H.O.P.E. Blog

Breast Cancer Basics

Breast Cancer Basics - Detecting / Diagnosing/ TreatingBy Jean Lillquist

Breast cancer often has no symptoms, but you may notice something you want the doctor to check. Keep an eye out for:

  • A painless lump in the breast
  • Changes in breast size or shape

Detecting Breast Cancer

The earlier you find the disease, the easier it is to treat. Mammograms, an X-ray of the breast, can show tumors before they get large enough to feel. The American Cancer Society says women with an average risk level should get a yearly mammogram beginning at age 45. Continue them as long as you’re in good health. The U.S. Preventive Services Task Force says until you’re 50 you should talk to your doctor about your need for testing. After that, get a mammogram every 2 years from age 50 to 74. You don’t have to stop at 75; the group just doesn’t assess the pros and cons. You can work it out with your doctor.

Don’t panic if a tumor is found. Eighty percent of breast lumps aren’t cancerous. They often turn out to be harmless cysts or tissue changes related to your menstrual cycle. Also, let your doctor know right away if you find anything unusual in a self-check. If it is cancer, the earlier it’s found, the better. And if it isn’t, testing can give you peace of mind.

Diagnosing Breast Cancer

The only sure way to know a lump is cancer is to do a biopsy. This means removing a sample of the lump so it can be examined. Your doctor may be able to do this with a small needle. But you might need surgery to take part of or the entire lump for testing. The results will show whether it’s cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to each type.

Some types of breast cancer are fueled by the hormones estrogen or progesterone. Your doctor will call these receptors -- they’re proteins that pick up signals from the hormone that tell cells to grow. A biopsy can show if a tumor has receptors for estrogen (it’s ER-positive) and progesterone (it’s PR-positive). About two out of three breast cancers are hormone sensitive. There are several medications that keep the hormones from causing further cancer growth.

HER2-Positive Breast Cancer

In about 20% of patients, breast cancer cells have too much of a protein called HER2. This type is known as HER2-positive, and it tends to spread faster than other forms.  It’s important to know whether a tumor is HER2-positive, because there are special treatments for this type of cancer.

Breast Cancer Stages

If breast cancer is the diagnosis, the next step is to figure out how big the tumor is and how much of your body it affects. This process is called staging. Doctors use stages 0-IV to describe whether cancer is only in the breast, or if it has moved into nearby lymph nodes or spread to other organs, like the lungs. Knowing the stage and type of breast cancer will help your health care team create a treatment plan.

Survival Rates

The odds of beating breast cancer are strongly tied to how early you find it. The American Cancer Society says 100% of women with stage I breast cancer live at least 5 years, and many women in this group remain cancer-free for good. The more advanced the cancer, the lower this figure becomes. By Stage IV, the 5-year survival rate drops to 22%. But these rates will rise as more effective treatments are found.

Breast Cancer Treatment

 

Radiation Therapy

This treatment kills cancer cells with high-energy rays. It may be used after breast cancer surgery to wipe out any cancer cells that remain near the tumor site. It might be paired with chemotherapy to treat cancer that has spread to other body parts. Side effects include fatigue and swelling or a sunburn-like feeling where you were treated.

Chemotherapy

This treatment uses drugs to kill cancer cells anywhere in the body. They’re often given by IV, but they can be taken by mouth or a shot. You might have it before surgery to shrink a large tumor or after to lower the odds of your cancer coming back. In women with advanced breast cancer, chemo can help control the cancer’s growth. Side effects may include hair loss, nausea, fatigue, and a higher risk of infection.

Hormone Therapy

This is for women with ER-positive or PR-positive breast cancer. These cancers grow faster in response to the hormones estrogen or progesterone. Hormone therapy can block this effect. It might be used after surgery to help keep the cancer from coming back. Doctors sometimes give it to women with high risk factors to reduce the chances of getting breast cancer.

Targeted Treatments

These newer drugs pinpoint specific things inside cancer cells. For example, women with HER2-positive breast cancer have too much of a protein called HER2. Targeted therapies can stop this protein from making cancer cells grow. These drugs are often used along with chemo because they tend to have milder side effects.

This article is reprinted from H.O.P.E. Lifeline (October, 2016) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter.  If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).



Every Four Minutes, Someone is Diagnosed With Blood Cancer

Every Four Minutes, Someone is Diagnosed With Blood CancerWhat are the blood cancers?

Leukemia, Lymphoma, Myeloma, and Myelodysplastic syndromes (MDS) are types of cancer that can affect the bone marrow, the blood cells, the lymph nodes, and other parts of the lymphatic system. Leukemia is a malignant disease of white blood cells in the blood and bone marrow. White blood cells traditionally are the disease fighters, but cancerous cells do not behave the way normal cells do, so they cannot fight disease effectively. Leukemia is divided into four types: acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML), which are rapid progression leukemia; and chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML), which are slow progression.

Leukemia

Whom does leukemia affect?

Leukemia is age-dependent. Children are at higher risk for ALL and adults are more at risk for ALL. Adults are increasingly at risk for AML as they age; the incidence of this disease increases even more rapidly in patients over 60. CML begins to occur in young to middle-age adults, but is slightly less common in older adults. Leukemia also occurs in twice as many patients who smoke cigarettes. The cure rate of childhood ALL is very high, approaching 75% of patients. The cure rate of in adult ALL patients is not quite as good, but has been improving.

What causes leukemia?

In most patients with leukemia the disease does not have any identifiable cause. It appears to be initiated by genetic events (inherited patterns for certain characteristics) occurring in the stem cells at a particular stage in development.

What are the symptoms of leukemia?

Signs or symptoms include tiredness or no energy, shortness of breath during physical activity, pale skin, slow healing of cuts and excess bleeding, black and blue marks (bruises) for no apparent reason, night sweats, enlarged lymph nodes. As with any cancer, some signs or symptoms are similar to other more common and less severe illnesses.

How is leukemia diagnosed?

Specific blood tests and bone marrow tests are needed to make a diagnosis.

What are the treatments?

Treatments and outcomes depend on the type and subtype of the leukemia. Patients with acute leukemia are treated with chemotherapy and bone marrow transplantation. Patients with chronic leukemia may be treated with an oral drug to keep the disease under control, or stem cell transplantation to cure it.

Lymphoma

The name for a group of blood cancers that develop in the lymphatic system. The two types are Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).

Hodgkin lymphoma

Hodgkin lymphoma is one of the most curable forms of cancer. It affect the lymphatic system, and is caused by an abnormal change to a white cell important to the body’s immune system (lymphocyte) which then becomes a lymphoma cell and spreads through the lymphatic system throughout the body. If untreated, the cancerous cells crowd out normal white cells and the immune system can’t guard against infection effectively. The most common early sign of the disease is painless swelling of one or more lymph nodes. Most people have affected lymph nodes in the upper part of their body, usually the neck or upper chest. Sometimes you can feel the affected lymph nodes in your armpit, stomach area, or groin. Many Hodgkin lymphoma patients are cured after their initial treatment. For the smaller number of patients who have disease recurrence or relapse, additional treatments with chemotherapy, sometimes combined with stem cell transplantation, is often successful. A large number of these patients are cured or have long disease-free periods. The five-year relative survival rate is 94.1 percent for people with HL who were less than 45 years old at diagnosis.

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma, which generally develops in the lymph nodes and lymphatic tissues, affects the lymphatic system. It starts with an abnormal change in one of three major types of lymphocytes, B, T, or NK (natural killer) cells. These abnormal lymphocytes accumulate and form masses (tumors) and if not treated crowd out normal white cells. The most common early sign is painless swelling of one or more lymph nodes in the neck, armpit, or groin. In addition to this, other signs or symptoms may include fever, drenching sweats, especially at night, tiredness or no energy, loss of appetite, and unexplained weight loss. Diagnosis usually involves performing a lymph node biopsy. Treatment can include chemotherapy and other drugs, radiation, usually in combination with chemotherapy, stem cell transplantation, watch and wait, or participation in a clinical trial. The five-year survival rate for people with NHL is 71.9 percent as of 2011.

This article is reprinted from H.O.P.E. Lifeline (September, 2016) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter.  If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).

Children—Our Most Vulnerable Cancer Patients

Children -- Our Most Vulnerable Cancer PatientsChildhood or pediatric cancer is more prevalent than you may have realized. Currently, one in nearly 300 children in the United States develops cancer before the age of 19, and the incidence of cancer among children is increasing. Although pediatric cancer death rates have declined by nearly 70 percent over the past four decades, cancer remains the leading cause of death by disease in children under the age of 15, and two thirds of childhood cancer survivors will have long lasting chronic conditions from treatment.

Childhood cancers are mostly those of the white blood cells (leukemias), brain tumors, and lymphomas. Each of these behaves differently. Cancers in very young children are highly aggressive and behave unlike malignant disease seen at other times of life. The median age for childhood cancer is six. Children frequently have a more advanced stage of cancer when they are first diagnosed; 80% of children show that cancer has spread to distant sites in the body when the disease is first diagnosed.

The causes of most childhood cancers are not known. About five percent are caused by an inherited mutation, while others are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer. In adults, these gene mutations are often the result of exposure to environmental factors, such as cigarette smoke, asbestos, and UV radiation from the sun. However, environmental causes of childhood cancer have been difficult to identify, partly because cancer in children is comparatively rare, and partly because it is difficult to determine what children might have been exposed to early in their development.

Children's cancers are not always treated like adult cancers.. Children who have cancer are often treated at a children’s cancer center, which is a hospital or unit in a hospital that specializes in treating children with cancer. Most children’s cancer centers treat patients up to age 20. The types of treatment that a child with cancer receives will depend on the type of cancer and how advanced it is. Common treatments include: surgery, chemotherapy, radiation therapy, immunotherapy, and stem cell transplant. There are exceptions, but childhood cancers usually respond well to chemotherapy because they tend to be cancers that grow fast. (Most forms of chemotherapy affect cells that are growing quickly.) Children’s bodies are also generally better able to recover from higher doses of chemotherapy than are adults’ bodies. Using more intensive treatments gives doctors a better chance of treating the cancer effectively, but it can also lead to more short- and long-term side effects. Unlike chemotherapy, radiation can often cause more serious side effects in children (especially very young children) than in adults, so its use sometimes needs to be limited. Children face unique issues during their treatment for cancer, after the completion of treatment, and as survivors of cancer. For example, they may receive more intense treatments, cancer and its treatments have different effects on growing bodies than adult bodies, and they may respond differently to drugs that control symptoms in adults.

And this…..

Did you know that in the last six years 77 new cancer drugs have been approved by the FDA? Yet only two new drugs have been approved for pediatric cancer (bringing it to a grand total of three). This is because a federal law that requires companies developing drugs for adults to also develop them for children, the Pediatric Research Equity Act (PREA), has never applied to cancer. Because children’s cancers occur in different organs than adult cancer, PREA pediatric study obligations are waived. So a number of cancer specialists and cancer centers (among them MD Anderson, St. Jude’s, Dana Farber, Duke University) and more than a hundred pediatric cancer advocacy organizations are seeking passage of a better law, The RACE (Research to Accelerate Cures and Equity) for Children Act, which will authorize the FDA to “Require PREA pediatric studies when a molecular target of an adult cancer drug is relevant to a children’s cancer.”

On July 15 a bipartisan group of U.S. Senators and Representatives introduced the RACE for Children Act in Congress. If you are interested in reading more about the act and signing a petition, go to Four-Suare Clobbers Cancer. Childhood cancer is not going away.

This article is reprinted from H.O.P.E. Lifeline (September, 2016) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter.  If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).

Fruits and Veggies and Fiber and Protein

Fruits and Veggies and Fiber and ProteinEveryone knows that fruits and vegetables are low in calories and packed with vitamins, minerals, antioxidants, and fiber. But did you know that the more colorful the food item, the higher the concentration of all these good ingredients? So when you select vegetables, think color! Here’s why.

  • Red (raspberries, tomatoes, watermelon, red cabbage, kidney beans, cherries, strawberries, beets) are likely to be rich in the antioxidants lycopene and anthocyanin. The lycopene in tomatoes is known to help prevent prostate, lung, and stomach cancers and was found to stop endometrial cancer cell growth. Lycopene seems to be best available to the body when tomatoes are cooked and eaten in a meal that provides a small amount of fat, and one study showed that tomato paste contained nearly three times the lycopene as fresh tomatoes.
  • Orange and yellow fruits and vegetables are rich in beta-carotene which the body converts to vitamin A that helps keep skin, teeth, and bones healthy, and improves night vision.
  • Green vegetables are also good for the eyes, bones, and teeth, and contain antioxidant vitamins C and E, as well as vitamin K which helps blood clot properly. Broccoli in particular contains sulforaphane, a compound that boosts the body’s protective enzymes and flushes out cancer-causing chemicals.
  • Blue and purple fruits and vegetables contain anthocyanins, which have powerful antioxidant properties, and flavonoids and ellagic acid, compounds that may destroy cancer cells. The anthocyanins and ellagic acid in blueberries and black raspberries have been shown to fight cancer cells in the lungs, stomach, breasts, and pancreas. Anthocyanins and ellagic acid also show anti-inflammatory properties that may prevent cancers of the esophagus and colon.
  • White fruits and vegetables, including apples, pears, bananas, cauliflower, and cucumbers, are high in dietary fiber which helps protect you from high cholesterol, and also lowers your risk of stroke.

Shoot for 21 to 38 grams of fiber per day. Good sources include whole grains, wheat cereals, barley, oatmeal, beans, and nuts; vegetables such as carrots, celery, and tomatoes; and fruits such as apples, berries, citrus fruits, and pears. Fiber stays in the stomach longer than other foods which leads to eating less and aids in maintaining a healthy weight.

Protein gives us the energy to get up and go—but for cancer patients it is especially important for cellular regeneration. If you don’t make enough red blood cells you will feel weak and tire easily, and if you don’t make enough white blood cells you will have a tough time fighting off even the mildest of colds. The best sources of protein are eggs, fish, chicken, and plant-based foods such as beans, nuts, and grains. Soy is an especially good source of protein and contains myriad substances that protect the body from cancer, particularly breast and ovarian.

Weight and Body Type

A healthy weight depends on two factors: body mass index (BMI) and waist size or circumference. Body mass index is a number based on a person’s weight and height that provides a way to estimate the effect of weight on health.

To calculate BMI, the following equation is used: the person’s weight in pounds and height in inches times 703 divided by the person’s inches squared.

So for a person who weighs 200 pounds and is 5’ 10” tall (70 inches) the BMI would be 28.69. Another person of the same height who weighs 175 pounds would have a BMI or 25. Here’s what those numbers mean.

If your BMI is less than 18.5, you are in the underweight category, which can have its own health implications. If the number is between 18.5 and 24.9, you’re in the recommended weight range for your height. If your BMI falls between 25 and 29.9, you are in the overweight category, which still may not be unhealthy providing your waist size is below risk and you are eating right and exercising. If your BMI is 30 or over you’re considered obese and probably need to change your eating and activity habits to stay healthy. As for our two hypothetical people above, the first is in the overweight range and the second just falls in at recommended.

Waist circumference is associated with increased risk of type 2 diabetes, high cholesterol, high blood pressure, and cardiovascular disease because of excess abdominal fat. You probably know the worst place to carry excess weight is in this area. (Better to have a ‘pear’ shape than an ‘apple’ shape.) To measure your waist circumference place a tape measure around your body at the top of your hipbone. This is usually at the level of your belly button. Men are at an increased risk for health problems if their waist is greater than 40 inches in circumference. For women the risk is 35 inches.

This article is reprinted from H.O.P.E. Lifeline (August, 2016) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter.  If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).


How To Eat Smart and Stay Healthy

How to Eat Smart and Stay HealthyWe all know that eating right can help us maintain a healthy weight and avoid certain problems. But did you realize that diet can affect your mood and sense of wellbeing? Studies have linked the typical Western diet—filled with processed meats, packaged meals, takeout food, and sugary beverages and snacks—with higher rates of depression, stress, bipolar disorder, and anxiety. Eating an unhealthy diet may even play a role in the development of mental health disorders such as ADHD, Alzheimer’s disease, and schizophrenia.

Following are some suggestions that deal with more than just the foods that you should and should not eat.

  • Prepare more of your own meals.
  • Opt for more fresh ingredients and fewer prepackage and processed foods.
  • Focus on how you feel after you eat. The more healthy food you eat, the better you’ll feel. The more junk food you eat, the more likely you are to feel uncomfortable, nauseous, or drained of energy.
  • Drink plenty of water.
  • Think smaller portions. Be especially wary when eating out; some restaurant portions are more than twice the size and twice the calories.
  • Take your time while eating.
  • Try to avoid eating in front of the TV or computer or other distraction that can lead to mindless overeating.
  • Eat breakfast and eat smaller meals throughout the day.
  • Avoid eating at night.
  • Consider substitutes for salt. Too much of it can cause high blood pressure and lead to an increased risk of stroke, heart disease, kidney disease, and memory loss, and has been linked to stomach cancer. When cooking at home try other seasonings like herbs and spices. Turmeric does double duty—in addition to adding flavor it also contains curcumin, a spice that can that help prevent pancreatic, colon, prostate, liver, esophageal, and multiple myeloma cancers.

Read labels

  • Starting with calories—a rule of thumb to follow is 40 calories is low; 100 calories is moderate; 400 calories or more is high.
  • You want foods that have less than 10 grams of fat per serving and less than 3 grams of saturated fat. Another way to look at this is percentage: 5% is low and 20% or more is high. (However, polyunsaturated and monounsaturated fats are ‘good fats’ because they can help lower your cholesterol.)
  • Sugar content should be 15 grams or less.
  • Sodium should be under 1,500 milligrams. (Try to keep your overall daily sodium intake to below 2,400 mg.)
  • Protein is necessary in a diet but very easy to get. Women should have around 50 grams a day; grams a day; men 60 grams.
  • Fiber is a good ingredient; the more the better. Look for 3 grams or more in breads and cereals.

Sugar Is Evil 

Probably the most significant recent finding in health research has been how harmful sugar is. Not only does it add weight but it causes energy spikes and has been linked to diabetes, heart disease, depression, and even an increase in suicidal behaviors among young people.

But it also helps cancerous tumors grow. A team of doctors from MD Anderson found that fructose, a major component of refined sugar (sucrose), helps cancer cells metastasize, or spread, and that cancer patients who eat more sugary foods are more likely to have advanced cancer. One study fed sugar to mice, and at the age of six months the mice that had been fed extra sugar had breast tumors, and the more sugar they were fed, the bigger the tumors grew. Other studies found that pancreatic tumors also thrive on fructose. The World Health Organization recommends that people get no more than five percent of their calories from sugar. The USDA is slightly more generous, recommending 10 percent, which breaks down to around six teaspoons a day for women and nine for men. That was the lowest dose of sugar the scientists fed the mice in their study, and even that amount fed tumor growth. And consider this: an average 12-ounce can of soda contains ten teaspoons of sugar.

This article is reprinted from H.O.P.E. Lifeline (August, 2016) - monthly newsletter distributed by H.O.P.E. Click here to view the full newsletter.  If you would like to receive the newsletter by e-mail each month, you may subscribe today (no cost or obligation and you may unsubscribe at any time).


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