Wow, have I got a mad on. Last week a slew of articles made the online rounds, and after reading them and the reader comments, my blood is boiling.  I want to talk first about an article which was posted on many news organization sites and other websites. The title perked me up: “Could Half of All Breast Cancers Be Prevented?”  The premise of the piece was that half of breast cancers might be due to lifestyle choices. I’m willing to accept that there are certain things you can do to lessen your risk of breast cancer, but, as someone who was the epitome of health upon diagnosis, my jaw clenches when the “You can prevent breast cancer” tagline gets thrown around.  The only thing that might have made my BCS (before cancer self) healthier is BCS me living in a remote, stress-free monastery practicing martial arts, yoga and meditation all day long, drinking pure spring water, sucking in unpolluted fresh air, and growing my very own sustenance in the form of an all-organic garden. Hey, I now live in Manhattan, so I can dream, right??  It sounds pretty awesome, but pretty unrealistic. At 37, I wasn’t ready to make that kind of leap, and two years later, I’m still not ready to make that leap.  I want to live IN this world, not be apart from it.  (And after that intro paragraph, I guarantee some readers are poised to type a reactive response, perhaps questioning if I was really healthy and really did everything to be healthier… I ask those readers to wait, and to read the rest of this before giving in to that response.)

What people are readily grasping onto is the HALF aspect…. Half of all breast cancers could be preventable.  Half is not an insubstantial number and if we could wipe out half of all future breast cancer diagnoses by lifestyle choices, yes, yes, yes, let’s do everything we can to make it happen!!  However, I think many choose to ignore the obvious counterpart of that figure… HALF are not preventable.  And considering the number of breast cancers diagnosed each year, that half is still a staggering number.  As a smoothie-chugging, juice-hogging, veggie lover with a serious craving for fitness adrenalin, I am stung when I hear the lifestyle argument as the reason for getting breast cancer.  But it also stings because as a young survivor, I am connected to a host of other young survivors of many different forms of cancers. The lifestyle choice argument doesn’t hold much water when you see women developing breast cancer in their 20s and 30s and sometimes even in their teens.  How can your lifestyle choices cause your cancer when your life as an adult has only just begun at age 24?  When we start slinging around the “breast cancer can be preventable if you make wise choices” slogan, we run the risk of blaming people for their illnesses. And, I’m going to go out on a limb here and say that none of the young sisters I am honored to know were diagnosed with cancer because they made bad lifestyle choices.

I devoured the reader comments of this article and was left shaking my head (and my little tiny fist of fury at some points).  More than a few readers left exactly these types of blaming comments, along with other such helpful gems as “All cancers are preventable,” “Drink more green juice” and “Did you get immunizations? That must be the reason for your cancer.” Yeah, very unhelpful and personally offensive.  But what really fired me up was a separate article, written perhaps in response to the first, titled “I Did Everything Right and I Still Got Breast Cancer.”  The author is a doctor who is very honest about her response to her diagnosis at 47 and her treatment journey. And guess what? I know many of you may find this utterly shocking and it may challenge your world views (Sarcasm!), but her lifestyle choices were the “correct” ones and she still got cancer!  OMG!

I was pleased to see the support the author received from readers, mostly from other survivors who totally got it, but about half the responses were people questioning if she really did everything right. Is she really a vegetarian?  Did she wear make-up? Use personal bath products excessively? Use deodorant? Wear constricting bras?  Sleep uninterrupted?  Sniff glue as a child? Pull the toenails off of puppy dogs? It was a torrent of ugly “blame the victim” rhetoric. Never mind that millions of people worldwide do ALL these things daily (well, maybe not the glue sniffing and puppy maiming) and never develop cancer.  And never mind that the judgmental people who wrote these questions probably have zero experience with cancer.

So many  things are wrong with this all-too-common blame the victim response, and sadly, this response isn’t just on trendy health web sites (like the one this article appeared on) where people tend to be judgmental and overzealous.  It’s all over the media that you can “prevent cancer.” Eat more vegetables! Take Vitamin Z!  Burn your bras!  Meditate 5 hours a day!  Cut out all toxins!  I’m poking gentle fun here, because I do believe many things can help overall wellness and health before cancer or after cancer, but seriously, if I had eaten any more vegetables in the decade leading up to my diagnosis, I’d have needed to be put out to pasture with the rest of the herbivores.

Blanket statements such as “You can prevent cancer” set up the logical conclusion that if you can prevent cancer… then anyone who gets cancer gets it because of something he or she did. A+B=C.  Person A   did/ate/thought certain activities/foods/negative images  which led directly to her cancer diagnosis.  If we take this to its linear conclusion, Person A practically deserves her diagnosis.

This ugly blame response is primarily a fear-based reaction to cancer. People need to think cancer is totally preventable and that people who get cancer did something wrong to get their cancer. To think otherwise opens up a vast chasm of fear and uncertainty.  To think otherwise opens up the possibility that illness can be random and nonsensical, and if that is the case, then anyone could get cancer. YOU could get cancer…. And that’s too damn scary to contemplate.  If my friend at age 37 got cancer because she has a family history, then, phew!, I don’t have to worry about that! Relief!  But if my friend didn’t have a family history and still got cancer, then OMG!!  I could also get cancer!  Scary stuff, no? It’s terrifying to contemplate the randomness of cancer and it is far, far easier to blame the victim, thus feeling safe and secure in delusion.

My heart aches for a fellow sister in the breast cancer fight.  It sucks, it’s horribly unfair, and very often it doesn’t make sense.  But my heart aches most for her because she lives in a society where she feels the need, the pressure, to defend herself because she got cancer. She’s fighting cancer!  Her fighting energy is needed for more important things.  The last thing she needs to do is fight fearful, judgmental people who think she got cancer because she didn’t get enough sleep.  It’s unwarranted, it’s ill informed, and it’s just plain selfish.  To all these people I say: It’s not about you. It’s not about you. It’s not about you. Keep your fear to yourself.

Jennifer Jaye is an editor, writer, actress, yogini, former karate instructor, and in her newest role, a cancer survivor. She lives, works, and plays in Manhattan as she attempts to navigate life as a young survivor of breast cancer.  

 

Posted in Cancer Support, Inspirational, Survivor Story | Tagged | 11 Comments

NOTE: The following guidelines apply to the affected area only.

Keep the affected area meticulously clean:

  • wash skin thoroughly and frequently
  • keep the skin moist to avoid drying and cracking
  • use low PH lotions to protect the skin from pathogens

 

Try not to injure the skin as this may cause infection. Avoid:

  • exposure to animal scratches and bites
  • exposure to biting or stinging insects
  • unnecessary skin punctures (vaccines, venipuncture, acupuncture, piercings)
  • chronic self-induced scratching, nail biting, etc.

 

Other activities which cause more extensive trauma to the delicate lymph vessels:

  • excessive strain during exercise
  • physical overexertion in affected limb(s) (heavy lifting, joint over-rotation)
  • restriction of blood and lymph circulation (blood pressure cuffs, pneumatic pumps, poor fitting elastic garments, unskilled bandaging, tight bra straps, waist bands, watches, rings, etc.)
  • any other blunt trauma or bruising
  • unnecessary surgical procedures (consult a lymphedema specialist first)
  • burns from heat sources including the sun

 

Temperature extremes cause the lymphatic system to labor. Avoid:

  • frostbite or extreme cold
  • extreme heat from saunas, whirlpools, hot weather
  • heat treatments, hot packs, etc.

 

Other lifestyle changes may lessen the risk of starting or of worsening lymphedema.

  • when traveling by air use compression garments or low stretch bandaging (those who do not have lymphedema but are predisposed should seek the advice of a lymphedema specialist)
  • keep body weight at optimal levels (obesity can cause lymphedema or worsen pre-existing lymphedema)
  • exercise regularly (special exercises are recommended)
  • seek medical assistance immediately if infection exists
  • seek appropriate treatment for your lymphedema (Complete Decongestive Therapy) – CDT is safe and reliable

 

By: Steve Norton

Posted in Daily Matters, Lymphedema, Treatments & Side Effects | Tagged | Leave a comment

Spoiler alert – this will hardly be the last word on the screening mammography debate…

Last week, the British Medical Journal published a Canadian Study which concluded that mammograms are not effective in reducing breast cancer deaths. The study involved 90,000 women. However, there are some major flaws in the study, and “rapid response” letters to the editor were published within hours of the study release. So while the headlines scream “mammograms are not helpful”, the study is of poor quality and it is not possible to truly draw this conclusion.

While previous randomized trials have shown a reduction in breast cancer mortality due to screening mammography, there is no doubt that mammography is far from perfect. We have to screen a large number of women to diagnose one with breast cancer. In doing so, a percentage of women will require additional imaging and/or will undergo a needle biopsy for a benign finding. Mammography is not as helpful in younger women and in those with dense breast tissue. In addition, as technology has improved to allow us to see through the breast with more detail, we are diagnosing cancer (and precancerous conditions) that may never become a threat to a woman’s life. We are trying to find the balance between early detection which often (but not always) leads to improved survival, versus over diagnosis and over treatment.

 

Part of the problem is our technology. The results of screening mammography are highly variable depending on the patient’s age, breast density, weight, use of hormone therapy, and other factors. We have a one-size-fits-all test, which as every one knows, is really one-size-fits-none. We are also limited in who we screen. Women younger than 40 without a family history of breast cancer have no routine screening options, and mammography is not very helpful in this age group. Many will use this as an argument for the use of ultrasound or MRI examinations. While these modalities may be extremely helpful in a given patient, they have not been proven to be effective in reducing mortality from breast cancer when applied to a general screening population.

It is important to realize that we have an imperfect technology, and our application of that technology to the individual is also imperfect. More research is needed to determine who is actually at risk, and who will truly benefit from screening. In addition, screening needs to be more individualized – a mammogram is not the right screening tool for all. Dr. Peter Beitsch, President of the American Society of Breast Surgeons, has said on many occasions that “female and 40 is no longer acceptable for screening mammography – we need to risk assess each woman individually and use appropriate breast imaging tailored to them..” This will be the subject of a symposium held at our annual meeting in May – “Breast Cancer Screening – Does One Size Really Fit All?”

In addition to more individualized screening, research is needed into which cancers even need to be treated. Many breast cancers found on mammography may never become a threat to a woman’s life. However, a hallmark of cancer is cell mutation – the slow-growing cancer today may not behave that way in the future, so at this point we err on the side of over treatment, as we cannot reliably predict future biologic behavior. Dr. Robert Miller, a medical oncologist at Johns Hopkins, stated that “we simply can’t tell if early breast cancer diagnosed by mammogram will be indolent or not. For the individual patient we can’t say it’s ‘over diagnosis’. ”

And that’s really the bottom line. For an individual patient, we do not always have the right answer – our science and technology are just not there yet. While this is frustrating for many patients as well as for physicians, it is exciting to be practicing in a time when we are making progress (albeit slow) towards more individualized screening and treatment recommendations.

American Society of Breast Surgeons Statement

By: Dr Deanna Attai

 

Posted in Cancer Education, Diagnostic Imaging | Tagged | Leave a comment

Can Herbal Medicine and Chemotherapy work together for the benefit of cancer patients? 

Several studies show that the extract of Milk Thistle seeds (Silybum marianum), particulary the phytochemicals silibinin and silymarin not only protect delicate kidney cells and tubules from damage, but also protect nerve cells from damage and the development of chemotherapy induced nerve pain. Components of Milk Thistle have also been shown to enhance the effects of some chemotherapy agents.  Milk Thistle is one of the great multi-tasking herbs that helps to restore normal function to patients suffering from chemotherapy side effects.

Researchers discovered that kidney damage occurs primarily within one hour after chemotherapy administration with the platinum based drugs cisplatin, carboplatin and oxaliplatin which are administered intravenously (IV) for a variety of cancers.  Therefore it is important to give milk thistle extract before chemotherapy is infused. This seems to decrease the high levels of oxidative stress that contribute to kidney cell damage.

Research has also shown that substances that increase our body’s own innate oxidation control may offer further protection.  Supplements which increase SOD (super oxide dismutase) within cells include sulphur containing forms of selenium such as selenomethionine and methylselenocysteine.

Silymarin and other components of Milk Thistle may increase our own super antioxidant glutathione.  Both N Acetyl Cysteine and Undenatured Whey protein are known to improve the availability of glutathione as a free radical scavenger within cells. Although we most often think of whey as a source of high quality protein, it is also a source of precursors and greatly enhances the quenching of oxidative stress within cells which is key in reducing the toxic and damaging effects of chemotherapy.  Whey Protein is an outstanding source of high quality concentrated protein so important to patients undergoing chemotherapy which is a very high energy demanding state requiring extra nutrients and extra protein at a time when many patients lose their appetite or feel nauseous and do not want to eat.  A protein drink if often an easy and satisfying source of much needed nutrients and calories.

Studies show that when silymarin from milk thistle seeds was administered before platinum chemotherapy  there was a marked decrease in kidney cell damage.  Remarkably, normal cells were protected and there was no apparent interference with or reduction of effect of the platinum chemotherapy drugs.

Oxidative stress and kidney damage may peak within one hour of drug exposure, the damage continues on until it is quenched by anti-oxidants. Chemotherapy drugs typically exhaust our own innate anti-oxidant systems. This is one reason they kill fast growing cancer cells, but it is also why cells with higher rates of turnover and metabolism such as nerve cells, brain cells, heart muscle, the lining of the digestive tract , hair follicles and kidney tubules are so vulnerable to chemotherapy drug side effects with agents that act on cancer cells by increasing oxidative stress.

Good management in an Integrative Cancer Care plan involves careful selection of  high quality botanical  and nutritional supplements that will mitigate side effects without interfering the therapeutic actions of the cancer treatment while at the same time offering protection from toxicity and damage as well and preserving  normal function.  This will be different with different drugs. Therefore it is important to consult with a health care professional with experience and knowledge of drug-nutrient and drug-herb interactions.

Not all interactions are bad. In fact some drug-herb and drug-nutrient interactions actually may enhance and improve drug efficacy and may even decrease chemo-resistance which is the predicament wherein cancer cells adapt and change so that they are no longer effected by the drugs.  Some cancer cells are so smart that they develop a pump mechanism for moving the toxic drug back outside of the cell!!!  This is one reason cancer is so challenging to treat. All the better to find ways to improve treatments and decrease side effects and drug resistance.

Milk Thistle is an herbal medicine that is a multi-tasker and has many effects on cancer physiology as well as its protective effects against kidney damage and loss of kidney function.  It is one of the main herbs used to protect the kidneys from the chemotherapy side effects of cisplatin, oxaliplatin and carboplatin.  Milk Thistle is well known as an herb that enhances inflammation function and protects liver function.  It is therefore a suitable herb to consider for patients undergoing and recovering from exposure to toxic chemicals and drugs.

Patients receiving platinum chemotherapy drugs also experience the side effect of neuropathy or nerve damage and nerve pain, usually in the hands and feet.  The damage to nerves is also caused by oxidative stress.  Therefore quenching the cascade of damaging electrons and providing nourishment for the restoration of healthy nerve function is essential as chemotherapy induced neuropathy may linger as a long term side effect.  L-Carnitine, L-Glutamine, Lipoic Acid, N-Acetyl-Cysteine as well as Omega 3 Fatty Acids are a good strategy for restoring healthy nerve function after chemotherapy.   Both Acupuncture as well as Milk thistle has also been traditionally used to normalize liver dysfunction and associated nausea side effects of chemotherapy.

Acupuncture is also a useful supportive therapy for patients undergoing chemotherapy, radiation therapy, surgery and suffering from side effects of hormonal treatments.

Learning to choose foods rich in antioxidants will give you even more protection on a daily basis.  All of the recipes on our site a rich in plant antioxidants.  Additionally many herbal medicines are particularly concentrated in these protective phytochemicals.  Eating a wide range of color in your diet guarantees that you are eating a diet rich in antioxidants.

 

By: Dr Nalini Chilkov

Posted in Acupuncture, Chemotherapy, Complementary Therapies, Treatments & Side Effects | Tagged , | Leave a comment

 

Do you remember what you had for dinner last night?  Or for breakfast this morning? 

Was it enjoyable?  Delicious?  Satisfying? 

Hot?  Cold?  Spicy?  Crunchy?  Smooth? 

Were you relaxed?  Tense?  Happy?  Rushed?  Anxious?  Bored?

How often are you truly aware of why, when, what, how and how much you eat?  Do you eat when you are bored or dealing with certain emotions?  Or on a regular schedule even if you are not hungry?  And why does it matter?

When we consistently eat without paying attention, our health eventually suffers.  How often have you eaten squishy French fries, stale corn chips, “cheese” made from a powder or an entire box of cookies?  Did you connect your stomach-ache, fatigue or bad mood to the food you had eaten?   

The first step to mindful eating is to determine WHY you eat.  Often, people will eat when they are bored or trying to avoid doing something else, or just because it is “lunch-time” or “dinner-time”.  Check in with your body to see if you are truly hungry.  It could be that you are thirsty instead.  Try having a glass of water and wait a few minutes.  If you are hungry, make your best effort to have something that actually has nutritional value.  An apple and a small handful of almonds is the ultimate “fast food”. 

Next, take a look at HOW you are eating.  Perhaps you are in the car or at your desk doing 3 other things at the same time.  Take baby steps to make meal time just that – time for your meal.  Try to avoid distractions and multitasking. 

Finally, really chew and taste the food you are putting into your body.  If you gulp your meals, your digestive system must work overtime and you could very well end up with heartburn, a stomach ache or worse.  Our taste buds have been deadened and coated from years of processed foods which is often the reason many people claim to not like vegetables – the flavors are simply too pure and clean!  Many flavors don’t truly come out until the food is broken down completely. Vegetables release their sweetness after being well-chewed.  At your next meal, take small bites and try to chew each one at least 20 times before swallowing.  See if you notice anything different! 

Remember…if something isn’t worth savoring, substitute it with something that is!

By: Cheryl Rojic

Posted in Daily Matters, Nutrition | Tagged | Leave a comment