Well, I warned everyone that the next few weeks would be challenging and it has been so and more. I have not been regular in my blogs as I have not had a regular office to work from and in addition to that I have had computer issues which has landed me back in IT numerous times and I carry two computers with me and one at home and try to access one at work.  This also brings us to breast cancer awareness month and with  construction and the already difficult circumstances, I have been running in circles literally and so now I will share my last excuse and it entails a floor safe, a two year golden doodle and two miss carpet patches and one nose dive from, yup, me.  I am surviving with some limitations. I have never liked a cane but having had total knees I am versed in its use.  I am now using a cane as I bunged up the left knee so that is purple from the knee down and then to add to it I bounced my head off the dresser or bed going down and hit my head on the right side and having said that I tripped getting up and broke my toe on my right foot next to the big toe.  Now that is what I call challenges.  I have debated what to do next, find a bunker and hide for a bit till the storm blows over but to be honest but that isn't helping my patients or myself so I am back in the saddle and I will be getting some info out to you soon on dose dense chemotherapy.  I was in the midst of doing it when all this happened so, I will fulfill my promise by the end of this week I promise.  I am participating the making strides walk although I think a 4 wheeler would be nice at this point. At any rate, time to make it a great day!  Yes, I know it sounds ridiculous but I promise it all happened, and even I can laugh a little at it at this time. 
:}  Make it great!S

Mutations of BRCA1 may increase the risk of developing fallopian tube and peritoneal cancer.  Men with BRCA 2 mutations are also at increased risk of breast cancer. Men with BRCA 1&2  also have a higher risk of prostate cancer. Men and women with BRCA 1&2 my also be at increased risk of pancreatic cancer.  About 12  percent of women in general population will develop breast cancer but it also states that 55-65 percent with the BRCA 1 and 45 percent of BRCA  2 will develop breast cancer by age 70.  About 1.4 percent of women in general population will develop ovarian cancer sometime in their lifetime but according to recent estimates 39 percent with BRCA 1 mutation and 11-17 percent of women who have the BRCA2 mutation will develop ovarian cancer by age 70.  BRCA 1 &2 definitely increases your risk for breast and ovarian cancer.  This test thus helps us to be ever vigilant and observant in following these people with these mutations.  Eduction and early intervention can  and should be discussed  with a healthcare professional the most positive benefit to genetic testing.  It helps to put you back in the drivers seat.
Mak

  The ARMY of WOMEN- a program of the Dr. Susan Love Research Foundation is doing a research study on women with early-stage breast  cancer on hormonal therapy and experiencing joint pain.  This study is looking for women throughout the United States who are taking a hormonal therapy-Arminidex (anastrozole), Femara(letrozole), or Aromasin (exemstane).  for a research study evaluating whether acupuncture can help reduce joint pain and stiffness.

The purpose of this study is to test whether 12-weeks of acupuncture can help reduce joint pain or stiffness caused by hormonal therapy for breast cancer.  The researchers need to enroll 228 women in this study.

What's involved  is to contact the4 participating site closest to you.  They then will request medical history and physical aned complett4e a questionaire on joint pain and stiffness and blood work to check your menopausal status if necessary..  Please pass this information on t o anyone you know that might be willing to participate.

Army of Women< studies@

ONCOLOGY TIMES- Heather Lindsey

I had often heard as a nurse that prognosis was worse for pregnant women that had breast cancer.  The exiting news from an international study, showed survival rates are the same when both groups receive the same treatment.  It also shows that pregnant women with breast cancer should be treated according to standard practice.  It also talks about  the fact that chemo exposure during the second and third trimester did not congenital malformations.  It also mentioned that babies are often born early in women with breast cancer because their physician asked them to so that they could proceed with the next form of therapy..  This study did not look at post partum  patients .  All of this is very interesting as we are all aware that during pregnancy your hormones are in super drive but it doesn't prove that those levels produce an adverse outcome on the breast cancer.  It also proved that chemo starting at least in the second trimester seemed to be safe and maybe even better than waiting until the pregnancy was done.  The most important outcome from this study is that cancer symptoms sometimes mimic pregnancy symptoms and therefore should not be ignored because the patient is pregnant.  Finally I would like to restate that the final information that I found interesting is that pregnancy after treatment of breast cancer because of concerns for recurrence and death, is not supported even for the ER positive disease.  Ongoing research is imperative to follow up on children born to women who where treated for breast cancer during the pregnancy.  It is also important that we continue to get information on drugs that cross the placenta and the outcomes.

This information was very interesting and thought provoking, we continue to learn and grow and understand more and more and the day will come that we will look back at what breast cancer was as it will no longer be a threat in our lives, I

I have to bring a point to all of you facing your diagnosis that I am sure you already know but you need to hear it from me.  I want you to see me, I am alive 8 years after diagnosis.  I am proof that life goes on and that I am a survivor like so many women and men out there that have had or are going through breast cancer.  There is hope and one day you will look back and even be amazed how far you have come.  I don't dwell on what if's.  Recurrence is not part of my vocabulary and if I had to have cancer, breast is easily cured if caught early.  I am thankful for my life and I never once said why me.  AM I stronger than you, NO!  I made a conscience decision  to be positive, that doesn't mean I was 100% every day but it does mean I would have my cry and I would get back on the horse as they say and move forward.  Is it easy to do, no but positive self talk of what you have to do and if you find it difficult make little signs to put up to remind you or make a list to repeat each day.
 
It hasn't always been easy and I have had my scares but I am determined to do everything proactive I can by have my check ups and follow up tests done.  I strive to laugh and that is every day.   Get out and exercise or do something for someone else in need.  Look for inspiring stories, books and information.  I am living proof that life does go on and your life will get back to an even keel.  I don't let cancer ruin my day or my life and I am thankful everyday.  So I am reaching out to those of you that are struggling out there and I do hear you but I am going to be the mean mom and tell you  that you can do this, there is no other choice and that I love you all. I am a winner even if it is only in my mind which hopefully my light willl help give you some light and you can then reach out to another and we will get through this.  There will be friends and well intentioned  people that will say and do the wrong thing as they just don't know what to say and how to handle your current status.  This is when you change the conversation, laugh and move on in the conversation, or stop and say I don't want to discuss that right now.  REMEMBER, make it a great day.S

According to a study in  CANCER, nearly 34/4 of deaths from breast cancer occur in women who have not been screened.  Medical records of over 7000 women who were diagnosed with potentially curable (stages I-III) invasive breast cancer for a set period of time and followed.  There were over 600 deaths of which almost 3/4 of the deaths occurred in unscreened  women ,And yet the guidelines continue to speak to having mammograms starting at 50.  In this  study the women constituted  half of that group and  were younger than fifty.  We remain aware of the fact that younger women normally have more aggressive  disease.
(Amy Orciari Herman)

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According to a recent article I read in FRONTLINE,  Take Action. Save lives.   A young lady was diagnosed with late-stage breast cancer in 2012 but she should have been diagnosed earlier because she had dense breast tissue which masked her breast cancer on mammograms.  She was not aware of this.

The PA Breast Cancer Coalition worked with the PA Senate to pass legislation that can increase early detection of breast cancer in thousands of women like her.  Senate Bill 358 requires radiologists to notify women about their breast density.  Women with dense breasts have an increased risk of being diagnosed with breast cancer at a later stage.  This is the time that we need to make sure this legislation passes the PA House of Representatives.  This is important for all of us as we can make a difference.

I have been aware of these issues and I fully want to see this bill passed to help women like this gal in early detection of breast cancer, those with dense breast tissue.  Look to your representatives and stand up with a voice. 

(ASCO annual meeting 2013- Mark Fuerst

Treatment for estrogen positive women with breast cancer has been adjuvant treatment of Tamoxifen for 10 years.  According to a recent study, there is definitely a benefit of this adjuvant therapy and even recommendations of continuing the Tamoxofen for an extra five years.  It is found that the benefits of extending the Tamoxifen  far outweighs the risks of the extended use.

There are ongoing clinical trials comparing the 5 year and 10 year use of aromatase inhibitors.  Stage really matters when looking at this data and outcome as well as looking at the risks, symptoms, and quality of life.  Future research to help improve the understanding of this information and although we have been treating, we need a larger group in order to see if the efficacy of the 10 years may help those remaining questions as to the longer use of the drug.

Just a little food for thought. Great

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  I feel so blessed in my life.  Family and friends gathered with us on Saturday and we laughed and ate and had a wonderful time.  My kids are all far away but my sister and brother and families were there with some missing but a great time was had by all.  I often have to stop and remember to be thankful what I do have.  I can sit and be sad and disappointed that my kids weren't there but that doesn't change a thing.  I need to be thankful for all the good things I do have in my life.  I have a  place to sleep and a place to eat and I have a wonderful husband that has loved me through the good and the bad and I am eight years from my cancer diagnosis.
  Each check up has me melting just a bit and wondering if I will continue to be cancer free but I do kick myself and say, live each moment of every day.  There is so much sadness and strife and I look at a country that I just don't recognize anymore but I do know there are good people out there and we have to keep prayerful and hopeful.  Yes, I did say the P word and I am not ashamed of it nor will I apologize for.  I have often gotten lost along the way and my diligence to prayer has sometimes faltered but I do now and always will believe that is my lifeline.  No, I don't always get an answer nor and do I get the answer I want sometimes but it is my faith that I trust I am in God's hands. 
  Pray for our country, for people that are hungry, sad, facing awful circumstances and all the things out there that make life so difficult but also remember to be thankful for the blessings.  I had a patient one day that opened my eyes completely by saying they were thankful for cancer. I can't say that I got that far but after listening to how it changed their lives and those around them, I did understand.  It gives you pause to think about..
  I talked to my grandson's tonight from Texas and was informed that it was Labor Day and that I should take the day off.  It made me chuckle because as adults do we ever take the day off, truly?
  I hope you had blessings today and everyday and you find the good in each day.  Make your faith shine on your face and make it a great day!
  Back to "real work" tomorrow and I will get some breast