Items in Caring Currents tagged with Cancer

Men, Women, Illness, and Caregiving: A Recipe for Divorce?

Melanie Haiken — Fri, 20 Nov 2009 08:00:00 -0000

A new study published this week in the journal Cancer has doctors, patients, and families talking -- and asking hard questions -- about what happens in a couple when it's the wife, rather than the husband, who becomes ill.

Here's what researchers found when they followed 515 patients with cancer or multiple sclerosis over a period of five years.

• A woman is six times more likely to end up separated or divorced soon after a diagnosis of cancer or MS than a man who becomes ill with the same disease.
• In couples in which the woman fell ill, the divorce rate was more than 20 percent.
• In couples in which the man got sick, the divorce rate was just 2.9 percent.
• The older a woman was at the time she got sick, the more likely she was to end up alone.
• However, the longer a couple had been married, the less likely they were to end up divorced.

The researchers at Seattle Cancer Care Alliance, Huntsman Medical Center, and Stanford University were studying a phenomenon that has already been documented in numerous other studies. It's called "partner abandonment," and sadly, it's very real. The researchers who designed the study, Marc Chamberlain, a neuro-oncologist at Seattle Cancer Care Alliance, and physician Michael Glanz, of Huntsman Cancer Center, said they'd previously noticed in their practices that divorces occurred almost exclusively when women became ill.

(And yes, many news outlets covering this story are linking it to the story of John Edwards and his wife Elizabeth, and his cheating while she battled breast cancer. It's easy to see why they made the link, though cheating isn't leaving.)

The researchers also studied the effect that divorce or separation had on the MS and cancer patients, and found that their ability to effectively pursue treatment was affected by the loss of their relationship. Women who end up separated or divorced while being treated for cancer or MS were more likely to suffer from depression, were hospitalized more often, were less likely to join a clinical trial, and were less likely to complete radiation treatment, than women whose partners stayed with them as caregivers. They also found that women whose partners left them were less likely to die at home.

All of these facts resonate with those of us in Cancer World; I previously wrote a post about the challenges I watched a single friend face while battling breast cancer without a partner.

Rather than focus just on the disheartening aspects of this research, I think it's important to talk about why men leave, and what we can do to help them take on and succeed as caregivers. The study's authors, who are both men, commented that men's decision to leave a sick spouse can be partly explained by their lack of ability, compared to women, to make the rapid shift in commitment to being caregivers to a sick partner. The caregiving role simply doesn't come as naturally to men as it does to women, and it's easy for men to feel overwhelmed and ill equipped to handle such an enormous change in their lives.

So what can we do about that? To start, here are some tips about how to support a woman with breast cancer, many of which can be generalized to other types of cancer and other illnesses.

But what I'd really like is to hear from those of you, women and men, in the midst of illness and caregiving. What makes some men panic when suddenly finding themselves caring for an ill spouse, and how can we help prevent this from happening? A wonderful, devoted husband commented on Wednesday's post about mammograms, detailing his wife's breast cancer diagnosis and treatment, and the fact that a mammogram may have saved her life. Caring.com's Editor in Chief, Jim Scott, helped found Caring.com after caring for his wife until her death from cancer in 2007. And there are many more stories like these. With some support and education, we can help other men step into this role, and avoid the fears and temptations that have made John Edwards a household name for abandonment.

Breast Cancer Controversy: No More Routine Mammograms for Women Ages 40 to 49?!

Melanie Haiken — Wed, 18 Nov 2009 08:00:00 -0000

This week a decision was made that could affect many lives. Currently mammograms are recommended as a yearly screening technique for women starting at age 40. If you have health insurance, it tends to happen pretty much automatically; your doctor sends you a reminder, and off you go to the radiology lab. Now all that might change.

The preventive services task force issued a recommendation that women under 50 shouldn't have routine screening mammograms unless individually recommended. And after age 50, mammograms should only be performed every two years instead of annually, the panel said.

What that means is that women between ages 40 and 50 won't be offered mammograms as a routine part of their wellness health care. And after age 50, they'll be offered mammograms only every two years, which is a long time for a tumor to grow.

As with so many health care decisions, this could come down to money. What I -- and many breast cancer advocates -- are worried about is that health insurers may stop covering mammograms outside these guidelines unless a woman can demonstrate that she's at some sort of elevated risk. This puts the burden on us to demand mammograms, or even prove somehow that there's enough cause for concern that we should have them. Many women aren't going to know to ask, and women who do ask may have to "prove" there's cause for concern. And what if you can't prove it? What if you're just worried?

To think about the impact this decision might have on your own life, ask yourself how you'd answer these questions:

How many women do you know who've been diagnosed with breast cancer between the ages of 40 and 50?
How many of your friends and family members who've had breast cancer were first alerted by a mammogram?
Of those women, how many had some type of risk factor that would have caused them to demand screening if it wasn't routinely offered?
Have you, or someone else you know ever had a concerning mammogram and had to have additional exams? Do you feel safer, having had that care?

You probably see what I'm getting at. Yes, routine mammograms do turn up "false positives" and can lead to scares that then turn out to have been unnecessary. And yes, you can argue that having a mammogram every year -- if we don't turn out to have breast cancer -- exposes us to extra radiation. There are cases where a woman ends up having a biopsy that turns up negative, and now she has a scar.

But when you put that against the number of women between 40 and 49 whose cancer will now not be caught and treated as soon, it seems like we're putting practicality (and possibly money) over safety.

Almost more disturbing to me was the final and less-talked-about pronouncement of the task force. Their new guidelines also call into question physical breast exams. They say breast exams by doctors should be discontinued, as it isn't clear that doing breast exams is a valuable diagnostic tool. And in addition, they also state that teaching women to do their own breast exams should also be discontinued. I just have to ask: What's the downside to doing a physical breast exam?!

But this again could become a significant money issue. Now that we have Gardasil, the cervical cancer vaccine, and many younger women don't need to go in for annual pap smears anymore, annual breast exams may quickly fall by the wayside too. And if insurance companies can get away with not covering annual exams, and doctors aren't required to take the time to perform breast exams and teach young women how to do them, we've removed one of the only tools available for women under 40 to discover they have breast cancer.

I'm not a medical expert; it's possible I don't understand all the pros and cons. So I turned to oncologists and other cancer experts and found them up in arms. "Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it," said Daniel Kopans, a radiology professor at Harvard Medical School. "It's crazy - unethical, really."

Could money and insurance be factoring into what should be, pure and simple, a public health issue? Consider this: Under the health care reform legislation pending in Congress, the conclusions of the 16-member task force would set the standard for what preventive health care services insurance plans would be required to cover at little or no cost. Yikes.

The controversy started brewing so fast that experts at cancer centers were already saying they wouldn't abide by the guidelines. The M. D. Anderson Cancer Center in Texas voiced concern and announced they aren't changing their screening protocol. "We disagree with their conclusions," said physician spokeswoman Therese Bevers. "You have to screen more women. It's the value we put on zero women dying."

Len Lichtenfeld, a physician blogger for the American Cancer Society, analyzed the task force's data in his blog post and summarized the ACS point of view on the controversy with a rational, point by point approach:

Mammograms are indeed successful in reducing deaths from breast cancer in all age groups
Since the actual incidence of breast cancer is less in women ages 40-49, the absolute/actual numbers of lives saved is also less; but lives are saved.
All this means is, you have to screen more women to get the same benefit.
Stated another way, the Task Force agrees that mammography reduces deaths in women ages 40-49; it just doesn’t save enough lives, in their opinion.

Lichtenfeld ends with this conclusion: "Until we have something better, what we have to work with to detect breast cancer early is the screening mammogram. Is it imperfect? Yes. Has it saved lives and reduced deaths from breast cancer? Absolutely. And that is the fact that simply cannot be ignored."

Lichtenfeld's blog generated a lot of comments from patients and doctors. Many are from women ages 30 to 50, detailing their battles with breast cancer, diagnosed via mammogram and breast exam. But this one from a Dr. Hampton says it all:

"As a breast surgeon focused on benign and malignant disease, and treating a young population of women, these guidelines will undo all of the work done thus far. I read in a CNN article that not one of the members of the task force is an oncologist (doctor who treats cancer).... I have plenty of patients in their 40's who might be dead if they had waited."

I'd love to hear the thoughts of Caring.com members on what's sure to become one of the biggest breast cancer controversies yet.

When Chemo-Brain Won't Go Away

Melanie Haiken — Wed, 11 Nov 2009 08:00:00 -0000

"I just don't feel as sharp as I used to; it's like my brain is moving in slow motion." My close friend Amy, who recently finished treatment for breast cancer, was speaking to me and two other friends who are also cancer survivors. It was as if her admission yanked open a door; suddenly all three began talking about how emotionally devastating it's been to feel that cancer has changed their ability to concentrate, create, remember.

Sam, who's in his 60s and has had surgery for colon cancer, told everyone that his doctor had just told him about some research done at UCLA that demonstrated what cancer patients have been arguing for years: that "chemo brain," as the memory and concentration problems resulting from cancer treatment are known, can be very serious and doesn't necessarily go away after treatment is finished, as doctors had previously thought.

Everyone was so excited that we went to the computer, found the study, and read through it together. Here are some of the situations the study participants described:

Not being able to remember numbers or words
Leaving the house and not remembering where you were trying to go
Not being able to read anymore because of concentration problems
Not being able to absorb and retain information; feeling like you've lost the ability to learn
Having to give up driving because you don't feel "safe" due to concentration problems and spaceyness.
Going back to work and not being able to do the same job because you've lost the ability to keep track of schedules and details
Feeling anxiety and panic because the memory loss was severe enough to feel like a complete personality change

That particular scenario resonated with one of my friends, Jane, an ovarian cancer survivor in her 50s. "I'm more than two years post chemo and my memory isn't nearly as good as it was," she said."I used to be the one who remembered everything; my whole family relied on me. Now I'm the one asking people to remind me, and having to write everything down. It makes me feel terrible -- like I'm a different person. And people treat me differently because I can't be the responsible one anymore."

I noticed that as Jane said this, her husband and daughter exchanged glances; clearly this was an issue the whole family was aware of.

The more we talked about it, the more emotional it got. Amy, who runs her own business, admitted she's had to scale way back, even though she's considered cured of cancer. "I just can't handle the stress anymore; I feel like such a wimp, but I get exhausted and I forget everything. It's like all the details are falling through holes in a strainer. And the harder I try, the worse it gets. So I just have to sit down and give myself a break, and I finally realized I had to cut back on my work volume because I was falling behind."

Another friend, Rose, who was close to retirement when she got cancer, had been quiet during all this, and finally spoke up. She said for her, the feeling was more emotional -- "it's like I get overwhelmed and I just can't cope." Rose said she's been having to ask her adult son for help paying her bills and taking care of other things she used to do fine on her own, and it feels like a loss of independence. "Feeling dependent is really scary; I feel like I should be able to manage on my own, and I feel terrible when I can't. And if I'm having these kinds of problems now, what will it be like when I'm older?"

The discussion didn't resolve itself; these kinds of talks rarely do, of course. But sharing our experiences and feelings seemed to help, and everyone left feeling less alone. We all agreed it was a good thing the study had come out, validating cancer patients' and their families' experience. Now we can at least agree the problem is real. Maybe in the future we can also share ideas on how to cope.

What Every Caregiver Knows: Love Is a Verb

Paula Spencer — Thu, 12 Nov 2009 08:00:00 -0000

Even though my father just died, I'm not going to repeat the relationship-building advice that caregivers hear so often: to tell your sick or aging mother, father, husband, wife, grandparent, other relative, or friend, now, while you can, and at every opportunity --- hurry, hurry, hurry! --- how much you love them.

Because if you're a caregiver, they know. Say the words because you can't help saying them, not because you feel you're supposed to.

Full disclosure: This is coming from someone infamous in her family for loathing to say, "I love you." I'm not averse to the sentiment –- far from it! –- only to the thinning of its meaning when the words are tossed off too casually, too robotically, too often, as has become the modern norm. (Pet peeve: The perfunctory "Byebyeloveyou!" at the end of every phone call.)

When I hear, or say, "I love you," I want the words to be fully intentional. For me, there's nothing casual about them. (Okay, contributing factor: I'm one of those reserved people who's missing the emotion-burbling gene!)

I'm a bigger believer in telling by showing. It's the old "actions speak louder than words." If you love someone, you're there for him or her. You do things without questioning or rationalizing. You perform acts of love because you want to, not out of obligation. You don't expect thanks. You don't even expect notice (although it's wonderful not to be taken for granted; love is always nicest when it's reciprocal).

You do what must be done, in ways large and small. You cancel prior lunch plans to take coughing Mom for last-minute x-rays, as my high school best friend did this week when I was in town for my dad's funeral. (We squeezed in breakfast.) You take Dad into your home, as my brother and sister-in-law did for the last two years of his life. (Angels among us.) You do all that caregiver stuff – you don't need me to detail it. You're living it.

Don't let anyone make you feel like a repressed throwback to another era, or a curmudgeon who risks "missing out" on anything, if you don't speak up with the sweet nothings. You're already expressing "I love yous" aplenty.

I did say those three not-so-little words to my Dad last week. My brother held the phone up to his ear, and they popped right out. Dad said them back, in a voice as firm as it was faint...his last words to me. By morning, he'd lost consciousness to heavy morphine, as I'd been forewarned he would. Two days later, he died.

Do I regret not having this wonderful exchange more often? Not at all. That wouldn't make have made those final words more meaningful.

I had a similar experience telling my mom that I loved her on the day she signed herself into hospice two years ago. Ironically, she died before a Woman's Day magazine column I'd written on this subject was published, though I'd told her about it. As with Dad, the relative rarity of my words underscored them.

Some people say they hand out "love yous" in abundance because you never know when one might be the last. I respect that. But I doubt I'd recall an autopilot "love youbye" with the same intensity as, say, that last exchange with my Dad or the one on that hard hospital day with my Mom (which I realize I was lucky, in each case, to have).

I do tell my remaining loved ones how I feel, though not every minute of the day or even every day. And I don't care whether they parrot the words back to me, or not. What's critical is that, whether by words or deeds, each side leaves the other in no doubt about where we stand.

Early Stage Breast Cancer Alert

Melanie Haiken — Wed, 04 Nov 2009 08:00:00 -0000

If you or a woman you know has early stage breast cancer that's HER2-positive, she needs to know about some new research published yesterday in the Journal of Clinical Oncology.

An early stage tumor that's as tiny as one centimeter or smaller still has a high risk of deadly recurrence if it's HER2-positive, new data show.

Researchers from the M.D. Anderson Cancer Center reviewed recurrence data on breast cancer patients whose tumors were one centimeter or smaller -- typically considered to present a very low recurrence risk. (See size chart; one cm is about the size of a black-eyed pea.) What they found was that if a woman's tumor, no matter how tiny, was HER2-positive, her 5-year recurrence rate was 23 percent -- almost one in four.

Led by Ana Gonzalez-Angulo, MD, the researchers analyzed the center's breast cancer research database, which contained data on 965 women whose tumors were less than one centimeter when diagnosed, and who did not receive treatment with Herceptin.

The reason this is so important is that it suggests a big change in treatment protocol is in order. Based on this study, which was then confirmed by a second, European study, it seems clear that women with early stage HER2-positive tumors need to be treated with Herceptin, no matter how small their tumors.

Between 15 and 20 percent of breast tumors test positive for the HER2 growth protein, which is basically a growth factor that makes cancer more aggressive. Herceptin, the brand name for trastuzumab, has become a life-saving drug for women with HER2-positive breast cancer; it latches onto the HER2 proteins and inhibits their growth, stopping them from fueling tumor growth.

In the past, the "cut-off" for Herceptin has been six centimeters; current treatment guidelines for women whose tumors are five centimeters or smaller call for only surgery and radiation. And for women whose tumors are six to ten centimeters, the guidelines say doctors should "discuss" the option of Herceptin treatment.

M.D. Anderson doctors now say it's time to change the guidelines - and fast. "The risk of recurrence was much higher than we suspected," says oncologist Jennifer Litton, another author. "Herceptin alone or combined with chemotherapy should be strongly considered as adjuvant therapy" (meaning either before or after surgery) even in patients whose tumors are "miniscule."

Honestly, after reading the M.D. Anderson research, I would want to make sure any woman whose tumor tested positive for HER2 received treatment with Herceptin, regardless of tumor size.

As for women who were diagnosed with a HER2-positive tumor in the past and didn't receive Herceptin, that's a moving target. The study didn't include them, and doctors have in the past been unwilling to prescribe Herceptin therapy separately because it hasn't been studied.

But if it were me or someone I loved, I'd talk to the doctor about whether Herceptin even post-treatment could help minimize risk of recurrence. Discussions on this topic are raging on medical websites, and it's certainly worth asking.

So: Herceptin even for very small early stage tumors -- Let's spread the word.

Cancer Heroes and Heroines -- How They're Helping You and Your Family Cope With Cancer

Melanie Haiken — Wed, 28 Oct 2009 07:00:00 -0000

Going through cancer treatment is traumatic enough, and no one expects cancer patients to do anything more than try to get well. But some cancer survivors and their families turn around and use their experience with cancer to create foundations and services to help other cancer patients. And many times these services are among the best, because they're created with the insights that only another cancer patient can have. Here are a few inspirational -- and useful --- stories about cancer services created by cancer-stricken families. They're my cancer heroes and heroines of the day.

A Matching Service to Help Breast Cancer Patients Find the Right Clinical Trials
A new and incredibly valuable service,BreastCancerTrials.org was conceived by two San Francisco breast cancer patients, Joan Schreiner and Joanne Tyler, who met when a breast surgeon put them in touch with each other. Joan, whose cancer had metastasized before it was detected, found out firsthand how hard it was to find information on treatments that might help her. She became an advocate, envisioning a centralized searchable database that would match patients with trials that were right for them, saving patients time and getting them to the right trial faster. Following her vision, the site launched in 2005 with support and execution from UC San Francisco's Center of Excellence for Breast Cancer Care. Then, in 2008, Quantum Health, a national health benefits program, stepped in with the financial resources to expand the website, which just relaunched with more firepower this month. Sadly, Joan didn't live to see her vision succeed; she died of breast cancer in 2005, just after the pilot site was launched.

Financial Assistance for Medical Treatments from the LivesSrong Foundation
Lance Armstrong's LiveStrong Foundation does more than raise awareness; the LiveStrong SurvivorCare program partners with many other organizations, such as the Patient Advocacy Foundation, to help cancer patients who are unable to pay for treatment find resources. Help available includes co-pay relief or prescription assistance programs for those who qualify, insurance company advocacy, and counseling and referrals to local resources. If someone you love doesn't have the money to pay for cancer treatment, call LiveStrong SurvivorCare, at 866-467-7205 and ask for help accessing resources.

Education About Screening from The Susan Cohan Kasdas Colon Cancer Foundation
This new foundation, created in honor of a 42-year-old Florida mother of two whose colon cancer had metastasized throughout her body by the time it was diagnosed, focuses on educating people about available screening tools and helping access them. Although Susan herself didn't survive, her diagnosis led her sisters (pictured with Susan during chemo) to get colonoscopies, and two were found to have pre-cancerous growths. This family foundation's goal: Make everyone aware that while colon cancer screening guidelines don't call for colonoscopies until after age 50, many people with family history should be screened much earlier.

Family Financial Help from the Eric Beverly Family Foundation
Created by former NFL star Eric Beverly to honor his wife Danielle, who's a three-time breast cancer survivor, the Eric Beverly foundation works with other organizations in Michigan and Atlanta to provide financial assistance to the families of cancer patents.

Cancer Education from the Prevent Cancer Foundation
When Carolyn Aldigé lost her father to cancer, she was angry -- and she got busy. Determined that there wasn't enough focus on cancer prevention and screening, she founded the Prevent Cancer Foundation to fund research and education. Although they don't give treatment grants per se, the website is a wealth of information about early cancer detection and prevention. They've also provided more than $100 million in funding to 400 scientists at over 150 leading medical institutions across the country.

Family Travel Grants from Alex's Lemonade Stand Foundation
Alexandra Scott died in 2004 after battling neuroblastoma for seven of her eight years. But every year, starting at the age of 4, after her first stem cell transplant, Alex set up a lemonade stand, the proceeds from which she donated to fund childhood cancer research. By the time Alex died she'd raised over 1 million dollars, most of it from other people who set up their own lemonade stands, then donated the proceeds to the foundation Alex's parents set up: Alex's Lemonade Stand Foundation. Today, families of pediatric cancer patients can obtain travel grants from the foundation to support the family while a child travels to be treated at one of a long list of prominent cancer hospitals. They also fund research, and a new program offers grants to nurses who want to study better ways to care for children with cancer.

Of course, this is only a tiny fraction of the number of family foundations offering some type of cancer research, prevention, or treatment aid to cancer patients and their families. Search the Internet using the name of your state and the type of cancer that afflicts you or the person you're caring for. You'll be surprised at all the help that's out there, and touched by the stories behind these efforts.

Cancer Proof Your Home: 5 Ways to Rid Your Home of Cancer-Triggering Toxins

Melanie Haiken — Wed, 21 Oct 2009 07:00:00 -0000

It's scary to think about cancer, but even scarier to think that we might unknowingly be doing things that put our families at risk.

I'll never forget the day I was cleaning my mom's bathroom, and her caregiver arrived. She smelled the bleach spray I was using all the way from the front door and asked me what I was doing, then gently admonished me that the harsh chemicals weren't good for my mom's lungs, already weak from a lifetime of cigarette smoking. I felt terrible, of course, but also bewildered. After all, I'd been trying to do something nice. Using my experience as a starting point, I thought I'd round up the latest thinking on household chemicals and the risk of cancer and other serious illness. Here are my top five tips.

1. Spring clean the cleaning products. The number one rule of thumb, doctors and environmental safety experts say, is read the ingredient list carefully on anything you're going to be spraying in the air or wiping on touchable surfaces. Air fresheners are among the biggest culprits; many contain either Isopar, which is deodorized kerosene, or paradichlorobenzene, both of which are carcinogenic and toxic to the lungs, liver, and kidneys. Among cleansers, oxygen bleach cleansers are particularly dangerous; you also want to watch out for products containing chlorine bleach and ammonia. Both of these aren't good to breathe. The worst practice, experts say? Spraying chlorine bleach in the shower or bathroom where the steam makes you more likely to breathe it. There are lots of good "green" cleaning products on the market now, so when you shop, replace your old standbys with these. Your lungs and cells will thank you.

2. Practice plastic safety. The popular e-mail saying that freezing a plastic water bottle releases dioxin is a hoax; if you like frozen water bottles, no problem. However, experts say, the truth about microwaving plastic wrap or microwaving food in plastic containers isn't so clear. Some plastics contain Di-ethylhexyladipate (DEHA), which is added to make plastic more pliable. Experts still consider DEHA a possible carcinogen. Heating plastic does make it more likely that any chemicals contained in it will be released into food. So use only containers specifically labeled microwave-safe; glass is safest of all, of course.

3. Test for radon and remove it. An odorless, radioactive gas that's produced by the natural decay of uranium, radon is more common than you might think. After smoking, it's the leading cause of lung cancer in the United States, according to the Environmental Protection Agency. The only way to find out if there's radon in your home is to test for it. Call the National Safety Council's National Radon Hotline (800)767-7236, and they'll send you a low-cost test kit; test kits also available at hardware stores.

4. Clean out the kitchen cupboards. The scientific community has argued back and forth over whether non-stick pans (aka Teflon) pose a cancer risk. Non-stick Teflon coating is made from perfluorooctanoic acid (PFOA), a chemical known to cause cancer, but most studies show that not enough PFOA gets into the human body from pans to pose a risk. Still, the EPA has called on manufacturers to phase out PFOA, and some experts say heating the pans on high heat or using them once they're scratched is not a good idea. The takeaway: Don't use non-stick pans to cook foods over 300 degrees, and toss them when the coating gets scratched.

5. Weed out dangerous pesticides and weed killers. Several common pesticides have been linked with health conditions, including cancer and Parkinson's. For example, chemicals used in household pesticides like Raid and flea bombs were detected at high levels in the urine of children with leukemia; another study linked herbicides with a higher incidence of childhood brain cancer. Methyl bromide, a crop fumigant, has been linked with prostate cancer, while atrazine, used on corn and other crops, particularly in the Midwest, has been linked to cancer and birth defects. One recent study found people diagnosed with Parkinson’s are more than two times more likely to report pesticide exposure than people not diagnosed with the disease. Try to grow your garden as organically as possible, and pull weeds by hand. If you have a pest problem in the house, do your best to control it without airborne sprays. If you have to spray or bomb, send everyone away and air the house out for a day before coming back in.

Top 10 Breast Cancer Prevention Tips

Melanie Haiken — Wed, 14 Oct 2009 07:00:00 -0000

What with October being Breast Cancer Awareness Month and the pink ribbons everywhere, breast cancer is even more on our minds than usual. What better time to think about prevention and awareness? Are you worried about the possibility of breast cancer in your future, or in the future of someone you love? Here are the top ten things you can do to ensure a breast cancer-free future for yourself and your loved ones.

Detection:

1. Get regular mammograms. It sounds obvious, but you'd be surprised how many women don't. Last week an Australian study found that women who get regular mammograms had a 4 percent risk of dying of breast cancer; women who weren't screened had a 56 percent mortality rate. Ready to make that appointment?

2. Find out whether you or women close to you have dense breasts. What does this mean? It means the breast cells grow and multiply more rapidly, raising your risk. Plus dense breasts make it harder for a mammogram to "see" through the tissue and detect a tumor. While dense breast tissue is more common in younger women who haven't yet had children, it's also hereditary and can affect any woman. I have a dear 43-year-old friend whose breast tumor failed to show up on three years' worth of mammograms before her doctor finally ordered an MRI. How to find out? Schedule a breast exam and ask your doctor. Also talk to the radiologist who's administering your mammogram.

3. Ask your doctor to recommend other tests. Surprise: Mammograms are only 16 to 40 percent accurate, studies show. Meanwhile, ultrasounds and MRIs can detect breast tumors that may not show up on mammograms. MRIs, the gold standard, are 70 to 100 percent accurate. This fall Dartmouth University published a study showing that MRIs found tumors in 20 percent of patients who'd already "passed" a mammogram or ultrasound. If you have any reason for concern, ask your doctor to refer you for an ultrasound, MRI, or both.

Prevention:

4. Know your BMI -- and lower it if necessary. Studies show that women whose body mass index (BMI) is at the lower end of the scale for their height lower their risk of breast cancer. Even more important, though, is getting rid of belly fat, which acts like a ‘hormone pump’ releasing estrogen into the bloodstream as well as raising levels of other hormones.

5. Get 30 minutes a day of exercise. We all know this is one of the best ways to keep our weight down, but research also shows that activity itself helps prevent cancer by keeping hormone levels healthy. This is important for preventing hormone-fueled breast cancer.

6. Limit alcohol to one drink a day -- or save it for special occasions. More than one drink a day is associated with a significant increase in breast cancer risk, and teetotalers have the lowest risk of all. It seems that alcohol boosts the effect of other toxins, such as nicotine from smoking, and can directly damage DNA, leading to cancer.

7. Eat those fruits and veggies. For more information, check out these top 10 foods known to prevent cancer.

Avoid These Don'ts:

8. Quit smoking. Sorry, I know you don't want to hear it. But there are great new helpful tools to make it easier to quit -- and doing so will reduce your risk of not only breast cancer, but lung, colon, and throat cancer too.

9. Skip the supplemental soy. Soy contains chemicals called isoflavones, which -- when concentrated -- act like estrogen in your body, so they can stimulate estrogen-sensitive breast cancer. But it's soy supplements that are the concern; eating tofu or drinking soy milk is fine unless you're at specific risk of estrogen-sensitive cancer. Overall, women who eat a diet high in soy have a lower breast cancer risk.

10. Don't take hormones, or limit how long you take them. There's still plenty of controversy, but most experts agree that long-term use of estrogen and progesterone combination hormone therapy boosts your breast cancer risk. If you or someone you care for is really desperate, ask your doctor to prescribe the lowest possible dose, and plan to use it as a six month respite, and then reevaluate. Five years is considered the maximum time a woman should be on hormones.

Resveratrol Supplement and Diabetes: A New Way to Balance Blood Sugar

Melanie Haiken — Fri, 09 Oct 2009 07:00:00 -0000

The supplement resveratrol, a key ingredient in red wine and grapes, has been endlessly touted as an alternative treatment for preventing and treating many conditions. I wrote about its anti-cancer benefits in a previous post, and it's also thought to help with general anti-aging. Now experts are saying it may be particularly beneficial for people with diabetes and pre-diabetes.

I know from tough experience that when you or a family member has diabetes or pre-diabetes, it feels like a constant struggle -- and source of tremendous worry -- to keep blood sugar under control.

Recently, studies have suggested that taking the supplement resveratrol could be a safe and simple way to do this. Research shows resveratrol appears to boost insulin sensitivity, helping the body process sugar into energy.

The latest study, released this week, was important for people with diabetes and their families because it proved definitively that resveratrol activates sirtuins, which are proteins in the brain that have immediate control over glucose metabolism.

Research by Sirtris Pharmaceuticals, the company founded by Harvard professor David Sinclair, is perhaps more exciting because it's being conducted in people and is testing resveratrol against a placebo. Last year, Sirtris released results from the first study testing resveratrol in people with diabetes, and the results were impressive: Of 98 people with diabetes studied, the 67 who took either 2.5 or 5 grams of resveratrol improved their body's ability to break down sugar significantly compared with the control group.

Because resveratrol acts to improve insulin sensitivity, it could also be a boon to those at risk for diabetes, helping them prevent the onset of the disease. Resveratrol also shows potential to block the damaging effects of glucose, preventing and treating complications of diabetes such as eye and nerve damage.

How Should I Take Resveratrol?

Previous reporting has focused on red wine as a source of resveratrol; I've even seen articles titled "red wine and diabetes." This is not the way to go, as drinking alcohol causes your blood sugar to rise, which is why people with diabetes are advised not to drink!

Instead, consider resveratrol supplements. Interestingly, the resveratrol used in much of the recent research is actually from the root of the plant Chinese knotweed, which is now being considered one of the best sources of resveratrol. (Sirtris has created a proprietary synthetic formulation of resveratrol, but it won't be available anytime soon; the company is following the slow and painstaking FDA approval process to bring a diabetes drug to market, and Sinclair says 2012 is the earliest they'll get there.)

Meanwhile, many people are already betting that you can get the same results by taking one of the resveratrol supplements available at your local health food store. Look for one with 1000 milligrams of resveratrol, the amount most commonly touted by alternative health experts.

There's still an awful lot we don't know about how resveratrol works. Sirtris's proprietary drug is a time-release formula, which is important because studies have shown resveratrol levels in the blood decline quickly. So if you want the full benefits found in resveratrol research, some alternative health experts are suggesting that you take resveratrol supplements several times a day, to mimic the effects of a time-release formulation. Three 1000 mg resveratrol pills would be the equivalent of 3 grams, putting you within the ball park of the dosage used by the Sirtris trial. If you took them morning, noon and night, you'd get a reasonable time-release effect.

Who Shouldn't Take Resveratrol?

The effects of resveratrol aren't completely understood, and some experts have warned that taking a lot all at once could cause unexpected drops in blood sugar. So there's another reason not to take one big dose all at once. Also, resveratrol has estrogenic properties, so some experts say women with estrogen-sensitive breast cancer shouldn't take resveratrol.

The American Diabetes Association ran a long article on resveratrol a few months ago in their Forecast, in which they basically say more study is needed, but there doesn't appear to be much of downside to experimenting with resveratrol, as long as you follow the basic guidelines I mention above.

Celebrate Cancer Survivors on LiveStrong Day

Melanie Haiken — Fri, 02 Oct 2009 07:00:00 -0000

Today is LiveStrong Day, the day Lance Armstrong's powerful organization has set aside to focus awareness on cancer, cancer research, and cancer survivors continuing to live healthy lives.

It's a great day to take a few moments and think about the people in your life living with cancer (including you!), how strong and brave they are, and what we can all do to support one another better. LiveStrong Day isn't about feeling sad -- it's about feeling empowered to go out and do something to make people think about the presence of cancer in their lives, no matter how small.

The LiveStrong Foundation has a cool interactive map that you can use to find LiveStrong Day events near you. I checked out my area and found a wonderful and inspiring collection of grassroots happenings, including a motorcycle gang and an equestrian team riding in support of LiveStrong, elementary schools planning health awareness days, and bike teams everywhere planning "LiveStrong Loops" decked out in yellow.

For even more inspiration, the LiveStrong Blog posted highlights of some of the amazing things LiveStrong members are doing to raise awareness about cancer, LiveStrong, and LiveStrong Day.

Here are a couple of the folks going all out for LiveStrong this week:

• Jaime Lindsay, a wingwalker, stunt pilot, and skydiver, as well as a Stage 4 lymphoma survivor, flew a LiveStrong banner behind his plane in an airshow to tell everyone about LiveStrong Day. He gave out LiveStrong bracelets and raised $500 too.

• Leana May, a New York doctor, is collecting Beanie Babies and sending them to children in pediatric oncology wards around the world, with empowering messages and cancer facts translated into foreign languages.

How about you? What would you like to say to or do for your loved ones with cancer, or what would you like them to say or do for you?