Wednesday, October 22, 2014

Saturday, October 11, 2014

Hope and TNBC: Now in Paperback

Remember when your doctor told you that you had breast cancer?

Oh, yes, you sigh.

And remember when your doctor told you it was an especially aggressive form called triple-negative, or estrogen negative?

Oh, yes, you shudder.

I suspect your reaction was like mine—confusion and terror.

Well, I was there eight years ago and now, look what I have done. I survived. Eight years!  I have seen the birth of two grandsons since then, started painting again, traveled all over the darn place, and just generally get up every day like a regular person.   

And the thing is, I am not unusual.  The majority of women with non-metastatic triple-negative survive and go on to live long, full, meaningful lives.

And that is one of the many messages of my book, Surviving TripleNegative Breast Cancer:  Hope, Treatment, Recovery, now in paperback.

Notice the emphasis on hope.  That’s because I know so many women are terrified at this diagnosis—they think they cannot survive.  And I understand that completely.  

When I was diagnosed, I went online—of course, isn’t that what we all do?  And what I found there terrified me—so many stories about this being an especially lethal form of cancer, about how aggressive it is, how the odds are against you.

The reality is far less scary.  Far, far less. It is true that the survival rates for the more common form of breast cancer—hormone-positive cancer—are better than they are for triple-negative breast cancer.  And it is true that metastatic TNBC can be touch to beat. But, still, I repeat, the majority of women with TNBC survive.  That has become my mantra. Repeat after me: The great majority of women with TNBC survive.  

In studies, as many as 90 percent of those with early stage TNBC survived.  That’s a great statistic.  Survival rates go down with higher stages, but even through stage 3, studies show that TNBC is highly survivable.  
So, through my book and my blog, I am trying to counter the gloomy prognosis that is often automatically connected with this disease by doctors, journalists, and researchers.  This is not a disease to take lightly—but in the great majority of cases, it responds to treatment.

I repeat, The great majority of women with TNBC survive.    

Here are some of the things I talk about in my book:

• I tell my story—briefly.  And I tell the stories of 11 other marvelous women who had estrogen negative or triple-negative and survived quite beautifully.  One was breast-feeding her son when she was diagnosed.  That son is now past 30.  Two had babies after treatment, one got married in her 50s, one is competing in triathlons.  One had two bouts of TNBC and has survived the second for ten years.

Wonderful women.  Wonderful stories.

• But the core of the book is in research—triple-negative breast cancer is now the subject of some important studies worldwide, and I share the results of that research.

• I explain the disease and what we know about risk factors.  I show you how to read your pathology report.  And I expand on treatment options.  Triple-negative responds well to chemotherapy, so most women have some form of surgery, chemo, and radiation.  Metastatic, or stage 4 TNBC, is hard to fight, as are all stage 4 cancers, but it is the focus of most of the current research, so I am hopeful we find a treatment soon.   

• And I talk about things we can control ourselves—diet and exercise.  And give some tips on how to maintain a healthy approach to both.  Plus, I offer the triple-negative breast cancer diet—a blueprint for healthy eating.

I approach the reader as a real person—I understand that she needs information and encouragement and perspective and, sometimes, a reason to laugh.   

I am a journalist and a college professor, so I applied the skills I learned as a teacher, writer, and researcher to this book.  Most important, I survived.  And you can do.

Surviving Triple Negative Breast Cancer can show you how, and can give you the hope—based on detailed research—you need.

Friday, October 10, 2014

Radio Frequency Technology Can Replace Getting Your Breast Wired for Surgery

The localization wire was one of the most outrageous aspects of my breast cancer surgery.  The thin wire is inserted into the breast through a needle to help mark the location of a tumor on the day of surgery.  In my case, the wire then was covered with a Dixie cup—yes, a Dixie cup—to protect it while I was wheeled toward surgery.  This was especially humiliating because I had the wire inserted in a clinic and then was then transported through a well-populated atrium to the hospital with that cup sticking out of my cup.  

Certainly, I thought, this isn't common.  Turns out it is and it is still happening.  (Without the extra cup, I hope.) But a team of docs at the University of Wisconsin-Madison are hoping to make some changes.

The team's solution: a system that replaces the localization wire with a radio-frequency tag that helps the surgeon track the tumor's location with greater precision.   

"It's not something I think I would wish on anyone," says Dan van der Weide, a UW-Madison professor of electrical and computer engineering. "It's stressful to place this wire on the day of a difficult surgery."

And to an engineer's eye, the localization wire creates all kinds of obstacles to the end goals of removing a tumor while preserving as much healthy breast tissue as possible. For example, the wire is inserted when the breast is compressed in a mammogram machine or under ultrasound guidance. If the mass or cancer is in the center of the breast, there may be a distance of more than two inches from that mass to the skin where the wire must exit.

"I get a 2-D picture of where  the wire is in the breast, but it's a 3-D event—and requires piecing the pictures together to find the cancer," says Lee Wilke, director of the UW Health Breast Center and a UW-Madison professor of surgery.

Even at best, the localization wire is simply marking one point along the boundary of the tumor, leaving it to the surgeon to figure out the rest of the picture. "The wire can be very biased, because it only comes from one direction," Wilke says. "It's been this way for more than 30 years."

One possible workaround is to implant a small radioactive pellet at the location of the tumor, then track it with a handheld radiation detector. But Wilke points out that cancer clinicians are already exposed to a lot of radiation, and putting them at even more risk obviously isn't good for anyone.

Radio frequency identification (RFID), a widespread technology with many applications in tracking and communication, offers a compromise.

Because the tag could be implanted while the patient undergoes a biopsy, it essentially eliminates not only the wire but also the entire localization wire-implant procedure, which, according to a news release, "can save up to $2,500 per patient."

My question:  $2500?  Is that what we were paying for that wire?  I wonder if I got charged extra for the cup. 

Source:  News release from the University of Wisconsin-Madison.

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Thursday, October 9, 2014

A Prayer in Itself

This beautiful Vermont scene feels like a prayer to me—a thankful, hopeful moment with God.  Sometimes we think prayer has to be formal.  To me, just giving thanks for this and for all the beauty in our lives is the best prayer we can offer.

PHOTO BY PAT:  Warren, Vermont

Wednesday, September 24, 2014

To Joan Lunden: Most Women Beat TNBC

Joan Lunden is being treated for triple-negative breast cancer, according to People magazine.  It's the same type of cancer Robin Roberts has battled.  And, of course, me and many of those who read this blog.

She has started chemotherapy and has agreed to go public with her treatments, which I hope takes some fear out of the disease for others facing it.   I send her virtual hugs, but more important, I send hope. Even though this disease can be aggressive, it is not necessarily so, and the great majority of women with non-metastatic TNBC beat it.  

Go, Joan. 


Monday, September 22, 2014

Breastfeeding Reduces Risk of TNBC in African-American Women

[Information below is from Boston University and has been edited to eliminate misleading comments, such as that triple-negative breast cancer is automatically aggressive.]

African-American women who have had children and never breastfed appear to have an increased risk of developing estrogen receptor-negative breast cancer, including triple-negative breast cancer, according to a study published in the Journal of the National Cancer Institute.  

This is consistent with previous research that showed that breastfeeding reduced TNBC risk in all women.

Researchers combined data on breast cancer cases and controls from four large studies, including the Boston University Black Women's Health Study. The combined analyses included 3,698 African American women with breast cancer, including 1,252 with the estrogen receptor-negative subtype.

They found that women who had four or more births and had never breastfed any of their babies had a 68 percent higher chance of developing this type of cancer compared with women who had only one birth and had breastfed that baby.

African-American women are more likely die of breast cancer than white women, and are more likely to be diagnosed with triple-negative.

Although previous studies have shown that overall risk of breast cancer may be elevated during the first 5 or 10 years after giving birth with a subsequent reduction in risk, this study suggests that the adverse impact on estrogen receptor negative breast cancer persists over time. The biologic mechanisms behind the association, however, are unclear. One hypothesis is that the immune system/inflammatory processes that occur after birth may play a role.

Whatever the cause, breastfeeding looks like one way to reduce risk—not to mention that it is just good for both mom and baby.

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Saturday, September 13, 2014

Fruit Fly Another Tool Against TNBC

Photo from the University of Wisconsin
Researchers at Mount Sinai Hospital in New York are trying the ultimate approach in personalized therapy, targeting medullary thyroid cancer, colorectal cancer, and triple negative breast cancer. 
They inject the common fruit fly with a genetic copy of a patient’s tumor and test “thousands of drugs to see if any of them—either alone or in combinations—eradicates the tumor without killing the fly. The next step: to administer the successful drug cock­tail to the human patient.”  Read more.