Posts Tagged ‘Breast cancer’


The latest ruling, delivered on 29 March, is the result of a lawsuit brought in May 2009 against Myriad Genetics, based in Salt Lake City, Utah, and the University of Utah Research Foundation, which hold the patents on the BRCA1 and BRCA2 genes. Mutations on BRCA1 and BRCA2 are responsible for most hereditary breast and ovarian cancers. A woman who tests positive on Myriad’s BRCA test has on average an 82% risk of developing breast cancer in her lifetime and a 44% risk of developing ovarian cancer, according to the company.

The patents, which Myriad has actively enforced, grant the company the exclusive right to perform diagnostic tests on the two genes. The company charges over $3,000 for its BRACAnalysis test. In 2009, Myriad’s revenues from molecular diagnostics grew by 47% to $326.5 million. BRACAnalysis accounts for the lion’s share of those revenues.

The plaintiffs in the case included individual physicians and patients as well as the Association for Molecular Pathology and the American College of Medical Genetics; they were represented by the American Civil Liberties Union (ACLU) and the New York–based Public Patent Foundation. The American Society of Human Genetics and the American Medical Association also filed briefs in support of the plaintiffs’ challenge to the patents.

The plaintiffs called the patents illegal on the basis that they restrict both scientific research and patients’ access to medical care and that patents on human genes violate patent law because genes are “products of nature”.

Complete article http://www.nature.com/news/2010/100330/full/news.2010.160.html

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More about Carolyn Scott Kortge, author of  The Spirited Walker: Fitness Walking for Clarity, Balance, and Spiritual Connection

Recent post – Spirited Walking and Pheasants


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hollissiglerHollis Sigler was a visual artist who created a body of work called, Breast Cancer Journal: Walking with the ghosts of my grandmothers. In 1985, she was diagnosed with breast cancer and had a mastectomy, chemotherapy, and radiation treatment. At that time, her disease was a much more private concern and she got on with her life, “hoping that she would be among those who had experienced a sobering confrontation with cancer, one that for the most part was resolved.”

In 1992, the cancer was found in her bones, and “she got angry, and then she got busy. Her frustrations with the confusing and meager flow of sometimes contradictory clinical information, with the lack of outreach resources, with the sense of being isolated with a potentially terminal disease while simultaneously certain that everywhere there were thousands, no millions, of women in precisely her position,” led to her activism and to the journal.

She began publicly acknowledging her cancer by painting to express not just her own experience, but her family history, and as political consciousness raising. Both her mother and grandmother had breast cancer.  Her paintings express the challenge of the disease, “all its moments of despair, revelation poignancy, sorrow, exhilaration, agony, hope, dejection, frustration, and tenderness,” James Yood wrote in one of the introductions. The other introduction was written by Susan M. Love, M.D. 

Sigler came of intellectual and artistic age in the 1970s and she understood those aspects of feminism that led to publications like Our Bodies, Ourselves. “She knew that women, one by one, often beginning in isolation, had created new networks of communication to provide exchanges of information that would directly address critical issues in women’s lives, that would combat those structures, intended or unintended, that had hitherto frustrated women’s efforts to inform themselves more fully.”

Sigler also had experience with art activism through her role in the Artemisia Gallery, a feminist cooperative in Chicago the 1970s.

Sigler describes the creative process throughout the series, and how it evolved as she gained some emotional distance. The first works directly related her feelings and experiences with the diagnosis, and later became more reflective. One group of drawings was done almost immediately after readings of Tibetan Buddhists, specifically The Tibetan Book of Living and Dying. Sigler said that that book, along with The Cancer Journals of Audre Lorde, gave her perspective about her attitude toward permanence.

Sigler was featured in “Paint Me a Future,” a documentary film about art therapy produced by Dr. David Kaminisky, Palm Springs, CA.  Her breast cancer journal was published by Hudson Hills in 1999.

Sigler was born in 1948 in Gary, Indiana and died March 29, 2001, in Prairie View, Illinois.  She received the distinguished artist award for lifetime achievement from the College Art Association just one month before she died.

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Living Beyond Breast Cancer has a new Guide to Understanding Treatment Decisions that will help newly diagnosed breast cancer patients interpret their test results and create an individualized plan for care. The brochure explores understanding the pathology report and the results of genomic tests, paying for tests, working with treatment teams and making decisions about surgery, chemotherapy, radiation and other adjuvant treatments.

Visit their web site to download or order a free copy.
PDF copy of the report

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Living Beyond Breast Cancer reported in a story published  January 28, 2009, that radiation for three weeks  for invasive, node-negative breast cancer may be as effective as the standard five weeks.

The study examined the effectiveness of hypofractionated radiation, a technique in which higher doses of radiation are given for a shorter time period.

The article said:

Invasive breast cancer occurs when cancer has traveled outside of the ducts or lobules of the breast into the surrounding tissues. When the cancer does not travel into the lymph nodes near the breast and when the tumor remains small, a doctor may remove only the lump and some of the tissue surrounding the lump, also called lumpectomy, or breast conserving therapy. The standard treatment for invasive breast cancer that is confined to the breast is lumpectomy plus radiation for five to seven weeks. Radiation kills any cancer cells that might remain in the breast area after a tumor is removed. Radiation normally is given five days a week for five to seven weeks; the researchers of this study wanted to find out if radiation given at a higher daily dose over three weeks would be equally effective in preventing locally invasive breast cancer recurrence.

In the study, women who had undergone lumpectomy for invasive breast cancer were randomly assigned to receive three weeks of higher dose radiation or five weeks of standard dose radiation. The women did not have cancer in their lymph nodes. 

After 12 years, both groups had similar rates of recurrence. Women who received three weeks of radiation had a 6.2 percent risk of recurrence compared to a 6.7 percent risk of recurrence in the five-week group.

The researchers determined that shorter radiation is just as effective as standard radiation in controlling recurrence. They suggest that this approach should be more widely considered because it is more convenient and less costly to women in treatment for breast cancer.

The article went on to tell women they could share the results of the study with their doctor and ask if the shorter radiation could be an option for them.

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(SOURCE: Journal of the National Cancer Institute, news release, Dec. 30, 2008)

TUESDAY, Dec. 30 (HealthDay News) — Women with high levels of insulin in their blood appear to be more likely to develop breast cancer than those with lower insulin levels.

And that might be the link between obesity and breast cancer, say researchers from the Albert Einstein College of Medicine in New York City. High insulin levels have already been associated with obesity.

The researchers compared insulin levels in 835 women who developed breast cancer and 816 women who did not. All women were participating in the Women’s Health Initiative study. Those whose fasting insulin levels were the highest had a 1.5 times greater risk of breast cancer than did women with the lowest fasting insulin levels, the study found.

The risk was even greater among women who were not taking hormone therapy. The study found that those women were 2.4 times more likely to have developed breast cancer if their insulin levels were high than if they were low.

The findings were published in the Dec. 30 issue of the Journal of the National Cancer Institute.

In laboratory studies, insulin has been shown to stimulate the growth of breast cells. And, being overweight or obese has been identified as a risk factor for breast cancer, according to the American Cancer Society.
“These data suggest that hyperinsulinemia [excess insulin in the blood] is an independent risk factor for breast cancer and may have a substantial role in explaining the obesity-breast cancer relationship,” the researchers wrote.

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Not Grace

Not Grace

I imagined the perfect dog . . . a substantial dog. A dog that a person could respect. A five-year-old female black lab who was housetrained, well behaved, with a mellow personality (yet a watch dog), who had lost her person and was just looking for a quiet home in the country where she could lay at someone’s feet while they worked at a desk, that would curl up for an evening of reading or tv, a dog that would only need an occasional stroll (never running! or frisbee!) and liked riding in the car without having a nervous breakdown, needing a tranquilizer, or throwing up.  I had already named this imaginary but substantial dog, Grace.

Then I actually found her online.  A five-year-old female black lab named Grace. The rescue organization across the state line in Kansas didn’t give any information on the rest of the qualities.  But they never returned my call. In the meantime, my mother encouraged me to get a puppy, and, to make a long story short, I got another “insubstantial” dog – a Malitpoo (cross between a Maltese and a Poodle).  Just like Jessica Simpson’s dog Daisy.  (Sigh. How embarrassing!)

The first few days after I got her home – along with new crate, blanket, dishes, toys, puppy training papers, and after the vet checkup, I slept on the couch with her in the crate on the floor beside me. I woke up every three to four hours all night long, put on her halter and leash, and we went outdoors no matter what. She soon got the message, and I was soon exhausted. Maybe she was, too, because she took a nap each morning and afternoon.

When I went to Arizona for a week, my mother baby-sat the dog. Mom reported that they both slept all night long without any trouble or mess. So when I got home, we did, too!

Then the puppy  got sick — really sick, and I was very upset. I couldn’t go through another sick dog already — my last poor doggy who was 17 years old was so sick for so long before I lost her that I couldn’t face it again. I was crying around, “what have I done!!!”  So there were more vet bills, but the medicine worked, and after incurring yet more vet bills, the lab reports confirmed that she was okay now — she was cured.  $$$$$$$$.  $$$$$$$$.

pinky-001Now we’ve gotten used to each other and we’re best buddies.  She isn’t the perfect dog. Her hair is growing out and it looks like this. She will never have a substantial stature or command respect, especially if she always has a bad hair day.  She likes to unroll the toilet paper, she takes every shoe left on the floor into her crate, and her name isn’t Grace. It didn’t suit her.  So her name is Pinky Sparkle Twinkle.  (All my other pets were named after Greek and Egyptian gods and goddesses and radical personalities from the 60s.)

But she doesn’t have to have a long run outdoors every day and she can play fetch in the house with her tiny toys. She likes to lay on the desk or in my lap while I work. She’s trained to her puppy pads so we don’t have to go outdoors if it’s really cold and snowing, like it was the last couple of days. And she likes to ride in the car.

Now I know why my mom encouraged me to get her. She makes me laugh – and that churns up the endorphins. I have something to think about and take care of besides myself. She’s a little demanding, and that’s okay because I have to give in some times and do what she wants even though we pretend I’m still the boss of both of us. She likes to play, so I have to play, too, sometimes, and it’s a long time since I played. She likes to cuddle, and I haven’t had anything to cuddle for a while.  Having her around is more fun than eating fresh broccoli. This may be why “they say” (as Mom said) that people who live alone “do better” when they have a pet.

So we’re committed now.

And some day we may get a call from Grace, and we’ll have room for her, too.

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Since I accidentally discovered the Mayo Clinic report that breast cancer survivors with asthma have a two-fold risk of mets to the lung, I have been to Arizona and discovered that my asthma didn’t bother me as much while I was there. I didn’t, though, go to Mayo’s to followup.  Why? My insurance company said I hadn’t met the deductible yet this year and I would have to pay for a pulmonologist visit and pulmonary function tests out of my pocket.

Haven’t met my deductible yet this year?! A year of visits with specialists, biopsies, mammograms, ultrasound tests, ob-gyn visits and tests, genetic testing, and all that medicine.  I found out none of my co-pays or payments for those things counted toward my deductible OR my “out of pocket maximum” this year.

Other reasons I didn’t have the testing yet: I changed insurance companies before the end of the year, and my tumor marker tests were good and even in the range for a person who has never smoked, even though I did until about 8 years ago. And my new primary physician was gone all November having surgery.

When I was in Arizona I felt like I could breathe WELL and DEEPLY, and didn’t need to use the inhaler I took along.

I got a flu shot the day after flying home in a sardine can and then was sick for 10 days with a cold and sinus infection.  Being back indoors with a forced air furnace was a drag on my spirits as well as my asthma.  Then it was Thanksgiving and I had company, and now here we are in December and I haven’t gone back to Arizona or talked to the doctors again about the asthma connection, but I started taking my steroid inhaler twice a day.

The reports say that breast cancer patients/ survivors who use steroid inhalers to keep their asthma under control have a better outcome.

My next three-month checkup is in early January.  I’m determined to follow through with this to keep this from being an issue. I don’t want lung mets because I couldn’t control asthma.

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FROM breastcancer.org

All types of breast cancer surgery have a risk of side effects. Some may last for a few weeks — or a few years — after surgery. You may wonder if side effects such as tingling or tightness are normal, whether or not you can continue regular activities if you’re at risk for lymphedema, or if scar tissue formation might affect reconstruction decisions. So, how do you manage these and other issues after surgery?

On Wednesday, May 21st, Kristin Brill, M.D., F.A.C.S. and Linda Miller, P.T., D.P.T. answered your questions about short-term and long-term side effects of breast surgery, and what you can do about them.

If you missed our online conference, you can read the transcript here:

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The woman nurse practitioner that I liked moved away, and the next spring when I was due for my annual “well woman check” I let some time go by while I looked for another health care provider because I didn’t like the new woman doctor and I didn’t want to see any of the men doctors for my pelvic and breast exams.  Time flew, and before I knew it, spring came around again – it was two years since my last mammogram.   When I had it, I discovered I had breast cancer.

Another thing I did wrong was fail to do monthly self-exams. 

And I didn’t go to the doctor as soon as I discovered the lump.  I knew all winter that I had a lump and that it needed to be checked.  While I was busy distracting myself so I didn’t have to face what it might mean, it kept growing. 

If I had done monthly self-exams, if I had gone for my regular annual exams, if I had gone to the doctor when I first knew something was wrong, it is entirely possible that my breast cancer could have been found while it was still DCIS (ductal carcinoma in situ – meaning still in the duct) rather than invasive ductal carcinoma (broken out of the duct and invaded surrounding tissue).  

Shoulda woulda coulda doesn’t help me. But if I tell other women what I did wrong, maybe it will help them.

May 8, 2008 Reuters Health Article says: 




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I just read in the latest issue of AARP magazine about a new treatment advance called image-guided radiation therapy.  A doctor was quoted as saying, “I would guess almost everyone living in the U.S. is now within an hour of a center that has this.”   The system is supposed to give radiologists a more accurate picture of a tumor, which allows them to target it more accurately and reduces the number of treatments needed. 

Not only is our area not within an hour of a treatment center with image-guided radiation therapy, it is at least 2 hours to the nearest radiation treatment center of any kind.   I’m thinking there are lots of rural places that are not within one hour of treatment. 

The first radiation oncologist I saw said treatment was 5 days a week for 6 weeks, but it only took a few minutes, so I would have the rest of the day free.  Yes, I said, unless you counted the 5 hours it would take to drive there and back.

She said,

Oh, yes. There is that.

WWAMI Rural Health Research Center  has several access to care studies, including rural access to radiation oncology centers. 

This study will use cancer registry data from 10 U.S. states to examine which rural cancer patients are receiving recommended radiation therapy and what factors influence receipt of recommended treatment. Identifying gaps in radiation therapy will inform cancer centers, rural program planners, and policy makers in rural cancer service location and cancer support program development. This project is expected to be completed by August 2008.
I would like to hear comments from rural women cancer patients on how far it is to treatment and how you overcame the distance barrier.  Were there organizations that provided transportation or financial assistance with transportation costs? Did you have to stay out of town during treatment? Was there any help with those associated costs?

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I’m rolling up my sleeves, getting outdoors, and enjoying the sun!  So far I got some petunias, pansies, violets, tomatoes, and lavendar to plant.  I’m cleaning out old beds, and working on the mower to get it started.  Before I had enough energy to do these things, and it was still cold but sunny, I tried to sit out in the sun for 20 minutes a day.

When I was first diagnosed with breast cancer, one doctor checked my Vitamin D levels and found out they were very low. He recommended that I take 2,000 units of Vitamin D3 each day and I have been taking that amount for a year now.  I had my levels checked a month ago and they were on the low side of normal, so I am continuing to take the same amount, as well as spending time working outdoors in the sunlight.

Last year I read about a study done in Nebraska that said women with low levels of Vitamin D had a higher rate of breast cancer.

Today I read this:

Research now links vitamin D deficiency with a significantly elevated risk of breast cancer. So why isn’t there public outcry to continue funding this breakthrough science?

The research on vitamin D and breast cancer prevention to date is impressive:
• A 2006 paper published in Anticancer Research established that women with higher vitamin D levels are 50 to 70 percent less likely to develop breast cancer.
• A 2007 study in the American Journal of Epidemiology reported that women with high sun exposure levels – the most natural and abundant source of vitamin D – had half the risk of developing advanced breast cancer.
• A 2002 paper in Occupational and Environmental Medicine established that women who received regular sun exposure were less likely to die from breast cancer.


A Mayo’s web site says that health professionals are realizing that the recommended dosage of Vitamin D may not be high enough, but they haven’t agreed on what it ought to be. 


The National Academies of Sciences currently recommends 200 international units (IU) of vitamin D for children and adults up to age 50 and 400 to 600 IU for adults older than age 50. However, researchers now question whether these levels are adequate for optimal health.

So, how much vitamin D is enough? There’s still much debate about what the recommendations should be. But most researchers agree that a daily intake of 800 to 1,000 IU would benefit many people . . .

One article says the benefits of Vitamin D in preventing breast cancer may be found more in younger women.  On the other hand, an April 2008 article in Science Daily says

Genetic variations in the body’s receptor for vitamin D could increase the risk of breast cancer in postmenopausal women, according to a new study.

and this in another Science Daily article

The result of the study involving 1,394 breast cancer patients and an equal number of healthy women after menopause was surprisingly clear: Women with a very low blood level of 25(OH)D have a considerably increased breast cancer risk. The effect was found to be strongest in women who were not taking hormones for relief of menopausal symptoms. However, the authors note that, in this retrospective study, diagnosis-related factors such as chemotherapy or lack of sunlight after prolonged hospital stays might have contributed to low vitamin levels of breast cancer patients.

On the other hand. . . . .

ScienceDaily  Low blood levels of vitamin D have long been associated with disease, and the assumption has been that vitamin D supplements may protect against disease. However, this new research demonstrates that ingested vitamin D is immunosuppressive and that low blood levels of vitamin D may be actually a result of the disease process. Supplementation may make the disease worse.

So who knows? If the last article is right, then sunshine is okay and supplements are not.  That makes sense.  In a workshop on nutrion for cancer patients, we learned about getting what we need from what we eat, rather than looking to supplements.  We may not be able to get enough Vitamin D from what we eat, but we can get it from sunlight.  


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I got a call with the results of the genetic testing. I am negative for BRCA1 and BRCA2.  

Information from National Cancer Institute:

What does a negative BRCA1 or BRCA2 test result mean?

A negative test result will be interpreted differently, depending upon whether there is a known mutation in the family. If someone in a family has a known mutation in BRCA1 or BRCA2, testing other family members for that specific gene alteration can provide information about their cancer risk. In this case, if a family member tests negative for the known mutation in that family, it is highly unlikely that they have an inherited susceptibility to cancer. This test result is called a “true negative.” Having a true negative test result does not mean that a person will not get cancer; it means that the person’s risk of cancer is the same as that of the general population.

In cases where no known mutation in BRCA1 or BRCA2 has previously been identified in a family with a history of breast and/or ovarian cancer, a negative test is not informative. It is not possible to tell whether a person has an alteration in BRCA1 or BRCA2 that was not identified by the test (a false negative), or whether the result is a true negative. In addition, it is possible for people to have an alteration in a gene other than BRCA1 or BRCA2 that increases their cancer risk, but is not detectable by this test.

Information from National Cancer Institute

What are BRCA1 and BRCA2? Each year, more than 192,000 American women learn they have breast cancer. Approximately 5 to 10 percent of these women have a hereditary form of the disease. Changes, called alterations or mutations, in certain genes make some women more susceptible to developing breast and other types of cancer. Inherited alterations in the genes called BRCA1 and BRCA2 (short for breast cancer 1 and breast cancer 2) are involved in many cases of hereditary breast and ovarian cancer. Researchers are searching for other genes that may also increase a woman’s cancer risk.The likelihood that breast and/or ovarian cancer is associated with BRCA1 or BRCA2 is highest in families with a history of multiple cases of breast cancer, cases of both breast and ovarian cancer, one or more family members with two primary cancers (original tumors at different sites), or an Ashkenazi (Eastern European) Jewish background. However, not every woman in such families carries an alteration in BRCA1 or BRCA2, and not every cancer in such families is linked to alterations in these genes.

More information from National Cancer Institute

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