Reduce the Risk of Breast Cancer

Since I was diagnosed with breast cancer, I have become very breast aware and am anxious that I should know how to advise my daughters so that their risk of this horrible disease is minimized. So, whatever your age, size or shape it is so important to take care of your breast mammogrambreasts. Breast cancer is the most common cancer in the UK. It affects men as well as women. So it is important to look after your breasts by being breast aware. This means getting to know how your breasts look and feel, so you know what is normal for you. You will then be more confident about noticing any unusual changes.

Before my breast cancer diagnosis, I did not check my breasts. I did not know I should. I know now this was a big mistake. Try to get used to looking at and feeling your breasts regularly. You can do this easily in the bath or shower or when you get dressed. Check all parts of your breasts, your armpits and up to your collarbone.

breast dischargeIt will not surprise you to know that before I was told I had breast cancer, I did not know what changes to look for – many of us don’t. Make sure you know what your own breasts feel like. Everyone’s look and feel different, so when yo check your breasts, be aware of any changes that are different for you.

This might be a change in size or shape; redness or a rash on the skin or around the nipple or lumps or thickening that feels different from the rest of the breast tissue. Alternatively, you might become aware of  change in skin texture such as puckeringbreast dimpling or dimpling like orange peel. I found a discharge from my right nipple, but I did not recognise this as a sign of breast cancer. Other changes might be swelling in the armpit or around your collarbone. Be aware if your nipple becomes inverted when it is not usually so or changes its position or shape in another way; you may also have constant pain in your breast or armpit.

If you notice any change in your breasts go to see your GP as soon as possible. Most changes are benign, but if you are struck by breast cancer, give the doctors a chance to help you by going to see them as early as possible.

My breast cancer was discovered as the result of a breast screening appointment arranged by my GP. Breast screening, or mammography as it is known, is an X-ray examination of the breasts. For me, it helped to detect breast cancer before I was aware of any signs or symptoms. The sooner the breast cancer is detected and diagnosed, the more effective treatment will be and the more likely you are to have a more satisfactory outcome.

Valerie Penny

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Osteoporosis and Breast Cancer

Osteoporosis literally means porous bones. The result is that the bones can become thin or snap. Osteoporosis cannot be cured and often is not found until after bones break. It affects half of women over 50 and one in five men in that age range and some people who receive treatment for breast cancer are at an increased risk of ostoeporosis, however, treatments are available to try to keep bones strong and less likely to break.

Women who have not gone through the menopause before they are treated for breast cancer have an increased risk of osteoporosis. Indeed, chemotherapy can cause an early menopause and a rapid, significant reduction in bone density and result in osteoporosis.Even women who have been through the menopause may be at increased risk of osteoporosis because of the hormone therapies they take for breast cancer.

balanced her 2.jpgI am being treated with letrozole for my breast cancer. My tumour was of the fast growing HER2 positive variety. The letrozole is one of the drugs that reduces the amount of oestrogen circulating in my body and this could result in osteoporosis. I have my bone density checked with a bone density scan and, so far, I do not show signs of osteoporosis. Generally speaking, people with a good bone density before getting treatment for breast cancer are less likely to develop osteoporosis while taking an aromatase inhibitor such as letrozole.

I have been careful to put some simple lifestyle choices to help keep my bones strong and healthy. I ensure that, although I am vegetarian, I have a well-balanced diet. Although dietbalanced-diet changes will not cure bone defects, it may stop them osteoporosis getting worse. Eating meals that incorporate a wide variety of foods including fruit and vegetables, carbohydrates, milk and dairy products and proteins help achieve this. As a general rule it is recommended that we eat at least five portions of fruit and vegetables a day. You would be amazed how many people, including vegetarians, do not manage this! I have also significantly reduced my alcohol intake and the amount of fizzy drinks I take.

Calcium is a vital mineral for teeth and bones. It gives them strength and rigidity. Most of the calcium found in our bodies is in our bones. Dairy produce is our main source of calcium. People  can usually get enough calium through a healthy diet that includes dairy products. If your diet did not include dairy produce you would need to ensure you got calium from another source such as a calcium supplement.

I also have to bear in mind that vitamin D is needed to help my body absorb calcium. The best source of vitamin D is sunlight. Human bodies use the sunshine to make vitamin D in the skin. The vitamin D is fat-soluble and the body stores it for use in the winter months. balanced sunWe only need to be out in the sun for about quarter of an hour a day during the summer months to give most people enough vitamin D for the whole year. So a walk, some gardening or a round of golf should make sure we get enough vitamin D. In addition to that, margarine, egg yolks and oily fish also contain vitamin D.

Regular weight-bearing exercise is also important to put force through the bones. This helps stimulate growth and strength and keep bones strong and healthy. Such exercise includes skipping, aerobics, tennis, and dancing are good bone building activities, even a brisk walk can be of benefit to bones. I try to do some exercise at least three times a week in order to combat the cancer-related fatigue I suffer and the potential for weight gain that my medication induces. I really try very hard to make sure that I do not add osteoporosis to my list of worries.

Valerie Penny

 

Radiotherapy after Breast Cancer

My Uncle suffered from colon cancer and had told me that radiotherapy was not nearly as difficult to bear as chemotherapy. However, when I came to receive radiotherapy for my breast cancer, I came to disagree with him. Radiotherapy treatment is planned and delivered by specially trained professionals called therapy radiographers. It is given by a machine called a linear accererator. Breast cancer patients are usually treated for between 3 to 6 weeks.

The treatment only lasts a few seconds, but to get prepared and settled on the machinery, the period each patient is in the room is about 10 minutes. I needed four weeks treatment. It is given on week days, every week day except for public holidays, for the stated period, so I had to go for treatment 5 days a week for four weeks.

The treatment, at least at first, is painless. Still, reasons that I did not agree with my uncle were that the journey to the hospital that delivers the treatment is an hour’s drive from where I live, and an hour’s drive back. Given that and the wait for treatment at the beatsonhospital could mean a 3-4 four round trip. That was terribly tiring. Also, the treat ment is given in a large room that contains nothing but a chair to place my cloths on, a screen for the radiographers to stand behind as they deliver treatment and the machine, itself.

Patients are not treated by the same radiographers each day and students, male or female, may be amongst the team. I should have been asked if I was willing to have a student present , but I never was. Like many who suffer from breast cancer, I come from a generation that is not used to displaying my body to other people, especially much younger men. I was simply told to take off the clothes on my top half and come over to the machine. It was embarrassing and demeaning. I was just given a piece of paper towel to cover my modesty. Needless to say, that did not work!

The way this treatment was delivered was embarrassing and demeaning. The journey to get the treatment was long and tiring. During treatment I had to lie in a specific position so that the radiotherapy could be delivered most accurately. The radiographers dimmed the lights for a short time while they positioned the machine. They then stood behind the b machinescreen while the treatment was delivered.Once or twice the treament given was slightly different in that it was a boost to my scar area. However, the method of delivery and the lack of attention to personal sensitivities was the same as ever.

The treatment results in a cumulative effect to the cancer and side effects. At first, I felt no different after treatment. It was only after two weeks or so that I bagan to feel side effects and so terribly tired, weary, as a result of the treatment. It also caused burning on and in the flesh around my breast. The hospital provded aqueous cream to soothe that.

I needed the radiotherapy to help beat the cancer, but it was difficult to bear.

Valerie Penny

FEC Chemotherapy for Breast Cancer

When I was diagnosed with breast cancer, apart from being completely taken aback that something like this could happen to me, I got detailed advice from the oncologist about the type of treatment I would need.

fecI was told that after surgery to remove the tumours, the oncologist told me that I would receive chemotherapy and then  radiotherapy. The chemotherapy I received was called FEC. This is a combination of three chemotherapy drugs 5 fluorouracil, epirubican and cyclophosphamide. FEC takes its name from the initial of these three drugs.It is normally used to treat people with primary breast cancer that has not spread to other parts of the body. Chemotherapy destroys cancer cells by interfering with their ability to divide and grow.

All cells in our bodies continually divide and grow. This enables growth and repair of body tissue. Cancer cells are different because they grow by dividing in a disorderly and uncontrolled way. Different chemotherapy drugs work in different ways and attack the cancer cells at different stages of their growth. This is why a combination of drugs is often more effective than just one drug.

I was given my FEC intravenously. I had a Hickman line fitted because the veins in my hands did not allow easy acces for the cancer nurses.  All my medication was given through my Hickman line. I did not like having it, but it was useful. I was given the FEC as an out patient, every three weeks for 18 weeks. This meant I could go home on the same day after treatment, that was nice, but the days were long and tiring. The time involved is not just that required to give the drugs, but also waiting time, blood tests and time for the drugs to be prepared.fec tired

I suffered side effects with FEC. The common side effects include bone marrow suppression.Bone marrow suppression or myelotoxicity is the decrease in production of cells responsible for providing immunity, carrying oxygen and those responsible for normal blood clotting. Bone marrow suppression is a serious side effect of chemotherapy. The decrease in blood cell counts does not occur right at the start of chemotherapy because the drugs do not destroy the cells already in the bloodstream. However, the drugs affect new blood cells that are being made by the bone marrow. The suppression of bone marrow activity causes a deficiency of blood cells. This condition can rapidly lead to life-threatening infection, as the body cannot respond to invading bacteria and viruses.It can also leading to anaemia due to a lack of red blood cells and spontaneous severe bleeding due to deficiency of platelets. This resulted in me suffering from severe tiredness and exhaustion. It is difficult to describe the depth of the feelings of exhaustion. I also had several spontaneous nose bleeds.

Other side effects include nausea and vomiting. The hospital supplied medication to minimise this. I was instructed to take the medication at specified times after my treatment. However, the most visual side effect of chemotherapy is hair loss. I did try an ice-cap to reduce that, but to no avail. It did not work.

fec baldWhen people think of hair loss, they, and women in particular think of the loss of hair on their head. Certainly that does go. The result is a cold head in winter! However, all of the hair on my body was lost. This included the hair on my limbs and inside my nose. The good news was that I did not need to shave my legs for a year, the bad news is that it meant there were no hairs to stop my nose from running. Always carry a handkerchief!

I was not going to bother buying a wig. However, my cancer nurse advised that I should. This was partly because it might make the sight of me during my illness less difficult for my children and my elderly mother. She also pointed out that it would keep my head warmer, especially in winter. She was right on both counts.

Cancer affects not just the person who is diagnosed, but all the people who love them: their friends and family. I hope you never suffer such a diagnosis, but if you do, bear in mind the agony of those around you.

Valerie Penny

 

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