Below is information about new research being published soon:

The potential cancer risk that radiation from mammograms might cause is slight compared to the benefits of lives saved from early detection, new Canadian research says.

The study is published online and will appear in the January 2011 print issue of Radiology.

This risk of radiation-induced breast cancers “is mentioned periodically by women and people who are critiquing screening [and how often it should be done and in whom],” said study author Dr. Martin J. Yaffe, a senior scientist in imaging research at Sunnybrook Health Sciences Centre and a professor in the departments of medical biophysics and medical imaging at the University of Toronto.

“This study says that the good obtained from having a screening mammogram far exceeds the risk you might have from the radiation received from the low-dose mammogram,” said Dr. Arnold J. Rotter, chief of the computed tomography section and a clinical professor of radiology at the City of Hope Comprehensive Cancer Center, in Duarte, Calif.

Yaffe and his colleague, Dr. James G. Mainprize, developed a mathematical model to estimate the risk of radiation-induced breast cancer following exposure to radiation from mammograms, and then estimated the number of breast cancers, fatal breast cancers and years of life lost attributable to the mammography’s screening radiation.

They plugged into the model a typical radiation dose for digital mammography, 3.7 milligrays (mGy), and applied it to 100,000 hypothetical women, screened annually between the ages of 40 and 55 and then every other year between the ages of 56 and 74.

They calculated what the risk would be from the radiation over time and took into account other causes of death. “We used an absolute risk model,” Yaffe said. That is, it computes “if a certain number of people get a certain amount of radiation, down the road a certain number of cancers will be caused.”

That absolute risk model, Yaffe said, is more stable when applied to various populations than relative risk models, which says a person’s risk is a certain percent higher compared to, in this case, those who don’t get mammograms.

What they found: If 100,000 women got annual mammograms from ages 40 to 55 and then got mammograms every other year until age 74, 86 breast cancers and 11 deaths would be attributable to the mammography radiation.

Put another way, Jaffe said: “Your chances are one in 1,000 of developing a breast cancer from the radiation. Your changes of dying are one in 10,000.”

But the lifetime risk of breast cancer is estimated at about one in eight or nine, he added.

Due to the mammogram radiation, the model concluded that 136 woman-years — that’s defined as 136 women who died a year earlier than their life expectancy or 13 women who died 10 years earlier than their life expectancy — would be lost due to radiation-induced exposure. But 10,670 woman-years would be saved by earlier detection.

The data to estimate deaths from radiation exposure was gathered from other sources, such as from patients who received radiation from the nuclear weapons used in Japan. “We really don’t have any direct evidence that any woman has ever died because of radiation received during the mammogram,” Yaffe said.

“I’m not minimizing the concern of radiation,” Rotter said. “Everything is a balance.” For example, younger breasts, particularly those of women aged 40 to 49, are more sensitive to radiation than breasts in older women, but the new study shows it’s better to get the screening mammography than skip it.

You may recall

 The study:  ”Estrogen Plus Progestin and Breast Cancer Incidence and Mortality in Postmenopausal Women“ is a further analysis of the Women’s Health Initiative randomized study of postmenopausal women taking conjugated equine estrogen plus medroxyprogesterone acetate, conjugated equine estrogen  alone or placebo (sugar pill).    After a follow-up of 11 years,  it is found that  the women taking estrogen with progestin had increase risk of  invasive breast cancer compared with women taking placebo.   Even more important was the evidence that women on the combined hormones had a  higher risk of dying from the disease. Ok, I know this is scary, but before you trash your hormones…

This is what you need to consider:

•  A 2004 report published in JAMA on the estrogen-alone component of the WHI found no increase in breast cancer risk among women with hysterectomy over an average of 7 years of randomized treatment.  
• The absolute risk  amounts to 2.6 deaths from breast cancer (in the combined hormone group) vs 1.3 deaths (in the placebo group) per 10,000 women per year.
• While the absolute risk of breast cancer death  is small, it is  increased for women taking combined estrogen plus daily progestin.
• Experts continue to recommend hormone therapy for menopause symptoms only, using the lowest dose for the shortest period of time.

This is what you should do:   

• If you have had a hysterectomy and are on estrogen only, don’t sweat it.
• Weigh the risks and benefits. Can you manage your symptoms with life style changes?   Exercise, weight, stress and alcohol management can make a huge difference.  It takes more committment than taking a pill but the rewards are worthwhile.   
• Consider a trial off your hormones every 6-12 months. Things change. Maybe your symptoms have too.
• Lower your dose.  Use the lowest effective dose, for the shortest period of time.
• If  life is so much better with hormones that you decide to continue, there are other ways you can reduce your risks.  To repeat: Exercise, weight, stress and alcohol management can make a huge difference. 

Remember that if you have a uterus, taking estrogen alone can cause cancer of the lining of the uterus.  Progestins are needed to prevent that from happening.  Good for the uterus, bad for the breasts.  So researchers continue their quest for answers to the following questions:

• Do the same risks for breast cancer apply for different kinds of progestins such as micronized progesterone?
• Can risk safely be reduced by reducing exposure to progestins by taking them intermittently,  like every 3 months instead of daily?

Stay tuned, talk to your health care provider and keep asking your own questions.

As far as emotion, I think the fear of breast cancer is bred in to every woman.   It was described  3500 years ago by Egyptian physicians as always fatal and remained so until relatively recently.  A hundred fifty years ago Dr. Halstead, a New York surgeon, pioneered the radical masectomy.  This is a surgery removing the whole breast, chest muscle and underarm lymph nodes.  This offered some hope but left women disfigured and in chronic pain.    In the early 20th century breast cancer survival rate was 10%.   The first mammogram machine debuted in 1966.  Routine mammograms became standard for breast cancer detection just 34 years ago.  Now with early detection, a woman with stage 1 breast cancer has a 100% survival rate.  Less than 10% of women need more than a lump removed from their breast.   Radiation and chemotherapy side effects are improving.  Three years ago when I was diagnosed with breast cancer, the fear was numbing.  But it did not turn out as bad as (anywhere near)  what I imagined and more and more women are relieved to have that same experience. 

Which brings me to my next subject: breast cancer survivors.   I always shy away from this label.  To me, survivors have endured something life threatening.  And if you have been diagnosed with Stage 1, then not so much.   But this term is now generally defined as anyone who has been diagnosed with breast cancer.  To read more about the pros and cons of this label, read Elaine Schattner’s interesting post discussing this issue: ttp://www.slate.com/id/2268104/pagenum/all/.

To get a real perspective on the breast cancer experience come join us on Wednesday, October 13, 6:30-8:00 pm at Fairlane Medical Center, Dearborn.  See Support Circle page  for link to register and click on Fairlane link for direction.  This promises to be a very enlightening evening and we will also have a fun drawing for “pink stuff” for all participants.  Hope to see you there. Go pink!

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Hormone therapy prevents and treats osteoporosis but is rarely used solely for this indication. Estrogen is as effective as the other treatments for osteoporosis, so most women using HT for menopausal symptoms will not need additional treatment for their bones except for adequate calcium and vitamin D intake. If only vaginal symptoms are present, low-dose local estrogen therapy is preferred. There are creams, pills, and an estrogen ring which can be used to treat vaginal symptoms. They are all equally effective and which is used may be based on the woman’s preference. The risk profile for vaginal therapy is very different from systemic therapies, and there is no data that suggests a link between use of vaginal estrogen and the development of breast cancer or heart disease. There are safety studies up to 1 year showing no adverse endometrial effects, but studies of long-term effects of low-dose vaginal estrogen therapy are lacking. Therefore, women using vaginal estrogen therapy should report any vaginal bleeding and should undergo thorough evaluation.

Contraindications to HT use include breast or endometrial cancer, cardiovascular disease, history of blood clots, and active liver disease. Alternatives to HT is advised for women with or at increased risk for these conditions. The lowest effective estrogen dose should be used for the shortest duration necessary. Women should be informed of the potential benefits as well as the risks of all therapeutic options. Care should be individualized, based on a woman’s medical history, needs, and preferences.

Women’s Health Initiative (WHI) followed 97,000 postmenopausal for more than 8 years and found that optimistic women had a lower rate of heart disease than those with higher levels of cynical hostility and mistrust.  In fact, cheerful women had a lower risk of dying from any cause.

This is not the first time optimism and better survival has been looked at.  A study published in the British Medical Journal last year found that optimistic women had a 25% less chance of breast cancer than pessimists.

Other studies have not found a link between optimism and survival rates but a positive outlook has been found to be linked to reduced pain and eased side effects of cancer treatments.

The whole mind-body connection has achieved much more attention in recent years.   Several books are available addressing the subject.  Leslee Kegan M.S., FNP from the Mind-Body Medical Institute at Harvard wrote a book and developed a whole program called Mind over Menopause.    Check out this link for her essay on the North American Menopause Society site-  http://www.menopause.org/positivepassage.aspx.   There are some great suggestions about getting into a positive frame of mind. 

 But if life is really getting you down and you are tending toward crotchity as you get older, what else can you do to put a smile on your face?   How about Laughter Yoga.  Just going to the web site and looking at the video will crack you up! Go to www.laughteryoga.org.

For the sake of your health find ways to cultivate your happiness.  As  Abraham Lincoln himself once said-” Most folks are about as happy as they make up their minds to be.”

Acupuncture has been around for about 5,000 years.  Very thin “needles” are placed in key areas of the body called meridians to stimulate and balance the flow of energy through the body.  It has been used by an estimated 8.2 million U.S. adults.  Benefits have been published in peer-reviewed western medical literature and studies conducted by the National Institutes of Health

Acupuncture is often used in combination with Chinese herbal medicine and referred to as Traditional Chinese Medicine (TCM).  Increasingly TCM and other alternative health modalities such as mind/body therapy and massage is being combined with conventional ( allopathic) western medicine to achieve enhanced results.  Referred to as Integrative Medicine it is hoped, by practitioners in both camps, to bring the best of both worlds together.  TCM is being used for various women’s health issues such as menopausal symptoms,  cancer support, emotional health issues and chronic disease management.  All issues close to the hearts of many of us of a certain age.

In 2008 Henry Ford Health System oncologist, Dr. Eleanor Walker with the assistance of  acupuncturist, Beth Kohn conducted a study with 47 breast cancer patients.  These patients were all on tamoxifen or Arimidex to reduce cancer recurrence.   Hot flashes are a common side effect of these two drugs.  Half of the women received acupuncture treatment and half were given the antidepressant venlafaxine (Effexor).  Effexor has also been shown to reduce hot flashes.  At the end of 12 weeks both groups reported 50-75%  fewer hot flashes.  The acupuncture group reported no side effect and other improvements such as  improved sense of well being, more energy and higher sex drive.  The antidepressant group did not experience these benefits.

This is useful information to those of us who may be struggling with menopausal symptoms but do not want the side effects of hormone therapy or antidepressants.  Although most health insurance companies do not cover the cost of acupuncture, it is eligible for reimbursement from a health care  flexible spending account.  Many large health care organizations around the country have Integrative Medicine Centers were you can be assured of getting well trained, reliable practitioners.  If you are interested in more information and live in  southeastern Michigan, contact Henry Ford Center for Integrative Medicine  at 248-380-6201.  Tell them you are “poking around” for some answers.

September 2009

 Illuminating Elimination New approaches to pelvic problems. Learn about techniques and methods for managing and preventing bladder, bowel and prolapse problems. This is a talk that shouldn’t be missed.

October 2009

Taking Care of the Girls” : In honor of breast cancer awareness month, you will learn how to reduce your risk for breast cancer. Discussion will include the newest methods of detection in breast cancer and treatment options.

November 2009

Sizzle or Fizzle: Menopause and Sex: Your body is changing and so is your sex drive. Come join the discussion and have your questions answered about what is normal and what might be cause for concern.

On Wednesday, Dec. 3, Elizabeth Edwards brings her message of finding hope and inspiration in life’s challenges to the Troy Hilton, at 5500 Crooks Road. The Henry Ford Health System, Ford Motor Company and Metro Parent Magazine are proud to present this unique opportunity, entitled “An Evening with Elizabeth Edwards.”

The event is rescheduled from its original Wednesday, Oct. 15 date, which was cancelled due to Mrs. Edwards mother’s illness.

The country has gotten to know Elizabeth Edwards as she campaigned across the country during her husband’s political campaigns. The day after the general election in 2004, she was diagnosed with breast cancer. Mrs. Edwards was in remission until March 2007 when she discovered her cancer had returned. Her courageous battle with breast cancer has served as an inspiration to women across the country, which she shares in her memoir “Saving Graces: Finding Solace and Strength from Friends and Strangers.” A passionate supporter of children and families, as well as an accomplished attorney, she has been an advocate for many important causes.

One that is dearest to her heart is the Wade Edwards Foundation. The foundation, which helps finance educational and enrichment programs for young people, is named after Mrs. Edwards’ eldest child, Wade, who tragically died in a car accident in 1996 at the age of 16. Mrs. Edwards is the proud mother of three other children: Catharine, Emma Claire and Jack.

Despite a battle with breast cancer, the loss of a son and the pressures of living a life in the public eye, Mrs. Edwards has remained determined to live what she calls “an inspired life.” Mrs. Edwards will share her story of how she’s persevered through tough times. “An Evening with Elizabeth Edwards” is sure to be an uplifting and inspiring event for anyone who is or has experienced difficulty in their lives, especially those affected by breast cancer.

“An Evening with Elizabeth Edwards,” will be held at the Troy Hilton in Troy, Mich. General admission tickets cost $25.

The event is presented by Henry Ford Health System, Ford Motor Company and Metro Parent Magazine. It is sponsored by the Michigan Education Savings Plan (MESP), Magic 105.1 and Inforum.

To purchase tickets or for additional information, visit MetroParentEvents.com or call 248-398-3400, ext. 128.

SOURCE Metro Parent Magazine

MetroParentEvents.com

Who doesn’t know that October is Breast Cancer Awareness Month?  This is a disease that has about the best media coverage and public relations promotions of any disease I can think of.   I read an opinion that this is because there are so many breast cancer survivors who have a lot of energy after their treatment to promote awareness.  This is unlike, say lung cancer, which actually kills more women but leaves less survivors.  I think it may also be because in the past breast cancer truly was always a death sentence and  still carries the lingering emotions of that terror.  Survivors feel touched by death.

I personally felt that terror after being diagnosed with breast cancer last year.  A very small non-invasive cancer was discovered in my left breast after a routine mammogram.  No lump, no family history but there it was.  If I had known at the time how easy the lumpectomy and radiation therapy would be, I would not have been so terrified.  But I can tell you now, it turned out not to be a big deal for me.  I was lucky.  I did not need chemotherapy.  I have survived some difficult things in my life, but I do not feel like a “breast cancer survivor”.    A survivor is someone who has endured catastophe, like a hurricane or a life threatening disease.  My disease got no where near life threatening.  It is not at all likely that I will die from breast cancer.

I am one of a growing number of women whose disease was caught so early that it is not the monster it used to be.  We can thank technology for that.   That includes access to regular mammograms and better mammograms, better scientific knowledge about the disease and how to treat it.  Key, too is a growing knowledge about how to prevent  breast cancer.   A generation ago breast cancer meant little choice but to have one’s breast loped off and weeks of debilitating treatments and more often than now, death.  Now with early detection, it is possible to come through it with little more than a barely visable scar.  With changes in life-style it may be prevented and many women will be spared.  We each have the power to fight this disease with education about prevention and early detection.

I honor my sisters who have battled life threatening breast cancer and have survived or succumbed.  I look forward to the next step in the battle in which someday the disease may be extinguished by a vaccine.  And I honor all of you who have survived all the battles of life- death of loved ones, lost jobs, diabetes, heart disease, lupus, other cancers and so on.  As Gilda Radner’s Rosanna Rosanadanna (who died of ovarian cancer) said, “It’s always something.” So I urge you to keep surviving whatever it is you are surviving.  Continue to be brave and fight.  Get your annual mammograms- and eat healthy, get exercise, stop smoking, limit or stop alcohol use, manage your stress, lose weight if you need to and, gosh darnit just take good care of yourself!

What have you survived?  What advice do you have for someone going through a difficult time?