Thursday, December 12, 2013

Oh No! It is December.. the month of numerous activities, family events and holiday celebrations.

For a  Cancer patient this month can be a time of reflection,  changing  or finding a new "normal".  It can also be very stressful and if you are in active treatment very tiring.  There may also be depression and anxiety about your future health.

It is hard to "let go" of things you have always done in the past and just may not be able to do this year.

Remember: Taking Care of Yourself is the most important item on this year’s  Holiday " to do" list. 

Consider asking family members or friends for help with shopping, food preparation, cleaning or child care. Your family members or friends may be at a loss of how to help you and you may need to sit down and make a list.  And after you make this list ASSIGN Duties! 

Cancer-related fatigue is a common and distressing side effect of having cancer and can be fairly severe in patients going through treatment. It often occurs with  sleep disturbance, emotional distress, such as depression and anxiety, and pain. 

There are many well established studies that support  increased physical activity and exercise as an intervention to help cancer related fatigued.  

Exercise rather than rest to help fatigue??    Really??    

Yes, really. 

An exercise program twice weekly that has a combination of aerobic exercise and resistance training can help improve your fatigue, increase your energy, improve sleep and decrease feelings of depression.  You can also improve your endurance and flexibility.  

Think about it as a New You for the New Year.  

Check out some programs at the YMCA, Gold’s Gym or a program closer to your home.

If you have other health issues that you think need addressed prior to starting an exercise program please consult you Primary Care Provider to discuss a plan.     

You can overcome the fatigue related to cancer!

Friday, October 25, 2013

Great News for Pennsylvania Women!

The PA Breast Cancer Coalition’s Dense Breast Notification Act was passed by our state legislature!

It just needs signed by our Governor, Tom Corbett.   This Act will require Radiologists in PA to notify women of their breast density at the time of their mammogram.

Why is this Important?

Because there are a group of women “falling through the cracks” that are not having their breast cancer diagnosed until a later stage because of the density of their breast tissue.

There is enormous variability in the density of breast tissue from woman to woman.   Some women have very dense fibrous tissue decreasing the ability of a mammogram to “see” through this tissue to diagnose a cancer.  Some women have very fatty and not so dense breast tissue making finding a cancer a little easier with mammogram.  

There are many factors that may increase our risk of breast cancer over time such as our family history, having radiation therapy for cancer as a child, carrying the BRCA gene mutation and others.

It has been known for a long time that breast density can also be an independent risk factor for breast cancer.

Well, if a mammogram doesn't work that well, what will help to make that diagnosis if you have dense breast tissue?

Discuss this with your physician and consider evaluation possibly with Breast Ultrasound, Mammogram with Tomosynthesis, or possibly breast MRI screening.

Be sure you know your Risks and your options for screening!  And Don’t Miss your Mammogram!  You are very Important!

Tuesday, October 1, 2013


One of the most important discoveries concerning breast cancer has been the realization by many scientists that breast cancer is many diseases.

Have you heard of HER-2 and what does that mean if your cancer is HER-2 positive?

HER-2 stands for human epidermal growth factor receptor-2.  This protein can promote the growth of cancer cells.  One in every 5 breast cancers makes too much HER-2 due to a gene mutation.  This causes the cancer to be more aggressive; however treatment that specifically targets HER-2 is very effective.

This discovery was made by a group of researchers lead by Dr. Dennis Slamon, Head of the Revlon/UCLA Women’s Cancer Research Program.   He states that “ there is a molecular diversity of human cancers that has largely gone unappreciated , and it has gone unappreciated because we lump things together.”   Dr. Slamon and his team looked at this HER-2 protein and found that if an antibody was added to the receptor gene that had mutated , tumor growth dropped dramatically.   Hence the “ birth” of the drug Herceptin to treat HER-2 Positive breast cancers.

More and more we are learning about the genetics of breast cancer and how individualized each women’s cancer may be.  As we learn more about the molecular differences we are learning more about treatments for each individual patient.

If you would like to hear more from Dr. Slamon he will be a guest at  this year’s  Breast Cancer Coalition Conference at the Harrisburg Hilton on October 15, 2013.   This conference is open to patient’s and families as well as caregiver’s.   

More information:  PinnacleHealth Breast Care Center

Friday, August 16, 2013

Is DCIS Breast Cancer?

Is DCIS Breast Cancer?

This seems to be a hot topic of late.. Appropriate for August . We know that the use of screening mammograms definitely saves lives.  Its widespread use has led to the increased diagnosis of so called “ high risk lesions “  in the breast as well as Noninvasive carcinoma of the breast called Stage 0 ductal carcinoma  or DCIS.

DCIS cells in the breast are true cancer cells located entirely within the milk ducts of the breast. These cells have not traveled outside the duct and are not invasive.  A woman’s chance of dying from DCIS itself is almost Zero.

BUT.. there is always a but… if left untreated it does have the potential to become Invasive breast cancer.  It is the most common form of non-invasive breast cancer, found in more than 60,000 women in the U.S. each year according to the American Cancer Society. 

Because of the risk that DCIS is a forerunner of invasive disease, treatment is recommended.

Treatment usually includes a lumpectomy, radiation therapy and possibly Tamoxifen for further prevention.   Sometimes mastectomy is advised if the DCIS is extensive throughout the breast.

The problem with DCIS is that there is no current proven way to predict which form of DCIS is more aggressive and will go on to develop invasive cancer.   

There is currently ongoing research that we hope will increase our understanding of DCIS and improve out treatments. 

If you have been diagnosed with DCIS  bring all your questions to your visit with your breast surgeon and make sure you have a full understanding of your diagnosis.   

Monday, June 24, 2013

The Breast Cancer Gene

Angelina Jolie’s recent announcement that she had bilateral mastectomies without a diagnosis of cancer has everyone talking about the breast cancer genes.

Since the initial discovery of the breast cancer genes called BRCA1 and BRCA2, in the mid 1990s, researchers and clinicians have worked hard to create recommendations for those families that are affected by these gene mutations.

Through intensive cancer surveillance, chemoprophylaxis (medications to decrease risk), and risk reduction surgeries, such as Ms. Jolie’s, thousands of lives have been saved.

Dr. Mark Perlman from the department of OB/GYN and Surgery at the University of Michigan Medical School in Ann Arbor,Michigan, describes this as "the major scientific accomplishment in clinical cancer genetics during the past decade".

What does having this gene mutation mean?

What we do know about the BRCA gene mutation is that if you are found to have this type of mutation your risk of breast cancer by age 70 increases to 87% while the general population is only about 8%. This is a pretty scary jump in risk for the person with this mutation.

This mutation can also increase our risk for ovarian cancer. This risk would jump to 44% by age 70, while the general population risk is less than 1%.   Also very scary.

Are you only at risk for breast or ovarian cancer if you have the BRCA gene mutation?

The answer is No.  Approximately 1in 7 ovarian cancers are related to the gene and approximately 5-10% of breast cancers are related to this gene mutation.

How do I know if I should be tested for this gene mutation?

Here are 8 reasons why you should consider testing for this gene mutation.

  1. Personal history of breast cancer at age 50 or younger
  2. Ovarian cancer at any age
  3. Male breast cancer at any age
  4. Ashkenazi Jewish ancestry
  5. Two breast cancers in the same person or on the same side of the family
  6. Triple negative breast cancer at any age
  7. Pancreatic cancer and an hereditary breast or ovarian cancer in the same person or on the same side of the family
  8. A previously identified BRCA1 or BRCA2 mutation in your family

Discuss your family history with your Health Care Provider and consider a referral to a genetics counselor for further evaluation of your Family Tree.

Asking questions and discovering your family history will help you make informed health decisions for the future.

Knowledge is both Power and Hope.

Wednesday, May 8, 2013

Let’s Talk Mammograms

There has been a great deal of discussion of late, concerning mammograms. Who should have them?  How often should you have one?  What do they look for? Are they really helpful??

The American Cancer Society recommends screening mammograms yearly for women 40 years old and older. Mammogram is still an effective and valuable tool for finding breast abnormalities.  

However, mammograms do have limitations. They can miss a cancer and /or a mammogram may lead to further testing or biopsy of findings that are not cancer.

There are 2 types of mammograms :  Screening and Diagnostic.

A screening mammogram is an x-ray of the breasts used for women with no breast symptoms. Usually 2 views or pictures are taken of each breast. This type of mammogram looks for areas in the breast that have an abnormal appearance.

A diagnostic mammogram will focus on an area in the breast that has been identified as an abnormal looking area. This type of mammogram involves more views and possibly 3-D images of the breast called Tomosynthesis. This offers a closer look at a particular area in the breast.

PinnacleHealth’s newest women's health campaign is “ Make a Date Every 8.” Challenge yourself  the 8th of every month to learn more about your health.  Sign up at  for health tips and reminders.

So here are my 8 tips  to make mammograms easier , with the help of the American Cancer Society  and PinnacleHealth Women’s Imaging.

  1. Try and schedule your mammogram when you usually have the least amount of breast tenderness.  The week to avoid would be the week  prior to your menstrual cycle. PinnacleHealth allows you to request a mammogram online.
  2. If needed , try an over-the-counter pain medication prior to your mammogram such a Tylenol or Ibuprophen.
  3. Don’t use deodorant prior to your mammogram. All those “ sparkles” in your deodorant can appear on the x-ray film. Most facilities have wipes you can use if you forget. 
  4. You will need to remove you top and bra and will wear a gown. Wear something easy to remove.  
  5. Inform your mammogram Tech if you are currently having a breast problem or have found a lump.  You are your own best advocate!
  6. The mammogram Tech will help you get positioned in the mammogram machine for your pictures.  The only people in the room will be you and your Tech. 
  7. If you are going to a new facility please bring your old records or films if possible. The best way to read mammograms is to compare year to year and look for changes.
  8. Remember your insurance info and if you don’t have insurance there are funds available through PinnacleHealth WomenCare to help you! Just ask! 

Take care of yourself and see you next month!

Thursday, March 14, 2013

March Check-In

How are you doing with those New Year’s Resolutions?  

I am not sure I actually made any resolutions this year because I am still trying to do a few from last year! I guess the point is to keep trying and don’t give up, particularly if your resolution is increasing your activity with exercise and eating a better diet.

If only we all had a personal chef and a fitness trainer to take care of us! If this just seems too overwhelming just consider changing one thing. Try walking the stairs at work over lunch if you can’t get outside. Or add a piece of fresh fruit to your lunch in place of a bag of chips. You can do one thing! We all can.  

Why is this important for breast cancer survivors? Many studies have indicated that being overweight
and/or obese are well-established risk factors for increasing our risk for breast cancer or a recurrence of breast cancer. Weight management is now considered a priority standard of care for overweight women diagnosed with early stage breast cancer.

There is also substantial research on physical activity in breast cancer survivors that noted statistically significant improvements in quality of life, physical functioning, peak oxygen consumption and reduction in fatigue.  

So think of an activity you loved to do as a child… maybe that was riding your bike, so why not try this again.

Or maybe it is time to visit the local YMCA and see what they have to offer.

You can change! We all can … one step at a time.

Thursday, February 7, 2013

Love Yourself Enough to Get An Annual Mammogram

February, the month of love. This is a great time to think of something positive we can do for ourselves. As women we are always doing for others first, our family, our friends, our jobs. But every once in a while we really do need to take care of ourselves.

One quick thing you can do , if you are 40 years old or more ( like some of us), is to make sure you are caught up on your latest mammogram screening or if you have never had one call and schedule one at your nearest Radiology center.

You don’t need an order from you doctor unless you are having a problem and need a diagnostic mammogram.

Why get a mammogram? Because finding a breast cancer early CAN SAVE YOUR LIFE! And your family, your friends and your coworkers want you  around for a long time!

Did you know that 1 in 8 of us will have breast cancer by the time we are ninety? I don’t know about you, but I have the cutest grandchildren and plan to live until I am 100.

Nearly 8 out of 10 breast cancers occur in women over the age of 50. A 70 year old is almost twice as likely to develop breast cancer as a women of 50, according to American Cancer Society. So we should have our yearly mammograms no matter how old we are, unless we are medically unable to do this test.

Are mammograms safe to do yearly? YES! Over the past 20 or so years, both the equipment and how the mammograms are done have greatly improved. The level of radiation exposure used today is very, very low.

Here at PinnacleHealth we have the latest in 3-D mammogram technology called Tomosynthesis and this type of mammogram can allow us to see through very dense breast tissue with better accuracy.

Almost all insurances provide coverage for a yearly mammogram and if you don’t have insurance.  PinnacleHealth also has a low cost program to help with the costs.

You can do this! Give yourself extra special attention  during this month of love. You deserve it!

Thursday, January 3, 2013

Is it time to stop your Tamoxifen ? Maybe and maybe not.

New findings are just out from the ATLAS trial and were presented at the San Antonio Breast Care Symposium and then published in The Lancet on December 5, 2012.

This was a large study, nearly 7,000 women, with early stage, estrogen receptor positive breast cancer.  They were enrolled between 1996 and 2005. All participants took Tamoxifen for the 5 year course and then were assigned to either continue for another 5 years or stop  the medication at the 5 year mark.

From years 5-9 there was little difference in outcomes in the 2 groups. The improved outcomes emerged only after the 10 year mark.

Among the women who took Tamoxifen for 10 years the risk of breast cancer returning between the 10th and 14th years after starting Tamoxifen was 25% lower than for the women in the 5 year group and the risk of dying from breast cancer was nearly 30% lower than in the 5 year group.

So, what does this mean for you?  Well, there are no “ cookie cutter answers” and the first thing to do is to discuss with your oncologist how this would work for you.

Some things to think about :

Have you already tried Tamoxifen and had side effects?

Is your cancer Estrogen Receptor Positive ?

Does your type of cancer put you at a higher risk of recurrence after your therapy ends?

Talk to you oncologist!