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Cathy Sullivan
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Towns go pink
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ALSO INSIDE:
`` How to Support a Breast Cancer Patient `` The Best Prevention Foods `` Advances in Breast Reconstruction and Technology
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The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
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ve spent a lot of time talking about breast cancer awareness during the past several weeks. The great news is that community support of this Salem News special project has been overwhelming. The bad news is that just about everyone Ive spoken to has a personal connection to the disease. And some of the stories do not have happy endings. Wives. Mothers. Sisters. Best friends. Everyone knows a woman, or a man, affected by breast cancer. Through the efforts of the Salem News and the generosity of 57 business leaders on the North Shore, we are hopeful that the number of those stories will diminish, and that far more will have happy endings. I am very proud of this effort to put breast cancer awareness front and center. This special edition offers much more than pink ink and pink ribbons. On these pages you will find the inspirational story of Cathy Sullivan of Beverly, who bravely shares her experience battling breast cancer; words from retired Marine Peter Devereaux, one of the thousands of men diagnosed each year; news of the 5K walk/run in Karen Andreas memory of Danvers beloved Lynda Talbot, who died in 2010 at age 61. A special thank you to the leaders here on the North Shore who helped make this effort possible through their sponsorships. You will see their messages of hope and support throughout this special edition, as well as on our website and regular Salem News pages. The National Breast Cancer Foundation tells us that when breast cancer is detected early, at the so-called localized stage, the five-year survival rate is 98 percent. That means prevention is key. Monthly selfexams and mammograms are a must. Still, other facts are alarming: 1 in 8 women will be diagnosed with breast cancer in their lifetime. And more than 232,000 women and 2,200 men are expected to be diagnosed in 2013 alone. The fight is on. And your Salem News, and your local leaders, stand ready for action.
KAREN ANDREAS Publisher The Salem News and North of Boston Media Group
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Elaine Ham Glass, left, and Elaine Seifert attach pink bows to the pillars at the Peabody Institute Library as part of their campaign to pink up Danvers for breast cancer awareness.
BY ETHAN FORMAN
STAFF WRITER
DANVERS Some North Shore women have decked the town in pink as a way to raise awareness about breast cancer and cancer in general. Ham Glass, Ruth DeSoto and Elaine Seifert have put up pink ribbons and bows around town to mark October as National Breast Cancer Awareness Month. Seifert, 62, is a retired nurse and a nineyear survivor of breast cancer, after a nine-month battle with the disease in 2004. Definitely, the town of Danvers has been aware of this situation (the prevalence of breast cancer) because we are just surrounded by hospitals. You name it, theyre there, said Glass, a former longtime Marblehead resident. The woman recently approached selectmen and the town manager for guidance about putting up pink ribbons on lamp posts and various fixtures around town. Pink it up, Selectwoman Diane Langlais told the women. It was really nice to see everyone was so forthcoming with the yes you can do it, the support was really good, said Seifert, a resident of West Peabody. DeSoto, who works at Hospice of the North Shore and Greater Boston, also lives in West Peabody.
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Cities and towns all over the country are putting up pink ribbons to make people more aware of breast cancer, which one in eight women will be diagnosed with in their lifetime
The women even suggested Danvers firefighters wear pink T-shirts, but fire Chief Kevin Farrell said the departments uniform policy does not allow it. Instead, this month, firefighters are wearing pink ribbons on their uniforms, and the department has installed pink ribbon decals on the cabin windows of fire trucks. The whole push at the Fire Department is to make people aware of cancer in general, Farrell said. One of the departments former firefighters, Matthew Smith, 45, died in March 2012 after a two-year battle with melanoma. Firefighters face an increased cancer risk because of the toxins they are exposed to when they battle a blaze, Farrell said. The idea of the cancer awareness is to make sure people get their annual checkups because early detection can make a difference. Glass said cities and towns all over the country are putting up pink ribbons to make people more aware of breast cancer, which one in eight women will be diagnosed with in their lifetime, according to the National Breast Cancer Foundation Inc. The women have been raising money for breast cancer since 2005, walking with a team in Susan G. Komen for the Cure walks. The team has raised $2 million over the years. For the past year, the women having been raising money for the Dana-Farber Cancer Institute, holding a recent peach festival at Connors Farm on Valley Street for the cause. Glass said the pink ribbon
From left, Capt. Ken Reardon, Paul Lapointe, Steve Deroche, Pete Carter, Brandon Lamson, Jim Ciman and Nancy Libby, all of the Danvers Fire Department, stand in front of one of their engines displaying a pink ribbon for breast cancer awareness. The firefighters will also wear pink ribbons on their uniforms throughout the month of October.
awareness campaign is not meant as a fundraiser. We are not asking for money this year, but people are walking up and saying, can I give you money? Glass said. On a recent morning, the women decorated the headquarters of Hospice on Sylvan Street, the Holten Richmond Middle School on Conant Street, and they are eyeing some private historic homes as well. They have pinked up Danvers High, Danvers Town Hall, Danvers Square and the Peoples United Bank. The pink ribbons were donated by Currans Brothers Florists and Greenhouses on Park Street in Danvers, Nunans Florist and Greenhouses in Georgetown, The Leonhards Florist in Beverly and Flores Mantilla in
Marblehead, Glass said. Staff writer Ethan Forman can be reached at 978-3382673, by email at eforman@ salemnews.com or on Twitter at @DanverSalemNews.
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THE BUTCHERY
The Difference is Delicious!
DANVERS
978-777-3000
Open 9AM-7PM 7 days a week
2 Morgan Avenue
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Directions to the Danvers Store: Take Route 1 North Danvers To Traffic Lights, Turn Right Directions to the Newbury Store: Take Route One North to Rotary. Take 1st Exit onto Parker Street. Proceed across 1A to Morgan Ave. (next to Town Hall)
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It takes a team
Andrea McKee, MD, and Kim Willis, NP-C, MSN CBPN-IC
intraoperative radiation Breast cancer affects therapy (IORT) coming to more than 200,000 women Today, specialists address all aspects of a womans care Lahey Hospital and Medievery year; however, death cal Center this fall mean not just the treatment itself, but its effects on her life, rates are falling, and the that we can provide the odds are shifting in favor her family and those closest to her. We work to provide level-of-care treatment that of patients. Today, more best meets the patients women are surviving a patients with the education, resources and support they needs. For example, IORT breast cancer diagnosis, reduce typical radiathanks to greater puband their families need to help manage the unique physical can tion treatment therapy lic awareness about the from daily for six weeks to importance of annual and emotional challenges that diagnosis brings. one dose delivered in the mammograms, extraordioperating room. Imagine nary advances in diagnoshow this will significantly tics and treatment, and a emotional challenges that diagnosis brings. improve the quality of life for patients. more personalized approach to care. Lahey Health member hospitals are privA significant development in recent years When breast cancer is detected, patient is the addition of the patient nurse naviga- ileged to treat and truly care for women support is vital to treatment success. In a study published this month in the Journal tor who guides women through the process during this challenging time in their lives. We take pride in our work to not only proof Clinical Oncology, Harvard researchers of care every step of the way, helping to vide patients with the latest clinical care, confirmed what weve always seen: Support reduce stress and anxiety. Patient navigabut also the most thoughtful and conscientors are integral members of the team, from spouses, family and friends signifiworking closely with our breast surgeons, tious care for their emotional well-being, cantly improves chances of survival. and that of their families. At Lahey Health member hospitals, care oncologists and social workers to explain Our commitment to patients does not end clinical information, coordinate appointis provided by dedicated teams breast when treatment does. As health care proments, and locate resources within the surgeons, medical and radiation oncoloviders, we continue to offer each woman hospital and the community for patients gists, social workers and patient navigathe support and resources she needs to that enhance care and provide emotional tors who work together to educate and maintain breast health, remain cancer-free support for women and her loved ones. engage women about their treatment and live the best life she can. Also important for patients is access to options. Discussions go beyond the parsupport groups. Support groups, a number ticulars of her breast cancer such as of which are offered through our hospitals, the tumors type, size and location, and Andrea McKee, MD, is chairman of the provide vital connections for women who whether lymph nodes are involved to Department of Radiation Oncology at the are experiencing the same challenges; and Sophia Gordon Cancer Center, Lahey Hosinclude her emotional health, values, suphelp arm newly diagnosed patients with port system and quality-of-life needs. pital and Medical Center. knowledge about breast cancer, provide Today, specialists address all aspects of Kim Willis, NP-C, MSN CBPN-IC, is a cerinsights into their own personal strengths tified breast imaging/cancer care navigator a womans care not just the treatment and often lead to lasting friendships. itself, but its effects on her life, her family at Lahey Outpatient Center, Danvers an Advances in treatment options, such as and those closest to her. We work to prooutpatient center of Beverly Hospital. vide patients with the education, resources targeted drug therapies, breast conservLaheys member hospitals include Addiing surgery and accelerated partial breast and support they and their families need son Gilbert Hospital in Gloucester and Bevirradiation (APBI) including advanced to help manage the unique physical and erly Hospital.
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PEABODY When retired Marine and North Andover resident Peter Devereaux, 51, bumped his hand into his chest one morning and felt a lump, he thought it was a cyst or fatty tissue. Disbelief and shock overwhelmed him when the doctor called back with the results: breast cancer. I had no idea men could have breast cancer. I repeated my name on the phone because I wanted to make sure he was looking at my records, said Devereaux, who was diagnosed with stage 3B invasive ductal carcinoma in January of 2008. I can remember the day: It was a Wednesday night, my wife was working late and my daughter, Jackie, was watching Sponge Bob in the other room, he said. She was 10 years old at the time. Devereaux enlisted in the Marines after graduating from Peabody High School in 1980, and is one of 82 men diagnosed with breast cancer from a speculated water contamination at Camp Lejeune in North Carolina. Devereaux, who was at the base from 1980 to 1982, did not know this was a possible cause until he was already six months into treatment. After 14 months of aggressive radiation, a mastectomy and the removal of 22 lymph nodes, Devereaux was exhausted and knew there was a high probability of the
cancer returning. The body gets beat up. Even now, Im 51, but I feel like Im 80, said Devereaux. In 2009, Devereaux, a former boxer and ultramarathon runner, learned that the cancer had spread to his spine and ribs, reaching stage 4, metastatic breast cancer. Just this year, Devereaux was told that the cancer had spread again to his lung and liver. Despite repeatedly disappointing news, Devereaux took action early on and remains hopeful, working hard to live an active, healthy and positive life. If you do just conventional treatment, you wont live. Thats the fact, said Devereaux. You have to be proactive and do alternative stuff, everything from juicing, to changing your diet, to exercise, to acupuncture, massages and mediation. Anything to help all of the poison being put in you. Anne Kelly, 60, a nurse practitioner with Bostons Dana-Farber Cancer Institute in the Susan F. Smith Center for Breast Cancer, has known Devereaux since he was diagnosed. We try to encourage people to stay active, like Peter has done, and we try to make sure their treatment will allow them to be active, because maintaining a healthy mind-and-body connection is the best way to handle treatment, said Kelly. You also need to have family support. As one of seven siblings and a husband and father, Devereaux surrounds
You have to be proactive and do alternative stuff, everything from juicing, to changing your diet, to exercise, to acupuncture ...
worth something. I have to be involved in the change and finding a cure, said Devereaux. It cant be for nothing. I have cancer, but it doesnt have me. In 2011, some of his biggest supporters, a group of men he played basketball with, approached Devereux about starting a four-onfour basketball tournament to raise money for breast cancer awareness. What has now become the Turkey Shoot Out fundraiser is an action-packed event that takes place after Thanksgiving at the World Gym in Danvers. This years event is Saturday, Nov. 30, and costs $25 per person and $100 a team. The proceeds KATHERINE STEPHENS/Gordon College News Service go to the Hope and FriendPeter Devereaux, a retired Marine, works to raise awareness of the fact that men can also be ship Metastatic Breast Cancer group. struck with breast cancer. You have to do things you love, surround yourself awareness. He has had an himself with the people he Breast Cancer Coalition on with the right people and loves, and remains active in effect locally and nationally, breast cancer awareness, train all of your friends and and as long as hes feeling raising awareness for men and to MD Anderson Cancer family on how you want to good, hell do whatever he and breast cancer. be treated, said Devereaux. Center in Houston, Texas, The advocacy work keeps can. They know its never going for a conference. He has Devereaux has parhim going sometimes. He also traveled to Washington, to be a pity party around ticipated in events with Art D.C., eight times to create loves sharing his story, me. I want positive energy. beCAUSE, a breast cancer said Fiona Maguire, 48, I have a great life, and Im awareness. foundation. He has travDevereauxs wife. I can one of the richest guys I I ask a lot why was I see the difference he has given this disease, but since know, besides having stage 4 eled to San Diego to take a made in male breast cancer class hosted by the National I have it, Ive got to make it breast cancer.
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MARBLEHEAD Six years ago, Sheila Vitale of Marblehead beat breast cancer. Even as she battled the disease, she continued playing the violin for the Boston Ballet. Now shes meeting with local survivors to continue recovering an active lifestyle. Vitale is one of eight cancer survivors who are participating in a new pilot program at the Lynch/van Otterloo YMCA on Leggs Hill Road. On Sept. 23, the organization partnered with the LIVESTRONG Foundation to offer a new 12-week fitness program for cancer survivors. Although the program has been underway at YMCAs across the nation more than 22 are in Massachusetts Lynch/van Otterloo is the first to offer it on the North Shore. It really was very emotional for me to meet with the group and to say again that I am a cancer survivor, said Vitale, 70. Even though we are different ages and at different stages of treatment, the fact that we all have cancer in common gives us space to talk about things that worry us. The new group was launched because everyone knows someone who has been affected by cancer, Lynch/van OtterlooHealth and Wellness Director
they can feel better and move forward in their lives. Potvin said one participant had to walk with a cane and was unable to take the stairs when he began the program. Now, he walks without the cane and tackles the stairs to class. You cant attribute (that progress) to exercise quite yet, Potvin said. But it is a sign that confidence is being built. Andrea Klein, 63, who completed her treatment for breast cancer this past August, said the program has already helped her feel better. I already feel such a difference, mentally and physically, she said. The radiation and surgery took more out of me than I thought. I was feeling weak, but now my strength is really coming back. When the class concludes the YMCA plans to begin a second session for a new group of survivors in January. This will be an ongoing program, Bloch said. We will keep offering (the program) for as long as there is a demand. And despite being a quarter of the way through her Courtesy photo time with the program, Vitale said she had no regrets. YMCA fitness instructors who run LIVESTRONG programs are trained in the elements of cancer, post-rehab exercise and I get the feeling that even supportive cancer care, according to the programs Web page. though we will be finished, which they exercise under women and one man. Each open to any cancer surviJaime Bloch said. that wont be the end of our the guidance of three certi- group, she said. We are vors from the North Shore. participant went through Our question was: what Participants are given a free an assessment process that fied personal trainers. can we do? she said. We getting a great chance to We want to help them included gaining permisdecided this was a great way YMCA membership with know and encourage each build a community, said sion from their physician to support survivors in our access to any of the North other. As more and more and articulating their goals. Martha Potvin, 43, trainer Shore YMCAs. community, so we moved people begin to join in, I They meet twice a week for and program coordinator. The programs inauguforward with it. really think were just going To provide a setting where to grow. 90-minute sessions, during ral group includes seven The program is free and
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BREAST RECONSTRUCTION
By Cheryl Lecesse
STAFF WRITER
BEVERLY New trends and technological advances give women faced with a lumpectomy or mastectomy more options for breast reconstruction. Dr. Beverly Shafer, a plastic surgeon with an office in the Cummings Center, said the number of mastectomies, or removal of a breast, is decreasing in relation to the number of lumpectomies. A lot of that is because of earlier detection, Shafer said.
For a patient who is undergoing a lumpectomy followed by radiation, Shafer recommends undergoing breast reconstruction surgery before beginning radiation. I can do a plastic surgical procedure that can give the breasts a new shape, she explained.You want to have all the surgery before radiation starts. The breast tends to shrink a little during radiation, making it difficult to reconstruct an even shape across both breasts for some patients, reconstruction may involve a breast reduction in the healthy breast. Shafer said theres a three- to four-week golden window between surgery and treatment in which she likes to see patients.She stressed, however, that reconstruction after radiation is not impossible, and patients shouldnt be deterred from consulting a plastic surgeon. Plastic surgeons are beginning to use a patients own fat to fill any divots or hollows during reconstruction. The process is similar to skin grafting, in which surgeons take skin from one part of the body and transplant it to another. The fat that we graft contains some stem cells, Shafer said, allowing the fat to adapt easily to its new location. While surgeons cant completely reconstruct a persons breast with fat, Shafer said this form of grafting can take care of any indentations. An injection of a patients own fat can also help alleviate pain in a part of the breast where the skin may tighten during treatment, she said. For women who undergo a mastectomy, Shafer said surgeons have developed a
Plastic surgeons are beginning to use a patients own fat to fill any divots or hollows during reconstruction. The process is similar to skin grafting, in which surgeons take skin from one part of the body and transplant it to another.
breast cancer or ovarian cancer, they really should be seen by a geneticist, Shafer said. First, a computer program can help determine a persons risk for the disease. From there, the person can decide whether to undergo testing for the BRCAgene mutations. A person who tests positive can greatly reduce her chances of developing breast cancer by undergoing a bilateral mastectomy. Angelina Jolie made headlines earlier this year when she made the same choice. Shafer said women have been making the same decision for some time now, but there was a flurry of women seeking reconstruction after a bilateral mastectomy after Jolies announcement. Its helped to have somebody as prominent and visible as Angelina Jolie to help people face it positively and bravely, Shafer said. Finally, Shafer reminds women that, under the Breast Reconstruction Act, anyone who has any type of breast cancer surgery is covered under insurance for their reconstruction procedures.
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Lahey Medical Center, Peabody 978.538.4250 Lahey Outpatient Center, Danvers An outpatient facility of Beverly Hospital
This fall, Lahey Medical Center, Peabody will become the rst medical center in Massachusetts Breast to offer Breast Intraoperative Radiotherapy (IORT), tive Intraopera y p a advanced one-dose radiation treatment for Radiother ) early-stage breast cancer. (IORT
is Coming th fall
Learn more breast health tips with Kim Willis, NP-C, Certied Breast Patient Navigator, Lahey Outpatient Center, Danvers at YouTube.com/BeverlyHospital
SM
Lahey Health mammography facilities possess a valid license and certicate of inspection by the Massachusetts Department of Public Health.
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Stephanie Rooney and Cheri Johnson, both of Danvers, cross the finish line at last years run/walk.
Courtesy photo
DANVERS Last year, more than 500 people came to the Danvers YMCA to walk or run in honor of Lynda Talbot. Were just overwhelmed with the amount of support we get from the local people, said Stacy Bazylinski, one of Talbots daughters. Talbot, a lifelong Danvers
resident, fought breast cancer for more than two decades before succumbing to the disease in 2010 at the age of 61. My mother was an amazing person, she had the biggest heart, said Talbots daughter Julie Donnelly. She would do anything for anyone, so generous and thoughtful. Donnelly, Bazylinski and their family and friends are
Last years run/walk raised money for Art beCAUSE, which funds research on the environmental causes of breast cancer, and the Beth Israel Plastic and Reconstructive Surgery Fund.
organizing the third annual Lynda J. Talbot Memorial 5K Run/Walk, set for Saturday, Oct. 19, at the Danvers YMCA. Proceeds from the $30 registration fee go toward the Lynda J. Talbot Memorial Scholarship and to benefit breast cancer research.
Last years run/walk raised money for Art beCAUSE, which funds research on the environmental causes of breast cancer, and the Beth Israel Plastic and Reconstructive Surgery Fund. Talbot underwent her treatment at Beth Israel Deaconess Medical Center.It wasnt until after her fourth breast cancer diagnosis that Talbot was tested
for the BRCA1 and BRCA2 gene mutations, which are known to cause breast cancer. She tested positive for BRCA2. Four days after Talbots death, Donnelly tested positive for the same gene mutation. Donnelly also went to Beth Israel, where she underwent a bilateral mastectomy. She also had breast reconstruction.
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The Lynda J. Talbot Memorial Run/Walk takes place Saturday, Oct. 19, from 11 a.m. to 2 p.m., with same-day registration starting at 8:30 a.m. The event takes place at the Danvers YMCA, 34 Pickering St. The fee is $30 for the 5K run, $20 for children under 18. Go to www.racewire.com/talbot to sign up.
Committee members at the Lynda J. Talbot Fundraiser Night at Mattys Food and Spirits in Danvers. In top row from left, Keri Smith Demers and Jani Haibon Wilichoski. In second row from left, Dani Gianino Baldassare, Kristen Haibon Clark, Kristen Cullen, Natasha Romsavich Coyne, Dena DeLuca Chase, Jennifer Mahoney Chase and Lauren Jalbert Burke. In bottom row from left, Brooke Bazylinski, Stacy (Talbot) Bazylinski, Kathy Gardner, Julie (Talbot) Donnelly and Michelle Frasier Dustin. Missing from photo is Allison Jansky Eaton.
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No one food or diet plan has been proven to keep cancer at bay. But research shows that a healthy, primarily plant-based diet will provide your body with the nutrients it needs to stay healthy and keep your weight in check, too, which will further reduce your risk of breast cancer. Eat these nine nutrition superstars on a regular basis:
1. Oatmeal. Oatmeal is high in fiber, which helps soak up excess estrogen circulating in the blood stream. Plus, oatmeal is a good source of antioxidants called phenols, which may help repair cell damage that contributes to cancer growth, says Franella Smith Obi, a registered dietitian/nutritionist at Greenville Health System Cancer Institute in Greenville, S.C. 2. Broccoli, cauliflower and cabbage. These cruciferous vegetables are rich in sulforaphane, phytochemicals that have anti-cancer properties, Obi says. 3. Beans. In addition to being high in fiber, theyre an excellent source of protein making them a good swap for red meat and other animal protein, which can be high in saturated fat and has been linked to a higher risk of breast cancer, says Sally Scroggs, clinical program manager of integrative health in cancer prevention at University of Texas MD Anderson Cancer Center. 4. Kale, collards and spinach. All three have super-high levels of carotenoids, a type of antioxidant that protects against free radical damage that contributes to cancer development. 5. Citrus fruit. A recent Korean study found that women who regularly consumed oranges, grapefruit and other citrus had a 10 percent reduction in their breast cancer risk. 6. Berries. Strawberries and raspberries, in particular, are a potent source of ellagic acid, a phytochemical that has been shown to prevent cancers of the breast, skin and lung in lab studies, according to the American Institute for Cancer Research. 7. Fatty fish. Lab studies suggest that the ultra-healthy omega-3 fatty acids in fish like salmon and mackerel may slow the growth of breast cancer cells. 8. Lentils. Lentils are one of the best sources of folate and research suggests that women who have high levels of folate are up to 44 percent less likely to develop breast cancer. 9. Spices. University of Michigan researchers found that piperine (a compound found in black pepper) and curcurmin (the main ingredient in turmeric) reduced the growth of breast cancer-initiating team cells in lab studies. Other research has shown that pepper and turmeric have anti-inflammatory benefits and theyre a smart way to add flavor to food without adding fat or calories, too.
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12.3%, OR A 1 IN 8, LIFETIME RISK of being diagnosed with breast cancer. An estimated 232,340 NEW CASES OF INVASIVE BREAST CANCER will be diagnosed among women in the United States this year. Approximately 39,620 WOMEN ARE EXPECTED TO DIE FROM BREAST CANCER this year. Only lung cancer accounts for more cancer deaths in women. About 2,240 MEN WILL BE DIAGNOSED with breast cancer and 410 men will die from the disease this year. Excluding cancers of the skin, breast cancer is the most common cancer among women in the United States, accounting for 29% OF NEWLY DIAGNOSED CANCERS.
breast cancer; however, they should REPORT ANY CHANGE IN THEIR BREASTS to a physician. 79% of new cases and 88% of breast cancer deaths occurred in WOMEN 50 YEARS OF AGE AND OLDER. Breast cancer INCIDENCE RATES ARE HIGHER IN NON-HISPANIC WHITE WOMEN than African American women for most age groups. An estimated 5% to 10% of breast cancer cases result from INHERITED MUTATIONS, including those in the breast cancer susceptibility genes BRCA1 and BRCA2.
Source: American Cancer Society (www.cancer.org)
BREAST
States.
CANCER IN MEN accounts for one percent of all breast cancers in the United
Source: Susan G. Komen for the Cure (www.Komen.org)
LEADING CAUSE OF DEATH among women aged 35-54. MAMMOGRAPHY DETECTS APPROXIMATELY 2 TO 3 TIMES AS MANY early breast cancers as physical examination. 85% of women diagnosed with breast cancer have NO PRIOR FAMILY HISTORY. A woman is diagnosed with breast cancer EVERY 3 MINUTES. A WOMAN DIES from breast cancer every 11 minutes.
The Kelly Automotive Group Supports the Fight Against Breast Cancer. Brian K elly
HONDA
AUTOMOTIVE GROUP
DANVERS
LYNN
PEABODY
LYNNFIELD
LYNNFIELD
DANVERS
LYNNFIELD
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DANVERS When people think of preventative measures against breast cancer, early detection in the form of self-exams and annual mammograms are among the first thoughts that comes to mind. These days, health care centers on the North Shore have technology available allowing physicians to determine quickly and more assuredly whether a patient has breast cancer. Next week, Dr. Mansi Saksena, a radiologist at Mass General/North Shore Center for Outpatient Care in Danvers, will give a free presentation on breast cancer and the latest innovations in breast cancer imaging at Hathorne Hill rehab and care center. Saksenas presentation is part of an annual breast cancer program that has taken place over the last four years, first at Cedar Glen Nursing Home and now at Hathorne Hill, which replaced Cedar Glen in February. Christine Baldini, administrator at Hathorne Hill and previously at Cedar Glen, said past activities included a pink blanket campaign, in which residents created hand-tied pink blankets for donation, product reviews and presentations on the environmental factors of the disease. Obviously breast cancer is something that affects almost everyone, said Baldini. That statement was true at Cedar Glen and now at Hathorne Hill, as several employees either had family members diagnosed with breast cancer or battled the disease themselves. Saksena has been with Massachusetts General Hospital since 2011 and is also an instructor at Harvard Medical School. She said her presentation will include an overview of breast imaging. One of the technological innovations she will discuss is
Tomosynthesis has helped doctors both increase their cancer detection rate and decrease their patient callback rate. Were calling fewer patients back who have nothing wrong with them and calling more patients back who have something wrong, Saksena said.
Mass General/North Shore Center for Outpatient Care for a mammogram will get tomosynthesis, unless theres a special reason against its use. For example, Saksena said a patient who Dr. Mansi Saksena cannot hold still would not be a good candidate for tomosynthesis. Preparation for a three-dimensional tomosynthesis, or three-dimensional mammogram is exactly the same, she mammography. This type of breast said. imaging is entering its third year of Doctors also use magnetic resouse in the field and has been at Mass Generals Danvers facility for the past nance imaging, more widely known as MRI, to screen a patients breasts year and a half. and helps to detect tumors. The machine is exactly the same Were kind of sitting on the cutting as a mammography machine, Saksena explained. The only differ- edge here, said Michael Auerbach, ence is the X-ray cube moves. It basi- senior manager of public affairs cally provides multiple images of the and communication at North Shore same breast and from multiple spots. Medical Center. Its certainly a great benefit to people in this area. . .they Tomosynthesis takes longer than dont have to go a distance to get the a regular, two-dimensional mammogram does about 15 seconds longer treatment they need. Saksena will also talk about the but provides doctors with a much Breast Health Program at Mass more detailed image of the breast, General/North Shore Center for Outallowing physicians to get a clearer patient Care which includes many look at any abnormalities. aspects of care, including diagnostic Saksena said the process has testing, surgery and reconstruction, helped doctors both increase their and support. cancer detection rate and decrease Im really looking forward to actutheir patient callback rate. Were calling fewer patients back ally meeting members of the community that we have started to practice who have nothing wrong with them in, and looking forward to presenting and calling more patients back who all the services we offer here on the have something wrong, she said. North Shore, she said. Today, everyone who comes to
IF YOU GO
What:Innovations in Breast Imaging, presented by Mansi Saksena, MD, Mass General/ North Shore Center for Outpatient Care When:Wednesday, Oct. 23; tours begin at 5 p.m.; hors doeuvres and light refreshments at 5:30 p.m.; dinner and presentation from 6 to 7 p.m. Where:Hathorne Hill,15 Kirkbride Drive,Danvers Cost:Free; open to the public RSVP: By Friday, Oct. 18, to Pam Wall at 978-551-3656or pamela.wall@genesishcc.com
S21 The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
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www.thewomensfundec.org
THINK PINK!
The Womens Fund is a community of women, families, and businesses dedicated to creating social change for women and girls. Our vision is to empower all women and girls to reach their full potential. We raise funds and make grants to non-profit programs in Essex County that are changing the lives of women and girls in significant and sustainable ways.
The Womens Fund Essex County Community Foundation 175 Andover Street Suite 101 Danvers 978-777-8876
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The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
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Sarah Merchant
To the Courageous
During the month of October, this special time dedicated to breast cancer awareness, I pause to praise the many brave men and women who confront such challenges in their lives as breast cancer. It touches so many of us so profoundly, so your courage and tenacity is truly inspirational to so many. I have the privilege of knowing you during these times and am consistently amazed by your strength to battle against breast cancer. I also say thank you to the incredibly talented researchers who continue the fight for innovation and excellence, allowing the medical community to have the important advancements necessary to treat our patients treatments not available even ten years ago. My deepest gratitude, patients and researchers. I applaud you.
Beverly MA
978.927.8844
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I was metastatic, and at some point I was going to die of breast cancer. My plan for surgery was changed to chemotherapy first, then possibly surgery, radiation, and more chemotherapy. I was going to be on some sort of chemotherapy for the rest of my life. My doctors never gave me a timeline, yet I knew that living another five years would be a dream.
I was 28 years old, only a few years after I graduated from college. I had a beautiful son and a great career. It was then that I noticed a ping pong sized lump in my left breast. I waited a week before I went to the doctors, thinking I had just banged into something and that it would heal on its own. When I did go to the doctors they said I was much too young for breast cancer and that it was most likely a cyst, but they sent me to the breast clinic to be examined anyway. After many biopsies, mammograms, and a breast MRI, I was told that I had breast cancer. At the time the breast cancer only seemed to be in my breast, so we started to schedule a mastectomy for the following week. Before my surgery I was going to have to meet with an oncologist to discuss chemo after surgery, have a CAT scan, brain MRI, bone scan, and PET scan just to be sure everything was contained to the breast. Two days before my scheduled surgery I found out that the cancer had spread to my liver and sacral spine. I underwent a liver biopsy, however it was clear at that point that everything had changed. My surgery was cancelled and I was no longer cureable. I was metastatic, and at some point I was going to die of breast cancer. My plan for surgery was changed to chemotherapy first, then possibly surgery, radiation, and more chemotherapy. I was going to be on some sort of chemotherapy for the rest of my life. My doctors never gave me a timeline, yet I knew that living another five years would be a dream. I am now 32, and my son is 12. Thankfully the drug regimens I have been on have kept the cancer at bay and I am currently considered No Evidence of Disease, which means the cancer is too small to be detected on scans. I am almost four years out, and I have no plans on going anywhere anytime soon. Thanks to medical research for metastatic breast cancer I am still here, and my son still has his mother.
For more about Merchant, her experiences and Beyond Stage 4, visit www.insertboobshere.com or www.beyondstage4.org.
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Show of support
Throughout October, firefighters at the Beverly Fire Department are wearing pink t-shirts in honor of Breast Cancer Awareness Month. From left, standing in front of the ladder truck at the BFDs Hale Street headquarters, are firefighters from Group 1, Dean Julien, Chris Halloran, Brad Saunders, Chad McCormack, Dave Genest, Scott Steeves, AJ Petronzio, Bob Bergeron, Mike Zarbano, Pat Brady, and Sean Murray.
Footprint power
Be Aware and beat breast cancer
Footprint Power supports our friends, family, and neighbors in our community in the fight against breast cancer. Schedule your screening today and take a step toward beating breast cancer.
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Dr. Andrea McKee, left, and Dr. Rebecca Yang look over a patients test results.
of care based on all of the unique characteristics of her cancer. For example, a woman who comes to a Lahey Health affiliate for treatment is seen by a coordinated group of skilled cancer specialists, from surgeons and radiologists to social workers and nurse navigators, who are on hand to walk the patient and her family through every step in the process. Breast cancer is scary for many women. As anyone who has been diagnosed or who has had a friend or family member receive a diagnosis knows, there are many variables and unknowns that can be frightening. But through medical advancements, and changes in the way we deliver care, we hope to make the process easier for women and their families and ultimately advance treatment techniques to decrease patient suffering and increase survival.
The move to minimize treatment started when researchers concluded that extensive surgery did not improve survival over less aggressive surgery.
women arent subjected to as much radiation or chemotherapy, and their chances of survival are higher. Our hope for the future is that, rather than a host of invasive surgeries and chemotherapy and radiation, an affected woman (or man) will need only a small sample of their cancer to provide all of the necessary information to guide successful treatment. With enhanced coordination of care among the breast cancer disciplines, we are excited about these new treatment options. Today, a woman who has been diagnosed with breast cancer has a team of specialists who work together to develop the best plan
Rebecca C. Yang, MD, is a board-certified surgeon by American Board of Surgery and the medical director of the Lahey Hospital & Medical Center Comprehensive Breast Health Center.
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From left, Adam Smith, Matt Dolan, Carol Smith, Rick Cuzner and Tim Twombly.
Tracy and Adam Smith (left and center) with the Edwards family.
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A group of students from The Village School in Marblehead made and sold bracelets at the walk.
Courtesy photos
Adam Smith, bottom center, with the group from the Massachusetts General Hospital outreach program in Chelsea, the beneficiary of the Breast Friends Walk.
For the love of a Mother, For the love of a Sister, For the love of a Grandmother, For the love of an Aunt, For the love of a Friend, For love, schedule your screening today!
877-712-7000 l www.northshore-bank.com Beverly l Danvers l Middleton l Peabody l Salem l West Peabody l Vinnin Square
Member FDIC l Member SIF
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The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
Stress, diet, smoking, exercise for the average breast cancer patient, bad habits are now fair game for public discussion. Changing everything overnight is impossible heres how to set yourself up for success, and a healthier life.
Dealing with breast cancer and treatment is physically and emotionally stressful, but experts say that lifestyle changes can slow the disease, reduce the risk of recurrence and give much-needed energy, as well as peace of mind. While making too many changes at once is undeniably daunting, many patients, and survivors, can make and build on small modifications to their diet, body and mind. Although stress has not been shown to impact the effectiveness of cancer treatment, finding ways to manage life during cancer treatment can go a long way to making this time more tolerable, says Dr. Ruth Steinman, a Philadelphia-area psychiatrist who has been working with cancer patients for more than 20 years. Stress is hard to avoid when undergoing breast cancer treatment and it helps to understand that, she says.Our lives are complicated and busy, and for many not that manageable on a good day.
Mindfulness meditation, which involves visualization and progressive muscle relaxation, can be helpful especially at night when ruminative worry often takes hold.Many of my patients listen to a relaxation CD with guided imagery before going to bed, she says. Steinman points out that sometimes people who think they are stressed may be clinically depressed, which can lead to suicide and actually be more life-threatening than breast cancer. People with depression should always seek help from a mental health professional.
She is also quick to denounce the once-held belief that stress and a negative outlook can promote recurrence
of breast cancer.It is very important to understand this, that no matter how much you are a glass half empty kind of person, you are not going to negatively impact your chances of survival, Steinman says.Many others in your life will spend a lot of effort getting you to think otherwise, which can cause even more stress and demoralization. However, stress and feeling overwhelmed can interfere with behaviors that have been found to help keep recurrence at bay, she adds, such as diet, maintaining a healthy weight and exercise. Registered dietician Cynthia
Thomson tells patients to focus on the broader health benefits of a healthier diet. While most women are not going to die of breast cancer, treatments and other risk factors may contribute to the onset of other diseases, she says. We survive breast cancer, but are we going to be dealing with heart disease at an earlier age? asks Thomson, director of the University of Arizona Canyon Ranch Center for Prevention & Health Promotion. She points out that a couple of diet changes are more important than others. The main one she emphasizes is increasing the amount of vegetables in
ones diet. Her tips: Begin grocery shopping in the produce department, filling the cart with a variety of colors and choosing one new vegetable each week. It makes it fun and not so prescriptive, she says. Then, she stresses, eat the vegetables. You really do have to plan to eat them, says Thomson, who recommends searching for recipes online, especially when trying new foods. Fruit is also important but, in general, people are more likely to eat their daily servings, since fruit is an easy snack, she says. Moderating alcohol is also an
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BACK OFF
Just about all breast cancer patients and survivors experience a common side effect: unsolicited advice. Cancer support groups spend a lot of time on this topic because it is so ubiquitous and can be maddening, says Dr. Ruth Steinman, a Philadelphia-area psychiatrist who has been working with cancer patients for more than 20 years. I think it can be helpful to say something like, I know your heart is in the right place and that your intentions are to help me, but it doesnt help me to talk about this. Can we talk about something else? Of course, finding someone to talk to is essential, whether it be for informational, emotional or practical support. According to Susan G. Komen for the Cure, the benefits of solid support include reduced anxiety, psychological distress and depression, and improved mood, self image and feelings of control. A support group comprised of other patients and survivors may be the key. A number of studies have found that support groups helped increase the quality of life for women dealing with breast cancer, although they did not extend their lives.
important diet change, since alcohol intake has long been associated with breast cancer risk and recurrence, Thomson says. In addition, alcohol can exacerbate depression, which breast cancer patients and survivors can suffer from for an extended period of time. Diet and exercise always go hand-in-hand, but a recent study by researchers at the Fred Hutchinson Cancer Research Center found that only 34 percent of women met the U.S. physical activity guidelines two years after treatment, 39.5 percent at five years and only 21.4 percent after 10 years. But exercising during or after breast cancer treatments has many benefits, lymphedema, says Andrea Leonard, such as improving tolerance to treat- president of the Cancer Exercise ments, increasing energy, reducing Training Institute in Portland, Ore., pain and preventing and managing
and author of Essential Exercises for Breast Cancer Survivors (Harvard Common Press, 2001). Anything they do to move is going to be a benefit, she says. Walking included. Walking is great, she adds, as is stretching, yoga and even breast cancer specific DVD workouts. But for more complex exercise routines, Leonard advises working with a trainer who is certified to work with cancer patients and can take into account variables like surgeries, reconstruction and treatments. Its not a cookie cutter workout, she says. Its pretty complex.
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The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
AGeneral Cancer Support Group meets from 4:30 to 6 p.m.on the fourth Tuesday of each monthin the Longan Room at Addison Gilbert Hospital, located at 298 Washington St. in A Breast Cancer Support Group Gloucester.There is no at Addison Gilbert Hospital fee or pre-registration meets from 6:30 to 8 p.m. on required.For more informathe third Tuesday of each tion or to register, call978month in the Longan Room 283-4001, ext. 585.
All Mass General and North Shore Medical Center mammography facilities are licensed and accredited by the ACR, FDA and the Commonwealth of Massachusetts, Department of Radiation Control Program.
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BEVERLY Cathy Sullivan has always been an active person. She swims, bikes and eats right. She even works with athletes in her profession, helping them determine their weaknesses and develop exercises and strategies to increase their performance. So when she was diagnosed in midNovember 2012 with stage 2B breast cancer, she was caught by complete surprise. At that time I thought they must be making a mistake, said Sullivan, 56, of Beverly. Doctors found a tumor during a routine mammogram at the Breast Health Center at Lahey Outpatient Center in Danvers. The tumor was deep inside, behind the nipple, and I didnt feel it, she said. When they told me I had a sizable tumor I was shocked. Sullivan went back for an MRI, and other tests followed. I was there at 7:45 in the morning and I didnt go home until 2, she said, adding that her husband was with her at the hospitals suggestion that she not come alone. They just kept running tests on me. The day gave her insight into how the health center operated and connected her with the medical team she would be working with throughout her treatment. I felt secure right from the onset from what I knew was going to be a changing event in my life, she said. After the diagnosis, she met with anoncologist, surgeon and radiation oncologist to discuss next steps. Sullivan had strong hopes that radiation would be all she would need, but doctors recommended surgery. For my type of cancer, (radiation) really wouldnt have been effective, Sullivan said. She initially pushed harder for radiation. Her doctors listened to her concerns and provided statistics that led her to the conclusion that the surgery, along with four rounds of chemotherapy and seven rounds of radiation, was her best option. Looking back on that now, I am so glad I did that, she said. As for surgical options, they discussed
Shes pushed through it all, even going back to work for a few days in between rounds. She had a lot of support from family, friends and work colleagues.She also sought out a support group for cancer patients.
support from family, friends and work colleagues.She also sought out a support group for cancer patients. I wanted to be around people who understood what I was going through, Sullivan said. I had never known anybody who had cancer at my age. The group she attends, at Addison Gilbert Hospital in Gloucester, is no pity party. Patients share with and learn from one another, helping everyone to grow. Experts frequently come to talk about topics specific to health and recovery. Next month, for example, the group will hear from a nutritionist. I think Ill probably always go to them, Sullivan said. You learn so much from the Courtesy photos American Cancer Society, from the nurses Cathy Sullivan in February during her third 1/2 months after her final who are running it ... Im not a support Cathy Sullivan, 2 chemotherapy session what she described group type of girl, but Ive found these so radiation treatment, at the top of Mt. as the worst session ever. beneficial I dont think Ill ever stop. Monadnock in New Hampshire. My goal was Today, Sullivan is doing well. Shes back to climb, swim a mile, and ride 25 miles. All both full and partial mastectomies. to work four days a week and shes staying completed this summer. Life moves on with Together, Sullivan and her team decided on new normals, new goals, new outlooks. Thank active. Over the summer, four months after a quadrantectomy, or partial mastectomy, her last treatment, she took part in a local you, Lahey team. in which part of the breast is removed. Swim Across America event, swimming I did want to try to conserve some mus- get out in the fresh air. to raise money and awareness for cancer Her chemotherapy didnt go without cle, she said of her decision to keep part of research. her breast. I wanted to go back to my way challenges, however. She developed an Im very fortunate because I have been allergic reaction to the chemo during her of life. able to go back to all the things that I love, third round and at one point went intoana- she said. Sullivan had surgery and radiation at phylactic shock. There was a 10-day period Beverly Hospital and went through cheSullivan hopes her story encourages during the treatment in which she was motherapy at Lahey Hospital and Mediwomen to go for regular checkups, no matincredibly sick. And then theres chemo cal Center.She did her best to stay active ter how healthy they feel or active they are, brain, which she still experiences Its throughout her treatment and recovery. and, if faced with a diagnosis, to remember almost like your engine in your car slips Each day, she promised herself she would theyre not alone. down in second gear; you can still drive have an empowering conversation with Cancer is not easy, its never easy. But I someone and that she would go for a walk, the car, but it just goes a little slower, she think the support is out there for those who described. no matter how long or short. want to take advantage of it, she said. Shes pushed through it all, though, Sometimes that was just to the end even going back to work for a few days of the driveway, and that was called the Cheryl Lecesse can be reached at 978-338chemo shuffle, she said. I felt so happy to in between rounds. She had a lot of 2664 or clecesse@salemnews.com.
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S33 The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
November 2013
Culinary Centre
Sun
Mon
Tue
Wed
Thur
Fri
1 Flavors of Italy Rome 7-10
Sat
2 Autumn Dinner Party 6-9 9 Tuscany Food and Wine 6-9 16 French Country 6-9
Book your Corporate Its not too early to event with us! Team plan your holiday Building, Employee party at Eurostoves Dinners, Office Party, Retirement event. 3 Flavors of Italy Florence 3-6 10 Healthy Kitchens 3-6 4
Celebration, whatever Visit us on the web the occasion Eurosat eurostoves.com toves is the place to or on facebook be! 978-232-0007 5 6 Knife Skills 6:30-9 7 Girls Night Out New Orleans 6:30-9:30 14 Puff Pastry 6:30-9:30
13
18
19
23 Thanksgiving Cake Boss 10-1 Flavors of Italy Rome 6-9 30 Parent-Child Cupcake Crazy 10-1 Winter Warming 6 p
Mon
3
Tue
Wed
4 Hors doeuvres Made Easy 6:30-9:30
Thur
5 Private Event
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6 Winter Warming 7-10
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7 Italian Christmas 6-9
The human spirit is stronger than anything that can happen to it.
~ C.C. Scott
8 Eurostoves Party
14 Kids: Cookies and Candies 10-1 21 Christmas in Provence 6-9 28 Tuscan Food and Wine 6-9
16
Eurostoves stands with those who have been affected by cancer and supports the crucial effort to raise awareness and improve treatments.
23 22 Christmas Candies Buche de Noel 10-1 3-6 29 Tapas, Paella and Sangria 3-6 30
31
For information on our cooking class schedule or on any other special events, please call or visit our website. 978.232.0007 | www.eurostoves.com
The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
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Culinary Centre
The human spirit is stronger than anything that can happen to it.
~ C.C. Scott
Eurostoves stands with those who have been affected by cancer and supports the crucial effort to raise awareness and improve treatments.
S33 The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
November 2013
Sun Mon Tue Wed Thur Fri
1 Flavors of Italy Rome 7-10 7 Girls Night Out New Orleans 6:30-9:30 14 Puff Pastry 6:30-9:30 8 Couples Cooking Food and Wine 7-10 15 Spanish Tapas 7-10
Sat
2 Autumn Dinner Party 6-9 9 Tuscany Food and Wine 6-9 16 French Country 6-9
Book your Corporate Its not too early to event with us! Team plan your holiday Building, Employee party at Eurostoves Dinners, Office Party, Retirement event. 3 Flavors of Italy Florence 3-6 10 Healthy Kitchens 3-6 4
Celebration, whatever Visit us on the web the occasion Eurosat eurostoves.com toves is the place to or on facebook be! 978-232-0007 5 6 Knife Skills 6:30-9
13
18
19
23 Thanksgiving Cake Boss 10-1 Flavors of Italy Rome 6-9 30 Parent-Child Cupcake Crazy 10-1 Winter Warming 6 p
Mon
3
Tue
Wed
4 Hors doeuvres Made Easy 6:30-9:30
Thur
5 Private Event
Fri
6 Winter Warming 7-10
Sat
7 Italian Christmas 6-9
8 Eurostoves Party
14 Kids: Cookies and Candies 10-1 21 Christmas in Provence 6-9 28 Tuscan Food and Wine 6-9
16
23 22 Christmas Candies Buche de Noel 10-1 3-6 29 Tapas, Paella and Sangria 3-6 30
31
For information on our cooking class schedule or on any other special events, please call or visit our website. 978.232.0007 | www.eurostoves.com
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Letty Cottin Pogrebin, author of How to Be a Friend to a Friend Whos Sick, shares advice on helping a friend through an illness
For one reason or another, sickness tends to render people awkward and uncomfortable. Even with longtime friends, visitors might be unsure how to treat them in light of their sickness. It might be difficult to find a balance between the desire to be considerate and sympathetic and the desire to pretend nothing has changed. Visiting a friend in the hospital can be hard. How should we approach the situaThe disconnect between how tion so it isnt uncomfortable? patients want to be treated and how they are treated prompted Letty CotWhen talking to a friend who is tin Pogrebin to write her book How going through treatments, establish to Be a Friend to a Friend Whos absolute honesty the minute you hear toward her. Sick (PublicAffairs, 2013). Pogrebin was the diagnosis. If you establish honesty from I wanted to say, Stop treating me like recently treated for breast cancer and says the beginning, you dont have to worry about she was often shocked by how friends acted cancer girl, Pogrebin says. Treat me like a whether youre being intrusive or offensive
normal friend who happens to be going through something hard. In her book, Pogrebin offers proper etiquette advice for treating someone when theyre sick. She covers topics such as what to say, how to act and what types of gifts to bring. If you have a friend or loved one who is sick, you might be asking yourself the very same questions that Pogrebin answered for us.
With ConfidenCe
12 Page Street Danvers, MA 978.774-0296 Daniel.C.Bennett@verizon.net www.DanBennettRealEstate.com
SuPPorter
of the fight againSt
Proud
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Friends should be alert to a patients body language, facial expressions and the type of response they give to your questions. If they try to slough off your question with a short, nondescriptive answer, thats your signal to back off. Not everyone wants to be interviewed about their illness, treatment or Should you ever try to relate to the condition. They may consider patient through experiences of your your questions to be intrusive or they may simply be tired of When is offering to help helpful and own or of someone you know? when is it degrading? talking about their problem. No Some people immediately one wants to become their illrespond by citing their own Offering help is never degradness in the eyes of their friends. experience with illness, or theyll ing but it may be infantilizing. start recommending treatments, People dont want to be treated vitamins and so on. None of this is Whats the best way to end your as helpless. I recommend that visit or talk? you should ask directly how you helpful to a patient. Your story is can help. You should add that you your story; your illness and your This goes back to what I was response to it are unique to you. genuinely mean it. Otherwise, saying earlier about honesty. Ask Try not to be self-referential in people will assume youre just your friend to tell you when to your remarks to any patient unless leave. You need to tune into the saying it to be polite. she specifically asks for your expe- cues of the patient. If I had to give an answer for how long to stay, I What are the best ways to comfort rience with the same disease. a friend? would say long enough to show that you care, but not as long as Bringing gifts can be comfortHow do you know when to step back? you think. ing to patients, but be sure the
because youve established a policy. In terms of how to behave, kindness equals empathy plus action. You have to be able to listen to their needs, as well as actually help with those needs. If youre unsure how to help, tell your friend that you want to be helpful but really dont know how to be.
gifts are thoughtful. Chances are, shes not going to eat all that fruit, but she may be really excited if you give her a certificate for a manicure or pedicure. Take time to think about what you will bring, and ensure that whatever you choose will really help her feel good.
How to say what you want to say in the most tactful way
Everyone should be especially thoughtful of what phrases they choose when speaking with a sick friend, Pogrebin says. Old greetings that have become second nature might suddenly have a different connotation for someone whos sick. I resented being asked how are you? all the time, Pogrebin says. That simple line becomes a problematic line for someone with breast cancer because it means we have to calibrate how much that we want to tell our friends. She suggests instead that you should establish honesty from the start so you know what conversations are on or off-limits. Also, dont be afraid to talk about daily activities not just the illness. In her book How to Be a Friend to a Friend Whos Sick, Pogrebin offers seven examples of phrases that sick people typically want to hear: 1. Im so sorry this happened to you 2. Tell me how I can help 3. Im here if you want to talk 4. Just give me my marching orders 5. That sounds awful; I cant even imagine the pain 6. Im bringing dinner 7. You must be desperate for some quiet time. Ill take your kids on Saturday.
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MIND?
Memory loss is a common complaint of breast cancer patients
BY RACHEL GRAF
WHERE IS MY
Misplaced car keys, difficulty with multitasking and the need to write down everyday tasks are all symptoms of chemo brain, a form of cognitive decline that affects many women after chemotherapy treatments for breast cancer. Post-treatment breast cancer patients report higher complaints about their memory and their higher-level cognition than do women who have not undergone treatment, according to a recent study by researchers at the University of California, Los Angeles. The study is one of the first to demonstrate that patients self-reported memory complaints are backed by objective test results. In the past, many researchers said that we cant rely on patients self-reported complaints or that they are just depressed, because previous studies could not find this association between neuropsychological testing and cognitive complaints, says Patricia Ganz, director of cancer prevention and control research at UCLAs Jonsson Comprehensive Cancer Center. In this study, we were able to look at specific components of the cognitive complaints and found they were associated with relevant neuropsychological function test abnormalities. The researchers subjects were 189 breast cancer patients with an average age of 52. The patients had completed the initial cancer treatments but had not yet undergone hormonereplacement therapy. These patients completed a self-report questionnaire about cognitive abilities. Generally, women with breast cancer
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reported higher complaints regarding memory than the control group of healthy women about the same age who do not have breast cancer. About 23 percent of the women with breast cancer reported greater complaints about memory, and about 19 percent of those women reported greater complaints about higher-level cognition and problem-solving ability. Women who had undergone both chemotherapy and radiation were especially likely to report memory problems compared to women who had undergone only chemotherapy or only radiation. Typically, cognitive decline affects patients anywhere from two months to three years, says Dr. Virginia Kaklamani, an oncologist at Northwestern Memorial Hospital and associate professor of hematologyoncology at Northwestern University Feinberg School of Medicine. Neuropsychological testing that was also conducted during the study supports the results of these self-report questionnaires. Patients who reported even subtle memory changes showed significant differences in neuropsychological testing. The women who were tested completed about two hours of standardized tests that included many questionnaires. For example, the women may have been asked to read a story without any further initial instruction. About 15 minutes later, the testers would ask these women what details they could recall from the story. Women who had undergone therapy performed worse than those who had not. Although a link between chemotherapy and cognitive decline has been proven, doctors do not yet know its cause. A couple of leading hypotheses are that its due to a lack of oxygen to the brain or an early onset of menopause due to chemotherapy. Because there are confounding factors present during breast cancer treatments, such as a spike in estrogen levels, it is difficult for doctors to know what effects
are due to chemotherapy and what effects are due to a change in estrogen levels that accelerate menopause. Women experiencing menopause often experience cognitive decline, as well. Partly because of the uncertainty regarding its cause, doctors have not determined a cure for chemo brain. Research is being conducted about how to minimize or mitigate these effects, but nothing definitive has been determined. Angie Plagman, 39, of Casey, Iowa, completed treatment for breast cancer nearly a year ago and is still suffering from symptoms of cognitive decline. Plagman says she has difficulty remembering everyday tasks at work and at home, so she now takes notes about everything. Doctors rarely alert breast cancer patients about the possibility of mental decline, although the majority of patients complain about it, Kaklamani says. This is largely because there is very little that doctors can do to prevent the memory loss or loss of focus. Honestly, at the time, you have so many things that theyre telling you will happen to you, even if they wouldve told me, that was probably the least of my worries, Plagman says. Kaklamani says that doctors instead focus on post-treatment therapy that these women can complete after chemotherapy. Exercises to combat the effects of chemotherapy include sudokus, memory games and similar brain-focused exercises. Most women eventually do recover from the effects of chemo brain. In the meantime, experts urge patients to encourage family and friends to be understanding. These women should acknowledge that theres a problem and not be afraid to ask for help, says Jamie Myers, adjunct assistant professor at the University of Kansas school of nursing. Give yourself permission not to be perfect, Myers says. You dont have to be superwoman.
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Q: Why did you found the Program forYoung Women with Breast Cancerat Dana-Farber?
A: Early in my career, when I first started caring for patients in the breast oncology center, I recognized the unique concerns that young women with breast cancer face and how
Q: What are some of the unique challenges for young women with breast cancer?
A: Young women are more likely than older women to be diagnosed at a time in their lives when they are going through school, startAnn Partridge, MD ing a career, raising young families, trying to get pregyoung women often struggle nant or trying to get a date. They tend to be much less with the diagnosis, treatestablished in their social ment decisions, as well as and work lives, and breast survivorship issues. We
cancer and its treatment can threaten or interrupt many important experiences and goals for young women. Young women are also more likely to have more advanced and more aggressive disease at diagnosis, often requiring more aggressive treatment. Further, young women are more likely to harbor a genetic predisposition for the disease and this has implications for their treatment as well as for their families. All of these things together lead to the fact that young women often have a more difficult time emotionally after a diagnosis of breast cancer.
To date, it is not clear if young women develop different disease or if they are just more likely to develop more aggressive subtypes of the disease than older women. Researchers are working hard to understand this issue.
Q: Is breast cancer different in younger women? Q: Are treatment options different for younger women?
A: To date, it is not clear if young women develop different disease or if they are just more likely to develop more aggressive subtypes of the disease than older women. Researchers are working hard to understand this issue.
A: Treatment options vary for young women predominantly surrounding hormonal therapy issues, given that young women are most often pre-menopausal and thus manipulation of their ovarian function is an option for treatment and other
www.northshorechamber.org
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IF YOU GO:
moderation (6 to 12 ounces of wine or the equivalent, or less per day on average) are less likely to develop breast cancer over their lifetimes. Further, there are other health benefits from these general recommendations, and thus most experts agree that it is prudent for women to follow them.
The Program for Young Women with Breast Cancer at Dana-Farber Cancer Institutes Susan F. Smith Center for Womens Cancers and the Dana-Farber/ Brigham and Womens Cancer Center are sponsoring a forum for patients and survivors to share their experiences and hear experts speak about breast cancer in younger women.
AlignCU.com
AMESBURY DANVERS FRAMINGHAM HAVERHILL LOWELL
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The Danvers High School girls soccer team wore special shirts to support Breast Cancer Awareness month as well as pink socks and pink ribbons in their hair for their game against Salem on Wednesday evening.
Jack Lambert of St. Johns Prep drives his legs through an attempted tackle by a Malden Catholic defender on Oct. 5. Prep players, including Lambert, were decked in pink for the game.
ROSE RAYMOND/Photo
In Loving Memory of
a dedicated employee for 20 years we love and miss you
Lynda J. Talbot
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Cheryl Lecesse
Pink at Precision Pilates new Danvers location, at Timothys on Route 1 north. The owner, Nancy Higgins, is battling breast cancer herself. The duo is planning an hour-and-45-minute set, split into two classes to give people a break. Our goal is to start small this year and see how we do, said Buccafusca. Danvers will be the site of a second Party in Pink, by Kerri Kelley on Oct. 27 at Boston North Fitness. This will be Kelleys fourth event. People bring their friends, their relatives, their neighbors, said Kelley, who is expecting a large turnout. Shes also done Zumbathons for Operation Troop
Support and ALS. Everyone no matter what skill or experience level is invited and encouraged to take part. Zumbas just fun, exciting, Kelley said. Its a party. Theres no limits or restrictions. Thats what makes these kinds of events successful I think, because anybody can do it. With raffles of movie passes, salon products and wine baskets, and vendor tables including breast cancer T-shirts and Mary Kay, Kelleys Party in Pink is a draw for people who dont want to take the class but still would like to donate to the cause.
Danielle Roberts hopes her Party in Pink fundraiser this year Zumba, Page S46 raises more than the $1,500 the Zumbathon raised last year.
Courtesy photo
HILL
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October is
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Education
prEvEntion
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Cranney Home Services is proud to support the fight for cancer awareness. Also, we support those who fight the battle every day.
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978-750-6900
District Attorney Jonathan Blodgett is proud to support breast cancer awareness month.
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NEWBURYPORT Margot Labadini is a three-time cancer survivor whos battled breast cancer twice and lived to tell about it. But its been a long road back to recovery from a surgery and treatment plan that left her broken, in pain and fearful about her future. For at least two years, Labadini, an Amesbury resident, was in such physical and emotional pain she could scarcely get up off the couch. It was a YWCA-branded program in Newburyport called Encore that ultimately coaxed her up off the couch and restored her faith that life would once again be good even great. Its a very special place for me, said Labadini of the group of women and instructors that make up the Encore and After Encore programs at the YWCA. I didnt know what I was walking into, because my world had become so narrow and small, sitting on that couch. I had forgotten that there was a whole beautiful world out there and thought this was going to be my life and nothing was going to help or work. Margot Labadini with her Newfoundland puppy.
Labadini was first diagnosed with cancer in 1986 and fought it successfully into remission. But two years later, in 1988, she was diagnosed with breast cancer. She thought her second successful fight was the end of it and enjoyed 16 years in remission before the cancer came back, in a different form in the same breast. Labadini recalls that she was only six months into her new job as a nurse at a state-run hospital at the time of her diagnosis and money was tight so tight that she rushed to return to work after surgery and treatment, even though she was suffering from a chemotherapy-induced nerve condition that attacked her nerve endings. The condition left her in horrible pain and with compromised brain function. I tried to go back to work, and I went back too soon because we were losing our house, she said. They basically had to tell me I couldnt do my job because I was so focused on trying to work for money. They were very gracious, and being a state facility, they embraced me and did everything they could for me to make sure
Courtesy photo
I got benefits. I shouldnt have been there. I couldnt even write. Labadini was suffering from a condition known in the industry as chemo brain, which attacks the memory centers of the
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ABOUT ENCORE
Encore is a YWCA-branded program, according to Grady, thats completely free to participants and was designed especially for the breast cancer survivor. All instructors are trained as facilitators through the YWCA Training Network, Grady said. Were the only ones who offer this on the North Shore. For Grady, her work as an instructor and trainer in the program, a task she shares with instructor Gayle Calistro, is deeply personal. Grady lost her sister Pammy to breast cancer and looked on helplessly while another sister battled the disease. She lost her father to cancer, as well, so her annual mammograms and MRIs are fraught with an intensity that helps her relate to those who come through the door of the YWCA. I couldnt help Pammy, but I can help these women, and I can give back, and theres nothing that gives me greater joy than giving back to these women that sense of confidence that they can resume a normal active life, which is critical in reducing the rate of recurrence. It doesnt have to be that you were like that forever. You just have to start doing it. We also offer After Encore that many women stay on and
amount of confidence to go to those classes. Ilene and Gayle are magnificent. What they do and the way they care their knowledge, their sharing and listening ear, is incredible. I feel like Im back. I can lift and go and move and do whatever I want, be it lifting grocery bags or doing stuff for my children. It really brought me back from a very dark place. Mogavero was fortunate to discover her cancer at an early stage and underwent a lumpectomy and reconstruction but was able to forgo chemotherapy and radiation. Still, she experienced after her surgery an all-too-common ailment for women who go through breast cancer, one seldom spoken aloud by survivors. When you have a breast issue and a reconstruction like that, as a woman youre different, she said. You have to learn who you are again and to be comfortable in your own skin again. Thats something Mogavero has learned to do through Encore. I was nervous about a group expeBRYAN EATON/Staff photo rience, sharing in a group, being in a Participants in the Encore program, a fitness program especially designed for breast cancer group, she said. I didnt know other patients at the YWCA in Newburyport. people were going through what I was going through, but they were, and continue to exercise here on an ongoing the way it healed, I hadnt used my worse. Some were recovering better upper body in months. Encore really basis. taught me how to move again and gave than me, some recovering worse than Gloria Mogavero of Georgetown is me, and yet, we bonded and were able one of those women who continued on. me my life back. to share, and that sharing led me to Mogaveros surgery left her with an She was diagnosed in winter 2012 with overwhelming fear fear of hurting the a new doctor and really is probably breast cancer. going to affect my health for the rest of surgical site, fear of everything. My surgery was in November 2012, my life. Im really not kidding. I cant I had fear of that whole area, she and I just had no range of motion from say enough about this program. It was said. It gave me just an incredible the surgery. The pain and healing and life-changing.
brain in a small percentage of patients and leaves them with pins and needles in their extremities and unable to organize themselves, remember words or recall important details and events essential to living an independent life. Following her leave of work, weeks and months went by, and Labadini became increasingly depressed and despondent. She noticed articles in the local newspaper about YWCA Encore, a group that meets weekly to restore physical and emotional strength in breast cancer
survivors, but money was so tight that she figured she could never afford the program. Finally, I ran into someone at the Newburyport Yoga Center, which does a once-a-month class for cancer survivors. Thats how I found out about Encore, that the first 10 weeks are free. Thats how I got there, never knowing I was going to end up with a scholarship and that it was going to completely change my life. Encore Program Director Ilene Grady, who has overseen 10 sessions of
the program in the past three years, said Labadinis story is one that shes seen replayed many times for the women who walk through the YWCAs doors after months sometimes years of silent suffering. They come in a little fearful because theyre post-surgery and theyre worried about pain, said Grady. Some of them have had several bouts of cancer and havent been active, so they dont really know what their ability is. Through a lot of discussion, we help them push through and find
the confidence to really try. They leave us so much more empowered and strong that they can, in fact, be healthy and active individuals. I saw change and saw that I was achieving change and my body was improving, said Labadini, who found the warm-water pool at the YWCA the ideal environment to mount a physical comeback. I couldnt even do the exercises when I first got there. Labadini has come so far from those dark days of being housebound that she has taken on a role in
her church and welcomed a new puppy into her life that shes now able to walk and care for. Shes even come to the revelation that cancer may just be the best thing to have ever happened to her. I was a drunk, and I did drugs marijuana and all that social stuff and that was my life, because I had no self esteem, Labadini said. It wasnt me. The first time I had cancer, I was able to give up that lifestyle, so for the first time in my life, I had hope. Two years later, I had breast cancer, and thats
when I got into the 12-step program. Rather than circling the drain and ending up in the gutter where I thought I belonged, its just been this uphill climb where I was able to just blossom. Now Im working on becoming my authentic self. Im finding out who I really am, and my relationships have changed so much. I had a really lousy past, so Im giving up the past, and my depression is lifting. Im in the moment, and Im able to give to other people. I feel Im a role model for other people with cancer.
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www.gardencitypediatrics.com
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They tell you youre going to lose your hair. They prepare you for that. But in my particular case, when it started to fall out of the follicles, it was like thousands of pin pricks across my scalp. I wasnt prepared for it, Haschke says. When friends and family found out I was having chemotherapy, they knitted or crocheted caps for me, for the hair loss. These brought comfort and relief from the pain. I dont think theres any science behind it, but when someone is thinking of you and your recovery and offers you a handmade gift like that, I think theres a psychological benefit. After my experience I started Halos of Hope, an all-volunteer nonprofit organization that distributes free handmade caps to chemotherapy patients. Count your blessings. New York-based psychologist Paulette Kouffman I dont want to sound corny, but I was grateful if Sherman, a breast cancer survivor, also relied on the someone in my family had support of loved ones and to get cancer, I was glad it says treatments go faster if was me, says Griggs, of Bedford, Texas. I am a man you Bring a chemo buddy. of faith. I never said, Why me? I never questioned Chemotherapy can be an my faith. My wife and two all-day thing. Its important daughters, three brothers, to occupy your mind in a my parents and nieces and good way, says Sherman, nephews were all looking who recommends bringing to me to see how I would a laptop, DVDs and readhandle going through some- ing material as well. I had thing as painful as this was. books and meditations, and
The first time I had chemotherapy, they wanted me to bring somebody. After that, I realized I preferred to be alone. I found the process to be very personal, Butterworth explains. Chemotherapy is hard, and I had to get ready for it mentally. It was a 40-minute drive and on the way I listened to Led Zeppelins Kashmir and Ramble On because both songs are about journeys, and I considered chemotherapy a journey inward. My friends and family really wanted to be there for me, but I was really honest with them. I told them I appreciated their support but I felt like I needed to do it alone. Its almost a spiritual moment, when you need to focus on getting cured. Id also advise people to stay away from online message boards because they can end up scaring you more than they help. Some people totally isolate themselves and stop working, which I dont recommend. I think its important to keep up your normal routine as much as youre able and to live your life. While Butterworth found message boards upsetting, Kathy Kanavos, a breast cancer survivor who
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Pink Deadpool
Photo courtesy of Ross Liberti
800-772-1090
peoples.com
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ALEM Bostons Marvel comic book character Deadpool has traded in his red suit for a pink one in honor of Breast Cancer Awareness Month. James Jwanowski, 26, of Peabody, is a local cosplayer, or a person who dresses up as a fictional character from a comic book, video game or film and attends conventions known as Comic Cons. Jwanowski has taken his passion beyond the Comic Con events to become what he calls a cause-player and has been dressing up in his original pink Deadpool suit at various breast cancer charity events since October of last year.
Jwanowski since preschool. Last summer, Liberti stumbled across a Facebook video of Jwanowski in the pink Deadpool outfit, speaking at a Comic Con event. Then, he had an idea. It seemed natural, given our ties to Salem, the spirit of Halloween, said Liberti, and the fact that Sylvana Joyce & The Moment makes it a point to get involved with charities and benefits, to merge our plans for a Salem Halloween show with Jamess cause (breast cancer awareness). Liberti said Jwanowski was on board from the get-go. The show is free to attend, and donations will go to Susan G. Komen for the Cure, the largest breast cancer organization in the nation. Individually and as a band, we feel very strongly that we would like to see cancer become a preventable and curable condition in our lifetime, said the bands front woman Sylvana Joyce, 28, of Jersey City, N.J. Anything we can do to help that become a reality would be a great honor for us. In the past, Sylvana Joyce & The Moment have played for Project Animal Worldwide, Sing for Hope, Women of Song and various fundraisers for cancer research. They also advocate for the awareness of Parkinsons disease and Crohns disease. Liberti and Joyce said these causes are personal for them. Joyces mother was diagnosed with Parkinsons 18 years ago, and a good friend of Libertis has been battling Crohns for most of his life. They and Jwanowski have also lost friends and family members to cancer. According to Joyce, the band is entirely grass-roots and selfmanaging. They handle their own publicity, book their own shows, design posters and flyers and call friends in the area to get the word out. Because Jwanowski has been working toward cancer research funding for a year now, Joyce said his experience is invaluable for fundraising at the Gulu Gulu Caf show. Jwanowski is also taking donations for Komen on his FirstGiving.com fundraiser page. He has already raised $390, with $1,000 as his goal. To me, music is not just about expression, said Joyce. Its about sharing a sense of unity and passion with each other, taking care of each other emotionally, connecting and using our music as a force for the greater good. And in this case, its also about working with a pink superhero to fight breast cancer.
I want to actually be a superhero for people, Jwanowski writes on his FirstGiving.com fundraiser page. Since I cant fly, jump over buildings or stop a speeding bullet, I figured I could always dress up for charities for kids, the less fortunate, the sick or whoever wants a great costumed hero at their event. His next destination? The Gulu Gulu Caf in Salem, Saturday, Oct. 19, at 8 p.m. alongside Sylvana Joyce & The Moment, a gypsy/ blues rock band out of Astoria, N.Y. The bands drummer, Ross Liberti, 26, of Jersey City, N.J., grew up in Peabody and has known
Proud Supporter
October 2013
Kevin & Jill Michaud Supporting Breast Cancer Awareness Month
Rte. 114 Danvers 978-774-4040 michaudmitsubishi.com
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Lucy, a regular at Anna Jaques Hospital, visits the Oncology Department every Tuesday.
Pet therapy is a medically recognized treatment that employs a variety of animals to help boost patients emotional and physical well-being. Lucy, a 3-year-old black Labrador, is that source of comfort for many patients at Anna Jaques Hospital. Lucy has been a pet therapy dog for two years. After passing a series of tests to prove that she had the temperament and skills, she was certified and earned a red vest (and hospital ID card) identifying her as a therapy dog. Her certification as a qualified pettherapy animal required Lucy to prove that she wasnt easily startled and not aggressive toward humans and other animals, to help ensure she would be a calming force for the patients that she visits. Lucy, now a regular at the hospital, visits the Oncology Department every Tuesday, as well as other areas of the hospital, providing comfort and a much-needed break to patients.Once, during a procedure with
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In every company there are compelling reasons to support Breast Cancer Awareness Month. At Moynihan Lumber these are our reasons:
Vikki Rundlett, wife of Webb Rundlett, breast cancer victim - 2003 Sandra Moynihan, wife of Gerard Moynihan, breast cancer victim - 2005 Lisa Bernstein, breast cancer survivor Carol Karsadi, breast cancer survivor Eileen McNeil, breast cancer survivor Rita Mullin, breast cancer survivor Barbara Surdam, breast cancer survivor
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Angelina Jolies double mastectomy made headlines, as did the swell of support and criticism of her choice.
It certainly was Angelina Jolies revelation of her preventive double mastectomy in the May 14, 2013, New York Times that got the general public talking about preventative mastectomies. However, since genetic testing has become more widely available in the last 10 to 15 years, more and more women are being tested for BRCA1 and BRCA2 gene mutations, the presence of which significantly raises a womans risk for developing breast and ovarian cancers, explains Dr. Lisa Kay Jacobs of the Johns Hopkins Breast Center in Maryland. Increased genetic awareness has likely led to the steady rise in mastectomies performed in the last 10 years (including those in women who have not been diagnosed with cancer), as has the growing number of women who want to be proactive and avoid dealing with cancer, she notes. However, a mastectomy, or a double mastectomy in the case of preventive procedures, is an involved surgery and not a choice to be made lightly. Its a personal decision even with the highest risk, because it is prevention, Jacobs says. When you talk about prevention, you want to compare the risk of the procedure to the benefit to be gained. So, the place to begin is with an accurate assessment of a womans risk for breast cancer. The higher her risk, the greater potential benefit from a preventive mastectomy.
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Genetic mutations BRCA1 and BRCA2 account for only about 5 percent of breast cancers, but among those who have them, the risk of developing cancer can be as high as 85 to 87 percent.
PREVENTIVE MASTECTOMY
A true story
By Jessica Royer Ocken
CTW FEATURES
The general populations risk of developing breast cancer over a lifetime is 12 percent, Jacobs says. Factors raising a womans risk include a family history (particularly among immediate female relatives) of breast and/or ovarian cancer before menopause and any male family members with breast cancer. Family histories dont often take the fathers side into account, but breast and ovarian cancers among female relatives on the fathers side can indicate the presence of a genetic mutation, which is another risk factor. Genetic mutations BRCA1 and BRCA2 account for only about 5 percent of breast cancers, but among those who have them, the risk of developing cancer can be as high as 85 to 87 percent, reports Dr. Marisa Weiss, founder and president of breastcancer.org. A strong family history without a BRCA mutation may yield a risk of 30 to 40 percent, Jacobs notes. So if you have an elevated risk and want to lower it, explore all your options, Weiss urges. Lifestyle adjustments like getting to a healthy weight, exercising, quitting smoking, limiting alcohol consumption and avoiding unnecessary radiation might reduce your risk by 40 percent, she says. And anti-estrogen medicines like Tamoxifen can reduce risk 40 to 50 percent. However, if your risk is 85 percent, even if you reduce it by 40 percent, its still significant. Prophylactic mastectomy can lower risk by 90 or 95 percent. That sounds pretty damn good when youre looking at a situation of high risk and you feel unsafe, Weiss says.
Whos a candidate?
The fact that a preventive mastectomy can eliminate a significant portion of the risk of breast cancer is its greatest benefit. Its a huge peace of mind thing, says Dr. Deborah M. Capko, surgical oncologist and member of the Breast Surgical Service at Memorial Sloan-Kettering Hospital in New York and New Jersey. Women who have their breasts removed (Well, 97 to 99 percent of their breasts its virtually impossible to get all the tissue, Capko notes) can also reduce the amount of screening and testing mammograms, ultrasounds, MRIs, biopsies they do each year to detect cancer. These tests can cause anxiety, as each one has the potential to find something, and theyre also not much fun. For some women, preventive mastectomy is a better alternative than taking Tamoxifen, which can have menopauselike side effects and is not recommended for women who may become pregnant, Capko adds. And, in 10 to 15 percent of prophylactic mastectomy procedures, biopsy reveals that cancer was present in the breasts, even if it hadnt been detected previously, Weiss says. The biggest drawback to preventive mastectomy is the fact that its a major surgical procedure. The risks of the surgery vary depending on the technique employed and the type of reconstruction chosen, but theres a risk of bleeding and infection with any surgery, note
When Stephanie Spences older sister, Crystal Hildreth, called a little over a year ago to say shed found a lump in her breast, Spence, then 41 and a mother of three living with her family outside Atlanta, Ga., sprang into action to reassure her. Id found cystic lumps before, so I was already having annual checks and mammograms, she says. They were all just cysts, and my mom had cysts, so I was sure my sisters was just a cyst too. But her sisters was not a cyst. It was cancer. And her sister had tested positive for the BRCA2 gene mutation. The morning Spence got that phone call, she flashed back to her dads sister, whod had breast cancer and passed away from ovarian cancer in her 30s. Then she remembered a story a friend at work had told her: his wife lost her sister to breast cancer in her 20s, so she elected to have a double mastectomy rather than experience that herself. That was the first moment I thought about treatment for myself, Spence says. Her sister said there was a 50-percent chance Spence had the gene too, so she called immediately to schedule genetic testing at a nearby hospital. The test itself was so simple, she recalls just a quick swish of mouthwash and analysis of the sample but
Stephanie Spence
the results were much more complicated. She returned from vacation in April 2012 and sat in her doctors office, waiting for the news. It didnt really hit me until she opened the folder and said I had [a mutation], she says. Then it was a blur for the next 24 hours. I had up to an 87-percent risk of developing breast cancer, and up to a 44-percent risk of ovarian cancer. Spence describes herself as a woman of action, not one to sit and ponder, so she wanted to make a decision right away. I didnt have cancer, but I did not want to get it, she says. My kids are my everything, and Id breastfed all three, so my reaction was Thank God we found out. Take it all away! But she was concerned about what her husband might think. This, our life, doesnt work without you, he told her. This is easy. Were going to get it done. She was so thankful for his
support and says the process of going through all of this has brought them closer, but even with the initial decision made, she remained concerned about how her breasts would look and feel post-surgery. Then she remembered a Facebook post shed seen from a fellow mom a year or so before. Hell yeah, theyre fake! the woman had written. My real ones almost killed me. Though she didnt know her all that well, Spence immediately reached out and asked if they could have lunch. The next day, they swapped stories. Spence is BRCA2 positive, and her friend was positive for BRCA1. She shared her experience with preventive mastectomy and helped Spence get in touch with the doctors she ultimately decided to use. On our second date she showed me her breasts, Spence says with a laugh. Now were super close friends. Now I knew the results didnt have to be scary, she continues. Id seen someone who went through this and the results were beautiful. This was very helpful, she remembers, because the journey was about to get a lot harder. She cried through her first appointment with the plastic surgeon, but he put her in touch with several of his other patients who could talk with her about their reconstructions and what
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She didnt want them for a moment to be worried or afraid. But in her closet, packing Continued from Page S53 to go to the hospital with her husband, Spence melted to expect from the surgery into a puddle. She still hadnt breast friends, Spence decided on her final reconnow calls them. She had a struction options, and it just terrible time deciding what sort of reconstruction to do. seemed all too much. Have the eye of the tiger, her husIf you keep your nipple, you band told her. Your scars have to leave a little tissue will be a badge of courage. with it, and some doctors think this is a risk for BRCA And that got her to the place where she could do it, she patients, she explains. And says. her sisters doctor (they Just hours before her compared information and surgery in June 2012, when treatment options all along the way) thought Spence was the doctor drew on me with a Sharpie, she says, thats too young to even consider when I finally decided to a procedure involving her latissimus muscle to support keep my nipples. Spence had a double mastectomy implants. with immediate reconstrucShe did a lot of crying tion using implants and her and struggling, but it was latissimus muscle, which mostly with strangers, she surgeons pulled forward says. At home, I was very positive. I told the kids I was from its natural position having surgery over dinner. in her back to support the implants. This made her We made it seem small.
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come see her until day two or three, and before they arrived despite the fact that she could barely lift her arms she put on makeup and twisted her hair into its usual bun. I was so determined for them not to see me as anything but tired, she explains. I didnt want to scare them because theres a solid chance my daughter [who is currently 6] will go through this too. Their visit lasted just long enough for them to collect the goodie bags shed prepared for them and see that she was OK. However, once she got home, she couldnt hide. My mom is just the opposite of me, she says with a laugh. If one of her children appeared while her mom was changing her drains, she treated them like little nurses. She had them wash their hands and help, which made them feel empowered. The drains came out after a few weeks, and Spence has had two more (much simpler) procedures to get her new breasts just right. The third surgery was the charm, she reports, and now a year later my results, according to my husband and all the girlfriends Ive forced to look at them, are very beautiful. However, this summer is the first time shes really felt like her breasts are part of her, like she can wear a bathing suit and be comfortable. It was a long road to get used to her body again, and her back was swollen for months. Ive never regretted my decision for a second, but some moments were harder than others, she says. To further reduce her risk of cancer Spence had a hysterectomy in May, and she says she finally feels ready to get back to her life. Im ready to start walking, to start hot yoga, and just get back to normal. Shes reduced her risk of breast cancer from 87 percent to less than 5 percent and says she feels very lucky to have had a choice in her treatment. My aunt didnt have a choice, and thankfully my sister caught it in time, she says. I think my sister got cancer first so I wouldnt die from it, she adds. And shes thanked Hildreth for that. It made [my sister] feel better because she knew shed been the alarm system for me, Spence says. Hildreth is now in remission and has had a double mastectomy and reconstructive surgery as well. Spence is now looking for ways she can be an alarm for others her nieces, her daughter someday, even her Facebook friends. [This experience has] brought our family closer together, she says. It gives you clarity on whats important.
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surgery more complex, and more painful, but ultimately yielded very natural results. She recalls waking up in recovery, shocked that the procedure was over and feeling like an elephant sat on her chest. The plastic surgeon had put just enough fluid in her expander implants to give her a little cleavage, like shed had before. She also had four surgical drains, two in front and two on her back. She was in Atlantas Piedmont Hospital for four days, on a lot of pain medication, and the first night, in particular, was miserable, she recalls. Her husband stayed home to keep things normal for their children, so her mom stayed with her, rubbing her arm all night long and calling the nurse for more medication whenever possible. She didnt have her kids
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A persons overall health should also be a factor in decision making, because women who smoke, are diabetic or have had radiation to their chest for treatment of Hodgkins disease have additional risk factors that may complicate the mastectomy and reconstruction surgeries.
reconstruction using body tissue. And its safe to estimate a week of recovery time for every hour of surgery, Weiss says. At Memorial Sloan-Kettering Hospital, patients can expect a 23-hour, overnight stay after this procedure, and at Johns Hopkins, patients may stay three days after an involved reconstruction. After that they recover at home. These experts say that at least one follow-up surgery (a much simpler procedure) will likely be required to replace the temporary tissue-expander implant with the larger final one, and additional adjustment procedures may be required to get the look and feel the patient desires for her new breasts. Long term, these women will still need annual breast exams to monitor the remaining tissue, and those with silicone implants will need to have them replaced after 10 or 20 years. If surgery is not the right choice, the alternative is vigilant screening for those at increased risk for breast cancer: a breast exam conducted by a physician every six months, a yearly mammogram and perhaps even an annual MRI, Jacobs says. And again, taking Tamoxifen as a preventive measure is an option for women done with with a preventive mastectomy, a great deal childbearing, she notes. Capko adds that ultrasounds may be useof planning begins. The breast cancer surgical team and plastic surgery reconstruc- ful for screening as well, and she suggests that younger women begin mammograms tion team must coordinate on a time, and the surgery is usually scheduled at least a when they are 10 years younger than the youngest cancer diagnosis in their family. couple of months in advance. In addition to the screening benefits, In the meantime, the patient will likely annual testing provides a good opportuhave breast imaging done, and shell meet nity for patient follow-up and assessment, with both surgeons to discuss procedures Capko says. We can evaluate how theyre and make decisions about the type of feeling about surgery. Are you still happy reconstruction shed like, says Capko. with this [course of action]? Has anything Smokers must stop smoking, says Weiss, changed? and some patients may do a little physical Whatever decision a woman makes, therapy to prepare their abdomens if theyll its important that she do so with all be using tissue from that area to reconthe information she needs and after struct their breasts, Jacobs adds. Theyll appropriate counseling, these experts also have additional counseling to make say. I dont think its good to do surgery sure they understand the procedure and based on fear, Capko says. But if you what to expect. do it based on knowledge and informed The surgery itself can range from three consent, it becomes a powerful tool for to four hours if implants will be used for women. reconstruction to six to eight hours with
A lot of patients select themselves, Capko says. For women who are gene positive and have seen other family members go through cancer, its often a relatively easy decision, she says. That person is a lot more proactive. However, she adds, not every woman who is gene positive needs to have a bilateral mastectomy. The only real time you need to do that is if you have cancers in both breasts that are beyond the capability of breast-conservation surgery. So its important to weigh your options carefully and keep things in perspective. Even those at highest risk dont know if or when theyll get breast cancer, and if a cancer does develop, it can be treated when found early with screening tests, Capko explains. Jacobs always talks to her patients about medications before they discuss preventive mastectomy. Tamoxifen can reduce risk by half, and thats a tablet once a day for five years, she notes. For some thats a better option. A persons overall health should also be a factor in decision making, because women who smoke, are diabetic or have What to expect if you do it had radiation to their chest for treatment of When a woman decides to move forward
Hodgkins disease have additional risk factors that may complicate the mastectomy and reconstruction surgeries, these experts note. They also recommend that a woman considering preventive mastectomy meet with a plastic surgeon so she can understand her best options and likely outcome for reconstructive surgery, which are impacted by her anatomy and the shape and size of her body. We spend a lot of time talking about the patients expectations, Capko says. The patient needs to understand the procedure because if we cant fulfill her expectations, she will always be disappointed. A final decision-making factor is timing, these experts note. This is not a decision that should be made urgently. Because of increased genetic screening, many women are learning theyre BRCA mutation-positive quite early in their lives. But you dont need to remove your breasts at 20, Jacobs says. Someone whos at high risk needs to be vigilant 10 years before the age of the earliest diagnosis in her family. If breast cancer runs in a womans family, but her relatives have been diagnosed in their 40s or 50s and shes 25, she might decide to wait, Weiss notes. Some younger women elect to have children before considering bilateral mastectomy, Capko adds. And those who are gene positive may elect to remove their ovaries before their breasts. [Preventive mastectomy] is always an option thats a great way of looking at it, Capko says. Once you find out youre at high risk, you dont have to decide today. You should feel youre ready to make the decision because its right for you at that time.
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The Salem News BREAST CANCER AWARENESS Wednesday, October 16, 2013
ANASTACIAS STORY
day, Connie said, and she ended up having a mastectomy. At that time they didnt use the word cancer, Connie said. My mother lived a wonderful life but she was cut very, very deeply. Soon after the surgery, a customer at the store inquired about Anastacias health and offered an invaluable piece of advice. According to Connie, the customer said Anastacia should keep the surgical area of her chest especially covered and protected because it could still
By Cheryl Lecesse
attract infection. Thats what happened to the customers mother, who had also undergone a mastectomy but died of illness afterward. She stressed that you have to keep warm, Connie said. She really, truly saved my mothers life. Anastacia went on to live until she was 82 years old. She was a survivor and it never came back, said Connie. They havent really solved it [breast cancer] but theyve come a long way.
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Eva Andersson-Dubin, founder of The Dubin Breast Center at The Mount Sinai Medical Center in New York.
STEFAN ANDERSSON/Courtesy
The Dubin family, from left, Jordon, Celina, Maya, Glenn and Eva.
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When did you decide you wanted to become a breast surgeon and did your mothers diagnosis play a factor in that?
Ive always been interested in science and biology. During the last couple years, Ive been shadowing a lot of surgeons and specifically have become interested in breast surgery after spending some time with Dr. Elisa Port, chief breast surgeon at Mount Sinai, who is very inspiring. This, more than my mothers diagnosis, has led me to be interested in breast surgery. My mothers diagnosis probably has strengthened my interest in medicine.
Your mother had breast cancer. Talk about how you feel about your risk increasing?
I know by being a daughter of a breast cancer survivor, Im at an increased risk of breast cancer myself. However, I am lucky that my mother does not carry the mutation called the BRCA gene. As a result of my mothers diagnosis, I am definitely more aware of early screening and will be followed in a center that specializes in breast cancer.
I see myself living in New York City, hopefully having completed medical school at a great institution and working as a surgeon, specializing in breast surgery.
the sounds, and I could see myself taking care of people. When I got older, I knew I needed to go into the field so I could learn more. It was always fascinating to read about your body, and it was interesting being a mix of a detective and a scientist. It was a right fit for me. But she was also drawn to the life of a model. I wanted to see the world and make money, so I figured I would take off one year, but one turned into four, she says. It was very hard to stop. I was having a good time traveling, but an opportunity came up to go back to school and I took it. Today, Andersson-Dubin is a board-certified internist at Mount Sinai Medical Center. After her experiences with breast cancer, she decided that it was time to give back. My husband, Glenn, and I looked into doing something for the hospital, and we suggested creating a breast cancer center, she says. The couple donated $16 million to create The Dubin Breast Center at The Mount Sinai Medical Center. I had no intention to enter into the breast cancer field, she says. But its very unusual to have the experience of being philanthropist, patient and physician. It makes me very invested in the place because it carries our name. The Dubin Breast Center is a multidisciplinary facility that includes oncofertility, nutrition and mental health counseling in addition to massage therapy, acupuncture and other complementary services, all under one roof. Mount Sinai offers 3D mammography and new procedures like seed localization, which allows surgeons to better target and remove breast tumors. Our goal for the Dubin Breast Center is to provide patients with seamless care, she says. From breast cancer screening to diagnosis to treatment
and survivorship, patients receive personalized, comprehensive care in a welcoming, private and reassuring setting. She says that she is obsessed with keeping the place clean. We dont use wall-to-wall rugs, and I almost want to ask patients to take their shoes off, she laughs. But I want it to be clean, and the quality of care inside the center is the most important thing. All of our doctors are handpicked and the best of the best. Im most proud of the personnel we have hired. She meets with every employee to ask them how they are doing and how they can make the center better. I meet with patients too, she says. They have a different experience than I had and I want to hear what their ideas are. To those women who are going through treatment or were just diagnosed, Andersson-Dubin says, Breast cancer today has a very good prognosis. We find breast cancer earlier, we have very high survival rates. Dont panic, and go to someone who specializes in breast cancer. Its a journey that, at the end of the day, will make you a stronger, better person. Andersson-Dubin says it changed her life for the better. All of a sudden, I was faced with the fact that something was affecting my life, and I started appreciating my life, friends and family on a level I wasnt aware of before. Im humble and thankful for every day. Today, Andersson-Dubin is healthy and makes sure to get checked every six months. I get nervous, though, but Im not walking around looking for lumps and bumps. For more information, visit http://www.mountsinai.org/ patient-care/service-areas/ cancer/cancer-services/ dubin-breast-center.
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ust 10 percent of breast cancers are due to genetic factors. The rest? Theyre related, directly or indirectly, to lifestyle, says Dr. Marisa Weiss, president and founder of BreastCancer.org, who is a breast cancer survivor herself. While that may sound like cause for concern, Weiss says its actually empowering: Whether youve never been diagnosed or youve had the disease in the past, theres plenty you can do to reduce your risk. Here are six positive steps to take today:
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You can reduce the likelihood of getting the disease with these methods 1. Get moving
Numerous studies have shown that women who exercise reduce their likelihood of being diagnosed, or re-diagnosed, with breast cancer. Among the evidence, University of North Carolina, Chapel Hill researchers found that two hours of daily physical activity (from working out, as well as activities like household chores), reduced womens odds of breast cancer by a notable 30 percent. New research from the University of Minnesota suggests that exercise helps by allowing the body to break down estrogen, the hormone that plays a major role in the diseases development. Tight on time? Every little bit makes a difference, says Dr. Kathy J. Helzlsouer, director of prevention and research at Mercy Medical Center in Baltimore. I tell all of my patients to look for free moments; for example, I always take the stairs instead of the elevator. It adds up throughout the day. shows that using smoking cessation aids such as counseling, nicotine patches, gum and/or medication more than triples your chances of success. Visit SmokeFree.gov for free resources.
Women who have at least one child in their 20s are less likely to develop breast cancer than those who give birth later; those who breastfeed for two years of their lives, total, are also less likely to have breast cancer for similar reasons. Researchers arent sure why, but it may be related to a reduction in overall estrogen exposure.
2. Go easy on alcohol
Alcohol consumption increases risk of breast cancer and the more women drink, the higher their odds, studies show. Thats not to say you should never have a cocktail again, but keeping your intake to no more than three to five drinks a week is a good idea, both for breast cancer and overall health, says Weiss. (One drink is the equivalent of 11/2 ounces of liquor, 5 ounces of wine or 12 ounces of beer).
When it comes to prevention, One size does not fit all, says Dr. Nancy Klauber-DeMore, a surgical oncologist and professor of surgery at the University of North Carolina School of Medicine. Women should talk to their physicians about their health history, family history and lifestyle to figure out their Fat tissue increases the production of estrogen. individual risk, then Researchers believe that may be why women who tailor their approach are overweight or obese are at a higher risk for accordingly. If you have a breast cancer. Fortunately, losing just 5 percent of first-degree relative whos body weight if you weigh 170, thats 81/2 pounds had breast cancer, or a genetic lowers postmenopausal womens blood levels of risk factor such as the BRCA1 or estrogen and reduces breast cancer risk by 22 perBRCA2 gene, your doctor may cent, according a study from the Fred Hutchinson recommend extra steps, such as Cancer Research Center in Seattle. biannual screenings (including The closer you can get to a body mass index (BMI) of 25 or lower, the better, Helzlsouer says. Go physical exams, mammograms and/or MRIs), or preventive to CDC.gov for a free BMI calculator. medication like Tamoxifen. If youve had breast cancer in the past, perhaps the most important thing you can do is Smoking gets a bad rap because of lung cancer, to stay the course with your but its a major breast cancer risk, too, stresses treatment, Helzlsouer says. Dr. Maurie Markman, national director of mediNo ones better equipped cal oncology at the Cancer Treatment Centers of to help you with that than America. Even secondhand smoke is dangerous, your physician. Markman says. Smoke is a carcinogen that damages tissue and triggers cell abnormality. If you need to kick the habit, dont go cold turkey; research
4. Kick butts
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