Thursday, May 30, 2013

This Beautiful Day

I hesitated over my morning prayer today: Thank you for this beautiful day; help me to use it well.   I looked out the window at the unending Iowa rain  and thought, "How can I say this is beautiful?" This is dreary and a little scary. I am not thankful for it. Not. At. All.   But then I realized that the beauty for which I give thanks is in the day itself—the people I cherish, the meaning of the work I do, the amazing resilience of my body, the fact that I am healthy right now.  This is a prayer, after all, and not a weather report.  So, I said it: Thank you for this beautiful day; help me to use it well.

Saturday, May 25, 2013

Protein may be path to targeted TNBC treatment

A protein called Numb (seriously) may  promote the death of cancer cells by binding to and stabilizing the tumor suppressor protein p53, which is implicated in many cases of triple-negative breast cancer, according to research published in the May 23rd issue of Molecular Cell.   When Numb is reduced by the Set8 enzyme , it will no longer protect p53.  

“If you don’t have Numb in a cell, then the p53 can be degraded very quickly, and these cells become resistant to chemotherapy,” said Shawn Li, PhD, a professor of Biochemistry and Canada Research Chair in Cellular Proteomics and Functional Genomics at Western Ontario University.  

Now that he’s identified the Set8-Numb-p53 pathway, Li is investigating various drugs to find a Set8 inhibitor which could be used as a novel breast cancer therapy alone, or in  combination with other chemotherapy regiments. View this video to see Li explain his findings.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Progesterone metabolites linked to hormone-negative breast cancer

Progesterone metabolites, often considered waste products by endocrinologists, may be potent hormones that can fight against hormone-negative breast cancer, according to a new study published in Breast Cancer Research.
A research team at Western Ontario University team discovered that the progesterone metabolites 5α-dihydroprogesterone (5αP) and 3α-dihydroprogesterone (3αHP), respectively, exhibit pro-cancer and anti-cancer effects on receptor-negative human breast cells.
“We’ve found that they are potent hormones that can play a vital role in the fight against breast cancer,” said lead author and biology professor John P. Wiebe.  He will share the findings at the Endocrine (ENDO) Society Annual Meeting and Expo in San Francisco in June.
“Our findings provide unequivocal evidence that 5αP and 3αHP deserve to be considered as active hormones in their own right, rather than inactive waste products, and that they need to be considered in the development of new approaches to prevention, detection and treatment of breast cancers,” Wiebe said.
The study may also lead to an understanding of the cause and potential regulation of receptor-negative breast cancers.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Wednesday, May 15, 2013

Does Angelina Jolie's Story Help or Hurt?

I've been traveling and have had little time to post about—or even process—Angelina Jolie's opinion piece, “My Medical Choice,” in the NY Times

I am not sure I have anything to add to the discussion, but I have had so many people ask me about it that I felt I should respond.  I am doing so in a highly equivocal way, as  I have mixed emotions on the piece. (The more I learn about breast cancer and its treatment, the fuzzier my opinions.  Things used to be clearer when I knew less.)

I do think Jolie does an exceptional job explaining her specific case, providing great details for those who are unsure what might be ahead of them. She certainly makes it real and true—and doesn't glamorize it.  This is a hard decision and the treatment is hard on your body.  She makes that clear—and good for her for taking the risk of going public with a decision that some might trivialize, with insensitive and uninformed comments.

I do worry, though, about how we approach celebrity information.  Too often we want to do what they do, be who they are.  It concerns me, then, that women who do not have the risk factors Jolie faced—she had an 87 percent risk of breast cancer—might also think they need a double mastectomy.  This could be much more aggressive treatment than makes sense for them—more aggressive than might be good for them.  In fact, there has been an increase in the number of double mastectomies in recent years, sometimes in cases of DCIS.

I hope we keep the risks—of cancer as well as of the effects of it treatment— in perspective.  It is a fine line—I want us to be informed, proactive, and in control.  But I do not want us unnecessarily fearful.  I think Jolie helps us with the former but also puts us at risk of the latter.

As I said, the more I learn, the less I truly understand.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Saturday, May 11, 2013

My Mom and the Golden Shoes

I just bought a pair of shoes in a color that reminds me of rocks in a mountain stream.  The manufacturer calls it “pewter,” but I think it looks more gold. It shimmers and takes on the hue of whatever I wear.  As I tried them on in the store, I loved them immediately.  They are excellent shoes, made even more so because they are dead ringers for my favorite pair from more than 50 years ago.

I was in the eighth grade when my mom worked as a sales clerk at Sweetbriar’s dress shop in Pueblo, Colorado.  It was a pretty fancy place for Pueblo in the early 1960s, with central air and a sunken dressing room area surrounded by mirrors.  One Christmas, Mom brought me home a special outfit from the store.  The dress had a velvet top and a full brown chiffon bottom with taffeta underneath.  With it came the dark gold shoes, with black lace anklets.

Now, very few little girls had dark gold shoes and black lace anklets, I have to tell you.  That was one classy fashion statement.

I was a tall, skinny kid without a lot of grace. (After dance class once, one of the nuns asked me how I could be so graceful on the dance floor and so clumsy everywhere else.  Yes, she did.)  But in the outfit Mom brought home, I was Grace Kelly. 

I wore in on Christmas, feeling like my own sort of ornament, and I did not want to ever take it off, because I knew I had nowhere else special enough to wear it. 

So it hung in the closet for a few months and then I could stand it no more. I decided I should wear it to school on one of the days we got to wear something other than our navy blue serge uniforms. Mom said it might be a little too fancy, but I insisted and she ultimately gave in.  Drama was involved.

That's how, one warm March day, I trotted down Spruce Street in velvet, chiffon, taffeta, gold shoes, and black lace anklets, headed to a normal day of eighth grade.  I was a sight, I just knew it.  OK, I am now sure of it.

I was by far the fanciest little girl at St. Francis Xavier School that day.  Maybe that year.   I did not know what “overdressed” meant and certainly would not have thought that I was capable of it.  I just thought I was pretty doggone special.

The nuns kindly commented on my pretty dress and reminded me that I should be a little careful on the playground.  (Was I trying to play baseball?  Perhaps.  I honestly don't remember, but I would not put that past me.)  The other kids just sort of shrugged it off, as far as I know.  I don't remember anybody teasing me for wearing dance recital duds on a plain old Friday. 

Were we kinder back then, or was I just oblivious?  I am pretty sure the second is true, and I hope the first is as well.  Maybe, though, they just saw how happy I was and left me alone.

And now, as I look at my new shoes, I miss my mom, like I have missed her since she died 20 years ago.  She was a great mom.  Like all of us, though, she often focused on what she didn't do, what she wished she could have given me. She wanted to splurge on these kinds of gifts all the time and was sad that her extravagance was so unusual.  We didn't have much money, so this dress and shoes were an  unexpected treat for me. But that is why they are such an important memory.

And when I remember my Christmas outfit,  I don't wish I’d had more like it.  Instead, I treasure that one warm memory and, as I do, I think of the love that came with those clothes. I know Mom sacrificed something else, no doubt for herself, to buy it for me.  Her main focus at that moment of time was making me happy.

That was my mom.  Loving, generous, and dear, but worried that she was just not doing enough.

If I could talk to her, I would tell her that love was always more than enough.  And always will be.

That she'll be with me whenever I wear my new shoes.

And when I don't.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Thursday, May 9, 2013

I've been fiddling with the paint brushes and am about 75 percent finished with this. I am not sure when—and if—it will be at 100 percent, but at least I no longer feel like throwing it away. Creating is good for my soul, even when the result isn't what I expect.  As with many things, it is all about the journey.

Wednesday, May 8, 2013

Rudeness, Social Media, and Cancer

Mary says Robin Roberts is “more concerned about her 'star ness' than her health.”  When Kathy and Michele object, calling Mary “rude,” Mary responds.  “If she wasn't a celebrity, you wouldn't care, admit it. She wouldn't care about me. So, I just treat them as regular folk. Can't be PC all the time. I work in the real world.” 

That was the discussion one morning last week on

Mary sounds like a royal pain in the asterisk.  And she naturally has to share it because we share every blasted thing because we can in our 24/7 wired world.

Roberts had posted on Facebook that she had to stay home from her job as cohost of Good Morning America due to an infection that could be related to treatment for myelodysplastic syndrome brought on by chemotherapy treatment for breast cancer.

So ran the story, encouraging comments, which, in the way of comments went their own way from unnatural coziness to unnatural nastiness. 

Mary says she lives in some “real world” somewhere. But in what world is it OK to be rude to people who are sick?  (Or, for that matter, who aren’t sick?)  Robin did not ask for this media scrutiny and, I suspect, wishes it would go away.  Imagine people following your prognosis and posting/printing/tweeting it over and over and over? You’re trying to beat the beast of cancer while also fighting constant reports about your fight—many of which are inaccurate and most of which are invasive.  That seems at least one fight too many.  

And Robin didn't ask for strangers like me to blog about her using her first name as though we were buddies.  Hey, Robin, whazzup?

But, Robin’s "star-ness aside" (that's not a word, Mary), what’s with being rude? Mary appears pretty unapologetic—  she used her full name, after all.   Does that signal the fact that she thinks it is just fine to be so critical of a fellow human being fighting a deadly disease?   Worse, does she think she is somehow right?  That because she thinks it, it is therefore good and worth sharing?  

That seems to be a mentality right now.  We think it therefore we say it.  I wish this tendency  would go away—this sharing of our deepest misunderstandings and darkest thoughts.  But it is truly sad that it has infected the cancer world, which already has enough infections to fight.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!

Tuesday, May 7, 2013

A Calming Labyrinth

All spiritual traditions have some form of meditative repetition.  Catholics have the rosary, others have prayer beads.  Eastern religions have mantras.

The labyrinth is one of the oldest of these forms.  As you follow a labyrinth, you focus only on the action at hand—where you walk, how you turn, making your way step by step in a well-patterned maze.  The goal is not so much to get through as to lose yourself in the process, to think of nothing but the moment.

I have tried a lot of different forms of meditation, but this is the one that works best for me—it gives my mind something to do while I try to rest it.  What I gain is a reprieve from the many daily worries that weigh on my spirit.

If you have a local labyrinth, I encourage you to try it.  It will not solve your problems, but it can help ease your mind for a while.  The one pictured above is at the Paleakula Gardens Peace Sanctuary on the island of Hawaii.

Saturday, May 4, 2013

HMGA1 Turns TNBC Cells Back to More Normal and Slows Their Growth

From a News Release from the Johns Hopkins University School of Medicine

Researchers at Johns Hopkins have identified a gene that, when repressed in tumor cells, puts a halt to cell growth and a range of processes needed for tumors to enlarge and spread to distant sites. The researchers hope that this so-called “master regulator” gene may be the key to developing a new treatment for tumors resistant to current drugs.

“This master regulator is normally turned off in adult cells, but it is very active during embryonic development and in all highly aggressive tumors studied to date,” says Linda Resar, M.D., an associate professor of medicine, oncology and pediatrics, and affiliate in the Institute for Cell Engineering at the Johns Hopkins University School of Medicine. “Our work shows for the first time that switching this gene off in aggressive cancer cells dramatically changes their appearance and behavior.” A description of the experiments appears in the May 2 issue of the journal PLOS ONE.

Resar has been investigating genes in the master regulator’s family, known as high mobility groupor HMG genes, for two decades. In addition to their role in cancer, these genes are essential for giving stem cells their special powers, and that’s no coincidence, she says. “Many investigators consider cancer cells to be the evil twin of stem cells, because like stem cells, cancer cells must acquire special properties to enable the tumor to grow and metastasize or spread to different sites,” she explains.

In a previous study, she and her team devised techniques to block the HMGA1 gene in stem cells in order to study its role in those cells. In their prior work, they discovered that HMGA1 is essential for reprogramming adult cells, like blood or skin cells, into stem cells that share most, if not all, properties of embryonic stem cells.

In the newly reported study, the Resar team applied the same techniques to several strains of human breast cancer cells in the laboratory, including the so-called triple negative cells — those that lack hormone receptors or HER2 gene amplification. The Resar team blocked HMGA1 expression in breast cancer cells and followed their appearance and growth patterns.

"Remarkably, within a few days of blocking HMGA1 expression, they appeared rounder and much more like normal breast cells growing in culture,” says Resar. The team also found that the cells with suppressed HMGA1 grow very slowly and fail to migrate or invade new territory like their HMGA1-expressing cousins.

The team next implanted tumor cells into mice to see how the cells would behave. The tumors withHMGA1 grew and spread to other areas, such as the lungs, while those with blocked HMGA1 did not grow well in the breast tissue or spread to distant sites.

“From previous work, we know that HMGA1 turns on many different genes needed during very early development, but it’s normally turned off by the time we’re born,” says postdoctoral fellow Sandeep Shah, Ph.D., who led the study. “Flipping that master regulator back on seems to be necessary for a cancer to become highly aggressive, and now we’ve seen that flipping HMGA1 off again can reverse that aggressive behavior.”

The next step, Resar says, is to try to develop a therapy based on that principle. The team is working with other researchers at Johns Hopkins to see whether HMGA1-blocking molecules could be delivered to tumors inside nanoparticles. Another possible approach, she says, would be to block not HMGA1 itself, but one of the pathways or processes that it affects.

• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

• Please consider a donation to Positives About Negative to keep this site going.  This work is entirely supported by readers.  Just click on the Donate button in the right of the page.  Thank you!