No Boobs About It, Inc., www.noboobsaboutit.org is a not for profit organization sharing information , resources and support on getting through treatment and on with life.

Caregiver, Take Care of Yourself!

caregiverWhether you are the spouse, partner, mother, daughter, other family member or friend, if you are the primary caregiver of a woman or man going through breast cancer treatment, you need to take good care of yourself while care giving.

The last thing you need, as a caregiver, and the last thing the person with breast cancer needs is for you to get burnout with all the miserable feelings that burnout carries with it. Taking care of yourself is not selfish, it is a necessary and loving thing to do.

Take an inventory of what your caregiver activities entail and what can be shared or taken over by others to lighten your load. Here are some suggestions that may help:

  • Ask for and accept help. You can’t be the only caregiver. You just can’t.  Ask adult children, other family members, and even friends. Help with meals, kids play dates, chores and shopping will go a long way to lighten your schedule and give you much needed time-outs. Having someone visit the person you are caring for, from time to time, eases your role as companion and gives you the opportunity to get out for “you time.”
  • Alert school personnel. If children are a part of your caregiver responsibilities; make school personnel aware of your spouse’s illness so they may be on the lookout for changes in school performance, behavior and moods and provide needed supports.
  • Stay in touch with friends and family. Social activities can help you feel connected and may reduce caregiver stress. Your friends and family may also notice caregiver burnout signs that you aren’t aware of.
  • Find time to be physically active each week. With your jammed schedule, this may seem impossible, but it’s important. Keep in mind that you don’t need a solid block of time. Doing 10 minutes of physical activity throughout the day can add up and have health benefits.
  • Establish a regular routine. Find a system and schedule that works for you and stick to it as often as possible. Make a list if you need to. Knowing that a tidal wave of tasks isn’t going to crash down on you can be a huge relief. It can also give you a better sense of control.
  • Join a support group for caregivers. Sometimes you just need to talk to people who can relate to what you are going through. You can share ideas and resources for coping.
  • If you can afford to, get help. It doesn’t even have to be a home health aid. Whether it’s a cleaning service, grocery delivery, or someone to walk your dog, it’s one less thing you have to do.
  • Take time for you. Make sure you do something for yourself every day. You could take a brief walk or a calming bath. Catch up with a friend over coffee. Take a power nap. Or just some take time to sit, listen to music, read, meditate, or just think. Try to find the time to pursue hobbies you enjoy.
  • Try to get enough sleep and rest. Studies have shown that not getting enough sleep increases the level of stress hormones in your body. This can sap your mood, energy, and health. The reality, however, is that many caregivers have problems sleeping due to stress or because they are needed to provide care during the night. Talk to your doctor if sleep problems are keeping you from feeling well-rested.
  • Eat healthy, well-balanced meals that are rich in fruits, vegetables, and whole grains. You’ve heard it before, but if you eat better, you really will feel and function better.
  • Take one day at a time. Stop asking yourself “what if.” Don’t obsess about all you have on your plate. It doesn’t solve anything and it can be overwhelming.
  • Watch the caregiver frustration and/or guilt. You are doing your best. The person you are caring for will have bad days when nothing you do seems to help. It isn’t your fault. It’s the disease,the side effects of treatment, the sadness, anger and depression that often accompanies a life-threatening illness.

Source: womens health dot gov

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Surgical Marker Improves Therapy and Cosmetic Results

Until we can actually prevent breast cancer; until we can cure those who have breast cancer; I take some comfort from the improvements in techniques for screening and treating breast cancer. In my last post, I shared about new screening methods for detecting breast cancer  These methods reduce the number of false positives and increase the number of cancers found in their earliest stages.

This post, courtesy of Dowling & Dennis Public Relations, speaks to the use of a new surgical marker that helps deliver more precise radiation to the breast(s). With it there is far less risk of damage to healthy tissue during treatment, and women can expect better cosmetic results.

SAN FRANCISCO – A new surgical marker enables radiation oncologists to deliver more precise radiation therapy for breast cancer patients, according to research presented at the annual meeting of the American Society for Therapeutic markerRadiology and Oncology (ASTRO).

The study was conducted by Robert Kuske, M.D. at Arizona Breast Cancer Specialists and researchers at two other sites. They documented physicians’ clinical experiences with a three-dimensional surgical marker (the BioZorb(TM) Tissue Marker, Focal Therapeutics, Inc.). In the study of 51 cases, the FDA-cleared surgical marker was reported to result in reduced radiation treatment volumes and smaller radiation doses, for both boost and accelerated partial breast irradiation (APBI).

“Like many great innovations, the design of the new marker is relatively simple and its effects are profound,” said study co-author Robert Kuske, M.D., a breast cancer-specific radiation oncologist and co-founder of Arizona Breast Cancer Specialists. “The reduction in treatment volumes means that with this marker, women have far less risk of damage to healthy tissue during treatment, and that they can expect better cosmetic results.”

Another study result concerned use of the new marker in conjunction with oncoplastic surgery. The study found that the marker provided a “supporting structure for oncoplastic repair” that produced excellent cosmetic outcomes. “The marker proved to have a unique ability to complement oncoplastic techniques,”said study co-author Linda Ann Smith, M.D., breast surgeon at Comprehensive Breast Care in Albuquerque, N.M. “This is due to its three-dimensional, open spiral shape. Our research showed that the marker improves cosmetic results across the board. This is especially true when combined with reconstructive oncoplastic surgery.”

Among patients in the study was Charmazel Dudt, a retired literature professor in Albuquerque, who had a lumpectomy performed by Dr. Smith, during which the new tissue marker was placed. She then traveled to Scottsdale, Ariz. to receive interstitial brachytherapy from Dr. Kuske. “Dr. Smith told me that normally, she would have been worried about my receiving radiation because my cancer was located near my heart and I have two stents,” said Dudt. “But using this new marker made her much less concerned because my treatment was going to be very precise. That meant there was less risk of radiation damage to my heart. And, of course, that’s just how things turned out. I’m so grateful.”

Oncoplastic surgery combines plastic surgery techniques with surgical oncology methods,to help maintain the treated breast’s natural shape and contour. While the approach can improve cosmetic outcomes for breast cancer surgery patients, it involves rearranging the patients’ own tissues. This increases the challenge of using traditional markers to accurately visualize the exact surgical site for radiation treatment.

The new surgical marker’s unique open-spiral design incorporates six permanent titanium clips in a fixed 3D array and provides specific landmarks at the site of the excised tumor. This allows the surgeon to secure the tissue to the device and use it for oncoplastic reconstruction, patient positioning, and radiation treatment planning.

The marker has been used successfully in both the U.S. and New Zealand. It is made of a bioabsorbable material commonly used in other medical devices, allowing the patient’s body to absorb the material slowly so it does not require surgical removal after treatments are completed.

Dr. Kuske is an internationally known innovator in radiation therapy for breast cancer. He is the pioneer of APBI, a 5-day alternative to conventional, six-week-long whole-breast irradiation for select early-stage breast cancer patients.

Also among Dr. Kuske’s innovations is the multi-catheter APBI technique known as interstitial brachytherapy. In the study, the new tissue marker allowed radiation oncologists to use an average of 47% fewer catheters while performing interstitial brachytherapy.

For more information: E-mail: Liz@DowlingDennis.net or call Liz Dowling, (415) 388-2794

 

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The Future of Breast Cancer Detection

Here is what the Food and Drug Administration says about a new era in breast cancer detection.

Scientists at the Food and Drug Administration are studying the next generation of screening and diagnostic devices, some of which borrow from the world of entertainment. Soon, three-dimensional (3D) images in actual 3D might help your doctor find hidden tumors and better diagnose cancers, thanks to the regulatory work being done by a team at FDA’s Division of Imaging, Diagnostics, and Software Reliability.

The team is led by Division Director Kyle Myers, a physicist with a Ph.D. in optical sciences. It includes Aldo Badano, Ph.D., a world-renowned expert in display evaluation technology, and Brian Garra, M.D., a diagnostic radiologist doing research in regulatory science at FDA.

They are studying how clinicians receive visual information and analyze it to diagnose a disease. At the center of their research are breast cancer screening devices, which are making the leap from traditional two-dimensional (2D) screening such as mammography to 3D breast tomosynthesis, 3D ultrasound and breast computerized tomography (CT). This technology is very exploratory and years away from becoming standard in your doctor’s office.

New Era in Breast Cancer Detection

There are many new technologies being developed for breast cancer screening, especially 3D alternatives that may eventually replace today’s 2D mammography. FDA has already approved two of these state-of-the-art devices: The

breastbreastSelenia Dimensions 3D System, which provides 3D breast tomosynthesis images of the breast for breast cancer diagnosis; and the GE Healthcare SenoClaire, which uses a combination of 2D mammogram images and 3D breast tomosynthesis images.

The technologies under development include 3D breast tomosynthesis, which artificially creates 3D images of the breast from a limited set of 2D images. Tomosynthesis reveals sections of the breast that can be hidden by overlapping tissue in a standard mammogram.

“The problem of overlapping shadows has confounded breast cancer screening because mammograms don’t show cancers that are hidden by overlapping tissue,” Myers says. And compounding the problem is overlapping tissue that can look like cancer but isn’t. “The new technologies we’re studying overcome these barriers,” she adds.

Another benefit of 3D breast tomosynthesis: It’s more accurate than mammography in pinpointing the size and location of cancer tumors in dense breast tissue, Myers says. With 3D breast tomosynthesis, doctors can detect abnormalities earlier and better see small tumors because the images are clearer and have greater contrast.

“Clinical studies have shown that 3D breast tomosynthesis can increase the cancer detection rate, reduce the number of women sent for biopsy who don’t have cancer, or achieve some balance of these two goals of this new screening technology,” she adds.

There’s also a lot of research and development in 3D ultrasound, which automatically scans the breast and generates 3D data that can be sliced and examined from any direction. Garra, who is a leader in this field, says 3D ultrasound improves breast cancer detection in women with dense breast tissue.

“Both 3D breast tomosynthesis and 3D ultrasound detect breast cancer. But for radiologists and other doctors, there are many more images to examine, and that can reduce the speed at which studies can be interpreted,” he says.

Another promising technology—the dedicated breast CT system—creates a full 3D representation of the breast. The scan is taken while the patient lies face down on a bed with her breast suspended through a cup and the X-ray machine rotates around it. For patients, the procedure is more comfortable than regular mammography because the breast isn’t compressed. Also, there’s less radiation exposure than during a CT exam of the entire chest because only the breast is exposed to X-rays.

Health care practitioners using this technology have to learn how to read and interpret hundreds of high-resolution images produced by the scanner. But what makes the task easier is that the images have less distortion than mammography, and the system is optimized to differentiate between the breast’s soft tissue and cancer tissue.

“These images will be very different from 2D mammograms. They’re truly 3D images of the breast from any orientation. You can scroll through the slices—up and down, left and right—and get a unique view of the breast like never before,” Myers says. “It gives doctors tremendous freedom in how they look at the interior of the breast and evaluate its structures. It’s almost like seeing the anatomy itself.”

New Era in How We See

How can radiologists look at these images and convert them into three dimensions? That’s where Badano’s work comes in. His research lab is exploring various display device technologies to improve how radiologists review 3D images. The studied technologies include devices supported by mobile technologies and special-purpose 3D displays developed specifically for 3D imaging systems.

“These are no longer conventional images, so you need to examine them in the 3D space,” he says. “Using a 2D display might no longer be ideal.” Device manufacturers are building on technologies developed primarily for other markets, including the gaming industry, to show 3D images in actual 3D. But the work is painstaking and far from ready for a medical use.

“As people have experienced in movie theaters and when playing videogames, 3D displays have problems, including the image resolution and added noise. When wearing 3D glasses, our brain needs to separate the images from the left eye and the right eye and reconstruct a 3D object,” Badano says. “In the lab, we’re doing experiments to see how different technologies handle these tradeoffs.”

One of the challenges is that 3D displays for medical imaging require better resolution. For a medical use, the specifications are high—“and so are the stakes,” he adds.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

September 30, 2014

 

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Post Surgical Treatment and Women Over 70

Recently, I was speaking with a friend considering having radiation treatment following a lumpectomy for a stage 1 breast cancer.

She had just turned 70 and didn’t see the need to expose herself to radiation and then take Tamoxifen or one of the other adjuvant therapies for five years and contend with all the possible side effects. As she put it, “Given my age, I want a quality of life.”

Her doctor was encouraging her to take radiation and a hormonal therapy to insure the greatest possible chance of avoiding a recurrence. In the end, she decided to take external beam radiation for the usual 6+ weeks and forgo taking the hormone therapy that she felt would only aggravate other chronic medical problems.

I decided to see what other doctors are advising their older patients about radiation and hormone therapy following a lumpectomy for early stage breast cancer and came across the following information.

Until recent years, post surgical treatment for women over 70, with early stage breast cancers, was often limited based on their age. Most had a mastectomy without reconstruction. These days more and more women, in this age group, are opting for a lumpectomy over a mastectomy. However, taking the standard radiation therapy following a lumpectomy is a decision some older women are choosing not to make.

treatmentAn article in Science Daily, Cancer News speaks to the changing trends in radiation therapy among women over 70 following a lumpectomy for stage 1 breast cancer. The article reports on abstracts presented at the annual meeting of the American Society of Clinical Oncology in Chicago by researchers from the Thomas Jefferson University Hospital.

According to researchers, more women are choosing radioactive implants over traditional external beam radiation therapy. Others, with estrogen-positive cancers, are deciding against getting radiation therapy treatment following a lumpectomy; opting instead for hormonal therapy, such as Tamoxifen. Among those women with estrogen-negative tumors, for whom hormonal therapy is not an option, 91 percent were more likely to die of breast cancer if they did not receive radiotherapy after a lumpectomy.

Researchers summed up their findings by stating that adjuvant radiation after lumpectomy reduces breast cancer mortality for women over 70 with early stage breast tumors that are estrogen receptor-negative, and that radiation is currently underutilized in these women.

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Bringing Breast Cancer Awareness to the “Hoods”

Social media is filled with comments about the coming of October’s rush of pink items for sale on the web and in stores. Some of those who shared their comments feel we have reached the saturation point on breast cancer awareness. 

Really? I am here to say we will be a long time reaching saturation point in the “hoods” across the USA.

These days, I spend part of my time speaking to women living and working in socio-economically disadvantaged communities. Their lack of knowledge about breast cancer and their need to be vigilant about early detection can only be described as limited, at best.

Through an interpreter, I speak to women who do not speak English. There awareness is all but non-existent.

breast cancerMost of the women attending technical, trade and other adult learning schools, where I have spoken, are surprised to hear that young women get breast cancer. Many, under 40 years of age, do not get comprehensive breast exams. They assume that breast cancer is a disease of older women. They are shocked to hear the statistics on the incidence of breast cancer in women under 50. They are even more upset to hear of women in their childbearing years getting breast cancer. They don’t know about the BRCA mutations.

Recently I spoke to 400+ students, mostly women returning to the work force. Most live in neighborhoods where there is little breast cancer awareness, where October doesn’t bring a flood of breast cancer awareness activities, where few have the spare cash to purchase the pink products found in department stores outside their “hoods.”

During my talk, women shared about their mothers, grandmothers, sisters, friends who now had breast cancer and those who had died from it. Many of the women never made the connection between early intervention, detection and survival rates. Most didn’t go for annual pap smears, never mind have a comprehensive breast exam. A handful of those women over 40 had ever had a mammogram. Few knew that having a mom, sister, or grandma with breast cancer put them in a risk category.

Many of the women comfort themselves with myths that make them feel safe; the same myths that delay their seeking early detection services. They believe that if breast cancer isn’t in their family, they don’t need to be screened; they believe they are safe.

They don’t know about the different types of breast cancer, or the treatments they will need if they should get breast cancer. They don’t know that, if caught early, the prognosis for survival is excellent. They don’t know that if their cancer is caught in a mammogram, before it can be felt, if it is small and hasn’t spread beyond the breast they may not need chemotherapy.

Most importantly, those who are uninsured, often the working poor, don’t know that can get a free mammogram that could save their lives.

Until there are more breast cancer health educators in our “hoods,” women that know the cultures and speak the languages of the women living in these communities, there will never be enough awareness.

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