Saturday, January 28, 2012
Friday, January 27, 2012
Thursday, January 26, 2012
Wednesday, January 25, 2012
The most intriguing research, from a TNBC perspective, was conducted in Germany on 1,948 women with an average tumor size of 4 centimeters (about 1.6 inches). All received neoadjuvant chemotherapy of docetaxel, epirubicin and cyclophosphamide. Some were randomly assigned to receive Avastin.
Pathological complete response (pCR) was increased in the 663 women with TNBC who were given the Avastin.
• The pCR of those with TNBC who were not given Avastin was27.9 percent.
What is vitamin D? Well, although we refer to it as a vitamin, it is, in fact, a hormone. It is obtained from the diet or from exposure to sun. The most potent form of vitamin D is that associated with sunlight exposure. Once in the body, vitamin D interacts with cells at very specific receptors. The term receptor reflects the role of these “landing sites” contained within the cell’s nucleus. As the vitamin D molecule traverses the cell membrane and enters the cell nucleus, it binds with the vitamin D receptor, which connects to the chromosome at a hormone response element and drives the cell machinery forward.
The vitamin D receptor is part of a large collection of genes called the steroid super gene family. These include receptors for estrogen, progesterone, testosterone, and, yes, vitamin D. Read more.
Sunday, January 22, 2012
I was diagnosed eighteen months ago with TNBC Stage 3C Grade 3 with 33 positive lymph nodes and a 5.2 cm. tumor. I immediately had a left mastectomy and a complete axillary node dissection. Then I entered a study at UNMC [University of Nebraska Medical Center] and received 4 cycles of Adriamycin plus Cytoxan followed by 4 cycles of Taxol plus 4 cycles of gemcitabine plus 4 cycles of Avastin and an added 6 months of Avastin every three weeks. After chemo, I had 35 daily treatments of IMRT radiation with a boost at the end.That was what my doctors did.I changed my diet and eliminated sugar and fat and lost 35 pounds. I still eat that way - except when I went to Spain. I walked a mile a day through treatment and added pilates two times a week after I recovered from surgery.I went to a wonderful twelve-week program called A Time to Heal and my type of program included our caregivers, so my husband came too. My friends fed me healthy, fresh organic food through chemo. I continued to work part time - which was really good for me.In May I finished treatment and took my first trip to Spain to visit my daughter, son-in-law and grandson. In August I went back to work full time. I just returned from my second trip to Spain and feel very, very blessed.I have a ton of energy -- probably walked 4-5 miles per day in Spain and kept up with my toddler grandson - even helping my daughter carry him and his stroller up and down many stairs at the metro station! I have a strong faith and look at each day as a gift from God. I believe I am at this point because of Him, my doctors and caregivers, my family and friends, my students and co-workers and my positive attitude.
Saturday, January 21, 2012
OK, today is silly time.
This image, titled "Paper Training Our Little Dog Frank" made me laugh. I hope it gives you a little glee as well. It is from Bent Objects.
• Two fish are in a tank, and one says ''How do you drive this thing?''
• I went to buy some camouflage trousers the other day but I couldn't find any.
• I slept like a log last night...woke up in the fireplace.
• Two snowmen are standing in a meadow. One snowman turns to the other and says, "Do you smell carrots?"
Laughter can be excellent therapy. Go for it.
Breast cancer survival rates are measured from the date of diagnosis. Research has shown that the risk of recurrence for triple-negative breast cancer is highest up to three years after diagnosis; at that point, it drops significantly.
In one study, published in Clinical Cancer Research, researchers followed 1,601 women for up to 8.1 years. 180 of these women (11.2%) had triple-negative breast cancer.
Compared with other women with breast cancer, those with triple-negative breast cancer had an increased likelihood of distant recurrence…within 5 years of diagnosis but not thereafter. The pattern of recurrence was also qualitatively different; among the triple-negative group, the risk of distant recurrence peaked at ∼3 years and declined rapidly thereafter.
And according to the National Cancer Institute, survival rates are measured from time of diagnosis. Some definitions:
Cancer-specific Survival: The period from diagnosis until death from the same cancer, whether the original lesion or to a second primary, same cancer or related causes. (Adapted from DJA Punt et. al., 2007)
Disease Free Survival, Disease Free Interval :The period from date of diagnosis until date of first recurrence, loco-regional or systemic. (RTOG)
Overall Survival :The period from date of diagnosis until death from any cause. (RTOG)
Progression Free Survival, Progression Free Interval : The period during and after treatment in which a participant is living with a disease that does not get worse. Typically it is the period from date of diagnosis until 1) loco-regional or systemic recurrence, 2) second malignancy, or 3) death from any cause; late deaths not related to cancer or its treatment are excluded. (RTOG)
Tuesday, January 17, 2012
Monday, January 16, 2012
“When I reach three years past diagnosis, I can breathe again,” a friend with triple-negative breast cancer told me recently. Triple negs, as we sometimes call ourselves, can begin celebrating our cancerversary at the three-year mark. TNBC is generally more aggressive than hormone-positive breast cancer, but if it does not recur within three years, our chances of beating it are high.
Still, the friend planned to start living in three years.
That’s about three years off schedule.
We have today to live, today to appreciate, today to enjoy, today as a blessing. Today as a celebration. Really, today is all anybody can really plan on, so why not make the most of it?
I am reading Joan Didion’s A Year of Magical Thinking, about the death of her husband, John Gregory Dunne. He died of a heart attack in the middle of a conversation as they were sitting down to dinner. Neither had gone into that day with the slightest thought that it would be his last. Yet one minute they were chatting and the next he was slumped over the table; he never recovered.
So, if you are stewing about what you might have done differently in the past to avoid cancer and planning what you will do in the future when you finally believe the disease is behind you,it may be time to think a little differently. Think about what you can do today. And try to appreciate the beauty of this day.
We have it.
It is ours.
Photo by Pat: wild orchids in the Andes, off the Inca Trail near Machu Picchu
Saturday, January 14, 2012
Monday, January 9, 2012
FROM A NEWS RELEASE PROVIDED BY LIVING BEYOND BREAST CANCER(LBBC):
January 10, 2012; Philadelphia, PA | Living Beyond Breast Cancer (LBBC) has announced the release of Understanding Palliative Care, the newest title in the organization’s library of “Guides to Understanding Breast Cancer.” It joins three other LBBC publications designed specifically to address the needs of women living with metastatic breast cancer.
“The best way for women to face breast cancer is to obtain the resources necessary to make informed decisions that allow them to become advocates for their own health,” comments Jean Sachs, MSS, MLSP & CEO of Living Beyond Breast Cancer, “and palliative care is often highly misunderstood. Some people believe it is equivalent to planning for the end. But, palliative care has been shown in studies to improve quality of life and in some cases lengthen (life). It is our intention to demystify some of the myths about palliative care with this guide.”
Understanding Palliative Care was authored by Michael J. Formica, MS, MA, EdM, Editor and Project Coordinator at LBBC with the assistance of healthcare professionals and women living with advanced breast cancer.
“A challenge facing many women with advanced breast cancer is getting the most out of treatment while continuing to live life fully,” adds Formica. “Understanding Palliative Care was written to help make sense of and better understand the role this type of care can play in developing a more complete approach to treatment. LBBC provides the most up to date information on medical advances, treatment and management of physical and psychological side effects, clinical trials and practical information on improving quality of life.
Understanding Palliative Care is divided into eight sections that explain palliative care and its benefits, as well as related options that can support and sustain treatment. In addition, Formica adds that the new guide has been designed to provide valuable information about choosing palliative care, how it can enhance quality of life, strategies for coping with the difficult feelings associated with managing metastatic disease and practical information on financing this type of care.
In addition to Understanding Palliative Care, LBBC also provides three additional guides specific to the metastatic breast cancer community. A guide for women newly diagnosed with advanced disease will be released later this year.
All of Living Beyond Breast Cancer’s publications are available free to women affected by breast cancer in print or PDF format. Healthcare providers can order multiple copies of these or any of LBBC’s extensive selection of guides for a small shipping and handling fee.
For twenty years, Living Beyond Breast Cancer has been empowering women to live as long as possible with the best quality of life regardless of educational background, social support or financial means. LBBC provides national educational programs and services that include a website, lbbc.org; a toll-free Survivors’ Helpline, (888) 753-LBBC (5222); the “Understanding Breast Cancer” guide series; national conferences; free teleconferences; networking programs; quarterly newsletters; publications for African-American and Latina women; healthcare-provider trainings; transcripts, video and MP3 podcast recordings and the Paula A. Seidman Library & Resource Center.
Saturday, January 7, 2012
If you think of our DNA as an immense piano keyboard and our genes as keys—each key symbolizing a segment of DNA responsible for a particular note, or trait, and all the keys combining to make us who we are—then epigenetic processes determine when and how each key can be struck, changing the tune being played.One way the study of epigenetics is revolutionizing our understanding of biology is by revealing a mechanism by which the environment directly impacts genes. Studies of animals, for example, have shown that when a rat experiences stress during pregnancy, it can cause epigenetic changes in a fetus that lead to behavioral problems as the rodent grows up. Other epigenetic changes appear to occur randomly—throwing a monkey wrench into the engine of nature versus nurture. Still other epigenetic processes are normal, such as those that guide embryonic cells as they become heart, brain, or liver cells, for example.
In the last decade we have learned by studying very simple organisms such as bacteria that gene expression -- the extent to which a gene is turned on or off -- varies greatly among individuals, even in the absence of genetic and environmental variation. Two cells are not completely identical and sometimes these differences have their origin in random or stochastic processes.
So, while identical twins may appear identical, and while they as genetically close as two humans can be, they remain individuals on the cellular level. One may be more cancer-prone than the other even without differences in the environment.
So, what is it: Nature? Nurture? Both? Neither?
It seems to be a complex mix of all of the above, with our cancers as unique as we are.
Improving our diet and exercise certainly have been shown in multiple studies to reduce our risk of breast cancer. But sometimes the environmental risks that make one twin more prone to illness are no more under their control than their DNA. The way the fetuses develop in the womb, for example, might improve one twin's health while imperiling the other's. And sometimes, that tiny variation in DNA between twins makes all the difference in susceptibility to cancer.
Epigenetics, while not answering the question of what causes cancer, is absolutely getting us closer.
Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.