Photo courtesy of freedigitalphotos.net and marin
An Explanation of Breast Cancer Staging
If you have just been diagnosed with breast cancer, you will be anxious to learn in which stage your surgeon considers you to be, because that will more than likely determine the treatment protocol suggested for you. Your pathology report will discuss staging
The term “staging” refers to the extent of the disease and this is based on several factors – the size of the tumor, whether any lymph nodes are involved, whether the tumor is considered to be invasive or non-invasive, and whether the cancer has spread beyond the breast.
I found a great You Tube video explaining this in detail and the animation is interesting and helpful. It seems there is a You Tube video for everything these days!
Breast Cancer Staging
Stage 0 – The cancer cells are non-invasive, such as Ductal Carcinoma In Situ (DCIS), and there is no evidence that the cancer cells have spread into neighboring breast tissue or beyond the lobule or duct.
Stage I – This is an early stage of invasive breast cancer, divided into two classifications, IA and IB:
IA – the tumor is up to 2 cm and the cancer has not spread outside the breast and no lymph nodes are involved.
IB – there is no tumor in the breast but there are small groups of cancer cells, larger than 0.2 mm but not larger than 2 mm, found in the lymph nodes; OR there is a tumor in the breast that is no larger than 2 cm, and there are small groups of cancer cells, larger than 0.2 mm but not larger than 2 mm, in the lymph nodes
Stage II – Invasive breast cancer, divided into two classifications, IIA and IIB:
IIA – There are three scenarios in Stage IIA:
- no tumor is found in the breast, but cancer (larger than 2 mm) is found in 1-3 axillary lymph nodes (the lymph nodes under the arm) or in the lymph nodes near the breast bone (found during a sentinel node biopsy); OR
- the tumor measures 2 cm or smaller and has spread to the axillary lymph nodes; OR
- the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes.
IIB – There are also three scenarios in Stage IIB:
- the tumor is larger than 2 cm but no larger than 5 cm; small groups of breast cancer cells, larger than 0.2 mm but not larger than 2 mm, are found in the lymph nodes; OR
- the tumor is larger than 2 cm but no larger than 5 cm; cancer has spread to 1-3 axillary lymph nodes or to lymph nodes near the breastbone (found during a sentinel node biopsy); OR
- the tumor is larger than 5 cm but has not spread to the axillary lymph nodes.
Stage III – This is considered locally advanced cancer (where large tumors have involved the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that your doctor can feel during an exam) and is split into 3 classifications, IIIA, IIIB and IIIC:
IIIA – There are three scenarios in Stage IIIA:
- no tumor is found in the breast, or the tumor may be any size; cancer is found in 4-9 axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam); OR
- the tumor is larger than 5 cm; small groups of breast cancer cells (larger than 0.2 mm but not larger than 2 mm) are found in the lymph nodes; OR
- the tumor is larger than 5 cm; cancer has spread to 1-3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy)
IIIB – There are two scenarios in Stage IIIB:
- the tumor may be any size and has spread to the chest wall and/or skin of the breast and caused swelling or an ulcer, and may have spread to up to 9 axillary lymph nodes; OR
- may have spread to lymph nodes near the breastbone.
IIIC – There are three scenarios in Stage IIIC:
- there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast, and the cancer has spread to 10 or more axillary lymph nodes; OR
- the cancer has spread to lymph nodes above or below the clavicle (collarbone); OR
- the cancer has spread to axillary lymph nodes or to lymph nodes near the breastbone.
Stage IV – The cancer has spread (metastasized) from the breast to other organs and other parts of the body.
Inflammatory breast cancer is generally considered to be Stage IIIB, at least. Symptoms of IBC include:
- reddening of a large portion of the breast skin
- the breast feels warm and may be swollen
- cancer cells have spread to the lymph nodes and may be found in the skin.
Information courtesy of breastcancer.org
The most important thing to remember is not to panic, regardless of which stage you are considered to be. YOU CAN COME BACK FROM THIS AND BE PERFECTLY HEALTHY. I have a friend who brought herself back from Stage 4 breast cancer, so I know it can be done. Will it be easy? No. You will need to be extremely proactive and involved with every stage of your healing process. But it can be done.
I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClark.com) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
A SCIENTIFIC MAP TO NAVIGATE THE MEDICAL MAZE WITH A BREAST CANCER DIAGNOSIS TO EMERGE CANCER FREE AND LOOK ABSOLUTELY STUNNING!
by Catherine Doughty, MS, CCHI, Award Winning Author
The award winning book, Breast Cancer! You’re Kidding…Right? Living Life Through The Prism Of Uncertainty And Having A Good Time is the distilled essence of my cancer experience and the use of scientific methodology to assist in navigating the medical maze bringing clarification to treatment decisions in an uncertain decision space. I have condensed the subject matter into the smallest compass possible because, as everyone knows who has fallen into what I call the “Cosmic Cancer Bunny Hole,” conciseness, tools for clinical discussions with physicians, and precision in treatment scenario planning is of the greatest assistance in decision making.
Once you have heard the three little words, “You have cancer!” The first thing that needs to be realized is a fact of fundamental importance, and that is uncertainty. Because it means breaking away from all of the ordinary predispositions of thought you were living with and reconstructing a new phase of your life. You also need to give yourself some room to understand the absolutely fresh new scale of values which the prism of uncertainty presents to you. After you get ahold of uncertainty as the true reality for everyone, it is the sexiest way to live and, every day you will have a rocking hot good time!
In the beginning, don’t imagine that you can assimilate a breast cancer diagnosis, what you will or won’t accept in the treatment planning stages and all that it contains in one or two clinical visits with your surgeon, oncologist or other subject matter experts, or in one or two readings. You need strategy to navigate the medical maze and fast. You should review your reports and go over your options again and again with your physicians until you have thoroughly grasped the magnitude of the treatment plans you are willing to consent to because it is you who will live with the aftermath of every clinical decision carried out.
I designed the book with the principles and elements for success, in response to the requests I received from all the cancer patients who I coached voluntarily. So often, they had been crying for days and weeks at a time and they all had the same question, “Where do I begin to unravel this, and where do you start?” Hence, the birth of the book, which is loaded with thought provoking strategy to assist anyone with any stage of breast cancer emerge stunning, and get their life back in control while learning how to make decisions in an uncertain decision space and live their life through the prism of uncertainty. The fascination lies in the simplicity and pure scientific methodology used to provide a complete step by step guide inclusive of discussion documents, clinical consultation worksheets, criteria solution matrices and treatment scenario planning which is critical to a successful outcome.
The book is literally pulling the curtain back and getting the word out there that there is a clear cut strategy for anyone with any stage of breast cancer needing treatment planning that is on the merits and works with life threatening and lifesaving clinical decision making in uncertain decision spaces to minimize the risk for recurrence. The book provides perspective and a practical method for selecting an appropriate treatment plan that is right for you.
Honestly, you will be on the edge of your seat with every single word in this book. It captures the reader from beginning to end, and makes them want to live their life through the prism of uncertainty and have one rocking hot good time. This is an adrenaline thrill ride from start to finish, that you cannot put down.
One of the questions people want to know is how do I get a copy of the book? The book is available worldwide, including Amazon.com, both paperback and Kindle versions at http://www.amazon.com/Breast-
About the Author: Catherine Doughty, MS, CCHI is an award winning author who lives in Bellaire, Texas. She serves as an adjunct associate professor for three universities and holds a Master of Science in Biomedical Informatics earned at the University of Texas. Her career as Director in a Department of Diagnostic and Interventional Imaging is enhanced by the fact that she is a Lean Six Sigma Black Belt.
She is available for interviews, media appearances, bloging, radio interviews, book signings, and speaking engagements. If you would like additional information on the secrets of scientific methodology or would like to meet the physicians that endorsed this award winning book, please visit her website at http://www.thecancercat.com/. In order to contact the author directly, send an e-mail to http://cldoughty@yahoo.com or telephone at 832-545-6239.
Photo courtesy of freedigitalphotos.net and artur84
Newly Diagnosed? Dealing with Anxiety and Fear
It has been my observation that newly diagnosed cancer patients generally have anxiety that is off the charts, and who could blame them?
Fear obviously plays a part in their anxiety – fear of death, pain, loss of function – it can all be life-changing and very scary.
The Difference Between Anxiety and Fear
In an effort to help move you through these sometimes paralyzing feelings, I’ve found some words that I hope will help you.
It comes from the book Living Beyond Limits by David Spiegel, MD:
“There is an important difference between anxiety and fear. Anxiety is a general sense that something is wrong, which can lead to discomfort, restlessness, and worry, but which is not specific enough to point the way to any resolution of the problem. Fear is something more specific – you know what you are afraid of, and this tends to make the possibility of effective action to control or reduce the fear more real. One of the best means of treating anxiety is to convert it to fear, to change a general sense of discomfort to a fear of something in particular. Thus, a general sense of anxiety in relation to cancer or other illness is best addressed by seeking to define exactly what it is you are anxious about: the discomfort associated with the treatment, the possibility that the disease will spread, the threat of death. Each of these issues can be explored and addressed, which can reduce the discomfort they cause. The way to tame anxiety is to confront it directly. Ask rather than avoid.”
Learning The Language of Cancer
I believe Dr Spiegel gave excellent advice. A lot of the anxiety of a new diagnosis comes from, I believe, all the new language you have to learn about medical treatments, from those overwhelming discussions of survival chances based on this therapy or that, the side effects of this or that.
Here are a few tips to help you deal with anxiety and fear:
You must ask questions until you come to understand what is being recommended by your doctors and treatment providers. No one could absorb all of that information the first time around, so take notes. It is also good to have a friend or spouse with you – another set of ears listening is really important because I guarantee you, at some point you will be in overload mode and stop listening and possibly miss an important point.
Dr Spiegel also makes the point that as a newly diagnosed patient you must study for the role as though you were learning a new job. He suggests that doctors, nurses, social workers, and other patients can be your teachers.
I would add to that list of people/teachers: other breast cancer survivors, psychotherapists (to help you manage your stress levels), naturopaths or nutritionists, and massage therapists.
That’s the role of a good healing team – to help you manage your anxiety and fear, to provide you with excellent care, to answer all of your questions in ways that you are able to understand, and to refer you to other members on the team when it’s necessary.
Try not to stay in fear-mode for too long. Dr Spiegel’s advice to convert your anxiety to a specific fear and then tackle it by addressing each fear is a good one because if you are living in a state of fear you are not focusing on your healing and I believe that’s important to do, especially with a life-threatening disease like cancer. Don’t beat yourself up because you are experiencing fear and anxiety, but do your best to move through it so that you can start the healing process.
I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClark.com) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
Photo courtesy of Ambro and stock.xchng
Normally, getting ready for my day is a pretty mundane thing. But today, my iPod was playing some really great music and I was dancing (trying not to be too critical in front of the bathroom mirror – just enjoying the movement and the tunes) and it got me thinking about the healing power of music.
A Supercharged Brain and U2
When I was going through chemotherapy, the night following my infusion would generally be mostly wakeful. Those darned chemicals were racing around my body and seemed to supercharge my brain. So I’d lie for hours and listen to music.
You are never so attentive and mindful of a song and what goes into it as you are during the black of night when there are no distractions. Using headphones also brings the music closer, you can hear every drum beat, every nuance of the singer’s voice. It was pure magic – I would listen for hours. (My favorite night-time listening music was by U2, I love them).
The Healing Power of Music
I found a wonderful website called caregiver.com – written for caregivers of dementia patients. They had this to say about the healing power of music:
Positive results include elevated mood, increased socialization and appetite and reduction in agitation. These benefits are attributed to the stimulation the brain receives during a music therapy session, a sort of “cognitive workout” inspiring us to coin the phrase, “What exercise is to the body, music is to the brain.” The power of music often inspires physical movement and can be used in combination to encourage gentle exercise.
I was able to find a number of articles on-line that spoke of the healing power of music. Benefits include:
- Soothing jangled nerves
- Calming mind and body
- Lowering blood pressure
- Boosting immune system
- Focusing mind and attention
- And so much more!
PBS has a video you can view (you’ll have to wade through the commercial first) about the Healing Power of Music. Pretty powerful stuff for brain injury patients.
Anyway – I believe music can be very powerful for those trying to overcome a disease such as cancer. It can soothe your soul, help you through the treatments, and boost your immune system. My suggestion? Get an iPod or MP3 player and load all your very favorite songs on it and take it with you to your treatments.
I am currently also putting together some healing meditations for cancer patients and will post them when they are available.
By the way, the song I was dancing to in the bathroom? Martha Reeves and the Vandellas, “Nowhere to Run”. Yep, it’s an oldie, but hey – I grew up in the era of the Vietnam War and that song meant a lot to us! Still sounds great today.
I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClark.com) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
Photo courtesy of adamr, stock.xchng
Making Healing Choices
Because every person is different – we come from different families, we have different ways of coping with life, different belief systems, different spiritual beliefs, different experiences, emotions and fears — all of this makes us who we are and directly affects how we make healing choices when dealing with a disease such as breast cancer.
One Size Does Not Fit All
I also feel that that very difference between each of us means that not one size fits all with regard to medical treatments, both conventional and alternative/complementary. It is because each person is so unique that I feel medicine in the future will stop throwing the exact same therapies at each of us to help us heal from breast cancer.
We have already seen a leaning toward that future of medicine with chemosensitivity testing, although it is currently more prevalent in EU countries than here in the US.
Being a natural therapist, I needed to be able to make my healing choices from a combination of both conventional medicine and complementary and alternative medicine. I was able to choose each modality and combine them to help me get to that healing place quickly and because I had the breast cancer background already (having gone through it with both grandmother and mother) and had studied it so intensively, I felt very blessed and fortunate to have those healing choices.
Honoring Choices
I believe it’s important to honor the wellness choices every person makes and to respect their religious and spiritual beliefs, even if they are quite different from our own. Many doctors don’t take these important differences into consideration though – some act absolutely outrageously if one of us doesn’t follow their recommendations to the finest detail.
What Are They Thinking?
My own very good oncologist, although baffled at me sometimes, respected my decisions and did his level best not to say things like “You’ll come to regret that decision” or “Well, if you get it back again, don’t expect me to treat you.” Amazingly, other cancer patients hear those statements all too frequently.
One of my subscribers was told by her oncologist that she was a “dead woman walking”. That kind of negative, defeating statement fills me with rage!
It’s a pity that so many treatment providers tend to believe that the therapies they offer are the ONLY ones that should be considered. I know they do their best, but what I’ve discovered is that the answers to healing come from many different directions.
It is so very important to have doctors and natural therapists that really hear you, respect you as a separate human being, and treat you accordingly.
Trusting Our Inner Wisdom
We need to trust our inner wisdom with any healing choices. Pay attention to your differences and make the best choice for you. This is your journey and your body and you have every right to choose what happens. Choice may be the only true power that we have during this difficult journey with breast cancer.
Can I Help You?
If I can help you on your path, I’m honored to do so. I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClarkcom) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
Lastly I’d like to share this quote from Buddha (this also appears on my “About Me” page):
“Don’t blindly believe what I say. Don’t believe me because others convince you of my words. Don’t believe anything you see, read, or hear from others, whether of authority, religious teachers or texts. Don’t rely on logic alone, nor speculation. Don’t infer or be deceived by appearances. Do not give up your authority and follow blindly the will of others. This way will only lead to delusion. Find out for yourself what is truth, what is real. Discover that there are virtuous things and there are non-virtuous things. Once you have discovered for yourself, give up the bad and embrace the good.”
Photo courtesy of pat138241, stock.xchng
How To Tell Your Child You Have Breast Cancer
A few of my newly diagnosed readers have intimated to me that they need help with how to tell their children they have breast cancer, so I’ve done a bunch of research and my heart goes out to everyone concerned.
To Tell Or Not To Tell…
Experts recommend that the sooner you tell your children that you have breast cancer, the better. Mothers may not want to distract their children from their daily activities or make them worry, but they deserve to be told.
Children are very perceptive and know that you are not feeling well, so not talking about your breast cancer may bring on anxiety and fear for them. Telling them shows your children that you have confidence in their ability to cope and decreases their feelings of being useless during your breast cancer treatment.
Also, by not telling them, you risk that someone else might tell them and in so doing, might not have the sensitivity of telling them all they should know in a kind and loving way.
Age Is A Factor
Age is an important factor when deciding what to tell a child about a breast cancer diagnosis. The articles I read all agreed that the child should be told the truth in such a way that they are able to understand and prepare themselves for the changes that will happen in the family. All kids thrive on routine – it helps them to feel safe. When life becomes unpredictable, they will need help adjusting to the changes.
All children need the following basic information:
- The name of the cancer that you have
- The part of the body where the cancer is
- The treatment you will receive
- How their own lives will be affected
Telling Younger Children – Up to 8 Years
Young children won’t need a lot of detailed information but they do need to understand the family’s concerns and be told the above 4 things. Younger children can also be told that the body is made up of lots of different parts and that when someone has cancer, it means that something has gone wrong with one of these parts and it has stopped doing what it’s supposed to do, that part of the body is no longer normal.
They are able to understand that a bunch of bad cells started to grow and that’s called a tumor and that the tumor (or the bad cells) should not be there. Cancer can spread and grow into other parts of a person’s body, so the person needs treatment to either take out the tumor or stop the bad cells from spreading to other places. Some children may not have any questions at first, but invite them to ask you later if they think of any.
Telling Older Children & Teens
Older children (8-12 yrs) and teens will need to know more. Teens, who are busy testing their independence and pushing their limits, will have a very different set of concerns from a 5-year-old who needs parents for basic care giving.
Older children may be able to understand a more complex discussion of cancer – they may want to see pictures of cancer cells or read about cancer treatment. Again, encourage them to ask questions and answer the best way you can. If they ask something you can’t answer, promise to get them the information they requested. They will appreciate this.
11 Tips For Telling Your Child You Have Breast Cancer
- Set up a quiet time when you won’t be disturbed. If you have more than one child, you may want to talk to each child alone so that information can be tailored to each child’s age and understanding. Be aware that each child will respond differently – by telling them separately, you can pay close attention to how each child responds. Each child may also be more willing to ask questions when away from the other children and possible distractions.
- You may also want to include another family member that your child is close to, for support.
- Turn off phone, put the pets outside, and don’t answer the door while you are having this talk. If you stop to answer the phone, turn off the stove, or let the dog out when your child is opening up to you, the child may find it more difficult to try again.
- Plan ahead of time what you want to say and how to answer questions on a level that each child is able to understand. It’s good if you can lay the groundwork for an open line of communication with the child, a way for the child to come to you with their concerns, needs, and fears. If you can start this and keep it going by regularly checking in with each child during and after your cancer treatments, it can be a great comfort to them and help them to feel you aren’t hiding anything.
- Make sure to stress that you will be getting good care and treatment and that new and better cancer treatments are being discovered every day.
- Help your children know what to expect during your breast cancer treatments so they will not be surprised about your lack of energy or your hair loss if you are having chemotherapy. You don’t have to tell them everything at once. You can give the information in small doses so that they will not be overwhelmed.
- Make sure your kids understand that cancer and chemotherapy treatments are NOT permanent conditions! There will come a day when you will be done with your treatments and that you and your doctors will do everything possible to help you regain your health.
- Because children tend to feel that they are the center of the world, they might feel that something they did or didn’t do might have caused your cancer. Studies show that most children believe this at some point during the cancer experience. It’s a good idea to reassure them by saying something like, “The doctors have told us that no one can cause someone else to get cancer — it’s nothing that any of us made happen.” It’s better not to wait to see if children bring this up because they could be feeling guilty without saying so.
- Make sure your kids know that cancer is not contagious and they cannot catch it. They also need to know that not everyone dies from it. It’s a good idea to correct these ideas before the child has a chance to worry.
- Let your children express their fears, confusion, anger or tears. Comfort them and let them know that you care, and allow them to express their feelings so that they will be able to move through this journey with you.
- Try to keep a positive outlook. However, there will be days when you might not cope so well. You could explain to your kids that you might have difficult days with pain from surgery or medication, but tell them those are the days when you will need them to be extra helpful.
A Beautiful Book – Butterfly Kisses and Wishes On Wings
There is one more wonderful resource available in the form of a beautiful book titled “Butterfly Kisses and Wishes on Wings” by Ellen McVicker and Nanci Hersh. It uses clear, candid text, the illustrations are yummy, and it is a touching resource that can be used to educate and support children who are facing the cancer of a loved one. The book is available in both English and Spanish and you can purchase it by clicking on the link. There is a lot of information on the website, I highly recommend you pay it a visit.
Sources of information:
American Cancer Society
About.com
Parents Magazine
I send my love to everyone taking this journey right now. If you would like my help with getting through breast cancer in an inspiring and ultra-healthy way, please sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClark.com) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
I would like to recommend that you support a breast cancer advocacy group called Breast Cancer Action, a national organization founded in 1990 by a group of women who understood that together we can effect much change.
Breast Cancer Action was born (according to their website) “from a need for a grassroots organization with a unique understanding of the political, economic, and social context of breast cancer.”
BCA’s Mission Statement
“Breast Cancer Action carries the voices of people affected by breast cancer to inspire and compel the changes necessary to end the breast cancer epidemic.”
What I Love About Breast Cancer Action
Their strict contributions policy allows them to be an independent voice for women who are either at risk of breast cancer or are living with it. They do not take money from anyone who profits from or contributes to the breast cancer epidemic. I believe that’s important.
They advocate for more effective treatments for breast cancer (and less toxic – which is what I’m all about too).
They are committed to raising the public awareness of environmental exposures to harmful chemicals that put people at risk for breast cancer (one of my favorite topics as well).
They have a Think Before You Pink Campaign which you should find out about. It’s gotten so that I hate the month of October for all the pink ribbons everywhere and the companies who CLAIM to be supporting the fight against breast cancer but continue marketing their toxic chemical-laden body products and cosmetics to unsuspecting women. GRRR!
Most importantly, BCA is actively opposing gene patenting because the patents give one company the exclusive rights to all testing and research on BRCA genes. This monopoly effectively prevents anyone else from so much as examining the genes, and creates barriers to scientific research and medical care relating to breast and ovarian cancer.
Sign Up For Their Webinars
Yesterday I attended one of BCA’s webinars titled “Reducing Inequities in Breast Cancer – Why Experience Matters”. So they are also advocates for communities where inequalities exist in getting the proper treatment for breast cancer – whether due to language or cultural barriers, racial inequities, financial barriers, or geographical location).
This webinar was well presented and made me aware that just because we live in the United States, we are not all treated equally with regard to being able to get the proper information and treatment for breast cancer.
Please support Breast Cancer Action with your contributions.
If you’d like to stay connected, sign up for my free e-newsletters on the right, or “like” me on Facebook (MarnieClark.com) and I’ll do my utmost to keep you informed and empowered on your healing journey… and beyond.
Photo courtesy of freedigitalphotos.net and marin
While I was doing my research for yesterday’s article, I came across an article concerning needless mastectomy, a matter of which I was blissfully unaware. Today I’m sharing that with you because you need to know.
Women are often enduring mastectomies for no good reason.
I’m not saying it’s always the case, but by the time you’ve finished this article, hopefully you’ll know the best reasons for having a mastectomy and when you should go after a second opinion.
Back on October 27th, Nicholas Regush of ABC News wrote “While we hear news almost daily of the need for women to have mammograms and to inspect their breasts for changes that could suggest breast cancer, the actual treatment for breast cancer that many women receive, especially poor ones, is often outrageously out-of-date, if not bordering on the criminal.” Here’s a link to the full article.
The article goes on to state, “In Texas, for example, a study of breast cancer treatment at one large urban hospital revealed that 84 percent of the women with early stage breast cancer had mastectomies and only 16 percent had lumpectomies. The women who lost their breasts were mostly poor.”
Mr Regush referenced an article written by Diana Zuckerman, President of the Washington, DC-based National Research Center for Women and Families. The article was published in the Journal of the American Medical Women’s Association. Despite much digging, I wasn’t able to get hold of a copy of that article, but I did discover that Ms Zuckerman has been extremely proactive with the Breast Cancer Public Education Campaign.
Because many women diagnosed with breast cancer do not have all the facts they need to get the treatment that is best for them, the National Research Center has been working to raise awareness of this issue.
Unnecessary Mastectomies
What I discovered from some of the online articles I read was that if a doctor was trained before 1981, his patient is much more likely to have a mastectomy. Apparently, old medical habits are hard to break.
Research is clear that lumpectomies are as safe as a mastectomy for most women with early stage disease.
Back in my grandmother’s day, nearly every woman who was diagnosed with breast cancer underwent mastectomy, often while under anesthesia for the biopsy itself with no participation in a discussion about treatment options. How fortunate we are that this is no longer the case.
However, tens of thousands of women with breast cancer are losing a breast (sometimes both) unnecessarily each year. Many women are getting their breasts removed for no good reason — meaning that such decisions are often not based on sound medical judgment but more on the basis of other factors such as her income (it’s cheaper to perform a mastectomy than lumpectomy followed by expensive radiation treatments), the training of her doctor, the age of her doctor, and where she lives. Sometimes it’s based purely on fear of the return of the disease.
There is absolutely no data that mastectomy (either single or bilateral) in a breast cancer patient improved survival rates or helped them live longer. It appears that many women are doing this in panic mode.
Mastectomy vs Lumpectomy
Presuming you have already found a breast lump and your doctor has told you it’s malignant, you will need to make the decision between a mastectomy and lumpectomy.
There’s a helpful article in www.breastcancer.org titled Mastectomy vs Lumpectomy. Please read the article, it references the deciding factors, advantages and disadvantages, and there’s no need for me to reiterate it here.
When Mastectomy Makes Sense
- If the tumor is big and, after the lumpectomy, very little breast tissue would remain
- If there are multiple tumors in more than one quadrant of the breast
- If you do not want to undergo radiation therapy after the surgery (and you don’t have to – I chose against radiation after my lumpectomy but I was very proactive in my health care and chose something else)
- If you believe you will have less anxiety about a recurrence of breast cancer with a mastectomy
There is an alarming trend of more and more women removing healthy breasts because they are panicked or in fear of breast cancer returning or migrating to the other breast. In some cases, doctors recommend prophylactic mastectomy, which is surgery that is performed to reduce your breast cancer risk. That is a whole, huge topic unto itself and the subject of my next article.
While I can’t tell you what to do, I do want you to be aware that YOU HAVE CHOICES. Please don’t choose mastectomy purely out of fear. Sign up for my newsletters (the bright colored box on the right) and let me help you through this process. I will share with you what I did, help you with your anxiety and walk with you through this journey.
Remember, the greatest enemy cancer has is a great functioning immune system.
The Paralysis of Analysis
When you are first diagnosed with any life-threatening disease, it is easy to be overwhelmed by all of the decisions you have to make.
Sometimes you might make the conscious decision NOT to make any more decisions until you have more information, or until you’ve talked to that friend who has been through it. Sometimes you feel absolutely frozen in fear and can’t make any decisions at all, what the Rev. Dr. Martin Luther King termed “the paralysis of analysis”. Good turn of phrase!
Getting past that immobilization can sometimes be difficult. I would encourage you to do just that, however, because there is nothing worse than paralysis in the face of a threat. You must have a plan for dealing with the threat. You will notice, in the coming weeks and months, that as you face the fact of your diagnosis you begin to observe that life goes on, even with this threat hanging over you.
I have some recommendations on getting through the decision making time.
4 Ways to Help You Move Beyond the Paralysis
- If a lack of information or understanding about the path you need to take is holding you back, talk to your doctor. Talk to me. Discuss it with that friend who has been through breast cancer. Do some searches on the Internet, or have a friend do the searches for you. Don’t let lack of information hold you back – we live in the age of technology when information is in abundance.
- If fear is holding you back, talk to a therapist. Discussing your plight with a neutral party can often be extraordinarily helpful.
- If anxiety is keeping you from making the necessary decisions, and if you don’t know how to meditate, learn. There is nothing more calming, more grounding, and more helpful than meditation to calm anxiety. It will also help you with your treatments for the disease. Meditation will help you focus on the problem at hand and help you make your decision for the right reasons and when you are calm and thoughtful.
- Seek solitude. A long walk along the beach or a river often helps because the atmosphere surrounding places with water is full of negative ions, which help you feel better. It can help to clear your mind and put things in perspective.
Psychology Today offers us this tasty little bit of advice: “You can practice confident decision-making by remembering a simple dictum over and over: You cannot have certainty and you don’t need it. By accepting that no certainty exists and that you don’t need it, you’ll instead harness intuition and, by extension, confidence.”
Decisions are an inevitable part of being human. It requires the right attitude. Every problem, properly perceived, becomes an opportunity.
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The Difference Between DCIS, LCIS, ILC, IBC, Paget’s Disease & Phyllodes Tumors
Some of my subscribers have voiced a little confusion in past weeks over the various types of breast cancer and exactly how they differ, prompting me to write this article and hopefully untangle that confusion.
The 8 Faces of Breast Cancer
Ductal Carcinoma In Situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma means any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and “in situ” means “in its original place.” DCIS is considered “non-invasive” because it hasn’t spread beyond the milk duct into any of the surrounding breast tissue. DCIS is not considered to be life-threatening, however, having DCIS can increase the risk of developing an invasive breast cancer later on. Experts feel that when you have had DCIS, you can be at an increased risk for the cancer returning or for developing a new breast cancer than a person who has never had breast cancer. Studies indicate that most recurrences happen within 5-10 years after initial diagnosis (but this is certainly not always the case).
Invasive Ductal Carcinoma (IDC), sometimes referred to as infiltrating ductal carcinoma, is the most common type of breast cancer, comprising about 80% of all breast cancers. Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues. Ductal is defined in the paragraph above, and carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. All together, “invasive ductal carcinoma” refers to cancer that has broken through the wall of the milk duct and begun to invade the tissues of the breast. Over time, invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body. According to the American Cancer Society, about 2/3 of women are 55 or older when they are diagnosed with an invasive breast cancer, however, it can strike at any age. IDC also affects men.
There are 5 sub-types of IDC – tubular carcinoma, medullary carcinoma, mucinous carcinoma, papillary carcinoma and cribriform carcinoma. These all refer to a specific type of tumor and these further classifications help your oncologist decide on treatment. You can find out a lot more about these subtypes on www.breastcancer.org.
Invasive Lobular Carcinoma (ILC) is the second most common type of breast cancer after IDC. Invasive is defined above, lobular refers to cancer that has grown in the milk-producing lobules which empty out into the ducts that carry milk to the nipple. Carcinoma is defined above. All together, “invasive lobular carcinoma” refers to cancer that has broken through the wall of the lobule and begun to invade the tissues of the breast. Again – over time, ILC can spread to the lymph nodes and possibly to other areas of the body. According to the American Cancer Society, this type of breast cancer is more common as women age.
Lobular Carcinoma In Situ (LCIS) is when abnormal cells grow inside the lobules of the breast, but have not spread to any nearby tissue or beyond. With LCIS, the abnormal cells are still in place inside the lobules and have not invaded any other tissues. Experts feel that it is rare for LCIS to become invasive breast cancer, however, having LCIS increases the risk of invasive breast cancer, statistically speaking. Compared to women without LCIS, those with LCIS are 7-12 times more likely to develop invasive cancer in either breast. Studies show that women with LCIS “may” go on to develop ILC or IDC.
Inflammatory Breast Cancer (IBC) is a rare and more aggressive form of breast cancer. According to the National Cancer Institute, about 1-5% of all breast cancer cases in the USA are IBC. Inflammatory breast cancer generally starts with the reddening and swelling of the breast rather than a distinct lump. The alarming thing about IBC is that it tends to spread and grow quickly, with symptoms worsening within days or even hours. It is very important to recognize symptoms and seek treatment PROMPTLY. Although IBC is considered a serious diagnosis, keep in mind that treatments today are better at controlling the disease than they used to be. The average age at diagnosis for IBC in the USA is 57 for white women and 52 for African American women, and that’s about 5 years younger than the average ages at diagnosis for other forms of breast cancer. I’ve found an excellent resource for women with IBC. Go to http://eraceibc.com – they are wonderful over there and will provide you with extra support for your specific diagnosis.
Paget’s Disease is a rare form of breast cancer in which cancer cells collect in or around the nipple. The cancer usually affects the ducts of the nipple first (small milk-carrying tubes), then spreads to the nipple surface and the areola (the dark circle of skin around the nipple). The nipple and areola often become scaly, red, itchy, and irritated. According to the National Cancer Institute, Paget’s disease accounts for less than 5% of all breast cancer cases in the USA. It’s important to be aware of the symptoms because more than 97% of people with Paget’s disease also have cancer, either DCIS or invasive cancer, somewhere else in the breast. The unusual changes in the nipple and areola are often the first indication that breast cancer is present. Doctors aren’t quite sure how Paget’s develops. It is more common in women, but is sometimes found in men as well and usually develops after the age of 50.
Phyllodes Tumors – Prior to my doing research for this article, I have to admit I’d never even heard of this type of tumor. It’s a rare one and accounts for less than 1% of all breast cancers. A phyllodes tumor can be benign (harmless) or malignant (cancerous). This type of tumor is called a “sarcoma,” because it occurs in the connective tissue (stroma) of your breast, rather than in the tissue lining of ducts and lobes. Phyllodes tumors take their name from the Greek word phullon (leaf) because of their leaf-shaped growth pattern. This type of tumor will feel like a firm, smooth-sided, bumpy (not spiky) lump in your breast tissue and the skin over the tumor may become reddish and warm to the touch. This type of tumor seems to grow very fast – so much so that the lump can become bigger in a couple of weeks.
Male Breast Cancer – Breast cancer in men is rather rare, less than 1% of all breast cancers occur in men but no discussion of the types of breast cancer would be complete without mentioning this. In 1998 I lost a family friend to male breast cancer that was diagnosed too late (RIP, Bud). In 2011, about 2,140 men were diagnosed with male breast cancer. For men, the lifetime risk of being diagnosed with breast cancer is only about 1 in 1,000. For risk factors, symptoms, diagnosis of male breast cancer and treatment for male breast cancer go to www.breastcancer.org, an excellent resource.
A Good Visual For You
Someone clever has photographed a bunch of lemons and used them to illustrate things like lumps, a growing vein, nipple retraction – all things to be aware of in reference to breast changes. The photo is on Stumble Upon (click this link). I hope this information helps someone!
Sources:
http://www.breastcancer.org/symptoms/types/
http://breastcancer.about.com/od/types/p/phyllodes_sa.htm
http://www.eraseibc.com/ibc.html
http://ww5.komen.org/understandingbreastcancerguide.html
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