Breast Cancer Blog

Submitted by The Stupid Cancer Blog

Increasing numbers of young women continue to be diagnosed with the most dangerous form of skin cancer even as the rate has leveled off in young men, federal health officials reported today.

An analysis of government cancer statistics between 1973 and 2004 found that the rate of new melanoma cases in young women had jumped 50 percent since 1980, but had not increased for young men in that period.

“It’s worrying,” said Mark Purdue, a research fellow at the National Cancer Institute, who led the analysis published in the Journal of Investigative Dermatology. “What we are seeing in young adults right now could foretell a much larger number of melanoma cases in older women.”

The new research did not examine the reasons for the trend, but Purdue said it could be due to such factors as women spending more time outdoors and indoor tanning. Young women are much more likely than young men to frequent tanning salons, Purdue and others said.

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Submitted by Dr.Kattlove’s Cancer Blog

Many things increase a woman’s risk of developing breast cancer. Some she can control, others she can’t. Uncontrollable items are, starting periods at a young age, ending them at a late age, having few or no babies and having them late in life. Of course, the biggest uncontrollable gorilla in the room is what a woman inherits from her parents, but I’m not going to talk about that this time.

High-risk items a woman can control are, whether if she has a baby she doesn’t nurse, whether she takes hormones after menopause, gets fat or drinks too much.

Another important question is, if a woman gets breast cancer, how these factors affect her chance of surviving the cancer. It turns out that most of these don’t hurt her chances and some my even help.

We know this because of research done by some British researchers that was published in this month’s Journal of Clinical Oncology. The Brits looked at the history of some 4500 women with breast cancer and matched them with some of the risk factors I mentioned above.

It turns out that survival in women with most of these risk factors is not affected. That is, if a woman who began her periods early, or ended them late, or took hormones developed breast cancer, she did as well as women without these issues. In fact, the women who took hormones may have fared better with their breast cancers than women who stayed away from them. This makes sense because these women tend to develop hormone sensitive breast cancers that are generally less aggressive and more easily treated – as long as they are caught early.

Big surprise was with alcohol. Although drinking increases a woman’s chance of developing breast cancer, women who drank had better outcomes – were less likely to die of their cancer - than women who kept away from the stuff. The researchers couldn’t explain this but weren’t recommending trips to the local pubs; they couldn’t be sure this finding would hold up if more studies were done. Still, there’s no harm in a drink or two and it might get a woman through some rough spots.

One risk factor was dangerous – obesity. The more overweight a woman was, the more likely she was to die of her breast cancer. So take this to heart and keep slim – even if you have to cut down on the booze.

In addition, women with any of these risk factors should be especially sure to get their mammograms. Even heavy drinking won’t help if the cancer is caught too late.

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Submitted by Dr.Kattlove’s Cancer Blog

One of the most challenging complaints from patients in my practice came from older women who had been treated for breast cancer. Their complaint; “Dr. Kattlove, I can’t stand these hot flashes anymore”. And I would say, “Well, you know, hormone replacement therapy isn’t recommended in women who have had breast cancer”.

Not good enough. These women were miserable. And so, I, as well as some of my partners would slip these women their hormones. Sometimes I felt like a crack dealer. Still feeling a little guilty (although none of these women suffered any ill effects and were definitely grateful) even after leaving practice, I was cheered by a study published in 1997 that found no increase in cancer recurrence in over 50,000 women who had received hormones after treatment for breast cancer.

But alas, that was what we call an observational study. There was no control group of women who didn’t get hormones. The study authors just compared their results with national averages of what should be expected. But we know that isn’t the most scientific way to study an issue.

So, in 1997 two groups of researchers, one from Great Britain and the other from Sweden did the study the right way. They prescribed hormones for half of their patients with treated breast cancer and hot flashes and no hormones for the other half with the same history. And wouldn’t you know it, the British group found that the women on hormones had a higher rate of breast cancer recurrence, while the Swedes found no difference in recurrence rate between the two groups. Go figure.

But here is the good news. Just this week, the Brits published a second paper with a longer follow-up of their two groups. They still found more breast cancer recurrences in the women who got the hormones, but it turns out that most of the recurrences were local – in the breast - and could be handled easily. When it came to spread outside the breast and death, there was no difference between the two groups.

Now this doesn’t completely reassure us that hormones are entirely safe for women who have had breast cancer. An excess of local recurrences is still a problem, even though it only occurred in the British study. But, knowing this and the results of the Swedish study we can at least say to women that hormone therapy won’t kill them.

Many of my patients would have replied that they were already dying from the hot flashes. The risk from hormones was no big deal.

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Submitted by Dr.Kattlove’s Cancer Blog

The most recent update of cancer statistics has just been published, and the news is mildly encouraging. First, the bad news. If you are a man, the chance of developing cancer in your lifetime is nearly one in two. For women the chance is lower, at one in three. Cancer has replaced heart disease as the leading cause of death for people younger than 85. Over 85, heart disease wins, but cancer is slowly taking over. The reason cancer is overtaking heart disease is not because cancer rates are increasing. They are not (more on that later). Instead, deaths from heart disease are dropping quickly. Blame better treatment to lower cholesterol and blood pressure.

But there is a lot of good news. Both the rate of new cancers and death rate in men have dropped. Most of this is due to a drop in the rates for lung cancer (more men are avoiding smoking) and prostate cancer (don’t know why there are fewer of these). There has also been a downward trend in colorectal cancer, probably because of screening – although more needs to be done.

For women, the picture is not as bright. Lung cancer deaths have not dropped, meaning women haven’t yet given up their cigarettes as readily as the boys have. But colorectal and breast cancer death rates have gone down.

The best news comes from the data on children. Survival rates from all sorts of cancers continue to rise, making the chance that a child will die of cancer less likely than ever.

But, there is one more preventable cancer risk factor, overweight and obesity. These increase cancer risk by around 30%, meaning we are our own worst enemy. So after putting away the cigarettes, we need to push back from the table earlier and start with less on our plates. A little exercise wouldn’t hurt either.

These are all small but important steps, especially for adults. Still we can’t eliminate the next most important risk factor, aging. Cancer is a disease of aging and as our population gets older, our cancer numbers are sure to climb.

Nothing we can do about aging (or want to).

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Submitted by The Stupid Cancer Blog

ScienceDaily (2008-01-16) — The overall survival rate from cancer now is lower in older adolescents and young adults with cancer than in younger children, in part because of a lack of access to clinical trials nationally for the older age group, according to a new study.

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Submitted by Jayne’s Breast Cancer Blog

Thoughts on Blogging

About a month ago, Lorelle on Wordpress did a post on Cancer Blogs and Blogging.

I discovered this post because my blog was listed, so that was kind of cool. Considering that Lorelle is not a “cancer blogger” she sure did manage to hit on one of the fundamental aspects of blogging about cancer. She writes: “If the disease ends, should the blogger keep blogging about being a ‘victim’ or ‘patient’? Shouldn’t their blogging move on as their life has? What happens to the blog?”

It’s a conundrum that so many of us face as we move further out from active treatment. Some of my favorite bloggers have all but stopped updating their blogs. I guess that’s good - they’re off living their post-cancer lives, right? But without any updates, I’m left to wonder how they are doing.

I know other cancer bloggers who have kept up their cancer blog but started another blog, too. I’ve thought about doing this (and I still might). But am I up for maintaining two blogs?

So I find myself at a bit of a blogging crossroads. I do still have plenty to say on this blog. Creative breast cancer projects come to my attention all the time, and I want to blog about them. Cancer continues to influence my own creative efforts, and I want to blog about that too.

Bad News

I am so so so so sorry to report that I have something sinister weighing on my mind again. On Wednesday, I found a little, hard lump right near my port-a-cath scar. It’s tiny. Like smaller than a B-B. It could be scar tissue, but that scar is almost two years old. How likely is it that this would occur now? It hurts. If I push on it in a certain way, the pain is sharp. Almost like this little bump has a shard on it. I think that it would be unusual for a tumor to present pain in this manner.

It’s not even on my cancer side. But… certainly there are lymph nodes in the area. It’s just an inch or so below the collarbone. Maybe, despite a bilateral mastectomy, it is a new primary tumor. They can’t get all of that breast tissue out, you know.

I had something happen to me a couple of weeks ago. It was related to the bleeding colon polyp that I dealt with last year. I had a few dark days. I had to go in for a test. The test came out fine. I didn’t even write about it. I hardly even told any of my IRL (in real life) friends. Just didn’t feel like dealing with it.

I had a pretty good run of it this past year. I’ve been able to play, work, travel. I’ve had days when cancer didn’t even cross my mind.

Now?

Can’t concentrate. Can’t cope. Can’t breathe. Appointment with breast surgeon on Monday.

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Submitted by Jayne’s Breast Cancer Blog

Has cancer taught you to slow down, to savor the moment, to spend more time “being” and less time “doing”?

If so, then I’d like to be more like you. But I’m just not wired that way.

I do worry far less about the future than I used to, but I live with a heightened sense of urgency. I have big plans, and I’m afraid that I’m going to run out of time.

As a result, I love January and the promise of a new year. I can’t relate to people who resist resolutions. So what if I make the same (or similar) resolutions year after year? I don’t care. I like to have goals. I like to make lists. I like to dream big.

For several years, I have been loosely operating with David Allen’s Getting Things Done method of productivity. While I have a shelf full of time-management books, this one really changed the way that I do things.

You can find GTD all over the web. There’s the David Allen Company’s official site, and a concise description at The Executive Assistant’s Toolbox with lots of links to GTD-stuff in the blogosphere. But if GTD intrigues you, I highly recommend reading the book to capture a complete understanding of the methods and benefits.

I draw from some other organizing methods, but this is the one that I rely on the most. The reasons that I like it so much? Here you go:

However, while I am completely sold on the GTD method, sometimes I drift terribly far away from it. It’s only when I get back on it that I feel like I’ve corralled my interior life. A fundamental concept of the GTD method is the weekly review. which I almost never do. This is bad. It’s like dieting without exercise. It doesn’t quite get you there.

So goal #1 for 2008: Use GTD faithfully. I have a lot to do!

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Submitted by Dr.Kattlove’s Cancer Blog

Yesterday, I was visiting a friend who had just had surgery for breast cancer. She showed me her pathology report and I was impressed by how thoroughly her cancer was examined and how carefully they measured her cancer’s HER2 status (which was negative).

HER2 is a molecule present in about one-fourth of breast cancers. It is important for several reasons. Women whose cancers have this molecule are a little more likely to die of their cancer. They also will have a better outcome with adjuvant chemotherapy if drugs called anthracyclines (like Adriamycin) are included in the treatment. Finally, these women will also be helped by the drug, Herceptin, which specifically targets the HER2 molecule.

The downside of all this treatment however, is a small but definite risk of heart failure. Anthracyclines damage heart muscle, which can lead to heart failure.

But what if a woman’s cancer doesn’t contain this molecule (like my friend)? This week’s Journal of the National Cancer Institute contains an article summarizing many of the studies done on chemotherapy in women whose cancers were analyzed for HER2. The results are clear. Women whose cancers contain HER2 have better survivals if they receive anthracyclines. But, women whose cancers do not contain this molecule aren’t helped by them.

So if you are like three-fourth of all women with breast cancer (including my friend) and your cancer doesn’t have HER2, you can avoid heart-damaging anthracyclines. But you need to have your cancer carefully analyzed for HER2. This is not a simple test to perform. Make sure your hospital’s laboratory is up to speed. The most frequent error is to say that HER2 is present when in fact, it is not. So make sure your cancer is tested at a laboratory accredited by the America College of Pathologists and save your heart!

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Submitted by The Stupid Cancer Blog

If there’s anything that shows that cancer survivors need help and support throughout their lifetimes, it’s this article from The Wall Street Journal. I would have thought that most childhood leukemia survivors live fairly normal adult lives. It’s a great shock to find out that a significant number have difficulty finding and keeping jobs.

read more | digg story

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Submitted by the stupid cancer blog

Children stricken at some point in their lives with the same cancer as their parents are also likely to share a similar rate of survival, according to a study released Friday. I call ’shopped, pwned and wtf.

read more

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According to the results of a new study released during a meeting of the American Society for Therapeutic Radiology and Oncology, 20% of black women diagnosed with breast cancer are under 40. The incidence of breast cancer for white women under 40 is 12%.

According to the data, black women are also more likely to have large tumors.

2400 women with breast cancer were followed over a 30 year period

 The overall cost of treating a typical breast cancer is $50,000 and can even exceed $100,000 in some cases.

Here is some data that really tells the story on how the burden of paying for cancer treatments is really affecting some American families.

33 percent of cancer patients have trouble paying medical bills and 43 percent report skipping payments or not filling prescriptions because of the cost.

Look around the Internet long enough and you may come to the conclusion that unless you live in a bubble and starve yourself, your risk of getting breast cancer is 18% higher than someone that lives in a bubble.

Look at this article that was published today by 2 doctors. Too many times, studies that are looking to publish statistics draw a conclusion based on a pre-conceived hypothesis that ultimately misleads the public. For example, many studies have been released that infer a direct cause between drinking and breast cancer. But is there really a direct cause?

I would want to know what was the population of the study. For example, did they just include people between the ages of 40 and 50, follow them to see if they got breast cancer, and then ask them if they were consuming 3 or more drinks per day? However, even if the data from that group of people that consumed 3 or more drinks per day had a higher occurrence of breast cancer than the women who did not, can we reasonably conclude there was any direct cause? For example, couldn’t a reasonable person assume that anyone who consumes 3 or more drinks per day is less likely to exercise than someone who doesn’t drink? So what is the cause, the drinks of the lack of exercise? I can also reasonably assume that a person who consumes 3 or more drinks per day is more overweight than a group that does not drink. Once again, what is the cause? You see my point?

Medical news is confusing. Now it gets more confusing.

There is more news out of the European Cancer Society in Barcelona, Spain.

The new study was lead by Dr. Yan Li who evaluated 70,000 female members of Kaiser Permanente HMO in Oakland, CA.

Breast cancer increased by 30% in women who drank 3 or more drinks per day.

The American Cancer Society released new data on breast cancer. From 2001-2004, breast cancer diagnoses fell by an average of 3.7 percent per year while death rates fell by 2% during the period. ACS credited the positive trends to a drop in hormone replacement therapy and less mammograms. Unfortunately, blacks and young women did not see the same positive trends.