Articles from May 2012

Permission Granted…Bonus Time Beginnings are Realities!

In my last two posts, I wrote about new beginnings in survivorship. This post, the last in a three-part series, is about how new beginnings are an opportunity to thrive.



After a few years of earning a living as a writer, I gave myself permission to start a company providing writing services for nonprofit organizations and small corporations.

One of these jobs was to put me in touch with hundreds of women who had survived breast cancer. These women came from diverse cultures, ranged in age from late twenties to mid-sixties and most had English as a second language. What most of them had in common was they were in the process of, or had made a new beginning after active treatment. Most spoke of becoming more assertive in their relationships, others took jobs outside their homes, some were getting their GED diploma others were taking college courses. A few had left abusive or loveless relationships.

Many of these women were “paying it forward” as volunteers in hospital clinics where newly diagnosed women received treatment. As survivors, they gave the gift of hope that only a survivor can give. They gave comfort to patients, speaking to them in their native language.

After treatment for my second breast cancer, it was time for new permissions and beginnings. The first beginning, the realization of a 20 year dream…a web site helping young children learn how to make good choices. Can Do Street, now in its second year, is for families and their children 3-7 years.

Also in its second year, is this site, another of my new beginnings. No Boobs About It, Inc. is a nonprofit organization, helping women and men navigate breast cancer and survivorship by providing the most up-to-date information on research, resources and support services.

I continue to meet women who used their breast cancer experience to reinvent themselves. Two of the many women I’ve met, in the past two years  that are doing amazing work, are Jeanine Patten-Coble, founder and director of Little Pink Houses of Hope and Kimberly Luker, founder and director of Botanicals for Hope.

Walking along the Carolina shore, trying to come to grips with her own breast cancer diagnosis, Jeanine got the idea for beach get-a-ways for women in treatment and their families and Little Pink Houses of Hope was born. Jeanine’s organization provides week-long beach retreats in the Carolinas for breast cancer patients and their families.

While going through chemo for breast cancer, Kimberly developed a line of natural cosmetics suitable for women going through cancer treatment whose skin was dry and sensitive as a result of chemo and radiation treatments.

According to the National Cancer Institute, there are over two million breast cancer survivors in the U.S. today. That’s a lot of survivors. That’s a lot of beginnings.

Permission:The Key to Every Beginning

permissionThe long months of breast cancer treatment with their exhausting side effects are a great time to take inventory of how we have been living our lives and how we want to live post treatment. But, thinking and planning are only half of what it takes for a beginning. A beginning isn’t possible without permission.

We are adults. Whose permission do we need? We need our permission. And, giving ourselves permission isn’t always easy. It’s about entitlement. Are we entitled to change course? Do we have the right to do something just for us? What about our obligations to our family our job or any other responsibilities we may have?

We have just come through breast cancer. Family and friends have been there for us. Don’t we need to pay back their kindness and support by picking up our lives where we left off before cancer treatment?

Even if we wanted to, we couldn’t. Breast cancer, any cancer is a life-changing experience. Survivorship is a new place to be and we need to adjust to the concerns, issues and yes freedoms that come with being a survivor.

We find, without planning it, that we covet our time. If we want to waste it, that’s one thing, but we don’t want anyone else to waste our time. We want our time to count. We know that recurrence is always a possibility and we don’t want any regrets if that should occur. There is an urgency to do something meaningful, to make a difference for ourselves and perhaps for others.

A beginning can be dramatic with the start of a new career, a move, a new business. It can be incremental with small but significant changes such as taking a class, traveling or pursing new activities.

Whatever the beginning, it remains an idea, a plan, until you give yourself permission to make it a reality. Permission is an ongoing process. We may need to give ourselves permission many times before making a new beginning a reality. For most of us, breast cancer’s gift is that permission. We feel, maybe for the first time in our lives, that we have the right, that we are entitled, to do life our way.

After my first breast cancer, I gave myself permission to leave a full-time position as director of a nonprofit health care organization. I took a part-time position as a grant writer, which gave me the time to try my hand at writing for publication. The first year was tough.  With every rejection notice, I had to; once again, give myself permission to stick with my beginning.

My first published article led to many more. When I accepted a position with a trade paper, my beginning became a reality. Giving myself permission worked. I was earning a living as a writer!

Bonus Time…A Time for Beginnings

timeJust before I finished treatment for my first breast cancer, my son and I were speaking about what I wanted to do with my time when treatment was over; what beginnings was I planning.

After I rattled off a series of conservative changes, my son cautioned me, saying, “Ma, you’re not on borrowed time. You’re on bonus time and you don’t spend bonus time the way you would ordinary time.”

Survivorship time, the time following treatment for any life-threatening illness, is bonus time.

Why? Because for most of us, a life threatening illness teaches us that time is the most important commodity we have. We take stock of how we are living and what we are doing with our time. We begin to think of our time as a survivor as a time to do what we’ve been planning to do, but putting off. We have a renewed interest and drive to make things happen. We’ve learned what we gave lip service to before our life-threatening illness but now know in our gut is true…no one is guaranteed the time to do everything they want accomplish or experience.

Breast cancer is a life threatening illness that packs an added wallop. Beyond the concerns that every cancer survivor feels, a breast cancer survivor may have to cope with long-term or permanent changes in her body image. Not every woman is a candidate for reconstruction. Some women’s hair will thin out during the five years of hormone therapy taken to prevent a recurrence of breast cancer. Still others will gain weight on hormone therapy. Others will experience long-term side effects of active treatment.

These physical changes can cause depression, doubts about femininity, interfere with existing relationships and the forming new relationships as well as impact on the self-confidence critical to career and personal development.

Beginnings are the needed boost that helps preserve the emotional well-being of breast cancer survivors. It gives women the opportunity to feel in control of their lives at a time when there are things about the way they look and other issues that are beyond their control.

During my years as a patient navigator for the American Cancer Society in New York City, I had the opportunity to speak with thousands of breast cancer survivors. I learned that most of us make that beginning happen after breast cancer and we are happier and more fulfilled for doing so.

Some of us give ourselves permission to live our dreams. We use bonus time to reinvent ourselves by going back to school, developing a business, starting a new career, volunteering, getting involved in our communities, or just doing the things that are important to us, whatever they are.

Many of us need to make a difference for others as well as ourselves. We use bonus time to “pass it forward.” We create products and services and even businesses that make getting through treatment and getting on with life a bit easier for women just starting their breast cancer experience.

As for me, well, after my first cancer I began using some if my time writing for publication. After my second breast cancer, I gave myself permission to use a large chunk of time to start a business.



How Possible is it to Prevent Cancer?

Because breast cancer is just one of many cancercancers, because having had breast cancer doesn’t exempt us from other cancers, we need to take a look at what the experts are saying about prevention of all cancers.

Early this month, I had the opportunity to attend a presentation, “Cancer Prevention: What’s Working, What Isn’t and What’s Next,” given by a panel of experts from Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James). Designated as a Comprehensive Cancer Center by the National Cancer Institute (NCI),  OSUCCC-James is one of only seven  centers, across the US  funded by NCI to conduct both phase I and phase II clinical trials.

The presentation covered several topic areas including foods we need to be eating to prevent cancer, the role of genetic studies in predicting who is at risk and how knowing that information can help to prevent getting cancer, and issues and concerns of long-term survivors. I will post on these areas in future blogs, drawing on information from the OSUCCC-James presentation.

I am limiting my sharing from the presentation, in this post, to a statistical overview on cancer in the US and the need for adopting risk-reducing behaviors known to prevent developing cancers

  • 1.5 million people in the US will be diagnosed with cancer this year
  • 1 out 0f two men will be diagnosed with cancer in his life time
  • 1 out of 3 women will be diagnosed with cancer in her life time
  • Every minute a person in the U. S. dies of cancer
  • There are twelve million people alive today who have survived cancer in the US
  • Over 50% cancer deaths in the US are caused by human behaviors such as smoking, excessive alcohol consumption, obesity, poor diet, and lack of physical activity
  • Environmental causes account for 1-2% of cancers
  • 5-10% of cancers are hereditary

Numbers don’t lie; they tell a story of too much cancer, over half of which, that can be prevented by eliminating known causes of cancer.

The experts presenting from OSUCCC-James were quite clear  that living a balanced life style that includes; a diet rich in foods that are known to reduce the risk of cancer, maintaining a healthy weight, a daily routine that includes exercise, abstaining from using tobacco products and limited alcohol consumption is the best means available to us for preventing cancer.

It is good to know that we have it withing our power to live a balanced life style. Hopefully that will help many of us from getting cancer. However, we need to always remember that there are exceptions.

There are those of us who have always lived a healthy, balanced life style and yet we got cancer. We may have no family history of  the cancer we have or have had. We are at a loss to explain it to ourselves or to others.

So what do we tell ourselves? Until the day scientists can tell us otherwise…causes unknown.

For more information about OSUCCC-James, go to


More on Brachytherapy

On May 7th, I wrote about a study that stated that whole breast radiation following breast conserving surgery may be a better choice than brachytherapy. The study was published in the May 2 issue of the Journal of the American Medical Association. Since the study appeared, a few groups within the medical community, have challenged certain aspects of the study.

What follows is a report on the outcomes of a multi-site study, with a median follow-up of four years, on the uses of Strut-based breast brachytherapy, a 5-day radiation therapy, a form of accelerated partial breast irradiation (APBI), which follows lumpectomy surgery.

The study was presented at the European Society for Radiotherapy & Oncology (ESTRO) World Congress of Brachytherapy in Barcelona, May 10-12. The study documented that breast brachytherapy with a strut-based applicator is a well-tolerated and effective treatment for early-stage breast cancer.

The data from UC San Diego Moores Cancer Center and two other institutions encompasses the longest-term study to date on breast brachytherapy with a strut-based applicator.

brachytherapy“This longer term follow-up gives more weight to the evidence that strut-based brachytherapy is a valid option for women with early-stage breast cancer,” said Catheryn Yashar, lead author of the study and a radiation oncologist at UC San Diego Moores Cancer Center.

“It’s an approach women should consider,” Dr. Yashar said.  “Women lead busy lives and they want a radiation option that will control their cancer, spare their healthy tissue and fit into their schedule more easily than six weeks of whole-breast radiation therapy.”

Other sites participating in the study were Arizona Breast Cancer Specialists (Phoenix,Az.) and 21st Century Oncology (Fort Myers, Fla.)

The research is based on 50 patients treated at those three different institutions with APBI using the Strut-Adjusted Volume Implant (SAVI). Successful completion of treatment was achieved in all 50 cases with favorably low recurrence rates and minimal acute and late toxicities.

“It is significant that these findings encompass patients over a median follow-up of four years since treatment – meaning we now have longer term data with outstanding results that show the efficacy of this therapy,” said Constantine Mantz, M.D., a study co-author and a radiation oncologist and Chief Medical Officer of 21st Century Oncology, the largest radiation oncology provider in the U.S.  “One likely reason for these favorable findings is that this technology spares healthy tissues and directs the radiation more precisely to the immediate area that needs to be treated.”

There were no symptomatic cases of seroma, fat necrosis, or breast asymmetry from radiation treatment. Rates of other side effects including fibrosis, breast pain and hyperpigmentation were also reported to be acceptably low.

The cancer recurrence rate in the study was comparable to the recurrence rate reported in the literature for whole-breast irradiation, which takes six weeks and is the traditional form of radiotherapy for early-state breast cancer.

A second study presented at the Barcelona conference, on the dosimetry of a small strut-based APBI device (SAVI 6-1 Mini), showed that the device is an excellent solution for patients with smaller breasts. The finding helps confirm the applicator’s ability to make breast brachytherapy an option for more women.

The 38-month study of 72 patients, by Serban Morcovescu, MS, and physician colleagues at Texas Oncology and North Texas Hospital (Denton, Texas) showed that the breast brachytherapy device, which is the smallest of its kind, allowed for precise targeting of radiation.

Content Sources: Dowling & Dennis Public Relations

Cianna Medical , Inc manufacturers of SAVI® (strut adjusted volume implant)