Thursday, November 12, 2015

I have mouth sores from receiving chemotherapy. I've heard that something called "magic mouthwash" might help. What is it?

Answers from Timothy J. Moynihan, M.D.
Magic mouthwash is the term given to a solution used to treat mouth sores (oral mucositis) caused by some forms of chemotherapy and radiation therapy.
Oral mucositis can be extremely painful and can result in an inability to eat, speak or swallow. Magic mouthwash provides some relief.
There are several versions of magic mouthwash. Some are available in pre-measured kits (First-Mouthwash BLM, First-BXN Mouthwash) that can be mixed together by pharmacists, while others are prepared to order by a pharmacist. If it's determined that magic mouthwash might be helpful, your doctor will write a prescription.
Magic mouthwash usually contains at least three of these basic ingredients:
  • An antibiotic to kill bacteria around the sore
  • An antihistamine or local anesthetic to reduce pain and discomfort
  • An antifungal to reduce fungal growth
  • A corticosteroid to treat inflammation
  • An antacid that helps ensure the other ingredients adequately coat the inside of your mouth
Most formulations of magic mouthwash are intended to be used every four to six hours, and to be held in your mouth for one to two minutes before being either spit out or swallowed. It's recommended that you don't eat or drink for 30 minutes after using magic mouthwash so that the medicine has time to produce an effect.
It's unclear how effective magic mouthwash is in treating oral mucositis. That's because of the lack of standardization in the formulations of mouthwash, and poorly designed studies done to gather data.
Side effects of magic mouthwash may include problems with taste, a burning or tingling sensation in the mouth, drowsiness, constipation, diarrhea, and nausea.
If you have mouth sores, discuss your options with your doctor. In addition to magic mouthwash, medications and other treatments may help relieve your discomfort.

Personalized anti-nausea therapy better for cancer patients

November 12, 2015

A new research study led by Dr. Mark Clemons, oncologist and associate cancer research scientist at The Ottawa Hospital, has shown that a personalized approach to treating one of the most expected side-effects of chemotherapy is far more effective than the existing "one size fits all" set of guidelines. The randomized trial is published in the November 12 issue ofJAMA Oncology.
Nausea and vomiting are among the most feared side-effects of chemotherapy for , and in some cases the symptoms can be so debilitating that patients stop treatment. To date, physicians have treated these side-effects with a range of anti-nausea drugs, following a set of set of established guidelines.
"Unfortunately, these guidelines don't take into account the personal factors that put patients at higher risk of nausea and vomiting," said Dr. Clemons, who is also an associate professor of medicine at the University of Ottawa. His study included 324  receiving chemotherapy at The Ottawa Hospital and the Irving Greenburg Cancer Centre, . The study demonstrated that when personal risk factors for chemotherapy induced nausea and vomiting (e.g. age under 40, those with a history of pregnancy-associated morning sickness or travel sickness, or those with lower alcohol consumption) are taken into account when prescribing anti-emetic medications then nausea and vomiting control was significantly improved, when compared with standard physician choice of antiemetics.
"This is the first time it's been shown anywhere in the world that using  significantly improves nausea and vomiting control," explained Dr. Clemons. "Anti-nausea drugs potentially have their own side-effects, and it's very expensive for the healthcare system to simply give them to every patient regardless of effectiveness. We think these findings can lead to a much better, much kinder, much gentler way of treating  patients."
The approach is also important because, some patients at particularly high risk still had poor control of  and  despite "optimal" antiemetic prescribing. For these patients new treatment strategies need to be developed. On the other hand it is very likely that patients at low risk do nto require all the anti-sickness drugs currently recommended.
"These results are very straightforward, but they challenge the dogma of the way the guidelines are written," Dr. Clemons said. "It's very easy to simply follow a guideline. Now we're suggesting that physicians just ask their  a few key questions first."
More information: "A Randomized Trial Comparing Risk Model Guided Antiemetic Prophylaxis to Physician's Choice in Patients Receiving Chemotherapy for Early Stage Breast Cancer" JAMA Oncology, 2015. 

Blood test detects when hormone treatment for breast cancer stops working

November 11, 2015

Blood test detects when hormone treatment for breast cancer stops working
Breast cancer patients with mutations in the estrogen receptor gene ESR1 are known to develop resistance to hormone therapy. A new study finds that resistance to hormone therapy usually evolves in the advanced stage of disease, suggesting …more
Scientists have developed a highly sensitive blood test that can spot when breast cancers become resistant to standard hormone treatment, and have demonstrated that this test could guide further treatment.
The test gives an early warning of resistance to aromatase inhibitors, which are used to treat women with oestrogen receptor (ER)-positive , the most common kind.
A team at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust found that the test could detect mutations to the oestrogen receptor gene ESR1 - which conveys resistance to hormone  - specifically in women treated with aromatase inhibitors.
Detecting mutations in this gene from  DNA in the bloodstream could allow doctors to rapidly identify which patients are no longer benefiting from treatment and switch them to an alternative drug.
The work is published in the journal Science Translational Medicine today (Wednesday), and was funded by several organisations including the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), Breast Cancer Now, The Cridlan Ross Smith Charitable Trust and Cancer Research UK.
Researchers initially took blood samples from 171 women with ER-positive breast cancer, and then validated their results in three independent groups of patients.
They found that ESR1 mutations could be detected by an ultra-sensitive method known as multiplexed digital PCR analysis, which can read the genetic code of tiny amounts of DNA released by tumours.
This method proved able to detect DNA errors as sensitively as tumour biopsies, with 97 per cent matching between the two methods, and could in future remove the need for such an invasive procedure.
Researchers at the ICR and The Royal Marsden found that once ESR1 mutations were detected, mutated cancer cells multiplied and became the dominant type in the body - driving the disease to become more aggressive and progress rapidly.
Women who had breast cancers with ESR1 mutations were three times more likely to progress than those without.
The stage at which the cancer was treated had a huge influence over how cancers became resistant to aromatase inhibitors, which are used as standard after surgery in postmenopausal women with ER-positive breast cancer. Mutations in ESR1 only occurred in 6 per cent of patients first treated with  when their cancers had not spread, but in 36 per of patients when the disease had already spread round the body by the time the drugs were administered. The research suggests more advanced cancers evolve drug resistance much more readily, reinforcing the importance of early diagnosis and early treatment for cancer.
Study leader Dr Nicholas Turner, Team Leader in Molecular Oncology at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:
"Looking for cancer DNA in the blood allows us to analyse the genetic changes in cancer cells without the need for invasive biopsies. Our study demonstrates how these so-called liquid biopsies can be used to track the progress of treatment in the most common type of breast cancer.
"The test could give doctors an early warning of treatment failure and, as clinical trials of drugs that target ESR1 mutations are developed, help select the most appropriate treatment for women with advanced cancer."
Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said: "We are in a new era of personalised cancer medicine, and liquid biopsies offer the hope that treatment can be monitored and adapted according to the evolution of an individual patient's cancer.
"In the space of the last couple of years there has been astonishingly rapid progress in the development of liquid biopsies to detect specific cancer  in the bloodstream. I am excited by the prospects of these new tests and would like to see them assessed in clinical trials as soon as possible, so we can show that their use to adapt treatment can offer real benefits for cancer patients."
More information: "Analysis of ESR1 mutation in circulating tumor DNA demonstrates evolution during therapy for metastatic breast cancer," by G. Schiavon et al. 

Study of breast cancer metastasis upends conventional wisdom, suggesting new treatment strategy

Study of breast cancer metastasis upends conventional wisdom, suggesting new treatment strategy
From left: Dr. Ding Cheng Gao, Kari Fischer, Dr. Vivek Mittal. Credit: Carlos Rene Perez
Breast cancer cells do not undergo a commonly accepted transformation in order to spread to distant organs such as the lungs, Weill Cornell Medicine investigators have found in a new study. This discovery may settle a longstanding debate about how cancers spread, the investigators say, and may profoundly change the way many forms of the disease are treated.
For more than a decade, many researchers have believed that a biological process that transforms the shape of cells that line cavities, organs and blood vessels in the body was necessary for metastasis. Epithelial to mesenchymal transition, or EMT, strips away the cells' ability to hold on tightly to their neighbors, allowing them to migrate throughout the body. During fetal development, EMT provides a way for cells in the embryo to travel long distances for the generation of complex organs and bony appendages. Cancer biologists in the early '90s discovered that a subpopulation of tumor cells behaved the same way, positing that EMT gave  "legs" upon which to crawl away from a tumor. But other scientists have questioned the theory, and a vigorous controversy has ensued.
In their study, published Nov. 11 in Nature, Weill Cornell Medicine investigators discovered that while EMT occurred in a small number of primary breast tumor cells, they were not involved in cancer metastasis. What's more, metastasis was derived from non-EMT cancer cells, contradicting the common theory about how cancers spread. About 90 percent of all cancer-related deaths are due to metastasis. Strikingly, the EMT status changed with the addition of chemotherapy. The recurrent lung metastases that appeared after chemotherapy treatment were from EMT tumor cells, indicating that that EMT contributes to the survival of chemoresistant tumor cells. Their findings may offer a more effective treatment strategy for and many other kinds of cancer.
"EMT has been considered cancer's Achilles heel, and now we show that this is true, but not in the way many thought," said co-senior author Dr. Vivek Mittal, an associate professor of cell and developmental biology in cardiothoracic surgery and of cell and developmental biology at Weill Cornell Medicine, director of the institution's Neuberger Berman Foundation Lung Cancer Research Center Laboratory, and a member of its Sandra and Edward Meyer Cancer Center.
"There is a substantial effort underway to develop drugs aimed at reversing the EMT process in order to halt metastasis, but our findings suggest that this approach may not work," he added. "Instead, we suggest combining chemotherapy with a drug that blocks EMT as the first treatment given to breast cancer patients—and likely others with cancer as well."
Study of breast cancer metastasis upends conventional wisdom, suggesting new treatment strategy
The top panel of this image shows breast cancer cells designed to change from red to green when they transition from epithelial to mesenchymal through the EMT. The bottom panel shows breast cancer cells in primary tumors, which progress to …more
"Our study clarified a longstanding question in the field by finding that lung metastases mainly arise from tumor cells that have not undergone EMT," said co-senior author Dr. Ding Cheng Gao, an assistant professor of cell and developmental biology in cardiothoracic surgery and of cell and developmental biology, and a member of the Meyer Cancer Center at Weill Cornell Medicine. "However, the EMT tumor cells appear more resistant to chemotherapy, suggesting that the combination of anti-EMT approach and traditional chemotherapy is a better way for combating the deadly metastatic disease."
For their study, the Weill Cornell Medicine investigators and their collaborators at Columbia University, Houston Methodist Research Institute, and Soonchunhyang University in South Korea, developed a new technique called EMT cell lineage tracing to understand the role of EMT in breast cancer. The system, which took three years to develop, tracks individual in preclinical models of metastatic breast cancer. The investigators engineered the original cells to emit a red fluorescence. While EMT occurs, the cancer cells switched from red to green fluorescence.
"As would be expected, we found that within a predominantly epithelial primary tumor, a small portion of tumor cells had undergone EMT," Dr. Mittal said.
But strikingly they also found that cells that metastasized to the lung were red, not green. "This finding was unexpected and suggested that the general notion that EMT is important for generating metastasis was not correct," he said.
To confirm their discovery, the researchers blocked EMT with an inhibitor and found it had no effect on metastasis to the lungs. Then they investigated what happened after the mice received chemotherapy. The chemo treatment efficiently eliminated the glowing red cells—including those in the lungs—but not the green EMT tumor cells. Researchers then observed green metastatic lesions in the lung, which are derived from the EMT cancer cells.
Study of breast cancer metastasis upends conventional wisdom, suggesting new treatment strategy
This schematic shows epithelial (red) and mesenchymal (green) cancer cells in primary breast tumors. These tumors metastasize to the lungs to form red nodules, indicating EMT does not generate metastasis (left), but following chemotherapy …more
"This can explain why patients initially respond to chemotherapy, only to find later that the cancer has spread because of chemoresistant EMT ," Dr. Mittal said.
Researchers then tested a therapy that combines chemotherapy with their experimental EMT blocker and found that no metastasis—and no chemoresistance—occurred in the mice.
"The EMT was a wonderfully compelling explanation for how metastasis could occur, and we certainly did not expect these findings," said first author Kari Fischer, a doctoral candidate in the Weill Cornell Graduate School of Medical Sciences. "Hopefully this will redirect efforts toward other explanations for how epithelial cancer cells move. In the meantime, we have made very exciting inroads towards discovering the root of chemoresistance."
Drs. Gao and Mittal are now using their EMT lineage tracing system as a platform to develop and test combination therapies that can be used in patients that will eliminate both epithelial and drug-resistant EMT cancer cells. The translation of their findings could aid the 90 percent of late stage metastatic patients with treatment-refractory disease.
More information: Kari R. Fischer et al. Epithelial-to-mesenchymal transition is not required for lung metastasis but contributes to chemoresistance, Nature (2015). DOI: 10.1038/nature15748 

Tuesday, November 10, 2015

Cancer Survivors Talk About What It’s Really Like to Have Cancer

November 9, 2015
Cancer is hard. As much as you want to be there for a recently-diagnosed friend, it’s difficult to know what to say. And if you’ve recently been diagnosed, you may be at a total loss for how to react. 
Truth is, cancer is different for everyone. There’s no universal experience, but there are a few things that all cancer survivors know to be true. Watch along as people who’ve lived through a cancer diagnosis explain what it’s really like and how they got through it.

Wednesday, November 4, 2015



  1. What side effects can I expect from chemotherapy
  2. If I lose my hair how soon will it fall out and what are my options
  3. Skin care is extremely important due to changes in your body chemistry
  4. What happens after my mastectomy/Are there products for me
  5. Cancer is an individual experience. There is only one way to handle all of the choices presented to you – Your Way
Susan is an oncology nurse and breast cancer survivor and author. She was diagnosed in 1992 and elected to have a mastectomy and full course of chemotherapy. She had been working with cancer patients her entire career. She quickly discovered the trials experienced with the initial diagnosis and ensuing treatment. She lost her hair and went into menopause. She was surprised to find how few products were available. She now has a business helping women undergoing chemotherapy and radiation treatment. Susan's Special Needs carries a beautiful selection of human hair, synthetic and blended wigs custom tailored to fit your head in comfort, mastectomy bras and breast forms, all natural skin care products, fashionable headwear and scarves.

We address the emotional issue of appearance with our clients all the time. Our own individual impression of who we are and how we present ourselves to the world influences the choices we make to accommodate changes during treatment. In my experience as an oncology nurse, breast cancer survivor, and what I have learned in my own practice, there is no right way or wrong way to address the changes that occur in our appearance. There is only “your” way. Women should be given options and then choose what is best for them, their comfort, their lifestyle and budget.

Susan’s Special Needs is conveniently located at 24052 Woodward Avenue, Pleasant Ridge, MI 48069. Please contact us at 248-544-4287 or visit

Monday, November 2, 2015

It’s Not Always A Lump: 6 Little-Known Signs That May Indicate Breast Cancer

It’s common knowledge that a lump in the breast may indicate cancer, but breast cancer can also have other lesser-known symptoms. Some of these symptoms may appear before a lump is large enough to detect. Increasing your awareness can help you detect breast cancer in its early stages and have the best chance for effective treatment.

1. Changes In Skin


Changes in the skin similar to what Lewis describes can be a symptom of breast cancer. These changes may appear as a thickening of the skin on the breast or other change in the texture of the skin. Enlargement of the pores may also indicate breast cancer and may make the skin look similar in texture to an orange peel. The skin may also turn red or develop a scaly texture.

2. Changes In Appearance Of The Breast Or Nipple

Breast cancer can cause changes in the appearance of the breast that range from dimpling of the skin to inversion of one or both nipples.

3. Changes In Breast Size

If one of your breasts becomes swollen or seems to change in size relative to the other breast, consult a health professional. Another change that could be cause for concern is shrinking of a breast. All of these changes are of greater concern if they affect only one breast, according to the National Breast Cancer Foundation.

4. Nipple Discharge

Discharge from the nipple that is clear, brown or tinged with blood may also indicate breast cancer. If you notice a milky colored discharge, the National Breast Cancer Foundation advises consultation with a doctor, although this type of discharge does not normally indicate cancer.

5. Breast Pain


Although breast pain is not a common symptom of breast cancer, sometimes a cancerous lump in the breast can result in pain. Breast pain that occurs on a sporadic or cyclic basis is less likely to be a breast cancer symptom. If you have breast pain that lasts longer than three weeks, report it to your physician, states WebMD.

6. Lump In The Armpit

A lump or swelling in the armpit can occur for many reasons that don’t necessarily indicate a serious health problem, but breast cancer can also cause this symptom, according to Healthline. Hormonal changes during the menstrual cycle are also a common cause of lumps in the armpit. Performing self-exams within three days of the end of your period can reduce false alarms related to hormonal changes.

All of these symptoms can have benign causes that don’t indicate cancer or another serious health issue, but the only way to know for sure is to talk to your doctor. Although women often seek medical advice quickly upon detection of a lump, they tend to wait longer to see a doctor to investigate other types of symptoms.


Tuesday, October 27, 2015

Secrets to Surviving a Cancer Diagnosis and Treatment: Observations of an Oncologist

US News 
Three weeks after her 54th birthday, while taking a shower, Maria felt a lump in her right breast. Initially, she tried to ignore it. But when it started pulling the skin and causing a nagging pain, she mentioned it to her husband, Bill.
He immediately encouraged her to see a doctor. It was all too familiar for Bill; his sister wasdiagnosed with breast cancer few years back. Unfortunately, he knew the painful sequence of events that would follow.
Their life turned upside down in a matter of 24 hours. Maria had mammograms, a biopsy and was seen by a team of doctors. Maria's daughter was getting married in seven months; she was supposed to help her only daughter with the wedding planning. Bill was planning to retire by the end of the year, as soon as the wedding was over.
But they quickly realized they wouldn't be in control of planning their days ahead. Instead, their future was now being planned by a group of doctors and nurses at the cancer center. A strong feeling of loss of control and unpredictability quickly seeped into their life.
Initially, they hadn't planned to tell their daughter about the cancer. But it became imperative that they not keep it from her. The next day, their daughter flew in to be with Maria for her appointments. She came prepared with questions about the treatment plan and prognosis.
Soon they were convinced they were with the right team of doctors that were focused experts in breast cancer. They worked together as a team. They even left the door open for a second opinion, if Maria prefers.
Maria learned to trust the team; she knew they had her best interest in mind. Treatment was not easy, but her focus was the wedding in seven months. Throughout the treatment, she tried to work as much as possible and dedicated a lot of time to wedding preparation.
Bill and their daughter stood by her side for much of her treatment. It was not easy, but Maria made it through.
Cancer is not an easy diagnosis. In the past 15 years of taking care of patients, family members and friends, I have become intimately involved in this very tough and intense emotional journey. It is fascinating to see how each person and family face such a life-changing diagnosis.
Some patients are outright negative and angry and really struggle through it. Others breeze through with a smile.
Cancer and its treatment can take an emotional, physical and financial toll on anyone. Once you have a diagnosis, it's not easy to wish that away. We can ask questions to try to understand why for a while, but not forever. We can question the treatment options, but not every step of the way. Getting upset is not going to get you anywhere. But it is real and unfortunately, you need to face it.
Making decisions about cancer treatment is almost like traveling in an airplane. When you are on a flight, you need to trust the pilot and the airplane. If you question every tremor, and up and down, of the plane, you will be totally paralyzed throughout the journey. You just have to trust the pilot and the plane to take you to the right destination safely. Jumping out of the plane isn't an option.
Patients who deal with a cancer diagnosis in a positive manner tend to do five things:
1. Find the right team and a champion for you, and trust their recommendation.
2. If needed, get a second opinion.
3. Surround yourself with the people you love.
4. Focus on your life rather than the cancer or cancer treatment.
5. Try not to compare your story with your neighbors; your treatment and prognosis is tailored for you.
The most important decision you can make in your cancer treatment is to find the right doctor and the team for you. Do your homework, investigate and even consider a second opinion. Once you have done the due diligence and are satisfied, trust you've made the right decision.
Having a diagnosis of cancer is not fair -- just like life. Don't delay or put your life on hold because of cancer treatment. Keep your focus on living your life, and not on the cancer. 
Dr. Jame Abraham is the director of the Breast Oncology Program at the Taussig Cancer Institute, and co-director of the Comprehensive Breast Cancer Program at Cleveland Clinic. Follow him on Twitter @jamecancerdoc.

Thursday, October 22, 2015

Breast, ovarian cancer risk may have association with sense of smell

October 21, 2015

The association between menstrual cycle activity and breast and ovarian cancer risk may have an unexpected intermediary - odors.
Keck Medicine of USC researchers have discovered for the first time that the estrous cycle (the equivalent of human) in  carrying a mutation known to cause familial predisposition to breast and  in humans is more readily stimulated by scent than in normal mice. Even more surprising was the finding that the ovary, independently of the nose, mediated the olfactory signals.
"This research indicates that a better sense of smell may contribute to the elevated  of women with BRCA1 mutations," said corresponding author Louis Dubeau, professor of pathology and medical director of molecular pathology, USC Norris Comprehensive Cancer Center. "We found that the presence of the mutation in the ovary mediated a stronger response to scent, implying that the mutation may influence the menstrual cycle, which in turn is an established risk factor for breast and ovarian cancer."
The research will be published Oct. 21, 2015 in the peer-reviewed journal PLOS ONE.
Springing off the observation that menstrual cycles often synchronize between female college roommates, indicating some sort of communication with environmental signals, the scientists compared female mice genetically engineered to carry the BRCA1 mutation to normal, or wild-type mice. They isolated the females from males, causing estrous to pause in the females. When the females were exposed to male bedding, those with the BRCA1 mutation restarted estrous faster than the wild-type mice.
To confirm that the results were mediated by the ovary independently of the nose, the scientists transplanted ovaries from mice with the BRCA1 mutation into wild-type mice and also transplanted ovaries from normal mice into the genetically engineered mice carrying the mutation. The wild-type mice with the BRCA1 mutation present in their ovarian transplants responded more quickly when introduced to the male scent than mutant mice with wild-type ovarian transplants carrying the mutation in all tissues except the ovary.
"We've known for a long time that smell receptors are expressed in all kinds of tissues, but we know very little about what these receptors do outside of the nose," Dubeau said. "Only certain tissues in the breast and reproductive organs have an elevated cancer risk in women who carry a BRCA1 mutation. We found that BRCA1  do not only influence these tissues directly, but also indirectly by changing how they communicate with other cells. This research is one of several examples shown in my laboratory where BRCA1 controls how different cells communicate from a distance. If we can understand how disruption in such communications leads to elevated cancer risk in BRCA1 mutation carriers, we can develop therapies to control these cancers, including perhaps therapies based on smell."

Wednesday, October 21, 2015

Six Lessons Learned From Breast Cancer

“The period of greatest gain in knowledge and experience is the most difficult period in one’s life.”  — Dalai Lama
Writing in Oncology Times, radiation oncologist, Matthew Katz MD, described cancer as an illness of transformation. “Biologically” he wrote, “it represents a change in growth and homeostasis. Metaphorically, a cancer diagnosis can transform how you see yourself and the way you experience life afterward.” When the dust settles after the cancer storm has passed, it is not uncommon for patients to reappraise their lives. Cancer forces us to slow down and look at what really matters. Caught up in the routines of daily living, it is easy to avoid doing this; but cancer stops us in our tracks and pushes us to the edge of what is familiar. With cancer there is no hiding place; its sharp glare strips away pretence and artifice, revealing the true nature of our lives and relationships.
Cancer is an invitation to take stock and re-examine your life, to discover ways of leading a more meaningful and fulfilling life. Richard G. Tedeschi, PhD, professor of psychology at the University of North Carolina Charlotte, reports five common growth outcomes from interviews he conducted with trauma survivors.
  • A deepened appreciation of life.
  • Enhanced relationships with others.
  • An appreciation for personal strength and endurance.
  • Setting out on new pathways or pursuing new interests and opportunities.
  • Spiritual growth and development.
As part of breast cancer awareness month, I extended an invitation to six women to share what they have learned from their personal experience of breast cancer. Their answers to the question, “what did cancer teach you?” reflect the themes identified by Dr Tedeschi. The women’s experiences span a trajectory of breast cancer from recent diagnosis and active treatment, to several years’ post-treatment.
Elizabeth McKenzie, a licensed psychologist who lives in Seattle, WA, was diagnosed with breast cancer in 2012. She learned to appreciate the value of stillness and find healing in solitary pursuits.
“When I was diagnosed with cancer in 2012, I knew that I had just been enrolled in a crash course with countless learning objectives. Some of the lessons, however, have been unexpected.
I learned to appreciate stillness, the silence in life. I am an extroverted person. I work as a child/adolescent psychologist. I am married. I am a mother. I am a daughter and a sister. I have many friends. Before cancer, I thought that the foundation of my life was largely my connection with others. The time I was forced to be alone to heal from many surgeries for my own health, led to my pursuing other solitary pursuits, mindfulness meditation, nature photography, personal writing, and exercise.
Over time, I have learned that my individual experience was also part of that foundation; to have time alone to live in mindful stillness is a basic need for my mental and physical health, one that I had long neglected. In working on this solitary foundation, I have also strengthened my connection with others. I am now giving serious consideration to attending a residential mindfulness retreat, one that would require that I be silent, except for counseling with teachers, for 3-7 days. That is something that in the past, I would have considered myself neither able to do nor willing to give myself that kind of time. Today, I feel emotionally and physically ready for the experience of being by myself, with myself, surrounded by nature, for days on end. This gives me sense of peaceful willingness, a gentle hopefulness, in a life full of uncertainty.”
Becky Hogue, a PhD Candidate (Education) at the University of Ottawa, was diagnosed with breast cancer in 2014. Becky wanted to share a cautionary tale so others could learn from her hard-earned experience.
“When I think back about one thing that I’ve learned, it is that treatments change over time but advice is full of ‘old wives tales’ which are often based upon older treatments. This was never more poignant than during my last round of AC chemotherapy. Throughout AC chemo, I had been suffering from nausea. I knew from support group that people who tolerated it well only had nausea for three to five days. I had nausea for at least eight days. Given I was on a 13-day cycle, this meant more days with nausea then without. Now, my nausea was never really bad. When I complained to my oncologist, he asked me “when was the last time you threw up?” Never. My nausea was never that bad, it just lingered.
The folks at support group (especially those a year or so ahead of me) would talk about different nausea meds. The meds I was on were not the meds that everyone was talking about. I found myself wondering if I should be on different meds? In my mind, a change of meds would mean less nausea. I would tolerate the chemotherapy side effects so much better.
What I didn’t realize was that these different nausea meds were the old school meds. The meds my oncologist had me on were the new ones. People in support groups, and some of the older chemo nurses, were not familiar with the new meds. The recommendations I was getting about ‘what works’ were ‘old wives tales’, and I bought into them instead of trusting my oncologist.
For my last bout of AC chemo, I tried a different combination of anti-nausea meds. My oncologist was away, so his nurse practitioner changed my meds (in part because I asked for it). I’m sure that if my oncologist was there, he would have explained that I was on the new meds, but also that they were doing their job. I didn’t know the other option was the older option. I didn’t realize that the folk lore about the effectiveness was in part just because it was the older meds. The new meds had not been around long enough to be part of the lore. With the change my nausea was no better, but the side effects of the meds were much worse. I ended up with terrible mouth sores (so bad I needed liquid morphine to manage the pain). One of my biggest regrets regarding my treatment was that I changed anti-nausea meds for the last cycle of AC chemo.  I had forgotten my own advice. I had forgotten who I had decided to trust (my oncologist), and let the ‘lore’ effect my treatment.
This tale is meant to be a cautionary one. Not so much about seeking advice, but about remembering that people who have followed this path before you did so at a different time. The treatment options (and side effect management options) available to you today may not be the same ones that were available for someone else a year ago. Although older treatments may work, chances are the newer ones are better. Before changing treatment plans based upon what you are hearing on the net or in support groups, ask yourself ‘is this an old tale’? And finally, decide who you are going to trust, and trust them.”
Audrey Birt, a two-time breast cancer survivor, focussed on lessons of courage, connection and resilience.
“Cancer taught me I’m more resilient than I would have believed, it helped make me braver. It also taught me that life cannot be controlled. This made me more able to live in the moment and for the moment and that’s probably not so good for my bank balance but it’s great for my life balance in a way. It taught me to reengage with writing through my blog and in a funny way it changed my life and connection to others. But it also taught me my fragility and that’s a lesson I’m still learning, one day at a time!”
Author of From Zero to Mastectomy, Jackie Fox, has written of how breast cancer “gave me part of myself back”.
“One of the obvious benefits of cancer is reconnecting with friends and family, but old loves like art and music may reappear in your life as well. In my case, I started writing poetry again. I hadn’t written or published anything for nearly 20 years and I really thought that part of my life was over. I’m so grateful to have it back and I hope I never lose it again.”
Liz O’Riordan was diagnosed with breast cancer in July 2015. From her unique perspective as a consultant breast surgeon, she is learning what it’s like to be a patient from the other side.
“Being a patient in my own speciality has opened my eyes to a lot of little things that could be changed to improve patient care. I learned that the language of cancer is completely different for a patient compared to a doctor. I have been made acutely aware that some of the phrases I’ve used in clinic when breaking bad news, that I’ve heard others say, or come up with myself, now make me cringe. A lot of women get recalled from screening with tiny low grade cancers (<1cm), and I’ve said “If you’re going to get breast cancer, this is a good one to have”, or “You’re lucky that we caught it early”. All of these phrases were said with good intentions, to try and reassure the women that they were unlikely to die of their cancer, and would not need chemo. And most women are still in shock, so I never see them truly react to what I have just said. But no cancer is a good one to have, and no-one is lucky to get cancer. I will pay close attention to what I say to patients in the future.”
The final lesson is one of authenticity and integrity, something Eileen Rosenbloom who was diagnosed with breast cancer in June 2010, believes cancer cannot take away.
“Although I often felt like cancer was a thief that had taken everything from me, being so ill also created an opportunity to see what it could never take — the very essence that is me. Sometimes I’d look at my eyes in the mirror and think: There I am, right there. I’m still me. It felt empowering to realize no matter how dark things got, I still had control over some part of myself. My very essence remained intact, even if stripped down to a raw version without any frills.”
Whatever place you are at with a diagnosis of breast cancer, there are lessons to be learned. These will be unique to you; but you can also learn from those who have walked this path before you. Reach out to them, and lean on their experience to help make the way a little smoother for your own journey.