Monday, January 11, 2010

Breast cancer survivors: Am I cured yet?

pink ribbon
Image via Wikipedia

[Republished from with permission]

October has become so synonymous with Breast Cancer Awareness month that it's almost a total pink-out. Signs, stores, and even scarves urge us to stamp out breast cancer. And following on October's (high) heels this year was the Mammogram Media-Monstrosity (for a bullet-sized version, check out #9 in the Doc Gurley Year in Review: Top Ten Health Lessons of 2009, or, for a more detailed look at the issue, check out the article, Battle of the Breasts: 16 Crucial Facts for You to Know). Now that we're into a new year, it's a good time to reflect on, well, life. Specifically, life after breast cancer. What with all the hula-baloo about prevention and screening, I'm thinking that the people who've already been diagnosed might have been just a wee bit overlooked.

So how do you embrace health post-breast-cancer? And what's with the weird reluctance of doctors to use the C-word ("cured")? Are there important, simple steps you can take to tilt the odds in your favor for living well? These are the kinds of issues you don't hear so much about in the news - despite the fact that shockingly large numbers of us know and love a mother, sister, friend or daughter who's been diagnosed. To cover some of these issues, I had the pleasure of talking with the charming Zennie - who's very interested in this topic on behalf of his mother. More and more we LIVE with diagnoses and diseases. And that's a good thing. But often we're left trying to decipher life-style advice, and, as research shows that our groups of family and friends is crucial to success, lots of us want to know what might help. So here are some recent, positive research results that you can consider when it comes to life after breast cancer.

Obligatory disclaimer: An article (ANY article) is, in no way, a replacement for actual medical care, and should not be mistaken for personal medical advice. When it comes to random, non-customized medical discussion, take to heart the message that the deep voice says (at the end of gazillions of soft-focus pharmaceutical ads) and see your doctor.

1) The "C-word." Or, why won't my doctor say I'm cured? Doctors don't tend to say that anyone is cured, and even just the absence of that word feels like a heartbreaker for many people. Refusing to say you're cured feels like a HUGE statement that professionals may be lacking-faith in your future. But that's not true. So why won't doctors say it? At it's worst, you could say that doctors don't generally pronounce anyone cured because the doctor is worried it will come back to haunt them if a patient relapses - after all, no doctor can tell the future. At its best, you could say that life is a continuum, that finding a breast cancer and treating it is the beginning of a process - a lifelong process of prioritizing your health. So what kinds of things can a person do to promote health after a diagnosis of breast cancer?

2) Should I lose weight? Exercise? Even at 60? What's clear is that being overweight significantly increases your risk of getting breast cancer in the first place. But what about after you've been diagnosed - should you lose weight? The answer is still being debated. But some well-done research shows that obese patients have worse outcomes, even after diagnosis, and even when you control for the same stage of tumor. What is clear is that promoting your health is a good thing. Eating well, walking everywhere, lifting weights three times a week for as little as 20 minutes at a time - all those things are important to your health. Simple steps can make a big difference - cut out all sugar drinks, including those with sugar-substitutes (become an unsweetened water/tea/coffee-only person!) and buy smaller plates to help with portion control. But keep in mind, fixating on weight-loss alone is probably not a healthy approach - instead, focus on nurturing yourself with only the best. You deserve it, and, heck, you're in this for the long-haul. These changes will help protect you from other significant diseases too. Lifting weights, for example, is important since many of the drugs women take after breast cancer can cause osteoporosis, or thinning of your bones. Lifting weights helps combat this. It's never too late to start - exercise and eating well can make a difference, even in the very elderly.

3) Vitamin D? More and more studies are showing a strong connection between low vitamin D, breast cancer and survival - even after diagnosis. In fact, in my opinion, if vitamin D was a patented drug, it would have more ads running continuously than any other pill (and that's saying a lot!). Here's the deal - vitamin D is about the only thing that doesn't just boost your immune system, it also makes it work smarter (a really hard thing to do!). In contrast, indiscriminately boosting your immune system can result in cases where your immune system attacks the wrong thing, or flares in a way that's, frankly, ineffective. But, keep in mind, you CAN overdose on vitamin D - so it's important to know where your body is living, and then optimize it. You want your vitamin D level well into the normal range - luckily, finding out is a simple, easy blood test. Your doctor can help you safely dose up to a good range, then make sure you stay there.

4) Do I have to take pills forever? Here's one of those good new/bad news kind of situations. Women tend to get two very distinct types of breast cancer - those cancers that have a receptor for estrogen, and those that don't. In general, it's much better to get the kind of breast cancer that "feeds" on estrogen. Studies have shown that type of tumor, in large groups of patients, is much more likely to be treatable without recurrence. That's the good news. The "bad" news is that studies also show survival can be definitely improved for groups of patients who take an estrogen-blocking pill for 5 or more years. Even if the tumor comes back! There are now pills that a patient should be taking for ten years after a diagnosis - even if the diagnosis was at age 81! In another of the weird good news/bad news twists, women who get joint pains from taking one of these pills, Femara, are less likely to have the tumor come back (now that's a motivation for enduring some joint pain if there ever was one!).

6) Sleeping, drinking and smoking: The good, the bad and the ugly. Sleep is good for you. While there are no huge, well-designed studies showing a strong link between sleep and disease-free survival from breast cancer, sleep IS associated with a better-functioning immune system, as well as improvement in many other health areas like blood pressure, and diabetes. Many Americans (if not most, in some subgroups) are just not getting enough sleep. Why take the time to make sleep a priority? Sleep is free, has no side-effects, and generally beneficial to your overall health and mood. I believe it's also a marker of other life issues - if you're unable to get enough sleep, there are probably other things impacting your health (like a high-stress life that can result in grab-and-go-bad-food-choices, and a lack of exercise, for example). Alcohol, on the other hand, when it comes to breast cancer, may be bad for you. Most of us have heard that alcohol, in moderation, can be beneficial for some heart disease prevention. [What does "moderation" mean? For women, zero-to-one drinks per night, with a max of less than 7 a week, for sure.] What many of us may not have have heard, however, is that many studies show that alcohol is not good for breast cancer - in fact, the larger the number of alcoholic drinks a week, the worse the risk. If you're living post-breast-cancer diagnosis, when it comes to alcohol, you want to be the picture of moderation. In fact, teetotalling may be the way to go. So if sleep may be the good, and alcohol the bad, smoking is just flat out the ugly. Smoking, and even passive smoke exposure, are associated with breast cancer. Getting a diagnosis can be the wake-up call to help see you through a solid quit. You'll reap mega benefits for ALL your health.

7) Mammograms...what's the point? Once you've been diagnosed with breast cancer, your regular screening becomes even more important. Recurrences can be treated too - and the earlier the better. It's important to not become discouraged (or worse yet, to despair). After the emotional shock of a diagnosis, it can be really hard to remember that finding a cancer is better than NOT finding one (until it's too late...).

So if you know, love, or care about a person who's living with a diagnosis of breast cancer, what can you do to help promote health after treatment is over? Here are some tips - keeping in mind that nagging is never a good way to go, but loving support, and encouragement can make a world of difference!

1) Be eager to move too. Exercise works best when done with a social group, at every age. Take the time to drive grandma to the mall for a gentle stroll each Sunday. Form a lunch-walking or Tai Chi group. Be the person who makes moving fun for those you love! 2) Encourage appropriate testing - mammograms and regular doctor visits (especially waiting for results!) can be grueling rocky experiences without support from those who care. Be aware, and be there, if you care. 3) Help your loved one to remember to ask about a vitamin D test at her next doctor's appointment. Spread the word! 3) Eat well. Just as with exercise, good eating works best when those around you are supportive. Don't be the person who sighs heavily and says, while gazing at the salad, how much nicer some spicy chicken wings would be. But also don't be a criticizer. Mindful nurturing is the way to go when it comes to improving your diet. As Michael Pollan says, "Eat food, not too much. Mostly plants."

What do you think? Got some tips to share for those who care? Post them in the comments section. Get on the Twitter bandwagon and follow Doc Gurley! Also check out Doc Gurley's joyhabit and iwellth twitter feeds - so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your wellth this coming year.

Got a thingie on your doohickey? Or are you pondering how to tell your doctor he's a jerk? Send your burning healthcare questions to Doc Gurley by emailing docgurleyatgmaildotcom. Doc Gurley cannot answer every question, and she cannot practice medicine through a keyboard (not even with her stethoscope pressed firmly against the monitor) but be assured - your questions will be kept strictly confidential and identifying traits are changed.
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Breast Cancer detection and treatment: an Interview with Doc Gurley

"Doc Gurley" is Doctor Jan Gurley, who's my colleague at's City Brights blog section, and an expert on all aspects of Breast Cancer detection, treatment, and survival. Last week I had the pleasure of interviewing her for a video on Breast Cancer.

Doc Gurley

The reason for my motivation was that my Mom's a Breast Cancer survivor (since 2005) and as an only child, my mind's on constant alert status, making sure that she's OK and ready to basically alter my life if anything happens to her again, which I'm thankful has not been the case.

So, I turned to Doc Gurley with a lot of questions that are not just for people in my situation but really tailored for women who have questions about what to do about Breast Cancer at every stage of our lives.

Doc Gurley wrote a blog on Breast Cancer for Friday's That companion to this post is here.

Doc Gurley and I met at Lake Chalet Restaurant in Oakland, where we talked by the fireplace in what is called "The Pump Room". Here's the video in two parts:

Part One:

Part Two:

California High Speed Rail defies Jerry Brown's letter

In considering an alternative to the downtown San Francisco terminus for the planned California High Speed Rail System, The California High Speed Rail Authority (CHSRA) is acting against a letter written by California Attorney General Jerry Brown.

The CHSRA has gained the anger of San Francisco Supervisor Chris Daly and residents and businesses around "The Beale Street Alternative", particularly the Rincon Hill Neighborhood Association.

The fear of homeowners is that their properties may be demolished to make way for High Speed Rail in the Rincon Hill Neighborhood area. As stated in the blog Rincon Hill Neighbors by "Jamie",

The remote possibility of the Authority choosing to build a second train station in the Rincon Hill neighborhood, in addition to the already in progress Transbay Transit Center which will extend Caltrain from 4th and King, leaves 424 condo units (disclosure – I own one of those units) in Rincon Hill and South Beach under the shadow of a remote possibility that they will need to be demolished in the future to make way for a high-speed rail station along Beale Street between Harrison and Mission Streets.

San Franciscans have always had the idea that High Speed Rail would be located in downtown San Francisco at the Transbay Terminal. It was to be the centerpiece of a $2 billion redevelopment plan. To that end, a design competition was held, where the competing designed were shown in San Francisco City Hall and a winner was selected. This video discusses the competition:

Now the CHSRA wants to include alternatives sites for study. In a letter dated December 28, 2009, California Attorney General Jerry Brown urged the High Speed Rail Authority not to consider any other site as an alternative and focus on the TransBay Terminal Terminus plan:

"..the Authority need not and cannot consider alternative that would displace the Transbay Terminal as a San Francisco High Speed Rail terminus."

The reason for this is the Attorney General asserts that when the voters approved Proposition 1A it was not intended to approve an action that would replace the Downtown Transbay Terminal plan. But even with the letter, the Beale Street Alternative continues to be active in the Authority's plans, much to the displeasure of Jerry Brown and many San Franciscans.

Stay tuned.

Sarah Palin to join Fox News, gains official wingnut status

Former Alaska Governor Sarah Palin will join Fox News as a contributor, according to Howard Kurtz at The Washington Post. Sarah Palin, who was the GOP vice presidential candidate in the 2008 Election Race, will be used on various Fox shows and will join 2008 GOP presidential candidate and former Arkansas Governor Mike Huckabee on Fox News.

This officially solidifies Sarah Palin as a television pundit and moves her further away from being considered a serious candidate for the 2012 Presidential Race. Governor Palin joins Bill O'Reilly, Glenn Beck, and Sean Hannity, thus she risks being considered only a Right-wingnut and not a politician.

If Palin does run, when 2012 approaches every ill-considered comment or quip will be gathered, blasted on television and online, and used against her again and again, wrecking any chance she has of being considered electable.

On a positive note, Kurtz reports that Palin will also host an occasional program that will examine inspirational tales involving ordinary Americans.

For Fox News, the move is genius.  It takes CNN away from the habit of using a Sarah Palin comment as news without feeding Fox News' ratings machine.

No official word on compensation or if Palin will eventually get her own show (and not an "occasional program") as of this writing. After she appeared on The Oprah Show, Palin said she would like to have a talk show of her own.

Stay tuned.

Casey Johnson funeral: Tila Tequila not invited, issues Twitter rant

Adding insult to the injury of the death of her loved one Johnson & Johnson heiress Casey Johnson, Reality Show TV Star Tila Tequila was not invited to the funeral for Casey Johnson, according to

Casey Johnson and Tila Tequila in 2009

Casey Johnson was found dead at her home Sunday, January 4th by Tila Tequila, who announced it on Twitter. As of this writing, the LA County Cornorer's Office has not reported an official cause of death and the investigation is continuing, but its known that Casey Johnson suffered from diabetes and drug problems.

Tila Teguila was engaged to be married to Casey Johnson late in 2009, and just weeks before Johnson passed away. Tila Tequila said to RadarOnline Sunday:

"Yes her funeral is today and I can't even see my wife for the last time to say goodbye to her and see her. It's breaking my heart... I'm crying so bad, they are horrible, mean people. Sure, one day I can visit her grave but I will never ever get to see her face again to say goodbye and kiss her before they bury her. I can't talk about this now it's making me cry."

The funeral was hosted by Casey Johnson's father Robert "Woody" Johnson and attended by a small group reportedly including Casey's friend Nicky Hilton. Last week, Tila Tequila called 911 against Paris Hilton and Nicky Hilton when they went to recover Casey Johnson's dog from her.

The revelation that she was not invited to the funeral caused Tila Tequila to lash out at everyone using her Twitter page, including herself:

PPL say I need 2 get off twitter & grieve with friends & family...WHERE? I DONT HAVE ANY! Casey was my only family & my Dogs! Worst day ever
about 18 hours ago from web

Why do I tweet so much? Even BEFORE Casey passed away? BECAUSE I HAVE NO FRIENDS! THERE! THE TRUTH COMES OUT! Just pray 4 her please!
about 18 hours ago from web

about 18 hours ago from web

Im upset. What would YOU do if you were MADLY IN LOVE & then ur fiance died & their family blamed you for it when it was THEIR FAULT? hmm.
about 18 hours ago from web

If I was a GUY as her fiance, I wouldn't be treated like this. They did NOT like lesbians. Neither did Nikky Hilton. Casey told me. SAD!
about 19 hours ago from web

Casey wanted me to Adopt Ava & was already calling me her Mommy. I bet this is all because they are against LESBIANS! So wrong!
about 19 hours ago from web

Sen. Harry Reid racist comments; George Will is wrong

The firestorm over the discovery of Nevada Senator Harry Reid racist comments regarding now-President Barack Obama prove that memories are short. Much has changed since Barack Obama became the 44th President of The United States, specifically attitudes about race and the overall willingness to talk about race and racism.

Harry Reid, the Democratic Senator, is accused of essentially saying that Obama would be a good presidential candidate even though he's African American. According to ABC News' George Stephanopoulos, In a new book by John Heilemann and Mark Halperin called Game Change, Reid reportedly said this:

“Harry Reid was wowed by Obama’s oratorical gifts and believed that the country was ready to embrace a black presidential candidate, especially one such as Obama -- a ‘light-skinned’ African American ‘with no Negro dialect, unless he wanted to have one,’ as he said privately.”

At the time, Harry Reid's comments were both race-concious and racist. ABC News George Will is really wrong when he said "there's not a scintilla of racism in what Harry Reid said. At long last, Harry Reid has said something that no one can disagree with, and he gets in trouble for it."

But what he said, and what George Will rubber-stamped on ABC News' This Week, Sunday, is both race-concious and racist. One is OK, but the other, racism, is not. To be race-concious is to be keenly aware of racial differences in people, but not use that to the detriment of the person who's being judged. To be racist is to put down a person - to reject them or avoid associating with them - because that person's skin color is different.

What Harry Reid said both acknowledged and supported the common view that to be black in America is to be judged by whites, and now some blacks, as less than. That a "common" black person speaks in a certain way and has dark-skin. By contrast, Harry Reid was saying, and George Will is acknowledging, that Barack Obama can "pass" for white and that makes him OK.

That view is racist but it was also very common to hear or read in 2008. Barack Obama's successful campaign challenged people who were used to seeing a "whites only" political arena, and even those considered not racist at all, specifically former President Bill Clinton, were recorded making questionable comments regarding Barack Obama.

Clinton's approach in comparing Obama's run to that of Jesse Jackson's in 1984 was attacked as racist, and doomed Hillary Clinton's presidential run.

And some African Americans, particularly many of those over 40, didn't give Barack Obama a chance to win before the 2008 Presidential Primary started. When Obama performed well during that time, some blacks were quick to say that Obama's "not black." That too is racist and is expressed from a "self-hating black" perspective.

All that is in the past; now we have Obama as president and a new America, where commercials pairing interracial couples are the norm. That wasn't true even as recently as 2008. America has gone through a rapid and far reaching wave of cultural change that continues today, that does not mean the past should be rewritten.

What Harry Reid said was in 2008 was racist; but that does not mean he's racist. Reid has apologized to Obama Moreover Reid, like other Americans, has learned a lot about himself and the country in just over one year.

Mick Jagger hangs with USC Volleyball star Jess Gysin

While USC Football Head Coach Pete Carroll was mulling over a possible return to the NFL that eventually led to his resignation from USC for the NFL Seattle Seahawks, USC Vollleyball star and grad student Jess Gysin was enjoying the beach in her bikini with The Rolling Stones' legendary singer Mick Jagger.

Ok, it's not what you think. A well-dressed for the beach Mick Jagger stopped to take a photo with Jess Gysin and her friends. Jessica Gysin (on the left) put the photo up on the Internet December 27th and via her Twitpic account.

From the looks of the photo, satisfaction was had by all, and Mick Jagger still knows how to find time to be photographed with beautiful women. Jessica Gysin is considered by sports fans at the blog Busted Coverage to be one of the hottest women in college sports.

Pete Carroll resigns from USC for Seattle Seahawks

After a controversial deal struck while The Seattle Seahawks were simultaneously interviewing Minnesota Vikings Defensive Coordinator Leslie Frazier, Pete Carroll resigns from USC as head coach and is expected to officially become the Seattle Seahawks next head coach on Monday, according to the LA Times and The LA Daily News.

The LA Times reports that Pete Carroll came to agreement on a 5-year $35 million contract.

The news that Pete Carroll was desired as the next head coach of the Seahawks surfaced as far back as last Thursday and was reported that Friday. But to comply with an NFL rule known as "The Rooney Rule", the Seahawks would have to interview with at least one minority candidate.

After saying no to being the minority candidate because he believe the Seahawks wanted Pete Carroll anyway, Minnesota Vikings Defensive Coordinator Leslie Frazier said "yes" at the behest of the Fritz Pollard Alliance (FPA), which looks at NFL Rooney Rule compliance performance. The FPA was under the impression that because Seahawks CEO Tod Leiweke reportedly said to the FPA they would not give general manager duties to Carroll, that meant Carroll was not "the guy" preferred by the Seahawks.

The FPA was wrong.

While Leslie Frazier never got a real shot at a job that wasn't his to start with, soon-to-be former USC Head Coach Pete Carroll gets a job and deal he reportedly wanted, else he was going to remain with the University of Southern California. Pete Carroll returns to pro football and a won-loss record that is the reverse of the one at his storied tenure with USC.

Pete Carroll's NFL record is 33-31 in four seasons with the New York Jets and the New England Patriots, and 1997 with the New England Patriots. At USC Pete Carroll's record was 97 wins, 19 losses. A list of Pete Carroll's accomplishments at USC and posted at Wikipedia is worthy of review:

Two BCS Championship Game appearances (win over Oklahoma, and a loss to Texas in 2005)
Two national championships, including the AP 2003 national championship and the undisputed 2004 national championship.
Seven consecutive Associated Press Top-4 finishes
A record six BCS bowl victories
A record seven consecutive BCS bowl appearances
A record seven consecutive years as Pac-10 Champions or Co-Champions
A national-record 33 consecutive weeks as AP's No. 1-ranked team
A winning record of 97–19 (85.6%), including 16–2 against traditional rivals Notre Dame and UCLA
A NCAA record of 63 straight 20-point games
Twenty-five All-American first teamers
53 players selected in the NFL Draft, including 14 in the first round.[49]
Three Heisman Trophy winners (Carson Palmer, 2002; Matt Leinart, 2004; Reggie Bush, 2005)
Four Top-5 recruiting classes
Win streaks for home games (34) and Pac-10 home games (22).
In 2007, USC became the first NCAA FBS team to achieve six consecutive 11-win seasons.[50] In 2008, USC added an unprecedented seventh consecutive 11-win season.
28–1 in the month of November
Only team in history to win three consecutive Rose Bowl Games

With all of this, why leave USC and a job Carroll once said he not leave for the NFL? The consensus is that Pete Carroll wants to make up for his first two failures in the NFL.

Stay tuned.