While most risk factors have only a modest impact on overall lifetime risk of developing breast cancer, women with mutations in BRCA1 and BRCA2 have up to a tenfold increase in risk. According to Michael Jones MD, red flags for hereditary increased risk include a personal history of or close family history of:

• Ovarian cancer
• Breast cancer diagnosed before age 50
• Two primary breast cancers
• Male breast cancer
• Triple negative breast cancer
• Some types of pancreatic cancer
• Ashkenazi Jewish ancestry
• Other family members with a BRCA abnormality

The Agnesian Cancer Center has numerous women (and men!) that seek our advice and help obtaining genetic testing to ascertain this risk. In addition to two medical oncologists, the center has two registered nurses that are specifically trained to inform and support patients who are undergoing this testing. Testing is simple, and involves completion of paperwork and obtaining a small blood sample to be sent to a reference lab specializing in genetic testing. This lab will assist patients in obtaining authorization from their insurance carrier to help cover the cost of testing.

Written by: Kelli Little, Care Navigator at the Agnesian Cancer Center

The American Cancer Society is celebrating its 100 year anniversary this year.  Just to highlight a few beginning milestones….

1913: The American Cancer Society is founded.

1927: Women make noise to save lives.

1946: American Cancer Society launches its ground-breaking research program.

1947: The first successful chemotherapy treatment for cancer is discovered.

As you can see, we have come a long way!

Having cancer is hard, finding help should be easy. The American Cancer Society is available 24 hours a day, seven days a week, including holidays either by phone or on-line. They provide informational tools to help with treatment, clinical trials, day-to-day help finding transportation and lodging, financial and insurance questions, gas cards, support groups. as well as an on-line community for cancer patients and their families.

The Agnesian Cancer Center has a patient navigator that works one-on-one between the patient/family needs and the American Cancer Society.  As each individual patient is experiencing something different, the navigator helps cancer patients and caregivers in the community get through their journey. It is as simple as written information, a web site, a phone call or a trip through our wig room.  Best of all – this help is free!

Cancer is a journey and there are many around that help along the journey.

Although breast cancer is the most common malignancy (tumor) in American women, many barriers in its diagnosis and treatment remain prevalent. In her article in the February 2013 issue of the Clinical Journal of Oncology Nursing, Sabrina Meredith discussed the current research in breast cancer disparities. Meredith found four major barriers to breast cancer diagnosis and treatment. Removal of these barriers will help to address the disparity.

Lack of health insurance and access to screening: While all women aged 40 and older should receive annual breast cancer screening, many do not. Educating women about the types of screening covered by their insurance may help increase screening rates. Here in Wisconsin, the Wisconsin Well Women Project can also assist under or uninsured women get needed screening.

Racial disparities: African American women with breast cancer are diagnosed later and have decreased survival when compared to their Caucasian counterparts.

Socioeconomic status: Poor socioeconomic status and lack of access to screening may result in delayed diagnosis and more advanced breast cancer stages at presentation, ultimately affecting outcomes.

Under use of available therapies: Although adjuvant therapy for early-stage breast cancer has shown significant benefit to disease-free and overall survival, it continues to be underused.

The concept of patient navigation was created as intervention to decrease barriers among women diagnosed with breast cancer. In addition to developing a trusting relationship with patients, navigators are responsible for problem solving, critical thinking, and supporting patients as they move through the process from diagnosis to surveillance. At Agnesian HealthCare, we are fortunate to have two breast navigators assist patients in this journey.

This blog summarizes “Disparities in Breast Cancer and the Role of Patient Navigator Programs,” by Sabrina M. Meredith, MSN, ARNP, AOCNP®, which is featured in the February 2013 issue of Clinical Journal of Oncology Nursing.

That pot of coffee that I have every morning or all the caffeinated soft drinks I have in the afternoon will cause me to get breast cancer.

Fact: Some research has been done on this topic, and in fact it is suggested that caffeine may lower your risk of breast cancer. However, in hindsight, it is possible that breast soreness/tenderness is linked to caffeine. It is not recommended to alter caffeine intake in an effort to lower your risk. Please talk to your healthcare provider first.

Does the radiation from a mammogram cause breast cancer?

Fact: The amount of radiation is so small that the benefits from a preventive mammogram far outweigh any risks associated with the radiation received from a mammogram. A patient would have to receive 100 to 1,000 times higher radiation to have statistical increase in breast cancer risk. A mammogram gives about the same amount of radiation as flying in an airplane from New York to California.

Well, I don’t have any breast lumps, so I don’t need a mammogram. Are lumps the only form of breast cancer?

Fact: Breast cancer does not always come in the form of a lump. That is why it is not only important for self-breast examination, clinical breast examination, but also a mammogram. The American Cancer Society recommends that women starting at the age of 40 have a yearly mammogram until physically not capable to do so.

My mammogram is negative! Phew! I don’t need to worry about breast cancer!

Fact: Ten to 20 percent of breast cancer is not detected by a mammogram. Again, that is why it is so important to do all three breast examinations: Self-breast exam, clinical breast exam and screening mammogram.

Resources: 

www.health.com

www.cancer.gov

www.prevention.com

www.cbcf.org

I have been on birth control pills forever! This will for sure increase my risk of breast cancer.

Fact: Some studies from the 90s have shown that birth control use slightly increases your risk of breast cancer. Evidence is not strong enough for healthcare providers to recommend that women stop taking birth control pills. However, a patient would need to discuss with their provider their risk factors before determining if birth control is a good choice from them.

No! Stop! Don’t drink out of that water bottle! It can cause breast cancer, right?

Fact: There is not enough evidence to make a correlation between drinking from plastic bottles and increased risk of breast cancer. But, if you are concerned, drink from a BPA-free plastic bottle or choose bottles with a 1, 2, 4 or 5 in the recycling symbol on the bottom.

My girlfriend has implants; she will for sure get breast cancer.

Fact: Breast implants do not cause breast cancer. However, breast implants do make detection of breast cancer more difficult. Patients with breast implants do require extra mammographic views which mammography technologists are trained in performing. Instead of the normal four views for a bilateral mammogram, breast implant patients require eight views of their breasts.

I heard that women with smaller breasts are more likely to get breast cancer.

Fact: There is no connection between the size of your breast and your risk of breast cancer.

Written by: Stacy Hammack, Senior Mammography Technologist, RT (R)(M) at Ripon Medical Center

Am I going to get breast cancer if I wear deodorant or shave my underarms?

Fact: There have been several studies done looking at the link between breast cancer and deodorants/antiperspirants and shaving your underarms. The American Cancer Society really pooh-poohs this rumor! There is so little scientific evidence to support this idea. Some antiperspirants contain parabens, but so far, studies have not shown any direct link between parabens and any health concerns. However, researchers continue to look at this possible breast cancer risk factor, and more studies are needed.

What about if my bra is too tight, or not tight enough or has an under wire, that increases the risk of breast cancer, right?

Fact: There really is not any good scientific or clinical basis making a connection to neither the type of bra or tightness of the bra and the risk of breast cancer.

Holy cow! I live near power lines! I talk on my cell phone all the time! I am for sure going to get breast cancer!

Fact: A 2003 study concluded that there was not a definite connection made between breast cancer and electromagnetic fields emitted by power lines. This research is still on going with the potential environmental risk factor of cancer and electromagnetic fields. However, in 2011 the International Research on Cancer did suggest that radiofrequency fields from cell phones causing cancer cannot be confirmed yet; more research must be done. Again, there is no conclusive link between cell phone use and increase in the risk of breast cancer. Suggestions were made by the American Cancer Society to not carry your cell phone in your bra and to use a headset/ear piece and to limit the amount of time you use your cell phone.

Could my miscarriage or abortion increase my risk of breast cancer?

Fact: Numerous studies have been done researching and studying the correlation between abortions, miscarriages and breast cancer. A particular study done in February of 2003 by the national Cancer Institute concluded that having an abortion or a miscarriage does not increase your risk of breast cancer.

Cancer begins to grow when cells in your body start to grow rapidly out of control; we call these cells abnormal cells. As you can imagine, abnormal cells grow much different than normal cells. Instead of dying, abnormal cells continue to grow and form new cells, which are also abnormal. These abnormal cells grow and take over the normal body tissues, causing a cancer cell to form.

In most cases, a group of cancer cells assemble to form a mass lump – better known as a tumor. But cancer cells can also grow in the bloodstream and spread throughout the body. When cancer cells are carried through the bloodstream to other parts of the body, they will begin to replace normal tissue with abnormal cells and form tumors.

It is important to remember that not all tumors are cancerous. Abnormal masses that are not cancer are called benign tumors. These tumors can also cause major concerns because they grow and invade the space of other vital organs and tissues. When a benign tumor grows too large, it can press on and restrict healthy organs and tissue. The good news is that these tumors cannot spread because their cells do not enter the bloodstream.

Half of all men and one-third of all women in the Unites States will develop cancer sometime during their lifetimes. For most types of cancer, the sooner a cancer is found and treated, the better the chances are for treating it. Early detection is possible with screening exams.  According to Michael Vander Kooy, MD, a board-certified radiation oncologist at the Agnesian Cancer Center, it is important for individuals that do not have any symptoms to participate in cancer screening exams and tests.  Screening exams and tests are based on your age, gender and family history.  Only you and your doctor can determine which tests are right for you. Here is a list of some common screening tests:

Age 21

Women should begin cervical cancer screening

Age 40

Women should have annual mammograms

Age 50

Men and women should be screened for colon cancer with colonoscopy or flexible sigmoidoscopy

To learn more about the Agnesian Cancer Center, visit agnesian.com, or call (920) 926-4100.

March is Colorectal Cancer Awareness Month.  In 2012, there were approximately 103,000 people diagnosed with colon cancer and approximately 51,000 people died from colon cancer in the United States. The good news is people are living longer, and there are more colon cancer survivors than ever before, mostly due to early screenings like colonoscopies.

The American Cancer Society recommends individuals begin screening for colon cancer at age 50 and even younger if you have a family history of colon or other cancers.  One of the best screening tests for colon cancer is a colonoscopy.

Many people fear colonoscopies or don’t understand what a colonoscopy is.  A colonoscopy is an exam that uses a small camera to allow a physician to see inside the colon and rectum.  The exam is usually done with special medication to make the patient sleepy.  Most patients experience no discomfort and wake up not even remembering the exam.

Many individuals are concerned about the preparation before the test. With most preparations, you drink a special solution that causes you to have frequent bowel movement to empty your colon.  The cleaner your colon is, the better your doctor can see and determine if you have a healthy colon or if there are any polyps or areas of concern.

Almost all colorectal cancers are believed to arise from adenomatous polyps, which are small growths in the colon that grow over time and possibly turn into cancer. The number of adenomatous polyps increases with age (30 percent in 50 year olds, 40 percent in 60 year olds, and 50 percent in 70 year olds). According to Nathan Slinde, MD, a board-certified gastroenterologist with Agnesian HealthCare, finding these polyps and removing them can help prevent colorectal cancer. In patients without symptoms, finding cancer at the time of a screening colonoscopy results in early detection and treatment with high cure rates.

Waiting for symptoms to develop (change in bowel habits, rectal bleeding, weight loss, etc.) too often results in cancer detection at more advanced and difficult to treat stage.

If you have a family history of cancer, or are over the age of 50 and have never had a screening colonoscopy, call your doctor to set up a screening appointment.

Cancer has impacted nearly everyone in one way or another. Yet, despite cancer being the second leading cause of death in America, many people do not understand the difference between chemotherapy and radiation therapy. Chemotherapy and radiation therapy are two of the most effective treatment approaches for cancer. Until you have to undergo the treatment, it is difficult to understand the difference.

Chemotherapy refers to a chemical or drug given to destroy cancer cells. Chemotherapy is prescribed by a medical oncologist. Because the chemo drug is given through an intravenous (IV) injection, it spreads throughout the entire bloodstream. This type of treatment is effective because it kills cancer cells that have spread beyond the initial affected tissue or organ. On the other hand, as the drug spreads through the bloodstream killing cancer cells, it also has effects on other rapidly dividing cells such as those in your blood, mouth, nose, nails, vagina, intestinal tract and hair. This can cause patients to feel ill after treatment and lose their hair.

Radiation therapy is a local high energy X-ray treatment, focusing only on the areas affected by cancer. Radiation treatments are prescribed by a radiation oncologist. The radiation does not travel through the bloodstream so it does not have systemic side effects. Typically, side effects caused by radiation will only affect the direct area that is treated. Radiation therapy is commonly used for treating cancer of the head and neck, breast, bladder, lung, prostate, brain and Hodgkin lymphoma.

Many of our patients receive a chemotherapy and radiation therapy combination to achieve the most effective treatment outcome. Patients at the Agnesian Cancer Center have the opportunity to see both a medical oncologist and radiation oncologist on the same day. It is best to consult an oncologist before deciding on the treatment best suited for you or your loved one. For more information, contact the Agnesian Cancer Center at (920) 926-4100.

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However, many cancers can be treated successfully, or at least kept in check, if caught early enough. And the screenings represent the best route to early detection.

The longer the cancer is in the body, and the longer it remains untreated, the more likely it will move to another part of the body through the circulatory system or lymph glands.

The good news is that being screened for cancer doesn’t have to be a traumatic experience for anyone.

Exactly what screenings you should have depends on your age and risk factors. Adults should start with a physical exam and then ask a healthcare provider which screenings are needed. Do as much research about cancer screenings as possible. Find reliable sources to verify information you find in popular media. Take a friend with you who has already been through a screening.

Finally, tell your friends to get the screenings. You can help a great deal by going out and encouraging people to get their cancer screenings. Even if you can encourage just one person to get screened just one time a year, that can help. The American Cancer Society offers general guidelines on cancer-related screenings on its web site at cancer.org.

Annually, Agnesian HealthCare offers its free Living Smart community cancer screening event at the Agnesian Cancer Center, 480 E. Division Street. This year’s event is scheduled from 8 a.m. to noon on Saturday, April 20.

The screening event offer the following educational booths, tests and exams performed by Agnesian HealthCare physicians and community dentists: oral (mouth and tongue) exams; skin exams; prostate cancer check with prostate-specific antigen (PSA) blood test (must be 70 years old or less and no past history of prostate cancer to participate, cost is $5); rectal exams; colorectal cancer check with fecal immunochemical test (FIT test) also known as a stool sample ($5 fee); breast self-exam education; cancer risk assessment surveys for breast and colorectal cancer; and cancer prevention super food cooking demo and taste testing.

To register, call (920) 926-4100.