Screening

Screening for new cancers

“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

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Dear neighbor!

The summer is passing quickly. Many of you are likely already starting to prepare for the next 6 months – health, school, work, family, house, car, travel, and the Holiday season….etc!

Life can feel like a never-ending whirlwind at times – pulling you in many different directions, leaving you to organize and streamline the chaos.

Having been told that you have cancer, one of life’s “worst case scenarios”, you may have, unconsciously, lost trust in your body or life, and started to be more ‘on guard’, ready for “the other shoe to drop” or deal with whatever or whenever the next ‘worst case scenario’ may be. You may also know this as the Fight-or-Flight response. But this response can go into overdrive at times, affecting all aspects of your life, even the routine ones. Perhaps you used to be a glass-half-full person, but now you may have become more of a glass-half-empty person.

I hope this writing will allow you to try to Stop-and-Think-First before you act, when you feel your body tensing up for a ‘fight’….(unless, of course, there truly is a life-or-death emergency, like a lion chasing you!).

Pause to get yourself e.g. a delicious meal, a good night’s rest, a meaningful conversation with a loved one, whatever it takes to regain a more neutral and realistic perspective….and then rethink your decision-making again….you may discover that your glass is neither half-full, nor half-empty…..it may actually be refillable, maybe even to the top….!

Life is not always fair….some people may have more suffering on their path than others….but some may also choose to keep their suffering more private….please don’t give up hope….and find “neighbors” who can help you carry your backpack!

Won’t you be my neighbor…please? Please…find below a few things for education and entertainment!

Learn and Think:

Certain breast implants have been in the news this week due to a FDA recall:

Based on the currently available information, our analysis demonstrates that the risk of breast implant associated lymphoma (BIA-ALCL) with Allergan BIOCELL textured implants is approximately 6 times the risk of BIA-ALCL with textured implants from other manufacturers marketing in the U.S.

At this time, the FDA does not recommend removal of these or other types of breast implants in patients who have no symptoms due to the low risk of developing BIA-ALCL. The FDA will continue to evaluate any new information and may, as a result, take action regarding other breast implants, if warranted. Source

If any questions or concerns, it may be best to contact your plastic surgeon.

Live and Feel:

Lately, I have become fascinated with Mr Rogers’ legacy, probably encouraged by the upcoming release of the Its a Beautiful Day movie in which Tom Hanks portrays Mr. Rogers. Mr. Rogers courageously displayed his own vulnerability/sensitivity and preached “love” to encourage “being”, acceptance, respect, confidence, and health. His award-winning messages and poetry are simple, yet deep, and just as helpful as they were 50 years ago, independent of your age! His thought-to-be-last video message to his grown-up fans gently encourages “the expression of feelings in ways that will bring healing”.

Fred Rogers once said:

“Part of the problem with the word ‘disabilities’ is that it immediately suggests an inability to see or hear or walk or do other things that many of us take for granted. But what of people who can’t feel? Or talk about their feelings? Or manage their feelings in constructive ways? What of people who aren’t able to form close and strong relationships? And people who cannot find fulfillment in their lives, or those who have lost hope, who live in disappointment and bitterness and find in life no joy, no love? These, it seems to me, are the real disabilities.” Source

 

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Being (a) Patient – Colonoscopy, Happiness, Lion King

Being (a) Patient – Colonoscopy, Happiness, Lion King

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Dear Travel Buddy!

Great to see you have stopped by to check in – always appreciate the company! This weekend, my family (thank you!) assembled a few pieces of furniture….which inspired me to write about ‘patience’….! 

When my patients express concern that their medical care is moving (too) slowly or their recovery is taking longer than expected or desired, I often ask them if they know why a patient is called ‘a patient’. Usually this results in an inquisitive, speechless gaze. The word patient is derived from Latin:

Adjective: Able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious.

 

Noun: Person receiving or registered to receive medical treatment.

Citation

 The precise meaning of the medical definition of patient continues to be inconsistent, likely as the medical field and society continue to evolve. As such, a renowned medical journal had even devoted an article in 1999 (!) to the discussion of the pros and cons of finding a new word for patient. The article’s conclusion was that the massive undertaking of changing the word ‘patient’ to something else (requiring it’s own research, implementation, and distribution efforts) is likely not worth the diversion of time, effort, and resources away from providing and innovating patient care.

A similar discussion is ongoing about the ‘cancer survivor’ label. For some, the term cancer survivor may allow recognition and unity. For others, it may result in discomfort, because they don’t feel that their journey was heroic enough or because the label may allow division among survivors or represents survivors’ guilt or even a Post-Traumatic Stress Disorder trigger. 

The reason for your impatience may change over time:

  • Initially, when you are newly diagnosed (and undergo testing, await treatment plan decisions and insurance authorizations), being impatient may be a reflection of a fear of the unknown, lack of control, or feeling overwhelmed. Starting cancer therapy is usually the best remedy to provide some relief. But in the interim, it may help to know that only a few cancer types and situations represent a true medical urgency/emergency. Even though anyone would like to have their cancer treated as soon as humanly possible, for the majority of cancer diagnoses, it is more important to be strategic. The quality performance of a number of strategically selected and rapidly evolving imaging, laboratory, and pathological tests will facilitate informed decision-making and the creation of a personalized cancer treatment plan that aims to optimize benefit and minimize harm. Furthermore, it also may help to know that there are many official organizations that hold cancer centers accountable for administering cancer treatments in a timely manner (e.g. the Commission on Cancer in the USA).  
  • Next, as you transition from the active treatment phase into the post-treatment phase, impatience may become more reflective of a frustration with the slow or incomplete recovery process, a need to gain more control over your life (and survival), or a desire to catch up on life that was abruptly put on hold for the cancer treatments. With respect to a frustration with delayed/incomplete recovery/healing, I would like to refer to a previous post on acceptance. The instinctive urge to catch up on lost time could be interpreted literally, since some cancer treatments can be really intense and prolonged. But it can also be interpreted figuratively: the cancer experience may have increased one’s awareness of their own mortality and ignited an urge to get certain things done ‘before time runs out’. It may help to know that your priorities will often change after a cancer diagnosis, allowing you to live closer to the essence of your life, catch up with (and perhaps even surpass) your pre-cancer trajectory! 

Please try to be more patient with yourself…..this is not a sprint, but a marathon! And I sincerely hope you will feel comfortable enough to ask your health care providers for help, if you feel ‘your mind is becoming your worst enemy’ and leads to dysfunction. There is no need for shame or embarrassment in this current time and age. You are only human – everyone has a breaking point!   

Together we stand strong! Please find below a few things for education and entertainment!

Learn and Think:

  • Health maintenance alert! The American Cancer Society recommends that most people – those at average risk – start regular colon cancer screening at 45. People with an increased risk may need to start screening before age 45. Please discuss this with your health care providers! 

Live and Feel:

  • This non-profit organization, Action for Happiness, is devoted to making the world a happier place by providing various insightful tools and resources that promote the 10 essential keys to happier and more resilient living (for free or low cost).  
  • The original Lion King movie from 1994 is one of my favorites. Its music and story themes (circle of life, the good prevails) resonate with me. [The Lion King 1 1/2 movie is hilarious, which tells the Lion King story from the perspective of Timon and Pumbaa]. This weekend the Lion King movie’s remake premiered – I didn’t get to see it yet – did you?! I love the Circle of Life song – click here for the video, see below for the lyrics! 

“Circle of Life”, partial lyrics

From the day we arrive on the planet
There's more to see than can ever be seen
More to do than can ever be done
There's far too much to take in here
More to find than can ever be found
But the sun rolling high
Keeps great and small on the endless round

It's the Circle of Life
And it moves us all
Through despair and hope
Through faith and love
Till we find our place
On the path unwinding
In the Circle
The Circle of Life

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Breast Implant Associated Lymphoma

Breast Implant Associated Lymphoma

Breast Implant Associated Lymphoma is not a new entity and remains a relatively rare phenomenon. But it made the headlines this week due to a recent FDA advisory meeting that may trigger more research and future changes in clinical management. But until then, the bottom line:

If you have breast implants, there is no need to change your routine medical care and follow-up. You should expect swelling and pain immediately after surgery. If you notice changes in the way your breast looks or feels after you recover from surgery—including swelling or pain around the implant—be sure to talk to your health care provider about the possibility of BIA-ALCL. Although not specific to BIA-ALCL, you should follow standard medical recommendations including:

– Follow your doctor’s instructions on how to monitor your breast implants. If you notice any changes, contact your health care provider promptly to schedule an appointment.

– Follow your doctor’s instructions for routine mammography screening. Be sure to inform the mammography facility that you have breast implants so enough time is scheduled for your mammogram. Your doctor may also recommend other tests, such as magnetic resonance imaging (MRI).

FDA

This link may also be helpful: FDA’s FAQ.

Toxins Actually….Toxins Are All Around….!

Toxins Actually….Toxins Are All Around….!

Throughout every generation of human existence there have been dangers that threaten our longevity. Science has made many discoveries that make us better at preventing and even eradicating some threats such as disease, (i.e. influenza and smallpox) and in anticipating or managing natural disasters such as those caused by severe weather. The unfortunate trade-off is that we have created new dangers that can pose as much, or even greater, harm to our earth and body. The line between the natural and man-made disasters often becomes blurry.

In this twenty-first century, we have become aware that our environment can pose a danger to our health and, depending on our level of exposure and susceptibility, can have significant implication for an individual’s health and wellness. Cancer survivors, who may be wondering why they developed cancer to begin with, may be very concerned about what their body meets; what they inhale, eat, drink, or even apply to their skin. Consequently, everyday life takes on new challenges and everyday habits, such as a trip to the grocery store, can become a stress-filled and lengthy experience. In an ever-changing environment there is a new reason to explore and educate ourselves constantly to minimize the risk of exposure and find ways to work around them. Even then, there is no assurance that we have done ‘enough.’

Since it is not socially acceptable, nor desirable to live in a balloon, we need to have some confidence in the work that government and medical organizations like the CDC and the Human Exposome Project have set in action. Bringing together investigators and professionals to measure and understand the impact of complex environmental influences and human health, we must have some measure of trust that best practices are implemented and care for our world is a priority. 

Hopefully, as time progresses, the impact of our environment on the health of future generations will lessen, making a place instead to reduce the impact and effects of the next ‘disaster’. Until then, all we can do is use common sense. At the end of the day there is only so much we can do to protect our body without jeopardizing the quality of our lives. The psychological impact of this vast awareness of the dangers around us may haunt you at times in your cancer survivorship journey. If you notice that it starts to interfere with your ability to function and live your life, then please let your provider know, so they can provide support to help you through this time of stress. A little well directed guidance can help you quicker and faster than you may be able to accomplish on your own. Remember the mind can become another one of our biggest enemies; don’t let it run away with worst case scenarios. Be brave, be strong, be wise!