Two Weeks Off

I am doing something revolutionary, something I haven't done in years.  I expect it to improve my life and perhaps help me relax.

I am going on vacation for two weeks without my computer.

How I will handle being untethered remains to be seen.  If I want to write, I will make notes in a notebook. Egads.  Remember back when we wrote things by hand?  No, some of you might not.  I remember when computers became commonplace in American journalism and I was appalled.  Really?  Writers were supposed to compose on a machine, like robots?  Well, meet Pat, happy robot.

OK.  Full disclosure.  I will still have my iPhone, and I can still check email.  So I can still be connected, but it will be more difficult for me to actually work.  More difficult, I say, but probably not impossible.

I am trying to sync my new Surviving Triple-Negative Breast Cancer Facebook page with my phone and that is not going as well as I would like, but if I get it figured out, I will check in every now and then on Facebook with a link or two.  If you don't hear from me until mid-April,  know you are all on my mind and in my prayers.

Alcohol can increase TNBC risk

More than 3000 studies have been published on the link between alcohol consumption and breast cancer.  Those studies that have looked at the effects of alcohol in relation to hormone receptors have generally shown that the cancer risk is more closely tied to estrogen-positive than for estrogen-negative breast cancers such as triple-negative.

Now, researchers have looked at 3,431of those studies, which included 44,552 non-drinkers and 77,539 light drinkers, and made some general conclusions using that huge body of work.  They determined that women who had one drink a day increased their cancer risk by 4 percent as compared with women who did not drink.  Increased alcohol consumption also increased breast cancer risk, with women who had three or more drinks a day facing a breast cancer risk by as much as 50 percent higher than those who did not drink or had lower levels of consumption.

But the scientists went a step further and looked at the risk based on receptor status and determined that
alcohol consumption increased the overall risk of estrogen-positive breast cancer by 27 percent and increased the overall risk of estrogen-negative breast cancer by 14 percent.  

So, yes, the risk is lower for women with TNBC and other forms of estrogen-negative breast cancer.  But it exists.  And it increases with increased alcohol consumption.

I limit myself to alcohol 2-3 times a week.  When my husband has a glass of wine, I often make myself some cranberry tea or pour a glass of all-fruit black cherry juice.  I don't even miss the wine I used to think I needed.

The research is published in the journal Alcohol and Alcoholism. More information on the link is at Medical News Today.

LBBC Sponsors Conference on Metastatic Breast Cancer

From the News Wire:

HAVERFORD, Pa., March 27, 2012 (GLOBE NEWSWIRE) -- Living Beyond Breast Cancer (LBBC) has announced it will host its annual conference for women with metastatic breast cancer at the Loews Hotel in Philadelphia on Saturday, April 28 and Sunday, April 29, 2012. This event, now entering its sixth year promoting the theme Enhancing Your Health and Quality of Life, is designed to address the unique challenges faced by women diagnosed with metastatic disease, their families and their caregivers. Breast cancer is considered metastatic (often referred to as Stage IV) when it spreads from the breast to other parts of the body, such as the lungs, bones, liver or brain. 

Women living with metastatic disease face ongoing decisions depending on chosen treatment plans. Approximately 151,600 women in the United States are currently living with metastatic breast cancer and this number is projected to increase to over 164,000 by the year 2015.1 

Attendees from across the country will join together for this two-day event featuring a variety of workshops that focus exclusively on the specific needs of women living with this type of cancer. The program includes topics such as ways to manage stress and anxiety, triple-negative breast cancer, end-of-life care, and intimacy and sexuality. Workshops for caregivers will also be conducted. Participants will have the opportunity to ask questions about research, treatment and quality-of-life concerns to an expert panel composed of the nation's top healthcare providers with a special interest in metastatic disease. Additionally, attendees are given the chance to meet, connect and network with hundreds of women facing the same choices and challenges. "Women living with metastatic breast cancer need targeted information that will help them make informed decisions and improve their quality of life," said Jean A. Sachs, MSS, MLSP, chief executive officer of Living Beyond Breast Cancer. "It is easier to find resources for early stage disease. LBBC is committed to meeting the needs of women facing metastatic breast cancer by producing this national conference." 

Travel grants and fee waivers for financial hardship, generously provided by Susan G. Komen for the Cure, are available to eligible individuals. The conference is presented by Celgene Corporation and Eisai Oncology. To register or for more information, visit lbbc.org or call Living Beyond Breast Cancer at (610) 645-4567. 

Additional resources can be found through LBBC's Understanding Guides: Metastatic Breast Cancer Series. Titles include: Treatment Options for Today and Tomorrow, Managing Stress and Anxiety, Symptoms and Treatment Side Effects and Understanding Palliative Care. Later this year, LBBC will produce a guide for women newly diagnosed with advanced disease.
Anyone interested in attending the conference can register online at lbbc.org or call (610) 645-4573. 

Annual Conference for Women with Metastatic Breast Cancer Panelists
Adam M. Brufksy, MD, PhD is director of academic medical oncology at the University of Pittsburgh Cancer Centers in Pittsburgh, Pennsylvania, and an associate professor of medicine at the University of Pittsburgh. Dr. Brufsky also serves as director of the Comprehensive Breast Cancer Center at Magee-Womens Hospital/University of Pittsburgh Cancer Institute and as associate division chief of the division of hematology/oncology of the department of medicine at the University of Pittsburgh. This year, Dr. Brufsky is serving as moderator as well as a panelist. 

Helen L. Coons,* PhD, ABPP is the President and Clinical Director of Women's Mental Health Associates, Philadelphia. Dr. Coons is a Clinical Psychologist and board certified Clinical Health Psychologist who specializes in women's health and mental health. She is also a Clinical Associate Professor of Psychiatry, Drexel University College of Medicine, and is Adjunct Faculty, Department of Psychiatry, Pennsylvania Hospital, University of Pennsylvania Health System. Dr. Coons received her Ph.D. in Clinical Psychology from Temple University in 1990 after interning in Medical Psychology at the Duke University Medical Center. In 2005, she represented the American Psychological Association at the DHHS Primary Health Care Policy Fellowship. 

Julie R. Gralow, MD is a professor of medical oncology at the University of Washington School of Medicine and an associate member of the clinical research division for the Fred Hutchinson Cancer Research Center. She is director of breast medical oncology at UWSOM and Seattle Cancer Care Alliance, serves as associate program head for the UW/FHCRC Consortium Breast Cancer Program, and is a member of the FHCRC Scientific Steering Committee. 

Harold A. Harvey,* MD is a professor of medicine at the Milton S. Hersey Medical Center at Pennsylvania University and board certified with an oncology subspecialty through the American Board of Internal Medicine. Dr. Harvey participates in numerous committees as a member of the American Society for Clinical Oncology and was on the Board of Examiners for the American Board of Internal Medicine for Medical Oncology.
Beth Overmoyer MD, FACP is director of the Breast Cancer Research Program through Case Medical School, and has obtained funding for clinical/translational research from the NIH, AVON, and the American Cancer Society. Dr. Overmoyer was the director of the Clinical Trials Core at Case Medical School, and focuses her academic endeavors on therapies for breast cancer, specifically directing research in inflammatory breast cancer as the Director of the Inflammatory Breast Cancer Program at the Dana Farber Cancer Institute.
Debra Wolf,* Esq specializes in Disability Law and has represented clients in various issues including discrimination, disability leave, insurance matters, estate planning and employment accommodations. Debra currently works for LegalHealth, a division of the New York Legal Assistance Group. LegalHealth provides free legal services to patients within the medical setting and educates healthcare professionals to better address their patients' needs where she works primarily with clients with cancer. 

Closing Speaker
Don S. Dizon, MD, FACP is board-certified in medical oncology and has received special training in sexual education from the Planned Parenthood League of Massachusetts. Dr. Dizon is involved nationally as the co-chair of the Integrated Media and Technology committee of the American Society of Clinical Oncology (ASCO) and is a member of the program committees for the annual meetings of ASCO, the Society of Gynecologic Oncology (SGO), the National Consortium of Breast Centers (NCBC), and the International Gynecologic Cancer Society. He currently serves as the immediate past president at the NCBC and a member of the Breast Task Force for SGO.  

Reference1. Data on File. 1006812. AstraZeneca Pharmaceuticals LP. Wilmington, DE.
*Dr. Coons, Dr. Harvey and Ms. Wolf are available for press interviews.  

FOR IMMEDIATE RELEASE: Tuesday, March 27, 2012
Media Contact: Rachel Pinkstone-Marx | (484) 708-1802 | rmarx@lbbc.org
Founded in 1991, LBBC is a national nonprofit organization dedicated to empowering all women affected by breast cancer to live as long as possible with the best quality of life. Programs and services include an educational website (lbbc.org), a toll-free Survivors' Helpline at (888) 753-LBBC (5222), national conferences, free teleconferences and networking programs, quarterly newsletters, publications for medically underserved women, healthcare-provider trainings, recordings and the Paula A. Seidman Library & Resource Center.

SOURCE: Living Beyond Breast Cancer

GM Awards Grants to Study TNBC

GE has announced five winners of its competition for the development of early breast cancer detection and diagnostic technologies—and two of the grants go to researchers studying triple-negative breast cancer.   Yea! Check out GE's interviews with the five winners and their research.


The two that focus on TNBC are:

• MyCancerGenome.org, a freely available online tool for doctors, patients, researchers and others that helps personalize the treatment of triple negative breast cancer by providing easily accessible, mutation-specific information and even clinical trials related to different forms of breast cancer.

• Researchers at Vanderbilt-Ingram Cancer Center, who have shown that gene expression analysis reveals at least six different subtypes for triple negative breast cancer, each of which is likely to respond differently to chemotherapy. The Center is now designing clinical trials with personalized therapy for each subtype.

New site on permanent hair loss related to chemo

A group of women with permanent hair loss after chemotherapy have started a site, A Head of Our Time, to spread the word, support others with this condition, and look for a cause and remedy.  All of the women who contribute to the site—more than 40 at this point—took the drug Taxotere.  According to one of the site's creators:

We are not doctors or researchers.  We cannot tell you the best course of treatment for your cancer.  We cannot tell you what percentage of women are affected by permanent hair loss after Taxotere.  What we can tell you is this:  we have experienced permanent hair loss after using Taxotere.  We have been deeply affected by our hair loss and want to warn others.  We want people to PLEASE Ask their doctor for the facts before they or their loved ones make a decision to use Taxotere.  And PLEASE help us spread the word so women can make informed decisions about their treatment.

More data on androgen and TNBC

News release from the Mayo Clinic March 23, 2012

SCOTTSDALE, Ariz. -- Could blocking a testosterone receptor lead to a new way to treat an aggressive form of breast cancer? That's a question researchers at Mayo Clinic in Arizona and the Translational Genomics Research Institute (TGen) are exploring. Preliminary results of a Mayo Clinic - TGen collaborative study shows the testosterone receptor may be a potential target to attack in treating triple negative breast cancer (TNBC).

Lead researcher Barbara Pockaj, M.D., a surgical oncologist at Mayo Clinic in Arizona will present the results of the study at the 65th annual Society of Surgical Oncology conference on March 23 in Orlando, Fla.

Unlike other forms of breast cancer in which treatments are tailored to specifically target hormone receptors such as estrogen and progesterone or the HER-2 proteins that promote the growth and spread of cancer cells, triple negative cancer cells do not possess markers for estrogen, progesterone or HER-2, Dr. Pockaj says. There are no targeted therapies other than chemotherapy to TNBC, she says.

Researchers at Mayo Clinic and TGen say that could change if the androgen (testosterone) receptor shows potential as a therapeutic target.

"The goal of the study was to define what may be fueling TNBC, thereby identifying new potential options for effective targeted treatment," says co-lead researcher Heather Cunliffe, Ph.D., Associate Professor and head of TGen's breast and ovarian cancer research unit. "The team discovered that the androgen receptor is expressed in a significant proportion of these tumors, and moreover, the androgen-receptive positive tumors shared a unique clinical behavior."

Researchers found 22 percent of the patients with TNBC had the androgen receptor in their tumors.

"These cancers appeared in women who were older and there was a higher likelihood of the cancer spreading to the lymph nodes. Even though the women with androgen-receptor positive TNBC had more aggressive cancer to start, their survival was no different than patients with TNBC whose cancers did not possess the androgen receptor," Dr. Pockaj says. "Importantly, while all normal breast tissue had androgen receptors, it was lost in the majority of patients with TNBC. Our data shows us that there is a definitive group of patients who may be sensitive to treatment directed against the androgen receptor."

While further research with a larger number of patients is needed to define clinical implications of androgen receptor positive TNBC, Dr. Cunliffe says this study provides important insights.

An important next step of the research will be to determine how the androgen receptor functions in TNBC.

"We will look at all the genes within the cancer cells from each patient using genomic approaches. This way we can find ways to manipulate the cancer cell which hopefully will translate into new treatment strategies for the women with TNBC," Dr. Pockaj says.

Dana-Farber did similar research that was released about a year ago.  I blogged about it at the time.  Researchers in Belgium also began studying the link between androgen receptors and TNBC in 2009; that post is here. 

Scientists Identify Which TNBC Cancers May Respond to Platinum Chemo Drugs

FROM THE Dana-Farber Cancer Institute March 22, 2012

DNA marker predicts platinum drug response in breast, ovarian cancer

Marker identifies tumors unable to repair DNA damage by platinum agents

		IMAGE: Andrea Richardson, M.D., Ph.D, and her colleagues have found a genetic marker that predicts which aggressive "triple negative " breast cancers and certain ovarian cancers will likely respond to platinum-based chemotherapies.... Click here for more information.

BOSTON—Scientists from Brigham and Women's Hospital and Dana-Farber Cancer Institute and their colleagues have found a genetic marker that predicts which aggressive "triple negative" breast cancers and certain ovarian cancers will likely respond to platinum-based chemotherapies.

The marker, found on chromosomes within the cancer cells, could lead to a test for identifying patients whose cancers could be effectively treated by a single platinum-based drug, "and avoid the toxicities of other chemotherapy combinations," says Andrea Richardson, MD, PhD, co senior author of the study and a surgical pathologist at Brigham and Women's and Dana-Farber.

The report is being published in the April issue of Cancer Discovery, a journal of the American Association for Cancer Research.

Many cancer treatments work by damaging DNA within tumor cells, rendering the cells unable to grow and divide. While some cancer cells can readily repair broken DNA molecules, allowing them to survive drug or radiation therapy, others have lost this repair capacity, making them vulnerable to DNA-damaging agents.

The new marker, Richardson says, flags breast and ovarian cancer cells that can't repair the type of DNA damage caused by treatment with platinum drugs, including cisplatin and carboplatin. A clinical test for the marker could be particularly valuable in treating triple-negative breast cancers, which are resistant to anti-hormonal therapies or targeted drugs like Herceptin.

"We currently do not have any targeted therapies for patients with triple-negative breast cancer, so if these laboratory findings are confirmed and an assay is created to predict sensitivity to drugs that target defective DNA repair, it would be a major step forward," says Richardson, the primary pathologist for the study. However, she adds, such an assay isn't likely to be developed soon.

The new genetic marker was discovered when Richardson and others studied tumor tissue collected from triple negative breast cancer patients who participated in two clinical trials of platinum drug therapy. Triple-negative tumors develop in about 80 percent of women who carry mutated breast cancer genes BRCA1 and BRCA2. These tumors are characterized by a lack of estrogen, progesterone, and HER2 receptors, which makes them unresponsive to targeted treatments that block those receptors.

[EDITOR'S NOTE:  Not all TNBC tumors are associated with BRCA mutations.]

The two clinical trials, led by Judy Garber, MD, MPH, of Dana-Farber, were investigating whether platinum drugs would also be effective in so-called "sporadic" triple negative tumors -- those that develop in the absence of BRCA1 and BRCA2 genetic mutations. Overall, about 20 percent of breast cancers are triple negative. Some of these cancers respond to standard chemotherapy drugs, while others don't. The patients whose triple negative tumors do not go away after chemotherapy have a particularly poor prognosis.

A total of 79 patients in the two trials received cisplatin alone or in combination with bevacizumab (Avastin) to shrink their tumors prior to removing them surgically. In both trials, approximately 40 percent of patients had a complete or near-complete disappearance of the cancer after the cisplatin therapy.

The researchers analyzed tissue from the patients before and after the cisplatin treatment, looking for features in the cancer cells' DNA that predicted a favorable response to the pre-operative chemotherapy. They found one -- a high level of partial chromosome losses in the tumor cells that responded to the cisplatin treatment.

The tell-tale pattern, or genetic marker, was finding a high number of chromosome regions showing allelic imbalance, meaning that instead of the normal equal distribution of DNA from both parents, the tumor cells had lost one parental copy of the DNA in parts of many chromosomes. This didn't surprise the researchers: in fact, they expected it, since allelic imbalance is also found in triple-negative breast cancers associated with BRCA 1 and BRCA2 mutations. Specifically, the strongest indicator of defective DNA damage repair was in cancer cells when the regions of allelic imbalance included the tips of the chromosomes, called telomeres.

The scientists also analyzed data on tumor characteristics and treatment outcomes from The Cancer Genome Atlas, a federally funded database, to demonstrate that allelic imbalance predicted defective DNA damage repair and sensitivity to platinum drugs in serous ovarian cancers.

In the future, the scientists say, allelic instability "may prove useful in predicting response to a variety of therapeutic strategies exploiting defective DNA repair."

###

Along with Richardson, co-senior authors of the report are Daniel Silver, MD, PhD, of Dana-Farber, and Zoltan Szallasi, MD, of Children's Hospital Boston. First authors are Nicolai Birkbak, PhD, and Zhigang Wang, PhD, BM, of Brigham and Women's and Dana-Farber.

The research was supported by grants from the National Cancer Institute and several foundations.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute. It provides adult cancer care with Brigham and Women's Hospital as Dana-Farber/Brigham and Women's Cancer Center and it provides pediatric care with Children's Hospital Boston as Dana-Farber/Children's Hospital Cancer Center. Dana-Farber is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding. Follow Dana-Farber on Twitter: @danafarber or Facebook: facebook.com/danafarbercancerinstitute.

Aspirin May Reduce Cancer Risk and Even Keep Cancer from Spreading

Low-dose aspirin may reduce the risk of cancer, including breast cancer,  and may even keep it from spreading, according to two articles published in the journal Lancet.    Previous research has shown that aspirin benefits those with both hormone-receptor-positive breast cancer and those with hormone-receptor-negative, such as triple-negative.

Some key points:

• The benefits of aspirin may come within three years of regular usage, not after ten years, as had previously been thought.
• The results were strongest for colorectal and esophageal cancer and less pronounced for breast cancer.
• Daily aspirin usage was linked to a 35 percent reduction in death in patients with solid tumors

• The risks of gastrointestinal bleeding—a significant concern associated with regular aspirin use—diminished over time.
• Testing was done with baby aspirin, and docs say the cheap variety work as well as the more expensive.
If you have any history of gastrointestinal bleeding, check with your doctor before taking aspirin, as even l0w-dose aspirin can be dangerous.  I have a history of ulcers and even mild aspirin irritates my stomach.  According to Eric Jacobs, PhD, of the American Cancer Society, quoted in  Medpage Today it is important to weigh the risks against the benefits:

Eric Jacobs, PhD, a spokesperson for the American Cancer Society, characterized the analyses as "important new evidence that long-term daily aspirin, even at low doses, may lower the risk of developing cancer." Even so, the decision to initiate regular aspirin use should be individualized after a discussion between patient and physician, he said. 

"Because these results are new, it will take time for the broader scientific community to evaluate the data in the context of existing knowledge and to consider whether the clinical guidelines should be changed ... Clinical guidelines require a systematic analysis of for whom the benefits of aspirin use are likely to outweigh the risks."

For more coverage on this, check The New York Times, Medical News Today, Medical News Today, and ABC News.

New Facebook Page on Triple-Negative Breast Cancer

Hey,  folks, I have a new Facebook page dedicated to my book, Surviving Triple Negative Breast Cancer.  The page will have some duplication with the blog, but will allow more interaction with readers.  So head there and hit "Like."   The Surviving TNBC page is here.

You can also friend me on the author's page here.

I am feeling my way here, with the help of a wonderfully talented Drake University student.  If you have trouble finding either page, let me know.

Lymphocytes could mean positive prognosis for some basal-like cancers

Researchers say the presence of CD8 tumor-infiltrating lymphocytes may mean a good prognosis in some early-stage breast cancers, especially in cases that normally come with a poor prognosis—those that are high grade, basal-like, estrogen-negative, and her2-positive.

The research, on tumors from 3992 breast cancer patients, was published in the March 15, 2012 Breast Cancer Research. 

Tumor-infiltrating lymphocytes can help the body’s immune system fight cancer, which is why the presence of CD8 could come with positive survival rates.  This could ultimately help doctors determine more specific survival risks for tumors that are now lumped together as once group, with the group usually called aggressive. Basal-like tumors with CD8 might not be aggressive at all.  The positive prognosis did not extend to non-basal tumors.

“ER- breast cancers have worse prognosis than those that are ER+, but not all ER- breast cancer patients have poor survival,” researchers wrote.  In the Discussion section of the report, they cite additional research on gene expression and its value in developing prognoses for estrogen-negative breast cancers.

When cancer comes back...go surfing

About a month ago, Justin—pictured in Maui this week—got the news nobody wants.  She had a recurrence of TNBC in her brain.  Doctors were quick in their response and immediately excised the tumor with  gamma knife surgery--an amazing process that means  the patient can avoid the horrors of brain surgery.    She says  she is  "working on climbing out of my temporary hole and taking hold of life's reins again."  Meanwhile, she headed to Maui, where she is learning to surf.   "I am determined to beat this sucker," she says.  Surf on Justin!  Three cheers for attitude—and many, many hugs and prayers.

Cadmium link to TNBC is weak; association stronger for hormone-positive breast cancers

Cadmium in agricultural crops, especially root crops, has been linked to hormone-positive breast cancer in post-menopausal women.  The link to hormone negative, such as triple negative breast cancer, however, was weak—not statistically significant, according to research published in Cancer Research, the publication of the  American Association for Cancer Research. 

First, this is only a link—researchers are not saying cadmium causes breast cancer.  Second, the link occurs with high levels of cadmium-- more than 16 micrograms a day. And, third, a diet rich in whole grains and vegetables  appeared to reduce the effects of cadmium.

The research looked at the effects on cadmium on post-menopausal women.  The fact that no significant association was found between estrogen-negative breast cancers and cadmium could be because estrogen-negative breast cancer is more likely to affect premenopausal women and, therefore, the number of women with TNBC and other hormone-negative breast cancers in this study was too small to show an effect.

The research, done at the Karolinska Institutet in Sweden, followed 55,987 women for more than 12 years. Researchers estimated the dietary cadmium exposure using a food frequency questionnaire. During the 12 years the women were observed, 2,112 were diagnosed with breast cancer, including 1,626 estrogen receptor-positive and 290 estrogen receptor-negative cases.

Researchers divided cadmium consumption into three groups:

• The lowest group consumed less than 13 micrograms a day.

• The middle group consumed about 13 to 16.

• The highest group consumed more than 16 micrograms a day.

Overall, a higher exposure to cadmium in the diet was linked to a 21 percent increase in breast cancer. Among lean and normal weight women, the increased risk was 27 percent.  Interestingly, the effect was lessened by being overweight—some comfort for those trying to drop those extra pounds.

"Because of a high accumulation in agricultural crops, the main sources of dietary cadmium are bread and other cereals, potatoes, root crops and vegetables," said Agneta Åkesson, Ph.D., associate professor at Karolinska Institutet in Sweden. "It's possible that this healthy diet to some extent can counteract the negative effect of cadmium, but our findings need to be confirmed with further studies. It is, however, important that the exposure to cadmium from all food is low."

Cadmium has estrogen-like properties, which is why it might be linked to estrogen-positive disease.

To be safe, opt for organic vegetables when you can afford them.  


NOTE:  Cadmium is a natural element that occurs in the soil at low concentrations, but high levels in plants can be due to contamination of farmland because of deposits from the atmosphere and use of fertilizers.

Juicing recipes: A healthy way to drink to St. Paddy

I have a big glass of juice every night as part of my anti-cancer regimen.  I use an Omega juicer, which works quite well.  So, when I got the recipes below from Omega, I thought I would share them with you.  I would especially recommend the ones with kale, bok choy, or broccoli.  These are cruciferous vegetables that are especially good cancer fighters. 

Omega's PR folks presented these as healthy ways to celebrate St. Pat's day—a good plan, especially if it means cutting out the alcohol, which is linked to cancer risk. Interestingly, though, I never celebrate the day named for my namesake.   

So let's drink to our health!

The Ultimate Pot of Gold

Orange Apple Green Juice

2 stalks celery
1/2 cucumber
1 apple
2 oranges
3 big handfuls of sunflower sprouts
1 big handful of broccoli sprouts
3 leaves of kale
1 handful of spinach
1 handful dandelion greens
1 handful cilantro
1 handful beet greens
2 baby bok choy
juice of 1 lemon
1 inch of grated ginger

Luck of the Parsley

1 handful parsley

2 apples
1 handful spinach
1 cucumber
1 lemon
1-inch piece ginger

The Crazy Dublin

3-4 leaves of Kale

5 large Romaine Lettuce leaves

1 Beet, 1/2 bunch of Cilantro

1 Lime, 2 cups fresh Spinach

1/2 Apple

Cherry tomatoes for garnish (optional)

Irish Twist

3 cups fresh baby Spinach

1 Lime, 1 large Tomato

2-3 Carrots and 1/2 Carrot top bunch

1/2 bunch Parsley

1 stalk Celery

Green Morning
4-6 Carrots

4 stalks of Celery

1 Lemon

1 Macintosh or Yellow Apple

Surviving Triple-Negative Breast Cancer: Hope, Treatment, and Recovery: Take Two

Look!  It's a book.  Publication date:  October 1, 2012.  Email me if you want to be on my list for updates on when it is available.

Today's To-Do List: Drink Tea

And do it right.   Use loose tea for brewing so you get the full, rich aroma that is part of the charm of a cup of tea.  Use a pretty cup--this should be an experience, not just a brief cup on the run. Take a moment away from everything else--sit in front of a window, or before the fire, or in a comfy chair.  Someplace special.  And take a few deep breaths while you savor the taste and warmth of one of life's easiest pleasures. 

Ahhhhhhh.

Drink the tea while it is hot.  By the time it is cold, it's OK to get back to whatever else you were doing.

My new favorite tea is Cranberry Lover's Tea, which is a mix of a few things I have never heard of--honeybush and rooibos--plus cranberry, blended with rosebuds.  I get it at Gung Fu Tea in Des Moines.  And the other day I splurged and got a Handy Brew Teapot, which really makes the taste pop.

Ahhhhhhhhhhhhhh.

Surviving Triple-Negative Breast Cancer: Hope, Treatment, Recovery

That's the title of my upcoming book: Surviving Triple-Negative Breast Cancer: Hope, Treatment, Recovery.

I hope you like it.

Thank you to all who filled out my survey, left comments, and sent me emails about the title.  The consensus was that some form of "survive" should be in the title, and several of you suggested the need for a reference to hope.

It will be published this fall by Oxford University Press.

Women with TNBC find they share more than disease

The Atlanta Journal-Constitution has a good piece about two women in Atlanta who leaned on one another as they both faced triple-negative breast cancer.  I would correct one line here, though.  The article says triple-negative is "one of the deadliest breast cancers there is."  I would say the women face a form of breast cancer that can be aggressive but is highly survivable.  Ugh.  I do get tired of tired journalism that uses thoughtless language that can terrify women unnecessarily. (As though it is ever necessary to terrify women.)  Especially in a positive piece such as this.