Paint Yates

AN EDITION OF THE CHRONICLE-EXPRESS | 2011

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Cancer screening guidelines for women

CONTACT US Phone: 315.536.4422 Fax: 315.536.0682 Editorial ChronicleNews1@rochester.rr.com Advertising ChronicleCandy@rochester.rr.com Online www.Chronicle-Express.com PAINT YATES PINK is created by GateHouse Media, Inc., The Chronicle-Express parent company, and is distributed with various GateHouse papers across the country. Reproduction in whole or in part without prior written permission is strictly prohibited. Opinions expressed in the publication are those of the authors and do not necessarily represent those of the management of the publication. Cover photos: stock.xchng, flickr
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here was an increase in breast cancer diagnoses in the 1990s due to improved screening; in fact, most of this increase was for early stage disease. A decline in breast cancer cases after 2003 was due to the decline in hormone usage for postmenopausal women because of the Womens Health Initiative results reported in 2002. However, breast cancer remains

a major health issue, with more than 200,000 American women diagnosed and 40,000 dying from this disease each year. Risk factors for developing breast cancer include advanced age, genetic factors and estrogen exposure. Overall, mammography is still the most useful tool to

screen for this disease. The U.S. Preventive Services Task Force no longer recommends routine screening mammography for non-high risk women in their 40s (but the American Academy of Family Physicians still recommends mammography starting
See Guidlines on page 3

Breast Cancer Awareness 2011

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GUIDELINES
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column
sult although there is no cancer). Women of Hispanic, Asian and Pacific Island ancestry are more likely to be diagnosed with breast cancer in their 40s than Caucasians. There are other screening tests that may be considered for breast cancer: Digital mammography offers a screening advantage for women younger than 50 and for those with dense breasts. Women at very high risk of breast cancer benefit from screening with MRI in tandem with mammography. This is not true for all women; the American Cancer Society specifically recommends against MRI screening for women with a lifetime risk of breast cancer estimated to be less than 15 percent. CBE is beneficial, even though some studies have noted that mammography detects 90 percent of screening-detected breast cancer whereas CBE only 50 percent. Ultrasound has been shown to be useful to further evaluate suspected breast cancer noted from CBE or mammograms, and is also useful to help guide biopsies. Jeff Hersh, Ph.D., M.D., F.A.A.P., F.A.C.P., F.A.A.E.P., can be reached at DrHersh@juno.com.

at age 40). Note that screening with a Clinical Breast Exam (a thorough breast exam performed by a health care provider) is still recommended. Although the total number of women ages 40 to 50 saved by screening mammography is less than screening the same number of DR. JEFF HERSH women older than 50, this does not mean that earlier mammography does not save lives. In fact, a meta-analysis (a review of many studies combined together) found that screening women ages 39 to 48 decreases the risk of death from breast cancer by 15 percent. Other studies have shown that mammograms for women in their 40s detect tumors at an earlier stage than if only CBE is done. There is a downside to screening mammography; the number of unnecessary biopsies is higher because of occasional false-positive mammograms (suspicious test re-

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breast cancer facts

Facts & gures

Rates are declining, but breast cancer still 2nd-leading cause of cancer death for women
By Danielle Braff | GateHouse News Service

The odds
One in eight women in the United States or 12 percent of women will develop invasive breast cancer at some point in her life. Last year, 207,090 new cases of invasive breast cancer were expected to have been diagnosed in women living in the United States, as well as 54,010 new cases of noninvasive breast cancer, according to Breastcancer.org, a non-profit informational website.

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breast cancer facts Survival rates

The overall five-year relative survival rate from 2001 to 2007 was 89 percent, but this varies according to race, says the National Cancer Institute. The fiveyear relative survival rate for white women was 91 percent, but 77 percent for black women.

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Age matters
From 2004 to 2008, the median age at diagnosis for breast cancer was 61. Just 1.9 percent of people were diagnosed between ages 20 and 34, 10.2 percent between 35 and 44, 22.6 percent between 45 and 54, 24.4 percent between 55 and 64, 19.7 percent between 65 and 74, 15.5 percent between 75 and 84, and 5.6 percent who were 85 and older, according to the National Cancer Institute.

Hormone replacement therapy

In the years since women decreased their use of hormone replacement therapy, the number of breast cancer incidences in the United States dropped, says Breastcancer.org. From 1999 to 2006, breast cancer incidence rates in the U.S. decreased by 2 percent per year. The study examining hormone replacement therapy was published in 2002.

Good news
While breast cancer is still the second-leading cause of cancer death in women exceeded by lung cancer the death rates from breast cancer have been declining since 1990, according to the American Cancer Society. The decreases are believed to be the result of early detection through increased screening procedures, and better treatment methods.

Men and breast cancer

Its rare, but its still something to worry about in the United States. Last year, an estimated 1,970 new cases of breast cancer occurred in men, says Susan G. Komen for the Cure. There were 390 male breast cancer deaths in 2010.

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consumer savvy

Think before you pink

Pink-ribbon products abound, but theyre not all equal
By Wynne Everett | GateHouse News Service

When October rolls around, it seems like pink is everywhere. In recent years, companies that sell everything from NFL players shoes to candy have picked up on the popularity of pinkhued merchandise made especially for Breast Cancer Awareness Month. Buying a cleverly pinked-up item may give you a warm feeling about contributing to a worthy cause, but paying for pink-ribbon products doesnt necessarily mean youre donating to breast cancer research or awareness. The familiar pink ribbon created to promote breast cancer awareness has been around for about 20 years and is so popular with consumers that some clever marketers have created pinkribbon items that sell very well, but dont contribute much, if any, money to charity. Few regulations apply to the marketing of pink items, so its important to do your homework if you want your purchases to benefit your favorite cancer-related charities, said Better Business Bureau spokeswoman Reanna Smith-Hamblin. You need to educate yourself and ask the right questions, she said. Companies that market these items are good businesses and all, but they may not be contributing to charity as you believe. Youve just got to do your research. Here are some tips for choosing the right pink merchandise this month:

Know the rules. The pink ribbon symbol isnt trademarked and can be used on nearly anything. Pink ribbons, pink packages and other marketing gimmicks do not mandate that companies give money from that product to any charity. 2003 Curves International

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Identify the charity that gets the proceeds. Some products vaguely say they donate a portion of their profit to charity. Watch out for nonspecific language on packaging that says money will go to cancer charities or cancer research. Be sure you know which charity is benefiting. Understand how much gets donated. Research what percentage of your purchase or what portion of profits goes to the charity. Conrm your favorite charitys corporate sponsors. Most charities list their corporate sponsors on their websites so you can shop for items you know will benefit a good cause.

Research the charity. The Better Business Bureaus Wise Giving Alliance, as well as the American Institute of Philanthropys Charity Watch, can help you discern legitimate charities from less worthy groups. Responsible charities are well-established; file tax forms that give detailed information about their officers, revenues and expenses; and dont spend an unreasonable portion of their contributions on solicitation or administrative costs. Beware of cold-call solicitations. Along with pink-ribbon merchandise, October often brings these out. Be cautious of charity solicitors who wont answer your questions, or who emphasize an emotional appeal over the facts about the organization for which theyre soliciting. Beware of charities with names that are very similar to, but not the same as, familiar and trusted charities.

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ONLINE SUPPORT
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We Support Breast Cancer Awareness Month

help & healing

Internet abounds with 24/7 outlets for those with cancer

By Dan Rafter | GateHouse News Service hether youre searching for the latest news on emerging treatments, looking for a reference for a local oncologist, or just want advice from someone whos also fighting cancer, youll find a growing network of support among the many breast-cancer forums. A host of online organizations from the well-known such as Y-ME and Susan G. Komen for the Cure to smaller local message boards provide advice, comfort and information to women battling breast cancer. There are so many new ways to use technology to help women get what they want when they need it today, said Pamela Green, public relations spokeswoman for online support and information center BreastCancer.org. That is a positive change. Here is a partial list of online resources that provide support and information for women with breast cancer. If youre fighting cancer, make sure to visit these sites when you need some extra support.

BreastCancer.org: This busy site features message boards, forums, chat rooms and a blog all dedicated to helping women diagnosed with breast cancer find the support and advice they need. One of the more popular features on the site is the Stories of Hope. These stories, as the name suggests, feature women who are living with cancer or who have beaten the disease.

Komen.org: This site, home to Susan G. Komen for the Cure, includes a long list of cancer support groups; a profile section, called Breast Cancer Faces, that highlights the stories of women living with breast cancer; and, of course, information about Race for the Cure, the individual races that each year raise money for breast cancer research.

BreastCancerSupport.org: This popular site includes an online meeting place for women who have survived breast cancer to swap stories and advice. The site also offers photos of breast cancer survivors, a chat room and a long list of online support boards, including those dedicated to women dealing with surgeries and reconstruction and those who are working through grief issues. The site also runs news stories highlighting the most recent treatment news.

Y-ME.org: The online home of the Y-ME National Breast Cancer Organization offers women access to 24/7 support from breast cancer survivors. Women, then, can call a survivor at any time for support, advice or just to act as a sounding board. Theres also an online matching service that connects women with a personal peer counselor with a similar diagnosis. Women can use this online service to order wigs and prostheses.

Breastcancersociety.org: The online home of the Breast Cancer Society lists special events such as breast cancer runs, cruises and fundraising activities. Theres also a link here that allows women diagnosed with breast cancer to share their stories, a forum, chat room and video section.

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family

Breaking the news

How to talk to children about a breast cancer diagnosis
By Kathryn Sucich | GateHouse News Service

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You have cancer are three of the worst words you can hear. And if you have school-age kids, it can be nearly impossible to fathom how youre going to tell them the news. Nancy Borstelmann, director of patient and family support and education at Dana-Farber Cancer Institute in Boston, says, Talking to your kids is a formidable task. Theres not an easy way to tell them, but you do have to tell them to help them deal with how their world will be affected. Here are her tips for telling your children about a cancer dignosis:

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family
TELL THEM SOON, BUT NOT TOO SOON. Youll want to tell your kids about your breast cancer before it affects the flow of your life. Kids are very attuned to their environment, and if you start talking to other family members or disrupt your (and their) schedules, kids will notice. At the same time, you dont want to tell kids right away about your diagnosis. You have to deal with your own feelings first and have a plan in place; otherwise, your fear and uncertainty will rub off on your children. GIVE ENOUGH INFORMATION, BUT NOT TOO MUCH. Once you tell kids about your cancer, theyll likely be most interested in how it will impact their lives. Tell your kids what they need to know right now, such as who will be picking them up from school or making dinner each night. Dont provide too much detail, as it might overwhelm them. Do reassure your kids that you will inform them as you receive new information about your diagnosis. REASSURE YOUR KIDS THAT ITS NOT THEIR FAULT. Many kids, especially younger kids, will feel as if they somehow made the cancer happen. Borstelmann says they may think that because they got mad at you, you got sick. Its important to tell younger children that they did nothing to give you cancer. Also reassure them that cancer is not contagious. Kids of all ages may be concerned about this, even older children. MAKE SURE YOUR KIDS HAVE SOMEONE TO TALK TO. Its important to let your children know that they can come to you with any questions. Still, many kids, especially older ones, may withdraw and not want to talk. Make sure your children know that they can go to a coach, teacher or friend with any concerns. Its important that your children have someone to confide in. You dont want to ignore it if your children just shut down, as that can lead to many other problems for your kids. TRY TO KEEP SOME SEMBLANCE OF A ROUTINE. Its important to acknowledge that your diagnosis will affect your family and change many things, but you also want to create some sense of normalcy for your kids. Try to stick to your kids daily schedules to help them feel more secure. Also let your kids provide input on their schedules, such as deciding who will drive them to soccer or take care of them while youre in treatment.

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ST OC

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Helping out
Ways to care for someone undergoing cancer treatment
By Erika Enigk |
GateHouse News Service

Proud to Support Breast Cancer Awareness, Early Detection & Research

hen a friend or family member is diagnosed with breast cancer, her whole life changes in an instant. Emotional, physical and practical support from loved ones is integral to her treatment and recovery. Cathie Kakec, a breast cancer survivor and breast-imaging patient navigator at Adventist LaGrange Memorial Hospital in LaGrange, Ill., offered advice for helping care for a breast cancer patient.

take care of yourself, Kakec said. To suddenly be handling an entire household while a spouse or parent is in treatment on top of the stress of supporting the patient can be difficult. Its normal to feel resentful of having to spend time and energy taking care of a loved one, she said. And everyone needs time away. In fact, not taking time away may jeopardize your own health and well-being, making it even more difficult to care for the patient, she said.

After treatment
Helping out can be trickier, Kakec said. Friends who are healthy and feeling good physically will still need emotional support and possibly financial support. Some patients may not be able to make a seamless transition back to their pre-diagnosis lives. You grieve what youve lost, and you grieve for what youd be losing in the future, she said. Its important to remember that breast cancer patients are the same people they were before and should be treated as such, Kakec said. Let them be the decision-makers as to what assistance theyre willing to accept, and always be there to listen if they need to talk.

When a friend is receiving treatment

Her family could probably use some help. When Kakec had surgery and couldnt lift her arms for an extended period of time, her sister-in-law would help by braiding her daughters hair for the high school bands flag squad. Once a week, a hospital volunteer would bring dinner for Kakec to take home to her family. Theres little things you can do, she said. The biggest complaint of people receiving treatment is fatigue, Kakec said. So something that seems small, like walking the dog or dropping off the kids at school, could make a world of difference. Many people may be too proud to make a request, even if you ask what they need, Kakec said. And simply taking over may make her feel dependent and devalued. The best thing to do is offer something specific (like a homemade meal) and let her accept or decline the offer. It may also help to ask the patients spouse or children (if they are old enough) what the family could use help with. It also helps to get the patient out of the house for a while, she said. Take her shopping or to a movie. And above all, be available to listen.

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The family will still need help with everyday things like meal preparation and errands, but to help the patient, listening becomes even more important, Kakec said. The patient may want to talk about things like planning her funeral or dealing with end-of-life legal issues. However awkward it might feel to discuss these things, its important to help the patient take care of them, she said. Hospice can point families and patients toward many services that help broach difficult topics. A pastor or therapist may also be a valuable resource, she said.

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When its family

Its important to remember to

Komen

Susan G. Komen for the Cure

A look at the leader in breast cancer research and education fundraising
By Erinn Hutkin | GateHouse News Service

t started with $200, a shoebox full of names and a promise between sisters. From those sparse beginnings, Susan G. Komen for the Cures mission to eliminate breast cancer began. The organization was founded in Dallas by Nancy Brinker, whose sister, Susan Goodman Komen, died of breast cancer in 1980 at age 36. It was Brinkers way of keeping a promise to her sister to end the disease. Today, Komen is the worldwide

leader in the fight. There are more than 120 chapters or affiliates across the globe. Since its launch, more than $1 billion has been spent on education, screenings, treatment and research, and since 1990, the breast cancer mortality rate has dropped 31 percent. Now, 75 percent of funds stay with local affiliates, while the rest goes toward research. Each affiliate assesses the community to determine its needs which can include lack of educational mate-

rials to lack of health insurance. In cities such as Chicago, a

grant-funded task force found

See Komen on page 14

PAINT YATES PINK 2011

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KOMEN
CONTINUED FROM PAGE 13

Other groups that help

people to get mammograms and be proactive about their health. She said access to medical care will be an ongoing issue, as will research to cure cancers most lethal forms. There will also be a global effort to spread awareness. Theres a long road ahead of us, Ziener said. But the organization has truly moved the needle. Susan G. Komen for the Cure is not alone in the fight against breast cancer. Here are a few other groups working with the organization: Living Beyond Breast Cancer: Empowers women to live as long as possible with good quality of life. www.lbbc.org Young Survival Coalition: A resource for young women facing breast cancer. youngsurvival.org Cancer Treatment Centers of America: A leader in cancer care. cancercenter.com

Hispanics, African-Americans and low-income residents are the least-served, which the affiliates executive director, Michael Ziener, said is a nationwide need. Moving forward, Diana Rowden, Komens survivorship and outcomes vice president, said emphasis will shift from cancer awareness to action prompting

Participants in a Susan G. Komen Race for the Cure event in 2008. RENEE
V/FLICKR

Susan G. Komen for the Cure timeline

1982: The organization is launched with $200 and a shoebox full of names to call for help. Breast cancer was not widely discussed, and treatment was scarce. Komens first fundraiser is held and its first grant for $30,000 goes to M.D. Anderson and Baylor University Medical Center in Dallas.

1983: The inaugural Komen Race for the Cure happens in Dallas with 800 participants. 1986: The first Komen race outside Dallas is held in Peoria, Ill., Susan G. Komens birthplace. 1989: The organization adds its first chapter outside Dallas; Brinker is the first breast cancer advocate named by President Ronald Reagans cancer panel. 1990: Komen Affiliates give communities the first grants for education, treatment and screening. 1991: Pink ribbons debut at the New York City Race for the Cure. The $1 million mark in funding research and project grants in one year is reached. 1992: Komen holds its 10th-anniversary gala; the group plays a role in getting an act passed that creates a national standard for breast cancer screening. 1995: Race for the Cure is held in 57 cities. There are 27 Komen chapters nationwide, renamed affiliates. 1998: The U.S. Postal Service issues a breast cancer stamp to collect funding for awareness and research; the first Race for the Cure is held outside the U.S. in Costa Rica. 14
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See Komen on page 15

KOMEN
CONTINUED FROM PAGE 14

1999: Komen starts the African-American National Advisory Council to help reduce the mortality rate, the highest of any ethnic group; the first international Komen Affiliates are started. 2001: Komen representatives take part in a White House round table on breast cancer; Worth Magazine names Komen one of the nations top 100 charities.

2006: More than 40 Komen affiliates take part in Champions for the Cure, a program aimed at educating the president and lawmakers about breast cancer. 2007: The group reaches the milestone of investing $1 billion in the breast cancer fight and vows to invest $1 billion more in the next 10 years. 2008: Komen celebrates awarding $100 million in research grants. 2011: The first Komen Bahamas Race for the Cure is held as part of a mission in the Bahamas.

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