Wednesday, January 14, 2009
Help for Maintaining a Healthy Weight
The January Calorie Count newsletter offers some good advice on maintaining your diet and exercise plan. Check it out.
Wednesday, January 7, 2009
Want to Beat Cancer? Exercise!
Research shows a strong correlation between exercise and reduction in breast cancer. In a 2006 study in the journal Cancer Epidemiol Biomarkers Prevention, researchers evaluated participants, ages 25 to 64 years, in Shanghai, China from August 1996 to March 1998. Women were given a questionnaire in which they reported their exercise patterns from adolescence through the ten years before the interview. The researchers determined:
• Exercise in adolescence and within the past ten years was also associated with decreased risk for receptor-positive and receptor-negative breast cancers s in both premenopausal and postmenopausal women. That means, basically, all women.
• Exercises benefited with a risk reduction of 30 to 60 percent over non-execisers. Again, this was true of premenopausal and postmenopausal women. As in, all.
• Activity during both adolescence and the last 10 years resulted in a risk reduction of 62 to 79 percent for receptor-negative breast cancer.
• Postmenopausal women benefited the most from exercise.
• Sweating during exercise within the last 10 years was also associated with decreased risk for receptor-positive and receptor-negative breast cancers among postmenopausal women.
So we mature ladies benefit from a little sweat. Researchers aren’t sure why.
SA Adams, CE Matthews, JR Hebert, CG Moore, JE Cunningham, XO Shu, J Fulton, Y Gao,and W Zheng, “Association of physical activity with hormone receptor status: the Shanghai Breast Cancer Study,” Cancer Epidemiol Biomarkers Prevention, June15, 2006, Volume 15, No. 6, 1170-8.
• Exercise in adolescence and within the past ten years was also associated with decreased risk for receptor-positive and receptor-negative breast cancers s in both premenopausal and postmenopausal women. That means, basically, all women.
• Exercises benefited with a risk reduction of 30 to 60 percent over non-execisers. Again, this was true of premenopausal and postmenopausal women. As in, all.
• Activity during both adolescence and the last 10 years resulted in a risk reduction of 62 to 79 percent for receptor-negative breast cancer.
• Postmenopausal women benefited the most from exercise.
• Sweating during exercise within the last 10 years was also associated with decreased risk for receptor-positive and receptor-negative breast cancers among postmenopausal women.
So we mature ladies benefit from a little sweat. Researchers aren’t sure why.
SA Adams, CE Matthews, JR Hebert, CG Moore, JE Cunningham, XO Shu, J Fulton, Y Gao,and W Zheng, “Association of physical activity with hormone receptor status: the Shanghai Breast Cancer Study,” Cancer Epidemiol Biomarkers Prevention, June15, 2006, Volume 15, No. 6, 1170-8.
Triple Negative Breast Cancer: Research Review
Triple negative breast cancer, an especially aggressive form of the disease, is prevalent among young women and African-American women. Researchers Carey Anders, M.D., and Lisa A. Carey, M.D., published a thorough research review of triple negative in the journal Oncology October 1, 2008. The entire article is available online.
Key points:
• Triple negative breast cancer is a breast cancer subtype in which all hormone receptors are negative. That is, it is estrogen-negative (ER-), progesterone-negative (PR-) and negative for the human growth factor receptor Her2-neu.
• Estimates are that 172,000 women will have been diagnosed with triple-negative breast cancer in 2008.
• Most, but not all, BRCA1 breast cancers are triple negative.
• Triple negative responds well to chemotherapy, especially anthracycline and anthracycline/taxane.
• Triple negative does not respond to tamoxifen or aromatase inhibitors like Arimidex, so there is no standard follow-up treatment.
• Research on new treatments shows promise. These include epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and poly (ADP-ribose) polymerase (PARP) inhibitors, which are currently in clinical trials.
Source: C. Anders and L. A. Carey, “Understanding and Treating Triple-Negative Breast Cancer,” Oncology, Vol. 22, No. 11, October 1, 2008.
Key points:
• Triple negative breast cancer is a breast cancer subtype in which all hormone receptors are negative. That is, it is estrogen-negative (ER-), progesterone-negative (PR-) and negative for the human growth factor receptor Her2-neu.
• Estimates are that 172,000 women will have been diagnosed with triple-negative breast cancer in 2008.
• Most, but not all, BRCA1 breast cancers are triple negative.
• Triple negative responds well to chemotherapy, especially anthracycline and anthracycline/taxane.
• Triple negative does not respond to tamoxifen or aromatase inhibitors like Arimidex, so there is no standard follow-up treatment.
• Research on new treatments shows promise. These include epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and poly (ADP-ribose) polymerase (PARP) inhibitors, which are currently in clinical trials.
Source: C. Anders and L. A. Carey, “Understanding and Treating Triple-Negative Breast Cancer,” Oncology, Vol. 22, No. 11, October 1, 2008.
Thursday, December 18, 2008
What's the proper follow-up after breast cancer treatment?
What type of treatment do you absolutely need once you finish breast cancer treatment? How much is too much? What’s too little? And what about diet and supplements?
Three doctors recently discussed helping patients stay healthy after breast cancer. Their discussion, available through Medscape, helps answer some of these questions.
Three doctors recently discussed helping patients stay healthy after breast cancer. Their discussion, available through Medscape, helps answer some of these questions.
Participants were:
Antonio C. Wolff, MD, FACP, Associate Professor of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland
Jennifer A. Ligibel, MD, Instructor in Medicine, Harvard Medical School, Boston, Massachusetts; Staff Physician, Dana-Farber Cancer Institute, Boston, Massachusetts
Anne F. Schott, MD, Associate Professor of Medicine, University of Michigan, Ann Arbor, Michigan; Staff Physician, University of Michigan Health System, Ann Arbor, Michigan.
My take-away points on all this:
• Most women with a diagnosis of breast cancer will survive their disease and go on to live full lives.
• Follow-up visits every 3 to 4 months for the first two years after completion of treatment is standard. This can be with an oncologist, radiation oncologist, surgeon, or a primary care physician. Usually it is a combination of the above.
• A mammogram at least yearly is recommended.
• The American Society of Clinical Oncologist guidelines recommend against “any surveillance blood testing or imaging studies in an otherwise-asymptomatic patient with a normal clinical exam.” Translation: If you do not have symptoms or problems, the recommendation is that there is no need for additional tests. Doctors often do testing to reassure women, although the reassurance, apparently, is not all that substantive.
That includes x-rays, PET scans and CT scans.
• Even though studies have not been conclusive, there’s enough evidence to support the benefits of low-fat diet and exercise in limiting risk of recurrence. A low-fat diet is especially important for hormone negative breast cancer.
• Vitamin D is beneficial, even though research so far is not clear on its benefits to reduce risk of recurrence and on the dosage necessary. It has been shown to reduce bone loss.
• Carbohydrate-restricted diets like Atkins are not good for breast cancer survivors, especially those with ER-negative tumors.
Antonio C. Wolff, MD, FACP, Associate Professor of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland
Jennifer A. Ligibel, MD, Instructor in Medicine, Harvard Medical School, Boston, Massachusetts; Staff Physician, Dana-Farber Cancer Institute, Boston, Massachusetts
Anne F. Schott, MD, Associate Professor of Medicine, University of Michigan, Ann Arbor, Michigan; Staff Physician, University of Michigan Health System, Ann Arbor, Michigan.
My take-away points on all this:
• Most women with a diagnosis of breast cancer will survive their disease and go on to live full lives.
• Follow-up visits every 3 to 4 months for the first two years after completion of treatment is standard. This can be with an oncologist, radiation oncologist, surgeon, or a primary care physician. Usually it is a combination of the above.
• A mammogram at least yearly is recommended.
• The American Society of Clinical Oncologist guidelines recommend against “any surveillance blood testing or imaging studies in an otherwise-asymptomatic patient with a normal clinical exam.” Translation: If you do not have symptoms or problems, the recommendation is that there is no need for additional tests. Doctors often do testing to reassure women, although the reassurance, apparently, is not all that substantive.
That includes x-rays, PET scans and CT scans.
• Even though studies have not been conclusive, there’s enough evidence to support the benefits of low-fat diet and exercise in limiting risk of recurrence. A low-fat diet is especially important for hormone negative breast cancer.
• Vitamin D is beneficial, even though research so far is not clear on its benefits to reduce risk of recurrence and on the dosage necessary. It has been shown to reduce bone loss.
• Carbohydrate-restricted diets like Atkins are not good for breast cancer survivors, especially those with ER-negative tumors.
Sunday, December 14, 2008
Check Out the Triple Negative Foundation
The Triple Negative Foundation has an online replay of an educational teleconference on triple negative breast cancer. The foundation’s site also offers the opportunity to talk with experts and other women with triple negative breast cancer. The foundation was started in 2005 to honor Nancy Block-Zenna, who was diagnosed at age 35 with triple negative breast cancer and died in 2007. Nancy's friends launched the TNBC Foundation to raise awareness and support research on triple negative breast cancer. Check it out.
Sunday, November 30, 2008
My Story: Weight Loss Through Diet Change
First: Don’t diet. Dieting implies a short-term change built on forcing yourself to eat unnaturally. A boiled egg for breakfast, yogurt for lunch, salad for dinner. Nobody can sustain that. You’re so hungry that when you see a Snickers, you head for a corner and snarf it down. And even if you conscientiously stick to the diet plan, you face trouble when you return to “normal” eating. Remember normal eating? That was what caused the weight gain to begin with.
Losing weight comes from changing your attitude toward food. Food is a source of energy and health, not a reward or a way to kill time. And eating healthy doesn’t mean you’ve ruined the social aspects of food. You can enjoy a convivial visit with friends over a well-balanced meal. And eating healthy can be every bit as satisfying as eating the fatty stuff.
The pleasures of overeating are fleeting, but the results long-lasting.
Some tips:
1. Create a spreadsheet and write down everything you eat. I focused only on calories, to simplify things, but I kept my eyes open to foods that were high in sodium or sugars. You’ll be surprised at how much the little things add up. Use a site like caloriecount.about.com to help you find nutrition information on the foods you eat. For example, that Snickers bar has 271 calories, 122 of those from fat. One bar has 26 percent of your daily recommended allotment of trans fat. It has a substantial 28.8 grams of sugar. Dieticians recommend that you keep sugar under 48 grams a day, so a Snickers gives you more than 50 percent of that. Think about it: Look at the fleeting pleasure, the lasting damage.
2. Be honest in the spreadsheet. If you have a glass of wine, look at the size. Five ounces of red wine have roughly 147 calories, according to the USDA. Yet, do you limit yourself to that small a portion? My wine glasses contain eight ounces, and I tend to fill them up, which raises the calorie count to 235. The larger glass then, has 88 more calories. In 40 days that extra wine will turn into a pound of fat. That’s nine pounds a year.
3. Remember the math. One pound equals 3500 calories. The average moderately active adult woman should consume 1800 to 2200 calories a day; moderately active adult males can consume 2200 to 2400 calories a day. If you cut 100 calories a day, you will lose one pound every 35 days. Likewise, if you add just 100 calories a day—about a third of a Snickers— you will add a pound every 35 days. I am here to tell you that it does add up, slowly, and with great chubbiness.
4. Replace high-fat habits with body-pleasing options. Before I turned healthy, I started each Sunday with two chocolate long johns and a Diet Coke. At the beginning of my weight-loss program, I cut this down to one long john and a Diet Coke. Eventually, I cut out both pastries and the Diet Coke. Instead, I now have whole wheat toast with cinnamon sweetened with Stevia. Cinnamon is an antioxidant, Stevia is a natural sweetener, and whole wheat can cut your breast cancer risk. I drink black cherry juice or decaffeinated coffee sweetened with natural agave juice. And I am fine with it. I do not feel like I am sacrificing treats at all.
5. Eat breakfast. The Weight Control Registry monitors people who have lost more than 30 pounds and kept it off for more than a year. Seventy-eight percent of respondents eat breakfast every day. Breakfast gets you going with energy, balances your metabolism, and keeps you from getting too hungry and overeating. I actually eat two breakfasts. I start with organic oats with blueberries and almond milk. In mid-morning, I drink a smoothie.
6. Smoothies are wonders. You can pack healthy goodies into a blender and make enough ahead of time for two to three days. I sip on the smoothie when others are drinking high-caffeine, high-fat coffee drinks. My recipe is simple: fat-free yogurt, a banana, green tea, black cherry juice, and whatever fruit I have on hand, usually some type of organic berries, either fresh or frozen.
7. Keep healthy snacks on hand. I have a mid-afternoon snack of organic broccoli dipped into hummus. I make a trail mix of pumpkin seeds, sunflower seeds, organic raisins, organic unsweetened dried cranberries, and almonds. You need no extra salt or sugar. I sometimes get fancy and buy yogurt almonds. I keep a Baggie of this in my purse for snacks whenever. Sometimes I mix it with broccoli for a truly yummy snack. I also like strips of green or red peppers, both powerful antioxidants high in Vitamin C and E
8. Keep unhealthy foods out of reach. Keep them out of the house if possible. I love peanuts and potato chips and tend to lose control when eating them. My husband has more sense and keeps them in his basement office drawer. I know where they are but have enough dignity to keep from stealing them from his office. I mean, really.
9. Eat at home. Restaurants are full of temptations, and there’s a reason they taste so good. Wonder why the pasta is so much better at your favorite Italian bistro than at home? Butter. Lots of it. You’re far more likely to maintain a healthy diet at home.
10. A low-fat diet can help reduce the risk of recurrence of hormone-receptor-negative (HR-)breast cancer, the type I was diagnosed with in 2006, according to the Women’s Intervention Nutrition Study (WINS). A low-fat diet—of 32 grams a day, or roughly 20 percent of your daily allotment of fat—caused women not only to lose weight, but to lower their risk of breast cancer. Those with HR- reduced their risk of recurrence by an impressive 42 percent. Women with hormone-receptor-positive breast cancer (HR+) also benefit from lower weight, according to a more recent study published in the November 26, 2008 issue of the Journal of the National Cancer Institute. The study, of 280,000 postmenopausal women, showed that the risk of breast cancer increased with weight gain.
11. Weigh yourself regularly. I do it daily and find it a significant motivator. If I am up more than three pounds several days in a row, I up my exercise and cut my calories until I get back down.
12. Exercise. Diet alone is usually not enough. Ninety percent of Weight Control Registry members exercise an average of an hour a day. I don’t do that much—I try for four hours a week.
Losing weight comes from changing your attitude toward food. Food is a source of energy and health, not a reward or a way to kill time. And eating healthy doesn’t mean you’ve ruined the social aspects of food. You can enjoy a convivial visit with friends over a well-balanced meal. And eating healthy can be every bit as satisfying as eating the fatty stuff.
The pleasures of overeating are fleeting, but the results long-lasting.
Some tips:
1. Create a spreadsheet and write down everything you eat. I focused only on calories, to simplify things, but I kept my eyes open to foods that were high in sodium or sugars. You’ll be surprised at how much the little things add up. Use a site like caloriecount.about.com to help you find nutrition information on the foods you eat. For example, that Snickers bar has 271 calories, 122 of those from fat. One bar has 26 percent of your daily recommended allotment of trans fat. It has a substantial 28.8 grams of sugar. Dieticians recommend that you keep sugar under 48 grams a day, so a Snickers gives you more than 50 percent of that. Think about it: Look at the fleeting pleasure, the lasting damage.
2. Be honest in the spreadsheet. If you have a glass of wine, look at the size. Five ounces of red wine have roughly 147 calories, according to the USDA. Yet, do you limit yourself to that small a portion? My wine glasses contain eight ounces, and I tend to fill them up, which raises the calorie count to 235. The larger glass then, has 88 more calories. In 40 days that extra wine will turn into a pound of fat. That’s nine pounds a year.
3. Remember the math. One pound equals 3500 calories. The average moderately active adult woman should consume 1800 to 2200 calories a day; moderately active adult males can consume 2200 to 2400 calories a day. If you cut 100 calories a day, you will lose one pound every 35 days. Likewise, if you add just 100 calories a day—about a third of a Snickers— you will add a pound every 35 days. I am here to tell you that it does add up, slowly, and with great chubbiness.
4. Replace high-fat habits with body-pleasing options. Before I turned healthy, I started each Sunday with two chocolate long johns and a Diet Coke. At the beginning of my weight-loss program, I cut this down to one long john and a Diet Coke. Eventually, I cut out both pastries and the Diet Coke. Instead, I now have whole wheat toast with cinnamon sweetened with Stevia. Cinnamon is an antioxidant, Stevia is a natural sweetener, and whole wheat can cut your breast cancer risk. I drink black cherry juice or decaffeinated coffee sweetened with natural agave juice. And I am fine with it. I do not feel like I am sacrificing treats at all.
5. Eat breakfast. The Weight Control Registry monitors people who have lost more than 30 pounds and kept it off for more than a year. Seventy-eight percent of respondents eat breakfast every day. Breakfast gets you going with energy, balances your metabolism, and keeps you from getting too hungry and overeating. I actually eat two breakfasts. I start with organic oats with blueberries and almond milk. In mid-morning, I drink a smoothie.
6. Smoothies are wonders. You can pack healthy goodies into a blender and make enough ahead of time for two to three days. I sip on the smoothie when others are drinking high-caffeine, high-fat coffee drinks. My recipe is simple: fat-free yogurt, a banana, green tea, black cherry juice, and whatever fruit I have on hand, usually some type of organic berries, either fresh or frozen.
7. Keep healthy snacks on hand. I have a mid-afternoon snack of organic broccoli dipped into hummus. I make a trail mix of pumpkin seeds, sunflower seeds, organic raisins, organic unsweetened dried cranberries, and almonds. You need no extra salt or sugar. I sometimes get fancy and buy yogurt almonds. I keep a Baggie of this in my purse for snacks whenever. Sometimes I mix it with broccoli for a truly yummy snack. I also like strips of green or red peppers, both powerful antioxidants high in Vitamin C and E
8. Keep unhealthy foods out of reach. Keep them out of the house if possible. I love peanuts and potato chips and tend to lose control when eating them. My husband has more sense and keeps them in his basement office drawer. I know where they are but have enough dignity to keep from stealing them from his office. I mean, really.
9. Eat at home. Restaurants are full of temptations, and there’s a reason they taste so good. Wonder why the pasta is so much better at your favorite Italian bistro than at home? Butter. Lots of it. You’re far more likely to maintain a healthy diet at home.
10. A low-fat diet can help reduce the risk of recurrence of hormone-receptor-negative (HR-)breast cancer, the type I was diagnosed with in 2006, according to the Women’s Intervention Nutrition Study (WINS). A low-fat diet—of 32 grams a day, or roughly 20 percent of your daily allotment of fat—caused women not only to lose weight, but to lower their risk of breast cancer. Those with HR- reduced their risk of recurrence by an impressive 42 percent. Women with hormone-receptor-positive breast cancer (HR+) also benefit from lower weight, according to a more recent study published in the November 26, 2008 issue of the Journal of the National Cancer Institute. The study, of 280,000 postmenopausal women, showed that the risk of breast cancer increased with weight gain.
11. Weigh yourself regularly. I do it daily and find it a significant motivator. If I am up more than three pounds several days in a row, I up my exercise and cut my calories until I get back down.
12. Exercise. Diet alone is usually not enough. Ninety percent of Weight Control Registry members exercise an average of an hour a day. I don’t do that much—I try for four hours a week.
My Story: Weight Loss Through Exercise
What I learned by using exercise as one tool to lose weight (with special thanks to the trainer who helped me succeed):
1. My pleasant strolls around the lake with my friend were lovely, but they were doing nothing for my cardiovascular system and were not helping me with weight loss. To be beneficial, exercise has to increase your heart rate. My goal was to get my heart rate up to 120 at least mid-way in a walk, and keep it there most of the way. That transformed my 45-minute stroll around the lake into a 30-minute workout.
Some tips on heart rate:
• Adults typically have a resting heart rate of 60 to 100 beats a minute. The lower the number, the better.
• On the other end of the spectrum is your maximum heart rate. Determine this by deducting your age from 220. I began my program at age 59, so my maximum heart rate was 161.
• When exercising, your aim should be reaching 60 to 80 percent of your maximum heart rate. My goal of 120 was about 75 percent of my maximum.
• It’s simple to measure your heart rate: Find the pulse point in your wrist or your neck until you can feel your pulse regularly enough to begin counting. Time yourself for 15 seconds. Multiply that by 4, to get the rate for a minute, or 60 seconds. If your rate is 30, your heart rate is at 120. A heart rate monitor can do this electronically, but your finger is cheaper and needs no batteries.
• Don’t overdo it. If you exercise at 85 percent or higher, you can do damage to your heart and your bones.
• Check with your doctor before getting started to make sure you have no health risks that would affect your exercise.
2. When I reached a goal, it was time to push myself more, not sit back and congratulate myself. If you want to continue losing weight, you have to keep increasing your exercise. Be reasonable. If you walk 30 minutes a day, add another five every two weeks or so. You can stop the increases once you have met your goal. At that point, keep exercising at the same rate to maintain that weight loss. Same thing with lifting weights. If you have been lifting 20 pounds at ten counts, gradually add more counts and more weights—first, go for 12 counts at 20 pounds, then 15 at 20 pounds. Then add five pounds and start the process again with ten counts at 25 pounds.
3. I had to listen to my body and do what it could handle. I tried jogging and liked it for a while—mostly I liked that I could do it. Eventually, though, my bones began to hurt and I had to be honest that it was just too jarring for my body. It helped me lose the weight, but I do not need it for maintenance. Occasionally, I run for a minute or two during a walk, just to get my heart rate up, but I do not try for any significant length. I am not opposed to jogging—for others. I just know it is not for me, and I know that if I hate doing something I will simply avoid it. I love walking and hiking, so that is my exercise of choice.
4. I don’t let myself get lazy. I stopped working with the trainer after a year, but I still have him in my head—it’s as though he’s sitting on my shoulder. When I am on a hike and think it is time to rest, or stop altogether, my interior voice tells me to keep going just a bit longer, push myself just a bit more. I have learned I can. And I am pretty doggone proud of that. And thankful.
1. My pleasant strolls around the lake with my friend were lovely, but they were doing nothing for my cardiovascular system and were not helping me with weight loss. To be beneficial, exercise has to increase your heart rate. My goal was to get my heart rate up to 120 at least mid-way in a walk, and keep it there most of the way. That transformed my 45-minute stroll around the lake into a 30-minute workout.
Some tips on heart rate:
• Adults typically have a resting heart rate of 60 to 100 beats a minute. The lower the number, the better.
• On the other end of the spectrum is your maximum heart rate. Determine this by deducting your age from 220. I began my program at age 59, so my maximum heart rate was 161.
• When exercising, your aim should be reaching 60 to 80 percent of your maximum heart rate. My goal of 120 was about 75 percent of my maximum.
• It’s simple to measure your heart rate: Find the pulse point in your wrist or your neck until you can feel your pulse regularly enough to begin counting. Time yourself for 15 seconds. Multiply that by 4, to get the rate for a minute, or 60 seconds. If your rate is 30, your heart rate is at 120. A heart rate monitor can do this electronically, but your finger is cheaper and needs no batteries.
• Don’t overdo it. If you exercise at 85 percent or higher, you can do damage to your heart and your bones.
• Check with your doctor before getting started to make sure you have no health risks that would affect your exercise.
2. When I reached a goal, it was time to push myself more, not sit back and congratulate myself. If you want to continue losing weight, you have to keep increasing your exercise. Be reasonable. If you walk 30 minutes a day, add another five every two weeks or so. You can stop the increases once you have met your goal. At that point, keep exercising at the same rate to maintain that weight loss. Same thing with lifting weights. If you have been lifting 20 pounds at ten counts, gradually add more counts and more weights—first, go for 12 counts at 20 pounds, then 15 at 20 pounds. Then add five pounds and start the process again with ten counts at 25 pounds.
3. I had to listen to my body and do what it could handle. I tried jogging and liked it for a while—mostly I liked that I could do it. Eventually, though, my bones began to hurt and I had to be honest that it was just too jarring for my body. It helped me lose the weight, but I do not need it for maintenance. Occasionally, I run for a minute or two during a walk, just to get my heart rate up, but I do not try for any significant length. I am not opposed to jogging—for others. I just know it is not for me, and I know that if I hate doing something I will simply avoid it. I love walking and hiking, so that is my exercise of choice.
4. I don’t let myself get lazy. I stopped working with the trainer after a year, but I still have him in my head—it’s as though he’s sitting on my shoulder. When I am on a hike and think it is time to rest, or stop altogether, my interior voice tells me to keep going just a bit longer, push myself just a bit more. I have learned I can. And I am pretty doggone proud of that. And thankful.
My Story: Healthy Weight Loss
I weigh the same today as I did 25 years ago. In between, though, I gained and lost 50 pounds. Losing that weight, I am sure, helped me beat the breast cancer I was diagnosed with in 2006. And research shows that the exercise plan and low fat diet I adopted can help keep my cancer from returning.
So, yea for me for losing the weight. Why, though, did it take me so long to get to it?
The weight began creeping up in my early 40s when I started teaching. I loved the work, but it was exhausting while not being much of a workout; I spent hours at a time sitting and grading papers. I went home too pooped to exercise, but eager for a glass of wine and some comfort food. I went from a size 10 to a 12, 14, then 16.
I tried to diet. I would lose a few pounds, then gain them right back. It took me two months once to lose ten pounds. I regained it in two weeks. Clearly losing weight was impossible.
Then came my wellness exam of 2005. It did not go well. My blood sugar was high enough to put me at risk for diabetes, My cholesterol had spiked. And my weight was at an all-time high. My body mass index was 29.5—just .5 short of obese. I was a hair’s breadth away from being plain old fat and it was affecting my health.
I was 50 pounds overweight. I was carrying the equivalent of a four-year-old child of extra fat.
Plus, I was getting urinary tract infections as much as four times a year. I did research and was sobered by the fact that these can be a sign of immune system problems and diabetes. An out-of-whack immune system, I am sure, was one cause of my cancer.
When I got the written report than follows up the exam, nearly all of the ten pages listed one health risk I faced: diabetes, heart attack, cancer, stroke, you name it. Each page had the same reminder: “This would be improved if you would lose weight.”
Never before had I been given that message so blatantly: Lose weight if your health matters to you.
I considered my options. I wanted to focus on exercise as much as I could. I had always been active and enjoyed the outdoors and I wanted to enjoy hikes in the mountains again without puffing. But I knew I needed to eat less as well. And I knew I needed a system to keep me in line, to keep me in track.
Several friends recommended a personal trainer. One had lost 100 pounds working with him and was now running marathons. That had appeal, but the cost was high--$1500 for twice-weekly sessions for five months.
A colleague, though, reminded me that $1500 wouldn’t even cover my deductible if I had a heart attack. That was the permission I needed.
Rather than a luxury, I considered Tim Ives, my trainer, an investment in my health. He helped me drop the pounds gradually and, more important, keep them off.
And he taught me to change my perception of what I could do.
I learned that losing weight is a process that simply takes time and commitment. I began to actually work out—lifting weights, jogging, and walking briskly at least four hours a week. And I dieted. I limited myself to 1200 calories a day and kept track of them religiously. I usually lost weight consistently, but occasionally I would step on the scale and be a pound or two over. I was thrown, but I didn’t give up. I kept at it and the pounds dropped off.
I was paying a trainer good money. I was determined to show a benefit. Plus, I made a big deal out of the fact that I was going to lose weight. I had made a commitment in front of friends, family, and colleagues. And research shows that I did two things right: I got help, rather than trying to go it alone. And I went public. Both made me accountable for my weight loss.
When I signed up, I told Tim I wanted to lose 20 pounds. When I hit that level, I kept going because I had simply changed the way I lived. I plateaud at 50 pounds and stayed there. It feels like I am where I should be.
There are far cheaper ways to do much the same thing, such as group trainers, online supports like caloriecount.about.com, and weight loss group like Weight Watchers. Tim was valuable, though, in educating me about how to benefit from exercise and how to keep from hurting myself. I had once tried a do-it-yourself exercise regimen and threw out my hip, sidelining me seriously for weeks and costing me a nice chunk of money for physical therapy.
Plus, Tim pushed me and didn’t let me slow down when things got tough. He showed me that I could do things I never thought possible. Bench press? Me? I was almost 60 and I had never lifted a weight in my life. High time, Tim said.
Tim weighed me every week and wrote down the results. With him watching and recording, I was embarrassed when I didn’t lose. More motivation.
The change in my diet was all my own.
On most days, I gave up butter, salad dressing, bread, dessert, fried foods, and cream sauces. I ate lots of vegetables and a good amount of fruit. I drank much water. Occasionally, though, I allowed myself a treat, because I could not stick to a diet that was too austere.
I never veered off the exercise, though. I took one day off a week, but adamantly laced up my running shoes on all other days.
I’ve lost that four-year-old child I used to carry everywhere and I’ve kept her off for nearly two years. As a result, exercise is easier and more fun. I hike quicker and easier, with far less puffing. This summer, I made it up the mountain by our Colorado cabin, my original goal when I began working with Tim. I was two years late, the cancer throwing me off a bit.
Exercise and eating right have become a new way of living, not a short-term change. I know I can never go back to my life of literally chewing the fat and spending my days in a desk chair. But feeling healthy and energetic and looking at myself in a size 10 is more important than the taste of any hot fudge sundae. Well, usually.
For details on how I did it, read My Story: Weight Loss Through Exercise and My Story: Weight Loss Through Diet Change.
Saturday, October 25, 2008
Treatment options for early-stage breast cancer
Curetoday.com has a thorough article assessing the different treatments available for early stage breast cancer. It does a nice job of explaining how options differ between hormone-negative and hormone-positive. Complex stuff, so you might want to print it and take it with you to your doctor's appointment.
Saturday, October 18, 2008
High-Fiber Bread Associated with Reduced Hormone Negative Risk; Fried Potatoes Associated with Increase
I grew up loving white bread—a piece of lunch meat, some mayo and good old Wonder bread was my idea of the best grade school lunch ever. Yummm. Add some potato chips and it didn’t bother me that I had just tried to recite Joyce Kilmer’s “Trees” and kept starting at the last line and Sister Mary Schoolteacher made me sit down in humiliation. (I kept starting with the final line: “Poems are made by fools like me.” No doubt Sister thought, “Fool indeed.”)
It took me decades to get to truly like whole wheat bread. Fried potatoes remain one of my favorites, although I seldom eat them now. And now I can Google the words to “Trees.” (See below.)
New research shows that I was absolutely on the wrong track for most of my life, but my post-cancer diet is right on the money. Swedish researchers monitored the diets of 544 women for 10.3 years. They discovered that those with a diet that regularly included high-fiber bread had a significantly reduced risk of breast cancer—both hormone negative and hormone positive.
Fried potatoes were significantly associated with an increase in hormone negative breast cancer. Their research was published in August in the journal Carcinogenesis.
So, cut the French fries and chomp on whole wheat bread. Chances are you’ll feel better, fight cancer, and lose weight. Had I done that, maybe I would have recited the poem correctly.
Trees
by Joyce Kilmer
I think that I shall never see
A poem lovely as a tree.
A tree whose hungry mouth is prest
Against the earth’s sweet flowing breast;
A tree that looks at God all day,
And lifts her leafy arms to pray;
A tree that may in Summer wear
A nest of robins in her hair;
It took me decades to get to truly like whole wheat bread. Fried potatoes remain one of my favorites, although I seldom eat them now. And now I can Google the words to “Trees.” (See below.)
New research shows that I was absolutely on the wrong track for most of my life, but my post-cancer diet is right on the money. Swedish researchers monitored the diets of 544 women for 10.3 years. They discovered that those with a diet that regularly included high-fiber bread had a significantly reduced risk of breast cancer—both hormone negative and hormone positive.
Fried potatoes were significantly associated with an increase in hormone negative breast cancer. Their research was published in August in the journal Carcinogenesis.
So, cut the French fries and chomp on whole wheat bread. Chances are you’ll feel better, fight cancer, and lose weight. Had I done that, maybe I would have recited the poem correctly.
Trees
by Joyce Kilmer
I think that I shall never see
A poem lovely as a tree.
A tree whose hungry mouth is prest
Against the earth’s sweet flowing breast;
A tree that looks at God all day,
And lifts her leafy arms to pray;
A tree that may in Summer wear
A nest of robins in her hair;
Upon whose bosom snow has lain,
Who intimately lives with rain.
Poems are made by fools like me,
But only God can make a tree.
Who intimately lives with rain.
Poems are made by fools like me,
But only God can make a tree.
Wednesday, October 15, 2008
Caffeine Might Increase Hormone Negative Risk
The more caffeine you drink, the higher your risk of hormone negative breast cancer, according to a study published in the October 12, 2008 Archives of Internal Medicine. The research was part of the Women’s Health Study, with 39,310 participants who filled out a comprehensive questionnaire on their eating habits. This study looked at the links between caffeine intake—coffee, black tea, and colas primarily—and breast cancer.
Researchers assumed that the content of caffeine was 137 mg per cup of coffee, 47 mg per cup of tea, 46 mg per can or bottle of cola, and 7 mg per serving of chocolate candy.
The big caffeine Kahuna here, then, is coffee.
Twenty-four percent of the women never drank coffee; 13 percent drank less than a cup a day; 14.2 percent had two to three cups a day, and 15.4 percent had four cups a day. Yikes!
No matter the quantity, though, caffeine had no significant effect on hormone positive breast cancer. But the risk of hormone negative does go up with each cup of coffee. Likewise, the chance of having a tumor larger than 2 cm went up with increased coffee consumption.
Still, as is the case with many breast cancer studies, the number of cases of hormone negative breast cancers was so small that researchers didn’t have enough data to state conclusively that high caffeine leads to hormone negative breast cancer. These findings, they say, may be “due to chance and warrant further study.”
Until the data are in, though, it might be best to cut the coffee.
Researchers assumed that the content of caffeine was 137 mg per cup of coffee, 47 mg per cup of tea, 46 mg per can or bottle of cola, and 7 mg per serving of chocolate candy.
The big caffeine Kahuna here, then, is coffee.
Twenty-four percent of the women never drank coffee; 13 percent drank less than a cup a day; 14.2 percent had two to three cups a day, and 15.4 percent had four cups a day. Yikes!
No matter the quantity, though, caffeine had no significant effect on hormone positive breast cancer. But the risk of hormone negative does go up with each cup of coffee. Likewise, the chance of having a tumor larger than 2 cm went up with increased coffee consumption.
Still, as is the case with many breast cancer studies, the number of cases of hormone negative breast cancers was so small that researchers didn’t have enough data to state conclusively that high caffeine leads to hormone negative breast cancer. These findings, they say, may be “due to chance and warrant further study.”
Until the data are in, though, it might be best to cut the coffee.
And, on a side note, most media notices I have read on this focus on the fact that caffeine does not lead to breast cancer, once again making generalizations about breast cancer while ignoring hormone negative.
Monday, October 13, 2008
Plastic Bottles May Hurt Cancer Treatment
Bisphenol A, (BPA), a chemical found in a number of plastic products, can reduce the effectiveness of chemotherapy treatments on breast cancer, according to a study reported in the October 8, 2008 online edition of the journal Environmental Health Perspectives. Researchers at the University of Cincinnati subjected breast cancer cells to low levels of BPA, similar to levels found in the blood of humans. They found that BPA mimics estrogen, which can protect cancer cells from the effects of chemo, thus reducing chemo’s strength. Estrogen has been previously linked to chemotherapy resistance, but researchers have wondered why post-menopausal women can also be resistant. This study might provide some explanation for that connection. It might also be provide some answers for hormone receptor negative cancer.
BPA is found in drinking bottles and the lining of food cans. Some experts recommend avoiding plastic bottles marked with the recycling symbols 3,6 or 7. Others say all plastic, even that promoted as being BPA-free, is suspect and can leach dangerous estrogen-like chemicals.
BPA is found in drinking bottles and the lining of food cans. Some experts recommend avoiding plastic bottles marked with the recycling symbols 3,6 or 7. Others say all plastic, even that promoted as being BPA-free, is suspect and can leach dangerous estrogen-like chemicals.
Sunday, October 5, 2008
Obama and McCain On Coverage of Pre-Existing Conditions
Several organizations and publications have evaluated the health care plans proposed by John McCain and Barack Obama recently.
In its November 2008 issue, Consumer Reports compared the two based on real-life needs. One scenario presented the case of 59-year-old Susan Braig, a self-employed artist and grant writer who was diagnosed with breast cancer in 2004. Her current insurance costs only $2,496 a year, but when she was sick, it did not cover chemo and other out patient treatments, leaving her $40,000 in debt. Consumer Reports looks at how McCain and Obama would cover her and offers this bottom line:
Obama would probably do more to cut costs and improve coverage for those like Braig with limited income or a poor health history. Among other things, he’d prohibit insurers in the individual and small-business market from selling plans with coverage with loopholes like those in Braig’s plan.
In a comparison chart, the magazine looks at the “Ability to get coverage regardless of a pre-existing condition” and says:
MCCAIN: In McCain’s deregulated market, insurers could choose whether or not to cover pre-existing conditions, so rules would vary from policy to policy. People with health issues could instead apply for coverage under a federal-state GAP plan. The campaign promises GAP insurance will be comprehensive and affordable but has offered few details. Existing high-risk pools tend to be costly.
OBAMA: Obama would explicitly require insurers to cover pre-existing conditions. The campaign says those policies would be affordable, since its plan would make the health system more efficient and cut $2500 yearly from the average family’s bill. It offers no specific calculations to support that number, however, and others say costs would go up since more sick people would be covered.
Mary Carmichael, in Newsweek’s October 6 issue, asked Katherine Swartz, a professor of health policy and economics at Harvard, to compare the two programs. An excerpt:
Can you explain McCain's plan to help out people with previously existing conditions by expanding "high-risk pools"? We've had state-sponsored high-risk pools for several decades, but they cover fewer than 200,000 people. They were set up so insurance companies could essentially cede people who they predicted would have very high health-care costs. At one point McCain said he would subsidize high-risk pools with between $7 billion and $10 billion a year. That would cover maybe 3 million people, which is not much of a dent in the 47 million people without insurance now.
Obama would also require insurers to cover people with pre-existing conditions. Wouldn ' t insurers raise premiums? Yes, premiums may be higher. I think people need to consider the alternative—if patients are closed off from coverage, they still go to the ER, and we all pay for that.
The Kaiser Family Foundation gives a side-by-side comparison of the two candidates’ plans. It doesn’t provide a specific category on pre-existing conditions, so it says nothing about McCain’s plan in that respect, saying only that Obama would “Prohibit insurers from denying coverage based on pre-existing conditions.”
In its November 2008 issue, Consumer Reports compared the two based on real-life needs. One scenario presented the case of 59-year-old Susan Braig, a self-employed artist and grant writer who was diagnosed with breast cancer in 2004. Her current insurance costs only $2,496 a year, but when she was sick, it did not cover chemo and other out patient treatments, leaving her $40,000 in debt. Consumer Reports looks at how McCain and Obama would cover her and offers this bottom line:
Obama would probably do more to cut costs and improve coverage for those like Braig with limited income or a poor health history. Among other things, he’d prohibit insurers in the individual and small-business market from selling plans with coverage with loopholes like those in Braig’s plan.
In a comparison chart, the magazine looks at the “Ability to get coverage regardless of a pre-existing condition” and says:
MCCAIN: In McCain’s deregulated market, insurers could choose whether or not to cover pre-existing conditions, so rules would vary from policy to policy. People with health issues could instead apply for coverage under a federal-state GAP plan. The campaign promises GAP insurance will be comprehensive and affordable but has offered few details. Existing high-risk pools tend to be costly.
OBAMA: Obama would explicitly require insurers to cover pre-existing conditions. The campaign says those policies would be affordable, since its plan would make the health system more efficient and cut $2500 yearly from the average family’s bill. It offers no specific calculations to support that number, however, and others say costs would go up since more sick people would be covered.
Mary Carmichael, in Newsweek’s October 6 issue, asked Katherine Swartz, a professor of health policy and economics at Harvard, to compare the two programs. An excerpt:
Can you explain McCain's plan to help out people with previously existing conditions by expanding "high-risk pools"? We've had state-sponsored high-risk pools for several decades, but they cover fewer than 200,000 people. They were set up so insurance companies could essentially cede people who they predicted would have very high health-care costs. At one point McCain said he would subsidize high-risk pools with between $7 billion and $10 billion a year. That would cover maybe 3 million people, which is not much of a dent in the 47 million people without insurance now.
Obama would also require insurers to cover people with pre-existing conditions. Wouldn ' t insurers raise premiums? Yes, premiums may be higher. I think people need to consider the alternative—if patients are closed off from coverage, they still go to the ER, and we all pay for that.
The Kaiser Family Foundation gives a side-by-side comparison of the two candidates’ plans. It doesn’t provide a specific category on pre-existing conditions, so it says nothing about McCain’s plan in that respect, saying only that Obama would “Prohibit insurers from denying coverage based on pre-existing conditions.”
Friday, October 3, 2008
Thriving, Not Surviving
I attended a breast cancer survivor’s luncheon today, met a good group of women, and had a surprisingly lively conversation about chemotherapy, oncologists, wigs, and how it feels to be a survivor. Many of us, though, object to being called survivors. “I’m a thriver,” one woman said. I like that. It’s active rather than passive. I can choose to thrive, but calling me a survivor only means I didn’t die.
“Hi, I’m Pat. I’m not dead.”
My friend Diane says she hopes that, of all the dimensions that define her, the fact that she is alive should not be at the top of the list. It’s great, and she likes it, of course, but she’s also smart, accomplished, thoughtful, witty, loving.
Still, when you get cancer, you’re awfully aware of your mortality and you don’t take being alive for granted.
But you want to. The way you did when you thought other people got cancer, not you.
“Hi, I’m Pat. I’m not dead.”
My friend Diane says she hopes that, of all the dimensions that define her, the fact that she is alive should not be at the top of the list. It’s great, and she likes it, of course, but she’s also smart, accomplished, thoughtful, witty, loving.
Still, when you get cancer, you’re awfully aware of your mortality and you don’t take being alive for granted.
But you want to. The way you did when you thought other people got cancer, not you.
Wednesday, September 24, 2008
NCRCC Site Covers Politics and Breast Cancer
The National Breast Cancer Coalition's Web site is worth a look because of its coverage of breast cancer issues related to the presidential campaign. The non-partisan advocacy group was formed in 1991 to lobby "at the national, state and local levels for public policies that impact breast cancer research, diagnosis and treatment. Our grassroots advocacy effort has hundreds of member organizations and tens of thousands of individual members working toward increased federal funding for breast cancer research and collaborating with the scientific community to implement new models of research, improve access to high-quality health care and breast cancer clinical trials for all women, and expand the influence of breast cancer advocates in all aspects of the breast cancer decisionmaking process."
The organization's blog has some informative posts. One compares Obama and McCain's health care plans and is worth poking into. Obama's plan has been criticized as being more expensive, but that's because it covers more Americans, even those with existing conditions, such as cancer. As I have noted before, McCain does not cover those with existing conditions. The site links to an excellent Wall Street Journal article explaining the impact of the two candidates' plans. One difference the newspaper notes: Obama's plan would increase regulation. McCain's would decrease it. Interesting.
I have placed the group's pledge on the left column of my site. Vote to let the candidates know that quality health care is a priority. By signing, you also pledge to take the candidates' health care positions into consideration when voting.
While the economy is getting the attention this week, as well it should, health care cannot be ignored. The financial health of the country, yes, is of prime importance. The physical health, however, is equally important.
Saturday, September 13, 2008
Risk of Late Recurrence Lower for Hormone Negative
Here’s a good news/better new flash: women with early stage breast cancer remain at low risk of recurrence years after treatment. That’s good. Better is that women with hormone negative cancers face a much smaller risk of later recurrence than those with hormone positive. This, despite the fact that hormone negative is considered to be more lethal than positive.
The study, by researchers at the University of Texas M.D. Anderson Cancer Center, included 2,838 women with stage I, II, or III breast cancer between 1985 and 2001. Five years after beginning therapy—chemotherapy, radiation, tamoxifen or all three—those with hormone negative disease faced a seven percent chance of recurrence, while those with hormone positive had a 13 percent chance.
The really good news: 89 percent of all patients had no recurrences within 10 years; 80 percent had no recurrences after 15 years. Within five years, those with stage I cancer had a 7 percent risk of recurrence; stage II faced an 11 percent risk; and stage III faced a 13 percent risk.
The research was published online in the Journal of the National Cancer Institute on August 11, 2008. Because HER2 was not routinely measured at the time and Herceptin and aromotase inhibitors had not been introduced, they were not included in the data. Until 2000, tamoxifen was the only drug for follow-up breast cancer care, and it was limited to women with hormone positive disease.
Researchers say that, while the numbers are small, the fact that cancer can recur years after therapy points to a need for more follow-up care. An interesting conundrum, considering the fact that women with hormone negative cancer faced a lower rate of late recurrence than women with hormone positive disease. That is, women for whom there never has been a long-term drug treatment option did better than women with the drug.
The study does point to continued need for regular follow-up exams and mammograms. I would also emphasize the importance of focusing on a low-fat, healthy diet with plenty of exercise, which have been proven to lower the risk of recurrence of hormone negative breast cancer.
The study, by researchers at the University of Texas M.D. Anderson Cancer Center, included 2,838 women with stage I, II, or III breast cancer between 1985 and 2001. Five years after beginning therapy—chemotherapy, radiation, tamoxifen or all three—those with hormone negative disease faced a seven percent chance of recurrence, while those with hormone positive had a 13 percent chance.
The really good news: 89 percent of all patients had no recurrences within 10 years; 80 percent had no recurrences after 15 years. Within five years, those with stage I cancer had a 7 percent risk of recurrence; stage II faced an 11 percent risk; and stage III faced a 13 percent risk.
The research was published online in the Journal of the National Cancer Institute on August 11, 2008. Because HER2 was not routinely measured at the time and Herceptin and aromotase inhibitors had not been introduced, they were not included in the data. Until 2000, tamoxifen was the only drug for follow-up breast cancer care, and it was limited to women with hormone positive disease.
Researchers say that, while the numbers are small, the fact that cancer can recur years after therapy points to a need for more follow-up care. An interesting conundrum, considering the fact that women with hormone negative cancer faced a lower rate of late recurrence than women with hormone positive disease. That is, women for whom there never has been a long-term drug treatment option did better than women with the drug.
The study does point to continued need for regular follow-up exams and mammograms. I would also emphasize the importance of focusing on a low-fat, healthy diet with plenty of exercise, which have been proven to lower the risk of recurrence of hormone negative breast cancer.
Thursday, September 11, 2008
Younger Women With Hormone Negative Benefit from Removing Second Breast
Having both breasts removed improves survival rates for young women with early stage hormone-negative breast cancer, according to a study presented at the 2008 Breast Cancer Symposium in Washington DC. And the reduction was significant—a 31 percent drop in mortality rates. Researchers at the University of Texas M.D. Anderson Cancer Center in Houston studied records of more than 80,000 breast cancer patients diagnosed from January 1998 through December 2003.
Women 18-49 with stage I-II breast cancer benefited from contralateral prophylactic mastectomy—or removing both the affected breast and the opposite—or contralateral—one. Older patients, those with stage III disease, or with hormone-receptor-positive breast cancer, saw no significant survival benefits from contralateral prophylactic mastectomy.
Women 18-49 with stage I-II breast cancer benefited from contralateral prophylactic mastectomy—or removing both the affected breast and the opposite—or contralateral—one. Older patients, those with stage III disease, or with hormone-receptor-positive breast cancer, saw no significant survival benefits from contralateral prophylactic mastectomy.
Presidential Politics and Health Care: Pay Attention
With presidential politics mired in lipstick on varied animals, it’s time to force a break from the silliness and look at how the candidates handle issues of actual importance, such as health care. Eerily enough, in her criticism of John McCain’s health care plans last April, Elizabeth Edwards called his proposals “painting lipstick on a pig.” (Perhaps it is time to put that phrase to rest, and leave the poor pigs to their mud.)
Edwards’ major complaint, cosmetics aside, is that McCain’s plan would not apply to either her or McCain—or me. It does not include any provisions to keep insurance companies from denying coverage for preexisting conditions. Elizabeth, John and I are all fine, with affordable health insurance and the resources to pay for care. Well, the other two have quite a few more resources than I do, but I still can afford the health care I need, which makes me fortunate indeed. Had I been diagnosed with breast cancer and not had insurance, though, I would have been in a truly scary place, at risk physically and financially. That happens to far too many Americans with serious illness and it is just plain wrong.
Paul Krugman, in the New York Times, agrees, and wrote at the time of Edward’s comments, “It's about time someone said that and, more generally, made the case that Mr. McCain's approach to health care is based on voodoo economics -- not the supply-side voodoo that claims that cutting taxes increases revenues (though Mr. McCain says that, too), but the equally foolish claim, refuted by all available evidence, that the magic of the marketplace can produce cheap health care for everyone.”
The McCain Web site says: John McCain will reform health care making it easier for individuals and families to obtain insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.
Sounds good until you realize that there currently is plenty of competition in the insurance market and we still have 45.8 million uninsured American citizens —in a country with a population of 305 million. That means 15 percent of Americans are uninsured. And 21 percent of those are under 17. So more of the same seems a weak argument. Competition in the market has only led to continued increases in insurance and health care costs. What’s more, portability applies only to those people whose employers offer them insurance in the first place, which happens less and less in this damaged economy.
Barack Obama proposes simply to cover all Americans. In May, he said, “If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”
The Obama site defines Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.
Obama’s plan is similar to one developed in Massachusetts and instituted in 2006, which mandates coverage. Obama would subsidize costs for those at lower income levels through tax increases on those making more than $250,000.
Chris Hedges of Truthdig says neither candidate has it right, and that only a single-payer national health insurance system makes sense, citing a Harvard Medical School study that says this would save the country $350 billion a year.
Still, we need to at least take baby steps, and proposing to shut down one of the country’s largest industries just isn’t going to happen overnight. Change will have to come incrementally, and Obama’s plan is a beginning. Canada went to a single-payer system in the 60s, so there is precedent for it happening. We need somebody with the courage and smarts to force that move. Obama’s 18-month focus on change is clearly the way to go, as evidenced by the fact that McCain is now using the same theme.
Whatever your politics, if you have a chance to visit with the candidates or their staffs, hold them accountable to health care change. More of the same is unthinkable. Make the candidates talk specifics on who they would cover and how. And make them stop talking about lipstick.
Edwards’ major complaint, cosmetics aside, is that McCain’s plan would not apply to either her or McCain—or me. It does not include any provisions to keep insurance companies from denying coverage for preexisting conditions. Elizabeth, John and I are all fine, with affordable health insurance and the resources to pay for care. Well, the other two have quite a few more resources than I do, but I still can afford the health care I need, which makes me fortunate indeed. Had I been diagnosed with breast cancer and not had insurance, though, I would have been in a truly scary place, at risk physically and financially. That happens to far too many Americans with serious illness and it is just plain wrong.
Paul Krugman, in the New York Times, agrees, and wrote at the time of Edward’s comments, “It's about time someone said that and, more generally, made the case that Mr. McCain's approach to health care is based on voodoo economics -- not the supply-side voodoo that claims that cutting taxes increases revenues (though Mr. McCain says that, too), but the equally foolish claim, refuted by all available evidence, that the magic of the marketplace can produce cheap health care for everyone.”
The McCain Web site says: John McCain will reform health care making it easier for individuals and families to obtain insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.
Sounds good until you realize that there currently is plenty of competition in the insurance market and we still have 45.8 million uninsured American citizens —in a country with a population of 305 million. That means 15 percent of Americans are uninsured. And 21 percent of those are under 17. So more of the same seems a weak argument. Competition in the market has only led to continued increases in insurance and health care costs. What’s more, portability applies only to those people whose employers offer them insurance in the first place, which happens less and less in this damaged economy.
Barack Obama proposes simply to cover all Americans. In May, he said, “If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness.”
The Obama site defines Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress.
Obama’s plan is similar to one developed in Massachusetts and instituted in 2006, which mandates coverage. Obama would subsidize costs for those at lower income levels through tax increases on those making more than $250,000.
Chris Hedges of Truthdig says neither candidate has it right, and that only a single-payer national health insurance system makes sense, citing a Harvard Medical School study that says this would save the country $350 billion a year.
Still, we need to at least take baby steps, and proposing to shut down one of the country’s largest industries just isn’t going to happen overnight. Change will have to come incrementally, and Obama’s plan is a beginning. Canada went to a single-payer system in the 60s, so there is precedent for it happening. We need somebody with the courage and smarts to force that move. Obama’s 18-month focus on change is clearly the way to go, as evidenced by the fact that McCain is now using the same theme.
Whatever your politics, if you have a chance to visit with the candidates or their staffs, hold them accountable to health care change. More of the same is unthinkable. Make the candidates talk specifics on who they would cover and how. And make them stop talking about lipstick.
Wednesday, August 20, 2008
PST May Offer Hope for Hormone-Negative
The Windsor Star reports that Canadian and Indian researchers are collaborating on a study to determine the use of the drug pancratistatin (PST) specifically for hormone-negative breast cancers. PST, made from the Hawaiin spider lily, has been shown in studies to kill cancerous cells while sparing healthy ones. If successful, it will be the first drug for hormone-negative cancers.
Tuesday, August 19, 2008
Take One Off the Bucket List: I Made it Up the Mountain
Here I am at the miners’ cabin at approximately 10,700 feet on the East Spanish Peak in Southern Colorado. The long shot is of our cabin from the mountain—we’re tucked in that green little valley. And the final shot is of my son, Josh, as a stick figure on top of the ridge, making his way down from the peak, about 2,000 feet above us.
We have owned this property for 16 years and I have been looking up at “our” mountain—it is our focal point here—and imagining myself up there. My husband, son, daughter, brother, and nephews have made it up to the “bowl,” an expanse of rock about 75 percent of the way up the peak. I have heard the stories of the beautiful views, the miners’ cabin, the challenge of the climb, and have envied those who have made it. Three years ago, before I was diagnosed with breast cancer, I began a fitness regimen, with one goal being to make it up to the bowl. I have not had a desire to go the entire way up to the peak, as traversing that rock seemed seriously out of my league. Instead of climbing the East Peak at that time, though, I climbed my own mountain of chemotherapy and radiation. So, finally making the hike last week felt like a double victory—over the mountain and over the cancer.
So, there, I did that.
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