I Started a New Blog

I started this blog when I was diagnosed with breast cancer in 2007. Blogging really helped me cope with my cancer and its treatment.

However my life has moved on. I have blogged about it in the past - that my life was changing - breast cancer is no longer the main focus in my life.

My chronic ailments have replaced that focus. While breast cancer never really goes away it turns more to be chronic illness than a terminal one, unless metastases appear. So I have a total of four chronic illnesses - breast cancer, thyroid cancer, rheumatoid arthritis, and fibromyalgia. I also have chronic physical ailments - bone spur, desiccated disks, and degenerated disks.

I may continue to post here periodically but not as often. My primary new blog is "Life With Chronic Illnesses".

What A Stupid Policy

I guess I am back to blogging. I woke up this morning and read the paper. I could not believe this policy.

"Breast cancer screening is offered to all women aged 50 to 70 in England every three years; they are sent invitation letters to make an appointment for the test."

Apparently in the UK, patients are 'sent invitations' every THREE years for a mammogram. The parts that piss me off are that patients are only invited for a mammogram (shouldn't it be automatically scheduled by their primary care's - or another doctor's - office?) every three years. What's wrong with annually? Or is it too expensive for the NHS?

And they missed 'inviting' 450,000 women since 2009? How do you miss that large a group of people? Why couldn't they get their mammograms without an invitation?

What a crazy policy that was obviously set up by people who do not understand breast cancer. but never fear:

"Hunt apologized ‘‘wholeheartedly and unreservedly’’ for the suffering caused and promised there would be an independent review of the national breast screening program."

Maybe they should get a new policy instead.

Looking for Clues in Art

We think of art, whether modern, post modern, classical, or even neolithic, as a way to express the painter's thoughts on their surroundings. It doesn't matter if the scene is posed, still life, mythical or something else. The artist take that and makes their artwork a memory of their surroundings to last for centuries.

Recently researchers looking at breast cancer iconograpy through history found two portraits from the early 16th century showing late stage breast cancer.

"Signs of breast cancer can clearly be seen in "The Night", painted by Michele di Rodolfo del Ghirlandaio, and "The Allegory of Fortitude", depicted by Maso di San Friano."

If you look at the close ups of these two paintings in the Forbes article you can see them clearly. In addition it is noted that the Renaissance was a time of medical advancement so perhaps this was a way of showing the realities of life. What have other artists done? Intentionally omitted body defects so as not to show signs of disease?

But I also would not want to be the patients in the photos which show necrotizing tissue.

More Annoyance

I try to eat and drink healthy. I try to avoid premade 'chemical' food and use whole ingredients, meaning real, unprocessed food. In the mornings it may not be wise to get between me and my first cup of coffee. Later in the day, I like my herbal tea for its flavors and lack of caffeine anytime after 10 am. My husband makes fun of all the different kinds of herbal teas I have. I just like to be able to choose which one I am in the mood for.

I also subscribe to tips from WebMD to help keep me up on how to be healthier, what to do or eat or what not to. Usually I find this helpful.

But not yesterday.

I got an email on good and bad herbal teas. I know there are some herbs in teas that can interact with medications. I made a point of reading the information each of the herbal teas and stopped at Rooibos because I don't know much about it and I know I have some. This is what I learned:

"It comes from a plant native to South Africa, and the drink there is called redbush tea. It’s caffeine-free and is often touted for its antioxidants. Some researchers believe, based on studies done on animals, that this herb may boost the immune system and help prevent cancer. They are also looking into whether it can benefit your heart and fight diabetes. Check with your doctor before you use it if you have a hormone-sensitive cancer or you’re on chemotherapy."

Did you read that last sentence? Hormone sensitive cancer? That's me. Now I have to sort through all my teas to pull out any with rooibos. 

This just annoys me. One more thing that just aggravates me. Can't I just be a person who had cancer instead of having to check labels on herbal teas, and everything else for soy? Annoyance, annoyance, annoyance.

Cancer Not As Scary?

How scary is a breast cancer, or any other type of cancer diagnosis these days? This article, Thanks to advances, diagnosis of breast cancer isn’t as frightening as it was, claims it's not as scary as it used to be due to advances in diagnosis and treatment. However I beg to disagree. That is not the only reason. And societally, we have not changed enough.

Do you remember in the 1970s and earlier when people didn't talk about cancer? No, they whispered about it. So-and-so has cancer.... when's the funeral? Nice sequence there. But that is how life was. No one talked about cancer because it was a death sentence.  No one really knew anyone who had cancer and survived. Now as adults, we probably know people who have had cancer and didn't die. And are actually they are thriving.

Yes there have been lots of advances since the 1950s when the first chemotherapy became available. But it was not broadly available and sometimes the 'cure' was worse than the 'disease' due to the side effects. Now, we have targeted therapies and immunotherapy is coming into its own. But we don't yet have a cure.

But as a cancer person (when does one end being a cancer patient? When one is no longer here.) it is still very scary to be diagnosed with cancer. Just because it is easier to diagnose and treat now, it doesn't mean that it still isn't scary as hell. Cancer kills a lot of people. There is a lot that is not known about cancer and its diagnosis and treatment. More is learned every day. And the proverbial cancer cure is not yet available.

I am not sure if saying a breast cancer diagnosis is not as scary yet is premature or not. It probably is. Because most of us grew up with cancer as a whisper and not as a dinner table conversation. And more generations successfully live through cancer, it will still be very scary. If you choose to disagree, wait until you are diagnosed.

Genetic Testing and Non-High Risk

A person can be considered medically high risk due to their or a family member's medical history. If you are considered medically as high risk, you get popped into the category of give them lots more medical attention and 'lovely' tests.

Now with the progress of genomic testing, its no longer a big expensive, rare proposition. However, why do we only test the high risk people? These are the people who already know they are high risk. But that leaves a lot of people who don't know they are high risk and could be. This doesn't make sense. Some new research asks if it wouldn't it make more sense to test more people who aren't necessarily considered high risk? That might be more practical and save lives.

"A study published in the Journal of the National Cancer Institute indicates that screening the general population for mutations in specific genes is a more cost-effective way to detect people at risk and prevents more breast and ovarian cancers compared to only screening patients with a personal or family history of these diseases.

Current guidelines recommend that only those with a personal or family history that could indicate a greater risk of developing cancer be tested for gene mutations that can cause the disease. However, the successful use of testing for high-risk groups has led many to consider extending genetic testing for cancer to the whole population."

As I said it does make a lot of sense to do this. You would find people who did not know they were high risk and help prevent many more cases of breast and ovarian cancer. 

Mutations that cause cancer can occur in many people with no history to indicate a risk. These people are therefore not included in screening programs that target high-risk patients and the mutations remain undetected. The researchers of the new study estimate that implementing a program to test all women over the age of 30 could result in thousands fewer cases of ovarian and breast cancer in women in the US and UK.

However my response to this idea is a big fat 'No'. Isn't it kind of 'big brother-ish'? Yes it is. I'm sorry, but I would not approve of their approach to testing all women over the age of 30. The researchers then suggest:

"Population testing for breast and ovarian cancer gene mutations is the most cost-effective strategy which can prevent these cancers in high risk women and save lives,” said the paper's lead researcher, Ranjit Manchanda. "Our findings support broadening genetic testing for breast and ovarian cancer genes across the entire population beyond just the current criteria based clinical approach...""

It may be cost effective but that is not a way to treat patients. We are not little cost effective units that can be modernized or tested to meet some kind of cost effective study. We are human beings and need to be treated as such.

Yes I agree that we are normally subject to requirements to be immunized for certain illnesses. But this is different. Part of the reason for immunizations are that they are to prevent contagious diseases that can be passed from person to person. They can cause epidemics that can kill multiple people and cost significant amounts in medical bills.

Ailments causes by genetic mutations are not contagious. They affect only one person at a time. A person's genetic traits are unique. They should be kept private. They do not belong in some database anywhere to follow people around.

This would result in discrimination and bias if known to potential employers, health insurance companies, and life insurance companies. Even if such discrimination was illegal it would still happen. So no way in my opinion.

Finally, what if patients do not want to be tested. Some people (myself included) would not want to know the results of such testing. This is why I will not go to a fortune teller or tarot card reading. I do not want to know. I have enough to worry about as it is.

Clearly this is a case of 'just because we can, doesn't mean we should'.

Overloaded with Instructions

I get it. I have a lot of ailments so I am in a lot of groups and follow a lot of organizations for their health tips. So I get lots of email. Tons of email to be precise. Some of it gets the delete button right away - especially if the subject line doesn't tell me anything.

But then I read glance at a lot of them before deleting. But often they provide suggestions or instructions how to be healthier for whichever ailment. But now I am overloaded with instructions/suggestions this week:

• No more asparagus for me because it can lead to breast cancer spread. I like asparagus. Damn.
• Exercise can reduce breast cancer recurrence. I'm exercising, I'm exercising, I'm exercising.
• Milk and beef can trigger RA. What? No more cheese?
• Yoga can help with fibromyalgia. Too bad my doctors told me no yoga because of my bad back. And my knees don't bend that way.
• Fibromyalgia can cause dizziness. This is actually good news because we have been trying to figure this one out.

This is a partial list of what I have received this week. Last week there was something about coffee being bad. I have gotten instructions on so many things, I can get confused (which is not difficult at times). 

I realize one option is to stop reading about my ailments and receiving these emails. But I think it is important to understand as much as possible on your ailments. The more you understand about what is wrong with your body and what you can do to improve your situation.

On the other hand, it is definitely an overload. I do not have time to read all the emails I get. I pick and choose which get deleted immediately. Some I save for more in depth reading scanning at a later point. 

So not only do I get bombarded with ailments, I also get overloaded with instructions. Sometimes I cope by taking a nap or going to the gym to burn off stress. A nap usually sounds best.

I Am Very Confused

I realize this must be part of the vast conspiracy to keep breast cancer patients confused. Nancy, over at Nancy's Point, blogged about the AJCC’s Updates to the Breast Cancer Staging System, asking if we are confused about it. Well, since I didn't know about the updates (or even who the AJCC is) I was and still am very confused.

Let's start with the AJCC or the American Joint Committee on Cancer. Apparently they are the people who set up cancer staging criteria. They set the original TNM staging system in 1959. TNM means Tumor size, Nodes positive, and Metastases. 

"The panel recognized the need to incorporate biologic factors, such as tumor grade, proliferation rate, estrogen and progesterone receptor expression, human epidermal growth factor 2 (HER2) expression, and gene expression prognostic panels into the staging system. AJCC levels of evidence and guidelines for all tumor types were followed as much as possible. The panel felt that, to maintain worldwide value, the tumor staging system should remain based on TNM anatomic factors. However, the recognition of the prognostic influence of grade, hormone receptor expression, and HER2 amplification mandated their inclusion into the staging system."

I used to know what stage I am - IIA. Now I can't figure it out. With all this other stuff included. I am very confused. I looked at the American Cancer Society's website for help. And I am even more confused. There is no more little chart that shows what you stage you are. 

So here is my game plan: I will ignore all this new information until I meet with my oncologist sometime next summer and ask her. I feel this is better for more. A little ignorance and confusion will go a long way in reducing my stress. 

Now all of us breast cancer people can have these little conversations:

'What stage are you?'

'IIa, I think.'

'Is that the old staging or the new staging?'

'What new staging?'

'You didn't hear about it?'

'No.' 

All the breast cancer staging changed in 2018. They added all sorts of new information, grade, hormone status, etc'

'Oh, so if I was stage IIb, do you know what new stage I am?'

'No, I don't even know what stage I am. I can't figure  it out. I'm going to ask my oncologist.'

'Crap, let me call my oncologist too.'

But I swear there is a vast conspiracy out there to keep us all confused.

San Antonio Breast Cancer Symposium

I have found there are two key conferences to follow to keep up with the latest cancer news annually. First of all, each June there is the annual ASCO (American Society of Clinical Oncologists) conference held around the country. As oncologists come together and the outcome produces a slew of new research news for all types of cancer translated into normal English.

Second, is the annual San Antonio Breast Cancer Symposium held in early/mid-December each year in San Antonio TX. That was just held and so much news was just released. There was so much new news that you should go read it all yourself if you want to stay up on the latest.

As with any professional conference, this is when a group of professionals who are scattered across the country, and the rest of the world, get together and find out about new research, get ideas for more research, and compare notes. The benefit to us cancer people is huuuuggggge.

So go read.

Aggressive Breast Cancer In Younger Women

Younger women with breast cancer always seem to (my tiny non-medical mind) be either very late stage and/or aggressive and require more aggressive treatment. And some new research may explain why.

"Researchers at the University of Southampton in the United Kingdom found that women aged 15–39 who had early-onset breast cancer possessed specific gene variations that were associated with increased disease progression.

Lead study author Dr. William Tapper — from the Faculty of Medicine at the University of Southampton — and team say that their results not only shed light on why younger women with breast cancer have lower survival rates, but they could also offer new treatment targets for the disease."
This news seems to be leading to a real breakthrough. I have always found it interesting that young women were diagnosed with late stage breast cancer and required aggressive treatment. Yes you can argue that under 40 they are unlikely to receive regular mammograms so their disease was more likely to be caught at a later stage. But it seems to happen too frequently to be chance.

Now a gene variation has been found that could be the root of this.

"Among younger women diagnosed with early-onset breast cancer, it was found that two single nucleotide polymorphisms (SNPs) in the ADAMTSL1 gene were associated with greater risk of disease progression.

SNPs are variations in a DNA sequence that can affect how a gene functions, and this plays a role in disease.

The researchers say that this finding "suggests that unique disease mechanisms may influence survival in younger women and provide some biological insight into why younger-onset breast cancer has a worse prognosis."

What is more, Dr. Tapper and team say that the results could pave the way to new diagnostic and treatment strategies for young women diagnosed with early-onset breast cancer.

"Our findings increase our understanding of the genes and pathways that are involved in breast cancer prognosis, and may provide new targets for the development of novel therapies." - Dr. William Tapper

"In the short- to medium-term," continues Dr. Tapper, "this genetic factor may be used to improve prognostic models."

"In the long-term," he adds, "when more is known about the mechanism underlying this association and its relationship with treatment response, it may have an influence on approaches to the most effective breast cancer treatments."

So this is a real breakthrough. It could explain why some younger women have a more aggressive cancer, lead to better treatment for those with this variation, and lead to real changes in the future for all women with breast cancer.

Tumor Evolution

It turns out that tumors do evolve. And the result of the evolution is that sometimes the cancer treatment stops working.

"A new study by researchers at Huntsman Cancer Institute (HCI) at the University of Utah observed how breast cancer tumors evolve over time and demonstrated how changes within tumors may contribute to the process by which cancers no longer respond to treatment. Further, the research identifies that some of these changes may be shared across certain treatment-resistant breast cancers."

The problem in examining tumors is getting samples because that is that can be invasive. You can't really say to a woman with breast cancer 'be sure to stop by for your yearly tumor biopsy'. They really do not want to keep the tumor around if they don't have to. So they had to be unique, which also meant a very small study size:

"For this study, Werner and her collaborators were able to trace the timeline of treatment of four breast cancer patients, over the course of between two to fifteen years for the patients analyzed. In a unique collaboration between several researchers and medical oncologists, samples of cancerous tissues were collected from breast cancer patients during their regular course of treatment. The tissue samples were then sequenced to study how the samples changed over time and how the tumors responded to each treatment. Using these data, the researchers were able to assess how changes in the tumor coincided with when the patient's cancer stopped responding to treatment."

Four patients is a very small study. However what can be learned from this study can lead to new research. Due to the invasiveness of tumor access, I can't see how tumor access is going to ever be much easier. With most patients, tumors are removed as soon as possible. I guess if there is a recurrence, presto you get a new tumor to biopsy - but if its not the same tumor does it count? Or sometimes tumors are not removed right away because chemo is used to shrink them..... But what do I know? I am a mere patient who is rambling on here.

"The ultimate goal for the researchers is to understand what is happening in a patient's tumor in as close to real time as possible, to predict what will happen next, and to adjust treatment accordingly.

Two new clinical trials set to start early next year at HCI and City of Hope will build on this research. Werner says "ultimately we want to actually predict what is really going to work best for your tumor during the course of your disease. While we're not ready to apply this to standard patient treatment now, with this work we are one step closer to doing that."

So if this tiny study is going to result in more research, I am all for it. You have to start some where and I find it fascinating that this area is one to be explored. I never really considered tumor evolution but if you think about it, tumors must acquire new characteristics as they grow in size. I'm ready to learn more and wait for more results.

Personalizing Personalized Medicine

What is personalization? Its making things for the individual. This is seen all the time online. If you visit Amazon's website and search for toothpicks, you will start seeing ads for toothpicks popping up all the time. Until you search for something else.... Amazon's site is responding to your needs by reminding you about your recent search - meeting your needs.

Personalizing personalized medicine means not doing the same thing over and over again, and taking into account patient's individual needs. However, we talk about personalized medicine and then discuss starting mammogram screening for all women at age 40. Where is the personalized part of that? Its just changing the requirement for insurance companies. And no mention of who pays for the additional screenings.

Take this opinion for example, from Dr Montijo on Clinical Advisor:

"I am often concerned about articles summarizing screening mammography data. Without fail, organizations that materially benefit most from performing mammography conclude and advocate more frequent and earlier screening mammography. Organizations composed of primary care or with minimal material benefit conclude that a more conservative screening program and more personalization, such as shared decision making, has the greatest net benefit. The cost alone, from the most aggressive screening design to the most conservative design, is in the billions of dollars. No tradeoff analysis of alternative uses of such cost is entertained."

Again, just because we can, doesn't mean we should all the time.

"Mammography started in the early 1950s with a study from HIP of New York, among others. The use of screening mammography increased precipitously during the ensuing decades typical of new technology, often for assumed or wished for benefits. A major industry was born. As happens with most new technologies, finding the optimal use or non-use takes time but almost always perseveres past the optimal benefit point or in some cases full retirement."

I am not saying mammography does not have its benefits. It does. Some women should start screenings early. Maybe in their 20s - I had a benign lump at 23 and have had annual mammograms since. My breast cancer was found at age 45. And another benign lump appeared at age 46. I am someone who needed mammograms starting young. But this does not apply to everyone. 

In my opinion, anyone who is BRCA positive or has a family history of breast cancer should have annual screenings start at age 25 even. That should not be a discussion, but should be a standard for those women. I am sure there are other cases like this where mammograms should start early.

This is a basic idea to start a personalization discussion with an individual patient. But a global requirement for everyone doesn't help. Mammograms have a financial cost but also the cost of missed time at work for the patient to go to the appointment as well as emotional stress for the patient.

We need much more personalization if we are to make any progress in this area.

On Not Blogging About Breast Cancer

You might have noticed that I haven't been blogging about breast cancer recently. Why? Because my brain has been filled with non-breast cancer issues that take up the entire health section of it.

My brain is full of knee, RA, fibromyalgia, and other health issues. Like why can't I stop taking a couple of medications (a couple of serious conversations are upcoming)? Or why can't my hands and feet hurt less even though I am taking all these meds to make them stop hurting? Or when will my knee be all better and get back to normal? And why did I manage to get so tired yesterday when all I did was go to a yarn store (and spend too much money)?

Anyway, breast cancer doesn't fit in anywhere. I am happy that it doesn't fit.

I think its a sign that I am moving on in some ways in my life. This is a good thing. Breast cancer will never go away in my brain, as thyroid cancer, never does. Cancer never goes away.

But breast cancer will be happy to fill my brain up again at the next little twinge. [Wait, is that a lump I feel?]

I'm just going to focus on my knee for now.

Breast Cancer Changed Me Too

I like Joan Lunden. I mean I like what I saw of her on TV. She was very professional and did a good job on the air. I am not sure I would have 'volunteered' to have a mammogram on television, even if it was to raise awareness of breast cancer screening.

Now, three years after her diagnosis, she is through with treatment and says that having breast cancer changed her. She has started a website to educate women about the benefits of early detection.

Then another woman, much younger, Yolanda Jenkins, has also been diagnosed with breast cancer. She has created a platform to encourage young women to get checked and wants to get the age for mammograms lowered so younger women have access to this critical tool.

These two women make me think should I be doing something different? I mean I have a blog that's about me. I don't run around educating people about cancer. I know I talk about breast cancer and other cancers but I don't educate or advocate or anything... Should I be doing something different? I am not sure I could.

Eek! Hair Dye Causes Breast Cancer!

How many women color their hair? I think most of my friends do. I don't and I am unusual among the women I know.

But, brace yourselves, the news is now going to be filled with the warning that coloring your hair with anything but natural dyes will cause breast cancer and you will die very quickly. Why? Because a researcher in the UK said so:

"Frequently dying your hair has been linked to an increased risk of developing breast cancer.

According to a study by London surgeon Kefah Mokbel, women who colour their hair have a 14 per cent rise in rates of breast cancer.

Professor Mokbel, who works at the Princess Grace Hospital in Marylebone, London, advises that women dye their hair no more than two to five times a year."
But here is the kicker:

“Although further work is required to confirm our results, our findings suggest that exposure to hair dyes may contribute to breast cancer risk.”

Professor Mokbel has also made clear that the link is merely a correlation: “The positive association between the use of hair dyes and breast cancer risk does not represent evidence of a cause-effect relationship,” he wrote on Facebook.

You need to note the word 'CORRELATION' before jumping to any conclusions. And then he opted to clarify more on Twitter (that ever so helpful 140 character way of communicating scientific and political information).

In addition, there was a Finnish study which also found a link between hair dye and breast cancer risk. But that researcher points out more information is needed because maybe women who use hair dye are also more likely to use make up which has some kind of chemical in it which could be more likely to cause breast cancer.

"Sanna Heikkinen from the Finnish Cancer Registry said separate Finnish research found a link between women who use hair dye and likelihood of developing breast cancer.

“We did observe a statistical association between hair dye use and risk of breast cancer in our study,” she said.

But like Mokbel, Heikkinen stressed that scientists aren’t certain of a cause-effect relationship though.

“It is not possible to confirm a true causal connection,” she said. “It might be, for example, that women who use hair dyes also use other cosmetics more than women who reported never using hair dyes.”"

So please use common sense and don't jump on the hair dye will kill you bandwagon which you will find far and wide in the news in the upcoming weeks. 

New Research Which Could Have More Thought

There is always more research going on - especially cancer research. Especially breast cancer research. I swear sometimes the world is full of research labs papered in breast cancer research papers.

Anyway, this time I don't necessarily agree with this new research. In a ten year study, maybe not all breast cancer patients need an AND (Axillary Node Dissection) if they have a positive sentinel node with their lumpectomy. Why? Because if you are going to have chemo and full breast radiation, they would catch all the cancer cooties and nuke them anyway. Hmmmm.....

An AND can give you lymphedema.... which I have now.... the real reason for skipping this surgery. And who wants additional surgery anyway?

Okay so this study looked at around 900 women who had early stage breast cancer and one or two positive sentinel nodes and then were having chemo, radiation and hormonal therapy. They split them in two groups and followed them for ten years. After that time both groups had similar recurrence rates. This study did not include women who had mastectomies or suspicious or enlarged lymph nodes in a physical exam.

"To make sure that women have the appropriate lymph node surgery, the American Society for Clinical Oncology released guidelines on sentinel lymph node biopsy for people diagnosed with early-stage breast cancer. The guidelines say sentinel lymph node biopsy SHOULD be offered under these circumstances:

• breast cancer in which there is more than one tumor, all of which have formed separately from one another (doctors call these multicentric tumors); these types of breast cancers are rare
• DCIS treated with mastectomy
• women who have previously had breast cancer surgery or axillary lymph node surgery
• women who have been treated before surgery with chemotherapy or another systemic treatment (treatment before surgery is called neoadjuvant treatment)

The guidelines say sentinel node biopsy SHOULD NOT be offered under these circumstances:

• the cancer is 5 cm or larger or locally advanced (the cancer has spread extensively in the breast or to the nearby lymph nodes)
• the cancer is inflammatory breast cancer
• DCIS treated with lumpectomy
• the woman is pregnant

The guidelines also say:

• Women with negative sentinel node biopsies shouldn’t have axillary node surgery.
• Women with one or two positive sentinel nodes who plan to have lumpectomy plus radiation also don’t need axillary node surgery.
• Women who have one or more positive sentinel nodes and plan to have mastectomy with no radiation should be offered axillary node surgery."

Well, I say whoop-di-doo to all this. Why? Because they do not raise the issue of younger women with breast cancer. I was under 50 when I saw diagnosed with breast cancer - otherwise I meet the criteria. And it was my second cancer before the age of 50 (which puts me in a special class of people). 

I think that while these recommendations sound great and I like it when guidelines are updated and progress is made. But I think this research clearly overlooks the group of younger women who should be regarded differently. Often younger women are diagnosed with more aggressive breast cancers than older women. Now you see my concern?

Being Breast Cancer Savvy

Buried in another article based on a woman doctor's problems getting screened for breast cancer by the UK's NHS, are three rules on how to be 'Breast Cancer Savvy'

• You Don't Need to Examine Your Breasts
  All women, no matter what age, should get to know their breasts. But experts have stopped recommending self-examination routines. Studies have shown that most women who find breast tumours do so during the course of everyday life: while dressing, or just rolling over in bed. The key is to know what looks and feels normal to you.

I wholeheartedly agree with this. I am incapable of finding any lumps.

• Don't Ignore Symptoms
  The most common sign of breast cancer is a lump within the breast. But you might find one in the armpit or notice skin changes on the breast such as dimpling, and changes in the appearance of the nipple, or its shape or how it feels, or a discharge. Breast pain on one side that lasts after a period, a rash and any change in the size, shape or symmetry should be investigated.

Well 'doh!' If something not right, get it checked asap

• Make Sure You Go To That MammogramIf breast cancer is detected early, it is more treatable. Screening uses mammograms – a type of X-ray – to look inside the breast. All women between 47 and 70 are invited for screening every three years. NHS screening is opt-in after 70, so make sure you get in touch with your local unit to make an appointment: nhs.uk/breastscreening.

Um yes. Its a great tool for finding breast cancer before it gets really big and ug

I think I will be forced to blog about the rest of the article tomorrow maybe. 47 is way too late to start mammograms. My maternal aunt was diagnosed at 76 with breast cancer....  Grrr.

But in the meantime. Be savvy. Savvy is almost like being cool.

Mammograms Under or Over Diagnosis?

There has been a long debate, since mammograms were put into use in the early 1980s, if they over or under diagnose breast cancer. Now someone has finally decided to take another look at all this data. There are two main parts to this issue: Are small tumors that would never grow into something 'bad' being over diagnosed and over treated? Are too many other tumors missed in mammograms? This group of researchers examined data from 2001 to 2013 and determined that:

"The results showed that most overdiagnosis occurred in older patients with biologically favorable, slow-growing tumors."

These tumors are ones that will not become problematic 'go bad' for 15-20 years. These do not need treatment..... In addition they revised their thinking on which tumors were going to become 'problematic' (what a sanitary word for cancer diagnosis).  

""Until now, we thought that the lead time, or time until a cancer becomes problematic for a patient, for most breast cancers was about three or four years. This paper shows that lead times vary widely depending on the tumor type. A large portion of aggressive cancers have a lead time of two years or less, whereas another large portion of breast cancers grow so slowly that the lead time is 15 to 20 years,...""

This is new thinking.

"It is important that we educate physicians, patients, and the public on the indolent, slow-growing nature of some breast cancers. This knowledge will allow us to individualize treatment options, provide 'personalized medicine,' and avoid the major harms of overdiagnosis, which can result in overtreatment and the anxiety and fear that a cancer diagnosis causes,..."

So maybe instead of blindly following what we have been told in the past, we look at what is now known.... This is called progress. 

How Long Are You On the 'Hook' For A Recurrence?

After cancer, we always wonder 'will it come back?' Actually, we don't just wonder, we obsess over this. For a long time, we think every little owie is probably cancer. We can only get our life back on the rails when we learn to cope with this. But still then every so often we still freak ourselves out about something. And life goes on.

But post cancer, every so often our doctors tell us something we don't like and we go back on that cancer roller coaster. Time goes on. Years start to roll by.... We assume we are good because its been a decade or two....

Now I must ask the question 'how long are you on the 'hook' for a cancer recurrence'?

I know that research and the past has shown that thyroid cancer has been known to recur 30 or 40 years later.... How fun. Breast cancer I always kind of thought 15 years or so you are good.

The news told us this week that Olivia Newton John has had a breast cancer recurrence. She thought she had back pain but instead it was cancer metastases. I made a point to look up how long ago was her original diagnosis. That was in 1992. You can do the math. 25 years ago.

Damn.... So my ten years out doesn't mean that much. Damn, damn, damn.....

No Tofu for Me!

I hate tofu. I have never been a fan. And now I have reasons for not starting to eat it.

There has been a lot of discussion on whether soy is good or bad for breast cancer. Now finally, new research has exposed the answers.

• If you have always eaten a lot of soy your breast cancer risk is lower, and your recurrence rate is also lower.
• If you have not always eaten a lot of soy, your breast cancer risk is at normal levels (whatever they are but I didn't want to use the word 'worse' when talking about cancer rates).
• If you have not always eaten a lot of soy, starting to eat soy after a breast cancer diagnosis, doesn't help you and could even cause your recurrence rate to be not as good.

So, I hate tofu and will never be a fan. Now because of my medical history (one of the few good things due to it) I never have to consider eating it. Here's to a tofu free life!