Follow me on my journey as I heal from Breast Cancer.
In March of 2011 I was diagnosed with breast cancer. I decided to have a bilateral mastectomy three weeks after my diagnosis. I tested positive for the gene and this seemed the best way to heal.
After my surgery I started looking for a support group my spouse and I could attend with other lesbians. I was shocked, surprised and angered that I couldn't find something in the greater Denver metro area.
It's this need for support that brings me to this blog. I will share what I learn as I heal, bringing you links to educate myself and anyone who joins me in nutrition, mind body spirit healing and general cancer information.
My approach to life is holistic, the glass is always half full and some how I'm having experiences so my soul can grow and experience.
Let me know your thoughts, connect with me, let's support each other.
Just know, I will share my story, what's important to me on this journey. I'm not a health care provider nor do I recommend you follow in my footsteps. Each of us knows what path is right as we dance with cancer, this is my way.
Namaste
A Lesbian's Journey with Breast Cancer
January 12, 2012 Things They Don’t Tell You Before Your Mastectomy Part 1
Something weird happens to your brain when you are told you have a cancer in your breast. All of a sudden you are running and I mean running to get this thing out of you and along that run you possibly forget things the Doctors tell you.
For some, the Doctors never tell you. For most of us, we forget what they tell us. That's one reason why you bring someone with you for those all-important consultations and you go to the appointment with as many questions as you or those around you can think of.
As a lesbian, my wife and I were very focused on what would give me the best chance for full healing and would my medical team treat my wife like all other spouses. We did research before our appointments but we still did not ask the questions that I wish I'd known to ask before surgery.
Things like, how will this double mastectomy change my body?
How much pain can I expect 6 months, 1 year and later in life after surgery.
We did ask about surgery complications but not about complications long after surgery.
We knew about lymphedema when nodes were taken but not how the removal of nodes would impact nerve pain down the road.
I read many message boards and the women there told of returning to work in a couple of weeks, part time, but returning to work. Here I am 9 months later and I still don't understand how they did that, and I've not had chemo or radiation. All of a sudden I think of myself as a wimp and I know better.
I was lucky to enter physical therapy with a lymphedema specialist three weeks after surgery. I had to wait three weeks because it took me that long to move my arms enough to safely drive. My therapist has saved me from so much of what is a by-product of mastectomy.
I have full range of motion, no lymphedema issues and a real understanding of what this surgery means to me long term.
Even with this guidance, I've had muscle spasm that makes it difficult to walk. Who knew muscle spasm in my chest could impact the way I walk. It's true all those muscles are connected. Often a pain in my chest means a pain in my butt - kind of cracks me up.
It's taken months to understand why that tight band around my chest I woke up from surgery is and what to do about it. Stretch those peck muscles and the band lessens. I now know about something called, Post Mastectomy Pain Syndrome.
It explains so much of what I feel today, I now understand my random pains, burning sensations, and muscle spasms and overall feeling of exhaustion are normal and have a name. I now have permission to accept I am still healing even nine months later.
For those of you who have had a bilateral mastectomy without reconstruction, what are you feeling today? How are you doing?
December 19, 2011 Overcoming Our Unhealthy Food Culture
This is a wonderful article by Kelly Hayford that speaks to the core issues with our food supply and eating habits. As someone who is healing from Cancer, this article has been of particular interest to me.
I know that when I eat clean food, when I eat primarily organic veggies, fruit and meat, I lower my risk of future cancer and I heal from having had a cancer in my breast.
If you are interested in preventing cancers in your life or the lives of your children, then read Kelly's suggestions here .
It's been almost ten months since my diagnosis and surgery. In some ways life is back to normal and in many, life will never be what it once was.
My body is changed forever, looking in the mirror; I'm still surprised that this is my chest - my new look. Seems to be something others notice too. Can't tell you how many times people have stopped me going into a public bathroom. It's become rather fun to mess with people who find themselves confused about my gender. Yes, humor in everything.
I've had a near flawless recovery; my only issue has been muscle spasms. Seems the muscles in your chest are connected to the muscles in your leg. Who knew, seems I kind of remember something about this from school anatomy, but lately I've been acutely reminded of the connection.
My physical therapist has used dry needle trigger point therapy to help the muscle relax. It's a love hate with the process. For just a minute the needles hurt, but then the next day or two I'm better. Very effective, not so pleasant in the moment.
The muscles tighten in my chest as a result from the mastectomy; no one tells you what that tight band is around your chest when you wake up. Seems the nurses and doctor don't really address it.
My physical therapist explained it to me and it made so much sense. During surgery those muscles become inflamed as the breasts are removed. Then your body has to adjust to the loss of the breast weight, in my case almost 7 pounds, so your posture changes. Then as life progresses and you heal, you use your arms more and the other muscles become affected and before you known it, you have muscle spasms in your leg. All because you are well enough to do more in life.
Still better than many of the side effects of having had a cancer in one's breast.
December 4, 2011 Breast Cancer in Lesbian and Bisexual Women(From The Komen Foundation)
Important Statistics
An increasing number of research
studies in recent years suggest that lesbian, gay, bisexual and transgender
(LGBT) individuals are at greater risk than the general population to suffer
adverse health outcomes. A review of the literature explored cancer-related
screening behaviors, risk factors, and self-reported breast cancer histories
among lesbian and bisexual women. (Cochran et al., 2001).
·Lesbian and
bisexual women are less likely to undergo routine mammography screening.
This may be explained by fewer triggers to seek routine gynecologic care and
lower rates of insurance due to the absence of spousal health insurance.
(Cochran et al., 2001).
·Lower rates
of screening might result in later detection of cancers, thereby increasing
morbidity and mortality rates. (Cochran et al., 2001).
·Lesbian and
bisexual women are less likely to have had a full-term pregnancy (Cochran et
al., 2001), a risk factor for breast cancer. (American Cancer Society [ACS],
2009).
·Lesbian and
bisexual women are more likely to be overweight (Cochran et al., 2001), a risk
factor for postmenopausal breast cancer. (ACS, 2009).
·Lesbian and
bisexual women are more likely to consume alcohol at higher rates.
(Cochran et al., 2001), a risk factor for breast cancer. (ACS, 2009).
·Lesbian and
bisexual women are more likely to have negative experiences with practitioners
and mistrust the health care community. (Cochran et al., 2001).
Other studies have found that the
experience of homophobia and heterosexism within the health care system is
related to avoidance of routine health care screenings by lesbian and bisexual
women. (McNair, 2003).
Limitations of the Data
The question of whether or not LGBT
women are at an increased risk for developing breast cancer is an emerging
research question in public health. (Cochran et al., 2001). However, in
the past twenty years, there has been limited research on health disparities
experienced by sexual and gender minorities.
·LGBT individuals
represent a small and largely hidden subpopulation, with lesbians representing
approximately 3 percent to 4 percent of adult women. (Cochran et. al., 2001).
·Most studies
of LGBT health behaviors have used small convenience samples from community
settings without heterosexual controls. (Cochran, 2001).
·Little
research has been directed towards LGBT individuals. Between 1980 and
1999, only 0.1 percent of the MEDLINE database focused on LGBT individuals.
(Boehmer, 2002).
·Between 1982
and 1992, there was a disproportionate allocation of funding by the National
Institutes for Health for LGBT-related research that focused more on HIV
(average $20 million annually) in comparison to funding for LGBT-related
research for all other diseases (average $532,000 annually). (Boehmer, 2002).
·This data
indicates that public health research neglected the LGBT population and that
LGBT persons are underrepresented as explicit research subjects in breast
cancer research. (Boehmer, 2002).
December 4, 2011 What Healthcare Providers Can Do to Support GLBT Cancer Patients
1.Ensure intake forms and
questions are welcoming, e.g., ask about a patient’s partner rather than
husband or wife.
2.Acknowledge the relationship of
your patient. Treat the patient’s partner as you would a husband or wife of one
of your patients.
3.Educate yourself on language
used and cultural differences of the GLBT population.
4.Learn about GLBT sexuality and
sexual practices to better understand how cancer and treatment may impact
patients.
5.If you are unsure, it is okay
to ask about an individual’s sexual orientation.
6.Be aware of your own biases in
working with the GLBT population.
7.Implement a visible
non-discrimination policy that includes gender identity and sexual orientation.
8.Provide inclusion training to
staff on GLBT population.
9.Become knowledgeable on other
issues or barriers GLBT patients may be experiencing, such as lack of access to
insurance through a partner, lack of legal recognition of a same-sex
relationship, or lack of family support due to their sexual orientation.
December 4, 2011 Can these Vegetables Fight Breast Cancer
A new study has found that a
compound in parsley and other plant products, including fruits and nuts, can
stop certain breast cancer tumor cells from multiplying and growing.
In the study, rats with a certain
type of breast cancer were exposed to apigenin, a common compound found in
parsley and other plant products. The rats that were exposed to the apigenin
developed fewer tumors and experienced significant delays in tumor formation.
Science Daily reports:
"Apigenin is most prevalent in
parsley and celery, but can also be found in apples, oranges, nuts and other
plant products. However, apigenin is not absorbed efficiently into the
bloodstream, so scientists are unsure of how much can or should be
ingested."
Dr. Mercola's comments:
A healthy lifestyle, one that
includes eating plenty of fresh, raw vegetables, can not only help prevent
cancer, it may help treat it as well. This study from University of Missouri
researchers is the latest to show that compounds in plant foods, in this case
one called apigenin, are natural cancer fighters.
The study found that rats with
breast cancer developed fewer tumors and had delays in tumor formation when
exposed to apigenin, a compound found naturally in parsley, celery and many
other plant foods, such as apples, oranges and nuts.
How do Veggies Help Fight Breast
Cancer?
The apigenin in celery and parsley
appears to block the formation of new blood vessels within tumors, thereby
cutting off their nutrient supply and slowing or stopping their development.
This healing, restorative power of vegetables has been researched and known for
some time, but remains largely obscured and overshadowed by the massive
marketing of pharmaceutical drugs.
For example, one 2001 study
revealed that women who consumed at least 2.5 servings of fruit and vegetables
daily as adolescents were 46 percent less likely to develop ovarian cancer. I
can't think of any drug that can beat those prevention odds.
As a general rule, when it comes to
eating veggies the greater the variety and the larger the volume, the better.
Tailoring your vegetable consumption to your nutritional type is also recommended
to take your health to the next level.
But aside from celery and parsley,
broccoli and even more so, broccoli sprouts, have also emerged as powerful
cancer fighters. Sulforaphane, a type of isothiocyanate compound found in
broccoli, has been found to potentially help treat breast cancer by targeting
cancer stem cells, which fuel the growth of tumors.
More Support for Cancer-Fighting
Veggies
The isothiocyanate in cruciferous
vegetables like broccoli sparks hundreds of genetic changes, activating some genes
that fight cancer and switching off others that fuel tumors.
As stated in a study published in
Carcinogenesis, sulforaphane has been shown to reduce the incidence and rate of
chemically induced mammary tumors in animals. It also inhibits the growth of
cultured human breast cancer cells, leading to cell death.
Said lead author Olga Azarenko:
"Breast cancer, the second
leading cause of cancer deaths in women, can be protected against by eating
cruciferous vegetables such as cabbage and near relatives of cabbage such as
broccoli and cauliflower."
Other studies have confirmed the
protective benefits of these vegetables for other types of cancer as well, such
as:
Bladder cancer -
Researchers found that the higher the intake of cruciferous vegetables, the
lower the risk of bladder cancer in men
Lung cancer -
Researchers found that men with detectable amounts of isothiocyanates in their
bodies had a 36 percent lower chance of developing lung cancer over 10 years
Prostate cancer
- This study, published in PLoS ONE in 2008, discovered that just a few
additional portions of broccoli each week could protect men from prostate
cancer
An Easy Way to Eat More Veggies
Despite the well-known health
benefits of veggies, a Consumer Reports survey found that only 30 percent of
Americans eat five or more servings of vegetables or fresh fruit daily.
If you want to increase your veggie
consumption, one of the absolute easiest and most efficient ways to do so is to
juice your vegetables.
Not only will juicing help your
body absorb all the nutrients from the vegetables by making them easily
digestible, but you're also avoiding the risk of damaging any of their
sensitive micronutrients through cooking, which destroys micronutrients by
altering their shape and chemical composition.
It also allows you greater freedom
to add a wider variety of vegetables to your diet that you may not normally
enjoy eating whole. This way, you're working with the principle of regular food
rotation, which will lessen your chances of developing food allergies, while
also getting a wider variety of nutrients.
Celery and parsley happen to be two
of the easiest vegetables to juice and they are delicious when combined with
leafy greens and limes. When juicing your veggies I recommend also eating the
pulp. I typically add freshly chopped onions and avocados, plenty of Himalayan
salt, some balsamic vinegar and four lightly poached eggs so it really is a
full meal that allows me to get all of the nutrients from the vegetables.
For more in-depth guidelines and
information about juicing, review the juicing section of my nutrition plan.
More Tips for Breast Cancer
Prevention
One woman in eight who lives to age
85 will develop breast cancer, and 200,000 new cases will be diagnosed each
year in the United States, making it three times more common than other
gynecological cancers.
Unfortunately, the current medical
paradigm is relatively clueless about what causes breast cancer and how to
effectively prevent and treat it.
In the largest review of research
into lifestyle and breast cancer, the American Institute of Cancer Research
estimated that about 40 percent of U.S. breast cancer cases could be prevented
if people made wiser lifestyle choices. I believe these estimates are far too
low, and it is more likely that 75 percent to 90 percent of breast cancers
could be avoided by strictly applying the recommendations below.
Avoid sugar, especially fructose.
All forms of sugar are detrimental to health in general and promote cancer.
Fructose, however, is clearly one of the most harmful and should be avoided as
much as possible.
Optimize your vitamin D. Vitamin D
influences virtually every cell in your body and is one of nature's most potent
cancer fighters. Vitamin D is actually able to enter cancer cells and trigger
apoptosis (cell death). When JoEllen Welsh, a researcher with the State
University of New York at Albany, injected a potent form of vitamin D into
human breast cancer cells, half of them shriveled up and died within days. The
vitamin D worked as well at killing cancer cells as the toxic breast cancer
drug Tamoxifen, without any of the detrimental side effects and at a tiny
fraction of the cost. If you have cancer, your vitamin D level should be between
70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment
I'm aware of, with no adverse effects. I suggest you to watch my one-hour free
lecture on vitamin D to find out what your optimal vitamin D levels should be
and how to optimize them.
Get plenty of natural vitamin A.
There is evidence that vitamin A also plays a roll in preventing breast cancer.
It's best to obtain it from vitamin A-rich foods, rather than a supplement.
Your best sources are organic egg yolks, raw butter, raw whole milk, and beef
or chicken liver. However, beware of supplementing as there's some evidence
that vitamin A can negate the benefits of vitamin D. Since appropriate vitamin
D levels are crucial for your health in general, not to mention cancer prevention,
this means that it's essential to have the proper ratio of vitamin D to vitamin
A in your body. Ideally, you'll want to provide all the vitamin A and vitamin D
substrate your body needs in such a way that your body can regulate both
systems naturally. This is best done by eating colorful vegetables (for vitamin
A) and by exposing your skin to sun every day (for vitamin D).
Avoid charring your meats. Charcoal
or flame broiled meat is linked with increased breast cancer risk. Acrylamide-a
carcinogen created when starchy foods are baked, roasted or fried-has been
found to increase breast cancer risk as well.
Avoid unfermented soy products.
Unfermented soy is high in plant estrogens, or phytoestrogens, also known as
isoflavones. In some studies, soy appears to work in concert with human
estrogen to increase breast cell proliferation, which increases the chances for
mutations and cancerous cells.
Improve Your Insulin Receptor
Sensitivity. The best way to do this is by avoiding sugar and grains and making
sure you are exercising, especially with Peak 8.
Maintain a healthy body weight.
This will come naturally when you begin eating right for your nutritional type
and exercising. It's important to lose excess body fat because fat produces
estrogen.
Drink a quart of organic green
vegetable juice daily. Please review my juicing instructions for more detailed
information
Get plenty of high quality
animal-based omega-3 fats, such as krill oil. Omega-3 deficiency is a common
underlying factor for cancer.
Curcumin. This is the active
ingredient in turmeric and in high concentrations can be very useful in the
treatment of breast cancer. It shows immense therapeutic potential in
preventing breast cancer metastasis. It's important to know that curcumin is
generally not absorbed that well, so I've provided several absorption tips
here.
Avoid drinking alcohol, or at least
limit your alcoholic drinks to one per day.
Breastfeed exclusively for up to
six months. Research shows this will reduce your breast cancer risk.
Avoid wearing underwire bras. There
is a good deal of data that metal underwire bras increase your breast cancer
risk.
Avoid electromagnetic fields as
much as possible. Even electric blankets can increase your cancer risk.
The majority of breast cancer is
preventable, but in the event you or anyone you know is diagnosed with cancer,
I strongly encourage you to listen to my interview with Dr. Nick Gonzalez, a
physician focused on alternative cancer treatment using a three-pronged
nutritional approach.
I liked this article because it reminds me to tell my LGBT friends to do their screenings and why it's important to do so. Some of our Life Ways create an environment for a cancer in our breasts. Enjoy, I hope you find it of interest.
So far, the information we have on breast cancer in lesbians has been both limited and contradictory. The large national cancer registries and surveys do not collect data about sexual orientation, leaving lesbians embedded and invisible among this vast wealth of information. Other ethnic, geographic and racial groups have been able to use the data gleaned from these statistics to develop programs to erode the health disparities they face. They know precisely how prevalent cancer is in their communities. We don't.
Some research has been conducted that specifically addresses lesbian cancer risks and experiences, but the results have been inconsistent. In almost every case, the sample sizes have been too small for us to draw reliable conclusions. We need more organizations like the Lesbian Health Research Center at the UC Medical Center in San Francisco and major financial backing to develop solid data about lesbians and cancer.
While we still await definitive state-of-the-art research, some people currently believe that lesbians have an increased risk of developing breast cancer, based on a "cluster of risk factors" theory. Certainly, there is no physiological or genetic difference between lesbians and heterosexual women. The increased risks are a result of behaviors that are a result of the stress and stigma of living with homophobia and discrimination. Each of these behaviors carries with it an increased risk of cancer.
Taken together, as a cluster, they could more than double a lesbian's chance of getting cancer. Again, the data on these behaviors is mixed in its results and it important to remember that many people with known risk factors never develop cancer.
The four most-cited cancer risk factors in the research on lesbians and breast cancer risk are:
• Cigarette smoking - data suggest that lesbians smoke cigarettes at a substantially higher rate than heterosexual women.
• Alcohol use - some research reports higher rates of heavy drinking among lesbians than heterosexual women
• Obesity - some studies report that lesbians are more likely to be overweight or have a BMI over 25.
• Pregnancy - lesbians are less likely to have biological children before age 30, which would offer some protection against cancer.
The research on lesbian cancer screening rates is consistent, disturbing, but not surprising. In every location surveyed, lesbians reported lower rates of mammography, colonoscopy and pap smears than their heterosexual counterparts, due to a combination of limited financial access and perceived unwelcome. To begin with, lesbians are less likely to have adequate health insurance coverage than heterosexual women, as most employers do not offer coverage for unmarried domestic partners.
Even when cost is not a factor, previous or feared negative responses from health care providers keep too many lesbians from seeking routine screenings. Provider insensitivity and ignorance follows the unwelcome that begins in the waiting room with the magazines and medical forms that do not match our lives. Until health care facilities and providers become knowledgeable, respectful and safe for lesbians, even free screening services will continue to be underutilized.
Unfortunately, this can also result in cancers being detected at later stages when the prognosis is worse.
I live in New York City and do not have cancer. Sometimes, I imagine a lesbian who has just been diagnosed with cancer and is living in a small town in Utah or Iowa, not in one of the few cities with lesbian cancer programs. I wonder if it is safe for her to be out to her oncologist.
This woman doesn't have the option of joining a lesbian cancer support group.Will she go to a group that is comprised of heterosexual women? Will she feel safe being out there? Her partner can't go to a caregiver group for lesbians. And do we really think she'll be comfortable talking about the effects that chemo has on her sex life in a roomful of men?
I picture the two of them using the internet to learn more about their cancer and survivorship issues. Whenever I visit a website, I pretend I am this couple and type the word "lesbian" in the search box. More often than not, the search produces no results. Invisible still.
We need solid research about the breast cancer risks of lesbians. We need health care facilities and cancer organizations to respect our "families" and lives. We need to find information about our cancer experiences on all major cancer websites. There are many of us, committed activists and organizations, across the country working on these issues right now. It will take all of us to make a difference.
This article, written by Liz Margolies, LCSW, first appeared on Dr Susan Love's Research Foundation website
December 4, 2011 YOUNG GIRLS MAY HOLD KEY TO BREAST CANCER
By Lindy Washburn, staff writer
What if you could do something to
save your daughter from ever developing breast cancer?
Would you insist on breastfeeding her
as an infant? Never use plastic while microwaving her food? Guide her to an
active lifestyle, with exercise each day? Prepare meals from scratch? Make sure
the school did, too? Buy organic?
We've all heard of changes in diet
and lifestyle to prevent cancer in adults. But it looks more and more as if a
cancer-free adulthood is determined years earlier -- maybe even before birth.
If my own experience raising kids is
a guide, these things are easier said than done. But having recently come
through cancer treatment myself, I'd want to do anything I could to prevent my
children from ever having a doctor tell them they have cancer. First, however,
I'd like to know which recommendations are supported by scientific evidence.
Answers may be coming.
Scientists now are focusing on
childhood development and environmental influences as factors in certain
cancers. One of the hottest topics: the declining age of sexual maturity in
girls and its links to breast cancer.
Girls who have their first period
before age 11 are at triple the risk for breast cancer, compared to those who
have it after. Those who have it before age 12 are at double the risk.
The link between early puberty and
breast cancer is estrogen. The greater the lifelong exposure to estrogen, the
greater the risk of breast cancer. The years between a girl's first period and
her first pregnancy -- when her breast cells have not differentiated and are
multiplying rapidly -- appear to be a time of particular vulnerability to
mutation or environmental damage.
The audience always gasps when Elisa
Bandera, an epidemiologist at The Cancer Institute of New Jersey, presents
those facts.
Bandera's "Jersey Girls
Study" is one of a few around the country - and the only one in New Jersey
-- trying to tease out the environmental, hormonal and nutritional factors
involved in causing early puberty.
"I want to go beyond
breast-cancer prevention and help these girls," Bandera says. "I want
to understand what causes early puberty -- not just menarche [the arrival of
the first period], but breast development and pubic hair growth. We're looking
at diet and physical activity, collecting body measurements, asking about
environmental exposures, even prenatally and in early childhood.
She's especially interested in diet
and whether eating organic food can delay the onset of puberty.
A girl's genes set the tempo of
puberty's arrival -- her timing will be similar to her mother's, for the most
part. But the variation from one generation to the next is more than half
determined by environmental influences, experts say.
The arrival of a girl's first period
is the last step in a series of changes that generally unfolds over a 41⁄2-year
period, beginning with the production of new hormones and usually proceeding to
breast development, growth of pubic and underarm hair and menstruation.
Today's mothers know that their
daughters and daughters' friends develop sexually at younger ages than the
mothers did. Ilise Zimmerman, a women's health agency executive from Haworth
who also coaches girls' basketball, says she's amazed each year at the
voluptuousness of her 12-year-old players. "We see it when we order T-
shirts," she says. "There are no size 'smalls.' "
While the age at first menstrual
period has declined slightly over the last two decades, the onset of the other
signs of puberty is dropping faster, and appears to be influenced in part by
different factors.
"They moved up that little talk
they do for the girls now to fourth grade," says Monica Dottino, a Mercer
County mother of four whose 10- year-old daughter is part of the study. "A
lot of parents don't want to talk about it."
Puberty at age
As early as the third grade, nearly
half of African-American girls and 15 percent of white girls begin breast
development or pubic-hair growth. The average age to begin breast development,
according to a landmark 1997 study, is 8 years and 9 months for African-
American girls and around the 10th birthday for white girls. The cause of the
racial difference is not known.
So many girls now begin puberty at
younger ages that the Pediatric Endocrine Society officially lowered the
definition of precocious puberty, from 8 years old to 6 for African- American
girls and 7 for white girls.
The Jersey Girls Study -- which is to
include approximately 150 9- and 10-year-olds -- asks whether the girl was fed
breast milk, milk formula or soy as an infant; whether she sucked on a
pacifier; and what her birth weight and growth rate were, among other
questions. The girl's physician and mother report periodically on her physical
maturation. The girls are asked to spit in a cup so their DNA can be extracted
from the saliva. Their urine is tested for chemical compounds and hormones.
Their food consumption for three days in a two-week period is analyzed.
"It makes you realize how many
things go on in a day that affect a child's health," says Dottino, the
Mercer County mom. "We had to track hair products, shampoos, perfumes,
everything she ate."
Dottino's own mother had breast
cancer 15 years ago, so she values the study's potential contribution to
breast-cancer prevention. "It was pretty interesting to track
everything," she said. "You look at all the crap these kids
eat."
Michele King of Lawrenceville, the
mother of five girls ages 2 to 13, has two daughters in the study. She says
that "using organic dairy products has always been part of what we did,
but five years ago, we expanded to more natural products throughout our
diet." The girls complained a bit, especially about the whole-grain
cookies.
The study showed the girls that
"it's not just Mom and Dad who think about this," King says.
"Other people do, too. There must be something to it."
She adds: "I'll be curious to
see where this all goes."
Early puberty has other downsides
besides the future risk of breast cancer. It's associated with more risky
behaviors, such as smoking, drinking and unprotected sex, and depression and
anxiety. That is not to say, of course, that all girls with early periods turn
out that way, but the risk is greater.
"We have to have the
conversation earlier" about the consequences of early sexual activity,
says Zimmerman, chief executive of the Northern New Jersey Maternal-Child Health
Consortium and the mother of two daughters.
Obesity a factor
Scientists are concentrating on two
broad factors associated with puberty's early onset: obesity and hormonally
active chemicals in the environment.
"Girls who are heavier go into
puberty earlier," says Dr. Frank Biro, a pediatrician and the principal
investigator in a study of 400 girls at the University of Cincinnati College of
Medicine. American girls eat more
than they did 30 years ago and exercise less. Childhood obesity is three times as
common. Fat is related to hormone levels.
Not only does
"over-nutrition" contribute to earlier onset of puberty, but exercise
-- by upping the production of certain hormones and taking weight off -- delays
it.
At the same time, girls today live in
a world with microwave ovens, computers, and fertilized and bio-engineered
lawns and crops.
"We've become a plastic nation
-- a plastic nation that super-sizes everything," Biro says. "It's
the chemicals we're all exposed to by putting plastics in microwaves, using
cleaning agents around the house and spreading lawn-care products on the
grass" that, in combination, can mess with hormone levels.
Research in 2002 found that the
combination of 11 different chemicals people are exposed to in everyday life,
each present below the level known to cause any observable effect, produced a
cumulative effect. When all were present together, "Poof! There was an
estrogenic effect," Biro says. "I find that incredibly
sobering."
Phthalates, the substances that make
plastic soft and pliable, are used in food packaging, IV tubing and
personal-care products. They've been found in breast milk and in the urine of
average Americans, and are the subject of intensive study about their possible
role in cancer, early puberty in girls, low sperm counts and male reproductive
disorders.
California became the first state to
ban phthalates in toys and baby products in October. The European Parliament
also banned some forms of plasticizers and restricted others in children's
items in 2005. Canada has had voluntary restrictions in place since 1998. Not
New Jersey.
"We shouldn't be nuking anything
that isn't in glass or porcelain in our microwaves," says Biro, ruefully
describing his own past history of reheating Saran-wrapped leftovers. "I
was dosing myself with phthalates." Microwaving can cause phthalates to
leach into food, according to a fact sheet prepared by the federally funded
Breast Cancer and the Environment Research Center at the University of
Cincinnati.
Common-sense steps
What else should a parent do? For the
most part, the recommendations about preventing early puberty, at least so far,
are common-sense approaches to good health.
Help your kids maintain a healthy
weight. Encourage physical activity. Eat plenty of fruits and vegetables.
When I asked Bandera, the mother of a
10-year-old daughter and a 14- year-old son, how she combined her role as a
scientist and a mother in raising her kids, she said there's no need to overdo
it.
She buys healthy food, including
whole grains, organic milk, and plenty of fruits and vegetables, and tries to
cook from scratch. She tries to keep her kids active. And she models the
healthy choices she'd like them to make: She doesn't smoke or drink; she
controls her weight and stays active.
"They're going to be exposed to
other things sooner or later," she says, "but they will know what the
good choice is. That's all you can do. Then you hope for the best."
I have two sons and no daughters. But
I think this is sound advice for all of us, if we want to spare our children
the suffering of cancer.
Participants still being sought
The Jersey Girls Study is still
recruiting participants.
Healthy 9- and 10-year-old girls who
live with their biological mothers are eligible. Girls who are twins, triplets
or other multiples, or who have certain chronic health conditions, are not
eligible.
The girls will receive a free
analysis of their dietary intake, body measurements (including percent body
fat), a $25 gift card and some cute knickknacks.
The study is a collaboration of The
Cancer Institute of New Jersey, the Robert Wood Johnson Medical School, UMDNJ's
School of Public Health, and the Environmental and Occupational Health Sciences
Institute.
If the number of potential
participants from northern New Jersey warrants, says Dr. Elisa Bandera, the
principal investigator, the research team will arrange with a local hospital or
pediatrician's office to assess the girls on a single evening, or a series of
evenings.
For further information, call
732-235-9860 or e-mail jerseygirlstudy@umdnj.edu.
October 31, 2011 Direct-to-implant procedure with Dr. Lisa Hunsicker
By Holly Hatch
For the past eight years Dr. Lisa Hunsicker, who specializes in breast and body contouring, has helped pioneer a direct-to-implant procedure where breast cancer mastectomy patients are able to emerge from surgery fully reconstructed. At her private practice, Revalla Plastic Surgery and Medical Aesthetics in Littleton, Hunsicker began implementing this less common technique because she knew there had to be a better way to help breast cancer patients cope with the loss of their femininity and the multiple invasive surgeries. Hunsicker discusses the benefits of reconstruction and the importance of options for women regarding their bodies.
Why is the direct-to-implant procedure such an innovative step? Traditional breast reconstruction that occurs after a mastectomy involves at least two, sometimes three surgeries for a patient to be fully reconstructed. When I perform the direct-to-implant procedure, the implant is placed as part of the same surgery as the mastectomy, allowing for the patient to wake up fully reconstructed. Any revisionary surgeries that take place are usually only performed to improve the cosmetic result, or to address nipple reconstruction if nipple-sparing has not been an option.
What has your experience with women who have had this procedure been like? All women appreciate options - and they seem to be much more grateful to have solutions presented to them when under the stress of a cancer diagnosis. I consult with each of my patients about which reconstruction method makes the most sense for them. It's a very personal decision, and one that only they can make. I believe that giving patients choices about their course of treatment helps restore some of their power and confidence, and they seem to engage more fully in their treatment knowing that they've made a deliberate choice about how to proceed.
What does it save the patient? A single-stage procedure means one set of surgeon's fees, one anesthesia fee, and one facility fee - versus two of each with traditional reconstruction. Most importantly though, it saves women from having to disengage in the part of their femininity associated with having breasts, by allowing them to wake up from surgery with fully reconstructed breasts. The emotional component to this disease should not be discounted.
What is the most difficult part of plastic surgery reconstruction? The most challenging aspect of breast cancer reconstruction is increasing awareness among women regarding their options. In 2009, there was a statistic published by the American Society for Plastic Surgeons that almost 70 percent of women who were eligible for breast reconstruction were not informed of their options - 70 percent! So as women, we need to keep the conversation going so that we can make informed decisions regarding our treatment. We need to advocate for our friends and loved ones, and educate each other.
What does having breasts do for a woman's confidence? Why is reconstruction essential? For many women, having breasts is integral to their femininity, and thus their identity. Being able to wake up from mastectomy surgery and look down to see a pair of fully reconstructed breasts helps mitigate the loss of self that many breast cancer patients have the potential to experience. It's challenging for anyone to feel like they're their most confident-selves when their identity is compromised. So for the patients I encounter, reconstruction is an essential option in helping them heal, allowing them to reclaim their vibrancy and life after a breast cancer diagnosis.
October 15, 2011 Most LGBTs aren’t out to doctors, Colorado survey shows
By Matthew Pizzuti
October 6, 2011 | 3:07 pm
A survey of LGBT health care experiences found fewer than half of LGBT Coloradans and only 30 percent of transgender respondents report sufficient access to "friendly" health care providers.
One Colorado, a statewide LGBT advocacy group, released results Sept. 26 from its 2011 LGBT Health Survey to Out Front Colorado and small group of policy experts, health care practitioners and community members. The survey had 1,193 Colorado respondents share their experiences with doctors, how often they access health care and their top priorities for improving care.
One Colorado's director Brad Clark said he heard "heartbreaking stories" about discrimination in the healthcare system from focus groups held before the survey, and in comment sections on the survey itself.
Among the stories: one respondent said that physicians "assume I'm mentally ill because I'm transgender ... instead of taking my health issues seriously, I get brushed off as just needing psychological help. I haven't been able to get the help I need for my health problems."
One Colorado provided several comments from the survey, withholding names.
One respondent wrote, "Doctors ... don't want to acknowledge us as a couple," while another complained that a provider awkwardly kept referring to her committed partner as a "lady-friend."
Yet another respondent said a doctor didn't want to touch her after learning she was a lesbian.
Some comments described experiences with doctors who lack knowledge in LGBT health concerns - particularly with trans patients.
"I haven't met a single doctor who knows more about HRT [Hormone Replacement Therapy] than I do, and that seems backward," said one responder.
The survey questions were based in part on concerns One Colorado heard in focus groups held throughout the state, Clark said. In the survey, One Colorado sought to understand how being "out" to a provider is connected to a patient's perceptions on whether her or his physician is LGBT-friendly, and how those factors relate to the patient's experiences and quality of care.
"We gained insight in how to fix it," Clark said.
A steering committee of experts and LGBT people will analyze the data and make recommendations later this year.
"Institutional policy change is going to be our focus," Clark said.
Clark said recommendations might include things like training for providers, improving intake forms in doctors' offices, and making hospitals and the LGBT community aware of their rights - including a 2010 executive order from President Obama expanding LGBT visitation rights in hospitals.
"This conversation is not in a vacuum," Clark said. "Similar conversations are going on at a national level."
A concern that stood out in the survey's findings, Clark said, was that LGBT people who don't think their doctor is "friendly" may be discouraged from seeking care. Of respondents who said their own doctor is "LGBT-friendly," 72 percent saw one in the past six months.
Of those remaining, only 41 percent have seen a doctor in the same period.
The survey also found that 19 percent of transgender respondents haven't seen a doctor in more than two years, and 53 percent said a doctor's refusal to provide services to LGBT people has been a problem.
The survey's sample - reached mostly online in both English and Spanish - reported higher income and educational achievement than is found in the general population. For example, the Census Bureau reported in 2010 that roughly 28 percent of Americans age 25 and older have a bachelors' degree or higher, while 72 percent of One Colorado's survey respondents did.
That highlighted some of the challenges of gathering accurate information from the LGBT community, especially from LGBT people without Internet access and those who are closeted.
Respondents also had a higher rate of health insurance coverage - only 10 percent of respondents as a whole were uninsured - than is found in other surveys of the general population. But 15 percent of LGBT people of color and 27 percent of the transgender respondents were uninsured.
The behavioral risk factor survey from the Colorado Department of Public Health - which began asking about sexual orientation in 2006 - suggests health insurance coverage rates for LGBT people in Colorado are similar to the general population.
Clark said that the health insurance system is "broken," but One Colorado is better positioned to address relationships between LGBT people and their doctors.
Part of that relationship is a doctor being aware a patient is LGBT. Of survey respondents who considered their own doctors to be "friendly," 57 percent reported it was because doctors specifically asked about sexual orientation or gender identity.
"Which should come first," Clark asked rhetorically, "should you come out to your provider, or should your provider demonstrate [LGBT]-friendliness? My hope for what will come out of the recommendations is both - we can meet somewhere in the middle."
Cancer, no word strikes fear as quick and as fast.
Cancer tears and worry.
Cancer changing lives.
Cancer lives in my body.
What a weird thought, cancer lives in my body. Something so menacing dwells within me. Hidden growing, poisoning me.
Now cancer is in the light, it's the word we speak first with fear, then, with power. My breast has cancer; I have a cancer in my breast.
My first thought after the word is spoken on March 8, 2011 right at high noon- how do I take care of my sweet spouse through this? How do I protect her and make sure she is safe and cared for through this journey?
All the attention is on me and how I'm doing, what does this mean for me? My question is what does this mean for my spouse, how is she doing?
A very interesting response in hindsight. So telling as to MY priorities. I know how I am, I know I will make it through this, that my life will change, I know I will live through this and go on. I know I do not die from this experience.
I find that in the first day of living with cancer, that I spend as much time taking care of those I love as I do myself. So much fear, so much worry, we are all so scared today.
Finding my laugh again, finding my power and embracing my strength and building my team.
It's so weird to write cancer to say the word cancer and know it lives within me.
Such a shock, such a surprise.
In some ways I feel the universe let me down, this was never suppose to be my reality, not after losing my mom and grandmother to this disease at such a young age. Not suppose to happen to me, I've already dealt with this.
So, here I am wondering what happened, why is this lesson in my sphere? How will it change me, how will it change my world, my friends, my family?
Love and support - as I tell my world- so much love and support it's overwhelming. I am so grateful to have so many care. I think of those who are alone, and I give thanks that I am surrounded and I cry for those who face this alone.
So overwhelmed by the emotions, so much love, so much support. Who knew I mattered this much, that people would wrap their arms around me and fight with me. Who knew?
The fear bubbles up out of nowhere. Filling out a form for a museum membership and I stall trying to figure out whose name to put on the membership. My beloveds, or mine will I be here in a year? Will she have difficulty changing the membership over to her name if I'm not here?
Cancer consumes every aspect of your life. Sometimes you are friends and it stays safely hidden in the background and other times you are so deeply in anger with it yelling and screaming at it to go away and stay away.
Will the fear go away when all the test results are in and we know what we are dealing with? So far there are many hopeful signs, the tumor is small and on the inside of my breast meaning it is further from my lymph nodes.
Early tests results bring good news, early detection by mammogram has shown I am one of the lucky ones. I await the gene tests and we decide how to proceed.
