By now, it’s common knowledge that October is Breast Cancer Awareness Month, an observance commemorated worldwide. Simply put, breast cancer is the uncontrolled growth of abnormal cells in the tissues of the breast. The abnormal cells ultimately form a lump, or tumor, in the breast.

Breast cancer is the second most common cancer in women in the United States, behind skin cancer. It accounts for about 30 percent of all new cancers in females each year. While breast cancer is much more common in women, men can be affected as well.

According to the American Cancer Society, about 287,850 new cases of invasive breast cancer and about 51,400 new cases of noninvasive breast cancers are expected to be diagnosed in women in 2022. About 43,250 women are expected to die from breast cancer in 2022. In addition, about 2,710 new cases of invasive breast cancer are expected to be diagnosed in men in 2022, and about 530 men are expected to die from it.

Each breast is composed of three main parts: lobules, ducts and connective tissue. The lobules are glands that produce breast milk. The ducts are tiny tubes that carry the milk to the nipple, and the connective tissue holds all the breast tissues in place. Most breast cancers begin in the ducts and lobules and are called invasive ductal carcinoma and invasive lobular carcinoma. Invasive ductal carcinoma makes up 70 to 80 percent of all breast cancers.

Ductal carcinoma in situ (DCIS) is a breast disease that may lead to invasive breast cancer. It is also referred to as stage 0 breast cancer because the abnormal cells are only found in the lining of the ducts. They haven’t spread to other tissues in the breast or other parts of the body.

Symptoms of breast cancer can vary from person to person. Some people experience no signs or symptoms. Possible warning signs include a change in the size, shape or contour of the breast; a mass or lump in the breast or underarm; a rash around or on a nipple; discharge from a nipple that may contain blood; armpit or breast pain that doesn’t change with the menstrual cycle; and irritation or dimpling of the skin of the breast.

Doctors don’t know what causes abnormal cells in the breast to divide and multiply, but genetics seems to play a role in the development of some breast cancers.

Researchers have also identified several factors that increase the risk for developing breast cancer. These include age (risk is higher in those 55 and older); family history of breast cancer; smoking; alcohol use; obesity; previous radiation exposure, especially to the head, neck or chest; and hormone therapy. Women who use hormone replacement therapy (HRT) after menopause or the pill for contraception are at an increased risk.

Breast cancer screening can detect signs or symptoms. It cannot prevent breast cancer, but it can catch it in its early stages when it’s easier to treat. Screening begins with you. Examine your breasts regularly to look for changes in size and shape. Also feel your breasts for lumps.

The most common screening test for breast cancer is the mammogram, which is an x-ray of the breast to look for abnormalities, including tumors. Another screening test is ultrasound, which uses sound waves to create pictures of the insides of the breasts. Ultrasound can differentiate between a solid mass and a fluid-filled cyst.

The doctor may follow up with a breast MRI, which provides detailed images of the inside of the breast. An MRI can help a doctor identify cancer and other abnormalities within the breasts. If a tumor is detected, the doctor may take a sample of its tissue to analyze under a microscope, a process called biopsy.

Treatment options for breast cancer include surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy and targeted drug therapy. The treatment or combination of treatments chosen depends on the type of breast cancer and how far it has spread from its original site.

There are different types of surgery for breast cancer. A lumpectomy removes the tumor and an area of healthy tissue surrounding it. A mastectomy is the removal of the entire breast, which is often followed by a breast reconstruction. Other procedures remove lymph nodes affected by the cancer.

Chemotherapy may be recommended before surgery to help shrink tumors or after surgery to kill remaining cancer cells. Radiation therapy is typically used after surgery to destroy remaining cancer cells.

Some types of breast cancer feed on hormones, such as estrogen and progesterone. Hormone therapy is used to either lower these hormone levels or stop the hormones from attaching to cancer cells. This is often used after surgery to prevent hormone-sensitive cancers from recurring.

Immunotherapy energizes the body’s infection-fighting immune system to fight cancer cells. Targeted drug therapy uses certain drugs that target specific cell characteristics that lead to cancer.

Unfortunately, there is no way to prevent breast cancer. However, there are steps that can significantly lower the risk for developing the disease. These include limiting alcohol consumption, eating a healthy diet with plenty of fruits and vegetables, exercising regularly, maintaining a healthy weight and following doctor recommendation for screening exams, including mammograms.

With more emphasis on screening and improved treatments, the survival rates for people with breast cancer are increasing. That’s the best news to celebrate this Breast Cancer Awareness Month.

Patti DiPanfilo

September is Blood Cancer Awareness Month. Blood cancers affect the production and function of blood cells, of which there are three types. White blood cells are part of the immune system. They help fight infection and disease. Red blood cells transport oxygen from the lungs to the organs and tissues. Platelets help form blood clots to control bleeding.

Most blood cells form from stem cells in the bone marrow, the soft, spongy tissue inside of bones. These cells normally mature into white blood cells, red blood cells or platelets. Hundreds of billions of new blood cells are produced in the bone marrow each day. As a result, the body is provided with a continuous supply of fresh, healthy cells.

With blood cancers, however, this natural blood cell production goes haywire, and abnormal blood cells develop and grow out of control. Excess abnormal cells eventually crowd out the healthy blood cells and prevent them from performing their important functions.

There are three main types of blood cancers: leukemia, lymphoma and myeloma. These cancers affect different types of white blood cells and act in different ways. Each year, these cancers account for approximately 10 percent of cancer diagnoses.

Leukemia involves the overproduction of abnormal white blood cells that — unlike healthy white cells — are unable to fight infection. With the proliferation of these leukemia cells, there’s insufficient room left in the marrow for the production of healthy white blood cells, platelets and red blood cells.

As a result, there aren’t enough red blood cells to provide oxygen to the body’s organs and tissues so they can function properly. There aren’t enough healthy white blood cells to help the body fight off infection, and there aren’t enough platelets to help blood clot.

Lymphoma starts in the infection-fighting cells of the immune system, called lymphocytes. These cells are found in many parts of the lymphatic system, which carries white blood cells throughout the body. The lymphatic system includes the lymph nodes, spleen, thymus gland and tonsils.

There are two main types of lymphoma: non-Hodgkin and Hodgkin, which involve different types of lymphocytes. Most non-Hodgkin lymphomas arise from B cells, a type of white blood cell that makes antibodies. Hodgkin lymphomas begin in special cells called Reed-Sternberg cells, which are abnormal white blood cells that typically contain more than one nucleus.

Myeloma, also called multiple myeloma, is a rare cancer of plasma cells, which, like B cells, are white blood cells that make antibodies. With myeloma, the marrow produces an abundance of abnormal plasma cells, called myeloma cells. These cells crowd out the other healthy cells in the marrow.

The abnormal plasma cells can accumulate in the body and cause health problems that may include weakened bones, anemia (a lack of red blood cells to carry oxygen to your body’s organs and tissues) and abnormal kidney function.

Each blood cancer has its own signs and symptoms. There are, however, some signs and symptoms that are common to the three cancers, including persistent fatigue, swollen lymph nodes, fever, shortness of breath, unexplained weight loss, loss of appetite, abdominal discomfort, bone or joint pain, frequent infections, and easy bruising or bleeding.

Diagnosis begins with a thorough history and physical exam. The doctor will likely order blood tests, such as a complete blood count (CBC), which provides details about white blood cells, red blood cells and platelets. The doctor may also order a blood cell examination to further check blood cells and look for other substances that may be signs of disease.

The doctor may recommend a bone marrow biopsy, also called a bone marrow aspiration, to look for abnormal cells.

There are specific courses of treatment for leukemia, lymphoma and myeloma. In general, however, blood cancers are treated using chemotherapy and radiation therapy. Another treatment often recommended for blood cancer is stem cell transplantation, during which healthy stem cells replace damaged stem cells in the marrow.

With improvements in diagnosing and treating blood cancers, the survival rates have dramatically increased over the past few decades.

Improve the odds even more: If you notice any of the signs and symptoms of blood cancer, visit your doctor right away so you can catch leukemia, lymphoma and myeloma in their early, most treatable stages.

Patti DiPanfilo

March is designated as National Colorectal Cancer Awareness Month, to bring attention screening treatment and research. Of note, it’s not just a disease for senior citizens.

Diagnosis rates for people younger than 50 has increased 2.2% annually from 2007-16, according to the Colorectal Cancer Alliance.

The alliance also says the nation’s third most diagnosed cancer, afflicting an estimated 151,030 people in 2022. It’s also the second leading cause of cancer death, with an estimated more than 52,000 fatalities this year.

In observance of the awareness month, Manatee Memorial Hospital and We Care Manatee are hosting a free screening event this Tuesday (March 8) from 5-7 pm in the main lobby of the hospital, 206 Second St. E., Bradenton.

Anyone over the age of 45 is qualified to receive an at-home colorectal cancer screening kit at no cost.  Specimens must be returned to the hospital by March 31 to complete the screening. 

Also, colorectal surgeons, oncologists, gastroenterologists, primary care physicians and their staff will be there to discuss colorectal cancers and other care needs. 

The American Cancer Society recently recommended that adults without a family history of the disease should begin screening at age 45.

We Care Manatee, a nonprofit organization, will have information on-site regarding free and reduced-cost options for patients without insurance. 

For information, call We Care Manatee at (941) 755-3952.

/

The colon and rectum are part of the body’s gastrointestinal tract. The colon makes up the first 6 feet of the large intestine, and the rectum makes up the last 6 inches. Cancers of the colon and rectum are typically grouped together as colorectal cancer because they have some characteristics in common, most notably the presence of abnormal growths called polyps.

According to the American Cancer Society, an estimated 104,610 new cases of colon cancer and 43,340 cases of rectal cancer will be diagnosed in the US in 2020, and an estimated 53,200 people will die of colorectal cancer this year. Not counting some skin cancers, colorectal cancer is the third leading cause of cancer-related deaths in the US. Approximately 4.4 percent of men and 4.1 percent of women will be diagnosed with colorectal cancer in their lifetime.

Colorectal cancers generally begin as polyps that form in the lining of the colon or rectum. Most of the time, these polyps are harmless, but over time – sometimes many years – one or more of the polyps can turn cancerous. Often, the polyps cause no symptoms, especially early on, but eventually symptoms may develop.

When they are present, symptoms of colorectal cancer may include rectal bleeding; blood in your stool or in the toilet following a bowel movement; diarrhea or constipation that won’t go away; changes in your normal bowel habits, such as size, shape or frequency; abdominal pain or cramping; bloating or feeling full; appetite changes; weight loss; and fatigue.

Cancer is the result of mutations to the genes responsible for cell growth and reproduction, and these changes cause the cells to grow out of control. Some gene mutations are inherited and passed on in families, and some are acquired during your lifetime.

There are several inherited syndromes, including familial adenomatous polyposis (FAP) and Lynch syndrome, that can lead to colorectal cancer, but most gene mutations that lead to cancer are acquired mutations. That is the case with colorectal cancer, and certain risk factors may play a role in causing the mutations that lead to colorectal cancer.

Some of those risk factors you can change and some you can’t. Risk factors you cannot change include age – colorectal cancer is much more common after age 50; having a personal history of colorectal polyps or colorectal cancer, a personal history of inflammatory bowel disease, or a family history of colorectal cancer;, race – African Americans have the highest incidence and mortality rate of all racial groups in the US; or having type two diabetes.

There are also colorectal cancer risk factors that you can change. These include being overweight or obese, being physically inactive; eating a diet that is high in red meat and processed food, not getting enough Vitamin D, smoking, and drinking a lot of alcohol.

If you have symptoms that are suspicious of colorectal cancer or if something shows up on a screening test, your doctor will likely order certain diagnostic tests for colorectal cancer. These include blood tests and a diagnostic colonoscopy, which looks at the full length of your colon.

During both screening and diagnostic colonoscopies, your doctor will remove any abnormal looking polyps and surrounding tissue to examine under a microscope to look for cancer cells. This procedure is called a biopsy. If cancer is detected, you and your doctor together will plan a course of treatment.

Treatment for colorectal cancer may include surgery, which is the main treatment for this cancer, radiation therapy, systemic therapy, or a combination of these treatments. Systemic therapy is the use of medication to kill cancer cells. The types of systemic therapies used for colorectal cancer include chemotherapy, targeted therapy, and immunotherapy.

The key to winning the battle against colorectal cancer is to find it in its early stages, when treatment is most effective. The best way to catch it early is through routine screening. The US Preventive Services Task Force recommends several screening strategies, including stool tests, flexible sigmoidoscopy, colonoscopy, and CT colonoscopy (virtual colonoscopy).

You should begin screening for colorectal cancer when you turn 50 and continue to be screened at regular intervals determined by your doctor. The timing of your screening is based on your personal risk factors for colorectal cancer. If you have multiple risk factors, you may need to begin screening at an earlier age or get screened more often.

Don’t be a statistic. Get screened for colorectal cancer and save your life!

Bad news: More Florida women getting breast cancer.

Good news: Death rate now among nation’s lowest.

When I scanned the first sentence of her Facebook post, I thought at first that it was just another attempt to raise awareness for a worthy cause that would eventually ask me to do my part in the fight by sharing the post with others.

If only it had been.

“I have breast cancer,” it said.

In the paragraphs that followed, my friend explained how she had known for a week that the two-centimeter lump she found last month was malignant. She then talked about the uncertainty, the fear and the battle ahead, and how she planned to kick cancer’s, um, rear end.

It’s an all too familiar post. In the past few months, my pastor’s wife made a similar announcement on Facebook.  Last week, a former colleague who survived breast cancer 12 years ago told me she is having another biopsy.

It’s no wonder we are seeing more of these posts. According to statewide figures from the Florida Department of Health, the breast cancer incident rate increased from 137.6 to 161.7 per 100,000 women between 2006 and 2016.

In 2016 alone, doctors diagnosed 16,721 new cases of breast cancer among women.  Last year, 2,955 women died from breast cancer. That translates to a death rate of 18.5 per 100,000 women.

In 2018, Glades County topped the list with a death rate of 41.9 per 100,000 people, though deaths totaled five. Other counties with high rates included Holmes, Walton, Franklin, Wakulla, Dixie, Gilchrist, Lafayette, Marion, Citrus, Pasco, Nassau, Brevard, Okeechobee and Hendry. Counties reporting the lowest rates were Calhoun, Liberty and Washington, all of which reported no deaths.

Nationally, the good news is that Florida is among the states with the lowest death rates. After peaking in 1999 and 2000 at 24.4 deaths per 100,000, the rate has decreased, with 19.7 in 2016, according to the latest figures from the Centers for Disease Control and Prevention.

Though researchers at the Mayo Clinic in Jacksonville say a vaccine could be available in eight years, the best ways to prevent breast cancer right now is to adopt a healthy lifestyle and get regular screenings to ensure early detection.

So, we’ll continue to wear our pink, participate in three-day walks, and support our friends who make those heartbreaking social media announcements as much as we possibly can.

We’ll also perform regular self exams and screening mammograms as soon as they’re due. No procrastination. Taking care of ourselves is critical, especially if we are taking care of others. Thankfully, we have help in that endeavor.

To make sure every woman is able to get a screening, the Florida Breast and Cervical Cancer Early Detection Program provides free or low-cost mammograms to women who are residents of Florida, 50-64 with no insurance and low income. To see if you qualify, call your county Health Department.

 

At the end of May, the latest Annual Report to the Nation on the Status of Cancer was released, and it offered some encouraging news. The report included cancer statistics from the years 1999 through 2016, the most recent year statistics are available. The report was created by a consortium of the country’s top cancer organizations.

The updated annual report noted that US cancer death rates continued to fall during those years. It stated that overall, cancer death rates decreased 1.8 percent per year in men and 1.4 percent per year in women. This decrease continued am an ongoing trend in declining cancer death rates.

The report also noted that the rate of new cancer cases among men consistently fell between 2011 and 2015, decreasing two percent per year. This is good news after the rate of new cases increased between 1999 and 2008. The rate of new cancer cases in women, however, remained stable from 2011 to 2015.

In addition, the Annual Report to the Nation described progress in the battle against two major cancers, lung cancer and melanoma. Lung cancer gains were attributed to increasing declines in smoking. The reason cited for the improved success against melanoma was the development of new and better treatments for it.

There was some negative news in that report, however. It stated that cancers related to obesity, such as colon cancer, breast cancer in older women and uterine cancer, are on the rise. This should strike a chord in those of us who are struggling with excess weight.

The report also found that the incidence of cancer in women ages 20 to 49 rose an average of 1.3 percent per year. And cancer deaths in this age group were higher for women than for men. Apparently, we’re failing to get the cancer prevention message to these women.  Fortunately, their cancer death rates declined by about 1.7 percent per year from 1999 to 2016.

The American Cancer Society has its own annual report called Cancer Facts & Figures 2019. This report is a companion piece to Cancer Statistics 2019, a scientific paper that was published in January in the American Cancer Society’s CA: A Cancer Journal for Clinicians. In these publications, the Society estimates the numbers of new cancer cases and deaths in 2019.

According to Cancer Facts & Figures 2019, more than 1.7 million new cancer cases are predicted to be diagnosed in the United States in 2019, and approximately 606,880 Americans are expected to die of cancer this year. The number of new cases is the same as last year, but the number of deaths expected in 2019 is slightly lower, down from 609,640 estimated for 2018.

Cancer is the second leading cause of death among children ages 1 to 14 years, second only to accidents. Cancer Facts & Figures 2019 estimates that 11,060 new cases of cancer will be diagnosed in American children ages birth through 14 in 2019, and 1,190 deaths are predicted to occur. The report notes that childhood cancers have increased by 0.6 percent per year since 1975.

Tobacco use remains the most preventable cause of death in the US, despite declines in cigarette smoking. Cancer Facts & Figures 2019 reports that cigarette smoking among American adults ages 18 and older decreased from 42 percent in 1965  to 14 percent in 2017. Among high school students in the US, smoking decreased from 29 percent in 1999 to 8 percent in 2017.

Still, about 30 percent of all cancer deaths are caused by smoking. Cigarette smoking increases the risk of at least 12 types of cancer and may be a factor in two others. Secondhand smoke is also a risk factor for the development of some cancers. In 2014, 5,840 nonsmoking adults in the US were diagnosed with lung cancer as a result of inhaling secondhand smoke.

Most cancers have risk factors. Some are non-controllable, such as age, gender and family history. Other risk factors are controllable, such as smoking, being overweight and having a sedentary lifestyle.

You can reduce your risk of many cancers by modifying your controllable risk factors. This includes stopping smoking, eating a healthy diet, getting regular physical activity and maintaining a healthy weight.

In addition, follow your doctor’s recommendations for getting routine tests and screenings for various cancers. In many cases, uncovering cancer in its early stages means catching it when it’s most treatable and, in some cases, curable.

With cancer, the cells of a part of your body grow out of control. When this occurs with the cells of your colon or rectum, it’s colorectal cancer. Colorectal cancer is an equal-opportunity disease. It affects men and women of all racial and ethnic groups. Aging is a key factor for this disease, so it’s more common in people ages 50 and older.

According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosed in both men and women in the US, excluding skin cancer. ACS estimates there will be more than 100,000 new cases of colon cancer and more than 44,000 new cases of rectal cancer in this country in 2019. Colorectal cancer is also expected to claim more than 51,000 lives in 2019.

On a positive note, death rates from colorectal cancer have dropped over the last 30 years in both men and women, and are still dropping. This decrease is attributed to more attention being given to screening and early detection, as well as the development of improved methods of diagnosis and treatment.

As with other cancers, colorectal cancer is caused by changes, or mutations, in your cells’ DNA, which controls cell growth. Some of these mutations are inherited; they’re passed along in families. These include certain genetic disorders such as familial adenomatous polyposis (FAP). With FAP, many growths called polyps form on the inner lining of the colon and rectum. Most colorectal cancers start as polyps.

Other mutations are acquired, meaning they occur during your lifetime and you don’t pass them on to your children. There are certain risk factors that can lead to these mutations in your DNA. Some risk factors you can’t control, like your age, but others you can control, and doing that can help you lower your chance of developing this cancer.

Many controllable risk factors are linked to your lifestyle habits, including diet, weight and exercise. The risk of developing colorectal cancer is higher in people who are overweight or obese, are inactive, or eat a diet high in red meats and processed foods. Other lifestyle habits that can have a negative impact include smoking and heavy drinking.

Colorectal cancer might not have symptoms in its earliest stages, and some of its symptoms are common to other disorders. But if you experience any unusual symptoms for four weeks or longer, see your doctor right away. Symptoms of colorectal cancer include:

• Changes in bowel habits
• Diarrhea, constipation or a feeling that your bowel is not emptying completely
• Blood in your stool that makes it appear black
• Bright red blood coming from your rectum
• Frequent gas pains, bloating or cramps
• Unexplained weight loss
• Feeling very tired
• A feeling of fullness in your belly, even after not eating for a while

If your doctor suspects colorectal cancer after you describe your symptoms, he or she will likely perform a digital rectal exam (DRE) to feel for lumps in your rectum. Your doctor may then order certain tests to confirm a diagnosis. Among these tests are a fecal occult blood test (FOBT), which looks for blood in your stool, and a barium enema, during which x-rays are taken of your colon and rectum after you drink a contrast liquid called barium.

Your doctor may also order a sigmoidoscopy, which looks inside your rectum and lower colon with a lighted scope, and/or a colonoscopy, which looks at your rectum and deeper into the colon. These tests are used to look for and remove polyps and/or take tissue samples for examination under a microscope for signs of cancer, which is called a biopsy.

Surgery is the most common treatment for colorectal cancer. Your doctor will remove the areas affected by the cancer using one of several techniques, which cut out varying sections of the rectum and/or colon. The technique used depends on the stage of the cancer and how far it has spread. But all of the techniques have the same goal: to remove as much of the cancer as possible.

Chemotherapy and radiation therapy are other options that are sometimes used, often following surgery to kill any remaining cancer cells. Ablation is another treatment option that destroys cancerous tumors without surgery to remove them.

Ablation can be accomplished using radiofrequency waves, microwaves, ethanol or cryosurgery. These treatments are performed through a probe or needle that is guided by ultrasound or CT scanning technology.

Targeted therapy and immunotherapy are newer methods for treating colorectal cancer. Targeted therapy works differently than standard chemotherapy. It uses drugs aimed at specific genes and protein changes known to cause the cancer. Immunotherapy works to boost your body’s own immune system to fight against the cancer cells.

While not all cases of colorectal cancer can be prevented, you can take steps to lower your risk. Make changes to those controllable risk factors: eat healthy, manage your weight, exercise, stop smoking and moderate your drinking. Also, follow your doctor’s advice about when to get screening exams for colorectal cancer.

The outlook for people with colorectal cancer varies by the extent of the cancer, but is best when the cancer is found in its early stages. That can only be done if you’re vigilant about managing your risk factors, monitoring your body for symptoms and getting screened appropriately. Do that and you can be a survivor.

Fact graphics courtesy of

If you read the recent posting, you learned the basics of breast cancer. You know it’s a nasty disease. In fact, death rates from breast cancer are higher than those of any other cancer except lung cancer for American women. Knowing that may help you appreciate these remarkable breakthroughs recently announced by breast cancer researchers.

The results of one study were released in February and published in the journal Nature. The investigators in the study reported their findings that a certain protein found in many foods may reduce a dangerous type of breast cancer’s tendency to spread. This suggests that your diet may be a factor in treating this form of breast cancer.

The type of cancer is called triple-negative breast cancer because its cells lack receptors   for estrogen and progesterone and don’t make very much of a protein known as HER2. It is often deadly because it tends to travel to distant sites in the body.

In this multicenter study, which used laboratory mice, investigators found that by limiting an amino acid called asparagine, they could dramatically reduce the cancer’s ability to spread to the farther reaches of the body. That’s great news!

One of the drawbacks of this good news is that many foods contain a lot of asparagine. These include beef, poultry, fish, seafood, dairy products, eggs, potatoes, nuts, seeds, soy, whole grains and, surprise, surprise, asparagus. Most fruits and vegetables are low in the amino acid.

Unless you’re vegan, your diet will change dramatically. But it’s worth it if it stops the spread of this deadly cancer. The next step for researchers is to begin an early phase clinical trial using healthy subjects. The subjects would eat a low-asparagine diet, and the investigators would test for drops in asparagine levels.

After that, investigators will move on the next phase clinical trial and test their diet treatment on cancer patients. In that case, diet changes would be made in combination with the patients’ chemotherapy or other traditional treatments.

The results of another study were made public in September but are not due to be officially presented until the 2018 American Society of Clinical Oncology Annual Meeting in June. This study was a federally funded phase III clinical trial of women with an early-stage breast cancer that had certain characteristics.

The early stage breast cancer studied must be hormone receptor-positive, HER2-negative and axillary node-negative. It must also score in the mid-range on a specialized test called a 21-tunor gene expression assay. The study investigators have some welcome news for women with this type of cancer.

Here’s something you’ll want to hear. The clinical trial showed that women with this breast cancer do not need to have chemotherapy after surgery. That’s awesome because you avoid all those horrible side effects. Apparently, there wasn’t any improvement in disease-free survival when chemotherapy was added to other treatments after surgery.

This is especially good news when you consider that half of all breast cancers are hormone receptor-positive, HER2-negative and axillary node-negative. That means a lot of women are affected by this study’s outcome. Read what the study’s lead author, Joseph A. Sparano, MD, has to say about it:

“Our study shows that chemotherapy may be avoided in about seventy percent of these women when its use is guided by the test (21-tumor gene expression assay), thus limiting chemotherapy to the thirty percent who we can predict will benefit from it.”

These are the results of just two recently completed studies on breast cancer. These are many more that have been completed or are in progress. Because breast cancer is so deadly, research on it is ongoing. If you want to get involved in a clinical trial of a new drug or treatment, ask your doctor about one close to you or visit clinicaltrials.gov.

Between the last posting and this one, we’ve increased our awareness of breast cancer two-fold. Don’t keep your knowledge to yourself. Share a fact about breast cancer with someone else. Keep the awareness alive in others.

It’s October. Everybody knows it’s Breast Cancer Awareness Month. Look around. You see pink everywhere. The color is a reminder to get the facts about breast cancer and then get screened. Don’t think this doesn’t apply to you, men. You can get breast cancer, too, even though it’s much more common in women.

Consider these statistics. About one in eight American women will develop invasive breast cancer over the course of her lifetime. This year, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the US, as well as 63,960 new cases of non-invasive breast cancer.

Sadly, an estimated 40,920 American women are expected to die in 2018 from breast cancer.

Listen up, men. An estimated 2.550 new cases of invasive breast cancer are expected to be diagnosed in American men in 2018. You have a one in 1,000 chance of developing breast cancer over your lifetime. It’s much lower than the risk in women, but it’s still a risk.

Let’s start at the beginning. Breast cancer happens when cells in the breast start growing  uncontrollably. Most of the time, but not always, these extra cells collect and form tumors. These are the lumps that can be detected in the breasts on your self-exams or mammograms.

Feeling a lump in your breast is one warning sign of breast cancer, but there are others as well. You might notice thickening, swelling or dimpling of an area of your breast. Look for red or flaky skin, or other changes near the nipple, as well as any secretion from the nipple other than breast milk. Pain in the breast could also be a sign of breast cancer.

If you have any of these symptoms, see your doctor for a proper diagnosis.

Breast cancer is the result of a mutation or abnormal change in the genes that regulate the growth and reproduction of breast cells. Only about five to ten percent of breast cancers are caused by mutations passed on from your parents. The rest are caused by abnormal changes that occur as a result of aging and life in general.

That makes getting older a risk factor for breast cancer, one you can’t do anything about. Other risk factors out of your control include inheriting a genetic mutation, getting your period before age 12 and menopause after 55, having dense breasts, having a personal or family history of breast cancer and having been treated with radiation therapy.

There are also risk factors for breast cancer that you can do something about, things like being physically inactive, being overweight, drinking a lot of alcohol and taking hormones. In addition, having your first baby after age 30, not breastfeeding and never having a full-term pregnancy can also increase the risk of breast cancer.

You can’t change your age or your genes, but there are steps you can take to reduce your risk of developing breast cancer. A few of these suggestions are no-brainers. We already know that we should maintain a healthy weight, exercise regularly and limit our alcohol consumption to no more than one drink a day.

These suggestions you may not have heard. For one, think hard and have a heart-to-heart discussion with your doctor about the risks of taking the Pill or hormone replacement therapy (HRT). They may not be right for you. If you have a baby, consider breastfeeding, if you’re able. If you have a family history or a genetic mutation, talk to your doctor about things you can do to lessen your risk.

With breast cancer, as with most cancers, detecting it early is critical to treatment success. It’s best to find it before the cancer cells have had a chance to invade the nearby lymph nodes and spread to other areas of the body from there. Maintaining a routine screening schedule can assist with early detection.

The first part of the screening process is regular breast self-exams. You know the look and feel of your breasts, so you’re likely to notice changes such as lumps, pain, or differences in size or shape. You should also get regular clinical breast exams by a doctor or nurse, who use their hands to feel your breasts for lumps.

 

The next step is to get a mammogram. The current recommendations are that women ages 50 to 74 at average risk should get a mammogram every two years. Women 40 to 49 should talk to their doctors about when to start and how often to get the test. If lumps are detected, your doctor may perform a biopsy to determine if their cells are cancerous.

If cancer is detected, there are many approaches to treating it. Doctors often use more than one approach on each patient.

Chemotherapy is a common approach. It uses drugs to kill cancer cells and shrink tumors. Surgery, called mastectomy, is often used to remove the breasts and the tumors. Radiation therapy uses high-energy rays directed at the spot of the cancer to kill cancer cells. Unfortunately, chemotherapy and radiation have uncomfortable side effects.

Doctors use additional treatment approaches including hormonal therapy. Hormonal therapy doesn’t allow the cancer cells to get the hormones they need to survive. Another approach is biological therapy, which works with the immune system, your body’s natural defense against disease. Biological therapy helps the immune system fight the cancer. It also helps control the side effects of other cancer treatments.

Breast cancer is the subject of a lot of research, and if you’re interested, you can participate in a clinical trial to test the safety and effectiveness of new drugs and treatments. To find a clinical trial near you, ask your doctor or go to clinicaltrials.gov.

Now, you’ve got the facts on breast cancer. Put on something pink and share what you’ve learned!

On Saturday, Aug 25, Arizona Senator John McCain succumbed to an especially heinous brain cancer called glioblastoma. Glioblastoma, the most common of all of the malignant primary brain tumors, is the same illness that killed Sen. Ted Kennedy and Beau Biden, the son of former Vice President Joe Biden.

In the United States, there are approximately 18,000 people diagnosed with glioblastoma every year, and an estimated 13,000 die from it annually. As you can see, glioblastoma is a very deadly disease. It is a primary tumor because it starts in the cells of the central nervous system, the brain and spinal cord, and quickly spreads to other cells in the brain.

Glioblastoma is more common in men than in women, and the chances of getting it increase with age. Glioblastoma tumors tend to occur in adults between 45 and 70 years old. A study conducted between 2005 and 2009 found that the median age group for death from brain and other central nervous system cancers was 64.

There are two main types of cells in the brain: neurons, which transmit messages from cell to cell, and glial cells, which provide support to neurons and help regulate the transmission of those messages. Glioblastomas start in the star-shaped glial cells called astrocytes. The tumors generally begin in the cerebrum, the largest part of the brain.

A glioblastoma tumor is highly malignant, or able to spread, because it can rapidly invade nearby healthy brain tissue. As the tumor grows, it puts increasing pressure on the brain, which leads to various symptoms. These include headaches, blurred or double vision, difficulty thinking or remembering, changes in mood or personality, seizures, vomiting and trouble speaking.

In most cases, the exact cause of glioblastoma is not known. In rare cases, it can occur in people with certain genetic syndromes. In these cases, the affected people typically also have additional symptoms characteristic of those syndromes. Those syndromes are generally caused by mutations to a specific gene.

Diagnosing glioblastoma begins with a history of symptoms and a full physical exam. Your doctor will likely order an imaging test, most commonly an MRI. The MRI can show the size and location of the tumor. Your doctor may also perform a biopsy, the removal of a sample of  tumor tissue to study under a microscope.

If you are healthy enough to have a procedure, treatment for glioblastoma will begin with surgery to remove the tumor. Due to the location of the tumor and how far it has invaded into healthy brain cells, doctors are often unable to remove the entire tumor. However, removing as much as possible, or debulking it, can release some of the pressure on the brain and help reduce symptoms.

Following surgery, you will be given radiation therapy and chemotherapy. Radiation therapy uses high-energy beams, such as x-rays or protons, to kill cancer cells remaining after surgery. Chemotherapy uses drugs to kill cancer cells. For people who are unable to undergo surgery, radiation therapy and chemotherapy are the primary treatments for glioblastoma.

Newer treatments that have been showing promise are biological therapies. These therapies target the specific biological functions that are essential for the tumor to grow. They are also designed to be less toxic to healthy cells than radiation therapy and chemotherapy.

Often, glioblastoma tumors return after treatment. If this happens, you can repeat the cycle of surgery, radiation and chemotherapy. You may also want to consider a clinical trial of a new treatment still in the testing phase. Ask your doctor about available clinical trials in your area or visit www.clinicaltrials.gov.

Your doctor may also recommend palliative care. This is a specialized type of medical care that aims to provide relief from your pain and other symptoms. The palliative care doctors work with you, your family and your cancer specialists to provide care that complements any other treatment you may be receiving.

Unfortunately, because glioblastoma is such a malignant and aggressive cancer, the outlook for those affected by it is not promising. There is currently no cure for the disease, and many people who get it live less than a year after their initial diagnosis. Currently, the median survival for adults with aggressive glioblastoma is approximately 14.6 months. The two-year survival is 30 percent. Thank God this is a relatively rare cancer.