Friday, July 3, 2015

The Odds Are Overwhelmingly In My Favor

When the radiologist used the ominous “I’m very concerned” about my latest mammogram, my mind just stopped. He kept asking if I had questions. “No,” I said. No, I thought. Again? No, not again. My surgeon, whom I had not seen since he had given me my all-clear four years ago, made time for me that afternoon. He looked at the films and ordered a biopsy, but he began talking treatment immediately. Yes, again.

Eventually I caught my breath and cleared my head, and then I called Pat Jones, one of the many virtual friends I have met since my first breast cancer diagnosis in 2006.

In addition to sharing a name and being the same age, Pat and I now share a diagnosis: two different bouts of triple-negative breast cancer.  Pat was diagnosed the first time in 1987, the second in 2003. She’s 28 years past her first diagnosis and 12 past her second.

I am nine years past my first and three weeks past my second.

Oh, and ugh.

If I have to follow Pat’s footsteps by getting TNBC twice, I plan to also follow her long disease-free lifeline.

To be clear: This is a second primary cancer, not a recurrence. My original cancer is long gone, but I am special and get to have a second serving. The second cancer was tiny—4 mm, or .4 cm. Miniscule. So small that the surgeon couldn't even feel it, despite knowing exactly where it was. My prognosis is excellent. We got it exceptionally early.

It was in the same breast as the last one, so I could not have a lumpectomy, as that breast has already been radiated; radiation only works once.

Still, I would have chosen a double mastectomy even if a lumpectomy had been an option. I would have done this with my first diagnosis had I been better informed. (Lumpectomies plus radiation are as effective as mastectomies on treating individual tumors, but they leave breast tissue that can get a second cancer later.)

I now know the territory much better and felt it was time to send both sisters packing, including the healthy one. I didn't want to worry about the possibility of cancer in the other breast, plus I didn't want to be a one-breasted wonder. I did not have reconstruction. I have never defined myself by my breasts, and I did not want to add more foreign elements to my body, so I am good with my new boyish charm, some occasional polyester fiberfill and eventually, perhaps, breast prostheses.

Talking to Pat was a godsend—she made me laugh, she sent me pictures of cheap padded bras she gets at Walmart, she told me about her full life after a double mastectomy, and she encouraged me to blog about this. We talked for more than half an hour and I got off the phone with renewed faith and energy.

Our talk and subsequent emails made me realize how much I have gained from my relationships with other women on this little journey of ours. My introduction to Pat came six or seven years ago, when I saw her comments regularly on various breast cancer discussion sites, encouraging others with TNBC under the name Noni Jones. I contacted her, asking to interview her for my book, and she agreed. Her daughter Candy was also diagnosed with TNBC several months after Pat and she is also 12 years past diagnosis, cancer-free.

How fortunate I am to know just who to contact to calm me. To provide the been-there-done-that-and-moved-on.   

For a remarkable professional perspective, I also emailed Carol Scott-Conner, a surgeon at the University of Iowa Medical Center, who wrote the foreword of my book.  Carol is, first, a warm and wonderful woman who, interestingly, is also my age. Equally important at this point, she is a breast cancer surgeon who also became a breast cancer patient; she had a mastectomy in 2013. She called me right away. Her assessment of my prognosis: “The odds are overwhelmingly in your favor.” Yes! I hung up, reassured and blessed to have this caring woman in my life.

So this was a shock and not how I planned to spend my summer. But, hey, as Pat reminds me, I am “one lucky chick.” This puppy was in its infancy and it is now gone. Had I put the mammogram off until this fall, as I had considered, I could be facing a different scenario.

As it is, the odds are overwhelmingly in my favor.

The Details
I had a routine mammogram June 3, then was called back the next day because the radiologist had seen calcifications. Most women have calcifications at some point and the great majority of them are benign. They come and go and are more common as we age. Some, though, spell trouble. I had a close-up mammogram that showed dense tissue behind the calcifications. An ultrasound didn't help much—the mass was so small the technician had trouble finding it.

(One annoying, sort of heartless tidbit: The technician called in another woman to help her find the mass. The second woman zoomed in and found it right away. “There!” she said, with smug satisfaction, obviously pleased with her success. Good for her, she found that I probably had cancer. Glad it made her day.)

The radiologist invited me into his lab to look at my film. My calcifications were linear, with uneven sizes and shapes—he made it clear he thought I had breast cancer again. Very small, very early, perhaps DCIS. But breast cancer nevertheless.

My surgeon ordered a stereotactic, or mammography-guided, biopsy. That didn't work because the calcifications were so close to the skin the radiologist was afraid he’d tear a hole in me with the machine. So I ended up with an ultrasound-guided biopsy.

The radiologist who eventually did the biopsy was the same one who did my original and who told me, at that time, encouragingly, “This is not that bad.”  This time, she said, “You know this is tiny, don't you?” So I again was benefitting from her positivity, again benefitting from a strong woman I had met through my first cancer.  She said the calcifications could actually be benign lines caused by the radiation. Think about that, though: caused by the radiation.

She called the next morning, June 12, with the results. From her tone, I knew what was coming: It was cancer. Infiltrating ductal carcinoma, 5 mm, with accompanying DCIS. It was high grade, which told me it was likely TNBC again, although receptor status was not yet indicated.

My surgeon was on vacation in California, but called when he got the results. I scheduled the surgery for ten days later, June 22. Surgery was a success, with no lymph node involvement, and the tumor was even smaller than they thought: 4mm. It was indeed TNBC again. I had the dreaded drains for a week, but blessedly had them removed three days ago. No more treatment is needed. It’s too small for chemo to be worth the risk and tamoxifen does not work on TNBC.

I am thankful for that eagle-eyed radiologist who first saw my weird calcifications and called me back in, and for the timing of my mammogram.

I am once again going for daily walks with my husband. Today we did two miles and I hope to keep pushing that until I get back to the four miles that had been our standard.

Family and friends have surrounded me, reminding me I am cherished. Our daughter came to pamper us with love and life and amazing food. And for days after the surgery, our doorbell regularly rang with floral deliveries. I’ve illustrated this post with some of them. I got personal and virtual hugs galore; happy, funny, and thoughtful cards; and I have celebratory lunches with friends every day next week. Soon we will finally head to our Colorado cabin for the rest of the summer.

Now that I have processed it all and got the final, encouraging pathology report, I have regained my perspective. On a scale of one to ten of the worst things that could happen to me, I would rank this at about a four.

My morale is great and I am healing well. I am usually surprised when I try to reach something and it hurts. Then I remember, "Oh, yeah, surgery." 

But I know I got this sucker.


Saturday, April 25, 2015

When And How You Eat May Affect BC Risk

Women who fast for at least 12 hours overnight—from 7 p.m. to 7 a.m., for example—may reduce their risk of breast cancer, according to research in the journal Cancer Epidemiology, Biomarkers & Prevention and presented at the American Association of Cancer Research’s annual meeting in Philadelphia.
They also reduced their blood glucose, which helps fight against diabetes. And some forms of breast cancer, especially triple-negative, are linked to insulin resistance, including high glucose.
And get this: Each three-hour increase in nighttime fasting was associated with a 4 percent lower glucose level after eating, regardless of how much they women ate.
“The dietary advice for cancer prevention usually focuses on limiting consumption of red meat, alcohol and refined grains while increasing plant-based foods,” said co-author Ruth Patterson, PhD, UC San Diego Moores Cancer Center associate director for population sciences and program leader of the cancer prevention program. “New evidence suggests that when and how often people eat can also play a role in cancer risk.”
Women in the study reported eating five times per day with a mean nighttime fasting of 12 hours. Those who reported longer fast durations also indicated they consumed fewer calories per day, ate fewer calories after 10 p.m. and had fewer eating episodes.
Source: News release from the American Association of Cancer Research

Early Stress Management May Reduce Cancer Risk

Managing stress early on has long-term benefits to women undergoing treatment for breast cancer, according to the online journal CANCER.
Patients who learned relaxation techniques and new coping skills in a supportive group over 10 weeks were less depressed and had a better quality of life up to 15 years later.
“Women with breast cancer who participated in the study initially used stress management techniques to cope with the challenges of primary treatment to lower distress. Because these stress management techniques also give women tools to cope with fears of recurrence and disease progression, the present results indicate that these skills can be used to reduce distress and depressed mood and optimize quality of life across the survivorship period as women get on with their lives,” said lead author Jamie Stagl, who is currently at Massachusetts General Hospital, in Boston.
Women with breast cancer worry for years about recurrence, which can strongly affect their view of life after cancer and this research may guide docs in warding off some of those most serious effects. The key: deal with the issue of stress directly, professionally, and early on. And this may do more than improve our moods. It may reduce risk of recurrence, says Michael Antoni, PhD, of the University of Miami, who developed the stress management techniques used in this research:
“Because depressive symptoms have been associated with neuroendocrine and inflammatory processes that may influence cancer progression, our ongoing work is examining the effects of stress management on depression and inflammatory biomarkers on the one hand, and disease recurrence and survival on the other.”

Wednesday, January 7, 2015

I’ve Had My Say

My art teacher reminded me of one basic rule last night: Know when to stop. Too often, artists overdo it, adding details to a painting that is already actually finished, ruining it in the process. I have done a lot of this in my artwork—extra lines that end up fighting with the rest of the scene and colors that don't match the original.

It’s the same with writing. As a writing teacher, I usually have to tell students that they have already ended an article, that any extra work only adds words but not meaning, perhaps even confusing the reader.

End when you are finished, I tell them.

Not helpful, they say. How do I know when I am finished?

Do you have anything more to say?” I ask.

Usually, the answer is no. They have exhausted the topic but don't feel secure to let it go.

So it is with this blog. I have been doing this for a tad over seven years and I now know it is time for me to stop. I have said what I have to say. I have gone as far as I can.

The world is far different in terms of triple-negative breast cancer than when I started. Other media outlets now regularly write about TNBC. And research has significantly increased, with the focus on metastatic disease and genomic testing. 

Women with TNBC are no longer the wallflowers at the breast cancer prom.  Fewer and fewer reports use the scary language—incurable, lethal, deadly—that defined the disease and the reporting on it in its early days. Yes, those words still sneak into some news releases, but that is no longer the standard.

So the time is right for me to move on. I will leave the blog up, as the information here remains current. I am not going to add to it, though. Instead, I am going to focus on general health writing, essays, and art. I am developing a more general blog on my website at It is a work in progress, so if you head there, be patient as I begin building a new body of work. And while I learn how to handle the blasted technology.

My book, of course, will remain a resource. And I will continue to give talks, but my approach will be more focused on overall health. And I will do writing workshops and coaching.

I have loved getting to know all of you and I appreciate how you have invited me into your lives. This has been rewarding and fulfilling.

But I have had my say.

Hugs to all of you.

Saturday, December 13, 2014

Women with TNBC worry more, want more information

The good people at Living Beyond Breast Cancer have put numbers to what we all know: Women with TNBC worry a lot and we really, really want information. The study was presented at the 2014 San Antonio Breast Cancer Symposium. Says LBBC CEO Jean A. Sachs:
 Women with triple-negative breast cancers are information seekers, as we can see from the thousands of interactions we have with them via LBBC sponsored webinars, community meetings, conference workshops and first-person blogs on LBBC’s website. And they’re frustrated that they don’t have more treatment options.” 
LBBC presented two studies at SABCS. The first was Education and information preferences for women with triple-negative breast cancer: Should personal or medical demographic variables impact program tailoring?” It found that TNBC women "had a significantly stronger preference for information tailored to breast cancer subtype."

The second abstract,“Emotional/psychological characteristics of women with triple-negative breast cancer: Do socioeconomic, demographic, and provider variables impact emotional change from diagnosis to post-treatment?” concluded that:

 “Women with TNBC experience greater fear, anxiety, and worry than women with non-TNBC subtypes at all points from diagnosis though post-treatment. While women with all breast cancer subtypes report a reduction in negative emotion over time from treatment to post-treatment, this change is less profound in TNBC women and appears to be driven nearly entirely by concern about the disease. The marginal effect on change in fear with respect to income may reflect concerns about paying for care, and increased worry in women with small children may reflect concerns about prognosis. Most strikingly, cancer stage was the strongest modifier of emotional change: TNBC women at cancer stage >=2 showed the least decline in negative emotion compared to corresponding non-TNBC women. These data support the development of TNBC-specific interventions focused on these patients’ emotional needs during and after treatment.”

Friday, December 12, 2014

Reduced Dietary Fat Again Connected to Reduced Death Rates for TNBC

Women with early-stage hormone-negative breast cancer (negative for both estrogen and progesterone)  who reduced their dietary fat intake for five years following a diagnosis had a 56 percent reduction in death from all causes in comparison to those who did not modify their diets, according to 15 years of data as part of the Women’s Intervention Nutrition Study (WINS) presented at the 2014 San Antonio Breast Cancer Symposium.

This was an even better response than was seen in the original WINS report, published in 2006, after five years of follow up

“HER2 evaluation was not available when this study was conducted, but it is likely that a
substantial number of ER/PR-negative breast cancers were also negative for HER2, making them
triple-negative breast cancers, which generally have a poor prognosis,” said said Rowan Chlebowski, MD, PhD, medical oncologist at the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center.

"Our findings suggest that if a lifestyle intervention is to have long-term influence on clinical outcome, it must be a lifelong change rather than be a short-term alteration."

The WINS was a randomized trial of 2,437 women ages 48 to 79 years with early-stage breast cancer receiving standard-of-care treatments at 39 centers in the United States. Of them, 1,597 had ER-positive breast cancer, 478 had ER-negative breast cancer, and 362 had ER/PR-negative breast cancer. Within six months from diagnosis, all women were randomly assigned either to a dietary intervention group (975 patients, of whom 205 had ER negative cancer, and 147 had ER/PR-negative cancer) or to a control group (1,462 patients, of whom 273 had ER-negative cancer, and 215 had ER/PR-negative cancer).

Women in the study group were given a fat gram goal by centrally trained, registered dieticians implementing a low-fat eating plan, explained Chlebowski. The women underwent eight biweekly individual counseling sessions with subsequent contacts every three months. They self-monitored their fat/gram intake using a “keeping score” book. Fat intake was externally monitored by unannounced 24-hour telephone recalls performed annually.

The study group kept fat intake at about 20 percent of daily diet.  This meant eating more vegetables and fruit. Women who did best emphasized healthy fats such as olive oil, fish and avocados and also added exercise to their regimen.

After five years of dietary intervention, fat calories were lowered by 9.2 percent and body weight
was lowered by nearly 6 pounds in the intervention group, compared with the control group.

Monday, December 8, 2014

TNBC tumors should be tested for genetic mutations, research says

Most patients with triple-negative breast cancer should undergo genetic testing for mutations in known breast cancer genes, including BRCA1 and BRCA2, according to the largest analysis to date of genetic mutations in TNBC, published in the Journal of Clinical Oncology.
The study found that almost 15 percent of triple-negative breast cancer patients had harmful mutations in breast cancer-related genes. The vast majority of these mutations appeared in genes involved in the repair of DNA damage, suggesting that the origins of triple-negative breast cancer may be different from other forms of the disease. The study also provides evidence in support of the National Comprehensive Cancer Network (NCCN) guidelines for genetic testing of triple-negative breast cancer patients.
Recent studies have suggested that triple-negative breast cancer patients might harbor genetic mutations that make them more likely to respond to alternative treatments like cisplatin, a chemotherapy agent, or PARP inhibitors, anti-cancer agents that inhibit the poly (ADP-ribose) polymerase (PARP) family of enzymes.
In the current study, researchers sequenced DNA from 1,824 triple-negative breast cancer cases seen at 12 oncology clinics in the U.S. and Europe, as part of the Triple-Negative Breast Cancer Consortium.They found dangerous mutations in almost 15 percent of triple-negative breast cancer patients. Of these, 11 percent had mutations in the BRCA1 and BRCA2 genes and the rest had mutations in 15 other predisposition genes, including the DNA repair genes PALB2, BARD1, and RAD51C. No mutations were found in predisposition genes involved in other processes like the cell cycle.
The study also found that individuals with mutations in predisposition genes were diagnosed at an earlier age and had higher-grade tumors than those without mutations. The researchers used their dataset to assess whether the current screening guidelines would identify all the triple-negative individuals with mutations in the two most common predisposition genes, BRCA1 and BRCA2.
They found that the NCCN guidelines, which recommend screening when there is a family history of cancer or a diagnosis under age 60, missed only 1 percent of patients carrying mutations. In contrast, the UK’s National Institute for Clinical Excellence (NICE) guidelines, which use the probability of actually finding a mutation to determine who should be tested, missed 24 percent of mutation carriers. They suggested expanding the NICE guidelines for TNBC patients.
Source: The Mayo Clinic.
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For more details on triple-negative breast cancer, check out my book, Surviving Triple-Negative Breast Cancer.

miR-21 most dangerous in TNBC tumor environment

High levels of the microRNA miR-21 in the environment around a tumor, but not in the cancer cells, are associated with worse outcomes for patients with triple-negative breast cancer,   according to a study in The American Journal of Pathology.
miRNAs are short RNAs that modulate gene expression. In previous research, miR-21 was associated with poorer disease outcomes in cancers of the colon, pancreas, and breast. The goal of this study was to explore in greater detail the influence of miR-21 on TNBC outcomes, looking both at the amount and the location of miR-21 expression. The authors suspected that changes in the tumor's surrounding microenvironment could be even more important than changes within the cancer cells.
miR-21 expression was found in 42.8 percent of the 901 cases tested. Patients with TNBC with high levels of miR-21 in the tumor microenvironment faced outcomes three times worse than those with lower expressions or at other locations.  
Researchers say this emphasizes the need for genetic testing of TNBC tumors and could lead to targeted treatment for those with miR-21.
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For more details on triple-negative breast cancer, check out my book, Surviving Triple-Negative Breast Cancer.

Tuesday, November 25, 2014

Genetics Lead the Way to Targeted TNBC Treatment: 17q25.3

The q25.3 region of chromosome 17 may be another genetic marker that defines subtypes of triple-negative breast cancer and, therefore, could lead to the golden grail: targeted treatment, especially for those forms of TNBC linked to the BRCA1 mutation.  In research published in the journal Breast Cancer Research, 17q25.3 was detected in 86 percent of the mutated TNBC tumors.

This is significant because, as the researchers note, the BRCA1 mutation is closely linked to TNBC, with  as many as  90 percent of tumors with the mutation being triple negative.  This does not mean, however, that all TNBC tumors have the BRCA1 mutation.  In fact, only 10 to 20 percent of all TNBC tumors have the BRCA1 mutation.  I explain this link in my book on TNBC.

Identifying patients with the BRCA1 mutation will ultimately help select patients who could benefit from  selective treatments 17q25.3.   First, though, we need those treatments.  Baby steps, friends.  But at least they are steps.

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For more details on triple-negative breast cancer, check out my book, Surviving Triple-Negative Breast Cancer.

Monday, November 3, 2014

Protein Successfully Stops TNBC in Mice

A team at the University of Kansas School of Medicine has identified a potential target for treating triple-negative breast cancer: atypical protein kinase C signaling. In a recent paper, published in the journal Cell Death and DifferentiationSoumen Paul, Ph.D and his colleagues conclude that this finding holds "tremendous" promise for treating breast cancer.

The researchers analyzed tissue samples of breast cancer that had spread to the liver, lung and other organs and found that atypical protein kinase c lambda/iota, which is known to influence cell growth, was highly expressed and phosphorylated in metastatic breast cancers.

In tests conducted on mice, the researchers depleted the protein in a line of triple-negative breast cancer and found that this significantly slowed the breast tumor growth.

Previous studies have implicated the atypical protein kinase c lambda/iota in the other cancers, they say, but no prior study had indicated any role in breast cancer metastasis. 

"We have been able to show that this protein is highly expressed in metastatic triple-negative breast cancer, and when we are depleting it from triple-negative breast cancer cells, we found that the cancer cells are not metastasizing," Dr. Paul said. "The tumor growth is slowing down. This is giving us an opportunity for a targeted therapy."

The next step would be to begin clinical trials on humans, but that could be years away.

Source: The University of Kansas

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Friday, October 31, 2014

Genetic Screening Can Predict Breast Cancer Risk

Genomic sequencing might successfully identify women who would benefit most from breast cancer screening option such as mammography. And knowing their risk for breast cancer at birth may help women take measures to modify their non-genetic risk factors, such as diet and lifestyle, and lower their risk. All this from a study published in Cancer Epidemiology, Biomarkers & Preventiona journal of the American Association for Cancer Research.

“We need low-cost screening tools that can discriminate between women who will and won’t develop fatal breast cancer that are more effective than those currently available,” said Alice S. Whittemore, PhD, professor of epidemiology and biostatistics in the Department of Health Research and Policy at Stanford Cancer Institute in California.

“Previous studies using theoretical models have predicted that sequencing the genomes of women, ranking them by risk, and then targeting those at highest risk will provide little gain in cost-effective disease prevention,” she said. “However, our estimates suggest that preventive strategies based on genome sequencing will bring greater gains in disease prevention than previously projected. Moreover, these gains will increase with increased understanding of the genetic etiology of breast cancer,” she said.

Whittemore and colleagues used data from published literature on the frequency of 86 known breast cancer variants associated with breast cancer risk. They then developed a model to estimate a woman’s lifetime probability of developing breast cancer.

“Variance is a relative measure of the heterogeneity of breast cancer risks in the population,” Whittemore said. “The more genetic variants we discover, the more heterogeneous our genetic risks will be, and the more effective it will be to target those at highest risk.”

Knowing our probability of getting cancer also might change how we live our lives, said Weiva Sieh, MD, PhD, assistant professor and epidemiologist at Stanford and first author on this study. “If a girl knew, from birth, what her inborn risk was, she could then make more informed choices to alter her future risk by altering her modifiable factors, such as diet and lifestyle.”

Source: The American Association for Cancer Research

Thursday, October 30, 2014

Five Things You Can Do Now To Reduce Your Risk of Breast Cancer

What can you do to reduce your risk of breast cancer?  These research-based tips can improve your breast health and make you feel better overall. An added benefit: you'll look better too.

1. Eat a plant-based diet of fruits, vegetables, seeds, nuts and whole grains.  Make sure you include five servings a day of fruits and vegetables. Your best best: cruciferous veggies such as cabbage, kale, broccoli, cauliflower, bok choy.  You can pack a lot of nutrition in a smoothie that takes about ten minutes to make.  Just blend a handful of kale, 1/8 a small cabbage, 2-3 carrots, 2-3 stalks of celery, and an apple, with some filtered water or all-fruit juice.  That makes enough for two, so you can encourage your partner's health.

2. Exercise at least a half an hour five times a week and do it consistently.  The more strenuous the better—running, race-walking, or boxing, for example—as long as your knees and heart and lungs can handle it.  Go for a mix of aerobic and resistance-training.  You don't need weights—sit ups and push ups will do.  And yoga is a great way to mix all-over toning with mental breaks. Try a yoga CD that takes 15 or 20 minutes first thing in the morning, before you even get out of the bedroom and get distracted.  Yoga classes are also a great way to socialize.  Walk outside as much as you can because it also reduces stress.  Amuse yourself by taking photos of your surroundings.

3. Lose weight.   Aim for the "normal" column of the body mass index.  A 5-foot, 5-inch woman who weighs 130 pounds has a BMI of 21.6, right in the middle of the healthy range.  If you eat healthy and exercise, you will naturally lose weight.  This is hard, I know. I lost 50 pounds nine years ago and it was the best thing I have ever done for myself.  I didn't dodge the cancer bullet, but I know my recovery was easier and faster because my body was geared up.  Start small and just keep at it.  Instead of going on a diet, change the way you eat so you pack your plate with plant-based foods and avoid unhealthy fats (in fried and processed foods, cookies, cakes, and other goodies.  Just switching to a smaller plate can help.

4. Limit alcohol to less than one drink a day.  Some experts say to cut it out completely.  Don't pitch the wine glasses, use them for all-fruit juice instead.  You can juice a watermelon, rind and all, put it in a fancy glass, and treat yourself.   Add some seltzer water to any old juice for extra sparkle.

5. Reduce toxins in your environment.  Add filters to your drinking water and your shower.  Use chemical-free cleaning supplies—you can do a lot with baking soda and vinegar.  Encourage your city and state officials to invest in low-pollution energy sources and to maintain clean water, free of agricultural and manufacturing run-off.  And, speaking of those drill bits, evidence is growing that dangerous fracking chemicals make their way into our groundwater—and even the best filter won't help keep them out.

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.