It is important for a man to report a palpable mass in his breast and sometimes and ultrasound guided needle biopsy is done if there is enough evidence to warrant doing so. Mammography is very good at detecting male breast cancer but it is important that clinically it be correlated as well. Usually mammography is done on both sides just so there is a baseline or understanding of what the breast/chest area demonstrates. As always we should check lymph nodes. There may be false positives when we are looking at some of the radiological tests which could come from fat, or abscesses, or gynecomastia which is rather common and actually is just enlargement of the breast tissue. Now having said all that, I will bring to the forefront the issue that it is not easy to get a man to the doctor even if he has a significant cut or broken arm. Then to add to that we are talking a disease that is more known in the female arena and that adds to the delay in follow up by the patient to get to the doctor. I encourage all to do a monthly self breast exam and keep your body running in tune and properly as much or more so than you do your car. Make it a great day! S
Male breast cancer is very similar to female breast cancer when we look at prognosis, treatment, and family history although it is rare. Risk factors are again similar as we look at the BRCA mutation and hormone related issues, obesity and radiation exposure just to name a few. Male cancer is normally invasive ductal or DCIS because males lack lobular units. Most of the male breast cancers are estrogen and progesterone positive like in female breast cancers. There are approximately 2000 men a year diagnosed with breast cancer.
It is important for a man to report a palpable mass in his breast and sometimes and ultrasound guided needle biopsy is done if there is enough evidence to warrant doing so. Mammography is very good at detecting male breast cancer but it is important that clinically it be correlated as well. Usually mammography is done on both sides just so there is a baseline or understanding of what the breast/chest area demonstrates. As always we should check lymph nodes. There may be false positives when we are looking at some of the radiological tests which could come from fat, or abscesses, or gynecomastia which is rather common and actually is just enlargement of the breast tissue. Now having said all that, I will bring to the forefront the issue that it is not easy to get a man to the doctor even if he has a significant cut or broken arm. Then to add to that we are talking a disease that is more known in the female arena and that adds to the delay in follow up by the patient to get to the doctor. I encourage all to do a monthly self breast exam and keep your body running in tune and properly as much or more so than you do your car. Make it a great day! S
0 Comments
Cancer is not something you normally can see from the outside unless you see the person has no hair due to treatment or looks extremely tired and has lost a lot of weight and you still wonder what the circumstances are. There are mental, emotional, and physicals scars though that we may not be able to see. When a women looses part of her whole identity as in the case of a mastectomy, there is not only a physical part of the body missing but it may also take part of her womanhood. I nursed my babies and so I felt a loss with the process of the lumpectomy to remove the cancer from my body even though my children were of teenage years when I found I had breast cancer. My clothes no longer fit right and I was so aware that I just felt off center. The scars that remained long after the actual treatment: included the fear of recurrence, the acceptance of an altered body, the loss of being healthy because now and forever, I would be known as someone who had cancer, and heaven only knows the effect of chemo brain, financial considerations after the fact and considering what may or may not lie ahead in the future and how to remain positive and proactive. To realize that I was just as vulnerable as the next person to get cancer was an eye opener. It was never "why me" it was more of the idea of "Why not me?"
Many people carry their scars so no one can see and move through life with choosing to hide those scares so as to avoid the constant reminder of where they have been. Others decide to share their scars in hopes that they can be a beacon for others. I am alive, there are scars that remain but I move forward each day and work towards the mantra ,"Make it a great day". Yes, my body is not the same, nor is my mind. I hate when I struggle for a word and wonder if it is chemo brain or alzheimers or just old age, I have experienced menopause because of surgery and also chemically due to medications, I deal with the fear of recurrence when it hits me in the face which includes when it is time to test again or when I see someone that has had a recurrence themselves. I don't feel survivor's guilt but I do feel great empathy for those that are back on the treadmill of cancer. I try to chose a healthier lifestyle although it does not keep me from having a glass of wine. In all honesty, I could count on one hand the amount of drinks I would have in a year, now I have decided that if I want a glass, I have one. Now that may sound like a risk but it is not the same as driving without a seatbelt. I have learned to enjoy life more and treasure the moments and look for opportunities to appreciate what I have been blessed with in my life. There is much to be gained by having a positive outlook and each day starting anew. Phone calls, hugs, a card, text, email...staying in touch and reaching out to others- Makes it a great day! S I am an avid reader and as such, I am gleaning many things throughout the day and evening. Sometimes I may have as many as five books going at once and although I used to be much better at keeping the stories straight, I can usually get back on track in a page or two. Unfortunately, I don't always remember the name of the book or author but the essence of the story remains. A recent article stirred me to tears and I must share the special attributes of this story. A single mother in her forties was diagnosed with a rapid growing type of cancer and realized that she would not be able to raise her eight year old son. There were no family members capable of taking over the task either and so this special mom was struggling to find an answer. She had been in and out of the hospital numerous times and had met a "special nurse" that had immediately made her feel a sense of peace and comfort. She was sure her prayers were answered but she did ask this nurse if she would raise her son after she passed. The nurse had older children and a 10 year old son as well and had recently been approved to be a foster parent. She went home and discussed the situation with her husband and family and shortly thereafter the Mom and her son moved in with this family and even went on vacation together. They were given the opportunity to make memories as a blended family and were there to support this mom and son. Now, this is a true story and it makes me so happy to know and hear about the good things that are happening in a world were everything is negative.
I overheard yet another patient today talking to a patient beside her that she didn't know and this patient was very negative and down. She listened and then talked in a most positive, supportive way and the patient with the negativism walked away thanking for listening. What does all this mean and how are the stories connected? The answer is compassion, empathy, and love and hoping that as I continue to read that I find more good than bad each day and that we renew each other as we all move forward with whatever and hour lives are planned I am an early bird riser and am most productive in the morning. It is amazing how much I can get completed in a morning not to mention the time before everyone is here at work and I am able to focus without interruptions. I truly appreciate when co-workers stop for a quick update on whatever is happening in their lives but getting back on task gets harder and harder. I find that the age I am at now, I have crossed the continental divide. I am no longer among the young pack and quite honestly there are just a few of us at this stage of our careers. Much has changed, some good and some bad. I am considered an old nurse now and there are days that I certainly feel that. To think that I started back as an aide when I was in high school and now some 40+ years later, I am still here. Nursing has been challenging, rewarding, frustrating, exhausting, and I wouldn't have wanted it any other way. When I was growing up there was a series of Cherry Ames books ( she was a nurse) and with each book, a different type of nursing. I have had so many opportunities and different types of nursing that I could probably write my own series.
As new nurses come out, I see a difference in training and understanding and without preaching we have lost some of the best parts of nursing despite all the advances technologically that we have. Nursing is about be by the patient, assessing, talking, observing, listening and more. It is not about data entry and computers and machines. Granted we need all the new technology but we need the bedside nurse as well. Medicine is changing and as such, so will I have to in order to stay current. Patients are still patients though and we must remember that. Basics in nursing as well as in life are the mainstay. We can't lose sight of what is important. I still sit and listen to patients and I will always be vested in each and everyone that comes my way. My job is to help you through what is happening now. No matter what age, what is happening in my life, or time of day, I must be present for the patient. Unlike the caregiver that goes home with the patient to follow through until they return for further treatment, my day closes at the end of my working day. I don't just shut that book when I leave though as each patient is important and I have often woken in the middle of the night to think of something that could possibly help the patient I am caring for. To all the new nurses coming up through the ranks, be present for your patients,don't let the technological tools take over for you to the point you have given up your nursing abilities and insights and or course, care and take pride in a profession that has great valor and worth. To the patient, know that I care and I am here for you and your family. Illness is the great leveler! Your looks, your talents, your education, your money, does not qualify you or disqualify you but if and when something might happen, remember that there are those An article that I found today relates that Israeli life-sciences company Evenus Diagnostix has developed a blood test for early detection of breast cancer. It is in several European nations but is undergoing clinical trials by the US Food and Drug Administration. The information is that there is a definite connection between breast cancer and the immune system. Interestingly the proposal is that the immune system of people with cancer is not functioning properly.
There in lies the question and possibly the answer. Our body does recognize cancer as a foreign invader and it kicks our immune system into high gear to kill it and that is what the antibodies work to do. This new test states that it is extremely accurate in correctly diagnosing healthy women and those with breast cancer. The test at this time is approximately $200 for the tool itself but does not factor in any other costs. This is something to look for in the future and with the FDA approval, hopefully it will be a test that will be useful in the medical field. Disclaimer: This website is for informational purposes only and is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of any medical institution. It is yet another great day! S According to a new study as reported in AACR journal Cancer Epidemiology, Biomarkers & Prevention, that past nine years after diagnosis with cancer, these survivors remain smokers with a large portion of them being daily smokers. Now to me, that was quite revealing although we all know that smoking is addictive and just because you have cancer doesn't mean you will stop even if the cancer is directly tied to smoking. That is not to say they don't want to quit and many of them state they are planning to quit. Smoking was found to be more prevalent in younger survivors with less education and income and who drank more alcohol but with that the intention of quitting was lower in married, and older survivors. Obviously outcomes improve when you reduce comorbidities, but with some, the diagnosis may also open the door to the fatalism that may actually influence the desire and motivation to quit. Interventional techniques to each patients unique needs should be emphasized. Follow up is important for years to come and counseling and interventions and medications to help the patient quit may be a consideration.
I know we are all aware of a friend or relative that is a diabetic and when feeling better, sneaks that larger than life piece of cake or candy and feels that just won't hurt this time, how do you judge anyone that is dealing with an addiction? It is without recrimination but with support and consideration to help each individual with their own survival. Disclaimer: This website is for informational purposes only and is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of any medical institution. How many of you have heard that bra's can increase your risk for breast cancer? That is something that I have heard for years so I went on a fishing trip to find the answer. For myself, I had been told after breast cancer that I should not wear and underwire but that was more because of irritation after treatment than anything else and since it wasn't something I had ever used before, I wasn't about to start it after I completed treatment. The interesting part of this today is the fact I did find a recent study funded by the U.S. National Cancer Institute that actually looked at the risk of breast cancer related to bras. This included a large group of women with two of the most common types of breast cancer and compared it to women that didn't have breast cancer. Many variables were included but suffice to say, Bras are not culpable in relationship to getting breast cancer and that it is safe to wear a bra. As always, I say consult your PCP or Oncologist or whoever is following you with your health concerns and in the interi
Patients often come in after having chemo and the weekend off and will tell me that they are experiencing side effects that may include diarrhea and more. Each patient receives chemo teaching and are repeatedly told that we do have 24 hour coverage and that they should call with any issues. By the time they come in on Monday, they are dehydrated and feeling worse each day. I understand that you don't want to inconvenience the doctor and that you don't want to be thought of as a complaining patient but more importantly, we need you to help us do our job more effectively and helping to deal with your side effects is part of that job. We need your input in order to better treat you and it may be using different drugs, a different combination of drugs, or even changing the timing or dosing of the drugs you are to be taking to treat your specific type of cancer. It is important that you tell us about you symptoms as you feel them. I often say, that you can't catch a car that is going downhill if you are behind it and that is often the example that clears up that we need you tell us your concerns and symptoms as they happen, not three days later. We are better able to handle them at that time and it helps you from experiencing things that may not be necessary if we know of it and can treat it then. Your caregiver may notice you are more fatigued and even other symptoms but the bottom line, is you are your own best expert. Please help us help you by providing accurate and timely information.
As a child I can remember when you heard red lipstick caused cancer and there were many such things along the way. One controversy these days is soy and for estrogen positive breast cancer patients that is something to use in moderation if at all. Then comes the red meat controversy and there are some studies related to the link of red meat and other dietary proteins that may be associated with a risk for breast cancer. There are various protein sources though and they do not all seem to pose the same risk. A study that I have long participated in is the Nurses' Health Study and some of what has been determined is that there is an association between breast cancer and red meat in premenopausal women and with those that have positive hormone receptors. We have since looked at the introduction of other meats beside beef and reducing the amounts and how often as well as substituting fish, legumes, nuts, and poultry. Poultry is more often served in my house than beef at this point not just because the possible health implications but also the cost. I am learning to eat fish and some meatless dishes as well. The guidelines as to what proportions should be on your plate has changed as well. No longer are the vast majority of us out there plowing fields and working in the same intensity. Many days I am at my desk, popping up and down all day. Of course it is always necessary to look at other risk factors as well. I was giving a tour to a group of high school kids and had my granddaughter with me. I talked about the use of tobacco products including "Chew" and the relationship to cancer. My five year old granddaughter rushed home and told her mom she would never chew gum again. Now of course, that is not what I meant but if we could all modify our behaviors so that we can have better life outcomes, it would be worth it. We continue to look at height, weight, race, age at first pregnancy, menopausal status, oral contraceptives and smoking and that may just be parts of the puzzle. Education and awareness hopefully will get us to a better outcome and life changes may be necessary to do so. So what flavor of chicken am I having tonight? I think I will do brushetta chicken and a salad with spinach. Making it a better day!
S What does that word mean to you? It really doesn't matter if you are the patient or the caregiver, advocacy should be part of your vocabulary as well as your healthcare team. It can be where a healthcare professional provides support to help the patient make a decision/decisions related to some aspect of their health care. It can also mean a family member who works on behalf of the patient and in the best interest of the patient. Advocacy is an active process: it can involve, talking, writing or even interceding on behalf of the patient to assure the best possible care of that individual.
Often times, the patient can and needs to only have one job and that is to be the patient. It is always better to have a different set of eyes and ears that is involved with your care and can provide you with the support you need and reinforcement of the decisions that are made. As a former breast cancer patient, I can recall walking out of one doctor's office at the time of my diagnosis and my husband asking me what it all meant. I said after I heard the word cancer I heard nothing else and at this point in time, I am a patient and no longer a nurse. I can't imagine what those that don't have a medical background hear or understand as you definitely information overload very quickly. I often advised the person accompanying the patient to take notes so that when they get home they can review it and formulate questions for the next visit. That support person is better capable of processing the information at that time and asking questions. I have also seen and heard the nurse be the advocate for the patient in asking for something that may be needed by the patient and then it is discussed with those involved. My friend( a nurse ) was with me when I had my surgery and she more than advocated for me just by her assessment and relaying information to the staff. She helped in so many ways not only physically but mentally, emotionally and so much more. People often say, I don't know what to do. My response is become an Advocate: support and care for that person and step up to the plate as needed. Don't we all need an advocate in our |
AuthorMy name is Sue Kilburn and I am a clinical nurse breast cancer educator at the Yolanda G. Barco Oncology Institute in Meadville, Pennsylvania. Archives
March 2015
Categories |