vegetables that contain vitamins A, B, C, and E and wearing a broad-spectrum sunscreen every day are better actions to prevent wrinkles and fine lines.

Unprotected sun exposure is a proven cause of skin cancer as well as wrinkles andhyperpigmentation. This is one reason that legislation in California was recently passed that banned teens under 18 from tanning salons even if they had their parents’ permission. Sun exposure breaks down the support structures in the skin speeding up the aging process and producing fine lines and sunspots.

While it’s still important to regularly drink water, Dermatology Associates of Atlantaencourages our patients to take further measures to ensure the health of their skin and postpone the signs of aging from appearing.

For more information on anti-aging, skin cancer prevention or treatment, skincare, or dermatology contact us. You can also find us on Facebook and Twitter with the latest in dermatology news and updates!

http://www.dermatlanta.com/Blog/2011/12/06/study-emphasizes-sun-protection-over-water-consumption-for-beautiful-skin/

What is a Mammogram & How Does It Detect Breast Cancer?

BREAST CANCER PREVENTION | by April Zubko | December 26th, 2011

A mammogram, also known as a digital mammography, is a low dose x-ray which captures a picture of the breast tissue. The breast is carefully positioned on a film cassette and gently compressed with a special paddle so that the maximum amount of tissue will appear in the image. This flattening also helps spread the tissue in dense parts of the breast more evenly so that a clearer picture of these areas can be obtained. It also helps doctors determine which changes are noncancerous (benign) and which are cancerous (malignant). Unlike the standard mammography, the digital mammography captures the images electronically and allows them to be viewed on a computer screen. Although the test is administered the same, the digital mammography enhances visibility by up to 300% making it more likely to see lumps and other abnormal changes that may be present in the breast tissue.

Women should begin their first mammogram at age 35 (first mammogram is a baseline x-ray). If the results of this screening are normal, then begin annual mammograms at age 40. For all women regardless of age, the Maurer Foundation recommends a monthly breast self-examination and a yearly clinical breast exam with a doctor.

There has been much confusion about whether the importance of cancer screenings have been overstated. The United States Preventive Services Task Force (USPSTF) has even recommended that women ages 40-49 no longer needed to undergo routine mammograms. We couldn’t disagree more! It is our firm position and that of our founder breast surgeon Dr. Virginia Maurer that screenings can only give you knowledge and knowledge saves lives. (See our official statement.)

Many women ages 40-49 have had their breast cancer caught in it’s early stages as a result of a routine mammogram. Had these same women waited until age 50, their survival rate would certainly be lower as a result of their more advanced stage of breast cancer. According to a 2010 Swedish study, breast cancer mortality was reduced 29% for women ages 40-49 who received mammograms. Sandra Palmaro, CEO, Canadian Breast Cancer Foundation – Ontario Region explains, “Since 1-in-6 women who die from breast cancer are diagnosed in their 40s, we simply cannot afford to see missed opportunities for earlier detection.”

Until there is a cure for breast cancer, early detection must play a vital role in safe-guarding lives; mammograms are a significant part of a breast cancer early detection strategy.

Screening mammograms are the routine basic mammograms that most women receive annually. Diagnostic mammograms take longer, are usually performed to receive a proper diagnosis and involve more pictures from different angles and even the magnification of suspicious areas.

Discuss your plan to get a mammogram with your doctor if you are pregnant, have breast implants, or you are positive for the breast cancer gene BRCA1 or BRCA2; special mammography recommendations may apply in these situations. Review our mammogram tips to prepare for the day. There’s also some great mammogram videos that explain the process and will help you visualize the process and the mammography machine a little better.

These are some example mammograms. The one on the left is normal. The one on the right shows an abnormality that would require further investigation.

Mammograms are only one type of breast imaging. Other types include breast MRIs and breast ultrasounds. These two types of breast imaging are usually only performed if a routine mammogram is inconclusive or if the patient has a high risk for breast cancer, due to lifestyle, genetics, or other breast cancer risk factors.

[Photos by istockphoto]

http://www.maurerfoundation.org/what-is-a-mammogram-how-does-it-detect-breast-cancer/3117

Wednesday, January 25, 2012

When Does Survivor Status Start?

By Melanie Bone, MD, PA

The latest data available from the National Cancer Institute tells us that there are almost 12 million cancer survivors in the United States. But when do you actually become a survivor? Are you a survivor from the day you get cancer even if you don’t know you have it? Are you a survivor from the day you are diagnosed? Are you a survivor from the day you finish treatments? Five years later? Forever?

As a survivor, I can tell you that not everyone agrees on the definition. Before my own cancer, I thought that you could consider yourself a survivor if you made it five years from diagnosis. Now I realize how arbitrary and unimportant it is to assign a time frame to the definition.

My confusion about survivorship began when I was diagnosed with Stage III breast cancer at age 40. I had found an enlarged lymph node just before my fortieth birthday; but because my mammogram and sonogram were both normal, it was seven months before I went in for a biopsy. To say I had a lot on my plate at the time is an understatement: my four children were ages 2, 3, 4, and 5; I was working too much and too hard in my solo OB/GYN practice; I was doing my best to be a great wife to my trial lawyer husband; and I was training for marathons to stave off the heart disease that is so rampant in my family. Despite the overwhelming obligations that filled my life, I finally listened to my sixth sense and asked to have the node taken out. The diagnosis that followed was no surprise to me; somehow I knew.

I was less certain about when to call myself a survivor. While in bed suffering from chemotherapy-induced fatigue, I surfed the Internet to find cancer-related information and became interested in various advocacy and support organizations. But the membership forms stumped me; I didn’t know how to answer the question of how long I’d survived breast cancer. In my mind I wasn’t a survivor yet—I was a hanger-on in the middle of treatment.

I was confused. Did that mean I couldn’t join? A cheerful operator at one of the organizations cleared things up: anyone diagnosed with cancer is a survivor from the day they are diagnosed. What a great membership ploy! Theoretically, I could die of the disease before the end of chemotherapy and radiation and still be a member—and a very short-lived survivor.

As I considered the various definitions of survivor I encountered during this time, I came to realize that survivorship is highly individual. There are some survivors who, having just recently completed treatment, are well adjusted to their diagnosis and move forward like 10-year survivors. Conversely, there are some survivors who, at 15 years out, struggle with issues similar to patients still in the midst of initial treatment.

Still there are similarities in the stages and the challenges that survivors face. For most of us, the first five years are spent trying to avoid a recurrence while living in a state of chronic anxiety. We try to perfect our diet and exercise regimens and live “better.” We feel pressured to make the most of each day, just in case. Every ache and pain might be the cancer coming back. The scans we undergo to check for recurrence are torture.

Each of us engages in various techniques to control this anxiety and cope with the reality of the diagnosis: We work on rhythmic breathing and creative visualization; we listen to music; we distract ourselves with other activities; we engage in advocacy work. And some, like me, find that denial is the most useful approach, going on about their daily business and pushing their fears into the back of their minds, consciously and subconsciously ignoring or forgetting them.

For many of us, the coping strategies in these first years gradually give way to a fragile peace. Cancer stops being the first thing we think about in the morning

or the last thing we think about before bed. We slide back into old habits, stopping just short of settling completely back into being our old selves, always aware of the scars—emotional and physical—that remind us of the disease. The fear of a recurrence, even if dampened over the years, never completely goes away. Each person has triggers that bring cancer right back to the fore. It might be a smell or taste associated with cancer or hearing about someone else’s diagnosis. As we continue along, it becomes clear: our survivorship status will never really end.

Though we are individuals, our commonalities as survivors make us members of a club. Make no mistake; it is a club we never planned to join, but it has its benefits. Cancer survivors who meet other cancer survivors already have common ground on which to base a friendship. And many of us survivors, in time, feel that cancer was one of the best things that ever happened to us. In facing our own mortality, we are empowered to change our lives for the better. There is a reason why more than 50 percent of women treated for breast cancer get divorced: once they are diagnosed, there is no time to waste in an unhappy marriage or with superficial friends who take but don’t give back.

To this day when someone asks me how many years I have survived, I get a millisecond of anxiety inside. I was diagnosed in August 2000 and finished chemotherapy and radiation therapy in April 2001. Am I an 11-year survivor since diagnosis, or am I a 10-year survivor since the end of treatment? Or am I a six-year survivor since my five-year mark?

To take the pressure off, I answer differently depending on my mood. Sometimes I say that I was diagnosed in 2000. Other times I give a number just to make them happy. Recognizing that many people have asked the question just to ask, not really caring what answer I give, I don’t worry too much. On occasion I smile demurely and say that I’ve lost count or don’t even remember. After all, does it really matter? I’m still here.

http://awomanshealth.com/when-does-survivor-status-start/

Saturday, January 21, 2012

Cognitive Problems of Breast-Cancer Survivors--What Are the Real Causes?

By Lillie Shockney, R.N., M.A.S.
Jan 20, 2012

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Breast Cancer Chronicles

by Lillie Shockney, R.N., M.A.S.

Why breast-cancer survivors?

Why are breast-cancer survivors the only ones who seem to be are wrestling with these cognitive problems after cancer treatment? I believe the answer might be related to three things that all come together in this particular patient population. My theories:

During breast cancer treatment, estrogen levels are pushed down to zero. This could certainly contribute to fuzzy thinking.
The specific drugs we use for treating breast cancer are not given to other groups of cancer patients; it's possible that these meds might be behind the cognitive troubles.
Of individuals with breast cancer, 99 percent are women; perhaps women, when in crisis, have a higher incidence of post-traumatic stress disorder (PTSD) than men do.

What might behind brain freeze?

An interesting research study conducted at the Moffitt Cancer Center and Research Institute in Tampa, Florida, and published in the December 12 online edition ofCancer, finds that chemotherapy might not be the guilty party here.

What might be? Believe it or not, these scientists say that getting hit with a diagnosis of cancer might be enough to muddle a person's mind in this way. Yep, this new analysis has determined that breast-cancer survivors can experience problems with certain mental functions several years after treatment--whether they had chemo and radiation, or just radiation with no chemo.

Both test groups affected the same

This study compared breast-cancer survivors who had had surgery and chemo with survivors who had had surgery, chemo, and radiation. A third group of participants had no breast-cancer history at all. All the study participants completed neuropsychological assessments 6 months after completion of their treatment and again 36 months later. The results showed that both groups of breast-cancer survivors had problems with cognitive functioning.

Another interesting finding of the researchers: Hormonal therapy had neither a positive nor a negative influence on the results.

A closer look at PTSD?

Such a study will, I hope, open the door to more research looking at whether PTSD is perhaps a contributing factor to the long-term, psychological side effects experienced by these women. After all, those of us who have been diagnosed and treated for breast cancer did go to war--and back--against our cancers.

Watch for additional research studies to pop up now that this one has been published. All food for thought.

http://health.yahoo.net/experts/breastcancer/cognitive-problems-breast-cancer-survivors-what-are-real-causes

Essential Sun Safety Information for Skiers and Snowboarders

Winter sports enthusiasts are at increased risk for overexposure to the sun's ultraviolet (UV) radiation. The combination of higher altitude and UV rays reflected by the snow puts skiers and snowboarders at an increased risk of sun damage, and ultimately skin cancer. More than 90 percent of all skin cancers are associated with sun exposure.

"It's easy to associate winter with frostbite and windburn, but most people are unaware that UV rays can be every bit as damaging on the slopes as on the beach," said Perry Robins, MD, President, The Skin Cancer Foundation. "With the winter sports season ahead of us, it's more important than ever to take proper precautions on the slopes."

Higher altitude means increased risk of sun-induced skin damage, since UV radiation exposure increases 8 to 10 percent with every 1,000 feet above sea level. At an altitude of 9,000 to 10,000 feet, UV radiation may be 45 to 50 percent more intense than at sea level. In addition, snow reflects up to 80 percent of the UV light from the sun, meaning that you are often hit by the same rays twice. This only increases the risk for damage.

Both snow and strong wind can wear away sunscreen and reduce its effectiveness, so you have to take extra precautions. To protect your skin from the bitter cold, heavy winds and winter sun, follow these important sun protection tips:

Use a broad-spectrum sunscreen with an SPF (Sun Protection Factor) of 30 or higher and some combination of these ingredients: avobenzone, ecamsule, oxybenzone, titanium dioxide, and zinc oxide whenever you spend extended time outdoors. Apply 30 minutes before hitting the slopes. Be aware that the sun's reflection off the snow is strong even on cloudy days. (Up to 80 percent of the sun's rays can penetrate clouds.)
Apply sunscreen liberally and evenly to all exposed skin - most skiers and snowboarders do not use enough. You should apply at least a teaspoon to the face.
Use a moisturizing sunscreen with ingredients like lanolin or glycerin. Winter conditions can be particularly harsh on the skin.
Be sure to cover often-missed spots: the lips, ears, around the eyes, and on the neck, the underside of chin, scalp and hands.
Reapply every two hours, and immediately after heavy sweating.
Always wear a lip balm with an SPF 15 or higher - lips are very sensitive.
Carry a travel-sized sunscreen and lip balm with you on the slopes. Reapply on the chairlift, especially after a long, snow-blown run.

Cover your head - it will protect your scalp and help keep you warm.
Wear items like ski masks, which will leave very little skin exposed to the wind and sun.
Sunglasses or goggles that offer 99 percent or greater UV protection and have wraparound or large frames will protect your eyes, eyelids and the sensitive skin around your eyes, which are common sites for skin cancers and sun-induced aging. The sun's glare can make you squint, so it's important to wear sunglasses or goggles to clearly see the terrain. Plus, it will increase your enjoyment and may even improve your performance while skiing!

If possible, ski early in the morning and later on in the day, before 10 AM and after 4 PM. This decreases the amount of time spent outdoors in the most intense sunlight and helps you avoid long lines.
If you are on the slopes for most of the day, take a few breaks indoors to reapply sunscreen.
Drink plenty of water to avoid dehydration.

Enjoy the winter season, but be sure to take care of your skin to avoid the damage the cold season can cause.

http://www.skincancer.org/healthy-lifestyle/outdoor-activities/essential-sun-safety-information-for-skiers-and-snowboarders