Breast Cancer Prevention

John Kerry’s Wife Fights Breast Cancer

John Kerry, the former Democratic presidential nominee, has a wife named Teresa Heinz who is currently fighting breast cancer.  I feel bad describing her that way, but didn’t know how else to tell you who she is, although she is quite an active spokesperson herself, and John Kerry’s whitehouse bid seems somehow that it was now ions away. How is that anyways?  I think that Teresa Heinz was alarmed by what she has seen in the news as of late about the mixed messages that women are getting about mamograms and when they should start getting them, some say at 40 others at fifty, and she wanted to come out and voice her opinion since this is clearly something that is close to her heart.

To refresh your memory, a panel has recently instructed women that they do not need to have their mammographies starting at the age of forty as previously indicated, and having them yearly, but rather they can wait until they are fifty and not have them as often. This recommendation set off a litany of criticism, by man women as well as men, as a lot of people think that mammographies saved lives, and many women who were diagnosed through these screenings say they would have never known had it not been for these tests. Not to mention, the recommendation is really pissing a lot of people off who are in the health profession themselves.

As a matter of fact, I’m only 35, and because I have breast cancer in my family history on the female side, my doctor recommended that I receive a mammogram now. She did not believe in the recommendation that the panel gave, and advised me of her opinion. I trust her, so I actually took her prescription for the mammogram and intend to go have one done, and of course report back to you about my experience once it’s done.

Since Ms. Heinz herself was diagnosed through a mammogram, although at age 71, she says that she doesn’t see why they would instruct against them for younger women. Especially when it is more treatable at these early stages, and saves a lot of hassle, heartache and pain, not to mention money and insurance premiums, when it is caught earlier on and the survival and treatment rate is much more successful. I feel like we were kind of dealt a bad blow with this recommendation, and they should just take it back, it’s confusing too many women over an already intensely private decision and a hard one at that.

At Risk Breast Cancer Patients Refusing MRIs?

Many women apparently are refusing to have MRIs done that could greatly benefit from one of the magnetic resonance imaging tests due to their status as high risk breast cancer potential patients.  MRI’s have a much better chance at detecting breast cancer when it’s in the very earliest stages in these at risk women because it thoroughly scans the body for any irregularities.  However, in studies where patients were identified as high risk breast cancer patients, about 42% of these women actually refused the MRI for various reasons, even when it was offered free of charge.

This really surprised the doctors that offered the tests for free in the study, because, like me, they thought these patients would want to participate in almost a 100% rate since the test was free and their health could potentially be at risk with something that may not be identified otherwise.  The patients had many reasons, one of them being financial, but not directly related to the cost of the MRI, rather to any costs they were afraid of incurring because of anything that might be found, or the ever popular false positive readings.

There have been known to be false positive readings from breast cancer screenings that result in unnecessary further medical costs like biopsies and other things that may add up to hundreds or thousands of dollars in costs.  Some women in the study cited claustrophobia and not being able to be in the cylindrical, restrictive environment that you are required to be in for a long period of time for the MRI reading.  Even when offered sedation, many women still did not want to subject themselves to that.

Some women cited time restraints, which I can understand as the process can be lengthy, however even that seems like a somewhat weak excuse for something that could save your life in the end, although I suspect that these women were giving reasons that really only were part of the real reason why they didn’t want one, and in fact they may have had several reasons for not wanting the MRI.  At any rate, MRI’s are coming up as one of the better, more thorough ways of screening for breast cancer, however they have to figure out a better way to do them, and at a lower cost, before patients really start wanting to have one done.

Herceptin and Tykerb Combo May Prove Effective

For women with advanced breast cancer, there may be some very good news on the horizon in extending their lives longer and perhaps helping to put them into remission, even when all hope seems lost.  But does it really improve their quality of life as well? To me that is the real question.  So  read more about this new super combo that has shown promise, the combination of two existing breast cancer drugs, one called Tykerb, one called Herceptin, both of which we have discussed here before, one, Tykerb, I think when it had just first come out, so I don’t even think that one has been on the market all that long.

Here’s the scoop, thus far, on the findings.  In a study involving 300 women with breast cancer in it’s advanced stages, the women who were receiving the Tykerb and Herceptin combo lived nearly five months longer than the women who did not receive this new drug combo. Does that mean that their quality of life was also better, or did it really improve the cancer? It doesn’t really say. Let’s hope so.  The real finding here too is that if it can help women with advanced breast cancer this much to extend their life span, then what can it do for women with less advanced forms of the cancer?

They are hoping that it really helps to improve odds for women who are in their earlier stages, so that is the next phase of experiments.  The specific job that Herceptin and Tykerb do inside the body of a breast cancer patient, is that they take aim at and destroy proteins called HER-2, which are found in abnormal abundance in the breast cancer patient.  By destroying these, they presumably increase the life span of the breast cancer patient who otherwise would not have that benefit.

The unique combination attacks the HER-2 cells from both the inside and outside of the cell, one drug doing the outside attack and the other drug doing the inside attack, a very comprehensive approach to destroying a main component of breast cancer reproduction.

This way, if one of them doesn’t work at cracking the inside, or alternatively, the outside of the cell, then the other one kicks in and at least delivers one of the two pronged fatal blows to the deadly cells.  Potential side effects of the drugs include severe diarrhea and potentially fatal blood clots, but if properly managed, these potential side effects I’m sure could be minimized. Plus, I’m sure that if I were faced with two options, I’d probably choose one that could potentially extend my life and maybe even save my life versus the risks it could have against my health. Heck, they sound better than chemo and radiation to me.

Breast Thermography an Alternative to Mammography

A newer technique in screening for breast cancer may soon be taking hold as a preferred method over the often uncomfortable mammogram.  It’s called the breast thermography.  How it works is it takes thermal image “photos” of your breasts from several different angles and with your body in several different positions to get the different parts of the breasts on the screen.

The thermal images are supposed to be able to detect higher heat areas, which may indicate abnormalities in the breast tissues, and can also detect cancer, instead of actually scanning it via mammography, which has been a  subject of debate as well since some say it’s not as accurate on denser breast tissue (which generally means younger breasts).

It is believed by advocates of breast thermography that this technique of scanning the breast tissue can detect abnormalities and precancerous conditions in the tissue years before a typical mammogram can. It does this, they say, by showing where there is more blood flow activity and therefore showing signs of trouble that may lead to cancer years in advance. Even so though, I wonder what a woman could really do about that knowing it, besides try to change her diet and lifestyle habits to be healthier and help prevent the cancer from forming. Nonetheless, this is a very intriguing newer way of detecting breast cancers.

Advocates also prefer the thermography scan over mammography because there is no radiation exposure at all, which in comparison to the mammogram makes it desirable to those who prefer to be “au naturelle”.  Sounds like it would be the right option for me then too!  I’m actually supposed to schedule a mammogram for myself in the next few weeks, at the suggestion of my doctor. Even though I’m only 35 years old, she believes I should start getting them now because I have a maternal aunt who had aggressive breast cancer and died from it.

However, you should note that there are still die hard doctors out there who do not recommend the thermography over the mammography yet. They say it has not been compared rigorously enough to the mammogram and that it’s not quite ready to really replace anything, although some day it might be ready for the spotlight, there still needs to be research done to prove that it catches cancers just as often.

Whatever your choice might be, it may be a little harder to find thermography than it is to find the traditional screening since it is still fairly new. I know one thing I wouldn’t miss, all that pulling, pressing and compressing – youch!

Mammogram Guideline Confusion

**Since I published this, there have now been back and forth debates between a president-appointed health adviser, Kathleen Sebelius, and the government appointed panel’s recommendations to not get mammograms til your fifty. The long and short of it?  Just get them when it’s right for you, or consult your doctor to figure out what is right for you, considering your family history, and ALWAYS do your self exams.

These days, apparently the guidelines differ as to when you should start getting mammograms, depending on who you happen to ask.  The American Cancer Society still recommends that women begin getting them done in their forties, and now a new government panel/task force has done some research and recommended that these guidelines be revised to starting them when you are fifty, and getting them every two years thereafter.  The American Cancer Society has stook by their 40 recommendation steadfastly and even refutes the idea that 50 years of age is the right time to start worrying about breast cancer.

Some are concerned that this recommendation may lead to more confusion than clarification when it comes to women who are in their forties, since it really tends to gloss over the fact that a lot of women now are getting breast cancer in their earlier age. It’s not clear though, if many of these breast cancers that are caught on women in their forties, are more often than not life threatening. In fact, the reason the panel came to the decision they did was because they said that comparatively, women in their forties getting mammograms leads to more misdiagnoses and unnecessary biopsies and worry than it does to successfully catching and treating truly life threatening cancer.

What is also under review is the fact that self examinations have come under scrutiny for being basically useless.  Many women totally disagree with this assertion, and I happen to disagree with it as well.  I know too many women and have heard too many stories of women who have discovered what turned out to be cancerous lumps in their breasts, by doing the breast self examination regularly.  These women certainly wouldn’t tell you that a self exam is worthless, if you ask me!

In the end, no matter who is making whatever recommendation, the decision is up to you.  You should also check into what is covered under your medical program or insurance, to see if mammograms would be covered for certain ages or with certain family backgrounds.  I myself found out that my insurance company through my employer will cover a mammogram for me, and I’m only 35 years old.  They just changed their guidelines to allow that, by the way, because younger patients are getting more agressive breast cancers and doctors are becoming concerned with prevention at an earlier age, especially when a family history exists on the female side, as I have on my side of the family.

Tiny Chip to Measure Breast Estrogen Levels?

Estrogen is one of the things that can feed breast cancer, and it is one of the concerns that doctors have as to the levels of the hormone in a woman’s breast when they have breast cancer, or to determine their likelihood of getting breast cancer, so they have been trying to figure out a way to measure breast estrogen levels without actually doing anything invasive, like cutting into the breast tissues (ouch).

They still may have to invade the breast tissue, but with a new possible invention, they may only need to prod the breast tissue with a needle that is headed up by a tiny microchip which can read the levels of estrogen inside of a woman’s breast.  But the implications for this type of minimally invasive therapy to tell what a person’s hormones levels are in certain areas of the body go much further than breast cancer treatment and testing whether breast cancer therapy is actually working in a patient by looking at her hormone levels when she is on estrogen limiting medications.

The implications may spread to diagnosing and successfully treating infertility in women (and potentially men too), helping to figure out the likelihood and the treatment of choice for prostate cancer in men, and basically any disease that has connections to hormone levels in the male and female body, which are unfortunately aplenty in the world of disease and physical conditions that range from burdensome to life threatening.

The idea behind this high tech, under development high tech hormone detecting chip is that it uses electrical currents to separate hormones from other cells, and then gathers them together to test for their levels.  It does this all, miraculously, on the surface of a tiny, almost microscopic chip. Of course, this product is years away from any type of release into physicians and oncologist’s hands, but it is nonetheless intriguing to think of how this could be used in the future of medicine.

Breasts have a high concentration of estrogen in them normally, and women with breast cancer have an even higher concentration of the hormone in their breast tissue, so this signifies a higher likelihood of a woman developing breast cancer, however right now the technology to detect hormone levels in a breast are highly invasive, with a large chunk of breast tissue being needed from the patient in order that a scientists/researcher may study it and determine the hormone levels.

Obviously, this is not preferable and results in a lot of trauma, so if a better method can be attained, that would be awesome for women everywhere.

Emotional Impact of Breast Cancer on Couples

One part of breast cancer that isn’t addressed nearly enough by the caretakers that are thrust into the situations, such as the hospital, medical centers and the oncologists themselves, is the fact that breast cancer has a real emotional impact on couples.  It often puts a strain on even the most loving and supportive of relationships because of the unresolved feelings of guilt, pain, frustration, and even resentment that may brew over the woman’s illness and her partner’s and her feelings the go along with the debilitating and crippling feelings that come with such a serious illness.  Especially the more serious the disease gets or the further into stages it gets.

There are a lot of things that couples in intimate relationships really don’t want to talk about because they are afraid it will make them look weak or not supportive enough.  Things like feelings of lessened sexual attraction, perceived selfish motives of wanting one’s spouse to be in good health, spirits and physical appearance. These things are not only embarrassing to talk about, but they are hard even to admit to one’s self.  Often times men feel guilty and helpless that they cannot help their wives or their partners out of their pain, and they also feel conflict because they feel selfish that maybe now their own needs won’t be met.

Here they are, threatened with the loss of their loved one, and also fighting feelings over viewing the breasts, which were once an object of desire and eroticism as the very thing that threatens the life of the woman they treasure, love and need, and who may also be the mother of their children already or in the future.  They face feelings of fear over being left alone, over having their lives as they know it taken away from them, and yet they don’t feel they can talk about this with their partner because she is already going through enough as it is.

Women have it even worse, because they are the ones that are facing the possibility of mortality. Women often feel guilty too because we often feel that we always have to be the consummate caregivers and providers of comfort and affection toward our spouses and any involved children, and when that prospect is threatened, women often feel conflicted over taking care of themselves properly and taking care of their families. They often find this hard to voice to their spouse, and this becomes a communication breakdown that can really harm the relationship.

Getting counseling is vital for any couple going through the journey of a cancer battle if they are to come through it intact and without any real drama or serious damage to the relationship.

Depression and Loneliness Equal Higher Breast Cancer Risk?

As you know, there are many, many risk factors that contribute to the likelihood of you getting breast cancer.  Number one is still supposed to be genetics, since there are genetic markers that can make you several times more predisposed to getting this common cancer, although I still believe personally that lifestyle and diet habits also play a large role as well.

And, of course, you know that lifestyle factors such as smoking, drinking alcohol, and your diet regimen also make a difference in your risk profile as well.  That is why it’s important to manage these facets of your life. Well, there is another one that you may want to closely manage now as well, and unfortunately managing it isn’t so easy for some of us, especially those of us  who are naturall prone to it or have livelihoods where it happens to be a natural biproduct of what we do. I’m talking about stress.

Not just stress though, isolation.  In other words, it has been found that isolation in women many times is accompanied by stress and anxiety, which has been shown to be linked to higher risk of breast cancer.  Studies were actually done on mice, who have biological systems much like us humans, and it was found that when they were witheld from socialization and put in an isolated situation, the stress that was caused by the isolation altered the way the genes acted, making it more likely they would succumb to abnormal cell growth (aka cancer) of the breast tissue.

This led researchers to believe that stressful lifestyles definitely can lend a hand to determining whether someone will develop cancerous growth of tissues that are prone to cancer from the beginning.  If one can control their stress better, obviously this is better for your overall health, and also contributes to lessening of heart disease and other stress triggered and aggravated conditions, but it also now can definitely help with the likelihood of developing breast cancer in females.

Avastin Drug Trials Stopped

A new and promising breast cancer drug called Avastin was being clinically trialed in patients with breast cancer, when the trials were recently stopped due to potential signs of heart failure in six of the 200 patients who were enrolled in the trials started to show signs of possible heart failure. The drug is actually already approved as part of therapy for various other kinds of cancer, and was undergoing trials to see if it could help treat and cure breast cancer.  It’s a shame it was found to have potentially serious side effects, as we can use all the effective drugs in our corner as we can get when it comes to invasive breast cancer.

The studies that were being done with the 200 patients who were enrolled voluntarily were how the Avastin drug might work in combination with the most common type of treatment for most cancers (and in my opinion the most deadly), chemotherapy.  The drugmaker Roche, who I’m sure is disappointed since Avastin is their biggest seller currently, said they halted the trials when patients who were in the early stages of breast cancer began to exhibit symptoms of heart failure, which included shortness of breath, fatigue, and swelling in certain tell tale parts of the body which are traditionally indicative of heart failure.

Since the study was halted after the agreement that it would be halted if six in the first 200 exhibited any types of signs of heart failure, since this was a study to help determine it’s safety for the heart, five of the six patients have totally returned to normal heart function, while it is unclear whether the last person has returned to normal.  It is not clear whether the combination with chemotherapy had anything to do with the side effects that occurred that may have affected heart function, but to me it wouldn’t be surprising since chemotherapy is toxic to so many different organs in the human body.

This is obviously a disappointment that we don’t have another viable and somewhat safe alternative for treating breast cancer, but I’m sure there will be more trials that the medical community comes up with in the future, it’s just a matter of how safe and when they come up with them.  For now, it looks like Avastin may not be an option offered for the treatment of breast cancer, at least not in the dosage and specifics that were administered for this trial.

Milk Duct Pre Cancer Diagnosis

I had never known that there could be a sort of “pre cancerous” diagnosis of the breast (the milk ducts in particular that supply milk to infants when a mother is breastfeeding), kind of like the diagnosis of precancerous cells in the cervix which are usually due to HPV, which it is thought currently can lead to full blown cervical cancer if left untreated.  Apparently, you can be diagnosed with this fairly common carcinoma, which is a type of abnormal cell growth (cancer) that grows within the milk ducts of the breasts, but typically does not invade the body like invasive breast cancer does.

For this reason, this type of carcinoma is not as deadly, in fact only about 2% of women die from it over the next ten years of their lives after being diagnosed, however, it is still important to get it treated either via some sort of radiation or even chemo, or a surgery, so that it does not become invasive.  It is thought but not completely proven that if it is left untreated, much like HPV cells on the cervix, it could indeed become cancerous and invasive and require much more serious treatment and become a much more serious diagnosis.

Doctors want to be able to call this precancerous stage something other than the current term “carcinoma” because they feel that some of the other names for it that are floating around, such as precancer or stage 0 breast cancer are less scary and more patient friendly. They feel that these names, rather than carcinoma, which is obviously always mentally associated with serious cancers, more adequately addresses what it is while conveying to the patient that it is not very serious of life threatening, and yet it does need to be treated effectively to prevent any future problems.

The whole problem with this precancerous growth in the breast’s milk ducts is that doctors do not currently have any way of identifying patients with any sort of certainty who are truly a high risk for having the cancer come back as a full blown invasive breast cancer.  Sure, they should treat it anyways, but it would be nice to be able to accurately identify the patients who are at higher risk to determine what type of treatment to pursue, and identify their risk factors to communicate this to the patient.  Some women even have the breast removed to prevent a possibility of invasive breast cancer in the future, and if that sort of traumatic experience isn’t necessary, then why put the patient through all of that?