Monday, October 13, 2014

THE SILVER LINING COMPANION GUIDE


TSL_CompanionGuide_CoverAllstate Logo
The Silver Lining Companion GuideA Supportive and Insightful Guide to Breast Cancer is available free, thanks to the generosity of Allstate.
The Silver Lining Companion Guide is a practical and supportive resource to help everyone impacted by a breast cancer diagnosis. Author Hollye Jacobs, a nurse and breast cancer survivor, offers practical, realistic and hopeful advice that helped her from the time of her diagnosis throughout treatments and into recovery. This valuable resource is now available FREE of charge to help you and your loved ones through the experience
Silver Linings are the heartbeat of The Companion Guide. They gave Hollye the perspective, balance and hope to cope with the most difficult circumstances. Hollye’s Silver Lining is that she now uses her experience to help others on this difficult path. She is the experienced girlfriend who sheds light in the darkness and holds your hand along the way.
Hollye’s words are balanced with inspiring photographs by her friend, co-author and award-winning photographer, Elizabeth Messina. Her images reveal the honesty, beauty and light found within the darkness of breast cancer. They are also informative visual aids for everyone impacted by the disease.
The Silver Lining Companion Guide is available in electronic and print formats. Starting in mid-October, the printed version will be offered through select Direct Relief partners. Click here for a list of participating community health centers and clinics.
The electronic version is offered in English and can be downloaded from the panel on the right hand side of this page. A Spanish Version will be available soon.
Thank you, Allstate, for making this important and helpful book available for free.
About the Authors
Hollye Jacobs, RN, MS, MSW is a speaker, writer, nurse and breast cancer survivor. After being diagnosed with breast cancer in 2010, the 39-year-old mother created The Silver Pen blog. The award-winning blog captured her thoughts and feelings about her diagnosis, as well as documented her experiences through a double mastectomy, chemotherapy, radiation and recovery. The Silver Pen reached audiences far beyond Hollye’s circle of friends and family and became the foundation for her New York Times bestseller, “The Silver Lining.” Hollye lives in Santa Barbara, Calif. with her family. You can read her award-winning blog, laugh and be inspired at TheSilverPen.com
Elizabeth Messina is an award-winning photographer whose artistic images captivate hearts around the world. Her soulful images grace the covers of countless magazines and books. To see more of her photographs, visitElizabethMessina.com. Elizabeth lives in Santa Barbara with her family.


Hospital Cancer Program Confronts The Existential

Hospital Cancer Program Confronts The Existential

Posted: Updated: 

People who battle stage 4 cancer are familiar with words like chemotherapy, radiation and metastasize. But words they may not hear at a hospital as often are existentialism, mindfulness, legacy and humor.
Dr. Arash Asher at Cedars-Sinai Medical Center in Los Angeles is dedicating his life to changing that.
asher
Asher, 38, is a physiatrist -- a rehab doctor. Before his new program, Asher focused his training on the physical aspects of cancer treatment -- things like cogitative rehab, and the management of pain and nausea. But a good number of patients kept coming back to him to talk about their deep and persistent fears. “We can treat someone’s physical pain, but I just felt like we weren’t doing enough as a system," Asher says. "An antidepressant will not solve the issue.”
So Asher decided to create a rehabilitation program that focuses on the emotional fallout of cancer treatment. He recruited patients for the first course that began in mid-July and is currently in the fourth cycle of the program, called Growing Resiliency and Courage with Cancer, or GRACE.
Two hours a week, for five weeks, seven to nine patients meet in a conference room at Cedars-Sinai with Asher and Jeffrey Wertheimer, a neuropsychologist who co-developed the program. The group focuses discussions on themes or lessons -- like wisdom, gratitude, humor, courage and legacy-creation. Patients are assigned homework reading, learn meditation techniques and conclude class with a piece on mindfulness.
The emphasis on mindfulness has a basis in research: it lowers the stress hormonecortisol and helps the brain control pain and emotions. That makes mindfulness a perfect tool for sick patients. Gratitude, a hallmark pillar of any mindfulness practice, has even been said to make us feel happier. Much of the GRACE programming is experimental, based on Asher's instinct and clinical experience.
A book Asher read at age 17, by Austrian neurologist and psychiatrist Viktor Frankl, who also was a Holocaust survivor, has been a guiding inspiration for the Cedars-Sinai program.
frankl
Asher holds up an old copy of the book he’s kept since he was a teenager, the pages dog-eared and the edges frayed. “Frankl noticed that the people who survived the Holocaust weren’t necessarily the strongest or the most physical. They had this capacity to say, ‘I’m going to endure this pain and endure this humiliation because I have to write my book or I have to tell my story or I have to go back to my art.’”
Asher says his greatest lesson from Frankl’s memoir was this: “Nobody can take away the last of the human freedoms -- which is one’s ability to choose his or her attitude in any given set of circumstances.”
This is the premise of Asher’s work -- helping people cope with the inevitable and often painful conclusion of their lives. There are certain things you can’t treat with medications, Asher explains bluntly.
“When people come to you with fear -- and these aren’t psychologically abnormal fears -- these are people with stage 4 cancer and they are facing their own mortality, there’s a deep sense of loss of control,” Asher says. "Because you have no control over what your next CT scan will show or your next tumor marker.”
cedars
Instead of relying solely on anxiety medications, Asher uses tools like meditation and mindfulness, looking at how to find gratitude as a way to regain perspective.
"We’re never trying to be Pollyannaish, like, ‘Thank goodness for cancer because now you’re not materialistic.’ Or, ‘Thank goodness for cancer because now you know who your friends are,’” Asher says. “That’s just crap. But to say, ‘Okay, cancer is here. We are making the best of our circumstances. Are there things that we could gain that you were not really focusing on before?’”
So far, 22 patients have participated in the program. By early November, the total will be 31. Asher is keeping the groups small so that everyone gets attention and all voices are heard.
“We are used to prescribing meds and ordering tests and having control. But human nature is unpredictable and these are perceivably cheesy, non-scientific topics that we are covering,” he says.
For that very reason, Asher wasn’t always so convinced the program would be a hit. It took him nearly five years just to present the idea to colleagues.
“These are people with advanced-stage illnesses and my worst fear was wasting someone’s time when they don’t have a lot of time,” he says.
matthew morgan
Matthew Morgan, 51, recently completed the GRACE program with Asher. After being diagnosed with head and neck cancer at the end of 2012, Morgan, a former television producer for shows like “Saved By The Bell” and “California Dreams,” had surgery to remove a portion of his tongue where a tumor was found. Despite a successful surgery, the cancer metastasized to his lungs, which made him a stage 4 cancer patient.
“Cancer is such a big umbrella. It covers a lot of different illnesses, different symptoms, different treatments, different prognoses,” Morgan explained in a quiet corner of the expansive waiting room at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai. “But there’s [always] something existential about it that is frightening.”
Morgan has a little trouble speaking, but manages well considering his surgery, which involved partial reconstruction of his tongue. “Over time, you learn how to work with what you have,” he says. “I had no idea that the surgery was going to be as dramatic as it was.”
Morgan has been through surgery, radiation and chemotherapy, facing the unknown at every stage. As he spoke to HuffPost, he awaited new scans that would help show his prognosis. “I think it’s helpful to do more than just sit at home and scratch your head about it,” he says.
cedarssinai
Morgan was an eager recruit when he first heard of the GRACE program in its nascent stage from Asher. He claims to have had no expectations, but was excited to participate.
GRACE is not a just a support group. It's more than a venue for patients to share experiences with cancer. In fact, Asher asked GRACE patients if they would have participated if he had billed it as a support group. Almost no one said yes. “Most of these patients are tired of being in a situation where everyone is just kind of bitching,” he says.
The group discusses assigned poems and essays, watches “Seinfeld” clips to facilitate a conversation about humor, and learns meditation methods. With a lesson plan and structured discussion, the program is more college course than group therapy.
One of Asher’s favorite lessons is on legacy creation. He observes that people often have the idea that a legacy is something tangible to be handed down to children.
“But we really reframe it as, ‘What do you want to be known for?’ ‘What is your identity?’ Because if you know where you want to go, you can live your life now working towards those goals,” Asher says.
The GRACE program also is shorter than a support group -- just five weeks. For some participants, that's about all the time they have left.
“Several people who have done the class have already passed," Asher says. "I think it gave them something to focus on and think about. It gave them a sense of control.”
Morgan says he identified most deeply with the concept that he can choose his response to his situation. “This can be a very powerful tool for dealing with something like cancer," he says. "The notion that you’re not responsible for it, but you’reresponse-able to deal with it.”
The sense of ownership has larger implications for the larger conversation about cancer. When asked what he feels is missing from the national dialogue about cancer, Asher doesn’t hesitate. “The idea that it’s possible to heal even if you can’t be cured,” he says.
cedars
That feeling was echoed in a recent email from one of Asher's patients who had reached the end of his treatment options. Asher was eager to share the note, albeit anonymously. It read:
As someone expressed at our last class ‘we are as one.’ However anyone else responded to treatment, I responded differently. To hear ‘me too,’ from everyone in the group was unbelievably bonding.
“So much of the focus tends to be on the cure. And our patients identify themselves with that: cured or not cured,” Asher says.
He recalls his original inspiration in Frankl, who was able to keep his full identity in mind, despite his circumstances in the concentration camp. This ability, Asher believes, allowed Frankl to persevere, cope -- and find solace in others.
“For the first time in many years,” the dying patient concluded his email. “I did not feel alone.”

Saturday, October 11, 2014

Living with Cancer: Hiding Under a Wig?

Photo
CreditDan Kitwood/Getty Images
Living With Cancer
LIVING WITH CANCER
Susan Gubar writes about life with ovarian cancer.
http://well.blogs.nytimes.com/2014/10/09/living-with-cancer-hiding-under-a-wig/?_php=true&_type=blogs&emc=edit_tnt_20141011&nlid=52389906&tntemail0=y&_r=0

My wig (I named her Sally) was looking worse for wear. I decided to use a trip to visit my grandchildren in Manhattan as an opportunity to get another so-called “cranial prosthesis.” That way I could give Sally a much needed shampoo.
I picked up the phone and made the appointment. Afterward, a strange thing happened. I felt the spirit of the poet-activist Audre Lorde descend on my shoulder. (Are such visitations the reason parents discourage their children from becoming English majors?) In her book, “The Cancer Journals,” Ms. Lorde was voluble in her attack on prostheses, inveighing especially against bra inserts and breast reconstruction. Her objections to cancer patients engaging in any and all forms of camouflaging went well beyond the fact that in her historical moment surgical implants could be dangerous.
Glaring at Sally, Ms. Lorde hissed in my right ear, “Power vs. Prosthesis,” which also happened to be the name of one of her book chapters. By denying the mutilations of cancer treatments, she argued, we become complicit in a culture that refuses to acknowledge its manufacturing and marketing of carcinogenic products. Women, she cautioned, ought not to conform to some ridiculous definition of what constitutes attractive femininity. Like the honorable wounds of war, scars and lopsidedness, a flat chest and hair loss bear witness to the disfigurement resulting from the battle against disease.
If we remain invisible, Ms. Lorde insisted, the population at large will never understand how many people are being destroyed by an epidemic that has taken untold lives and continues to do so decades after her death. We should be directing our energies into working for cancer prevention and cure, not into pretending we are unharmed.
I mulled Ms. Lorde’s heroic message. But what was this odd presence alighting on my other shoulder? An ungainly specter holding a mask murmured in my left ear the words of Voltaire, “Illusion is the first of all pleasures.”
Since cancer patients are robbed of physical stamina and libido as well as a sense of security and of a normal body, why not at least create an illusion of well-being?
And then I imagined the spirit of the playwright Oscar Wilde, patting Sally on the head and confiding why he loved acting. “It is so much more real than life,” he said.
Could it be that a prosthesis is not a lie but a costume that allows us to pass as healthy people? Or perhaps it allows us to experiment with a series of personae that short circuit the pathos produced by thinking of oneself as a victim. When a misshapen, aberrant, or downright ugly body emerges from treatment — if only in one’s own mind’s eye (and what other eyes count?) — there is no need to be tethered to it. What else is artistry for?
Brushing off these spectral voices was not easy as I made my way to New York and then to Bitz-n-Pieces, a salon I had read about in cancer memoirs. The waiting room — all chrome and white — featured a wall of photographs, each inscribed to its founder, Barry Hendrickson. They were a gorgeous crew: Katie Couric, Robin Roberts, Carly Simon, Raquel Welch, Susan Sarandon, Marilyn Horne, Mary Wilson.
An emaciated woman paying the cashier glanced at me and then came over to where I was sitting. “Is this your first time?” she asked. When I nodded, she said, “On my first visit, I loved seeing these glamorous people. Next year, you and I will be up there.” I sort of doubted that, but relished the camaraderie.
Moments later I was ushered into a private booth where a youthful man named Edward asked me what wig style I thought would look best. “An urbane relative of Sally’s,” I thought. He went off and brought back three wigs, and I picked the one that resembled a city mouse to Sally’s country mouse.
I asked Edward if my new wig had a name. “Her name is Tori,” he replied, “But we call her Torian Gray.” English majors rule!
At the end of “The Cancer Journals,” Audre Lorde corrected an earlier declaration that she would “give anything not to have cancer.” She knew that she would not give up her life, her partner, her poetry or her arms. I agree: I would not give up my vision or hearing; I would not give up the health of my children and grandchildren.
Like Audre Lorde, I do not want to deny the mutilations of cancer. And I do want to protest the lack of prevention and cures. So why in the world would I continue to walk around with a synthetic helmet on my head?
Perhaps it’s because I refuse to relinquish my various identities prior to and unrelated to the onset of disease. I do not want to be instantaneously pigeon-holed as a cancer patient in every social situation I encounter. My wigs, Sally and Torian Gray, give me that freedom.
Though I have cancer, it does not have all of me … yet.

Finding Hope on the Journey Through Cancer


Rick Boulay, MD
Rick Boulay, MD
August 7, 2014
 · Rick Boulay, MD
Dr. Rick Boulay is the Director of Gynecologic Oncology at Lehigh Valley Hospital in Allentown, Pennsylvania, and the founder of The Catherine Boulay Foundation. As a cancer surgeon and the husband, son, and grandson of cancer survivors, he writes, speaks, and connects with others to share the wisdom of cancer survivorship.
Hope.
The magnetic attraction drawing us toward a Seven-Eleven to drop a couple bucks on a small card with a series of six numbers. The spark within us, ignited by passion, now flaming brilliantly focusing all effort and intention on achieving a given purpose. The driving force propelling us through our deepest fears and adversities. Hope runs the gamut from passive to active, mundane to life-altering, concrete to ethereal.   
But to the cancer survivor, hope is so much more than a lofty subject of the intellectual curiosity of thoughtful poets, philosophers, and religious scholars. Hope is a way of life. Hope is a choice that once made, once grasped, once clung to, provides the security in knowing that after a restful night’s sleep, you will wake with the contentment of so many blessings, worldly or otherwise.
But where do we find hope? Where does it live? And how do we access it when we need it most? At the time of our greatest vulnerability—the time when cancer knocks at our door—there is, of course, no single concrete answer. But in my experience as an oncologist and caregiver, hope exists in one of two places: externally or internally.
Hope as an external focus
At the time of initial diagnosis and in early treatment, the cancer survivor may find hope within the myriad of therapeutic options or even from the strong relationship bonds forged with the care team. I’ll often hear comments like: “This chemotherapy and surgery is my only hope for a cure,” or “You are the only one who has ever offered me any hope.” The people with an external focus tend to use outside measures as validation of their hopefulness: “My scan looks great!” or “My blood work is completely normal.” When all is going well, the external focus of hope is very reassuring. But in the chaotic times, when treatments fail or disease recurs, this group is often left cold. Alone and vulnerable, their hope strategy has failed them.
Hope as an internal focus
For others, hope exists within themselves. It stems from a trusting relationship with the divine and an acceptance that all things work together for good. From these cancer survivors I will hear comments like: “Sure, treat me with whatever you need to, but the overall plan rests with His will,” or “If it is my time, it’s my time.” There is no measure to validate this hope.
Interestingly, I often have to negotiate follow-up blood work and scans with this group as they see no need because they believe “God will provide.” Some will get follow-up testing to appease me and have no desire to know the result. This is a group that responds in deeply divergent ways when tested at times of cancer recurrence. They either become even more deeply hopeful, clearly able to see their position in the universe, or they become despondent, hopeless, faithless, and depressed.
My advice to my patients is to develop a little bit of both philosophies: an internal focus resulting from a deeper spirituality to help answer life’s more complex questions and carry you through the most challenging times and an external focus to manage the short-term issues of acute cancer treatment. For a further discussion of hope, please watch this short video excerpt of a live event called Being Alive: Songs and Lessons of the Journey Through Cancer that I wrote, moderated, and performed.
What gives you hope? Share your thoughts in the comments section below or on Twitter.

Friday, October 10, 2014

Resistance training helps cancer survivors

Living with cancer blog

Resistance training helps cancer survivors

By Sheryl M. Ness, R.N. October 3, 2014
Research shows that cancer survivors may benefit from weight training.  Resistance training is exercise that uses weights, weight machines or elastic bands.
The study, published last year in "Medicine & Science in Sports & Exercise", looked at both men and women who were being treated or had completed treatment for cancer (breast, prostate and head/neck cancers).
Participants did light to moderate resistance training two to three times a week. Early results after 12 weeks showed that participants increased muscle mass and decreased body fat.
After one year, the effects continued with participants reporting a positive effect on their quality of life with a notable decrease in cancer-related fatigue, which is a common and long-lasting symptom reported in cancer survivors.
Resistance training can help to increase strength, range of motion and balance which is important as survivors recover and move on to life after treatment. Exercising with free weights and resistance bands is inexpensive and easy to work into a home routine.
If you'd like to get started, ask for a referral to meet with an exercise physiologist, physical therapist or rehabilitation specialist who can provide the tools and knowledge you need to learn the proper technique. While resistance training is safe for most people, it's always wise to check with your provider to see if it's a good idea for you.
Remember to begin slowly with lower intensity until you feel comfortable moving up a level to higher intensity. Even low intensity exercises make a difference.
I'd love to hear from survivors who have tried resistance training. What's been your experience?
With
Follow on Twitter: @SherylNess1
Join the discussion at #livingwithcancer.

Thursday, October 9, 2014

The Most Important Breast Cancer Findings Of 2014

Posted: Updated: 
BREAST CANCER
It's estimated that 1 in 8 U.S. women will develop invasive breast cancer in their lifetimes, and about 40,000 American women are expected to die from the disease this year.
Learn more about the potentially life-saving research that has been published from research centers around the world.
The "Angelina Effect" Is Real
angelina jolie
Actress and humanitarian Angelina Jolie made waves in May 2013 when she opted to have preventive double mastectomy after testing positive for the BRCA1 gene mutation, a mutation that greatly increases one’s chances of developing breast cancer in the future.
This year, a study published in the journal Breast Cancer Research reveals that Jolie’s announcement may be responsible for inspiring a wave of requests for genetic counseling and tests for breast cancer risk. In the U.K., referrals for genetic testing more than doubled after Jolie went public with her surgery, and they were mostly women who had a good reason to be concerned; many had a family history of breast cancer, just like Jolie. It was no one-time spike, either -- data from 12 different clinics and 9 genetic testing centers in the U.K. showed that a doubling of genetic test referrals for BRCA1 lasted from immediately after the announcement through October of that year.
A Simple Blood Test Could Soon Predict Breast Cancer Risk 
Testing for the BRCA1 gene mutation isn’t the only way to test for elevated breast cancer risk. A simple blood test is currently being developed by researchers at University College London that will be able to predict a woman’s likelihood of developing the cancer by testing for a certain epigenetic signature -- the way certain genes express themselves, or the way genes are turned “on” or “off” -- that is present in women who had breast cancer but didn’t have the BRCA1 gene mutation.
"The data is encouraging since it shows the potential of a blood based epigenetic test to identify breast cancer risk in women without known predisposing genetic mutations,” said lead researcher Prof. Martin Widschwendter, Head of University College London's Department of Women's Cancer. The test was already being evaluated in human trials back when it was announced in June.
3-D Imaging May Be The Future Of Cancer Detection
A new kind of 3-D imaging technique called tomosynthesis could make the tumor search more accurate. A study published in JAMA found that in over 170,000 examinations that used both digital mammography and tomosynthesis, doctors were able to increase cancer detection rates while decreasing the amount of times they needed a patient to return because of an inconclusive reading (referred to in the study as “recall”).
Researchers found that using mammography and tomosynthesis together was better able to detect cancer than just mammography alone (the norm) at a rate of 5.4 per 1,000 vs. 4.2/1,000. The combined detection technique also detected invasive cancer at a rate of 4.1/1,000 vs. 2.9/1,000. As for recall, which wastes time and resources, mammography and tomosynthesis reduced the rates from 107/1,000 to 91/1,000.
Certain Birth Control Pills May Increase Risk
birth control pills
Women who had recently taken certain kinds of oral contraceptives -- specifically high-estrogen pills -- had a 50 percent higher risk of breast cancer than women who had never taken birth control pills or who stopped taking birth control pills. But the results should be interpreted with caution, said lead researcher Elisabeth F. Beaber, PhD, MPH of Fred Hutchinson Cancer Research Center in a press release about her study.
"Breast cancer is rare among young women and there are numerous established health benefits associated with oral contraceptive use that must be considered,” Beaber said. "In addition, prior studies suggest that the increased risk associated with recent oral contraceptive use declines after stopping oral contraceptives."
Instead of asking women to report how much birth control they had taken, which is the norm in these sorts of studies, Beaber culled information about pill brands, doses and length of time taken from pharmacies. She analyzed data from 1,102 women with breast cancer and compared them to 21,952 control women and found that pills with high estrogen increased breast cancer risk 2.7-fold, while pills with ethynodiol dictate increased risk 2.6-fold. Low-estrogen pills did not increase cancer risk. The study waspublished in the journal Cancer Research.
Common Fertility Drugs Do Not Increase Risk
Women who take the common infertility drug Clomid or gonadotropins (e.g. Pregnyl, Novarel, Profasi) needn’t worry that their quest for a baby opened them up to increased breast cancer risk. A study that followed women over 30 years finds that taking those drugs did not increase breast cancer risk, except for a very small amount of women who took Clomid for 12 or more cycles, who had more than 1.5 times the risk of contracting breast cancer as women who had never taken fertility drugs. Women who weren’t able to conceive after taking Clomid or gonadotropins had almost twice the risk of breast cancer as those who have never taken either medication, which suggests that the conditions that made them infertile could also have contributed to their eventual breast cancer diagnosis.
Doctors today recommend taking only six cycles of Clomid at up to 100 mgs per dose before moving on to other fertility strategies. In the past, Brinton pointed out, doctors used to prescribe up to 250 mgs per dose, and for many years. The research analyzed data from more than 12,000 women being treated for infertility between 1965 and 1988. The study was published in the journal Cancer Epidemiology, Biomarkers & Prevention.
Diabetes May Increase The Size Of Breast Tumors
Adult onset diabetes could be making breast cancer tumors grow bigger, faster. A study presented at the European Breast Cancer Conference found that patients with Type 2 Diabetes were more likely to have advanced tumors when doctors first diagnose them with breast cancer.
"We think that hyperinsulinemia -- where there are increased levels of insulin circulating in the blood -- may encourage the growth of tumour cells by providing them with large amounts of glucose, said lead researcher Dr. Caterina Fontanella, MD in a press release. "We therefore believe that strict control of blood sugar levels is essential to the successful treatment of breast cancer."
Skirt Size Is Linked To Breast Cancer Risk
It turns out that a growing “skirt size” makes women more likely to be diagnosed with post-menopausal breast cancer, according to a study published in the British Medical Journal.
Analyzing results from almost 93,000 women, researchers found that going up one skirt size every 10 years was linked to a 33 percent greater risk of breast cancer, while going up two skirt sizes in 10 years was linked to a 77 percent greater risk. Measuring “skirt size” isn’t really a proxy for weight gain; instead, think of it as a gendered way to describe waist circumference. Researchers already know that bigger the waist circumference is, the higher the risk for cancers like colon cancer and cancer of the uterus, as well as health risks like obesity, diabetes and cardiovascular disease.
The study doesn’t establish cause and effect, but researchers speculate that because abdominal fat is more “metabolically active” than fat in other parts of the body, it could be increasing estrogen levels, which can fuel the grown of breast cancer cells.
Good Quality Sleep Is Really Important For Recovery
sleep cancer
Not only will being well-rested keep your immune system stronger, but it may predict a better recovery for breast cancer patients. Researchers at Stanford University found that “sleep efficiency,” or the ratio of actual sleep compared to total time spent in the bed, predicted survival time for patients with advanced breast cancer. Adjusting for factors like age and treatments for a pool of 97 women with advanced breast cancer, they found that efficient sleepers survived an average of 68.9 months, while inefficient sleepers survived an average of 33.2 months after studying them for six years.
"Good sleep seems to have a strongly protective effect, even with advanced breast cancer,” said researcher Oxana Palesh, PhD, assistant professor in the Department of Psychiatry and Behavioral Sciences at Stanford University in a press release.
Another sleep study demonstrated how melatonin, the hormone that makes you sleepy at night, is absolutely crucial to the success of tamoxifen, a widely used breast cancer drug. The only problem is that exposing yourself to light from your TV, mobile phone or computer at night shuts off that melatonin production, which in turn could weaken tamoxifen. To show this, researchers from Tulane University implanted rats with human breast cancer cells and then regulated their light to alternate between 12 hours of light and 12 hours of total darkness for several weeks. Then they repeated the light/dark cycles, but this time they shone a very dim light during the dark portion, which suppressed melatonin production. Tamoxifen was most effective in rats that had 12 hours of unadulterated darkness, or rats who received melatonin supplements.
"High melatonin levels at night put breast cancer cells to 'sleep' by turning off key growth mechanisms,” explained researcher David Blask of Tulane University in a press release. "These cells are vulnerable to tamoxifen. But when the lights are on and melatonin is suppressed, breast cancer cells 'wake up' and ignore tamoxifen.” 

Vitamin D Levels Predict Breast Cancer Patient Survival
Patients with high levels of vitamin D were more than twice as likely to survive breast cancer than women with low levels of vitamin D, according to a study published in the journal Anticancer Research. Researchers from University of California, San Diego analyzed five past studies of breast cancer patients, which altogether had data from 4,443 people. Women who had a greater chance of surviving breast cancer had an average vitamin D level of 30 nanograms per milliliter, while the women who had less chance of surviving had an average of 17 nano grams per milliliter. Unfortunately, the average breast cancer patient in the U.S. has vitamin D levels that mostly resemble the latter, not the former.
Because this was an observational study, the researchers recommended randomized clinical trials to confirm the causal relationship, but added that there’s no harm in adding vitamin D supplements to strengthen a breast cancer treatment regime now.
Breast Cancer Vaccines Could One Day Be A Reality
An experimental breast cancer vaccine called GP2 is showing a lot of promise in human trials and could one day be an important option to prevent recurrence in breast cancer survivors. Researchers divided 190 breast cancer survivors into two groups: a control which received only an immune stimulant and an experimental group which received the immune stimulant and the vaccine. The group which received the experimental vaccine had a 57 percent reduced breast cancer recurrence rate as compared to the control group.
"The ultimate goal is to develop a preventative tool that will minimize the risk of recurrence in women who have already had breast cancer and for whom standard therapies have failed,” wrote principal investigator Elizabeth Mittendorf, M.D., Ph.D. of the University of Texas.
It’s Never Too Late To Make Lifestyle Changes
Two studies from Yale Cancer Center find that breast cancer survivors who start regularly exercising and eating healthier can decrease their risk for breast cancer recurrence and death, as well as improve overall quality of life.
The first study divided obese or overweight female cancer survivors into two groups: those who got help and counseling about weight loss, and those who received simply a brochure. In addition to losing more weight, the women who got help with weight loss experienced a decrease in C-reactive protein, which is linked to a higher risk of breast cancer recurrence.
The second study divided breast cancer survivors into two groups: those who strength-trained twice a week and did 2.5 hours of aerobic activity per week, and those who did not exercise. After a year, the exercisers had also experienced a significant decrease in C-reactive protein compared to the control group -- as well a decrease in body weight and body fat.